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Researchers have revealed the advantages of experiential learning for students and professionals at all levels of the health care delivery system. The purpose of this study is to determine the effectiveness of the use of head simulators in dental school in acquiring proficient periodontal knowledge, dental skills, and confidence by practicing oral health professionals. Of the 117 purposive sampled participants surveyed using a 5-point Likert scale questionnaire, 60 respondents used head simulators during their dental school education. On the effect of the head simulator enhancing knowledge. The findings regarding the effect of the head simulator in dental school revealed varying perspectives. A significant majority of participants agreed the head simulator had a beneficial effect on their skills. Among these findings, a third of participants strongly agreed the use of the head simulator notably enhanced their skills. When considering the influence on knowledge, the responses were more evenly distributed. Almost 40% of participants agreed the head simulator positively affected their knowledge, while almost 20% of participants generally disagreed. Examining the effect on confidence, findings also depicted varying viewpoints among the participants with 42% acknowledging the head simulator had a positive effect on their confidence. The findings suggest that head simulators positively affect dental education, particularly in enhancing knowledge, skills, and confidence.

Purpose: To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD. Methods: A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression. Results: Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721). Conclusion: Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD.

Fluoride hesitancy is a growing public health challenge and interventions to address it may need to be tailored for minoritized subgroups to address oral health inequities. The goals of this qualitative study were to investigate the extent to which an existing conceptual model on topical fluoride hesitancy is applicable to Latino parents and whether applicability differed between Spanish-speaking Latino (SL) and English-speaking Latino (EL) parents. We conducted semi-structured one-on-one interviews with non-Latino English-speaking parents (N = 50), SL parents (n = 8), and EL parents (n = 8). We coded the transcripts deductively and compared our findings both qualitatively and quantitatively to an existing model on topical fluoride hesitancy comprising 21 categories classified into six domains. We compared frequencies across model domains and categories for Latino versus non-Latino parents as well as for SL versus EL parents. Latino parents were represented across all six domains and 21 categories of the conceptual model. Comparing Latino and non-Latino parents, representation was similar across Domains 1 to 3 (necessity, chemicals, and harm); Latino parents were more highly represented in Domains 4 to 6 (uncertainty, pressure, and choice) compared with non-Latino parents. A larger proportion of EL parents thought a healthy diet was more important than fluoride (Category 1d) and a larger proportion of SL parents felt they did not know enough about fluoride (Category 4a). An existing conceptual model on topical fluoride hesitancy was generally a good fit for SL and EL parents. However, differential representation across model categories suggests that fluoride-related communication and intervention approaches may need to be tailored to Latino parents based on language preference.

Children vary in how sensitive they are to experiences, with consequences for their developmental outcomes. In the current study, we investigated how behavioral sensitivity at age 3 years predicts mental health in middle childhood. Using a novel repeated measures design, we calculated child sensitivity to multiple psychological and social influences: parent praise, parent stress, child mood, and child sleep. We conceptualized sensitivity as the strength and direction of the relationship between psychosocial influences and child behavior, operationalized as toothbrushing time, at age 3 years. When children were 5-7 years old (n = 60), parents reported on children's internalizing and externalizing problems. Children who were more sensitive to their parents' praise at age 3 had fewer internalizing (r = -0.37, p = 0.016, p[subscript FDR] = 0.042) and externalizing (r = -0.35, p = 0.021, p[subscript FDR] = 0.042) problems in middle childhood. Higher average parent praise also marginally predicted fewer externalizing problems (r = -0.33, p = 0.006, p[subscript FDR] = 0.057). Child sensitivity to mood predicted fewer internalizing (r = -0.32, p = 0.013, p[subscript FDR] = 0.042) and externalizing (r = -0.38, p = 0.003, p[subscript FDR] = 0.026) problems. By capturing variability in how children respond to daily fluctuations in their environment, we can contribute to the early prediction of mental health problems and improve access to early intervention services for children and families who need them most.

Background: Children with intellectual and developmental disabilities are at a higher risk of developing dental caries. Few scoping reviews have been conducted in India to understand their issues. We aimed to summarise the distribution and risk factors of dental caries among children and adolescents with intellectual disabilities in India. Methods: A scoping review was conducted based on the Arksey O Malley framework. Quality assessment of studies, descriptive and thematic analyses were also conducted. Results: We charted, collated, and summarised from four databases. Thirty-one studies met the study criteria consisting of children and adolescents with intellectual disabilities. Median caries prevalence was 70%, decayed missing and fIlled permenant teeth (DMFT) was 2.4, decayed missing and filled decidous teeth (dmft) was 2.36, and DMFS was 3.7. Major determinants were the severity of disability, socioeconomic status and parents' education. Oral care and dental visits were inadequate. Conclusion: Further exploration is required to improve access and reduce caries experience and prevalence among children with intellectual and developmental disabilities in India.

