Oral Health Training Research Articles

Caring for smiles – a new educational resource for oral health training in care homes

doi: 10.1111/j.1741‐2358.2011.00457.x Caring for smiles – a new educational resource for oral health training in care homes

Oral Health Promotion Through an Online Training Program for Medical Students

The objective of this study was to compare the impact on knowledge and counseling skills of face-to-face and Internet-based oral health training programs on medical students. Participants consisted of 148 (82 percent) of the 180 invited students attending their fifth academic year at the Faculty of Medicine, University of São Paulo, Brasil, in 2007. The interventions took place during a three-month training period in the clinical Center for Health Promotion, which comprised part of a clerkship in Internal Medicine. The students were divided into four groups: 1) Control Group (Control), with basic intervention; 2) Brochure Group (Br), with basic intervention plus complete brochure with oral health themes; 3) Cybertutor Group (Cy), with basic intervention plus access to an Internet-based training program about oral health themes; and 4) Cybertutor + Contact Group (Cy+C), the same as Cy plus brief proactive contact with a tutor. The impact of these interventions on student knowledge was measured with pre- and post assessments, and student skills in asking and counseling about oral health were assessed with an objective structured clinical examination (OSCE). Multivariate logistic regression models were applied to identify the odds ratios of scoring above Control's medians on the final assessment and the OSCE. In the results, Cy+C performed significantly better than Control on both the final assessment (OR 9.4; 95% CI 2.7-32.8) and the OSCE (OR 5.6; 95% CI 1.9-16.3) and outperformed all the other groups. The Cy+C group showed the most significant increase in knowledge and the best skills in asking and counseling about oral health.

Teaching Oral Health in U.S. Medical Schools: Results of a National Survey

Good oral health is an important aspect of good overall health. Past studies show physicians have had limited oral health training. In 2009, the authors sent a 22-question online survey to the deans of education of 126 MD-granting and 28 DO-granting U.S. medical schools to determine the extent to which these schools have an oral health curriculum. Eighty-eight schools (57.1%) responded. Of these, 61 (69.3%) reported offering less than five hours of oral health curriculum; 9 (10.2%) offered no curriculum. Schools with greater than 150 students per class were more likely to offer five or more hours of oral health curriculum compared with small or midsize schools (P = .022). School location and having a dental school and/or residency were not significantly related to the number of hours of oral health curriculum (P = .728 and .271, respectively). Awareness of oral questions on the United States Medical Licensing Examination board exams and/or the Association of American Medical Colleges report on oral health education was also not associated with curriculum volume. In schools with an oral health curriculum, topics being covered ranged from 10.0% teaching hands-on skills training to 81.7% covering oral cancers. Only 29.9% reported evaluating students around oral health topics. The majority of the responding U.S. medical schools offer very little oral health education. There are few meaningful correlations as to what contributes to schools having a more robust curriculum. Further study is needed to explore how to improve this educational void.

Oral Health Care for Inmates of Central Prison, Bangalore - An Institutionalized Approach

Oral health is an integral part of general health. The society consists of different groups of people having different level of perception towards good oral health. The prison population is unique in nature because of the complexities of their psychological, social and behavioral aspects. Prisoners who are entangled in legal matters and imprisonment are isolated from family members and other social activities, rarely give attention and neglect their health including oral health. Prisoners have a different lifestyle and routine dental care and maintenance of oral hygiene are not the regular components, although they have many oral problems. This paper reports the activities of the oral health care programme undertaken to meet their oral health needs. It includes oral health assessment, training and utilization of dental professionals, for the delivery of oral health care .The key concept is to develop access to care and disease prevention for all the prisoners in the prison itself. Also discussed are priorities that needs to be met to make oral health an integral part of general health among inmates of Central Prison

A comparison of the nutritional knowledge of dental, dietetic and nutrition students

