The association between serum vitamin D status and dental caries or molar incisor hypomineralisation in 7-9-year-old Norwegian children: a cross-sectional study.

BACKGROUND: Research focusing on the association between serum vitamin D and oral health outcomes in children, such as dental caries and molar incisor hypomineralisation (MIH), shows inconsistent results. Previous studies have predominantly investigated dental caries and MIH as dichotomized outcomes, which limits the information on their distribution. In addition, the methods used for analysing serum vitamin D have varied. The present study aimed to investigate potential associations between serum vitamin D status measured by Liquid Chromatography with Tandem Mass Spectrometry (LC-MS/MS) and the prevalence, as well as the number of teeth, affected by dental caries or MIH among 7-9-year-old Norwegian children. METHODS: The study had a cross-sectional design and included 101 children aged 7-9 years. Serum 25-hydroxyvitamin D (25(OH)D) was measured and included as continuous (per 25 nmol/l) and categorised (insufficient (< 50 nmol/l) and sufficient (≥50 nmol/l)) exposure variables. Adjusted negative binomial hurdle models were used to investigate the potential associations between serum vitamin D and the oral health outcomes (dental caries and MIH) adjusted for sex, age, body mass index, season of blood draw, and mother's educational level. RESULTS: Of the 101 children in the total sample, 27% had insufficient vitamin D levels (< 50 nmol/l). The descriptive analysis indicated that the children with insufficient vitamin D levels had a higher prevalence (33.3%) and a higher number of teeth affected by dental caries (mean (SD) = 0.7 (1.4)), compared to children with sufficient levels of vitamin D (21.6% and mean (SD) = 0.4 (0.8), respectively). The same holds for MIH, with a higher prevalence (38.5%) and a higher number of teeth affected (mean (SD) = 1.2 (2.3)), compared to children with sufficient levels of vitamin D (30.1% and mean (SD) = 0.8 (1.6), respectively). However, in the adjusted hurdle model analysis, neither the prevalence or number of teeth affected by caries or MIH showed statistically significant associations with having insufficient or lower vitamin D levels. CONCLUSIONS: Vitamin D status was not significantly associated with the prevalence and number of teeth affected by caries and MIH among the participating children. Large prospective studies with multiple serum vitamin D measurements and oral examinations throughout childhood are warranted to elucidate the relationship.

A Right to Health-Based Approach to Dental Caries: Toward a Comprehensive Control Strategy.

BACKGROUND: Health is a matter of human rights, and dental caries is the most common noncommunicable disease globally. Consequently, dental caries is a matter of human rights and its control, particularly prevention, must be a priority. Although largely preventable, this is too often neglected, both in the literature of human rights and health law, and in dental research. The right to oral health has recently been acknowledged by the World Health Organization (WHO), but it is insufficiently clear what this right entails. SUMMARY: This article introduces a right to health-based narrative in the context of dental caries. The right to health is stipulated in human rights treaties, including the International Covenant on Economic, Social and Cultural Rights (ICESCR) and the Convention on the Rights of the Child (CRC). States that are parties to these treaties, which are virtually all States globally, are mandated to ensure the enjoyment of individuals' right to the highest attainable standard of health, including oral health. KEY MESSAGES: Dental caries is a matter of human rights. States have binding obligations to address dental caries: they require the regulation of the healthcare system, i.e., the traditional focus on operative care, but also put the regulation of other risk factors on an equal footing, such as the regulation of the living environment and access to fluoride. A right to health-based approach to dental caries thus offers a comprehensive approach to dental caries control, particularly prevention.

A Cluster Randomised Controlled Trial of a Targeted Distributed Toothpaste and Toothbrushing Programme.