Background: Toothbrushing, limiting intake frequency, and scheduled visits to an oral healthcare professional (OHP) are key for good oral health. We aimed to explore factors influencing these oral health behaviours in Dutch adolescents with mild to borderline intellectual disabilities (MBID) in residential care. Method: Using a qualitative, descriptive approach, we conducted focus groups and interviews with 12 adolescents, 9 counsellors, and 6 OHPs. Thematic analysis mapped factors influencing adolescents' knowledge, attitude, planning, and execution of oral health behaviours to oral care stakeholders. Results: Of nine identified influencing factors, three were pivotal: Structure (influencing toothbrushing and intake frequency), Anxiety (impeding dental visits), and Support (provided by counsellors). Conclusions: Counsellors should provide structured daily guidance on oral hygiene and diet for adolescents with MBID, while respecting the adolescents' autonomy. As intermediaries between adolescents and OHPs, counsellors are key in reducing dental anxiety. Counsellors need clear oral health policies within care facilities to address competing priorities.

Background: Chewing difficulty, poor oral health, inadequate and imbalanced nutrition are serious health problems in individuals with intellectual disabilities. The participants' chewing abilities, oral health and nutritional status were analysed in this study. Methods: Forty-five adult participants with intellectual disabilities were included. Anthropometric measurements, oral health assessments, chewing ability evaluations and dietary intake analyses were conducted. Results: A 56.8% of the participants were classified as overweight or obese. Teeth grinding was reported in 33.3% of the participants, while 40.0% experienced drooling. All participants with Down syndrome and 58.6% of the participants with developmental delay had chewing difficulties. Inadequate nutrient intake was observed and the fibre, vitamins B1, B3, B9, sodium, phosphorus and iron intakes were significantly lower than reference values in those with chewing difficulty (p < 0.05). Conclusions: Chewing difficulties were associated with lower intake of certain nutrients, highlighting the importance of addressing oral health and dietary counselling in this population.

An eBook for Oral Health Literacy© curriculum was used as a brief intervention to help school-aged children use their functional health literacy skills of reading, writing, and speaking to learn about oral health hygiene and the importance of choosing healthy food and beverages for their teeth. The curriculum focused on building functional knowledge about oral health hygiene and nutrition behaviors through a health literacy intervention that highlighted the need for reasoned actions when setting food goals for healthy teeth and making decisions to keep teeth healthy and strong. The aims of the study included: (1) determining what children learned about their teeth from two chapters of the eBook for Oral Health Literacy© curriculum and what they remembered from reading the oral health and nutrition stories; (2) determining whether children liked to read and what they liked about the words and the pictures of the stories; and (3) determining whether children brushed their teeth in the morning and at night; had any cavities; had teeth or mouth pain; and visited the dentist every six months for a dental checkup. The visual textual narrative helped children to build a vocabulary about oral health when reading and writing about health. Children wrote about words and phrases that they recalled after reading each chapter. Their elaborations exemplified the importance of using a constructivist theoretical framework to elicit children's functional health knowledge about oral health and nutrition. Chi-square results showed that there was a moderate significant correlation between children who reported brushing their teeth in the morning and having been to the dentist in the past year (p = 0.021).

This study aimed to conduct a scoping review to know children and adolescents' main oral health concerns with Autism Spectrum Disorder (ASD) and thus identify any oral characteristic that stands out, aiming at preventive and interceptive clinical conduct. A search was performed in the three electronic databases and the gray literature; in September 2021. A total of 562 studies were identified, and after applying the eligibility criteria, 73 articles were included in the synthesis of this scoping review. The mean decayed, lost, and restored teeth index (DMFT/dfmt) ranged from 0 to 12.37; the mean DMFT index (permanent dentition) from 0.06 to 6.2; and the average dmft index (deciduous dentition) ranged from 0.29 to 9.91. The mean simplified oral hygiene index (OHIS) ranged from 0 to 3.4; gingival index (GI) from 0.29 to 2; and plaque index (PI) from 0.005 to 3.15. Plaque prevalence was 25.9% to 90%; dental calculus from 4.7% to 59.41%; gingivitis from 36.7% to 100%. Bruxism was 10.3% to 73%, and dental trauma was 4.7% to 100%. This disparity in the results shows the heterogeneity of this population, with different degrees of socio-behavioral impairment, which can directly influence oral hygiene and the consequent accumulation of biofilm.

