Cost-effectiveness and cost-benefit analyses of fluoride varnish for caries prevention in Guangxi, China.

OBJECTIVES: The objectives of this study were to evaluate the cost-effectiveness and cost-benefit of fluoride varnish (FV) interventions for preventing caries in the first permanent molars (FPMs) among children in rural areas in Guangxi, China. METHODS: This study constituted a secondary analysis of data from a randomised controlled trial, analysed from a social perspective. A total of 1,335 children aged 6-8 years in remote rural areas of Guangxi were enrolled in this three-year follow-up controlled study. Children in the experimental group (EG) and the control group (CG) received oral health education and were provided with a toothbrush and toothpaste once every six months. Additionally, FV was applied in the EG. A decision tree model was developed, and single-factor and probabilistic sensitivity analyses were conducted. RESULTS: After three years of intervention, the prevalence of caries in the EG was 50.85%, with an average decayed, missing, and filled teeth (DMFT) index score of 1.12, and that in the CG was 59.04%, with a DMFT index score of 1.36. The total cost of caries intervention and postcaries treatment was 42,719.55 USD for the EG and 46,622.13 USD for the CG. The incremental cost-effectiveness ratio (ICER) of the EG was 25.36 USD per caries prevented, and the cost-benefit ratio (CBR) was 1.74 USD benefits per 1 USD cost. The results of the sensitivity analyses showed that the increase in the average DMFT index score was the largest variable affecting the ICER and CBR. CONCLUSIONS: Compared to oral health education alone, a comprehensive intervention combining FV application with oral health education is more cost-effective and beneficial for preventing caries in the FPMs of children living in economically disadvantaged rural areas. These findings could provide a basis for policy-making and clinical choices to improve children's oral health.

[Comfortable initial periodontal therapy: step by step].

With the transition of the medical model from the traditional biomedical model to the biopsychosocial one, there is a growing trend and requirement for oral operations that prioritize comfort, pain management, minimally invasive techniques, and visualization. Consequently, demands for comfortable dental treatments among individuals are increasing. However, initial periodontal therapy is often accompanied by pain, and patients' reactions to pain range from nervousness to dental fear, such as irritability, hyperventilation, even nausea, vomiting, and refusal to cooperate, which make the implementation of initial periodontal therapy difficult or even impossible. This article will focus on three key steps: firstly, the preparation of the clinic, the acquisition of patients' trust and the implementation of preventive sedation before treatment; secondly, the use of comfort operation and nursing, psychological intervention measures, local anesthesia, and sedation techniques during treatment; thirdly, the health education and follow-up after treatment. By addressing these aspects, we aim to clarify how to perform comfortable initial periodontal therapy step by step.

O-HEALTH-EDU: A viewpoint into the current state of Oral Health Professional education in Europe: Part 1: Programme-level data.

INTRODUCTION: Current legislation leaves Oral Health Professional (OHP) education open to wide interpretation and may result in significant variation in educational practice and resultant professional attributes across Europe. Data regarding the current state of OHP education across Europe is limited. The aim of Part 1 of this series is to provide programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education. METHODS: A 91-item questionnaire was developed following the Delphi method. The questionnaire and the Articulate glossary of OHP education terms were developed concurrently to facilitate a common understanding of language. Piloting was performed in multiple stages and included institutions internal and external to the research group. The questionnaire was uploaded online and converted to a data hub, allowing dental schools to control their own data and update the data provided whenever they wish. All ADEE member schools (n = 144) were invited to provide data. Forty questions relating to school details, Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education were included in this part of the series. RESULTS: Seventy-one institutions from 25 European countries provided data between June 2021 and April 2023, which represents a response rate of 49.3% of ADEE members. Programme-level data for Primary Dental Degree Programmes, Dental Hygiene and Postgraduate Education is presented including programme length, funding, languages and fees, student numbers and demographics, student admission and selection processes and permission to practice after graduation. CONCLUSION: This series of papers, as far as the authors are aware, are the first attempts to build a comprehensive picture of the current state of OHP education in Europe. A comprehensive view of the state of OHP education in Europe is not yet available but the O-Health-Edu data hub provides a means for all education providers in Europe to contribute data to reach this goal. It is anticipated that the data hub will be updated and built upon over time to continually establish a clearer picture of the state of OHP education in Europe.

