Oral health services during COVID-19: screening, triaging and reception (video 1 of 3)

This short video describes recommendations from the World Health Organization for the screening, triaging and reception of people seeking oral health care during the COVID-19 pandemic. It explains step-by-step the measures that should be in place to ensure appropriate and effective care for patients while protecting both patients and personnel from COVID-19 infection. The video is primarily intended for use in trainings for oral health teams on infection prevention and control. More generally, target audiences are public health authorities, in particular those responsible for oral health, and oral health-care personnel undertaking or assisting in the procedures described, working in both the public and private sectors. People considering making an appointment for oral health and dental care may also find it useful as a reference for the practices that they should expect to see in oral and dental health-care centres during the pandemic and beyond.

Oral health services during COVID-19: protecting patients and personnel during treatment (video 2)

This short video explains World Health Organization recommendations for protecting both patients and oral health-care personnel from infection with the COVID-19 virus during oral health and dental treatment during the COVID-19 pandemic. The video is primarily intended for use in trainings for oral health teams on infection prevention and control. More generally, target audiences are public health authorities, in particular those responsible for oral health, and oral health-care personnel undertaking or assisting in the procedures described, working in both the public and private sectors. People considering making an appointment for oral health and dental care may also find it useful as a reference for the practices that they should expect to see in oral and dental health-care centres during the pandemic and beyond.

Oral health services during COVID-19: cleaning, disinfection and sterilization procedures (video 3)

This short video explains World Health Organization recommendations for cleaning, disinfection and sterilization procedures that should be in place in oral health-care services during the COVID-19 pandemic. The procedures are designed to protect both patients and oral health-care personnel from infection with the COVID-19 virus. The video is primarily intended for use in trainings for oral health teams on infection prevention and control. More generally, target audiences are public health authorities, in particular those responsible for oral health, and oral health-care personnel undertaking or assisting in the procedures described, working in both the public and private sectors. People considering making an appointment for oral health and dental care may also find it useful as a reference for the practices that they should expect to see in oral and dental health-care centres during the pandemic and beyond.

Content analysis of nutritional information in paediatric oral health education leaflets.

BACKGROUND: The aim of this study was to determine if paediatric oral health education leaflets with a food and nutritional focus provide messages that are clear and consistent with the current Australian Dietary Guidelines and the Infant Feeding Guidelines. METHODS: Forty-three leaflets aimed at parents were sourced from Australian state and territory Health Departments, oral health industry partners and commercial organisations, and a content analysis was performed. Recommendations on food and drink type, consumption frequency and general diet and nutrition advice were considered and cross-referenced with the Australian Dietary Guidelines and the Infant Feeding Guidelines to identify areas of consistency and discrepancy. RESULTS: Twenty leaflets recommended reducing the consumption of sugary and/or acidic food, while 23 leaflets recommended reducing the consumption of sugary and/or acidic drinks. The majority of the leaflets advised water (n = 35) and milk (n = 23) to drink. Although 33 leaflets encouraged a healthy diet, seven of these did not specify what a healthy diet was. Twenty-eight leaflets provided early childhood-related (0-2 years) feeding advice. Confusing messages were found in nine leaflets, with ambiguous recommendations that were open to individual interpretation. CONCLUSIONS: There were some inconsistencies between the leaflets and the dietary and infant feeding guidelines in Australia; and across the leaflets, as not all important messages were included in any one leaflet. Government Health Departments and other relevant agencies should ensure that advisory messages regarding diet, particularly those with dental implications, are clear, complete and consistent across all dental educational leaflets.

YouTube as a source for parents' education on early childhood caries.

BACKGROUND: Patients can and do search the Internet for information on various health-related topics. YouTube™ is one popular website they may consult. AIM: To examine the quality of information offered by YouTube™ for patients seeking information on early childhood caries (ECC). DESIGN: YouTube™ was searched for videos on ECC. The usefulness of selected videos in providing adequate information about ECC was evaluated using a 13-point usefulness score. The guidelines of the American Academy of Pediatric Dentistry were used for benchmarking. RESULTS: Most videos were uploaded by healthcare professionals (60%, n = 18). Videos had generally low usefulness scores (mean: 5.1 ± 2.9; range: 1-11). An average YouTube™ video on ECC was viewed two times/day (range: 0.07-34.4 views/day). Less useful videos ranked early on the viewing list, and viewer's interactions with videos were not affected significantly by their usefulness. CONCLUSION: YouTube™ should not be used as a trusted site for educating patients on ECC.

