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1.
Health Expect ; 24(2): 700-708, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33606905

RESUMO

BACKGROUND: The oral health promotion sessions for young children and parents in a clinical setting pose challenges to the dental team. AIM: To apply PaeD-TrICS (Paediatric dental triadic interaction coding scheme) to investigate the interaction of child, parent and dental nurse and determine the effect of nurse and parental behaviours on child participation within an oral health promotion session. METHOD: A video observational study was applied. The sample consisted of a dental nurse and 22 children aged 2-5 years in a general dental practice in Scotland. Behaviours were catalogued with time stamps using PaeD-TrICS. Analysis of behavioural sequences with child participation as the dependent variable was conducted using multilevel modelling. RESULTS: Children varied significantly in their participation rate. The statistical model explained 28% of the variance. The older the child and longer consultations significantly increased child participation. Both nurse and parental behaviour had immediate influence on child participation. Parental facilitation had a strong moderating effect on the influence of the nurse on child participation. CONCLUSIONS: Child participation was dependent on nurse and parent encouragement signalling an important triadic communication process. The coding scheme and analysis illustrates an important tool to investigate these advisory sessions designed for delivering tailored messages to young children and parents. PATIENT OR PUBLIC CONTRIBUTION: The dental staff, child patients and their parents were involved closely in the conduct and procedures of the present study.


Assuntos
Promoção da Saúde , Saúde Bucal , Criança , Pré-Escolar , Comunicação , Humanos , Pais , Encaminhamento e Consulta
2.
BMC Oral Health ; 21(1): 383, 2021 08 05.
Artigo em Inglês | MEDLINE | ID: mdl-34353301

RESUMO

BACKGROUND: People experiencing homelessness have high levels of dental decay, oral cancer and poor oral health-related quality of life. The Scottish Government sought to address these issues by developing a national oral health improvement programme for people experiencing homelessness, named Smile4life. The aim was to investigate implementation behaviours and the role of work-related beliefs upon the delivery of the Smile4life programme across NHS Board areas in Scotland. METHODS: Non-probability convenience sampling, supplemented by snowball sampling, was used to recruit practitioners working across the homelessness sector. The overall evaluation of the implementation of the Smile4life programme was theoretically informed by the Behaviour Change Wheel. The questionnaire was informed by the Theoretical Domains Framework and was divided into three sections, demography and Smile4life Awareness; Smile4life Activities; and Smile4life work-related beliefs. A psychometric assessment was used to develop Smile4life Awareness, Smile4life Activities, Ability to Deliver and Positive Beliefs and Outcomes subscales. The data were subjected to K-R20, exploratory factor analysis, Cronbach's alpha, t-tests, ANOVA, Pearson's correlation analysis and a multivariate path analysis. RESULTS: One hundred participants completed the questionnaire. The majority were female (79%) and worked in NHS Boards across Scotland (55%). Implementation behaviour, constructed from the Delivering Smile4life scale and the summated Smile4life activities variable, was predicted using a linear model a latent variable. The independent variables were two raw variables Positive Beliefs and Outcomes, and Ability to deliver Smile4life. Results showed relatively good model fit (chi-square (1.96; p > 0.15), SRMR (< 0.08) and R2 (0.62) values). Positive and highly significant loadings were found describing the Implementation Behaviour latent variable (0.87 and 0.56). The two independent variables were associated (p < 0.05) with Implementation Behaviour. CONCLUSIONS: Work-related factors, such as positive beliefs and outcomes and ability to deliver are required for implementation behaviours associated with the delivery of the Smile4life programme. Future work should include training centred on the specific needs of those involved in the homelessness sector and the development of accessible training resources, thereby promoting implementation behaviours to assist the progression and sustainability of the Smile4life programme.


Assuntos
Pessoas Mal Alojadas , Qualidade de Vida , Feminino , Humanos , Masculino , Psicometria , Escócia , Inquéritos e Questionários
3.
BMC Oral Health ; 20(1): 69, 2020 03 12.
Artigo em Inglês | MEDLINE | ID: mdl-32164703

