Oral health and its determinants among Mongolian dentists

This study compares the dental health of dentists with that of their population counterparts, and relates dentists' oral health to oral health behavior and professional preventive knowledge and orientation. A questionnaire requesting information on the dentists' oral health, preventive knowledge, and orientation and oral health behavior, was targeted at all actively practicing dentists (n = 250) in the Mongolian capital of Ulaanbaatar. A self-reported dentigram served as the basis for assessing dental health, while the 1996 National Oral Health Survey provided data for comparison with population counterparts. The response rate was 98%. Compared to their general-population counterparts, younger dentists exhibited a similar level of caries experience (DMFT) and missing teeth (NMT), whereas older dentists exhibited a lower level. In all age groups, mean numbers of decayed teeth (DT) among dentists were much smaller than for their population counterparts, whereas mean numbers of filled teeth (FT) were much higher. Of all, 81% reported brushing their teeth twice daily or more, 62% used fluoride-containing toothpaste always or almost always, and 52% consumed sugar-containing foods between main meals less than once a day. The better oral health behavior of dentists was best explained by their greater preventive knowledge and their better dental health by better oral health behavior in logistic models. It is concluded that among these dentists there is room for improvement of their own oral health behavior. Towards this end, specially designed continuing education courses could serve to improve dentists' health-related knowledge and change their oral self-care behavior.     

The pediatric dental workforce in 2016 and beyond

BackgroundChildhood caries is a major oral and general health problem, particularly in certain populations. In this study, the authors aimed to evaluate the adequacy of the supply of pediatric dentists.MethodsThe authors collected baseline practice information from 2,546 pediatric dentists through an online survey (39.1% response rate) in 2017. The authors used a workforce simulation model by using data from the survey and other sources to produce estimates under several scenarios to anticipate future supply and demand for pediatric dentists.ResultsIf production of new pediatric dentists and use and delivery of oral health care continue at current rates, the pediatric dentist supply will increase by 4,030 full-time equivalent (FTE) dentists by 2030, whereas demand will increase by 140 FTE dentists by 2030. Supply growth was higher under hypothetical scenarios with an increased number of graduates (4,690 FTEs) and delayed retirement (4,320 FTEs). If children who are underserved experience greater access to care or if pediatric dentists provide a larger portion of services for children, demand could grow by 2,100 FTE dentists or by 10,470 FTE dentists, respectively.ConclusionsThe study results suggest that the supply of pediatric dentists is growing more rapidly than is the demand. Growth in demand could increase if pediatric dentists captured a larger share of pediatric dental services or if children who are underserved had oral health care use patterns similar to those of the population with fewer access barriers.Practical ImplicationsIt is important to encourage policy changes to reduce barriers to accessing oral health care, to continue pediatric dentists’ participation with Medicaid programs, and to urge early dental services for children.     

Determinants of oral health behaviour among Iranian dentists

AIM: To study the oral health behaviour of Iranian dentists. DESIGN: A cross-sectional study. Setting: Two annual dental meetings in Tehran, Iran. PARTICIPANTS: 1,033 dentists responded, 980 were eligible for this study. METHOD: Data were collected using a self-administered questionnaire which covered dentists' oral self-care, dental attendance, and smoking. Recommended oral self-care (ROSC) included tooth brushing > 1/day, eating sugary snacks < daily, and regularly using fluoride toothpaste. Knowledge of preventive dental care was assessed by nine Likert-scale statements. Dentist's gender, age, and professional reading were recorded. Statistical evaluation was by the Chi-square test and logistic regression. RESULTS: In total, 59% of respondents reported brushing their teeth at least 2/day, 59% consumed sugary snacks < daily, 74% used fluoride toothpaste regularly, and 76% were non-smokers. Of all, 27% followed ROSC. Women reported desirable behaviours more frequently than did the men (p < 0.01). Female gender (OR 1.4-2.3), being a non-smoker (OR 1.3-1.5), and wider professional reading (OR = 1.2) were the major factors that contributed to dentists' desirable oral health behaviour. CONCLUSIONS: That only a small number of Iranian dentists follow the ROSC calls for more attention to behavioural contributions to oral diseases and its consequences with general and oral health, regarding both dental curriculum and continuing education.     

