Oral Health-related Practices Research Articles

Oral Health-Related Knowledge, Attitudes, and Practices of Diabetic Patients in Tanzania

AimTo assess oral health-related knowledge, attitude, and practices (KAP) of patients with diabetes mellitus (DM) attending public diabetic clinics in Dar es Salaam, Tanzania. MethodologyThis study involved adult patients diagnosed with DM. A questionnaire with questions related to oral health KAP was used. Data analysis was done using SPSS software v26. Multivariate regression analysis was utilized for response analysis. An alpha of less than 0.05 was considered to indicate statistical significance. ResultsParticipants with good levels of KAP related to oral health comprised 51.0%, 82.3%, and 20.6%, respectively. The odds of good oral health knowledge among participants were almost 2 folds higher in participants with high education levels and 7 folds higher in those who had been referred to a dentist by a physician. Participants with good oral health knowledge had 5.5 times higher odds of having a good attitude. The participants with high education levels were almost 3 times more likely to have good practice. ConclusionAbout half of the patients with DM have good oral health-related knowledge. A majority have good compliance towards oral health, but only a limited number have good oral health-related practices. The level of education and previous referrals to dental professionals were found to be predictors of good knowledge regarding dental health.

Awareness, perception and practices regarding oral health among school-going adolescents in Ahmedabad City, India

Objective. The study aimed to assess the awareness, perception, and practices regarding oral health among school-going adolescents in Ahmedabad City, Gujarat, India. Materials and methods. A total of 600 school-attending adolescents with a mean age of 14.2 ± 1.19 years were enrolled. Ten schools (five public and five private schools) were selected randomly. They were interviewed by using a face-to-face questionnaire which comprised 13 items. Out of 13 questions four questions were related to awareness, four questions were related to attitude, and five questions were related to the practice of oral health. The statistical association between the two genders, age groups, and between public and private schools was determined using the Chi-square test. Results. Most of the participants were aware of the number of permanent teeth present; however they were unaware of the number of primary teeth, and the effect of sugar and tobacco consumption on oral health. Male and private school-going students had better knowledge compared to females and government school students... A total of 73% of the participants brushed their teeth twice daily. Tooth pain was the most common reason (49.7%) for visiting a dentist. 44.7% of them visit the dentist only when needed while 23.5% visit the dentist every 6 months for regular check-ups. Conclusion. The findings of the study conclude that oral health-related awareness, perception, and practices of adolescent students were not satisfactory. Hence, there is a need for regular oral health education for adolescents, as well as their parents and school teachers, which could impart a better and long-lasting understanding of oral health awareness, which in turn will reflect better oral health-related practices.

여자 청소년의 좌식 시간 및 주관적 수면 충족감과 구강건강 실천과의 관련성

Objectives: The purpose of this study was to examine the relationship among sedentary time, subjective sleep sufficiency, and oral healthpractice- related factors in adolescent girls. Methods: They analyzed a group of 25,453 adolescent girls. Results: Weekend sedentary time was related to the use of oral hygiene products, and subjective sleep sufficiency was related to brushing one’s teeth after lunch and sealant experience Conclusions: There is a need for a program to improve oral health-related practices by improving sedentary time and subjective sleep sufficiency among adolescent girls.

Design, Implementation, and Evaluation of Educational Program in Oral Health for Midwives and Other Antenatal Care Providers in Iran.

