Search

Objectives: The study aimed to assess whether psychological distress mediates the association between financial strain and oral health and dental attendance in the Dutch adult population. Methods: The study followed a cross‐sectional design based on 2812 participants from the 2014 wave of the Dutch population‐based GLOBE study. Financial strain was considered the exposure, while psychological distress measured with the Mental Health Inventory‐5 (MHI‐5) was the mediator. The outcomes included self‐reported number of teeth, self‐rated oral health, and self‐reported dental attendance. Generalized regression analyses were used for the mediation analysis adjusted for several covariables. Results: Greater financial strain was significantly associated with poorer self‐rated oral health (total effect: 0.09, 95%CI: 0.05; 0.14) and restorative or no dental attendance (i.e. participants never visiting a dentist or only visiting a dentist for regular treatments or when they have complaints with their mouth, teeth, or prosthesis) (total effect: 0.05, 95%CI: 0.02; 0.09). Greater financial strain was not significantly associated with self‐reported number of teeth (total effect: −0.14, 95%CI: −0.91; 0.64). Psychological distress significantly mediated the association of financial strain with self‐rated oral health (average causal mediation effect [ACME]: 0.02, 95%CI: 0.01; 0.03) and self‐reported dental attendance (ACME: 0.01, 95%CI: 0.00; 0.02), respectively. However, it did not significantly mediate the association of financial strain with self‐reported number of teeth (ACME: −0.11, 95%CI: −0.25; 0.02). The estimated proportion of the total effect of financial strain on self‐rated oral health and self‐reported dental attendance that could be explained by psychological distress was respectively 24% (95%CI: 14%; 48%) and 19% (95%CI: 6%; 62%). Conclusions: Psychological distress partly explains the association of financial strain with self‐rated oral health and dental attendance, but not with self‐reported number of teeth. Future studies using longitudinal data are necessary to confirm the results. [ABSTRACT FROM AUTHOR]

Background: Limited data exist about the relationship between acculturation and oral health. Hence, the aim of this study was to assess the association of integration with self-reported oral health, behaviours, and oral healthcare utilization among Indian migrants living in the Netherlands, a cross sectional survey study. Methods: Between February and April 2021, a random sample from Dutch municipalities was obtained for the Indian migrants living in the Netherlands (n = 147). A validated questionnaire was used to collect information on independent variables, namely socio-demographic, integration assessment tool: Immigration Policy Lab (IPL-12) and everyday discrimination scale (EDS). The outcome variables were self-reported oral health, oral health behaviours, and oral healthcare utilization. Multiple regression analysis was used to assess the associations. Results: Higher integration among Indian migrants was associated with longer stay in the Netherlands, having a Dutch passport, intention to settle in the Netherlands, and having a permanent residence. After adjusting for covariates such as age, gender, marital status, education, income, occupation, and dental insurance, regression analysis showed that Indians with higher integration had lower odds of reporting their oral health as fair to poor [OR = 0.92(95%CI:0.0.85;0.99)] than the Indians with low integration scores. Also, Indians with higher integration had lower odds of using a manual toothbrush as compared to an electric toothbrush or use of both [OR = 0.86(95%CI:0.76;0.97)]. Highly integrated Indians had lower odds of consuming Indian sweets than lower integrated Indians (OR = 0.91; 95%CI:0.86;0.97). Indians with higher integration had 1.15 times (95% CI:1.03;1.29) higher odds of visiting a Dutch dental professional than visiting a dentist in both places (India and the Netherlands). No significant association was found between discrimination and the three outcome variables. Conclusion: Integration is positively association with self-reported oral health outcomes among the Indian migrants. Measure to improve integration among Indian migrants may help to promote healthy oral health behaviours and improve their oral health care utilization. [ABSTRACT FROM AUTHOR]