RESUMO

BACKGROUND: The Filling Children's Teeth: Indicated Or Not? (FiCTION) randomised controlled trial (RCT) aimed to explore the clinical- and cost-effectiveness of managing dental caries in children's primary teeth. The trial compared three management strategies: conventional caries management with best practice prevention (C + P), biological management with best practice prevention (B + P) and best practice prevention alone (PA)-based approaches. Recently, the concept of treatment acceptability has gained attention and attempts have been made to provide a conceptual definition, however this has mainly focused on adults. Recognising the importance of evaluating the acceptability of interventions in addition to their effectiveness, particularly for multi-component complex interventions, the trial design included a qualitative component. The aim of this component was to explore the acceptability of the three strategies from the perspectives of the child participants and their parents. METHODS: Qualitative exploration, based on the concept of acceptability. Participants were children already taking part in the FiCTION trial and their parents. Children were identified through purposive maximum variation sampling. The sample included children from the three management strategy arms who had been treated and followed up; median (IQR) follow-up was at 33.8 (23.8, 36.7) months. Semi-structured interviews with thirteen child-parent dyads. Interviews were transcribed verbatim and analysed using a framework approach. RESULTS: Data saturation was reached after thirteen interviews. Each child-parent dyad took part in one interview together. The participants were eight girls and five boys aged 5-11 years and their parents. The children's distribution across the trial arms was: C + P n = 4; B + P n = 5; PA n = 4. Three key factors influenced the acceptability of caries management in primary teeth to children and parents: i) experiences of specific procedures within management strategies; ii) experiences of anticipatory dental anxiety and; iii) perceptions of effectiveness (particularly whether pain was reduced). These factors were underpinned by a fourth key factor: the notion of trust in the dental professionals - this was pervasive across all arms. CONCLUSIONS: Overall children and parents found each of the three strategies for the management of dental caries in primary teeth acceptable, with trust in the dental professional playing an important role.


Assuntos
Cárie Dentária , Pais/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Adulto , Criança , Pré-Escolar , Assistência Odontológica , Cárie Dentária/prevenção & controle , Cárie Dentária/terapia , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Dente Decíduo
4.
BMC Oral Health ; 20(1): 64, 2020 03 04.
Artigo em Inglês | MEDLINE | ID: mdl-32131801

RESUMO

BACKGROUND: The lack of evidence for the effective management of carious lesions in children's primary teeth has caused uncertainty for the dental profession and patients. Possible approaches include conventional and biological management alongside best practice prevention, and best practice prevention alone. The FiCTION trial assessed the effectiveness of these options, and included a qualitative study exploring dental professionals' (DPs) experiences of delivering the different treatment arms. This paper reports on how DPs managed children with carious lesions within FiCTION and how this related to their everyday experiences of doing dentistry. METHODS: Overall, 31 DPs from FiCTION-trained dental surgeries in four regions of the UK participated in semi-structured interviews about their experiences of the three treatment arms (conventional management of carious lesions and prevention (C + P), biological management of carious lesions and prevention (B + P) or prevention alone (PA)). A theoretical framework, drawing on social practice theory (SPT), was developed for analysis. RESULTS: Participants discussed perceived effectiveness of, and familiarity with, the three techniques. The C + P arm was familiar, but some participants questioned the effectiveness of conventional restorations. Attitudes towards the B + P arm varied in terms of familiarity, but once DPs were introduced to the techniques, this was seen as effective. While prevention was familiar, PA was described as ineffective. DPs manage children with carious lesions day-to-day, drawing on previous experience and knowledge of the child to provide what they view as the most appropriate treatment in the best interests of each child. Randomisation undermined these normal choices. Several DPs reported deviating from the trial arms in order to treat a patient in a particular way. Participants valued evidence-based dentistry, and expect to use the results of FiCTION to inform future practice. They anticipate continuing to use the full range of treatment options, and to personally select appropriate strategies for individual children. CONCLUSIONS: RCTs take place in the context of day-to-day practices of doing dentistry. DPs employ experiential and interpersonal knowledge to act in the best interests of their patients. Randomisation within a clinical trial can present a source of tension for DPs, which has implications for assuring individual equipoise in future trials.


