Development of interprofessional education programmes in nursing care and oral healthcare for dental and nursing students.

BACKGROUND: Interprofessional education (IPE) is essential for healthcare students to collaborate effectively in multidisciplinary teams. This study aimed to identify the effect of IPE programmes in nursing care and oral healthcare on dental and nursing students' perceptions of interprofessional collaboration. METHODS: The study included 101 third-year dental and 98 fourth-year nursing students. The participants were divided into mixed-professional groups of four (2 dental and 2 nursing students). They participated in nursing care and oral healthcare training programmes that included student-on-student training and discussion groups. Questionnaires regarding perceptions of interprofessional collaboration were distributed to the participants before and after the programmes to compare the programmes before and after and between the dental and nursing students. The Wilcoxon signed-rank test and chi-square test were used to compare the data. RESULTS: Data from 79 dental students (42 males and 37 females) and 89 nursing students (4 males and 85 females) who completed both questionnaires were used for the comparisons. Perceptions of the differences between the approaches of different health professionals to nursing care, the roles of other professionals, and the need for multiprofessional collaboration improved significantly among both dental and nursing students after the programmes. Although the perception of their ability to communicate with unfamiliar or new people improved significantly only among the nursing students, other perceptions of their ability to communicate did not improve for either group. More dental students than nursing students chose nursing trainings as good programmes to participate in with other professional students, while more nursing students than dental students chose oral care trainings as good programmes. Many students commented that they learned about nursing and oral healthcare skills as well as the importance of teamwork and communication with other professionals. Seven students commented that they were more motivated to become dentists and nurses. CONCLUSIONS: This study showed that IPE programmes for nursing care and oral healthcare might be effective at helping students understand other professionals and promoting multiprofessional collaboration. However, further studies are needed to develop IPE programmes to improve attitudes and abilities related to interprofessional communication skills.

Comparison of attitudes, awareness, and perceptions regarding oral healthcare between dental and nursing students before and after oral healthcare education.

BACKGROUND: Oral healthcare education for health professional students is important to promote collaborative oral healthcare practice among health professionals. The purpose of this follow-up, cross-sectional study was to investigate attitudes, awareness, and perceptions regarding oral healthcare among dental and nursing students and to compare them both between baseline and the completion of the education programme and between dental and nursing students to identify problems with oral healthcare programmes in dental education. METHOD: The subjects included 88 dental and 119 nursing students. The dental students participated in geriatric and preventive dentistry courses for oral healthcare education. The nursing students participated in independent oral healthcare courses comprising 45 h of training with case-based learning and were taught and instructed by multiple health professionals, including dentists. Questionnaires were distributed to the participants to compare attitudes, awareness, and perceptions regarding oral healthcare between baseline and the completion of the education programme and between dental and nursing students. A chi-square test, Wilcoxon signed-rank test, and Mann-Whitney U test were used to compare the data. RESULT AND CONCLUSION: The data of 48 (28 male and 20 female) dental students and 103 (9 male and 94 female) nursing students who completed the questionnaires both at baseline and after the education programme were used for the comparisons. After the education programme, more than 90% of the students were interested in oral healthcare practice; hoped to practise oral healthcare post-qualification; and perceived oral healthcare to be effective for preventing dental caries, periodontal diseases, and aspiration pneumonia. These attitudes and perceptions were statistically significantly improved after the education. However, the level of awareness of oral healthcare and the level of perception of the importance of collaboration with healthcare workers in oral healthcare practice after education were lower in the dental students than in the nursing students. Multi-professional oral healthcare education with case-based learning has the potential to improve awareness of oral healthcare and perceptions of the importance of collaborative oral healthcare practice.

Associations of Oral Health-Related Quality of Life with age, oral status, and oral function among psychiatric inpatients in Japan: a cross-sectional study.

