Practical Oral Care for People with Developmental Disabilities: Continuing Education for Oral Health Professionals

2013 ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Masaki Kobayashi ◽  
Mio Ito ◽  
Yasuyuki Iwasa ◽  
Yoshiko Motohashi ◽  
Ayako Edahiro ◽  
...  

Abstract Background The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme, Humanitude™, was associated with an improvement in empathy for people with dementia among oral health care professionals. Methods This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-h multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and 1 month after the training (primary outcome). Each participant listed 3 patients with poor oral health due to the refusal of usual oral care or dental treatment from his or her clinical practice. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and 1 month after the training (secondary outcome). Results The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P < 0.05, effect size = 0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients with dementia who resisted usual oral care or dental treatment, as assessed by the OHAT, were significantly improved compared with those before the training. Conclusions The multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia. These findings suggest that randomized controlled trials with large sample sizes will be needed. Trial registration UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586


2020 ◽  
Author(s):  
Masaki Kobayashi ◽  
Mio Ito ◽  
Yasuyuki Iwasa ◽  
Yoshiko Motohashi ◽  
Ayako Edahiro ◽  
...  

Abstract Background: The prevalence of oral diseases in people with dementia has increased, and patients with dementia have worse oral health than people without dementia. However, in the provision of oral care, these patients often exhibit care-resistant behaviours. Empathy is important for health care professionals who provide dental care for people with dementia. A study was conducted to assess whether a multimodal comprehensive care methodology training programme: HumanitudeTM is associated with an improvement in empathy for people with dementia among oral health care professionals.Methods: This research was a pre-post prospective study. A total of 45 dentists and dental hygienists participated in a 7-hour multimodal comprehensive care methodology training programme. Participants’ empathy for their patients was evaluated with the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) before the training and one month after the training (primary outcome). Each participant listed 3 patients from his or her clinical practice for whom he or she felt difficulty to provide oral care due to dementia. The oral health of the 3 care-resistant patients listed by each participant was evaluated by the Oral Health Assessment Tool (OHAT) before the training and one month after the training (secondary outcome).Results: The post-training response rate was 87% (21 dentists and 18 dental hygienists). From pre-training to post-training, the multimodal comprehensive care methodology training significantly increased the mean empathy score (from 113.97 to 122.95, P<0.05, effect size=0.9). Regardless of gender, profession and years of clinical experience, all post-training subgroup scores were higher than the pre-training subgroup scores. The tongue, natural teeth, and oral hygiene scores of patients, as assessed by the OHAT, were significantly improved compared with those before the training.Conclusions: Multimodal comprehensive care methodology training was associated with an improvement in oral health professionals’ empathy for patients with dementia and an improvement in the oral health of their patients. These findings suggest that randomized controlled trials with large sample sizes will be needed.Trial registration: UMIN Clinical Trials Registry (UMIN-CTR), UMIN000041687. Registered 4 September 2020 – Retrospectively registered, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000047586


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e040541
Author(s):  
Quinn Grundy ◽  
Anna Millington ◽  
Cliodna Cussen ◽  
Fabian Held ◽  
Craig M Dale

ObjectivesTo assess the nature, quality and independence of scientific evidence provided in support of claims in industry-authored educational materials in oral health.DesignA content analysis of educational materials authored by the four major multinational oral health product manufacturers.SettingAcute care settings.Participants68 documents focused on oral health or oral care, targeted at acute care clinicians and identified as ‘educational’ on companies’ international websites.Main outcome measuresData were extracted in duplicate for three areas of focus: (a) products referenced in the documents, (b) product-related claims and (c) citations substantiating claims. We assessed claim–citation pairs to determine if information in the citation supported the claim. We analysed the inter-relationships among cited authors and companies using social network analysis.ResultsDocuments ranged from training videos to posters to brochures to continuing education courses. The majority of educational materials explicitly mentioned a product (59/68, 87%), a branded product (35/68, 51%), and made a product-related claim (55/68, 81%). Among claims accompanied by a citation, citations did not support the majority (91/147, 62%) of claims, largely because citations were unrelated. References used to support claims most often represented lower levels of evidence: only 9% were systematic reviews (7/76) and 13% were randomised controlled trials (10/76). We found a network of 20 authors to account for 37% (n=77/206) of all references in claim–citation pairs; 60% (12/20) of the top 20 cited authors received financial support from one of the four sampled manufacturers.ConclusionsResources to support clinicians’ ongoing education are scarce. However, caution should be exercised when relying on industry-authored materials to support continuing education for oral health. Evidence of sponsorship bias and reliance on key opinion leaders suggests that industry-authored educational materials have promotional intent and should be regulated as such.


