ABSTRACT Objective: To evaluate the effectiveness of the WhiteTeeth mobile app, a theory-based mobile health (mHealth) program for promoting oral hygiene in adolescent orthodontic patients. Methods: In this parallel randomized controlled trial, the data of 132 adolescents were collected during three orthodontic check-ups: at baseline (T0), at 6-week follow-up (T1), and at 12-week follow-up (T2). The intervention group was given access to the WhiteTeeth app in addition to usual care (n=67). The control group received usual care only (n=65). The oral hygiene outcomes were the presence and the amount of dental plaque (Al-Anezi and Harradine plaque Index); and the total number of sites with gingival bleeding (Bleeding on Marginal Probing Index). Oral health behavior and its psychosocial factors were measured through a digital questionnaire. We performed linear mixed model analyses to determine the intervention effects. Results: At 6-week follow-up, the intervention led to a significant decrease in gingival bleeding (B=-3.74; 95%CI -6.84 to -0.65), and an increase in the use of fluoride mouth rinse (B=1.93; 95%CI 0.36 to 3.50). At 12-week follow-up, dental plaque accumulation (B=-11.32; 95%CI -20.57 to -2.07) and the number of sites covered. Conclusions: The results show that adolescents with fixed orthodontic appliances can be helped to improve their oral hygiene when usual care is combined with a mobile app that provides oral health education and automatic coaching. Netherlands Trial Registry Identifier: NTR6206: 20 February 2017.
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OBJECTIVES: This systematic and meta-analytic review aimed to quantify the association of psychosocial correlates with oral hygiene behaviour among 9- to 19-year olds. METHODS: A systematic search up to August 2015 was carried out using the following databases: PubMed, PsycInfo, Embase, CINAHL and Web of Science. If necessary, authors of studies were contacted to obtain unpublished statistical information. A study was eligible for inclusion when it evaluated the association between the psychosocial correlates and oral hygiene behaviour varying from self-reports to clinical measurements, including plaque and bleeding scores. A modified New Castle Ottawa Scale was applied to examine the quality of the included studies. RESULTS: Twenty-seven data sets (k) presented in 22 publications, addressing nine psychosocial correlates, were found to be eligible for the meta-analysis. For both tooth brushing and oral hygiene behaviour, random effect models revealed significant weighted average correlation (r+ ) for the psychosocial factors: 'intention', 'self-efficacy', 'attitude' (not significant for tooth brushing), 'social influence', 'coping planning' and 'action planning' (r+ ranging from 0.18 to 0.57). Little or no associations were found for 'locus of control', 'self-esteem' and 'sense of coherence' (r+ ranges from 0.01 to 0.08). CONCLUSIONS: The data at present indicates that 'self-efficacy', 'intention', 'social influences', 'coping planning' and 'action planning' are potential psychosocial determinants of oral health behaviour. Future studies should consider a range of psychological factors that have not been studied, but have shown to be important psychosocial determinants of health behaviours, such as 'self-determination', 'anticipated regret', 'action control' and 'self-identity'. Effectiveness of addressing these potential determinants to induce behaviour change should be further examined by intervention trials.
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OBJECTIVES: To make practical recommendations for improving oral hygiene behavior (OHB) potential predictors based on the Theory of Planned Behavior (TPB) were assessed. Measurements of oral health knowledge (OHK) and the expected social effect for having healthy teeth were included.METHODS: 216 recruits in the Dutch Army ground forces completed a questionnaire about oral hygiene behavior, attitudes, social norms, perceived behavioral control (PBC), intention to perform optimal OHB, OHK, and expected social outcomes.RESULTS: The multivariate regression analysis revealed that attitude and PBC explained 37.2% of the variance in intention to perform optimal oral hygiene behavior, which is a substantial proportion. Furthermore, actual oral hygiene behavior was only predicted by attitude, explaining 7.1% of the variance.CONCLUSION: The present findings suggest that recruits' oral hygiene behavior may be improved by promoting a more positive attitude and especially by enhancing perceived behavior control.
