Knowledge, attitudes and self-reported practices toward children oral health among mother's attending maternal and child's units, Salé, Morocco.

BACKGROUND: The occurrence of severe dental caries is particularly prevalent and harmful in children. A better understanding of parental factors that may be indicators of children's risk of developing dental caries is important for the development of preventive measures. This study was conducted to assess knowledge, attitudes, and practices (KAP) of mothers in Salé, Morocco regarding oral health and their predictors. METHODS: A cross-sectional KAP study was conducted of Mother and Child units in Salé, Morocco. Mothers attending the selected units from November 2014 to 29 January 2015 were recruited. Data were collected using a semi-structured questionnaire, administered by face-to-face interviews, to record socio-demographic factors and KAPs. The main outcome measures included knowledge about oral health diseases and preventive measures, and attitudes and practices related to oral health prevention measures and dental care. KAPs scores were then recoded based on responses and scores were determined for each KAP domain. Linear regression analysis was conducted to assess predictors of KAP scores. RESULTS: Among 502 mothers included, 140 (27.8%) were illiterate and 285 (60.9%) were aware that fluoride has a beneficial effect in caries prevention. Mothers' own practices about dental care were statistically related to their children's use of dental care services (p < 0.001). Multiple linear regression analysis revealed that the knowledge score was associated with mother's age (ß = 0.05; 95% CI; p < 0.001), education level, and median income (ß = 0.38; p = 0.04). Significant predictors of oral health-related practices were mother's education level and children's health status. CONCLUSIONS: Limited KAP scores were observed among the studied population. A great emphasis on oral health education and some risk factor modifications are recommended.

Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

OBJECTIVES: Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. MATERIALS AND METHODS: A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. RESULTS: Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. DISCUSSION: The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. CONCLUSION: We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers.

A simple point of care test can indicate the need for periodontal therapy to reduce the risk for adverse pregnancy outcomes in mothers attending antenatal clinics.

INTRODUCTION: Although the association between periodontal disease (PD) and adverse pregnancy outcomes has gained recognition amongst antenatal healthcare workers, not much has changed in practice to address it. This prospective study tested the hypothesis that BANA (N-benzoyl-DL-arginine-2-naphthylamide), a diagnostic test for PD, may inform obstetricians and other antenatal healthcare practitioners, of the risk of adverse pregnancy outcomes in mothers attending antenatal clinics. METHODS: At first visit, the presence of suspected periodontopathogens was assessed by BANA testing of dental plaque from 443 mothers attending antenatal clinics in KwaZulu-Natal, South Africa and an association later sought with pregnancy outcomes. The accuracy of BANA to predict adverse pregnancy outcomes was evaluated by the calculation of likelihood ratios. The study complied with the Declaration of Helsinki. RESULTS: Significant differences were found between pregnancy outcomes of BANA-negative and BANA-positive mothers (p < 0.0001). BANA showed sensitivity and negative predictive values of 87% and 91%; 75% and 78%; 87% and 94% in detecting low birth weight, preterm delivery, and preterm low birth weight delivery respectively. CONCLUSION: This study confirms that BANA may indicate the need for periodontal therapy to reduce the risk of adverse pregnancy outcomes and could form part of the routine antenatal examination.

Looking at graduates of Title V MCHB-funded training programs through the lens of the MCH pyramid.

OBJECTIVES: To examine the distribution of professional responsibilities as reflected in each level of the MCH Pyramid for 208 graduates of five Maternal and Child Health Bureau (MCHB)-funded training programs-Leadership Education in Neurodevelopmental and Related Disabilities, nutrition, pediatric dentistry, public health, and social work-at the University of North Carolina at Chapel Hill. METHODS: Graduates completed a web-based survey, 1-8 years after graduation. For each program, we constructed means of the reported percentages of total work time spent in infrastructure-building, population-based, enabling, and direct health care services. RESULTS: Although generally consistent with the goals of the training programs, the percentages of time spent in each level of the Pyramid varied substantially among the five programs. For example, for a clinically focused program like pediatric dentistry, 80.2 % of time is spent in direct care services in contrast to 14.8 % for public health graduates. For each program, however, graduates report responsibilities among the different levels of the Pyramid. CONCLUSIONS: Reporting job responsibilities within the MCH Pyramid provides a more informative picture of the contributions of training program graduates than do conventional metrics such as institutional or agency appointments. The fact that graduates from all five programs engage multiple roles is consistent with the MCHB workforce training goal to develop leaders in the field of MCH. Given the central role of the MCH Pyramid in planning and reporting for the MCH Services Block Grant, MCH training programs should include metrics such as graduates' roles according to the MCH Pyramid to assure that training goals are more closely aligned with workforce needs.