Effectiveness of theory-based educational interventions of promoting oral health among elementary school students.

BACKGROUND: The aim of the present study was to determine the effect of oral health education programs on the oral health of primary school students. METHODS: In this randomized controlled trial study, 190 elementary fifth-grade female students were chosen using the multistage cluster sampling method. In this study, the Plaque Index (PI), Simplified Oral Hygiene Index (OHI-S), Community Periodontal Index (CPI), tooth brushing using fluoride toothpaste, dental flossing frequency and factors affecting them were determined according to social cognitive theory (SCT). Interventions were implemented using the play method and with the help of three pamphlets, five posters, a celebration of oral health, and the creation of a Telegram group. Data were analyzed using descriptive statistics indexes, t tests, paired sample t tests, chi-square tests, and Pearson correlation tests. RESULTS: The results showed that 3 months after the intervention, compared to before the intervention, the percentage of participants in the intervention group who brushed their teeth twice or more per day increased by 48.5%, and the percentage of participants who used dental floss at least once per day increased by 64.2%. The rate of gum bleeding decreased by 6.3%. The good OHI-S rate increased by 44.4%. Dental plaque decreased by 38.1%. CONCLUSION: The results demonstrated that a gamification design can be effective and useful in promoting the oral health of students. TRIAL REGISTRATION: registration timing: retrospective, registration date: 18/10/2022, registration number: IRCT20141128020129N2.

The impact of school-based social media and online technology on oral health education for individuals with disability.

AIM: To evaluate the impact of school-based online communication methods on the oral health-related behavirs of individuals with disability. METHOD: A prospective interventional study was conducted on 154 students (age 3-22 years) with various disabilities attending educational centers. A clinical examination was carried out before and after a school-based online educational program. Online in-person sessions were held for the participants, and educational videos were shared with parents and teachers over social media. The clinical examination included the Special Olympics HAS form, (1) Oral Hygiene Index-Simplified (OHI-S) (2) and the Modified Frankl Behavior Index. (3) Dietary and oral hygiene habits were collected via parent-administered questionnaires. RESULTS: Improvements in behavior in a dental setting (p < .001), oral hygiene levels (p < .001) and dietary choices (p < .001) were observed throughout the study. CONCLUSION: Oral health education online modalities can be used effectively by dental professionals to educate individuals with disabilities and their carers regularly, thus helping improve oral health and rapport with dental professionals.

Evaluating an oral health education program for Korean soldiers during the COVID-19 era: Applying quantitative light-induced fluorescent technology-A pilot study.

PURPOSE: This study aimed to provide a basis for the development of a remote oral health education program for soldiers enlisted during the COVID-19 era(August-September 2021) by conducting oral health education using quantitative light-induced fluorescent technology and then comparing Quigley-Hein Plaque Index (QHPI) and oral health knowledge, awareness, and behavior. METHODS: Thirty soldiers serving in a military hospital in South Korea were classified into two groups using simple random sampling. The experimental group implemented oral health education and self-managed using quantitative light-induced fluorescent technology, whereas the control group implemented oral health education alone. It was performed for 8 weeks at 2-week intervals. Thereafter, oral health knowledge, awareness, and behavior were surveyed, and QHPI was measured. Changes between and within groups over time were analyzed. RESULTS: QHPI was statistically significantly reduced in the experimental group over time. Oral health knowledge, awareness, and behavior scores were higher in the experimental group than in the control group, with statistically significant differences. Oral health education considering the characteristics of soldiers, who utilized quantitative light-induced fluorescent technology, was shown to be effective, and this effect requires further research through a longitudinal study. CONCLUSION: This study demonstrated that oral health education based on quantitative light-induced fluorescent technology should be a useful tool for improving the oral hygiene status, oral health knowledge, awareness, and behavior of Korean soldiers.

