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Background. – Fetal alcohol syndrome (FAS) is a major problem in the Reunion Island and the Public Health Authorities decided to determine its prevalence in their medico-social centers on 31 December 1996.Material and methods. – A questionnaire was etablished to identify affected patients in the 20 medico-social centers in charge of 1320 children. Eighty-eight children were selected and 87 could be analyzed.Results. – Sixty-four of 87 (76.3%) were FAS and 23 of 87 (23.7%) had closely alcohol-related diseases. The prevalence was between 7.1 and 14.1% and lower than expected from available data.Conclusion. – The study allowed to precise the social and familial factors predisposing to alcohol addiction during pregnancy. A TV prevention message will be broadcasted after this study. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to provide a reliable instrument to assess evidence-based practice (EBP) dimensions in French-speaking dental students. To do so, a transcultural adaptation into French of the self-administered KACE questionnaire (Knowledge, Attitude, Access and Confidence Evaluation) and the evaluation of its psychometric properties in a sample of French dental students and teachers were performed. The effects of individual and academic factors on student performance in the KACE were also investigated., Method: Teachers and fourth-year students completed once the translated KACE and fifth-year students completed twice the questionnaire before and after an epidemiology course. Cronbach's alpha coefficient analysis, Kruskal-Wallis and post hoc Dunn's tests, paired samples Wilcoxon tests and a generalised linear mixed model were performed to assess the psychometric properties (reliability, internal consistency, discriminant validity and responsiveness) of the questionnaire and to identify the factors associated with KACE scores, respectively., Results: 186 participants completed the survey. Cronbach's alpha ranged from 0.06 to 0.48 for Knowledge, 0.21 to 0.59 for Attitude, 0.42 to 0.76 for Access and 0.82 to 0.93 for Confidence. The discriminant value and sensitivity of the French KACE revealed significant differences amongst students and teachers and accurately identified the effect the training course had on the students who had completed it. Preparing for a residency programme or having received add-on modules in science improved the students' performance in the test. Being female negatively impacted the KACE Confidence score., Conclusion: This version of the KACE is appropriate to assess EBP dimensions in French dental students. Academic background and gender may affect test performance., (© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The effect of probiotics in improving or maintaining oral health in orthodontic patients is understudied. The aim of this study is to evaluate the effect of probiotic administration in addition to tooth brushing on clinical gingival inflammation, plaque formation, subgingival microbiota composition, and salivary biomarkers of inflammation in adolescents with fixed orthodontic appliances. The present study is a 6-month, double-blind, two-arm, placebo-controlled, single-center trial, in which 116 adolescent volunteers aged 12-16 years will be recruited from the patients of the orthodontics clinic of the University Hospital of Lille, France. Subjects who meet the eligibility criteria will be allocated to one of the following groups: (i) control: two placebo lozenges per day for 90 days together with regular oral hygiene, (ii) test: two probiotic lozenges per day for 90 days together with regular oral hygiene. Clinical assessment and biological sample collection will be performed at baseline, 3 and 6 months. In addition, compliance outcomes and adverse events will be monitored.

Background: As far as we know, little data, whether obtained from self-administered questionnaires or upon dental clinical examination, has been published on the prevalence of sensitive teeth (ST) in the French adult population. The objectives of the present work were to estimate ST prevalence and characteristics in the general population of France and to explore the associated factors., Method: A multicentre cross-sectional study was conducted between November 2011 and March 2013 in six French cities. Adult passers-by in public places were invited to answer an electronic questionnaire on a tablet computer. Only people who declared having at least one natural tooth were included in the study. A logistic regression model was used for the multivariate analysis., Results: The prevalence of ST during the previous 12 months reported by the sample of 2413 participants was 42.2% [95% CI: 40.2-44.1%]. The final logistic regression model showed significant statistical associations between ST and female gender, use of tobacco, consumption of soft drinks, limited access to oral care and poor oral hygiene habits (p < 0.05)., Conclusions: This study provides prevalence data on ST in a general population in France, which seems to remain high despite the existence of many therapies. It should alert professionals to a clinical manifestation that is becoming increasingly prevalent and that they will have to take into consideration to help reduce the discomfort arising from it.