BACKGROUND: As the general population of Japan ages, the population of hospitalized psychiatric patients is also ageing. The purpose of this study was to investigate the associations of oral health-related quality of life (OHRQoL) with age and oral health, including oral and swallowing function, among psychiatric inpatients. METHODS: The subjects included 165 psychiatric inpatients in psychiatric hospitals in Japan. The General Oral Health Assessment Index (GOHAI) and the Eating Assessment Tool (EAT-10) were included in the questionnaire survey for the measurement of OHRQoL and the screening of dysphagia. A score ≥ 3 on the EAT-10 was defined as suspected dysphagia. Oral examinations and oral diadochokinesis (ODK) measurements for the tongue-lip motor function evaluation were conducted. The inpatients with acute psychiatric symptoms, moderate and severe dementia, and cognitive impairment that affected their ability to communicate and relate their feelings were excluded. A chi-squared test, the Mann-Whitney U test, and linear regression analysis were used for the analysis. The data were analysed at the 5% significance level. RESULTS: A total of 100 (64.5%) psychiatric inpatients (mean age, 67.3 [SD, 14.5] years, 49% males, and 51% females) participated in this study. The means ± SDs for the decayed missing filled teeth (DMFT) index and GOHAI score were 20.6 ± 6 and 49.7 ± 7.9, respectively. The GOHAI score in the older age group (≥ 65 years) was significantly lower than that in the younger age group (< 65 years). The mean ODK scores were less than 3 times/s for all syllables. The percentage of the participants with suspected dysphagia was 45.0%. Tooth loss and suspected dysphagia were significantly associated with low GOHAI scores. The EAT-10 score was significantly correlated with the GOHAI score only after adjusting for age and sex (ß = - 0.725, 95% CI - 0.97, - 0.64). CONCLUSIONS: In hospitalized psychiatric patients, impaired oral health in the older subjects was more pronounced compared with that among general adults. Tooth loss and swallowing function were associated with OHRQoL. Therefore, oral care for the recovery of occlusal and swallowing functions may be needed to improve OHRQoL among psychiatric patients.

Factors associated with nurses' performance of oral assessments and dental referrals for hospital inpatients.

BACKGROUND: Nurses' oral assessment and dental referral performance for inpatients are important to provide appropriate oral care services in hospitals. The purpose of this study was to investigate the knowledge, attitudes, and performance of oral assessments and dental referrals for their inpatients among nurses and to identify factors associated with that performance to promote oral health care in hospitals. METHODS: All nurses (n = 919) who worked at five hospitals in Japan were recruited as responders. A questionnaire regarding their performance of oral assessments and dental referrals was distributed to the subjects in each hospital. The data were collected from August 2018 to September 2018. RESULTS: A total of 757 (82.4%) nurses (82 males and 675 females) responded to the questionnaire. With respect to each of the 8 oral assessment categories, 16.2-41.2% of the nurses performed oral assessments for more than 50% of their inpatients, and 20.3-29.9% had encouraged more than one inpatient to see a dentist within the previous 3 months. Significant differences were found by ward and hospital in their performance of oral assessments for inpatients. Additionally, their oral assessment performance, knowledge of the usage of oral assessment tools, wards, and hospitals were significantly associated with their dental referral performance. CONCLUSIONS: The performance of oral assessment and dental referral was not developed sufficiently in the hospitals. Thus, oral health professionals should support oral assessment education for nurses, including usage of assessment tools, to promote dental referral by nurses. These results may contribute to promotion of dental referral performance by nurses and provision of oral health care by oral health professionals for hospital inpatients.

Association between subjective well-being and presence of primary care dentists in community-dwelling elderly people: A cross-sectional study.

OBJECTIVE: The aim was to investigate the relationships between subjective well-being and the existence of primary care dentists in community-dwelling elderly people. BACKGROUND: Some studies have reported subjective well-being focusing on oral health, but no studies have examined the relationship between subjective well-being and primary care dentists. METHODS: This cross-sectional study used data from community-dwelling elderly people aged ≥70 years (n = 624). The Philadelphia Geriatric Center Morale Scale (PGCMS; range = 0 [low morale]-17) was used to assess subjective well-being. Additional information regarding age group, sex, medical consulting situation (ambulatory care/home care), primary care dentists, family structure, economic status, health status was collected via questionnaire. RESULTS: The average PGCMS score in ambulatory care patients (ACP) group who have primary care dentists was highest among community-dwelling elderly people. In a logistic regression model, a low PGCMS score (0-11) was independently correlated to 80-89 age group (OR = 1.70; 95% CI, 1.13-2.54; P = 0.008), ≥90 age group (OR = 3.86; 95% CI, 1.83-8.18; P < 0.001), unsatisfied for economic status (OR = 2.68; 95% CI, 1.59-4.53; P < 0.001), unsatisfied for health status (OR = 3.94; 95% CI, 2.60-5.98; P < 0.001) and having no primary care dentists (OR = 1.81; 95% CI, 1.09-3.01; P = 0.021) in ACP group. CONCLUSIONS: The subjective well-being of ACP who have primary care dentists was higher than in other people. Primary dentists contributed to the subjective well-being of elderly people.

