A mixed methods evaluation of the effectiveness of an oral health training program for disability care workers in Burkina Faso.

BACKGROUND: While efforts to improve the oral health of vulnerable populations have received little attention in general, the situation of children with disabilities in low- income countries (LICs) remains especially challenging. The present study evaluated the effectiveness of an oral health training provided to disability care workers in Ouagadougou, Burkina Faso thereby contributing to closing the knowledge gap in disability research in relation to oral health in LICs. METHODS: This was a single-arm pre-post study following an embedded mixed methods design using the New World Kirkpatrick training effectiveness evaluation model. For the purposes of this study, three levels of the Kirkpatrick (KP) evaluation were considered: reaction, learning and behaviour. RESULTS: A total of 44 care workers from 6 disability centres participated in the study. Care worker post-training scores (Md = 17) were significantly higher compared to pre-training scores (Md = 13) [Wilcoxon signed-ranks test: Z= -5.53, p < .001, r = .59.] The median value for care worker confidence in applying training material in their everyday job was 7 out of 10 points (IQR = 3). At the 1-month training follow-up, 3 centres had implemented daily toothbrushing for people with disabilities. CONCLUSION: These findings suggest that tailored training led to an increase in care worker confidence and motivation to implement oral health activities, in knowledge about oral health and a partial implementation uptake of daily toothbrushing in disability centres. Further long-term evaluations with dental care provision in rural and urban settings are needed to lower the high oral disease burden of people with disabilities in Burkina Faso.

Prevalence, Severity of Extension, and Risk Factors of Gingivitis in a 3-Month Pregnant Population: A Multicenter Cross-Sectional Study.

The scope of this study was to assess the prevalence, severity of extension, and risk factors of gingivitis among pregnant women. In this cross-sectional study, 220 nulliparous women at 3 months of pregnancy were recruited in 2022 at the first obstetrical visit in Dakar, Senegal. Demographic characteristics, lifestyle habits, prenatal clinical status, and oral clinical parameters were recorded. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. Eighty-eight percent of women had gingivitis, 15% were classified as moderate and 73% as severe. A total of 66.7% (95% CI [28.8-92.1]) of the sites had bleeding on interdental brushing. The odds for gingivitis decreased significantly for women consuming more than five portions of fruits and vegetables per day (OR = 0.15; 95% CI [0.03-0.66]) and increased in women who had a professional activity (OR = 6.75; 95% CI [1.27-35.87]) and high education. Concomitantly, the percentage of dental plaque (OR = 131.6; 95% CI [10.80-1619.71] and the severity of clinical attachment loss (OR = 7.70; 95% CI [3.16-18.92]) were important risk factors. Inverse associations were observed with increasing body mass index (OR = 0.76; 95% CI [0.63-0.93]). Our results underline that gingivitis cases and bleeding were particularly high among 3-month pregnant women. Literacy and adequate oral hygiene actions to modify behaviors and to achieve meticulous biofilm disorganization could make a favorable change in the gingival health outcome. Additionally, further research is necessary to precisely determine the role of biofilm-induced gingivitis and systemic-induced gingivitis in improving gingival conditions.

Evaluation of Oral Hygiene-Related Mobile Apps for Children in Sub-Saharan Africa.

In sub-Saharan Africa, oral health is a real epidemiological challenge. Mobile applications represent a hope for the learning of oral hygiene in children and the fight against oral diseases. This study overviews and assesses the quality of mobile applications linked to oral hygiene for children currently featured on the iOS and Android stores in sub-Saharan Africa. Ten oral health professionals (OHP) used the French Mobile App Rating Scale (MARS-F) to rate 15 selected applications. The highest MARS-F scores for overall quality were reported for Bonne nuit Caillou (3.89 ± 0.74), Mon Raccoon (3.63 ± 0.95), and Chomper Chums (3.54 ± 0.54) while the lowest MARS-F scores for overall quality were achieved by Brushing time (2.31 ± 0.61), De belles dents (2.55 ± 0.55) and Brushing Hero (2.77 ± 0.53). The subjective quality scores ranged from 1.50 ± 0.68 for Brushing time to 3.25 ± 0.97 for Bonne nuit Caillou. Specificity scores ranged from 1.95 ± 0.88 (Brushing time) to 3.75 ± 0.84 (Bonne nuit Caillou). Thus, OHP rated positively the quality of the majority of mobile applications linked to oral hygiene for children, their effect on users' knowledge, attitudes, and intentions to change, and the probability of effective oral hygiene behavior modification. They stated that they would recommend their use to their patients who need them. However, studies analyzing the change in oral hygiene behavior of children using these apps need to be conducted.

