Community Dentistry And Oral Epidemiology[JOURNAL]
Sun
200 papers
The Political Determinants of Oral Health Inequalities: Lessons in Policy Development and Implementation From Six Case Studies.
Serban ST, Perdomo S, Borges-Yañez A … +8 more , Allen F, Guarnizo-Herreño C, Navarro-Ramírez MK, Hobbs M, Cohen LK, Tsakos G, Baker SR, Conway DI
Community Dent Oral Epidemiol · 2025 Oct · PMID 40717040 · Full text
OBJECTIVES: Oral diseases are the most prevalent diseases globally, affecting almost half of the world's population with a disproportionate burden on the most vulnerable groups. Despite growing attention on the social an...
OBJECTIVES: Oral diseases are the most prevalent diseases globally, affecting almost half of the world's population with a disproportionate burden on the most vulnerable groups. Despite growing attention on the social and commercial determinants of health, there is still a largely unexplored area in understanding the political determinants of health and oral health. The aim of this paper is to describe national policy development processes for policies impacting population oral health. METHODS: A multiple case study approach was used to analyse six case studies focused on national policy development processes targeting oral health. Kingdon's Multiple Streams Model was used to examine how problems, policy solutions, and political factors aligned to influence policymaking. RESULTS: Some of the most common barriers to policy adoption and implementation were misinformation strategies, legal challenges, industry lobbying, ideological opposition to state intervention, and lack of transparency regarding conflicts of interest. Important common facilitators included robust scientific evidence presented in an accessible manner to the appropriate audiences, identification of key decision-makers, support from parties from across the political spectrum, intersectoral collaboration, and ongoing policy monitoring and evaluation. CONCLUSIONS: This study provides novel insights into how political determinants influence social and commercial determinants of health, demonstrating how political contexts and power dynamics shape national public health policy development processes. Understanding these dynamics is essential for ensuring that evidence-based public health interventions are politically feasible and resilient to opposition from certain private industry and ideological interests. In a time of growing inequalities, neutrality in the face of structural injustice risks entrenching a status quo that favours those with the greatest influence. To address these problems sustainably, public health practitioners must recognise and engage with the political nature of policymaking.
The Dental Recall Examination: Room for Overtreatment?
Raittio E, Baelum V
Community Dent Oral Epidemiol · 2026 Jun · PMID 40588780 · Publisher ↗
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Environmental Impact of a Tooth Extraction: Life Cycle Analysis in a University Hospital Setting.
Künzle P, Frank AC, Paris S
Community Dent Oral Epidemiol · 2026 Feb · PMID 40579390 · Full text
OBJECTIVES: The global impact of health care on the human environmental burden is enormous, but medical care is currently not realising the potential of sustainable practice. Similarly, dentistry and the various forms of...
OBJECTIVES: The global impact of health care on the human environmental burden is enormous, but medical care is currently not realising the potential of sustainable practice. Similarly, dentistry and the various forms of dental treatment are not provided in a sustainable manner. This study focussed on quantifying the environmental burden of a standard dental treatment, specifically a tooth extraction, and on identifying the environmental impact of the process. METHODS: A life cycle analysis was performed, simulating the entire process of a tooth extraction-including patient and staff travel, materials and washing/sterilisation procedures-using the software OpenLCA 1.11.0 and the database ecoinvent 3.9.1. The facilities, instruments and items used were those of Charité - Universitätsmedizin Berlin. For travel impact estimations, questionnaire data on travel modalities were gathered from patients and clinic staff. To evaluate possible approaches for more environmentally friendly processes, a change of the information/consent meeting from face-to-face to an online meeting was simulated. RESULTS: The greatest single contributors to the environmental impact of an extraction procedure were travel, the production of steam (e.g., for sterilisation), electricity, soap, and waste. After normalisation, the process impact was highest on the categories: human toxicity (cancer effects and non-cancer effects), freshwater ecotoxicity, resource use (energy carriers) and ionising radiation (human health). The total environmental impact was 13.8 kg CO equivalents, which compares to driving a distance of 56.3 km with a gasoline-powered vehicle. The implementation of a digital consent process could reduce greenhouse gas emissions by 36.1% to 8.8 kg CO equivalents. CONCLUSIONS: Modelling the environmental impact of a dental extraction in a university hospital setting provided a detailed account of absolute and relative environmental impact contributions. The reduction of treatment-related travel is the most effective measure to reduce the environmental impact of dental practice.
Deep Learning for Detecting Dental Plaque and Gingivitis From Oral Photographs: A Systematic Review.
Moharrami M, Vahab E, Bagherianlemraski M … +5 more , Hemmati G, Singhal S, Quinonez C, Schwendicke F, Glogauer M
Community Dent Oral Epidemiol · 2025 Dec · PMID 40571994 · Full text
OBJECTIVES: This systematic review aimed to evaluate the performance of deep learning (DL) models in detecting dental plaque and gingivitis from red, green, and blue (RGB) intraoral photographs. METHODS: A comprehensive...