Comparison of Practices, Knowledge, Confidence, and Attitude toward Oral Cancer among Oral Health Professionals between Japan and Australia.

The purpose of this study was to investigate the practices, knowledge, confidence, and attitude toward oral cancer among Japanese oral health professionals (J-OHPs) and to identify Japanese-specific problems in oral cancer practices by comparing them between Japan and Australia. A questionnaire survey regarding oral cancer practices among Australian oral health professionals (Au-OHPs) was conducted in Australia in 2014-2015. The questionnaire was translated into Japanese, and a Web-based questionnaire survey was conducted among 131 Japanese dentists (J-Dentists) and 131 dental hygienists (J-DHs) in 2016. To compare the J-OHPs' findings with the Au-OHPs', the data of Australian dentists (Au-dentists) and Australian dental hygienists (Au-DHs) were extracted from the Australian survey. Those findings were then compared via a statistical analysis. Eighty-two J-Dentists, 55 J-DHs, 214 Au-Dentists, and 45 Au-DHs participated in this study. Only 34.1 % of J-Dentists and 36.4 % of J-DHs performed oral cancer screenings on their patients; J-OHPs were significantly less likely to perform them than Au-OHPs. The level of knowledge and confidence regarding oral cancer among JOHPs were significantly lower than among Au-OHPs. About 90 % of J-OHPs felt that they needed additional training in oral cancer practices. Less than 40 % of J-OHPs performed oral cancer screenings in their patients. The low level of knowledge and confidence regarding oral cancer among JOHPs may contribute to their low performance of oral cancer practices. Therefore, further education and training programs for oral cancer practices should be provided to Japanese OHPs for the prevention and early detection of oral cancer.

Practices, Attitudes, and Confidence of Nurses in the Performance of Oral Health Checkups for Elderly Patients in a Japanese Hospital.

PURPOSE: To investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups in order to develop an educational oral health checkup training programme for nurses. MATERIALS AND METHODS: A cross-sectional questionnaire survey was distributed to nurses (n = 184) who worked in a hospital and an affiliated long-term care facility in Japan from September to October in 2016. The questionnaire survey investigated their practices, attitudes and confidence in the performance of oral health checkups for elderly patients who were in their care and the factors that were associated with the performance of oral health checkups. RESULTS: A total of 143 (77.7%) nurses participated in this study. Almost half (51.7%) performed oral health checkups for elderly patients. More than 60% examined the lip, tongue and tongue coating, gingiva and oral mucosa, and oral cleanliness; however only 32.4% examined the present teeth and 8.1% examined the saliva. Approximately 90% of the nurses felt that all health professionals should perform oral health checkups for elderly patients who were in their care. Their confidence of the oral examination was statistically significantly associated with their performance of oral health checkups for elderly patients. CONCLUSIONS: This is the first survey to investigate the practices, attitudes, and confidence of nurses in the performance of oral health checkups. These findings will contribute to the development of a training programme for nurses who perform oral health checkups in elderly patients.

Oral cancer screening practices of oral health professionals in Australia.

