Oral Health Education for Children: Development of a Serious Game with a User-Centered Design Approach.

Background: Children can learn efficiently with well-designed serious games. The use of applications to promote health has proliferated, but there is a lack of scientific studies on educational games in oral health. Materials and Methods: We developed the Brazilian version of a British and Jordanian oral health education game for children from the perspectives of Brazilian specialists and users. This descriptive study, with a qualitative and quantitative approach, comprised three phases: I-Experts' discussion of the appropriateness of the previous version of the game to Brazil; II-Development of the first Brazilian version of the game; and III-Evaluation of the first version with 15 children from 4 to 8 years of age. Results: In Phase I, the specialists agreed with the development of the Brazilian version of the game, with minor adjustments on: advice on eating; advice on oral hygiene habits, users' age group, game characters, and game purpose. Phase II: a version with a few changes in images and recommendations, written and spoken in Brazilian Portuguese. Phase III: The global average of correct answers in the game's tasks was 75.3%, ranging from 50.0% to 100%. Children reported having fun with the game, and most understood the content and its interface; their parents found the information relevant and enjoyed the gameplay with their children. Conclusions: The Oral Health Education Game offered basic information for preventing dental caries to Brazilian children aged 4-8 years old in an interactive and fun way; it could support professionals in improving oral health education.

Periodontal health literacy in Germany-Results of a telephone survey.

OBJECTIVE: Assess the periodontal health literacy of German adolescents, adults and senior residents. BACKGROUND: The prevalence of periodontitis is high. One explanation for this may be that people lack periodontal health literacy (PHL). METHODS: This was a cross-sectional descriptive study. Former participants of the 5th German Oral Health Study (n = 333 16-year-olds, n = 307 39-48-year-olds, n = 332 69-78-year-olds) participated in a computer-assisted telephone interview. Open-ended questions (OEQs) were used to assess the participants' current knowledge. Corresponding single- and multiple-choice questions (SCQs and MCQs) supplemented the OEQs to allow detailed analyses of the nature of the knowledge gaps. RESULTS: Less than 10% of the participants in the three age groups could explain the term 'periodontitis' or select the correct answer in an SCQ. Responding to the OEQs, 89% of 16-year olds, 64% of 39-48-year-olds, and 59% of 69-78-year-olds, could not name any consequence of periodontitis, and 83%, 51%, and 60%, respectively, could not name any risk factors. The OEQs regarding proper oral hygiene behaviour revealed that participants lacked awareness regarding important aspects of oral hygiene (e.g., systematics) or areas to which they should pay attention to (e.g., interdental spaces and gingival margins). CONCLUSIONS: The survey revealed PHL deficits in German adolescents, adults, and seniors and a need for community-based measures to improve PHL in all age groups. Dental teams should be aware that their patients might lack the PHL necessary for understanding and adherence to professional dental advice, and that they might even lack PHL regarding the proper use of oral hygiene devices.

Exploring Malaysian schoolchildren's perception of the advantages and disadvantages of the ToothPoly board game: a qualitative study.

The effectiveness of children's oral health education (OHE) is determined by the appropriateness of the educational materials used, which can influence their attitude towards oral health. However, there is a lack of studies exploring the benefits of OHE materials from the perspective of schoolchildren. This study aimed to explore schoolchildren's opinions on the newly developed ToothPoly board game as an OHE tool. A qualitative approach using focus group discussions (FGDs) was conducted among 44 schoolchildren aged 12 years old from a public school in Malaysia. Convenience sampling was employed to recruit the schoolchildren. The ToothPoly board game was playtested and FGDs were conducted after the playtesting session ended. Data collection and analyses were performed concurrently until data saturation was reached. The data were transcribed and coded using Atlas.Ti software version 9.1.3 followed by the framework method analysis. Mixed opinions were observed among the schoolchildren with a majority expressing favourable opinions on the advantages of the ToothPoly board game as an OHE tool. Five themes emerged from the advantages aspect, i.e., fun and enjoyable, promote focus, attention and oral health-related learning, attractive board game features, and enhance peer interaction. Meanwhile, two themes emerged that were related to the disadvantages of the board game, i.e., "competition with online games and media" and "not practical for a large group activity". The findings showed that the ToothPoly board game was perceived as a useful, interactive, and enjoyable tool to learn about oral health in small groups. The findings of the study highlight the importance of tailoring OHE activities to fulfil the needs of specific target groups to ensure its acceptance and future success.

