Lasten ja nuorten suun terveystarkastukset Suomessa

Tiivistelmä Lähtökohdat: Tutkimuksen tarkoituksena oli selvittää, miten lakisääteiset lasten ja nuorten suun terveystarkastukset toteutuvat Suomessa. Lisäksi selvitettiin tarkastuksista poisjäävien tuen tarpeen arviointia. Menetelmät: Sähköinen kyselylomake (Webropol) lähetettiin kaikkiin Suomen suun terveydenhuollon yksiköihin (n = 194). Kysymyksiin vastasivat yksiköiden johtavat tai vastaavat hammaslääkärit. Tulokset: Kaikki kyselyyn vastanneet yksiköt (n = 110) ilmoittivat, että koululaisten lakisääteiset suun terveystarkastukset toteutuvat. Alle kouluikäisten tarkastukset eivät toteutuneet yhdessä yksikössä. Useimmiten alle kouluikäisten tarkastukset tekivät suuhygienistit tai hammashoitajat; hammaslääkärit tekivät lakisääteiset koululaisten tutkimukset. Pelkästään yksilölliset tarkastusvälit, jolloin asetuksen mukaisia koululuokkia ei tarkastettu kattavasti, olivat käytössä 12 %:ssa yksiköistä. Kolmasosa (31 %) yksiköistä antoi tilastoihin perustuvan tiedon, 69 % vastauksista perustui arvioon. Yksiköistä 14 % ilmoitti, että tarkastuksista poisjää­vien tuen tarvetta ei selvitetä millään tavalla. Johtopäätökset Lakisääteiset lasten ja nuorten määräaikaiset suun terveystarkastukset toteutuvat Suomessa pääsääntöisesti hyvin. Tarkastuksista poisjäävien tuen tarpeen selvittely on vielä puutteellista

National reference centiles of anthropometric indices and BMI cut-off values in a child population in Nepal

Abstract Background: There is a need for national- or ethnicity-specific growth reference values in developing countries like Nepal, where rapid urbanisation and consequential nutritional transition is taking place. Aim: To establish national growth reference percentiles for anthropometric indices and to propose body mass index (BMI) cut-off values for Nepalese schoolchildren. Methods: This study comprised 1135 Nepalese schoolchildren of four World Health Organization (WHO) indexed age groups (5-, 6-, 12- and 15-year-olds). The age- and gender-specific smoothed percentile curves for anthropometric indices (height, weight, BMI, waist circumference, waist-to-hip-ratio and waist-to-height-ratio) were constructed using LMS method and the corresponding Z-scores were computed. The Receiver Operating Characteristic analysis was used to determine BMI cut-off values based on the International Obesity Taskforce (IOTF) and the WHO growth references. Results: The age- and gender-specified smoothed percentile values of anthropometric indices at 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were computed. The BMI cut-off values for thinness (−1.2 SDS/12th percentile), overweight (+1.2 SDS/88th percentile) and obesity (+2.1 SDS/98th percentile) had high discriminating power, and high sensitivity and specificity. Conclusion: The Nepali anthropometric cut-off values proposed here can be recommended to be applied into research, and to identify public health risks in Nepal among these age groups

Frequent consumption of sugar-sweetened beverages and sweets starts at early age

Abstract Objectives: We aimed to investigate the habitual consumption of sugar-sweetened beverages (SSBs) and sweets in relation to mothers’ behaviours and practices with their infants. Methods: We targeted mothers with children 1–24 months (N = 200) visiting Public Child Health clinics in Finland. During routine visits mothers (N = 179) volunteered to complete a self-administered anonymous questionnaire about their child’s health-related behaviours (consumption of sweets and SSBs, tooth brushing frequency). The questionnaires also included questions about the mothers’ background (age, education) and health-related behaviours (consumption of sweets, tooth brushing frequency and smoking habits). The children were categorised by age, and Chi-squared tests, Fischer’s exact test, ANOVA and correlation coefficient served for the statistical analyses. Results: Of those under 6 months, almost half (44%) received SSBs, and 45% of them more than once a week. Their use gradually increased by age such that by 19–24 months, all received SSBs at least sometimes, and 56%, frequently. Fewer than half of the mothers (33–43%) gave sweets to their children between the ages of 10–15 months, but 92% by the age of 2 years. Children’s twice-a-day tooth brushing increased from 14% to 33%. The child’s age and tooth brushing frequency correlated with the consumption of sugar-sweetened products (r = 0.458). Conclusions: Infants frequent consumption of sugar-sweetened products begins early in childhood. Thus, tackling these common risk factors in the first years of life is essential and calls for health-promoting actions in multiple areas that target primarily the parents of infants

