The Usefulness of Dental Health Education for the Prevention of Dental Disease - Term Paper Example

Article Review Assignment Student’s Name Institutional Affiliation 1.0 Introduction The article states that early childhood caries is an infectious dental disease among children and it is presented in numerous forms that include; being one or a more decayed, absent due to caries or in other cases results from filling primary tooth in children under 6 years of age. In children that fall below 3 years of age any given sign associated with smooth surface caries is deemed to be severe ECC. It is argued that the despite efforts being made in developed countries to eliminate caries affecting children these countries still face enormous challenges attributed to the disease. Caries affects children quality way of living, their immediate well-being as well as impacts the life of their guardians in relation to both psychological and financial aspects. In Australia, ECC is deemed to be the core reason for hospitalisation of kids. There has not been any individual factor that has been solely identified for being responsible for the current prevalence of caries hence preventive programmes have been only attained some level of success. The authors note that caries can be fairly eliminated in the case of well-informed guardians taking distinctive pro-active measures on their children’s immediate oral health well-being. The limitations in current research on preventive programmes prompted the authors to embark on conducting research related to randomalised control trial in order to investigate mothers that were expecting their first children. In essence, results of the study indicate a significant level of differences in severe early childhood caries between the intervention as well as their immediate control groups. Certainly, it was not established why, despite of most of decay being associated with demineralisation of incisors, there were no ready solutions to whether intervention also assisted to decrease any possible ranges of cavitated lesions that played a greater role in affecting children’s’ quality of life. The study was directed towards examining the end results of interventions for children of up to 7 years and goes ahead to compare the caries experienced by these children with one observed in an almost similar group of children that had been registered by South Australian School Dental Services. 2.0 Article Summary 2.1 Randomised Trial/ Intervention Group The participants in the randomised trial group were 649 in number and were all recruited in 2002 in an oral health promotion intervention initiative. The study allowed the participating women expecting their first children with ethical approvals through a signed agreement on their consent in 5 main public based maternity hospitals that were based in such places as Adelaide, South Australia in their course of attending antenatal visits. These participants were furnished with relevant information pertaining to how they will attend to their individual health needs and that of their children at certain stages of development. In fact, the study was conducted in three phases; registration of the study, 6months into the pregnancy and finally at 12 months of pregnancy. Of the 649 participants only 24 were eliminated from the study due to a lack of mother-infant pair. The study adopted 22 techniques to contact all of the participants. There was an invitation letter mailed to each of them, a survey questionnaire as well as a request to obtain consensus for the child’s immediate records at the SA SDS and a phone interview was also used to establish the necessity of sending further materials for the study. 2.2 Control/Comparison Group There was another level of participants; SA SDS comparison group. A total of 641 records of children born as first kids to families in 2002 that did not suffer any form of congenital or developmental defects and who also portrayed similar postcode distribution as the first participants were derived from the database by independent individual not associated with the study at any level. The questionnaire survey used in the study assisted in the collection of at least six variables that included; dental challenges faced and immediate use of dental services for the first born kid, feeding patterns, overall oral health, general health, social support as well as demographics. Another important aspect used for the study was tooth-ache experiences within the two randomised groups as well as the comparison group to ascertain possibility of caries. Dental examinations on both of the participants ‘group was executed by SA SDS practitioners that had already undergone training and calibration. The study’s data analysis involved dmft and dmfs that were analysed and related to certain dentine lesions except noncavitated lesions. It also involved a computation of caries severity index that was supposedly defined as the mean dmft in relation to 30 per cent of children with significant levels of caries scores. PASW Statistics 18 was adopted for statistical analysis that also included chi-square tests as well as logistic regression for certain binary outcomes data. The t-test as employed to oversee equality of means for continuo data in the entire study. 2.3 Results The study shows a significant level of results. First, the response rate for questionnaires disbursed was about 44.3 per cent for mothers and 62.8 per cent for children who got examined at the third phase; at 20 months into the pregnancy. 32 per cent of the children lacked data since they might have been seeking dental services from private practitioners. In fact, the intervention to control ratio stood at 12:10. 49 out of 641 families approached for the study were eliminated due to undeliverable mail, language barriers or in cases where children lived far or with foster parents. Secondly, it was noted that the two participant’s groups, which were comparable at the immediate time of randomisation, had chosen to remain comparable at follow-up. In essence, cases where there were no follow-ups involved mothers that were younger, separated, had lower education or income levels, or failed to have private dental insurances. Notably, results indicate that there were no significant levels of statistical differences between the two participant’s groups. Thirdly, it was found out that the percentage of children suffering from caries did not differ significantly among the two groups. Markedly, in the case of randomised trial there was insignificant trend for lower d3mfs andd3mft values in the intervention as opposed to the control participant’s group. There were no statistical differences between the randomised control and nonrandomised comparison groups. On the contrary, the mean d3mft and d3mfs were deemed to be significantly lower in the intervention group as opposed to the SA SDS comparison groups. Notwithstanding, there were no significant level of differences that could be associated caries severity index between intervention and control groups. However, children falling in the trial and intervention groups portrayed a lower severity index as opposed to the comparison group. Needless to say, there was a 3.1 per cent increase in caries prevalence for each of the additional month attributed to children’s age. By use of a logistic regression analysis, which could have been easily adjusted for differences in age, indicated lower caries prevalence within the trial specifications in comparison to SA SDS. In the case of adjusted logistic regression analysis, there was a significant level of differences perceived between the intervention and control groups as all of them generated odd rations with broadened confidence intervals that