Tooth brushing and oral health: how frequently and when should tooth brushing be performed?

This review shows that there is consensus in the literature that (meticulous) tooth brushing once per day is sufficient to maintain oral health and to prevent caries and periodontal diseases. Tooth brushing is also regarded as an important vehicle for application of anti-caries agents, such as fluorides. However, most patients are not able to achieve sufficient plaque removal by performing oral hygiene measures at home. Therefore, tooth brushing twice daily is recommended by most of the dentists in order to improve plaque control. This rule is followed by most of the patients taking care for their oral health and has shown to be effective in maintenance of oral health in numerous studies. Study of the literature gives no clear evidence as to the optimal time-point of tooth brushing (before or after meals). However, in order to eliminate food impaction and to shorten the duration of sucrose impact by tooth cleaning after meals seems to be recommendable. Although--with our current knowledge of potential harm due to brushing of erosively altered and softened tooth surfaces--giving advice on a more individual basis is recommended for patients suffering from erosion.     

Pharmacologic behavior management of pediatric dental patients diagnosed with attention deficit disorder/attention deficit hyperactivity disorder

PURPOSE: The purpose of this study was to conduct a survey of Texas pediatric dentists to determine: (1) the percentage of patients they treat with attention deficit disorder (ADD)/attention deficit hyperactivity disorder (ADHD); (2) the behavior management techniques that are utilized to treat their patients who suffer from ADD/ADHD; and (3) the relative success rates of these techniques in their practices. METHODS: A 17-question, single-answer, multiple choice survey was mailed to 343 Texas pediatric dentists. The mailing list was obtained from American Academy of Pediatric Dentistry and Texas Academy of Pediatric Dentistry member rosters. One mailing was sent, including a self-addressed stomped envelope, for returned responses. RESULTS: A 54% response rate (186 surveys) revealed that nitrous oxide was the most frequently used pharmacologic behavior management technique; however, demerol/promethazine/nitrous oxide was rated as effective most often for treating ADD/ADHD patients. CONCLUSIONS: Practitioners believe the incidence of attention deficit disorder/attention deficit hyperactivity disorder is increasing, and they are familiar with the medications used to treat the conditions. Texas pediatric dentists are using a variety of sedation techniques and are interested in developing guidelines for sedation of these patients.     

Rural versus urban analysis of dental procedures provided to Virginia Medicaid recipients

PURPOSE: The purpose of this study was to report the distribution of procedures provided to Virginia Medicaid children by 3 types of dental providers in rural and urban areas. METHODS: Medicaid claims filed for dental patients less than 21 years old were obtained and analyzed for fiscal years 1994-1995. Dental providers were categorized according to their practice type: (1) general practice (GP); (2) pediatric (PD); and (3) public health (PH) dentists. Each type of practice was categorized as practicing in a metropolitan, urban, rural, or completely rural location and evaluated for percentages of preventive, diagnostic, and corrective services provided. RESULTS: Rural areas had a higher percentage of significant providers than did metropolitan or urban areas. General dentists performed more diagnostic and preventive but fewer corrective procedures than pediatric dentists. Pediatric dentists and general dentists in completely rural areas performed more corrective procedures than their counterparts in metropolitan or urban areas. CONCLUSIONS: General, pediatric, and public health dentists in metropolitan and urban areas perform slightly more diagnostic services and fewer corrective services than practitioners in more rural areas.     

