Dental Health Education Program Research Articles

The Effects of Dental Health Education Program by Applying the Protection Motivation Theory and Social Support on Behavioral Modification for Gingivitis Prevention Among the Six Grade Students, Muang District, Nakhon Ratchasima Province

The Effects of Dental Health Education Program by Applying the Protection Motivation Theory and Social Support on Behavioral Modification for Gingivitis Prevention Among the Six Grade Students, Muang District, Nakhon Ratchasima Province

Oral Malodor and Related Factors in Japanese Senior High School Students

Oral malodor (halitosis or bad breath) might be an important motivation tool for improving oral health in adolescents. There are few studies that report the epidemiology of oral malodor in high school students and the relationships with lifestyle and oral health status. This research was conducted to obtain underlying data for introducing an oral health education program which targeted prevention of oral malodor as a motivation tool for changing oral health behavior in high school students. A questionnaire, school oral examination, and oral malodor measurement were conducted on senior high school students in a Tokyo metropolitan school in 2007. A total of 474 students (male: 219, female: 255) were used for the analysis. Over 42% of subjects reported that they had experienced anxiety, or were conscious of oral malodor, on at least 1 occasion. The students who had detectable oral malodor comprised 39.6% of subjects. The binary logistic regression analyses showed that whether or not subjects ate breakfast before the oral examination (p < .05), the presence of plaque (p < .01), and presence of a substantive tongue coating (p < .01) were related to the presence of detectable oral malodor. Cleaning the oral cavity and eating breakfast are important to prevent oral malodor in high school students. This study indicated that school health education incorporating prevention of oral malodor as a motivation tool for oral health promotion could be a valuable procedure to include in high school dental health education programs.

The Development and Effectiveness of a Dental Health Education Program Including Self-Evaluation for Junior High School Students

The Development and Effectiveness of a Dental Health Education Program Including Self-Evaluation for Junior High School Students

The self-reported oral health status and behaviors of adults who are deaf and blind

This qualitative study explored perceived oral health, felt need, oral health knowledge and behaviors, and utilization of dental services among a community of deaf and blind adults in Toronto, Canada. Seven adults participated in in depth interviews facilitated by intervenors skilled in communication with people who are deaf and blind. Subjects reported that their oral health was good, however oral health knowledge was poor and daily oral hygiene practices were minimal. Few subjects had ever received dental health education and were largely unaware of how to prevent dental disease. A subsidized dental program enabled subjects to have regular dental visits, though they were concerned about the costs of more complex dental treatment not covered by the program. They also worried about finding an alternative source of care once their eligibility for the program ceased at the age of 65. The presence of the subsidized sympathetic dental program and the facilitative role of intervenors promoted utilization of dental care for many of the subjects who participated in this study. There is a clear need to develop appropriate dental health education programs for this group of people, which would harness the support of the community of deaf and blind people and their intervenors. The interventions need to be sensitive and appropriate for the individual's level of impairment.

Belief, Knowledge, and Practice about Oral Health Care of Middle-aged Women

Purpose: This study was performed to identify the relationship between belief, knowledge, and practice about oral health care of middle-aged women, and to prepare baseline data for developing a dental health education and promotion program, Method: For the survey, 120 individuals(middle-aged women) were chosen by convenience sampling and agreed to participate in the study. Their belief, knowledge, and practice about oral health care were measured, For descriptive statistics, t-test, ANOVA, Tukey and Pearson's correlation coefficient were used with SPSS Win 14,0. Result: The level of belief and practice about oral health care was middle for the subjects, However, the level of knowledge about oral health care was relatively high. The level of practice about oral health care related to characteristics of subjects showed significant differences according to level of education and oral health status. There was no significant correlation between the level of practice and the belief about oral health care, The practice about oral health care showed a significant positive correlation with knowledge. Conclusion: These findings demonstrate a need for the development of oral health care programs that is effective in improving belief, knowledge, and practice about oral health care reported by middle-aged women.

