Preventive Oral Health Program Research Articles

Evaluación del conocimiento del programa preescolar de salud bucal en parvularias, mediante una encuesta

Objetivo: Diseñar y determinar un instrumento que evalúe el conocimiento de las educadoras de párvulo respecto a la salud oral de los niños en Valparaíso.Métodos: Estudio de serie de casos, transversal. Se realizó una encuesta de 23 preguntas que se basaron en los contenidos del “Programa de promoción y prevención en salud bucal para niños y niñas preescolares, MINSAL, 2007” aplicada a 244 parvularias.Resultados: La encuesta presentó un Alpha de Cronbach de 0,84. Se obtuvo una media de nota 3,5 (IC 95%: 3.4-3.6) según la escala del 1 al 7, que representa el nivel de conocimiento de las parvularias, en donde el área mejor calificada fue la alimentación. Conclusiones: Las parvularias presentan conocimiento deficiente en relación al programa de salud bucodentaria, por lo que es necesaria una capacitación en relación a esta temática.

Quality appraisal of economic evaluations done on oral health preventive programs-A systematic review.

If economic evaluations are to be used by decision makers, such evidence has to be robust so that the relevant policy maker use them. This study was undertaken with the purpose of identifying economic evaluations done on oral health preventive programs and to assess the standard of economic evidence in this field. A systematic search was conducted using four major electronic databases in order to search for economic evaluations done on oral health preventive programs. This included economic evaluations that were published between January 1975 and May 2018 on preventive interventions for periodontal disease, oral cancer screening, and other common oral health conditions. To avoid duplications with previous studies, for dental caries interventions, this review included studies from April 2012 and May 2018. "Guidance to undertaking reviews in health care," developed by York University, was used to assess the quality of reporting in the evaluations, using which strengths and shortcomings were identified. A total of 2026 records were initially found. After title and abstract screening, and elimination by full text review, 33 relevant economic evaluations were identified. Majority of the economic evaluations included were conducted on dental caries prevention; a few were done on oral cancer screening, periodontal disease, and general preventive dentistry (health promotion, oral hygiene etc.). In comparison to the findings observed in previous reviews, there has been improvements in the quality of reporting in economic evaluations. Several areas still in need for improve were identified (e.g., productivity costs, currency and prices, and generalizability issues).

Association Between Body Mass Index and Dental Caries in a Turkish Subpopulation of Adults: A Cross-Sectional Study.

To evaluate the relationship between decayed, missing and filled teeth (DMFT index) and body mass index (BMI) in a Turkish population of adults aged 20-30 years who did not have any chronic diseases. This study was conducted on a total of 394 patients. DMFT index was used to define the number of teeth with decays, teeth with fillings, and missing teeth. The body weight and height of the study participants were measured with a digital scale and height rod. BMI was calculated by dividing the body weight by the square root of the height. One-way analysis of variance (ANOVA) and Bonferroni tests were used to compare three or more groups and to compare two groups, respectively. The statistical significance level was evaluated at p < 0.05. Differences in DMFT index among BMI groups was found to be statistically significant (p = 0.001; p < 0.01). DMFT index was significantly higher in the obese group than in the normal-weight group (p = 0.001) and overweight group (p = 0.001). No statistically significant differences were found between DMFT indices of study participants of normal weight and those who were overweight (p > 0.05). Positive correlation was observed between obesity and DMFT index. Coadministration of obesity prevention programmes and preventive oral health programmes can improve public health to a better point.

Greater caries-free survival of first permanent molars: Findings from a 7-year follow-up evaluation of a community-based oral health preventive program.

The occlusal surface of the first permanent molar is the most frequently affected site by dental caries. To assess the caries-free survival of first permanent molars in children participating in a community-based oral health preventive program. This was a retrospective study conducted on 426 children under 12years of age, beneficiaries of a preventive program from 2009 to 2015, in El Cedro, Colombia. The program offered oral health care education, supervised brushing and mouth washing, and application of topical fluoride. By using parametric survival models for interval-censored data, primary and secondary caries-free survival of any first permanent molar was estimated and analyzed. Before program implementation, dental caries lesions presented at an average age, adjusted by age of eruption, of 8.3years for primary caries lesion and 9.3years for secondary caries lesion. After 7years of the program, the estimated average age for presenting primary dental caries lesion was delayed by 4.6years and by 5.3years for secondary caries. The implementation of the oral health program led to improved caries-free survival of first permanent molars.