INTRODUCTION: The aim was to assess the effectiveness of a distributed, targeted toothbrush and toothpaste programme on referrals for tooth extraction under Dental General Anaesthetic (DGA), in children of high-risk families compared to usual care. METHODS: A recruiter and assessor-blinded, clustered parallel randomised control trial (RCT). Families with one or more children aged between 3 and 10 years having undergone a DGA operation for extraction of carious teeth, were approached within hospitals in the North West of England. Families were randomised at the cluster level in a 1:1 ratio. All eligible children within the family consented to the study. The primary outcome was participant referral for a DGA 6-24-month post-randomisation. RESULTS: A total of 961 families (1,671 children) were randomised, 482 families (832 children) to the intervention, and 479 families (839 children) to the control group. Families (1,662 children, 955 families) were included in the final analysis (825 intervention, 837 control). Marginal regression models (generalised estimating equation approach) taking into account cluster membership were used to model the effectiveness of the intervention at 24 and 48 month follow-up, including the variables, age, sex, and IMD quintile. Seventy-six children (9.2%) in the intervention group had a DGA referral within 2 years compared to 57 children (6.8%) in the control group. The study found no effect of a clinically meaningful difference between the intervention group and usual care (risk ratio 1.36, 95% CI: 0.98-1.89) in reducing referral for DGA for a targeted postal toothpaste/toothbrush program in a contemporary, population with previous family experience of DGA residing in an area of high deprivation. CONCLUSION: The target of the intervention (families of children with a DGA) was the correct focus given the referrals observed over 2 and 4 years. The study can aid policymakers, local authorities and commissioners to understand repeat DGA within families and further need for intervention.

Oral microbiome research from a public health perspective and implications for oral health.

Advancing oral microbiome research has revealed the association between oral microbiome composition and oral disease. However, much of the research has predominantly focused on comparing health and disease conditions, overlooking the potential dental public health implications. This article examines the evolution of oral microbial research from inception, advancement, and current knowledge of health-associated microbiota. Specifically, we focus on two key aspects: the impact of lifestyle and environmental factors on the oral microbiome and using the oral microbes as a therapeutic modality. The complex interaction of host intrinsic, environmental, and lifestyle factors affects the occurrence and development of the oral microbiota. The article highlights the need for ongoing research that embraces population diversity to promote health equity in oral health research and integrate public health practices into microbiome-based research. The implication of population-level interventions and targeted approaches harnessing the oral microbiome as an intervention, such as oral microbiome transplantation, should be further explored.

Social inequities in early childhood caries in Australia: A population-based study on statewide public dental services data.

BACKGROUND: Social disadvantage leads to dental caries during childhood. AIM: This study investigated whether dental caries occur earlier in children from households experiencing social disadvantage than those not experiencing social disadvantage. DESIGN: The overall risk of, and relative time to, early childhood caries (ECC) according to sociodemographic characteristics in Victoria, Australia, was quantified. Records for 134 463 children in Victoria, Australia, from 2009 to 2019 were analysed. Time ratios (TR) and hazard ratios (HR) of carious lesion(s) in early childhood were estimated. RESULTS: Compared with reference groups, Indigenous children had an adjusted TR of 0.80 (95% CI: 0.78, 0.82), children from households with languages other than English had an adjusted TR of 0.83 (95% CI: 0.82, 0.84), and dependants of concession cardholders had an adjusted TR of 0.81 (95% CI: 0.80, 0.81); therefore, 20%, 17% and 19% reduced times to the first carious lesion, respectively. The estimated HRs were 1.57 (95% CI: 1.49, 1.67) for Indigenous children, 1.46 (95% CI: 1.42, 1.50) for children from households with other languages and 1.57 (CI: 1.53, 1.60) for dependants of concession cardholders. CONCLUSION: Preventive oral health interventions must be targeted early in children from households experiencing social disadvantage to avoid social inequities in ECC.

A systematic review and meta-analysis on early-childhood-caries global data.

