Content analysis of nutritional information in paediatric oral health education leaflets.

BACKGROUND: The aim of this study was to determine if paediatric oral health education leaflets with a food and nutritional focus provide messages that are clear and consistent with the current Australian Dietary Guidelines and the Infant Feeding Guidelines. METHODS: Forty-three leaflets aimed at parents were sourced from Australian state and territory Health Departments, oral health industry partners and commercial organisations, and a content analysis was performed. Recommendations on food and drink type, consumption frequency and general diet and nutrition advice were considered and cross-referenced with the Australian Dietary Guidelines and the Infant Feeding Guidelines to identify areas of consistency and discrepancy. RESULTS: Twenty leaflets recommended reducing the consumption of sugary and/or acidic food, while 23 leaflets recommended reducing the consumption of sugary and/or acidic drinks. The majority of the leaflets advised water (n = 35) and milk (n = 23) to drink. Although 33 leaflets encouraged a healthy diet, seven of these did not specify what a healthy diet was. Twenty-eight leaflets provided early childhood-related (0-2 years) feeding advice. Confusing messages were found in nine leaflets, with ambiguous recommendations that were open to individual interpretation. CONCLUSIONS: There were some inconsistencies between the leaflets and the dietary and infant feeding guidelines in Australia; and across the leaflets, as not all important messages were included in any one leaflet. Government Health Departments and other relevant agencies should ensure that advisory messages regarding diet, particularly those with dental implications, are clear, complete and consistent across all dental educational leaflets.

YouTube as a source for parents' education on early childhood caries.

BACKGROUND: Patients can and do search the Internet for information on various health-related topics. YouTube™ is one popular website they may consult. AIM: To examine the quality of information offered by YouTube™ for patients seeking information on early childhood caries (ECC). DESIGN: YouTube™ was searched for videos on ECC. The usefulness of selected videos in providing adequate information about ECC was evaluated using a 13-point usefulness score. The guidelines of the American Academy of Pediatric Dentistry were used for benchmarking. RESULTS: Most videos were uploaded by healthcare professionals (60%, n = 18). Videos had generally low usefulness scores (mean: 5.1 ± 2.9; range: 1-11). An average YouTube™ video on ECC was viewed two times/day (range: 0.07-34.4 views/day). Less useful videos ranked early on the viewing list, and viewer's interactions with videos were not affected significantly by their usefulness. CONCLUSION: YouTube™ should not be used as a trusted site for educating patients on ECC.

How readable are Australian paediatric oral health education materials?

BACKGROUND: The objective of this study was to analyse the readability of paediatric oral health education leaflets available in Australia. METHODS: Forty paediatric oral health education materials were analysed for general readability according to the following parameters: Thoroughness; Textual framework; Terminology; and Readability (Flesch-Kincaid grade level (FKGL), Gunning Fog index (Fog) and Simplified Measure of Gobbledygook (SMOG)). RESULTS: Leaflets produced by the industry were among the hardest to read with an average readability at the 8th grade (8.4 ± 0.1). The readability of leaflets produced by the commercial sector was at the 7th grade (7.1 ± 1.7) and the government at the 6th grade (6.3 ± 1.9). The FKGL consistently yielded readabilities 2 grades below the Fog and SMOG indexes. In the content analyses, 14 essential paediatric oral health topics were noted and Early Childhood Caries (ECC) was identified as the most commonly used jargon term. CONCLUSION: Paediatric oral health education materials are readily available, yet their quality and readability vary widely and may be difficult to read for disadvantaged populations in Australia. A redesign of these leaflets while taking literacy into consideration is suggested.

English and Spanish oral cancer information on the internet: a pilot surface quality and content evaluation of oral cancer web sites.

OBJECTIVE: Oral and pharyngeal cancers are responsible for over 7600 deaths each year in the United States. Given the significance of the disease and the fact that many individuals increasingly rely on health information on the Internet, it is important that patients and others can access clear and accurate oral cancer information on the Web. The objective of this study was threefold: (a) develop an initial method to evaluate surface and content quality of selected English- and Spanish-language oral cancer Web sites; (b) conduct a pilot evaluation; and (c) discuss implications of our findings for dental public health. METHODS: We developed a search strategy to find oral cancer sites frequented by the public using Medline Plus, Google, and Yahoo in English and Spanish. We adapted the Information Quality Tool (IQT) to perform a surface evaluation and developed a novel tool to evaluate site content for 24 sites each in English and Spanish. RESULTS: English-language sites had an average IQT score of 76.6 (out of 100) and an average content score of 52.1 (out of 100). Spanish-language sites had an average IQT score of 50.3 and an average content score of 25.6. CONCLUSIONS: The study produced a quality assessment of oral cancer Web sites useful for clinicians and patients. Sites provided more information on clinical presentation, and etiology, and risk factors, than other aspects of oral cancer. The surface and quality of Spanish-language sites was low, possibly putting Hispanic populations at a disadvantage regarding oral cancer information on the Web.