BACKGROUND: To evaluate oral cancer-related screening practices of Oral Health Professionals (OHPs - dentists, dental hygienists, dental therapists, and oral health therapists) practising in Victoria, Australia. METHODS: A 36-item survey was distributed to 3343 OHPs. Items included socio-demographic and work-related characteristics; self-assessed knowledge of oral cancer; perceived level of confidence in discussing oral health behaviors with patients; oral cancer screening practices; and self-evaluated need for additional training on screening procedures for oral cancer. RESULTS: A total of 380 OHPs responded this survey, achieving an overall response rate of 9.4%. Forty-five were excluded from further analysis. Of these 335 OHP, 72% were dentists; (n = 241); either GDP or Dental Specialists; 13.7% (n = 46) were dental hygienists; 12.2% (n = 41) were oral health therapists, and the remaining 2.1% (n = 7) were dental therapists. While the majority (95.2%) agreed that oral cancer screening should be routinely performed, in actual practice around half (51.4%) screened all their patients. Another 12.8% "Very rarely" conducted screening examinations. The probability of routinely conducting an oral cancer screening was explored utilising Logistic Regression Analysis. Four variables remained statistically significant (p < 0.0001). Results indicate that the likelihood of conducting an oral cancer screening rose with increasing levels of OHPs' confidence in oral cancer-related knowledge (OR = 1.35; 95% CI: 1.09-1.67) and with higher levels of confidence in discussing oral hygiene practices with patients (OR = 1.25; 95% CI: 1.03-1.52). Results also showed that dental specialists were less likely to perform oral cancer screening examinations compared with other OHPs (OR = 0.18; 95% CI: 0.07-0.52) and the likelihood of performing an oral cancer screening decreased when the "patient complained of a problem" (OR = 0.21; 95% CI: 0.10-0.44). CONCLUSION: Only half the study sample performed oral cancer screening examinations for all of their patients. This study provides evidence of the need for further oral cancer-related education and screening training for OHPs, which is vital to enhance oral cancer prevention and early detection.

Evaluation of the Oral Health Education Programme for Nurses using an Oral Lesion Simulator.

PURPOSE: This study aimed to investigate the usefulness of a newly developed oral simulator for nursing students' oral assessment education on oral diseases and symptoms. MATERIALS AND METHODS: The participants were first-year students (n=105) at a nursing school in Japan. Ten identical oral simulators with angular cheilitis, missing teeth, dental caries, calculus, periodontitis, hypoglossal induration, food debris, and crust formation were created by a team of dentists. After a 45-minute lecture programme for oral assessment performance with the Oral Health Assessment Tool (OHAT), the ability test with the simulators and the OHAT as well as test feedback were conducted in a 30-minute practical programme. To evaluate the effectiveness of the programmes, questionnaires and ability tests with slides of oral images were conducted at baseline and after the programme. RESULTS: Ninety-nine students (94.3%) participated in this study. The results of the ability test with the simulators and the OHAT in the practical programme showed that the correct answer rates of assessing tongue, gingiva, present teeth, and oral pain were less than 40%. Their levels of confidence, perception, and oral assessment performance were statistically significantly higher after the programmes than they were at baseline. Their level of confidence in assessing the need for dental referral had the largest increase in scores compared to the lowest scores at baseline in the nine post-programme assessment categories. CONCLUSIONS: This study identified several problems with nursing students' oral assessment skills and improvements of their oral assessment confidence, perceptions and performance.

Implementation of peer-to-peer oral care objective structured clinical examination-based learning for nursing students.

AIM: Nurses' skills and confidence in providing oral care to patients play important roles in healthcare. Studies have proved that peer-to-peer learning and assessment can help improve nurses' skills and confidence. However, no study has investigated it using an objective assessment checklist. This study investigated an oral hygiene practice training program for nursing students. It focused on their oral healthcare skills, confidence, and perspectives regarding implementing an objective structured clinical examination (OSCE). METHODS: A pre- and post-survey of 97 nursing students from a nursing school in Japan was conducted as a peer-to-peer oral health education training program that included an assessment and performance checklist. RESULTS: Confidence in performing and assessing oral care significantly improved after attending the program. Furthermore, the changes were significantly greater in the developed program than in the training program without the checklist. The mean total assessment scores (0-25) of the first, second, third, and fourth participants in the four-student groups were 22.1, 23.4, 23.9, and 24.1, respectively. The mean scores of the second, third, and fourth participant groups were significantly higher than that of the first participant group (p < .01). Fifty-two positive and 58 negative comments were received regarding the implementation of the program with professional assessments and the checklist. The most common positive comment mentioned that the evaluation by professionals improved oral care learning and skills. CONCLUSIONS: This study developed a program to improve nursing students' confidence and oral care delivery skill building in an OSCE-style delivery.

Association between perception of dentist oversupply and expectations of dentistry: a survey of dental graduates in Japan.

