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This case-control study compared dietary sugar exposure and oral health status between children with and without Autism Spectrum Disorder (ASD), aged 5-12 years (n = 136, each). Data regarding socio-demographics, child's oral hygiene practices and behavior, diet-related behavior, oral habits and dental trauma were obtained. Child's diet on the previous day was recorded using 24-h recall method and sugar exposure was calculated using Dental Diet Diary (D3) mobile application. Oral Hygiene Index-Simplified (OHI-S), deft and DMFT were recorded. Results showed no significant differences in sugar exposure, deft and DMFT between the groups. Although oral hygiene practices were significantly better in children with ASD, their OHI-S was significantly worse. Significantly more children with ASD reported mouth-breathing, bruxism and self-injurious habits.

The main objective of the present review is to evaluate the knowledge and attitudes of physical education (PE) teachers concerning dental trauma first-aid through a systematic appraisal of the literature, meta-analysis and meta-regressions. The entire content of PubMed and ISI/Web of Science was mined. Eligibility criteria for selecting studies were studies evaluating dental trauma first-aid knowledge and/or attitudes and/or the effectiveness of mouthguards use by PE teachers. Articles written in any language and published or accepted by peer-reviewed journals were considered. Methodological quality was assessed using an adapted version of the Downs and Black instrument. Of 15 selected articles, three were of strong quality, three were moderate, and the remaining nine were rated as weak. The majority of studies showed that PE teachers had an inadequate knowledge of the initial management of dental trauma. Specifically, there was a lack of knowledge concerning an appropriate washing and transporting medium and the extra-alveolar period of an avulsed tooth. Due to the inadequate knowledge of PE teachers regarding dental trauma management, specific education should be added to PE classes to improve the emergency treatment of dental injuries.

Caries is a problem that often occurs in school-age children. Special Region of Yogyakarta is a province that has a high DMF-T index by 5.9 and exceeds the national DMF-T index. One of the efforts to improve dental and oral health of school-age children is the health education method using simulation methods, as well as simple techniques that may attract children's attention and be understood. The aim of the current study is to knowing the influence of oral and dental hygiene education intervention on dental and oral hygiene level at SD Negeri 3 Sleman students. This research used a kind of quasi experimental research with one group pretest posttest design. The research was done in SD Negeri 3 Sleman, the sample used was the 3rd graders from 57 students in 2017. The intervention was done by dental and oral hygiene education. Respondents were examined related to their dental and oral hygiene levels. It was measured by the PHP Index (Patient Hygiene Perfomance) before and after the intervention. According to results, The average score of respondents'dental and oral hygine pre test was 0.082 and the average post test score of respondents'dental and oral hygiene was 1.483. There is the difference of 1.4007. This shows an increament in oral hygiene of the respondent before and after the education. The results of statistical analysis show that there is an influence of oral and dental hygiene which pvalue 0.000. Thus, there is a need for dental and mouth hygiene education to be conducted regularly and delivered with an interesting method.

Background: Schools have a long history of delivering health services, but it is unclear how the COVID-19 pandemic may have disrupted this. This study examined changes in school-based health services and student needs before and during the pandemic and the factors important for delivering school-based health services. Methods: A web-based survey regarding the impact of the pandemic on school-based health services was distributed via email to all 1178 Virginia public elementary schools during May 2021. Results: Responding schools (N = 767, response rate = 65%) reported providing fewer school-based health services during the 2020-2021 school year than before the pandemic, with the largest declines reported for dental screenings (51% vs 15%) and dental services (40% vs 12%). Reports show that mental health was a top concern for students increased from 15% before the pandemic to 27% (P < 0.001). Support from families and school staff were identified by most respondents (86% and 83%, respectively) as very important for the delivery of school-based health services. Conclusions: Schools reported delivering fewer health services to students during the 2020-2021 school year and heightened concern about students' mental health. Understanding what schools need to deliver health services can assist state and local education and health officials and promote child health.