OBJECTIVES: The present study systematically reviewed and provided a meta-analysis on early childhood caries (ECC) global prevalence and its association with socioeconomic indicators, both geographical and regarding unemployment rate, national income as well as income inequalities. METHODS: Only cross-sectional or cohort studies covering ECC prevalence and experience in children younger than 71 months, reporting sample size, diagnostic criteria and conducted in urban and rural communities were considered. No language restriction was selected. Studies published from 2011 to 2022 available in PubMed, Web of Science, Embase and Open Grey literature were retrieved by ad hoc prepared search strings. The meta-analyses were conducted for both overall ECC prevalence and experience stratified by country of publication as well as measures of socioeconomic indicators using a random effects model using STATA 18®. RESULTS: One hundred publications reporting ECC data from 49 countries (published from 2011 to 2022) were included and summarized by meta-analysis. The lowest prevalence was reported in Japan (20.6%) and Greece (19.3%). The global estimated random-effect pooled prevalence of ECC was 49% (95%CI: 0.44-0.55). The random-effect pooled caries prevalence (ECC) was 34% (95%CI: 02.20-0.48) (Central/South America), 36% (95%CI: 0.25-0.47) (Europe), 42% (95%CI: 0.32-0.53) (Africa), 52% (95%CI: 0.45-0.60) (Asia-Oceania), 57% (95%CI: 0.36-0.77) (North America) and 72% (95%CI: 0.58-0.85) (Middle East). When stratified by gross national income (GNI) the ECC prevalence ranged from 30% ($20,000-$39,999) to 57% in countries with the lowest GNI (<$5000). Stratification by inequality index (Gini index) resulted in an ECC prevalence range of 39% (low inequality) to 62% (no inequality), while for life expectancy the ECC prevalence ranged from 28% in countries with the highest life expectancy (< 80 years) to 62% in countries with 71-75 years life expectancy. DISCUSSION: Within the limitations of this study (lack of certainty about the results as many countries are not represented and lack of uniformity in prevalence and experience data represented), results from 49 different countries reported a wide range of ECC prevalence. These reports indicated persisting high worldwide distribution of the disease. Both ECC prevalence and experience were associated with geographical areas and GNI. REGISTRATION: PROSPERO: CRD-42,022,290,418.

Should we be concerned about the use of non-fluoride toothpaste? A survey study in two European countries.

BACKGROUND: Toothpastes available in Europe contain a range of fluoride concentrations, with some meeting the recommended level for caries prevention (>1000 ppm fluoride (ppm)) and others containing low or no fluoride. This study evaluated toothpaste fluoride concentrations in Latvia and Lithuania to inform targeted public health strategies in regions with a high prevalence of dental caries. METHODS: This cross-sectional study was conducted from May 2019 to May 2020, using a validated questionnaire in Latvia and Lithuania. Nationally representative samples (1309 families and 5436 members) provided data through a mixed-mode survey (paper and online) on sociodemographic information, toothpaste type, brand, and type. Descriptive statistics and chi-square tests (p < 0.05) were used for analysis. RESULTS: Fifteen percent of families used non-fluoridated toothpaste and 12% used <1000 part per million (ppm) fluoride. In Latvia, 56.8% of preschoolers and 28.7% of schoolchildren used <1000 ppm or non-fluoride toothpaste, whereas in Lithuania, 47.2% of preschoolers and 29.1% of schoolchildren used <1000 ppm or non-fluoride toothpaste; 63% of adolescents and 73% of adults used toothpaste with optimal fluoride content (≥1000 ppm). Of the 228 registered toothpaste types, 62% contained more than 1000 ppm, which is optimal for caries prevention; 29% of Latvian and 24% of Lithuanian families used at least one non-fluoridated toothpaste. CONCLUSION: This study revealed significant gaps in the use of fluoride toothpaste among families in Latvia and Lithuania, especially among children. To effectively prevent dental caries, targeted interventions, and education must promote optimal fluoride toothpaste use, particularly among vulnerable populations.

Being Left Alone at Home and Dental Caries of Children Aged 6-7 Years.