儿童口腔科医师实施行为管理相关问题调查分析

目的 对儿童口腔科医师在门诊工作中与行为管理有关的工作内容及医生的工作压力进行调查，并就相关因素进行分析。方法 对参加第五届全国儿童口腔医学会议的139名医生进行问卷调查，并对有关因素进行分析。结果 在大学附属医院工作的医生更倾向于进行母子分离、过去一个月内44．6％的医生接诊过有行为问题的儿童。获得了具体各种行为管理方法应用情况的资料。另外51．5％的医生感觉门诊工作有比较大的压力。结论 目前儿童口腔医生在镇静全麻等特定方法的应用上还有待加强，工作压力所可能导致的对健康的影响不容忽视。     

Effectiveness of an oral health education and caries prevention program in kindergartens in China

OBJECTIVES: To evaluate the effect of a 2-year oral health education and caries prevention program implemented in kindergartens in China. METHODS: Seven hundred and thirty-one 3-year-old children were recruited from 10 kindergartens in Miyun County, Beijing, China. The kindergartens were randomly divided into two groups. Oral health education was provided to teachers in the test kindergartens every 3 months. Oral health education sessions were conducted for the test children monthly and for their parents semiannually. Children in the test kindergarten brushed their teeth twice daily with fluoridated toothpaste (1100 ppm F-) in their kindergarten under the supervision of teachers during weekdays. No oral health education session and no supervised tooth brushing activities were carried out in the control kindergartens. A clinical examination of the study children and a questionnaire survey of their parents were conducted at baseline and after a 2-year program. RESULTS: Five hundred and fourteen children remained in the study after 2 years. The mean caries increments of the test group (n = 258) and the control group (n = 256) were 2.47 and 3.56 dmfs, respectively. The reduction in dmfs increment was 30.6% (P = 0.009). At the evaluation, a significantly higher percentage of children in the test group than in the control group reported brushing their teeth twice a day (87.6% vs. 69.0%; P < 0.001). Parents of children in the test group had better oral health knowledge and attitude than the parents of children in the control group. CONCLUSION: This oral health education program was effective in establishing good oral health habits among preschool children and in increasing oral health knowledge of their parents, in conjunction with supervised daily tooth brushing with fluoridated toothpaste, which could reduce the development of new dental caries in preschool children in China.     

家长态度与儿童口腔卫生习惯形成的关系

目的：从刷牙次数和甜食消费两个方面,分析家长对龋病易感因素的态度与儿童实际龋相关行为的关系,为开展口腔卫生宣教提供依据.方法：用配对法研究儿童家长对儿童龋病易感因素问题的关心程度与儿童实际行为的联系,dmft=0的儿童及其家长作为对照组,dmft≥3的儿童及家长作为试验组.所得数据用SPSS10.0软件包进行Logistic回归,分析家长对儿童刷牙与甜食摄入相关问题所持的态度与儿童实际行为的关联程度.结果：家长对待儿童刷牙的态度与儿童实际刷牙情况有密切关系（P=0.000）,家长对待儿童甜食问题的态度与儿童实际甜食摄入行为有密切联系（P=0.001）.结论：家长对待儿童刷牙和甜食的态度,在一定程度上反映儿童的相关行为.可通过卫生宣教,提高家长在儿童龋病预防中的作用,减少龋病的发生率.     

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目的了解中日友好医院口腔门诊患者口腔卫生知识的知晓及口腔健康行为情况,为今后该院口腔门诊患者健康教育及诊疗服务提供参考。方法参考全国口腔流行病学调查问卷自行设计问卷,对2011年1—12月来该院口腔门诊就诊、年龄≥7周岁的患者进行调查,调查的内容为:一般人口学信息、口腔卫生知识的知晓情况、口腔健康行为情况及口腔疾病的患病情况。调查结果通过Epidata3.0软件建立数据库,SPSS15.0统计软件进行统计分析。结果 2011年来该医院口腔门诊就诊的8362例患者,患病以牙周疾病和龋齿为主,所占的比例分别为36.0%和28.7%;正确刷牙方法的知晓率为30.2%,牙结石、合理洁牙频次、牙菌斑知晓率分别为22.1%、10.9%、2.4%;日常行为中采取正确刷牙方法的比例占15.1%,曾经洗过牙的占10.2%,睡觉前经常吃甜食的占20.4%,未接受过口腔门诊健康教育的比例占37.8%,最近5年未曾看过口腔门诊者占65.2%,经常吸烟的比例占39.2%,经常饮酒的占36.5%,经常熬夜的占40.6%,不经常锻炼身体的占76.4%;被调查患者获取口腔卫生知识的主要途径是报纸、电视及网络。结论该医院口腔门诊就诊患者口腔卫生知识知晓率较低,口腔健康行为比例较低,应通过口腔门诊进一步加强对患者的健康教育。     