Maintaining oral health during pregnancy has been considered an essential public health issue worldwide. One of the various preventive strategies is to train antenatal care providers to guide pregnant women. This study aimed to design, implement, and evaluate an educational program's effect on the oral health-related knowledge, attitudes, and practice of antenatal care providers in Iran. All of the antenatal care providers working at Isfahan health centers were invited for this study in April 2019. A total of 340 volunteers (120 midwives and 220 others) finally participated in this interventional study with a pre-test-post-test design. A questionnaire was developed to assess the participants' knowledge, attitudes, and practice before and after the intervention. A lecture-based educational session containing similar issues asked in the questionnaire was held for all the participants. The participant's total knowledge scores before and after the intervention, and their attitudes and practice were evaluated and compared through paired t-test. The participants' mean total knowledge scores before and after the intervention were 42.87 and 52.25, respectively. The paired t-test revealed a statistically significant difference between pre- and post-intervention scores (p < 0.001). The frequency of participants' answers to attitude and practice questions was also determined. Improving oral health-related knowledge of antenatal care providers can be achieved through a single educational session designed by accurately assessing their needs. The participants' attitudes revealed barriers to seeking dental care by pregnant women; however, the participants' oral health-related practice was acceptable.

Knowledge, attitudes, and practices regarding the oral health of children

Parents are responsible for their children’s health care, and their oral health-related knowledge, attitude, and habits can affect their children’s oral health. Aim: The objective of this study was to evaluate parents’ knowledge, attitudes, and practices regarding their children’s oral health. Methods: In this study, a sample of 398 parents of 4- to 6-year-old children completed a self-designed questionnaire. The parents’ oral health-related knowledge, attitudes, and practices were assessed. Children’s oral health was evaluated using decayed, missing, and filled tooth index (dmft). Data were analyzed using the SPSS version 23.0 with a p &lt; 0.05 as statistically significant. Categorical data were reported as frequency (%), and continuous data were reported as mean ± SD. Moreover, Spearman’s correlation, multiple regression, Mann-Whitney test, Kruskal Wallis test, and Kolmogorov-Smirnov test were used. Results: Most of the parents had a satisfactory level of knowledge and positive attitudes regarding their children’s oral health. The knowledge and attitude scores were higher among parents with higher education (p&lt;0.001), and the knowledge score was higher among mothers (p=0.004). Also, the attitude score was correlated with the number of decayed, missed, and filled teeth of children (p=0.01, p=0.04, and p=0.007, respectively). However, there was no significant relationship between dmft and the parents’ knowledge, attitudes, and practices using multiple regression. The mean dmft of children was 6.86 ± 3.56, and most of the parents had poor oral health-related practices. Conclusion: The parents’ level of knowledge and attitudes were satisfactory, but they had poor oral health practices. Moreover, there was no significant relationship between children’s oral health and their parents’ level of knowledge, attitudes, and practices. Educating programs and strategies are needed to enhance parents’ oral health-related attitudes and knowledge and, more importantly, change their oral health practices.

Guardian Reports of Children's Sub-optimal Oral Health Are Associated With Clinically Determined Early Childhood Caries, Unrestored Caries Lesions, and History of Toothaches.

Background: Parents'/guardians' perceptions of their children's oral health are useful proxies of their clinically determined caries status and are known to influence dental care-seeking behavior. In this study, we sought to examine (1) the social and behavioral correlates of fair/poor child oral health reported by guardians and (2) quantify the association of these reports with the prevalence of early childhood caries (ECC), unrestored caries lesions and toothaches.Methods: We used guardian-reported child oral health information (dichotomized as fair/poor vs. excellent/very good/good) obtained via a parent questionnaire that was completed for n = 7,965 participants (mean age = 52 months; range = 36-71 months) of a community-based, cross-sectional epidemiologic study of early childhood oral health in North Carolina between 2016 and 2019. Social, demographic, oral health-related behavioral data, and reports on children's history of toothaches (excluding teething) were collected in the same questionnaire. Unrestored ECC (i.e., caries lesions) was measured via clinical examinations in a subset of n = 6,328 children and was defined as the presence of one or more tooth surfaces with an ICDAS ≥ 3 caries lesion. Analyses relied on descriptive and bivariate methods, and multivariate modeling with average marginal effect (A.M.E.) estimation accounting for the clustered nature of the data. Estimates of association [prevalence ratios (PR) and adjusted marginal effects (AME) with 95% confidence intervals (CI)] were obtained via multilevel generalized linear models using Stata's svy function and accounting for the clustered nature of the data.Results: The prevalence of fair/poor oral health in this sample was 15%–it increased monotonically with children's age, was inversely associated with parents' educational attainment, and was higher among Hispanics (21%) and African Americans (15%) compared to non-Hispanic whites (11%). Brushing less than twice a day, not having a dental home, and frequently consuming sugar-containing snacks and beverages were significantly associated with worse reports (P < 0.0005). Children with fair/poor reported oral health were twice as likely to have unrestored caries lesions [prevalence ratio (PR) = 2.0; 95% confidence interval (CI) = 1.8-2.1] and 3.5 times as likely to have experienced toothaches [PR = 3.5; 95% CI = 3.1-3.9] compared to those with better reported oral health.Conclusions: Guardian reports of their children's oral health are valuable indicators of clinical and public health-important child oral health status. Those with fair/poor guardian-reported child oral health have distinguishing characteristics spanning socio-demographics, oral-health related practices, diet, and presence of a dental home.

