The Older Adults' Intention to Use Silver Diamine Fluoride for Dental Caries Treatment.

Purpose: This study aimed to determine the intention of older adults to use silver diamine fluoride (SDF) for treating tooth decay. Patients and Methods: A group of Thai-speaking individuals between the ages of 60 and 90 were asked to participate in the study. They were provided with information about SDF and then asked to complete a questionnaire based on the Theory of Reason Action (TRA). The questionnaire consisted of 23 questions divided into seven constructs aimed at determining the determinants of the intention to use SDF. These constructs were behavioral belief, evaluation of behavioral outcome, normative belief, motivation to comply, attitude towards behavior, subjective norm, and intention. The responses were rated on a 4-point Likert scale ranging from 1 (Strongly disagree) to 4 (Strongly agree). The characteristics and TRA scores of the participants were analyzed and compared based on their intention to use SDF, using the Chi-square test and t-test. Multiple logistic regression was employed to determine the determinants of the intention to use SDF. Results: The study involved 588 participants, with an average age of 65.3 years (SD= 5.53). Of the participants, 52.7% were women, 58.1% were unemployed or retired, 80.8% lived with family, 63.4% had less than sixth-grade education, 62.9% had a monthly family income of less than 10,000 baht, and 63.6% had underlying diseases. The study found that 82.7% of the participants intended to use SDF for dental caries treatment, with an average score of 2.86 out of 4. The study also found that age, family income, underlying diseases, dental health problems, and fear of the dentist significantly affected their intention. Behavioral beliefs and evaluations of behavioral outcomes significantly affected the intention to use SDF treatment. Conclusion: Most older adults in the study intended to use SDF for dental caries treatment.

Impact of oral diseases on 12- and 15-year-old children's quality of life: condition-specific oral health related quality of life analysis.

BACKGROUND: Oral diseases can affect children's quality of life. The aim of the present study was to assess the Condition-Specific (CS) impacts from oral diseases in 12- and 15-year-old Thai population using data from the two consecutive national oral health-related quality of life surveys. METHODS: The oral health-related quality of life surveys were conducted for this study as a part of 6th and 7th national oral health survey. The study sample of 1,066 12- and 815 15-year-olds from 6th national oral health survey; and 556 12- and 351 15-year-olds from 7th national oral health survey were from Bangkok and four regions of Thailand. Oral impacts were assessed by the Child-Oral Impacts on Daily Performances index for 12- and Oral Impacts on Daily Performances index for 15-year-olds. The overall impacts and CS impacts attributed to oral diseases were calculated. The detailed characteristics of the CS impacts were analyzed. Cochran's Q test and McNemar's test were used to determine the difference between the proportions of CS impacts of caries, gingival diseases, oral lesions, and malocclusion. RESULTS: CS impacts-caries were prevalent for both age, followed by gingival disease and oral lesions. CS impacts-caries were the highest in the intensity and extent for both age groups. CS impacts-caries were significantly higher than those of gingival diseases for eating, speaking, relaxing, emotional state, and studying. CS impacts-gingival disease was significantly higher than caries for cleaning in one survey. CONCLUSIONS: CS impacts-caries were the most prevalent and severe among adolescent. Gingival disease was infrequently related to severe impacts on daily performances.

Factors associated with complications of submental intubation in 339 patients with facial fractures: A German retrospective cohort study.

PURPOSE: For nearly four decades, submental intubation (SI) has been introduced and employed to avoid tracheostomy in facial trauma cases where nasal/oral intubation is infeasible or associated with possible risks. The purposes of this study were to estimate the frequency and to identify variables associated with complications of SI (CSI). METHODS: The authors organised a retrospective cohort study and enrolled a group of patients with facial trauma and SI during a seven-year interval at two German level one trauma centres where SI has routinely been used in complex facial trauma cases. The predictor variables included demographic, medical, dental, fracture-related, operative, and postoperative parameters. The outcome variable was CSI. We used descriptive, bivariate, and multivariate analyses at the 0.05 significant level. RESULTS: The sample included 339 patients (24.5% females, 9.4% had complications) with an average age of 58.2 ± 12.0 years (range, 17-89). Bivariate analyses revealed nine significant variables. However, forward stepwise multiple logistic regression modelling identified three variables statistically associated with CSI: smoking (OR, 691.8; 95% CI, 75.9 to 6303.9; P < 0.0001; number needed to harm [NNH], 6), moderate to high gingival inflammation (OR, 786.7; 95% CI, 66 to 9378.9; P = 0.002; NNH, 12), and postoperative use of chlorhexidine mouthwash (OR, 0.03; 95% CI, 0.001 to 0.77; P = 0.0003; number needed to treat [NNT], 2). CONCLUSIONS: smokers and subjects with gingivitis were more likely to experience CSI. Postoperative chlorhexidine rinsing was the potentially modifiable, albeit low-OR, factor. These findings could help to draw an effective guideline against the CSI.