Dutch dental hygiene students' knowledge of HPV-related oropharyngeal squamous cell carcinoma and HPV vaccination.

INTRODUCTION: The incidence of human papillomavirus (HPV)-related oropharyngeal cancer is rising, thus the understanding of HPV infection and vaccination among oral healthcare professionals is becoming increasingly important. This study aimed to investigate the knowledge of Dutch dental hygiene students on HPV infection and vaccination and assessed various aspects of HPV-related oropharyngeal cancer. METHODS: This descriptive cross-sectional study invited the entire Dutch dental hygiene student population registered in September 2016 to complete an online questionnaire concerning the knowledge of HPV infection and vaccination, including the aspects of HPV-related Oro-Pharyngeal Squamous Cell Carcinoma (OPSCC). Data were analysed using t-tests, Mann-Whitney U tests and Chi-square tests. RESULTS: Invited were all 1248 Dutch dental hygiene students and 232 (18.6%) students completed the questionnaire. More than 95% of the students indicated HPV infection as a risk factor for OPSCC and 48.7% was aware of the availability of HPV vaccination. Additionally, students considered it important to discuss HPV as a risk factor for oropharyngeal cancer with their patients. In general, the students scored highest on the questions about risk factors for OPSCC and poorest on the questions about general HPV knowledge and HPV vaccination. Although the mean overall knowledge score was significantly higher in senior compared with junior students, knowledge scores of senior students remained insufficient. CONCLUSION: This study identified deficits in knowledge of HPV and HPV vaccination among Dutch dental hygiene students. Future research should focus on improving the content of dental hygiene curricula and development of ongoing educational tools for dental hygienists.

Intervención interdisciplinaria para la prevención primaria de la caries en lactantes de 0 a 18 meses / Interdisciplinary intervention for the primary prevention of dental caries in children under 18 months

Introducción: la caries es la enfermedad crónica más frecuente en la infancia. La presencia de caries en la dentición temporal es el principal factor de riesgo para desarrollar caries en la dentición definitiva. La mayoría de los factores de riesgo de la caries son modificables y pueden convertirse en elementos para la prevención y control de la enfermedad. Con el objetivo de reducir la incidencia de caries a la edad de 18 meses se diseña una intervención interdisciplinaria de prevención primaria dirigida a familias con niños que se visitan siguiendo el Protocol d’activitats preventives i de promoció de la salut a l’edat pediátrica (PAPPS). Material y métodos: ensayo clínico no aleatorizado, realizado en dos centros de asistencia primaria de Catalunya desde enero de 2019 hasta junio de 2022. En uno de los centros se diseñó e implementó una intervención educativa de prevención primaria de la caries con consejos y habilidades para las familias. En el otro centro se mantuvo el protocolo habitual de recomendaciones. Se evaluó y comparó la incidencia de caries en ambos grupos a la edad de 18 meses con un modelo de regresión logística estimado con el programa R. Resultados: la incidencia de caries a los 18 meses fue superior en los niños del grupo control (OR = 6,0; IC 95% 1,8-20,2), a pesar de que la valoración del riesgo de caries basada en el sistema llamado Caries Management by Risk Assessment (CAMBRA) indicó mayor riesgo de desarrollo de caries en los lactantes del grupo intervención. Conclusión: la intervención interdisciplinaria de prevención primaria de la caries incorporada en los programas de salud infantil reduce la incidencia de caries en los primeros años de vida. (AU)

