Canadian Journal of Dental Hygiene (CJDH)

Background: Caries risk assessment (CRA) is an important step in preventive and therapeutic management of caries in children. This study assessed the sensitivity and specificity of a new Canadian Caries Risk Assessment Tool (<6 years) for preschoolers to predict caries development. Methods: In this prospective cohort study, CRA was performed at baseline and 12 months among 190 children aged <6 years from 3 clinics in Manitoba, Canada. CRA included information on child’s fluoride exposure, teeth cleaning, diet, socio-economic status, and oral examinations. Sensitivity and specificity were calculated, and logistic regression for new caries at follow-up was performed. Results: The sensitivity and specificity for baseline CRA rating and development of new caries at follow-up were 87.2% and 42.7%, respectively. Presence of visible caries and/or past evidence of dental treatment for caries at baseline was the strongest independent indicator of new caries by follow-up (OR = 6.49; CI = 3.28, 12.85; p < 0.001). Children with high caries risk (score =3) were more likely to develop new caries by follow-up (OR = 4.58; 95% CI = 2.07, 10.11). Discussion: The combined sensitivity and specificity score is comparable to findings from other studies examining CRA. Results support the increased weighting of the score for the presence of visible caries and/or evidence of dental treatment for caries at baseline. Results from this study provide evidence for the CRA tool’s predictability. Conclusion: The Canadian Caries Risk Assessment Tool for preschoolers has high sensitivity to identify children with high caries risk, and modest specificity to identify children with low caries risk. However, future population-based studies with primary care providers are recommended.

Background: The Student Health Initiative for the Needs of Edmonton (SHINE) dental clinic is a student-run clinic that provides free oral health care to low-income inner-city individuals in Edmonton, Canada. SHINE was managed and operated by the Dental Students’ Association, independent from the University of Alberta, at the time of data collection. Students care for patients under the supervision of volunteer dentists and dental hygienists from within the community. Although not a formal education facility, the SHINE clinic appears to offer valuable learning opportunities, based on anecdotal feedback from students and preceptors. The purpose of this study was to explore how the SHINE volunteer experience contributes to student learning. Methods: Ethics approval was granted by the University of Alberta Research Ethics Board (Pro00101981). Using maximum variation purposeful sampling, dentistry and dental hygiene students were recruited to participate in 5 focus groups (N = 19). Interpretive description informed the study, and data were analyzed using manifest thematic analyses. Results: Three themes captured how SHINE benefitted student learning: 1) learning in a facilitative environment (contextual factors, including pace, preceptor ratios, autonomy, and collaborative learning); 2) learning-conducive roles (tasks and responsibilities students undertook that supplemented existing clinical skills); 3) learning from patients (patient encounters that promoted empathy, communication strategies, and awareness of diverse patient circumstances). Conclusion: Students’ experiences volunteering at SHINE had beneficial learning outcomes and brought to light 3 considerations for dentistry and dental hygiene education: the need for further cultural sensitivity training, student desire for “real-life” experiences, and a reduction in grading upon achieving competency.

Background: The Western diet contributes to the onset and progression of gingivitis. In contrast, an anti-inflammatory low-carbohydrate diet (AILCD) has been proposed as a dietary recommendation to improve gingival health. Although a few published studies have investigated the influence of an anti-inflammatory diet on gingivitis in individuals of normal weight, this study aimed to evaluate the association between an AILCD and gingivitis in women with obesity. Methods: Twenty-three women with obesity and gingivitis participated in the 2-month study. Clinical parameters, including plaque index (PI), gingival index (GI), probing pocket depth (PPD), and bleeding on probing (BOP), were recorded at baseline, 1 month, and 2 months. Mouthwash samples were collected for real-time PCR detection of oral microbiota, including Streptococcus mutans, Aggregatibacter actinomycetemcomitans, Tannerella forsythia, Porphyromonas gingivalis, and Fusobacterium nucleatum. Salivary inflammatory cytokines (IL-6, TNF-a, and IL-10) were measured using ELISA. Anthropometric parameters, including weight, body mass index (BMI), skeletal muscle mass (SMM), and percent body fat (PBF), were assessed using body composition analysis. Results: After 2 months, all clinical parameters were significantly reduced. The baseline PI was 1.14 ± 0.48 reduced to 0.54 ± 0.38, GI was 0.77 ± 0.32 reduced to 0.38 ± 0.17, PPD was 1.83 mm ± 0.22 mm reduced to 1.35 mm ± 0.30 mm, and BOP was reduced from 37% to 19%. Baseline weight, BMI, SMM, and PBF were significantly reduced by 3.8 kg, 1.3 kg/m2, 0.5 kg, and 1.6%, respectively. However, no significant differences were observed in the periodontal pathogens and salivary inflammatory cytokines except for Tannerella forsythia, which showed a significant increase in its counts with a p value of 0.01. Conclusion: The AILCD followed by participants in this study was associated with significant improvements in clinical and anthropometric parameters. However, Tannerella forsythia showed a significant increase in women with obesity.

