Personalised dental education for caries risk reduction in an adult population in the Republic of Ireland
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Date
2018
Authors
Nishi, Makiko
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Publisher
University College Cork
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Abstract
Overall aim: To investigate the impact on caries risk reduction of a personalised dental
education approach based on individual caries risk assessment using mobile-phone short
text messages in an economically disadvantaged adult population in the Republic of
Ireland. Methods: Two studies were conducted: a cross-sectional study with patients
recruited through a non-profit organisation in Japan using questionnaires, and a 2-arm
parallel-group, single-blinded, randomised controlled study with medical-card holders
recruited in Ireland; caries risk was assessed using the Cariogram and participants
responded to a survey questionnaire. Results: A higher proportion of Irish participants
(n = 159) identified “Not visiting the dentist for check-up and cleaning” (odds ratio
(OR) 2.655; 99% confidence interval (CI) 1.550, 4.547) and “Not using fluoride” (OR
1.714; 99% CI 1.049, 2.802) than did Japanese participants (n =482) as caries risk
factors. There was an association between assessed caries risk (Chance-AC) and
self-perceived caries risk in the four risk groups (n = 165). Approximately two-thirds of
participants in the high-risk groups did not consider themselves as being more prone to
dental decay than the average person. Caries risk profiles among participants (n = 167)
were clustered into five groups. As a result of protocol violations, 84% of the 111
participants (56: personalised group; 55: non-personalised group) were not sent their
assigned number and combination of text messages. Intent-to-treat analysis did not
show a personalised intervention effect in Chance-AC. Of the secondary outcome
measures, the stimulated saliva amount factor showed a personalised intervention effect,
P = 0.036 (OR 0.3; 95% CI 0.1, 0.9). Conclusions: This thesis could not reach a
definitive conclusion as to whether a personalised mHealth approach was more effective
than a non-personalised mHealth approach, the exception being for the saliva amount
parameter. It is worth further exploring the potential of mobile-devices for personalised
caries risk reduction.
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Keywords
Dental caries , Risk factors , Risk assessment , Preventive dentistry , Perception , Knowledge , Vulnerable populations , Cell phone , Telemedicine
Citation
Nishi, M. 2018. Personalised dental education for caries risk reduction in an adult population in the Republic of Ireland. PhD Thesis, University College Cork.