Introduction: caries is the most common chronic disease in childhood. The presence of caries in the primary dentition is the main risk factor for developing caries in the permanent dentition. Most of the risk factors for caries are modifiable and can become elements for the prevention and control of the disease. With the goal of reducing the incidence of caries in children at age 18 months, we designed an interdisciplinary primary prevention intervention aimed at families with children who attended routine preventive visits within the PAPPS (“Protocol d’activitats preventives i de promoció de la salut a l’edat pediàtrica”) child health programme. Methodology: non-randomized clinical trial carried out in two primary care centres in Catalonia between January 2019 and June 2022. In one of the centres, an educational intervention for the primary prevention of caries was designed and implemented to provide families with guidance and skills. In the other centre, patients received standard care. The incidence of caries was assessed and compared in both groups at age 18 months by means of a logistic regression model fitted with the R software. Results: the incidence of caries at 18 months was higher in children in the control group (OR=6.0; 95% CI: 1.8-20.2), despite the fact that the caries risk assessment by means of the “Caries Management by Risk Assessment” (CAMBRA) protocol indicated a higher risk of caries in infants in the intervention group. Conclusion: the interdisciplinary primary caries prevention intervention integrated into the child health prevention and promotion programme achieved a reduction in the incidence of caries in early childhood. (AU)

A mobile augmented reality-integrated oral health education for community dwelling older adults: A pilot study.

Background/purpose: Providing oral healthcare education can be an optimal strategy for imparting knowledge and developing self-care skills for older adults to enhance their oral health conditions. However, traditional passive lecture-based education programs have several limitations. Integrating mobile augmented reality (MAR) into oral health education can potentially enhance the effectiveness of the education by mitigating those limitations. The objectives of this study are to develop and evaluate the effectiveness of MAR-integrated oral health education. The objectives of this study were to develop and evaluate the effectiveness of MAR-integrated oral health education. Materials and methods: Twenty-four older adults from community dwellings participated in this study. The participants received MAR-integrated oral health education once at activity centers. Self-report questionnaires were utilized to assess oral healthcare-related knowledge and self-efficacy, and the usability score of the MAR system. The assessment was conducted before and after the educational program. Data were statistically analyzed using descriptive statistics and paired-t test. Results: The mean scores of oral healthcare-related knowledge and self-efficacy showed a significant increase after the educational program, with P-values of <0.001 and 0.002, respectively. A majority of the participants exhibited a lack of knowledge and self-efficacy regarding the proper selection of toothpaste and interdental brushes. However, there was an improvement after the intervention. The usability score of the system was lower than the average level. Conclusion: MAR-integrated oral health education effectively increases oral health-related knowledge and self-efficacy among community dwelling older adults. Still, the usability of the MAR system needs to be improved. Further investigation of long-term effects and clinical outcomes, and the inclusion of comparative groups are recommended for the future study.

Trends in Dental Hygiene Academic Leadership Development: Influencers, barriers, and enabling mechanisms.

Purpose This quantitative exploratory study was designed to learn about trends and forces impacting leadership development (LD) opportunities for dental hygiene (DH) program directors.Methods A 10-item electronic survey was created and disseminated using Qualtrics system to directors of all accredited DH programs in the United States (n=325). Surveys included closed and open-ended response items to capture quantitative and qualitative data. Analysis included descriptive statistics and thematic categorization of free responses.Results Eight-two surveys were returned (25% response rate). Leadership development training experiences varied among participants; 79% (n=65) reported completing some form of LD training. Institutional support was variable amongst the DH program directors, yet most (76%, n=62) indicated some level of school support for LD training opportunities for DH program directors. Feedback indicated that most options included campus-sponsored courses or events (28%, n=47), professional association courses or events (24%, n=40), and programs within the school, department, or division (24%, n=40).Conclusion Study findings support positive perceptions of the need, demand, and value of LD. Respondents shared beliefs in the benefits of LD and the value of placing resources to support these opportunities, yet also acknowledged substantial challenges including time, funding, and workforce needs. By addressing barriers and capitalizing on driving forces, programs can create systemic approaches to fostering LD for current and future DH program directors.

Disseminating oral health educational content and evaluating its use on non-dental safety net clinic websites.

