Special education teachers' involvement and perceived barriers to delivering oral health education for students with disabilities-A cross-sectional study.

BACKGROUND: Dental caries is prevalent among children, including those with disabilities. Although the World Health Organization recommends school-based oral health promotion (OHP) programmes involving teachers, limited research has explored teachers' roles and perspectives. AIM: To assess special education teachers' involvement and difficulties regarding oral health education (OHE), attitudes towards OHP and barriers to oral healthcare access for students with disabilities (SWDs). DESIGN: This descriptive cross-sectional study, conducted in Al-Ahsa, Saudi Arabia, involved 264 special education teachers using a validated, self-administered questionnaire, and descriptive and analytical statistics were used for data analysis. RESULTS: Only 39% of teachers incorporated OHE into their teaching, and just 20.8% received training for OHE delivery. Teachers showed strong support for integrating OHE into the curriculum (84.1%) and a no-sugar policy (78%). There was, however, less support for school-based toothbrushing (39%). OHE barriers included insufficient resources (56.1%), limited knowledge (29.2%) and misconceptions about primary teeth removal (47.4%). The three most common barriers to oral healthcare access were extended waiting lists (75.0%), long waiting times (73.1%) and fear of dental equipment (67.4%). CONCLUSION: This study highlights the need for collaboration between healthcare professionals, educators and parents to enhance OHE and reinforce OHP for SWDs within special education and beyond.

Effectiveness of Educational Videos Comparing Single Versus Multiple Topics: A Cluster Randomized Controlled Trial.

Background Dental caries and gingivitis are preventable diseases that remain highly prevalent among children globally and, while transmissible through the transfer of oral bacteria typically from mother to child, differ from communicable diseases that are spread through direct contact, air, or vectors. Unlike communicable diseases, dental caries and gingivitis can be effectively prevented through proper oral hygiene practices and dietary modifications. Oral health education (OHE) intends to improve oral hygiene practices and reduce oral health problems. However, evidence of the impact of multiple topics in OHE on preschool children is lacking. This study aimed to examine the effects of single- versus multiple-topic OHE delivered via video presentations on the plaque and gingival status of preschool children. Methods A parallel five-arm cluster randomized controlled trial was conducted on healthy preschool children aged five and six years. Children with chronic illnesses, disabilities, or conditions that could affect their oral health or ability to participate in the OHE intervention were excluded. OHE interventions were given to children from eight of the 10 classes assigned as intervention groups, while two classes served as the control group and received no intervention. The intervention groups received one, two, or three oral health topics using specially developed animation videos, in Malay language: toothbrushing technique (T), toothbrushing technique and the effects of sugar consumption on oral health (TS), toothbrushing technique and pathogenesis of dental caries and gingivitis (TP), and toothbrushing technique, the effects of sugar consumption on oral health, and pathogenesis of dental caries and gingivitis (TSP). Plaque and gingival scores, along with oral health knowledge, attitude, and skills (KAS), were recorded before and after the intervention. The CONSORT guidelines were followed in reporting. The analyses included descriptive statistics, one-way ANOVA, effect sizes, and multivariate analysis of covariance (MANCOVA) at a 5% significance level. Results A total of 160 participants were equally distributed into five groups (n = 32). There were no baseline differences in plaque or gingival scores. All groups showed significantly lower plaque and gingival scores post-intervention (p < 0.05), with effect sizes ranging from -1.1 to -0.7. No changes in oral health (KAS) were observed. The intervention groups had significantly lower plaque and gingival scores compared to the control group (p < 0.05), but no differences were found between them after adjusting for baseline KAS (p > 0.05). Conclusions This study suggests that including multiple topics in OHE programs for preschool children may not necessarily improve oral health outcomes. Simplified OHE may be more advantageous in terms of time, cost, human resources, and organization.

A novel oral medicine-centered interprofessional curricular initiative to promote collaboration and build oral health capacity.

