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1.
Gerodontology ; 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33529440

RESUMEN

OBJECTIVE: To evaluate the impact of an online oral health education module on personal support workers' (PSW) knowledge and beliefs in their care for long-term care (LTC) residents in one Canadian LTC residence. BACKGROUND: LTC residents are dependent on PSWs for their oral health needs. However, PSWs receive minimal to no oral health education placing residents at risk for poor oral health. METHODS: A mixed-methods convergent design comprising a before-and-after questionnaire (N = 88), focus groups (N = 23) and interviews (N = 4) exploring module learning. Analysis of each data set was followed by their amalgamation and comparison. RESULTS: The online module had limited impact on the PSWs' knowledge and beliefs regarding resident oral health care. The quantitative results demonstrated knowledge improvements in two domains and changes in two belief domains. However, the qualitative results demonstrated new knowledge was not developed or sustained in practice. Themes that emerged include the following: lack of module recall, unmet learning needs and methods for oral care delivery, and timing of oral care in a busy clinical environment. CONCLUSION: Online oral health education alone has limited impact on PSWs' knowledge and beliefs. Research evaluating multifaceted education interventions including hands-on training with a dental expert is warranted.

2.
J Prosthet Dent ; 2021 Jan 07.
Artículo en Inglés | MEDLINE | ID: mdl-33423821

RESUMEN

STATEMENT OF PROBLEM: The clinical success of monolithic lithium disilicate glass-ceramic (LDGC) crowns manufactured with computer-aided design and computer-aided manufacturing (CAD-CAM) technology provided by predoctoral students has not been fully investigated. PURPOSE: The purpose of this retrospective clinical study was to evaluate the performance of laboratory-fabricated monolithic posterior LDGC CAD-CAM crowns provided by predoctoral students at the University of Toronto. Specific patient- and provider-related factors were also investigated. MATERIAL AND METHODS: A sample of posterior LDGC CAD-CAM crowns (IPS e.max) provided by predoctoral students was evaluated. Crown preparations were made according to specific criteria, and crowns were milled in an in-house laboratory by using the CEREC Bluecam system. The crowns were cemented with Rely-X Unicem (3M ESPE) and Calibra Universal (Dentsply Sirona) resin cements. Clinical assessments of the crowns and supporting periodontal structures were performed following the modified California Dental Association (CDA) criteria. Intraoral photographs and periapical and bitewing radiographs were obtained for further assessment by 2 evaluators. Descriptive statistics, McNemar, t test, log rank (Mantel-Cox) tests, Pearson chi-squared tests, simple logistic regression, odds ratios, and Kaplan Meier survival analyses were performed (α=.05). RESULTS: A total of 189 patients receiving 210 crowns (108 premolar and 102 molar) were examined with a follow-up period of up to 6 years. Altogether, 28 complications were observed (12 technical, 11 biological, and 5 esthetic). No significant association was found between patient age, sex, periodontal condition, tooth type, tooth vitality, cement type, and crown longevity. However, significantly lower survival and success rates were found for mandibular crowns than for maxillary crowns (P=.029). The provider's experience had no significant effect on the clinical performance of LDGC CAD-CAM crowns. The 6-year cumulative survival rate was 93.0%, and the success rate was 86.4%. CONCLUSIONS: The ease of use of the CAD-CAM system and clinical performance of LDGC suggest that this technology should be used in the dental school setting by predoctoral students.

3.
Community Dent Oral Epidemiol ; 48(2): 152-162, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31851397

RESUMEN

OBJECTIVES: To investigate the association between dentists' geographic density and perceptions of market competition with clinical decision-making among a representative sample of dentists in Ontario, Canada's most populated province. METHODS: Competition was quantified using dentist density, defined as the number of dental clinics lying within a one kilometre radius around the respondents' clinic address and by self-reported perceived pressure from other dental clinics. The outcome (clinical decision-making or treatment intensity) was measured using a set of clinical scenarios, which categorized dentists as either relatively aggressive or conservative. Associations were assessed using bivariate analysis and logistic and linear regression. RESULTS: Dentists who perceived large competitive pressure from other dentists (OR = 1.63, 95% CI: 1.07-2.49) were relatively more aggressive in their treatment choices. Interestingly, dentists located in very low dentist density areas (OR = 1.31, 95% CI: 1.03-1.68) were also relatively more aggressive in their treatment choices. CONCLUSION: This study is the first to explore the impact of competition on the clinical decision-making of dentists in a Canadian context. It presents a valuable addition to the competition literature and helps to understand current dynamics in the Canadian dental care market.