Dental Caries and Associated Risk Indicators among Married Saudi Women

Objective The aim of this study was to evaluate decayed, missing, and filled teeth (DMFT) experience among married females in Saudi Arabia and provide an exploratory data for subsequent primary prevention. Materials and Methods A cross-sectional quantitative study was conducted at a general hospital in Hofuf, Saudi Arabia. All married women attending the general hospital from March 1st to April 15 th , 2021 were requested to participate. Data was collected on a validated self-reported questionnaire consisting of sociodemographic factors, medical history, dietary pattern, and DMFT. Descriptive and regression analyses were performed using p ≤0.050. Results Four hundred forty-eight married females with the mean age of 30.81 ± 6.11 years, mean duration of marriage of 9.55 ± 6.58 years, and having average number of children 2.32 ± 1.69 participated in the study. 61.7% mothers had ≥10 years of education. 63.6% were non-working and 56.5% were found with low family income. 66% participants reported of doing exercise less or more often yet 51.7% were ≥overweight. Consumption of energy drinks and dairy products was found significantly associated with increasing number of DMFT. Use of fluoridated toothpaste and dental visits was also found associated with increasing number of dental caries. Increasing age ( p = 0.040), increasing number of children, and middle family income were also significantly associated with higher DMFT, respectively ( p = 0.002, p = 0.022). In multi-logistic adjusted analysis, only consumption of dairy products, dental visits, and the unsure status of the use of fluoridated toothpaste were significantly associated with DMFT ≥1. Conclusion DMFT status in married Saudi women was associated with participants' dietary habits, oral health-related practices, family income, married years, and number of children.

Implementation of oral hygiene practices in nursing homes – the view of supervisor nurses

Objectives The aim of our study was to analyse the implementation of oral health-related practices in private enhanced service housing units and nursing homes in Finland reported by supervisor nurses. Methods We sent an anonymous, voluntary Webropol-questionnaire to the supervisor nurses of private enhanced service housing units and nursing homes (N = 245). The questionnaire included items about the implementation of oral healthcare-related practices in the care units and items based on the Nursing Dental Coping Beliefs index (DCBS index). Five dimensions of the implementation of oral healthcare-related practices, Oral hygiene practices and Favourable diet for oral health, Oral hygiene equipment, Professional dental services, and Knowledge and opinions were used as outcomes. The factors in the nursing DCBS index and background variables were used as explanatory variables. Results Our main results showed that in care units, Oral hygiene practices, Favourable diet for oral health, Oral hygiene equipment, and Professional dental services were partly implemented. Furthermore, according to Knowledge and opinions supervisor nurses had challenges in oral health-related knowledge and difficulties in managing oral care. In the DCBS index, better self-efficacy in “Managing bleeding gums” was associated with better implementation of oral health practices. Furthermore, supervisor nurses’ better own oral health habits were associated with better implementation of oral health-related practices. Conclusions It can be concluded that based on the responses of the supervisor nurses, oral health-related practices were partly implemented in private enhanced service housing units and nursing homes in Finland.