Purpose: The adenoids, or pharyngeal tonsils, consist of a pad of lymphoid tissue, located on the posterior pharyngeal wall of the nasopharynx. During childhood, the adenoid pad serves as a contact site for the soft palate to assist with velopharyngeal closure during oral speech. During adenoidal involution, most children are able to maintain appropriate velopharyngeal closure necessary for normal speech resonance. The purpose of this study is to determine age-related trends of normal adenoid growth and involution from infancy through adulthood. Method/Description: Lateral view magnetic resonance imaging was used to analyze velopharyngeal variables among 270 participants, between 3 months and 34 years of age. The velopharyngeal measures of interest included velar length, effective velar length, pharyngeal depth, adenoid height, adenoid thickness, adenoid depth, and adenoid area. Participants were divided into four age groups for statistical comparison. Results: There was a statistically significant difference (p < .05) in all linear and area measurements between the four age groups. Adenoid depth reached peak growth at age 4 years, whereas adenoid height and adenoid thickness peaked at 8 years of age. Qualitatively, adenoid growth progresses in an anterior and inferior direction whereas involution occurs in a posterior and superior direction. Conclusions: This study contributes to the knowledge of time specific changes across an age span for adenoid growth and involution and presents a visualization of the shape and growth trends of adenoids. A new sequence of involution is reported beginning first with adenoid depth, followed by adenoid height at a slightly faster rate than adenoid thickness.

Background: Dental caries is the most common chronic illness for children. Caries can reduce the quality of life, cause missed classroom hours, and decrease cognition. Strategies to improve children's oral health must be evidence-based, developed, and implemented in consultation with communities. Methods: A community-academic partnership was formed between East Carolina University School of Dental Medicine and the Bertie County Public School District to develop and implement a school-based oral health prevention program using the PRECEDE-PROCEED Model. Results: The PRECEDE component involved social, epidemiological, environmental, educational, ecological, administrative, and policy factors that informed the development of the oral health program. The PROCEED component consisted of implementation and evaluation. Conclusions: School-based oral health programs can increase access to care for vulnerable children and improve learning. The application of the PRECEDE-PROCEED model proved to be a valuable method for developing, implementing, and evaluating a school-based oral health program.

Literature reviews generally analyse and synthesis the evidence (or lack thereof) in a particular topic area and they are an increasingly popular form of scholarly activity. The scoping review is a popular literature review approach that has been adopted across the social and health sciences over the last fifteen years. With this upsurge in use, differences of opinion about how to analyse and report scoping reviews has also grown. Drawing on work carrying out a scoping review on oral health and child maltreatment, we put forward a structured approach to analysis and reporting of such reviews: the PAGER (Patterns, Advances, Gaps, Evidence for practice and Research recommendations) framework. In this article, we reflect on the strengths and limitations of the framework, drawing on examples, laying out the methodological processes, and making suggestions as to how it might improve reporting. The article makes a contribution to efforts that seek to improve the reporting and utility of scoping reviews in health and social research.

Background: Dental neglect results in dental caries, gum disease, and contributes to chronic diseases such as heart disease, stroke, diabetes, and cancers. Poor oral health habits developed in childhood persist into adulthood and can contribute to chronic diseases. School settings are a practical platform for teaching oral health skills. Purpose: The purpose was to assess the effectiveness of school-based, primary prevention oral health interventions for children and adolescents and to examine these programs for health behavior theory applications. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement and Checklist was used in reporting systematic review data. EBSCOhost database was utilized to search interventions by applying inclusion criteria. Data extraction occurred in four distinct phases to ensure all examined interventions met acceptable standards. Results: Eight interventions satisfied the inclusion criteria. Each study utilized oral health knowledge as an outcome variable. Two of the eight interventions stated that they utilized a specific health behavior theoretical framework. Each study applied health behavior concepts. Interventions were efficacious for improving oral health knowledge. Translation to Health Education Practice: Oral health education interventions in schools appear to be effective in providing dental skills and oral health knowledge.

The power of process drama as a dynamic tool for exploration and learning is well documented. Far less is known about its potency as a qualitative research methodology. This article aims to address that deficit, drawing on lessons learnt from a collaborative project investigating the causes of dental anxiety in children. It argues that process drama can serve as a democratic methodological tool that invites multiple ways of knowing. It reconsiders process drama as an art form that has hitherto been overlooked by researchers committed to pursuing participatory methodologies with children that encourage distributed power-sharing and co-produced knowledge.