Objectives: Evidence for affordable and pragmatic programmes to address the burden of untreated tooth decay in children in low‐ and middle‐income settings is limited. This study aimed to (1) assess the effect of a government‐run, school‐based daily group toothbrushing programme compared to standard school‐based oral health education on the incidence of dental caries and odontogenic infections in Filipino children over a period of 3 years; and (2) assess the additional preventive effect of on‐demand oral urgent treatment (OUT) and weekly fluoride gel application. Methods: A cluster‐randomized trial was conducted in Camiguin, Philippines. Schools in three regions were randomly assigned to one of three intervention groups: The Essential Health Care Programme (EHCP), which includes daily toothbrushing with fluoride toothpaste; EHCP plus twice‐yearly access to on‐demand urgent oral treatment (EHCP + OUT) and EHCP plus weekly application of high‐concentrated fluoride gel (EHCP + Fluoride). Schools in a nearby province with a similar child population were selected as external concurrent control group. Clinical oral examinations were performed by calibrated dentists from a random sample of 682 seven‐year‐old students who were examined at baseline and over the following 3 years. Outcome variables were the number of decayed primary teeth, the number of decayed, missing and filled permanent teeth (DMFT) and surfaces (DMFS), and the number of permanent teeth with pulpal involvement, ulcerations, fistula or abscess (PUFA). Data were analysed using multilevel mixed‐effects negative binomial regression. Results: Three years after implementation, increments in dental caries and odontogenic infections in permanent teeth did not significantly differ between the EHCP and control group, yet the incidence of DMFT was lower by 22% in children receiving EHCP. Compared to controls, children receiving EHCP + Fluoride had a significantly lower increment of DMFT, DMFS and PUFA by 40%, 40% and 47%, respectively. Children receiving EHCP + OUT had lower incidence rates of DMFT and DMFS than control children by 23% and 28%, respectively. A lower incidence rate was also found for PUFA, but the effect was not statistically significant. Conclusions: Findings suggest that the weekly application of fluoride gel and urgent oral treatment, in addition to daily school‐based toothbrushing with fluoride toothpaste, are realistic and effective strategies to lower the burden of dental caries in Filipino children. Implementation challenges may explain why no substantial caries‐preventive benefits were demonstrated for school‐based toothbrushing only. Intervention compliance should be considered in future programme implementation and evaluation research. [ABSTRACT FROM AUTHOR]

Objective: Undocumented migrants in Europe face multiple barriers in access to oral health care. This study aimed to explore the accessibility of a voluntary dental network providing dental treatments to undocumented migrants in the Netherlands, from the perspectives of patients, dentists and staff members of nongovernmental organizations involved. Methods: This qualitative study used semi‐structured interviews (n = 21) with undocumented migrants (n = 12), dentists (n = 7) and staff members of nongovernmental organizations (n = 2) during the implementation of a voluntary dental network. Interviews were analysed using a framework analysis method. Results: As a temporary answer to problems in access to oral health for undocumented migrants, the voluntary dental network targeted initial barriers to dental care. Main challenges within the network were conflicting expectations and perceived treatment outcomes by patients, dentist and NGO staff members, limited financial resources, logistic and communication barriers and an increasing administrative burden. Furthermore, feelings of compassion for and trust of the patient affected the ethics of the professional relationship and influenced treatment decisions of dentists. Conclusion: Through the implementation of a voluntary dental network, treatments could be provided to undocumented migrants as a temporary solution. However, the voluntary nature of dental care in the network resulted in a fragmented provision of oral health care among undocumented migrants. To reduce inequalities in oral health on the long term, systemic barriers in access to oral health care need to be addressed. [ABSTRACT FROM AUTHOR]

Abstract Background Severe dental caries and the treatment thereof are reported to affect growth and well-being of young children. The objective of this study was to assess the effects of extraction of severely decayed pulpally involved primary teeth on weight and height in underweight preschool Filipino children. Methods Underweight preschool Filipino children with severe dental decay had their pulpally involved primary teeth extracted during a stepped wedge cluster randomized clinical trial. Day care centers were randomly divided into two groups; children from Group A day care centers received treatment as soon as practical, whereas children from Group B day care centers were treated four months after Group A. Clinical oral examinations using WHO criteria and the pufa-index were carried out. Anthropometric measurements were done on both groups immediately before treatment of Group A and at follow-up four months later. Height and weight z-scores were calculated using 2006 and 2007 WHO Growth Standards. Multilevel analysis was used to assess the effect of dental extractions on changes in anthropometric measurements after dental treatment. Results Data on 164 children (85 in Group A and 79 in Group B), mean age 59.9 months, were analyzed. Both groups gained weight and height during the trial period. Children in Group A significantly increased their BMI (p z-scores (p Conclusions The extraction of severely decayed primary teeth resulted in significant weight gain in underweight Filipino children. Untreated dental decay should be considered an important co-factor affecting child growth and should be considered when planning for interventions to improve child growth. Trial registration ISRCTN90779069 http://www.controlled-trials.com/isrctn/isrctn_loa

