Oral Health Promotion Strategies Research Articles

Oral Health Care Among Women in Perimenopause or Menopause: An Integrative Review.

Women in menopause are at a higher risk of developing oral health problems, affecting their overall quality of life. Several studies have identified the role of health care providers in addressing women's oral health needs across various phases of their lives, yet a review in the area of perimenopause and menopause has not been undertaken. Therefore, the aim of this review was to explore current evidence regarding the oral health knowledge, attitudes, and practices of women in perimenopause or menopause and their health care providers. Additionally, guidelines and recommendations to inform strategies for oral health promotion are included. A systematic search was carried out across 5 databases. Inclusion criteria included articles published in English that examined at least one study outcome: oral health knowledge, attitudes, and practices of either women in perimenopause or menopause or of health care providers or guidelines around oral health care. Qualitative, quantitative, mixed-methods, and experimental studies with survey components were included with no restrictions on publication period, quality, or setting. A total of 12 articles met the inclusion criteria, with a majority being of poor quality and mostly from low-income and middle-income countries. Overall findings indicated that there was a lack of knowledge and limited practices in maintaining oral hygiene and visiting the dentist among women in perimenopause or menopause. Health care providers exhibited poor attitudes in advising the importance of periodic dental check-ups and informing oral health changes during this period. There were also insufficient guidelines to adopt care for women and guide health care providers in their practice. Women in perimenopause or menopause have limited oral health knowledge and unmet oral health needs. Appropriate guidelines and supportive strategies are required to assist health care providers in providing comprehensive care and encouragement to women in perimenopause or menopause to improve their oral health.

The Public Health Approach to Oral Health: A Literature Review

Background: Oral health (OH) has evolved beyond dental concerns to encompass psychosocial dimensions and overall well-being. This study reviews OH strategies within a public health framework to identify key elements for effective OH promotion. Methods: A literature review following PRISMA guidelines identified 42 relevant articles from 62 screened. Five themes emerged: group-level, individual-level, policy-level (emphasizing devising OH policies), healthcare delivery, and communication. Common components included OH education, behaviour change, access to OH services, and policy integration. Results: Thematic analysis identified five overarching themes in oral health (OH) promotion strategies, with a focus on tailored approaches for specific populations and components such as education, access to services, interventions, and policy, emphasizing the multifaceted nature of OH promotion. Conclusion: Effective OH promotion requires a multifaceted approach and tailored strategies with interprofessional collaboration. Future research should focus on cost-effectiveness and user-friendly resources for OH professionals and policymakers.

Alterations in salivary biomarkers in relation to periodontal health and obesity among Hong Kong adolescents

ObjectivesTo explore the association among salivary biomarkers, periodontal inflammation, and adiposity status in adolescents. MethodsThis study included 180 Hong Kong adolescents aged 12–15 years. Anthropometric measurements including central obesity surrogate, waist-to-height ratio (WHtR), and dental examinations were conducted. The participants were classified into four groups as follows: with normal WHtR and less extensive periodontal inflammation (NW+LP); with high WHtR and less extensive periodontal inflammation (HW+LP); with normal WHtR and more extensive periodontal inflammation (NW+P); and with high WHtR and more extensive periodontal inflammation (HW+P). Saliva were collected to measure salivary physicochemical parameters, total bacterial load, and levels of protein biomarkers including secretory phospholipase A2 group IIA (sPLA2-IIA) and interleukin-6 (IL-6). Data were analysed by Kruskal-Wallis test and Spearman correlation coefficient. ResultsSalivary IL-6 levels and sPLA2-IIA and IL-6 output differed significantly between groups (P = 0.041, 0.027, and 0.043, respectively). The NW+P group had significantly higher salivary IL-6 output than the NW+LP group (P = 0.034) and significantly lower salivary sPLA2-IIA output than the HW+LP group (P = 0.038). Salivary IL-6 levels were negatively correlated with the number of sextants with healthy gingivae and positively correlated with salivary sPLA2-IIA levels in participants with normal WHtR. Salivary sPLA2-IIA levels were negatively correlated with total salivary bacterial load in participants with high WHtR. ConclusionsSalivary IL-6 levels were associated with the extent of periodontal inflammation in participants with normal WHtR but not in those with high WHtR. Adolescents with different adiposity status may have different mechanisms of periodontal inflammation. Clinical significanceInvestigating salivary biomarkers of periodontal health holds potential benefits in identifying individuals at risk and customizing oral health promotion strategies for individuals with varying levels of adiposity, even as early as adolescence.