Background: Dental diseases are associated with chronic health conditions and decreased psychological and sociological wellbeing. Young adulthood presents a pivotal stage as dental hygiene behaviors developed and practiced during this time persist into later life. The Theory of Planned Behavior (TPB) is a commonly used theoretical framework to examine intention to engage in dental behaviors. Purpose: To systematically summarize research studies using TPB questionnaires to assess predictive factors of oral hygiene behaviors among young adult populations. Methods: A four-phase article identification process ensured articles met the inclusion criteria. Quality appraisal assessments were used to evaluate questionnaire construction methodology. Results: Twelve articles met the study's inclusion criteria. Each study incorporated supplemental predictive factors such as oral health knowledge and expected social outcomes in addition to the TPB constructs. Discussion: Evidence from this systematic review suggests that TPB is a useful theoretical framework for designing questionnaires that assess dental hygiene behaviors of young adults. Translation to Health Education Practice: Health education specialists should administer oral hygiene behavior surveys that utilize TPB and TPB-related constructs to better understand factors associated with improved intentions toward dental hygiene behaviors among young adults.

Transgender youth face several comorbidities with oral health implications, including depression, harmful eating behaviors, and pharmaceutical side-effects. No information exists on how transgender youth view oral health or how they interface with oral health providers. The purpose of this study was to elicit experiences, knowledge, and perceptions of oral health among transgender youth and their caregivers. This was a qualitative study using in-person and telephone interviews with English-speaking transgender youth (12-24 years old), with and without their caregivers. Interviews were conducted using a semi-structured interview guide and transcribed verbatim. Statements from interviews were coded by theme. Recruitment ended when thematic saturation was reached, determined by investigators. 16 patients and 16 caregivers completed interviews. Overall, participants indicated no connection between transitioning and oral health. Many reported abandoning self-care, including oral health practices. Patients and caregivers alike did not prioritize disclosing transition-related information with oral health providers, despite uncertainty on the effects of related treatments on the oral cavity. At a time when transitioning youth may be in contact with health care providers more frequently and may be more inclined to share transition related details with them, the healthcare provider is uniquely positioned to encourage improved oral health emphasis and outcomes.

Visual pedagogy and social stories have been widely used to assist children with Autism Spectrum Disorder (ASD) in learning various skills. A toothbrushing visual pedagogy (TBVP) was developed adapting existing toothbrushing social stories for children with ASD. This TBVP consists of 13 toothbrushing steps with scripts describing the toothbrushing technique. To evaluate its feasibility, a review panel was formed to provide feedback on the TBVP and three other published toothbrushing social stories. Effectiveness of the TBVP was further evaluated among 119 preschool children with ASD with significant improvements in toothbrushing skills observed at 3-month and 6-month follow-ups. It is concluded that TBVP is a feasible and an effective educational means that assists children with ASD in learning toothbrushing skills.

Purpose: This study reports on how very old (VO) Finnish people without dementia perform in the Western Aphasia Battery (WAB) and two verbal fluency tasks and which demographic factors predict the performance. Method: The study included fifty 80- to 100-year-old community-dwelling Finnish speakers with no dementing illnesses or speech-language disabilities, who completed the WAB and two verbal fluency tasks. Multifactorial statistical analyses with recursive partitioning were carried out to determine the significant predictors out of five predictor variables (age, gender, education, dentition, and Mini-Mental State Examination [MMSE]) for four response variables (WAB Aphasia Quotient [AQ], Language Quotient [LQ], semantic, and phonemic word fluencies). Results: Overall, individual variation was notable in VO speakers. All predictor variables were statistically significantly associated with one or more of the language skills. Age was the most significant predictor; the critical age of 85-86 years was associated with a decline in WAB-AQ and semantic fluency. Poor dentition and the MMSE score both predicted a decline in WAB-LQ and phonemic fluency. A high level of education was positively associated with the skills of the best-performing individuals in WAB-AQ, WAB-LQ, and semantic fluency. Conclusions: VO age is a significant factor contributing to language performance. However, a younger age, a good cognitive performance, intact teeth, and a higher educational level also seem to have a preservative power as regards language skills. Gender differences should be interpreted with caution. The results of this study provide culture- and language-specific normative data, which aids in differentiating typical aging from the signs of acute or degenerative neuropathology to ensure appropriate medical and therapeutic interventions.

