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Assessment validity, reliability, and constructive alignment to planned learning outcomes are less understood in the context of integrated, problem-based curricula. This conceptual paper examines a Triple Jump Assessment (TJA) employed as a formative and summative assessment system in the first year of an undergraduate dental program. Specifically, we deconstructed this instantiation of a TJA in terms of management and co-ordination; assessment design and item development; assessment administration; and assessment review, refinement and modification. Four core principles of TJA design for constructive alignment in an integrated, problem-based curriculum were identified as: (a) viewing the assessment design process as a collaborative and collective faculty endeavor; (b) recognizing the assessment design process as dependent on faculty and students' shared understandings of learning, teaching, and assessment; (c) highlighting the centrality of ongoing review and monitoring to ensure validity and reliability; and (d) prioritizing student learning in the development of the TJA as an assessment system.

Objectives: To explore the effects and improvement needs of an outreach dental care programme (ODCP) for older adults using residential care or daycare services from the perspectives of the caregivers, the dentists and administrative staff involved in the implementation of the ODCP. Methods: A qualitative study was conducted through semi‐structured interviews with three stakeholders, long‐term care (LTC) facility caregivers, administrative staff and dentists working for the ODCP. Combined maximum variation and snowball sampling strategies were adopted, and 22, 9 and 7 participants were interviewed from each stakeholder, respectively. The interviews were conducted via telephone, which were audio‐recorded and transcribed verbatim for analysis. NVivo software was used for storing and analysing the data. Data analysis was conducted continuously during the study. Results: Most participants opined that the ODCP benefited older adults by raising their oral health conditions and awareness. However, they complained of the complicated administrative procedures, unmet dental treatment needs, inefficient coordination, unclear work guidelines and shortage of dental manpower. More advanced dental treatment options, better coordination among different parties, simpler administrative processes and better incentives for dentists were proposed to further improve the programme. Conclusions: According to the stakeholders, ODCP seems beneficial to older adults using LTC services. Further improvements in the scope of dental treatments, cooperation between the outreach dental teams and caregivers, and streamlining of the administrative process are needed for the provision of effective outreach dental care to satisfy the unmet treatment needs of older adults who use LTC services. Better incentives are needed to attract and retain dentists. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the effects of an outreach dental care program (ODCP) on the oral health status and oral health‐related quality of life (OHRQoL) of older adults who used residential or day care services in Hong Kong. Methods: Older adults who had received dental treatments provided in the ODCP were recruited. Clinical examinations were performed by one calibrated examiner (SXY) at baseline and 1‐year follow‐up in the residential homes or day care centres. Face‐to‐face interviews were conducted using the transition scale of the Oral Health Impacts on Daily Living (OHIDL) questionnaire to investigate the perceived change in OHRQoL at baseline, 2‐month and 1‐year follow‐ups. The Wilcoxon matched‐pair signed‐rank test or McNemar/McNemar‐Bowker test was used to explore the change in oral health status after dental treatments. Factors associated with the perceived change in OHRQoL were explored with binary logistic regression. Results: Four hundred and thirteen older adults (mean age = 83.8 years) participated in the study at baseline, and 377 (91.3%) and 359 (86.9%) were successfully followed 2 months and 1 year after receiving the outreach dental service, respectively. At the 1‐year follow‐up, the number of decayed teeth and functional tooth units, and the prevalence of poor denture hygiene decreased while there was more dental plaque deposition and a higher proportion of participants with gingival bleeding upon probing. More than 50% of the participants perceived no change or an improvement in OHRQoL in all domains at both follow‐ups. Older adults who perceived their oral health status as 'healthy or fair' and those who suffered from toothache at baseline had a higher chance to perceive having a better or at least the same OHRQoL at the 2‐month and 1‐year follow‐ups, respectively. Conclusions: The ODCP in Hong Kong can solve some of the dental problems of older adults using long‐term care services and keep most of them from deterioration in OHRQoL, especially those suffering from toothache. [ABSTRACT FROM AUTHOR]

