In 1921, New Zealand began training school dental nurses, subsequently deploying them throughout the country in school-based clinics providing basic dental care for children. The concept of training dental nurses, later to be designated dental therapists, was adopted by other countries as a means of improving access to care, particularly for children. This paper profiles six countries that utilise dental therapists, with a description of the training that therapists receive in these countries, and the context in which they practice. Based on available demographic information, it also updates the number of dental therapists practising globally, as well as the countries in which they practice. In several countries, dental therapy is now being integrated with dental hygiene in training and practice to create a new type of professional complementary to a dentist. Increasingly, dental therapists are permitted to treat adults as well as children. The paper also describes the status of a current initiative to introduce dental therapy to the United States. It concludes by suggesting that dental therapists can become valued members of the dental team throughout the world, helping to improve access to care and reducing existing disparities in oral health.
This survey encompasses 3 comparable datasets of newly admitted dental students in 1972 (n=236), 1982 (n=197), and 1994 (n=108). The objectives of the survey were to describe selected socio-demographic characteristics of dental students and to analyze possible changes over time as well as possible changes in the reasons reported by the students for choosing dentistry as a career, their motivations and their expectations concerning the study and the profession of dentistry. The results showed that the ratio of women to men remained unchanged at 6:4 in all 3 cohorts of students and that the students were increasingly recruited from the 2 upper social classes. The motives for choosing dentistry mainly included altruistic motives, the desire for varied work with the opportunity to put theory into practice, economic rewards, and the implicit social status. Compared to the 1972 students, those in 1994 placed greater emphasis on social status as a motive, on the opportunity to work in the biological and scientific field, and on the ready availability of work outside Denmark. The students in all 3 years had strong altruistic motives for choosing dentistry, and it would seem that this stable continuity in the cohort of dental students would ensure the continuous controlled development of dentistry in the new millennium.
Emergency department dental visits are a significant and costly public health problem for vulnerable individuals. Future efforts should focus on implementing multilevel interventions to reduce ED dental visits.
BackgroundDental caries (decay) is an international public health challenge, especially amongst young children. Early Childhood Caries is a rapidly progressing disease leading to severe pain, anxiety, sepsis and sleep loss, and is a major health problem particularly for disadvantaged populations. There is currently a lack of research exploring the interactions between risk and protective factors in the development of early childhood caries, in particular the effects of infant feeding practises.Methods/DesignThis is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence.DiscussionThis study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney.
A population's utilization of dental services is an important parameter in oral health care planning, which has rarely been studied in China. The objectives of this report were to describe the dental service utilization pattern of middle-aged and elderly Chinese and to analyze the influence of selected variables on the use of dental services. A Guangdong Province population of 1,573 35- to 44-year-olds and 1,515 65- to 74-year-olds recruited from urban and rural communities was interviewed in their local dialect. It was found that 23% of the middle-aged and 24% of the elderly subjects had visited a dentist within the preceding year. The two most commonly cited reasons for not having seen a dentist for at least 3 years were: no perceived need, and no serious dental problems. Among subjects who had visited a dentist within 3 years, the 3 most commonly received treatments were: fillings, extractions, and dental prostheses. Furthermore, a logistic regression analysis showed that women, subjects who lived in urban areas, were better educated, were wealthier, and had better oral health knowledge were more likely to be a recent dental service user. In conclusion, dental service utilization among the adult Southern Chinese was found to be low, problem-driven, and influenced by some socio-economic factors.
The objectives of the study were to describe the oral health status and treatment needs of the 5- to 6-year-old and 12-year-old children in Southern China; to describe the patterns of oral health behaviors, knowledge, and attitudes among the 12-year-olds; and to assess the effects of socio-behavioral factors on the 12-year-old children's dental caries experiences. The study sample was comprised of 1,587 5- to 6-year-old and 1,576 12-year-old urban and rural schoolchildren living in Guangdong Province. Three calibrated dentists clinically examined the children, and trained interviewers interviewed the 12-year-olds. Caries prevalence of the 5- to 6-year-old children was high (urban 78% vs. rural 86%); the mean dmft of the urban and rural children was 4.8 and 7.0, respectively. The caries prevalence and mean DMFT score of the 12-year-olds were 41% and 0.9 (urban) and 42% and 0.9 (rural). Only 2% of the 12-year-olds exhibited no calculus or gingival bleeding, while more than 70% had calculus. In conclusion, there is an urgent need for establishing caries-preventive activities for preschool children. The prevalence of caries among the 12-year-olds was not high, but their periodontal condition was unsatisfactory. Knowledge about gum bleeding and the use of fluoride was low. More oral health education activities should be organized, especially for the rural children.
BackgroundWith the increasingly polarized distribution of dental caries among children and adolescents, the usual DMFT measure has become a less meaningful population descriptor. To re-focus on identifying the high caries prevalence group the Significant Caries Index (SiC) was created. The aims of this study were to analyze the prevalence and severity of dental caries in Nevada youth over a period of eight years and to compare its expression by means of DMFT and SiC; analyze the caries trends in the population and their underlying factors, and determine whether Nevada youth were at risk for significantly high levels of dental caries.MethodsRetrospective data was analyzed from a series of sequential, standardized oral health surveys across eight years (2001/2002-2008/2009) that included over 62,000 examinations of adolescents 13-19 years of age, attending public/private Nevada schools. Mean Decayed-Missing-Filled Teeth index (DMFT) and Significant Caries Index (SiC) were subsequently computed for each academic year. Descriptive statistics were reported for analysis of comparative DMFT and SiC scores in relation to age, gender, racial background, and residence in a fluoridated/non-fluoridated community. Logistic regression analysis was used to analyze the differential impact of the variables on the probability of being in the high caries prevalence group.ResultsComparison of students' mean DMFT to National (NHANES) data confirmed that dental caries remains a common chronic disease among Nevada youth, presenting higher prevalence rates and greater mean scores than the national averages. Downward trends were found across all demographics compared between survey years 1 and 6 with the exception of survey year 3. An upward trend began in survey year six. Over time, the younger group displayed an increasing proportion of cariesfree individuals while a decreasing proportion was found among older examinees. As expected, the mean SiC score was significantly higher than DMFT scores within each survey year across comparison groups (p < 0.001).ConclusionsUsing both caries indices together may help to highlight oral health inequalities more accurately among different population groups within the community in order to identify the need for special preventive oral health interventions in adolescent Nevadans. At the community level, action should focus on retaining and expanding the community fluoridation program as an effective preventive measure. At the individual level the study identifies the need for more targeted efforts to reach children early with a focus on females, Hispanics and Blacks, and uninsured children.
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