Background: Academic detailing (AD) is a defined form of educational outreach that can be used to influence decision making and reduce unwarranted variation in healthcare delivery. This paper describes the results of the proof of concept phase of the ADVOCATE Field Studies. This study evaluated the feasibility, acceptability and usefulness of AD reinforced with feedback data, to promote prevention-oriented, patient-centred and evidence-based oral healthcare delivery by general dental practitioners (GDPs). Methods: In the Field Studies, six groups of GDPs (n = 39) were recruited in The Netherlands, Germany and Denmark. Each group had four meetings reinforced with feedback data for open discussions on dental practice and healthcare delivery. Conventional and directed content analysis was used to analyze the qualitative data collected from focus group interviews, debriefing interviews, field notes and evaluation forms. Results: A total of nine themes were identified. Seven themes related to the process of the Field Studies and covered experiences, barriers and facilitators to AD group meetings, data collection and the use of an electronic dashboard for data presentation and storage. Two themes related to the outcomes of the study, describing how GDPs perceived they made changes to their clinical practice as a result of the Field Studies. Conclusions: The ADVOCATE Field Studies approach offers a novel way of collecting and providing feedback to care providers which has the potential to reduce variation oral healthcare delivery. AD plus feedback data is a useful, feasible approach which creates awareness and gives insight into care delivery processes. Some logistic and technical barriers to adoption were identified, which if resolved would further improve the approach and likely increase the acceptability amongst GDPs. [ABSTRACT FROM AUTHOR]

Objective: In the last 30 years, innovations in oral healthcare (OHC), such as advanced restorative techniques, shifts towards preventive and evidence-based care and changes in patients' expectations, have increased the complexity of clinical decision-making in OHC. Little is known about the perspectives of general dental practitioners (GDPs) on the value of providing preventive, patient-centred and evidence-based OHC. This study aimed to explore the range of perspectives present amongst GDPs on OHC. Method: Q-methodology was used to explore perspectives among 78 GDPs working in the Netherlands. Participants were asked to sort 50 statements representing three central domains in OHC: i.) restorative versus preventative OHC, ii.) disease-centred versus patient-centred OHC and iii.) expertise-based versus evidence-based OHC. Opinion statements about delivering OHC were formulated on the basis of published literature and input from OHC professionals. By-person factor analysis was used to reveal clusters of communality in statement rankings, which were interpreted and formed perspectives on OHC. Results: Four perspectives, explaining 47% of variance, on OHC were identified amongst GDPs: 'the patient-focused dentist who values prevention', 'the outcome-oriented dentist who values learning from colleagues', 'the team player with ultimate care responsibility' and 'the dentist who considers oral health the responsibility of the patient.' Conclusion: Q-methodology can be effectively used to describe the different perspectives that GDPs have on the challenges of preventive, patient-centred and evidence-based OHC. GDPs should not be seen as a homogenous group; rather they have different views and approaches to the care they provide. This has implications for health systems; awareness of the heterogeneity of practitioners' perspectives can potentially be used to develop bespoke quality of care improvement strategies that constructively engage with each of these different groups. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review aimed to (a) provide an overview of existing quality measures in the field of oral health care, and to (b) evaluate the scientific soundness and applicability of these quality measures. Methods: A systematic search was conducted in three electronic databases MEDLINE (via PubMed), EMBASE (via OVID) and LILACS (via BIREME). The search was restricted to articles published between 2002 and 2018. Publications reporting on the development process or clinimetric properties of oral health care quality measures for outpatient oral health care in dental practices were included. The identified publications reporting on oral health care quality measures were critically appraised with the Appraisal of Indicators through Research and Evaluation 2.0 (AIRE 2.0) instrument to evaluate the soundness and applicability of the measures. Results: The search strategy resulted in 2541 unique and potentially relevant articles. In total, 24 publications were included yielding 215 quality measures. The critical appraisal showed a large variation in the quality of the included publications (AIRE scores ranging from 38 to 78 out of 80 possible points). The majority of measures (n = 71) referred to treatment and preventive services. Comparably, few measures referred to the domain patient safety (n = 3). The development process of measures often exhibited a lack of involvement of patients and dental professionals. Few projects reported on the validity (n = 2) and reliability (n = 3) of the measures. Four projects piloted the measures for implementation in practice. Conclusions: This systematic review provides an overview of the status quo with respect to existing quality measures in oral health care. Potential opportunities include the piloting and testing of quality measures and the establishment of suitable information systems that allow the provision of transparent routine feedback on the quality of oral health care. [ABSTRACT FROM AUTHOR]