Fluoridated food on preventing dental caries in Latin American and Caribbean children and adolescents: a systematic review

Dental caries is a significant global public health challenge, particularly among children and adolescents. It affects individuals' quality of life and can lead to various adverse outcomes, including pain, infection, and impaired school performance. Fluoride has been widely recognized as a key component in oral health improvement programs due to its ability to prevent tooth demineralization and promote remineralization. This systematic review aimed to evaluate the existing literature on the effectiveness of fluoridated food interventions in preventing dental caries in Latin American and Caribbean children and adolescents. The study focuses on this specific region, which faces unique challenges such as limited access to dental care services, socioeconomic inequalities, and cultural practices that may influence oral hygiene and dietary habits. The review follows the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. A comprehensive search was conducted in multiple databases, including EMBASE, MEDLINE, Scielo, and Web of Science. The search strategy utilized relevant MeSH terms and Boolean phrases related to fluoridated food interventions and dental caries in children aged 12 years and younger. After screening the articles based on predetermined inclusion criteria, no study met the eligibility criteria for inclusion in the systematic review. Overall, the systematic review highlights the absence of high-quality available evidence specifically focused on the effectiveness of fluoridated food interventions on children and adolescents of the Latin American and the Caribbean, underscoring the importance of conducting further studies to inform evidence-based decisions regarding public health policies, resource allocation, and oral health promotion strategies in this population.

Utilisation of Oral Health Services and Associated Factors in a Sub-Urban Population in Western Uganda

Aim: To determine the prevalence and factors affecting the level of utilization of oral health services in a sub urban adult population in Ishaka-Western Uganda. Methods: A community-based cross-sectional study was conducted among 384 study participants. Data was collected using pre-tested and structured questionnaires. Data was entered in Epi-info computer software version 3.5.1 and exported to STATA Version 14.0 for analysis. Univariate analysis and modified Poisson regression were done to identify factors associated with utilization of oral health services. Crude prevalence ratios with 95% confidence interval were used to determine the level of significance at bivariate meanwhile adjusted prevalence ratios were calculated at multivariate analysis to establish independent significant factors. Results: The mean age of the study participants was 30.22 ± 9.97. It was observed that 36.72% of the study participants had utilized oral health services. Factors affecting utilization of oral health services that were statistically significant were level of education (tertiary level of education versus none) (P<0.001), average monthly income of >1,000,0000 Shilings (about $300) versus <501,000 ( about $150) (P<0.001), no phobia for dental procedures (P=0.035), perception that oral health visits are important (P=0.017) and positive attitude of attending health workers ( P=0.028). Conclusion: This study has shown that the level of utilization of oral health services in the studied suburban adult population was poor. The level of education, income and phobia for dental procedures were associated with the utilization of oral health services. It is recommended that oral health promotion strategies be deployed in order to increase awareness and access to oral health care. Keywords: Oral health services, community-based cross-sectional study, Uganda

Impact of COVID-19 on Dental Care Utilization and Oral Health Conditions in the United States.