BACKGROUND: Leaving children alone at home is considered child neglect in some countries but is not prohibited in Japan. We investigated the association between being left alone at home and dental caries of children aged 6-7 years in Japan. METHODS: The data on first graders in all 69 public elementary schools in Adachi, Tokyo, obtained from repeated cross-sectional surveys in 2015, 2017, and 2019 were analyzed. Caregivers answered the questionnaire, and the data were linked to the information on children's dental caries evaluated in school dental health checkups (N = 12,029). Poisson regression analysis with propensity score matching (PSM) was applied to account for confounders. RESULTS: Leaving children alone at home for ≥1 hour during the weekdays was reported by 46.4% of the caregivers, which did not vary across years. The PSM analysis showed that, compared with children never being left alone at home, children being left alone at home for ≥1 time per week had more dental caries (mean ratio [MR] 1.11; 95% confidence interval (CI), 1.02-1.21; P = 0.016), while <1 time per week was not associated (MR 0.97; 95% CI, 0.92-1.03; P = 0.345). The difference between those being left alone at home for <1 time per week and those being left alone for ≥1 time per week was not significant after applying Bonferroni correction (MR 1.12; 95% CI, 1.00-1.26; P = 0.041). CONCLUSION: Leaving children alone at home for ≥1 hour every week might be a risk factor for dental caries of children aged 6-7 years.

One year of COVID-19 in dental health services in Norway: psychological impact, risk perceptions and vaccination status.

BACKGROUND: Increased psychological pressure on oral healthcare professionals (OHP) due to COVID-19 has been shown, yet little is known about the long-term psychological impacts. We aimed to study the psychological impact of COVID-19 and associated factors including perceived risk and preparedness and vaccination status among OHP in the first year after the lockdown period in Norway. METHODS: A structured questionnaire sent electronically to dentists, dental hygienists and dental assistants inquired experiences and perceptions during the second year following the outbreak in Norway. The questionnaire comprised a COVID-19 fear scale and questions about risk perception, preparedness and vaccination status. Exploratory factor analysis (EFA) and Structural Equation Modeling (SEM) were used to assess psychological impact, perception of risk and preparedness according to vaccination status of the respondents. RESULTS: The majority of the 708 respondents were female (92.8%), had ten or more years of work experience (67.1%), and worked in public dental clinics (95.9%). Fears and concerns related to COVID-19 were common, 72.6% feared getting infected and 85.4% feared infecting others. Of the 642 respondents who agreed that their workplaces handled the situation well, 55.6% were fully vaccinated. Three factors were retrieved from EFA: Insecurity, Instability and Infection. SEM showed that females were more concerned with Infection, and respondents with long clinical experience were less likely to express fear about Instability. Fully vaccinated individuals felt more insecure about becoming infected, and those agreeing that their workplaces handled the current situation well were concerned with Insecurity. CONCLUSIONS: Despite widespread perception of adequate preparedness and high vaccine coverage, a considerable psychological impact and high levels of fear of COVID-19 were observed among the majority of OHP. Fully vaccinated individuals had a larger psychological burden than not fully vaccinated and those with unknown vaccination status. These findings can inform means and interventions to reduce negative impacts of fear in populations with a high psychological burden.

Mini-publics in dental public health policymaking.

What are mini-publics and under what circumstances could they be applied to public health dentistry? This question is explored with reference to water fluoridation in England, a policy intervention characterised by a visceral politics that has embedded a systemic preference for non-decision-making. Mini-publics can nevertheless inform decision-making by inviting a representative sample of the affected citizenry to consider the available evidence and come to a set of conclusions and/or recommendations that if all parties cannot agree, none can reasonably object. In doing so, mini-publics have the potential to break the policy deadlock by adding an additional layer of legitimacy to the decision-making process, albeit this is dependent upon decision-makers granting value to their findings.

Diabetes and dental caries in US adults: an analysis of data from the National Health and Nutrition Examination Survey, 2011-2018.