Dental Caries in Relation to Socioeconomic Factors of 6 and 12-year-old Schoolchildren of Paonta Sahib, Himachal Pradesh, India: An Epidemiological Study.

Aims and objectivesDetermination of prevalence of dental caries in 6 and 12-year-old schoolchildren, dental caries prevalence between government and private schoolchildren, and the influence of socioeconomic factors on dental caries on children of Paonta Sahib, Himachal Pradesh, India.Materials and methodsIn the government and private schools at Paonta Sahib of Sirmour district, Himachal Pradesh, India, a cross-sectional study was carried out. The study population comprised schoolchildren of 6 and 12 years. A total of 1,004 children of both genders were surveyed for dental caries status. The decayed, missing, filled teeth (DMFT) index was used for clinical examination of caries. Prior collection of sociodemographic information was done in addition to information on oral health behavior by personal interview.ResultsIn the present study, dental caries prevalence was found to be higher in children of 6 years of age (63.6%) than that of 12 years (53.6%) (p = 0.001). The mean DMFT was 2.47 ± 2.75 for 6–year-old children and 1.18 ± 1.33 for 12–year-old children. No significant difference was observed in dental caries prevalence among children of government and private school (p = 0.167). Moreover, dental caries frequency was highest in children belonging to upper-middle (38.14%) class followed by lower-middle (32.32%), upper-lower (25.42%), and upper class (4.12%). The obtained data were analyzed using the chi-square test and one-way ANOVA test.ConclusionDental caries prevalence was high in children of 6 years of age in the study. The dental caries frequency was more in upper-middle-class children. These results suggest that emphasis should be given to scientific monitoring, effective implementation, and evaluation of school-based oral health promotion and preventive programs to increase the dental awareness and oral hygiene practices, in Paonta Sahib, Sirmour district.How to cite this articleJindal L, Dua P, Mangla R, et al. Dental Caries in Relation to Socioeconomic Factors of 6 and 12-year-old Schoolchildren of Paonta Sahib, Himachal Pradesh, India: An Epidemiological Study. Int J Clin Pediatr Dent 2020;13(4):395–398.

Impact evaluation of a school-based oral health program: Kuwait National Program

BackgroundThis study evaluated the relationship between enrolment in a school-based oral health prevention program (SOHP) and: 1) children’s dental health status and oral health-related quality of life (OHRQoL), and 2) mothers’ oral health (OH) knowledge, attitude, practice, and OHRQoL.MethodsThis cross-sectional study, in the Kuwait Capital, included 440 primary school children aged 11 to 12 years and their mothers. Participants were classified into two groups: SOHP and non-SOHP. The SOHP group had been enrolled in the prevention program for at least 3 years: children had twice-a-year applications of fluoride varnish and fissure sealants if needed; mothers had, at least, one oral health education session. The non-SOHP group had negative consents and had not been exposed to the prevention program activities. Dental examinations were performed at schools using portable dental units. Caries experience was determined using the decayed (D/d), missing (M/m), and filled (F/f) teeth (T/t)/surface (S/s) indices. Children’s OHRQoL was assessed using a self-administered validated Child Perceptions Questionnaire 11–14 (CPQ11–14). Mothers’ OH knowledge, attitude, practice, and OHRQoL were also assessed. After Bonferroni correction, a p-value of less than 0.05 was considered statistically significant for caries experience measures while a p-value of less than 0.013 was considered statistically significant for OHRQoL subscales and mothers’ OH knowledge, attitude, practice, and OHRQoL.ResultsMean (SD) DT/dt, DMFT/dmft and DMFS/dmfs were 1.41 (1.66), 2.35 (2.33), and 4.41 (5.86) for SOHP children, respectively. For non-SOHP children, the means were 2.61 (2.63), 3.56 (3.05), and 7.24 (7.78), respectively. The difference between the SOHP and non-SOHP was statistically significant (p < 0.001). Children enrolled in the program had a higher number of sealed and restored teeth. No significant differences were found in CPQ11–14 scores or subscale scores between the two groups. No significant difference in mothers’ OH knowledge, attitude, practices or OHRQoL was found between SOHP and non-SOHP groups (P > 0.013).ConclusionEnrolment in the SOHP prevention services was associated with a positive impact on children’s caries level with no significant impact on mothers’ knowledge, attitude, practice, or OHRQoL.