INTRODUCTION: Oral physicians should possess knowledge, skills, and attitudes required for functioning in the evolving integrated care systems. Paramount for addressing the existing oral health disparities is also adequate training of non-dental health professionals in the foundations of oral health. We conducted interprofessional oral medicine-centered case conferences to prepare dental students for collaborative care and to increase awareness of non-dental students about the mouth-body connection. Herein, we share our perspective and the students' feedback about this educational program. METHODS: Students from seven health profession and social work programs attended an interactive, online oral medicine-centered case conference facilitated by an oral medicine faculty and at least one faculty from another profession. Faculty facilitators guided students to identify key points and encouraged team-based care. Anonymous, voluntary online surveys were distributed to participants immediately after each session. Descriptive data tabulated and analyzed. RESULTS: A total of 151 students participated in conferences between 11/11/2022 and 3/24/2023 and 132 (87%) submitted postexperience surveys. Students agreed that the case conference was applicable to their profession (95%) and meaningful (94%), they learned new information about other professions (94%), they could contribute to discussions (90%), interactions were respectful (99%), and discussions emphasized interprofessional collaboration (96%). Non-dental respondents learned more about oral-systemic link (95%), recognized a broader role for dentists (90%), and agreed with inclusion of more oral health content in their curricula (79%). CONCLUSION: Oral medicine-centered case conferences provided an effective curricular path for demonstrating oral-systemic connection, promoting meaningful interprofessional collaboration, and building oral health capacity among students of non-dental health professions.

Oral health behavior of pregnant women in Nigeria: a scoping review.

BACKGROUND: Oral health care behaviors during pregnancy affects maternal and child health outcomes. This scoping review sought to map the existing literature on the oral healthcare behaviors of pregnant women in Nigeria. METHODS: PubMed, Science Direct, Web of Science, EBSCOHOST, Sabinet, African Index Medicus, and Scopus data based were searched in August 2023. Articles with reports on the oral health behavior of pregnant women in Nigeria, published in English in peer review were included in the review. Articles whose full lengths could not be accessed, and commentaries on studies, and letters to the editor were also excluded. Data on authors and year of publication of the study, study location, study objective, study design, methodological approach for data collection, and study outcomes were extracted and descriptively synthesized. RESULTS: The search yielded a total of 595 articles of which 573 were unique. Only 21 articles were left after titles and abstracts screening and only 18 articles met the eligibility criteria. The proportion of pregnant women had utilized dental services ranged from 4 to 62.9%, the use of toothbrush and toothpaste ranged from 59.6 to 99.3%, twice daily tooth brushing ranged from 5.2 to 66.9%, and the use of toothbrush among pregnant women in the studies varies from 70.9 to 100%. Chewing stick was used by 0.1-27.7% of study participants. Dental problems such as caries, pain, swollen gums, and excessive salivation were reasons for seeking dental care. We identified individual, structural, and behavioral factors, including myths as barriers for dental service utilization. CONCLUSION: This scoping review shows that dental service utilization by pregnant women in Nigeria is poor and mainly due to curative than preventive needs. Oral health behaviours also need to be improved through tailored oral health education accessible to pregnant women in Nigeria.

Effectiveness of immersive technologies in oral health promotion and education: A systematic review.

OBJECTIVE: To evaluate the effectiveness of immersive technologies in oral health promotion and education. METHODS: An extensive literature review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. This study was systematically performed in six electronic databases (PubMed, Google Scholar, Web of Science, Cochrane, Scopus, and EBSCO). The risk of bias was assessed with the Cochrane tools using RoB 2.0 and ROBINS-I. RESULTS: PICOS criteria were formulated for study inclusion. The bibliographical search identified 10,074 articles, which were filtered subsequently. Finally, the most pertinent nine articles were included and scrutinized for data synthesis and analysis. This includes five randomized controlled trials and four non-randomized controlled trials in different countries that focused on children (33.3%), adolescents (11.1%), and adults (55.6%). The interventions used virtual reality (VR) and augmented reality (AR) to promote knowledge and attitudes towards oral care, improve toothbrushing performance, and smoking cessation, and reduce anxiety levels in oral health education. CONCLUSION: This systematic review demonstrates that immersive technologies, including VR and AR, significantly enhance oral health knowledge, attitudes, and self-efficacy, leading to improved health outcomes. CLINICAL SIGNIFICANCE: Immersive technologies such as VR and AR have the potential to provide innovative and effective methods for enhancing oral health promotion and education, while promoting positive health behaviours, which are crucial for improving overall oral health outcomes.

