Knowledge about preventive dentistry versus self-reported competence in providing preventive oral healthcare – a study among Nepalese dentists

Source at https://dx.doi.org/10.1186/2Fs12903-017-0366-5 Background: Dentists ’ and dental healthcare providers ’ professional knowledge and attitude towards the prevention of oral diseases may have an impact on the oral health of the general population. The aim of this study was to describe Nepalese dentists ’ competency in giving preventive education and treatment to their patients, and to assess their level of knowledge about preventive dental health. Methods: This was a cross-sectional study of 195 dentists (71 males and 124 females). Knowledge of preventive oral healthcare and self-reported aspects of preventive oral healthcare were assessed using a close-ended multiple- choice questionnaire. Statistical evaluation was done using chi-squared test, independent sample t-test and factor analysis as appropriate. Results: More than 90% of dentists self-reported to be competent in providing preventive treatment and oral hygiene education to their patients. Female dentists reported being more competent in giving oral hygiene education than their male counterparts ( p = 0.045). Dentists scored a mean of 24.06 ± 3.8 [range (15 – 33)] out of 56 on knowledge based on self-reported awareness of seven different aspects of preventive dentistry. More than 70% of the dentists had relatively good knowledge regarding the use of fluoride, whereas the preventive knowledge in other aspects of dental health such as frequency of sugar consumption, xylitol use, dental visits, sealant, gingival health, dental and general health was found to be limited. Conclusions: The majority of participating dentists reported a high level of general competency in providing preventive treatment and oral health education to their patients, whereas their knowledge was found to be limited in some aspects of preventive dentistry

Oral health in pregnancy: changes in oral bacterial milieu related to cariogenic bacterial load, oxidative stress and nitric oxide levels in the saliva and their effect on pregnancy outcome

The physiological changes that occur during the pregnancy are known to affect women´s oral health. Pregnant women are more vulnerable to oral diseases when compared to non-pregnant. Better understanding of the relation between changing oral microbial milieu and risk of pregnancy complications and associated mechanisms could help to improve maternal and perinatal outcomes. Thus, we aimed to investigate the pregnancy associated changes in oral bacterial milieu with a focus on cariogenic bacterial load, oxidative stress and nitric oxide levels in the saliva, and their effect on pregnancy outcome. The study included a total of 146 participants, 96 healthy pregnant women at 18-20 weeks of gestation and 50 age-matched non-pregnant women for comparison. Saliva samples were collected from both groups under similar situation for investigating oral bacterial load of Streptococcus mutans (SM) and Lactobacillus (LB), and for determining salivary antioxidant capacity, oxidative stress (OS) and nitric oxide (NO) levels. We found an increase in salivary OS and a decrease in antioxidant capacity along with an increase in colonization by SM in pregnant women compared to non-pregnant. The salivary NO levels were also higher among the pregnant women compared to non-pregnant and the NO level increased with advancing gestational age. However, an association between dental caries and risk of preterm birth was not observed based on data obtained from the published literature. In conclusion, pregnant women had increased load of caries related bacteria, especially SM, in the saliva with higher OS levels and decreased antioxidant capacity compared to non-pregnant women. Likewise, there was an increase in salivary NO levels with advancing gestational age, and an increase in bacterial colonization by SM and LB among the pregnant women in their second and third trimesters. No significant association was observed between dental caries and increased risk of preterm birth

Nitric oxide, oxidative stress and streptococcus mutans and lactobacillus bacterial loads in saliva during the different stages of pregnancy: A longitudinal study

Hormonal changes associated with pregnancy promote oral bacterial growth, which may affect salivary nitric oxide (NO) levels, oxidative stress (OS), and antioxidant capacity (AC). We hypothesized that caries-related bacterial load, NO level, and OS in the saliva change with advancing gestation. The aim of this study was to investigate longitudinal changes in salivary NO, OS, and AC during pregnancy and correlate them with Streptococcus mutans (SM) and Lactobacillus (LB) colonization at different stages of pregnancy. We assessed NO level by Griess method, OS by measuring malondialdehyde (MDA), AC by ABTS radicals and bacterial load by culturing SM and LB in the saliva of pregnant women (n = 96) and compared with non-pregnant women (n = 50) as well as between different stages of pregnancy. Compared with non-pregnant women, NO was 77% higher (4.73 ± 2.87 vs. 2.67 ± 1.55 µM; p < 0.001), MDA was 13% higher (0.96 ± 0.27 vs. 0.85 ± 0.22 nM; p = 0.0055), and AC was 34% lower (60.35 ± 14.33 vs. 80.82 ± 11.60%; p < 0.001) in the late third trimester. NO increased with advancing gestation, but AC and OS did not change significantly during pregnancy. SM were more abundant in pregnant women compared with non-pregnant (p = 0.0012). Pregnancy appears to have an adverse impact on oral health emphasizing the importance optimal oral healthcare during pregnancy

