Impact of HIV on VA Dental Services: Report of a Survey

Objectives: This study assessed knowledge, attitudes, and behaviors related to the treatment of HIV-infected patients by Department of Veterans Affairs (VA) dental personnel. Methods : A questionnaire was mailed to all VA dentists, hygienists, and EFDA assistants and completed anonymously in May 1991. Descriptive results are reported along with comparisons between the findings from this study and a similar VA survey conducted in 1988, as well as several national surveys of non-VA dentists. Results : Nearly all VA respondents reported participation in some type of continuing education on HIV and infection control. They also reported high compliance with recommended infection control procedures. Furthermore, the findings suggest that VA dentists and hygienists have a high willingness to treat HIV-infected patients, far exceeding that expressed by non-VA dentists. However, a high level of anxiety related to occupational exposure to HIV seems to exist. Most respondents perceived a higher risk of HIV infection from commonly encountered occurrences in the workplace than actually exists based on current knowledge. Conclusions : While efforts to further reduce the risk of infection and improve care should continue, future efforts also should be directed toward reducing the anxiety of VA dental personnel in the treatment of infectious patients.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66390/1/j.1752-7325.1994.tb01215.x.pd

Patterns and correlates of tobacco control behavior among american association of pediatric dentistry members: a cross-sectional national study

<p>Abstract</p> <p>Background</p> <p>To determine the tobacco-related knowledge, attitudes, and practice behaviors among US pediatric dentists.</p> <p>Methods</p> <p>A survey was conducted in 1998 among a national, random sample of 1500 American Academy of Pediatric Dentistry members. Chi-square tests and logistic regression with odds ratios (ORs) and 95% confidence intervals assessed factors related to pediatric dentists' tobacco control behaviors.</p> <p>Results</p> <p>Response was 65% for the survey. Only 12% of respondents had prior tobacco prevention/cessation training. Of those untrained, 70% were willing to be trained. Less than two-thirds correctly answered any of four tobacco-related knowledge items. Over one-half agreed pediatric dentists should engage in tobacco control behaviors, but identified patient resistance as a barrier. About 24% of respondents reported always/often asking their adolescent patients about tobacco use; 73% reported always/often advising known tobacco users to quit; and 37% of respondents always/often assisting with stopping tobacco use. Feeling prepared to perform tobacco control behaviors (ORs = 1.9–2.8), a more positive attitude score (4 points) from 11 tobacco-related items (ORs = 1.5–1.8), and a higher statewide tobacco use prevalence significantly predicted performance of tobacco control behaviors.</p> <p>Conclusion</p> <p>Findings suggest thatraining programs on tobacco use and dependence treatment in the pediatric dental setting may be needed to promote tobacco control behaviors for adolescent patients.</p

When public action undermines public health: A critical examination of antifluoridationist literature

Background: The addition of the chemical fluorine to the water supply, called water fluoridation, reduces dental caries by making teeth more resistant to demineralisation and more likely to remineralise when initially decayed. This process has been implemented in more than 30 countries around the world, is cost-effective and has been shown to be efficacious in preventing decay across a person's lifespan. However, attempts to expand this major public health achievement in line with Australia's National Oral Health Plan 2004–2013 are almost universally met with considerable resistance from opponents of water fluoridation, who engage in coordinated campaigns to portray water fluoridation as ineffective and highly dangerous. Discussion: Water fluoridation opponents employ multiple techniques to try and undermine the scientifically established effectiveness of water fluoridation. The materials they use are often based on Internet resources or published books that present a highly misleading picture of water fluoridation. These materials are used to sway public and political opinion to the detriment of public health. Despite an extensive body of literature, both studies and results within studies are often selectively reported, giving a biased portrayal of water fluoridation effectiveness. Positive findings are downplayed or trivialised and the population implications of these findings misinterpreted. Ecological comparisons are sometimes used to support spurious conclusions. Opponents of water fluoridation frequently repeat that water fluoridation is associated with adverse health effects and studies are selectively picked from the extensive literature to convey only claimed adverse findings related to water fluoridation. Techniques such as "the big lie" and innuendo are used to associate water fluoridation with health and environmental disasters, without factual support. Half-truths are presented, fallacious statements reiterated, and attempts are made to bamboozle the public with a large list of claims and quotes often with little scientific basis. Ultimately, attempts are made to discredit and slander scientists and various health organisations that support water fluoridation. Summary: Water fluoridation is an important public health initiative that has been found to be safe and effective. Nonetheless, the implementation of water fluoridation is still regularly interrupted by a relatively small group of individuals who use misinformation and rhetoric to induce doubts in the minds of the public and government officials. It is important that public health officials are aware of these tactics so that they can better counter their negative effectJason M Armfiel

Reprodutibilidade de uma escala odontológica proposta como indicador de saúde bucal em crianças e adolescentes HIV+/SIDA Reproducibility of a scale for oral health among children and adolescents HIV+/AIDS

O objetivo deste trabalho foi estimar a reprodutibilidade de uma escala odontológica para avaliação da saúde bucal de crianças e adolescentes HIV+. A amostra, com delineamento não probabilístico, constituiu-se de 27 crianças e adolescentes HIV+. A escala foi aplicada, em duas ocasiões, com intervalo de sete dias. Estimou-se a reprodutibilidade intraexaminador pela estatística Kappa. Nas questões relativas à mãe, houve concordância máxima nos itens referentes à importância da saúde bucal, hábito de escovação diária e utilização de escova dental. A procura de atendimento odontológico motivado por estética e para manutenção de hálito puro apresentou concordância boa. Nas questões relativas à criança, observou-se concordância regular nos itens referentes ao fio dental. Com relação à organização do sistema de saúde, chama atenção a dificuldade dos respondentes em relatar o local e o profissional que realizou orientações educativas preventivas. A reprodutibilidade dos domínios percepção, cuidado e promoção foi de 0,48, 0,21 e 0,64, respectivamente. Sugere-se a necessidade de reestruturação das questões componentes dos algoritmos propostos pela escala para as dimensões de percepção e cuidado, a par da necessidade da saúde bucal ser inserida em programas de atendimento a portadores HIV+.<br>The aim of this study was to investigate the intraobserver reproducibility of a Portuguese version scale used to evaluate aspects of oral health among children and adolescents HIV+. The scale was proposed by Balbo and a questionnaire was applied in two occasions, within a one week period, to 27 children and adolescents. The reproducibility was estimated by kappa statistics by point (k). With relation to the mother, it was reached a maximum of agreement for items related to the importance of maintaining the oral health, diary tooth brushing and the individual utilization of dental brush; breath and esthetics presented a good agreement. Regarding the children, a regular agreement was observed on the dental floss use. In contrast, the respondents had difficulties in reporting the name and address of the professionals that gave guidance in prevention activities to them. The k-values for perception, care and promotion were 0.48, 0.21 and 0.64 respectively, pointing to reproducibility levels classified as regular, fair and good. Given the different levels of reproducibility offered by the dental scale for HIV+ oral health, we suggest that it could be modified, especially in the domain of care