Pediatric oral health: community-based participatory research.

BACKGROUND: The most common chronic disease affecting children in Canada is dental caries. The objective of this study was to explore, identify, and address the strengths and barriers related to oral health services with an independent Indigenous community in Saskatchewan. METHODS: Community-based participatory research used interviews with Elders, health care providers, teachers, and parents/guardians of elementary school-aged children. The research focused on the development of genuine partnerships with the community. During data collection, the findings/results were returned to the community to establish direction, build success, and establish next steps. Thematic analysis was undertaken with the community. Descriptive statistics were analyzed using SPSS. RESULTS: The most commonly identified themes included: community resilience; the need for resource development and process to improve oral health literacy and skills; and how access to care barriers dually affected and related to personal and community cost, time, and human resources. CONCLUSIONS: The research process involved the co-creation of tools to identify strengths within the community and drive opportunities for change; subsequently generating solutions to the practical problems and potentially transform the health system accessed by the community.

Community led: celebrating wellness with a smile.

Dental caries is the most common chronic childhood disease in Canada and creates a significant burden on both human and financial costs. In Canada, the annual cost of dental day surgery for children is $21.2 million. The objective of this study was to explore and address the strengths and barriers related to the provision of oral health services in an Indigenous community in northern Saskatchewan. This community-based participatory research project focused on developing authentic relationships with the community. This research is novel because it is community-led and from the perspective of Indigenous people. Descriptive statistics were undertaken to describe the 38 participants. Semi-structured interviews were conducted with elders, healthcare providers, teachers and parents/guardians of elementary school-aged children; and inductive, thematic analysis was undertaken with the qualitative data. The most commonly identified themes included: community resilience, the need to improve oral health literacy and skills and the mitigation of barriers to access care. The research process included co-creating tools with the community that built upon strengths, creating opportunities for change, generated solutions and transforming the health system the community accessed.

Comparative Analysis of Geographic Accessibility of Dentists, Physiotherapists and Family Physicians in an Urban Centre: A Case Study of Saskatoon, Canada.

BACKGROUND: The spatial arrangement of primary health care (PHC) services is influenced by many factors and varies across provider types. In Canada, unlike physician services, certain PHC services (i.e., dentistry, physiotherapy) are not fully funded under the health care system. As a result, one might expect the arrangement of these services to differ by neighbourhood, even in dense metropolitan areas. OBJECTIVE: This study examines the intra-urban variability of geographic access to dental (DS) and physiotherapy (PT) services in relation to family physician (FP) services in an urban area and identifies underserviced neighbourhoods. METHODS: Practice location information was gathered from publicly available and routinely updated provincial sources (physician, physiotherapy and dentistry regulatory colleges). A neighbourhood accessibility score for all 3 PHC services was calculated using a GIS-based, 3-step floating catchment area method. A set of parameters, such as catchment type (road network buffer), size (3 km radius) and census centroids (dissemination areas), was used. RESULTS: The overall access scores for FP, PT and DS services (based on the 281 FPs, 226 PTs, and 152 DSs) were 1.45 (SD 0.94), 1.18 (SD 0.81) and 0.79 (SD 0.53) providers/1000 population, respectively. Spatial comparison of the accessibility scores indicated a greater proportion of the Saskatoon population has lower access scores (< 0.5/1000 population) for both physiotherapy (n = 79 450) and dental (n = 101 270) services compared with family physician services (n = 64 420). Exploration of the relation between PHC service arrangement and key sociodemographic variables (e.g. low income, education levels) showed that a considerable proportion of those in each sociodemographic group has poor PT and DS access. CONCLUSION: This research has identified accessibility gaps and serves to inform the development of health policies focused on equitable distribution and funding of PHC services based on population health needs.

Risk Determinants of Dental Caries and Oral Hygiene Status in 3-15 Year-Old Recent Immigrant and Refugee Children in Saskatchewan, Canada: A Pilot Study.