Development of a School-Based Online Periodontal Education Programme for Adolescents.

INTRODUCTION AND AIMS: This study aimed to investigate the effects of a developed school-based online health education programme with a periodontal examination results sheet for high school students on their subjective oral symptoms, knowledge and attitudes regarding oral health, and oral health behaviours. METHODS: The participants were first- and second-year students aged 15 to 17 years (n = 847) at a high school in Japan. The students underwent a periodontal examination and were divided into periodontal condition (PC) and nonperiodontal condition (non-PC) groups. The students participated in the online oral health education programme, which included a periodontal examination results sheet after the examination. The data for identifying the effect of the programme were collected via questionnaire surveys at the periodontal examination (baseline), after 3 months, and after 1 year, and they were compared between baseline and 3 months later and between baseline and 1 year later by the chi-square test. Logistic regression analysis was used to determine the associations between the measured variables related to oral health at 3 months or 1 year and the presence/absence of periodontal conditions after adjustment for sex and variables at baseline. RESULTS: A total of 628 students (74.1%) participated in this study. The percentages of individuals with knowledge of how many teeth they had, knowledge of periodontal disease, and experience with toothbrushing instruction increased significantly after 1 year in both groups (p < .05). The awareness of gingival swelling and bleeding and the use of fluoride toothpaste at 3 months were positively associated with the presence of periodontal conditions. CONCLUSIONS: This study showed that an online oral health education programme contributed to improving oral health knowledge and behaviours among high school students and that the awareness of periodontal conditions according to the periodontal examination results sheet might improve the awareness of gingival swelling and bleeding at 3 months.

Effectiveness of oral health education on oral hygiene status among adult male inmates in central jail, Kolkata - an interventional study.

PURPOSE: Oral health is an integral part of general health. Different population groups have been assessed for oral health status in India, but still, many have been neglected; one such group is the prisoners. The prison population is a unique and challenging one with many health problems, including poor oral health, which may be due to lack of knowledge about good oral health practices. This study aims to assess effectiveness of oral health education on oral health knowledge, attitude and practices and oral hygiene status among the male prison inmates of central jail in Kolkata, India. DESIGN/METHODOLOGY/APPROACH: An interventional study was done among 240 male convicts. The data was elicited using a structured proforma; oral health status was assessed by recording OHI-S index, and the severity of gingivitis was assessed by recording the gingival index. Oral health education was delivered by using audio-visual aid. Oral health knowledge, attitude, practices and oral hygiene and gingival status were reassessed among the inmates before and after dental education at the end of three and six months. FINDINGS: A significant change in oral health knowledge, attitude and practices was seen, which in turn resulted in an appreciable decrease in the mean gingival index score (1.73 ± 0.382 to 1.20 ± 0.321) and OHI-S (3.31 ± 0.815 to 2.57 ± 0.551) in all the inmates after oral health education program over the period of time. ORIGINALITY/VALUE: The oral health education with reinforcement proved to be an effective tool to instil good oral hygiene practices in the inmates.

Evaluating the Effectiveness of the Nudge Theory in Improving the Oral Self-Care of Schoolchildren with Refugee and Immigrant Backgrounds in Mashhad, Iran.