Knowledge of preschool teachers in the prefecture of Attica of early childhood oral health. Association with their demographic and personal characteristics.

AIM: To investigate the knowledge of preschool teachers of early childhood oral health (OH) and its association with demographic and educational characteristics as well as with personal oral health habits and attitudes. METHODS: Teachers (594) of preschool children were invited to complete a questionnaire with 40 questions on demographic data, knowledge of early childhood OH issues, personal OH habits and attitudes, and participation in OH educational programmes at preschools. Statistical analysis included descriptive statistics, Spearman correlation coefficients, multiple linear and logistic regression modelling (p ≤ 0.05). RESULTS: The mean age of participants was 40.9 years (SD 7.5), 68.5% of them had children of their own, 72.6% had not attended any OH educational course during their studies, 70% believed that they had insufficient knowledge to implement an OH educational programme, 44.6% had implemented such a programme, 26.8% knew that the first dental visit should be at a child's first birthday and 36.7% knew the correct age that tooth brushing should start. The most significant factors that influenced overall teachers' knowledge on early childhood oral health were: their participation in OH educational programmes (p < 0.001), their belief that OH courses during their studies were necessary (p = 0.01), their confidence on OH knowledge (p = 0.03) and parenthood (p = 0.05). CONCLUSIONS: Based on the results of this study, there was a lack of knowledge among preschool teachers in significant OH issues for that age. Moreover, limitations in implementing OH educational programmes at preschools were attributed mainly to lack of self-confidence in relevant knowledge. Nevertheless, participants acknowledged the significance of OH and were willing to participate in relevant teacher training.

Children's Toothbrushing Practices Recommended on the Internet by Pediatric Dentistry Associations.

PURPOSE: The purpose of this study was to describe online recommendations by North and South American National Associations of Pediatric Dentistry (NAPD), intended for laypersons, concerning children's toothbrushing practices. METHODS: In February 2015, the International Association of Pediatric Dentistry (IAPD) website and the Latin American Association of Pediatric Dentistry (ALOP) Facebook webpage were searched to identify which countries had NAPD. Attempts were made to obtain the electronic addresses of ALOP national member societies, and Google and Facebook were used to identify NAPD not found using the previous strategies. RESULTS: Of the 35 countries in North and South America, 19 had NAPD that were shown on the Internet, and 11 of them provided data for the study. All NAPD gave advice on fluoride concentrations in toothpaste and when to start toothbrushing; most made recommendations on the amount of toothpaste, toothbrushing frequency, and when to brush, and a few gave advice on toothbrushing supervision and rinsing after toothbrushing. There was no consensus on most of the recommendations that were evaluated. CONCLUSIONS: Only a few National Associations of Pediatric Dentistry from the Americas provide online information for parents and laypersons concerning children's toothbrushing practices. Of the information provided, some are either controversial, outdated or lack scientific evidence.

Perceived competency towards preventive dentistry among dental graduates: the need for curriculum change.

BACKGROUND: A previous study has shown that dental practitioners in Benghazi believed that the less prevention-oriented education system is one of the barriers to applying preventive dentistry. OBJECTIVE: To assess attitudes and perceived competence of the dental graduates in Benghazi towards prevention and early management of dental caries. METHODS: A cross-sectional, questionnaire-based survey was conducted among internship students attending the Department of Community and Preventive Dentistry in Faculty of Dentistry, Benghazi, Libya. The participants were asked to provide demographic information, to respond to statements about their attitudes towards preventive dentistry, and to answer questions regarding their perceived competence in applying preventive dentistry procedures. RESULTS: Data from 108 Libyan dental graduates were analysed for this study, of which 64% of them were females and 42.1% of them passed their final year with grade: acceptable. The most acknowledged aspects of preventive dentistry were being useful and essential to the community (95.4 and 90.8%, respectively). The percentage of participants expressing a proficiency in providing oral hygiene instructions was the highest (95.4%). There were differences between study subgroups in their perceived competence of preventive dental practices by gender and academic performance (p≤0.05). CONCLUSION: This study highlighted that the currently implemented undergraduate education programme in Benghazi dental school does not provide dentists with the required attitude and skills to fulfil their role in providing preventive-oriented health services.