Perspectives of community-dwelling older adults with dementia and their carers regarding their oral health practices and care: rapid review

AimTo review evidence on oral health practices, beliefs/views and experiences of community-dwelling older adults living with dementia, including their carers.Materials and methodsA search of key terms across six databases including Pubmed, Web of Science and OVID (Embase, MEDLINE [R] and PsycINFO) and Google Scholar was conducted, supplemented by reference screening. The Mixed Methods Appraisal Tool (MMAT) 2018 was used to assess the methodological quality.ResultsEighteen studies reported across 19 papers were included in the review. Papers largely focused on normative needs (n = 13), whilst also reporting oral health-related experiences (n = 2), practices (n = 7), and beliefs/views (n = 9), of community dwellers with dementia. Generally, people living with dementia presented with poor oral and dental health, the exception being one study where dental care was integrated with memory clinic services. Maintenance of oral health focused only on toothbrushing. Overall, people living with dementia have reduced capacity for self-performed oral hygiene and high reliance on caregivers. There was a paucity of evidence on their perceptions of oral health and quality of life, the findings of which were equivocal, with weak evidence suggesting possible difficulty in identifying and communicating their needs. Experiences of accessing dental care, when explored, appear to be system dependent.ConclusionThere was limited research evidence on oral health-related practices, beliefs/views and experiences of people with dementia. Recommendations for future research are presented.

Prevalence of Untreated Early Childhood Caries of 5-Year-Old Children in Hong Kong: A Cross-Sectional Study.

This cross-sectional survey investigated untreated early childhood caries (ECC) and its associated factors among 5-year-old children in Hong Kong. Children were recruited using a multistage sampling method. One dentist examined the children in kindergarten to diagnose untreated ECC (dt) at the cavitation level. Each child’s demographic information, snacking behaviour, and oral health-related practice were collected using a parental questionnaire. The relationships between the untreated ECC and demographic information, snacking behaviours, and oral health-–related practice were analysed by zero-inflated negative binomial (ZINB) regression analysis. This survey recruited 404 children. Their dt score was 2.8 ± 3.8. The significant untreated ECC (SiUC) index, which was one-third of the children with the highest dt score, was 7.1 ± 3.6. Their untreated ECC prevalence was 57%, which was associated with the district the child lived in. Most children with untreated ECC (71%, 164/231) had never visited a dentist. Children who brushed without toothpaste had more untreated ECC. Children coming from low-income families and with a lower maternal education level had a higher risk of ECC. In conclusion, untreated ECC was prevalent and unevenly distributed among 5-year-old children in Hong Kong. Its prevalence was associated with toothpaste use, family income, maternal education level and the district they lived in.

Curtailing of myths and misconceptions regarding oral health among Indian adult population through health education and promotion: Cross sectional survey

Background/Aim: Myths related to oral diseases and oral health-related practices are very common among the population. Inadequate knowledge along with the persisting myths regarding the etiology, course and outcome of oral diseases makes it difficult to initiate health behavioural changes. Present study scrutinizes various myths and misconceptions regarding oral health among the outpatients. The aim of this study was to assess myths and misconceptions about oral health and imparting education regarding the same. Material and Methods: The calculated sample size was 200. A pre -tested closed ended questionnaire was prepared in both English and local language (Kannada). It comprised of four sections with 24 questions. The Content validity index value of 0.9 suggested a good validity. A Chi square test was applied and significance level was fixed at p&lt; 0.05. Results: We had 100% response rate. In our study half of the participants visited dental hospital for the very first time (57.5%). About 45.2% of subjects believed 3rd molar eruption is the sign of intelligence, while 64.8% had a notion that all dental procedures are painful. Conclusions: Myths and misconceptions related to oral health are still prevalent among the population. However, small steps like compulsory education about oral health in the school curriculum, available and affordable oral care also effective use of mass media could be the steps to reduce oral health burden to the society.

