METHODS: A questionnaire survey was conducted to assess self-reported dental injuries and knowledge of their management. An intraoral examination was performed using the decayed, missing, and filled teeth (DMFT) index following the World Health Organization guidelines.
RESULTS: A total of 61 para-athletes (men = 90.16%, n = 55; women = 9.84%, n = 6) from different sports categories with different disabilities randomly participated in this study. The incidence of self-reported dental injuries was 18.0% (n = 11), with the most common injury being crown tooth fracture (72.7%) and lip laceration (63.6%). However, the majority of the athletes (70.5%, n = 43) did nothing after experiencing dental trauma, and 82.0% (n = 50) were unaware of the immediate management of dental trauma. Based on the intraoral examination, only 9.8% (n = 6) of the athletes had perfectly sound teeth. The mean total DMFT index was 3.49 ± 2.371, while the mean DMFT index for decayed, missing, and filled teeth was 1.28 ± 1.293, 0.74 ± 0.705, and 1.48 ± 1.120, respectively. The mean DMFT index for decayed, missing, and filled teeth and total DMFT index significantly differed among the types of disabilities (P .05).
CONCLUSION: The most commonly reported injuries among para-athletes are crown tooth fractures and lip lacerations. The total DMFT index among para-athletes is moderate, emphasising the need for improvements.
OBJECTIVES: To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services.
SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 4 March 2019), the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Register of Studies, to 4 March 2019), MEDLINE Ovid (1946 to 4 March 2019), and Embase Ovid (15 September 2016 to 4 March 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status when searching the electronic databases; however, the search of Embase was restricted to the last six months due to the Cochrane Centralised Search Project to identify all clinical trials and add them to CENTRAL.
SELECTION CRITERIA: We included randomised controlled trials (RCTs) (cluster or parallel) that evaluated school dental screening compared with no intervention or with one type of screening compared with another.
DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane.
MAIN RESULTS: We included seven trials (five were cluster-RCTs) with 20,192 children who were 4 to 15 years of age. Trials assessed follow-up periods of three to eight months. Four trials were conducted in the UK, two were based in India and one in the USA. We assessed two trials to be at low risk of bias, two trials to be at high risk of bias and three trials to be at unclear risk of bias.None of the trials had long-term follow-up to ascertain the lasting effects of school dental screening.None of the trials reported the proportion of children with untreated caries or other oral diseases, cost effectiveness or adverse events.Four trials evaluated traditional screening versus no screening. We performed a meta-analysis for the outcome 'dental attendance' and found an inconclusive result with high heterogeneity. The heterogeneity was found to be, in part, due to study design (three cluster-RCTs and one individual-level RCT). Due to the inconsistency, we downgraded the evidence to 'very low certainty' and are unable to draw conclusions about this comparison.Two cluster-RCTs (both four-arm trials) evaluated criteria-based screening versus no screening and showed a pooled effect estimate of RR 1.07 (95% CI 0.99 to 1.16), suggesting a possible benefit for screening (low-certainty evidence). There was no evidence of a difference when criteria-based screening was compared to traditional screening (RR 1.01, 95% CI 0.94 to 1.08) (very low-certainty evidence).In one trial, a specific (personalised) referral letter was compared to a non-specific one. Results favoured the specific referral letter with an effect estimate of RR 1.39 (95% CI 1.09 to 1.77) for attendance at general dentist services and effect estimate of RR 1.90 (95% CI 1.18 to 3.06) for attendance at specialist orthodontist services (low-certainty evidence).One trial compared screening supplemented with motivation to screening alone. Dental attendance was more likely after screening supplemented with motivation, with an effect estimate of RR 3.08 (95% CI 2.57 to 3.71) (low-certainty evidence).Only one trial reported the proportion of children with treated dental caries. This trial evaluated a post screening referral letter based on the common-sense model of self-regulation (a theoretical framework that explains how people understand and respond to threats to their health), with or without a dental information guide, compared to a standard referral letter. The findings were inconclusive. Due to high risk of bias, indirectness and imprecision, we assessed the evidence as very low certainty.
