scholarly journals Evaluation of a national complex oral health improvement programme: a population data linkage cohort study in Scotland

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038116
Author(s):  
Jamie BR Kidd ◽  
Alex D McMahon ◽  
Andrea Sherriff ◽  
Wendy Gnich ◽  
Ahmed Mahmoud ◽  
...  
Keyword(s):  
Public Health ◽  
Oral Health ◽  
Dental Caries ◽  
Deciduous Teeth ◽  
Caries Experience ◽  
Health Improvement ◽  
Dental Practice ◽  
Global Public Health ◽  
Targeted Interventions ◽  
Improvement Programme

ObjectivesChild dental caries is a global public health challenge with high prevalence and wide inequalities. A complex public health programme (Childsmile) was established. We aimed to evaluate the reach of the programme and its impact on child oral health.SettingEducation, health and community settings, Scotland-wide.InterventionsChildsmile (national oral health improvement programme) interventions: nursery-based fluoride varnish applications (FVAs) and supervised daily toothbrushing, community-based Dental Health Support Worker (DHSW) contacts and primary care dental practice visits—delivered to the population via a proportionate universal approach.Participants50 379 children (mean age=5.5 years, SD=0.3) attending local authority schools (2014/2015).DesignPopulation-based individual child-level data on four Childsmile interventions linked to dental inspection survey data to form a longitudinal cohort. Logistic regression assessed intervention reach and the independent impact of each intervention on caries experience, adjusting for age, sex and area-based Scottish Index of Multiple Deprivation (SIMD).Outcome measuresReach of the programme is defined as the percentage of children receiving each intervention at least once by SIMD fifth. Obvious dental caries experience (presence/absence) is defined as the presence of decay (into dentine), missing (extracted) due to decay or filled deciduous teeth.Results15 032 (29.8%) children had caries experience. The universal interventions had high population reach: nursery toothbrushing (89.1%), dental practice visits (70.5%). The targeted interventions strongly favoured children from the most deprived areas: DHSW contacts (SIMD 1: 29.5% vs SIMD 5: 7.7%), nursery FVAs (SIMD 1: 75.2% vs SIMD 5: 23.2%). Odds of caries experience were markedly lower among children participating in nursery toothbrushing (>3 years, adjusted OR (aOR)=0.60; 95% CI 0.55 to 0.66) and attending dental practice (≥6 visits, aOR=0.55; 95% CI 0.50 to 0.61). The findings were less clear for DHSW contacts. Nursery FVAs were not independently associated with caries experience.ConclusionsThe universal interventions, nursery toothbrushing and regular dental practice visits were independently and most strongly associated with reduced odds of caries experience in the cohort, with nursery toothbrushing having the greatest impact among children in areas of high deprivation.

scholarly journals Free Sugars Intake among Chinese Adolescents and Its Association with Dental Caries: A Cross-Sectional Study

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 765
Author(s):  
Qiping Yang ◽  
Yue Xi ◽  
Hanmei Liu ◽  
Jing Luo ◽  
Yufeng Ouyang ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Cross Sectional Study ◽  
Chinese Adolescents ◽  
Food Sources ◽  
Caries Experience ◽  
Sectional Study ◽  
Cross Sectional ◽  
Free Sugars ◽  
Targeted Interventions

This study aims to estimate the free sugars intake, identify the primary food sources of free sugars, and explore the relationship between free sugars intake and dental caries among Chinese adolescents. This cross-sectional study included 1517 middle-school students aged 12–14 years in Changsha city, China. Adolescents completed a 12-item Food Frequency Questionnaire (FFQ) and oral health assessment. The students’ dental caries experience was available as DMFT score (number of decayed, missing, and filled permanent teeth). Statistical analyses included the Mann–Whitney test, Kruskal–Wallis test, Chi-square test, and binary logistic regression model. The average intake of free sugars was 53.1 g/d in adolescents, and 43.2% of the students consumed more than 50 g of free sugars daily. The primary contributor to free sugars was sugar-sweetened beverages (SSBs). Age, boarders, and high family income were risk factors for excessive free sugars intake (p < 0.05), and increased free sugars intake was a risk factor for dental caries (odds ratio, OR = 1.446, 95% confidence interval: 1.138–1.839). Both the free sugars intake and dental caries prevalence in Chinese adolescents were high. Targeted interventions are urgently needed to address the excessive consumption of free sugars and improve Chinese adolescents’ oral health.