OBJECTIVES: This systematic review aimed to evaluate the performance of deep learning (DL) models in detecting dental plaque and gingivitis from red, green, and blue (RGB) intraoral photographs. METHODS: A comprehensive literature search was conducted across Medline, Scopus, Embase, and Web of Science databases up to January 31, 2025. The methodological characteristics and performance metrics of studies developing and validating DL models for classification, detection, or segmentation tasks were analysed. The risk of bias was assessed using the quality assessment of diagnostic accuracy studies 2 (QUADAS-2) tool, and the certainty of the evidence was evaluated with the grading of recommendations assessment, development, and evaluation (GRADE) framework. RESULTS: From 3307 identified records, 23 studies met the inclusion criteria. Of these, 10 focused on dental plaque, 11 on gingivitis, and two addressed both outcomes. The risk of bias was low in all QUADAS-2 domains for 11 studies, with low applicability concerns in nine. For dental plaque, DL models showed robust performance in the segmentation task, with intersection over union (IoU) values ranging from 0.64 to 0.86 (median 0.74). Three studies indicated that DL models outperformed dentists in identifying dental plaque when disclosing agents were not used. For gingivitis, the models demonstrated potential but underperformed compared to dental plaque, with IoU values ranging from 0.43 to 0.72 (median 0.63). The certainty of the evidence was moderate for dental plaque and low for gingivitis. CONCLUSIONS: DL models demonstrate promising potential for detecting dental plaque and gingivitis from intraoral photographs, with superior performance in plaque detection. Leveraging accessible imaging devices such as smartphones, these models can enhance teledentistry and may facilitate early screening for periodontal disease. However, the lack of external testing, multicenter studies, and reporting consistency highlights the need for further research to ensure real-world applicability.
Frequent Sugar-Sweetened Beverage Consumption, Dental Caries, and the Federal Poverty Level in Children 1-18 Years, NHANES 2015-2020.
Wiener RC, Abuhalimeh B, Cochran J
Community Dent Oral Epidemiol · 2025 Oct · PMID 40515407 · Full text
OBJECTIVE: The objective of this research was to determine if the ratio of family income to poverty index is a modifier in the relationship of sugar-sweetened beverages (SSB) and dental caries in U.S. children. METHODS:...
OBJECTIVE: The objective of this research was to determine if the ratio of family income to poverty index is a modifier in the relationship of sugar-sweetened beverages (SSB) and dental caries in U.S. children. METHODS: A cross-sectional study design of NHANES 2015-2020 for ages 1 to < 18 years (n = 6212) was conducted. The What We Eat in America interview was used for classification and categorization (0, 1, and ≥ 2) of SSB in the NHANES daily dietary file. Untreated dental caries were determined by Centers for Disease Control and Prevention dental examiners and categorised as yes (untreated) or no. The poverty index was categorised as < 200% of the poverty line (low income, < 2), ≥ 200% to less than 400% (moderate ≥ 2 to < 4), and ≥ 400% (high ≥ 4). Chi Square and Logistic regression analyses were conducted. RESULTS: There were 11.6% of children with dental caries; 46.7% with a low income; and 43.0% who consumed no SSB. In subgroup analysis by income, among the children whose family had a moderate income (n = 1541), the unadjusted odds ratio for ≥ 2 SSB on dental caries was 2.70 (95% CI: 1.57, 4.67) and the adjusted odds ratio was 2.61 (95% CI: 1.48, 4.60) as compared with no SSB consumption. The relationship failed to reach significance among children whose family had a low or high income. CONCLUSION: Family income was a modifier in this research comparing SSB consumption and dental caries. This study highlights the complicated relationship of SSB consumption and family income on dental caries among children in the U.S.
Online Cognitive-Behavioural Intervention to Manage Dental Anxiety: A 12-Month Randomised Clinical Trial.
Tellez M, Dunne EM, Konneker E … +2 more , Zhao H, Ismail AI
Community Dent Oral Epidemiol · 2025 Oct · PMID 40514778 · Full text
OBJECTIVE: The study aimed to test the efficacy of an online cognitive-behavioural therapy dental anxiety intervention (o-CBT) that could be easily implemented in dental healthcare settings. METHODS: An online cognitive-...
OBJECTIVE: The study aimed to test the efficacy of an online cognitive-behavioural therapy dental anxiety intervention (o-CBT) that could be easily implemented in dental healthcare settings. METHODS: An online cognitive-behavioural protocol based on psychoeducation, exposure to feared dental procedures and cognitive restructuring was developed. A randomised controlled trial was conducted (N = 499) to test its efficacy. Consenting adult dental patients (18-75 years old) who met inclusion criteria (e.g., high dental anxiety) were randomised to one of three arms, (a) intervention assisted by psychology staff (PI) (n = 162), (b) intervention assisted by dental staff (DI) (n = 167), or (c) a control condition (C) (n = 170). Primary outcome measures were the Modified Dental Anxiety Scale (MDAS) and the Anxiety and Related Disorders Interview Schedule DSM-V (ADIS) rating of fear. Generalised linear models for repeated measures based on intention to treat analyses were used to compare the three groups on dental anxiety, fear, avoidance and overall severity of dental phobia. RESULTS: Dental anxiety was significantly lower in both PI and DI groups when compared to the control condition. Interestingly, reductions in dental anxiety favoured the DI group at 6 (p = 0.008) and 12 months only (p = 0.009). Overall, equivalency was observed between the two intervention groups (PI and DI), as there were no significant differences in dental anxiety when the dental arm was compared to the psychology arm across all time points (p > 0.05). CONCLUSION: The online cognitive-behavioural intervention was efficacious in reducing dental anxiety when compared to a control condition in an urban sample of patients receiving treatment in a dental school setting. Examination of its effectiveness when administered in dental offices under less controlled conditions is warranted. TRIAL REGISTRATION: NCT03680755.