Asunto(s)
Toma de Decisiones Clínicas , Odontólogos/psicología , Pautas de la Práctica en Odontología , Ubicación de la Práctica Profesional , Ansiedad , Actitud del Personal de Salud , Canadá , Humanos , Encuestas y Cuestionarios
4.
J Esthet Restor Dent ; 31(6): 613-619, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31565848

RESUMEN

OBJECTIVES: To evaluate the clinical performance and the effect of various patient and provider-related factors on the longevity of chairside monolithic posterior lithium disilicate glass-ceramic (LDGC) computer-aided design (CAD)-computer-aided manufacturing (CAM) crowns provided by predoctoral students. MATERIALS AND METHODS: A sample of posterior LDGC CAD-CAM crowns was evaluated. Crown preparations were milled chairside using the CEREC Omnicam system and cemented with Rely-X Unicem or Calibra Universal resin cements. Clinical assessment of the crowns and supporting periodontal structures was performed using the modified California Dental Association (CDA) criteria. Intraoral photographs as well as radiographs were taken for further assessment by two evaluators. Kaplan-Meier survival analysis was performed. RESULTS: A total of 40 crowns were inserted in 32 patients and evaluated for 4 years. Three complications were observed (two-technical and one-biological). No chipping or fracture of crowns was observed. No significant association was found between age, sex, periodontal condition, tooth type, tooth vitality, cement type, and longevity. The 4-year cumulative survival and success rates were 95.0 and 92.3%, respectively. CONCLUSION: Chairside LDGC CAD-CAM crowns exhibited a high survival rate after 4 years in function and were shown to be a viable and reliable treatment option for posterior teeth. CLINICAL SIGNIFICANCE: The high survival rate of chairside CAD-CAM crowns observed in this study suggests the likelihood of predictable performance in the predoctoral setup.


Asunto(s)
Porcelana Dental , Diseño de Prótesis Dental , Cerámica , Diseño Asistido por Computadora , Coronas , Humanos , Ensayo de Materiales
5.
JAMA Netw Open ; 2(3): e190648, 2019 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-30874781

RESUMEN

Importance: Testing the long-term usefulness of a childhood intervention and determining the best age of implementation are important for translation and policy change. Objectives: To investigate among children aged 3 years the long-term effectiveness an intervention that aimed to reduce dental caries among South Australian Aboriginal children and to assess if children in the delayed intervention (DI) group had any benefit from the intervention from ages 2 to 3 years and if the intervention usefulness was greater when delivered between pregnancy and age 2 years (immediate intervention [II] vs ages 2 to 3 years [DI]). Design, Setting, and Participants: Secondary analysis of a randomized clinical trial. The study enrolled 448 pregnant women across South Australia, Australia, at baseline (February 1, 2011, to May 30, 2012), with 223 randomly allocated to the II group and 225 to the DI group. Three-year follow-up data were collected November 2014 to February 2016. Interventions: The intervention comprised dental treatment to mothers, fluoride varnish application to children, and motivational interviewing delivered together with anticipatory guidance. This was delivered during pregnancy and at child ages 6, 12, and 18 months for the II group and at child ages 24, 30, and 36 months for the DI group. Main Outcomes and Measures: The mean number of decayed teeth measured at child age 3 years. Results: There were 324 children at age 3 years (52.3% male). The mean number of decayed teeth at age 3 years was 1.44 (95% CI, 1.38-1.50) for the II group and 1.86 (95% CI, 1.89-2.03) for the DI group (mean difference, -0.41; 95% CI, -0.52 to -0.10). The predicted mean number of decayed teeth at age 3 years for the DI group was 2.15. Between ages 2 and 3 years, the caries increment for the II group was 0.82 (95% CI, 0.75-0.89), compared with 0.97 (95% CI, 0.87-1.17) for the DI group (P = .05). Conclusions and Relevance: At the 3-year follow-up, II children had less dental caries than DI children, DI children developed dental caries at a lower trajectory than predicted had the intervention not been received at ages 2 to 3 years, and the caries increment was less between ages 2 to 3 years among II children compared with DI children. This study suggests that the best time to implement the intervention is earlier rather than later infancy. Trial Registration: Australian and New Zealand Clinical Trial Registry Ideintifier: ACTRN12611000111976.


