Background: Elderly today have an increased life expectancy and retaining their teeth longer than before, it is important that healthcare-professionals have knowledge about oral health and how to prevent oral diseases. Objective: To study knowledge and attitude of oral health among caregivers at nursing homes in Ga-Rankuwa, Pretoria, South Africa. Method: The study was a quantitative cross-sectional study. Data was collected by a questionnaire representing four dimensions; Internal Locus of Control, External Locus of Control, Self-Efficacy and Oral Health Care Beliefs (OHCB), consisting questions about oral health and oral hygiene. The population consisted of 130 caregivers. Result: A total of 50 out of 61 caregivers participated in the study, out of which 43 were females and 7 were males. The age-interval was between 20-75 years. Generally, no statistical significant differences in knowledge and attitudes between the two nursing homes and between the caregivers´ professional statuses was noticed. T-test showed a statistical significant difference (P=0.011) between the caregivers for OHCB-dimension, and (P=0.044) between nursing home “A” and “B” for OHCB dimension. Conclusion: The general level of knowledge and attitude among the caregivers was satisfactory but low. Monitored health intervention studies should be given to promote oral health care knowledge and beliefs. / Bakgrund: Äldre har idag en ökad livslängd och allt fler behåller sina tänder längre än tidigare. För att vårdpersonalen ska kunna förebygga orala sjukdomar hos dessa individer är det viktigt att dem har kunskap om oral hälsa samt hur man förebygger orala sjukdomar. Syfte: Att studera kunskap och attityder om oral hälsa bland personal på äldreboenden i Ga-Rankuwa, Pretoria, Sydafrika. Metod: Studien var en kvantitativ tvärsnittsstudie där datainsamlingen skedde genom ett frågeformulär som innehöll frågor om oral hälsa och munhygien. Populationen bestod av 130 vårdgivare. Resultat: Totalt deltog 50 av 61 vårdgivare i studien, varav 43 var kvinnor och 7 män. Åldersintervallen var 20–75 år. Generellt fanns det inga statistiskt signifikanta skillnader avseende kunskaper och attityder mellan dem två äldreboenden och mellan vårdpersonalens yrke. En tillfredsställande men låg kunskapsnivå och attityd uppmärksammades mellan äldreboenden och vårdgivarnas yrkesstatus. T-testen visade en statistisk signifikant skillnad (P = 0,011) mellan vårdpersonalen för OHCB-dimensionen och (P = 0,044) mellan äldreboenden "A" och "B" för OHCB-dimensionen. Slutsats: Generellt var deltagarnas attityd och kunskapsnivån tillfredställande men låg. Interventionsstudier med uppföljning bör göras för att bättra kunskap och attityd om oral hälsa.

Orientador: Silvia Cristina Mangini Bocchi / Resumo: Introdução: A instituição de políticas públicas voltadas ao envelhecimento populacional constitui uma forma efetiva dos países ocidentais lidarem com a transição demográfica. No entanto, poucos países têm programas de saúde pública que possibilitam idosos acessarem cuidados de saúde bucal, por exemplo, sem barreiras financeiras. Apenas em 2004, a política pública de saúde bucal brasileira passou a ofertar cuidados de saúde bucal, de maneira universal e integral, no contexto do Sistema Único de Saúde (SUS). Assim, esta pesquisa pretende analisar a operacionalização da política de saúde bucal por meio das experiências de idosos com o acesso aos cuidados bucais a partir da Atenção Primária à Saúde, bem como dos cirurgiões-dentistas com a oferta deste cuidado e dos gestores com a implantação e consolidação desta política. Desta maneira, questiona-se: — Os idosos brasileiros conseguem acessar cuidados de saúde bucal no SUS? — Como a política nacional de saúde bucal projeta as ações de saúde bucal em nível local? Objetivo geral: Fazer uma análise da operacionalização da política de saúde bucal brasileira a partir da metassíntese das experiências dos cirurgiões-dentistas, idosos e gestores da política de saúde bucal. Objetivos específicos: (a) compreender o processo experiencial de idosos adscritos às Unidades de Saúde da Família (USFs), de cirurgiões-dentistas que os atendem, assim como gestores municipais e federais, envolvidos na operacionalização da política de saúde bucal brasi... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: To proactively enact public policies which address the ageing process is an effective way for Western countries to tackle the demographic transition. However, few countries have public health programs that enable older people to access oral health care, for example, without financial barriers. Only in 2004, the Brazilian oral health public policy started to offer universal and comprehensive oral healthcare in the Unified Health System (SUS). Thus, this research aims to analyze the oral health policy operationalization throughout the elderly’s experiences with oral health care access at the primary health care, the dentists’ experience in providing care, and the managers’ experience with the implementation and consolidation of this policy. Thus, it is questioned: - Can the Brazilian elderly access oral health care in the SUS? - How does the national oral health policy project oral health actions at the local level? General objective: To analyze the operationalization of the Brazilian oral health policy based on the meta-synthesis of the experiences of dentists, elderly and oral health policy managers. Specific objectives: (a) understand the experience of elderly people attended by the Family Health Units (FHUs), the dentists’ experience in assisting them, and the municipal and federal managers’ experience with the Brazilian oral health policy; (b) propose theoretical models of each experience and; (c) elaborate metasynthesis from the theoretical models emerging, ... (Complete abstract click electronic access below) / Doutor