OBJECTIVES: Safety net clinics (SNC) provide healthcare to vulnerable populations and SNC websites are an important information source. In North Carolina (NC), all 100 counties are Dental Health Professional Shortage Areas, yet 91 of 317 SNCs are non-dental (ND-SNC). Our goals were to: (1) assess the presence and type of oral health (OH) information on ND-SNC websites; (2) develop and distribute an OH education webpage to ND-SNCs and track its use. METHODS: The website search function was used with common dental terms to evaluate the presence of OH content on each ND-SNC website. Key representatives from ND-SNCs were surveyed to assess patient care and willingness to implement an OH webpage. Webpage topics included oral hygiene and a map of NC dentists that provide services to low-income patients. Google Analytics was used to track consumer webpage engagement including acquisition source (AS), average time on page (AT), and unique page views (UPV). RESULTS: Of the 91 ND-SNCs websites, none contained OH education; 15% had information about nearby dental providers. For the 40 ND-SNCs using our webpage, January-December 2022, the primary AS for new webpage users was referrals; 72.5% of users visited directly from ND-SNC websites. Statewide AT was 2 min and 30 s (SD = 58 s), 2.88 times longer than the 52-s threshold marketing experts use to establish genuine user engagement. There were 1364 UPVs statewide for 2022. CONCLUSION: Our results suggest a need for OH education content on ND-SNC websites, as users are searching for and engaging with this information.

Artificial intelligence (A.I.) in dental curricula: Ethics and responsible integration.

The use of artificial intelligence (AI) is deeply embedded in all aspects of our daily lives, promoting efficiency and safety in routine tasks at home and work. Likewise, dentistry is rapidly exploring new uses of AI for image analysis, electronic health records, and clinical decision-making. The accelerating advancement of AI and its application in dentistry demands dental education conscientiously integrate AI into curricula and equip graduates to use it ethically and responsibly in practice. The approach must be threefold: instill knowledge of the basic algorithms and appropriate application of AI, discuss its limitations/biases, and examine current and potential ethical challenges in practice. Furthermore, dental education must protect the public from intentional and unintentional harm introduced by AI. Therefore, the purpose of this perspective paper is to discuss various considerations for integrating AI into the dental curriculum, prioritizing patient safety by ensuring knowledgeable, safe, and ethical application by future providers.

Evaluation of peer role models as oral health education providers among school children in Mysuru, Karnataka, India.

BACKGROUND: India lacks organized school oral health programs, resulting in limited access to oral health care among children. The peer role models, or teachers, may help in bridging the gap to enhance knowledge on self-care preventive practices. The aim of the study was to evaluate and compare the effectiveness of dental health education (DHE) offered by qualified dental professional, trained teachers, and peer role models in promoting oral hygiene status and behavior among school-going children in Mysuru, Karnataka. MATERIALS AND METHODS: This was an interventional study conducted over a period of 3 months in an academic year in three selected schools in Mysuru City, India. A total of 120 students were divided into three groups - group 1 were given DHE (dental health education) by a dental professional, group 2 were given DHE by a trained teacher, and group 3 were given DHE by peer role models. Oral health knowledge was assessed using a close-ended questionnaire, plaque levels were assessed using Turesky Gilmore Glickman modification of Quigley Hein plaque index, and gingival status was assessed using Loe and Sillness gingival index. After 3 months, the same index and questionnaire were used post intervention. RESULTS: The mean scores for knowledge on dental caries at baseline in groups 1, 2, and 3 were 3.75 ± 1.25, 3.65 ± 1.07, and 3.40 ± 1.17, respectively, with no significant difference between the groups, which changed to 4.43 ± 1.27, 3.37 ± 1.14, and 4.93 ± 0.99, respectively, following intervention. Similar results were observed with regard to knowledge on gingival and periodontal diseases. The mean plaque scores at baseline for groups 1, 2, and 3 were 4.17 ± 0.30, 3.24 ± 0.70, and 4.10 ± 0.31, respectively, which changed to 3.85 ± 0.32, 3.90 ± 0.39, and 3.69 ± 0.34, respectively, in three groups following intervention. Post intervention, plaque scores and gingival scores significantly improved in groups 1 and 3 but worsened in group 2. Overall, knowledge scores improved in groups 1 and 3 for some questions, but improvement was not noted in some questions. CONCLUSION: Under the limitations of the study, it was found that peer role models were as effective as dental professionals in providing DHE in schools.

Effectiveness of an Oral Health Education Program Using a Smart Toothbrush with Quantitative Light-Induced Fluorescence Technology in Children.