The aim of this pilot study was to assess the efficacy of a desensitization program developed by dentists and occupational therapists, targeted at autistic adults, to encourage their cooperation in the dental setting. The study group consisted of 18 individuals with autism (10 men and 8 women, aged 18 - 45 years). The patients underwent a baseline examination, after which they were progressively exposed to oral examination maneuvers and ultimately dental procedures. To this end, the participants engaged in a weekly desensitization session performed by an occupational therapist and a monthly assessment session by a dentist applying the Frankl scale, for a maximum period of 30 weeks. During the first session, 44% of the participants completed all oral examination procedures, reaching 94% by the fourth visit and 100% by the seventh visit. None of the participants completed a simple dental treatment up to the third session, subsequently increasing the percentage progressively until reaching a maximum of 61% in the seventh visit. In conclusion, a dental desensitization program implemented by dentists and occupational therapists could help in performing oral examinations and simple therapeutic procedures for a considerable percentage of adults with autism, without having to resort to pharmacological behavioral control techniques.

This study aims to evaluate the video modeling technique during the dental appointment. A blinded randomized clinical trial was composed of 2 groups, consisting of 20 autistic children (4 to 12 years) in each group: control (did not watch the video before the consultation) and intervention (watched the video before the consultation). The primary outcome was the mean number of visits to perform a dental appointment. The number of consultations was analyzed by T-test or Mann-Whitney test. The results showed that the mean number of consultations in the intervention group was 1.5 (± 1.53) and in the control group 2 (± 1.77) (p [less than or equal to] 0.05). The video modeling technique can be effective in minimizing the number of dental consultations in autistic children.

Background: School-based dental sealant programs are noted to increase sealant uptake among children, especially those from low-income families and those living in rural and underserved areas. However, nationally school-based dental sealant programs are substantially underutilized. This paper describes a partnership approach to a school-based dental sealant program for Title 1 public schools in Hawaii. Methods: The Hawaii Keiki--Healthy and Ready to Learn program partnered with the Hawaii Dental Service to develop and implement an interprofessional, school-based sealant program (SBSP). This article describes the development of key factors, such as partnerships, an interprofessional team, team roles, policies, and marketing tools to optimize program success. Results: The SBSP has completed over 3 academic years of implementation in Hawaii public schools. In its initial year (school year [SY] 2019-2020), which presented challenges due to the COVID-19 pandemic, it served 6 schools (106 students screened) on 1 island. It expanded to 14 schools on 1 island (193 students screened) in its second year (SY 2020-2021), 28 schools on 3 islands (653 students screened) in its third year (SY 2021-2022), and during the Fall of the fourth year, the program reached 50 schools on 3 islands (1821 students screened) and is projected to reach over 70 schools by the end of SY 2022-2023. Conclusion: Taking advantage of strategic partnerships and key interprofessional team members, a school-based dental sealant program can help to improve the oral health of children in public schools by helping to decrease barriers to care.

Background: Dental caries (cavities) experience is prevalent in US children, and national data show rates to be increasing among young children. Disparities are found for those in the low-income and non-Hispanic Black and Hispanic/Latinx groups. Use of caries prevention, specifically dental sealants, is low, even among school-based programs. Contributions to Theory: A population health management (PHM) framework may support targeted school-based case management to reduce oral health disparities. PHM-oriented tools were applied to a school-based oral health intervention and developed into a conceptual model. From 2014 to 2019, Chicago-based Oral Health Forum (OHF) developed a case management intervention in schools, utilizing PHM tools. Through programmatic and school-based partnerships, the PHM tools informed intervention to incorporate community-based organizations, case management staffing, oral health education, targeted community outreach, and Community Dental Health Coordinators' training. Conclusions: Through a PHM framework, school-based oral health partnerships targeting high-need children was implemented. Use of PHM tools in school-based health programs should be considered in other high caries schools.

