Quality measures for dental care: A systematic review

Objectives: This systematic review aimed to (a) provide an overview of existing quality measures in the field of oral health care, and to (b) evaluate the scientific soundness and applicability of these quality measures. Methods: A systematic search was conducted in three electronic databases MEDLINE (via PubMed), EMBASE (via OVID) and LILACS (via BIREME). The search was restricted to articles published between 2002 and 2018. Publications reporting on the development process or clinimetric properties of oral health care quality measures for outpatient oral health care in dental practices were included. The identified publications reporting on oral health care quality measures were critically appraised with the Appraisal of Indicators through Research and Evaluation 2.0 (AIRE 2.0) instrument to evaluate the soundness and applicability of the measures. Results: The search strategy resulted in 2541 unique and potentially relevant articles. In total, 24 publications were included yielding 215 quality measures. The critical appraisal showed a large variation in the quality of the included publications (AIRE scores ranging from 38 to 78 out of 80 possible points). The majority of measures (n = 71) referred to treatment and preventive services. Comparably, few measures referred to the domain patient safety (n = 3). The development process of measures often exhibited a lack of involvement of patients and dental professionals. Few projects reported on the validity (n = 2) and reliability (n = 3) of the measures. Four projects piloted the measures for implementation in practice. Conclusions: This systematic review provides an overview of the status quo with respect to existing quality measures in oral health care. Potential opportunities include the piloting and testing of quality measures and the establishment of suitable information systems that allow the provision of transparent routine feedback on the quality of oral health care

The relationship between parenting, family interaction and childhood dental caries: A case-control study

a b s t r a c t The aim of this case-control study was to explore the relationship between parenting practices, parent echild interaction and childhood dental caries, using a sample of 5e8-year old children from the Netherlands. Cases were defined as children with four or more decayed, missing or filled teeth and controls were caries free. Cases (n ¼ 28) and controls (n ¼ 26) were recruited from a referral centre for paediatric dental care and a general dental practice, respectively. Parenting practices and parentechild interactions of the child's primary caregiver were observed using Structured Interaction Tasks and subsequently rated on seven dimensions: positive involvement, encouragement, problem-solving, discipline, monitoring, coercion and interpersonal atmosphere. All Structured Interaction Tasks were videotaped, and coded by trained and calibrated observers blind to the dental condition. Differences in parenting dimensions between cases and controls were analysed using multivariate analysis of variance, independent samples T-tests, c 2 -tests and multiple logistic regression analyses. Controls had significantly higher scores on the dimensions positive involvement, encouragement, problem-solving and interpersonal atmosphere, compared to cases. Parents of controls were also less likely to show coercive behaviours. These associations remained statistically significant after adjustment for the mother's education level, tooth brushing frequency and the frequency of consuming sugary foods and drinks, except for coercion. There was no significant difference in discipline between cases and controls. In conclusion, this case-control study found a significant relationship between parenting practices, parent echild interaction quality and childhood dental caries. Our findings suggest that parenting practices may be an important factor to consider in caries preventive programs

Simulation Workshop to Test STAR: a Home-based Toothbrushing Intervention within Childsmile

In Scotland, where socio-economic inequalities in child tooth decay persist, Childsmile’s community-based Dental Health Support Workers (DHSWs) deliver tailored interventions to families in need of additional support in the home setting, including the promotion of supervised toothbrushing in the early years. Aims: The aim of this study was to test the feasibility and acceptability of the STAR toothbrushing tool with DHSWs and families in a simulated setting to support implementation of supervised toothbrushing in the home. Methods: In August 2022, the STAR tool was developed/co-designed with DHSWs. It aims to help families to identify barriers to toothbrushing and provide strategies to overcome these barriers. A two day simulation workshop, was held in Glasgow Dental School, with four DHSWs, two parents and two simulated parents, who tested the acceptability and feasibility of the tool. The simulated interactions between DHSWs and parents were video recorded and analysed using the Function Resonance Analysis Method (FRAM) - a novel approach in this area. Exit interviews with participants were audio recorded and analysed using Framework analysis and the modified Consolidated Framework for Implementation Research (CFIR). Full NHS ethical approval and participant consent were obtained. Results: DHSWs and parents responded positively to the use of the STAR tool and reported it was easy to use and adaptable to families with different barriers to toothbrushing. Six weeks follow-up found that parents had been able to use the strategies given to them to make beneficial changes to their toothbrushing routines. FRAM analysis showed that the STAR tool can be used flexibly by DHSWs to provide tailored toothbrushing advice to families. Conclusions: In this simulation study, use of the STAR tool was feasible and acceptable to DHSWs and parents and allowed families to make improvements to their toothbrushing routines. The STAR tool is currently being rolled out and evaluated across the 14 NHS Scotland Health Boards