Dental treatment provided under general anaesthesia (DGA) is an expectation for many children and young adults (CYA) diagnosed with Autistic Spectrum Disorder (ASD). Planning and delivery of DGA requires consideration of morbidity and mortality risks and implications for families and healthcare services. One hundred patient records of CYA with special healthcare needs were analysed to examine characteristics and experience of DGA revealing that 79% of CYA had a diagnosis of ASD. Forty-seven percent of CYA diagnosed with ASD had at least one previous hospital admission for DGA. For 24% of this repeat DGA group, the previous DGA was within a two-year period. Results highlight a high rate of DGA and need to investigate more effective primary dental care strategies.

Education of oral and dental hygiene for elementary students is often constrained by the nature of children who are easily saturated, so that media and games need to be an interactive, interesting and fun simulation that entices their interest and curiosity in learning. The purpose of this research is to develop a web-based dental health ladder snake game for oral health education of the elementary school students in Indonesia. The analysis, design, development, implementation and evaluation model approach is applied and tested by material and media experts. In this study, the fifth grade elementary students were participated as a trial group, and they were asked to use the designed ladder snake game. Questionnaire about the feasibility of learning media ladder snake game using a Likert scale was developed. The feasibility test results showed that the material experts were 80% (very good), media experts were 75% (Good) and 83% (excellent) for elementary students.

The aim of this study is to evaluate the extent of awareness and practices of oral hygiene among undergraduate female students in a residential college of a university at Malaysia and to assess the need for awareness programs about oral hygiene. The study was carried out using a self-administered questionnaire. Hundred undergraduate female Malay students were selected as sample through convenience sampling. The results indicated that a majority of the respondents used toothpaste and toothbrush as primary tools for cleaning their teeth twice a day and was found that they had never used Miswak (a wooden teeth-cleaning stick made from tree twigs). They had adequate knowledge about periodontal and gingival health and were aware of the importance of visiting dentist regularly; however, most of them visited dentists when having a toothache. They had also reported need for organizing oral hygiene awareness programs by college administration and showed adequate oral hygiene knowledge and practices. Nevertheless, few inadequate practices were also identified which were being considered under oral hygiene along with lack of awareness programs being organized in college for which recommendations are suggested.

Background: In this paper, we describe the design, program details, and baseline demographics and oral health of participants in ForsythKids, a regional, comprehensive, school-based mobile caries prevention program. Methods: We solicited all Massachusetts elementary schools with greater than 50% of students receiving free or reduced-price meals. Six schools initially elected to participate, ultimately followed by over 50 schools. Interventions were based on systematic reviews and randomized controlled caries prevention trials. Participating students received semiannual dental examinations, followed by comprehensive preventive care. Summary statistics regarding oral health indicators were derived from individual tooth- and surface-level data. Results: Over a 6-year period, data were collected on 6927 children. The number of students per school ranged from 58 to 681. The overall participation rate was 15%, ranging from 10% to 29%. Overall, 57% of the children were younger than 8 years at baseline. Approximately, 54% of children experienced dental decay on any tooth at baseline; 32% had untreated decay on any tooth, 29% had untreated decay on primary teeth, and 10% untreated decay on permanent teeth. Conclusions: Untreated dental decay was double the national average, even in schools within several blocks of community dental clinics. These data demonstrate the need for caries prevention beyond the traditional dental practice.