Effect of Oral Prophylactic Measures on the Occurrence of Pre-Eclampsia (OP-PE) in High-Risk Pregnant Women: A Cluster Randomized Controlled Trial.

Pre-eclampsia (PE), a pregnancy-specific hypertensive disorder, characterized by the development of placental endothelial dysfunction, remains a major source of maternal and perinatal morbidity and mortality, especially in low- and middle-income settings. Periodontal disorders during pregnancy, and particularly periodontal pathogens, may be related to the risk of PE. Standard oral hygiene methods, based mainly on the joint use of toothbrushes and interdental brushes, reduce periodontal inflammatory risk and modulate the dysbiosis of the oral microbiome. The aim of this trial is to compare the PE outcomes in high-risk pregnant women receiving oral prophylactic measures to a control group. This trial is designed as a two-arm, parallel, cluster randomized controlled trial with the antenatal obstetric clinic as the unit of randomization and an allocation ratio of 1:1. The pregnant women will be included at 3 months of pregnancy and will be followed throughout the pregnancy. The primary outcome measure will be the incidence of PE from a baseline during the pregnancy. Secondary outcomes measures will include changes from the baseline in quantification of the pathogenic bacterial load of the interdental microbiota, the severity scores of periodontal indicators, and the incidence of adverse perinatal outcomes. This trial should demonstrate that the implementation of daily oral hygiene reduces oral dysbiosis, the incidence of periodontal disease, and the risk of PE.

Periodontal Conditions and Pathogens Associated with Pre-Eclampsia: A Scoping Review.

BACKGROUND: Pre-eclampsia, the second most frequent direct source of maternal mortality, is a multisystem gestational disorder characterized by proteinuria and maternal hypertension after the 20th gestational week. Although the causes of pre-eclampsia are still discussed, research has suggested that the placenta has a central place in the pathogenesis of this disease. Moreover, current surveys indicated that periodontal disorders observed during the pregnancy and more particularly, periodontal pathogens could be link to the risk of pre-eclampsia. OBJECTIVES: This article aims to review recent studies focusing on periodontal conditions and pathogens associated with pre-eclampsia. METHODS: The process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. RESULTS: Metabolic conditions, immunological changes, fluctuating progesterone and estrogen levels of the pregnant woman induce a dysbiosis of the oral microbiota and contribute to increase inflammation of periodontal tissues. Periodontal pathogens could diffuse through the bloodstream inducing a placenta inflammatory response as well as inflammatory molecules produced in response to periodontopathogens could migrate through the bloodstream leading to a placenta inflammatory response. Also, periodontopathogens can colonize the vaginal microbiota through the gastrointestinal tract or during oro-genital contacts. CONCLUSION: A cumulative bi-directional relationship between periodontal conditions, pathogens and the pre-eclampsia exists.

Facteurs déterminants la prévalence de la carie dentaire chez les patients consultant au service d'odontologie du centre hospitalier régional de Tenkodogo, Burkina Faso

La carie dentaire est une maladie universelle répandue à travers le monde depuis des millénaires. C'est une maladie multifactorielle non transmissible évitable. Afin de réduire son impact, la présente étude a eu pour objectif de rechercher les facteurs déterminant la prévalence de la carie dentaire au service d'odontologie du Centre Hospitalier Régional (CHR) de Tenkodogo au Burkina Faso. Méthodologie. Il s'est agi d'une étude transversale descriptive qui s'est déroulée du 11 mars au 11 avril 2015. Un guide d'entretien individuel adressé aux patients a servi à la collecte des données. Le profil socio-économique, le niveau de connaissance sur l'hygiène bucco-dentaire, les pratiques en matière d'hygiène buccale, le mode alimentaire et le niveau de connaissance sur la carie dentaire ont été les variables recueillies. Résultats. Cent quarante patients dont 62,1 % de sexe féminin ont participé à l'étude. L'âge moyen était de 33,1 ans. La prévalence carieuse était de 97,1 % avec un indice DCAO moyen de 3,68 %. Un tiers des patients avait un niveau de connaissance suffisant sur l'hygiène buccale. La consommation quotidienne d'aliments sucrés était retrouvée chez 69,3 % et la pratique du grignotage chez 62,1%. La douleur était le motif de première consultation (57,1%). La visite préventive au cabinet dentaire était méconnue par 93,6 % des patients. Conclusion. Les résultats ont montré une insuffisance de connaissance de la maladie carieuse. Seule la sensibilisation pourrait aider à la réduction de la prévalence de la carie au sein de la communauté