Asunto(s)
Caries Dental/prevención & control , Salud Bucal , Adulto , Australia , Preescolar , Caries Dental/epidemiología , Femenino , Estudios de Seguimiento , Promoción de la Salud , Humanos , Masculino , Persona de Mediana Edad , Madres , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Ensayos Clínicos Controlados Aleatorios como Asunto , Adulto Joven
6.
Artículo en Inglés | MEDLINE | ID: mdl-30781882

RESUMEN

Canada received over 140,000 refugees and asylum seekers between 2015 and 2017. This paper presents a protocol with the purpose of generating robust baseline data on the oral health of this population and build a long-term program of research to improve their access to dental care in Canada. The three-phase project uses a sequential mixed methods design, with the Behavioral Model for Vulnerable Populations as the conceptual framework. In Phase 1a, we will conduct five focus groups (six to eight participants per group) in community organizations in Ontario, Canada, to collect additional sociocultural data for the research program. In Phase 1b, we will use respondent-driven sampling to recruit 420 humanitarian migrants in Ontario and Quebec. Participants will complete a questionnaire capturing socio-demographic information, perceived general health, diet, smoking, oral care habits, oral symptoms, and satisfaction with oral health. They will then undergo dental examination for caries experience, periodontal health, oral pain, and traumatic dental injuries. In Phase 2, we will bring together all qualitative and quantitative results by means of a mixed methods matrix. Finally, in Phase 3, we will hold a one-day meeting with policy makers, dentists, and community leaders to refine interpretations and begin designing future oral health interventions for this population.


Asunto(s)
Salud de las Minorías/estadística & datos numéricos , Salud Bucal/estadística & datos numéricos , Refugiados/estadística & datos numéricos , Adolescente , Adulto , Anciano , Canadá , Atención Odontológica/normas , Encuestas de Salud Bucal , Grupos Focales , Accesibilidad a los Servicios de Salud/normas , Humanos , Persona de Mediana Edad , Salud de las Minorías/normas , Salud Bucal/normas , Migrantes/estadística & datos numéricos , Adulto Joven
7.
EClinicalMedicine ; 1: 43-50, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31193658

RESUMEN

Background: Dental disease has far-reaching impacts on child health and wellbeing. We worked with Aboriginal Australian communities to develop a multifaceted oral health promotion initiative to reduce children's experience of dental disease at age 2 years. Methods: This was a single-blind, parallel-arm, randomised controlled trial. Participants were recruited from health service providers across South Australia. Women pregnant with an Aboriginal child were eligible. The intervention comprised: (1) provision of dental care to mothers during pregnancy; (2) application of fluoride varnish to teeth of children at ages 6, 12 and 18 months; (3) motivational interviewing delivered in conjunction with; (4) anticipatory guidance. The primary outcome was untreated dental decay as assessed by the number of teeth with cavitated and non-cavitated carious lesions (mean dt) at child age 24 months. Analyses followed intention-to-treat principles. The RCT was registered with the Australian and New Zealand Clinical Trial Registry, ACTRN12611000111976. Findings: Women (n = 448) were recruited from February 2011 to May 2012, resulting in 223 children in the treatment group and 225 in the control. Mean dt at age two years was 0.62 (95% CI 0.59 to 0.65) for the intervention group and 0.89 (95% CI 0.85 to 0.92) for the control group (mean difference - 0.27 (95% CI - 0.31, - 0.22)). Interpretation: A culturally-appropriate intervention at four time-points from pregnancy through to 18-months resulted in improvements in the oral health of Aboriginal children. Further consultation with Aboriginal communities is essential for understanding how to best sustain these oral health improvements for young Aboriginal children.

8.
Front Public Health ; 5: 138, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28713800

RESUMEN

The Baby Teeth Talk Study (BTT) is a partnership-based research project looking at interventions to prevent early childhood caries (ECC) in First Nations populations in Canada. Community-based researchers (CBRs) conducted preventive and behavioral interventions that targeted expectant mothers and their newborns, over a 3-year period. The work of the CBRs requires a great deal of training and skills to administer the interventions. It also requires a broad set of strategies to meaningfully engage participants to make health-promoting changes in their behavior to prevent ECC in their children. After implementing the intervention, BTT CBRs participated in interviews to explore the strategies they employed to engage participants in the prevention of ECC. CBRs perceived two key strategies as essential for meaningful engagement with BTT participants. First, CBRs indicated that their shared experiences through motherhood, First Nations identity, age, and childhood experience provided a positive foundation for dialog with participants that lead to build trust and rapport. Second, supportive interpersonal and culturally based communication skills of the CBR provided further foundation to engage with participants from a strength-based approach. For example, the CBRs knew how to effectively communicate in ways such as being gentle, non-intrusive, and avoiding any perception of judgment when discussing oral health behavior. In First Nations health research, CBRs can provide an essential link in engaging participants and the community for improvements in health. Researchers should carefully consider characteristics such as shared experience and ability to understand cultural communication styles when hiring CBRs in order to build a solid foundation of trust with research participants.