Early Life Trajectories of Household Poverty and Area-Level Deprivation and Childhood Dental Caries: A Longitudinal Data Linkage Cohort Study.
Cousins K, Conway DI, Bradshaw P … +1 more , Sherriff A
Community Dent Oral Epidemiol · 2025 Oct · PMID 40495359 · Full text
OBJECTIVE: This study aimed to explore the longitudinal impact of changes in household income poverty and area-based socioeconomic deprivation on dental caries prevalence in early childhood. METHODS: Data from the Growin...
OBJECTIVE: This study aimed to explore the longitudinal impact of changes in household income poverty and area-based socioeconomic deprivation on dental caries prevalence in early childhood. METHODS: Data from the Growing Up in Scotland (GUS) longitudinal study (2005/6-2009/10) were linked to dental caries experience data at age 5 from Scotland's National Dental Inspection Programme. Latent Class Analysis identified trajectories of household poverty (income below 60% of the national median) and area-based deprivation across multiple time points between birth and age 5. Cumulative exposure scores were also calculated, and modified Poisson regression assessed associations between socioeconomic pathways and caries experience in 2893 children. RESULTS: Children living in persistent household poverty or in socioeconomically deprived areas had the highest caries experience risk compared to children never in poverty or deprivation. Elevated caries risk was also observed in children falling into poverty (aRR = 1.4; 95% CI = [1.1-1.8]) and escaping poverty (aRR = 1.6; 95% CI = [1.3-2.1]). Children moving into more deprived areas had higher caries risk (aRR = 1.6; 95% CI = [1.2-2.2]), while moving out of deprived areas did not increase risk (aRR = 1.1; 95% CI = [0.8-1.7]). Caries risk increased with years spent in household poverty and in deprived areas. CONCLUSIONS: Unstable poverty and downward socioeconomic deprivation mobility were associated with greater caries risk in early childhood, underscoring the importance of considering the duration and persistence of socioeconomic disadvantage in relation to oral health outcomes and should inform early-years focused policies to address these. Longitudinal data linkage combining representative surveys and routine data is a powerful way to uncover these issues.
Oral Health of Rohingya Refugees Accessing Emergency Dental Care in the Refugee Camp in Cox's Bazar, Bangladesh.
Zaheer K, Hossain MJ, Debnath KC … +1 more , Coughlan J
Community Dent Oral Epidemiol · 2025 Jun · PMID 40495347 · Publisher ↗
OBJECTIVE: Oral health (OH) of refugees is under-researched and most publications are from developed countries despite the majority of refugees hosted in low-middle income countries. Most of the Rohingya refugees in the...
OBJECTIVE: Oral health (OH) of refugees is under-researched and most publications are from developed countries despite the majority of refugees hosted in low-middle income countries. Most of the Rohingya refugees in the camps in Bangladesh have no access to dental care. The objective of this study was to report on the OH behaviours and utilisation of an emergency dental service in the camp in Cox's Bazar, Bangladesh. METHODS: This study utilised the data from clinical records of Rohingya refugees attending an emergency dental clinic in camp four in Cox's Bazar, Bangladesh from February 2019 to March 2020. Data included education levels, OH practices, tobacco consumption, diagnosis and treatment provided. Descriptive analysis of the data was undertaken. RESULTS: A total of 4111 patients were included, of which 50.1% were female. Education levels were very low, with 75.8% reporting no formal education. Although daily toothbrushing was reported by 64.4%, there was significant variation in the materials used for a dentifrice, with 78.1% using abrasive substances. Tobacco use was high, with 65.7% reporting its use, and of those, 95.4% chewed paan. Pain was the commonly reported symptom (87.1%) and nearly half, 46.9%, reported poor OH. Functional difficulties and problems sleeping were highly prevalent, at 85.3% and 51.6% respectively. A high prevalence of caries was reported, at 79.8%, and a mean number of 2.8 teeth affected. Extraction and temporary restorations were the common treatment modalities, at 52.1% and 23.1% respectively. CONCLUSIONS: The Rohingya refugees in the camps in Bangladesh have low education levels, unhealthy oral health practices, high consumption of tobacco and a high prevalence of oral disease. Further research is required to inform the design and delivery of community-based oral health intervention strategies suitable for refugee camps to improve oral health literacy, knowledge and practices.
Improving the Oral Health of Older People in Care Homes: Results From a Randomised Feasibility Study.
Tsakos G, Brocklehurst PR, Syed S … +17 more , Harvey M, Daniyal S, Watson S, Goulden N, Verey A, Cairns P, Heilmann A, Hoare Z, Kee F, Langley J, Lievesley N, O'Neill C, Sherriff A, Smith CJ, Wassall RR, Watt RG, McKenna G
Community Dent Oral Epidemiol · 2025 Aug · PMID 40495338 · Full text
OBJECTIVES: Poor oral health is a considerable burden for older adults in care homes. The National Institute for Health and Care Excellence (NICE) issued guideline NG48 on "Improving oral health in care homes". However,...