Inconsistencies in recommendations on oral hygiene practices for children by professional dental and paediatric organisations in ten countries.

BACKGROUND: Some of the basic dental health practices that are recommended to the public by professionals are not evidence based. Incorrect oral health messages may adversely affect children's oral health behaviours. AIM: To identify and list the recommendations concerning children's oral hygiene practices provided by dental and paediatric organisations, and to assess how these recommendations relate to the scientific evidence currently available. DESIGN: Cross-sectional. The authors contacted professional organisations in ten countries requesting items (brochures, leaflets or folders) containing messages on children's oral hygiene practices. They then listed these recommendations and assessed how they related to scientific evidence obtained from systematic reviews available at PubMed and the Cochrane Library. RESULTS: Fifty-two of 59 (88%) organisations responded to our request and 24 dental health education materials were submitted to the authors. They mentioned recommendations on oral hygiene practices for children, such as toothbrushing frequency, supervision and technique; when to start and how long toothbrushing should last; toothbrush design and replacement; flossing; gums/teeth wiping; tongue cleaning; type and amount of toothpaste and advice on toothpaste ingestion. The search at PubMed and the Cochrane Library resulted in 11 systematic reviews addressing these topics. CONCLUSIONS: Several oral hygiene messages delivered by professional organisations showed inconsistencies and lacked scientific support.

Exploring the potential for foreign-trained dentists to address workforce shortages and improve access to dental care for vulnerable populations in the United States: a case study from Washington State.

BACKGROUND: To address dental workforce shortages in underserved areas in the United States, some States have enacted legislation to make it easier for foreign dental school graduates to become licensed dentists. However, the extent to which foreign dental school graduates will solve the problem of dental workforce shortages is poorly understood. Furthermore, the potential impact that foreign-trained dentists have on improving access to dental care for vulnerable patients living in dental Health Professional Shortage Areas (HPSAs) and those enrolled in public insurance programs, such as Medicaid, is unknown. The objective of this paper is to provide a preliminary understanding of the practice behaviors of foreign-trained dentists. The authors used Washington State as a case study to identify the potential impact foreign dental school graduates have on improving access to dental care for vulnerable populations. The following hypotheses were tested: a) among all newly licensed dentists, foreign-trained dentists are more likely to participate in the Medicaid program than U.S.-trained dentists; and b) among newly licensed dentists who participated in the Medicaid program, foreign-trained dentists are more likely to practice in dental HPSAs than U.S.-trained dentists. METHODS: The authors used dental license and Medicaid license data to compare the proportions of newly licensed, foreign- and U.S.-trained dentists who participated in the Medicaid program and the proportions that practiced in a dental HPSA. RESULTS: Using bivariate analyses, the authors found that a significantly lower proportion of foreign-trained dentists participated in the Medicaid program than U.S.-trained dentists (12.9% and 22.8%, respectively; P = 0.011). Among newly licensed dentists who participated in the Medicaid program, there was no significant difference in the proportions of foreign- and U.S.-trained dentists who practiced in a dental HPSA (P = 0.683). CONCLUSIONS: Legislation that makes it easier for foreign-trained dentists to obtain licensure is unlikely to address dental workforce shortages or improve access to dental care for vulnerable populations in the United States. Licensing foreign dental school graduates in the United States also has ethical implications for the dental workforces in other countries.

Children's Toothbrushing Practices Recommended on the Internet by Pediatric Dentistry Associations.

PURPOSE: The purpose of this study was to describe online recommendations by North and South American National Associations of Pediatric Dentistry (NAPD), intended for laypersons, concerning children's toothbrushing practices. METHODS: In February 2015, the International Association of Pediatric Dentistry (IAPD) website and the Latin American Association of Pediatric Dentistry (ALOP) Facebook webpage were searched to identify which countries had NAPD. Attempts were made to obtain the electronic addresses of ALOP national member societies, and Google and Facebook were used to identify NAPD not found using the previous strategies. RESULTS: Of the 35 countries in North and South America, 19 had NAPD that were shown on the Internet, and 11 of them provided data for the study. All NAPD gave advice on fluoride concentrations in toothpaste and when to start toothbrushing; most made recommendations on the amount of toothpaste, toothbrushing frequency, and when to brush, and a few gave advice on toothbrushing supervision and rinsing after toothbrushing. There was no consensus on most of the recommendations that were evaluated. CONCLUSIONS: Only a few National Associations of Pediatric Dentistry from the Americas provide online information for parents and laypersons concerning children's toothbrushing practices. Of the information provided, some are either controversial, outdated or lack scientific evidence.

