In recent years, more attention has been paid to virtual education methods in the field of oral health. Oral health literacy (OHL) plays a major role in reducing oral health inequalities. Individuals with inadequate health literacy are more susceptible to oral disorders. This study was a parallel randomized controlled trial with a non-inferiority design that aimed to compare a virtual educational intervention with traditional in-person education to improve OHL. This study was conducted in adults visiting a university dental school, from February 2022 to May 2023. After the inclusion and exclusion criteria were checked and informed consent was obtained, the participants were randomly allocated into two groups by balanced block randomization. One group received in-person education in the waiting room, and the other received an educational video through an online messenger. The Oral Health Literacy Adult Questionnaire (OHL-AQ) assessed participants' OHL levels before, immediately after, and three months after the intervention. The researchers who analysed the data were blinded. Generalized estimating equation (GEE) analysis was used to compare the groups (P < 0.05). The non-inferiority margin was determined using the fixed-margin method. In total, 149 individuals participated. Seventy-five patients were randomly allocated to the in-person group, and 74 were allocated to the virtual group; their data were analysed. GEE analysis revealed no significant difference in the change of OHL scores immediately after the intervention between the two groups (P = 0.07). However, at the three-month follow-up, the in-person group exhibited a significantly greater improvement in OHL scores compared to the virtual group (P = 0.03). After three months, virtual education was inferior to in-person education, unlike in the immediate post-test. After three months, an online video sent in a messenger environment was less effective than traditional in-person education in improving OHL. The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 08–02-2022, (IRCT20220106053643N1|| http://www.irct.ir/ ).
PURPOSE The aim of this study was to investigate the diagnostic delay and its determinants among oral cancer patients in Tehran, Iran. MATERIALS AND METHODS This study was conducted between September 2004 and September 2006 in three university hospitals, and included 100 consecutive patients with primary oral squamous cell carcinoma (international classification of disease, ICD-10 sites C01 to C06). Data were obtained through questionnaire interviews and medical records of the patients were reviewed to obtain information on the date of diagnosis, primary tumour site and the stage of the tumour at the time of diagnosis. Statistical analysis was performed by t test, ANOVA and logistic regression. RESULTS The mean diagnostic delay was 7.2 months (SD 7.5, range 1 to 36 and median 4). The most important determinants of longer diagnostic delay were being single (OR = 4.8; 95% CI = 1.5 to 14.8; P < 0.05) and being at advanced tumour stages (OR = 5.3; 95% CI = 1.8 to 15.6; P < 0.01). The mean patient and professional delays were 5.3 months (SD 6.1 and median 2) and 2.1 months (SD 2.1 and median 1), respectively. Patients at advanced tumour stages were more likely to have longer patient and professional delays than those at early stages (OR = 5.6; 95% CI = 1.8 to 17.3 and OR = 3.4; 95% CI = 1.2 to 9.4, respectively; P < 0.05). Living alone was also a determinant of longer patient and professional delays (OR = 7.1; 95% CI = 2.0 to 24.7, OR = 3.5; 95% CI = 1.2 to 10.3, respectively; P < 0.05). CONCLUSIONS Developing preventive programmes that focus on the enhancement of public and professional awareness about oral cancer is essential to promote earlier diagnosis in Iran.
Background: Social life is important in childhood and adolescence when appearance is more closely related to emotional and mental health. Malocclusion may cause several problems in the self-esteem and social satisfaction of children and adolescents. Objectives: We evaluated the association between malocclusion, happiness, and oral health-related quality of life (OHRQoL) in children 11–14 years old referring to the School of Dentistry, Tehran University of Medical Sciences. Materials and Methods: In the current descriptive-analytical study, to evaluate OHRQoL and happiness, child perception questionnaire (CPQ) and oxford happiness questionnaire were used. To study and classify malocclusion, the dental health component (DHC) of the Index of Orthodontic Treatment Need (IOTN) was implemented, by a calibrated dentist. To investigate the relationships, a linear regression model was utilized by means of SPSS-25. Results: All the children referred to the dental school during April–May 2019, of which 143 completed the questionnaires, and 78 (54%) were girls. The participants’ mean age was 12.42 (±1.13). A direct relationship was observed between CPQ and malocclusion ( P < 0.001), i.e., the more severe the malocclusion, the higher the CPQ score and the lower the child’s OHRQoL. Similarly, there was an inverse association between happiness and CPQ ( P < 0.001), indicating that an increase in happiness led to a decrease in the score of CPQ, which implied an increase in OHRQoL. The findings of regression analysis showed a relationship between happiness and IOTN, family history of dental irregularity, and psychological problems. Conclusions: Results of the present study revealed an association between happiness and OHRQoL with malocclusion in children. This signifies the malocclusion effect on different aspects of a child’s psychological health. Prevention and timely treatment of malocclusion has a remarkable influence on improving the quality of life and happiness in children.