A qualitative study of the multi-level influences on oral hygiene practices for young children in an Early Head Start program

BackgroundIndividual child-level risk factors for Early Childhood Caries (ECC) have been studied, but broader family- and community-level influences on child oral hygiene behaviors are less well understood. This study explored multiple levels of influence on oral hygiene behaviors for young children in Early Head Start (EHS) to inform a future behavioral intervention targeting children from low-income families.MethodsTwenty-four semi-structured interviews were conducted with mothers of children under 4 years old, enrolled in the home visitor (HV) component of one EHS program in Los Angeles, CA, who participated in the BEhavioral EConomics for Oral health iNnovation pilot study (BEECON) in 2016–7. Audio-recordings of interviews were translated if needed, and transcribed in English, and coding and analysis was facilitated by Dedoose qualitative software. This investigation used general thematic analysis guided by the Fisher-Owens child oral health conceptual framework to identify influences on oral hygiene behaviors for the young children.ResultsMany mothers reported brushing their children’s teeth twice/day, and concern that most children frequently resisted brushing. They identified children being sick or tired/asleep after outings as times when brushing was skipped. Several child-, family-, and community-level themes were identified as influences on child oral hygiene behaviors. At the child-level, the child’s developmental stage and desire for independence was perceived as a negative influence. Family-level influences included the mother’s own oral hygiene behaviors, other family role models, the mother’s knowledge and attitudes about child oral health, and mothers’ coping skills and strategies for overcoming challenges with brushing her child’s teeth. Overall, mothers in the EHS-HV program were highly knowledgeable about ECC risk factors, including the roles of bacteria and sugar consumption, which motivated regular hygiene behavior. At the community-level, mothers discussed opportunities to connect with other EHS-HV families during parent meetings and playgroups that HV coordinated. A few mothers noted that EHS-HV playgroups included brushing children’s teeth after snacking, which can be a potential positive influence on children’s hygiene practices.ConclusionChild-, family- and community-level factors are important to consider to inform the development of tailored oral health preventive care programs for families in EHS-HV programs.

Detection of dental plaque with disclosing agents in the context of preventive oral hygiene training programs

No studies have evaluated the relationship between the detection points for dental bacterial plaque (DBP or biofilm) and gender, age, socioeconomic status, body mass index (BMI), and oral health, hence the need to investigate and clarify their possible association. This study aimed to map out the occurrence of DBP, investigate and evaluate the factors affecting its localization, and design preventive interventions. The research was conducted on 588 public school children aged 4–18 years in a provincial area of Greece. The subjects’ oral health status and anthropometric characteristics were examined by a dentist (A.F.) and a dietitian (E.P.), respectively. To identify DBP, chewable double-staining disclosing tablets were used. The results of the present study indicate the following: (1) Age and socioeconomic status seem to be associated with DBP development, particularly in the oral cavity. (2) Overweight schoolchildren show more DBP on the upper posterior occlusal and upper posterior buccal surfaces compared to normal-weight children. (3) Moderate caries disease is associated with DBP detection on almost all tooth surfaces and especially on the tongue and lower anterior labial surface. (4) Severe caries disease is most strongly associated with DBP in the upper posterior palatal, lower posterior buccal, and lower posterior lingual spaces, as well as on the tongue. (5) Sex is the only variable without a significant impact on DBP detection surfaces. In conclusion, DBP identification in specific areas of the mouth seems to be influenced by age, socioeconomic level, BMI, and oral health. Gender has no influence on DBP detection points. Disclosing agents can be used in oral health prevention programs, both for more effective guidance on the use of oral hygiene tools and for their evaluation.