In French law, the state is responsible for ensuring equal access to health care for people with disabilities. No system exists within dentistry to guarantee this-there are no salaried public service workers, over 85% of dentists work in general practice, and hospital dentistry is poorly developed. Public funding is available for care coordination initiatives termed "Health Networks". The objective of this study is to report on an internal evaluation of the Réseau Santé Bucco-Dentaire et Handicap de la région Rhône-Alpes (RSBDH), a Health Network coordinating dentistry for persons with disability in the Rhône-Alpes region, and to discuss the French model of Health Networks as a response to improve access to care. Existing governmental guidelines for the evaluation of Networks were adapted for the RSBDH. The RSBDH coordinated dentists to ensure screening, prevention, and treatment for 3219 persons with disability in 2015. Identified strengths included the identification of vulnerable persons, improved access to treatment and collaboration with primary care services. Weaknesses included training of professionals, continuity of care, information sharing, and stakeholder participation. In 2015, the cost was €501 per patient. This model raises major issues of cost, training, equity, and quality of care within special care dentistry. This discussion is relevant to many countries where models of service provision are currently being developed.

This study aimed to investigate the effectiveness of an oral health promotion intervention implemented in special care establishments by dentists trained online. Twenty-six dentists intervening in 27 French special care establishments undertook a standardised oral health promotion intervention, including a conference presentation for care staff and hands-on toothbrushing workshops. Oral hygiene status of the residents was performed at baseline and at 6 months, and were compared using the McNemar test. Mixed logistic regression was performed to identify the factors associated with an improvement of dental plaque removal. The oral health intervention was completed by 890 residents: 445 children, 373 adults and 72 elderly adults. At baseline, dental plaque was observed for 79.8% of the 797 dentate residents. Among the 691 dentate residents included in the final analysis, dental plaque removal was improved for 34%. Improvement in dental plaque removal was recorded more often for the group of 13 to 20-year-old residents (OR = 1.97; 95% CI = 1.15-3.38). The results indicate that this programme failed to significantly improve the dental plaque removal of the residents. More research is needed to understand the limiting factors of such interventions., (© 2018 Special Care Dentistry Association and Wiley Periodicals, Inc.)

The objective of this study was to explore the therapeutic limitations experienced by a panel of special-care dentists in France when treating patients with sustained limitations of their decision-making abilities. We used a Delphi technique conducted in three rounds from 01 June 2014 to 30 September 2015. A first questionnaire comprising open-ended questions was addressed to 72 panellists. A content analysis of the returned questionnaires served to draft a second questionnaire comprising closed-ended questions; this was sent to the 28 panellists who responded in the first round. A third questionnaire was sent to the 20 panellists who responded in the second round to give them an opportunity to reconsider their response in the context of the second-round response group. Sixteen panellists answered the last round. A large majority agreed on the importance of providing comprehensive care, but they encountered obstacles at two time points: (i) when proposing the care; and (ii) when setting it up. The panel put forward recommendations in two main areas: (i) the training of those involved in oral health decisions; and (ii) dental care management and organization of the care system. The study provided a foundation for building future orientations in health care for patients with limited decision-making abilities., (© 2018 Eur J Oral Sci.)

Background: Cerebrospinal fluid (CSF) biomarkers (Aβ peptides and tau proteins) improved the diagnosis of Alzheimer's disease (AD) in research and clinical settings. We previously described the PLM-scale (Paris-Lille-Montpellier study), which combines Aβ42, tau, and phosphorylated ptau(181) biomarkers in an easy to use and clinically relevant way. The purpose of this work is to evaluate an optimized PLM R- scale (PLM ratio scale) that now includes the Aβ42/Aβ40 ratio to detect AD versus non-AD (NAD) participants in clinical routine of memory centers. Methods: Both scales were compared using 904 participants with cognitive impairment recruited from two independent cohorts (Mtp-1 and Mtp-2). The CSF Aβ42/Aβ40 ratio was measured systematically in Mtp-1, and only on biologically discordant cases in Mtp-2. Two different ELISA kit providers were also employed. The distribution of AD and NAD patients and the discrepancies of biomarker profiles were computed. Receiver Operating Characteristic curves were used to represent clinical sensitivity and specificity for AD detection. The classification of patients with the net reclassification index (NRI) was also evaluated. Results: Nine hundred and four participants (342 AD and 562 NAD) were studied; 400 in Mtp-1 and 504 in Mtp-2. For AD patients, the mean CSF Aβ42 and CSF Aβ42/40 ratio was 553 ± 216 pg/mL and 0.069 ± 0.022 pg/mL in Mtp-1 and 702 ± 335 pg/mL and 0.045 ± 0.020 pg/mL in Mtp-2. The distribution of AD and NAD differed between the PLM and the PLM R scales ( p < 0.0001). The percentage AD well-classified (class 3) increased with PLM R from 38 to 83% in Mpt-1 and from 33 to 53% in Mpt-2. A sharp reduction of the discordant profiles going from 34 to 16.3% and from 37.5 to 19.8%, for Mtp-1 and Mtp-2 respectively, was also observed. The AUC of the PLM R scale was 0.94 in Mtp-1 and 0.87 in Mtp-2. In both cohorts, the PLM R outperformed CSF Aβ42 or Aβ42/40 ratio. The diagnostic performance was improved with the PLM R with an NRI equal to 44.3% in Mtp-1 and 28.8% in Mtp-2. Conclusion: The integration of the Aβ42/Aβ40 ratio in the PLM R scale resulted in an easy-to-use tool which reduced the discrepancies in biologically doubtful cases and increased the confidence in the diagnosis in memory center.