Does non-institutionalized elders have a better oral health status compared to institutionalized ones? A systematic review and meta-analysis

2020 ◽  
Vol 25 (6) ◽  
pp. 2177-2192 ◽  
Author(s):  
Ilky Pollansky Silva e Farias ◽  
Simone Alves de Sousa ◽  
Leopoldina de Fátima Dantas de Almeida ◽  
Bianca Marques Santiago ◽  
Antonio Carlos Pereira ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Status ◽  
Oral Health ◽  
Dental Caries ◽  
Meta Analysis ◽  
Oral Health Status ◽  
Cochrane Library ◽  
Caries Experience ◽  
Institutionalized Elderly ◽  
Periodontal Status

Abstract This systematic review compared the oral health status between institutionalized and non-institutionalized elders. The following electronic databases were searched: PubMed (Medline), Scopus, Web of Science, Lilacs and Cochrane Library, in a comprehensive and unrestricted manner. Electronic searches retrieved 1687 articles, which were analyzed with regards to respective eligibility criteria. After reading titles and abstracts, five studies were included and analyzed with respect their methodological quality. Oral status of institutionalized and non-institutionalized elderly was compared through meta-analysis. Included articles involved a cross-sectional design, which investigated 1936 individuals aged 60 years and over, being 999 Institutionalized and 937 non-institutionalized elders. Studies have investigated the prevalence of edentulous individuals, the dental caries experience and the periodontal status. Meta-analysis revealed that institutionalized elderly have greater prevalence of edentulous (OR = 2.28, 95%CI = 1.68-3.07) and higher number of decayed teeth (MD = 0.88, 95%CI = 0.71-1.05) and missed teeth (MD = 4.58, 95%CI = 1.89-7.27). Poor periodontal status did not differ significantly between groups. Compared to non-institutionalized, institutionalized elders have worse dental caries experience.

scholarly journals Prevalence of Dental Caries Among Costa Rican Male Students Aged 12-22 Years Using ICDAS-II

2021 ◽  
pp. 378-392
Author(s):  
Sylvia Gudiño-Fernández ◽  
Adrián Gómez-Fernández ◽  
Katherine Molina-Chaves ◽  
Juan Barahona-Cubillo ◽  
Romain Fantin ◽  
...  
Keyword(s):  
Public Health ◽  
Dental Caries ◽  
Young People ◽  
Costa Rican ◽  
Assessment System ◽  
Male Students ◽  
Caries Experience ◽  
Dental Decay ◽  
Icdas Ii ◽  
Decayed Tooth

Objective: Dental decay is a public health challenge in Low- and Middle-Income Countries, particularly for young people, often confronted to healthcare access barriers. The aim of this study was to determine the prevalence and severity of dental caries among young male students in Costa Rica. Study design: A cross-sectional study was performed in 428 Costa Rican male students aged 12-22 years, who attended a nonprofit social welfare boarding school in 2019. A clinical examination was ran by three calibrated examiners following the International Caries Detection and Assessment System (ICDAS-II). Results: Caries prevalence was estimated at 83%, 15% have lost a tooth due to dental decay, 61% have at least one filled tooth, 36% have at least one filled and decayed tooth. The most frequent caries lesions were codes 2-Inactive (46.7%), and code 1-Inactive (23.8%). DMFT indicated a mean index using ICDAS-II 1-6>0 codes of 7.89. Using ICDAS-II 3-6>0 as threshold, the index decreases to 3.94. Finally, the lower and upper first permanent molars were found to be the most affected teeth. Conclusions: Dental caries experience represents a significant public health burden in young people, requiring better access to public dental healthcare.