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In BMC Oral Health verscheen het volgende artikel van Inholland-docente en promovenda Janneke Scheerman (en collega’s). Background: Adolescents with fixed orthodontic appliances are at high risk of developing dental caries. To date, new smartphone technologies have seldom been used to support them in the preventive behavior that can help prevent dental caries. After an intervention-mapping process, we developed a smartphone application (the WhiteTeeth app) for preventing dental caries through improved oral-health behavior and oral hygiene. The app, which is intended to be used at home, will help adolescents with fixed orthodontic appliances perform their oral self-care behavior. The app is based on the Health Action Process Approach (HAPA) theory, and incorporates several behavior-change techniques that target the psychosocial factors of oral-health behavior. This article describes the protocol of a randomized controlled trial (RCT) to evaluate the effects of the WhiteTeeth app on oral-health behavior and oral-hygiene outcomes (presence of dental plaque and gingival bleeding) compared with those of care as usual, in patients aged 12–16 with fixed orthodontic appliances.
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OBJECTIVE: The aim of this study was to develop an index for oral hygiene behavior (OHB) and to examine potential predictors of this actual behavior based on the theory of planned behavior (TPB). Measures of oral health knowledge (OHK) and the expected effect of having healthy teeth on social relationships were included too.MATERIAL AND METHODS: Using an Internet questionnaire, 487 participants were asked about actual OHB, attitudes (ATT), social norms (SN), perceived behavioral control (PBC), OHK, and expected social outcomes (ESO). Based on a Delphi method involving oral health professionals, a new index for OHB was developed, including tooth brushing, interdental cleaning, and tongue cleaning.RESULTS: Regression analysis revealed that the TPB variables (ATT, SN, and PBC) and OHK explained 32.3% of the variance in self-reported OHB.CONCLUSION: The present findings indicate that socio-psychological consequences play a role in oral health care.
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The purpose of this study was to identify predictors of oral hygiene behaviour (OHB) based on the Theory of Planned Behaviour (TPB) among dental care seekers in two cultural different regions: the Caribbean (Aruba/Bonaire) and Nepal. In addition, measures of oral health knowledge (OHK) and the expected social outcomes of having healthy teeth (ESO) were investigated. The main effects of the predictors as well as their interactions with region (Caribbean vs. Nepal) were examined. The interaction term contributed significantly to the amount of explained variance. In the Caribbean, OHB was determined by Attitude and Social Norms, and in Nepal by Perceived Behaviour Control and ESO. On the basis of these findings, quite different oral health care interventions are called for in developing and underdeveloped countries.
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Background: Regular inspection of the oral cavity is required for prevention, early diagnosis and risk reduction of oral- and general health-related problems. Assessments to inspect the oral cavity have been designed for non-dental healthcare professionals, like nurses. The purpose of this systematic review was to evaluate the content and the measurement properties of oral health assessments for use by non-dental healthcare professionals in assessing older peoples’ oral health, in order to provide recommendations for practice, policy, and research. Methods: A systematic search in PubMed, EMBASE.com, and Cinahl (via Ebsco) has been performed. Search terms referring to ‘oral health assessments’, ‘non-dental healthcare professionals’ and ‘older people (60+)’ were used. Two reviewers individually performed title/abstract, and full-text screening for eligibility. The included studies have investigated at least one measurement property (validity/reliability) and were evaluated on their methodological quality using “The Consensus-based Standards for the selection of health Measurement Instruments” (COSMIN) checklist. The measurement properties were then scored using quality criteria (positive/negative/indeterminate). Results: Out of 879 hits, 18 studies were included in this review. Five studies showed good methodological quality on at least one measurement property and 14 studies showed poor methodological quality on some of their measurement properties. None of the studies assessed all measurement properties of the COSMIN. In total eight oral health assessments were found: the Revised Oral Assessment Guide (ROAG); the Minimum Data Set (MDS), with oral health component; the Oral Health Assessment Tool (OHAT); The Holistic Reliable Oral Assessment Tool (THROAT); Dental Hygiene Registration (DHR); Mucosal Plaque Score (MPS); The Brief Oral Health Screening Examination (BOHSE) and the Oral Assessment Sheet (OAS). Most frequently assessed items were: lips, mucosa membrane, tongue, gums, teeth, denture, saliva, and oral hygiene. Conclusion: Taken into account the scarce evidence of the proposed assessments, the OHAT and ROAG are most complete in their included oral health items and are of best methodological quality in combination with positive quality criteria on their measurement properties. Non-dental healthcare professionals, policymakers and researchers should be aware of the methodological limitations of the available oral health assessments and realize that the quality of the measurement properties remains uncertain.