OBJECTIVES: Poor oral health is a considerable burden for older adults in care homes. The National Institute for Health and Care Excellence (NICE) issued guideline NG48 on "Improving oral health in care homes". However, empirical evidence for oral health interventions among care home residents is weak, and the feasibility of the NG48 recommended interventions is not established. This study aimed to determine the feasibility of delivering a co-designed oral health intervention, based on NG48 recommendations, in care homes in two sites in the UK. METHODS: This was a pragmatic cluster randomised controlled feasibility study with a 12-month follow-up, undertaken in 22 care homes across two sites (11 each in London and Northern Ireland). Care homes were randomised to an intervention arm (n = 11), and a control arm (n = 11) that continued with usual routine practice. The complex intervention contained materials were co-designed with care home staff and consisted of: care home staff training package; Oral Health Assessment Tool (OHAT) administered by trained care home staff; and a support worker assisted twice daily tooth-brushing regimen with 1500 ppm fluoride toothpaste. Rates of recruitment and retention, data completion, and intervention fidelity were recorded to determine feasibility. RESULTS: One-hundred-and-nineteen residents from 22 care homes were recruited and 82 residents from 19 care homes completed the study (retention: 86% for care homes and 69% for residents). Twenty residents were lost to follow-up and another 17 withdrew throughout the study. Data completion rates ranged between 88% and 97% at baseline and between 91% and 96% at the 12-month follow-up. Intervention fidelity records showed high completion rates for oral care plans (90%), and lower rates for weekly oral hygiene records (73%) and the OHAT (61%). CONCLUSIONS: This study documented the feasibility of an oral health intervention in care homes, while also highlighting issues to consider for a definitive trial to assess the effectiveness of the co-designed intervention. TRIAL REGISTRATION: Clinical Trial Registration: ISRCTN10276613.
Healthy Smiles: Promoting Good Oral Health for Youth With Serious Mental Illness.
Robertson CV, Clough B, Stewart V … +10 more , Tadakmadla S, Kisely S, Ware RS, Nguyen TM, Barry RJ, Kularatna S, Yung AR, Cooper J, Gill N, Wheeler AJ
Community Dent Oral Epidemiol · 2025 Oct · PMID 40488322 · Full text
BACKGROUND: Individuals with serious mental illness (SMI) are disproportionally affected by oral diseases, contributing to already poor physical health outcomes. Young adults are particularly vulnerable, with high psycho...
BACKGROUND: Individuals with serious mental illness (SMI) are disproportionally affected by oral diseases, contributing to already poor physical health outcomes. Young adults are particularly vulnerable, with high psychological distress and greater health service engagement barriers. Early adulthood is a key opportunity to change the trajectory of poor oral health among youth with SMI (YSMI) by supporting oral hygiene self-care routines and timely access to oral healthcare. OBJECTIVE: To explore factors that promote or inhibit Healthy Smiles: engagement in oral healthcare among Australian YSMI. METHODS: Exploratory interviews and a focus group were conducted. Purposeful sampling recruited 11 YSMI, a carer, peer support workers (n = 2) and oral and mental health practitioners (n = 3) providing health for YSMI (total = 17). RESULTS: Key strategies to improve oral health and access to services for YSMI were outlined: ensuring oral health practitioners had the mental health literacy, confidence and skills to work with this population and mental health practitioners had the oral health literacy and skills to support YSMI to practice oral hygiene self-care and access services; developing a range of youth-friendly promotional resources and communication channels to improve prevention awareness and reduce dental fear. A crucial element was the need for trusted relationships. CONCLUSION: To prevent negative and life-impacting consequences of untimely oral healthcare access in early adulthood, systematic and targeted strategies for YSMI that focus on co-designed innovative models of care are urgently required.
Psychometric Validation of the FACE-Q Dental Module in Patients With Malocclusions.
Tassi A, Klassen AF, Li J … +2 more , Wong Riff KWY, Rae C
Community Dent Oral Epidemiol · 2025 Aug · PMID 40468573 · Full text
OBJECTIVE: The FACE-Q Craniofacial Module is a patient-reported outcome measure (PROM) developed for children and young adults with craniofacial conditions. We hypothesised that some of its scales may be applicable to ot...
