Purpose: The purpose of this study is to determine if motivational interviewing with written/illustrated infant oral health education provided to caregivers of pediatric dental patients increases caregivers’ oral health literacy compared to verbal only motivational instruction. Methods: This is a cohort study of caregivers and their child receiving oral health anticipatory guidance utilizing motivational interviewing with and without visual aids. Caregivers (N=20) of pediatric dental patients age 0-4 that presented to the Virginia Commonwealth University School of Dentistry for a new patient exam were recruited for the study. Caregivers were randomly assigned into 2 groups: the intervention group (IG), and the control group (CG). Each caregiver took a pre-test to determine their infant oral health literacy. Then the IG received infant oral health education using a flipbook, and the CG received the same information in verbal form. Each caregiver had a brief motivational interviewing session. The caregivers then took the same test (post-test). At the pre-test time period, groups were compared by Fisher’s exact test or a two group t-test, as appropriate. The post-test score of the two groups were compared using an ANCOVA. Results: Currently, 20 patients have been enrolled in the study. There was no significant difference between the CG and the IG in the pre-test scores (P= 0.3913) or the post-test scores (P=0.3022). The intervention group had a nominally higher score after the education. Conclusions: This study was only a pilot study with N=20 caregivers. This study may be used to estimate the number of subjects needed to demonstrate a significant difference.

Magister Chirurgiae Dentium (MChD) / The evaluation aimed to assess the effectiveness of the school oral health education (ORE) programme in Thamaga, a rural village about 40km west of the capital Gaborone. The Oral Health Division (Botswana) had introduced the programme in schools throughout the country in 1984. The school ORE programme in Thamaga was introduced less than five years previously but not all schools could be covered before the time of the study. The delivery of weekly dental services at the primary hospital in the area had been inconsistent. The evaluation assessed the effectiveness of the programme in a cross-sectional study by comparing dental health knowledge, reported oral hygiene practices, DMFS scores and gingival bleeding index of randomly selected standard five schoolchildren, aged 10-16 years (n=135). Two schools in Thamaga were selected for the study, designated as programme (experimental) and non-programme (control) schools in this comparative study. The hypothesis proposed that children from the programme school will have better oral health (less dental caries and gingivitis), have better dental health knowledge and better oral hygiene practices than children from the non-programme school. The effects of this school ORE programme were measured firstly by a clinical examination for dental caries using the WHO DMFS index and for gingivitis using a bleeding index derived from the WHO CPI. This was to compare the proportion of children with these dental diseases in the two schools. Secondly, a close-ended questionnaire was administered to the children to assess most importantly, their knowledge of dental diseases (dental caries and gum disease) and their reported OH practices. The extent of correct dental health knowledge was minimal but about 88 percent of all the schoolchildren from both the programme and non-programme schools (n=135) reported their source of information as being the school. Generally, children from the non-programme school had higher average scores of correct responses on dental caries and gingivitis than those from the programme school. This difference in knowledge was not statistically significant (p>O.05).It was apparent from the results of the interview that the majority of the children have misinformation about disease-specific signs and symptoms, causes and prevention of dental disease, the use and benefits of fluorides and dental floss. The majority of the children reported that they do self-examination of their teeth and gums daily and the commonly reported OH practices were the use of a toothbrush and toothpaste at least twice a day. However, these reported oral hygiene practices were not commensurate with the level of gingivitis recorded. Out of all the study participants, only one child from the programme school reported using a chewing stick for cleaning teeth. The majority of the children were found to have poor periodontal health indicated by gingivitis. About 90 percent and 82 percent of the children from the programme and non-programme schools respectively had gingivitis. Only 10 percent (programme) and 18 percent (nonprogramme) of the children did not have any bleeding-gingival sites (GBI=O). The poor oral hygiene found in children from the programme school might imply that the practical aspects of plaque control and oral hygiene were not intensive enough to motivate the children. Most children were found to have minimal caries; mean DMFS scores of 0.14 (SD=0.49) and 0.12 (SD=0.45) for programme and non-programme schools respectively and 91 percent caries-free for each of the two schools. These differences were not statistically significant (p>0.05). The low prevalence of caries and the minimal difference between groups might be attributed to the following; the low prevalence of dental caries at baseline and the action of fluoride in drinking water. The study indicates that the programme has had a minimal impact if any, in the programme school. The findings suggest a need to correct the prevailing basic misinformation about dental health and motivation of teachers and the dental team to be more involved in the programmes.

