Exploring awareness, attitudes, and perceived role among oral health providers regarding HPV-related oral cancers

Objectives: Human Papillomavirus (HPV), the most common STI in the United States, is increasingly being associated with a number of cancers, including oral cancers (OC). This may change the approach of oral health providers (OHP) towards screening and identifying OC in their patients. Methods: Five focus groups were conducted in February and March 2009 with dentists and dental hygienists. Participants were recruited via presentations at monthly meetings of local dental and dental hygiene professional associations, and through association mailing and telephone lists. Results: A total of 38 OHP participated in the focus groups (17 dentists and 21 hygienists). Analysis of focus group data was framed by three general content areas regarding HPV‐related OC and the HPV vaccine, including: a) knowledge; b) attitudes; and c) perceived roles. Sub‐themes that emerged included issues related to the HPV vaccine, the role of professional organizations, and concerns with gender roles and confidentiality. Conclusions: As public awareness of the link between HPV and OC increases, OHP play an important role in addressing this issue with their patients. The current study clearly identified areas that must be addressed among OHP in order for effective and comfortable communication regarding the HPV‐OC link and the potential uses of the HPV vaccines to take place, including: a) increasing knowledge of the HPV‐OC link and HPV vaccine; and b) clarifying screening procedures, role, and expectations.     

Probiotics: contributions to oral health

Probiotics have been extensively studied for their health-promoting effects. The main field of research has been in the gastrointestinal tract. However, in the past few years probiotics have also been investigated in the oral health perspective, which is the topic of the present review. We discuss the mechanisms of bacterial adhesion, potential of probiotics in oral cavity colonization, interspecies interactions, and possible effects on immunomodulation, and means of probiotic administration. We suggest that probiotic treatment of diseases other than dental caries and periodontal disease should also be systematically investigated. In general, hardly any randomized controlled trials have been conducted in this area and the studies on probiotics vs oral health are still in their cradle. Hence, much more investigations are called for before any evidence-based conclusions can be drawn: if or not probiotic therapy can be recommended for oral health purposes.     

益生菌防治口腔和胃肠道放化疗黏膜炎的研究进展

黏膜炎是放疗、化疗最为常见的副反应,是一种发病机制不明、临床表现多样、尚无有效治疗方法的炎症性疾病,在口腔常表现为局部黏膜烧灼样刺痛,在胃肠道多表现为恶心、呕吐、腹泻等。目前发现局部菌群失调可促进放化疗黏膜炎发生发展,益生菌可作为防治黏膜炎的新兴路径。本文就益生菌防治口腔和胃肠道放化疗黏膜炎的研究进展予以综述,重点关注微生物对黏膜炎的发病机理和治疗的影响。文献复习结果显示,黏膜炎的发生发展与局部菌群组成和功能改变有关,益生菌可通过调节局部微生态及宿主免疫等机制发挥防治作用。目前用于防治黏膜炎的益生菌多为乳杆菌、双歧杆菌等,多数临床试验证实益生菌防治黏膜炎有积极作用。但由于益生菌品种繁多、肿瘤治疗方案不同,可能造成部分研究未观察到防治作用,选择有效性及安全性高的益生菌、设计最佳菌种组合及干预方案是当前领域的研究热点。     

Malaria and oral health

Half of the world population resides in malaria-prone areas, and the disease is responsible for more than a million deaths annually. This is apart from the economic impact of the disease through resources expended towards treatment and prevention and the loss of manpower. In addition to the overt clinical signs and symptoms, the association of malaria with other diseases such as tuberculosis and HIV infection has been described. However few studies have attempted to investigate its relationship to oral diseases. This review provides an overview of the relevance of malaria to the mouth and adjacent structures. The need for further research is also emphasized.     

Integration of oral health into primary health care: the role of dental hygienists and the WHO stewardship

Abstract:  Interest in addressing the unmet oral health needs of the citizens of the world has manifested itself, lately, in noteworthy expressions of commitment. Oral health is integrated with general health and support for community programmes offering 'essential oral health' within primary health care (PHC) is increasing. The WHO Global Goals for Oral Health 2020 has assumed a more directed public health orientation, and the Global Oral Health Programme has its focus on modifiable oral risk behaviours. Last, but not the least, opportunities are being created, under the 'stewardship' of the World Health Organization (WHO), for the expansion of oral disease prevention and health promotion knowledge and practices in communities. A review of the literature on community-oriented oral health primary care reveals one dominant and disease-oriented practice model with dental practitioners being the principal and exclusive actors. One alternative to this biomedical model of care that may be better suited to translate health promotion principles into action at community levels is the practice that involves hygienists serving as primary oral health care providers. The WHO 'stewardship' should include the support of dental hygiene practice within PHC, many legislative restrictions and regulatory barriers would be relaxed, thus enabling dental hygienists to respond to the WHO's call for community-based demonstration projects. With their focus on preventive oral care, hygienists are 'best poised' to help accelerate the integration of oral health with primary care, particularly in the light of the compelling evidence confirming the cost-effectiveness of the care delivered by intermediate providers.     