Background: Dental caries (tooth decay) is the world's most prevalent noncommunicable disease and can lead to pain, infection, and edentulism. Many children with caries lack access to traditional dental services. School-based caries prevention can increase access to care and reduce health inequities. Disruptions in school-based care due to pandemic control policies may result in children losing access to their primary dental care option. Methods: The CariedAway project was a school-based caries prevention program in operation from 2019 to 2023 in urban schools with a high proportion of low-income, minority students. Program operations were suspended for 2 years due to the COVID-19 pandemic. We estimated the prevalence of untreated decay, swelling, fistula, and pulpal involvement in participants at baseline and again after restrictions were lifted. Results: A total of 2998 children between the ages of 5 and 13 years were enrolled and received preventive care prior to pandemic shutdowns, and 1398 (47%) completed a follow-up observation after 2 years. At baseline, approximately 30% had untreated caries on any dentition, 11% of children presented with evidence of dental sealants, and no participants had swelling, fistula, or pulpal involvement. After 24 months, 12% of participants had swelling fistula, or pulpal involvement that was not treated during the pandemic period. Conclusion: There are considerable unmet dental needs in high-risk children that may be further exacerbated by a lack of access to care during disease outbreaks.

By 2040, more than one in four Europeans is expected to be over 65. Despite improvements in older patients' care, oral healthcare is still neglected. One of the major obstacles could be the negative representations associated with aging: ageism. The present study aims to quantify and qualify ageism for general and specific representations of aging associated with the mouth of an older patient compared to a young patient in dental students. Undergraduate students at the French dental school of Clermont-Ferrand were invited to participate in the study. Ageism was quantified by asking the students to estimate how many older adults have some negative conditions, which were then compared to real data. Representations of the mouth of a young vs. an older adult were collected by asking each student to write the first five words that came to their mind when they thought about the mouth of a young person and then the mouth of an older person. The students exhibited a large overestimation of health problems in the older adult population. The words given for a young adult were positive 49% of the time (vs. 23% negative), whereas 69% of the words were negative for an older adult (vs. 8% positive). The students in the second year were less negative than students in higher years. Our study contributes to assessing how dental students could exhibit implicit ageism. They show very negative representations of aging from the beginning of their training, which get even worse after they are exposed to clinical training with older patients.

Sleep problems are common in autistic children and adversely impact daytime functioning. Knowledge of predictive factors could help with treatment and prevention of these problems. This study aimed to determine predictors of sleep problems among young autistic children. Study cohorts consisted of autistic children aged 2-5 years who did not have sleep problems at a first visit and had sleep measure data available at a subsequent visit. Sleep problems for five study cohorts were defined by different methods: Children's Sleep Habits Questionnaire with two cutoff scores (41 and 48; cohort n = 101 and 204, respectively), Children's Sleep Habits Questionnaire--autism derived cutoff score (35; n = 188), and parent- (n = 205) or clinician- (n = 252) report. Separate predictive models of sleep problems were developed in each cohort using multivariable logistic regression with final model predictors determined by backward elimination selection. Model performance was evaluated. Two of the five models had both adequate discrimination and calibration performance predicting (1) Children's Sleep Habits Questionnaire score [greater than or equal to] 48 and (2) Children's Sleep Habits Questionnaire--autism score [greater than or equal to] 35. In both models, self-injurious behavior, sensory issues, dental problems, and lower primary caregiver education level were significant risk factors of future sleep problems. These predictors may be useful in helping clinicians provide prevention strategies or early intervention for children who are at a higher risk of developing sleep problems.

The oral health of people with intellectual and developmental disability is poorer than that of the general community. Any solution for people with intellectual and developmental disability living in residential services needs to include disability support workers (DSWs). Previous studies have used either didactic or train-the-trainer approaches to enhance DSW knowledge and skills. Taking a different approach, a novel program used DSWs as embedded oral health champions. This model provided educational opportunities for DSWs to learn about good oral health and then share with peers and provide benefits to people with intellectual and developmental disability that they support. Interviews with a sample of these champions were conducted and analysed using content analysis. Findings suggest that DSWs are capable of affecting change with the right type and depth of training, management and organisational support. A DSW-led champions model has merit, however requires ongoing expert support to help maintain and sustain benefits over time.

A randomized controlled trial established initial efficacy of a novel parent training (PT) intervention for improving oral hygiene and oral health in underserved children with ASD (Fenning et al., 2022), a population at risk for unmet dental needs. The present study describes our emic approach to PT development alongside treatment outcome data examining feasibility, acceptability, and engagement. Families with Medicaid-eligible children with ASD ages 3 to 13 years (85% male, 62% with intellectual disability) were assigned to receive PT (n = 60) or a psychoeducational toolkit (n = 59). Results indicate strong retention, fidelity, and adherence, with quantitative and qualitative metrics revealing high treatment satisfaction and utilization. Discussion focuses on implications for individualizing treatment to optimize engagement of underrepresented families.