BACKGROUND: The perception that there is a surplus of dentists may be an opportunity to explore attractive career options in dentistry in Japan. METHODS: A self-administered questionnaire was mailed to 2,114 graduates of a private dental school in Japan. We asked about the perception of oversupply, rated by a visual analogue scale, work environment factors, potential areas of dentistry and necessary medical subjects for their dental practice. The association of a strong perception of dentist oversupply with work environment factors, dental areas and medical subjects was examined by multivariate logistic regression analyses. RESULTS: The response rate was 66%, and data from 1,203 community dentists were analysed. Most respondents (76%) perceived either a strong or very strong surplus of dentists. A very strong perception was significantly associated with work environment factors, including practising in large cities and earning the second lowest of four levels of annual income, but no further associations were found with either the number of patients treated or with the other two ranges of income. This perception was negatively associated with the number of necessary medical subjects, specifically otorhinolaryngology, but no significant association was seen with the number of potential areas of dentistry. CONCLUSIONS: The negative correlation between the aspiration to acquire medical knowledge and the perception of dentist oversupply under the circumstance of the possibly excessive perception among community dentists invites further research on the benefits of teaching oral medicine to graduate entry students to build future working satisfaction.

Awareness, Attitudes, and Perceptions of Oral Healthcare among First Year Dental, Medical, and Nursing Students.

BACKGROUND: It has been reported that poor oral health can worsen general health conditions. Good collaboration between health professionals is important to provide proper oral healthcare. Thus, there is a need for oral healthcare interprofessional education (IPE). This study aimed to determine the baseline level of awareness, attitudes, and perceptions of oral healthcare among first-year students of dentistry, medicine, and nursing at Universitas Indonesia. METHOD AND PARTICIPANTS: A cross-sectional descriptive analytical study using a previously published questionnaire was conducted involving 442 students, consisting of dental students (DS), medical students (MS), and nursing students (NS) in Universitas Indonesia. RESULTS: Most students have shown good oral healthcare awareness, attitudes, and perception with no statistically significant difference between the groups (p < 0.05). The majority of the students did not perceive that (1) geriatric and nursing knowledge are required to practice oral care, (2) oral healthcare should be provided in cancer hospitals, and (3) oral healthcare can prevent cardiovascular disease and improve anorexia. CONCLUSIONS: This study showed that there were aspects of oral healthcare that should be improved in all student groups. Thus, oral healthcare IPE should be given to all students working in healthcare to develop knowledge and interprofessional collaboration in oral healthcare.

Current status and factors of periodontal disease among Japanese high school students: a cross-sectional study.

INTRODUCTION: This study aimed to investigate the prevalence of periodontal disease and the factors of the disease among high school students. METHOD: The participants were all students aged 15-18 years (n = 1202) at a high school in Japan. The data on oral health perceptions and behaviours were collected by a questionnaire survey. The prevalence of periodontal disease among them was investigated with the partial community periodontal index (PCPI). A logistic regression analysis was used to identify the factors associated with the PCPI. RESULTS: A total of 1069 students (88.9%) participated in this study. The prevalence of gingival bleeding, calculus, pocket depth of 4-5 mm, and pocket depth of 6 mm or more were 44.2%, 42.2%, 11.4%, and 1.6%, respectively. Approximately one-third of the students had a fear of dental treatment, and only 28.4% used dental floss. The results of logistic regression analysis, adjusted for sex and school year, showed that not visiting dentists regularly, not using dental floss, brushing teeth for less than 5 min, fear of dental treatment, and drinking sports drinks frequently were positively associated with periodontal conditions. CONCLUSION: This study identified a high prevalence of periodontal disease among Japanese high school students aged 15-18 years and its risk factors, such as poor oral health behaviours and fear of dental treatment.

Current status and future prospects for oral care education in Bachelor of Nursing curriculums: A Japanese cross-sectional study.

OBJECTIVE: This study sought to investigate the current status and faculty members' perceptions of oral care education in Bachelor of Nursing curriculums in Japan. METHOD: Data were gathered through a questionnaire survey of 196 participants, who were faculty members in charge of oral care education in the basic, adult, gerontological, and home nursing fields, from 295 nursing schools that offered Bachelor degrees in nursing across Japan. RESULTS: The quantitative data showed that 38.5% of the participants worked for less than 5 years as oral care educators, only 15.5% taught oral care in perioperative wards, only 62.2% used an oral care training simulator, and less than 30% believed that training in the prevention of oral diseases should be enhanced. From the descriptive responses, this study identified such problems as the inability of students to perform student-on-student and patient-based oral care training owing to the risk of SARS-CoV-2 transmission, and the lack of teaching materials, time, and human resources, and cooperation with other nursing fields and health professionals. CONCLUSIONS: This study revealed several problems in oral care education in the Bachelor of Nursing curriculums in Japan. To tackle these challenges, this study suggests the development of an interdisciplinary course that unifies oral care education in nursing fields, in order to promote collaborative oral care education and to improve nursing students' knowledge and skills of oral care.