OBJECTIVE: The FACE-Q Craniofacial Module is a patient-reported outcome measure (PROM) developed for children and young adults with craniofacial conditions. We hypothesised that some of its scales may be applicable to other populations. The aim of this study was to assess the validity and reliability of FACE-Q scales for patients with dental malocclusions. METHODS: The FACE-Q Dental Module includes 5 scales from the Craniofacial Module that measure appearance (Face, Jaws, Smile and Teeth) and function (Eating/Drinking). Data were collected from patients aged 8-29 years who presented with a dental malocclusion (pre-treatment) or 1-2 years after orthodontic treatment (post-treatment) at a large university-based orthodontic specialty clinic in Canada between September 2018 and March 2020. Patients completed a paper questionnaire booklet, and data were entered into a Research Electronic Data Capture (REDCap) survey. The psychometric analysis was performed using Rasch Measurement Theory (RMT) analysis. RESULTS: The sample of 434 patients was aged 9 to 29 years, with 249 female and 185 male participants. The sample included 252 pre-treatment and 182 post-treatment patients. The 4 appearance scales evidenced strong psychometric performance; all 37 items had ordered thresholds with good item fit to the Rasch model. Reliability was high, with person separation index and Cronbach alpha values, with and without extremes ≥ 0.86. As hypothesised, those participants who had a major difference in appearance, and those who reported liking their appearance less, scored lower on the appearance scales (p < 0.001). In the RMT analysis, the Eating/Drinking scale evidenced low reliability and poor targeting with close to 40% of particpants scoring at the ceiling. CONCLUSION: The FACE-Q Dental Module provides a means to collect evidence-based outcomes data from children and young adults who undergo orthodontic care for dental malocclusions.
Practice-Level Variation in the Provision of Subsidised Dental Services to Adult Danes in 2019: A Register-Based Study.
Raittio E, Baelum V
Community Dent Oral Epidemiol · 2025 Aug · PMID 40462288 · Full text
OBJECTIVES: The aim was to investigate practice-level variation in common dental diagnostic, preventive, and care services provided for Danish adults who underwent a dental examination. METHODS: This was a nationwide reg...
OBJECTIVES: The aim was to investigate practice-level variation in common dental diagnostic, preventive, and care services provided for Danish adults who underwent a dental examination. METHODS: This was a nationwide register-based study. Subsidised dental services delivered during the 13-week period subsequent to the provision of one of three eligible dental examinations (extended, basic, or recall examination) during the first 9 months of 2019 were investigated. Bayesian multilevel regression models were used to estimate the practice-level average predicted probability of supragingival care, subgingival care, individual prevention, bitewing radiographs, and endodontic treatment, and the average predicted count of extractions and direct restorations while adjusting for individual sociodemographics and dental treatments received during the previous 10 years. RESULTS: The final sample included 445 516 examinations conducted in 1593 dental practices. Supragingival care after basic or recall examinations showed the lowest practice-level variation, with around two-fold difference between top and bottom 2.5%. Individual preventive services after recall examinations showed the highest variation with over 30-fold difference between top and bottom 2.5%. All other outcomes showed around 3- to 8-fold differences between practices at top and bottom 2.5% across all examination types. The differences across practices were smaller-1.2- to 3.0-fold-when the top 25% and bottom 25% were compared instead. CONCLUSIONS: This study found considerable variation in diagnostic, preventive, and treatment services provided for Danish adults who underwent a dental examination. The findings highlight the need for research that can inform evidence-based practice through the development of quality clinical practice guidelines, continuing education programmes, and closer surveillance of care delivery.
Testing Dental Anxiety and Self-Care Behaviours as Mediators of the Association Between Executive Functioning and Oral Health Among Young Adults.
Rogers AA, Halvari AEM, Solbakk AK … +1 more , Johnsen JK
Community Dent Oral Epidemiol · 2025 Oct · PMID 40432184 · Publisher ↗
BACKGROUND: Increased support for oral health during young adulthood is needed to address trends in oral disease over the life course. Executive functioning (EF) may play a role in supporting oral health but has received...
BACKGROUND: Increased support for oral health during young adulthood is needed to address trends in oral disease over the life course. Executive functioning (EF) may play a role in supporting oral health but has received little attention. EF represents the capacity to control cognitive information, feelings and behaviour. The current study aimed to explore the association between EF and oral health among young adults and investigate potential mediators. METHODS: Young adults aged 18-30 years were recruited from five universities within Norway to take part in a cross-sectional digital survey. Participants self-reported EF, toothbrushing, flossing, dental fear and anxiety (DFA), and provided ratings on two measures of oral health: self-rated oral health (SROH) and self-reported oral health-related quality of life (OHRQoL). Separate analyses were conducted for each outcome. Linear regression was used to test the association between EF and oral health, and whether toothbrushing, flossing, or DFA mediated this effect. RESULTS: Data from 344 participants were analysed. Average SROH was quite good (M = 4.13), several participants (60.5%) reported some impact on OHRQoL. In the SROH model, EF difficulties directly predicted oral health (β = -0.26), and DFA mediated the relationship (ab = -0.03, p < 0.05). In the OHRQoL model, EF difficulties again predicted performances impacted (β = 0.27), and DFA mediated the relationship (ab = 0.04, p < 0.05). CONCLUSION: EF is related to oral health outcomes among young adults and the relationship is mediated by DFA. Studies are encouraged to continue exploring these relationships, with longitudinal studies needed to provide more insight into the potential role of EF as a protective factor for the development of DFA and oral health problems.
Exploring Barriers and Facilitators to Dietary Assessment and Advice in the Paediatric Population Attending Dental Clinics: A Scoping Review.
Hallewell L, Bescos R, Brookes Z … +2 more , Witton R, Casas-Agustench P
Community Dent Oral Epidemiol · 2025 Oct · PMID 40426333 · Full text
OBJECTIVES: This scoping review aimed to identify barriers and facilitators, from both dental clinic staff and caregivers, to effectively providing and implementing dietary assessment and advice (for both oral and/or sys...