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To assess the validity and reliability of the Dutch version of the Oral HealthImpact Profile (OHIP-14) in a sample of patients of a forensic psychiatrichospital
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Het doel van dit proefschrift betrof het verkennen van attituden en afwegingen rond taakherschikking tussen tandartsen en mondhygiënisten. Daarnaast werd nagegaan welke sociale kenmerken studenten toeschrijven aan elkaar, zichzelf en beide beroepsgroepen. Vervolgens werd het effect van een psychologische interventie in een onderwijssetting onderzocht op interprofessionele communicatie en percepties ten aanzien van interprofessionele taakverdeling. Tandartsen en mondhygiënisten hebben verschillende attituden ten opzichte van taakherschikking, vooral wat betreft de vrijgevestigde praktijk van mondhygiënisten. Dit laatste wordt het minst gewenst door tandartsen. Tandartsen en mondhygiënisten hebben verschillende afwegingen wanneer men een voor- of tegenstander is van dit beleid. De interprofessionele relatie tussen tandartsen en mondhygiënisten komt tot uiting in de attributie van specifieke sociale kenmerken. Tandheelkunde en mondzorgkunde studenten zijn beide de mening toegedaan dat tandartsen meer dominant zijn dan mondhygiënisten. Het faciliteren van interprofessionele groepsvorming kan zowel interprofessionele hiërarchie als tandarts-gecentreerde taakverdeling reduceren. Tijdens het eerste onderzoek (Hoofdstuk 2) werden verschillen tussen tandartsen en mondhygiënisten ontdekt ten aanzien van de taakuitbreiding van de mondhygiënist. De helft van alle tandartsen en de meeste mondhygiënisten hebben hierover een positieve attitude. Een interprofessionele kloof werd gevonden ten aanzien van de zelfstandige praktijkvoering van mondhygiënisten. Een minderheid van alle tandartsen heeft hierover een positieve attitude vergeleken met een meerderheid van alle mondhygiënisten. Dit suggereert dat de acceptatie van een zelfstandige mondhygiënist een groot obstakel is wanneer men taakherschikking wil implementeren. Tandartsen willen controle over de mondhygiënist behouden, daarom is het waarschijnlijk dat taakdelegatie boven taaksubstitutie wordt verkozen. Dit laatste betreft taakherschikking met professionele autonomie.
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Objectives: The aim of this scoping review was threefold: 1. to identify existing definitions of oral frailty and similar terms in gerodontology literature; 2. to assess the oral frailty definitions and analyze whether these are well formulated on a conceptual level; and 3. in the absence of existing definitions meeting the criteria for good conceptual definitions, a new conceptual definition of oral frailty will be presented. Methods: A search was performed in electronic databases and internet search engines. Studies explaining or defining oral frailty or similar terms were of interest. A software-aided procedure was performed to screen titles and abstracts and identify definitions of oral frailty and similar terms. We used a guide to assess the quality of the oral frailty definitions on methodological, linguistic, and content-related criteria. Results: Of the 1,528 screened articles, 47 full-texts were reviewed. Thirteen of these contained seven definitions of oral frailty and ten definitions of similar terms. We found that all definitions of oral frailty contain the same or equivalent characteristics used to define the concepts of ’oral health’, ’deterioration of oral function’, and ’oral hypofunction’. Between the seven definitions, oral frailty is described with a different number and combination of characteristics, resulting in a lack of conceptual consistency. None of the definitions of oral frailty met all criteria. Conclusion: According to our analysis, the current definitions of oral frailty cannot be considered ’good’ conceptual definitions. Therefore, we proposed a new conceptual definition: Oral frailty is the age-related functional decline of orofacial structures.
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