Exploring the Compliance of Resilient High-Caries-Risk Patients Who Reversed Caries Severity

Background: Behavioural factors, such as compliance and regular dental attendance, have been proven to reverse caries severity. However, these factors have not been explored enough. The aim of this study was to explore the behavioural characteristics of compliant patients who had severe dental caries in primary dentition but whose dental conditions were considerably improved in mixed or permanent dentition.Methods: The 'w and W' criteria were designed to classify patients who had a worse or higher caries risk in primary and mixed or permanent dentition. Resilience, or reversal of caries severity, was thus defined as improvement based on these criteria. Interviews were performed with two groups of participants, including eight resilient children (M/F= 5/3) and their ten caregivers (M/F=2/8) in the patient group and ten paediatric dentists (M/F=6/4; clinical experience mean=26.9 years, minimum=16 years) in the dentist group. Thematic analyses were used to identify main themes.Results: Four themes were identified: (1) dental things/teeth are their priority, (2) normalising, (3) tiger parenting/conscientiousness and (4) trust. These ideas were identically described by both the patient and dentist groups.Conclusions: Resilience is the behavioural characteristic of children who outperform expectations, given their caries history and risk. Resilient patients reverse the fate of their teeth by their compliance with treatment protocols following dental guidelines, changing their dental behaviours, and thus, leading to treatment success. Dentists' suggestions are the priority and provide the norms in resilient patients' daily life. These patients find no excuses for not implementing dentists' advice, not only because they trust their dentists but also because they and their caregivers were conscientious about following dentists’ orders.

Translation and Validation of the Short Form of the Fear of Dental Pain Questionnaire in China

The short form of the Fear of Dental Pain Questionnaire (s-FDPQ) is a validated measure developed to screen patients for their fear of pain associated with dental procedures. As there is a high prevalence of dental fear/anxiety in Chinese adults, the primary aim of our study was to translate the s-FDPQ into standard Mandarin and explore its reliability and validity with Chinese adults. The second aim of our study was to explore fear of dental pain (FDP) scores in relation to dental attendance, anxiety and gender. We translated the s-FDPQ using the forward-backward method. It was completed by 480 Chinese adults alongside the Modified Dental Anxiety Scale (MDAS; Chinese version) to test convergent validity. 109 participants completed the s-FDPQ again 14 days later to evaluate test-retest reliability. The Chinese s-FDPQ (s-CFDPQ) was internally consistent (alpha = 0.87) and demonstrated convergent validity (r = 0.73 when correlated with the MDAS). Test-retest reliability was good (ICC = 0.86). Individuals who had never attended the dentist (22%) had higher FDP scores than those that had, even if they were not dentally anxious. Also, females reported higher FDP scores (p < 0.001). These findings suggest that the s-CFDPQ is a reliable and valid measure for assessing fear of dental pain in Chinese adults. The s-CFDPQ could allow quick identification of individuals who are fearful of dental pain who may require specialist attention.

10-year follow-up study on attendance pattern after dental treatment in primary oral health care clinic for fearful patients

Background Dental fear may lead to avoidance of regular dental treatment. The scope of this long-term practe-based study was to monitor the dental attendance of patients who received chair-side dental and fear treatment. Methods In 2000–2006, patients in the City of Oulu, Finland, received treatment for dental fear in the Clinic for Fearful Dental Patients (CFDP) from primary health care dentists trained on this subject. Of the originally treated patients (n = 163), 152 (93%) with sufficient information in dental records made up the study population. Information on their age and sex was available. The number of dental examinations, emergency visits and missed appointments was collected covering the follow-up period of 10 years 2006–2016. For analyses, data were dichotomized according to age at baseline and preliminary outcome baseline condition of dental fear treatment evaluated in 2006. To investigate association further, Poisson regression as well as binary logistic regression models were conducted. As register keeper, the City of Oulu gave permission for this retrospective data-based study. Results Patients receiving dental fear treatment at younger age (2–10 y) had significantly more dental examinations than those treated at > 10 years. Preliminary success was associated with the number of examinations, but not with emergency visits and missed appointments. Sex was not a significant factor in later dental attendance. There was an association between few dental examinations and dental emergency care need with unsuccessful baseline outcome of dental fear treatment. Conclusions Successful dental fear treatment especially at an early age is beneficial for future dental attendance measured by the number of examinations and consequently, less need for emergency care than in the opposite case. Successful fear treatment has positive impact on later dental care and regular dental attendance.