A Survey of Oral Assessment and Healthcare Education at Nursing Schools in Japan.

OBJECTIVES: This study aimed to investigate the performance of oral assessment and health care education at nursing schools across Japan to identify problems and the need for oral health professional support. METHODS: The participants were the academic staff in charge of oral health care education in the basic, adult, gerontological, and home nursing fields of 295 schools in Japan that offered a bachelor's degree in nursing. A questionnaire was sent to 1180 heads of the nursing fields of these schools. They were requested to have oral health care educators complete the survey; data on the performance of oral assessment and health care education and human resources allocated were collected through a questionnaire. RESULTS: A total of 311 (26%) questionnaires were returned, 196 (63%) of which were completed by oral health care educators. Regarding the performance of oral assessment education, the majority (71%) of them spent less than 2 hours in teaching, and only 24.5% taught the usage of oral assessment tools. Regarding the performance of oral health care education, more than 90% spent less than 2 hours in lecture-based and practical oral health care education, respectively. Less than half taught the association of periodontal diseases with diabetes and cardiovascular diseases and use of fluoride for caries prevention in the lectures, and only approximately 30% taught the usage of an interspace brush or dental floss. Moreover, less than 10% of oral health professionals taught oral health care in lectures or practical oral health care. CONCLUSIONS: This study revealed problems associated with oral assessment and health care education in Japanese nursing schools. To address these, support from oral health care professionals is required. Further studies are also required to reveal problems in oral assessment and health care education in other nursing schools that do not offer a bachelor's degree programme in Japan and other countries.

Nurses' Perceptions of Oral Health Care Provision After the COVID-19 Lockdown.

OBJECTIVE: This study aimed to investigate nurses' perceptions of oral health care provision to inpatients in Japanese hospitals and the infection control measures taken by them after the coronavirus disease 2019 (COVID-19) lockdown to promote collaborative oral health care. METHOD: The participants were 1037 nurses working in inpatient wards at 4 hospitals in Fukuoka Prefecture, Japan. Data were collected through a questionnaire survey approximately 6 months after the first COVID-19 lockdown. RESULTS: More than 90% of the 734 nurses participating in this study positively perceived the preventive effect of oral health care on aspiration pneumonia, ventilator-associated pneumonia, and viral infection. However, approximately half of them had negative perceptions about their knowledge and confidence regarding the control of COVID-19 with oral health care provision, and 84.7% expected to be provided with the necessary information by oral health professionals. Further, 537 nurses (73.2%) provided oral health care to their patients; 9 nurses (1.7%) responded that those patients who received oral health care decreased after the lockdown; and 12 (2.4%) responded that they could no longer collaborate with oral health professionals because of the lockdown. Additionally, 41.7% of them used neither protective glasses nor face shields even after the lockdown began. CONCLUSIONS: This study showed that almost all the nurses perceived the benefcial effect of oral health care for the prevention of viral infection and pneumonia. However, some nurses perceived that their oral health care provision and collaborative oral health care were negatively affected. It also showed that most nurses' knowledge, confidence, and use of infection control measures were insufficient. The results indicate that oral health professionals should support nurses in providing oral health care by providing them with information on COVID-19 infection control measures to prevent infection transmission.

Effect of multi-professional education on the perceptions and awareness of oral health care among undergraduate nursing students in a nursing school.