Koruyucu Ağız Diş Sağlığı Programlarında Annenin Eğitimi ve Ağız Sağlığının İyileştirilmesi ile Erken Çocukluk Çağı Çürüklerinin Önlenmesi

Diş çürüğü; biyolojik, davranışsal ve sosyoekonomik faktörlerle ilişkili toplumsal bir hastalık olarak tanımlanmaktadır. Çocukluk döneminin en yaygın enfeksiyöz hastalığı olan diş çürüğünün bakteriyel kaynaklı bir hastalık olması gerçeği hastalığa bakış açısını değiştirmiştir. Güncel çalışmalar bakteriyel enfeksiyonun bireyden bireye taşınmasının engellenmesi, bireyin diyet alışkanlığının değiştirilmesi ve ağız hijyeninin iyileştirilmesi ile diş çürüğünün önlenebileceğini vurgulamaktadır. Doğumdan önce, annenin kötü ağız sağlığına sahip olması medikal risklere yol açmasının yanında, erken dönemde bebeklerde diş çürüğü gelişim riskini de artırmaktadır. Annelerin yenidoğan ve bebeklere çürük enfeksiyonunun geçişi için ilk kaynak olduğu ve bakteriyel geçişin 1,5-3 yaş arasında olduğu düşünülmektedir.

An assessment of strategies to control dental caries in Aboriginal children living in rural and remote communities in New South Wales, Australia

BackgroundA community-led oral health service for Aboriginal people in Central Northern NSW identified the need for oral health promotion, as well as dental treatment; in three remote communities with limited access to dental services. A three-stage plan based on the Precede-Proceed model was used to develop a school-based preventive oral health program. The program will be piloted in three schools over 12 months aimed at improving the oral health of local Aboriginal children.MethodsThe proposed program includes four components: daily in-school toothbrushing; distribution of free fluoride toothpaste and toothbrushes; in-school and community dental health education and the installation of refrigerated and chilled water fountains to supply a school water bottle program. Primary school children will be issued toothbrushing kits to be kept at school to facilitate daily brushing using a fluoride toothpaste under the supervision of trained teachers and/or Oral Health Aides. School children, parents and guardians will be issued free fluoride toothpaste and toothbrushes for home use at three-monthly intervals. Four dental health education sessions will be delivered to children at each school and parents/guardians at local community health centres over the 12 month pilot. Dental education will be delivered by an Oral Health Therapist and local Aboriginal Dental Assistant. The program will also facilitate the installation of refrigerated and filtered water fountain to ensure cold and filtered water is available at schools. A structured school water bottle program will encourage the consumption of water. A process evaluation will be undertaken to assess the efficiency, feasibility and effectiveness of the pilot program.DiscussionThe proposed program includes four core evidence-based components which can be implemented in rural and remote schools with a high Aboriginal population. Based on the Precede-Proceed model, this program seeks to empower the local Aboriginal community to achieve improved oral health outcomes.Trial registrationTRN: ISRCTN16110292 Date of Registration: 20 June 2018.

PROGRAMAS PREVENTIVOS DE SALUD BUCAL: FLUORACIÓN DEL AGUA POTABLE Y SAL COMÚN

A nivel mundial se observa un problema latente asociado con la salud bucal de la población, puesto que aproximadamente 2400 millones de personas padecen de caries de dientes permanentes. Tradicionalmente, la fluorización es la estrategia más común para brindar una solución adecuada que permita disminuir las elevadas estadísticas de caries en niños y adultos en todo el mundo. Las vías más comunes para desarrollar dicha estrategia son la fluorización del agua potable y la sal común. Por tanto, en el presente trabajo se analizan estas estrategias como vías para establecer programas preventivos de salud oral. En conclusión, los métodos de fluorización en agua y sal de mesa han demostrado ser efectivos en diferentes naciones, sin embargo, el programa preventivo de salud bucal aplicado sobre el cloruro de sodio representa ventajas significativas en cuanto a la relación costo/beneficio y a la cobertura en la población; más aún en países como Ecuador, en el que según las estadísticas de los organismos pertinentes, se alcanzan bajos niveles de accesibilidad al agua potable. Palabras clave: Prevención, salud oral, agua potable, cloruro de sodio, fluorización.