Conflicts in dietary messages remain widespread. Such conflicts can have negative effects on the behaviour, motivation and attitudes of individuals. Inconsistencies in dietary advice may be linked to inadequate training of professionals. Literature suggests that the nutrition training of dentists and oral health training of dietitians and nutritionists is limited. This study was designed to provide information on the nutritional knowledge of dental, dietetic and nutrition students and how this conforms to national nutritional guidelines, identifying differences between professional groups and conflicts in undergraduate training. Self-administered questionnaires were completed by 124 dental, dietetic and nutrition students at Cardiff University and the University of Wales Institute, Cardiff (UWIC). Significant inter-group differences (p <0.05) were observed in relation to recommendations concerning the between-mealtime consumption of a wide range of snacks and drinks. Dental students were mainly concerned with oral health problems (for example, acid erosion), while dietetic and nutrition students were mainly concerned with general health problems (for example, obesity). Just over a third of dental students felt that they had received sufficient training in the dietary management of patients. In conclusion, a common risk-factor approach and consistent nutrition guidelines are essential to improve health. In addition, recommendations should be made to incorporate oral health into the training of nutritionists and general health into the training of dentists.

Preventive Oral Health Care in Early Childhood: Knowledge, Confidence, and Practices of Pediatricians and Family Physicians in Florida

To examine the relationships among pediatricians' and family physicians' oral health training, knowledge, confidence, and practice patterns. A survey of physicians identified through the membership databases of the Florida Academy of Family Physicians and the Florida Pediatric Society was conducted in 2008. Responses of pediatricians and family physicians were compared through bivariate and multivariate analyses. Although training was not directly associated with performing recommended practices, there were positive associations between training and confidence and between confidence and performing recommended practices (P <.05). Pediatricians were more likely than family physicians to answer fluoride-related knowledge questions correctly and reported greater confidence (P <.05). Less than 20% of the respondents reported counseling parents about bringing their child to the dentist before age 1 year or inquiring about the parents' dental health. Oral health training appears to promote confidence in performing recommended oral health practices. Differences in fluoride knowledge by provider type suggest that fluoride guidance has been disseminated more effectively among pediatricians than among family physicians. Educational content of oral health training programs should place increased emphasis on current fluoride guidance, early dental visits, and assessing parents' oral health. Instructional methods should address physicians' confidence, particularly among family physicians.

Knowledge and Orientations of Internal Medicine Trainees Toward Periodontal Disease

There is growing evidence that periodontal disease may be a source of systemic inflammation that impacts overall health. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease and adverse outcomes in diabetes mellitus and pregnancy. With the aim of assessing oral health knowledge and orientations of physicians in training, we surveyed incoming internal medicine trainees about their general knowledge, attitudes, and behaviors/practices about periodontal health and disease. A 16-question survey was distributed during orientation to incoming internal medicine trainees at a single urban teaching hospital in New York City in 2007 and 2008. Questions aimed to assess the knowledge levels of the subjects about periodontal disease and their attitudes toward discussing/evaluating the periodontal status of their patients. The study was approved by the Montefiore Institutional Review Board. Of 125 incoming medical trainees queried, 115 responded (92% response rate). Of the 115 responders, 96% were medical interns. The median age of the trainees was 27 years (interquartile range: 26 to 29 years), and 61% were female. Overall, 34% of the trainees answered all five true/false general knowledge questions correctly, 82% reported that they never asked patients if they were diagnosed with periodontal disease, 90% reported not receiving any training about periodontal disease during medical school, 69% reported that they were not comfortable at all performing a simple periodontal examination, 17% agreed that patients expect physicians to discuss/screen for periodontal disease, 46% felt that discussing/evaluating the periodontal status of their patients was peripheral to their role as physicians, 76% reported never screening patients for periodontal disease, and 23% stated that they never referred patients to dentists. In this study, incoming internal medicine trainees had inadequate knowledge regarding periodontal disease. They were also generally uncomfortable with performing a simple periodontal examination. Oral health training in medical school and the medical postgraduate setting is recommended.