This study aims to raise awareness of dental health and care activities with pre-school children and cause desired behavioural changes in children, is basic qualitative research. The study group of the research consisted of 13 children studying in a pre-school class according to convenient/easily accessible sampling, which is one of the non-random sampling methods. For the research, data were collected through observations, interviews and research diaries, and the results were obtained by applying descriptive analysis by the researchers. For the research, data were collected through observations, interviews and research diaries, and the results were obtained by analyzing them by the researchers. In this direction, according to the descriptive analysis results obtained from the semi-structured observation form, it was seen that the preschool dental health activities increased the awareness of the children about the tools and equipment used in dental health, and thus gave the children an important tooth brushing routine. According to the descriptive analysis of the structured observation form and research diaries, the tooth brushing routine continued in the follow-up period after the application and became a behavior in children. In line with these results, suggestions were made for future studies.

Hygiene education is becoming increasingly popular and is now addressed in both formal and informal education systems. Examining hygiene education research and developing a vision for the future will lead to creating a roadmap for future research as well as an analysis of past research. Research on hygiene education encompasses a variety of subtopics. It is critical for future researchers and thematic studies in this area to determine if there is a pattern to these concerns that cover a wide range of topics. The purpose of this study is to examine the topic of hygiene education using bibliometric analysis. From the Scope Database, 503 records remain for bibliometric analysis. This results in an average number of 5.02 publications per year. 1973 people contributed to the study. Among the top 10, most influential sources in terms of the number of articles are four websites related to dental hygiene. The United States leads the world in both the number of publications and a total number of citations, followed by Canada and China. Most of the research was related to oral hygiene education.

Oral health is a very critical component of individuals' physical and psychological well-being. The present study aimed to investigate the dental health knowledge, attitude, and practice among schoolchildren in Abha. A cross-sectional epidemiological study was conducted. Each student completed a questionnaire regarding oral health. The participants were 800 students: 54.8% were male and 45.2% were female. Knowledge scores showed that -59.1% of the participants have fair knowledge. Statistically significant results were found between the age, school type, and students' educational level with the knowledge of oral health care (p < 0.05). More than half of the participants had positive attitudes (57.2%) and less than half demonstrated satisfactory oral health habits (45.3%). Students' educational level was significantly associated with attitudes and practices (p < 0.05). It can be concluded that the average knowledge, attitude, and practice level was 53.9%, which is not a positive indicator and needs to be strengthened.

Children and adults with developmental disabilities often experience oral health problems such as excessive plaque accumulation and dental restorations related to caries. Researchers have examined the efficacy of a variety of behavioral intervention packages to teach preventative strategies (brushing, flossing) and to decrease challenging behaviors such as aggression and non-compliance associated with dental examinations and restorative procedures for both typically developing and persons with IDD. This paper reviews these peer-reviewed studies for both typically developing individuals and those with developmental disabilities (e.g., intellectual disability and autism). Additionally, this paper highlights areas for future research, makes recommendations related to the integration of behavior analysis with the practice of dentistry, and provides recommendations related to clinical practices and research.

The aim of this study was to investigate the oral health status and quality of life (QOL) of the parental caregivers of individuals with Down syndrome (DS), and to evaluate whether there is an association between these variables. The sample of this cross-sectional study was composed by parental caregivers of children with DS (CCDS) and parental caregivers of children without DS (CNDSC). Oral examination was undertaken and a questionnaire was given to participants. QOL was evaluated by WHOQOL-Bref. CCDS presented a higher number of dental prosthesis users and higher gingival bleeding index compared to CNDSC. When oral health was associated with QOL, the use of dental prosthesis was associated with physical domain and the variables having chronic disease and family income were associated with the social domain for both caregivers. The results suggest that caregivers of children with DS have similar oral health and QOL compared to caregivers of children without DS. In both caregivers, oral health status is associated with QOL.

The purpose of this preliminary study was to identify oral problems and promote a healthy lifestyle at gimnazial school pupils, from a Romanian disadvantaged area. We wanted to identify the progress made by pupils following theoretical or practical interventions. Thus, along with the theoretical notions transmitted, either in the optional course of Health Education, to 6th grade pupils, or in Biology lessons, to 7th grade pupils, the new factor brought was the reinventing of the visit method, by extending the documentary feature, with that of practical applicability, extremely useful for participants coming from rural environment. Theoretical elements have been presented to all pupils. Additionally, at the 5th grade pupils, we added a practical intervention, respectively a dental control made during a visit to the dentist. Both through theoretical and practical methods, pupils have made progress concerning intellectual and practical skills in oral hygiene, which are essential to a healthy and responsible behavior. The visit at the dentist's office, the identification of the oral diseases, the recommendation and the treatment offered contributed decisively awareness of the importance of oral disease prevention, but also to identifying concrete solutions, connected to food, regular visits and correct brushing.