Effectiveness of various methods of educating children and adolescents for the maintenance of oral health: A systematic review of randomized controlled trials.

BACKGROUND: School-based oral health education has emerged as one of the most effective methods to instill a positive attitude toward oral health in children. AIM: This systematic review (SR) aimed to assess the effectiveness of different methods of oral health education in children and adolescents. DESIGN: Systematic search was conducted in PubMed, Cochrane, Web of Science, LILACS, Scopus, and EMBASE on January 29, 2023. Review included only randomized controlled trials (RCTs), and their risk of bias (ROB) was assessed by Cochrane RoB-2. Data were extracted and analyzed by expert group. The GRADE approach was used to assess the quality of evidence for each outcome. Every step was conducted in duplicate, and disagreements were resolved by consulting the third reviewer. RESULTS: The SR included 10 RCTs with majority showing a high ROB. They included 12 methods with the commonest being the use of leaflets/flash cards. Most interventions were effective in improving oral hygiene, gingival health, and knowledge except conventional teaching methods, lecture by using PowerPoint by dentists, and e-learning interventions. The grade of evidence in the majority of outcomes was found to be low or very low. CONCLUSION: Interventions using the interactive methods such as games, motivational-experiential learning, and audiovisual methods were found to be more effective than controls and other interventions. Variabilities in study methods and outcome variables must be addressed in the future.

Implementation of oral hygiene practices in nursing homes - a qualitative approach among supervisor nurses.

OBJECTIVES: This study describes daily oral health care in private enhanced service housing units and nursing homes in Finland using a qualitative method. METHODS: Nineteen supervisor nurses were interviewed in the six largest cities in Finland. The interviews consisted of semi-structured questions. The interviews were then transcribed and analyzed using inductive content analysis. RESULTS: The qualitative content analysis revealed five main categories: diet, education in the oral health of older people, oral care equipment and taking care of them, caring for the mouths of residents, and professional oral health care. The results revealed that sugary snacks were given daily in the units and there was a need for oral health care education. The dental equipment of residents was taken care of well and the oral health of the residents was taken care of moderately well. Furthermore, there was a need for co-operation between dental professionals and only half of the residents had an individual oral care plan. CONCLUSIONS: It can be concluded that based on this qualitative study, the implementation of daily oral health care in most nursing homes and enhanced housing units seems to be at a sufficient level and more oral health-related practical and theoretical education is needed.

Knowledge and Awareness of Emergency Medical Physicians on the Management of Traumatic Dental Avulsion at Sultan Qaboos University Hospital.

Objectives: This study aimed to assess the level of knowledge regarding traumatic dental avulsion management among emergency physicians at Sultan Qaboos University Hospital (SQUH), Muscat, Oman. Methods: This cross-sectional, survey-based observational study was conducted among emergency physicians at SQUH from August 2021 to October 2021. The data were collected through a standardised and validated questionnaire. Fisher's exact test and Mann-Whitney U tests were used to analyse the data. Results: A total of 18 completed questionnaire forms were received (response rate: 72.0%). The data revealed that 66.7% of the participants had prior knowledge of avulsion management, and 50% had received education on dental trauma. However, 83.0% of the participants did not feel comfortable replanting an avulsed tooth themselves. Regarding their knowledge level, 45.0% of the participating physicians demonstrated low knowledge, 22.2% demonstrated moderate knowledge and 33.3% demonstrated high knowledge. Thus, 94.0% of the participants were interested in acquiring information about avulsion management. Conclusion: The level of knowledge was significantly associated with receiving dental education and a higher clinical grade. As a result, it is crucial to include information about avulsion and its management in both medical undergraduate and post-graduate curricula.

