Dental hygienists working in schools - a two-year oral health intervention programme in swedish secondary schools.

PURPOSE: To investigate the possibility of influencing adolescents' caries incidence, knowledge and attitudes to oral health and tobacco through a school-based oral health intervention programme. MATERIALS AND METHODS: Four schools in a county in Sweden were randomised to one intervention and one control group. At the intervention schools, two dental hygienists worked 4 h every week for two years. Health education and preventive measures, such as fluoride varnish treatments every 6 months, were performed. The control group had no intervention. The study included a total of 534 participants aged 12-16 years. Outcome variables of the study were 1) caries incidence assessed on bite-wing radiographs and 2) knowledge and attitudes measured through questionnaires. RESULTS: The intervention programme impacted on the incidence of enamel caries, while no effect on dentin caries could be seen. Data from the questionnaires showed that the adolescents considered their teeth as important. Adolescents in the intervention group had better knowledge about oral health and oral hygiene compared to the control group after the two years, but no impact on attitudes toward tobacco could be seen. A majority of the adolescents were positive to the education about oral health and tobacco and they believed that the dental hygienists would help them improve their oral health. CONCLUSIONS: Although the effects of the intervention as regards to caries incidence, knowledge and attitudes were limited, the presence of dental hygienists in school was appreciated by the adolescents and seemed to increase their interest in their oral health.

The impact of behavioural interventions on young people's attitudes toward tobacco use.

PURPOSE: The objective of the present study was to study the ability to influence young at-risk patients' attitudes toward tobacco use through two intervention methods that were performed by dental health professionals. MATERIALS AND METHODS: Two interventions, a brief individual motivational interview and an adapted school lecture, were studied, and both were compared with a control group. Before and after interventions, a questionnaire was used. Patients born in 1989 and 1992 who were judged by the dental personnel as potentially at risk for dental diseases, a total of 301 individuals, were included. RESULTS: Both before and after interventions, the results showed a generally negative attitude towards tobacco use. A majority of the participants were positive towards measures that were taken to control the spread of tobacco use, younger participants (born 1992) to a greater extent (73%) than the older participants (born 1989) (54%). Important factors that kept the participants away from tobacco use were the harmful effects and the approaches of parents and friends. The older participants believed to a greater extent that they would try smoking as adults. No change in tobacco use was registered after intervention, although the participants reported an increased use among friends. CONCLUSIONS: The two pedagogical methods that were used in the present study influenced the young people's attitudes towards tobacco use only to a small extent. However, the period between 12 and 15 years old seems to provide a good opportunity to influence attitudes towards tobacco. The adolescents' demand for interactive learning and their development of attitudes and tobacco use habits in relation to family and friends provide opportunities to use new pedagogical models.

Patient Experiences of Therapeutic Jaw Exercises in the Treatment of Masticatory Myofascial Pain: A Qualitative Study.

AIMS: To investigate patients' experiences of therapeutic jaw exercises for treating masticatory myofascial pain. METHODS: A total of 10 patients were selected for the interview study. All patients had received treatment with jaw exercises at a specialist clinic. Semi-structured interviews were conducted in a nonclinical environment according to an interview guide with 10 domains. The interviews were transcribed and translated into English. Systematic text condensation (STC) was used to arrange and analyze the text material. RESULTS: In the systematic process of analyzing the qualitative data, four main themes were identified: "Patient Adherence," "Symptoms," "Treatment Effect," and "Participation." Most informants were initially skeptical of the jaw exercises due to their simplicity. Later on, the simplicity of the exercises and the fact that they did not need more advanced treatment were valued most by a majority of patients. Some informants suspected serious disease behind their symptoms. Treatment effects on pain and physical impairment were reported. To do the jaw exercises in conjunction with an already established routine seemed important to enhance adherence. Trust in the caregiver and being able to remedy their pain by themselves were also important to the informants. CONCLUSION: Jaw exercises are a useful treatment valued by patients due to their simplicity and effectiveness. However, before the treatment, patients should be informed about the cause of the symptoms, and any skepticism should be addressed. Results from this qualitative study cannot be generalized, but the study design and the selected population allow the results to be transferable to similar contexts.

Knowledge of and attitude to oral health and oral diseases among young adolescents in Sweden.

The aim of this study was to investigate the knowledge of and attitudes to oral health among 12- and 15-year-old students in Sweden. The results are designed to act as a baseline survey to evaluate future interventions. From all 85 schools in the County of Uppsala, ten schools were randomly selected. In all, 993 students were offered the chance to participate in the study. 793 (8o%) individuals answered a questionnaire consisted of fifteen structured questions about their knowledge and attitudes to oral health. The result showed that the level of knowledge by adolescents is relatively high. A large majority of the subjects felt that their teeth were important. Most of the adolescents had learned about oral health from the dental team. With the exception of the question about the meaning of the word "periodontitis", all the questions produced a distribution of correct answers in favour of the girls. Older students showed more knowledge compared with younger students. In none of the questions did the younger students display more knowledge than the older. The adolescents with an immigrant background showed less knowledge compared with natives of Sweden in several areas. Despite having less knowledge of oral health, more students with an immigrant background than natives of Sweden stated that their teeth were important. Several of the survey questions call for answers in the form of factual knowledge. Knowledge is therefore regarded as a quantitative measure of a reproduction, where the adolescents are expected to reproduce something that they have already learned. Increasing criticism has been levelled against this view of knowledge. Facts are not enough to induce young people to change their health behaviour. Facts are an important part of the message but must be complemented by reflection and consideration of how the receiver understands it.