Assuntos
Assistentes de Odontologia/psicologia , Assistência Odontológica para Crianças/métodos , Cárie Dentária/terapia , Odontólogos/psicologia , Dente Decíduo/patologia , Adulto , Criança , Cárie Dentária/patologia , Cárie Dentária/prevenção & controle , Humanos , Entrevistas como Assunto , Pessoa de Meia-Idade , Odontopediatria , Pesquisa Qualitativa , Reino Unido
5.
Int J Paediatr Dent ; 29(4): 489-495, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30710392

RESUMO

AIM: To test the psychometric properties of an Arabic version of the Child Fear Survey Schedule-Dental Subscale (CFSS-DS) a using confirmatory factor analysis. METHODS: Two convenience samples were obtained: Sample [1]: 600 boys (33%) and girls attending 4 public schools in Onizah and Sample [2] 800 girls attending 8 public schools in Buridah. The questionnaire asked the participant's age, gender, and completion of the CFSS-DS. The data were subjected to exploratory factor analysis (EFA), parallel factor analysis, Cronbach's alpha, confirmatory factor analysis (CFA), and goodness of fit statistics. RESULTS: A total of 513 children in Sample [1] and 503 children in Sample [2] participated giving a valid response rate of 86% and 67%, respectively. From the EFA, 3 factors were identified and confirmed statistically using parallel factor analysis. The internal consistency of the 3 factors, Dental Fear Subscale (0.86), Hospital Fear Subscale (0.77), and Stranger Fear Subscale (0.71), was good. The CFA showed that the current EFA model was an equivalent fit to the El Housseiny et al (BMC Oral Health 2016;16:49). model; however, the solution using El Housseiny et al's structure was distorted. CONCLUSIONS: A 3-factor structure with acceptable reliability exists for this Arabic version of the CFSS-DS, confirmed by a CFA using an additional data set.


Assuntos
Ansiedade ao Tratamento Odontológico , Criança , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes , Arábia Saudita , Inquéritos e Questionários
6.
BMC Oral Health ; 19(1): 162, 2019 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340799

RESUMO

BACKGROUND: There is a paucity of research concerning paediatric dental consultations in primary care. This is potentially due to the difficulty of measuring the communication behaviours in the complex triadic consultations. The present study aims to describe the development and refinement of a coding scheme to record the triadic communication between dental professionals, child patients and parents. METHODS: The PaeD-TrICS was developed from video observation of triadic communications and refined through an iterative process. Its practical applicability was assessed via implementation of the scheme on specialised behavioural coding software. Reliability was calculated using Cohen's Kappa. RESULTS: The PaeD-TrICS contains 45 codes. Forty-four dental professional-child-parent communications were successfully coded through administering the scheme on The Observer XT 10.5 system. Cohen's Kappa was 0.83 (inter-coder) and 0.90 (intra-coder). "Parental verbal facilitation" (mean = 1.68/min) was the most frequent behaviour. Dental professionals' "dentally engaging talk" (mean = 1.24/min), "praise" (mean = 1.10/min) and "instruction" (mean = 0.62/min) were frequently seen. Children's common behaviours included "speech other" (mean = 0.66/min) and non-verbal behaviour i.e. "non-verbal agreement" and verbal behaviour "speech yes" (mean = 0.26/min). CONCLUSIONS: The PaeD-TrICS is developed to capture the communication behaviour of the triadic consultations in a preventive dental setting. It demonstrates satisfactory intra- and inter-coder reliability and has been successfully used in paediatric dental consultations.


Assuntos
Codificação Clínica , Comunicação , Relações Dentista-Paciente , Odontólogos/psicologia , Pais/psicologia , Encaminhamento e Consulta , Criança , Comportamento Infantil , Pré-Escolar , Codificação Clínica/métodos , Humanos , Pacientes , Serviços Preventivos de Saúde/organização & administração , Psicometria , Reprodutibilidade dos Testes , Gravação em Vídeo
7.
Eur J Dent Educ ; 23(2): 95-100, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30461132

RESUMO

INTRODUCTION: Communication skills are an integral component of dental undergraduate education. Due to the complex nature of these skills, didactic teaching methods used in other educational contexts can be limited. Interactive and participative methods rooted in modern adult learning theories, such as Forum Theatre, may be more effective in the teaching of communication skills. AIM: To explore the usefulness of Forum Theatre in teaching clinical undergraduate dental students how to break bad news to their patients. METHODS: A purposive sample of 4th-year undergraduate dental students was invited to participate. An evaluation questionnaire was given to the students and collected after the Forum Theatre interactive session. Participants were asked to provide self-reported accounts on the most and least useful parts of the session, as well as the most important learning outcome. Usefulness of the session in clinical work, increasing confidence and ability in breaking bad news, were evaluated via a 5-point Likert-scale type question. Qualitative data were analysed using Framework Analysis to explore the themes found in the open-text component. Descriptive statistics were used to analyse the Likert-scale items. RESULTS: One hundred and fifteen completed questionnaires were collected from the 2015 and 2016 classes. Most students gave the Forum Theatre session a rating of 3 or above on a 5-point Likert scale; indicating that they found it useful. Qualitative results also showed that most participants liked the teaching session thanks to its interactive nature, the use of actors and the input of the facilitators. The majority of students showed preference towards smaller groups which give everyone equal opportunity to participate without unnecessary repetition. CONCLUSION: The results seem to confirm previous findings. Students rated their learning experience involving Forum Theatre favourably. Smaller groups and trained facilitators are required for the success of this teaching method. Further research is needed to assess the long-term educational benefits of Forum Theatre.