OBJECTIVES: This scoping review aimed to identify barriers and facilitators, from both dental clinic staff and caregivers, to effectively providing and implementing dietary assessment and advice (for both oral and/or systemic health) in dental clinics managing paediatric patients. METHODS: A protocol was developed a priori (Open Science Framework- https://osf.io/bp4ts.) and followed the PRISMA-ScR guidelines. Studies published in English from 1990 to December 2024 in MEDLINE, Cochrane Library, Embase and CINAHL databases were searched. Additional journal searches targeted articles on dietary assessment or advice in dental clinics treating paediatric patients (aged ≤ 18 years), exploring barriers and facilitators for caregivers and dental clinic staff. RESULTS: Of 4736 studies identified, 32 were included, with 5 additional studies included from manual searching. Sixteen studies were quantitative, 13 were qualitative, and 8 mixed methods. Across studies, 77 barriers and 45 facilitators were identified in providing and implementing dietary assessment and advice in the paediatric population attending dental clinics. Results were mapped to the Theoretical Domains Framework. Common barriers for dental staff included time constraints and financial compensation, while caregivers cited controlling children's dietary habits as a major barrier. CONCLUSIONS: Understanding the main barriers and facilitators in providing and implementing dietary assessment and advice in dental clinics treating paediatric patients is crucial to improving preventive healthcare.
Stakeholder Attitudes, Experiences and Perceptions of the New South Wales Primary School Mobile Dental Program.
Marcus K, Huckel-Schneider C, Killedar A … +9 more , Balasubramanian M, Rudman A, Sohn W, Sivaprakash P, Norris S, Liston G, Wilson N, Clarke K, Wilson A
Community Dent Oral Epidemiol · 2025 Aug · PMID 40391704 · Full text
OBJECTIVES: Tooth decay is a leading cause of total disease burden among Australian children. In 2019, the state government of New South Wales, Australia implemented the Primary School Mobile Dental Program (PSMDP) acros...
OBJECTIVES: Tooth decay is a leading cause of total disease burden among Australian children. In 2019, the state government of New South Wales, Australia implemented the Primary School Mobile Dental Program (PSMDP) across five local health districts. Understanding stakeholder satisfaction of the PSMDP is an important measure of quality, to determine appropriateness as relevant to the needs of populations. The aim of the study was to explore parent/caregiver and provider attitudes, experiences, and perceptions of the PSMDP. METHODS: This study reports on the qualitative component of a mixed methods study examining parent/caregiver and provider (oral health staff) experiences of the program. Two of the five local health districts were selected for study sampling. Parents/caregivers were recruited using flyers administered via schools and oral health teams. Interviews were conducted between 2022 and 2023. The interviews lasted 20-60 min, were recorded, and transcribed verbatim. A critical realist lens was applied, and thematic analysis was conducted. Data saturation was achieved, and bias was reduced through member checking, researcher reflexivity, and team triangulation of the data. RESULTS: In total, 79 individuals (58 parents/caregivers and 21 providers) were interviewed. Analysis revealed six key themes: (1) oral healthcare access, (2) informed consent, (3) parental attendance, (4) rewarding experiences, (5) operational barriers, and (6) communication clarity. The PSMDP promoted oral healthcare access while some parents/caregivers reported informed consent challenges. Providers cited rewarding experiences but face operational barriers including time constraints. Stakeholders diverged on parental attendance at school dental appointments, and most importantly, parents/caregivers requested follow-up communication clarity and coordination, particularly in feedback letters. CONCLUSIONS: Qualitative findings identified generally positive attitudes and experiences with the PSMDP, and implications have been identified that would support the scale-up and sustainability of the PSMDP across the state. Study insights could be useful for similar programs, such as extending the attendance time per child, giving greater consideration to parental involvement, and improving communication and follow-up coordination.
Oral Health Promotion Interventions in Residential Aged Care Facilities - A Systematic Review of Behaviour Change Techniques Used in Interventions.
Aurlene N, Ravichandran S, Bish M … +1 more , Tadakamadla SK
Community Dent Oral Epidemiol · 2025 Oct · PMID 40322846 · Full text
BACKGROUND: The oral health status of older people living in residential aged care facilities (RACFs) is found to be very poor. Many oral health promotion interventions have been tested in RACF settings around the world...
