Definition and Classification of Dental Hygiene Interventions Based on the Dental Hygiene Process of Care: A Delphi Study.

This study aimed to conceptualize the dental hygiene intervention performed by dental hygienists based on the dental hygiene process of care. The dental hygiene intervention classification was conducted on the qualitative content analysis method. The contents of the primary dental hygiene intervention classification were refined after review by three internal experts. The final classification of dental hygiene interventions was derived through an expert Delphi survey conducted twice with 15 professors in charge of clinical dental hygiene. In the Delphi survey, the content validity and clarity were evaluated. As a result of the first and second expert Delphi surveys, the content validity ratio for all dental hygiene interventions and definitions was ≥0.60, and the content validity index was ≥0.80. The degree of agreement was a minimum of 0.80 and a maximum of 1.00. Thirty-eight dental hygiene interventions were conceptualized, and the essence of the dental hygienist was confirmed. Dental hygienists are oral health experts who help in preventing oral diseases and promoting oral health by providing evidence-based comprehensive preventive management through interaction with their clients, and they are a primary care worker who could contribute to health promotion. In the future, dental hygienists are expected to be actively involved in the primary care system and dental clinical sites and contribute to health promotion through practical discussions for this purpose.

Do School-Level Factors Affect the Health Behaviors of High School Students in Korea?

We conducted a multilevel analysis to identify the individual- and school-level factors that affect Korean high school students' tooth brushing, soda intake, smoking, and high-intensity physical activity. We sampled 27,919 high school students from the 15th Korea Youth Risk Behavior Web-Based Survey. The individual-level variables included demographic, socioeconomic, and health-related factors. The school-level variables included school system and school type. Regarding the individual-level factors, economic level and academic performance had a significant effect on health behavior when the demographic variables were adjusted. In the final model, the school-level factors had a significant effect on health behavior. The odds ratio (OR) of brushing less than twice a day in vocational schools compared to general schools was 1.63 (p < 0.001), and the OR of soda intake more than three times a week in vocational schools was 1.33 (p < 0.001). In addition, the OR of smoking in vocational schools was 2.89 (p < 0.001), and the OR of high-intensity physical activity in vocational schools was 0.80 (p < 0.001). Therefore, both individual- and school-level factors affect Korean students' health behaviors. A school-based comprehensive health promotion strategy should be developed that considers schools' characteristics to equip all students with health awareness, regardless of socioeconomic status.

Factors Affecting Preventive Dental Treatment of Adolescents in Korea.

We conducted a multilevel analysis to identify factors affecting adolescents' preventive dental treatment experience in South Korea. We sampled 72,435 students who participated in the 9th Korea Youth Risk Behavior Web-based Survey. The individual-level variables were divided into demographic factors, socioeconomic factors, oral health behavioral factors, and oral symptom experience factors. The regional-level variables included oral health resources, rate of students receiving oral health education at school by region, social deprivation index, and the number of private educational institutions. A higher rate of receiving oral health education in school by region was associated with increased fluoride application (1.04 times, p = 0.003). However, the number of private educational institutes per 1000 people was negatively associated with fluoride application experienced by students (0.64 times, p = 0.039). Students underwent more scaling when there were more dentists per 10,000 individuals (1.14 times, p = 0.008) and less scaling in areas with a higher social deprivation index (0.88 times, p = 0.024). To increase the access to preventive care for oral diseases among adolescents, a preventive system should be established in schools, and a primary dental care system should be established through the cooperation of the government, private dental clinics, and schools.