Designing school programmes to be effective vehicles for changing oral hygiene behaviour

Schools are a commonly used setting for dental health education, health promotion and interventions with preventive agents. However, traditional dental health education programmes are rarely designed to be effective change agents. Twice daily tooth brushing with fluoride toothpaste has consistently been shown to be an important behaviour for controlling dental caries in children. Ideally, parents incorporate twice daily brushing into their child’s hygiene routine. Families where brushing is irregular are over-represented in areas of socio-economic deprivation and the effects of irregular oral hygiene are often compounded by cariogenic diets. Therefore, in communities with high caries levels, a targeted community approach to prevention can provide additional benefit, through fluoride programmes delivered in school. It is essential that dental health education programmes are designed to recognise the social, cultural and environmental context in which the behaviours occur. This paper provides a new framework to classify school programmes. In addition, evidence-based guidance is developed of the necessary components for programmes to enhance effectiveness in establishing the key behaviour of twice-daily tooth brushing with fluoridated toothpaste.

An Ecological Study on the Association of Public Dental Health Activities and Sociodemographic Characteristics with Caries Prevalence in Japanese 3-Year-Old Children

The aim of this ecological study was to determine the association of the frequency of dental health activities conducted as public health service and sociodemographic characteristics with caries prevalence in Japanese 3-year-old children using data for each municipality as one unit. Data on caries prevalence in 3-year-old children in 2000 were obtained from 3,251 municipalities (almost all municipalities in Japan). Caries prevalence for each municipality was recalculated using the empirical Bayes estimation model to make adjustments for variations in municipalities with small numbers of children. Explanatory factors included annual frequency of dental health activities such as dental health education and topical fluoride application programs and various sociodemographic characteristics. Multiple linear regression analysis was applied to examine the associations between caries prevalence and annual frequency of dental health activities with adjustment of other sociodemographic variables. Variations in caries prevalence in municipalities with small populations became smaller after being adjusted by the empirical Bayes estimation model. Multiple linear regression analysis showed significant associations of caries prevalence with sociodemographic characteristics such as the proportion of residents with university degrees, total fertility rate, and the proportion of workers in the manufacturing industry (p < 0.001). Annual frequency of topical fluoride application showed a significant but relatively weak association with caries prevalence (p < 0.001), explaining only 0.8% of the total variation in caries prevalence, whereas no correlation was found between caries prevalence and annual frequency of dental health education. It was concluded that the effect of the fluoride application service on caries prevalence in 3-year-old children, although statistically significant, was of far lower clinical significance than sociodemographic characteristics.

Cost-effectiveness of a long-term dental health education program for the prevention of early childhood caries

To evaluate the benefit-cost (B/C) and cost-effectiveness (C/E) of a long-term dental health education program to prevention early childhood caries (ECC) through home visits. The data collected over a three year period in a dental health education programme (DHE), previously reported [Kowash et al., 2000] for infants aged 8 months at start were analysed for B/C and C/E. Dental caries indices (BASCD) for dmft and dmfs were used. Costs were based on British National Health Service (UK) fees for treating children by general dental practitioners and salaries for community dental officers in the Community Dental Services in the UK. Comparisons were made for B/C and C/E with results from a clinical trial of a slow releasing fluoride device (SRFD), community water fluoridation (CMF) and a school based fissure sealant program (FSP) using the hypothetical community of Niessen and Douglass, [1984]. The cavities, as ECC, saved over the three year period indicated a B/C ratio for the DHE of 5.21 compared with SRFD of 4.17; CWF of 1.15 and FSP of 0.42. The C/E results were 1.92, 2.40, 8.66 and 23.74 respectively. A dental health education program of home visits with mothers of young infants to prevent early childhood caries and starting at 8 months of age, gave better benefit-costs and costs effectiveness ratios than other preventive programs.

Dental health status of adult population in Yemen (Thamar City)

Aims: To evaluate the oral health status (dental caries, periodontal disease and treatment needs) in Yemenis adult individuals. Material and Methods: The sample included 471 individuals, age ranging between 20–59 years of both sexes using sharp dental caries explorers with WHO periodontal probes to detect periodontal health by the use of DMFT index of WHO (1997) and CPITN by WHO (1987). Results: The mean DMFT for the total sample was 7.33 + 0.3 which was increased with increasing age for the different age groups with a significant difference but no significant difference in the mean DMFT for total males and females has been found. The results also showed that the total number of teeth (880) with a mean of 1.81 tooth/person in need of treatment is the most prevalent needed one surface filling, and 581 teeth with a mean of 1.23 tooth/ person needed two or more surfaces filling. According to the highest CPITN there was significant difference between male and female in calculus at p < 0.05 and shallow pockets at p < 0.01. The results also revealed that the mean number of healthy sextants for the total sample was 4.13 while for bleeding and calculus were 1.02 and 0.21, respectively. It means that the treatment needs for periodontal disease is more toward oral hygiene procedure and prophylaxis. Conclusion: Dental health education program is an essential activity for promoting optimal oral health and preventing oral diseases