9.
Community Dent Oral Epidemiol ; 45(3): 209-215, 2017 06.
Artículo en Inglés | MEDLINE | ID: mdl-28092100

RESUMEN

OBJECTIVES: To compare two methods of allocating general dentists to Canadian Armed Forces (CAF) dental detachments: a dentist-to-population ratio model and a needs-based model. METHODS: Data obtained from CAF sources were analysed to compare models. Times assigned to treatment plan procedures were used as a proxy for treatment needs. Full-time equivalents (FTEs) were used as an indicator for the number of dentists allocated to each detachment. FTE values were adjusted for military dentists to account for time spent on compulsory nonclinical duties. The paired-samples t test was used to assess differences between the models for all clinics (dental detachments) and by clinic size. RESULTS: The dentist-to-population ratio model for the CAF population (n=68 183) estimated an allocation of 83.25 FTE general dentists to CAF dental detachments. Based on a systematic sample of the CAF population (n=2226), the needs-based model estimated the requirement for 64.71 FTE general dentists. The average difference between models was 0.71 FTE (SE=0.273), which was statistically significant (P=0.015). In terms of differences by clinic size, differences were more pronounced in clinics serving more than 4000 CAF personnel (2.63 FTEs, SE=0.613, P=0.008). CONCLUSIONS: The findings reveal differences between estimation models of <1 FTE, with higher estimates produced from the dentist-to-population ratio model. A larger difference was found in clinics with larger populations. The perceived overestimation of dental human resource requirements suggests that changing to a needs-based model may result in cost savings.


Asunto(s)
Clínicas Odontológicas , Odontología Militar , Canadá , Clínicas Odontológicas/organización & administración , Necesidades y Demandas de Servicios de Salud/organización & administración , Humanos , Odontología Militar/organización & administración , Modelos Organizacionales , Técnicas de Planificación , Recursos Humanos
10.
J Health Care Poor Underserved ; 27(1A): 101-109, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27763434

RESUMEN

Early childhood caries is a global health issue for Indigenous populations. The study, "Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention," is being conducted in Australia, Canada, and Aotearoa/New Zealand. OBJECTIVE: To conduct the research in New Zealand using a kaupapa Maori (Maori philosophy) approach. METHODS: This is a mixed-method study incorporating quantitative and qualitative data whilst acknowledging Maori cultural practices by the utilization of Te Whare Tapa Wha, a model for Maori health and well-being. RESULTS: This paper describes the application of the four dimensions of this model, (spiritual, mental, physical and family dimensions) within the research activity. CONCLUSION: Health research projects that are undertaken with Indigenous populations must ensure that the research process embraces Indigenous cultural practices. In Aotearoa/New Zealand Maori leadership over the research process ensures meaningful and beneficial outcomes for the Maori Indigenous population.


Asunto(s)
Salud del Niño , Disparidades en Atención de Salud , Salud Bucal , Australia , Canadá , Niño , Caries Dental/prevención & control , Humanos , Nueva Zelanda , Grupo de Ascendencia Oceánica
11.
J Health Care Poor Underserved ; 27(1A): 178-206, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27763440

RESUMEN

This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on-reserve communities in Ontario and Manitoba. One-third of participants experienced racism in the past year determined by the Measure of Indigenous Racism Experience. In logistic regressions, outcomes significantly associated with incidents of racism included: wearing dentures, off-reserve dental care, asked to pay for dental services, perceived need for preventive care, flossing more than once daily, having fewer than 21 natural teeth, fear of going to dentist, never received orthodontic treatment and perceived impact of oral conditions on quality of life. In the context of dental care, racism experienced by Aboriginal women can be a barrier to accessing services. Programs and policies should address racism's insidious effects on both mothers' and children's oral health outcomes.