OBJECTIVES: To determine the relationship between diabetes and dental caries among US adults participating in the 2011-2018 National Health and Nutrition Examination Survey (NHANES). BASIC RESEARCH DESIGN: The NHANES was a cross-sectional study including clinical assessments, laboratory analysis, and interviews. The sample included 16,635 participants aged 20 years and older that represent 187,596,215 individuals in the US in a probability weighted sample. Outcome variables included overall total caries score (or number of decayed, missing, filled permanent teeth - DMFT index) and the presence of caries. Bivariate analysis, Poisson regression for total caries score, logistic regression for the presence of caries were used for analysis. RESULTS: Controlling for covariates, multiple Poisson regression revealed that total DMFT scores were associated with diabetes status (adjusted relative risk ratio (RR)controlled diabetes = 1.13, RRuncontrolled diabetes = 1.18; p⟨0.001), no college education, female sex, white race, elderly (≥ 65 years), cigarette smoking, obesity, yearly dental visits, seeing a dentist only for treatment. Similarly, multiple logistic regression shows that the odds of adults with diabetes having dental caries were higher than among those without diabetes (adjusted risk ratio (OR)controlled diabetes = 1.84, ORuncontrolled diabetes = 1.87; p⟨0.05). CONCLUSIONS: Diabetes was associated with a higher caries score and a greater risk for dental caries among US adults.

Dental public health education in Egypt: a cross-sectional survey.

BACKGROUND AND AIM: Dental Public Health (DPH) education prepares future workforce to promote positive oral health behaviors, prevent oral diseases, and monitor disease distribution and trends taking into considerations best practices, needs and available resources. Scarce information is available about dental education in African countries and Egypt has the greatest number of dental schools in Africa. This study assessed the undergraduate DPH education in Egyptian universities including topics taught, methods of teaching, assessment, and the academics' specialties. METHODS: A survey targeted 43 Egyptian universities with Bachelor of Dentistry (BDS) programs identified on the website of the Supreme Council of Egyptian Universities in 2022. Thirty-six deans could be reached by post and/ or email. The survey appraised the school profile and capacity, and methods of teaching and assessment in DPH courses in undergraduate dental programs. The survey also inquired who taught DPH courses and what was covered in the courses. Descriptive statistics were displayed. RESULTS: We received 21 (58.3%) responses from 36 deans/ senior officials. Of the universities, 52.4% were private and 47.6% were public. Most participants reported that DPH courses in BDS programs were taught by Pediatric Dentistry academics (71.4%) and DPH academics (57.1%) in 3rd, 4th and 5th years of the 5-year BDS programs. Teaching DPH consisted of face-to-face lectures (100%) and seminars (95.2%) and assessment included written exams with close ended questions (95.2%) and open-ended questions (71.4%). Twenty schools reported teaching the definition of DPH, definition of oral health, and determinants of oral diseases. Nine schools addressed the planning of oral health services and five schools taught about remuneration and payment systems. CONCLUSION: Teaching and assessment of DPH in Egyptian dental schools use traditional methods with limited active engagement of the students. Variations among the schools exist in the DPH topics covered and most instructors were not primarily specialized in DPH. Development of dental/ oral health services calls for more emphasis on DPH education in the curriculum in Egypt.

Oral and craniofacial research in the Generation R study: an executive summary.

OBJECTIVES: Oral conditions are of high prevalence and chronic character within the general population. Identifying the risk factors and determinants of oral disease is important, not only to reduce the burden of oral diseases, but also to improve (equal access to) oral health care systems, and to develop effective oral health promotion programs. Longitudinal population-based (birth-)cohort studies are very suitable to study risk factors on common oral diseases and have the potential to emphasize the importance of a healthy start for oral health. In this paper, we provide an overview of the comprehensive oral and craniofacial dataset that has been collected in the Generation R study: a population-based prospective birth cohort in the Netherlands that was designed to identify causes of health from fetal life until adulthood. METHODS: Within the multidisciplinary context of the Generation R study, oral and craniofacial data has been collected from the age of 3 years onwards, and continued at the age of six, nine, and thirteen. Data collection is continuing in 17-year-old participants. RESEARCH OUTCOMES: In total, the cohort population comprised 9749 children at birth, and 7405 eligible participants at the age of seventeen. Based on questionnaires, the dataset contains information on oral hygiene, dental visits, oral habits, oral health-related quality of life, orthodontic treatment, and obstructive sleep apnea. Based on direct measurements, the dataset contains information on dental caries, developmental defects of enamel, objective orthodontic treatment need, dental development, craniofacial characteristics, mandibular cortical thickness, and 3D facial measurements. CONCLUSIONS: Several research lines have been set up using the oral and craniofacial data linked with the extensive data collection that exists within the Generation R study. CLINICAL RELEVANCE: Being embedded in a multidisciplinary and longitudinal birth cohort study allows researchers to study several determinants of oral and craniofacial health, and to provide answers and insight into unknown etiologies and oral health problems in the general population.