2021 ◽  
Author(s):  
Lisa Friedlander ◽  
Caroline Nguyen ◽  
Elisabeth Celestin ◽  
Delphine Chambolle ◽  
Agnès Linglart ◽  
...  

Abstract Background. X-linked hypophosphatemia (XLH) is a rare, hereditary, progressive, and lifelong phosphate wasting disorder characterized by pathological elevations in fibroblast growth factor (FGF) 23 serum concentration and activity. In the oral cavity, spontaneous abscesses can occur often without any clinical signs of alteration of the causal tooth. The objective of our study was to evaluate the readability of the oral care pathway and the oral quality of life of patients followed in an expert oral medicine department located within a Parisian hospital and working in close collaboration with an endocrinology department expert in this pathology. Methods. This study employed a qualitative descriptive design including semi-structured interviews using guiding themes. Results. Twenty-one patients were included in the study, with an average age of 28 years. The topics discussed exceeded the initial objectives as the patients largely addressed the alteration of their oral and general quality of life, a very chaotic oral health care pathway with oral health professionals not aware of their pathology, consequences on their social, professional, and school integration and access to care complicated by financial factors. Patients reported the importance of having a multidisciplinary team around them, including medical and dental professionals.Conclusions. The variety of manifestations in patients with XLH necessitates a high coordination of multidisciplinary patient care to optimize quality of life and reduce disease burden. Education of oral health professionals on this disease is essential to enable patients to receive the best possible care as early as possible.


2021 ◽  
Vol 2 ◽  
Author(s):  
Thomas Gerhard Wolf ◽  
Maria Grazia Cagetti ◽  
Julian-Marcus Fisher ◽  
Gerhard Konrad Seeberger ◽  
Guglielmo Campus

Non-communicable diseases (NCDs) such as cardiovascular and metabolic diseases, diabetes, cancer and diseases of the oral cavity such as caries or periodontitis represent a global and highly relevant problem due to demographic and epidemiological changes. NCDs are not only responsible for millions of deaths worldwide, but they cause relevant costs for national economies arise for the health care of societies. Assuming that oral health and general health are directly linked, emerging interactions between systemic and oral diseases are increasingly being researched. Common important risk factors have implications for economic, social, and moral determinants of health. Interdisciplinarity trained oral health professionals are needed to address the excessively high rates of inequities in oral health. The main reason that oral diseases are still a global health problem is related to mainly individual subjective high-risk approaches, which resulting in high costs and low effectiveness. A paradigm shift for a public health approach is needed at population level that integrates different health professionals who deal with NCDs. Oral care, like physical activity, is one of the most important lifestyle-related determinants of health. Widespread recognition of this kind of approach is critical to both reducing the impact of oral and non-oral NCDs. A multi-sectoral, comprehensive and integrated strategy is therefore necessary. The focus should be on social, environmental and population strategies, but should also support individual strategies.


Author(s):  
Dr. Vishal Thakur ◽  
Dr. Reetika Thakur ◽  
Dr. Manpreet Kaur ◽  
Dr. Jasleen Kaur ◽  
Dr. Atul Kumar ◽  
...  

Pregnancy is a unique, exciting time in a woman's life, and there are so many changes going on in human body during pregnancy and mouth is no exception , so good oral hygiene is extremely important during pregnancy . Usually oral health is often the most neglected form of health during all stages of life & the most important cause for this neglection is lack of awareness among people & this problems also increases when a lady is pregnant because of mis-perceptions and mis-leading information in the society or due to lack of knowledge. But the fact is during pregnancy many complex physiologic changes occur in the women’s body, which can adversely affect oral health and in turn those oral health problems may lead to pregnancy outcomes like preterm birth or low birth weight. Proper oral care is of utmost importance during pregnancy to avoid these complications. Avoiding foods that may cause oral problems, proper brushing and flossing and having dental consultations on a regular basis are steps to ensure good oral health during pregnancy.


