Oral health promotion interventions have had limited success in reaching families in disadvantaged neighbourhoods resulting in persistent oral health inequality. This qualitative study provides insight into professionals' perspectives on children's poor oral health (≤ 4 years), their perceptions of the roles and responsibilities, and opportunities for child oral health promotion strategies.Thirty-Eight professionals from different domains (community, social welfare, general health, dental care, public health, private sector) working in a disadvantaged neighbourhood in Amsterdam, the Netherlands, participated through 24 semi-structured (group) interviews. Transcripts and notes were analysed through thematic analysis.Professionals indicate that unhealthy diet, children's non-compliance, poor parental coping, parental low oral health literacy, parent's negative attitude, family's daily struggles, and insufficient emphasis on childhood caries prevention in dental practices, general healthcare and social welfare organisations, underlie poor oral health. They hold parents most responsible for improving young children's oral health, but recognise that families' vulnerable living circumstances and lack of social support are important barriers. Interestingly, non-dental professionals acknowledge their beneficial role in child oral health promotion, and dental professionals stress the need for more collaboration.A broad child-, parental-, and societal-centred educational communication strategy is perceived as promising. Professionals working within and outside the dental sector acknowledge that local and collective action is needed. This involves a better understanding of family's complex daily reality. Furthermore, intensifying child oral health knowledge in dental practices is essential in collaboration with families, general health and social welfare organisations. 

/pdf/professionals-perspectives-on-how-to-address-persistent-oral-1mwo602o.pdf

Professionals’ perspectives on how to address persistent oral health inequality among young children: an exploratory multi-stakeholder analysis in a disadvantaged neighbourhood of Amsterdam, the Netherlands

The purpose of the work was to study the world literature on the socio-economic determinants of dental health among children. Materials and methods. An online information search was performed in the databases “PubMed”, “SciELO”, “Medcape” and “Science of Ukraine: access to knowledge” using the keywords “children caries”, “dental (oral) health”, “children and adolescents”, “social and economic determinants of health” with appropriate translations in foreign languages. Results and discussion. At the global level, dental diseases lead to serious medical and economic consequences which manifest themselves in the form of a significant decrease in the quality of life. The foundations of the dental health level are laid in childhood and are strengthened in adolescence, so these age groups of the population are the main “target audience” for disease prevention measures, valeological research, sanitary and educational work and the formation of appropriate habits. Socio-economic determinants of dental health in children, adolescents and adults on a global scale have been studied unevenly. Mostly, the results of research performed in the developed countries of the world are available. Such a situation creates a need for rethinking approaches and methods for assessing the problem of health care systems in separate countries and changing the methods for developing measures to influence the dental health of children and adolescents with high individualization and adaptation of socially oriented program products in health care. Giving a priority in the development of preventive programs in the field of health care to only individual and collective training measures and communal prevention does not allow to neutralize the negative impact of socio-economic conditions, and even more – it deepens inequality in dental health in the population, which is recognized as a problem by the World Health Organization. With regard to Ukraine, the presence of martial law and the continuation of fighting in certain countries have caused a number of demographic and socio-economic processes, which will be measured and evaluated after some time. But, unequivocally, the existing economic crisis, a decrease in the level of income of the population, negative demographic processes, complications of work in the health care system and other factors that can be defined as determinants of children's dental health continue to operate. Therefore, it is expected that we should be prepared for the deterioration of dental health indicators at the national level and the negative consequences of this. Conclusion. The main socio-economic determinants of children's dental health are recognized as: the level of economic development of the country, access to medical and dental care, the level of family wealth, the age and level of education of parents, their employment, the number of children in the family, the migration status of the family and separately – parents, local peculiarities of the culture of oral cavity care and nutrition, availability and level of coverage of educational and sanitary-educational measures, local levels of development of the system of health care institutions, effectiveness of interaction between health care institutions, education and social protection management bodies

/pdf/socio-economic-determinants-of-children-s-dental-health-12f5qyis.pdf

Socio-Economic Determinants of Children`s Dental Health. Literature Review

This study analyzed the socioeconomic profile and knowledge about oral health of high-risk pregnant women attended at the Lauro Wanderley University Hospital (HULW) of the Federal University of Paraiba (UFPB). This is an observational, descriptive, cross-sectional and quantitative study, which used the Epi Info program version 7.2.4 to perform statistical data analysis. The study was composed of 51 high-risk pregnant women assisted at the HULW of UFPB, from the application of a structured questionnaire, divided into two stages; the first with 5 questions that addressed the socioeconomic profile of patients and the second with 7 questions related to knowledge and care about oral health during pregnancy. As part of the results found, in relation to age group, 28 pregnant women (54.90%) were between 24 and 33 years old; 45 (88,24%) had up to 2 minimum wages as family income; 51 (100%) pregnant women know what caries is, but 33 (64.7%) believe that caries is not transmitted by saliva. Regarding the use of anesthetics and radiographs during pregnancy, 31 (60.78%) and 32 (62.74%), respectively, of the patients believe that it is not possible to perform such procedures during pregnancy. It is concluded that the knowledge of high-risk pregnant women about oral health care during pregnancy is limited, generating divergences and gaps in responses, predominantly low schooling and income level.