Global Burden and Inequality of Dental Caries, 1990 to 2019

2021 ◽  
pp. 002203452110562
Author(s):  
P.Y.F. Wen ◽  
M.X. Chen ◽  
Y.J. Zhong ◽  
Q.Q. Dong ◽  
H.M. Wong
Keyword(s):  
Dental Caries ◽  
Decomposition Analysis ◽  
Developed Countries ◽  
Sub Saharan Africa ◽  
Permanent Teeth ◽  
Deciduous Teeth ◽  
Global Burden ◽  
Global Public Health ◽  
Caries Prevalence ◽  
Uncertainty Interval

Previous studies on the global burden of caries primarily focused on simple descriptive statistics. We aimed to characterize the burden, trends, and inequalities of untreated caries of permanent and deciduous teeth from 1990 to 2019 at the global, regional, and national levels through an array of analytic approaches. Estimates of caries burden were extracted from the Global Burden of Disease Study 2019. Decomposition analysis was performed to examine the contribution of demographic and epidemiologic factors to the evolving number of prevalent caries cases. In portfolio analysis, the caries epidemiologic profile of each country was categorized by terciles of age-standardized prevalence in 2019 and average annual percentage change from 1990 to 2019. Sociodemographic attribution analysis was performed to reveal the scale of inequality in burden of caries. Age-standardized prevalence of caries in permanent and deciduous teeth decreased 3.6% (95% uncertainty interval, 2.6% to 4.5%) and 3.0% (1.3% to 4.9%), respectively. Population growth was the key driver of the changes in the number of caries cases, especially in sub-Saharan Africa (percentage contribution: 126.6%, permanent teeth; 103.0%, deciduous teeth). Caries prevalence in the permanent dentition was lower in more developed countries, whereas a reverse trend was noted in the deciduous dentition, except for the highest sociodemographic quintile where caries prevalence was the lowest. Globally, 64.6 million (95% CI, 64.4 to 64.9 million) and 62.9 million (62.8 to 63.1 million) prevalent cases of caries in permanent and deciduous teeth were attributable to sociodemographic inequality in 2019. This amounted to 3.2% (3.2% to 3.2%) and 12.1% (12.1% to 12.1%) of the global number of prevalent cases of caries in permanent and deciduous teeth. Burden of dental caries remains a global public health challenge. A systemwide reform of the global oral health care system is needed to tackle the causes of the burden and inequality of dental caries.

scholarly journals Fluoride Varnish in Nursery Schools: A Randomised Controlled Trial – Protecting Teeth @3

2020 ◽  
Vol 54 (3) ◽  
pp. 274-282 ◽  
Author(s):  
Alex D. McMahon ◽  
William Wright ◽  
Yulia Anopa ◽  
Emma McIntosh ◽  
Stephen Turner ◽  
...  
Keyword(s):  
Oral Health ◽  
Controlled Trial ◽  
Fluoride Varnish ◽  
Randomised Control Trial ◽  
Health Improvement ◽  
First Year ◽  
Number Needed To Treat ◽  
Individual Record ◽  
Secondary Endpoints ◽  
Improvement Programme

Studies suggest that fluoride varnish (FV) application can reduce dental caries in child populations. The multiple-component national child oral health improvement programme in Scotland (Childsmile) includes nursery-based universal supervised toothbrushing and deprivation-targeted FV applications, together with community and dental practice prevention interventions. This trial, a double-blind, two-arm randomised control trial, aimed to assess the effectiveness and cost-effectiveness of the nursery-based FV applications plus treatment-as-usual (TAU) Childsmile programme interventions, compared to TAU Childsmile interventions alone, in children not targeted to receive nursery FV as part of the programme. Participating children in the first year of nursery (aged three), with or without existing caries, were randomised to either FV or TAU and followed up for 24 months until the first year of primary school. Treatments were administered at six-monthly intervals. The primary endpoint was “worsening of d3mft” from baseline to 24 months. Secondary endpoints were worsening of d3mfs, d3t, mt, and ft. Individual record-linkage captured wider programme activities and tertiary endpoints. A total of 1,284 children were randomised, leading to 1,150 evaluable children (n = 577 FV, n = 573 TAU, 10% dropouts). Mean age was 3.5 years, 50% were female (n = 576), 17% had caries at baseline (n = 195), all balanced between the groups. Most children received three/four treatments. Overall, 26.9% (n = 155) had worsened d3mft in the FV group, and 31.6% (n = 181) in the TAU group, with an odds ratio (OR) of 0.80 (0.62–1.03), p = 0.078. The results for worsening of the secondary endpoints were: d3mfs 0.79 (0.61–1.01) p = 0.063, d3t 0.75 (0.57–0.99) p = 0.043, mt 1.34 (0.75–2.39) p = 0.319, and ft 0.77 (0.53–1.14) p = 0.191. We calculated a number needed to treat of 21 and a cost of GBP 686 to prevent a single worsening of d3mft. There was a modest non-significant reduction in the worsening of d3mft in the nursery FV group compared to TAU, suggesting that this intervention is unlikely to represent an effective or cost-effective addition to the population oral health improvement programme.