We aim to understand the impact of the COVID-19 on health care utilization and oral health conditions of patients at federally qualified health centers (FQHCs), where patients are disproportionately low income, publicly insured, or uninsured. Using deidentified electronic health records of patients at FQHCs in the United States from January 2019 through December 2020 (n = 431,509), variations in health care utilization since the COVID-19 outbreak were observed by procedure types and patient characteristics. Changes in dental utilization and oral health conditions were characterized using mixed-effect negative binomial and logistic regression models. Dental utilization decreased more drastically than medical utilization during shelter-in-place periods in 2020 and rebounded more slowly after the reopening. Greater demands for oral surgery and teledentistry and less demands for preventive services were observed in 2020. As compared to 2019, patients experienced more psychological stress-related dental conditions with odds ratios of 1.52 (95% confidence interval [CI], 1.31-1.76) for uninsured, 1.48 (95% CI, 1.07-2.02) for Medicaid enrollees, and 2.38 (95% CI, 1.68-3.40) for private insurance beneficiaries. As a result of COVID-19, patients received more invasive dental procedures due to delayed treatment and experienced a higher risk of psychological stress-related dental conditions. Continued support for statewide policies to expand access to oral health care and oral health promotion strategies for the vulnerable populations would be encouraged. Our study describes the impact of COVID-19 on dental care use and oral health conditions at Federally Qualified Health Centers, targeted to provide care for some of the most vulnerable populations in the United States. The results of this retrospective cohort study can be used by clinicians and policymakers on understanding the clinical needs of the vulnerable populations after the pandemic. It highlights the need for continued support to expand access to oral health care and oral health promotion to these populations.

Association between Oral Hygiene Information Sources and Daily Dental and Denture Care Practices in Urban Community-Dwelling Older Adults.

The purpose of this cross-sectional study was to explore the sources of daily oral hygiene information among urban community-dwelling older adults in Athens, Greece and associate them with their dental and denture care habits. One hundred and fifty-four older adults (aged 71.7 ± 9.2 years) participated in the study, and their dental status, denture use, daily oral care habits according to current gerodontology recommendations, and oral care information sources were investigated. Daily oral hygiene practices were poor, and a small number of individuals recalled having received oral hygiene advice from a dentist. Only 41.7% of the 139 dentate participants performed toothbrushing with fluoride-based toothpaste at least twice a day, and 35.9% completed regular interdental cleaning. Among 54 denture wearers, 68.5% removed their denture(s) at night, and 54% cleaned them at least twice a day. Oral hygiene information sources included dentists (for approximately half of the participants), media, friends/relatives, non-dental health care providers and dental technicians. Dentate participants who had received oral hygiene information from dentists had a greater probability of brushing their teeth with fluoride toothpaste at least twice a day (p = 0.049, OR = 2.15) and performing regular interdental cleaning (p < 0.001, OR = 29.26). Denture wearers who had received instructions about denture hygiene from dentists were more likely to use a brush and mild soap (p = 0.016, OR = 14.67) and remove their denture(s) at night (p = 0.003, OR = 8.75). Dentists should improve their oral health prevention and promotion strategies for their older patients.

Poor Self-Rated Oral Health Status and Associated Factors Amongst Adults in Algeria

BackgroundUnderstanding the proportion and correlates of self-rated oral health (SROH) can assist in prioritising interventions. The aim of this study was to assess the prevalence of poor SROH and associated factors in a national community survey amongst adults in Algeria. MethodsThis World Health Organisation (WHO) STEPS cross-sectional survey in Algeria in 2016 and 2017 included 6989 people (18–69 years; median age, 37 years) selected by multistage cluster sampling. The assessment included questionnaire information, physical measures, and biochemistry tests. The measures included questions on SROH, oral conditions, oral health behaviour, general health behaviour, and measures of health status. ResultsThe sample included 6989 people aged 18 to 69 years. Of the total sample, 17.1% had removable dentures, 35.5% had 0 to 19 natural teeth, 43.9% had dental pain in the past year, 40.5% had impaired oral health–related quality of life (OHRQoL), 26.9% cleaned their teeth 2 times/d or more, 79.6% used toothpaste, and 41.2% had visited a dentist in the past year. The prevalence of poor SROH was 37.3%. In the final logistic regression model, older age (45–69 years) (adjusted odds ratio [AOR], 1.34; 95% confidence interval [CI], 1.09–1.65), having removable dentures (AOR, 1.46; 95% CI, 1.14–1.87), dental pain (AOR, 2.16; 95% CI, 1.82–2.57), impaired OHRQoL (AOR, 2.69; 95% CI, 2.26–3.20), current smokeless tobacco use (AOR, 1.45; 95% CI, 1.12–1.89), and inadequate fruit and vegetable intake (AOR, 2.69; 95% CI, 2.26–3.20) increased the odds of poor SROH. Men (AOR, 0.76; 95% CI, 0.65–0.90), having 20 or more teeth (AOR, 0.35; 95% CI, 0.28–0.42), twice or more a day teeth cleaning (AOR, 0.72; 95% CI, 0.60–0.86), and using toothpaste (AOR, 0.67; 95% CI, 0.55–0.82) were protective against poor SROH. ConclusionsAdults in Algeria reported a high prevalence of poor SROH, and several associated factors (sociodemographic, oral conditions, oral and general health–compromising behaviour) were found that can guide in oral health promotion strategies in Algeria.