Effectiveness of a preventive oral health program in preschool children

Aim: To evaluate the effectiveness of an educational preventive program in oral health on preschoolers. Methods: The final sample was 71 children in the test group and 48 in the control group. Intraoral exams were conducted for caries experience (dmf-s), white spot lesions (WSL) diagnosis, dental biofilm and treatment needs (before and after intervention- the interval was 18 months). Caregivers answered a questionnaire about socioeconomic data and health behavior. The educational preventive program consisted of supervised brushing, education in oral health, fluoride application and lectures to caregivers. Mann Whitney and Wilcoxon tests (p &lt;0.05) were used to compare data between groups. Results: Mean caries experience was 0.94 (± 3.42) and 0.94 (± 2.87) in test and control groups, respectively. Baseline mean for dental biofilm was 4.95, and final mean was 0.21 in test group (p = 0.047). Conversely, the same variables were 4.11 and 0.84 in the control group (p = 0.047). The program was evaluated as very good (54.9% of caregivers), improvement of brushing was related by 62%, and more children went to the dentist (p &lt;0.01). Conclusion: The educational preventive program seems to be effective for dental biofilm reduction, improved brushing and dental visits, being an important strategy for oral health maintenance in children.

Effectiveness of a one year oral health educational and preventive program in improving oral health knowledge and oral hygiene practices of a group of Autistic Egyptian children and their caregivers

BackgroundAutism spectrum disorder (ASD) is a neuro developmental disorder characterized by severe damage in social interaction, language, behavior and cognitive function. AimThe current study aimed to assess the effectiveness of a specially designated educational and preventive program for 1 year in reducing caries activity and preventing caries and periodontal diseases among group of autistic Egyptian children, also to assess the behavior of each child in every visit and to assess the effectiveness of a specially designated educational program in improving oral health knowledge, attitudes and oral practices of parents and caregivers of these children. Basic research designLongitudinal field trial with before and after comparison. Participants30 Autistic Egyptian children (4-13years old) and their parents/caregivers. Clinical settingThree academies for autism spectrum disorder, situated in Cairo, Egypt. InterventionsPhase I: Information of the Cariogram parameters (caries experience, diet content, diet frequency, plaque amount, mutans streptococci, fluoride program, saliva secretion and saliva buffer capacity) were collected, which were used to generate the individual caries profile, based on which the children were divided into 3 risk groups. Phase II: Risk based preventive program was implemented. Phase III: At the end of 12 months, caries profile was generated again. Main outcome measuresThe effectiveness of the preventive program was assessed by comparing the baseline and follow-up caries profile for statistical analysis. ResultsA statistically significant difference was found in Frankl's behavior scale between the three periods of testing, regarding caries activity and periodontal diseases, a statistically significant difference was found between before and after the preventive program, on assessing dental knowledge of caregivers before and after the program, results showed that a statistically significance difference was found between the percentage of caregivers in answering the questions with right answers before and after the program where a higher percentage answered the right answer after the program than before. ConclusionsEducational and preventive program was effective in improving the various caries risk factors and increasing the chance to avoid caries to autistic children and in increasing children and caregivers' dental knowledge.

Factors influencing Patients' Utilization of Dental Health Services in Jazan, Kingdom of Saudi Arabia.