Individuals with advance-stage illnesses frequently face illness or treatment-related adverse effects in the mouth. These adverse effects can have serious consequences. Despite that, the importance of oral care in this population is often overlooked and there are no definitive guidelines as to what kind of oral care should be provided to these individuals. Given that, our study aims were to explore and better understand the oral health-related concerns, perceived oral care needs of palliative care patients and the berries that face in accessing dental care services. We conducted a qualitative description study by recruiting a purposive sample of 11 participants with advanced stage health conditions from the outpatient palliative care services of the University of Iowa Hospitals and Clinics. Data were collected using in-depth, semi-structured interviews using an interview guide. All interviews were fully transcribed, with the data managed with Atlas.ti software to facilitate the analysis. All participants had oral concerns although they varied widely from person to person and their illness statuses. The most significant concerns were related to dry mouth, loose dentures, and eating difficulties. Among those who stated that they would seek dental care if required, they were not planning on seeking dental care even though they had treatable oral problems, suggesting a mismatch between their oral health status and their perceived needs. The frequently observed barriers that prevented them from seeking dental care were their illness and illness related priorities, finances, feeling discriminated against by the dentist, and a dislike towards the dentist. Providing information to the palliative care clinicians about the significance of oral health and its impact, incorporating a dental care provider in palliative care team, and providing timely information to individuals with advanced health conditions may enhance the understanding of their oral health problems and help them better manage their oral health and may enhance their dental care seeking behavior.

Das Ziel der vorliegenden Arbeit war es die Mundgesundheit sowie die mundgesundheitsbezogene Lebensqualität (MLQ) von Patienten mit rheumatoider Arthritis (RA) zu erfassen und mit Allgemeingesunden zu vergleichen. Des Weiteren wurden das Mundhygiene- sowie das zahnärztliche Verhalten erfasst. In die Untersuchung wurden RA-Patienten gemäß den ACR-Kriterien einbezogen. Entsprechend des Alters, Geschlechtes und Rauchverhalten der RA-Patienten wurde soweit möglich eine Kontrollgruppe aus Allgemeingesunden zusammengestellt (Matching). Für die Erfassung der Mundgesundheit wurden alle Probanden hinsichtlich dentaler (DMF-T) und parodontaler Befunde (Sondierungstiefen = ST, Blutung auf Sondierung = BOP sowie klinischer Attachmentverlust = AV) untersucht. Anhand von ST und/oder AV erfolgte die Einteilung der Parodontalerkrankung nach Schweregrad in: gesund/milde, moderate oder ausgeprägte Parodontitis. Die subjektiv wahrgenommene MLQ wurde mit Hilfe des Oral Health Impact Profile G14 (OHIP G14) erfasst. Das Mundhygiene- und zahnärztliche Verhalten wurde im Rahmen einer Befragung mit Hilfe eines speziellen Fragebogens erhoben. Insgesamt wurden 103 RA-Patienten und 104 Gesunde einbezogen. Hinsichtlich dentaler Befunde (DMF-T) sowie gingivaler Entzündung (PBI) konnten keine signifikanten Unterschiede zwischen beiden Gruppen festgestellt werden, jedoch wiesen die RA-Patienten eine größere Anzahl fehlender Zähne (M-T) auf. Beim parodontalen Befund konnten in der RA-Gruppe geringfügige aber signifikant bessere parodontale Zustände (ST, AV und Parodontitisschweregrad) im Vergleich zur Kontrollgruppe detektiert werden. Jedoch wurde im Vergleich zur Kontrollgruppe ein signifikant höherer BOP festgestellt. Im Mundhygiene- und zahnärztlichen Verhalten zeigten sich zwischen beiden Gruppen nur geringfügige Unterschiede. So zeigten sich insbesondere signifikante Differenzen beim Informationsstand über Mundhygienemaßnahmen sowie den –hilfsmitteln; dabei wiesen RA-Patienten vornehmlich Defizite auf. Die untersuchten RA-Patienten nahmen eine signifikant höhere Beeinträchtigung in der MLQ wahr, als die Kontrollgruppe. Dabei ist diese subjektive Einschätzung der MLQ scheinbar unabhängig von der vorliegenden Mundgesundheitssituation (dental sowie parodontal). Hingegen war bei den allgemeingesunden Probanden ein signifikanter Zusammenhang von schlechteren dentalen und parodontalen Mundgesundheitszuständen mit einer zunehmenden Beeinträchtigung der MLQ zu verzeichnen. Weitere Einflussfaktoren, wie Geschlecht und Rauchverhalten, lassen sowohl bei den RA-Patienten als auch in der Kontrollgruppe keinen Einfluss auf die MLQ erkennen. Während bei den allgemeingesunden Probanden für das Alter ebenfalls kein Zusammenhang mit der MLQ festgestellt wurde, war in der RA-Gruppe ein signifikanter Einfluss des Alters (>60 Jahre) zu erkennen.:Inhalt 1. Einleitung 1.1 Erkrankungen der Mundhöhle 1.1.1 Karies 1.1.2 Parodontitis 1.2 Rheumatoide Arthritis 1.3 Zusammenhang zwischen Mundgesundheit und Rheumatoider Arthritis 1.4 Mundgesundheitsbezogene Lebensqualität und Rheumatoide Arthritis 1.5 Zielsetzung und Fragestellung 2. Publikationsmanuskript 3. Zusammenfassung der Arbeit 4. Ausblick 5. Literatur 6. Wissenschaftliche Präsentationen 7. Darstellung des eigenen Beitrages 8. Erklärung über die eigenständige Abfassung der Arbeit 9. Lebenslauf 10. Danksagung