This randomized controlled trial aimed to educate patients and manage oral hygiene remotely via a smart toothbrush (ST) by using mobile applications and to improve oral hygiene and habits by evaluating the plaque state via images from a Q-ray cam, which is a quantitative light-induced fluorescence (QLF) digital imaging device. In total, 68 children (aged 6-12 years) were randomly divided into three groups. Group I was assigned an electro-toothbrush (ET), group II was assigned a smart toothbrush (ST), and group III used a manual toothbrush (MT). Each group used an assigned toothbrush and was checked after 1 and 3 months. Oral hygiene status was evaluated using the patient hygiene performance (PHP) index and fluorescent plaque index (FPI), which are presented in the QLF program. In addition, questionnaires on oral health behaviors and attitudes were also evaluated. There was a 0.24 decrease in the PHP index and a 1.40 decrease in the simple hygiene score three months later compared with the baseline in the ST group, with no significant difference between the three methods (p = 0.518, p = 0.626). Many group II participants said that ST helped with oral hygiene, and they were willing to use it continuously. In addition, all participants' brushing times and attitudes toward oral hygiene improved after oral hygiene education using a Q-ray cam. Therefore, the use of STs provided good dental health education and a plaque-decreasing effect to children aged 6-12 years old. Furthermore, the QLF device can be used as a useful tool for maintaining good oral hygiene in children.

Auxiliary delivered school based oral health promotion among 12-14-year-old children from a low resource setting-A cluster randomized trial.

OBJECTIVES: This community intervention study compared the changes in oral health knowledge, attitude, practices (KAP), and oral health indicators among 12-14-year-old children who received a school based oral health promotion delivered by auxiliaries in a rural setting in India. METHODS: The interventions in this school based cluster randomized trial were delivered using schoolteachers and school health nurses. Oral health education (once in 3 months), weekly classroom based sodium fluoride mouth rinsing and biannual oral health screening/ referral were provided for 1 year. The control arm did not receive these interventions. Oral health indicators and self-administered KAP questionnaire were evaluated at baseline and 1-year follow-up. Oral health indicators included oral hygiene index simplified, DMFT/DMFS net caries increments, prevented fraction, number of sites with gingival bleeding, changes in care index, restorative index, treatment index, and dental attendance. RESULTS: The improvement in total KAP score, oral hygiene, and gingival bleeding from baseline to follow up was higher in the intervention arm (p < 0.05). The prevented fraction for net caries increment were 23.33% and 20.51% for DMFT and DMFS, respectively. Students in the intervention group had a higher dental attendance (OR 2.92, p < 0.001). The change in treatment index, restorative index, and care index were significantly higher in the intervention arm (p < 0.001). CONCLUSIONS: Inclusion of available primary care auxiliaries like school health nurses and teachers in oral health promotion is a novel, effective, and sustainable strategy to improve oral health indicators and utilization in rural areas in low resource settings.

Use of Social Media to View and Post Dentistry-related Information in Bahrain: A Cross-Sectional Study.

OBJECTIVES: Healthcare-related information sharing via social media is on the rise following the coronavirus disease 2019 (COVID-19) pandemic. Dental practices primarily use social media to search, share, and communicate health-related information. Considering the increasing trend of using social media, the primary aim of the present study was to identify the use of social media by dentists and laypeople to post and view dentistry-related content in Bahrain. METHODS: This questionnaire-based cross-sectional study included adult participants and dentists. A pretested validated questionnaire was administered. The chi-square test for association was used to assess the association between categorical outcomes. A p-value of ≤ 0.05 was considered statistically significant. RESULTS: In total, 249 adult participants and 53 dentists were included. A substantial majority (83.5%) of the participants reported that they always used social media to view dentistry-related content, and 69.8% of the dentists felt that patients who use social media have better oral health awareness. A longer duration of social media usage showed significant associations with particularly viewing dentistry-related content (p = 0.008) and contacting dentists directly through social media for consultation (p = 0.055). CONCLUSIONS: An extremely high percentage of the younger population in Bahrain is using various social media to discuss dentistry. This engagement should be wisely managed to promote dentistry-related information sharing, which can lead to increased awareness related to overall dental health. There is a definite need to enforce certain standard operating procedures in every country that will prevent the misuse of this technological advancement.

Using realist methods for intervention development to fill a methodological gap: A case study showing the development of an oral hygiene intervention for people with intellectual developmental disabilities.