Oral health status and treatment need among preschool children attending Anganwadi centres - a comparative study.

PURPOSE: To assess and compare the oral health status and treatment need among the preschool children attending Anganwadi Centres associated with a special learning programme (SLP) and the control group. MATERIALS AND METHODS: The study was designed to include 3- to 5-year-old preschool children attending Anganwadis. An Anganwadi (meaning courtyard) Centre is the focal point for the delivery of services to children and mothers. The Anganwadis associated with the special learning programme and the control group Anganwadis consisted of 255 and 275 children, respectively. The special learning programme comprised general health education and growth monitoring services that were continuously reinforced to expectant and nursing mothers of children below 6 years of age by a team of members of a nearby medical college. Information on demographic and socioeconomic parameters (maternal literacy and occupation, paternal literacy and occupation, family income), oral hygiene practices, dietary habits and dental visits was obtained, and oral examination was done in the two groups. RESULTS: The mean plaque index and mean gingival index score among the SLP Anganwadi group were 0.18 ± 0.22 and 0.15 ± 0.28, respectively, and among the control group these indices were 1.06 ± 0.50 and 0.50 ± 0.00, respectively. The mean dmft score among the SLP group was 3.40 ± 4.84 vs 4.32 ± 4.69 in the control group (p < 0.05). The distribution of children without any treatment need was 50.2% in the SLP group and 33.5% in the control group. CONCLUSION: The SLP Anganwadi group had a better oral health status and less treatment need than the control Anganwadi group. This demonstrates that there is a beneficial effect of general health education on oral health.

The UNC-CH MCH Leadership Training Consortium: building the capacity to develop interdisciplinary MCH leaders.

This article describes the UNC-CH MCH Leadership Consortium, a collaboration among five MCHB-funded training programs, and delineates the evolution of the leadership curriculum developed by the Consortium to cultivate interdisciplinary MCH leaders. In response to a suggestion by the MCHB, five MCHB-funded training programs--nutrition, pediatric dentistry, social work, LEND, and public health--created a consortium with four goals shared by these diverse MCH disciplines: (1) train MCH professionals for field leadership; (2) address the special health and social needs of women, infants, children and adolescents, with emphasis on a public health population-based approach; (3) foster interdisciplinary practice; and (4) assure competencies, such as family-centered and culturally competent practice, needed to serve effectively the MCH population. The consortium meets monthly. Its primary task to date has been to create a leadership curriculum for 20-30 master's, doctoral, and post-doctoral trainees to understand how to leverage personal leadership styles to make groups more effective, develop conflict/facilitation skills, and identify and enhance family-centered and culturally competent organizations. What began as an effort merely to understand shared interests around leadership development has evolved into an elaborate curriculum to address many MCH leadership competencies. The collaboration has also stimulated creative interdisciplinary research and practice opportunities for MCH trainees and faculty. MCHB-funded training programs should make a commitment to collaborate around developing leadership competencies that are shared across disciplines in order to enhance interdisciplinary leadership.

Providing a dental home for pregnant women: a community program to address dental care access--a brief communication.

OBJECTIVE: This paper describes a community-based intervention to provide a dental home for women covered by Medicaid in Klamath County, Oregon. In 2001, 8.8 percent of pregnant women served by Medicaid in Oregon received care. The long-term goal of the program is to promote preventive oral care for both mothers and their new infants. METHODS: Pregnant women received home/Women, Infant and Children visits and were assigned a dental home under a dental managed care program [Dental Care Organization (DCO)]. All initial care was provided at the Oregon Institute of Technology Dental Hygiene Clinic under the contract with the DCO. Emergency, preventive, and restorative care was provided. RESULTS: Between February 2004 and January 2006, 503 pregnant women were identified; 421 women were contactable. Of these, 339 received home visits (339/421, 80.5 percent) and 235 received care (235/339, 69.3 percent). Overall, 55.8 percent of eligible women received care (235/421). Most who did not have a visit either moved or were not the caretaker of the baby. The missed appointment rate was 9 percent. CONCLUSION: A community health partnership led to a successful and sustainable model extending care to pregnant women and is being extended to promote preventive care for both new mothers and their offspring.

Situational analysis of dental caries and existing oral health care of children and adolescents in Hubei Province, People's Republic of China: implications for change.