Assuntos
Competência Clínica , Comunicação , Relações Dentista-Paciente , Educação em Odontologia/métodos , Aprendizagem , Percepção , Estudantes de Odontologia/psicologia , Ensino , Feminino , Processos Grupais , Humanos , Masculino , Inquéritos e Questionários
8.
Eur J Dent Educ ; 23(4): 515-521, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31429501

RESUMO

AIM: To examine the perceived importance and knowledge of the dental students' in their treatment of dental anxiety according to their year of study and to find out patients' perceived importance of the dental students' knowledge of dental anxiety according to their level on dental fear. METHODS: Dental students (N = 219) at the University of Turku and non-probability convenience sample of 100 of patients attending the Dental Teaching Clinic were given questionnaires with multiple choice and open-ended questions. Students were categorised into three groups according to the year of study (1-3, 4, 5). Patients were categorised into three groups using the established cut points for Modified Dental Anxiety Scale (no fear = 5-9, low fear = 10-18, high fear = 19-25). The differences between groups were evaluated using cross-tabulations, chi squared and Fisher's exact tests. The open-ended questions were subjected to content analysis. RESULTS: Students' perceived importance of dental anxiety did not differ between three groups. Students with greater undergraduate education and clinical experience were more likely to have excellent or quite good knowledge (P < .001). Patients' perceived importance of dental students' knowledge of dental anxiety was greater in patients with high level of fear. The overlapping category that emerged from the open-ended question analysis was communication skills. This appeared to be important for patients with dental anxiety and for dental students in their management of dental anxiety. CONCLUSION: Clinical communication skills should be part of dental anxiety management teaching. Dental students should be able to gain sufficient knowledge and skills in treating dental anxiety before graduating.


Assuntos
Ansiedade ao Tratamento Odontológico , Estudantes de Odontologia , Competência Clínica , Comunicação , Educação em Odontologia , Humanos
9.
Community Pract ; 89(10): 40-5, 47, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-29944222

RESUMO

Smile4life is Scotland's national oral health improvement programme for people experiencing homelessness. Following an oral health and psychosocial needs assessment of 853 homeless people across Scotland, the Smile4life intervention was developed and rolled out across all NHS boards. Dental health and health and social care practitioners were invited to attend a training event at the launch of the Smile4life: Guide for Trainers - a training guide for practitioners working with homeless people. This paper presents results from HoPSCOTCH, a pilot study that took place in four NHS boards to examine the benefits of training for practitioners regarding their awareness of homelessness and the oral health needs of homeless people. Dental health (baseline: 10; follow-up: 8) and health and social care practitioners (baseline: 13; follow-up: 12) completed questionnaires about their knowledge, attitudes and behaviours. The results showed that there were increases in practitioner knowledge, confidence and motivation to help service users access dental care, to provide oral health education and to use motivational interviewing. The authors recommend that future training for practitioners who work with homeless people should include communication skills and advice on how to deliver tailored interventions, with the aim of strengthening practitioners' confidence and motivation to deliver the Smile4life intervention.


Assuntos
Pessoal Técnico de Saúde/educação , Promoção da Saúde/métodos , Pessoas Mal Alojadas , Saúde Bucal , Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Motivação , Projetos Piloto , Escócia , Inquéritos e Questionários
10.
Int J Paediatr Dent ; 25(5): 339-48, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26153527

RESUMO

BACKGROUND: Health literacy has been conceptualised to explain how health information facilitates the maintenance of health. What are the clinical implications of children's health literacy? Children have language skills, numeracy, and reading skills that are in a state of flux - how do they decipher and encode adult health messages to make them their own? AIM: To explore children's health and oral health literacy and discover what processes they use to convert adult health messages into useable information. METHODS: Observations and descriptive case study approach. RESULTS: A theoretical and developmental perspective on children's health and oral health literacy, based upon the ability of the adult to provide a health message with a common shared element, is proposed. It is this common element that the child uses to make adult words understandable and to generate health action. CONCLUSIONS: Children's health and oral health literacy development is achieved, through, a torturous path, supported by the way adults provide health messages to children. Taking time to identify this common element, helping children to encode and reflect upon the health message will help children convert adult oral health messages into their own oral health practices, and support their emerging health and oral health literacy.