EFFECTIVENESS OF MOTIVATIONAL INTERVIEWING AND GAMES ON ORAL HYGIENE OF CHILDREN AND ORAL HEALTH KNOWLEDGE, ATTITUDE AND BEHAVIOR OF MOTHERS:A Randomized Controlled Clinical Trial

Abstract: Objectives: To evaluate the effectiveness of motivational interviewing (MI) as well as games in changing oral health behaviors among preschool children in Edko administration, Beheira governorate, Egypt. Materials and Methods: The participating children, in this randomized controlled clinical trial, in 2018, were recruited from the 12 governmental preschools available within Edko administration of Beheira governorate, Egypt. A cluster random sampling strategy was used so that the contributors, mother/child dyads (pairs), in each nursery, were subsequently assigned to experimental group I (MI), experimental group II (MI+ gaming) or the control group (conventional dental health education (CE). The two outcomes, oral hygiene index simplified (OHI-S) for children and knowledge, attitude and practice of children’s mothers were measured at base line and after six months follow-up. Paired t-test was used. Results: After six months follow-up, compared with the control group (1.41 ± 0.77), preschool children in experimental group I and II had significantly lower mean ± SD of OHI-S (0.69± 0.61 and 0.70±0.72), P Conclusions: Using MI as an oral health education tool was significantly more effective in promoting preschool children's oral hygiene and improving mothers' knowledge, attitude and oral health related practices than CE alone. The protocol of the study was registered and posted on the ClinicalTrials.gov public website. ClinicalTrials.gov Identifier: NCT04258748.

The integration of oral health-related best practice recommendations in the management of patients with diabetes: a cross-sectional survey of primary care physicians.

To determine whether best practice recommendations are being followed by primary care physicians (PCPs) by examining the integration of oral health-related practices in their management of patients with diabetes. A cross-sectional study design was used to examine PCPs' knowledge of the bidirectional link between diabetes and periodontal disease (PD), their adherence to international best practice recommendations, and their experience of interprofessional collaboration with dentists via an online survey. In total, 79 of 173 PCPs completed the online survey. Almost 90 percent of PCPs neither inform patients with diabetes about the link with PD nor advise dental care. Approximately, one-third of PCPs (32 percent) felt confident facilitating access to dentists. However, 93 percent of PCPs do not refer patients with diabetes to dentists as part of diabetes management. PCPs tend not to inform their patients with diabetes of the bidirectional link with PD, or provide advice or referral to attend dental care as part of diabetes management.

Impact of Health Promotion Interventions on Early Childhood Caries Prevention in Children Aged 2-5 Years Receiving Dental Treatment Under General Anesthesia.

Aim: This study was conducted to evaluate the impact of health promotion interventions on early childhood caries prevention in 2–5 year-olds receiving dental treatment under general anesthesia.Materials and Methods: Thirty-seven mother-child couples presenting to the clinic of the Dental School of Tehran University of Medical Sciences for treatment under general anesthesia were randomly divided to two groups: 19 couples in the pamphlet and fluoride varnish four times a year, and 18 couples in the pamphlet plus six phone call reminders and fluoride varnish four times a year. A standard questionnaire on demographics and children oral health-related practice of parents was completed by respondents. On children's oral examination, the Simplified Oral Hygiene Index (OHI-S), dmft, and the presence of new white spot lesions (WS) were recorded in both phases. At the final stage, Early Childhood Oral Health Impact Scale (ECOHIS) was completed by parents. The length of follow-up was 24 months.Results: In both groups, there was an increase in the number of mothers who knew how to brush their children's teeth as well as the number of mothers who brushed their children's teeth (P < 0.05). In the reminder group, an improvement occurred in the mothers' perception of their perceived ability to make their children brush their teeth twice a day (P = 0.03). Clinical examination revealed a significant decrease in the OHI-S (from 1.9 ± 0.8 to 1.15 ± 0.5) and the number of WS (from 8.5 ± 5.5 to 0.08 ± 0.5) in both groups on the follow-up visit. The mean dmft was 11.0 ± 4.0 with a mean d component of 10.56 ± 4 at the baseline, which decreased significantly to 1.44 ± 1.96 after dental treatment. No significant increase was seen in new caries in the intervention groups. There was no significant difference in the ECOHIS score between the two groups.Conclusion: The similar impact of both interventions suggests the possibility of applying the simpler one, i.e., the educational pamphlet, fluoride varnish and frequent follow-ups. However, in the reminder group, the mothers' perception of their perceived ability to make children brush their teeth twice a day was improved.