Prevalence of Dental Caries, Severity, and Pattern in Age 6 to 7-Year-old Children in a Selected Community in Saudi Arabia

The aim of this study was to determine the prevalence, severity, and pattern of dental caries in 6 to 7-year-old children in military primary schools in Jeddah city, Saudi Arabia. A random sample of 300 children (6 to 7-year-olds) was drawn from six schools of military dependents. Clinical examinations were carried out under standardized conditions by two trained and calibrated examiners (MAM) and (YR). Caries were diagnosed using the British Association for the Study of Community Dentistry (BASCD) criteria. Caries were diagnosed in 288 (96%) of the children, and only 4% were clinically caries free. Mean decayed, missing, and filled teeth (dmft) for the 300 children was 8.06 (+ 4.04) per child and mean decayed, missing, and filled surfaces (dmfs) was 23.18 (+ 15.64). The teeth most affected by caries were mandibular primary second molars (83.35%), and the least affected were mandibular primary central incisors (1.15%). The level of caries was higher than seen in children of equivalent age in other studies. The level of caries is expected to increase in permanent dentition. The above findings stress the need for an effective program of oral prevention in these children, such as a school dental health education program for children and their parents in order to improve their oral health status.

Evaluating the effectiveness of school-based dental health education program among children of different socioeconomic groups

The aim of the present study was to evaluate the effectiveness of Dental Health Education programs among school children of different socioeconomic groups. The investigators made a visit to three different schools and studied 500 children. A ten items, open-ended, self-administered questionnaire was pretested on the primary and higher primary school children before and after an educational intervention. A second visit was made to one of the schools 1 year later and the same questionnaire was re-administered to those subjects who had participated in the original study. Results showed that although educational intervention was successful in improving the Dental health awareness of most children, the socioeconomic background is an important determinant for the same. Also, single-lecture technique seems to be inadequate in improving the knowledge of children in the long term.

Evaluation of a dental health education program for midwives.

The aim of the present study was to evaluate the effect of a dental health program for the midwives in primary health care services in Izmir, Turkey. One hundred sixty-four midwives participated in the pilot project. The program was evaluated by quantitative and qualitative methods. The quantitative method assessed the improvement of the dental knowledge level, whereas the qualitative method was conducted to determine the assessments of the participants. The percentages of correct responses given to knowledge items were higher after the program. The midwives defined their role as an important first step for dental services. Education atmosphere was the best characteristic of the program, whereas lack of a written document was an important limitation. Despite some limitations, the program was an effective way of improving the oral health knowledge of the midwives and their motivation for dental services.

An investigation into the value and relevance of oral health promotion leaflets for young adolescents

To determine if oral health promotion leaflets of a novel design and content would be read by, acceptable to and influence 11-12-year-old children. Three related leaflets were incorporated into a dental health education programme aimed at 11-12-year-old children. The leaflets were designed specifically, following consultation with focus groups. They had a romantic story line and emphasised the immediate gains from good dental health, relevant to this age group. A random sample of pupils completed a written questionnaire on the impact of the leaflets at the end of the one-year programme. These sample pupils underwent a clinical examination to measure plaque before and after the programme. 2,678 pupils with a mean age of 12.1 years participated in the programme. 895 were randomly selected to join the assessment study. Most pupils 81%, (725) reported they had read the leaflets; 61% (442) finding them enjoyable to read, 51% (370) attractive to look at and 71% (515) finding the story lines interesting. However, girls appreciated the leaflets more than the boys. There was some suggestion that the leaflets played a positive role in the overall success of the programme in that most pupils 83% (602) reported they thought more about caring for their teeth after reading the leaflets and 58% reported their brushing frequency had increased. The results indicate that for adolescents, leaflets which feature interpersonal relationships are well accepted and can stimulate better oral health behaviour.