Asunto(s)
Caries Dental , Salud Bucal , Racismo , Adulto , Femenino , Humanos , Ontario , Embarazo , Calidad de Vida
12.
Cochrane Database Syst Rev ; (8): CD007095, 2016 Aug 03.
Artículo en Inglés | MEDLINE | ID: mdl-27486835

RESUMEN

BACKGROUND: Acute otitis media (AOM) is the most common bacterial infection among young children in the United States. There are limitations and concerns over its treatment with antibiotics and surgery and so effective preventative measures are attractive. A potential preventative measure is xylitol, a natural sugar substitute that reduces the risk of dental decay. Xylitol can reduce the adherence of Streptococcus pneumoniae (S pneumoniae) and Haemophilus influenzae (H influenzae) to nasopharyngeal cells in vitro. This is an update of a review first published in 2011. OBJECTIVES: To assess the efficacy and safety of xylitol to prevent AOM in children aged up to 12 years. SEARCH METHODS: We searched CENTRAL (to Issue 12, 2015), MEDLINE (1950 to January 2016), Embase (1974 to January 2016), CINAHL (1981 to January 2016), LILACS (1982 to January 2016), Web of Science (2011 to January 2016) and International Pharmaceutical Abstracts (2000 to January 2016). SELECTION CRITERIA: Randomised controlled trials (RCTs) or quasi-RCTs of children aged 12 years or younger where xylitol supplementation was compared with placebo or no treatment to prevent AOM. DATA COLLECTION AND ANALYSIS: Two review authors independently selected trials from search results, assessed and rated study quality and extracted relevant data for inclusion in the review. We contacted trial authors to request missing data. We noted data on any adverse events of xylitol. We extracted data on relevant outcomes and estimated the effect size by calculating risk ratio (RR), risk difference (RD) and associated 95% confidence intervals (CI). MAIN RESULTS: We identified five clinical trials that involved 3405 children for inclusion. For this 2016 update, we identified one new trial for inclusion. This trial was systematically reviewed but due to several sources of heterogeneity, was not included in the meta-analysis. The remaining four trials were of adequate methodological quality. In three RCTs that involved a total of 1826 healthy Finnish children attending daycare, there is moderate quality evidence that xylitol (in any form) can reduce the risk of AOM from 30% to around 22% compared with the control group (RR 0.75, 95% CI 0.65 to 0.88). Among the reasons for dropouts, there were no significant differences in abdominal discomfort and rash between the xylitol and the control groups. Xylitol was not effective in reducing AOM among healthy children during a respiratory infection (RR 1.13, 95% CI 0.83 to 1.53; moderate quality evidence) or among otitis-prone healthy children (RR 0.90, 95% CI 0.67 to 1.21; low-quality evidence). AUTHORS' CONCLUSIONS: There is moderate quality evidence showing that the prophylactic administration of xylitol among healthy children attending daycare centres can reduce the occurrence of AOM. There is inconclusive evidence with regard to the efficacy of xylitol in preventing AOM among children with respiratory infection, or among otitis-prone children. The meta-analysis was limited because data came from a small number of studies, and most were from the same research group.


Asunto(s)
Otitis Media/prevención & control , Edulcorantes/uso terapéutico , Xilitol/uso terapéutico , Enfermedad Aguda , Goma de Mascar , Niño , Preescolar , Femenino , Geles/uso terapéutico , Humanos , Lactante , Recién Nacido , Masculino , Ensayos Clínicos Controlados Aleatorios como Asunto , Edulcorantes/efectos adversos , Xilitol/efectos adversos
13.
J Health Care Poor Underserved ; 27(1 Suppl): 101-9, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26853204

RESUMEN

UNLABELLED: Early childhood caries is a global health issue for Indigenous populations. The study, "Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention," is being conducted in Australia, Canada, and Aotearoa/New Zealand. OBJECTIVE: To conduct the research in New Zealand using a kaupapa Maori (Maori philosophy) approach. METHODS: This is a mixed-method study incorporating quantitative and qualitative data whilst acknowledging Maori cultural practices by the utilization of Te Whare Tapa Wha, a model for Maori health and well-being. RESULTS: This paper describes the application of the four dimensions of this model, (spiritual, mental, physical and family dimensions) within the research activity. CONCLUSION: Health research projects that are undertaken with Indigenous populations must ensure that the research process embraces Indigenous cultural practices. In Aotearoa/New Zealand Maori leadership over the research process ensures meaningful and beneficial outcomes for the Maori Indigenous population.


Asunto(s)
Características Culturales , Promoción de la Salud/métodos , Grupo de Ascendencia Oceánica , Salud Bucal/etnología , Proyectos de Investigación , Preescolar , Caries Dental/etnología , Caries Dental/prevención & control , Femenino , Humanos , Lactante , Nueva Zelanda , Grupo de Ascendencia Oceánica/estadística & datos numéricos , Embarazo , Investigación Cualitativa
14.
J Health Care Poor Underserved ; 27(1 Suppl): 178-206, 2016 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-26853210

RESUMEN

This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on-reserve communities in Ontario and Manitoba. One-third of participants experienced racism in the past year determined by the Measure of Indigenous Racism Experience. In logistic regressions, outcomes significantly associated with incidents of racism included: wearing dentures, off-reserve dental care, asked to pay for dental services, perceived need for preventive care, flossing more than once daily, having fewer than 21 natural teeth, fear of going to dentist, never received orthodontic treatment and perceived impact of oral conditions on quality of life. In the context of dental care, racism experienced by Aboriginal women can be a barrier to accessing services. Programs and policies should address racism's insidious effects on both mothers' and children's oral health outcomes.