Purpose: To assess a caregiver’s oral health attitudes, habits, and behaviors pre and post intervention, and to determine whether a particular delivery-style (verbal-only or with visual supplementation) of a motivational interviewing session is more effective in improving oral health behaviors as well as improving success of a chosen preventive goal. Methods: N=140 caregivers of pediatric dental patients were given questionnaires to assess readiness to change and current preventive oral health behaviors. Oral health education was communicated in a MI style (verbal-only or with visual supplementation). One preventive oral health goal was selected to focus on. The home preventive behavior survey was re-administered at follow-up. Results: Preventive home behaviors improved, with no significant difference between interventions. There was significance in the amount of change in items specified as a goal. Conclusions: Behaviors improved significantly after a MI educational intervention. Goal setting and providing oral health education in a MI style can improve home preventive behaviors.

Neste trabalho discutem-se aspectos de particular interesse para o planejamento do componente educativo de programas de Educação em Saúde Bucal, como parte dos currículos de ensino dirigidos a alunos do 1º grau. A amostra foi constituída por 980 alunos das 8ªs séries do 1º grau, de 38 escolas da Região Administrativa da Capital, DRECAP-3, de São Paulo. Os dados foram registrados em questionários, contendo perguntas abertas e fechadas, procurando-se, com este \"survey\", dar subsídios para o conteúdo dos Guias Curriculares de Programas de Saúde Bucal, de acordo com os pressupostos da Lei 5692 de 11 de agosto de 1971. Os resultados evidenciaram o alarmante desconhecimento, por parte dos alunos, de assuntos básicos para a Saúde Bucal, tais como, entre outros, cárie dental e problemas periodontais, ambos responsáveis por severos agravos na população brasileira. Tendo em vista estes dados, elaborou-se um Programa de Educação em Saúde Bucal, com fundamento no programa proposto pela \"American Dental Association\". Espera-se que o mesmo possa contribuir para facilitar e estimular o ensino da Saúde Bucal nas escolas de São Paulo. / The present work discusses aspects of special interest for the planning of educational components within the Program of oral Health Education, as part of the teaching curricula, focussing first grade students. The sample inclused 980 students of the 8th grade, of thirty-eight schools located at the Administrative Region of the capital of São Paulo - DRECAP-3. The data were recorded in a questionnaire containing open and closed questions. The purpose of the survey was to provide a source of information for Curriculum Guidance of Health Programs, according to the 5692 Law of August 11th, 1971. The results indicated an alarming lack of knowledge of the students about basic subjects of Oral Health, such as, dental caries and periodontal diseases, among others, not to mention that both factors are responsible for severe damage to the Brazillan population. With these results, an Educational Program of Oral Heal th was developed based on suggestion of the American Dental Association Program. We hope that the present work will be able to contribute to facilitate and to improve the teaching of Oral Health in the São Paulo schaol system.

Neste trabalho discutem-se aspectos de particular interesse para o planejamento do componente educativo de programas de Educação em Saúde Bucal, como parte dos currículos de ensino dirigidos a alunos do 1º grau. A amostra foi constituída por 980 alunos das 8ªs séries do 1º grau, de 38 escolas da Região Administrativa da Capital, DRECAP-3, de São Paulo. Os dados foram registrados em questionários, contendo perguntas abertas e fechadas, procurando-se, com este \"survey\", dar subsídios para o conteúdo dos Guias Curriculares de Programas de Saúde Bucal, de acordo com os pressupostos da Lei 5692 de 11 de agosto de 1971. Os resultados evidenciaram o alarmante desconhecimento, por parte dos alunos, de assuntos básicos para a Saúde Bucal, tais como, entre outros, cárie dental e problemas periodontais, ambos responsáveis por severos agravos na população brasileira. Tendo em vista estes dados, elaborou-se um Programa de Educação em Saúde Bucal, com fundamento no programa proposto pela \"American Dental Association\". Espera-se que o mesmo possa contribuir para facilitar e estimular o ensino da Saúde Bucal nas escolas de São Paulo. / The present work discusses aspects of special interest for the planning of educational components within the Program of oral Health Education, as part of the teaching curricula, focussing first grade students. The sample inclused 980 students of the 8th grade, of thirty-eight schools located at the Administrative Region of the capital of São Paulo - DRECAP-3. The data were recorded in a questionnaire containing open and closed questions. The purpose of the survey was to provide a source of information for Curriculum Guidance of Health Programs, according to the 5692 Law of August 11th, 1971. The results indicated an alarming lack of knowledge of the students about basic subjects of Oral Health, such as, dental caries and periodontal diseases, among others, not to mention that both factors are responsible for severe damage to the Brazillan population. With these results, an Educational Program of Oral Heal th was developed based on suggestion of the American Dental Association Program. We hope that the present work will be able to contribute to facilitate and to improve the teaching of Oral Health in the São Paulo schaol system.

