Oral Prevention Program Research Articles

Fluorosis and Oral Health Status in Adolescents Living in a High-Fluoride Groundwater Area: A Case Study of Nairobi Suburbs (Kenya)

Dental fluorosis is an irreversible defect in dental enamel caused by long-term undesired fluoride intake during tooth formation. The clinical manifestations may range from white spots to dark brown areas, which can initially represent only an aesthetic problem, but they can also lead to functional problems—in severe cases, pitting and fractures can occur. The aim of this cross-sectional study in a cluster of 215 Kenyan adolescents was to evaluate oral health status—especially with respect to fluorosis and dental caries risk factors—in the Nairobi suburbs. Clinical data were recorded using DMFT and TF indices in accordance with the WHO standards. A multivariate model with logistic regression was carried out. In total, 36.7% of individuals presented carious lesions. The DMFT index was 0.87 in the total sample. Around 78.6% were affected by mild-to-severe forms of fluorosis. Statistically significant associations were found between the presence of caries and consuming sweets during (OR = 3.9) and between meals (OR = 3.6), consuming soft drinks during (OR = 2.8) and between meals (OR = 4.3), tooth-brushing frequency (OR = 2.8), use of toothbrush and toothpaste (OR = 3.8), presence of bleeding (OR = 10.2), and calculus (OR = 12.1). It is critical to give people sufficient knowledge and to educate the communities to mobilize the implementation of preventive measures, such as reducing fluoride ingestion and paying attention to the dangers of drinking untreated water, in order to develop strategies to ensure equitable access to medical services and promote oral prevention programs to significantly reduce the impact of oral diseases.

Cost-effectiveness of school oral health prevention program: a case study of community dentistry, Mahidol University

School may be the only place where oral health services are provided for high-risk children with limited access to dental care. We found this to be a common situation in many low-income countries, compounded by a lack of dental personnel. A school oral health prevention program is widely implemented in Thailand; however, the program's cost-effectiveness is under-investigated. This research project evaluated the cost-effectiveness of a comprehensive school oral health program implemented in the academic setting from the provider’s perspective. The retrospective study was conducted using profile data of primary school children in low socioeconomic areas during the academic years 2009–2018 from the Mahidol school oral health program database. The program's effectiveness was measured as DMFT increment scores from the first to the sixth grade between the intervention and control groups. To estimate unit costs for preventive dental services, cost data were collected according to the WHO CostIt program. The total cost was determined based on two elements: recurrent cost and capital cost. The economic costs of the program in the 2015 academic year for first- to sixth-grade children were an average of 1,196,839.37 Baht (34,944.42 USD), comprised of recurrent costs (36.1%) and capital costs (63.9%). Personnel costs and equipment depreciation costs were a major part of recurrent costs and capital costs, respectively. Specifically, capital costs were accountable for more than half of total program costs. The incremental cost-effectiveness ratio (ICER) of the completed 5-year program compared with the control group was 4,035.31 Baht per DMFT avoided. The study findings, which suggested the effectiveness of this program, are useful for its extension and expansion. The cost-effectiveness of the oral prevention program indicated that it is worth implementing, especially for outreach and children of low socioeconomic status at high risk of caries.

A clinical-statistical study of patients with disabilities’ oral health problems, treated under general anesthesia, at the dental department of «Agios Dimitrios» General Hospital of Thessaloniki, Greece, from 01/01/2008 to 31/12/2009.

General anesthesia has proved to be an ef- fective mean for treating patients in need of restorative and surgical treatment, when other methods have failed. Aim: The aim of this retrospective clinical-statistical study was to assess the characteristics, oral health management of special needs patients attending for DGA treatment at Agios Dimitrios General Hospital of Thessaloniki,. Patients and method: Medical files retrieved from 169 male and 129 female patients, from 5 to 63 years of age and 36,2% of them were children and adoles- cence.257 patients during a twelve year old period, from 01/01/2008 to 31/12/2019. Demographic, quantitative and qualitative data were obtained from patients’ files (e.g place of residence, gender, age, type of disability, comorbidity, amount and type of treatments provided and were analyzed by means of descriptive and comparative statistics.Results: 298 DGA treatments were performed to 169 males and 129 female patients, from 5 to 63 years of age and 63,8% of them were over 18 years old. 68,5% of the patients were mentally retarded, 17,8% were au- tistic, 7% had cerebral palsy, 3,5% suffered from vari- ous syndromes and 3,2% were patients with systemic diseases and other health issues. A total of 2787 treat- ments were provided, with higher prevalence of 49,8% for restorative treatments. Conclusions: In many patients with severe disability, DGA is the only treatment option. The number and the geographic distribution of dental departments of Greek NHS that provide DGA, does not guarantee the equal and unimpeded access of special needs patients. Therefore, implementation of organized oral preventive programs is necessary, along with investment on the appropriate infrastructure, that would allow the creation of additional dental departments providing DGA treatments within the NHS.