Therapeutic education for children is developing in the treatment of dental caries. The Elmy pathway, a pedagogical game aiming to improve children's oral health skills, has been designed. The qualitative assessment of this tool seems to confirm its benefit for use in therapeutic education sessions., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

Objectives: This study was aimed at assessing the knowledge of oral health and training needs of health workers in geriatric nursing homes., Background: Providing daily oral care to dependent elderly people is the best way to prevent oral disorders. Because there are no dental hygienists in France, health workers play an important role in providing oral care in nursing homes and should have correct and adequate knowledge., Materials and Methods: Health workers from 8 geriatric nursing homes in Puy de Dôme (France) completed a 58-item questionnaire. Oral health knowledge regarding dental decay, periodontal diseases, oral hygiene and denture care was assessed. Univariate and bivariate analyses were performed., Results: A total of 99 health workers took part in the study. The total mean score was significantly different if health workers had received training in oral disorders (49.3 ± 11.7 vs. 43.9 ± 10; p < 0.05) or in the maintenance of oral health (50.5 ± 10.5 vs. 42.9 ± 10; p < 0.01). The mean scores obtained in the 'dental decay' subsection and in the 'oral and denture hygiene' subsection were the lowest., Conclusion: Geriatric nursing home staff need training in understanding the impact of oral health on general health. Theoretical knowledge of oral diseases has to be improved in order for health workers to understand oral hygiene procedures and to help them identify early oral disorders., (© 2013 John Wiley & Sons A/S and The Gerodontology Society. Published by John Wiley & Sons Ltd.)

Background: Few data are available concerning the dental health of adults in France. This study was designed to describe dental status, oral health behaviour and factors associated with caries among workers followed by an occupational health service in Northern France., Methods: A representative sample of workers was selected between May and July 2006. Data were collected by occupational health physicians using a questionnaire completed during a face-to-face interview and a dental examination. After descriptive analysis of the variables, two groups were defined according to the degree of caries as assessed by the Significant Caries Index. Factors associated with the degree of caries were investigated using logistic regression adjusted to age., Results: 420 workers with a mean age of 34.6(±10.4) years were included. The mean DMFT (Decayed Missing Filled Teeth) score and the mean number of decayed teeth were 8.9 (± 6.5) and 1.3 (±2.8), respectively. Three independent factors associated with high caries rates were identified: level of education less than Baccalaureate (ORa = 1.85; p < 0.05), regular consumption of sweet snacks and/or sweet drinks (ORa = 2.01; p < 0.05) and a last dental visit motivated by pain or a reason other than preventive care (ORa = 1.89; p < 0.05)., Conclusion: This study showed a high need for care and oral health education in this population of workers. More oral health education programmes should be set up in the adult working population by occupational health services.