Nudge theory proposes using subtle interventions to encourage individuals to make better decisions. The aim of this study was to evaluate the effectiveness of the Nudge theory in plaque control and assess caries experience among third-grade primary schoolchildren with refugee and immigrant backgrounds in Mashhad, Iran. Moreover, Afghan and Iranian schoolchildren were compared to assess differences in oral health outcomes. A quasi-experimental field trial was conducted in three public primary schools, comprising 309 participants approximately 9 years old. Interventions were randomly assigned to three schools: School I Messages based on Social Norms (MSN), School II Messages based on Fear of Negative Outcome (MFNO), and School III control group (C). MSN and MFNO received customized motivational video clips at baseline, while C only received Oral hygiene instruction (OHI). All participants received OHI, a brush, and toothpaste. Baseline plaque index (PI) and caries experience in primary and permanent dentition (dmft/DMFT) were recorded. PI was reassessed at two weeks, two months, and six months post-intervention. All data were subjected to statistical analysis. The mean PI decreased significantly in all three groups at the two-week follow-up (p < 0.01). The PI improvements declined over a six-month follow-up period in all groups, and the mean PI difference after six months compared to the pre-intervention was significant only in MSN and MFNO (p < 0.01), while C reverted almost to the pre-study level. Schoolchildren with at least one filled tooth or Iranian nationality showed a greater PI reduction (p < 0.01, p = 0.05). The overall mean ± SD dmft and DMFT were 4.24 ± 2.11 and 1.70 ± 1.24, respectively. Among all the examined participants, 32 (10.40%) individuals were caries-free. The mean dmft was statistically significantly higher in Afghan children than in Iranians (p = 0.01). MSN was more effective on PI reduction in the short term, while MFNO was more long-lasting. Using the Nudge theory via visual aids was more effective in motivating children to perform better oral self-care than solely traditional OHI.

Oral health education strategies for patients living with cardiovascular disease within hospital settings: a scoping review.

Objective: To identify and describe the impact of current oral health education programmes provided to patients in cardiology hospital wards and outpatient clinics. Methods: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews statement. Searches were conducted using electronic databases: Cochrane, Medline, and Scopus, as well as grey literature searching. Results: Three eligible studies were identified. All included studies reported generalised poor oral health in their participants at baseline, with significant improvement at follow-up. They all reported significant reductions in plaque deposits and gingival bleeding. One study reported significantly less bacteria on participant tongues, as well as fewer days with post-operative atrial fibrillation in the intervention group. Furthermore, in this study, one patient in the intervention group developed pneumonia, whilst four patients in the control group did. Conclusion: Oral health education for patients with cardiovascular disease is limited and many have poor oral health. Educational programmes to improve oral health behaviours in patients with cardiovascular disease can improve both oral and general health outcomes. Implications for public health: Oral disease is a modifiable risk factor for cardiovascular disease. Integrating oral health education into cardiology hospital settings is a simple strategy to improve access to oral health information and improve both oral and cardiovascular outcomes.

Comparison of Different Modes of Oral Health Education in Visually Impaired Children.

To compare the effectiveness of various modes of oral health education in visually impaired children. A total of 100 students aged 8-15 years were included. The children were divided randomly into four groups. Children in Group I received oral hygiene instructions through Braille pamphlets. In Group II, children received instructions through nonvisual desktop access (NVDA). For children in Group III, both Braille and NVDA were used to deliver the instructions. Children included in Group IV served as controls, who did not receive any information in any form for the study period. After oral examination to record plaque and OHI-S scores, a questionnaire was given to the children to assess their knowledge scores. The same questionnaire was repeated after 1 month to reassess the knowledge score in different groups. Chi-square test, Wilcoxon test, and post hoc analysis tests were used. The mean plaque scores among the control group children at the follow-up were significantly higher (2.5 ± 0.64) than any other group. Similarly, the control group had higher mean oral hygiene simplified scores (1.75 ± 1.32) than the Braille (1.12 ± 0.65), NVDA (0.85 ± 1.38), and Braille + NVDA (0.2 ± 0.64) groups at follow-up. With regards to the mean total knowledge score, the control group scored the least (2.16 ± 1.46), while the Braille, NVDA, and Braille + NVDA groups scored 3.16 ± 1.43, 4.52 ± 1.12, and 6.36 ± 0.52, respectively. Combination of Braille and NVDA was found to be effective in educating and motivating visually impaired children regarding maintenance of oral hygiene.