Asunto(s)
Indios Norteamericanos/psicología , Inuits/psicología , Salud Bucal/etnología , Racismo/estadística & datos numéricos , Adolescente , Adulto , Canadá , Servicios de Salud Dental , Femenino , Accesibilidad a los Servicios de Salud , Humanos , Indios Norteamericanos/estadística & datos numéricos , Inuits/estadística & datos numéricos , Persona de Mediana Edad , Embarazo , Adulto Joven
15.
BMC Oral Health ; 16: 18, 2016 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-26875752

RESUMEN

BACKGROUND: Inadequate functional health literacy is a common problem in immigrant populations. The aim of this study was to investigate the association between oral (dental) health literacy (OHL) and participation in oral health care among Brazilian immigrants in Toronto, Ontario, Canada. METHODS: The study used a cross-sectional design and a convenience sample of 101 Brazilian immigrants selected through the snowball sampling technique. Data were analyzed using descriptive statistics and logistic regression modeling. RESULTS: Most of the sample had adequate OHL (83.1 %). Inadequate/marginal OHL was associated with not visiting a dentist in the preceding year (OR = 3.61; p = 0.04), not having a dentist as the primary source of dental information (OR = 5.55; p < 0.01), and not participating in shared dental treatment decision making (OR = 1.06; p = 0.05; OHL as a continuous variable) in multivariate logistic regressions controlling for covariates. A low average annual family income was associated with two indicators of poor participation in oral health care (i.e., not having visited a dentist in the previous year, and not having a dentist as regular source of dental information). CONCLUSION: Limited OHL was linked to lower participation in the oral health care system and with barriers to using dental services among a sample of Brazilian immigrants. More effective knowledge transfer will be required to help specific groups of immigrants to better navigate the Canadian dental care system.


Asunto(s)
Emigrantes e Inmigrantes , Conocimientos, Actitudes y Práctica en Salud , Alfabetización en Salud , Salud Bucal , Brasil , Canadá , Estudios Transversales , Humanos
16.
Int J Prosthodont ; 28(6): 600-9, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26523719

RESUMEN

PURPOSE: The primary objective of this study was to assess the prevalence of temporomandibular disorders (TMDs) and comorbid factors (sleep bruxism and headaches). This study was a cross-sectional population survey in the city of Maringá, state of Paraná, Brazil. MATERIALS AND METHODS: Axes I and II of the Research Diagnostic Criteria for TMD (RDC/TMD) were used for assessment of TMD signs and symptoms. The population was users of the Brazilian public health system (SUS), of both sexes, between the ages of 20 and 65 years, and not seeking treatment for TMD. RESULTS: The selected population (N = 1,643) was composed mostly of (a) women (65.9%), (b) married or single individuals (90.6%), (c) Caucasians (70.1%), (d) individuals aged 32.7 ± 10.3 years, (e) individuals earning a medium income (75.1%), and (f) those who had completed a high school education or higher (79.9%). According to the chronic pain grade classification (CPG) in the RDC/TMD Axis II, 36.2% of the population had some degree of TMD pain (CPG I to IV); however, only 5.1% had severe limitation due to pain (CPG III or IV). In the RDC/TMD Axis I diagnoses, 29.5% presented with muscle disorders (group I), 7.9% with disk displacements (group II), and 39.1% with other joint disorders (group III). Headaches were present in 67.9% and awake and sleep bruxism in 30% and 33.4% of the population, respectively. CONCLUSION: The prevalence of signs and symptoms of TMD was high in this population, but with low disability; however, the proportion of patients in need of treatment was much lower.