Knowledge of preschool teachers in the prefecture of Attica of early childhood oral health. Association with their demographic and personal characteristics.

AIM: To investigate the knowledge of preschool teachers of early childhood oral health (OH) and its association with demographic and educational characteristics as well as with personal oral health habits and attitudes. METHODS: Teachers (594) of preschool children were invited to complete a questionnaire with 40 questions on demographic data, knowledge of early childhood OH issues, personal OH habits and attitudes, and participation in OH educational programmes at preschools. Statistical analysis included descriptive statistics, Spearman correlation coefficients, multiple linear and logistic regression modelling (p ≤ 0.05). RESULTS: The mean age of participants was 40.9 years (SD 7.5), 68.5% of them had children of their own, 72.6% had not attended any OH educational course during their studies, 70% believed that they had insufficient knowledge to implement an OH educational programme, 44.6% had implemented such a programme, 26.8% knew that the first dental visit should be at a child's first birthday and 36.7% knew the correct age that tooth brushing should start. The most significant factors that influenced overall teachers' knowledge on early childhood oral health were: their participation in OH educational programmes (p < 0.001), their belief that OH courses during their studies were necessary (p = 0.01), their confidence on OH knowledge (p = 0.03) and parenthood (p = 0.05). CONCLUSIONS: Based on the results of this study, there was a lack of knowledge among preschool teachers in significant OH issues for that age. Moreover, limitations in implementing OH educational programmes at preschools were attributed mainly to lack of self-confidence in relevant knowledge. Nevertheless, participants acknowledged the significance of OH and were willing to participate in relevant teacher training.

The process and outcome of a programme for preventing early childhood caries in Thailand.

OBJECTIVE: To evaluate the process and outcomes of a participatory dental health education (DHE) programme for preventing early childhood caries (ECC). DESIGN: A one-year intervention programme. SETTING: 21 health centres. PARTICIPANTS: 520 mothers/caregivers of 6-19 month-old children who lived in a rural area of Thailand. INTERVENTION: Small group discussion with active involvement in the intervention group and the national teaching DHE programme in the control group. MAIN OUTCOME MEASURES: Health centre staff impact evaluation, children's dental cavitated carious increment and stated changes in oral health behaviour. RESULTS: After one-year, the percent of subjects using a toothbrush and tooth brushing with fluoride toothpaste was 93% and 87% respectively in the intervention group, significantly higher (p<0.01) than the control group (73% and 58% respectively). Night time bottle-feeding, falling asleep with a bottle and sweet snack diet behaviour appeared the same in both groups. The net cavitated carious increment was 3.5 (SD=3.4) teeth in the intervention and 3.2(SD=3.5) in the control group. Health centre staff were very supportive of the programme and suggested extending the participatory format to other child health topics. CONCLUSIONS: The participatory dental health education model was shown to be a practical and effective method for increasing oral hygiene practice, but was not sufficient to prevent the development of ECC. This single intervention in the short term is not seen as sufficient to prevent the development of ECC.

Perceived competency towards preventive dentistry among dental graduates: the need for curriculum change.

BACKGROUND: A previous study has shown that dental practitioners in Benghazi believed that the less prevention-oriented education system is one of the barriers to applying preventive dentistry. OBJECTIVE: To assess attitudes and perceived competence of the dental graduates in Benghazi towards prevention and early management of dental caries. METHODS: A cross-sectional, questionnaire-based survey was conducted among internship students attending the Department of Community and Preventive Dentistry in Faculty of Dentistry, Benghazi, Libya. The participants were asked to provide demographic information, to respond to statements about their attitudes towards preventive dentistry, and to answer questions regarding their perceived competence in applying preventive dentistry procedures. RESULTS: Data from 108 Libyan dental graduates were analysed for this study, of which 64% of them were females and 42.1% of them passed their final year with grade: acceptable. The most acknowledged aspects of preventive dentistry were being useful and essential to the community (95.4 and 90.8%, respectively). The percentage of participants expressing a proficiency in providing oral hygiene instructions was the highest (95.4%). There were differences between study subgroups in their perceived competence of preventive dental practices by gender and academic performance (p≤0.05). CONCLUSION: This study highlighted that the currently implemented undergraduate education programme in Benghazi dental school does not provide dentists with the required attitude and skills to fulfil their role in providing preventive-oriented health services.