Development and psychometric test of the myRisk mobile application for caries risk assessment.

OBJECTIVES: To develop a caries-risk assessment application (myRisk app) and assess the psychometric properties based on content validity, construct validity, and how well it classifies the participants into different caries risk groups using caries increments at 10 months. METHODS: The myRisk mobile application was developed using Android Studio 4.1.1. The content validity was assessed by three dental experts. To evaluate construct validity and the prediction of future dental caries, the participants (N = 88) were recruited from Rajvithi Home for Girls in Thailand by convenience sampling. The participants were completed a caries risk assessment (CRA) of myRisk app and ADA form. The oral examination was performed at the time of CRA and 10 months following the baseline. RESULTS: Eighty-eight participants aged 12-29 used the myRisk app and completed the ADA form. The app content validity was acceptable (IOC = 0.67). According to myRisk, 7.9%, 71.6%, and 20.5% of the participants were classified into the low-, moderate-, and high-risk groups, respectively. The percent agreement of the caries-risk classification with the ADA form was 30.7%. Significant differences between the three risk groups were found in active caries (p < 0.001), type, and frequency of sugary snacks (p = 0.002). The app had a sensitivity of 68%, a specificity of 61%, and an area under the receiver operating characterisitic (ROC) curve of 0.61. CONCLUSIONS: The myRisk app has acceptable content validity and sufficient diagnostic accuracy (sensitivity, specificity, and ROC curve). However, there is a different outcome in caries-risk classification compared with the ADA form.

System dynamics modelling of health workforce planning to address future challenges of Thailand's Universal Health Coverage.

BACKGROUND: System dynamics (SD) modelling can inform policy decisions under Thailand's Universal Health Coverage. We report on this thinking approach to Thailand's strategic health workforce planning for the next 20 years (2018-2037). METHODS: A series of group model building (GMB) sessions involving 110 participants from multi-sectors of Thailand's health systems was conducted in 2017 and 2018. We facilitated policymakers, administrators, practitioners and other stakeholders to co-create a causal loop diagram (CLD) representing a shared understanding of why the health workforce's demands and supplies in Thailand were mismatched. A stock and flow diagram (SFD) was also co-created for testing the consequences of policy options by simulation modelling. RESULTS: The simulation modelling found hospital utilisation created a vicious cycle of constantly increasing demands for hospital care and a constant shortage of healthcare providers. Moreover, hospital care was not designed for effectively dealing with the future demands of ageing populations and prevalent chronic illness. Hence, shifting emphasis to professions that can provide primary care, intermediate care, long-term care, palliative care, and end-of-life care can be more effective. CONCLUSIONS: Our SD modelling confirmed that shifting the care models to address the changing health demands can be a high-leverage policy of health workforce planning, although very difficult to implement in the short term. of health workforce planning, although very difficult to implement in the short term.

Impact of sugar-sweetened beverage tax on dental caries: a simulation analysis.

BACKGROUND: The tiered sugar-sweetened beverage (SSB) tax was implemented in Thailand to encourage industries to reduce sugar content in beverages, and consequently reduce sugar consumption in the population. The aim of the study is to explore the expected impact of the new SSB tax policy in Thailand, a middle-income country in Asia, and other alternative policies on oral health outcomes as measured by the prevalence and severity of dental caries among the Thai population. METHODS: A qualitative system dynamics model that captures the complex interrelationships among SSB tax, sugar consumption and dental caries, was elicited through participatory stakeholder engagement. Based on the qualitative model, a quantitative system dynamics model was developed to simulate the SSB tax policy and other alternative scenarios in order to evaluate their impact on dental caries among Thai adults from 2010 to 2040. RESULTS: Under the base-case scenario, the dental caries prevalence among the Thai population 15 years and older, is projected to increase from 61.3% in 2010 to 74.9% by 2040. Implementation of SSB tax policy is expected to decrease the prevalence of dental caries by only 1% by 2040, whereas the aggressive policy is projected to decrease prevalence of dental caries by 21% by 2040. CONCLUSIONS: In countries where a majority of the sugar consumed is from non-tax sugary food and beverages, especially Asian countries where street food culture is ubiquitous and contributes disproportionately to sugar intake, SSB tax alone is unlikely to have meaningful impact on oral health unless it is accompanied with a comprehensive public health policy that aims to reduce total sugar intake from non-SSB sources.