PURPOSE: (1) To evaluate trends in dental caries of children and adolescents of Hubei Province and Wuhan Municipality over the last two decades. (2) To conduct a situational analysis of existing oral health care and to recommend changes to improve this care for children. MATERIALS AND METHODS: An analysis was performed on data from national oral health surveys carried out in China at the provincial level, and data on 12-year-old children of Wuhan Municipality. A review of the literature was conducted on available and utilised oral health care facilities by children. RESULTS: In 1983, the mean decayed, missing and filled teeth (DMFT) of 12-year-olds in Hubei Province was 1.0, and in 1995 it was 0.6. The studies in Wuhan Municipality in 1993-1995 among 12-year-olds reported DMFT values ranging from 0.7-1.5, however different methods of caries assessment were performed in the various studies making comparisons difficult. The caries prevalence and the mean dmft score of 5-year-old children in 1995 in Hubei Province were 69% and 3.6, respectively. The percentage of untreated caries for all age groups in Hubei Province was very high. CONCLUSIONS: Analysis of epidemiological information over the last two decades does not provide any conclusive evidence supporting either an increasing or decreasing trend of dental caries in the child and adolescent population of Hubei Province and Wuhan Municipality. There is, however, a clear need to prevent the incidence of dental caries from increasing and to provide care to address the treatment needs of pre-school and school-age children. The promotion of twice-daily tooth brushing with fluoride toothpaste at maternal and child health care centres, and the establishment of daily tooth brushing with pea-size amounts of fluoride toothpaste in the pre-school and primary school setting are recommended preventive strategies. Establishment of school-based oral health promotion should be accompanied with the provision of Atraumatic Restorative Treatment (ART) sealants and ART restorations which can be provided by dental nurses at dramatically lower costs than the traditional high-tech approach.

Compliance with fluoride supplements provided by a dental hygienist in homes of low-income parents of preschool children in Quebec.

OBJECTIVE: This study aimed to assess the compliance with fluoride supplements provided at home by a dental hygienist to mothers of at-risk preschool children. METHODS: Participants were recruited during pregnancy of low-income women. On the first visit, the mothers of 60 infants aged 6 to 9 months were handed free fluoride supplements. A questionnaire was administered at that time and after 6 and 12 months to assess compliance during the preceding week. RESULTS: At the beginning of the study, none of the mothers reported having given fluoride supplements, in comparison with 73 percent of mothers of 44 infants who received all three visits at the end of follow-up; 48 percent reported fluoride supplement use on a daily basis. CONCLUSIONS: Removal of financial and physical barriers and personal professional involvement are good strategies to achieve compliance with fluoride supplements. Further assessment regarding the possible application of this intervention to other professional or cultural contexts is warranted.

Prolonged effect of a mother-child caries preventive program on dental caries in the permanent 1st molars in 9 to 10-year-old children.

OBJECTIVE: To evaluate the prevalence of caries in the permanent 1st molars of a group of 9 to 10-year-old children, and to determine the long-term effect of a mother-child preventive dental program (PDP) that started when the women were pregnant and continued until the children were 6 years of age. MATERIAL AND METHODS: The permanent 1st molars of 37 children in the PDP group were evaluated for caries, both clinically and radiographically, and compared with those of a control group of 42 children who had not participated in the PDP. RESULTS: Of children in the PDP group, 70% were caries free compared to 33% in the control group (p<0.001). Of permanent 1st molars in the PDP group, 87% were caries-free compared to 61% in the control group (p<0.001). The mean DFS of the PDP children 10 years of age was 0.519+/-0.93 versus 1.57+/-1.38 for the control children (p=0.002). CONCLUSIONS: Examination of children 4 years after discontinuation of a caries preventive program reflected a long-term reduction in the DFS score of permanent 1st molars.

Evaluation of a dental health education program for midwives.

OBJECTIVE: The aim of the present study was to evaluate the effect of a dental health program for the midwives in primary health care services in Izmir, Turkey. METHODS: One hundred sixty-four midwives participated in the pilot project. The program was evaluated by quantitative and qualitative methods. The quantitative method assessed the improvement of the dental knowledge level, whereas the qualitative method was conducted to determine the assessments of the participants. RESULTS: The percentages of correct responses given to knowledge items were higher after the program. The midwives defined their role as an important first step for dental services. Education atmosphere was the best characteristic of the program, whereas lack of a written document was an important limitation. CONCLUSION: Despite some limitations, the program was an effective way of improving the oral health knowledge of the midwives and their motivation for dental services.