A Cluster Randomized Controlled Trial of a Dental Health Education Program for 10‐year‐old Children

Using a cluster randomized trial, this study tested the effectiveness of a dental health education program designed to improve the oral hygiene and dental knowledge of 10-year-old children. Thirty-two primary schools in the northwest of England participated. After a baseline assessment of plaque and the completion of a dental knowledge questionnaire by the children, the schools were allocated randomly to active or control groups. Children in schools allocated to the active group received the dental health program, which consisted of four one-hour lessons. After four months the children were examined clinically and scored for plaque, and a second questionnaire was administered. The schools in the control group were then allocated randomly to receive the program or not over the following three months, the program being withdrawn from the schools who initially received it. A further assessment of plaque was made and a questionnaire administered seven months after the baseline of the study. The active groups had 20 percent and 17 percent lower mean plaque scores than the control group at four and seven months (P < .001). The children's knowledge of which type of toothbrush should be used and the role of disclosing tablets improved in the initial test group when compared with the control group and this was retained over the second part of the study. The children receiving the program had significantly lower mean plaque scores and greater knowledge about toothbrushes and disclosing tablets than the control children who had not received the program.

The aetiology of dento-alveolar injuries and factors influencing attendance for emergency care of adolescents in the north west of England.

The aims of the study were to determine the main aetiological factors involved in injuries to anterior teeth and to identify factors influencing the attendance for emergency care. This information is essential, first, for planning dental health education programmes aimed at reducing the incidence of dental trauma and, second, to devise strategies for its effective treatment. Of 2022 schoolchildren examined for evidence of dental trauma, 696 (34%) had experienced injury and were interviewed regarding this injury. Of these, 403 knew about their damaged front tooth, but only 330 recollected the incident causing the injury. Over one third of accidents occurred at home and a further 25% at school. The most common cause of injury was falling onto a hard surface or object (34%) with accidents involving bicycles or other sporting activities accounting for a further 30%. Factors found to be significantly related to attendance for emergency care were experience of pain, unattractive appearance of the injured tooth and social classification, with children from higher income, more affluent areas being more likely to seek treatment. The majority of dental injuries were the result of genuine accidents which were almost impossible to prevent. This study highlighted the need for attention to be brought to parents, children, lay people and health care professionals that all dental injuries should be examined by a dentist, not just those injuries resulting in pain or poor aesthetics.

Geochemistry, genesis, and health implications of fluoriferous groundwaters in the upper regions of Ghana

The most appropriate and widely used source of drinking water for the populations of the upper regions of Ghana is groundwater. In general, groundwater quality is acceptable except for some parts of the Bolgatanga and Bongo Districts, where there are occurrences of elevated levels of natural groundwater fluoride. Concentrations of groundwater fluoride in excess of the World Health Organization (WHO) maximum guideline value (1.5 mg/l) in the Bongo area have been known since 1978. However, the effect of fluoride on people ingesting the water did not receive public and medical attention until October 1993, when health personnel were asked to investigate the cause of stained teeth in school children. The investigation established that 62% of the total population of school children in the Bongo area had dental fluorosis. Against this background, a study was initiated to understand the geochemistry, genesis, and distribution of fluoride in relation to the geology of the area. Groundwater fluoride in the upper regions ranges from 0.11 to 4.60 ppm, with the highest concentrations associated with the fluorine-enriched Bongo coarse-grained hornblende granite and syenite suite. The source of groundwater fluoride within the Bongo granitoids is dissolution of the mineral fluorite and dissolution of and anion exchange with micaceous minerals and their clay products. Applying the WHO recommended guideline values for fluoride in drinking water reveals that 49% of wells in the area deliver water below the optimum level of 0.5 mg/l F–; these populations are thus prone to dental caries. Twenty-eight percent of the wells fall within the optimum interval for good dental health (0.5–1.5 mg/l F–). Twenty-three percent of the wells have concentrations above the recommended maximum guideline limit of 1.5 mg/l F–; this population is susceptible to dental and possibly skeletal fluorosis. Climatic conditions of the area suggest that the individual water consumption is in the order of 3 to 4 l which is higher than the WHO estimate of 2 l/adult/day. In addition, dietary intake for the upper region population is probably higher than WHO baseline values (0.2–0.5 mg/day). This implies that a much higher population is susceptible to developing dental and skeletal fluorosis than originally suspected. Geochemical symbol plot maps help geochemists understand factors controlling the distribution and uptake of fluoride in the upper regions, but they are of minimal value to health officials responsible for planning epidemiological studies and dental health education programs in the region. By casting fluoride data into contoured 'geochemical health-risk maps' using intake interval guidelines more closely aligned to regional climatic and dietary conditions, health officals can better judge the impacts (regional and population based) of fluoride on segments of the population, such as various sex and age groups.

Water fluoridation results in Basel since 1962: health and political implications.