Objective: To assess US college students': (1) oral health behaviors; and (2) interest in university-based oral health information and services. Participants: Students at a large public university in the southeast participated in the survey (n = 102). All participants were over the age of 18 and able to speak and read English. Methods: An online quantitative survey was administered to collect information on oral health behaviors, interest in university-based oral health information and services, and sociodemographic factors. Frequencies, descriptive statistics, and bivariate analyses were utilized for this study. Results: Approximately 11% of students rated their oral health as fair/poor and 27% currently had a dental problem. Over half (53%) were interested in receiving oral health information from the university, 87% felt campus-based dental services were important, and 79% were likely to use campus-based dental services. Conclusions: College students may benefit from information and services to promote oral health within the college context.

Background: Oral health is fundamental to overall well-being. As teens are at high risk for tooth decay, we require a unique approach to motivate them to maintain oral health. Methods: Sixty-four adolescents (10-13 years) were recruited from 2 schools. Oral health education was based on cooperative learning guided by the social determination theory (SDT) principles. Students' oral health knowledge and oral self-care skills were assessed at baseline (before education), 3 weeks, and 6 months after the education. Results: Complete data were available for 51 students (follow-up rate 79.7%). There were significant (p < 0.001) changes in the mean (SD) toothbrushing score from 10.1 (±6.3) (baseline) to 26.5 (±6.0) (follow-up 1) and to 28.1 (±5.3) (follow-up 2). The mean (SD) tooth brushing time significantly (p < 0.001) increased from the baseline of 84.0 (±43.5) to the first follow-up to 107.0 (±39.8) and to 102.3 (±33.1) at the second follow-up. The mean (SD) diet knowledge scores significantly (p < 0.001) increased from 8.2 (±2.1) at the baseline to 10.2 (±2.7) at the first follow-up and remained the same at the second follow-up. Conclusion: Social determination theory-guided cooperative learning was efficient in improving student oral health-related knowledge and oral self-care skills, and this improvement was maintained for 6 months after the discontinued education.

Background: This study investigates the use of health and dental care services in adults with intellectual disability in the last 12 months according to Norwegian recommendations and in relation to age and intellectual disability levels. Method: A cross-sectional community-based survey including 214 participants (56% men). POMONA health indicators were used for data collection. Results: Health checks and contact with general practitioners in the last year increased with age but were less frequent in those with more severe intellectual disability. Hospital admissions were age independent. Less than one-fifth of women had undergone cancer screening, with small variations according to intellectual disability severity levels. Few had an individual plan. More than one-third experienced poor dental health despite frequent controls. Conclusions: The use of health checks was lower than recommended, especially in individuals with more severe intellectual disability. Service access and individual plan use need to be enhanced, and dental care services should be improved.

The importance of an integrated health promotion program has been proposed in recent years. However, the traditional program with lectures might decrease the effectiveness of learning. A game-based learning program provides a supportive social environment and further increases the quality of life and positive emotions. The present study evaluates the effectiveness of the proposed game-based health promotion program, KABAN!, to enhance health literacy, positive emotions, and quality of life for older adults. The proposed intervention included physical exercises, nutritional knowledge, social interaction, cognitive training, and oral health care skills. All activities were designed based on the gamification principles and experiential learning theory. Both qualitative and quantitative data were collected from participants and instructors. A total of 221 older adults were randomly recruited (age: mean = 71.1, SD = 7.1) as participants. To gather feedback on program implementation, 22 experienced instructors were selected based on the criteria of leading five or more sessions. Health literacy, quality of life, and emotional states before and after participation were collected. The instructors were invited to provide constructive feedback through open-ended survey questions. Analyses revealed that health literacy levels, positive emotions, and quality of life significantly increased after participation, while negative emotions remained identical. Further investigation of qualitative data via the constant comparison method showed positive feedback on instructors' perceived changes in participants. This study showed that participation in health promotion programs like KABAN! significantly enhanced older adults' health literacy, quality of life, and positive emotions.