Knowledge of oral cancer, distress and screening intentions: longer term effects of a patient information leaflet.

Study aim was to determine the influence of a patient information leaflet (PIL) on mouth cancer to improve knowledge, reduce distress and increase intention to accept a mouth screen over a 2-month period. The design was a randomised controlled trial. Two dental practices in the northwest of England participated. Standardised multi-item scales of the three outcome measures were employed. The PIL was given to a randomised intervention group of patients in waiting room. Single sheet questionnaire was completed by both groups of patients at baseline in waiting room (immediately following leaflet administration in intervention arm of study). Repeat questionnaire completion at 8 weeks by all patients through postal system. Mann-Whitney U-tests comparing outcome variables between patients with and without access to the leaflet at baseline and 8 weeks were performed. Multiple logistic regression was used to predict re-reading of the leaflet at home. Useable replies were received from 317 patients (60% response rate). All measures showed some benefit of immediate exposure to the leaflet at follow up. Older patients, less initial knowledge, and self-reported smoking positively predicted the re-reading of the leaflet. The introduction of a mouth cancer PIL into dental practice may help to inform patients about oral cancer, moderate distress and encourage acceptance of an oral health screen.

A longitudinal study of multiple approaches to dental health education.

An evaluation was made of the separate effects on oral hygiene of token reward treatments, discovery (project) learning, and plaque staining feedback demonstrations with children in the first through fifth grades. Both short- and long-term effects were assessed in an open classroom setting. Twenty classrooms were non-randomly assigned to treatment and control groups. Plaque scores were recorded according to the Podshadley Patient Hygiene Performance Index (PHP) at time T0, before initiation of any of the educational interventions; and again at times T1, T2, and T3; 7 days, 74 days and 255 days, respectively, following cessation of the educational interventions. The combination of dental health interventions at this school had short-range effects at every grade level, and those effects persisted for 9 months among the third and fourth graders. It was not possible to identify which of the various treatments produced the observed differences, although the project learning method was generally less effective. A linear regression analysis was used to evaluate the shifts in oral hygiene behavior, a method not previously used in studies of this type.

Conceptions of Finnish people about their periodontal situation.

The conceptions of Finns regarding their own periodontal status were surveyed in 1972. The interviewed sample, drawn to cover the total Finnish population aged 15 years and over, comprised 965 persons. After exclusion of 233 edentulous subjects, a total of 732 dentulous persons were accepted for the present interview study. 10 percent of the interviewees were aware of their having gingivitis at that time. 57 percent were of the opinion that they had never had gingivitis. On the other hand, 20 percent of the interviewed persons had recently observed gum bleeding while 54 percent stated that they had never observed it. 21 percent of the interviewees were aware of their having dental calculus and 46 percent had the impression that they had never had calculus. 24 oercent of those interviewees who presently had calculus or had had calculus stated that they had never had it removed. Generally Finns failed to realize that gingival bleeding is a symptom of gingival inflammation. This point should be made clear in the dental health education of the future. The knowledge could help individuals to evaluate the state of their own periodontal tissues in order to obtain the best possible benefit from efficient home care.

Effectiveness of methods of teaching dental health to 9- to 10-year-old schoolchildren in the United Kingdom.

Dental health education employing five different teaching methods was given to classes of 9- to 10-year-old schoolchildren. A control class received no teaching. The dental health knowledge of the classes was assessed before teaching, and immediately, 1 week and 3 months after teaching by the use of a questionnaire. All methods resulted in a variable increase in marks immediately after teaching. This was followed by a fall in marks for each class over the 3-month period. The poster and pack methods of presenting information, overall, had little or no effect on the recall of information. The talk, visual aids and project methods all significantly increased dental health knowledge for the 3-month period.

Participation, willingness and abilities of school-teachers in oral health education in Tanzania.

In Tanzania, teachers in primary schools conduct oral health education as part of the school syllabus, most of them without any training for the task. The participation, willingness and abilities of teachers involved in this duty were studied by means of questionnaire, interviews, oral hygiene examinations and practical exercises. The teachers' knowledge of oral health matters and their skills in toothbrushing were poor. Health lessons in general were not accorded high priority. The teachers preferred parents to instruct their children on toothbrushing, and were reluctant to teach pupils about dietary matters. They stressed the shortage of time and materials for teaching health lessons and their heavy workload at school. These findings indicate a necessity, and a point of departure, for organising training for oral health education and encouraging teachers to undertake this task.