The impact of a school dental service on the periodontal health and oral hygiene status of 6-year-old Sowetan learners.

The public oral health sector offers essentially two types of services to learners viz, (i) clinical services, where curative and restorative treatment, and prophylactic care is provided, and (ii) school-based services which focus on a primary preventive approach to oral health that consists of health promotion and specific protection initiatives e.g. brushing programmes. Learners may be exposed to a combination of clinical and school-based services or to school-based services only. The objective of this study was to compare the impact of services delivered by the public oral health sector on periodontal health and oral hygiene status of 6-year-old Sowetan learners to a control group who were not exposed to any organised oral health programme. Follow-up visits were conducted every 6 months from baseline for a period of 18 months. A significant decrease in the percentage of learners with healthy periodontal tissues and a significant increase in the percentage of learners with gingival bleeding was observed for all three cohorts. Oral hygiene performance, assessed according to the Patient Hygiene Performance (PHP) index, demonstrated no improvement after 18 months, although the mean scores remained within the 'fair' interval. No significant benefit could be demonstrated in providing a clinical services component in combination with school-based services. No significant positive impact of the brushing programme on oral hygiene and periodontal health status of learners was observed after 18 months when compared to a control group.     

Oral health attitudes, knowledge, and behavior among school children in North Jordan

The aim of this study was to assess the knowledge, attitude, and behavior of school children towards oral health and dental care as well as to evaluate the factors that determine these variables. School children (n=557) of an average age of 13.5 years attending public schools in North Jordan were recruited into this study. The subjects completed a questionnaire that aimed to evaluate young school children's behavior, knowledge, and perception of their oral health and dental treatment. The participants' oral hygiene habits (such as tooth brushing) were found to be irregular, and parents' role in the oral hygiene habits of their children was limited. The study population showed higher awareness of caries than periodontal conditions. Irregular visits to the dentist were found to be common, and toothache was the major driving factor for dental visits. Children had positive attitudes toward their dentists; nevertheless, they indicated that they feared dental treatment. The children in this study also recognized the importance of oral health to the well-being of the rest of the body. Parents were not proactive in making sure that their children received regular dental care. Parents' knowledge and attitudes about the importance of oral health care and their fears about dental treatment influenced their children's dental care. The results of this study indicate that children's and parents' attitudes toward oral health and dental care need to be improved. Comprehensive oral health educational programs for both children and their parents are required to achieve this goal.     

Dental knowledge regarding preventive measures of young adults

A study was undertaken to evaluate the oral health behavior and knowledge of preventive measures of young adults in Israel. A questionnaire was given to 442 Israeli young adults who were dentally screened immedi-ately after high school. Of these, 44 reported they were treated regularly by certified pediatric dentists, 244 regularly by general practitioners, and the remainder were treated irregularly by general practitioners. Participants who reported treatment by CPDs provided more correct answers to questions about prevention of oral disease. However, the percentage of participants who showed good knowledge was small and differences between the three groups on the various questions were only 1%-30%. Participants who were treated irregularly by GPs reported receiving significantly less instruction and explanations about toothbrushing, mouthrinses, dental flossing and carbohydrate consumption.     

