The oral health knowledge, attitudes and practices of primary school children and teachers in Mofolo, Soweto were determined. The enabling and inhibiting factors for oral health promotion in the school environment were also assessed. The aim of the study was to determine if there was any difference in knowledge, attitudes and, practices in learners and teachers and their environment at schools that were exposed to a preventive, educational and tooth brushing programme and those learners and teachers that were not exposed to the programme. Three hundred and thirty-six primary school children six to twelve years of age from four primary schools in Mofolo, i.e. Itekeng, Vukani, Emsebeni and Tshedimoso completed questionnaires. Itekeng and Vukani primary schools were part of an existing tooth brushing, educative and preventive programme, and Emsebeni and Tshedimoso primary schools were not. Four focus group discussions (one from each school) were held with regard to knowledge of oral health and hygiene and the school environment. Seven teachers from two of the four schools and eight teachers from each of the other two schools attended the discussions. Both the learners and teachers at all the schools had little knowledge of dental care, like tooth brushing with fluoridated toothpaste. Frequency of brushing was poor. Most of the learners (61 percent) for the exposed learners and 50 perecent from the unexposed learners reported brushing their teeth once a day. Dietary habits of the learners revealed a high consumption of sugary snacks in between meals and sugar. Fifty-five percent of the exposed learners bought sweets and cakes and 56 percent of the unexposed learners bought fizzy drinks and fruit juices at school. Forty-six percent of the exposed and 58 percent of the unexposed learners said they took more than three spoons of sugar with their breakfast. . Utilisation of primary dental health services in the community by both teachers and learners was poor. More learners from the exposed schools (97 percent) than the unexposed (82 percent) had been to a dentist because they had a toothache. Only 1 percent from the exposed schools and 8 percent from the unexposed had been for a routine check up. Learners from both school categories and teachers had no knowledge of fluoride or benefits of water fluoridation. Over 98 percent of learners from both school categories had never heard of fluoride. The teachers believed it was their responsibility to teach learners and parents about oral health and showed willingness to participate in oral health promotion programmes. The main source of oral health knowledge among the learners was home. Several inhibiting factors to oral health promotion like poverty, lack of adequate oral health knowledge and poor school environment were identified in all the schools.There was no school policy regarding oral health promotion In conclusion, there were no significant differences in the reported knowledge, attitudes and practices between the learners and teachers from the two schools that were part of the preventive, educational and brushing programme and those from the other schools that were not part of the programme. This therefore shows that while preventive and educational programmes are an important component of oral health promotion, they are not adequate in changing knowledge, attitudes and oral health practices.

Magister Scientiae Dentium - MSc(Dent) / Introduction: South Africa has an estimated HIV prevalence rate of 29.5%, in Gauteng province, the prevalence rate in women attending ante-natal clinic is 28.7% and in the Johannesburg Metro District, the prevalence rate is 41%. The early identification of HIV in the HIV positive well patient or HIV positive unwell patient can lead to the commencement of early intervention and treatment, thus resulting in a higher quality of life for the patient and lower treatment costs for the State. Aim: To determine the oral health knowledge, practices and treatment patterns of nurses at ARV clinics in Johannesburg Metro District. Materials and Methods: The study design was a convenient cross-sectional survey conducted between May 2014 and January 2015 in the Johannesburg Metro District. The study population comprised of nursing staff at ARV clinics in the Johannesburg Metro District. 147 questionnaires were distributed among the nurses that were in contact with the patients. Only 100 (n=147) questionnaires came back completed. The data collected was entered into Microsoft Excel and imported to STATA 13.1 to determine statistical significance using chi-squared test. A p-value was regarded significant if <0.05. Results: The results of the study depicted poor knowledge on oral manifestations of HIV/AIDS from the nursing staff at the ARV clinics in the district. Although 85% could describe the oral lesions found in the oral cavity and 66% perceived that they could identify Oral Candidiasis (OC), only 47% could correctly identify the lesion. 57% perceived knowing the condition associated with OC and only 46% correctly named the condition (p- value=0.001). Only two thirds of 43% of nurses could manage OC using drugs from the protocol accessible at the clinics, 25% referred and 32% did not know how to manage the OC (p-value=0.001). Only 40% (n=100) of the nurses referred patients for oral health promotion. Almost all the nurses (81%) indicated repeatedly that they need more training on oral health and oral health promotion. Conclusions: There is a need to include the oral manifestations of HIV in the nursing curriculum. Continued professional development should include Oral Health Promotion. Further research is needed to explore means of incorporating an oral health and disease module in the nursing curriculum.