scholarly journals Tongue Microbiota and Oral Health Status in Community-Dwelling Elderly Adults

mSphere ◽  
2018 ◽  
Vol 3 (4) ◽  
Author(s):  
Mikari Asakawa ◽  
Toru Takeshita ◽  
Michiko Furuta ◽  
Shinya Kageyama ◽  
Kenji Takeuchi ◽  
...  
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
The Elderly ◽  
Community Dwelling ◽  
Bacterial Density ◽  
Microbial Populations ◽  
Caries Experience ◽  
Elderly Adults ◽  
Content Type ◽  
Dominant Source

ABSTRACT Tongue microbiota are a dominant source of oral microbial populations that are ingested with saliva, and therefore careful attention is required for the maintenance of health of elderly adults, who are susceptible to aspiration of oral contents. This study aimed to investigate the variation in tongue microbiota among community-dwelling elderly adults. Following a dental examination, tongue coating was collected from a 15-mm-diameter circular area at the center of the tongue dorsum of 506 elderly adults aged 70 to 80 years inhabiting the town of Hisayama, Japan. The microbial composition and density were determined by a 16S rRNA gene sequencing approach using a next-generation sequencer and quantitative PCR analysis, respectively. Co-occurrence network analysis identified two cohabiting groups of predominant commensals, one of which was primarily composed of Prevotella histicola, Veillonella atypica, Streptococcus salivarius, and Streptococcus parasanguinis; these organisms have been previously associated with an increased risk of mortality due to pneumonia in the frail elderly. This bacterial group was more predominant in the elderly with fewer teeth, a higher plaque index, and more dental caries experience, whereas the total bacterial density was independent of these traits. A higher density of fungi was also observed in the elderly with these traits, as well as in individuals who wore dentures. These results suggest that elderly adults with poorer oral health swallow a more dysbiotic microbiota formed on the tongue. IMPORTANCE Aspiration of oral contents can lead to pneumonia, which is a major cause of death among elderly adults susceptible to swallowing impairments. Tongue microbiota are a dominant source of oral microbial populations that are ingested with saliva. This large-scale population-based study revealed variations in the tongue microbiota among community-dwelling elderly adults. The total bacterial density was independent of the conditions of teeth surrounding the tongue, whereas the microbiota composition, especially the relative abundances of predominant commensals, showed an association with tooth conditions. Our results demonstrate that the elderly with fewer teeth, poorer dental hygiene, and more dental caries experience constantly ingest more dysbiotic microbiota, which could be harmful for their respiratory health.

scholarly journals Systems leadership in practice: thematic insights from three public health case studies

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Charlotte Bigland ◽  
David Evans ◽  
Richard Bolden ◽  
Maggie Rae
Keyword(s):  
Public Health ◽  
Case Studies ◽  
Health Systems ◽  
System Structure ◽  
Health Improvement ◽  
Global Public Health ◽  
Structured Interviews ◽  
Public Health Systems ◽  
Systems Leadership ◽  
Indicators Of Success

Abstract Background ‘Systems leadership’ has emerged as a key concept in global public health alongside such related concepts as ‘systems thinking’ and ‘whole systems approaches.’ It is an approach that is well suited to issues that require collective action, where no single organisation can control the outcomes. While there is a growing literature on the theory of systems leadership in a number of fields, there remains a lack of published empirical studies of public health systems leadership for professionals to learn from. The aim of the current project was to conduct cases studies in UK public health to provide empirical evidence on the nature of effective systems leadership practice. Methods Three system leadership case studies were identified in the key domains of public health: health protection, healthcare public health and health improvement. A total of 27 semi-structured interviews were conducted. Data were thematically analysed to identify the components of effective systems leadership in each case and its impact. Results The thematic analysis identified themes around ‘getting started,’ ‘maintaining momentum’ and ‘indicators of success’ in systems leadership. In terms of getting started, the analysis showed that both a compelling ‘call to action’ and assembling an effective ‘coalition of the willing’ are important. To maintain momentum, the analysis identified themes relating to system structure, culture and the people involved. Regarding culture, the main themes that emerged were the importance of nurturing strong relationships, curiosity and a desire to understand the system, and promoting resilience. The analysis identified three components that could be used as indicators of success; these were a sense of enjoyment from the work, resource gains to the system and shifts in data indicators at the population level. Conclusions This study has provided insight into the nature of systems leadership in public health settings in the UK. It has identified factors that contribute to effective public health systems leadership and offers a thematic model in terms of establishing a systems leadership approach, maintaining momentum and identifying key success indicators.