Background: Tooth extractions are the most common cause of hospital admissions for children in England. Water fluoridation has the potential to reduce this number by 60%, is backed by the scientific and public health communities, and yet is currently consumed by only 10% of the population. Aims and objectives: This 'evidence-policy gap' is explored through Kingdon's 'multi-streams approach' which provides insights into the circumstances under which water fluoridation has made it onto the political agenda, the rationale underpinning opponent and advocate policy positions, and the role of the political arena in fostering or hindering policy action. Methods: Over 100 primary documents were reviewed to develop an understanding of the scientific and ethical arguments for and against water fluoridation, as well as to identify how they have all historically sought to mobilise their policy preferences. Eleven consultations were also conducted with stakeholders as part of the knowledge exchange process. Findings: The key finding of this research is that evidence is only likely to trigger policy change if it emerges into a receptive sociopolitical context. In substantiating this claim we identify evidence not of an 'evidence-policy gap' but of a more complex and multidimensional 'evidence-policy-politics gap'. Discussion and conclusions: The findings contribute to a range of debates in relation to--(1) the apparent irreconcilability of background ideas about what ought to form the basis of public health policymaking; (2) the presence of differing evidential standards that create an uneven playing field; and (3) the central underpinning role of politics in public health policymaking.

Aims were to: (1) investigate the parental difficulties toward their ASD children dental care and, (2) analyze factors influencing their access to such services. Questionnaires were completed by 142 mothers of ASD children. Children aged between 2.5 and 14 years old, with 3.9:1 male to female ratio. 68.3% perceived difficulties in finding dental care. Most barriers were: Cost (75.4%), finding a dentist to treat ASD child (74.6%), and behavior of their ASD child (45.1%). There was no difference among age and "difficulty finding dental care" (p = 0.429). Having medical insurance and previous bad experience showed significant effects on the difficulty in finding dental care (p < 0.05). Children with ASD and their parents encounter various barriers to dental services.

Oral health care can be a difficult experience for a child with Autism Spectrum Disorder (ASD), for their family and for the dentist. The purpose of this study is to provide an understanding of the challenges experienced by the three aforementioned figures during oral care treatment. A cohort of 275 parents of typical development children (TD), 57 parents of children with ASD (3-15 years old) and by 61 dentists, completed two different multiple choices questionnaires. The data obtained show a great difficulty in the treatment of children with ASD as seen by the dentists and by the parents. This is due to: caregivers' demographic issues; difficulties encountered before and during the dental examination; scarce presence of experts in ASD treatment.

Background: People with intellectual disabilities have worse health outcomes compared to their peers without. However, regarding oral health parameters, recent systematic reviews reported conflicting evidence. The aim was to assess whether adolescents with MBID differ from their peers in oral health and oral health behaviour. Methods: Ninety seven adolescents with MBID participated in this comparative study. Outcomes were compared to data of 17-year-old Dutch adolescents (n = 581) from a national epidemiological study on oral health and oral health behaviour. Results: Adolescents with MBID showed worse oral health outcomes and poorer oral hygiene than their peers from the general population. Furthermore, they visit the dentist less regularly, brush less frequently, eat main-dishes less frequently and have higher levels of dental anxiety. Conclusion: Adolescents with MBID have poorer oral health and show worse oral health-promoting behaviours than their peers in the general population. Targeted interventions to reach this vulnerable group are necessary.

Background: Individuals with intellectual disabilities (ID) may have difficulties in performing daily living tasks. Among other daily living tasks, independent oral hygiene is an essential life skill for people with ID. Materials and Methods: Four children with intellectual disabilities (two males and two females, ages 7-11) participated in the experiment. We employed the Kinect™ V2 sensor to gamify oral hygiene skill training. Specifically, a non-concurrent multiple baseline design was adopted to demonstrate the relation between game-based intervention and independent oral hygiene skills. Results: All students learned how to brush their teeth independently and maintained the skill 4 weeks later with the introduction of the game-based training. Social validity results showed the teachers and parents considered the video game was useful. Conclusions: The proposed Kinect-based video game might be used for effective training of elementary students with ID to improve oral hygiene independently.