Introduction: The literature review indicated that oral health is a serious health issue among Indian school adolescents. In India, less than 5% of adolescents have access to organised public dental health services in order to identify and treat dental caries at an early stage. Oral health literacy is important for adolescents to prevent and manage dental caries in their permanent teeth. Currently, there is no formal oral health education available in both the primary and secondary level school curriculum in Tamil Nadu. Objective: This thesis was conducted to collect baseline data to measure the epidemiology of dental caries and the level of oral health literacy among adolescents in rural and urban schools of Tamil Nadu, India. Methods: Oral health literacy and the epidemiology of dental caries were measured in 974 adolescent school students (12-15 year-olds) from both rural and urban areas of Tamil Nadu, India. There were three research questions answered in this thesis using a cross-sectional descriptive correlational quantitative study design. The first research question was addressed by measuring the Decayed, Missing and Filled teeth index (DMFT) using the WHO oral health survey method. The second research question was addressed by measuring the oral health literacy of 974 adolescent participants using a self-administered questionnaire developed for this study. The third research question was addressed by examining the association between the severity of dental caries (question 1) and oral health literacy (question 2). Results: The oral health survey indicated that prevalence of dental caries among adolescents in rural and urban parts of Tamil Nadu was 61.4% with an average DMFT score of 2.03. Multiple regression analyses indicated factors such as gender, age, mother’s education, type of schools and community/caste as significant predictors of dental caries. This is the first study to assess the impact of community on oral health literacy and status of adolescents. Almost 92% of participants reported that they had never been to a dentist. In total, 1980 teeth were affected and 98.6% (1953) affected teeth were decayed and not filled. The Cronbach’s alpha score (0.651) demonstrated the developed questionnaire had good internal consistency. In total, 35% of participants had poor oral health literacy (OHL) skills and only 8.3% of participants had good OHL skills to prevent dental caries. Parent’s education, gender and community/caste were identified as significant predictors of OHL in the regression analysis. A strong negative association between oral health literacy scores and dental caries prevalence and severity was identified in the study. Conclusion: The current study is the first to find an association between oral health literacy and dental caries in an adolescent population both in international and Indian literature. The prevalence of dental caries was decreased and severity of dental caries was increased when compared to previous research in Tamil Nadu. This result implies an imbalance in availability of oral health services in Tamil Nadu, India. The study results also imply that the majority of the study population had poor or moderate oral health literacy to prevent and manage dental caries. Females, Scheduled Caste and Tribes attending public schools in rural areas were identified as the more vulnerable populations to get affected by dental caries due to their poor oral health literacy. Oral health policies should be targeted to these adolescent populations in the Tamil Nadu region. Improving oral health literacy education in the school and pre-school curriculum could help to manage oral health in adolescents.

The purpose of this research was to examine potential sustainable delivery methods for Oral Health Promotion (OHP) in developing populations in India, utilising non-dental rural community development groups, specifically those led by Non-Governmental Organizations (NGO) involved in community development. The focus of this research was based on a longitudinal cohort study experimental design for exploratory purposes conducted over a period of one year, using a randomised cluster sampling of community developmental projects within the rural-tribal villages of Ambernath, Maharashtra, India. The study was measured in 4 phases: oral health knowledge of village parents through a questionnaire, dental screenings of children, and integration of a ‘train-the-trainer’ type of Oral Health Awareness Programme (OHAP) for three test groups, followed by one-year comparison follow-up data. Findings show evidence of comprehension and dissemination of the information in the OHAP course. Screening data also showed a reduction in decay in primary and permanent teeth in the children, after one year, and a positive change in oral hygiene behaviours. The collaboration and utilisation of non-dental NGO teams and local participatory groups from a ‘grass-roots’ level was proven to be effective for disseminating information and activities for oral health awareness and promotional programmes within these populations. Evidence supports a collaboration of these groups can be recommended for introducing a structured and understandable oral health programme utilising non-dental NGO and local participatory groups.