Asunto(s)
Trastornos de la Articulación Temporomandibular/epidemiología , Adulto , Factores de Edad , Anciano , Brasil/epidemiología , Bruxismo/epidemiología , Estudios Transversales , Escolaridad , Grupo de Ascendencia Continental Europea/estadística & datos numéricos , Femenino , Cefalea/epidemiología , Humanos , Renta/estadística & datos numéricos , Luxaciones Articulares/epidemiología , Masculino , Estado Civil , Persona de Mediana Edad , Vigilancia de la Población , Prevalencia , Factores Sexuales , Bruxismo del Sueño/epidemiología , Disco de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/diagnóstico , Síndrome de la Disfunción de Articulación Temporomandibular/epidemiología , Adulto Joven
17.
Rural Remote Health ; 15(4): 3566, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-26530126

RESUMEN

INTRODUCTION: To determine the effectiveness of the Healthy Smile Happy Child (HSHC) project, a community-developed initiative promoting early childhood oral health in Manitoba, Canada. Specific aims were to assess improvements in caregiver knowledge, attitudes, and behaviours relating to early childhood oral health, and the burden of early childhood caries (ECC) and severe ECC (S-ECC). METHODS: A serial cross-sectional study design was selected to contrast findings following the Healthy Smile Happy Child (HSHC) campaign in four communities with the previous baseline data. One community was a remote First Nation in northern Manitoba and another was a rural First Nation in southern Manitoba. The other two communities were urban centres, one of which was located in northern Manitoba. A community-development approach was adopted for the project to foster community solutions to address ECC. Goals of the HSHC program were to promote the project in each community, use existing community-based programs and services to deliver the oral health promotion and ECC prevention activities, and recruit and train natural leaders to assist in program development and to deliver the ECC prevention program. The HSHC coordinator worked with communities to develop a comprehensive list of potential strategies to address ECC. Numerous activities occurred in each community to engage members and increase their knowledge of early childhood oral health and ultimately lead them to adopt preventive oral health practices for their young children. Children under 71 months of age and their primary caregivers participated in this follow-up study. A -value ≤0.05 was statistically significant. RESULTS: 319 children (mean age 38.2±18.6 months) and their primary caregivers participated. Significant improvements in caregiver knowledge and attitudes were observed following the HSHC campaign, including that baby teeth are important (98.8%), that decay involving primary teeth can impact on health (94.3%), and the importance of a dental visit by the first birthday (82.4%). Significantly more respondents indicated that their child had visited the dentist (50.2%) and had started brushing their child's teeth (86.7%) when compared to baseline. Overall, 52.0% had ECC, 38.6% had S-ECC. The mean deft score was 3.85±4.97 (range 0-20). There was no significant change is ECC prevalence between the follow-up and baseline investigations. However, age-adjusted logistic regression for S-ECC in this follow-up study revealed a significant reduction in prevalence compared with the baseline study (=0.021). Similarly, age-adjusted Poisson regression revealed that there were significant reductions in both the decayed teeth and decayed, extracted and filled teeth scores between follow-up and baseline study periods (0.016 and .0001, respectively). CONCLUSIONS: Follow-up study results suggest that the HSHC initiative may have contributed to improvements in caregiver knowledge, attitudes, and behaviours towards early childhood oral health and subsequently modest yet statistically significant reductions in caries scores and the prevalence of S-ECC.


Asunto(s)
Bienestar del Niño , Odontología Comunitaria/organización & administración , Caries Dental/prevención & control , Promoción de la Salud/organización & administración , Salud Bucal , Canadá , Niño , Preescolar , Conducta Cooperativa , Estudios Transversales , Caries Dental/epidemiología , Femenino , Humanos , Masculino , Manitoba , Evaluación de Programas y Proyectos de Salud , Sonrisa
18.
BMC Oral Health ; 15: 49, 2015 Apr 09.
Artículo en Inglés | MEDLINE | ID: mdl-25888182

RESUMEN

BACKGROUND: Breastfeeding is a gift from mother to child and has a wide range of positive health, social and cultural impacts on infants. The link between bottle feeding and the prevalence of early childhood caries (ECC) is well documented. In Aboriginal communities, the higher rates of ECC are linked with low rates of breast feeding and inappropriate infant feeding of high sugar content liquids. METHODS: The Baby Teeth Talk Study (BTT) is one project that is exploring the use of four interventions (motivational interviewing, anticipatory guidance, fluoride varnish and dental care to expectant mothers) for reducing the prevalence of ECC in infants within Aboriginal communities. This research explored cultural based practices through individual interviews and focus groups with older First Nations women in the community. RESULTS: Participants in a First Nations community identified cultural based practices that have also been used to promote healthy infant feeding and good oral health. A wide range of themes related to oral health and infant feeding emerged. However, this paper focuses on three themes including: breastfeeding attitudes, social support for mothers and birthing and supporting healthy infant feeding through community programs. CONCLUSIONS: The importance of understanding cultural health traditions is essential for those working in oral public health capacities to ensure there is community acceptance of the interventions.