The combined effect of pit and fissure sealant application and oral health education on oral health status of children aged 6-9 years: a 12-month follow-up study in Northeast China.

BACKGROUND: Children aged 6-9 years are vulnerable to dental caries due to age-related limitations and a lack of adequate knowledge regarding oral health and hygiene practices. This study aimed to establish a cohort of children aged between 6 and 9 years and conducted a 12-month follow-up to examine the combined effect of pit and fissure sealant (PFS) application and oral health education on their oral health status. METHODS: A cohort study with 12-month follow-up was conducted in Liaoning province, China. A multi-stage stratified cluster sampling approach was employed in the study. The enrolled 6- to 9-year-old children were all from the selected primary schools, who had resided in the designated area for at least 6 months. Children who were unable to cooperate with the examiner or without informed consent from their guardians were excluded. Experienced dental professionals examined the oral health status of primary school children aged 6-9 years. All children and their guardians were mandated to complete a questionnaire (qualitative data) at the beginning of the study. In the experiment group, children underwent PFS application and chairside oral health education. Clinical examinations and questionnaire surveys were repeated at the 12-month follow-up. The chi-square test and binary logistic regression were conducted to investigate the potential risk factors associated with dental caries prevalence (dependent variable). Independent variables were items from the questionnaire (such as living place, parents' education level and children' birth weight). The significant variables identified in the chi-square tests were subsequently included in the binary logistic regression analysis. RESULTS: A total of 4,085 children aged 6-9 years were included in the study, with 1805 participants assigned to the experiment group and 2280 to the control group. At baseline, the caries rates of the experimental and control group were 77.95% and 80.35%, respectively without any statistically significant differences. However, at the 12-month follow-up, the caries rate in the experimental group (83.65%) was significantly lower than that in the control group (86.62%) (P < 0.05). The results from the binary logistic regression analysis indicated that parents with a college degree and children in the experimental group exhibited lower caries rates. Conversely, higher caries rates were associated with the consumption of sweet beverages and foods more than once a day and a lack of knowledge regarding the causes of caries (P < 0.05). CONCLUSIONS: In Liaoning, China, children aged 6 to 9 years exhibited a high prevalence of dental caries. Several factors, including the parent's education level, the frequency of consuming sweet beverages and foods, and the children's understanding of the cause of caries, significantly affected the caries prevalence rates. The implementation of PFS application and oral health education effectively reduce the caries rate among the surveyed children.

A proposal for an oral health educational programme for the first 1000 days of life: from pregnancy to childhood.

AIM: The aim of this paper is to highlight the need to consider oral health during the first 1000 days of a child's life with a view to developing appropriate educational programmes. CONTEXT: The first 1000 days of life represent a window of opportunity for prevention in children. This concept is built on a consideration of the overall health of mother and child, taking into account social inequalities in health. It is now established that the oral health of the mother determines the oral health of her child. Furthermore, parents' knowledge and behaviour have a direct influence on their child's health. CONCLUSION: The majority of the population does not have the necessary skills to adopt behaviours that promote oral health. The need for oral health education begins in the first 1000 days of life. Following the model of family health education, these programmes would involve providing pregnant women and, therefore, families with the skills they need to manage their own oral health and that of their future child as early as possible.

Assessing effectiveness of braille and audio-tactile performance technique in improving oral hygiene status of young adults with visual impairment.