Assuntos
Saúde da Criança , Letramento em Saúde , Saúde Bucal , Criança , Comunicação , Feminino , Humanos , Masculino , Lanches , Escovação Dentária
11.
Evid Based Dent ; 16(1): 6-7, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25909928

RESUMO

DATA SOURCES: PubMed, Embase, PsycoInfo, Scielo, Scopus, Web of Science, BBO, Lilacs and York databases supplemented by Google scholar. STUDY SELECTION: Qualitative studies with findings derived from individual or group interviews and structured questionnaires reporting factors that drove dentists towards or away from incorporating caries preventive measures were considered. Two reviewers conducted selection independently. DATA EXTRACTION AND SYNTHESIS: Data were abstracted independently by two reviewers and a qualitative metasummary carried out. This involves the extraction, grouping and formatting of findings and the calculation of frequency and intensity effect sizes in order to provide mixed research syntheses and to conduct a posteriori analyses of the relationship between reports and findings. RESULTS: Seven qualitative studies and 41 surveys (36,501 participants) were included. The reports were grouped together into six categories that were judged to be topically similar; education and training, personal beliefs, work conditions, remuneration, gender, place of residence and patients. Biologicism (27%), low remuneration (25%), length of time since graduation (22%) and male dentists (19%) were found to be the highest frequency effect size driving dentists away from using preventive approaches, and team work (21%), post-graduation (12%) and professional understanding of the benefits (12%) were identified as the main reasons for dentists' adherence to preventive measures. CONCLUSIONS: Despite the questionable quality of the included reports the evidence that emerged seems to indicate that further education and training coupled with a fairer pay scheme would be a reasonable approach to change the balance in favour of the provision of dental caries preventive measures by dentists. The results of this review could be of value in the planning and decision-making processes aimed at encouraging changes in professional dental practice that could result in the improvement of the oral health care provided to the population in general.


Assuntos
Assistência Odontológica/estatística & dados numéricos , Cárie Dentária , Odontólogos/estatística & dados numéricos , Humanos
12.
Med Princ Pract ; 23(4): 295-301, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24356305

RESUMO

OBJECTIVE: The aim of this review was to explore the peer-reviewed literature to answer the question: 'Why are people afraid of the dentist?' METHOD: Relevant literature was identified by searching the following on-line databases: PubMed, PsycInfo, the Cochrane Library and Google Scholar. Publications were extracted if they explored the causes and consequences of dental fear, dental anxiety or dental phobia. RESULTS: The research evidence suggests that the causes of dental fear, dental anxiety or dental phobia are related to exogenous factors such as direct learning from traumatic experiences, vicarious learning through significant others and the media, and endogenous factors such as inheritance and personality traits. Each individual aetiological factor is supported by the evidence provided. CONCLUSIONS: The evidence suggests that the aetiology of dental fear, anxiety or phobia is complex and multifactorial. The findings show that there are clear practical implications indicated by the existing research in this area: a better understanding of dental fear, anxiety and phobia may prevent treatment avoidance.


Assuntos
Ansiedade ao Tratamento Odontológico/etiologia , Ansiedade ao Tratamento Odontológico/psicologia , Relações Dentista-Paciente , Fatores Etários , Cognição , Condicionamento Psicológico , Ansiedade ao Tratamento Odontológico/epidemiologia , Medo , Humanos , Personalidade
13.
BMC Oral Health ; 14: 19, 2014 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-24621226

RESUMO

BACKGROUND: To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. METHODS: A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. RESULTS: The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (χ2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. CONCLUSION: In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.