Health Coaching-Based Interventions for Oral Health Promotion: A Scoping Review.

Health coaching-based interventions can support behaviour change to improve oral health. This scoping review aims to identify key characteristics of health coaching-based interventions for oral health promotion. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist and the Joanna Briggs Institute manual for evidence synthesis were used in this review. A search strategy using medical subject heading terms and keywords was developed and applied to search the following databases: CINAHL, Ovid, PubMed, Cochrane Library and Scopus. Thematic analysis was used to synthesise the data. Twenty-three studies met the inclusion criteria and were included in this review. These studies were predominantly based on health coaching and motivational interviewing interventions applied to oral health promotion. The following are the characteristics of health coaching-based interventions extracted from themes of the included studies: (a) Health professionals should be trained on the usage of motivational interviewing/health coaching interventions; (b) oral health professionals should acquire motivational techniques in their practice to engage patients and avoid criticisms during the behaviour change process; (c) routine brief motivational interviewing/health coaching intervention sessions should be introduced in dental clinics; (d) traditional oral health education methods should be supplemented with individually tailored communication; and (e) for cost-effectiveness purposes, motivational interviewing/health coaching strategies should be considered. This scoping review reveals that health coaching-based techniques of health coaching and motivational interviewing can significantly impact oral health outcomes and behaviour change and can improve oral health professional-patient communication. This calls for the use of health coaching-based techniques by dental teams in community and clinical settings. This review highlights gaps in the literature, suggesting the need for more research on health coaching-based intervention strategies for oral health promotion.

Prevalence Of Dental Caries Among Primary School Students In Madurai City, Tamilnadu, India

Aim: Dental caries is an important public health issue,influenced by various socio–demographic factors. The occurrence of carious teeth in school children is very much of concern as it will restrict their daily activities at the schools and homes instigating reductant loss of study, work and play hours.Therefore, the present study was aimed to determine the prevalence of dental caries amongprimary and middle school going childrenin Madurai city. Materials &amp; Methods: For this study, an overall of 40 Corporation schools were randomly selected from the Madurai city. About 3380 children aged between 6-10 years were selected from these schools.Assessment of dental caries prevalence was performed using WHO Basic Oral Health Surveys – Oral Health Assessment Form for the Children (2013). Each child was examined in their respective school by dental surgeons. Result: Out of the 3380 school children that wereexamined, 1475 were boys and 1905 were girls.43% school children had dental caries.Prevalence of dental caries was highest among the10-year-old school students (22.70%) and the lowest in 6- year-olds (17.62%). The dominance of dental caries was higher in girls (55.21%) than boys (44.78). Conclusion: The overall prevalence of dental carieswas 43% and it was higher in 10years old when compared to other age groups.Increased prevalence suggeststhat furtherfollow ups and likewise improving the awareness among teachers, parents and students are necessary too.Also, immediate oral health promotion strategies such as an increase in school dental health programmes are recommended.