BACKGROUND: The oral health status of older people living in residential aged care facilities (RACFs) is found to be very poor. Many oral health promotion interventions have been tested in RACF settings around the world with varying degrees of success. AIM: The aim of this systematic review is to analyse the health promotion strategies used in oral health promotion interventions in RACF settings and map the behaviour change techniques (BCTs) used in interventions to the Behaviour Change Techniques Taxonomy Version 1 (BCTTV1). This will help us identify the BCTs that are used and how effective they are in improving oral health outcomes for residents and the knowledge, attitudes and skills of caregivers in providing mouth care assistance to residents of RACFs. METHODS: A database search was conducted in MEDLINE, Cochrane CENTRAL, Cochrane Database of Systematic Reviews (CDSR), EMBASE, PsycINFO, CINAHL and Web of Sciences databases to screen for articles relevant to the topic of the review; after full-text review a total of 31 articles comprising both randomised controlled trials and non-randomised intervention studies were included in this review. Risks of bias in randomised studies were assessed using the ROB2 tool and ROBINS-I was used to evaluate non-randomised studies. The description of intervention content in each study was coded for the presence of BCTs by two independent review authors trained in coding BCTs according to BCTTv1. RESULTS: The most commonly used BCTs were 'demonstration of behaviour', 'instruction on how to perform behaviour' and 'credible source'. These BCTs were effective in improving oral health outcomes and knowledge of caregivers on short-term follow-up. A higher number of BCTs were coded in studies that showed significant improvement in oral health outcomes of residents on long-term follow-up with rarely used BCTs related to 'monitoring and feedback' being coded in majority of studies that showed consistent improvement in oral health outcomes of residents. CONCLUSION: This review identified the most commonly used BCTs used in health promotion interventions to improve oral health among older people in RACFs and found that majority of interventions were targeted towards 'knowledge transfer' and were inconsistent in improving oral health outcomes for residents over long-term. Well conducted studies with use of theoretical behaviour change frameworks to develop oral health promotion interventions are needed as majority of strategies used currently do not demonstrate consistent effectiveness in improving oral health outcomes for residents of RACFs.
Development and Content Validity of the International Association for Disability and Oral Health Universal Case Mix Tool: A Consensus Study.
Mac Giolla Phadraig C, Faulks D, McGrath C … +2 more , Dougall A, Molina G
Community Dent Oral Epidemiol · 2025 Aug · PMID 40304234 · Full text
OBJECTIVES: To develop the International Association for Disability and Oral Health Universal Case Mix Tool (iADH UCMT) that rates case complexity in the delivery of oral healthcare. METHODS: A modified e-Delphi survey s...
OBJECTIVES: To develop the International Association for Disability and Oral Health Universal Case Mix Tool (iADH UCMT) that rates case complexity in the delivery of oral healthcare. METHODS: A modified e-Delphi survey sought consensus on the content of a universal Case Mix Tool to rate the degree of adaptation over and above that required for the general population, with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The survey consisted of candidate domains, ratings and descriptors, following a scoping review of the literature. The consensus threshold was set a priori at ≥ 75% agreement. Expert agreement was sought on both content and wording, and free text comments were subsequently used to refine the exact wording of each domain and descriptor. A consensus meeting followed to rate descriptors for cultural acceptability and clarity, using 5-point Likert scales. Terms were aligned linguistically to ensure consistency across domains, scores and descriptors, and a glossary of definitions was refined. RESULTS: From the 70 registrants, 40 completed the survey (participation rate 59.7%). Respondents demonstrated a high level of agreement regarding the appropriateness of the seven domains, with agreement ranging from 90% to 100%. Consensus for rating descriptors was also high (85%-95%). Twenty-seven panellists and five development team members attended the consensus meeting, where cultural acceptability (means ranged from 4.6 to 4.8) and clarity (means ranged from 4.2 to 4.7) were demonstrated across domains. This consensus process produced an iADH Universal Case Mix Tool consisting of seven domains: Communication; Dental behaviour support; Medical status; Risk factors for oral disease and dysfunction; Autonomy; Legal and ethical barriers; and, Access to adapted care at the services, systems and policies level. Each Domain has four possible ratings to reflect the degree of adaptation required with respect to time, resources and/or expertise necessary to provide high-quality care and equitable outcomes. The domains, ratings and descriptors were found to be appropriate, clear and culturally acceptable. CONCLUSIONS: An international panel developed a Universal Case Mix Tool to rate complexity in the delivery of oral health care. Acceptable content validity was confirmed, and further psychometric testing is planned.
Psychosocial Profiles of Older Adults by Dentition Status and Dental Utilisation History.
Finlayson TL, Moss K, Jones JA … +2 more , Preisser JS, Weintraub JA
Community Dent Oral Epidemiol · 2025 Aug · PMID 40276943 · Full text
OBJECTIVE: Psychosocial factors can affect health. Patterns of psychosocial stressors and resources among older adults were examined for oral health status. METHODS: The Health and Retirement Study (HRS) is a representat...