This study aimed to identify the risk determinants of caries and record oral hygiene status in recent immigrant and refugee children residing in Saskatoon and Regina, Saskatchewan, Canada. Convenience samples of 133, 3-15 year-old recent immigrant and refugee children, and 86 adult guardians were recruited. Clinical examination of children and survey of their guardians explored the presence of at least one decayed tooth in the child's mouth; and the knowledge, attitudes, behaviors, among other aspects in adult participants. Refugee children had statistically significant higher decayed, missing, filled teeth (DMFT) scores (mean dmft/DMFT score 5.80 ± 4.24) than immigrant children (mean dmft/DMFT score 3.52 ± 3.78 (p < 0.001). Adult immigrants had significantly higher proficiency in English language, knowledge about preventive components like fluoride and dental floss compared to refugee adults. The results of this study confirm the poorer state of oral health among refugee and immigrant children compared to Canadian children.

Efficacy of a solar-powered TiO2 semiconductor electric toothbrush on P. gingivalis biofilm.

PURPOSE: To determine the efficacy of a solar-powered TiO2 semiconductor electric toothbrush on Porphyromonas gingivalis biofilm. METHODS: P. gingivalis cells were cultivated on sterilized coverslips under anaerobic conditions and were used as a biofilm. To evaluate the efficacy of the solar-powered TiO2 electric toothbrush on the P. gingivalis biofilm, the bacterial cell biofilm coverslips were placed into sterilized phosphate buffered saline (PBS) and brushed for 1 minute. Following mechanical brushing, the coverslips were stained with 1% crystal violet (CV) for 10 seconds at room temperature. The efficacy of P. gingivalis biofilm removal by the solar-powered TiO2 electric toothbrush was measured through the absorbance of the CV-stained solution containing the removed biofilm at 595 nm. The antimicrobial effect of the solar-powered TiO2 semiconductor was evaluated by the P. gingivalis bacterial count in PBS by blacklight irradiation for 0 to 60 minutes at a distance of 7 cm. The electrical current though the solar-powered TiO2 semiconductor was measured by a digital multimeter. The biofilm removal by the solar-powered TiO2 semiconductor was also evaluated by scanning electron microscopy (SEM). RESULTS: The biofilm removal rate of the solar-powered TiO2 electric toothbrush was 90.1 ± 1.4%, which was 1.3-fold greater than that of non-solar-powered electric toothbrushes. The solar-powered TiO2 semiconductor significantly decreased P. gingivalis cells and biofilm microbial activity in a time-dependent manner (P< 0.01). The electrical current passing through the solar-powered TiO2 semiconductor was 70.5 ± 0.1 µA, which was a 27-fold higher intensity than the non-solar-powered brush. SEM analysis revealed that the solar-powered TiO2 semiconductor caused a biofilm disruption and that cytoplasmic contents were released from the microbial cells.

Influence of private practice employment of dental therapists in Saskatchewan on the future supply of dental therapists in Canada.

The profession of dental therapy has long been held up as a model for reducing access to care barriers in high-risk, underserved populations worldwide. Dental therapists practice in many countries delivering preventive and basic restorative care to children and adults. In North America, dental therapy education and practice date back to 1972 with the establishment of training programs at the National School of Dental Therapy in Fort Smith, Northwest Territories, and the Wascana Institute of Applied Arts and Science in Regina, Saskatchewan, as a means of reducing access to care barriers in Canada's northern territories and to implement the Saskatchewan Health Dental Plan, respectively. At present, dental therapy in North America has reached a crossroads: in the United States, the profession is cautiously being explored as a solution for improving access to care in at-risk populations. In 2011, Canada's sole training program, the National School of Dental Therapy in Prince Albert, Saskatchewan, closed when the federal government eliminated its funding. This article examines the impact of private practice employment of dental therapists in Saskatchewan on the supply of dental therapist human resources for health in Canada's three northern territories (Northwest Territories, Nunavut, and Yukon), its role in the closure of the National School of Dental Therapy in 2011, and ramifications for the future of dental therapy in Canada.