Visual learning strategies for oral health promotion and treatment interventions in children and adolescents with hearing impairment - A systematic review.

People with hearing impairment (HI) prefer visual learning strategies in daily activities owing to their reliance on vision. The aim of this systematic review is to evaluate the effectiveness of visual learning as a communication strategy in improving oral hygiene and dental care of children and adolescents with HI. Four electronic databases were searched and complemented by hand searching for original intervention studies published till December 2021. Eligible studies were screened, data was extracted as per priori data collection form and analyzed by thematic content analysis. The quality of studies was assessed as per the validated tools appropriate for study designs including ROB2, ROBINS-I, and NIH quality assessment tool. Out of 4159 records identified and 1302 duplicates removed, 24 original studies were identified and the visual learning strategies were classified into sign language, visual aids with or without sign language, customized educational demonstrations and the interim role of training the teachers. These strategies helped in improving oral hygiene status, oral health-related knowledge and attitude as well as dental anxiety during treatment. Participants were found to be satisfied with these strategies, however, significant heterogeneity in the included studies precluded meaningful meta-analysis. ROB2 and ROBINS were rated as high and serious in all included trials, respectively, and NIH Quality Assessment Tool for Pre-Post Studies With No Control as fair in five studies and poor in three. Our findings emphasize the significance of visual learning, however, long-term rigorously designed trials are needed to better understand effective and patient-centered communication methods for people with HI.

Associations of Masticatory Muscles Asymmetry and Oral Health with Postural Control and Leg Injuries of Elite Junior Soccer Players.

The influence of asymmetry between masticatory muscles on postural control is still under debate and only few studies examined the impact of oral health on injury risk. The present study investigated the relationships between masticatory muscles asymmetry, oral health, postural control and the prevalence of (non-contact or traumatic) leg injuries in a sample of 144 male elite junior soccer players. sEMG of the masseter and temporal muscles was performed during maximum teeth clenching, postural control was tested by measuring sway velocity during the unipedal stance with eyes closed, while oral health and the number of leg injuries were assessed using a questionnaire. The time-1 assessment was repeated in a subgroup of 69 players after one year. Pearson and partial correlation coefficients and adjusted odds ratios (OR) were used to assess associations. Asymmetry between the masseter and temporalis muscles (AMTM, quantified as anteroposterior coefficient, APC) was associated with higher sway velocity on the dominant leg (using time-1 data partial r = -0.24, p = 0.004, using longitudinal data partial r = -0.40, p = 0.005). Higher prevalence of two or more leg injuries throughout a competitive season was associated with poor oral health (adjusted OR (95%CI) using time-1 data = 2.14 (1.02-4.46), using longitudinal data = 4.47 (1.25-15.96)). These results indicate that AMTM has a negative influence on the sway velocity of the dominant leg only, possibly because frequent balancing exercises on the non-dominant leg may counteract negative influences of AMTM. The association of oral health with leg injuries underlines the need for oral health promotion and monitoring strategies in sports.

Perception towards preventive strategies for dental caries and oral health promotion among school teachers

Background and Aim: There are numerous preventive strategies available globally for dental caries. However, the incidence of dental caries is high among school going children in most of the developing countries. School teachers play a major role in inculcating good habits and behaviour to the children. Thus, we aimed to assess the perception of dental caries among school teachers qualitatively by focus group discussion. Methods: One focus group discussion was conducted among the primary level government and private school teachers in Tamil Nadu. A group of 12 teachers, 6 from Government schools and 6 from Private schools were recruited. The discussion was held in a virtual platform due to COVID-19 Lockdown. The session lasted for 45-60 min. The areas of discussion included attitude towards aetiology, prevention and treatment for dental caries.&#x0D; Results: Analysis of interview transcripts recognized many influences on children’s oral health attitudes. Majority of teachers expressed a high efficacy using toothbrushes, tongue cleaners, mouthwashes, oil pulling and massaging gums as plaque control mechanisms. Most of the participants were aware of all treatment modalities for dental caries. However, they were not totally aware of the preventive strategies of dental caries. Conclusion:

Promoción de salud bucal de escolares en el marco de una intervención integral colectiva, desarrollada en el periodo 2013-2015, en Córdoba, Argentina

Objective: Oral health is a public health challenge that must be addressed by integrating its social and biological dimensions to adopt a dental practice with a sense of integrality that takes into account the needs and potentialities of each person and context. The objective of this study was to analyze the oral health status of schoolchildren in a socio-environmentally vulnerable urban area of the city of Córdoba, Argentina, within the framework of a comprehensive collective intervention, conducted in the period 2013-2015 at the María del Tránsito Cabanillas school. Material and Methods: The intervention was organized in 3 stages: diagnosis, collective design and implementation of oral health promotion strategies, and evaluation, applying qualitative and quantitative logics appropriate to the object of study. Diagnosis was carried out in 2013, performing a clinical-dental examination of schoolchildren aged 6 to 8 years and a participatory study of the school environment. Results: Based on the diagnostic data, the stage of collective design and implementation of promotion strategies and oral health care was carried out. The evaluation of the intervention was performed through the clinical-dental examination of schoolchildren aged 10 to 12 years who attended the school in 2015, and who, also having attended the same institution in 2013, participated in the diagnostic study and analysis of the qualitative records related to the intervention. Healthy clinical trends and positive assessments by the different actors were observed. Conclusion: The results encourage continuing conducting comprehensive intervention strategies for oral health promotion and care.

Factors Associated with Oral Cancerous and Precancerous Lesions in an Underserved Community: A Cross-Sectional Study.

Street-involved people with limited access to regular healthcare have an increased risk of developing oral cancer and a lower survival rate. The objective of this study was to measure the prevalence of oral cancerous/precancerous lesions and determine their associated risk factors in a high-risk, underserved population. In this cross-sectional study, English-speaking adults aged 18 years and older living in a marginalized community in Edmonton were recruited from four non-profit charitable organizations. Data were collected through visual oral examinations and a questionnaire. Descriptive statistics, chi-squared tests, and logistic regressions were applied. In total, 322 participants with a mean (SD) age of 49.3 (13.5) years completed the study. Among them, 71.1% were male, 48.1% were aboriginal, and 88.2% were single. The prevalence of oral cancerous lesions was 2.4%, which was higher than the recorded prevalence in Canada (0.014–1.42: 10,000) and in Alberta (0.011–1.13: 10,000). The clinical examinations indicated that 176 (54.7%) participants had clinical inflammatory changes in their oral mucosa. There was a significant association between clinical inflammatory oral lesions and oral cancerous/precancerous lesions (p < 0.001). Simple logistic regression showed that the risk of the presence of oral cancerous/precancerous lesions was two times higher in participants living in a shelter or on the street than in those living alone (OR = 2.06; 95% CI: 1.15–3.82; p-value: 0.021). In the multiple logistic regression analysis, the risk of oral cancerous/precancerous lesions was 1.68 times higher in participants living in a shelter or on the street vs. living alone after accounting for multiple predictors (OR = 1.67; 95% CI: 1.19–2.37; p-value: 0.022). The results demonstrated a high prevalence of cancerous/precancerous lesions among the study participants, which was significantly associated with clinical inflammatory oral lesions. The evidence supports the need for developing oral cancer screening and oral health promotion strategies in underserved communities.

Development and Validation of Oral Health Knowledge, Attitude and Behavior Questionnaire among Indian Adults.