2020 ◽  

Background: The relationship between oral health and general health is gaining interest in geriatric research; however, a lack of studies dealing with this issue from a general perspective makes it somewhat inaccessible to non-clinical public health professionals. Purpose: The purpose of this review is to describe the relationship between oral health and general health of the elderly on the basis of literature review, and to give non-clinical medical professionals and public health professionals an overview of this discipline. Methods: This study was based on an in-depth review of the literature pertaining to the relationship between oral health and general health among the older people. The tools commonly used to evaluate dental health and the academic researches of male elderly people were also reviewed. And future research directions were summarized. Results: Dental caries, periodontal disease, edentulism, and xerostomia are common oral diseases among the older people. Dental caries and periodontal diseases are the leading causes of missing teeth and edentulism. Xerostomia, similar to dry mouth, is another common oral health disease in the older people. No clear correlation exists between the subjective feeling of dryness and an objective decrease of saliva. Rather, both conditions can be explained by changes in saliva. The General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP) are the main assessment tools used to examine oral health and quality of life in the older people. The GOHAI tends to be more sensitive to objective values pertaining to oral function. In addition, oral health studies in male elderly people are population-based cohort or cross-sectional studies, involving masticatory function, oral prevention, frailty problems, cardiovascular disease risk, and cognitive status. Conclusion: It is possible to reduce the incidence of certain oral diseases, even among individuals who take oral health care seriously. Oral health care should be based on the viewpoint of comprehensive treatment, including adequate nutrition, good life and psychology, and correct oral health care methods. In the future, researchers could combine the results of meta-analysis with the clinical experience of doctors to provide a more in-depth and broader discussion on oral health research topics concerning the older people.


2021 ◽  
pp. 238008442110126
Author(s):  
J.L.P. Protudjer ◽  
C. Billedeau ◽  
K. Hurst ◽  
R. Schroth ◽  
C. Stavropoulou ◽  
...  

Introduction: Rates of periodontal disease and tooth loss are increased in individuals with rheumatoid arthritis (RA). Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and arthritis outcomes. Objectives: To determine the perceptions held by people with RA relating to their oral health, to identify patient-centered priorities for oral health research, and to inform optimal strategies for delivering oral health knowledge. Methods: Semistructured interviews were conducted with patients with RA. Recorded interview transcripts were iteratively reviewed to reveal surface and latent meaning and to code for themes. Constructs were considered saturated when no new themes were identified in subsequent interviews. We report themes with representative quotes. Results: Interviews were conducted with 11 individuals with RA (10 women [91%]; mean age, 68 y), all of whom were taking RA medication. Interviews averaged 19 min (range, 8 to 31 min) and were mostly conducted face-to-face. Three overall themes were identified: 1) knowledge about arthritis and oral health links; 2) oral health care in RA is complicated, both in personal hygiene practices and in professional oral care; and 3) poor oral health is a source of shame. Participants preferred to receive oral health education from their rheumatologists or dentists. Conclusions: People with RA have unique oral health perceptions and experience significant challenges with oral health care due to their arthritis. Adapting oral hygiene recommendations and professional oral care delivery to the needs of those with arthritis are patient priorities and are required to improve satisfaction regarding their oral health. Knowledge Translation Statement: Patients living with long-standing rheumatoid arthritis described poor oral health–related quality of life and multiple challenges with maintaining optimal oral health. Study findings indicate a need for educational materials addressing oral health maintenance for patients with rheumatic diseases and their providers.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1297.2-1297
Author(s):  
J. Protudjer ◽  
C. Billedeau ◽  
C. Stavropoulou ◽  
A. Cholakis ◽  
R. Schroth ◽  
...  

Background:Rates of periodontal disease and tooth loss are increased in rheumatoid arthritis (RA). Periodontal disease may exacerbate RA inflammation and complicate RA care. Understanding factors that contribute to the increased burden of periodontal disease in RA is critical to improving oral health and possibly arthritis outcomes. People with RA may have unique needs and/or barriers to maintain oral health.Objectives:To determine from people with RA what are their experiences and perceptions about their oral health, their most important questions relating to oral health, and how they wish to receive oral health information.Methods:Semi-structured interviews were conducted with RA patients. Recorded interview transcripts underwent iterative content analysis. Transcripts were initially reviewed to develop a coding guide. Latent content, or larger themes, were then applied to the transcripts. Constructs were considered saturated when no new themes were identified with subsequent interviews. We report identified themes with representative quotes.Results:Interviews with 11 RA (10[91%] female; all on RA medication) averaged 19 minutes (range 8-31 minutes) and were mostly conducted face-to-face. Many believed RA medication contributed to dry mouth. Most participants had not previously considered other links between oral health and RA. Themes identified included the need for complicated oral health routines, barriers of cost and access to dental care, and shame relating to oral health (Table 1). Participants preferred to receive oral health education from their rheumatologists or dentists over printed or online resources.Conclusion:RA patients have unique needs relating to oral health and report poor oral quality of life. Strategies to optimize oral health in RA may include educational tools for optimizing oral self-care appropriate for RA, and improved access to oral care professionals who are aware of the needs of arthritis patients.Disclosure of Interests:Jennifer Protudjer: None declared, Corrie Billedeau: None declared, Chrysi Stavropoulou: None declared, Anastasia Cholakis: None declared, Robert Schroth: None declared, Carol Hitchon Grant/research support from: UCB Canada; Pfizer Canada


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