The need for improved competency in the health care and caregiving workforce is shaped by several factors. These include demographic shifts, a shortage of trained geriatricians, lack of primary health-care providers with adequate training in geriatrics, and persisting unmet needs reflected by poor health status indicators of older Floridians. Geriatric education to meet the evolving needs of older adults is critical for primary care professionals, residents, and students to meet the ongoing shortage of geriatricians. Nova Southeastern University South Florida Geriatric Workforce Education Program delivered didactic education to two health-care systems involved with geriatric patient care. Participants of the educational program were fellows, primary care residents, and students. The objective of the training program was to build competencies to ensure that all providers have the knowledge and skills to provide care for older adults with chronic illnesses using didactic education on diabetes, oral health, and heart failure. We collected Pre-Post data through REDCapTM, a mature, secure web application for building and managing online surveys and databases. The results from the pre-post analysis indicate an increase in knowledge in all three geriatric modules. T-Test of Pre-Post education scores are significant for all three modules indicating a significant increase in knowledge with p < 0.05. Our study suggest that the educational intervention resulted in an improvement in the knowledge of the participants. Future studies should incorporate detailed knowledge assessments that suggesting an ongoing structured sustainable training program on geriatric issues.

Signature pedagogies are widely used in professional education to prepare students for the complex and unpredictable nature of professional work. We argue that assessment moments involving professional artefacts contribute to the evaluation and formation of professional knowledge, skills and moral understandings -- and thus to the signature of the pedagogy. The 'authenticity' these professional artefacts add to assessment is of particular relevance for understanding the pedagogic signature. Drawing on interviews from a professional study programme in dental hygiene, we employ sociocultural theories to analyse how different assessment moments are used to evaluate and develop students' competences of working with professional artefacts: dental radiographs. The findings show how the use of professional artefacts in three different assessment moments requires students to engage deeply with the epistemic, practical and moral dimensions of their profession. Our study contributes both empirical and conceptual insights to the field's understanding of the inner workings of signature pedagogies.

Background: Providing medical and dental care for adults with developmental disabilities requires specialised care that includes caregiver's perceptions of processes of care as integral to informing care delivery. Method: We examined the reach and efficacy of a medical-dental clinic serving adults with developmental disabilities as part of a program evaluation in the community setting. Using the RE-AIM framework, we analysed caregivers' perceptions of the processes of care and associations with sociodemographic factors and stress and depression levels. Results: Perceptions of the processes of care were correlated with caregiver stress levels. Low satisfaction with receipt of general and specific information suggests that care coordination should be prioritised. Conclusions: The ecosystem of care needs to be targeted in addition to services directed at the individual. Shared evaluation frameworks between service deliveries modalities would allow comparison of family-centred care delivery systems.

In this cross-sectional survey, this study aimed to determine the factors associated with oral health of elite athletes and to determine the clustering tendency of the variables by dendrogram, and to determine the relationship between predefined clusters and see how these clusters can converge. A total of 97 elite (that is, top-level performing) male handball players aged 18 to 29 years participated in the study. Two questionnaires with high validity scores were computed based on the results of the oral health of elite athletes (Geriatric/General Oral Health Assessment Index (GOHAI) and the Oral Health Impact Profile (OHIP)). The GOHAI mean and standard deviation score was 8.381 ± 3.988, indicating a low self-perception of oral health by the allocated sample The OHIP mean and standard deviation score was 11.25 ± 3.553, indicating a low self-perception of oral health by the allocated sample. OHIP shows low scores based on these results. According to the first sub cluster; dental floss, dental control, brushing, gingival health, age, dieting and education was found significantly related with these two indexes. The ratios of these variables were as follows: dental floss; 56.7%, dental control; 80.4%, brushing; 99%, gingival health; 96.9%, dieting; 94.8%, education; 100% and the mean age was 18.96 ± 3.731. These results indicate positive correlations among GOHAI and OHIP indexes and positive results for elite athletes included to the current study. As a result, the variables that affect the oral health of the athletes in the study based on multivariate analysis of the clustering results were observed to be healthy at the expected level. The relationships between variables with dendrogram by using hierarchical cluster analysis was discovered.

