Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A multi-centre randomised controlled trial

George, Ajesh; Dahlen, Hannah G; Blinkhorn, Anthony; Ajwani, Shilpi; Bhole, Sameer; Ellis, Sharon; Yeo, Anthony E. T.; Elcombe, Emma; Johnson, Maree

doi:10.1016/j.ijnurstu.2018.03.006

Cited by 65 publications

(92 citation statements)

References 26 publications

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“…A purposive sampling technique was utilised to recruit participants . All DOs and DAs, who worked in the Public Dental Service in NSW and were involved in the MIOH‐DS trial, were invited to participate. These participants were in the best position to provide feedback on the MIOH‐DS intervention as they were in close interaction with pregnant women throughout the multicenter trial .…”

Section: Methodsmentioning

confidence: 99%

“…All DOs and DAs, who worked in the Public Dental Service in NSW and were involved in the MIOH‐DS trial, were invited to participate. These participants were in the best position to provide feedback on the MIOH‐DS intervention as they were in close interaction with pregnant women throughout the multicenter trial . Focus groups were conducted between December 2015 and March 2016, which was within 6 months of completion of the trial.…”

Section: Methodsmentioning

confidence: 99%

“…The aim of this process evaluation was to understand the functioning of the intervention, delivered as part of the MIOH‐DS multicentre trial, from the point of view of dental staff [Dental Officers’ (DOs) and Dental Assistants’ (DAs)] who were involved in the trial. Specifically, the study sought to explore their perceptions about the acceptability, feasibility and effectiveness of the program if it were to be scaled up and replicated in other settings.…”

Section: Aimsmentioning

confidence: 99%

“…The program was evaluated through a multicentre trial and the findings showed significant improvement in the knowledge and confidence of midwives across NSW and Victoria in promoting oral health post‐training . Furthermore, women who received both the midwife and dental interventions were more likely to see a dentist have improved oral health, increased knowledge and better oral health quality of life during pregnancy . Details of the trial have been published elsewhere …”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, women who received both the midwife and dental interventions were more likely to see a dentist have improved oral health, increased knowledge and better oral health quality of life during pregnancy . Details of the trial have been published elsewhere …”

Section: Introductionmentioning

confidence: 99%

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Process evaluation of the midwifery initiated oral health‐dental service program: Perceptions of dental professionals

Ajwani

Sousa

Villarosa

et al. 2018

Health Prom J of Aust

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Issue addressed All pregnant women should have a comprehensive oral health evaluation. Unfortunately, many pregnant women seldom seek dental care and some dentists are hesitant to treat during pregnancy. To address these issues, the Midwifery Initiated Oral Health Dental Service (MIOH‐DS) program was developed in Australia. The aim of this study was to undertake a process evaluation and explore the perceptions of dental professionals involved in the program to determine the acceptability, feasibility and effectiveness of the program if it were to be upscaled. Methods A qualitative approach using content analysis was conducted on data from two focus groups involving 12 dental professionals. Results All participants were supportive of the MIOH‐DS program. They thought pregnant women were receptive to their care, and reported markedly improved oral health. The provision of free dental care and the involvement of midwives were cited as major factors that improved the uptake of the program. Some of the challenges encountered were the prevailing misconceptions about the safety of dental treatment and pregnancy‐related impairments. Conclusions Dental professionals found the MIOH‐DS to be acceptable, feasible and effective in improving oral health of pregnant women and their uptake of dental services. However, some challenges need to be addressed as the MIOH‐DS program is upscaled into a cost‐effective model. So what? Dental professionals are important stakeholders in the MIOH‐DS model. The process evaluation of the successful dental intervention is necessary to understand how and why such interventions work, and is an important step in scaling up to a population‐wide intervention.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Aimsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Process evaluation of the midwifery initiated oral health‐dental service program: Perceptions of dental professionals

Ajwani

Sousa

Villarosa

et al. 2018

Health Prom J of Aust

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Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Adults