This study aimed to identify factors, particularly positive parenting styles, associated with unmet dental needs, defined as no dental visit for the past 12 months, in children with developmental disabilities (DD). Participants included 263 primary caregivers of children with DD. Children exposed to less positive parenting styles were more than two times (aOR, 2.19, 95%CI, 1.12-4.32) more likely to have unmet dental needs. Children who were male (aOR, 1.88, 95%CI, 1.04-3.41), aged < 4 years (aOR, 2.95, 95%CI, 1.2-7.27) or aged [greater than or equal to] 11 years (aOR, 2.65, 95%CI, 1.25-5.64), had higher illness severity (aOR, 2.04, 95%CI, 1.09-3.81), had primary caregivers with less than or equal to high school education (aOR, 2.45, 95%CI, 1.13-5.30) were also more likely to have unmet dental needs.

Disability constitutes a significant health problem in the Kingdom of Saudi Arabia (KSA). Research assessing the health needs of people with disabilities in KSA is scarce. This study aimed to assess what physical and hearing disable persons need from healthcare services and to investigate difficulties in accessing these services in the Jazan area. A cross-sectional survey was conducted among hearing and physical disable persons between July, 2018, and May, 2019 in Jazan region, KSA using a modified Arabic-translated version of the validated Southampton Needs Assessment Questionnaire (SNAQ). Two hundred and eighty-nine hearing and physical disable persons completed the questionnaire with a response rate of 63%. Around half of the participants encountered difficulty in accessing appropriate healthcare services. More than half had difficulty obtaining mental healthcare, dental care, preventive periodic screening care, or medical care at home. Although 37.6% of the participants had previously received regular chronic disease care for diabetes, hypertension, or asthma, 52% reported difficulty obtaining medicine for such diseases, and 46.5% reported difficulty getting seasonal vaccinations such as the influenza vaccine. Finding specialized doctors or dentists using specialized means of communication was a struggle for over 50% of the participants. There is a need to optimize society for people with physical disabilities and improve access to healthcare facilities.

Background: This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self-reported school performance (SRSP) in adolescents enrolled in public schools in Brazil. Methods: This was a cross-sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self-administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self-rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models. Results: The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC. Conclusions: OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health-related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC.

Dental caries is a chronic oral condition that disproportionately affects low-income women. The aim of this research was to investigate relationships between dental nutrition knowledge, socioecological factors, and prevalence of dental caries in low-income women. This quantitative cross-sectional study involved 220 women who were recruited from Central Texas. Participants completed demographics, the Dental Nutrition Knowledge Competency Scale, United States Adult Food Security Survey Module, and the Multidimensional Home Environment Scale. Two dentists measured dental caries via the Decayed, Missing, Filled Teeth Index. Regression models were conducted to test the effects of dental nutrition knowledge and Multidimensional Home Environment Scale factors on dental caries. Finally, mediation analysis explored relationships between dental nutrition knowledge and dental caries, adjusting for Multidimensional Home Environment Scale scores. Results showed that dental nutrition knowledge and Multidimensional Home Environment Scale score were significantly associated with dental caries. Subscales of self-efficacy for eating healthy, oral hygiene practices, emotional eating, availability of unhealthy foods at home, and social support were related to dental caries. The relationship between dental nutrition knowledge and caries was mediated by Multidimensional Home Environment Scale scores. This research emphasizes the role of dental nutrition knowledge and socio-ecological factors on prevalence of dental caries. Public health interventions to reduce dental caries should involve strategies that increase dental nutrition knowledge and encourage behavior change in low-income populations.

Objective: This study aimed to compare the Dental Discomfort Questionnaire (DDQ) scores in children with and without intellectual disability (ID) and to measure correlation between the total DDQ and the Decayed, Missing, and Filled Teeth (DMFT/dmft) scores, as well as the condition of the tooth causing pain. Method: This cross-sectional study included 81 children with normal intellectual development who attended the Departments of Pediatric Dentistry at two Turkish Universities and 80 children with different levels of intellectual disability who reported dental pain in special education centers. The 12-question DDQ (Turkish version) was applied to the parents of the patients with their consent. The relationship of the DDQ scores with that of the DMFT/dmft, dental status, and demographic data was evaluated. Results: When the DDQ scores of children with intellectual disabilities were evaluated, it was found that the majority of the answers given to the questions were statistically similar (p < 0.05) to those of children with normal cognitive level. In the questions in which "pain when eating and brushing teeth" was evaluated, a higher score was obtained, which led to an increase in the total DDQ score (p < 0.001). There was a statistically significant difference between the groups in terms of the distribution of dental conditions (p < 0.001). When compared to the normal cognitive group, patients with mild and severe intellectual disabilities had more deep dentin caries, thoughy, frequent periapical abscess was less common in those groups (p < 0.001 and p = 0.022). There was no statistically significant relationship between DMFT scores. Conclusion: The DDQ was found to be a descriptive, functional, and easy-to-use questionnaire for children with intellectual disabilities in terms of detecting the presence of dental pain. No correlation was found between DMFT/dmft, dental status and DDQ scores.