The purpose of the pilot study was to investigate whether an interactive online module improved third-year dental students' radiographic caries diagnosis abilities and conceptual understanding. Third year dental students were given online tutoring modules and assessed afterward to determine whether their diagnostic skills improved, whether they perceived and improvement in their diagnostic skills, and whether following the modules with interactive group discussions was a more effective teaching method. The choice to use the module was left to each individual. Thirty-one students completed an assessment consisting of three full-mouth series (FMX) radiographs of varying number and severity of carious lesions first individually and then in teams. Performance was evaluated quantitatively and qualitatively. A T-test analysis revealed that the students who accessed the module did not perform significantly better than students who did not access the module; however, a ?[superscript 2]-test showed that students who accessed the module correctly diagnosed yet over- and under-diagnosed more frequently. Survey responses showed that students believed the module helped clarify lecture topics. The online radiographic caries diagnosis module has introduced a promising and beneficial adjunctive resource for dental students.

Problem Statement: As a result of wars, starvation, traffic accidents, homicide, infectious diseases, insufficient adult protection, migration, and inadequate legal reforms the mortality rate of children has become a serious problem in the world. Protective health education contributes to a child's physical and social health. In this case, the main problem of research is "How does the production and applications of educational materials affect the protective health knowledge level of prospective preschool teachers?". Purpose of the Study: The aims of this study are, to increase the health knowledge level of prospective teachers, to produce protective health education materials for children and to experience the applications of produced materials with these children. Method: The present study was used partially mixed sequential equal status design model. The quantitative data from the protective health knowledge level test including 20 open-ended questions were combined with qualitative data from interviews who (n = 131) were the pre-school prospective teachers. The qualitative data that were gathered from face to face interviews with 22 of the sample group. The interventions of research including theoretical and production of protective health education tools took place 12 weeks then prospective teachers applied tools on children. Ttest and content analysis techniques were used to analyze the data. Findings: There was a significant difference in the protective health knowledge level test scores of participants (t (131) = 10.53, p<0.00) before and after the research. There was a significant difference between the mean values of pre-test and post-test results on the immunity (t (131) = 5.51, p<0.00), traffic (t (131) = 1.53, p<0.00), nutrition (t (131) = 6.38, p<0.00), hygiene (t (131) = 5.83, p<0.00), mental health (t(131) = 4.05, p<.00). There was no significant difference between the mean scores of the pre-test and post-test of tooth health (t (131) = 1.53, p>0.00) and physical activities (t (131) = 1.53, p>0.00). The difficulties during the production of materials, the difficulties during the applications with students and the experiences of prospective teachers were obtained as themes from the qualitative data. Conclusion and Recommendations: Protective health education should be given to all prospective teachers in all subjects including practical as well as conceptual knowledge. In the future they can use this knowledge and these practices to decrease the mortality rate of countries as a teacher, as an individual in a society or as a parent.

Children with autism spectrum disorder (ASD) sometimes display an inability for information sharing through functional verbal communication. This may interfere with professional oral care. These children tend to process visual information more efficiently than auditory information. Picture schedules can briefly suffice as visual cues serving a vital function in helping children with ASD to function in a particular setting such as an oral care environment. A visual communication implement such as a dental communication board was developed in this study to allow for a facilitated communication process between the patient with ASD and the oral care professional. This study entailed two main phases, namely the selection of symbols for the construction of a dental communication board and the small scale testing of the board in a clinical setting. This study incorporated a combination of a quantitative non-experimental descriptive survey combined with a concurrent mixed method survey design which retrieved data for both close-ended and open-ended questions from the same respondent. A quantitative survey questionnaire at a structured dental seminar presentation was employed for the first phase, and a combination of a quantitative and qualitative questionnaire was employed for the second phase of this study. Documented responses were collated and analyzed using frequency and thematic analysis. The most frequently selected symbols were retrieved after a frequency analysis and displayed on a color coded background to distinguish the various categories on the dental communication board. The thematic analysis resulted in the emergence of three main themes, namely the strengths of the board; weakness of the board and suggestions. This study anticipates the incorporation of a dental communication board as a visual mode using graphic symbols to augment expressive and receptive language in an oral care environment to facilitate professional oral care for children with ASD.