Oral Health Status, Oral Hygiene Practices, and Factors Affecting Dental Treatment Utilization among Pregnant Women in Dubai

<b><i>Objective:</i></b> Oral health is an integral part of preventive healthcare for pregnant women. This study aimed to determine the oral health problems and oral hygiene practices and identify the factors affecting dental treatment utilization among a representative population of pregnant women in Dubai. <b><i>Methods:</i></b> A cross-sectional study was conducted using data from anonymous structured questionnaires filled by 1,450 pregnant women attending primary health centers across different geographical locations in Dubai. <b><i>Results:</i></b> Of the 1,450 women, 97.8% brushed at least once a day. At least one dental problem during pregnancy was reported by 49.9%, but dental attendance during pregnancy was only 17.4%. Factors associated with dental visits were nationality, previous pregnancy, oral health problems, brushing habits, routine dental visits, and professional advice on oral care. The odds of dental attendance increase for UAE national women by 1.48, women who had other children before the current pregnancy by 1.35, those having oral health problems by 1.85, those who brush more than once a day by 1.51, those who visited the dentist routinely at least once a year by 1.92, and those who received oral health education by 2.82. The most cited reasons for not going to the dentist were no perceived dental problem (51.8%) and concerns regarding the safety of dental treatment during pregnancy (33.9%). <b><i>Discussion/Conclusion:</i></b> In spite of acceptable oral hygiene practices, a significant number of pregnant women (49.9%) experience dental problems. However, only a few women (17.4%) visit the dentist during their pregnancy. It is critical to design and implements strategic oral health programs for pregnant women in Dubai.

Dental Attendances to General Medical Practitioners in Wales: A 44 Year-Analysis

One-third of the UK population is composed of problem-oriented dental attenders, seeking dental care only when they have acute dental pain or problems. Patients seek urgent dental care from a range of health care professionals, including general medical practitioners. This study aimed to identify trends in dental attendance at Welsh medical practices over a 44-y period, specifically in relation to dental policy change and factors associated with repeat attendance. A retrospective observational study was completed via the nationwide Secure Anonymised Information Linkage (SAIL) Databank of visits to general medical practice in Wales. Read codes associated with dental diagnoses were extracted for patients attending their general medical practitioner between 1974 and 2017. Data were analyzed with descriptive statistics and univariate and multivariable logistic regression. Over the 44-y period, there were 439,361 dental Read codes, accounting for 288,147 patient attendances. The overall attendance rate was 2.60 attendances per 1,000 patient-years (95% CI, 2.59 to 2.61). The attendance rate was negligible through 1987 but increased sharply to 5.0 per 1,000 patient-years in 2006 (95% CI, 4.94 to 5.09) before almost halving to 2.6 per 1,000 in 2017 (95% CI, 2.53 to 2.63) to a pattern that coincided with changes to National Health Service policies. Overall 26,312 patients were repeat attenders and were associated with living in an area classified as urban and deprived (odds ratio [OR], 1.22; 95% CI, 1.19 to 1.25; P < 0.0001) or rural (OR, 0.84; 95% CI, 0.83 to 0.85; P < 0.0001). Repeat attendance was associated with greater odds of having received an antibiotic prescription (OR, 2.53; 95% CI, 2.50 to 2.56; P < 0.0001) but lower odds of having been referred to another service (OR, 0.75; 95% CI, 0.70 to 0.81; P < 0.0001). Welsh patients’ reliance on medical care for dental problems was influenced by social deprivation and health policy. This indicates that future interventions to discourage dental attendance at medical practitioners should be targeted at those in the most deprived urban areas or rural areas. In addition, health policy may influence attendance rates positively and negatively and should be considered in the future when decisions related to policy change are made.

