Assessment of the Accuracy of Two Dental Screening Methods Used in a School Setting.

PURPOSE: To assess the accuracy of two screening methods used by dentists in the Health Insurance Organisation in Alexandria, Egypt aiming at identifying children who need referral for treatment. MATERIALS AND METHODS: The study included 45 dentists who examined 30 children using exclusively visual screening (VS) and visual screening with tongue blade (VSTB). A benchmark dentist examined the same group of children using mirror and probe (MP). VS and VSTB were compared to MP. Sensitivity (Sn), specificity (Sp), positive and negative predictive values (PPV and NPV, respectively) were calculated. The effect of dentist's gender, year of graduation and having postgraduate studies on the accuracy of the two methods was assessed. RESULTS: VS had greater accuracy than VSTB. Both methods had a Sn and Sp>82%. The PPV of both methods was >97%, whereas that of NPV was ≤44%. Males and recent graduates performed better than females and senior dentists when using VS and VSTB methods. CONCLUSIONS: It is questionable whether screening using VS or VSTB can ensure effective referral of children for treatment. Further studies are needed to assess other aspects of screening, including whether referred children actually seek care and whether screening improves children's oral health.

Massachusetts dental public health program directors practice behaviors and perceptions of infection control.

PURPOSE: The objective of this exploratory study was to deter mine the current infection control practices used in Massachusetts dental public health programs and assess the perceived compliance and challenges with infection control standards as outlined in the 2003 Centers for Disease Control and Prevention (CDC) infection control guidelines. METHODS: A convenience sample of program directors of dental public health programs in Massachusetts (n=82) were invited to participate. The directors were identified through the Massachusetts Department of Public Health, Massachusetts League of Community Health Centers, local dental/dental hygiene schools and key stakeholders in dental public health. The electronic questionnaire-based survey consisted of 26 open/closed-ended and Likert scale questions. Statistical analysis included frequency distribution and factor analysis. RESULTS: The overall response rate was 43%. The majority of responders to the survey were from public health settings using fixed/mobile dental equipment (82.9%), compared to settings using portable equipment (17.1%). Perceived lapses in the guidelines were attributed to lack of finances (r=0.938), lack of personnel (r=0.874) and lack of space (r=0.763). The only significant correlation between the program directors perceived adherence to the CDC guidelines was having access to necessary supplies and equipment (r=0.914). Program directors indicated that the CDC guidelines are hard to apply (r=0.895) and guide lines specific to settings using portable equipment would be helpful (r=0.925). CONCLUSION: Within the limitations of the sample size and response rate, directors from public health settings using both fixed/mobile and portable equipment reported being able to apply the current 2003 CDC infection control guidelines with few compliance challenges. However, respondents indicated that the guidelines were hard to apply and that infection control guidelines for settings using portable equipment would be useful.

Preventing dental caries through school-based sealant programs: updated recommendations and reviews of evidence.

BACKGROUND: School-based sealant programs (SBSPs) increase sealant use and reduce caries. Programs target schools that serve children from low-income families and focus on sealing newly erupted permanent molars. In 2004 and 2005, the Centers for Disease Control and Prevention (CDC), Atlanta, sponsored meetings of an expert work group to update recommendations for sealant use in SBSPs on the basis of available evidence regarding the effectiveness of sealants on sound and carious pit and fissure surfaces, caries assessment and selected sealant placement techniques, and the risk of caries' developing in sealed teeth among children who might be lost to follow-up. The work group also identified topics for which additional evidence review was needed. TYPES OF STUDIES REVIEWED: The work group used systematic reviews when available. Since 2005, staff members at CDC and subject-matter experts conducted several independent analyses of topics for which no reviews existed. These reviews include a systematic review of the effectiveness of sealants in managing caries. RESULTS: The evidence supports recommendations to seal sound surfaces and noncavitated lesions, to use visual assessment to detect surface cavitation, to use a toothbrush or handpiece prophylaxis to clean tooth surfaces, and to provide sealants to children even if follow-up cannot be ensured. CLINICAL IMPLICATIONS: These recommendations are consistent with the current state of the science and provide appropriate guidance for sealant use in SBSPs. This report also may increase practitioners' awareness of the SBSP as an important and effective public health approach that complements clinical care.

Dental survey at school with the purpose to select children with no actual need of dental treatment.