Low or marginal health literacy affect nearly 90 million citizens in the United States, compromising health outcomes, including oral health. Oral health literacy has been studied in diverse populations, yet the assessments used were developed and validated for English-speaking populations. A validated Spanish-language oral health literacy assessment was needed to help researchers and practitioners evaluate oral health literacy in the Hispanic population. Using the oral health literacy framework, the purpose of this study was to translate, culturally adapt, and validate a Spanish version of a previously validated English-language oral health literacy. A translation-back-translation process was applied to the English version of the REALD-30. Face and content validity were established using a panel of dental and health literacy experts. The Spanish version was field tested among Spanish-speaking community health center patients (N=114), and included a random subsample (N=11) to check for test-retest reliability. The results showed that the Spanish REALD-30 has a good internal reliability (=r=.687) and an acceptable convergent reliability (r =.857), when assessing health literacy against the SAHLSA-50. This study's implications for positive social change include providing the dental profession and research community with an assessment tool for oral health literacy. This tool may allow oral health professionals to understand the dynamics and challenges among Hispanics regarding oral health literacy, while the study fills an existing gap in scholarly literature.

Dental decay is a preventable disease, but it remains the most unmet healthcare need of American children. Untreated dental decay has adverse and long-lasting effects on a child's quality of life. Healthy oral habits among preschool children are essential for a healthy permanent dentition and are achieved primarily by 3 oral health related behaviors: proper dental hygiene, a healthy noncariogenic diet, and regular dental visits. This quantitative study, based on the theory of planned behavior, explored the relationship between these 3 oral health behaviors and 4 determinants: attitude, subjective norms, perceived behavioral control, and intention, using a 71-item questionnaire. The study utilized convenience sampling. A total of 436 parents or caregivers of children enrolled in the North East Independent School District Early Childhood Education program participated in this study; 81.5% were low-income, and 66% reported Hispanic identity. The relationship between variables was evaluated using multiple regression analysis. This study indicated that attitude alone toward a healthy diet and dental hygiene was not a significant predictor of behavior, but the attitude toward dental attendance was significant. Subjective norm, perceived behavior control, and intentions individually and combined were significant predictors of all 3 behaviors, except for subjective norm towards hygiene. Meaningful social change can be achieved by identifying and understanding the underlying motives that evoke planned and deliberate oral health behaviors among parents of preschool children. Targeted messages and cost-effective early interventions can be developed to prevent the onset of dental disease and improve the quality of life for low-income children.