Dental care received by children in the Autism Speaks Autism Treatment Network (ATN) was compared to National Survey of Children's Health (NSCH) data for children without special healthcare needs and children with parent-reported ASD. Correlates of obtained preventive dental services were examined within the ATN sample. Participants included 375 families of children ages 4 to 17 enrolled in the ATN. ATN families reported levels of preventive dental care that were similar to, or exceeded, NSCH-reported care. However, disparities in obtained preventive dental services emerged within the ATN sample. Lower intellectual functioning was the most consistent correlate of reduced access to and completion of preventive dental care. Implications for developing system-wide supports and targeted interventions are discussed.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder and systemic disease with multiple comorbidities and largely fragmented clinical care. In this article, we discuss three important components frequently missing from the current ASD standard care routine: oral health, nutrition, and house-call programs. Both ASD centers associated with tertiary-care hospitals and community ASD providers do not regularly offer these services. In this review, we address the benefits of and rationale behind incorporating dental care, nutrition, and house-call programs into ASD management. We also explain why these three services are closely intertwined, with potentially synergistic effects to improve health care outcomes for patients with ASD. Finally, we discuss strategies for service implementation and envision ways in which these three branches of ASD care can be best integrated into a primary care routine.

Children and adolescents with autism spectrum disorder are thought to be more vulnerable to oral diseases than typically developing individuals due to cariogenic dietary habits, self-injurious behaviors, and increased barriers to dental care services. This review aimed to summarize current evidence comparing the oral health status of people diagnosed with and without autism spectrum disorder. Study selection and screening, data extraction, risk of bias assessment, and quality-of-evidence evaluation was conducted using the Grading of Recommendations Assessment Development and Evaluation approach and performed independently by two reviewers. A total of 16 studies were found eligible for qualitative synthesis and 15 were included in quantitative analysis. When comparing children and adolescents diagnosed with and without autism spectrum disorder, significantly higher prevalence of bruxism was identified. Individuals diagnosed with autism spectrum disorder were also found to have significantly lower salivary pH. However, no statistically significant differences in terms of caries prevalence and severity, oral hygiene and periodontal status, prevalence of malocclusion, dental traumatic injuries, as well as salivary flow rate and buffering capacity were found. The quality of evidence of each outcome was graded as very low mainly due to the overall high risk of bias, considerable heterogeneity, and imprecision.

The objective of this meta-analysis was to assess the dental health status of children with ASD in terms of decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled deciduous teeth (dmft). PubMed, Embase, psycINFO, and Cochrane library were searched for studies published until September 2018. A random-effects model was applied to estimate the pooled results. Nine studies comprising 532 children with ASD and 622 controls were included. No significant differences between children with ASD and controls were observed for DMFT and dmft in the world. Subgroup analyses revealed that children with ASD had a significantly higher dmft index than that of controls in Asia. Children with ASD have a worse dental health status than healthy children in Asia, but caution is necessary given the limited studies available for analysis.

Background: Health insurance access and health literacy are critical components of "enabling resources" to encourage uptake of services. We sought to test whether health literacy boosts health services utilization in the context of expanded access to health insurance stemming from the Affordable Care Act. Method: We used individual-level data from 11 states included in the Behavioral Risk Factor Surveillance System 2016. We conducted a two-stage least squares instrumental variables analysis. We instrumented improved access to health insurance stemming from Affordable Care Act Medicaid expansion. As outcome variables, we examined cost as a barrier to needed care, having a personal doctor and receipt of routine health checkups, flu shots, Pap tests, mammograms, sigmoidoscopy/colonoscopy, and dental visits in the past year. We then tested whether the relation between improved health insurance access and health services utilization was moderated by health literacy. Health literacy was measured by a dichotomized scale comprising three items: difficulties obtaining advice or information about health, difficulties understating information from health professionals, and difficulties understanding written health information. Results: We found that improving health insurance access increased the likelihood of reporting a personal doctor while reducing the likelihood of reporting cost as a barrier to care. We also found an interaction effect between health insurance and health literacy on dental visits. However, there was no significant interaction effect between insurance access and health literacy for preventive services utilization. Conclusion: Health literacy did not explain why people fail to access "preventive" services even when they obtain access to insurance, with the sole possible exception of dental visits among individuals with high literacy.