IntroductionOne way of prevention and early detection of oral diseases is by utilizing the dental health care services on a regular basis. The current study aims to know the factors that play a role in influencing the dental service utilization in Jazan, Kingdom of Saudi Arabia.Materials and methodsA cross-sectional survey using a self-administered questionnaire was designed and implemented. Study subjects comprised of patients visiting the dental clinics at Jazan University and the primary dental centers of five different suburbs in Jazan region of Kingdom of Saudi Arabia. Items in the questionnaire were grouped into three sections; “demographic details,” “self-reported dental visits,” and “potential factors” contributing to dental visits. Chi-square p-value of 0.05 or less was considered as significant and logistic regression with 95% confidence interval (CI) was performed to get more precise results.ResultsThe sample size was 395 (N) of which 44.8% were males and 53.4% were females. Less than half (45.8%) of the studied sample reported that their last visit to a dentist was within a span of one year and 33% of them think that a dentist should only be visited if they experience pain. Patients following instructions given by a dentist were 7 times [odds ratio (OR) = 0.13; CI = 0.04, 0.40] less likely to miss their regular dental appointments. Following this, patients receiving knowledge on their dental problems were seen to be twice (OR = 0.50; CI = 0.25, 0.98) less likely to be irregular with their dental visits. Finally, the patients who are better educated and literate were also 2 times (OR = 2.21; CI = 1.14, 4.28) more likely to be regular with their dental appointments in comparison with the patients who completed just their primary level education.ConclusionFindings of this study will facilitate future oral health prevention programs to be more focused, thereby reducing the gap between high and low educated sectors of the population residing in Jazan.How to cite this article: Quadri FA, Jafari FAM, Albeshri ATS, Zailai AM. Factors influencing Patients’ Utilization of Dental Health Services in Jazan, Kingdom of Saudi Arabia. Int J Clin Pediatr Dent 2018;11(1):29-33.

Epidemiological profile of patients utilising public oral health services in Limpopo province, South Africa.

BackgroundDespite the impact of oral diseases on the quality of life, there is limited updated evidence on oral health status in Limpopo province.ObjectivesTo determine the epidemiological profile of patients utilising public oral health services in Limpopo province.MethodThis was a descriptive retrospective clinical chart review conducted in five purposively selected district hospitals in Limpopo province. The collected data included the patient’s sociodemographic information, reasons for dental consultation, information on the dental or oral diseases and the treatment received. Five hundred clinical files were systematically selected (100 from each district hospital) for the period 01 January 1995 to 31 December 2013. Data were collected using the World Health Organization’s indicator age groups, namely 6-year-olds, 12-year-olds, 18-year-olds and 35–44-year-old groups. A data capturing sheet was used to record the collected information. Data were analysed using the statistical software package for social sciences SPSS version 23.0.ResultsThe majority of patients were in the age group of 6 to 20 years (n = 375, 75%). The majority were male patients (n = 309; 62%). Dental caries was the most common complaint (n = 298, 60%). The second most common main complaint in this age group was retained primary or deciduous teeth (n = 60, 12%) affecting children mainly in the age group of 6 to 12 years. The most common clinical procedure across all five districts was dental extractions (n = 324, 64%). Other clinical interventions included scaling and polishing (n = 33, 12%) and dental restorative care (n = 20, 3%).ConclusionThere is an urgent need to reorient oral health service delivery in Limpopo province to focus more on preventive oral health programmes.

Effectiveness of Disease Prevention in Community Health Center Dental Programs

The goal of this paper is to describe and analyze oral health disease prevention at Community Health Center (CHC) dental programs in order to summarize the effectiveness of activities at the individual and community levels. Recent efforts to expand oral health prevention and care with children at community health centers have shown positive results. Although there is considerable literature regarding oral health disease prevention aimed at individuals and communities, there are few articles that specifically address preventive oral health programs at CHC. CHC dental programs are well positioned to address the prevention of dental diseases as an integral part of care based on their organization and strong community-based orientation. Recent trends in the integration of medical and dental care at CHC support dental disease prevention activities to increase oral health and provide opportunities for further research in monitoring effectiveness of disease prevention in CHC.

The virtual dental home: a critique.