AUTHORS' CONCLUSIONS: The trials included in this review evaluated short-term effects of screening. We found very low-certainty evidence that is insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening, there is no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty evidence to conclude that personalised or specific referral letters may improve dental attendance when compared to non-specific counterparts. We also found low-certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) may improve dental attendance in comparison to screening alone. For children requiring treatment, we found very-low certainty evidence that was inconclusive regarding whether or not a referral letter based on the 'common-sense model of self-regulation' was better than a standard referral letter.We did not find any trials addressing possible adverse effects of school dental screening or evaluating its effectiveness for improving oral health.
OBJECTIVES: To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services.
SEARCH METHODS: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 15 March 2017), the Cochrane Central Register of Controlled Trials (CENTRAL, the Cochrane Register of Studies, to 15 March 2017), MEDLINE Ovid (1946 to 15 March 2017), and Embase Ovid (15 September 2016 to 15 March 2017). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status when searching the electronic databases; however, the search of Embase was restricted to the last six months due to the Cochrane Centralised Search Project to identify all clinical trials and add them to CENTRAL.
SELECTION CRITERIA: We included randomised controlled trials (RCTs) (cluster or parallel) that evaluated school dental screening compared with no intervention or with one type of screening compared with another.
DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane.
MAIN RESULTS: We included six trials (four were cluster-RCTs) with 19,498 children who were 4 to 15 years of age. Four trials were conducted in the UK and two were based in India. We assessed two trials to be at low risk of bias, one trial to be at high risk of bias and three trials to be at unclear risk of bias.None of the six trials reported the proportion of children with untreated caries or other oral diseases.Four trials evaluated traditional screening versus no screening. We performed a meta-analysis for the outcome 'dental attendance' and found an inconclusive result with high heterogeneity. The heterogeneity was found it to be, in part, due to study design (three cluster-RCTs and one individual-level RCT). Due to the inconsistency, we downgraded the evidence to 'very low certainty' and are unable to draw conclusions about this comparison.Two cluster-RCTs (both four-arm trials) evaluated criteria-based screening versus no screening and showed a pooled effect estimate of RR 1.07 (95% CI 0.99 to 1.16), suggesting a possible benefit for screening (low-certainty evidence). There was no evidence of a difference when criteria-based screening was compared to traditional screening (RR 1.01, 95% CI 0.94 to 1.08) (very low-certainty evidence).In one trial, a specific (personalised) referral letter was compared to a non-specific one. Results favoured the specific referral letter with an effect estimate of RR 1.39 (95% CI 1.09 to 1.77) for attendance at general dentist services and effect estimate of RR 1.90 (95% CI 1.18 to 3.06) for attendance at specialist orthodontist services (low-certainty evidence).One trial compared screening supplemented with motivation to screening alone. Dental attendance was more likely after screening supplemented with motivation, with an effect estimate of RR 3.08 (95% CI 2.57 to 3.71) (low-certainty evidence).None of the trials had long-term follow-up to ascertain the lasting effects of school dental screening.None of the trials reported cost-effectiveness and adverse events.
AUTHORS' CONCLUSIONS: The trials included in this review evaluated short-term effects of screening, assessing follow-up periods of three to eight months. We found very low certainty evidence that was insufficient to allow us to draw conclusions about whether there is a role for traditional school dental screening in improving dental attendance. For criteria-based screening, we found low-certainty evidence that it may improve dental attendance when compared to no screening. However, when compared to traditional screening there was no evidence of a difference in dental attendance (very low-certainty evidence).We found low-certainty evidence to conclude that personalised or specific referral letters improve dental attendance when compared to non-specific counterparts. We also found low-certainty evidence that screening supplemented with motivation (oral health education and offer of free treatment) improves dental attendance in comparison to screening alone.We did not find any trials addressing cost-effectiveness and adverse effects of school dental screening.
OBJECTIVES: To assess the effectiveness of school dental screening programmes on overall oral health status and use of dental services.
SEARCH METHODS: An information specialist searched four bibliographic databases up to 15 October 2021 and used additional search methods to identify published, unpublished and ongoing studies.
SELECTION CRITERIA: We included randomised controlled trials (RCTs; cluster- or individually randomised) that evaluated school dental screening compared with no intervention, or that compared two different types of screening.
DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane.
MAIN RESULTS: The previous version of this review included seven RCTs, and our updated search identified one additional trial. Therefore, this update included eight trials (six cluster-RCTs) with 21,290 children aged 4 to 15 years. Four trials were conducted in the UK, two in India, one in the USA and one in Saudi Arabia. We rated two trials at low risk of bias, three at high risk of bias and three at unclear risk of bias. No trials had long-term follow-up to ascertain the lasting effects of school dental screening. The trials assessed outcomes at 3 to 11 months of follow-up. No trials reported the proportion of children with treated or untreated oral diseases other than caries. Neither did they report on cost-effectiveness or adverse events. Four trials evaluated traditional screening versus no screening. We performed a meta-analysis for the outcome 'dental attendance' and found an inconclusive result with high heterogeneity. The heterogeneity was partly due to study design (three cluster-RCTs and one individually randomised trial). Due to this inconsistency, and unclear risk of bias, we downgraded the evidence to very low certainty, and we are unable to draw conclusions about this comparison. Two cluster-RCTs (both four-arm trials) evaluated criteria-based screening versus no screening, suggesting a possible small benefit (pooled risk ratio (RR) 1.07, 95% confidence interval (CI) 0.99 to 1.16; low-certainty evidence). There was no evidence of a difference when comparing criteria-based screening to traditional screening (RR 1.01, 95% CI 0.94 to 1.08; very low-certainty evidence). One trial compared a specific (personalised) referral letter to a non-specific letter. Results favoured the specific referral letter for increasing attendance at general dentist services (RR 1.39, 95% CI 1.09 to 1.77; very low-certainty evidence) and attendance at specialist orthodontist services (RR 1.90, 95% CI 1.18 to 3.06; very low-certainty evidence). One trial compared screening supplemented with motivation to screening alone. Dental attendance was more likely after screening supplemented with motivation (RR 3.08, 95% CI 2.57 to 3.71; very low-certainty evidence). One trial compared referral to a specific dental treatment facility with advice to attend a dentist. There was no evidence of a difference in dental attendance between these two referrals (RR 0.91, 95% CI 0.34 to 2.47; very low-certainty evidence). Only one trial reported the proportion of children with treated dental caries. This trial evaluated a post-screening referral letter based on the common-sense model of self-regulation (a theoretical framework that explains how people understand and respond to threats to their health), with or without a dental information guide, compared to a standard referral letter. The findings were inconclusive. Due to high risk of bias, indirectness and imprecision, we assessed the evidence as very low certainty.
AUTHORS' CONCLUSIONS: The evidence is insufficient to draw conclusions about whether there is a role for school dental screening in improving dental attendance. We are uncertain whether traditional screening is better than no screening (very low-certainty evidence). Criteria-based screening may improve dental attendance when compared to no screening (low-certainty evidence). However, when compared to traditional screening, there is no evidence of a difference in dental attendance (very low-certainty evidence). For children requiring treatment, personalised or specific referral letters may improve dental attendance when compared to non-specific referral letters (very low-certainty evidence). Screening supplemented with motivation (oral health education and offer of free treatment) may improve dental attendance in comparison to screening alone (very low-certainty evidence). We are uncertain whether a referral letter based on the 'common-sense model of self-regulation' is better than a standard referral letter (very low-certainty evidence) or whether specific referral to a dental treatment facility is better than a generic advice letter to visit the dentist (very low-certainty evidence). The trials included in this review evaluated effects of school dental screening in the short term. None of them evaluated its effectiveness for improving oral health or addressed possible adverse effects or costs.
METHODOLOGY: This study was approved by the institutional Joint Research and Ethics Committee, International Medical University, Malaysia (number 373/2016); consisted of 180 eligible pre-school children from a private school. Study tools included demographic, clinical oral health data form, the Early Childhood Oral Health Impact Scale (ECOHIS) and family functioning-12-item general functioning subscale. Written consent was sought prior to data collection. Data were analysed by SPSS v.22.0; descriptive statistics for socio-demographic details, clinical information, HRQoL and FAD scores. The parametric tests included independent sample t test and ANOVA to evaluate the associations between the dependent variable. Binary logistic regression models were applied to assess the impacts on OHRQoL (P value
MATERIALS AND METHODS: A cross-sectional study was done among 253 children of 5-, 12-, and 15-year-olds living in various orphanage houses of Selangor, Kuala Lumpur, Malaysia. Demographic data, and dietary and oral hygiene practices were collected through a structured questionnaire. Clinical examinations of children were conducted to assess oral health status and recorded in the World Health Organization oral health assessment form (1997). Stimulated saliva was collected for S. mutans and Lactobacilli levels. The statistical software, namely, Statistical Package for the Social Sciences version 19.0 was used for the analysis of the data.
