Search

Abstract Background Evidence from Western countries indicates that there are fundamental discrepancies between self-perceived illness of immigrants and the provision of health care, according to the Western bio-medical health service model. These need to be understood in the planning and implementation stages of public health care programs for new immigrants. The objectives of the present study were to investigate self-perceived versus clinically diagnosed dental and periodontal health status among immigrants from Ethiopia. Methods During 2004–2005, dental and periodontal health status was recorded among 340 Ethiopian immigrants, utilizing the DMFT and CPI indices. Additionally, participants were interviewed using a questionnaire which included perceived dental and periodontal health status. Sensitivity and specificity levels of this perception were calculated and compared with the published scientific literature. Results Regarding dental caries, according to the three operational cut-off points, sensitivity ranged from 70% to 81%, and specificity ranged from 56% to 67%. Regarding periodontal status, 75% of the subjects clinically diagnosed with periodontal pockets self-perceived a "bad" health status of gums (sensitivity) and 54% of the subjects diagnosed without periodontal pockets, reported a "good" health status of gums (specificity). These indications of perception levels were higher than a previous study conducted among native born Israelis. Conclusion Minority ethnic groups should not be prejudicially regarded as less knowledgeable. This is illustrated by the unexpected high level of oral health status perception in the present population. Oral health promotion initiatives among immigrants should be based upon optimal descriptive data in order to accomplish the inherent social commitment to these diverse populations.

Abstract Good oral hygiene has always been the cornerstone of public and private dental health promotion. However, this has often been based upon incorrect assumptions. The public is not always willing and does not always need to change its oral health behavior to the same extent as that expected by the dental profession. The present commentary emphasizes the need to modify oral hygiene instruction according to specific risk and motivation levels. Dentistry needs to be flexible in accepting new evidence-based modalities of oral health promotion. Dentists, dental hygienists and the entire health care team need to accept that the traditional methods of oral health education are not always effective.

Abstract Background Dental epidemiology has indicated that immigrants and minority ethnic groups should be regarded as high risk populations on the verge of oral health deterioration. The objectives of this study were to measure the changing pattern of dental caries, periodontal health status and tooth cleaning behaviour among a cohort of Ethiopian immigrants to Israel between the years 1999–2005. Methods Increment of dental caries and periodontal health status was recorded among a cohort of 672 Ethiopian immigrants, utilizing the DMFT and CPI indices. Data were gathered during 1999–2000 and five years later, during 2004–2005. Participants were asked about their oral hygiene habits in Ethiopia and in Israel five years since their immigration. Results Regarding dental caries, at baseline 70.1% of the examinees were caries-free, as compared to 57.3% after five years. DMFT had increased from 1.48 to 2.31. For periodontal health status, at baseline, 94.7% demonstrated no periodontal pockets (CPI scores 0–2) and 5.3% revealed periodontal pockets (CPI scores 3&4), compared to 75.6% and 24.4%, respectively after five years. At baseline, 74% reported cleaning their teeth exclusively utilizing chewing and cleaning sticks common in Ethiopia. After five years, 97% reported cleaning their teeth exclusively utilizing toothbrushes. Conclusion The deterioration in the oral health status, especially the alarming and significant worsening of periodontal health status, among this immigrant group, emphasizes the need for health promotion and maintenance among immigrants and minority groups in changing societies. An "acclimatizing and integrating" model of oral health promotion among minority and immigrant groups is suggested.

Abstract Background Preventive dentistry has traditionally emphasized improvement of oral hygiene. School-based programs, often delivered by dental hygienists or other health educators, are usually limited to dental knowledge provision. The present study focused on promotion of health behavior. The objectives were to evaluate the effect of a pragmatic educational program on tooth brushing skills of young schoolchildren. Methods The population consisted of 196 first grade children in Jerusalem. One dentist interviewed the children and evaluated base-line brushing skills, applying simple visual index, based on dividing the dentition to eight different segments. a trained hygienist then educated the children, emphasizing brushing skills. A simple "scrubbing" brushing method was taught for all dental surfaces. Four months later a second examination was conducted, applying same evaluation methods. Results At base-line 92% of the children had brushed the labial surfaces of front teeth, but only 8% brushed the inner surfaces of posterior teeth. Only 32% brushed occlusal surfaces. These levels significantly increased after four months: 98% now brushed the labial surfaces; 43% brushed inner surfaces of posterior teeth, 87% brushed occlusal surfaces (p < 0.001). The average number of dental "areas" brushed had increased (among the eight areas recorded) from 2.8 to 5.7 (p < 0.0001). Conclusion This method of behavioural instruction emphasized improvement of personal manual skills specifically for those areas of the dentition which demand most efforts in oral hygiene promotion. These results are of practical help in improving future health education programs by the health promotion team.

