Objective: To conduct a capacity and needs assessment identifying important factors for the successful implementation of an oral health coach (OHC) at well-baby clinics. This Toddler Oral Health Intervention (TOHI) provides oral health promotion to parents to prevent early childhood caries. Methods: A two-round Delphi study was conducted with an expert panel consisting of OHCs and paediatric staff. The survey was based on the Consolidated Framework for Implementation Research (CFIR), consisting of 39 constructs divided over 5 domains: intervention characteristics (8), inner setting (14), outer setting (4), characteristics of individuals (5) and the process of implementation (8). Results: Constructs relating to the inner setting, outer setting and implementation process were identified as essential. Availability of resources, information on how to execute or facilitate the intervention, and the integration of the intervention into existing work tasks were also essential. Alignment and partnership between OHCs and paediatric staff, along with the prioritization of parents' and children's needs were emphasized. A formally appointed internal implementation leader within each organization, capable of transferring their enthusiasm to the team, and regular meetings for progress and experience sharing were considered essential. Conclusion: Specific strategies are needed in the implementation phase to increase the adoption, implementation and maintenance of the TOHI, ultimately leading to improved oral health in children. This study provides valuable insights into important factors for implementation of an oral health intervention in a public health setting.
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Openbare les van dr. Katerina Jerkovic-Cosic. De belangrijkste mondziekten zoals cariës (tandbederf), parodontitis (tandvleesontsteking) en mondkanker, worden net als welvaartsziekten veroorzaakt door een ongezonde leefstijl en zijn door middel van preventie te voorkomen. Een groot deel van de Nederlandse bevolking gaat minimaal één keer per jaar naar een tandarts of mondhygiënist voor een controle. Toch is mondzorg in Nederland nog steeds veelal gericht op curatie en minder op preventie. Het overgrote deel van de geleverde mondzorg is gericht op herstel, terwijl veel minder activiteiten zijn gericht op het voorkomen van mondziekten, door bijvoorbeeld aanpassing in de leefstijl of mondverzorging. De noodzaak voor preventie wordt steeds duidelijker. Een van de redenen is de enorme stijging van de zorgkosten.
OBJECTIVE: To identify the determinants of dental caries in relation to socio-economic status (SES) within oral health, children's eating habits and parental attitudes towards oral health.BASIC RESEARCH DESIGN: Dental screening data were collected from 6- and 10-year-old schoolchildren from low and high SES schools in The Netherlands in this cross-sectional study.METHODS: The clinical examination was performed by trained dental hygiene students who collected the data on dental caries, dental plaque and duration of brushing. The paper questionnaire completed by the parents included 18 questions about oral health behaviour, eating habits and parental attitudes towards oral health.RESULTS: Two of the six parameters of oral health behaviour were statistically associated with the high caries prevalence in the low SES group (brushing frequency (p = 0.028) and age at the first visit to the dentist (p = 0.044)). High intake of fruit juices and/or soft drinks (p = 0.043) and low calcium intake (p = 0.028) were identified as risk determinants for caries with low SES. All parameters of parental attitudes towards oral health were associated with caries, but not with SES.CONCLUSIONS: This study confirmed that the high caries prevalence in children from low SES schools was associated with oral health behaviour and eating habits. The role of parents was indirectly associated with the occurrence of dental caries. Therefore, it is important to include parents in all intervention programmes in order to reduce the prevalence of caries.