RESULTS: The final data analysis included 253 children of which 116 (45.8%) were boys and 137 (54.2%) were girls. Overall, 140 (55.33%) children were caries-free and 113 (44.66%) children presented with caries (decayed/missing/filled surface >0). High levels of salivary microbiological counts (S. mutans and Lactobacilli), i.e., ≥105, stress the importance of necessary preventive oral health services. Treatment needs among orphan children showed that most of the children, i.e., 58 (22.9%), need preventive or caries-arresting care followed by 49 (19.4%) who require two-surface filling as an immediate measure.
CONCLUSION: From the results of our study, orphan children have low utilization of preventive and therapeutic oral health services. Urgent attention is required to plan a comprehensive dental health-care program to improve their oral health status.
CLINICAL SIGNIFICANCE: Parents are the primary caretakers of children, but woefully some of them have to lead their lives without parents, the latter either being dead or incapable of bringing up their children. Such a group of children is known as orphans. As oral health is an integral part of general health, it is essential for health-care policy makers to address oral health needs of this underprivileged group of society. This article highlights the risk factors and treatment needs among orphan schoolchildren.
METHODS: A sample of 158 preschool children with ECC awaiting dental treatment under GA was recruited over an 8-month period. Parents self-completed the Malay-ECOHIS before and 4 weeks after their child's dental treatment. At 4 weeks follow-up, parents also responded to a global health transition judgement item. Data were analysed using independent and paired samples t tests, ANOVA and Pearson correlation coefficients.
RESULTS: The response rate was 87.3%. The final sample comprised 76 male (55.1%) and 62 female (44.9%) preschool children with mean age of 4.5 (SD = 1.0) years. Following treatment, there were significant reductions in mean scores for total Malay-ECOHIS, child impact section (CIS), family impact section (FIS) and all domains, respectively (P oral health improvement after treatment, supporting the responsiveness of the measure. The Malay-ECOHIS MID was found to be 7 scale points.
CONCLUSION: The Malay-ECOHIS is empirically shown to be sensitive and responsiveness to dental treatment of ECC under GA.
MATERIALS AND METHODS: This cross-sectional study involved 150 subjects attending the Primary Care Unit with no history of orthodontic treatment. The Dental Aesthetic Index (DAI) with 10 occlusal characteristics were measured on study models. Oral health-related quality of life (OHRQoL) was assessed with the Malaysian version of the Oral Health Impact Profile questionnaire (OHIP-14). The Spearman rank-order correlation coefficient was used to evaluate the relationship between the malocclusion and quality of life.
RESULTS: Significantly weak correlations (r = .176) were found between the DAI and the OHRQoL. Females and the younger age group (12-19 years) tended to score higher on the OHIP-14 than their counterparts. For males, domain 3 (psychological discomfort; r = .462), domain 4 (physical disability; r = .312), domain 7 (handicap; r = .309), and overall score (r = .289) were weak correlates but significant to the DAI compared with females. The older age group showed a significant weak correlation in domain 3 (psychological discomfort; r = .268) and domain 7 (handicap; r = .238), whereas the younger age group showed no correlation with any domain.
CONCLUSIONS: The DAI score does not predict the effect of malocclusion on the OHRQoL.
METHODS: National representative data from the 2009 Adult Dental Health Survey, United Kingdom, were used in this study. Periodontal disease severity was measured using periodontal pocket depth and categorized into three groups: pocket depth up to 3.5, 3.5-5.5 and more than 5.5 mm. OHRQoL was measured using the Oral Health Impact Profile-14 (OHIP-14) scores. Bivariate and multivariable Zero-inflated Poisson regression analysis was used.