Socioeconomic significance and prevention of caries in school children

Caries is a multicausal, progressivе, irreversible disease of infectious origin, often occuring in school children and being a major socioeconomic problem. The aim of this review was to emphasize the socioeconomic importance of tooth decay and to stress the role of school dental care in prevention of caries and provision of good oral health in school children. Nowadays, it is considered that in developed countries the problem with dental decay has been resolved, but in underdeveloped and rural areas caries is still increasing. Possible reasons for such situation are lack of pediatric dental offices in schools of rural regions (meaning a greater distance to a dentist), improperly organized school dental care, insufficient dental health awareness of parents, inappropriate role models, as well as lower socio-economic status. School dental care is one of the most efficient and cost-effective methods of implementation of oral prevention programs. A children`s dentists in school dental clinics are able to offer not only necessary dental care interventions, but also appropriate information on factors that could improve or endanger oral health. Balanced diet, regular and properly exercised oral hygiene, use of fluorides, motivation and re-motivation, as well as regular dental check-ups, are principal elements for preservation of good dental and oral health.

Medical, social, and economic significance of school dental care service

Introduction. A high prevalence of caries in children is a huge medical, social, and economic problem. Caries, as a disease of the modern way of life, presents a financial burden to both individuals and society. School dental care (SDC) is the most efficient and cost-effective method used in oral prevention programs. Material and methods. The study was done on 2 groups of examinees; rural inhabitants without school dental clinics in the Surdulica municipality were enrolled in the first, and the second group consisted of elementary school children from Niš with SDC in their school. The patients were aged 9, 11, and 13 years, and each sample consisted of 150 examinees. Systematic dental examination was done in all of them, with the calculation of caries prevalence using the standard formulas (CIP - caries index of persons, CIT - caries index of teeth, CIA - caries index average). After teeth sanation, the average and total costs of dental care were calculated according to the price list of the Republic Health Insurance Fund of Serbia (RHIFS). Results. The obtained results demonstrated a significant difference in the presence of caries in our examinees with and without dental clinic in their schools. From the point of view of economics, although we expected higher costs of the treatment of rural children than those with SDC, the costs were lower for those without SDC, because of the inavailability of regular dental treatment due to distance to nearest dental clinics, and complete sanation of their mouth never took place. Conclusion. CIA of the children aged 9, 11, and 13 years with SDC ranged from 3.6 to 5.15, while in those without SDC it was almost three times higher, ranging from 9.03 to 9.37. Acquirement of healthy habits, education, and information of children begins in the family and continues with pre-school and school education. Lack of investing into prevention programs and low prices of dental care services are directly associated with increased caries prevalence.

Oral health conditions in children with and without school-based oral preventive program

To assess the degree of plaque, gingivitis and caries in children who either did or did not take part in a regular oral preventive program, thus establishing an overview of the oral health condition of those populations. A population of 325 Brazilian children aged 8–12 years old, from two public schools, whose parents granted permission, were divided into two groups according to their school. The main group (G1) consisted of 203 children from the school, which has the preventive program, while the control group (G2) consisted of 122 children from the school without the program. The children were examined clinically by a single examiner to assess plaque and gingival status, as well as caries prevalence in order to assess their oral health status. Data was inserted in SPSS 11.0 and the Mann-Whitney test with a significance level of 5% was used for data analyses of the independent variables, while the Student t test was used for comparison between averages. The mean plaque score and mean gingival bleeding score of G2 were higher than G1 ( P < 0.05). Regarding the percentage of caries-free children, it was 31.0% with a mean DMFT+dmft of 2.07 (± 2.87) in G1 and 21.3% with a mean DMFT+dmft of 3.03 (± 2.79) in G2 ( P > 0.05). It was concluded that the oral preventive program seemed to demonstrate a satisfactory impact on the oral health condition of the target children when compared to the ones who were not enrolled in a school-based program.

Oral health conditions in children with and without school-based oral preventive program

Oral health conditions in children with and without school-based oral preventive program

Periodontal treatment needs in a native island community in Colombia determined with CPITN

To identify the prevalence and different degrees of periodontal disease in an isolated community (Isla Grande, Colombia) with no dental services and low educational level with the use of CPITN, and to establish periodontal treatment needs in different age groups. Of 116 people examined, 0.9% were in periodontal health (CPITN value 0), 18.1% had gingival bleeding (CPITN value 1), 51.7% had supra or subgingival calculus (CPITN value 2), 18.1% presented pockets 3.5-5.0 mm deep (CPITN value 3), and 11.2% had pathological pockets of 5.5mm or deeper (CPITN value 4). No clear differences were observed between sexes. This study shows that 81% of the sample has some type of periodontal treatment need, with 69.8% of them requiring periodontal treatment that may be supplied by a hygienist and 11.2% requiring specialised treatment. Implementation of oral health education and oral prevention programmes was recommended to the authorities for this community.

Quality assurance in prevention.

The successful prevention of caries in Sweden, as in many other countries, is an example of what might he obtained when a systematic and complete program is adopted. Fluoride programs, mechanical cleaning of the teeth, and improved nutrition and eating habits have been the most important fundamentals for the positive results. A diminished use of tobacco, with a reduced frequency of periodontitis as one of the consequences, has been successful in some groups in the population but less so in others. There is, however, evidence now in Sweden of a less active preventive approach concerning caries prophylaxis among some parents today than a generation ago. Thus, there are obvious reasons to continue with oral preventive programs, preferably integrated with general health programs. For acceptable quality in preventive programs to be obtained, concrete goals must be formulated. These should be based upon scientific findings. Those in the society who should be given priority in the program must be identified by epidemiological studies. Systems for follow-up of the preventive measures should be integrated into the programs when they are initiated. Total quality assurance programs should include parameters which describe the resources and the process needed to obtain the formulated goals. The qualifications of those involved in the process are among the most important resources for success.