Asunto(s)
Lactancia Materna/etnología , Cultura , Caries Dental/prevención & control , Indios Norteamericanos/etnología , Actitud Frente a la Salud/etnología , Cariostáticos/uso terapéutico , Servicios de Salud Comunitaria , Consejo , Atención Odontológica , Caries Dental/etnología , Sacarosa en la Dieta/administración & dosificación , Femenino , Fluoruros Tópicos/uso terapéutico , Grupos Focales , Educación en Salud Dental/métodos , Promoción de la Salud , Humanos , Lactante , Cuidado del Lactante , Salud del Lactante/etnología , Recién Nacido , Manitoba/etnología , Entrevista Motivacional , Salud Bucal/etnología , Embarazo , Atención Prenatal , Investigación Cualitativa , Apoyo Social
19.
Int Dent J ; 64(5): 269-77, 2014 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-25131429

RESUMEN

OBJECTIVES: Oral health personnel are limited in their ability to assess the readiness of patients to make changes to improve oral health. We aimed to develop and test the Stages of Change in Oral Health (SOCOH) model, a scaled index of the stages of change - pre-contemplative, contemplative or active - with particular emphasis on pregnancy. MATERIALS AND METHODS: Items were collected in a self-report questionnaire conducted among a convenience sample of 446 mothers (age range: 14-43 years) pregnant with Aboriginal children in South Australia, Australia. Scales representing openness (four items; Cronbach's alpha = 0.73), value (four items; Cronbach's alpha = 0.71), inconvenience (six items; Cronbach's alpha = 0.79) and permissiveness (four items; Cronbach's alpha = 0.66) were developed. Participants were categorised according to the Stages of Change model and were evaluated against key self-reported oral health outcomes. RESULTS: Some 11.9% of participants were classified as pre-contemplators, 46.4% as contemplators and 41.7% as active. A higher proportion of active participants had a higher education, last visited a dentist less than a year previously, had no dental fear, owned a toothbrush, brushed the previous day, used toothpaste, had no difficulties paying a $100 dental bill, self-reported their dental health as 'excellent' and in the previous 12 months did not experience dental pain, embarrassment related to their dental appearance or difficulties eating food. CONCLUSIONS: The SOCOH model offers an internally consistent and valid instrument for detailed assessment of the readiness for change in regarding oral health behaviours in pregnancy and has potential benefits for clinical decision making and research.


Asunto(s)
Actitud Frente a la Salud , Atención Odontológica/psicología , Conductas Relacionadas con la Salud , Mujeres Embarazadas/psicología , Adolescente , Adulto , Femenino , Humanos , Grupo de Ascendencia Oceánica , Salud Bucal , Embarazo , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Australia del Sur , Encuestas y Cuestionarios
20.
J Public Health Dent ; 74(4): 301-9, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24989691

RESUMEN

OBJECTIVES: We hypothesized that the psychosocial factors perceived stress and sense of personal control mediated the relationship between self-reported racism and experience of toothache. We hypothesized that social support moderated this relationship. METHODS: Data from 365 pregnant Aboriginal Australian women were used to evaluate experience of toothache, socio-demographic factors, psychosocial factors, general health, risk behaviors, and self-reported racism exposure. Hierarchical logistic regression models estimated odds ratios (ORs) and 95 percent confidence intervals (CIs) for experience of toothache. Perceived stress and sense of personal control were examined as mediators of the association between self-reported racism and experience of toothache. Social support was examined as a moderator. RESULTS: Self-reported racism persisted as a risk indicator for experience of toothache (OR 1.99, 95 percent CI 1.07-3.72) after controlling for age, level of education, and difficulty paying a $100 dental bill. The relationship between self-reported racism and experience of toothache was mediated by sense of control. The direct effect of self-reported racism on experience of toothache became only marginally significant, and the indirect effect was significant (ß coefficient=0.04, bias-corrected 95 percent CI 0.004-0.105, 21.2 percent of effect mediated). Stress was insignificant as a mediator. Social support was insignificant as a moderator. CONCLUSIONS: The findings indicate that high levels of self-reported racism were associated with experience of toothache and that sense of control, but not perceived stress, mediated the association between self-reported racism and experience of toothache among this sample of pregnant Aboriginal Australian women. Social support did not moderate the association between self-reported racism and experience of toothache.


Asunto(s)
Control Interno-Externo , Grupo de Ascendencia Oceánica , Complicaciones del Embarazo/psicología , Racismo , Apoyo Social , Estrés Psicológico , Odontalgia/psicología , Adolescente , Adulto , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/terapia , Odontalgia/complicaciones , Odontalgia/terapia , Adulto Joven
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