Copyright of TandartsPraktijk is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this study was to assess the association between externalizing behaviour problems and dental caries in children. A further objective was to explore direct and indirect pathways between sociodemographic factors, family functioning and parenting factors, oral health behaviours, externalizing behaviour problems, and dental caries using structural equation modelling. Cross‐sectional data were collected on 251, 5‐ to 8‐yr‐old children from a paediatric dental practice in the Netherlands. Children's decayed, missing, and filled primary teeth (dmft) scores were obtained from their dental records. Validated self‐report questionnaires were used to collect sociodemographic, behavioural, and family‐related data. Externalizing problem behaviour was significantly associated with a higher dmft score [incidence risk ratio (IRR) = 1.19; 95% CI: 1.06–1.34], but this association did not remain significant after adjustment for sociodemographic factors (IRR = 1.11; 95% CI: 0.99–1.26). A valid path model was presented after applying some modifications. Findings from the model suggest that it is plausible that child behaviour problems are directly associated with dental caries via toothbrushing behaviour. The model also provided support that maternal education level, the restrictiveness and warmth of parenting, and the communication of the family, play an indirect role in the association between children's externalizing behavioural problems and dental caries experience. [ABSTRACT FROM AUTHOR]

Background This study aimed to assess the contribution of material, behavioural, cultural and psychosocial factors in the explanation of socioeconomic inequalities (education and income) in oral health of Dutch adults. Methods Cross-sectional data from participants (25–75 years of age) of the fifth wave of the GLOBE cohort were used (n = 2812). Questionnaires were used to obtain data on material factors (e.g. financial difficulties), behavioural factors (e.g. smoking), cultural factors (e.g. cultural activities) and psychosocial factors (e.g. psychological distress). Oral health outcomes were self-reported number of teeth and self-rated oral health (SROH). Mediation analysis, using multivariable negative binomial regression and logistic regression, was performed. Results Education level and income showed a graded positive relationship with both oral health outcomes. Adding material, behavioural, cultural and psychosocial factors substantially reduced the rate ratio for the number of teeth of the lowest education group from 0.79 (95% confidence interval (CI): 0.75–0.83) to 0.92 (95% CI: 0.87–0.97) and of the lowest income group from 0.80 (95% CI: 0.73–0.88) to 1.04 (95% CI: 0.96–1.14). Inclusion of all factors also substantially reduced the odds ratio for poor SROH of the lowest education group from 1.61 (95% CI: 1.28–2.03) to 1.12 (95% CI: 0.85–1.48) and of the lowest income groups from 3.18 (95% CI: 2.13–4.74) to 1.48 (95% CI: 0.90–2.45). Conclusion In general, behavioural factors contributed most to the explanation of socioeconomic inequalities in adult oral health, followed by material factors. The contribution of cultural and psychosocial factors was relatively moderate. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to evaluate parents' Willingness to Invest (WTI) in their children's oral health in terms of money, visits to a dental practice, and brushing minutes. Objectives were to assess the association between parents' WTI and a) children's dental caries experience, b) children's oral hygiene behavior (OHB), and c) maternal education level and ethnic background.Methods: A sample of 630 five to six-year-old-children was recruited from pediatric dental centers in the Netherlands. Children's dmft scores were extracted from personal dental records. Parental questionnaires were used to collect data on parents' WTI, children's OHB, maternal education level and ethnicity.Results: On average, parents were willing to spend a maximum of €37 per month, 3.0 dental visits per year, and 4.5 brushing minutes per day to maintain good oral health for their child. The mean dmft was significantly higher in children whose parents were willing to pay more money and visit the dentist more often (P = 0.028 and P = 0.002, respectively), while the mean dmft was significantly lower in children of parents who were willing to invest more brushing minutes (P < 0.001). Parental WTI in terms of money and brushing minutes was higher in native and higher-educated parents, and was associated with more favorable OHB of children.Conclusions: Parents' WTI in their children's oral health is related to children's dental caries status and reported OHB. Results suggest that children are better off when parents are willing to invest in self-care, rather than in money or dental visits. [ABSTRACT FROM AUTHOR]

