Training rural women to improve access to oral health awareness programmes in remote villages in Nepal

Knevel, Ron

doi:10.1111/j.1601-5037.2010.00481.x

Cited by 6 publications

(7 citation statements)

References 12 publications

(13 reference statements)

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“…The ethnic composition of the study population was relatively homogenous, divided across the Pahadi group (people originally from the hills) and Madeshi group (people originally from the plains)) indigenous to Nepal. Risk factors for poor oral health that were prevalent in our population included rural location, low-socioeconomic status, and poor oral hygiene, specifically that women typically only cleaned their teeth once per day (sometimes with datiwan, rather than a toothbrush), few used fluorinated toothpaste, almost none flossed or used oral rinse, and access to professional dental health care was rare [26–28].…”

Section: Discussionmentioning

confidence: 99%

Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal

Erchick

Rai²,

Agrawal

et al. 2019

BMC Oral Health

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BackgroundThe oral health status of pregnant women in low-resource communities such as Nepal has not been well characterized. This sub-population is also of specific interest given associations between poor oral health and adverse pregnancy outcomes previously documented in other settings. We explored relationships between gingivitis and risk factors among pregnant women in rural Nepal.MethodsThe design was a community-based, cross-sectional study in a sub-area of Sarlahi District, Nepal. Pregnant women < 26 weeks gestation underwent clinical periodontal exams conducted by community-based oral health workers. Exams included a full mouth assessment measuring bleeding on probing (BOP), probing depth (PD) (six sites per tooth), and gingival recession, the distance from the cemento-enamel junction to the free gingival margin (two direct sites per tooth). Data on participant risk factors were collected through household surveys, including demographic characteristics, oral health behaviors, care seeking, and health attitudes. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors.ResultsWe enrolled 1452 participants, of which 40% (n = 582) had signs of clinical gingivitis and 60% (n = 870) clinical health. Average participant age was 23. Most participants (88%) had never received oral health care. Participants averaged 10% of sites with BOP with most (79%) having ≥1 site with BOP. Nine percent of participants had ≥1 site with PD ≥4 mm, although very few participants (0.7%) had sites with PD ≥5 mm. Few participants (13%) had any recession (≥1 mm). In the final adjusted model, odds of gingivitis increased by 3% for each year of age (aOR 1.03, 95% CI 1.00, 1.06) and were higher for women of short maternal stature (< 150 cm) (aOR 1.43, 95% CI: 1.14, 1.79) and among women reporting cost to be a barrier to seeking dental care (aOR 2.13, 95% CI: 1.09, 4.15).ConclusionsGingivitis was common and associated with age, maternal stature, self-reported high cost of dental care, and other risk factors among pregnant women in rural Nepal.Trial registrationClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study) and NCT02788786 (Pilot Trial).Electronic supplementary materialThe online version of this article (10.1186/s12903-018-0681-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal

Erchick

Rai²,

Agrawal

et al. 2019

BMC Oral Health

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“…This suggests that standardized, culturally-specific, and simple educational messaging need to be developed and delivered through appropriate behavioral change communication approaches. One such possibility includes training rural women in oral health promotion activities, an approach that has demonstrated improved oral health knowledge among female community members in Nepal [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Oral health knowledge, behavior, and care seeking among pregnant and recently-delivered women in rural Nepal: a qualitative study

Lubon

Erchick

Khatry³

et al. 2018

BMC Oral Health

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BackgroundOral health behavior and attitudes of pregnant women in low-income countries are rarely examined, yet should be considered when designing preventative or therapeutic studies to reduce burden of oral diseases. We aimed to understand dental care-seeking behavior, as well as oral health knowledge and attitudes of oral health among pregnant women in rural Nepal.MethodsSemi-structured in-depth interviews (n = 16) and focus group discussions (3 groups, n = 23) were conducted among pregnant and recently-delivered women in Sarlahi, Nepal. Transcripts were translated from the local language to English then analyzed using a hybrid approach to thematic coding with Atlas.ti version 7.ResultsWomen felt confident describing the signs and symptoms of tooth decay and gum disease, but were not knowledgeable about where to receive care for tooth and/or gum pain and relied heavily on the knowledge of their community. Some women used a toothbrush and toothpaste at least once a day to clean their teeth, but many reported the traditional use of a branch of a local shrub or tree as their teeth cleaning instrument. Women suggested a willingness to consider using an oral rinse throughout pregnancy, perceiving that it might have a positive impact on infant health.ConclusionsFuture studies should focus on providing adequate and sustainable resources for pregnant women in Nepal and other low income settings to engage in good oral health behaviors (possibly supported through community-based workers), to maintain dental hygiene, and to access qualified dentists as a means of improving their oral health.Trial registrationClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study) and NCT02788786 (Pilot Trial).

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“…They are likely to serve and remain in the rural areas . Training rural women to be oral health advocates in Nepal could be a cost‐effective means of increasing oral health awareness in different rural areas in Nepal .…”

Section: Discussionmentioning

confidence: 99%

Perception of Nepalese dental hygiene and dentistry students towards the dental hygienists profession

Knevel

Gussy

Farmer

et al. 2016

Int J Dental Hygiene

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Supervision of the dental hygienist by dentists and issues surrounding the scope of practice are polarizing the relationship between dentists, dental hygienists and the relevant professional organizations. This could hinder cooperation between these oral health professionals and might lead to underutilization of the dental hygienist. To improve the understanding about the roles of each oral health professional, establishing functional relationships and intraprofessional education involving dentistry and dental hygiene students needs to be introduced. This will benefit the introduction of preventative oral health services in Nepal. Government jobs and incentives to increase the retention and distribution of oral health professionals should be created. The government and professional organizations need to consider professionalizing the dental hygiene workforce and formalize the scope of practice. The unique demographic details of Nepal require a paradigm shift in oral health workforce management in Nepal.

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Training rural women to improve access to oral health awareness programmes in remote villages in Nepal

Abstract: A community-oriented educational intervention programme for rural women in basic oral health promotion activities could be a successful culturally sensitive means to support access to oral health awareness programmes for Nepalese people in remote areas.

Cited by 6 publications

References 12 publications

Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal

Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal

Oral health knowledge, behavior, and care seeking among pregnant and recently-delivered women in rural Nepal: a qualitative study

Perception of Nepalese dental hygiene and dentistry students towards the dental hygienists profession

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