Particle generation and dispersion from high-speed dental drilling.

OBJECTIVE: To investigate the characteristics of particle generation and dispersion during dental procedure using digital inline holography (DIH) METHODS: Particles at two locations, near-field and far-field, which represent the field closer to the procedure location and within 0.5 m from the procedure location respectively, are studied using two different DIH systems. The effect of three parameters namely rotational speed, coolant flow rate, and bur angle on particle generation and dispersion are evaluated by using 10 different operating conditions. The particle characteristics at different operating conditions are estimated from the holograms using machine learning-based analysis. RESULTS: The particle concentration decreased by at least two orders of magnitude between the near-field and far-field locations across the 10 different operating conditions, indicating significant dispersion of the particles. High rotational speed is found to produce a larger number of smaller particles, while lower rotational speeds generate larger particles. Coolant flow rate is found to have a greater impact on particle transport to the far-field location. Irregular shape dental particles account for 29% of total particles at far-field location, with the majority of these irregular shape particles having diameters ranging from 12 to 18 µm. CONCLUSIONS: All three parameters have significant effects on particle generation and dispersion, with rotational speed having a more significant influence on particle generation at near-field and coolant flow rate playing a more important role on particle transport to the far-field. CLINICAL RELEVANCE: This study provides valuable insights on particle characteristics during high-speed drilling. It can help dental professionals minimize exposure risks for themselves and patients by optimizing clinical operating conditions.

Dental unit waterline testing practices: an 11-Year retrospective study.

OBJECTIVES: This retrospective study examined the dental unit waterline (DUWL) testing practices of Saskatchewan dental clinics over a period of 11 years, with an emphasis on their responses after identification of high microbial levels. MATERIALS AND METHODS: Dental clinics (n = 137) aseptically collected samples of output water from their air/water syringes, handpieces, and ultrasonic scaler lines using Sigma-Aldrich® waterline test kits and delivered them to a quality assurance laboratory. Tests were incubated for seven days at room temperature, and those with heterotrophic plate counts > 500 CFU/mL were reported as failures. Statistical analyses were performed on a database containing 4,093 test results. RESULTS: Participating clinics submitted an average of 11 DUWL tests per year. Overall, 21% of tests failed, and a moderate positive association (rs=.52, p < 0.001) was found between clinics' DUWL testing frequency and failure rate. Only 7% of failed DUWL tests were followed up by collection of a subsequent test within two weeks, of which 47% still exceeded the 500 CFU/mL threshold. CONCLUSIONS: Our findings demonstrate an association between DUWL testing frequency and detection of unacceptable microbial levels, along with infrequent retesting and often-inadequate intervention after a failed test. This suggests the need for further efforts at the regulatory and educational levels to maintain adequate water quality during dental treatment. CLINICAL RELEVANCE: Procedural water can become contaminated in DUWLs and endanger patients. Regular DUWL monitoring and evidence-based interventions to treat contaminated systems are necessary to safeguard patient health.

Correlates of poor oral health related quality of life in a cohort of people who use methamphetamine in Australia.

OBJECTIVES: Methamphetamine use impacts oral health, but little is known about its impacts on oral health related quality of life (OHRQoL). In this study we examined OHRQoL in a cohort of people who use methamphetamine and assessed associations with sociodemographic, behavioural, psychosocial and dental service utilisation correlates. A secondary aim was to examine the relationship between methamphetamine route of administration and OHRQoL, to test whether smoking the drug is associated with reduced OHRQoL. METHODS: Cross-sectional analysis was performed, using data from VMAX, a cohort of people who use methamphetamine at least monthly in Victoria, Australia (n = 194). Utilising the oral health impact profile (OHIP-14), we assessed three OHRQoL outcomes: OHIP-14 prevalence, OHIP-14 extent and OHIP-14 severity. Regression analyses examined associations between independent variables and the three OHIP-14 outcome measures. RESULTS: A significant segment of the cohort (35%) reported poor OHRQoL. Overall, no statistically significant association was detected between methamphetamine route of administration and the three OHIP-14 outcomes. Participants living in rural areas, with moderate-to-severe self-reported depression and with methamphetamine dependence had significantly worse OHRQoL levels, which persisted after adjusting for other covariates. CONCLUSION: Overall, VMAX cohort participants reported reduced OHRQoL levels. Our findings highlight the need for upstream interventions to improve the OHRQoL of people who use methamphetamine, with specific focus on those living in rural locations. Further research on the links between OHRQoL and mental health among people who use methamphetamine is required.