The purpose of this study was to develop an examination method to select children without from children with need of dental treatment. Furthermore the objective was that these examinations could be performed as a survey at school, without utilizing an expensive and fully equipped dental clinic but still maintain the certainty for the individual not to be at increased risk to be declared false caries-free, in comparison with ordinary examination at a dental clinic. The material comprised 88 children 10-13 years old. The children were subject to a survey-examination at school and a few weeks later at a dental clinic by the same examiner. Initially the children were examined at school by two examiners in order to measure the inter-examiner variability. The results showed that 2 of the 88 examined children (2.3%) were judged false healthy at school examination with respect to caries. The inter-examiner variability in diagnosing caries was greater than the intra-examiner variability between survey at school and examination at the dental clinic.

A comparison of orthodontic screening methods used in school dental inspections.

The validity of two currently used orthodontic screening programmes was investigated and compared to an objective measure of need for orthodontic treatment. The results indicate that existing orthodontic screening methods underestimate the numbers of children with severe malocclusions. The use of a more objective measure of orthodontic treatment need is recommended.

[Selected etiological factors in dental caries among 18-year-old high-school students in Poland in the light of the results of the questionnaire and epidemiological studies]. / Wybrane czynniki etiologiczne próchnicy zebów u 18-letniej mlodziezy szkolnej w Polsce w swietle wyników badan ankietowych i epidemiologicznych.

The performed studies covered 1100 subjects being 18 years old (both girls and boys) representing large and small towns as well as villages situated in 13 provinces. The material and methods were based on the instruction provided by "WHO Basic Methods 1986". Answers given to questionnaire inquiries in the area of nutrition and oral cavity hygiene furnished an image of health consciousness and behaviours of 18-agers in Poland. Dental state and stomatologic treatment requirement jointly with the effects of stomatologic care were evaluated on the basis of the results established by epidemiological studies. The accomplished analysis encompassed the influence of sex, living environment, type of schools and variable content of fluoride in water, exerted on the pattern of the investigated epidemiological parameters. No correlation was recorded between health consciousness and behaviours in 18-year-old youth on the one hand, and the dental state as well as the therapeutic requirements on the other. The questionnaire responses and the epidemiologic studies made it possible to disclose some drawbacks in transmitting and introducing the education-health principles, which was reflected by not the best results concerning the health consciousness and behaviours particularly in male youth and in rural inhabitants. The dental condition is unsatisfactory in the studied population, despite being provided, in most instances, with permanent stomatological care. This indicates that optimization of adequate stomatological service is indispensable. A low percentage of youth with dentition does not predict good prognosis for them to achieve 3-rd health objective set up by WHO for the year 2000. The studies have confirmed the influence of big urban environment, with complete profile of stomatological care and water fluoridation, being exerted on the state of dental therapeutic requirements in 18-year-old youth. Difficult as it appeared was the detection of the sugars consumption role and that of oral cavity hygiene, in the course of one-stage investigation.

LOS TEST PROYECTIVOS, MEDIO AUXILIAR PARA EL ODONTOLOGO ANTE EL PACIENTE ESCOLAR

Introducción, Generalidades, Técnicas proyectivas, Metodología, Conclusiones, Sugerencias, Observaviones, del tribunal, Bibliografia

[Caries in deciduous teeth in children living in large cities]. / Milchzahnkaries bei Grossstadtkindern.

1,502 preschool children in Hamburg between the ages of three and six were given a dental examination. Half of the children attended Protestant kindergartens; the other half were enrolled in city day care centers. In general, the caries rate was extremely high. The day-care-center children had more caries than the kindergarten children. A distinctly positive correlation existed between social level and the number and/or frequency of caries. The relation of treated to untreated carious defects in the deciduous teeth was also expressly unfavorable. The dissemination of prophylactic measures is depressingly low. The effectivity of pediatric dental care in its present form must be called into question.

[Efficiency criteria and priorities in school age pedodontic care]. / Uber Bewertungskriterien und Schwerpunkte kinderstomatologischer Betreuung im Schulalter.

On the basis of findings in 1200 individuals aged between 7 to 16 years, the authors indicate priorities of dental care in the different age-groups. Apart from other criteria, the readiness for treatment and the disciplined behaviour of the children and adolescents during treatment may be used for assessing the dentist's achievements.