Perceptions of older people’s oral health care among nurses working in geriatric home care

Abstract Objectives: This study investigates nurses’ self-reported experiences and perceptions of older people’s oral health care using a qualitative method. Methods: We interviewed 10 nurses working in geriatric home care who regularly visit and take care of older people in their homes. The interviews consisted of semi-structured questions. The interviews were then transcribed and analysed. Results: All nurses were aware of the connection between oral health and general health, but more detailed knowledge about oral health was lacking and confidence in oral health care practices was limited. Many of the interviewees noted the cleaning of removable dentures and problems related to them, but did not mention anything about periodontal diseases. Oral health education among the nurses was rare. The nurses reported lack of time to take care of their clients’ oral health. As possible development steps, the interviewees suggested that including oral health care in the daily treatment plan would improve oral health care practices. Conclusions: The nurses’ lack of knowledge about oral health care and uncertainty in oral health practices among older people are major problems in daily geriatric home care. Oral health education and confidence in oral health practices should be improved in both basic and on-the-job education

Pienten lasten äitien suun terveyteen liittyvät tiedot, asenteet ja tottumukset

Tiivistelmä Perheessä erityisesti äidillä on suuri merkitys pienten lasten suun terveyteen liittyvän käyttäytymisen kehittymisessä. Suun terveys sekä yleisterveys ovat yhteydessä toisiinsa ja onkin luontevaa, että neuvolassa puhutaan myös suun terveydestä. Kyselytutkimuksen tarkoituksena oli kartoittaa odottavien ja alle kolmivuotiaiden lasten äitien tietämystä, asenteita sekä tottumuksia koskien lasten suun terveyttä ja siihen vaikuttavia tekijöitä. Äidit (N = 144) vastasivat kyselyyn vapaaehtoisesti ja anonyymisti neuvolakäynnin yhteydessä. Vastauksia tarkasteltiin frekvenssijakaumina ja ryhmien välisten erojen merkitsevyyttä testattiin khiin neliötestillä ja Fisherin tarkalla testillä. Äidit tiesivät sokerin käytön lisäävän hampaiden reikiintymistä (98 %) sekä fluorin (98 %) ja ksylitolin (98 %) reikiintymistä ehkäisevän vaikutuksen, mutta ientulehduksen etiologia oli heille tuntematon (10 %). Tupakoivien äitien suuhygieniatottumukset olivat huonommat ja he kokivat suun terveytensä heikommaksi verrattuna ei-tupakoiviin äiteihin (p < 0,05). Pienten lasten äidit tarvitsevat lisää tietoa suun terveyteen liittyvistä tekijöistä. Äitejä tulee opastaa ja tukea moniammatillisesti oikeaan suun terveyskäyttäytymiseen ja motivoida tupakoinnin lopettamiseen

Oral health behaviors associated with dental general anesthesia among healthy children

Abstract Background: The aim of this survey was to investigate family-related factors among healthy children treated under dental general anesthesia (DGA) compared to those treated in a normal dental setting. Methods: The survey comprised 87 children whose dental treatment was performed under DGA and 103 age-matched children who were treated in a normal setting. The children were healthy 3 to 11-year-olds, and their parents filled out the questionnaire on parental dental fear, DGA experiences in the family, and oral health behaviors. The data were collected in primary health care in the city of Oulu, Finland, during 2014–2016. Results: In the DGA group, the proportion of fearful parents was three-fold higher and the proportion of siblings with DGA experience four-fold higher than in the comparison group; the differences between the groups were statistically significant. The dietary habits were statistically significantly poorer in the DGA group than among the comparison group when several indicators were considered. Linear regression analysis showed that treating a child in DGA was associated with harmful oral health behaviors like eating candy, drinking juice, and poor tooth brushing habits. Conclusions: Parental dental fear, DGA experiences of siblings, and harmful oral health behaviors were more common among children treated in a normal dental setting. Screening children and families for the risk indicators identified in this study may help prevent unnecessary DGAs among healthy control