Addressing Children's Oral Health in the New Millennium: Trends in the Dental Workforce

Oral Health in America: A Report of the Surgeon General (SGROH) and National Call to Action to Promote Oral Health outlined the need to increase the diversity, capacity, and flexibility of the dental workforce to reduce oral health disparities. This paper provides an update on dental workforce trends since the SGROH in the context of children's oral health needs. Major challenges remain to ensure a workforce that is adequate to address the needs of all children. The dentist-to-population ratio is declining while shortages of dentists continue in rural and underserved communities. The diversity of the dental workforce has only improved slightly, and the the diversity of the pediatric population has increased substantially. More pediatric dentists have been trained, and dental educational programs are preparing students for practice in underserved areas, but the impact of these efforts on underserved children is uncertain. Other workforce developments with the potential to improve children's oral health include enhanced training in children's oral health for general dentists, expanded scope of practice for allied dental health professionals, new dental practitioners including the dental health aid therapist, and increased engagement of pediatricians and other medical practitioners in children's oral health. The evidence for increasing caries experience in young children points to the need for continued efforts to bolster the oral health workforce. However, workforce strategies alone will not be sufficient to change this situation. Requisite policy changes, educational efforts, and strong partnerships with communities will be needed to effect substantive changes in children's oral health.

Nursing staff's understanding of oral health care for patients with cancer diagnoses: an intervention study

The aim of this study was to evaluate long-lasting changes in the nursing staff's understanding of oral health care for cancer patients after an oral health care intervention. The study also assessed whether there were changes between registered nurses and auxiliary nurses. The maintenance of good oral health care in cancer patients is essential for nutrition, recovery and wellbeing and requires the involvement of nursing staff. However, several studies reveal that the need to prioritize oral health care has not been made sufficiently clear. The nursing staff (registered nurses, n = 133 and auxiliary nurses, n = 109) on five wards at different hospitals providing cancer care took part in a four-hour oral healthcare training session, including the use of an oral assessment guide and answered a questionnaire initially and after this intervention. The data were statistically analyzed. Several aspects of implementation opportunities improved, but they did not include attitudes to oral health care. Knowledge of oral diseases decreased, more for auxiliary nurses than for registered nurses. A four-hour oral health training session and subsequent activities improve the nursing staff's understanding of oral health care for patients with cancer diagnoses in some respects but not in terms of attitudes to oral health care or specific oral knowledge. Oral healthcare education and training activities for nursing staff can produce some improvements in the understanding of oral health care for cancer patients but not in attitudes and specific oral knowledge. These areas must be covered during the basic education period or/and by a routine oral healthcare programme for nursing staff, probably including an oral healthcare standard.

Oral cancer awareness amongst hospital nursing staff: a pilot study

BackgroundOral cancer is as prevalent as cervical and testicular cancer in the United Kingdom. Nursing staff provide the oral health care for the patient population in hospital. Admission to hospital provides a 'window of opportunity' for oral cancer 'screening' via an oral health check during nursing clerking. This study aimed to investigate whether nursing staff are aware of risk factors for oral cancer, its clinical signs, and could therefore provide a 'screening' service for oral cancer.MethodThrough the use of a questionnaire we assessed 121 nursing staff on oral health check behaviour and attitudes; their knowledge of risk factors for oral cancer; their understanding of common clinical signs of oral cancer; and their undergraduate and postgraduate training in oral health and oral cancer.ResultsOver 80% thought oral health checks were important although only 49% performed this task regularly; approximately 70% identified smoking as a risk factor but less than 30% identified alcohol. Awareness of the clinical signs of oral cancer was low with 21% identifying white patches, 15% identifying ulceration and only 2% identifying red patches despite their malignant potential. Nurses within 3 years of qualification were significantly better at recognising risk factors for oral cancer than their colleagues, identifying a need for continuing postgraduate education on oral health and oral cancer. Sixty-one percent of nursing staff received oral healthcare as an undergraduate with 34 percent receiving postgraduate training.ConclusionAn oral health check upon admission to hospital provides an opportunity for nurses to 'screen' for oral diseases including oral cancer and allows nurses a greater role in total patient care. Nurses' awareness of oral cancer risk factors and clinical signs was, however, poor. This study highlights a need for improved education of nurses on oral cancer to make the oral health check on admission viable for oral cancer screening.

Increasing Dental Care for Very Young Children: What Can Training Accomplish?