INTRODUCTION: Young adults with Visual impairment (VI) challenge the dentists' skills and knowledge due to a higher risk of developing oral diseases due to difficulty in attaining good oral hygiene (OH). AIMS: To assess the effectiveness of ATP (Audio-Tactile Performance) technique and braille versus braille alone in improving OH status of young adults with VI. METHODS AND MATERIAL: A parallel arm, randomized controlled trial was conducted among 70 young adults with VI. Participants were randomly allocated to either test group (braille combined with ATP) or control group (braille alone). A pre-validated braille questionnaire was used to obtain the baseline data followed by clinical examination. OH status assessment was recorded through Gingival Index (GI) and Plaque Index (PI) proforma followed by a thorough ultrasonic oral prophylaxis. Periodic reinforcement was carried out on the 7th day, after 1 month and 3 months. The outcomes were assessed at the end of 3rd and 6th month. RESULTS: There was an increase in the knowledge scores after 3 and 6 months and attitude scores, GI scores and PI scores after 6 months in the test group compared to the control group and this difference was found to be statistically significant. CONCLUSIONS: The findings of this study showed that a combination of ATP and braille proved to be more effective than braille alone in improving the knowledge and OH status of young adults with VI.

Comparative evaluation of "Tell-Tell-Tell," "Ask-Tell-Ask," and "Teach back" communication techniques on oral health education among 12-13-year-old children - An educational intervention trial.

Background: Effective communication with children can improve their understanding and aid in complying with oral hygiene instructions. Aim: The aim is to compare the retentiveness of oral hygiene instructions in children educated using three communication techniques. Methodology: One hundred and twenty children in the age range of 12-13 years were included in the study. Baseline awareness of oral hygiene maintenance was assessed using a questionnaire. Twenty children were randomly assigned to each group: Tell-Tell-Tell, Ask-Tell-Ask, Teach-back, and information provided. Knowledge was reassessed after a week; data were tabulated and assessed statistically. Results: There were no statistically significant differences in the baseline data among the groups (P > 0.05). Regardless of the group, there was an improvement in knowledge regarding the frequency and timing of brushing as well as the cause of dental caries after the intervention. However, children in Ask-Tell-Ask and Teach back showed significant improvement over Tell-Tell-Tell (P ≤ 0.01). Conclusion: Communication strategies, such as Ask-Tell-Ask and Teach back, which have a strategy to involve children, have been shown to be superior over Tell-Tell-Tell.

Integration of Oral Health Screening, Intervention, and Referral Into the Pediatric Well-Child Visit.

INTRODUCTION: Parents of children usually understand the importance of getting primary care pediatric well-child checkups during certain stages of childhood, yet few know the importance of early routine dental visits to proactively incorporate good oral hygiene and relate the connection of oral care to overall systemic physical health. The purpose was to determine the impact of integrating oral health screening, intervention, and referral into the pediatric well-child visit. METHOD: Children (aged 0-18 years) received oral health screening, oral photographs, fluoride varnish, oral health education, and referral during well-child visits. RESULTS: Forty-two percent of our population had never had a dental examination. Fifty-eight percent had no established dental home, and 73% drank sugar-sweetened beverages weekly. DISCUSSION: The overall impact of this model was providing comprehensive oral health care to children who have never been to the dentist and providing a smooth transition between medical and dental, increasing access to care.

Evaluation of oral health education programs for oral health of individuals with visual impairment: An umbrella review.

AIM: To exemplify, summarize and critically appraise the systematic reviews (SRs) that evaluated different oral health education (OHE) interventions in individuals with visual impairment (VI). METHODOLOGY: Six electronic databases were searched for SRs evaluating OHE programs in individuals with VI. The internal validity of the included SRs was evaluated using the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2) tool. The degree of overlap of the primary studies in the included SRs was calculated using the "corrected covered area (CCA)" approach. RESULTS: Seven SRs were included in this umbrella review that included 30 primary studies with a CCA of 26% (very high overlap). Six of the included SRs were assessed to have critically low confidence in the results, whereas only one had moderate confidence. CONCLUSIONS: A combination of various OHE methods for individuals with VI might be better than using one method alone to improve oral hygiene. There is no conclusive evidence that one OHE method is superior to others. However, the evidence of OHE in improving the outcomes related to dental trauma or caries is inconclusive. Furthermore, it appears that most of the evaluations of oral health programs come from limited parts of the world, and data from many other regions is lacking.