intertwined unity. Fourth, it was found that at least 29 per cent of all mothers categorised within the comparison participant’s group reported that their first born kids had experienced toothache as opposed to 11 and 17 per cents in the intervention and control groups respectively. It was also found out that more mothers within the control as opposed to intervention group had relied on professional advice on matters related to oral health maintenance for their children; an activity that was beyond what was availed in the trial materials. From the study, the article notes that the findings are that children registered in randomised trials prior to being born had experienced less toothache and showed less caries infection as opposed to other school-going children. Subsequently, it is argued that differences that existed in caries experiences between those in receivership and those that did not receive intervention had indeed lost its statistical significance by 6 to 7 years of age. The article identifies numerous limitations that relates to the findings of the study. First, the article argues that there was a loss that resulted from poor follow-ups of mothers. This was especially evident with the younger mothers that portrayed allegiance to other priorities of life, which affected the entire trial methodology perceptive. Subsequently, there were both random and systematic errors, which mainly came about as a result of over relying on records held by SA SDS. Consequently, errors arose because the SA SDS lacked specific training and calibration prior to the examination of caries. Systematic errors emanated from the fact that at least 32 per cent of the kids under trial lacked relevant data with SA SDS since their families had opted for private dental services. Significantly, the authors of the study note that there might have been contamination biasness that went ahead to negatively affect statistical significance existing between intervention and control groups at follow-ups. They also note that the contamination biasness could have been reduced in case no information was provided at the dental examination phase through replacing health promotion mail-outs by Christmas. The major strength of the entire study is efficient use of time span for examining children before their teeth erupted till they began replacing them with permanent dentition. It also ensured that attrition biasness remained at par in both of the trials at hand. The study also formulated SA SDS comparison group that was carried out by an independent person, which helped ascertain that children belonging to mothers that participated in the trial experienced less severe caries and toothache as opposed to other children. 3.0 Critique for the Article 3.1 Organisation of Content The article follows a standard format of a research study. The pattern; introduction-methods-findings-discussion-conclusion, is adhered to the latter. This pattern allows easier readability of the article as a researcher can effectively read one section to another without mixing-up concepts and notions. Most importantly, the article has effectively utilised titles and sub-titles to separate between a section and another. 3.1 Use of Titles The titles and sub-titles have been used effectively to discern the concepts and arguments being disseminated. A reader of the article can skim through the entire article especially when they are seeking specific information pertaining to the study like the number of participants, the statistical techniques employed as well as the data collection techniques can be found within the methods section. 3.2 Use of Tables & Figures Figures and tables have been used effectively to convey certain comparison especially when making references to end results for both intervention and control groups. For instance, a flow diagram has been incorporated to indicate randomised control trials as well as comparison groups from the first contact till follow-up phases. The diagram provides information related to the number of participants examined at each phase of the entire examination thus providing significant analysis. Tables have also been effectively used to present certain information like the characteristics pertaining to the enrolment of mothers randomised in the course of their pregnancies and retained within the underlying study at follow-up (Abanto, Carvalho, Mendes, Wanderley, Bo¨necker & Raggio, 2011). 3.3 Inclusion of Strengths and Weaknesses Certainly, the authors have successfully provided both the strengths and weaknesses that were encountered while conducting the study at hand. This aspect allows a researcher to utilise the information presented with certain level of caution in order to refrain from making premature conclusions about caries in children. 3.4 Use of References Most importantly, the article has utilised a substantial number of references that varies from peer reviewed journal articles, government publishing and websites as well as books for the analysis. There were 35 references used for the article with all being relevant for the study. 3.5 Adoption of WHO Principles of Ottawa Charter For Health Considerably, the article adopts WHO principles attributed to Ottawa Charter for Health Promotion in different ways. For instance, the study makes sure to accommodate local needs and possibilities for its research by enrolling mothers from all walks of life (WHO, N.d). There are younger, low income and lowly educated mothers as well as their immediate counterparts being enrolled for the study. The study also advocates for the principle associated with commitment to health promotion given that the participating mothers are fairly educated on matters related to their feeding patterns as well as maintenance of their respective oral health at all times. 4.0 Relevance to Usefulness to Oral Health Practice Abanto, Carvalho, Mendes, Wanderley, Bo¨necker & Raggio (2011) ascertains that the article provides extensive information needed to ascertain that people with fair education levels, income and socioeconomic statuses are highly willing and able to participate in oral health education initiatives as compared to the less fortunate groups. 5.0 Conclusion To sum up the discussion above, it can be ascertained that the paper fairly summarised and critiqued the article “Reassessment at 6-7 years of age of randomized controlled trial initiated before birth to prevent early childhood caries” by Plutzer and Keirse (2012). The article indicates that dental caries in children remains at a higher prevalence rates even in developed countries like Australia and UK. The presentation of the article has been done effectively in that it has employed numerous techniques of arrangement. There has been effective use of references, tables and figures, strengths and weakness as well as use of titles and sub-titles, all which have enhanced the readability aspect of the entire article. 6.0 References Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bo¨necker M& Raggio DP. (2011). Impact of oral diseases and disorders on oral health-related quality of life of preschool children. Community Dent Oral Epidemiol, 39:105–14. Plutzer, K, Spencer, AJ &Keirse, MJNC. (2012). “Reassessment at 6-7 years of age of randomized controlled trial initiated before birth to prevent early childhood caries. Community Dental Oral Epidemiol, 40,116-124 Vermaire JH, van Loveren C, Poorterman JHG & Hoogstraten J. (2011). Non-participation in a randomized controlled trial: the effect on clinical and non-clinical variables. Caries Res, 45:269–74. WHO. (N, d). The Ottawa Charter for Health Promotion. Retrieved on April 10, 2015 from http://www.who.int/healthpromotion/conferences/previous/ottawa/en/index1.html Read More