BACKGROUND: Realist methods offer a novel approach to intervention design. Such novelty is needed for effective oral health promotion interventions with people with intellectual developmental disabilities (IDD) and their carers because existing interventions are poorly described and lack theoretical underpinning. In this study, the steps between inception and final intervention development are presented, with an aim to expand understanding of how realist theorizing can be used to develop interventions, and to demonstrate theory-driven intervention development in the field of oral health promotion. METHODS: In this intervention development study, the use of realist methods to develop an intervention aiming to improve the oral hygiene of people with IDD is presented. Realist theories (RTs) arising from a mixed synthesis were used to develop the Keep My Teeth intervention. The use of realist theory in intervention development was mapped across seven domains and 18 actions with emphasis on how theory informed key actions. RESULTS: Realist theories informed many but not all actions in the development process. Where gaps arose, this was augmented with other systems of intervention development, such as the Behaviour Change Wheel (BCW) and Behaviour Change Technique (BCT) systems. The resulting intervention and underlying theory are presented using TiDieR criteria. CONCLUSIONS: It is demonstrated how realist methods could be integrated with substantive theory when developing an intervention. RTs enhanced the contextualization of the intervention that was developed but were insufficient in their own right to guide the development process from conception to intervention. This was overcome by augmenting with substantive theory, in this case, using the BCW and BCT behaviour change systems, to select and specify the behaviours that needed to change. In essence, the BCTs guided which techniques to select, while the RTs guided how to develop and intervene. Robust intervention development in the field of oral health promotion is also presented in this study.

Social Story Based Toothbrushing Education Versus Video-Modeling Based Toothbrushing Training on Oral Hygiene Status Among Male Students Aged 7-15 Years Old with Autism Spectrum Disorders in Tehran, Iran: A Quasi-Randomized Controlled Trial.

Individuals with autism spectrum disorders (ASD) are at higher risks of developing chronic oral health conditions. This trial compared the efficacy of two tooth-brushing educational interventions on the oral hygiene status {Simplified Oral Hygiene Index (OHI-S)} among 7-15-year-old students with ASD in Tehran. Four schools were divided to intervention (video modeling) and comparison (social story) school groups. The OHI-S of 137 participants had been evaluated at baseline and 133 were analyzed finally after one month. Baseline characteristics were similar between both groups. OHI-S improvement was significantly higher in intervention group. We concluded that tooth-brushing educational intervention using video modeling based on modern technologies would improve oral hygiene status more than traditional social stories (standard education) in individuals with ASD. Trial registration number: IRCT20200208046413N1, Registration date: 2020-07-05.

Childhood dental caries experience in northern Spain: a cross-sectional study.

PURPOSE: This study aimed to describe the caries experience in primary and permanent dentition of schoolchildren from a sample taken in public schools in Bilbao, to identify the most vulnerable child population, and compare them with the findings obtained by the Children's Dental Care Programme in the region of the Basque Country (Spain). METHODS: A cross-sectional study was conducted using a representative sample (n = 1682) of children from 5-year-old early childhood education classes and the first- and second-year elementary classes in public schools in Bilbao. The dependent variable was the caries experience determined through oral examinations carried out by a single dentist. On the other hand, independent variables were measured through questionnaires completed by families, with help from teachers as appropriate. In the statistical analysis, Mann-Whitney and Kruskal-Wallis nonparametric tests, as well as two logistic regressions, were performed, and the significance level was set at α = 0.05 for decision making. RESULTS: The mean (SD) values of dft, DMFT, DMFS and DMFT of first permanent molars scores were 1.25 ± 2.20, 0.16 ± 0.61, 0.20 ± 0.90 and 0.15 ± 0.57, respectively. Compared to the findings in the most recent PADI report, the schoolchildren in our sample had slightly greater experience of dental caries in primary dentition and much greater experience in permanent dentition. CONCLUSION: The dft index of the primary dentition for the current sample is 1.25, while the DMFT index for the permanent dentition is 0.16. Among pupils in early childhood and elementary education in public schools in Bilbao, children from families with low socioeconomic status and educational attainment are most vulnerable to developing caries.

eHealth, teledentistry and health workforce challenges: results of a pilot project.