Study protocol for a pilot quasi-experimental study on oral health education for nurses and community health workers in Nigeria.

Introduction: The primary health care system provides an ideal setting for the integration of oral health into general health care as well as equitable access to oral health care. However, the limited oral health knowledge of primary health care workers necessitates appropriate training before they can participate in health promotion efforts. This pilot training was designed to examine the impact of the Oral Health Education module for Nurses and Community Health Care Workers on their oral health awareness and referral practices. Methods: This study will utilize a quasi-experimental design (pre-and post with a non-equivalent control group) to assess the impact of a five-day pilot oral health education program on the knowledge and referral practices of Nurses and Community Health Workers in primary health care centers in three states in Nigeria-(Lagos, Oyo, and Kano). The training modules were developed based on the six iterative steps described in the intervention mapping framework - needs assessment, highlighting program objectives and outcomes, selection of theory and mode of intervention, designing program based on theory, designing implementation plans, and developing an evaluation plan. Only the intervention group will participate in the full educational training sessions but both groups will complete the pre-and post-intervention questionnaires. Discussion: This pilot training combined the standardized training modules from the recently launched "Oral Health Training Course for Community Health Workers in Africa" and a newly developed maternal and child oral health module by our group using an evidence-based approach. To the best of our knowledge, this is the first program to examine the impact of the standardized OpenWHO modules. The success of this training will lay the foundation for developing a sustained channel for providing oral health education at the primary health care level in Nigeria, West Africa, and Africa.

Oral Health Education in Patients with Diabetes: A Systematic Review.

Diabetes is known as a "silent epidemic" and is a public health problem that accounts for 9% of all deaths worldwide. The prevention of diabetes is a significant challenge, as its prevalence and incidence are both increasing rapidly. According to the World Health Organization (WHO), education is the cornerstone of diabetes treatment. Since the severity of oral diseases is significantly higher in diabetic patients, this systematic review aims to highlight the oral care of diabetic patients as a priority for glycemic control and the importance of education for diabetic patients' oral health. We evaluated 20 clinical studies and 15 meta-analyses from PubMed and Google Scholar over the last five years. Their main themes are the direct relationship between diabetes and oral health, especially periodontitis, and the necessity of education and behaviors that can lead to a better quality of life. Our analysis indicated that good oral health is a critical factor of glycemic control in diabetic patients and can be enhanced by targeted educational programs, backed by long-term medical and dental follow-up. Healthcare personnel should be encouraged to develop their knowledge of oral health in relation to the disease so that behaviors can be adopted to improve patients' quality of life. Telemedicine could also contribute to patient education and self-management of the disease.

Pediatric Oral Health Online Education for Rural and Migrant Head Start Programs in the United States.

Children living in rural and migrant areas in the United States disproportionately suffer from poor oral health. Additionally, there continues to be a shortage of pediatric dentists practicing in rural/migrant areas. The purpose of this formative research study was to assess whether staff, teachers and families from rural/migrant Head Start/Early Head Start (HS/EHS) programs in California were receptive to oral health online education workshops conducted by pediatric dental residents who were assisted by bilingual (English and Spanish) community oral health workers (COHWs). Our findings suggest that partnering pediatric dental residents with bilingual COHWs to educate HS/EHS teachers, staff and parents on oral health care in rural/migrant areas could result in a rewarding experience for pediatric dentists that might lead them to practice in these communities upon graduation from their residency program. Furthermore, the positive feedback received from the teachers, staff and parents who participated in the workshops indicates they were receptive to receiving oral health information related to oral health literacy from the dental providers and COHWs. COHWs can help increase access to oral health care by serving as a bridge between families and providers by relaying information in a cultural, linguistic and sensitive manner.