Background: The Fit for School (FIT) programme integrates school health and Water, Sanitation and Hygiene interventions, which are implemented by the Ministries of Education in four Southeast Asian countries. This paper describes the findings of a Health Outcome Study, which aimed to assess the two-year effect of the FIT programme on the parasitological, weight, and oral health status of children attending schools implementing the programme in Cambodia, Indonesia and Lao PDR.Methods: The study was a non-randomized clustered controlled trial with a follow-up period of two years. The intervention group consisted of children attending public elementary schools implementing the FIT programme, including daily group handwashing with soap and toothbrushing with fluoride toothpaste, biannual school-based deworming; as well as construction of group handwashing facilities. Control schools implemented the regular government health education curriculum and biannual deworming. Per school, a random selection of six to seven-year-old grade-one students was drawn. Data on parasitological infections, anthropometric measurements, dental caries, odontogenic infections and sociodemographic characteristics were collected at baseline and at follow-up (24 months later). Data were analysed using the χ2-test, Mann Whitney U-test and multilevel logistic and linear regression.Results: A total of 1847 children (mean age = 6.7 years, range 6.0-8.0 years) participated in the baseline survey. Of these, 1499 children were available for follow-up examination - 478, 486 and 535 children in Cambodia, Indonesia and Lao PDR, respectively. In all three countries, children in intervention schools had a lower increment in the number of decayed, missing and filled permanent teeth between baseline and follow-up, in comparison to children in controls schools. The preventive fraction was 24% at average. The prevalence of soil-transmitted helminth infection (which was unexpectedly low at baseline), the prevalence of thinness and the prevalence of odontogenic infections did not significantly differ between baseline and follow-up, nor between intervention and control schools.Conclusions: The study found that the FIT programme significantly contributed to the prevention of dental caries in children. This study describes the challenges, learnings and, moreover, the importance of conducting real-life implementation research to evaluate health programmes to transform school settings into healthy learning environments for children. The study is retrospectively registered with the German Clinical Trials Register, University of Freiburg (Trial registration number: DRKS00004485, date of registration: 26th of February, 2013). [ABSTRACT FROM AUTHOR]

Background: The prevention of childhood dental caries relies on adherence to key behaviours, including twice daily tooth brushing with fluoride toothpaste and reducing the consumption of sugary foods and drinks. The aim of this qualitative study was to explore parents' perceptions of barriers and facilitators that influence these oral health behaviours in children. A further objective was to explore parents' views on limitations and opportunities for professional support to promote children's oral health. Methods: Six focus group interviews were conducted, including a total of 39 parents of 7-year old children, who were recruited from paediatric dental centres in The Netherlands. Interviews were held with Dutch parents of low and high socioeconomic status and parents from Turkish and Moroccan origin. Focus group interviews were conducted on the basis of a pre-tested semi-structured interview guide and topic list. Content analysis was employed to analyse the data. Results: Analysis of interview transcripts identified many influences on children's oral health behaviours, operating at child, family and community levels. Perceived influences on children's tooth brushing behaviour were primarily located within the direct family environment, including parental knowledge, perceived importance and parental confidence in tooth brushing, locus of control, role modelling, parental monitoring and supervision, parenting strategies and tooth brushing routines and habituation. The consumption of sugary foods and drinks was influenced by both the direct family environment and factors external to the family, including the school, the social environment, commercials and television, supermarkets and affordability of foods. Parents raised several suggestions for professional oral health support, which included the provision of clear and consistent oral health information using a positive approach, dietary regulations at school and a multidisciplinary approach among dental professionals, child health centres and other institutions in providing parental support. Conclusion: In conclusion, this qualitative study provided detail regarding parental views on the influences on children oral health behaviours and their opinions on what further support is needed to promote children's dental health. Parents' suggestions for professional oral health support can guide the development or improvement of caries preventive interventions. [ABSTRACT FROM AUTHOR]

Background: Severe dental caries in young children is associated with underweight and failure to thrive. One possible mechanism for severe caries affecting growth is that the resulting pain and discomfort influences sleeping and eating, and that affects growth and weight. The objective of this study was to assess whether rate of weight gain after extraction of severely decayed teeth in underweight preschool Filipino children was related to reductions in oral health-related impacts and dental pain from severe dental caries affecting eating and sleeping. Methods: Data are from the Weight Gain Study, a stepped wedge cluster randomized clinical trial where underweight Filipino children with severe dental decay had their pulpally involved teeth extracted. Day care centers were randomly divided into two groups; A and B. Group A children received treatment first and Group B children were treated four months after Group A. Clinical oral examinations used WHO criteria and the pufa-index. Selfreported oral health-related impacts and anthropometric measurements were collected for both groups at baseline, four months after treatment of Group A children and four months after treatment of Group B children. Weight-for -age z-scores were calculated using 2006 and 2007 WHO standards. Data were converted to a one-group pre-test post-test study design, where all children received treatment. Associations between changes in oral health-related impacts and weight-for-age z-scores after dental treatment were assessed. Results: Data on 145 children (mean age 61.4 months) were analyzed. There was a significant association between oral health-related impacts and rate of weight gain after extraction of pulpally involved teeth (p=0.02). Children free of impacts on sleeping related to having severely decayed teeth extracted gained significantly more weight compared to children who reported sleeping problems after dental treatment (p<0.01). Conclusions: After extraction of severely decayed teeth in underweight Filipino children, levels of oral healthrelated impacts were associated with rate of weight gain. Decreases in oral health impacts on sleeping appeared to be most strongly associated with weight gain. Trial registration: ISRCTN: ISRCTN90779069 [ABSTRACT FROM AUTHOR]