Too few dental providers feel comfortable or are keen on seeing young children in their practices, and training in oral health has generally ignored the dental component of early childhood. Evaluation of California's $7 million First Smiles showed increased knowledge and skills among 3,369 dental professionals trained. Positive practice changes included increasing willingness to see more 1-5 aged children, including special needs; seeing children for a first visit by age 1; and conferring with a pregnant patient's medical provider.

Perceptions of Oral Health Training and Attitudes Toward Performing Oral Health Screenings Among Graduating Pediatric Residents

There is a lack of access to oral health services for American children. Some propose that pediatricians be trained to deliver preventive screening and education to families until they access a dental home. However, little is known about the current oral health training provided during pediatric residency. OBJECTIVE. The purpose of this work was to evaluate the oral health training that pediatricians receive during residency and their attitudes toward performing basic oral health screenings. The American Academy of Pediatrics Survey of Graduating Residents is an annual, randomly sampled national survey of graduating pediatric residents. The 2006 Survey of Graduating Residents surveyed 611 residents and examined their perception of their oral health training and their attitudes about performing oral health screenings. Thirty-five percent of residents received no oral health training during residency. Of those who did, 73% had <3 hours of training, and only 14% had clinical observation time with a dentist. Seventy-one percent felt that they had too little oral health training, and only 21% felt that their residency was very good or excellent in preparing them to perform oral health-risk assessments. Residents felt confident in their ability to offer anticipatory guidance but not to do the more technical oral health screenings. The majority of residents believed that pediatricians should conduct basic oral health screenings. Multiple regression analysis indicated that residents who received >or=3 hours of oral health training, who applied for jobs in the inner city, and whose career goal was to work in primary practice are those most likely to support this idea. Pediatric residents currently receive little training in oral health, and the majority wish for more. This study shows that oral health training during residency can increase pediatrician confidence in participating in important oral health promotion tasks, including anticipatory guidance, oral screenings, and oral health-risk assessment.

19. An Integrated Approach to Residency Training in Pediatric Oral Health at UCLA

19. An Integrated Approach to Residency Training in Pediatric Oral Health at UCLA

Advanced General Dentistry Program Directors’ Attitudes and Behaviors Regarding Pediatric Dental Training for Residents

The oral health of children became a more prominent concern with the U.S. surgeon general's report on oral health in America in 2000. The purpose of our study was 1) to assess General Practice Residency (GPR) and Advanced Education in General Dentistry (AEGD) (here jointly referred to as advanced general dentistry [AGD] programs) directors' current behaviors with regard to pediatric training of residents and 2) to assess their attitudes about which components of pediatric oral health training should be included in AGD programs. A twenty-one item survey was mailed to all GPR and AEGD programs accessed through the American Dental Association website. Seventy percent of directors (N=187) completed and returned the survey. Responses indicated that AGD residents receive adequate clinical exposure to pediatric patients and provide much-needed services to uninsured, underinsured, and underserved people. Although clinical training in pediatric treatment was high, didactic hours focused on pediatric treatment did not seem commensurate with clinical activity. Program directors indicated strong attitudinal support for teaching residents many components of pediatric oral health care, although most directors have concerns over increasing didactic hours spent on pediatric oral health due to already crowded curricula. Approximately 88 percent of directors said that they would implement a pediatric oral health module in their curricula if they had access to one.

Curriculum and Clinical Training in Oral Health for Physicians and Dentists

Journal of Dental EducationVolume 72, Issue S2 p. 73-85 Contemporary Issues in Dentistry: Panel Report Curriculum and Clinical Training in Oral Health for Physicians and Dentists Report of Panel 2 of the Macy Study First published: 01 February 2008 https://doi.org/10.1002/j.0022-0337.2008.72.2_suppl.tb04484.xCitations: 7Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume72, IssueS2February 2008Pages 73-85 RelatedInformation

Accuracy of Referrals to a Specialist Oral Medicine Unit by General Medical and Dental Practitioners and the Educational Implications