OBJECTIVE: Psychosocial factors can affect health. Patterns of psychosocial stressors and resources among older adults were examined for oral health status. METHODS: The Health and Retirement Study (HRS) is a representative sample of US adults > 50 years. Participants completed the 2018 HRS CORE survey and the Psychosocial and Lifestyle Questionnaire-Panel A "Leave Behind" survey (HRS-LB) (N = 4703). All measures were self-reported and stratified into outcome groups: (1) edentulous/dentate, (2) with/without a recent dental visit in the last 2 years. Psychosocial measures covered three domains: well-being, beliefs, and lifestyle. Specifically, loneliness, life satisfaction, perceived age, social status, control, mastery, and chronic stressors were included in this analysis. Latent class analysis (LCA) identified profiles of adults based on the distribution of psychological and social stressors and resources. Associations between latent classes and being edentulous and a recent dental visit were examined in logistic regression models. RESULTS: About 30% reported no recent dental visit; 14% were edentulous. Three latent classes were identified; profiles had different distributions of psychosocial factors. About half (47%) were in Class A: "Satisfied/Connected" (n = 2230), 28% in Class B: "Satisfied/Lonely" (n = 1293), and 25% in Class C: "Unsatisfied/Lonely" (n = 1180). "Satisfied/Connected" adults had the fewest psychosocial risk factors, most resources, were dentate, and had a recent dental visit. "Unsatisfied/Lonely" adults exhibited the most psychosocial risk factors and fewest resources and lacked a recent dental visit. "Satisfied/Lonely" adults exhibited characteristics between Classes A and C. In fully adjusted regression models, Class B adults had 1.29 (1.03-1.62) times greater odds than Class A to be edentulous and 1.26 (1.07-1.50) times greater odds to not have a recent dental visit. Class C adults had 1.22 (0.97-1.53) times greater odds than Class A to be edentulous and 1.31 (1.10-1.57) times greater odds to not have a recent dental visit. CONCLUSION: Adverse psychosocial factors are associated with edentulism and lack of routine dental visits. Exposure to psychosocial risk and resource factors can affect oral health. Health providers should assess older adults for loneliness and other psychosocial risk factors, and policies and programmes that support older adults' psychosocial needs should be expanded.
Cross-Sectional Clinical Validation of the Periodontal Disease Self-Report Measure.
Wright CD, Salman A, Garcia RI … +2 more , McNeil DW, Heaton B
Community Dent Oral Epidemiol · 2025 Aug · PMID 40191976 · Full text
BACKGROUND: The Periodontal Disease Self Report (PDSR) measure was originally created and psychometrically validated using a nationwide sample via online data collection. No clinical parameters were included in the prior...
BACKGROUND: The Periodontal Disease Self Report (PDSR) measure was originally created and psychometrically validated using a nationwide sample via online data collection. No clinical parameters were included in the prior validation of the PDSR. Thus, this study evaluated potential evidence for the clinical validity of the measure by examining associations between the PDSR scores and various clinical parameters obtained from a new sample of participants in which full-mouth periodontal examinations were conducted. METHODS: Adults from a community sample (n = 114) provided demographic information, responded to the PDSR measure and received a full-mouth clinical periodontal examination. Individual self-report items, subscale scores and total scores obtained from the PDSR were evaluated against clinical parameters of periodontitis. Regression models and receiver operating characteristic statistics were also utilised to test the ability of the PDSR to predict clinical outcomes. RESULTS: PDSR total scores were positively correlated with mean probing depth (r = 0.50, p < 0.01) and mean clinical attachment loss (r = 0.52, p < 0.01). After accounting for common risk factors in periodontal disease, the PDSR predicted mean probing depth (β = 0.45, 95% CI: 0.02-0.04; ΔR = 0.19). The area under the curve for the PDSR scores distinguishing between CDC/AAP no/mild periodontitis and moderate/severe periodontitis categories was 0.71 (95% CI: 0.62-0.81). CONCLUSIONS: Clinical data support the use of the PDSR measure as a screening tool for periodontal disease. Additionally, the PDSR may offer added utility compared to other measures due to less reliance on information obtained via clinical encounters.
Changes in Oral Health-Related Quality of Life According to Public Oral Health Procedures in Parents of Young Children From the FinnBrain Birth Cohort Study.
Palo K, Tolvanen M, Suominen A … +3 more , Karlsson H, Karlsson L, Lahti S
Community Dent Oral Epidemiol · 2025 Aug · PMID 40183326 · Publisher ↗
OBJECTIVES: The aim was to evaluate the association between public oral healthcare procedures and change in oral health-related quality of life (OHRQoL) over 4 years among parents in the FinnBrain Cohort Study, comparing...
OBJECTIVES: The aim was to evaluate the association between public oral healthcare procedures and change in oral health-related quality of life (OHRQoL) over 4 years among parents in the FinnBrain Cohort Study, comparing those who did not visit public oral healthcare. METHODS: The study used data on parents of young children from the FinnBrain Birth Cohort Study (www.finnbrain.fi) and healthcare centers' national patient data register. OHRQoL was measured with the 14-item Oral Health Impact Profile (OHIP-14). Of those who had answered the OHIP-14 questionnaire at gestational week (gw) 34 and 4-year time points (n = 1552), 589 had visited a public oral healthcare service. OHIP-14 severity score, two thresholds of prevalence and their changes were evaluated according to gender and public oral healthcare visits (Mann-Whitney U test, ꭓ test, and Wilcoxon signed ranks test). Correlations between treatment procedures and OHRQoL were evaluated among those who had visited public oral healthcare service. The association between OHRQoL and its change with different treatment procedures was evaluated by using Spearman correlation coefficients. RESULTS: OHRQoL did not change for the majority of parents, regardless of visiting public oral healthcare services, or if they received oral healthcare treatment or only preventive procedures. Change in OHRQoL and treatment procedures showed a weak association. OHRQoL worsened most for those receiving treatment in four or more procedure groups. Changes in OHRQoL were not clinically meaningful. CONCLUSIONS: Oral healthcare procedures seem to have a limited impact on OHRQoL changes among parents of young children.
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