How readable are Australian paediatric oral health education materials?

BACKGROUND: The objective of this study was to analyse the readability of paediatric oral health education leaflets available in Australia. METHODS: Forty paediatric oral health education materials were analysed for general readability according to the following parameters: Thoroughness; Textual framework; Terminology; and Readability (Flesch-Kincaid grade level (FKGL), Gunning Fog index (Fog) and Simplified Measure of Gobbledygook (SMOG)). RESULTS: Leaflets produced by the industry were among the hardest to read with an average readability at the 8th grade (8.4 ± 0.1). The readability of leaflets produced by the commercial sector was at the 7th grade (7.1 ± 1.7) and the government at the 6th grade (6.3 ± 1.9). The FKGL consistently yielded readabilities 2 grades below the Fog and SMOG indexes. In the content analyses, 14 essential paediatric oral health topics were noted and Early Childhood Caries (ECC) was identified as the most commonly used jargon term. CONCLUSION: Paediatric oral health education materials are readily available, yet their quality and readability vary widely and may be difficult to read for disadvantaged populations in Australia. A redesign of these leaflets while taking literacy into consideration is suggested.

[The effects of oral care education on caregivers' knowledge, attitude, & behavior toward oral hygiene for elderly residents in a nursing home].

PURPOSE: To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes. METHODS: In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0. RESULTS: 1) Scores on caregivers' knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers' attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks. CONCLUSION: Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregivers' knowledge, attitude, and behavioral change.

English and Spanish oral cancer information on the internet: a pilot surface quality and content evaluation of oral cancer web sites.

OBJECTIVE: Oral and pharyngeal cancers are responsible for over 7600 deaths each year in the United States. Given the significance of the disease and the fact that many individuals increasingly rely on health information on the Internet, it is important that patients and others can access clear and accurate oral cancer information on the Web. The objective of this study was threefold: (a) develop an initial method to evaluate surface and content quality of selected English- and Spanish-language oral cancer Web sites; (b) conduct a pilot evaluation; and (c) discuss implications of our findings for dental public health. METHODS: We developed a search strategy to find oral cancer sites frequented by the public using Medline Plus, Google, and Yahoo in English and Spanish. We adapted the Information Quality Tool (IQT) to perform a surface evaluation and developed a novel tool to evaluate site content for 24 sites each in English and Spanish. RESULTS: English-language sites had an average IQT score of 76.6 (out of 100) and an average content score of 52.1 (out of 100). Spanish-language sites had an average IQT score of 50.3 and an average content score of 25.6. CONCLUSIONS: The study produced a quality assessment of oral cancer Web sites useful for clinicians and patients. Sites provided more information on clinical presentation, and etiology, and risk factors, than other aspects of oral cancer. The surface and quality of Spanish-language sites was low, possibly putting Hispanic populations at a disadvantage regarding oral cancer information on the Web.

Inconsistencies in recommendations on oral hygiene practices for children by professional dental and paediatric organisations in ten countries.

BACKGROUND: Some of the basic dental health practices that are recommended to the public by professionals are not evidence based. Incorrect oral health messages may adversely affect children's oral health behaviours. AIM: To identify and list the recommendations concerning children's oral hygiene practices provided by dental and paediatric organisations, and to assess how these recommendations relate to the scientific evidence currently available. DESIGN: Cross-sectional. The authors contacted professional organisations in ten countries requesting items (brochures, leaflets or folders) containing messages on children's oral hygiene practices. They then listed these recommendations and assessed how they related to scientific evidence obtained from systematic reviews available at PubMed and the Cochrane Library. RESULTS: Fifty-two of 59 (88%) organisations responded to our request and 24 dental health education materials were submitted to the authors. They mentioned recommendations on oral hygiene practices for children, such as toothbrushing frequency, supervision and technique; when to start and how long toothbrushing should last; toothbrush design and replacement; flossing; gums/teeth wiping; tongue cleaning; type and amount of toothpaste and advice on toothpaste ingestion. The search at PubMed and the Cochrane Library resulted in 11 systematic reviews addressing these topics. CONCLUSIONS: Several oral hygiene messages delivered by professional organisations showed inconsistencies and lacked scientific support.