In this study we investigated the accuracy of diagnoses of oral mucosal diseases made by family physicians (without a dental degree), other categories of physicians, and general dental practitioners prior to referring patients to a university oral medicine unit. Over a three-year period, we compared the diagnoses proposed in referral letters with the definitive histological diagnoses made by the specialist unit. Only 305 of 678 (45 percent) of the referral letters included a clinical diagnosis. Eighty-six patients (86/305, 28 percent) were referred by general dental practitioners (GDPs) who had graduated in dentistry; seventy-six (76/305, 25 percent) were sent by GDPs who had graduated in medicine with a postgraduate degree in dentistry; and 143 (143/305, 47 percent) were referred by other categories of physicians. More than 50 percent of the referring professionals were not able to make a clinical diagnosis of oral mucosal diseases. Only 40 percent of the provisional diagnoses (122/305) coincided with the diagnosis made at the specialist unit. The proportion of correct diagnoses was 40 percent for GDPs who had graduated in dentistry, 33 percent for other categories of physicians, and 27 percent for GDPs who had graduated in medicine with a postgraduate degree in dentistry. These findings suggest that Italian dental and medical practitioners have limited knowledge in the field of oral medicine. Consequently, there is a need for better education in the diagnosis and treatment of oral diseases and for improvement in total oral health training.

The Responsibility of Dentists in Identifying and Reporting Child Abuse

The purpose of this article is to review the forms of child abuse and neglect with their clinical signs, together with a step-to-step guide for identification of suspected cases and the role of physicians, such us dentists in evaluating such conditions. The importance of an early recognition is based on the effective intervention. All members of dental team have a unique opportunity and legal obligation to assist in identifying and reporting child abuse. This special opportunity exists because a high proportion of abused children suffer injuries to the face and head, including the oral and perioral regions. However, physicians receive minimal training in oral health and dental injury and disease usually may not detect dental aspects of abuse or neglect, as readily as they do with symptoms and signs involving other areas of the body. Therefore, physicians and dentists are encouraged to collaborate to increase the prevention, detection and treatment of these conditions.

Oral health status and treatment needs among Tanzanians of different age groups

A national oral health survey is a collection of standardized information on oral health from a specific national population or some sample. Basic oral health surveys are used to collect information about the oral health status and treatment needs of a population and subsequently to monitor changes in levels and patterns of disease. In this way it is possible to assess the appropriateness and effectiveness of the services being provided and to plan or modify oral health services and training programs as needed (WHO 1997). In Tanzania, the first national oral health survey was conducted in 1982 and the Tanzanian economy remained stagnant at low level for nearly two decades (mid 1970's to mid 1990's). However, as of late, some signs of economic recovery are evident. These might have an impact on the current pattern of oral diseases, particularly dental caries. In this regard, a need to conduct the second national oral health survey (2004) in order to monitor oral health changes arised. The purpose of the study was to determine the oral health status and treatment needs among Tanzanians of different age groups. The findings of the study indicate that Dental caries experience is still very low among Tanzanians (mean DMFT for 12 year olds was 0.3 and for the whole population 1.8). This is in agreement with reported low frequency of sugar consumption where only 4.4% of the studied population reported to have a frequency of sugar consumption of five or more times per day. Majority of the studied population (76%) had proper knowledge on causes of dental caries being frequent consumption of sugary food stuffs and a substantial percentage (67%) agree that dental caries can be prevented by controlling frequency of sugar consumption or by use of fluoridated toothpaste. Calculus of varying severity (48%), low level of bleeding and a few pockets were identified. Although majority of the subjects (68%) responded that they brush more than two times a day, a high level of calculus was found, which raise doubts on effectiveness of tooth brushing methods used. Calculus was noted to be increasing with age and was predominant among 35-44 years olds. Generally there is low level of knowledge on oro-facial lesions coupled with ignorance on the treatment, and belief in witchcraft. Tobacco and its products are still being used by the subjects that could indicate lack of knowledge on the causes of oro-facial lesions. Overjet and openbite were very low and very few subjects needed orthodontic corrections. A very small percentage of the population studied (0.1% – 1.2%) had various TMJ disorders, and all disorders were recorded in 35+ year olds. The studied population demonstrated a proper knowledge on possibility of treating a fractured tooth or jaw. While the majority of the subjects believed in the existence of nylon teeth but the majority had not taken their children for extraction of nylon teeth. Dental fluorosis is common among both sexes and affects more than 30% of the population. All age groups are affected equally. The condition is more prevalent in Kilimanjaro and Shinyanga regions. There are very few prosthetic appliances among the population signifying that the services are not available, therefore there is low awareness on the availability of the services or purchasing power of the subjects is low despite a prosthetic treatment need of 11%. The finding that 6.5% of the studied population was found to need immediate oral health care implies that there is a need to have oral health care providers to lower levels to take care of such requirements. Nearly half of the studied population (48%) needed referral to a nearby dental clinic. If all those will decide to attend dental clinics an increased of dental personnel will be required to offer oral health services. Tanzania Dental Journal Vol. 12(1) 2005: 18-27