The Virtual Dental Home is a concept of the Pacific Center for Special Care of the Arthur A. Dugoni School of Dentistry in San Francisco. It is designed to improve access to dental care for underserved populations, specifically children and institutionalized adults. This article describes the development and implementation of the Virtual Dental Home, subsequently critiquing the concept. The criteria for a dental home are not met by the program. It is the equivalent of a traditional public oral health prevention and screening program, with the additional dimension of allowing dental hygienists and assistants to place interim glass ionomer restorations in dental cavities. The critique questions the need to insert a "cloud" dentist into the process. The routine utilization of radiographs is also challenged. The VDH not only lacks the attributes of a dental home, it has not been shown to be as efficient and effective as traditional programs staffed by dental hygienists and dental therapists. The article concludes by describing how programs utilizing dental therapists could address the deficiencies of the Virtual Dental Home, effectively improving access to oral health care for underserved populations.

The Importance and Role of Early Prevention Practices in Community-Based Preventive Oral Health Programs

The Importance and Role of Early Prevention Practices in Community-Based Preventive Oral Health Programs

Evaluation of Periodontal Status and Treatment Needs of Institutionalized Intellectually Disabled Individuals in Lebanon.

Aims and Objectives:No reported data is available on the periodontal health and treatment needs of the intellectually disabled in Lebanon. To evaluate the periodontal condition and treatment needs of institutionalized intellectually disabled individuals in Lebanon.Materials and Methods:A total of 272 individuals (141 males and 131 females) aged 15 years and 35–44 years were examined. Periodontal health was recorded following the community periodontal index of treatment needs (CPITN), and treatment need was assigned accordingly. The IBM® SPSS® statistics 20.0 and Stata/SE 11.1 statistical packages were used to carry out all statistical analyses. Statistical analysis was performed using linear regression (P ≤ 0.05).Results:Healthy periodontium was recorded in 26.1%, bleeding on probing in 27.9%, supra-/sub-gingival calculus in 31.3%, pockets of 4–5 mm in 11% and ≥6 mm in 3.7%. The largest proportion of the sample was in need for oral hygiene instruction and calculus removal (42.3%). Age, geographical location, consumption of carbohydrate-rich meals and sweets between meals were significantly associated with CPITN score severity in multivariate analysis (P < 0.05). Gender, severity of disability, frequency of tooth brushing, and caretaker characteristics were not significant predictors of CPITN (P > 0.05).Conclusion:The predominantly poor periodontal health and social inequalities warrant nationwide preventive oral health programs in addition to planning the provision of treatment services to meet existing treatment needs.

Integrating Maternal and Children's Oral Health Promotion into Nursing and Midwifery Practice- A Systematic Review.

BackgroundGlobally, oral diseases contribute to major disease problems and oral health disparities persistently exist amongst vulnerable population groups. Two contributory factors to these challenges are the shortage of dental practitioners and the characteristic separation between the medical and dental professions. Nurses and midwives, in particular, are in a potentially excellent position to assist in basic oral health services such as dental health education and intraoral screening. We aimed to assess the effectiveness of integrating promotion of oral health of young children and their mothers into nursing and midwifery practice.Methods and FindingsSeven electronic databases including CENTRAL, EMBASE, MEDLINE, GLOBAL HEALTH, CINHAL, Scopus, and Web of Science were systematically searched whereas conference proceedings and theses were retrieved via PROQUEST. Only randomized, non-randomized trials and observational studies on preventive oral health programs delivered by nurses or midwives in healthcare settings or through home visits were included. Two investigators reviewed full-text articles independently to decide on eligibility for inclusion. Quality assessment was done using Cochrane tool for risk of bias for randomized trials and Downs and Black assessment tool for all other studies. Out of 3162 retrieved records, twenty one trials on oral health interventions incorporated into standard nursing practice were reviewed. Eighteen programs reported significant positive outcomes including reduction in caries experience, better oral hygiene and dietary habits and increased rates of dental visits amongst young children as reported by their caregivers.ConclusionsIncorporating oral health promotion into nursing practice is a promising initiative for reducing oral health disparities by contributing to a downward trend in caries experience and increased access to dental care especially amongst the poor disadvantaged communities.