Assuntos
Ansiedade ao Tratamento Odontológico/epidemiologia , Cárie Dentária/epidemiologia , Adolescente , Ansiedade/epidemiologia , Distribuição de Qui-Quadrado , China/etnologia , Índice CPO , Restauração Dentária Permanente/estatística & dados numéricos , Etnicidade/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Índia/etnologia , Funções Verossimilhança , Malásia/epidemiologia , Masculino , Características de Residência/estatística & dados numéricos , Saúde da População Rural/estatística & dados numéricos , Perda de Dente/epidemiologia , Saúde da População Urbana/estatística & dados numéricos
14.
Evid Based Dent ; 15(4): 98-9, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25522936

RESUMO

DATA SOURCES: Medline, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), LILACS (Latin American and Caribbean Health Sciences), CNKI (China National Knowledge Infrastructure), Wanfang (China) and the South African Department of Health databases were searched. In addition the archives at the WHO Collaborating Centre for Nutrition and Oral Health at Newcastle University and reference lists of reviews were searched and experts contacted for further relevant papers. STUDY SELECTION: Intervention, cohort population or cross sectional studies were considered where there was any intervention to alter the intake of sugar or the intake of sugars or change of sugar intake was monitored. The main outcome was caries incidence. The GRADE (Grading of Recommendations Assessment Development and Evaluation) system was used to assess study quality. DATA EXTRACTION AND SYNTHESIS: Separate data abstraction forms were designed for RCTs and observational studies and meta-analyses were to be conducted where possible. RESULTS: Sixty-five papers reporting 55 studies were included. No RCTs were identified. Three studies (four papers) were interventional, eight (12 papers) were prospective cohort, 20 (25 papers) were population based and 24 (25 papers) were cross-sectional. Data variability limited meta-analysis. Of the studies, 42 out of 50 of those in children and five out of five in adults reported at least one positive association between sugars and caries.Five of the eight cohort studies allowed comparison of dental caries development when sugars consumption was equivalent to a level < 10% E (Energy) or > 10% E. All eight studies found higher caries with sugars intake > 10% E compared with < 10% E. CONCLUSIONS: This in-depth systematic review shows consistent evidence of moderate quality supporting a relationship between the amount of sugars consumed and dental caries development. There is evidence of moderate quality to show that dental caries is lower when free-sugars intake is < 10% E. Dental caries progresses with age, and the effects of sugars on the dentition are lifelong. Even low levels of caries in childhood are of significance to levels of caries throughout the life course. Analysis of the data suggests that there may be benefit in limiting sugars to < 5% E to minimise the risk of dental caries throughout the life course.


Assuntos
Cárie Dentária/etiologia , Carboidratos da Dieta/administração & dosagem , Humanos
15.
Int Dent J ; 63(2): 103-12, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23550524

RESUMO

AIM: To examine the use of dental therapist/hygienists to provide primary dental treatment in remote-rural areas with regard to their effectiveness, efficiency, sustainability, acceptability and costs (affordability). METHOD: The structured literature review of studies indexed in Medline, Embase and CinAHL was conducted using search terms relevant to 'dental therapists' and 'remote-rural'. Remote-rural was defined as 'those (individuals) with a greater than 30-minute drive time to the nearest settlement with a population of greater than 10,000'. RESULTS: From 1,175 publications screened, 21 studies from 19 publications were initially included. Only seven studies were included that explicitly focused on remote-rural areas. Four were surveys and three were qualitative studies. All of the included studies were reported within the last 7 years. The methodological quality of the surveys varied, particularly with regard to their response rates. All three of the qualitative studies were assessed as potentially weak methodologies. Regarding the research question, none of the studies included provided data relevant to understanding efficiency, cost issues or the acceptability of dental therapists. The available empirical evidence contained only indirect indicators about the sustainability of dental therapy in rural areas. CONCLUSIONS: The available data indicates that dental therapist/hygienists have suitable skills and could constitute a valuable asset to meet the dental demands in remote-rural areas. However, the evidence base is limited and of a poor quality. There is a need to put in place 'well-designed interventions with robust evaluation to examine cost-effectiveness and benefits to patients and the health workforce'.