Associations between dental care approachability and dental attendance among women pregnant with an Indigenous child: a cross-sectional study

Background Oral health during pregnancy is vital for both mother and child. Indigenous Australians face many barriers in accessing dental care. Service approachability is one of the key domains in accessing health services. There is little empirical evidence of the association between service approachability and dental care attendance or oral health outcome. The aim of this study is to examine the relationship between dental service approachability on dental care attendance and self-reported gum disease among South Australian women pregnant with an Aboriginal child. Methods Four hundred and twenty-seven women pregnant with an Aboriginal child completed questionnaires in both metropolitan and regional health settings in South Australia in 2011. Four variables related to approachability of dental services: (1) perception of need; (2) service-related health literacy; (3) oral health beliefs and; (4) trust and expectation of dental service. The association between service approachability-related factors, dental utilisation and self-reported gum disease during pregnancy were assessed using Generalised Poisson regression models, after adjusting for age, remoteness, employment status and education. Estimates were presented as adjusted prevalence ratios (APR). Results Most participants (85.8%) reported a need for dental care, had positive oral health beliefs (88.3%) and had expectations towards dental care (86.2%). Dental service utilisation during pregnancy was low (35.7%). Many participants (78.0%) expressed knowing what to do if they needed dental care, while most (39.8%) doubted that dental care would be available the next day. Poor health service literacy was identified as a risk factor for non-optimal dental attendance (APR = 0.86, 95%CI 0.74–0.99). Perceived need for dental care was positively associated with self-reported gum disease (APR = 1.24, 95%CI 1.06–1.45). Conclusion Inability to navigate the dental care system was a risk factor for poor dental attendance among South Australian women pregnant with an Aboriginal child. Perceived need for dental care was associated with gum disease.

Understanding behaviour change to promote regular dental attendance

Regular dental attendance is a key oral health behaviour. Behaviour change interventions are increasingly being used to promote positive oral health behaviours. A systematic approach to understanding behaviour has led to the development of frameworks which aim to guide the process of designing behaviour change interventions. One such framework is the Behaviour Change Wheel (BCW). This article aims to explore and identify barriers to regular dental attendance which may be targeted using behaviour change interventions based on the Capability, Opportunity and Motivation Behaviour model (COM-B) and the BCW, and suggests potential behaviour change techniques which could be utilised into a behaviour change intervention with the aim to promote regular dental attendance.

SOS teeth with advanced caries and sociodemographic indicators, health-related habits and dental attendance patterns: data from the Dental, Oral, Medical Epidemiological (DOME) nationwide records-based study

Background "SOS teeth" are teeth that need to be treated first, and represent dental teeth with deep caries seen clinically and radiographically which may require root canal treatment or extraction. The aims of the present research were to study the associations of SOS teeth with: socio-demographic parameters, dental attendance patterns, health-related habits among young to middle-aged adults. Methods This cross-sectional records-based research analyzed data from the Dental, Oral, Medical Epidemiological (DOME) repository that captures comprehensive socio-demographic, medical, and dental databases of a nationwide sample of 132,529 records of dental attendees to military dental clinics for 1 year aged 18 to 50 years. Results SOS teeth had a significant positive association in the multivariate analysis with male sex [OR 1.137, 95% Confidence Interval (CI): 1.079–1.199], rural versus urban Jewish locality [OR 1.748 (1.082–2.825)], and consumption of sweetened beverages [OR 1.415 (1.337–1.496)]. SOS teeth retained significant negative associations (protective parameter) with academic [OR 0.647 (0.592–0.708)] and technicians (OR 0.616 (0.556–0.682)] compared to high school education, high [OR 0.437 (0.401–0.476)], and medium (OR 0.648 (0.598–0.702)] versus low socio-economic status, urban non-Jewish versus urban Jewish locality [OR 0.746 (0.693–0.802)], Asia (OR 0.658 (0.452–0.959)], North America (OR 0.539 (0.442–0.658)] and Israel [OR 0.735 (0.686–0.788)] versus western Europe birth countries. Conclusions Health authorities should be familiar with this profile of the patient who is vulnerable to SOS teeth and formulate policies and allow the appropriate implementation of strategies in those in high-risk populations.