Do dentists have better oral health compared to general population: A study on oral health status and oral health behavior in Kathmandu, Nepal

BACKGROUND: Dentists are considered role models by the general population in regards to oral hygiene and oral health behavior. This study aimed to access the oral health status of dentists and laypersons, and compare the dentists’ practice of preventive dentistry and oral self-care behaviors to that of the laypersons. METHODS: This cross-sectional study recruited 472 participants (195 dentists and 277 laypersons from the general population). Their oral health/hygiene behavior was assessed using a standardized close-ended multiple choice questionnaire. Oral examination was performed to assess caries using Decayed Missed Filled teeth (DMFT) index and periodontal status using Community Periodontal Index of Treatment Needs (CPITN). RESULTS: Ninety-six percent of dentists brushed their teeth at least once daily, using fluoridated toothpaste and 80.5% twice daily. Although 94% of laypersons brushed their teeth once daily, they seldom used fluoridated toothpaste. Ten percent of participants in each group were caries free. The mean number of teeth present in the oral cavity (27.4 versus 25.4), mean number of teeth with caries (1.8 versus 3.7) and fillings (2.5 versus 0.4) were significantly different (p < 0.0001) between dentists and laypersons, respectively. Regarding the periodontal status, 82% of dentists had CPITN score of 0 whereas 71% of laypersons had the highest score 3 (p = 0.007), and 81% of the laypersons reported tooth mobility compared to 1% of dentists (p < 0.0001). CONCLUSIONS: The participating dentists had better periodontal status and better self-reported oral health behaviors than the laypersons. Despite similar prevalence of caries in the two groups, the prevalence of decayed and unfilled teeth was lower among the dentists

Modeling the theory of planned behavior for intention to improve oral health behaviors : the impact of attitudes, knowledge, and current behavior

The aim of this study was to test the efficiency of an extended model of the theory of planned behavior (TPB) in predicting intention to improve oral health behaviors. The participants in this cross-sectional study were 153 first-year medical students (mean age 20.16, 50 males and 103 females) who completed a questionnaire assessing intentions, attitudes, subjective norms, perceived behavioral control, oral health knowledge, and current oral hygiene behaviors. Attitudes toward oral health behaviors and perceived behavioral control contributed to the model for predicting intention, whereas subjective norms did not. Attitudes toward oral health behaviors were slightly more important than perceived behavioral control in predicting intention. Oral health knowledge significantly affected affective and cognitive attitudes, while current behavior was not a significant predictor of intention to improve oral health behavior. The model had a slightly better fit among females than among males, but was similar for home and professional dental health care. Our findings revealed that attitude, perceived behavioral control, and oral health knowledge are predictors of intention to improve oral health behaviors. These findings may help both dentists and dental hygienists in educating patients in oral health and changing patients’ oral hygiene habits. (J Oral Sci 53, 369-377, 2011)

Oxidative stress levels and oral bacterial milieu in the saliva from pregnant vs. non-pregnant women

Background - Saliva plays a significant role in maintaining oral health and oral bacterial milieu. Difference in oxidative stress (OS) levels in saliva in conjunction with bacterial load between pregnant and non-pregnant women has not been studied previously. We hypothesized that the physiological changes in pregnancy alter oral bacterial milieu by promoting growth of Streptococcus mutans (SM) and Lactobacillus (LB), and increase OS in saliva. The aim of this study was to measure and compare the oral bacterial milieu, OS and total anti-oxidative capacity (TAC) in the saliva of pregnant and non-pregnant women. Method - In this cross-sectional study, we assessed oral bacterial milieu by culturing the SM and LB by using commercial kits, TAC by measuring 2, 2′-Azino-Bis-3-Ethylbenzothiazoline-6-Sulfonic Acid (ABTS) free radical scavenging activity spectrophotometrically and OS levels by measuring malondialdehyde (MDA) levels with commercial kits in the saliva of pregnant women (n = 38) at 18–20 weeks of gestation, who were compared with age-matching healthy non-pregnant women (n = 50). Results - Streptococcus mutans were found to be more abundant in the saliva of pregnant women compared with non-pregnant women (p = 0.003) but the difference was not significant for the LB (p = 0.267). TAC was found to be 46% lower in pregnant women’s saliva compared to non-pregnant women [optical density (OD) measured at 731 nm as 0.118 ± 0.01 vs. 0.063 ± 0.02; p p = 0.023). Conclusion - Pregnancy has an adverse impact on oral bacterial milieu as demonstrated by increased colonization with Streptococcus mutans together with higher OS levels and decreased TAC levels in saliva. This emphasizes the importance of improved oral hygiene and provision of oral healthcare services during pregnancy care