Assuntos
Auxiliares de Odontologia/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Higienistas Dentários/estatística & dados numéricos , Atenção Primária à Saúde/estatística & dados numéricos , Serviços de Saúde Rural/estatística & dados numéricos , Atitude Frente a Saúde , Custos e Análise de Custo , Assistência Odontológica/economia , Eficiência , Humanos , Atenção Primária à Saúde/economia , Serviços de Saúde Rural/economia
16.
BMC Oral Health ; 13: 29, 2013 Jun 24.
Artigo em Inglês | MEDLINE | ID: mdl-23799962

RESUMO

BACKGROUND: A recent UK population survey of oral health included questions to assess dental anxiety to provide mean and prevalence estimates of this important psychological construct. METHODS: A two-stage cluster sample was used for the survey across England, Wales, and Northern Ireland. The survey took place between October-December 2009, and January-April 2010. All interviewers were trained on survey procedures. Within the 7,233 households sampled there were 13,509 adults who were asked to participate in the survey and 11,382 participated (84%). RESULTS: The scale was reliable and showed some evidence of unidimensionality. Estimated proportion of participants with high dental anxiety (cut-off score = 19) was 11.6%. Percentiles and confidence intervals were presented and can be estimated for individual patients across various age ranges and gender using an on-line tool. CONCLUSIONS: The largest reported data set on the MDAS from a representative UK sample was presented. The scale's psychometrics is supportive for the routine assessment of patient dental anxiety to compare against a number of major demographic groups categorised by age and sex. Practitioners within the UK have a resource to estimate the rarity of a particular patient's level of dental anxiety, with confidence intervals, when using the on-line percentile calculator.


Assuntos
Ansiedade ao Tratamento Odontológico/epidemiologia , Ansiedade ao Tratamento Odontológico/psicologia , Inquéritos de Saúde Bucal/estatística & dados numéricos , Escala de Ansiedade Manifesta/normas , Adulto , Fatores Etários , Análise de Variância , Teorema de Bayes , Distribuição de Qui-Quadrado , Análise por Conglomerados , Intervalos de Confiança , Interpretação Estatística de Dados , Ansiedade ao Tratamento Odontológico/diagnóstico , Inquéritos de Saúde Bucal/normas , Feminino , Humanos , Masculino , Sistemas On-Line , Prevalência , Psicometria , Valores de Referência , Fatores Sexuais , Classe Social , Reino Unido/epidemiologia
17.
Dent J (Basel) ; 11(7)2023 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-37504245

RESUMO

BACKGROUND: The current evidence on the relationships among child oral health-related quality of life, dental anxiety, and self-esteem indicates that we need to investigate these relationships to improve our understanding of the associations. Therefore, the current research aimed to enhance this evidence and provide an overview of the participating children's oral-health-related quality of life (as measured by the CPQ8-10), self-esteem (as measured by the Coopersmith SEI-SF), and dental anxiety (as measured by the CFSS_DS) and how these child-related outcome measures interacted and were related to one another. METHOD: A cross-sectional survey was conducted on a random sample of school children (n = 1900) aged 8 to 10 years. The questionnaire was collected through validated self-report measures: dental anxiety, COHRQoL, and self-esteem. Structural equation modelling (SEM) was used to test the strength of the association of our model to explore the relationships among these three psychological constructs. The moderating effects of age, gender, location, and the educational board were analysed for their possible influence on these relationships. RESULTS: Significant relationships between COHRQoL and child dental anxiety and between COHRQoL and SE were detected. The relationship subscale between COHRQoL and child dental anxiety was 0.24, (p < 0.001). A stronger correlation between COHRQoL, and SE was found, with B = -0.77, (p < 0.001). Although the association between CDA and SE was small, it was statistically significant (p = 0.03). These findings provide some important background information for designing effective educational programs for children.

18.
Dent J (Basel) ; 11(3)2023 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-36975570

RESUMO

BACKGROUND: Health coaching-based interventions can support behaviour change to improve oral health. This scoping review aims to identify key characteristics of health coaching-based interventions for oral health promotion. METHODS: The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute manual for evidence synthesis were used in this review. A search strategy using medical subject heading terms and keywords was developed and applied to search the following databases: CINAHL, Ovid, PubMed, Cochrane Library and Scopus. Thematic analysis was used to synthesise the data. RESULTS: Twenty-three studies met the inclusion criteria and were included in this review. These studies were predominantly based on health coaching and motivational interviewing interventions applied to oral health promotion. The following are the characteristics of health coaching-based interventions extracted from themes of the included studies: (a) Health professionals should be trained on the usage of motivational interviewing/health coaching interventions; (b) oral health professionals should acquire motivational techniques in their practice to engage patients and avoid criticisms during the behaviour change process; (c) routine brief motivational interviewing/health coaching intervention sessions should be introduced in dental clinics; (d) traditional oral health education methods should be supplemented with individually tailored communication; and (e) for cost-effectiveness purposes, motivational interviewing/health coaching strategies should be considered. CONCLUSIONS: This scoping review reveals that health coaching-based techniques of health coaching and motivational interviewing can significantly impact oral health outcomes and behaviour change and can improve oral health professional-patient communication. This calls for the use of health coaching-based techniques by dental teams in community and clinical settings. This review highlights gaps in the literature, suggesting the need for more research on health coaching-based intervention strategies for oral health promotion.