Chou,

Selph,

Bougatsos

et al. 2023

JAMA

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ImportanceDental caries and periodontal disease are common adult oral health conditions and potentially amenable to primary care screening and prevention.ObjectiveTo systematically review the evidence on primary care screening and prevention of dental caries and periodontal disease in adults to inform the US Preventive Services Task Force.Data SourcesMEDLINE, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews (to October 3, 2022); surveillance through July 21, 2023.Study SelectionDiagnostic accuracy studies of primary care screening instruments and oral examination; randomized and nonrandomized trials of screening and preventive interventions; cohort studies on primary care oral health screening and preventive intervention harms.Data Extraction and SynthesisOne investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. Diagnostic accuracy data were pooled using a bivariate mixed-effects binary regression model.Main Outcomes and MeasuresDental caries, periodontal disease, morbidity, quality of life, harms; and diagnostic test accuracy.ResultsFive randomized clinical trials, 5 nonrandomized trials, and 6 observational studies (total 3300 participants) were included. One poor-quality trial (n = 477) found no difference between oral health screening during pregnancy vs no screening in caries, periodontal disease, or birth outcomes. One study (n = 86) found oral health examination by 2 primary care clinicians associated with low sensitivity (0.42 and 0.56) and high specificity (0.84 and 0.87) for periodontal disease and with variable sensitivity (0.33 and 0.83) and high specificity (0.80 and 0.93) for dental caries. Four studies (n = 965) found screening questionnaires associated with a pooled sensitivity of 0.72 (95% CI, 0.57-0.83) and specificity of 0.74 (95% CI, 0.66-0.82) for periodontal disease. For preventive interventions no study evaluated primary care counseling or dental referral, and evidence from 2 poor-quality trials (n = 178) of sealants, and 1 fair-quality and 4 poor-quality trials (n = 971) of topical fluorides, was insufficient. Three fair-quality trials (n = 590) of persons with mean age 72 to 80 years found silver diamine fluoride solution associated with fewer new root caries lesions or fillings vs placebo (mean reduction, −0.33 to −1.3) and decreased likelihood of new root caries lesion (2 trials; adjusted odds ratio, 0.4 [95% CI, 0.3-0.7]). No trial evaluated primary care–administered preventive interventions.Conclusions and RelevanceScreening questionnaires were associated with moderate diagnostic accuracy for periodontal disease. Research is needed to determine benefits and harms of oral health primary care screening and preventive interventions.

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Screening and Preventive Interventions for Oral Health in Adults

Barry,

Nicholson,

Silverstein

et al. 2023

JAMA

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ImportanceOral health is fundamental to health and well-being across the life span. Dental caries (cavities) and periodontal disease (gum disease) are common and often untreated oral health conditions that affect eating, speaking, learning, smiling, and employment potential. Untreated oral health conditions can lead to tooth loss, irreversible tooth damage, and other serious adverse health outcomes.ObjectiveThe US Preventive Services Task Force (USPSTF) commissioned a systematic review to evaluate screening and preventive interventions for oral health conditions in adults.PopulationAsymptomatic adults 18 years or older.Evidence AssessmentThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions for oral health conditions (eg, dental caries or periodontal disease) performed by primary care clinicians in asymptomatic adults.RecommendationsThe USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of routine screening performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement) The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of preventive interventions performed by primary care clinicians for oral health conditions, including dental caries or periodontal-related disease, in adults. (I statement)

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Evaluation of a midwifery initiated oral health-dental service program to improve oral health and birth outcomes for pregnant women: A multi-centre randomised controlled trial

Cited by 65 publications

References 26 publications

Process evaluation of the midwifery initiated oral health‐dental service program: Perceptions of dental professionals

Process evaluation of the midwifery initiated oral health‐dental service program: Perceptions of dental professionals

Screening, Referral, Behavioral Counseling, and Preventive Interventions for Oral Health in Adults

Screening and Preventive Interventions for Oral Health in Adults

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