Virtual reality simulation has had a significant impact on training of psychomotor surgical skills, yet there is still a lack of work on its use to teach surgical decision making. This is particularly noteworthy given the recognized importance of decision making in achieving positive surgical outcomes. With the objective of filling this gap, we have developed a system for teaching surgical decision making in the field of endodontics, by integrating a virtual reality simulation environment with a conversational intelligent tutor. This work presents SDMentor (Surgical Decision-making Mentor) -- the first intelligent tutoring system for teaching surgical decision making. In this paper we focus on presenting the intelligent tutoring component of the training system. The design of the system and the teaching approaches are driven by information gained from an observational study of clinical teaching sessions. The tutoring system represents surgical actions and the procedure using a variant of the planning domain definition language (PDDL). Tutorial interaction places emphasis on teaching the rationale for decisions, as well as aspects of situation awareness. We evaluated the quality of the tutorial content by comparing it with tutorial feedback from ten experienced human tutors. We had three expert dental instructors rate the appropriateness of the tutorial feedback given by the human tutors as well as SDMentor over 20 scenarios. Bayesian analysis showed that tutoring interventions of SDMentor were significantly better than interventions by human tutors. To determine whether the expert scores may have been influenced by raters' knowledge of whether interventions came from human tutors or SDMentor, we carried out a type of Turing test. Results show that the expert raters were able to correctly guess which interventions came from SDMentor only 15% of the time, compared to a random baseline accuracy of 9%.

Background: Tooth avulsion is a common cause of tooth loss. However, there is a significant lack of knowledge about dental trauma and the appropriate emergency procedures to handle these cases. Aim: The aim of this study was to evaluate the educational effect of notebook covers illustrated with figures and informative texts about tooth avulsion and replantation in sixth-grade primary school pupils. Material and Methods: Sixth-grade pupils of two public school participated in this study. An experimental group consisting of 134 pupils received notebook covers illustrated with figures and informative texts about tooth avulsion and replantation, while a control group of 108 pupils received notebooks with neutral covers. An assessment of the educational effects on pupils was performed after 9 months, with a standardized questionnaire normally used to evaluate dental trauma. Statistical analysis was conducted with SPSS 21.0 ([alpha] = 0.05) for group description and comparison using chi-square and Student "t" tests. Results: Compared with the control group, the experimental group showed statistically significant improvements in correct meaning of dental trauma (38% vs. 58.2%); procedures to follow in the case of dental avulsion (2.8% vs. 70.9%); storing the avulsed tooth in milk (18.5% vs. 76.9%); general knowledge about dental anatomy (61.1% vs. 95.5%); and the ideal time for the tooth to remain outside the mouth prior to replantation (20.4% vs. 59.7%). Conclusion: The use of notebook covers illustrated with figures and informative texts about dental trauma led to a significant increase in the knowledge of schoolchildren about tooth avulsion, first aid, and replantation.

Background: Health perception is a subjective predictor of long-term morbidity and mortality. Few studies address the perception that pregnant women have of their oral health. Objective: The objective of this study was to explore the relationship between socioeconomic factors and self-assessment of oral health in pregnant women from Cali, Colombia. Method: A cross-sectional study was carried out with a sample of 998 pregnant women, calculated using the formula to estimate a proportion in finite populations, with a confidence level of 95%. A questionnaire was applied for sociodemographic characterization, as well as to enquire about oral health perception, knowledge, and practices of oral health. Results: The mean age of the surveyed mothers was 24.7, with a standard deviation of 6.1, of which 23.6% were adolescents. The perception they had about their oral health status was considered good by 60.8%. Of the 82.9% who reported having attended dentistry, more than half perceived good oral health. Pregnant women with no history of oral problems, with a perception of medium or high income, and with good oral hygiene practices tend to have a good perception of their oral health. Conclusion: Pregnant women with no history of oral problems, with a perception of medium or high income, and with good oral hygiene practices tend to have a good perception of their oral health.