19.
Front Oral Health ; 4: 1289348, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38239231

RESUMO

Introduction: Smile4life is Scotland's national oral health improvement programme for people experiencing homelessness, aimed at reducing oral health inequalities experienced by this population. This study forms part of an evaluation of how the Smile4life intervention was being implemented within Scottish NHS Boards. The aim was to investigate the influence of the Smile4life intervention upon the engagement behaviours of Smile4life practitioners. Methods: Focus groups were conducted with Smile4life practitioners, to provide an insight into how the Smile4life intervention affected their skills, attitudes and experiences while interacting with people experiencing homelessness and their services providers. A purposive sample of oral health practitioners, including dental health support workers, oral health promoters/educators, and oral health improvement coordinators working in three NHS Boards were invited to take part. One focus group was conducted in each of the three NHS Boards. The focus groups were audio-recorded and transcribed. The COM-B model of behaviour was used as a framework for analysis. Results: Eleven Smile4life practitioners took part in the focus groups. All had first-hand experience of working with the Smile4life intervention. The average focus group length was 67 min. Working on the Smile4life intervention provided the Smile4life practitioners with: (i) the capability (physical and psychological), (ii) the opportunity (to establish methods of communication and relationships with service providers and service users) and (iii) the motivation to engage with Third Sector homelessness services and service users, by reflecting upon their positive and negative experiences delivering the intervention. Enablers and barriers to this engagement were identified according to each of the COM-B categories. Enablers included: practitioners' sense of responsibility, reflecting on positive past experiences and success stories with service users. Barriers included: lack of resources, negative past experiences and poor relationships between Smile4life practitioners and Third Sector staff. Conclusion: The Smile4life programme promoted capability, provided opportunities and increased motivation in those practitioners who cross disciplinary boundaries to implement the Smile4life intervention, which can be conceptualised as "boundary spanning". Practitioners who were found to be boundary spanners often had a positive mindset and proactive attitude towards the creation of strategies to overcome the challenges of implementation by bridging the gaps between the NHS and the Third Sector, and between oral health and homelessness, operating across differing fields to achieve their aims.

20.
BMC Public Health ; 12: 681, 2012 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-22909327

RESUMO

BACKGROUND: Early Childhood Caries (ECC) is a widespread problem in Australian Aboriginal communities causing severe pain and sepsis. In addition dental services are difficult to access for many Aboriginal children and trying to obtain care can be stressful for the parents. The control of dental caries has been identified as a key indictor in the reduction of Indigenous disadvantage. Thus, there is a need for new approaches to prevent ECC, which reflect the cultural norms of Aboriginal communities. METHODS/DESIGN: This is a Phase II single arm trial designed to gather information on the effectiveness of a dental health education program for Aboriginal children aged 6 months, followed over 2 years. The program will deliver advice from Aboriginal Health Workers on tooth brushing, diet and the use of fluoride toothpaste to Aboriginal families. Six waves of data collection will be conducted to enable estimates of change in parental knowledge and their views on the acceptability of the program. The Aboriginal Health Workers will also be interviewed to record their views on the acceptability and program feasibility. Clinical data on the child participants will be recorded when they are 30 months old and compared with a reference population of similar children when the study began. Latent variable modeling will be used to interpret the intervention effects on disease outcome. DISCUSSION: The research project will identify barriers to the implementation of a family centered Aboriginal oral health strategy, as well as the development of evidence to assist in the planning of a Phase III cluster randomized study. TRIAL REGISTRATION: ACTRN12612000712808.


Assuntos
Cárie Dentária/prevenção & controle , Educação em Saúde Bucal , Promoção da Saúde/métodos , Havaiano Nativo ou Outro Ilhéu do Pacífico/educação , Pais/educação , Atitude do Pessoal de Saúde , Austrália/epidemiologia , Pré-Escolar , Agentes Comunitários de Saúde/psicologia , Cárie Dentária/epidemiologia , Seguimentos , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Necessidades e Demandas de Serviços de Saúde , Humanos , Lactente , Avaliação de Programas e Projetos de Saúde
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