Background: Some polymer-functionalized AgNPs (P-AgNPs) have been developed to optimize the biological properties of AgNPs. However, there are no studies in the literature comparing the differences in physicochemical and biological properties of AgNPs caused by various polymer-functionalizations and providing evidence for the selection of polymers to optimize AgNPs. Methods: Two AgNPs with similar nano-size and opposite surface charges were synthesized and functionalized by seven polymers. Their physicochemical properties were evaluated by UV-Visible absorption, dynamic light scattering, transmission electron microscopy and inductively coupled plasma optical emission spectroscopy. Their biological properties against Porphyromonas gingivalis and human gingival fibroblast were investigated by MIC determination, time-dependent antibacterial assay, antibiofilm activity and cell viability assay. Silver diamine fluoride, AgNO3 and metronidazole were used as positive controls. Results: Comparative analysis found that there were no significant differences between P-AgNPs and AgNPs in nano-size and in surface charge. Raman spectroscopy analysis provided evidence about the attachment of polymers on AgNPs. For antibacterial property, among the negatively charged AgNPs, only polyvinylpyrrolidone (PVP)-functionalized AgNPs-1 showed a significant lower MIC value than AgNPs-1 (0.79 vs. 4.72 mg/ml). Among the positively charged AgNPs, the MIC values of all P-AgNPs (0.34-4.37 mg/ml) were lower than that of AgNPs-2 (13.89 mg/ml), especially PVP- and Pluronic127-AgNPs-2 (1.75 and 0.34 mg/ml). For antibiofilm property, PVP-AgNPs-1 (7.86 mg/ml, P = 0.002) and all P-AgNPs-2 (3.42-31.14 mg/ml, P < 0.001) showed great antibiofilm effect against P. gingivalis biofilm at 5* to 10*MIC level. For cytotoxicity, all negatively charged AgNPs and PVP-AgNPs-2 showed no cytotoxicity at MIC level, but significant cytotoxicity was detected at 2.5* to 10*MIC levels. Conclusion: Among the polymers studied, polymer functionalization does not significantly alter the physical properties of AgNPs, but modifies their surface chemical property. These modifications, especially the functionalization of PVP, contribute to optimize the antibacterial and antibiofilm properties of AgNPs, while not causing cytotoxicity at the MIC level. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy of electric or manual toothbrushes in plaque removal and gingivitis control in visually impaired adolescents. Method and Materials: A randomized, controlled, examiner-blind crossover design was used in the study. Study subjects were 12- to 16-year-old visually impaired students from the School for the Blind in Guangzhou. Students in the test group used electric toothbrushes, whereas those in the control group used manual toothbrushes. The study consisted of two stages. Oral health status of the students was recorded at baseline, 2 weeks, and 4 weeks of each stage. In total, 42 visually impaired students were recruited in the study at baseline during the first stage. Quigley-Hein Plaque Index (Q-H PI) and Loe and Silness Gingival Index (GI) were used. One-way repeated measures analysis of variance followed by post hoc analysis was used to compare the mean Q-H PI and GI scores obtained at baseline, 2-week, and 4-week examinations between the test and control groups. Results: In total, 33 subjects completed the study. No significant differences were noted between the two groups regarding Q-H PI and GI at baseline, whereas Q-H PI and GI values of the test group were significant reduced compared with those of the control group at 2 weeks and 4 weeks (P < .001). Conclusion: An electric toothbrush reduced plaque and gingivitis more than manual toothbrushing among visually impaired school children. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this clinical research was to analyze the effectiveness of DIAGNOdent in detecting root caries without dental scaling.Materials and Methods: The status of 750 exposed, unfilled root surfaces was assessed by visual-tactile examination and DIAGNOdent before and after root scaling. The sensitivity and specificity of different cut-off DIAGNOdent values in diagnosing root caries with reference to visual-tactile criteria were evaluated on those root surfaces without visible plaque/calculus. The DIAGNOdent values from sound and carious root surfaces were compared using the nonparametric Mann-Whitney U-test. The level of statistical significance was set at 0.05.Results: On root surfaces without plaque/calculus, significantly different (p < 0.05) DIAGNOdent readings were obtained from sound root surfaces (12.2 ± 11.1), active carious root surfaces (37.6 ± 31.7) and inactive carious root surfaces (20.9 ± 10.5) before scaling. On root surfaces with visible plaque, DIAGNOdent readings obtained from active carious root surfaces (29.6 ± 20.8) and inactive carious root surfaces (27.0 ± 7.2) were not statistically significantly different (p > 0.05). Furthermore, on root surfaces with visible calculus, all DIAGNOdent readings obtained from sound root surfaces were > 50, which might be misinterpreted as carious. After scaling, the DIAGNOdent readings obtained from sound root surfaces (8.1 ± 11.3), active carious root surfaces (37.9 ± 31.9) and inactive carious root surfaces (24.9 ± 11.5) presented significant differences (p < 0.05). A cut-off value between 10 and 15 yielded the highest combined sensitivity and specificity in detecting root caries on root surfaces without visible plaque/calculus before scaling, but the combined sensitivity and specificity are both around 70%.Conclusion: These findings suggest that on exposed, unfilled root surfaces without visible plaque/calculus, DIAGNOdent can be used as an adjunct to the visual-tactile criteria in detecting root-surface status without pre-treatment by dental scaling. [ABSTRACT FROM AUTHOR]