Abstract Background ECC is commonly prevalent among underprivileged populations. The Jahalin Bedouin are a severely deprived, previously nomadic tribe, dwelling on the eastern outskirts of Jerusalem. The aim of this study was to assess ECC prevalence and potentially associated variables. Methods 102 children aged 12–36 months were visually examined for caries, mothers' anterior dentition was visually subjectively appraised, demographic and health behavior data were collected by interview. Results Among children, 17.6% demonstrated ECC, among mothers, 37.3% revealed "fairly bad" anterior teeth. Among children drinking bottles there was about twice the level of ECC (20.3%) than those breast-fed (13.2%). ECC was found only among children aged more than one year (p < 0.001); more prevalent ECC (55.6%) was found among large (10–13 children) families than among smaller families (1–5 children: 13.5%, 6–9 children: 15.6%) (p = 0.009); ECC was more prevalent among children of less educated mothers (p = 0.037); ECC was more prevalent among mothers with "fairly poor" anterior dentition (p = 0.04). Oral hygiene practices were poor. Conclusion ECC levels in this community were not very high but neither low. This changing population might be on the verge of a wider dental disease "epidemic". Public health efforts clearly need to be invested towards the oral health and general welfare of this community.

Abstract Background Clinical (normative) and subjective (self-assessment) evaluation of caries and periodontal diseases have been reported to demonstrate a significant disparity. The dental public health team is obligated to recognize and understand this gap. The objectives of the study were to investigate the practical values of using questionnaires (self–perceived assessment) as compared to clinical examinations (normative assessment) and to evaluate the implications of the results in understanding the public's perception of oral health. Methods The investigation was performed on 4920, 21 year-old Israeli adults upon release from compulsory military service between 1996 and 1998. Participants were asked to fill in a questionnaire inquiring how they would rate their personal dental and periodontal health levels. Clinical examinations, employing the DMFT and CPITN indices, were performed to determine normative oral health status. Perceived and normative assessments were compared for sensitivity, specificity, positive and negative predictive values and overall proportions using the clinical examinations as a gold standard. Results The sensitivity (disease perception) for dental status was found to be 0.34, while the specificity (health perception) was found to be 0.83. The positive predictive value for perceived dental status was found to be 0.68, whereas the negative predictive value was found to be 0.54. The sensitivity for perceived periodontal status was found to be 0.28, while the specificity was found to be 0.83. The positive predictive value for perceived periodontal status was found to be 0.05, whereas the negative predictive value was found to be 0.97. Regarding the overall proportions, a large discrepancy was found between self–assessment and professional assessment for both dental and periodontal health status. Conclusions Self-assessment questionnaires were of low value in evaluating oral health status both in the individual and public levels, though perception levels of health were higher than that of disease. Findings reflects a low level of awareness of the public that may influence care-seeking behavior and highlight the importance of oral health promotion and the crucial need for public health action.

A study examining the effects of poverty and malnutrition on dental caries, periodontal disease, oral cancer and tooth loss is presented.

Objective: To assess the impact of media exposure on oral health outcomes among Jewish adults in Jerusalem, Israel, by means of a conceptual hierarchical model. Method and Materials: A cross-sectional study was conducted using a stratified sample of 254 adults 35 to 44 years (mean age, 38.63 years) in Jerusalem, Israel. Media exposure was operationally categorized by type and frequency. Behavioral data included toothbrushing, dental attendance, oral hygiene aids use, plaque level, sugar consumption, and smoking. Clinical outcomes were assessed according to the decayed/missing/filled teeth (DMFT) index and the Community Periodontal Index (CPI). Results were analyzed by chi-square test, independent test, one-way ANOVA, and linear and multiple logistic regression models. Results: A total of 254 examinees consisted of 127 men and 127 mean (married couples). High type and high frequency of media exposure, as compared with other modes, revealed statistically significant higher caries experience (DMFT, 13.10), higher level of untreated decay (D, 1.67), and lower periodontal health (CPI [0], 0.39). A conceptual hierarchical regression model identified that the relationship described was mediated by sociodemographic determinants (education) and behavioral determinants (dental attendance and plaque level). Conclusion: Media exposure should be observed by community health program planners and general practitioners to examine the type and frequency of the messages. They also need to react on time to balanced bad advertising and add a good message at the community. This pragmatic approach could lead to better use of the media and improve oral health behavior and outcomes. [ABSTRACT FROM AUTHOR]