Oral hygiene practices and periodontitis in health care professionals

BACKGROUND: One in 3 adults in the United States has periodontitis, yet there are few widely applied methods for its prevention. Few studies have assessed oral hygiene practices related to periodontitis. METHODS: There were 533 participants in this study (14.8% male dentists; 13.7% male non-dentist health care professionals; and 71.5% female nurses), all of whom are enrolled in ongoing cohort studies in the United States which have inquired about their oral hygiene practices and whether they have professionally diagnosed periodontitis. We studied the relationship between oral hygiene practices and periodontitis, controlling for potential confounders. RESULTS: The participants were 69 years old on average, 84.2% white, 12.4% current smokers, and 8.3% diabetic. Seventy percent of the dentists and nurses brushed at least twice a day compared to 56% of the other health professionals. Two-thirds of the nurses, 56.3% dentists, and 36.4% other health professionals flossed at least once daily. Persons brushing twice daily were as likely to have periodontitis as those brushing once or less daily (odds ratio [OR] = 1.16; 95% confidence interval [CI]: 0.64 to 2.10); persons flossing less than once a day were as likely to have periodontitis as those who flossed daily (OR = 1.16, 95% CI: 0.63 to 2.13) after controlling for profession, age, gender, smoking, diabetes, coronary heart disease, history of periodontal surgery, and number of teeth present. CONCLUSIONS: People who reported better oral hygiene practices did not report less periodontitis, after controlling for potential confounders. Oral hygiene practices were not associated with periodontitis in this population.     

Study on oral health status and health behavior of workers at government office]

The purpose of this study was to investigate the oral health status and health behavior of the adult population in the workplace. In 1998, oral health examination of 388 workers (male: 287, female: 101) at a government office was performed. A questionnaire was administered to obtain data regarding oral symptoms and health behavior. The results were as follows: Overall, 48% needed treatment for dental caries, 44% needed calculus removal, and 23% needed treatment for periodontal disease. Although there were no oral health complaints, 20% had early caries, 40% had dental calculus, and 19% had periodontitis. Compared to males, more females brushed their teeth, had home dentists (44%) and received more regular dental health check-ups at least once a year (48%). For males, those with home dentists had higher FT and DMFT in the twenties and thirties. There was no relationship between oral health status and regular check-ups in both males and females. The results revealed that receiving regular dental check-ups from home dentists was not popular in Japan. Further, the role of home dentists is not preventive oriented. It was concluded that it is necessary to provide regular oral health examination and health promotion programs for adult population at the workplace in Japan.     

A role for the family in children's oral health

A large percentage of children from families of low socioeconomic status are still affected by early childhood caries. Barriers to receiving adequate dental care in these populations can include high costs of dental treatment, lack of insurance coverage, an insufficient number of dentists treating these children, as well as parental perceptions and motivation. This paper explores the role of parental perception on oral health and subsequent behaviors and how it ultimately affects the dental care of children. An emphasis is placed on increasing parent education and awareness regarding their children's oral health as well as their own.     

Infant oral health care: a survey of general dentists, pediatric dentists, and pediatricians in Virginia

PURPOSE: This study's purpose was to examine the current knowledge, attitudes, and experiences related to infant oral health for dental and medical providers in Virginia. METHODS: A survey of infant oral health care was sent to: (a) 300 randomly selected general dentists; (b) 300 randomly selected pediatricians; and (c) all pediatric dentists in Virginia. Survey respondents were tabulated, and percent frequency distributions for responses to each item were computed. RESULTS: The surveys return rate was 48%. A total of 100% of pediatric dentists treated infants and were more likely to recommend that children be seen by age 1 (P < .001). All pediatricians treated infants as well, while only 5% referred for the first dental visit by 1 year of age. Forty-five percent of general dentists surveyed treated infants, and only 12% referred for the first dental visit by 1 year of age. The logistic regression results indicated that there were differences between practitioner type regarding the recommended age of the first dental visit and years in practice. CONCLUSIONS: The majority of pediatricians and general dentists are not advising patients to see the dentist by 1 year of age. There is a need for increased infant oral health care education in the medical and dental communities.     