BACKGROUND: In the twenty-first century, health systems have to cope with the challenges posed by their rapidly changing environment. Among these changes, the emergence of digital health solutions is an opportunity to make health systems better, but also a compelling force to change. Community dentistry is one area of health care, where the rapid technological development has the potential for substantial performance improvement benefitting dental patients in terms of access to care and conveniance. METHODS: This study is based on a survey of the dental care provided by three units (Oral Medicine, Periodontology, Orthodontics) of the Department of Community Dentistry, Semmelweis University, Budapest. During a period of 12 weeks, we have collected time balance data on 1131 patients, 539 in the traditional and 592 in a pilot teledentistry setting, in order to estimate how much time could be spared by monitoring patients through videoconferencing instead of face-to-face visits. RESULTS: According to our findings, teledentistry has the potential to shorten the visit with an average of 5-10 min per patient, which adds up to 58-116 work hours in a year. If the pilot was rolled out to all the 13 chairs of the surveyed 3 specialties (orthodontics, periodontology and oral medicine) the time saving would sum up to 186 workdays in one shift alone, which would translate to close to 4500 additional patients per year, considering remote patient monitoring cases alone. Further, if inactive doctors and highly qualified dental hygienists were involved in delivering telecare, 2.67 times as many workdays could be spared, which would allow about 12,000 more patients treated per year. CONCLUSIONS: The rapid development of digital health technologies coupled with the evolving task distribution between health professionals have a great potential to improve health system performance in pursuit of population health. Unfortunately, the adaptation to these technological changes is uneven, and without a national strategy, the poor will unlikely benefit from these opportunities in public dental care.

Effectiveness of an integrated model of oral health-promoting schools in improving children's knowledge and the KAP of their parents, Iran.

INTRODUCTION: The aim of our study was to investigate the effect of an Oral Health Promoting School (OHPS) model on children's oral health in Iran. METHODS: This interventional quasi-experimental study was conducted in the academic year 2019-20 among 354 primary school students and their parents. A questionnaire including 17 questions was distributed among children before and 5 months after the program (The ranges of possible scores = 0-17). Training workshops for the parents based on the theoretical domains framework were designed. Using educational sessions, pamphlets, tooth brushing dairies, assignments to do at home, educational videos and messages as reminders in social networks, parents were educated about dental caries, its risk factors and prevention principles. Best recommended oral health behaviors including tooth brushing and the use of fluoridated tooth paste were also educated. A questionnaire consisting of 18 knowledge (The ranges of possible scores = 0-18), 13 attitude and 10 practice questions were distributed among parents before and after the workshops. The data were fed into SPSS and analyzed by descriptive and analytic statistics such as T-test, ANOVA and Correlation Coefficients (α = 0.05). RESULTS: The mean pre-test knowledge (7.8 ± 1.7) was increased significantly in three schools after program, p < 0.001. In the post-test, girls gained significantly higher scores (9.61 ± 1.98 vs. 9.06 ± 1.4, p = 0.025). Among 147 parents, the mean knowledge was raised from 12.3 ± 3.1 (5-18) to 15 ± 3.03 (6-18), p < 0.001. Knowledge score of the parents attending both sessions was higher. Practice of the parents regarding the use of fluoridated tooth-paste was significantly improved (p < 0.001). Also, their attitude toward the ability of children to take care of their teeth was improved (p = 0.029). Based on the self-report of parents, 71.4% (n = 47) of mothers and 45.6% (n = 67) of their children used to brush once or two times daily and there was a correlation between their behaviors (p < 0.001, Spearman Correlation Coefficient = 0.4). CONCLUSION: It seems that the education provided in OHPS had positive effects on increasing students' awareness and to some extent, the knowledge, attitude and practice of the parents.

Impact of a Dental Storybook on Parents' Knowledge of Children's Oral Health: A Randomized Controlled Trial.

