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      Using community participation to assess demand and uptake of scaling and polishing in rural and urban environments

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          Abstract

          Background

          One of the control tools for periodontal disease besides individual home care is professional oral prophylaxis that is, Scaling and Polishing (S&P).The aim of this study is to assess the effect of oral health awareness on the demand and uptake of scaling and polishing among dwellers of rural and urban environments.

          Methods

          This interventional study was conducted in Enugu, Nigeria. A questionnaire was used to obtain data on demographic details, presenting complaints and requests, and prior dental visits from consenting attendees in 4 community outreaches. The number of those demanding for scaling of teeth at point of presentation was extracted from their requests. Oral health talk was then given as the intervention for the study. Periodontal assessment was done using Community Periodontal index (CPI) and participants who received scaling thereafter were recorded. Data were analyzed with SPSS [version 20] employing Chi square to compare categorical variables and p was significant at ≤0.05. Multiple regression analysis of factors affecting oral health awareness was done and outcome of intervention was determined by percentage difference in number of participants demanding and receiving S&P.

          Results

          A total of 454 participants enlisted for the study. The outreaches served as first point of contact with dental professionals for 383 (84.4%) participants. 60 (80%) and 15 (20%) participants demanded for scaling in the urban and rural locations respectively ( p = 0.00). Out of 78 with CPI 3 score, only 8 (10.3%) demanded for S&P but uptake was by 73 (93.6%) [p = 0.00]. Outcome of oral health intervention was 80.6% difference among those with periodontitis. Multiple regression analysis of factors showed that participants’ locations, that is, rural or urban, was the only factor that significantly affected oral health awareness (C. I = 0.183–0.375, p = 0.000).

          Conclusion

          Demand for scaling was sub-optimal but the uptake was satisfactory. Rural or urban location of the participants significantly influenced their oral health awareness. The keenness to take up scaling suggests benefits accruing from the oral health education. Appropriate health policies and planning could help bridge the gap between rural and urban areas and strengthen gains from this study.

          Electronic supplementary material

          The online version of this article (10.1186/s12903-018-0548-9) contains supplementary material, which is available to authorized users.

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          Most cited references20

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          Evaluation of community-based oral health promotion and oral disease prevention--WHO recommendations for improved evidence in public health practice.

          Systematic evaluation is an integral part of the organisation and delivery of community oral health care programmes, ensuring the effectiveness of these community-based interventions. As for general health promotion programmes the common problems from effectiveness reviews of oral health interventions relate to the quality and validity of programme evaluations. Problems identified mostly refer to the quality of outcome measures, short-term timescales to assess change, inadequate evaluation methodologies and inappropriate evaluation of programme implementation and processes. It remains a challenge to oral health professionals to integrate community oral health programmes into a wider health agenda. Public health research focusing on the development of evaluation methodologies has identified a variety of issues including the importance of using pluralistic evaluation approaches (quantitative and/or qualitative), limitations of the randomised controlled trial (RCT) design for evaluation of public health interventions, the need to match evaluation methods with the nature of intervention, development of outcome measures appropriate for the nature of intervention, importance of developing workforce capacity in evaluation techniques, and the need for development of partnerships between health practitioners and academics in conducting evaluations. In June 2003, the WHO Oral Health Programme at Headquarters organised a two-day workshop to take forward the development and documentation of the evaluation of oral health promotion and oral disease prevention programmes. The aims of the workshop were to: (1) identify common problems and challenges in evaluating community-based oral health interventions; (2) explore developments in the evaluation approaches in public health; (3) share experiences in evaluating oral health intervention programmes implemented at national or community levels in developing and developed countries and (4) develop guidelines for quality evaluation of national and community oral health programmes. Twenty-two invitees from 15 countries attended in addition to WHO staff. The first day was devoted to presentations of oral health promotion and oral disease prevention programmes from around the world. During the second day, WHO staff at Headquarters in Geneva discussed aspects of evaluation of public health programmes. Two working groups were formed to discuss agreed topics, and the reports from their deliberations, together with the general discussion, resulted in the presentation of emerging key issues and recommendations. In summary, it was agreed that evaluation of oral health promotion and disease prevention programmes should integrate, whenever possible, with general health programmes. While the design and advantages of RCTs in clinical evaluations are well documented, the relevance of this design in evaluation of community oral disease preventive programmes and oral health promotion programmes are much less clearly defined. Subsequently, the conduct of such programmes may be inappropriately evaluated in systematic reviews. There is a need for more research into appropriate immediate, interim and ultimate outcome measures, as well as process evaluation, an assessment that is poorly understood and practised less often than outcome evaluation. Guidance on potential design, conduct, and especially the evaluation, of community oral disease prevention programmes and oral health promotion programmes should be developed and updated regularly. WHO Collaborating Centres could have a role in promoting good practice, training and collaboration between teams throughout the world. Centres undertaking systematic reviews should consider the guidelines given in the proposed WHO document when defining their evaluation criteria.
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            Utilization of dental care: An Indian outlook

            Oral health has a significant impact on the quality of life, appearance, and self-esteem of the people. Preventive dental visits help in the early detection and treatment of oral diseases. Dental care utilization can be defined as the percentage of the population who access dental services over a specified period of time. There are reports that dental patients only visit the dentist when in pain and never bother to return for follow-up in most cases. To improve oral health outcomes an adequate knowledge of the way the individuals use health services and the factors predictive of this behavior is essential. The interest in developing models explaining the utilization of dental services has increased; issues like dental anxiety, price, income, the distance a person had to travel to get care, and preference for preservation of teeth are treated as barriers in regular dental care. Published materials which pertain to the use of dental services by Indian population have been reviewed and analyzed in depth in the present study. Dental surgeons and dental health workers have to play an adequate role in facilitating public enlightenment that people may appreciate the need for regular dental care and make adequate and proper use of the available dental care facilities.
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              Time to take periodontitis seriously.

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                Author and article information

                Contributors
                234-8023036409 , ezi.akaji@unn.edu.ng
                nkolika.uguru@unn.edu.ng
                samaksclinique@yahoo.com
                etisiobindiokwelu@gmail.com
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                10 May 2018
                10 May 2018
                2018
                : 18
                : 80
                Affiliations
                ISNI 0000 0000 9161 1296, GRID grid.413131.5, Department of Preventive Dentistry, Faculty of Dentistry, College of Medicine, , University of Nigeria, UNTH, ; Enugu, Nigeria
                Article
                548
                10.1186/s12903-018-0548-9
                5946404
                29747620
                3ca6479c-8323-4470-8298-cb4ad48f68ce
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 July 2017
                : 27 April 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Dentistry
                periodontal disease,community health education,dental scaling,utilization,health services demand

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