Background: This study evaluated the effectiveness of community referrals to complimentary oral care services in improving access to care for immigrant children in Canada. It also explored financial and non-financial factors influencing parental adherence to their children's oral care referrals. Methods: Data from 610 parent–child pairs, including demographics and oral health behaviours of children aged 1 to 12 years, were analyzed. Oral health examinations were conducted at a community site, and 151 children needing treatment were referred to a university dental clinic. Univariate analyses and backward stepwise logistic regression identified factors associated with attending at least one oral care appointment. Results: Among the 151 referred children (average age: 6 years), 48% were girls and 40% were born in Canada. Only 42% had visited a dentist in the past year and only 36% had dental coverage. Oral health behaviours varied; 40% brushed their teeth once or less daily and 46% consumed at least one sugary snack per day. Approximately 66% of mothers had college education or higher. Despite the offer of complimentary care, attendance at referred appointments was 38%, with higher attendance among girls (p = 0.025). Discussion: Despite the elimination of financial barriers to oral care, attendance at appointments remained low, emphasizing the role of non-financial factors, including the unique social and cultural challenges encountered by immigrants, in accessing oral health care. Higher attendance among girls suggests gendered parental perceptions of oral health care. Addressing these factors requires culturally tailored outreach and improved provider–family communication. Conclusions: Financial support alone is insufficient to improve access to oral care for immigrant children. A multidimensional approach addressing both financial and non-financial barriers is essential to enhance oral health care utilization.

Objective: This position paper examined, through a systematic review, the role of intraoral radiographs as the standard of care for diagnosing and monitoring periodontal disease while also informing treatment planning, intervention delivery, and the evaluation of periodontal care. Methods: This review adhered to PRISMA guidelines and was registered under protocol nº CRD42024579081. Searches were conducted through Ovid MEDLINE, Ovid Embase, Web of Science, and the Cochrane Library, with additional screening of grey literature and reference lists. Studies evaluating intraoral radiographs for diagnostic accuracy and treatment-planning effectiveness for periodontal disease among adults were included. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) tool. Results: Thirty studies involving 1,645 adult patients (mean age 35 to 59 years), were included. Intraoral radiographs demonstrated a moderate to high sensitivity (60% to 90%) compared to direct measurement (flap surgery) or clinical attachment level measurements for assessing periodontitis and peri-implantitis bone loss. A moderate association (r = 0.5 to 0.8 across 13 studies) was observed between clinical measurements and intraoral radiographs of alveolar bone loss, with radiographs underestimating bone loss by 0.5 mm to 2.8 mm compared to clinical methods. Conclusion: Periapical and bitewing radiographs are tools with moderate to high sensitivity for periodontal assessment, suggesting that they are the most accurate and appropriate tools for oral health professionals to use as an adjunct to clinical evaluation.

Introduction: Dental radiographs are essential in oral health care, facilitating accurate diagnosis and treatment planning. In various situations, such as in rural communities, seniors’ homes, military settings or in patients with limited mobility, traditional wall-mounted X-ray machines may not be suitable. Hand-held dental X-ray devices have emerged as a valuable solution for these special circumstances. However, because Canadian regulatory bodies have only recently approved these portable devices, information on their proper use is limited. Description: This short communication consolidates relevant information on regulations, safety, and best practices to assist Canadian oral health care providers in adopting this technology effectively and safely. Additionally, it shares insights gained from using hand-held X-ray devices in a dental initiative that delivers care to underserved Canadians through mobile clinics.

Introduction: Asynchronous online courses are designed to offer flexibility. To promote student engagement, educators at a Canadian university incorporated game-based homework assignments in an online dental hygiene course. Case description: A study was conducted to describe student engagement and the impact of this intervention. Student performance data from summative exams and engagement data from the learning management system were analyzed. Results showed that students were highly engaged with the game-based assignments, created using Gimkit, the week before the course summative exams. Students performed significantly better on questions reviewed by the homework assignments compared to the other questions on the exam. Discussion: Although the results are from 1 cohort of students, they demonstrate the potential of game-based homework to significantly improve students’ learning experiences. Conclusion: The increasing popularity of online and hybrid learning necessitates the innovation of new techniques to engage students online; Gimkit can be a powerful and fun tool for this purpose.

Introduction: Sturge-Weber syndrome (SWS) is a sporadic, progressive, congenital condition that occurs due to hamartomatous malformation and is usually referred to as a “port wine stain.” It is characterized by trisymptomatic forms that include facial port wine stain, glaucoma, and leptomeningeal calcifications. Case description: A 42-year-old female patient presented with a chief complaint of missing teeth in the mandibular anterior region that had recently exfoliated following mobility. A unilateral port wine stain noted on the left side of her face appeared to follow the left maxillary division of the trigeminal nerve with minimal intraoral signs. The patient claimed it had been present since birth. Discussion: The origin, pathophysiology, clinical presentation, differential diagnosis, potential therapies, and prognosis of SWS are discussed. Conclusion: A multidisciplinary approach to individuals with SWS is required for the successful treatment of these patients.