Priorities in oral health care in non-EME countries.

This paper describes the prevailing problems pertaining to oral care in non-established market economy (non-EME) countries. The current situation with large numbers of untreated cases of oral diseases, the inequality in delivery systems and the virtual non-existence of an adequate community oriented prevention calls for action. What is needed is a turn towards an oral care system that meets the principles of primary health care (PHC). This implies an oral health care system which makes use of the existing health care infrastructures and which applies an appropriate technology with emphasis on community oriented prevention directed to all at an affordable price. Four components of oral care are proposed as priorities in basic oral care, aiming to achieve the objectives of the PHC philosophy. These four components are: emergency care; exposure to fluoride; oral health education (OHE); atraumatic restorative treatment (ART). These components should be available for all. The exact content and extent of each component in various countries depends on local existing supporting conditions and on the level of development as well as on specific perceived needs of the population. Therefore, small-scale demonstration projects containing one or more of the described components should firstly be launched in various countries to evaluate the acceptability, effectiveness and sustainability of the proposed basic oral care programme.

Periodontal status of pregnant and postpartum mothers aged 18-45 years attending MCH clinics in Tanga Municipality, Tanzania.

One hundred pregnant women and another hundred women post-partum aged 18-45 years were examined at Maternal and Child Health (MCH) clinics in Tanga Municipality, to determine their periodontal health status. The sample was selected by using convenient sampling method. Plaque was assessed as absent, score 0 and present, score 1, while calculus, gingivitis, shallow pockets and deep pockets were assessed according to the Community Periodontal Index for Treatment Needs (CPITN), for each of the six sextant examined. Findings were recorded on a special prepared oral health assessment form. Data analysis was done using SPSS Pc+. Results revealed that the majority of women examined had gingival bleeding and plaque on about 50% of the sextants during pregnancy as well as after delivery. Postpartum women in the age group 18-34 years had a higher number of sextants with plaque, calculus and gingivitis than pregnant women in the same age group both in the second and third trimester of pregnancy (p < 0.05). During the third trimester of pregnancy, women in the age group 18-34 had more sextants with plaque, calculus and gingival bleeding than women in the second trimester of pregnancy (p < 0.05). However, in the age group 35-45 women in the second trimester of pregnancy had more sextants with plaque, calculus and gingival bleeding than women in the third trimester of pregnancy (p < 0.05). Women postpartum in all age groups had shallow pockets, while in pregnant women they were found in the age group 25-45 in the second trimester and only in the age group 35-45 in the third trimester.(ABSTRACT TRUNCATED AT 250 WORDS)

The impact of WIC dental screenings and referrals on utilization of dental services among low-income children.

PURPOSE: This cross-sectional study examined whether referrals from nondental health professionals impacted utilization of dental services by low-income populations. METHODS: A sample of 309 mothers enrolled in the Women, Infant, and Children (WIC) clinic in Jackson County, Missouri, completed a self-administered, 32-item questionnaire to assess the mother and child's oral health behavior and past use of dental services. Dental utilization, the primary dependent variable, was defined as whether or not the child had ever been to a dentist. RESULTS: Findings showed 27% of the children in the sample had been referred for dental care. Bivariate analysis indicated that a dental referral, age of the child, age of the mother, mother's perceived dental need for the child, household size, number of children in the household, and dental insurance for the child were associated with a child having a dental visit. Logistic regression, however, indicated that only age was significantly related to utilization. CONCLUSION: The results showed a strong effect of increasing age being related to dental utilization, while additional research is needed to clarify the importance of WIC referrals.

Caries prevalence of children in an infant oral health educational program at a WIC clinic.

PURPOSE: The purpose of this study was to compare the prevalence of caries between children whose parents had previously participated in an infant oral health educational program (IOHEP) at a WIC clinic with those children whose parents had not participated previously. METHODS: One hundred and twenty children aged 1 to 5 years participated in the study. A single examiner previously standardized using the WHO diagnostic criteria for caries examined the children. RESULTS: One hundred and sixteen children were Hispanic (97%). Forty-one of the parents (34%) had previously participated in the IOHEP. Previous participation of the parents in the IOHEP was highly associated with fewer enamel carious lesions (P=.005) and lower dft (P=.043) scores. Children whose parents reported brushing their child's teeth with fluoride toothpaste had significantly lower prevalence of caries (P=.007). CONCLUSIONS: Infant oral health educational programs directed to parents at WIC can have a positive impact on caries prevention.