Purpose: To compare toothbrushing habits, unstimulated salivary flow rates and oral health status of elderly Hong Kong Chinese with and without dementia. Materials and Methods: A sample size calculation was performed and a sample of 82 elderly Chinese with dementia were invited who were aged 60 or above, fit for periodontal assessment with probing and attended day-care centres. Age- and gender-matched generally healthy people without dementia were recruited as controls. Toothbrushing practices were recorded using a questionnaire. Additionally, unstimulated salivary flow rate was measured. Caries experience and periodontal status were assessed through clinical examination by the DMFT index and Community Periodontal Index (CPI), respectively. Results: Fifty-nine people with dementia and 59 age- and gender-matched generally healthy controls were recruited. Their mean age was 80 (SD = 7). Compared with the individuals in the control group, fewer people with dementia performed toothbrushing twice daily (31% vs 5%; P < 0.001). Furthermore, their unstimulated salivary flow rate was lower than that of the control group (0.30 ml/min vs 0.41 ml/min; P = 0.043). Their caries experience in mean DMFT (±SD) was similar to the control group (22.3 ± 8.2 vs 21.5 ± 8.2, P = 0.59). There was also no significant difference in the prevalence of periodontal pockets (CPI ≥3) between the two groups (78% vs 74%, P = 0.64). Conclusion: Compared to those without dementia, fewer elderly Chinese with dementia practiced toothbrushing twice daily. Although their resting salivary secretion was reduced, their caries experience and prevalence of advanced periodontal disease were not significantly different from those without dementia. [ABSTRACT FROM AUTHOR]

Objectives: This systematic review was to evaluate the change of oral microbiome based on next‐generation sequencing (NGS)‐metagenomic analysis following periodontal interventions among systematically healthy subjects. Materials and Methods: A structured search strategy consisting of "metagenomics" and "oral diseases" was applied to PubMed, EMBASE, and Web of Science to identify effective papers. The included studies were original studies published in English, using metagenomic approach to analyze the effectiveness of periodontal intervention on oral microbiome among systematically healthy human subjects with periodontitis. Results: A total of 12 papers were included in this review. Due to the heterogeneity of selected study, quantitative analysis was not performed. The findings as to how alpha diversity changed after interventions were not consistent across studies. Six studies illustrated clear separation of microbial composition between dental plaque samples collected before and after intervention using principal coordinates/component analysis. The most commonly detected genera before intervention were Porphyromonas, Treponema, Tannerella, and Prevotella, while Streptococcus and Actinomyces usually increased and became the dominant genera after intervention. Correlation network analysis revealed that after intervention, the topology of network was different compared to the corresponding pre‐interventional samples. Conclusion: Existing evidence of metagenomic studies depicts a complex change in oral microbiome after periodontal intervention. [ABSTRACT FROM AUTHOR]

The biochemical definition of dental caries is reasonably understood and generally agreed upon, but there is no consensus on a clinical definition among dentists. There are many proposed diagnostic criteria of dental caries in the dental literature. The recently developed International Caries Detection and Assessment System (ICDAS II) has been constructed to allow data comparison between studies. It can be used in epidemiological studies, public health research, clinical research, clinical practice and dental education. A good study evaluating a caries detection method should contain information on caries prevalence of the study sample and other measures, including sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). It is noteworthy that measuring sensitivity and specificity provides no quantitative information on how likely a tested tooth is to be carious because the true caries status of the tooth is not known in a clinical situation. Moreover, the study design for caries detection should address the interpretation of predictive values because PPV and NPV are affected by the caries prevalence. The study design should also measure patient-oriented outcomes, address allocation concealment and avoid lead-time bias to generate valid and clinically relevant studies. Prudent evaluation of caries detection methods is the standard of care. This paper reviews current diagnostic criteria for caries detection and discusses proper ways to evaluate new diagnostic methods. [ABSTRACT FROM AUTHOR]

Objective: To investigate risk indicators associated with root caries among the Hong Kong older adults who attended long‐term care facilities regularly. Methods: Nonfrail older adults with at least six natural teeth from 10 long‐term social or residential care facilities were examined. The clinical examinations were conducted by two calibrated dentists in the institutions. Portal dental chairs, intra‐oral LED lights, disposable mouth mirrors, periodontal probes and CPI probes were used in the examinations. Negative binomial regression analyses were performed to identify the risk indicators associated with root caries. Multilevel logistic regression analyses were conducted to detect the associations between DF‐root and D‐root, and selected person‐level and tooth surface‐level factors. Results: A total of 353 older adults (mean age 74.9 years) were examined. The prevalence of DF‐root and D‐root was 43.1% and 30.0%, respectively. The mean DF‐root and D‐root scores were 1.3 and 0.7, respectively. Relative to participants without DF‐root, those with root caries experience were older and had more exposed root surfaces, and a higher proportion were partial denture wearers. There was a positive correlation between the DF‐root score and the age of the participant, and with the numbers of exposed root surfaces, missing teeth and teeth with coronal caries. Higher prevalence of DF‐root was observed among the older participants, and caries experience of root surfaces with greater gingival recession and visible plaque was higher. Lingual root surfaces and roots in the mandibular anterior region had the lowest rates of DF‐root. Conclusions: People who are older have a higher prevalence and severity of root caries. Coronal caries experience, maxillary teeth, buccal root surfaces, gingival recession and plaque on the root surface are positively associated with root caries in older adults. [ABSTRACT FROM AUTHOR]