OBJECTIVE: This study investigates the effects of a study course in oral health care on the perceptions of nursing students. The course was designed and evaluated by a multi-professional team at a Japanese nursing school. METHOD: The subjects were 119 nursing students. They participated in the oral health course that comprised 45h of training in 4 years. These were designed and taught by oral health professionals, a certified speech-hearing therapist, and nurses. Questionnaires were distributed to subjects to compare their perceptions and awareness about oral health care before, in between, and after the courses. A chi-square test was used to compare the data. RESULTS: After completing the courses, more than 95% of the participants were interested in the oral health care practice and expected to collaborate with oral health professionals after getting qualified. Additionally, they understood the effectiveness of oral health care for the prevention of aspiration pneumonia and perceived that oral health care should be provided to hospitalized patients and community-dwelling older adults. Their awareness of the need to learn techniques for tooth brushing support, salivary gland massage, oral management, swallowing training, removing tongue coating, and gargling, both in theory and practice, was significantly improved. CONCLUSION: Multi-professional education has the potential to improve the awareness of nursing students of oral health care and promote collaborative oral health care in the future.

Impact of a tobacco curriculum on smoking behaviour and attitudes toward smoking in dental students in Japan: a three-year follow-up study.

AIM: Dental professionals have the potential to influence global smoking rates. This study evaluated the impact of a tobacco curriculum on smoking behaviour and attitudes toward smoking in dental students. METHODS: Immediately before and three years after the implementation of a tobacco curriculum with a no-smoking policy, a questionnaire was administered to students to obtain information about their smoking behaviour and attitudes toward smoking. RESULTS: The number of students who responded to the questionnaire was 580 in 2003 and 554 in 2006. The smoking rate decreased significantly from 35% in 2003 to 26% in 2006; however, analysis of data for each school year suggested that this was due to the prevention of smoking initiation rather than quitting smoking. Attitudes toward patient smoking and public policy were more positive in non-smokers than in current smokers. Improvement in attitudes toward patient smoking was smaller in current smokers than in non-smokers. Little improvement occurred in attitudes toward public policy in both non- and current smokers. CONCLUSIONS: Implementation of a tobacco curriculum was effective in preventing smoking initiation and improving attitudes toward patient smoking in students. Further measures are necessary to improve attitudes toward public policy and to discourage smoking among students.

Factors associated with discontinuation and resumption of implant maintenance therapy.

Discontinuation of implant maintenance is the main risk factor for implant failure. The purpose of this study was to identify factors associated with previous discontinuation and resumption of maintenance among implant patients. A questionnaire survey was sent to 171 patients receiving implant maintenance at a university hospital; 169 patients responded. To assess the effect of job status, 26 patients (15.4%) with a history of maintenance discontinuation were classified as employed and nonemployed. The main reasons for previously discontinuing maintenance were work issues (in employed respondents) and dissatisfaction with treatment skill or chairside manner (in nonemployed respondents). The main reasons for resuming maintenance were those related to dental treatment (in employed respondents) and awareness of the importance of maintenance (in nonemployed respondents). There were significant differences in relation to job status in the reasons reported for discontinuing and resuming maintenance (both P < 0.05). The present findings suggest that oral health professionals should consider these factors when assisting patients in reducing the risk of implant failure.

Effect of interprofessional education on oral assessment performance of nursing students.

OBJECTIVES: The purpose of this study was to investigate the effect of interprofessional educational programmes on the improvement of nursing students' oral assessment performances by comparing their attitudes, confidence, abilities, and self-performance before and after the education. MATERIALS AND METHODS: The subjects included 112 first-year nursing students in a Japanese nursing school. They participated in the oral assessment educational programmes, which were supported by dentists and introduced into the 1-year curriculum. The first programme was a 1.5-hr lecture with a self-oral assessment training in May 2018, and the second was a 1-hr oral assessment training in October 2018. The questionnaire surveys investigating nursing students' attitudes, confidence, and self-performance regarding oral assessment and the tests measuring their oral assessment abilities were conducted before and after the programmes. The total scores on the tests were 0-9 points. RESULTS: A total of 101 (90.2%) nursing students responded to all the questionnaires and tests. Their attitudes and confidence regarding oral assessment were significantly improved after the programmes. The total average scores on the tests were significantly increased from 6.8 points at baseline to 7.9 points after the programmes. The percentage of their performance of self-oral assessment every day significantly increased from 15.8% at baseline to 32.7% after the programmes. CONCLUSIONS: These results suggested that the educational programme might be effective in improving not only the students' attitudes and confidence regarding oral assessment but also their oral assessment abilities and self-oral assessment performance. Therefore, future programmes must focus on training them to improve oral health care referrals.