This thesis is about a behavioural medicine approach in periodontal treatment and oral hygiene self-care. The aim of this thesis was to develop, describe, and evaluate an individually tailored oral health educational program on oral hygiene behaviour and non-surgical periodontal treatment success, and to determine factors of importance for predicting oral hygiene behaviour. Two separate studies, both conducted at a specialist clinic for periodontics in a Swedish county council are described. In the first study, the program was developed and described in two experimental single-case studies with multiple baseline designs (Paper I). The second study was a randomised controlled single-blinded trial [n = 113, mean age 51.2, 53% female] in which, the effectiveness of the program was compared with standard treatment on oral hygiene habits, plaque control, and gingivitis (Paper II), periodontal status (Paper III), and attitudes, subjective norms, and self-efficacy (Paper IV). The tailored oral health educational program included a motivational interviewing method and cognitive behavioural techniques, and the individual tailoring for each participant was based on participants’ thoughts and cognitions, intermediate and long-term goals, and oral health status. Participants in the individually tailored program reported higher frequency of daily interdental cleaning and were more confident about maintaining the attained level of behaviour change, had better oral hygiene, and healthier gingival tissue, particularly interproximally. There was a great reduction in periodontal pocket depth and bleeding on probing scores (BoP) for participants in both programs with a greater reduction in BoP scores in the tailored-treatment group. A lower dental plaque score at treatment start increased the predicted probability of attaining treatment success, and self-efficacy towards interdental cleaning predicted oral hygiene behaviour. These studies demonstrate an individually tailored oral health education program is preferable to standard program as an oral hygiene behaviour change interventions in non-surgical periodontal treatment. / Behavioural medicine perspectives for change and prediction of oral hygiene behaviour

An illuminative evaluation of the final year prosthodontic component of the Oral Health Science curriculum (OHSC 501 Component 1) at the University of the Witwatersrand, Johannesburg, South Africa was conducted. This evaluation method was employed to illustrate how an evaluation strategy was used to assess classroom practices following institutional curriculum reform. The aim was to use a qualitative evaluation process to assess the impact of the curriculum change at classroom level and to evaluate how a department had reformed its’ teaching and learning strategies within the hybrid problem based learning curriculum that had been implemented. Additionally, it was to evaluate how this curriculum operated in its own terms. From July through October 2007 small group teaching involving problem based learning, led by two faculty from the department of prosthodontics were observed. Six two hour long small group sessions (equivalent to twelve forty minute lessons), were observed and they revealed a variety of pedagogic strategies utilised. The plan, as outlined in the instructional system was held up against the reality through observations of what happened in the classroom. By and large the findings illustrate that much of what was planned was realised, with the more experienced staff member teaching more or less to the plan. However, from the themes that were inductively derived from analysis of the data, it was clear that integration of content knowledge and critical thinking necessary to assist in the comprehensive management of dental patients was not as robust as would be expected from the students at this level during their training. As part of the objectives of the curriculum innovation instituted, content knowledge integration and critical thinking skills are key to the success of the innovation and employing illuminative evaluation methodology afforded the opportunity to delve deeper into these. This finding illustrates the importance of using qualitative evaluation approaches as a mechanism to assess curriculum change efforts.