Impact of an Oral Health Education Program on the Oral Health Literacy of Refugees.

Inadequate comprehension of healthcare information contributes to poor health outcomes. Ethnic minorities are one of the populations most affected by low health and oral health literacy (OHL). The hypothesis of the current study was that an oral health education program (OHEP) can improve the OHL, oral health awareness and behaviors of refugees. We also hypothesized that there will be a difference between OHL in English and native language in the Pre-intervention phase. Fifty-two adult refugees participated in an educational program that included a comprehensive and culturally sensitive PowerPoint presentation and hands-on learning activities on oral health topics. The study used a cross-sectional pre-post study design. Before the program (Pre-intervention group), participants completed 2 surveys: Sociodemographic Survey and Oral Health Perceptions of Refugees in a bilingual format, and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English, and in the participants' native language. Immediately after an OHEP (Post-intervention group), participants completed the EOHL-BL40 survey in English only. Two weeks after OHEP (Follow-up intervention), participants completed again the Sociodemographic Survey and Oral Health Perceptions of Refugees and the Estimate of Oral Health Literacy-Bilingual40 (EOHL-BL40) in English only. The mean percentage of words understood on Pre-intervention EOHL-BL40 survey were significantly higher in native languages (47.3% ±3.7%) compared with survey in English (15.3% ±1.2%, P < 0.001). Post-intervention scores, immediately after educational program, were higher (28.6% ±2.4%), P < 0.001) for survey in English compared with the Pre-intervention (15.3% ±1.2%). The follow-up (2 weeks later) scores (25.5% ±2.4) were slightly lower than Post-intervention but still significantly higher (P < 0.001) than Pre-intervention. Results for both Sociodemographic Survey and Oral Health Perceptions of Refugees surveys were similar: the OHEP positively affected oral health awareness and oral health behaviors. Results of the study suggested that OHEP may improve oral health literacy, oral health awareness, and personal oral hygiene practices of refugees.

Effectiveness of Oral Health Education Interventions Using Braille on Oral Health among Visually Impaired Children: Proposal for a Systematic Review.

To assess how oral health education (OHE) techniques using braille affect visually impaired children's awareness of oral health, oral hygiene status and practices, plaque, gingival health, and dental caries status. From 2010 to 2020, a thorough literature search will be conducted for studies in the English language using PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, Google Scholar, and Open Grey. Data extraction will be done after two reviewers extensively evaluate the papers for qualifying requirements. In accordance with the research designs, a quality evaluation of the chosen studies will be conducted. With the use of the program Review Manager 5.3, a meta-analysis will be completed.

Evaluation of a student telehealth rotation at the Columbia University College of Dental Medicine.

OBJECTIVES: This study aimed to assess the impact of a telehealth rotation on the perceived benefits and challenges of telehealth use among third-year dental students at the Columbia University College of Dental Medicine (CDM). METHODS: A newly implemented weeklong telehealth rotation at CDM engaged all 95 third-year dental students from the 2022 graduating class through assigned readings and virtual interaction with patients. The telehealth rotation involves virtual visits with patients for screening and triage. An ongoing retrospective assessment of the students' post-rotation evaluation was analyzed qualitatively to identify emerging themes and was coded to describe students' attitudes and beliefs about telehealth. RESULTS: Students reported that the greatest benefit of telehealth is logistical convenience, while the greatest challenge to telehealth is related to the use of technology. After the telehealth rotation, students reported improvement in their clinically relevant skills and knowledge, including patient education, facilitating access to care, and communication skills. CONCLUSIONS: The skills reported by students as the most important learning takeaway from the telehealth rotation are applicable to many aspects of care delivery, beyond the scope of telehealth. The incorporation of telehealth education into dental curricula allows students to improve essential clinically relevant skills and knowledge beyond the procedural skills emphasized during in-person patient appointments.