Competencies for dental public health specialists: A thematic analysis.

INTRODUCTION: Competency frameworks have been used to accurately guide the training and assessment of professionals. Dental Public Health professionals require a variety of skills beyond clinical aspects to meet ongoing social, economic, epidemiologic, technological, etc. developments. The purpose of this study was to develop a primary competency framework for dental public health (DPH) professionals by reviewing existing documents that can be modified by authorities based on their needs. MATERIALS AND METHODS: To identify DPH competencies, first a literature review of current postgraduate DPH competencies was conducted in PubMed, Scopus, Google Scholar, and Google from May to June 2021. All English language documents addressing DPH competencies were included and transferred to MAXQDA software. Next, DPH competency domains were extracted and defined, using Clarke and Braun's six-step qualitative thematic analysis method. RESULTS: In total, 206 English documents were retrieved. After exclusion of 201 documents due to being duplicate or not related in screening stages, five full-text English documents describing competencies of DPH specialists from the United Kingdom, the United States, Australia and New Zealand, Canada, and Ireland were reviewed. Thematic analysis led to the provision of a framework consisting of all mentioned competencies in the reviewed documents including nine domains in education, research, management, policy, communication, leadership, professionalism, oral health status, and oral health services. CONCLUSION: The proposed primary framework covers all competency domains and, as a comprehensive tool, can be used as a guide by local, national, and international authorities to develop their own frameworks for training and evaluating the DPH workforce.

Oral cancer: Current status and public health perspectives / Le cancer oral : état des lieux et perspectives de santé publique

Despite advances in surgical and oncological treatments, the incidence and five-year survival rates (~50 percent) of oral cancers (OC) have not improved over the last decades and remain a major public health problem. Seventy percent are still diagnosed at a late stage (T3 or T4), with an average delay in diagnosis of two to five months. As the cure and survival of patients are directly related to the development stage of the tumor at the time of diagnosis, the objective of this work was to analyze all the determinants related to oral cancer and to propose new clinical approaches for diagnosis and screening. A proposal for new models of screening, training, and concrete action to improve public awareness of the major global problem of OC is made. The strengths and weaknesses of OC screening studies need to be objectively understood to effectively guide and energize testing in primary care settings, with the prospect of using new and emerging technologies that can help improve the discriminatory accuracy of case detection. Most national organizations have not, to date, recommended population-based mass screening, due to a lack of sufficient scientific evidence of associated mortality reduction. Where health care resources are high, opportunistic individual screening is recommended, although the low diagnostic capacity of front-line clinicians is alarming.

Malgré les progrès des traitements chirurgicaux et oncologiques, les taux d'incidence et de survie à 5 ans (~50 %) liés aux cancers oraux (CO) ne se sont pas améliorés au cours des dernières décennies et demeurent un problème majeur de santé publique. 70 % sont encore diagnostiqués à un stade tardif (T3 ou T4), avec un délai de diagnostic moyen de 2 à 5 mois. La guérison et la survie des patients étant directement liées au stade de développement de la tumeur au moment du diagnostic, l'objectif de ce travail est d'analyser l'ensemble des déterminants liés au cancer oral et de proposer de nouvelles approches cliniques de diagnostic et de dépistage. De nouveaux modèles de dépistage, de formations et d'actions concrètes sont proposés pour mieux sensibiliser la population à la problématique mondiale majeure que constitue le CO. Les forces et faiblesses des études de dépistage du CO nécessitent d'être objectivement appréhendées, pour orienter efficacement les essais dans les établissements de soins primaires et les dynamiser, avec la perspective d'utiliser de nouvelles technologies émergentes qui peuvent aider à améliorer la précision discriminatoire de la détection des cas. La plupart des organisations nationales n'ont, jusqu'à présent, pas recommandé le dépistage massif de la population, en raison d'un manque de preuves scientifiques suffisantes quant à la réduction de la mortalité qui lui serait associée. Lorsque les ressources en soins de santé sont élevées, un dépistage individuel opportuniste est recommandé, bien que la faiblesse de la capacité diagnostique des cliniciens en première ligne soit alarmante.