Objectives: The French dietary guidelines published in 2001 recommend daily consumption of 5 portions of fruit or vegetable. Despite this advice, the consumption of fruit in France, especially in the north of France, is low, whereas sale of 100% fruit juices, fruit drinks, and fruit-flavored beverages is increasing. The impact of contemporary changes in beverage patterns on dental caries has received less attention than the impact on childhood obesity. Nevertheless, the cariogenic potential of soft drinks is known. Drinking fruit juices, fruit drinks, or fruit-flavored beverages over a long period of time and continuous sipping could therefore be harmful for the teeth. The aim of this study was to examine the sugar content of such beverages., Methodology: Four different major supermarkets were visited to select a representative sample of beverages for sale. Fruit juices, nectars, fruit drinks (water and fruit juices) and fruit-flavored waters were included. Lemonades, teas, and drinks containing artificial sweetener were not included. The data were collected in April 2010 by reading nutrition labels. The variables studied were the sugar content (g/100mL), the presence of added sugar, and the percentage of fruit juices. A descriptive analysis of the variables studied was conducted. The mean sugar content of the French population's favorite juices (orange, grapefruit, pineapple, apple, and grape) was compared to the sugar content of a corresponding 100-g portion of fresh fruit. The data were processed using Microsoft Excel., Results: Hundred and eighty-seven different beverages were analyzed: 89 fruit juices, 26 nectars, 51 fruit drinks (sparkling or flat), and 21 fruit-flavored waters. Unlike fruit-flavored waters, nectars and fruit drinks contained fruit juices. Nectars and fruit drinks contained an average of 44.5% (± 10.7%) and 10.5% (± 3.8%) fruit juice, respectively. The sugar content varied from 0 g/100mL to 17.5 g/100mL. The average sugar content was 2.4 (± 2.1) g/100mL, 8.8 (± 2.3) g/100mL, 10.7 (± 1.9) g/100mL, and 10.8 (± 1) g/100mL for fruit-flavored waters, fruit drinks, fruit juices, and nectars, respectively. High sugar content was reported for grape juice, with an average of 15.6 (± 1.9) g/100mL. Nectars, fruit drinks, and 71.4% of fruit-flavored waters contained added sugar., Conclusion: These beverages are rich in sugar and labels should better inform consumers on the sugar content. Dental caries is a chronic disease of childhood, which has common risk factors with obesity. General practitioners, dieticians, and dentists must work together to provide preventive guidance: fruit juice intake has to be limited and other beverages restricted to occasional use; fruit juice may contribute to only one portion of the recommended five a day., (Copyright © 2011 Elsevier Masson SAS. All rights reserved.)

Background: The present study had three aims: to estimate for the first time with standardized methodology allowing international comparisons the prevalence and the severity of childhood allergies in Reunion Island, to determine their risk factors and to make a comparison with metropolitan France., Methods: The same standardized protocol (ISAAC) was used in population-based samples of adolescents recruited in metropolitan France between 1993 and 1994 (n=18555) and in Reunion Island in 2000 (n=2 362)., Results: Compared to metropolitans, the adolescents living in Reunion Island suffered significantly more from asthma in the past Year and in life (22 vs 13% and 19 vs 13% respectively). The trend was less clear for allergic rhinitis and eczema since in the case of these manifestations the adolescents reported more symptoms (27 vs 16% et 14 vs 10%, respectively) whereas the metropolitans reported more lifetime diagnostic labels (14 vs 17% et 18 vs 23%, respectively). In Reunion Island, allergies were slightly more severe (1.1 vs 0.8% for severe asthma and 15 vs 2% for eczema). Furthermore, 68% of asthmatics who had severe asthma attacks in the past Year and more than a third of adolescents with severe asthma did not take any asthma medication, which is different from the metropolitan situation. Risk factors for allergies were the same in Reunion Island and in metropolitan France, except the ownership of a pet in the first Year of life, which was not protective against the development of allergies as recently shown in some western countries but was a risk factor., Conclusions: Asthma and allied diseases are less frequent in metropolitan France than in Reunion Island where management appears to be insufficient. Improvement in prevention and management plans are required in Reunion Island.

In order to specify the epidemiological characteristics of attempted suicides on Reunion island, a quantitative study was carried out, using Emergency Room registers of all the hospitals on the island. This enabled collection of 9526 files. The results revealed a high proportion of suicide attempts (335/100,000/year), particularly prevalent in rural areas to the south of the island. There was a tendency towards over representation of women, though less distinct than in Europe, as well as an abnormally frequent use of pesticides or herbicides. Medication and violent means were not used as often as in France. These outcomes, in particular the very high frequency (especially in the rural areas of the south), along with the significance of medico-psychological factors, should be taken into account by anthropologists, linguists, clinical specialists, in order to help determine preventive measures.