Reza Yazdani

School‐based education to improve oral cleanliness and gingival health in adolescents in Tehran, Iran

BACKGROUNDnSchools can be an important setting for health education programmes, controlling the growing burden of oral diseases and promoting oral health. Aim. The aim of this study was to evaluate the short-term effect of school-based educational intervention on oral cleanliness and gingival health of 15-year-olds in Tehran, Iran.nnnDESIGNnThe present cluster randomized trial was based on exposing students (n = 287; control, n = 130) at public schools to oral health knowledge through a leaflet or a videotape. The outcome was evaluated after 12 weeks. A positive outcome was defined as at minimum a 50% reduction in numbers of teeth with dental plaque or gingival bleeding compared to baseline. Evaluation included percentage changes, number needed to treat (NNT), and students self-assessment.nnnRESULTSnAt baseline, all students had dental plaque, and 93% had gingival bleeding on at least one index tooth. Positive outcome for oral cleanliness was 58% (P < 0.001) of the students in the leaflet group, 37% (P < 0.001) in the videotape group, and 10% of controls. Corresponding figures for gingival health were 72% (P < 0.001), 64% (P < 0.001), and 30%. For oral cleanliness, NNT was 2 in the leaflet and 3 in the videotape group; for gingival bleeding, NNT in both groups was 3. More than two-thirds of the students assessed their oral health behaviours as having improved moderately.nnnCONCLUSIONnAn easy-to-organize and inexpensive school-based intervention can in the short term be effective in improving oral cleanliness and gingival health among adolescents; in particular, in countries with a developing oral health system.

Determinants of Oral Health: Does Oral Health Literacy Matter?

Objective. To evaluate oral health literacy, independent of other oral health determinants, as a risk indicator for self-reported oral health. Methods. A cross-sectional population-based survey conducted in Tehran, Iran. Multiple logistic regression analysis served to estimate the predictive effect of oral health literacy on self-reported oral health status (good versus poor) controlling for socioeconomic and demographic factors and tooth-brushing behavior. Results. In all, among 1031 participants (mean age 36.3 (SD 12.9); 51% female), women reported brushing their teeth more frequently (P < 0.001) and scored higher for oral health literacy (mean 10.9 versus 10.2, P < 0.001). In the adjusted model, high age (OR = 1.01, 95% CI 1.003–1.034), low education (OR = 1.88, 95% CI 1.23–2.87), small living area in square meters per person (OR = 1.85, 95% CI 1.003–3.423), poor tooth brushing behavior (OR = 3.35, 95% CI 2.02–5.57), and low oral health literacy scores (OR = 1.58, 95% CI 1.02–2.45) were significant risk indicators for poor self-reported oral health. Conclusions. Low oral health literacy level, independent of education and other socioeconomic determinants, was a predictor for poor self-reported oral health and should be considered a vital determinant of oral health in countries with developing health care systems.

Primary care nurses’ awareness of and willingness to perform children’s oral health care

BackgroundThe majority of young children receive no early dental examination while attending primary health care for routine check-ups. Our aim was to study primary care nurses’ knowledge of oral health care (OHC) and their attitudes toward delivering OHC, as well as to assess their willingness to obtain OHC information.MethodsWe conducted a cross-sectional survey of all primary-care nurses working in the public health centres of Tehran city. An anonymous self-administered questionnaire queried their knowledge in paediatric-, general and medicine-related areas of dentistry, providing knowledge scores for three domains. The nurses’ attitudes toward OHC and their willingness to obtain OHC information underwent evaluation with statements utilizing a five-point Likert scale. Altogether 680 nurses took part in the survey. The Chi-square test, t-test, one-way ANOVA and logistic regression model served for statistical analyses.ResultThe mean score for the paediatric dentistry domain (3.6, SD: 1.5) was lower than for the medical (4.4, SD: 2.3) and dental domains (5.8, SD: 1.5). Obtaining higher scores in the paediatric (ORu2009=u20091.2) and dental (ORu2009=u20091.3) domains, and a greater willingness to receive OHC information (ORu2009=u20095.3), were associated with a positive attitude toward OHC. Nurses with a lower education (ORu2009=u20091.9) and better oral health behaviour (ORu2009=u20091.1) as well as those working in a non-affluent region (ORu2009=u20091.6) had a more positive attitude toward OHC.ConclusionPrimary care nurses’ low level of knowledge in OHC and their positive attitude and willingness to obtain more information point to the need for appropriate OHC training and encouragement for the nurses to promote oral health and prevent dental diseases.

New oral health literacy instrument for public health: development and pilot testing

AIMnThe aim of the present study was to develop a functional oral health literacy (OHL) instrument for adults, including new measures of literacy skills (OHL Adults Questionnaire: OHL-AQ).nnnMETHODSnAn item pool was provided, and an expert panel evaluated the items by assessing the content validity index and content validity ratio. The reliability analysis, including internal consistency and reproducibility, were examined using Cronbachs alpha coefficient and intraclass correlation coefficient (ICC). In addition a known-groups comparison was performed to assess how well the questionnaire discriminates between individuals who differ in education and brushing behavior.nnnRESULTSnA total of 97 participants were studied. The mean age of the participants was 36.3 (standard deviation [SD]xa0=xa012.8) years; 34% had more than 12xa0years formal education. Overall, 39.2% of interviewees had inadequate, 16.5% had marginal, and 44.3% had adequate OHL. The internal consistency, as measured by Cronbachs alpha, was found to be 0.72, and the ICC was 0.84. Participants who brushed more frequently had significantly higher OHL scores (Pxa0=xa00.03). The association between OHL scores and years of education was also significant (Pxa0<xa00.001).nnnCONCLUSIONnThe OHL-AQ is a valid and reliable measure of functional OHL, with additional sections for evaluating listening and decision-making skills.

Effectiveness of two interactive educational methods to teach tobacco cessation counseling for senior dental students

Objective: Nowadays, one of the major health problems in many countries is tobacco use. Dental professionals are in a unique position to promote smoking cessation since they have the opportunity for regular interaction with their patients. The purpose of the present study was to compare the effectiveness of two educational methods to teach tobacco cessation counseling (TCC) in dental practice for senior dental students. Materials and Methods: In this interventional study, 93 eligible senior dental students from two dental schools in Tehran, Iran were randomly divided into two groups. Two educational programs, role play (RP) and problem-based learning (PBL), with the same aim about TCC in dental practice, were developed and implemented for the two groups. The score of knowledge, attitude, and skill were determined in both groups before and after participation in the course using a questionnaire. The changes in the scores from pre- to post-test were statistically analyzed using repeated measure ANOVA test. Results: Total scores of knowledge, attitude, and skill of the participants showed improvements when compared to scores before training (P < 0.001, P = 0.003, and P < 0.001, respectively). However, the differences between the two study methods were statistically insignificant (P > 0.05). Conclusion: The results suggested that TCC training through RP and PBL methods leads to improvement in knowledge, attitude, and skills of dental students in the short-term evaluation.