Dental caries status of Lisu preschool children in Yunnan Province, China: a cross-sectional study

BackgroundDental caries is still considered a major public health concern for human beings, especially minority groups and those living in disadvantaged communities. The Lisu is a minority group in China of more than 702,000 people located primarily in Yunnan Province. The present study was aimed at studying the status of dental caries status, as well as its risk factors, among Lisu children aged 5 years in Yunnan Province, China.MethodsA multistage cluster sampling method was employed for participants’ recruitment. Two calibrated dentists carried out the clinical examination with dental mirrors and CPI probes under an LED headlight. The dental caries experience was assessed by the dmft index. Oral hygiene status was evaluated using the visible plaque index (VPI). Information on the child’s socio-demographic characteristics and oral health-related practices were collected using a parental questionnaire. A zero-inflated negative binomial regression (ZINB) was employed to analyse the associations between the dental caries status and the children’s social-demographic status and their oral health–related behaviours.ResultsIn all, 470 Lisu children aged 5 were invited, and 404 were examined. Their mean dmft (±SD) and caries prevalence were 5.6 ± 4.8 and 80%, respectively. Their mean VPI scores were 58% ± 21%. Lisu children who brushed their teeth at least once daily had higher dmft scores, and children from high-income families were more likely to have dental caries.ConclusionThe prevalence of dental caries among Lisu children aged 5 years in Yunnan, China was high, and their caries status was severe, with a majority of carious teeth untreated. The dental caries experience of Lisu children aged 5 was related to their brushing frequency and families’ economic backgrounds.

Effectiveness of school dental health education on the oral health status and knowledge of children: A systematic review.

To evaluate the effectiveness of school dental health education on the oral health status, oral health-related knowledge, and practice behavior of 6-12-year-old children. Hand search and electronic search based on the keywords on school dental health education in seven search engines till 2017 identified 7434 articles. Trials involving school-based dental health education with a minimum follow-up period of 6 months were screened. Risk of bias assessment was done independently by two authors. Among the 18 articles which fulfilled the eligibility criteria, six were randomized controlled trials (RCTs) and 12 were non-RCTs. Quality assessment showed that 12 trials had a low risk of bias. Oral health-related knowledge improved in children. Oral health-related practice behaviors such as frequency and duration of brushing improved. Use of fluoridated toothpaste was increased. Plaque scores and gingival bleeding scores reduced. School dental health education had a positive impact on the oral health status, knowledge, and practice behavior of children. There is a definite need for high-quality RCTs analyzing the effectiveness of school dental health education on specific oral health outcomes.

Knowledge, attitudes and self-reported practices toward children oral health among mother\u2019s attending maternal and child\u2019s units, Sal\xe9, Morocco