General health and oral health self-ratings, and impact of oral problems among older adults

The aim was to assess associations of general and oral health perceptions, and the impact of general and oral health functional problems on general health perceptions. Data were collected from adults, 60-71 yr of age in 2008, and included global self-ratings of general and oral health, Oral Health Impact Profile (OHIP-14) scores, and health problem scores [using the five items from the EuroQol instrument (EQ-5D)]. Responses were collected from 444 subjects (response rate = 68.8%). Self-rated general and oral health showed fair to good agreement (kappa = 0.47). Adjusted estimates of self-rated general health showed that worse ratings were associated with lower social status [prevalence ratio (PR) = 0.42] and with more health problems (PR = 0.64). Adjusted estimates of self-rated oral health also showed that worse ratings were associated with lower social status (PR = 0.48) and with more health problems (PR = 0.63), as well as with higher OHIP scores (PR = 0.21). The interaction of health problems and OHIP scores was significant for self-rated general health, with self-rated general health being worse when both health problems and OHIP score were higher. For older adults, general health and oral health were associated, although oral health impact was only associated with general health for those with more health problems, indicating that those in worse health suffer more impact from oral health problems.     

Clinical evaluation of medications on oral and dental health

OBJECTIVE: To evaluate the effect of medications on oral and dental health on a group of dental patients taking drugs regularly. METHODS: The study comprised two groups, the medication group included 328 dental patients regularly taking medication and the control group of 201 dental patients who took no medication. The patients were questioned about occurrence of self-reported oral dryness and were evaluated for the occurrence of any oral mucosal lesions, gingival recession, bleeding and enlargement, alveolar bone resorption, dental caries, any restorations and missing teeth were recorded. Data were statistically analysed with chi-square and Fisher's exact tests. RESULTS: There was no statistically significant difference (p > 0.05) between medication and control groups for oral mucosal lesions, gingival recession and enlargement but a statistically significant difference (p < 0.05) was found between the groups for oral dryness and gingival bleeding. Statistically significant differences (p < 0.05) were found between the groups for dental caries, amalgam, fixed and removable prosthetic restorations and missing teeth. CONCLUSIONS: There was a statistically significant difference for self-reported oral dryness and gingival bleeding and these factors may have been influenced by the increased rate of missing teeth and prosthetic restorations in the medication group.     

口腔健康教育对泰州市城区小学生口腔卫生知识和口腔健康行为改变的影响

目的了解口腔健康教育对小学生口腔卫生知识和行为习惯的影响,为开展口腔疾病预防和制定学校口腔卫生工作政策提供依据。方法采用随机整群抽样方法,抽取泰州市海陵区6所小学2～3年级4 000名学生进行3个月的口腔健康教育,并在教育前后分别进行问卷调查,比较口腔卫生知识和行为习惯的变化。结果口腔健康教育后小学生的口腔健康基本知识、对窝沟封闭的认识、口腔健康行为的改变等17项内容均高于教育前,差异均有统计学意义(P<0.01)。结论泰州市小学生口腔健康教育应有计划、长期进行。     

Equity, social determinants and public health programmes--the case of oral health

The WHO Commission on Social Determinants of Health issued the 2008 report 'Closing the gap within a generation - health equity through action on the social determinants of health' in response to the widening gaps, within and between countries, in income levels, opportunities, life expectancy, health status, and access to health care. Most individuals and societies, irrespective of their philosophical and ideological stance, have limits as to how much unfairness is acceptable. In 2010, WHO published another important report on 'Equity, Social Determinants and Public Health Programmes', with the aim of translating knowledge into concrete, workable actions. Poor oral health was flagged as a severe public health problem. Oral disease and illness remain global problems and widening inequities in oral health status exist among different social groupings between and within countries. The good news is that means are available for breaking poverty and reduce if not eliminate social inequalities in oral health. Whether public health actions are initiated simply depends on the political will. The Ottawa Charter for Health Promotion (1986) and subsequent charters have emphasized the importance of policy for health, healthy environments, healthy lifestyles, and the need for orientation of health services towards health promotion and disease prevention. This report advocates that oral health for all can be promoted effectively by applying this philosophy and some major public health actions are outlined.     

Colonization of Lactobacillus rhamnosus GG in the oral cavity

BACKGROUND/AIMS: Lactobacillus rhamnosus GG (LGG) is one of the most widely studied probiotic bacterial strain. The benefits of LGG treatment in gastrointestinal disorders are well documented. The aim of the present study was to investigate whether LGG can be detected in the oral cavity after discontinuation of administration of a product prepared with this bacterium. MATERIAL AND METHODS: 56 volunteers consumed Gefilus juice (Valio Ltd, Helsinki, Finland) containing LGG during a 14-day trial period. Saliva samples were collected and cultured onto MRS agar after a clearance period and then daily after a 2-week intervention period for as long as LGG was found. LGG-like colonies were analyzed in saliva samples, identified by characteristic colony morphology, a lactose fermentation test, and PCR with specific primers. RESULTS: LGG was not able to colonize the oral cavity. It could only be temporarily detected. In one female subject, however, whose medical history revealed use of LGG in childhood, the bacterium was detected in all saliva samples taken up to 5 months. (She was excluded from the intervention trial). CONCLUSION: Permanent colonization of LGG in the oral cavity is improbable but seems possible in individual cases.     