A thesis submitted to the College of Dental Medicine of Nova Southeastern University of the degree of Master of Science in Dentistry. Goal and Objectives. The main goal of this study is to assess childcare center directors (CCCDs) oral health literacy, knowledge, and attitudes towards pediatric oral health. We also determined the associations between CCCDs oral health literacy, knowledge, attitudes towards pediatric oral health, and 1) number of oral health preventive strategies (OHPS) implemented in their child care center (CCC), and 2) intent to adopt OHPS in the future. Background. Childcare utilization has substantially increased over the past decade with children enrolled in these centers spending substantial amount of time. CCCs, a non-traditional setting, can be used to actively promote pediatric oral health. However, before this setting can be used to promote oral health, a better understanding of Florida CCCDs' oral health literacy, knowledge, and attitudes on pediatric oral health is needed. Methods. In this cross-sectional study we used a 45-item pre-tested questionnaire to survey Florida CCCDs working primarily in licensed CCCs through survey monkey online portal. Descriptive, bivariate statistics and multivariate regression analyses were conducted using SAS analysis software. Results. Of the 877 CCCD participants, 90% did not train staff about traumatic dental injuries, 87% did not have an oral health consultant, and 82% did not promote enrollees to brush their teeth after meals or snacks. Mean oral health literacy (12.3±2.3) and attitude levels (16.8±2.7) were high, however mean oral health knowledge (1.6±2.0) was low. CCCDs with more years of experience (p=0.01), who work at Head Start CCCs ( p<0.0001), and have more positive attitudes (p<0.0001), were more likely to have implemented OHPS in their centers compared to their counterparts. Non-White CCCDs (p=0.03), those with more positive attitudes(p=0.001), and who reported to have already implemented one or more OHPS (p=0.002) were more willing to implement OHPS in the future compared to their counterparts. Conclusions. No significant associations between oral health literacy, knowledge and number of OHPS implemented were observed. Similarly, oral health literacy, oral health knowledge was not associated with intent to implement OHPS in the future. CCCDs with more positive attitudes towards pediatric oral health had implemented more OHPS within their CCCs, and also were willing to implement more OHPS in the future compared to their counterparts.

<p>The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived&nbsp / by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with&nbsp / mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were&nbsp / coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred&nbsp / allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents&nbsp / </p>

<p>The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived&nbsp / by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with&nbsp / mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were&nbsp / coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred&nbsp / allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents&nbsp / </p>

Magister Public Health - MPH / The negative effect of poor oral health on quality of life and financial implication of work days lost as a result of dental pain can be accepted as a rationale for inclusion of oral health in the primary health care (PHC) package for South Africa. The norms of the PHC package for oral health services are to expose at least 50% of primary schools to organized school preventive programmes and to ensure basic coverage of everybody in the catchment areas. Currently these norms are not adequately fulfilled in Randfontein. The purpose of this study was to gather information that can be used to improve oral health services in Randfontein. The aim of the study was to gain an understanding of the factors that influence the choice of oral health care seeking behaviour as perceived by residents in different contexts and to use these perceptions to inform appropriate health planning strategies and implementation of measures that can improve health promotion in Randfontein. This qualitative study explored oral health care seeking behaviour. The study population comprised all residents of Randfontein above seventeen years old who had visited the oral health section in the Randfontein Primary Health Care (PHC) Facility. There were two focus group discussions (FGDs) from each of three separate residential areas namely Mohlakeng with mainly black residents, Toekomsrus with mainly coloured race residents and from town which is a predominantly Caucasian race area. Data collected was analysed during the data collection stage and thereafter until they made sense to the researcher. To strengthen validity, the accuracy of the interpretation of what respondents said was confirmed with them. Analysed themes were coded and categorized to enable the key researcher to interpret them for final reporting. Appropriate ethical procedures were followed. The findings were that although all focus groups preferred allopathic oral health care seeking, various barriers existed. The study concluded that there should be adequate oral health education and promotion, effectivecommunication and an expansion of these services to Toekomsrus, where they do not exist. Perceptions on factors influencing oral health seeking by Randfontein residents. / South Africa

Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall health. A total of 66 NPs were included in the study, primarily female (91%) with master’s degrees (77%). While knowledge and education were not significantly associated, this research found significant associations between confidence and assessments, less than one-third (30.3%) were confident in their knowledge and ability to evaluate oral abnormalities.