Implementation of oral health recommendations into two residential aged care facilities in a regional Australian city

Background Residents of aged care facilities usually have a large number of oral health problems. Residents who suffer from dementia are at particular risk. A systematic review of the best available evidence with regard to maintaining the oral health of older people with dementia in residential aged care facilities provided a number of recommendations. Objectives The aim of the implementation project was to introduce evidence-based oral hygiene practices for patients with dementia in two publicly funded residential aged care facilities and monitor for changes in nursing awareness, knowledge, documentation and practice to improve patient outcomes and ensure appropriate accreditation standards were met. An additional aim was to identify barriers and strategies to overcome barriers to implementation of evidence-based recommendations. Methods Two facilities, a 40-bed facility and a 71-bed facility in the health service district of the regional Australian city of Toowoomba, provided the setting. A quality improvement approach was taken, using a number of strategies from the National Health and Medical Research Council guidelines for implementation studies. The implementation involved a number of stages, including project development, interactive oral health education, oral audits of residents, changes to oral hygiene practice via care plans and critical reflection. Results The multidisciplinary approach to improving oral healthcare appeared to improve knowledge and awareness and move oral health practices in facilities closer to best practice. Specialised training in oral health was provided to a Clinical Nurse Consultant. Regular oral audits were introduced and facility staff were trained in the use of the oral audit tool. Care plans at one facility were of better quality and more comprehensive than before the intervention. Comments made during critical reflection suggested improvements in the oral health of residents, increased use of oral swabs and saliva substitutes, improved care of dentures and mention of the use of mouth props in resident care plans. There was also some evidence that changes brought about by the implementation are sustainable. Conclusion The majority of recommendations provided in the systematic review of oral healthcare for dementia patients were applicable to the applied context. The importance of day-to-day leaders was highlighted by the apparently varied outcomes across target facilities. The quality improvement approach would appear to have considerable advantages when applied to improving practice in residential aged care.

Oral health promotion among older persons and their care providers in a nursing home facility

To assess oral health status and oral health-related quality of life (OHRQoL) of residents in an extended care facility and to assess the care providers' oral health attitudes and knowledge. Participants included 137 residents (58.1% female, age range 32-94 years, 91% African-American) and 22 care providers. Residents received an oral examination and completed the Oral Health Impact Profile (OHIP-14), an OHRQoL questionnaire. Care providers completed an oral health knowledge (OHK) questionnaire before and after the on-site geriatric oral health education and training programme. Oral examinations showed that 58% of the residents had extensive oral health needs. On the OHIP-14, the mean severity was 9.2 (SD=12.0), extent (number of items rated as 'fairly often' or 'often') was 1.2 (SD=2.6) and prevalence (participants rating at least one item at least 'fairly often') was 37.8%. Most prevalent negative impact items were about 'oral pain', 'appearance' and 'self-consciousness'. Regarding OHK, caregivers' knowledge improved following instruction from 65% correct on the pre-test to 90% correct on the post-test (p<0.05). Subsequent to the eight in-service workshops, providers reported that physical limitations, fear of getting bitten and time constraints were barriers to providing oral hygiene to their residents. Examination data showed a high level of dental needs among the majority of residents, accompanied by significantly reduced OHRQoL. Although care providers' OHK improved following the geriatric service programme, they reported specific barriers regarding their provision of oral hygiene care to the residents.