/pdf/analise-socioeconomica-e-do-conhecimento-sobre-saude-bucal-2yrjcwj2st.pdf

Análise socioeconômica e do conhecimento sobre saúde bucal das gestantes de alto risco

BACKGROUND
Early childhood caries (ECC) has been found to be up to five times more common among children living in areas of low socio-economic status (SES) than among children in areas of higher SES.


AIM
To evaluate an ECC prevention programme from pregnancy to 3 and 6 years of age.


DESIGN
A prospective, controlled, intervention cohort study was initiated in 2013 in a low-SES area in Sweden. The intervention group received an individual interdisciplinary ECC prevention programme starting pre-birth, consisting of supportive oral health-promoting talks using motivational interviewing techniques and individual ECC preventive actions. A control group, consisting of pregnant women living in a comparable area, received ordinary routines.


RESULTS
Of the 336 pregnant women, 64 mothers (with 64 children) completed the programme, and 394 children were born in the control group. At the sixth year examination, the proportion of children with no caries was similar between the groups (53% resp. 52%, p = .976), whereas the proportion with decayed, missed, filled primary teeth (dmft = 1-5) was slightly lower (23% resp. 36%, p = .063), and the proportion with severe caries disease (dmft > 5) was higher (p = .013) in the intervention group (25%) than in the control group (12%).


CONCLUSION
No preventive effect regarding caries can be demonstrated at sixth year of age. Maternal behavioural change in dental care was not sufficient to even out inequalities in oral health in children, eventually due to difficulties in reaching the target group and the lack of effects among the families reached.

Evaluation of an early childhood caries preventive programme starting during pregnancy-Results after 3 and 6 years.

Interprofessional working must be approached within health promotion interventions using systematic methods to identify areas of suboptimal collaboration. We designed a qualitative study with a purposive sample of seven French therapeutic patient education programs. Semi-structured individual interviews were conducted with 14 healthcare providers and seven clinician leaders (coordinators) involved in patient education. We used the same interview guide and thematic grid regardless of the professional's profile to compare their perceptions on elements affecting outcome, participation and sustainability of programs. Healthcare providers and coordinators addressed non-convergent issues at both ends of a continuum from a micro-level nested in the program delivery to a macro-level corresponding to the structured implementation and sustainability of the program. Meso-level issues featured convergent perspectives. Our methodology could be used at the level of health services in a health system to provide a complete recovery of stakeholders' perspectives (without "blind spots" from one stakeholder or another). In our study, we focused on patient education in the French health system and pointed out possible considerations to optimize the functioning of programs. Such considerations include specific training plan development, encouraging reflection on the content and use of initial assessment, leading sessions in pairs to save on work time, and communication on the ins and outs of organizational imperatives that require healthcare providers' contributions.

Use of qualitative methods to optimize collaborative practices by highlighting differences in perceptions between professionals: an example of patient education.

To achieve good and equal oral health in children, interdisciplinary preventive oral health actions, directed toward disadvantaged areas, can be an important means. Staff play a crucial role in the implementation of these actions. The aim of the present study was to analyze circumstances of importance for conducting an interdisciplinary public preventive oral health project for children, directed toward parents in areas with low socioeconomic status from the interdisciplinary perspective of the involved staff. The present study consisted of a qualitative content analysis with an inductive approach, based on interviews with interdisciplinary staff who had participated in a public preventive oral health project directed toward parents in areas with low socioeconomic status. The interviews were analyzed using text-driven analysis. The main category concerned the staff members’ prerequisites and understanding necessary to perform their tasks in interdisciplinary public preventive oral health project. To have the right prerequisites and understanding regarding the oral health project enabled staff to be committed, able and willing to perform in it. Important aspects of this are to have knowledge, motivation and to experience a supportive professional context, to have good leadership and for certain resources to fulfilled. A crucial aspect was to reach the targeted mothers. For interdisciplinary cooperation in preventive oral health care to be achieved, it is essential for the involved disciplines and professions to embrace a common view on the project’s aim, their duties, and oral health, from the leadership to the individual level. Staff require competent leadership but also allocated time and adapted method support to be successful in this context. When allocating preventive health actions directed at low SES areas, it is important to acknowledge the risk of stigmatization and for staff to understand that families might be facing social challenges that prevent them from taking part in health-promoting actions. An important conclusion is that to be able to reach people, it is important for both those who design preventive programs for oral health and the staff who administer them to have sufficient knowledge about the target group.

/pdf/important-aspects-of-conducting-an-interdisciplinary-public-4cqrhx03wb.pdf

Important aspects of conducting an interdisciplinary public preventive oral health project for children in areas with low socioeconomic status: staff perspective

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Important aspects of conducting an interdisciplinary public preventive oral health project for children in areas with low socioeconomic status: staff perspective