This study sought to identify the level of oral health literacy held by people who live in transitional and distressed Kentucky Appalachian areas and if this effects how often they are using oral hygiene techniques. Data were also collected to describe the attitudes Kentucky Appalachian adults hold toward oral hygiene and oral health status. Current documentation shows that poor oral health remains a public health threat in this population despite efforts such as school-based sealant programs and increased dental insurance coverage. This study followed a quantitative design and 99 participants were polled using a survey specifically developed for this study's use. Composite median scores and Spearman's correlation values established the existence of a low oral health literacy level across the participant pool, an also documented that oral hygiene techniques are not used in frequencies recommended for proper oral health. A poor self-efficacy towards the ability to utilize these techniques properly was also identified. Using the Mann-Whitney U test, responses were compared based on county designation and few significant differences were found. These findings show that oral health status and related beliefs are similar across the region and not just isolated to the economically poorest areas as the currently available literature suggests. Applying the health belief model it is predicted that Kentucky Appalachians are unlikely to adopt proper oral hygiene habits until their self-efficacy is improved. A recommendation of this study is that public health officials should promote personal control when designing public health programs geared towards improving the oral health status of this population. To do so would introduce a positive social change in that people with good oral health are less likely to experience the pain, malnutrition, and negative social stigma that is associated with poor oral health.

Background: Treatment of oral diseases can have a long-lasting impact on a child’s life well beyond its childhood years. The purpose of this study was to compare the impact of treatment on the oral-health-related quality of life (OHRQoL) of children with severe caries and severe molar incisor hypomineralization (MIH). Methods: A total of 210 children (mean age 9 years; 49% female) with severe caries (inner third of dentin) and severe MIH (post-eruptive breakdown, crown destruction) were included in the study. Both groups were matched according to age, gender, and social status. The German version of the Child Perception Questionnaire for 8–10-year-olds (CPQ-G8–10) was used before and after treatment to analyze the impact on OHRQoL. Results: Patients with severe MIH showed a significantly higher total CPQ score (17.8 (±10.6)) before treatment compared to the caries group (13.8 (±14.3)). The mean CPQ score in all subdomains decreased significantly after therapy in the MIH group. Children with severe carious lesions had similar results except in the domain “functional limitations”, as treatment led to only minor changes (2.9 (±3.6) to 2.2 (±2.6)). Conclusions: Despite a narrower treatment spectrum, patients with severe MIH experienced a greater overall improvement in OHRQoL compared to the caries group.

Objectives: Aim of this systematic review was to assess oral health-related quality of life (OHRQoL) of patients after stroke. Methods: The systematic literature search was performed on December 2021 based on PubMed, Medline, Web of Science, and Scopus, with the search terms: “oral health-related quality of life” AND stroke OR apoplexy OR ischemic stroke OR apoplectic insult. Articles exclusively examining patients after stroke and reporting a well-documented and valid OHRQoL measurement were included. Results: Out of 68 findings, 8 studies were included. The number of patients ranged between 31 and 549 individuals, mean age between 55.7 and 73.9 years, and 49–72% of individuals were male. Two studies included a healthy control group. Oral health parameters were rarely reported across studies. Five studies reported on the Oral Health Impact Profile (OHIP) 14 for OHRQoL, showing means between 2.87 and 33.0 in sum score. Three studies applied Geriatric Oral Assessment Index (GOHAI), with sum scores between 45.6 and 55.0. Only one study found worse OHRQoL in stroke patients compared to healthy controls. Two studies reported on an association between OHRQoL and general quality of life. Three studies found OHRQoL to be associated with different oral health parameters. Only one study found OHRQoL to be associated with stroke-related parameters. Conclusions: Patients after stroke show a reduced OHRQoL. Medical staff and caregivers should support oral hygiene and dental visits, to foster patients’ oral health and OHRQoL.

Background: This systematic review evaluates the oral health-related quality of life (OHRQoL) of patients with chronic respiratory diseases. Methods: A systematic literature search was performed based on the PubMed, Medline, Web of Science, and Scopus, using the search terms: “oral health-related quality of life” and “respiratory disease” or “lung” and “oral health-related quality of life.” Full-text articles published until June 30, 2021 and reporting any OHRQoL measurement in children or adults with a chronic respiratory disease or condition were included and analyzed qualitatively. Results: A total of seven out of 44 studies were included, of which four studies examined adults and three studies investigated children. The respective diseases were chronic obstructive pulmonary disease (COPD) (n = 2), sleep apnea (n = 2), severe asthma (n = 1), cystic fibrosis (n = 1), and lung transplantation (n = 1). Four studies confirmed a worse OHRQoL in the respiratory diseased group compared to healthy controls. The overall OHRQoL was reduced in the included studies. Oral health, healthrelated quality of life, and disease-related parameters were rarely examined with regard to OHRQoL. Conclusion: Patients with chronic respiratory diseases show a reduced OHRQoL. Oral health should be fostered in these individuals to support their OHRQoL.