Background and objectives: The Indian population faces numerous challenges to attain better oral hygiene due to a lack of oral health literacy. For the past 10 years, the prevalence of dental-related conditions in India has become a considerable problem in every state of India. A health-education-based oral health promotion strategy will be an ideal choice for the Indian population instead of endorsing conventional oral health promotion. The use of unsuitable tools to measure may lead to misleading and vague findings that might result in a flawed plan for cessation programs and deceitful effectiveness. Therefore, the research aimed to develop and validate an instrument that can assess the oral health knowledge, attitude and behavior (KAB) of adults in India. Materials and Methods: This study was carried among adults in India, who live in Chennai, Tamil Nadu. A questionnaire was fabricated and then validated using content, face, as well as construct. The knowledge domain was validated using item response theory analysis (IRT), whereas exploratory factor analysis (EFA) was used to validate the behavior domain and attitude. Results: Four principal sections, i.e., knowledge, attitude, demography and behavior, were used to fabricate a questionnaire following validation. Following analysis of item response theory on the knowledge domain, all analyzed items in the domain were within the ideal range of difficulty and discrimination. The Kaiser–Meyer–Olkin measure of sampling adequacy was 0.65 for the attitude and 0.66 for the behavior domain. A Bartlett’s test of sphericity was conducted and demonstrated that outcomes for both domains were highly significant (p < 0.001). The factor analysis resulted in three factors with a total of eight items in the attitude domain and three factors with a total of seven items in the behavior domain depicting satisfactory factor loading (>0.3). Across the three factors, i.e., knowledge, attitude and behavior, internal consistency reliability was tested using Cronbach’s alpha, and the values obtained were 0.67, 0.87, 0.67, and 0.88, respectively. Conclusions: The findings of this study that assessed validity and reliability showed that the developed questionnaire had an acceptable psychometric property for measuring oral health KAB among adults in India.

Oral Hygiene Awareness, Practices and Attitudes among Syrian Refugees in Zaatari Camp and Their Impact on Oral Health Status.

To characterise the oral hygiene habits, attitudes, and oral health practices in relation to sociodemographic factors among refugees in Jordan and to investigate their impact on the oral health status of these refugees. This cross-sectional study consisted of two parts. First, a face-to-face interview was conducted using a structured questionnaire including demographic and oral health-related questions. Second, clinical oral examination was performed using WHO criteria, DMFT and oral health indices (OHI-S). The participants were adults, aged 18 and older. All patients attending dental clinics and accompanying personnel in the waiting areas at Zaatari camp during the study period were invited to participate, with a sample size of 547 refugees (males = 212, females = 335). 547 adult refugees participated. 75.3% reported toothbrushing less than twice daily, while flossing was uncommon (9.5%). Toothbrushing habits were significantly associated with gender and smoking status. Untreated carious lesions had a high incidence (94.1%); the mean number of decayed teeth was 5.4 and was statistically significantly higher in males and smokers. The mean number of missing teeth was 3.2 and was significantly associated with males, age, smoking, and presence of chronic disease. Participants who reported conditions that had persisted 1 year or more and required ongoing medical attention or limited activities of daily living or both (e.g. diabetes mellitus, hypertension, heart diseases, thyroid disease, chronic renal disease, rheumatoid arthritis, anemia, peptic ulcer, or asthma) were recorded as having chronic disease. The mean number of filled teeth was 3.2 and was statistically significantly associated with age and presence of chronic disease. The mean DMFT was 11.8 and was statistically significantly higher in males, older people, smokers, and those with chronic disease. The OHI-S was 2.2. The most common complaint was pain (92.2%), and only 1.1% visited a dentist for a check-up. The prevalence of caries was extremely high, with poor oral hygiene practices among refugees, justifying the urgent need to develop and implement targeted oral health promotion, preventive programs and curative strategies and to enable collaboration of the oral healthcare providers and funding agencies to design the most appropriate interventions for this disadvantaged population. In addition, this information can be used as a basis upon which preventive programs can be assessed for efficacy.

Oral health education and prevention strategies among remote Aboriginal communities: a qualitative study.