The population of the canton Basel-City has been provided with fluoridated water since May 1962. This paper presents a summary of basic findings from evaluations of this public health intervention. Standard methods were used for assessing dental caries, enamel fluorosis, urinary fluoride, and other data. Caries prevalence of schoolchildren declined until 1977 because of water fluoridation, after which it continued to decline until the late 1980s due to reasons other than water fluoridation. Caries prevalence in Basel was at least as low as in those other parts of Switzerland where either school-based dental health education programs or comprehensive salt fluoridation programs had been implemented for many years. Enamel fluorosis was seen in 38 percent of the children, similar to regions with comprehensive salt fluoridation, but higher than in low-fluoride regions. Overlap of salt and water fluoridation in families consuming both fluoridated water and fluoridated salt has occurred, but has not resulted in problems. Fluoride concentrations (close to, but mostly below 1.0 ppm) and excretions (0.45-0.80 mg F per day in children, around 1 mg in adults) corresponded to expected levels. Statistics from both the School Dental Service and the Public Dental Clinic indicate a dramatic reduction in the amount of conservation dentistry being done and, in adults, prosthetic services. Political steps to remove water fluoridation were taken in 1976, 1982, 1989, and 1993, but have not been successful. Water fluoridation has resulted in the expected benefit and continues to exist beside salt fluoridation used in the other cantons of Switzerland.

Dental health knowledge of Chinese kindergarten teachers

When developing dental health programmes for pre-school children involvement of kindergarten teachers must be considered as important. It becomes critical to assess the teachers' dental health knowledge and attitudes, because they will exert influence on the children and thus on the programme outcome. The purpose of the present study was to assess possible changes in the dental visit habits and the dental health knowledge of Chinese kindergarten teachers prior to their involvement in a kindergarten-based daily toothbrushing programme and after they had received dental health education from dental health professionals. Self-completed questionnaires were collected from two groups of kindergarten teachers of which one group received dental health education, whereas the other did not receive any information. The teachers were similar in age, education, experience and responsibilities. No difference in the dental visit pattern was found between the groups, but statistically significantly higher dental health knowledge was shown in the group who had received dental health education. The increase in the dental health knowledge was attributed to the influence from the dental health education programme. The results are considered important for the further development of dental health education in the Chinese kindergartens.

A dental health education programme, including home visits, for nursery school children

The aim of this study was to measure the effectiveness of three preventive programmes by measuring changes in oral hygiene, gingivitis and the uptake of dental care of nursery school and young primary school children living in areas of urban deprivation. The oral hygiene and gingivitis of a group of children who brushed their teeth daily at school improved during the study, but deteriorated during the summer holiday. A second group of children also brushed their teeth at school, and in addition their parents were given dental health education by a dental hygienist at home. Parents of a third group of children were given dental health education only at home. The oral hygiene and gingivitis of both the second and third groups improved and was maintained during the school holiday. The preventive programmes had little effect on the uptake of dental care in any of the study groups.

Predicting Mothers' Intentions to Limit Frequency of Infants' Sugar Intake: Testing the Theory of Planned Behavior1

This study examines the ability of the Theory of Planned Behavior to account for mothers' intentions to limit the frequency of their infants' sugar consumption. One group of mothers (experimental) was exposed to a dental health education program designed to promote this behavior, the other (control) group was not. Each group of mothers was interviewed twice; the intervention was delivered to mothers in the experimental group immediately after their first interview. The interviews incorporated measures of the key constructs in the Theory of Planned Behavior (attitudes to behavior, subjective norms, perceived behavioral control, and behavioral intentions). Results indicated that the addition of perceived behavioral control resulted in small but significant increments in the amount of explained variance in intentions, thereby supporting the theory. Although the change in intentions to perform the advocated behavior was not significantly greater in the experimental group than in the control group, there was a significant change in attitudes to the behavior in the experimental group but no such change in the control group. Moreover, amount of change in behavioral intentions was significantly correlated with amount of change in attitudes, but not with amount of change in subjective norms or perceived behavioral control. Analysis of behavioral beliefs indicated that the attitude change reflected a change in a specific behavioral belief that was targeted in the intervention. Further analyses focused on the role played by direct experience of the behavior and show that such experience tended to enhance the role of perceived behavioral control in intention formation, apparently because mothers who have older children have discovered that they have relatively little control over frequency of child's sugar consumption. The implication of these results for the Theory of Planned Behavior are discussed.