O presente estudo teve por objetivo avaliar a efetividade de um programa de educação odontológica em pacientes com fissura de lábio e/ou palato. A amostra foi composta de 38 pacientes com fissura de lábio e/ou palato, matriculados para tratamento no Hospital de Reabilitação de Anomalias Craniofaciais/Universidade de São Paulo (HRAC/USP), entre 5 a 12 anos, divididos em 2 grupos: Grupo 1 (controle) - pacientes que realizaram profilaxia profissional e Grupo 2 (experimental) - pacientes que receberam orientação de educação e motivação em saúde bucal e controle de placa bacteriana. Os pacientes foram avaliados durante 6 sessões, com intervalos de 30 dias entre as mesmas. Para avaliar o controle de placa, utilizou-se o índice PHP. A avaliação foi realizada por meio do Aplicativo Dent Clean que faz parte do programa de educação em saúde bucal. Para avaliar o conhecimento sobre saúde bucal foi utilizado um questionário composto de 16 questões na 1a e 6a sessão. Para as comparações do PHP inicial e após 6 meses entre os grupos utilizou-se os testes de Mann-Whitney e Wilcoxon. Os conceitos obtidos pelos questionários foram submetidos à análise estatística por meio do teste t e teste t pareado. Com relação ao exame PHP inicial, não houve diferença estatisticamente significante entre os grupos (p=0,792). Em relação ao exame PHP após 6 meses houve diferença entre os grupos (p<0,001). Em relação ao período estudado, no Grupo 1 não foi observada diferença estatisticamente significante em relação exame PHP inicial e após 6 meses (p=0,813). No Grupo 2, houve diferença quando comparado o período inicial e após 6 meses (p<0,001). Em relação ao questionário, verificou-se que no início e após 6 meses não houve diferença estatisticamente significante entre os grupos (p=0,503 e 0,494). Para avaliação do nível de conhecimento, no Grupo 1 não foi observada diferença em relação ao período estudado inicial e após 6 meses (p=0,067). No Grupo 2 houve diferença estatisticamente significante quando comparado o período inicial e após 6 meses (p<0,001). Com base nos resultados obtidos para amostra estudada, e de acordo com a metodologia aplicada, foi possível constatar que o programa de educação em saúde bucal foi efetivo para crianças com fissura de lábio e/ou palato. / The aim of this study was to evaluate the effectiveness of a dental education program in cleft lip and/or palate patients. The study sample comprised 38 cleft lip and/or palate patients enrolled at the Hospital de Reabilitação de Anomalias Craniofaciais/Universidade de São Paulo (HRAC/USP), aged between 5 and 12 years-old, who were divided into two groups: Group 1 (control) - patients who underwent dental prophylaxis and Group 2 (experimental) - patients who received instructions on education and motivation in oral health and plaque control. Patients were evaluated during six appointments, at 30-day intervals. PHP index was used to assess plaque control. This was accomplished by Dent Clean App which is part of the education program in oral health, at the first and sixth appointments in both groups. To evaluate the knowledge on oral health, patients filled in a questionnaire composed of 16 questions at the first and sixth appointments. Baseline and 6-month PHP of groups 1 and 2 were compared through Mann-Whitney and Wilcoxon tests. The scores obtained by the questionnaires were statistically analyzed through t test and paired-t test. Concerning to baseline PHP assessment, there were no statistically significant differences between groups (p=0.792). There were statistically significant differences in PHP assessment after 6 months (p<0.001). In relation to the studied period, Group 1 did not demonstrated statistically significant differences between baseline and 6-month PHP assessments (p=0.813). In Group 2, there were statistically significant differences between baseline and 6-month PHP assessments (p<0.001). With regard to the questionnaire, there were no statistically significant differences between groups, at both the first and sixth appointments (p=0.503 and 0.494). In Group 1, the level of knowledge on oral health assessment did not show statistically significant differences between baseline and 6-month periods (p=0.067). In Group 2, there were statistically significant differences when the questionnaire scores were compared between baseline and 6-month periods were compared (p<0.001). Based on the results obtained for the studied sample and the methodology used, it was possible to conclude that the oral health education program was effective in cleft lip and/or palate children.