Conhecimento e Práticas Maternas e Condições de Saúde Bucal de Crianças Assistidas em Uma Unidade Básica de Saúde de um Município no Sul do Brasil

UNICIÊNCIAS ◽  
2018 ◽  
Vol 22 (2) ◽  
pp. 92
Author(s):  
Karina Semencio Avelino ◽  
Ilma Carla de Souza Porcelli ◽  
Valéria Campos Mariano Francelino ◽  
Ermelinda Matsuura ◽  
Nathalia Maciel Corsi ◽  
...  
Keyword(s):  
Public Health ◽  
Oral Health ◽  
Dental Caries ◽  
Dental Care ◽  
Family Income ◽  
Treatment Time ◽  
Negative Impact ◽  
Health Network ◽  
The Public ◽  
Level Of Knowledge

A cárie precoce repercute, negativamente, na vida da criança. Este estudo avaliou o nível de conhecimento, práticas maternas e o padrão de saúde bucal de crianças assistidas pela rede pública de saúde de um município do Sul do Brasil. Foram analisados 279 prontuários de crianças que estavam sendo atendidas na clínica de bebê de uma Unidade Básica de Saúde. O conhecimento, as práticas nos cuidados com a saúde bucal infantil e o perfil sócio demográfico das famílias foram identificados em entrevistas realizadas com as mães no início do atendimento. Verificou-se os procedimentos clínicos-preventivos realizados, número de consultas e faltas e se avaliou a condição de saúde bucal da criança na última consulta. Foram aplicados os testes Mann-Whitney e Kruskal-Wallis, fixando-se o nível de significância em 5%. As mães apresentaram um conhecimento razoável, porém suas práticas, principalmente, com cuidados alimentares das crianças eram precárias. Procedimentos preventivos predominaram na atenção odontológica oferecida, contudo, 20,8% das crianças desenvolveram cárie dentária, sendo o índice ceo-d médio igual a 0,53 (DP=1,35). A maior severidade de cárie se associou à maior idade da criança (<0,001) e da mãe (p=0,006), menor renda familiar (0.036), maior tempo de tratamento (<0,001) e maior número de faltas às consultas (<0,001). A atenção odontológica é importante a partir do primeiro ano de vida, assim como as ações em saúde bucal, com atividades educativas direcionadas aos programas pré-natais, além do desenvolvimento de estratégias para aumentar a adesão das mães/ crianças aos programas promocionais em saúde bucal que são oferecidos pela rede pública de saúde. Palavras-chave: Criança. Saúde Bucal. Mães. Cárie Dentária. Conhecimento. AbstractEarly caries has a negative impact on the child's life. This study evaluated the level of knowledge, maternal practices and oral health pattern of children assisted by the public health network of a municipality in the south of Brazil. Information was analyzed from 279 medical records of children treated at the baby clinic of a Basic-Health-Unit. The knowledge, practices in care of children's oral health and sociodemographic profile of families were identified in interviews with mothers at the beginning of care. The clinical-preventive procedures performed, number of consultations, absences were checked and the child's oral health condition was evaluated at the last visit. The Mann-Whitney and Kruskal-Wallis tests were applied, setting the level of significance at 5%. The mothers presented a reasonable level of knowledge, however, their practices,particularly those about care related to feeding their children were precarious. Preventive procedures predominated the offered dental care, however, 20.8% of the children developed dental caries - mean dmf-t index 0.53 (SD = 1.35). The highest level of caries severity was associated with the highest age of both the child (<0.001) and mother (p = 0.006), lower family income (0.036), longer treatment time (<0.001) and higher number absences to the appointments. Dental care is important from the first year of life onwards, as well as oral health actions, with educational activities directed towards prenatal programs and the development of strategies to increase the adherence of mothers /children to the promotional programs offered by the public health network. Keywords: Child. Oral health. Mothers. Dental Caries. Knowledge. 

Sign in / Sign up

Export Citation Format

Share Document