The Effects of Oral Care Education on Caregivers' Knowledge, Attitude, & Behavior toward Oral Hygiene for Elderly Residents in a Nursing Home

PURPOSE: To investigate the effects of oral care education on knowledge, attitudes & behavior of caregivers in oral care and oral hygiene for residents in nursing homes. METHODS: In this quasi-experimental study, the intervention group (n=27) of residents received oral care from intervention group caregivers (n=28) who had received 6 weeks of oral care education. The control group (n=27) of residents received usual oral care from control group caregivers (n=26). Data on knowledge, attitude, and behavioral change in oral health care by the caregivers and plaque index & halitosis of the residents were collected. Data were analyzed using SPSS WIN 16.0. RESULTS: 1) Scores on caregivers' knowledge (p<.001) and behavior (p<.001) for oral care were higher in the intervention group 6 and 12 weeks. The caregivers' attitude (p<.001) score for oral care was higher in the intervention group 12 weeks. 2) The plaque index (p=.004) and halitosis (p=.002) of the nursing home residents were lower in the intervention group than the control group at 6 and 12 weeks. CONCLUSION: Oral care education programs for caregivers are effective in improving the oral hygiene of elderly residents in nursing homes through enhancement of caregivers' knowledge, attitude, and behavioral change.

Exploring the potential for foreign-trained dentists to address workforce shortages and improve access to dental care for vulnerable populations in the United States: a case study from Washington State.

BACKGROUND: To address dental workforce shortages in underserved areas in the United States, some States have enacted legislation to make it easier for foreign dental school graduates to become licensed dentists. However, the extent to which foreign dental school graduates will solve the problem of dental workforce shortages is poorly understood. Furthermore, the potential impact that foreign-trained dentists have on improving access to dental care for vulnerable patients living in dental Health Professional Shortage Areas (HPSAs) and those enrolled in public insurance programs, such as Medicaid, is unknown. The objective of this paper is to provide a preliminary understanding of the practice behaviors of foreign-trained dentists. The authors used Washington State as a case study to identify the potential impact foreign dental school graduates have on improving access to dental care for vulnerable populations. The following hypotheses were tested: a) among all newly licensed dentists, foreign-trained dentists are more likely to participate in the Medicaid program than U.S.-trained dentists; and b) among newly licensed dentists who participated in the Medicaid program, foreign-trained dentists are more likely to practice in dental HPSAs than U.S.-trained dentists. METHODS: The authors used dental license and Medicaid license data to compare the proportions of newly licensed, foreign- and U.S.-trained dentists who participated in the Medicaid program and the proportions that practiced in a dental HPSA. RESULTS: Using bivariate analyses, the authors found that a significantly lower proportion of foreign-trained dentists participated in the Medicaid program than U.S.-trained dentists (12.9% and 22.8%, respectively; P = 0.011). Among newly licensed dentists who participated in the Medicaid program, there was no significant difference in the proportions of foreign- and U.S.-trained dentists who practiced in a dental HPSA (P = 0.683). CONCLUSIONS: Legislation that makes it easier for foreign-trained dentists to obtain licensure is unlikely to address dental workforce shortages or improve access to dental care for vulnerable populations in the United States. Licensing foreign dental school graduates in the United States also has ethical implications for the dental workforces in other countries.

Survey of Brazilian governmental health agencies shows conflicting recommendations concerning oral hygiene practices for children.

The aims of this study were to detect whether recommendations concerning oral hygiene practices for children among Brazilian health agencies are consistent and to verify whether possible inconsistencies in these recommendations might be associated with an apparent gap in the scientific evidence. Fifty-four Brazilian health agencies were contacted by mail or electronic mail and were asked to send any material containing recommendations on oral hygiene practices aimed at children. A search was subsequently carried out on the Cochrane Oral Health Review Group and PubMed-Clinical Queries websites in order to assess the scientific evidence available on this subject. Forty (74%) agencies answered and 21 materials containing oral hygiene recommendations were obtained. Eleven pertinent systematic reviews were identified. This preliminary study detected some conflicting and not evidence-based oral hygiene messages, which emphasizes the need to carry out and disseminate systematic reviews on these controversial issues in order to bridge the gap between knowledge and practice.

A survey of oral health education provided by certified diabetes educators.