O presente estudo teve por objetivo avaliar a efetividade de um programa de educação odontológica em pacientes com fissura de lábio e/ou palato. A amostra foi composta de 38 pacientes com fissura de lábio e/ou palato, matriculados para tratamento no Hospital de Reabilitação de Anomalias Craniofaciais/Universidade de São Paulo (HRAC/USP), entre 5 a 12 anos, divididos em 2 grupos: Grupo 1 (controle) - pacientes que realizaram profilaxia profissional e Grupo 2 (experimental) - pacientes que receberam orientação de educação e motivação em saúde bucal e controle de placa bacteriana. Os pacientes foram avaliados durante 6 sessões, com intervalos de 30 dias entre as mesmas. Para avaliar o controle de placa, utilizou-se o índice PHP. A avaliação foi realizada por meio do Aplicativo Dent Clean que faz parte do programa de educação em saúde bucal. Para avaliar o conhecimento sobre saúde bucal foi utilizado um questionário composto de 16 questões na 1a e 6a sessão. Para as comparações do PHP inicial e após 6 meses entre os grupos utilizou-se os testes de Mann-Whitney e Wilcoxon. Os conceitos obtidos pelos questionários foram submetidos à análise estatística por meio do teste t e teste t pareado. Com relação ao exame PHP inicial, não houve diferença estatisticamente significante entre os grupos (p=0,792). Em relação ao exame PHP após 6 meses houve diferença entre os grupos (p<0,001). Em relação ao período estudado, no Grupo 1 não foi observada diferença estatisticamente significante em relação exame PHP inicial e após 6 meses (p=0,813). No Grupo 2, houve diferença quando comparado o período inicial e após 6 meses (p<0,001). Em relação ao questionário, verificou-se que no início e após 6 meses não houve diferença estatisticamente significante entre os grupos (p=0,503 e 0,494). Para avaliação do nível de conhecimento, no Grupo 1 não foi observada diferença em relação ao período estudado inicial e após 6 meses (p=0,067). No Grupo 2 houve diferença estatisticamente significante quando comparado o período inicial e após 6 meses (p<0,001). Com base nos resultados obtidos para amostra estudada, e de acordo com a metodologia aplicada, foi possível constatar que o programa de educação em saúde bucal foi efetivo para crianças com fissura de lábio e/ou palato. / The aim of this study was to evaluate the effectiveness of a dental education program in cleft lip and/or palate patients. The study sample comprised 38 cleft lip and/or palate patients enrolled at the Hospital de Reabilitação de Anomalias Craniofaciais/Universidade de São Paulo (HRAC/USP), aged between 5 and 12 years-old, who were divided into two groups: Group 1 (control) - patients who underwent dental prophylaxis and Group 2 (experimental) - patients who received instructions on education and motivation in oral health and plaque control. Patients were evaluated during six appointments, at 30-day intervals. PHP index was used to assess plaque control. This was accomplished by Dent Clean App which is part of the education program in oral health, at the first and sixth appointments in both groups. To evaluate the knowledge on oral health, patients filled in a questionnaire composed of 16 questions at the first and sixth appointments. Baseline and 6-month PHP of groups 1 and 2 were compared through Mann-Whitney and Wilcoxon tests. The scores obtained by the questionnaires were statistically analyzed through t test and paired-t test. Concerning to baseline PHP assessment, there were no statistically significant differences between groups (p=0.792). There were statistically significant differences in PHP assessment after 6 months (p<0.001). In relation to the studied period, Group 1 did not demonstrated statistically significant differences between baseline and 6-month PHP assessments (p=0.813). In Group 2, there were statistically significant differences between baseline and 6-month PHP assessments (p<0.001). With regard to the questionnaire, there were no statistically significant differences between groups, at both the first and sixth appointments (p=0.503 and 0.494). In Group 1, the level of knowledge on oral health assessment did not show statistically significant differences between baseline and 6-month periods (p=0.067). In Group 2, there were statistically significant differences when the questionnaire scores were compared between baseline and 6-month periods were compared (p<0.001). Based on the results obtained for the studied sample and the methodology used, it was possible to conclude that the oral health education program was effective in cleft lip and/or palate children.

Syfte: Syftet med litteraturstudien var att studera hälsofrämjande strategier för gravida kvinnor i syfte att förebygga karies i tidig barndom hos deras barn. Metod: Vetenskapliga kvantitativa artiklar söktes i två medicinska databaser, DOSS och MEDLINE, med relevanta sökord och sökordskombinationer. Tolv vetenskapliga artiklar valdes enligt inklusions- och exklusionskriterier. Resultat: De fyra hälsofrämjande strategier som identifierades var munhälsoutbildning, motiverande samtal, ökade kunskaper om god munhälsovård och interprofessionell strategi. Samtliga strategier visade på en minskning av karies hos studiedeltagarnas barn fast flera studier visade inte på en statistisk signifikans. Slutsats: Hälsofrämjande strategier under graviditeten med syfte att förebygga karies i tidig barndom hos det väntade barnet verkade ha en kariesminskande effekt. Hälsovårdspersonal kan främja oral hälsa hos den gravida kvinnan och det väntade barnet i förebyggande syfte mot karies i tidig barndom. Vidare forskning behövs dock för att fastställa effekten av hälsofrämjande strategier under graviditeten i kariesförebyggande syfte då flera studier saknade statistisk signifikans fastän de visade en minskning av karies hos studiedeltagarnas barn. / Aim: The aim of the literature study was to study health promotion strategies for pregnant women to prevent early childhood caries for the expectant child. Method: The literature study used quantitative peer-review articles that were searched in two medical databases, DOSS and MEDLINE, with relevant search terms and combinations. Twelve peer review-articles were selected according to inclusion and exclusion criteria. Results: Four health promotion strategies were identified: oral health education, motivational interviewing, increased knowledge of good oral health care and interprofessional strategy. The strategies presented a reduction in caries in the participants' children, although several studies did not show a statistical significance. Conclusion: Using health promotion strategies during pregnancy had an effect to prevent early childhood caries. Healthcare professionals can promote oral health to the pregnant woman and the expectant child as a preventive measure against early childhood caries. Several studies showed a reduction of caries in children but lacked statistical significance. However, further research is needed to determine the efficacy of health promotion strategies during pregnancy for caries prevention.