Towards planetary oral health / Vers une santé orale planétaire

It is time to consider the protection of our environment as a major public health issue in oral medicine. Evidence shows that activities related to dental practice, such as patient transportation, use of rare materials and chemicals, or energy consumption, affect our ecosystems and contribute to the global degradation we are increasingly observing. The degradation of our environment is considered the greatest threat to our health. Exposure of oral tissues to multiple environmental factors can lead to pathological conditions. In addition to these direct effects, there are more complex phenomena, leading to co-deficits in the health of populations. The example of the sugar industry illustrates the systemic failures resulting in the double degradation of the environment and the health of individuals. Face with these dynamically interacting phenomena, human communities must consider systemic responses such as those described in this article. The dental community will need to do its part and consider global oral health as a central issue. This conceptual work will help define the innovations and action needed to ensure equitable practice that respects planetary limits.

Il est temps de considérer la protection de notre environnement comme un enjeu majeur de santé publique en médecine bucco-dentaire. Des données probantes montrent en effet que les activités liées à la pratique dentaire, comme le transport de patients, l'utilisation de matériaux rares, de produits chimiques, ou la consommation énergétique, affectent nos écosystèmes et contribuent aux dégradations planétaires que nous observons de plus en plus. Par rétroaction, la dégradation de notre environnement est considérée comme la plus grande menace pour notre santé. L'exposition des tissus de la sphère orale à de multiples facteurs environnementaux peut en effet conduire à des états pathologiques. À ces effets directs s'ajoutent des phénomènes plus complexes, induisant des co-déficits sur la santé des populations. L'exemple de l'industrie du sucre illustre les défaillances systémiques menant à la double dégradation de l'environnement et de la santé des individus. À ces phénomènes en interaction dynamique, les communautés humaines doivent envisager des réponses systémiques comme celles que nous décrivons dans cet article. La communauté dentaire devra faire sa juste part et considérer la santé orale planétaire comme un enjeu central. Ce travail conceptuel permettra de définir les innovations nécessaires et les actions adaptées pour garantir une pratique équitable et respectueuse des limites planétaires.

Oral health promotion and programming provided by Aboriginal Community Controlled Health Organisations in South Australia.

BACKGROUND: Aboriginal Community Controlled Health Organisations (ACCHOs) play a critical role in supporting Aboriginal and Torres Strait Islander health in Australia. This article aims to identify and describe oral health programming and promotion provided by ACCHOs in South Australia. METHODS: All ACCHOs in South Australia were identified through the Aboriginal Health Council of South Australia. A targeted search strategy was designed to include the websites and social media pages (Facebook, Twitter, Instagram) for each organisation. Program characteristics were extracted and summarised, and oral health promotion content was analysed utilising content analysis. RESULTS: Twelve programs were identified across the 12 ACCHOs in South Australia. Of these, seven focused on oral health and five focused on nutrition. Oral health and nutrition information shared online by ACCHOs was extracted and aggregated into oral health and nutrition categories, which included reminders about visiting services, advocacy statements, oral hygiene messaging, appointment availability, education resources, and upcoming community-based activities. CONCLUSIONS: The evidence explored highlights the integral role ACCHOs play in oral health promotion and service delivery. It is critically important that ACCHOs are involved in development and implementation of oral health services to ensure programming reflects community knowledges and is effective in improving oral health equity.