Efectividad del programa educativo "Sonrisas desde el vientre". Hogar Materno Isabel María de Valdivia en Sancti Spíritus / Effectiveness of the educational program " Smiles from the womb". Isabel María de Valdivia Maternity Home in Sancti Spíritus

Fundamentación: En el período de gestación el organismo de la mujer sufre modificaciones, transformaciones fisiológicas y psicológicas, además de cambios en los tejidos bucales y cambios de conducta que pueden iniciar enfermedades bucodentales o agravar las ya establecidas. Objetivo: Evaluar la efectividad del programa educativo "Sonrisas desde el vientre" en embarazadas del Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Metodología: Se realizó un estudio preexperimental, con diseño antes y después en el período de enero a junio del 2022, la población estuvo constituida por 20 embarazadas ingresadas en el Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Se utilizaron métodos del nivel teórico, empírico (encuesta) y estadísticos. Se midió la variable conocimiento sobre salud bucodental. Resultados: Los conocimientos antes de la aplicación de programa educativo eran insuficientes (65 %), después de aplicado el programa educativo el 75 % de las embarazadas presentó conocimientos suficientes. Conclusiones: Al culminar la implementación del programa educativo "Sonrisas desde el vientre", se logró un nivel de conocimiento suficiente sobre salud bucodental en la tercera parte de las embarazadas de este hogar materno.

Background: During pregnancy, the women's body goes through many changes, physiological and psychological transformations, as well as changes in the oral cavity tissues and behavioral changes that may initiate oral diseases or aggravate the stablished ones. Objective: To evaluate the effectiveness of the educational program "Smile from the Womb" among pregnant women at the Isabel María de Valdivia Maternity Home in Sancti Spíritus. Methodology: A pre-experimental study with a before and after design was conducted from January to June 2022, the population consisted of 20 pregnant women hospitalized at Isabel María de Valdivia Maternity Home in Sancti Spíritus. Theoretical, empirical (survey) and statistical methods were used. The variable oral health knowledge was measured. Results: Before applying the educational program the knowledge was insufficient (65%), after applying the educational program 75% of pregnant women showed sufficient knowledge. Conclusions: By the end of the "Smile from the Womb" educational program, one third of the pregnant women in this maternity home had achieved a sufficient level of knowledge about oral and dental health.

Efectividad del programa educativo “Sonrisas desde el vientre”. Hogar Materno Isabel María de Valdivia en Sancti Spíritus / Effectiveness of the educational program "Smiles from the womb". Isabel María de Valdivia Maternity Home in Sancti Spíritus

Fundamentación:En el período de gestación el organismo de la mujer sufre modificaciones, transformaciones fisiológicas y psicológicas, además de cambios en los tejidos bucales y cambios de conducta que pueden iniciar enfermedades bucodentales o agravar las ya establecidas.Objetivo:Evaluar la efectividad del programa educativo “Sonrisas desde el vientre” en embarazadas del Hogar Materno Isabel María de Valdivia en Sancti Spíritus.Metodología:Se realizó un estudio preexperimental, con diseño antes y después en el período de enero a junio del 2022, la población estuvo constituida por 20 embarazadas ingresadas en el Hogar Materno Isabel María de Valdivia en Sancti Spíritus. Se utilizaron métodos del nivel teórico, empírico (encuesta) y estadísticos. Se midió la variable conocimiento sobre salud bucodental.Resultados:Los conocimientos antes de la aplicación de programa educativo eran insuficientes (65 porciento), después de aplicado el programa educativo el 75 porciento de las embarazadas presentó conocimientos suficientes.Conclusiones:Al culminar la implementación del programa educativo “Sonrisas desde el vientre”, se logró un nivel de conocimiento suficiente sobre salud bucodental en la tercera parte de las embarazadas de este hogar materno.[AU]