BackgroundThe occurrence of severe dental caries is particularly prevalent and harmful in children. A better understanding of parental factors that may be indicators of children’s risk of developing dental caries is important for the development of preventive measures.This study was conducted to assess knowledge, attitudes, and practices (KAP) of mothers in Salé, Morocco regarding oral health and their predictors.MethodsA cross-sectional KAP study was conducted of Mother and Child units in Salé, Morocco. Mothers attending the selected units from November 2014 to 29 January 2015 were recruited. Data were collected using a semi-structured questionnaire, administered by face-to-face interviews, to record socio-demographic factors and KAPs. The main outcome measures included knowledge about oral health diseases and preventive measures, and attitudes and practices related to oral health prevention measures and dental care. KAPs scores were then recoded based on responses and scores were determined for each KAP domain. Linear regression analysis was conducted to assess predictors of KAP scores.ResultsAmong 502 mothers included, 140 (27.8%) were illiterate and 285 (60.9%) were aware that fluoride has a beneficial effect in caries prevention. Mothers’ own practices about dental care were statistically related to their children’s use of dental care services (p < 0.001). Multiple linear regression analysis revealed that the knowledge score was associated with mother’s age (β = 0.05; 95% CI; p < 0.001), education level, and median income (β = 0.38; p = 0.04). Significant predictors of oral health-related practices were mother’s education level and children’s health status.ConclusionsLimited KAP scores were observed among the studied population. A great emphasis on oral health education and some risk factor modifications are recommended.

The Role of the Qur'an and Sunnah in Oral Health.

The aim of this study was to explore the ways in which the main texts in Islam, Holy Qur'an and the Sunnah of the Prophet Mohammed (pbuh), contribute to understandings of oral health. The AHadith provide guidance for oral health-related behaviour but were written at a time when their symbolic meanings were perhaps vastly different to those of today. In gaining more insight into the ways Islamic HRB shape oral health-related practices and outcomes, if at all, we may be better placed to develop a more culturally sensitive and diverse dental public health and oral health promotion which takes into account religious dimensions, mediating factors, HRB and salutogenic mechanisms.

Role of Pediatric Nurse Practitioners in Oral Health Care

Dental caries remain the most prevalent unmet health need in US children. Access to care is particularly problematic for poor children and is compounded by the shortage of dentists to meet the needs of this patient population. Expanding the roles of pediatricians, family physicians, and pediatric nurse practitioners (PNPs) who provide primary care services to children may be a strategy to address in this issue. Enhancements in current PNP education and certification processes are needed to support the expansion of oral health-related clinical responsibilities. Although oral health is included in the published curriculum for PNPs and certification exams require specific oral health knowledge, gaps in postgraduate training persist and few data document the extent to which current oral health-related educational goals are being achieved. We recommend enhancements in oral health education and research to evaluate curriculum innovations, the development of partnerships between stakeholder groups to leverage existing resources, and ongoing surveillance of oral health-related practice patterns among PNPs. Leadership at the national level is needed to develop policies that support curriculum changes and the implementation of oral health practice guidelines for PNPs that will improve access and reduce health disparities.

Early childhood caries and infant oral health: Paediatricians' and family physicians' knowledge, practices and training

To assess the knowledge of early childhood caries and to examine the current preventive oral health-related practices and training among Canadian paediatricians and family physicians who provide primary care to children younger than three years. A cross-sectional, self-administered survey was mailed to a random sample of 1928 paediatricians and family physicians. A total of 1044 physicians met the study eligibility criteria, and of those, 537 returned completed surveys, resulting in an overall response rate of 51.4% (237 paediatricians and 300 family physicians). Six questions assessed knowledge of early childhood caries; only 1.8% of paediatricians and 0.7% of family physicians answered all of these questions correctly. In total, 73.9% of paediatricians and 52.4% of family physicians reported visually inspecting children's teeth; 60.4% and 44.6%, respectively, reported counselling parents or caregivers regarding teething and dental care; 53.2% and 25.6%, respectively, reported assessing children's risk of developing tooth decay; and 17.9% and 22.3%, respectively, reported receiving no oral health training in medical school or residency. Respondents who felt confident and knowledgeable and who considered their role in promoting oral health as "very important" were significantly more likely to carry out oral health-related practices. Although the majority of paediatricians and family physicians reported including aspects of oral health in children's well visits, a reported lack of dental knowledge and training appeared to pose barriers, limiting these physicians from playing a more active role in promoting the oral health of children in their practices.