RESULTS: A total of 6378 participants was analysed in this study. Periodontal pocketing was significantly associated with higher OHIP-14 scores. Participants with periodontal pocket depths >3.5 mm had a significantly higher prevalence for functional limitation, physical pain and social disability than participants with pocket depths of less than 3.5 mm. Participants with periodontal pocket depth(s) >5.5 mm had significantly higher OFOVO prevalence in all the domains of OHIP-14 except handicap domain than participants with pocket depth(s) <3.5 mm.
PARTICIPANTS:
CONCLUSION: This study showed that for a nationally representative sample of the United Kingdom population, periodontal disease was significantly associated with the domains of OHRQoL.
METHODS: The Khadijah Rohani's Readability Formula (KRRF) and Suitability Assessment of Materials (SAM) instrument were used to assess the readability and suitability of the pamphlets respectively. All 23 Bahasa Malaysia pamphlets retrieved from the official portal of OHP on the 31st January 2019 were assessed for suitability. However, only five pamphlets were found to be eligible for readability assessment because the KRRF, the single formula available for Bahasa Malaysia text is applicable only for materials with 300 words or more. The readability is interpreted based on the level of formal education in Malaysia.
RESULTS: All pamphlets achieved superior suitability rating with a minimum and maximum score of 75% and 95% respectively. However, a few pamphlets did not fulfil SAM superior and adequate criteria for the following factors and were rated not suitable: did not include summary (73.9%), have few or no headers (4.3%), did not use captions to explain graphics (17.4%), and did not provide interactive learning (21.7%). Readability of the pamphlets eligible for assessment ranged from primary six to secondary three.
CONCLUSIONS: OHE pamphlets produced by the MOH are readable by most Malaysians. Most pamphlets are generally suitable for the intended audience although a few performed poorly in several areas.
METHODS: Fit to the Rasch model was examined in 6648 8-to-15-year-olds from Australia, New Zealand, Brunei, Cambodia, Hong Kong, Malaysia, Thailand, Germany, United Kingdom, Brazil and Mexico.
RESULTS: In all but two items, the initial five answer options were reduced to three or four, to increase precision of the children's selection. Items 10 (Shy/embarrassed) and 11 (Concerned what others think) showed an 'extra' dependency between item scores beyond the relationship related to the underlying latent construct represented by the instrument, and so were deleted. Without these two items, the CPQ was unidimensional. The three oral symptoms items (4 Food stuck in teeth, 3 Bad breath and 1 Pain) were required for a sufficient person-item coverage. In three out of 14 items (21 %), Europe and South America showed regional differences in the patterns of how the answer options were selected. No differential item functioning was detected for age.
CONCLUSION: Except for a few modifications, the present analysis supports the combination of items, the cross-cultural validity of the CPQ with 14 items and the extension of the age range from 8 to 15 years.
CLINICAL SIGNIFICANCE: The valid, reliable, shortened and age-extended version of the CPQ resulting from this study should be used in routine care and clinical research. Less items and a wider age range increase its usability. Symptoms items are needed to precisely differentiate between children with higher and lower quality of life.
MATERIAL AND METHODS: In this cross-sectional study, 408 elder people were randomly recruited from three day-care centres. In the translation process, the translated Urdu version was reviewed by a committee of experts, followed by back-translation into English and re-reviewed by the same committee of experts. The questionnaire sought information about socio-demographic characteristics information and self-perception of oral, general health and treatment needs. OHRQoL was examined using GOHAI-U, and intraoral examination recorded the decayed, missing, and filled teeth. Reliability, internal consistency, convergent and discriminant validity of GOHAI-U were examined.
RESULTS: The mean GOHAI-U score was 40.2 (SD = 5.7, range = 20-55). The Cronbach's alpha for GOHAI score was 0.71, item-scale correlation coefficients ranged from 0.63 to 0.76, and test-retest correlation ranged from 0.59 to 0.74. Three factors supported the theoretical construction in the component factor analysis of the index. For convergent validity, there was a significant relationship between the GOHAI score and self-perceived oral, general health and treatment needs (P oral health-related quality of life in the Pakistani elder population.