Purpose: To evaluate the effectiveness of a dental storybook on parents' knowledge about oral health of their children and to assess their perception of its effect in reducing dental anxiety levels among their children, as well as improving their oral health knowledge. Patients and Methods: This was a two-arm parallel, single-blind, randomized controlled trial (RCT) which was performed at the pediatric dental clinics in the Dental University Hospital, King Saud University, Riyadh, Saudi Arabia. Parents of 88 children (6-8 years old) were included in the present study. Parents and their children were randomly divided into two groups as follows: the intervention group (received the storybook and verbal oral hygiene instructions) and the control group (only received verbal oral hygiene instructions; same information included in the book). Three dental visits, including screening, examination/cleaning and treatment, were provided for each child. In the screening visit, baseline parental oral health knowledge was evaluated for all parents. Afterward, parental oral health knowledge was re-evaluated in the examination visit. In the treatment visit, a parental perception questionnaire was administered to parents following treatment to evaluate their satisfaction regarding the use of the storybook in reducing anxiety levels among their children. Results: There was a significant improvement in the total knowledge score at the follow-up visit in the intervention group compared to the control group (P<0.0001). Overall, the majority of parents perceived the storybook as a useful source of information, and they found it to be effective in reducing dental anxiety levels among their children. Conclusion: The dental storybook is an effective educational tool that can help parents become more knowledgeable about their children's oral health. Moreover, parents perceived the storybook as an effective tool for enhancing their oral health knowledge and lowering their children's dental anxiety.

Uso do Braile na Educação em Saúde Bucal Para Deficientes Visuais ­ Revisão Sistemática e Meta-Análise / Use of Braile in Oral Health Education for the Visually Impaired Person ­ Systematic Review and Meta-Analysis

Objetivo: Avaliar o uso do braile, de forma isolada ou conjunta, como método de educação em saúde bucal para pacientes com deficiência visual. Métodos:Uma estratégia de busca foi realizada em 6 bases de dados e na literatura cinzenta resgatando os estudos publicados até fevereiro de 2021. Seguindo o acrônimo PICOS, foram considerados elegíveis estudos clínicos controlados e randomizados (S) que avaliassem pessoas com deficiência visual (P), que receberam instrução de higiene oral com métodos educativos contendo braile de forma isolada ou conjunta (I), comparados a métodos educativos sem braile (C), e avaliaram sua influência em índices de higiene oral (O). O risco de viés dos estudos considerados elegíveis foi avaliado através da ferramenta ROB.2 e meta analises foram realizadas para comparar os diferentes métodos em relação ao índice gengival e de placa. A certeza da evidência foi avaliada (GRADE). Resultados: No total, 9 artigos foram incluídos na presente revisão e 5 na meta análise. Todos os estudos foram classificados como 'alguma preocupação' em relação ao risco de viés. O braile, quando utilizado de forma isolada, mostra-se inferior aos demais métodos (p<0,05); quando usado associado ao áudio ou áudio tátil performance (ATP) mostra-se semelhante ao ATP (p>0,05), e quando implementado juntamente com o ATP, mostra-se superior a técnicas sem braile (p<0,05). A certeza da evidência variou de muito baixa a moderada. Conclusão: O braile utilizado de forma isolada apresentou-se menos eficiente, enquanto métodos multissensoriais, incluindo o braile e ATP, são mais eficientes quando comparados a métodos de educação em saúde bucal sem braile.

Objective: To evaluate the use of Braille, alone or combined, as a method of oral health education for patients with visual impairment. Methods: A search strategy was performed in 6 databases and gray literature, and studies published until February 2021 were retrieved. Following the acronym PICOS, randomized controlled clinical trials (S) that evaluated people with visual impairment (P) who received oral hygiene instruction with educational methods containing braille alone or combined (I) compared to educational met hods without Braille (C) and evaluated its influence on oral hygiene indices (O) were considered eligible. The risk of bias of studies considered eligiblew was assessed using the ROB.2 tool and meta-analyses were performed to compare the different methods in relation to plaque and gingival index. The certainty of the evidence was assessed (GRADE). Results: Nine articles were included in this review and five in the meta-analysis. All studies were classified as 'some concern' regarding the risk of bias. Braille, when used isolated, is inferior to other methods (p<0,05); when used in association with audio or audio-tactile-performance (ATP) it is similar to ATP (p>0,05), and when implemented together with ATP, it is superior to techniques without Braille (p<0,05). The certainty of the evidence ranged from very low to moderate. Conclusion: Multisensory methods including Braille and ATP are more efficient, while Braille used alone is less efficient, when both are compared to oral health education methods without Braille.