The purpose of this study was to investigate certified diabetes educators' (CDEs) perceptions of the adequacy of their diabetes education curricula in providing oral health information. A questionnaire was mailed to all CDEs with a mailing address in South Carolina (SC), United States (US). Of the 130 respondents, between 50%-60% indicated that they adequately addressed frequent dental visits, daily brushing and flossing, and importance of good oral hygiene. Almost all (93.8%) reported that their curricula did not include an oral health module; the two predominant reasons were: not having enough time (61.0%), and not knowing enough about oral health and its relationship to diabetes (37.0%). Respondents who expressed that they did not know enough about oral health and its relationship to diabetes were less likely to provide adequate 'oral-health-related information' (p=0.008), especially information about the effect of periodontal disease on diabetes (p=0.016). This study indicates that SC CDEs do not routinely provide comprehensive oral health education to people with diabetes primarily due to lack of time and knowledge related to oral health. To better serve their patients, CDEs should integrate oral health education in the diabetes education curriculum.

Educative practices and attitudes within the pre-school environment: evaluating the education professionals.

School and family together play an important role in the individual development of children. Therefore, this study aimed at evaluating the practices and attitudes towards oral health care of 245 education professionals working in 24 public municipal pre-schools in Niterói, State of Rio de Janeiro, Brazil. The data were obtained from self-questionnaires consisting of both open and closed questions. The methodology was both quantitative and qualitative, and the quantitative analysis was based on frequency (%). Regarding oral health practices, it was observed that the majority of the education professionals emphasized toothbrushing as a vital method of oral hygiene. In addition, 70.7% of the education professionals performed other types of oral hygiene activities with the schoolchildren, and 17.1% did so with the children's families. All the participants of the study considered that education professionals have a key role in promoting healthy oral habits amongst the schoolchildren and they believe that involving the dentist in educative programs is important. It was therefore concluded that the education professionals surveyed have positive practices and attitudes regarding the children's care, and they recognize their role in fostering healthy habits and developing integrated pedagogic oral health programs.

Educative practices and attitudes within the pre-school environment: evaluating the education professionals

School and family together play an important role in the individual development of children. Therefore, this study aimed at evaluating the practices and attitudes towards oral health care of 245 education professionals working in 24 public municipal pre-schools in Niterói, State of Rio de Janeiro, Brazil. The data were obtained from self-questionnaires consisting of both open and closed questions. The methodology was both quantitative and qualitative, and the quantitative analysis was based on frequency ( percent). Regarding oral health practices, it was observed that the majority of the education professionals emphasized toothbrushing as a vital method of oral hygiene. In addition, 70.7 percent of the education professionals performed other types of oral hygiene activities with the schoolchildren, and 17.1 percent did so with the children's families. All the participants of the study considered that education professionals have a key role in promoting healthy oral habits amongst the schoolchildren and they believe that involving the dentist in educative programs is important. It was therefore concluded that the education professionals surveyed have positive practices and attitudes regarding the children's care, and they recognize their role in fostering healthy habits and developing integrated pedagogic oral health programs.

Evaluating oral health promotion: need for quality outcome measures.

Oral health promotion effectiveness reviews have identified the need to improve the quality of the evaluation of interventions. A project was undertaken to identify and assess the quality of available outcome measures. This paper describes the methodology adopted and highlights the need for further development of oral health promotion outcome measures. Initially a thorough and comprehensive search of both the published and unpublished literature was undertaken to identify potential outcome measures. A set of quality criteria was then developed and used to assess the identified measures. The search identified a total of 1202 outcome measures of which 39% (n = 466) were developed for use with schoolchildren. A high proportion of the identified measures were classified as health literacy and healthy lifestyle outcomes, appropriate for the evaluation of oral health education activities. Only 1% (n = 12) of measures identified were classified in the healthy public policy category. When reviewed against the quality criteria, 49% (n = 594) of the measures were considered satisfactory. The poorest performing measures were those classified as healthy lifestyle and health literacy measures in which only 33% (n = 72) and 41% (n = 240), respectively, were deemed to be of satisfactory quality. In conclusion, a significant number of oral health promotion evaluation outcome measures have been identified although their quality is highly variable. Very few high-quality outcome measures exist for use in the evaluation of oral health policy and environmental interventions. The lack of appropriate and high-quality outcome measures is hampering the development of oral health promotion.