Use of tobacco prevention and cessation strategies and techniques in the dental office.

To establish a uniform method of determining dental team members' involvement in tobacco prevention and cessation, the National Cancer Institute developed assessment guidelines. The Minnesota Department of Health, Dental Health Program, was named to design and implement the first major study using these guidelines. Study results show most Minnesota dentists and staffs have not received formal training, but want to learn how to help their patients.

Promoting oral health: guidelines for dental associations.

Dental associations throughout the world face many new challenges. For example, many industrial countries confront the potential of excess manpower to meet current demands, while developing countries try to cope with scarce resources to control existing and increasing disease levels. This guide is intended to facilitate the development of oral promotion programmes in both situations. In industrialized countries, an oral health promotion programme should increase awareness and interest among consumers, thus facilitating the conversion of unmet need to demand. In developing countries, the oral health promotion guidelines demonstrate ways to extend resources to meet a broader base of need. In all countries, oral health promotion can demonstrate the benefit of self-care and emphasize the consumer's responsibility for personal health. Dental associations enjoy a long history of promoting oral health, yet developing a coherent programme or realizing the results of these efforts can sometimes be disappointing or frustrating. The guide is organized around a recommended sequence of activities: policy formation and dissemination; planning group; information gathering; goal setting; strategic planning; implementation; and evaluation. This document presents guidelines, not recipes. Given the range of economic, social and health needs of the Fédération Dentaire Internationale member countries, a recipe would be inappropriate. These guidelines can be tailored to the needs of your association based on the oral health needs of your population. They can be used to determine new or modified policies, to assess long- and short-term goals, to monitor progress and to educate the membership. Case studies derived from actual experiences of dental associations as they planned and analysed their efforts to promote oral health are presented. This information is included to highlight different approaches as well as problems encountered. The case studies illustrate various parts of the planning implementation and evaluation process, while the text should serve as a comprehensive review of all these components.

The nature and quality of periodontal related patient information on the world-wide web.

BACKGROUND: The internet provides a potentially invaluable source of health education material for members of the public. OBJECTIVES: This study aimed to investigate the nature and quality of periodontal-related patient information on the world-wide web. METHODS: The search term ' "gum disease" AND "patient information" ' was entered into three common internet search engines. The top 50 sites identified by each search engine were downloaded and assessed for authorship, content, accord with accepted dental practice, currency, and references to peer reviewed data. RESULTS: The search term returned in excess of 3,615 hits across the three search engines. Of the top 150 identified, 68 were deemed relevant to patients seeking information on periodontal disease. Of these, 17 were duplicated either within or between search engines, therefore the following analysis is based on the remaining 51 sites. The majority of sites (25) were authored by individual dental practitioners, with sites originating in the USA predominating (80%). Information on the aetiology, signs and symptoms, and treatment options for periodontal disease was provided by 38, 38, and 29 sites respectively. This information was deemed in accordance with conventional periodontal practice in 27, 33, and 23 cases respectively. Only seven sites indicated the currency of the information and five provided peer-reviewed references for further reading. The rank order identified by the search engines meant that sites providing comprehensive and authoritative information, were not readily differentiable from sites whose primary objective was promoting attendance at specific dental practices. CONCLUSIONS: Judicious and active support from professionals is required to aid patients' interpretation of the information identified and to direct them to the most instructive sites.

[Motivation on plaque control and gingival bleeding in school children]. / Motivação no controle do biofilme dental e sangramento gengival em escolares.

The objective of the study is to evaluate the impact of two pedagogical motivational approaches for plaque and gingival bleeding control among 135 students of local public schools in Santa Tereza, Brazil, in 1999 The motivational program consisted of different educational strategies offered to two distinct groups: Group A, who attended only one explanatory session about oral hygiene, and Group B, who attended a total of four pedagogical sessions. In order to evaluate the methodology applied, the visible plaque index (according to Ainamo & Bay, 1975) and gingival bleeding index (according to L e and Silness, 1963) were calculated. A highly statistically significant reduction in the visible plaque index and gingival bleeding index was observed in both groups after the educational sessions (p<0.001). Moreover, a higher reduction in the gingival bleeding index and an even more accentuated decrease in the visible plaque index was found in group B when compared to group A (p<0.001). In conclusion, the motivational reinforcement in educational and preventive programs has a positive effect for the reduction and control of gingival bleeding and bacterial plaque.