The delivery of effective oral health promotion strategies is essential to improving oral health outcomes among remote Aboriginal communities. This study aimed to explore the perceptions and attitudes of Aboriginal Australians living in remote Kimberley communities towards oral health education and disease prevention. Semi-structured interviews and yarning circles were carried out following purposive sampling of Aboriginal adults living in the East Kimberley region of Western Australia. A total of 80 community members participated in the yarning process. School-based oral health promotion and community-driven restrictions on the sale of sugary food and drink were seen as positive strategies in improving oral health. Lifestyle changes brought about by modernity, internet availability and fixed community stores were perceived to create new challenges and shift the priorities for those living in remote communities. Community-based yarning may better inform future oral health strategies in the Kimberley. A neoliberal approach of shifting responsibility onto the individual ignores the complex social inequities faced by Aboriginal people living in remote communities where macro-level determinants such as remoteness, food security and education significantly influence decisions around diet and oral health.

Changes in oral health inequalities in adults in Chile.

A secondary analysis of data from 2003 and 2016-2017National Health Surveys (NHS) in Chile was performed on seven oral health outcomes in adults: prevalence of untreated caries, prevalence of severe untreated caries, number of teeth with untreated caries, prevalence of functional dentition, prevalence of edentulism, number of remaining natural teeth and utilization of dental services. Inequalities were measured with the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII) by education level. A decrease of caries inequalities measured with SII was observed from 2003 to 2016-17NHS but an increase of remaining teeth inequalities was measured. The SII of the remaining teeth increased from 6.6 [95% CI=5.0, 8.2] in 2003 to 8.8 [95% CI=7.3, 10.3] in 2016-17. The SII of functional dentition by education increased from 29.0 [95% CI=22.0, 36.0] in 2003 to 38.8 [95% CI=32.6, 45.0]) in 2016-17. The utilization of dental services ≤1year was the only outcome that showed a decrease in absolute and relative inequality, the SII was 33.9 [95% CI=23.3, 45.6] in 2003 and 26.2 [95% CI=16.6, 35.8] in 2016-17 and the RII decreased from 2.5 [95% CI=1.7, 3.3] in 2003 to RII=1.8 [95% CI=1.4, 2.3] in 2016-17. The increase of tooth loss inequalities in contrast to the decrease of inequalities in dental services utilization show the need to re-evaluate the current dental programmes for adults in Chile. This may include establishing a stronger oral health promotion strategy and greater dental treatment coverage focusing on avoiding tooth extractions in vulnerable social groups.

Self-perception of childrenś oral health by their parents

Abstract Background Neglecting oral hygiene can lead to early tooth loss, pain, discomfort and, consequently, a great monetary investment to repair the damage caused in the stomatognathic system, whether of masticatory, phonetic or aesthetic origin. The aim of the present study consists in the characterization of oral health perception and oral hygiene habits of the children by their own parents and the creation of a scale to classify children's oral health perception by their parents. Methods A cross-sectional observational epidemiological study was performed. The population of this study was made up of 422 parents whose children are between five and eleven years of age and who attend schools in the districts of Viseu and Lisbon. The data collection was achieved through the application of a self-administered questionnaire in order to characterize the parentś perception of the oral health of their own children. Results Through the analysis of the questionnaires, 54.8% of the sample considered that their own children present inadequate oral health behaviors; 40.3% sufficient and only 4.8% consider that their children have good and adequate oral health behaviors. Regarding oral hygiene, most of the children did it one to five times a day, 44.7% took ‘2 minutes' to perform this activity, 70.3% did not use dental floss, 77.9% do not brush their teeth after lunch, 49.3% only use toothbrush for oral hygiene, 13.6% never went to the dentist, 26.9% are afraid, 38.1% have already suffered from toothache, 28.8% had gingival hemorrhage and 12.6% had gingival inflammation. Conclusions Oral health is a determining factor for a good quality of life. To this end, it is essential to implement oral health education and promotion strategies with all members of the household, in order to guarantee better oral health indexes in the community. Key messages Oral health literacy and knowledge is essential in order to improve oral health indexes in the community. The characterization of the oral health of children and adolescents is crucial to improve oral health behaviors and establish the correct oral health promotion programs.