Conscious survey of dental patients. 2. Questionnaire related to prevention (in the case of the new patients of the Nippon Dental University Hospital)

A questionnaire on the consciousness of new patients was conducted in Nippon Dental University Hospital. Following our prior report, items regarding dental prevention were asked to 196 subjects in the present case. The results are as follows. 1. 53.1% of the subjects had experienced scaling of the teeth. However only 15.4% of them had regularly scaling. 2. 62.8% of the subjects had been given guidance in brushing and 39.8% of them had used toothbrushes by themselves in the guidance. 3. 99.5% of the subjects brushed their teeth everyday. 58.5% of them brushed twice a day. Regarding the brushing period, "3 minutes" amounded the highest radio, 33.3%. 4. Regarding the major purpose of brushing, "prevention of oral diseases" amounted to 50.5%, followed by "unknown". Namely, 23.0% of the subjects had no definite purpose of brushing. This figure suggests that the awareness on brushing was unexpectedly low. 5. 85.7% of the subjects wanted to have oral sanitation guidance and oral health management. Among them. 59.5% wanted to have "regular examination". To the question "How often can you visit our hospital except treatment?", 48.2% of the subjects answered "twice or more per year", 41.1% "a day for each examination" and 53.6% answered "60 minutes per day". Among those who wanted to have oral sanitation guidance and oral health management, only 32.7% wanted to participate in our oral sanitation class. These results indicate that many patients want to have passive management but for would start action by themselves. Thus it is the most important for dentists to carry out sufficient education and guidance under these situations.     

Oral health-related knowledge, attitudes, and beliefs among 11 to 12-year-old Finnish schoolchildren with different oral health behaviors

The aim of this study was to explore oral health-related knowledge, attitudes, and beliefs among 11 to 12-year-old schoolchildren with favorable, moderate, or poor behavior related to oral health. The data were gathered by questionnaire. Recommendations commonly used in Finland in oral health education were chosen as the criteria for selection of groups of children with favorable, moderate, and poor oral health behavior. Differences between groups were analyzed using crosstabulations and factors related to unfavorable behavior using logistic regression analysis. The percentage of children with appropriate knowledge was higher in the good behavior group (GB) than in the other groups. The groups differed most in the children's knowledge of the recommendation to use fluoride toothpaste at least twice a day. Most children in the GB group considered it important to brush their teeth for the fresh feeling this gave. The majority of children in all groups considered it important to brush their teeth when going to the dentist. The majority also considered brushing important for avoiding tooth decay and tooth discoloration as well as for having fresh breath. Unfavorable knowledge, attitudes, beliefs, and behavior tended to accumulate in the same children. Factors associated with unfavorable behavior were male sex, mother's low skill occupation level, and child's poor knowledge of oral health-related facts.     

Evaluation of recall examination system used in our clinic

In pediatric dentistry, it is important to continue periodical examinations after the initial treatment as the child continues to grow and develop, and a recall system used for patient follow-up is crucial for effective treatment by pediatric dentists. We developed our own recall system and have used it for more than 25 years. In this study, we evaluated clinical parameters for dental caries and periodontal disease in selected patients, and analyzed the correlation between them and the number of consecutive years each patient participated in recall examinations. The subjects were 9-, 12-, and 15-year-old children who came to our clinic for a periodical examination in the summer of 2005, in whom we analyzed several indices of dental caries and focused on their relationship to number of years of follow-up. There were no significant differences between the number of consecutive years and plaque index among the 3 age groups, though a negative correlation tendency was found in the 15-year-old group. Similar results were found between number of years and the rate of DFT. However, there was a significantly negative correlation between the number of consecutive years of follow-up and DFT scores for first permanent molars in our patients. Our recall system for follow-up examinations, which include brushing practice, diet consultation, and caries preventive treatment (application of fluoride and fissure sealant), was shown to be effective for maintaining the oral health of our pediatric dental patients.