Impact of dental health care on dental health of children with long-term diseases: a nested case-control study.

The objective was to study dental health among nine-year-old long-term ill and disabled children and their matched controls using DMFT/dmft-indices (decayed-missing-filled-teeth, of both permanent and deciduous teeth); to analyze similarities and differences of their family factors; the children's dental health habits which include dietary factors; to assess capabilities of the health care personnel in the identification of the risk groups and in the provision of services; and finally to investigate family satisfaction with the dental health care services provided. One dentist (M-L M) routinely carried out the clinical examinations of the children using the DMFT(dmft)-index. Only cavities extending to dentin were included in the DMF and dmf indices. X-rays were also used. It was found that less than half of the children (46%) had healthy teeth (DMFT and dmft both = 0), with 41% among the study group and 51% among the controls. The DMFS index of the longterm ill children was slightly, but not significantly greater than that of the controls, and these children used dental health care services more but their families were less satisfied with the services. The long-term ill children had less orthodontic care than the controls although they needed it more frequently, and they had a designated candy day significantly more often than the controls. Special diets were associated with long-term ill children, as were the sociodemographic factors of marital status, divorce, or stepfather present. No significant differences existed between the groups in toothbrushing and the use of fluoride products. In the status and health of teeth as measured with the DMFT/dmft indices, there were no statistically significant differences between the group of the long-term-ill children and healthy controls. Estimation of the focusing of care was considered successful concerning dental health, but resource limitations emerged and contributed to parents not being satisfied with the frequency dental care services offered.

[Utilization of Maternal and Child Health handbook in Japan].

OBJECTIVES: In Japan, Maternal and Child Health (MCH) handbook have been widely used for more than fifty years. However, there has been no evaluation research from the users' point of view. We therefore conducted a questionnaire survey of guardians to evaluate how they utilize MCH handbooks. METHODS: A well-structured questionnaire survey was carried out in 231 municipalities, towns and villages of four prefectures (Gifu, Hiroshima, Niigata and Shizuoka) and one city (Yokohama) in November and December 1999. The targets were 13,271 guardians who visited health stations for 18-month examinations of their children and agreed to participated in our research. The questionnaire covered situation of usage and loss by guardians, utility from the users' perspective, and suggestions for improvement. RESULTS: We obtained answers from 10,900 guardians. As for reading rate and writing rate, 98.3% of respondents had read and 97.8% of them had written down something in relation. Only 0.9% of respondents had lost this MCH handbook. Generally, 87.0% of respondents answered that MCH handbook was helpful for child bearing and 81.6% of them said the record for immunization was useful. However, 34.1% of respondents answered it was not simple to utilize MCH handbook and 60.6% of them requested more detail on child bearing. As for dental health, the completion rate for information was low and only 21.3% of respondents reported for the dental record was useful. CONCLUSIONS: The research shows MCH handbook are highly utilized in Japan by almost all guardians. However, there are still problems to be solved; many guardians feel that they are not simple to use and the section on dental health is not highly particularly helpful. Improvements should be made in future in light of the viewpoints of guardians and parents.

An idea that works. NYU Harris Infant Dental Education Area.

Dental decay continues to plague infants and toddlers, as evidenced by the continued prevalence of nursing caries. The Samuel D. Harris Infant Dental Education Area (IDEA) in the New York University College of Dentistry is the first of its kind in the nation and is especially designed for the promotion of oral health and prevention of diseases of the teeth and mouth of infants and toddlers. Teaching mothers-to-be and new mothers the ABC's of maintaining a healthy oral environment for their babies and themselves is the focus of activities at IDEA.

[Women's approach to childhood toothache, abdominal ache and earache]. / Kadinlarin dis, karin ve kulak agrisi olan çocuklarina yaklasimlari.

OBJECTIVES: This study was conducted to determine women's about attitudes child's teeth, abdomen and ear ache. METHODS: Those who had lived in Antalya that 6 number primary health care center between March-May 2004 were enrolled in the study. As data collecting tools. A questionnaire prepared by the authors. This study was determined that 29.2 % of the mothers carried out mixture who had prepared at home to child's abdomen and foot base; 30.3 % were to put breast milk childs' ear; 38.9 % were placed aspirin, salt and salts of lemon to childs' teeth ache. RESULTS: The majority of the women make a wrong practices child that teeth, abdomen and ear ache. This traditional practice effecting factors were the women's educational status and age. CONCLUSION: The results of the study that education about child care, common health problems and incorrect applications shoud be given to women by nurse.