Socioeconomic status and self-reported oral health in Iranian adolescents: the role of selected oral health behaviors and psychological factors

Objectives: This study investigated health inequality for self-reported oral health outcomes among adolescents. The role of oral health behaviors and psychological factors in explaining oral health inequality was investigated using the hypothesis of mediation. Methods: This was a cross-sectional study that used self-completed questionnaires. This study sampled 639 (315 male and 324 female) 15- to 17-year-old adolescents (second and third grade high school students) of both sexes in the city of Sanandaj in the province of Kurdistan, western Iran. Socioeconomic indicators of the study were subjective socioeconomic status, wealth index, and parental education. Oral health behaviors were measured as toothbrushing frequency, dental flossing frequency, and dental visits. Psychological factors were self-esteem, anxiety, and depression. Self-reported oral health outcomes were single item self-rated oral health and the experience of dental pain. Regression analysis was used to test four conditions for the hypothesis of mediation. Results: The results showed that the inequality is present in oral health for some pairs of relationships between socioeconomic status and oral health outcomes. Adjustment for oral health behaviors and psychological factors, individually and simultaneously, led to loss of statistical significance for some pairs of the relationships. However, adjustment for oral health behaviors and psychological factors led to only small changes in the associations between socioeconomic status and self-reported oral health outcomes. Conclusions: This study found a graded oral health inequality, but no strong evidence to support the hypothesis that oral health behaviors and psychological factors mediate oral health inequality for self-reported oral health outcomes.     

Caregivers' oral health literacy and their young children's oral health-related quality-of-life

Abstract

Objectives: To investigate the association of caregivers' oral health literacy (OHL) with their children's oral health related-quality of life (C-OHRQoL) and explore literacy as a modifier in the association between children's oral health status (COHS) and C-OHRQoL. Methods. This study relied upon data from structured interviews with 203 caregivers of children aged 3–5 from the Carolina Oral Health Literacy (COHL) Project. Data were collected for OHL using REALD-30, caregiver-reported COHS using the NHANES-item and C-OHRQoL using the Early Childhood Oral Health Impact Scale (ECOHIS). This study also measured oral health behaviors (OHBs) and socio-demographic characteristics and calculated overall/stratified summary estimates for OHL and C-OHRQoL. Spearman's rho and 95% confidence intervals (CI) were computed as measures of correlation of OHL and COHS with C-OHRQoL. To determine whether OHL modified the association between COHS and C-OHRQoL, this study compared literacy-specific summary and regression estimates. Results. Reported COHS was: excellent—50%, very good—28%, good—14%, fair—6%, poor—2%. The aggregate C-OHRQoL mean score was 2.0 (95% CI: 1.4, 2.6), and the mean OHL score 15.9 (95% CI: 15.2, 16.7). There was an inverse relationship between COHS and C-OHRQoL: ρ = ?0.32 (95% CI: ?0.45, ?0.18). There was no important association between OHL and C-OHRQoL; however, deleterious OHBs were associated with worse C-OHRQoL. Literacy-specific linear and Poisson regression estimates of the association between COHS and C-OHRQoL departed from homogeneity (Wald χ ² p < 0.2). Conclusion: In this community-based sample of caregiver/child dyads, a strong correlation was found between OHS and C-OHRQoL. The association's magnitude and gradient were less pronounced among caregivers with low literacy.     

遵义市小学教师口腔健康知识和对口腔健康教育态度的调查

目的 了解遵义市小学教师的口腔健康知识和对口腔健康教育的态度。方法 采用分层随机抽样的方法,抽取遵义市10所小学636名小学教师作为研究对象,自行设计调查问卷,收集教师的基本信息、口腔保健习惯、口腔保健知识知晓率、对口腔健康和口腔健康教育的态度等信息,所得数据采用SPSS 21.0软件进行统计。结果 本调查回收有效问卷614份,在口腔保健习惯方面,小学教师刷牙时长在3 min及以上仅占8.8%,23.8%有横刷牙习惯,64.7%没有洁牙习惯,78.2%未使用过牙线。口腔保健知晓率方面,教师对六龄齿是不会换的、窝沟封闭可以预防龋齿、使用牙线可以去除牙菌斑等方面的认识薄弱,但是,总体对口腔健康和口腔健康教育的态度较好。结论 可通过组织培训等多途径提高遵义市小学教师的口腔健康知识,发挥教师在引领和培养学龄儿童建立良好的口腔习惯中的积极作用。