Association of enamel caries lesions with oral hygiene and DMFT among adults

Abstract The aim of this study was to evaluate the prevalence of enamel caries lesions and their association with tooth brushing frequency, tooth brushing quality, and past caries experience among Finnish adults. The study population comprised 46-year-old members of the Northern Finland Birth Cohort 1966 (n = 1,961). Caries lesions were examined and recorded at surface level using the International Caries Detection and Assessment System (ICDAS). The cut-off point for enamel caries was set to ICDAS score 3. The cut-off point for brushing frequency was twice daily. Visible plaque on buccal tooth surfaces represented brushing quality. Using enamel caries lesions (ICDAS1–3) as a dependent variable, an adjusted logistic regression model was conducted to investigate the association with gender, brushing frequency, visible plaque, dentin caries lesions (ICDAS4–6), teeth with restorations, extractions and fractures. Almost all participants (99%) had enamel and 40% had dentin caries lesions; the mean number of teeth with enamel caries lesions was 13.8 (SD 4.6). According to the adjusted logistic regression model, the high prevalence of ICDAS1–3 lesions was associated with having visible plaque on more than 20% of teeth and having more than 13 restored teeth. In conclusion, the prevalence of enamel caries lesions is high among the Finnish adult population. The results of this study suggest that in addition to tooth brushing frequency, the presence of visible plaque seems to be critical when evaluating the association between tooth brushing and enamel caries

Implementation of oral hygiene practices in nursing homes:the view of supervisor nurses

Abstract Objectives: The aim of our study was to analyse the implementation of oral health-related practices in private enhanced service housing units and nursing homes in Finland reported by supervisor nurses. Methods: We sent an anonymous, voluntary Webropol-questionnaire to the supervisor nurses of private enhanced service housing units and nursing homes (N= 245). The questionnaire included items about the implementation of oral healthcare-related practices in the care units and items based on the Nursing Dental Coping Beliefs index (DCBS index). Five dimensions of the implementation of oral healthcare-related practices, Oral hygiene practices and Favourable diet for oral health, Oral hygiene equipment, Professional dental services, and Knowledge and opinions were used as outcomes. The factors in the nursing DCBS index and background variables were used as explanatory variables. Results: Our main results showed that in care units, Oral hygiene practices, Favourable diet for oral health, Oral hygiene equipment, and Professional dental services were partly implemented. Furthermore, according to Knowledge and opinions supervisor nurses had challenges in oral health-related knowledge and difficulties in managing oral care. In the DCBS index, better self-efficacy in “Managing bleeding gums” was associated with better implementation of oral health practices. Furthermore, supervisor nurses’ better own oral health habits were associated with better implementation of oral health-related practices. Conclusions: It can be concluded that based on the responses of the supervisor nurses, oral health-related practices were partly implemented in private enhanced service housing units and nursing homes in Finland

Adaptation and validation of a Nepali version of the Child-Oral Impacts on Daily Performances Index (C-OIDP)

Abstract The need for culturally validated measures of Oral Health-Related Quality of Life (OHRQoL) has been increasing in recent years. Objectives: To adapt the Child-Oral Impacts on Daily Performances (C-OIDP) index into the Nepali language and to validate it, to assess and compare the outcomes of self-reported oral problems, and to validate a structured questionnaire on general hygiene practices, oral hygiene practices, dietary habits, and use of tobacco. Basic research design: A school-based cross-sectional study on pilot and national samples. Participants: Nepalese schoolchildren representing WHO index age groups (5–6-year-olds, 12-year-olds, and 15-year-olds). The study was conducted on a pilot sample (n=128) selected conveniently and a national sample (n=1,052), selected from 18 sampling sites on the basis of the stratified random sampling method Main outcome measures: Adapted and validated Nepali C-OIDP Results: The Nepali C-OIDP showed excellent validation and reliability tests in both studies. The Cronbach’s alpha coefficients were 0.82 and 0.71 respectively in the pilot and national study. The most common self-reported oral problem was toothache, which was statistically significantly higher in the national sample. Conclusions: The Nepali C-OIDP index is valid and reliable for measuring oral impacts on daily performance among schoolchildren of Nepal