Intervention to promote preventive dental care for older Korean-American Medi-Cal enrollees in Los Angeles.

BACKGROUND: In California, preventive dental care is covered by Medi-Cal (California's Medicaid program). However, many beneficiaries do not use their dental benefits. Given that a lack of knowledge about oral health and insurance coverage contributes to this underutilization, promoting the use of dental benefits among eligible individuals via an educational program is imperative. Responding to the particular needs of older immigrants with limited English proficiency, we developed a digital oral health intervention for older Korean-American Medi-Cal enrollees in Los Angeles. This educational intervention is designed to be delivered via computers and the Internet. It consists of a 15-min self-running PowerPoint presentation narrated in Korean with links to additional information on the Internet. The slides contain information about the basic etiology of oral diseases, oral hygiene, common myths about oral health and dental care, Medi-Cal coverage of preventive dental care, and how to find a dental clinic. METHODS: We pilot tested the intervention with 12 participants to examine its feasibility and acceptability. We also obtained participants' qualitative feedback about the intervention. RESULTS: A post-intervention quantitative assessment yielded high participant satisfaction and improved oral health and dental care knowledge. Participant responses to the intervention yielded four themes: (1) content and structure, (2) linguistic and cultural aspects, (3) delivery mode, and (4) additional concerns and suggestions. CONCLUSIONS: Our findings confirm the intervention's feasibility and acceptability and suggest further refinement.

Effectiveness of School-Based Oral Health Education for Children and Adolescents in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis.

The global burden of oral diseases is high, but access to oral health care is still problematic, especially in low- and middle-income countries. The prevention of oral diseases in the child and adolescent population is the key as it can be prevented and potentially reversed at its early stages. This study aimed to provide evidence on the effectiveness of school-based oral health education in low- and middle-income countries through a systematic review and meta-analysis. Eligible studies had outcomes, such as oral health knowledge, behavior, oral hygiene, gingival health, and caries index, and those published from 1995 to 2019 in English. After screening and reviewing the retrieved articles, 20 studies were included in the systematic review and six eligible studies were selected for meta-analysis. The computed effect size of school-based oral health education in low- and middle-income countries showed improved knowledge, behavior, oral hygiene, and gingival health from the selected studies. However, most of the interventions took place for less than one year, and long-term evidence is still lacking. As repetition and reinforcement are critical in maintaining long-term effects, both country context and sustainability should be considered in school-based oral health education.

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.

Evaluation of a virtual interprofessional oral-systemic health simulation experience in nursing, dentistry, medicine, and pharmacy education.

PURPOSE: The annual teaching oral-systemic health (TOSH) virtual clinical simulation and case study activity exposes interprofessional teams of nurse practitioner, nurse midwifery, dental, medical, and pharmacy students to a virtual clinical simulation experience that uses oral-systemic health as a clinical exemplar for promoting interprofessional core competencies. The present study examines changes in participating students' self-reported interprofessional competencies following participation in virtual TOSH from 2020 to 2022. These findings are also compared to those from in-person TOSH (2019) to examine the equivalence of student outcomes of both the in-person and virtual programs. METHODS: A pre- and post-test evaluation design was used to examine the effectiveness of exposure to the TOSH program on self-reported attainment of interprofessional competencies for participating students using the interprofessional collaborative competency attainment scale. RESULTS: Analysis of pre- and post-surveys demonstrated statistically significant improvement in students' self-rated interprofessional experience competencies following the virtual TOSH program, which aligns with results from the in-person cohorts. Similar findings between the in-person and virtual cohorts indicated no statistically significant difference between the two formats. CONCLUSION: These findings demonstrate the success of TOSH in promoting attainment of interprofessional competencies among future health professionals. We encourage administrators and faculty who lead health professional programs to take advantage of using virtual simulations as an integral component of interprofessional oral health clinical experiences where students from different health professions learn from and about each other in assessing and treating patients across the lifespan.