The present study aimed to identify the social cognitive predictors of regular dental visits and mouth self-examination behaviors among the elderly population, based on the Health Action Process Approach (HAPA) model.Regular dental visits and mouth self-examination can prevent oral and dental problems among the elders. Little information is available regarding the social cognitive predictive factors of these two behaviors.A cross-sectional study was conducted in 24 municipality centers in Tehran, Iran in 2021. The centers were selected randomly using a multi-stage cluster sampling method and 301 elderly attendants aged 60≥years participated in the study. Data collection was done using a researcher-made questionnaire including demographic characteristics and the HAPA model constructs for two target behaviors. Data were analyzed using the Smart-PLS version 3.3.9 via correlation and PLS-SEM analysis.The mean age of the participants was 65.3±5.33 years and 79.7% were female. The SEM analysis showed that Action Self-Efficacy [b (SD) = 0.595 (0.065), P< 0.001] and Risk Perception [b (SD) = 0.218 (0.070), P< 0.002] were predictors of Intention for mouth self-examination but only Action Self-Efficacy [b (SD) = 0.651 (0.043), P< 0.001] was predictor of Intention for regular dental visits. Recovery Self-Efficacy and Planning directly contributed to the prediction of Mouth Self-Examination. The relationship between Maintenance Self-Efficacy and both behaviors is mediated by Planning. Also, the mediating role of Planning between Intention and target behaviors was confirmed.Action self-efficacy predicted the intention for regular dental visits and mouth self-examination behaviors. The relationship between intention and both behaviors was mediated by Planning. Emphasis on improving Action Self-Efficacy and Intention formation will enhance the effectiveness of interventions aiming at promoting the oral health of the elderly population.
Abstract Background The theory of planned behavior (TPB) is recognized as an effective theory for behavior change. The aim of the present study was to investigate the impact of two TPB-based educational interventions on oral self-examination (OSE) behavior and the related TPB constructs among adults in Tehran, Iran, in 2022. Methods This randomized controlled trial involved 400 healthy individuals recruited from 20 urban comprehensive health centers in the southern part of Tehran, Iran. The health centers were randomly assigned to two control (PowerPoint) and intervention (WhatsApp) groups (200 individuals in each group). In the control group (the recipient of the routine care), participants received a 20-minute lecture through a PowerPoint presentation and a pamphlet. In the intervention group (the recipient of an additional intervention alongside the routine care), participants were educated through messages and images on WhatsApp along with having monthly group discussions. Data was collected at baseline, as well as at 1- and 3-month follow-ups using a structured questionnaire. The outcomes assessed included OSE behavior and the related TPB constructs: intention, attitude, subjective norm, and perceived behavioral control. Linear and logistic generalized estimating equations (GEE) regression models were used to evaluate the impact of the interventions with STATA version 17. Results Of the total participants, 151 (37.75%) were men. The mean ± standard deviation (SD) of ages in the PowerPoint and WhatsApp groups were 39.89 ± 13.72 and 39.45 ± 13.90, respectively. OSE and the related TPB constructs showed significant differences between the groups at the 1-month post-intervention assessment. The effect of PowerPoint was more significant in the short-term (one month), while both methods showed similar effectiveness after three months, specifically in relation to OSE and the TPB constructs. At the 3-month post-intervention assessment, there were significant increases in OSE (OR = 28.63), intention (β = 1.47), attitude (β = 0.66), subjective norm (β = 2.82), and perceived behavioral control (β = 1.19) in both groups ( p < 0.001). Conclusions The present study provides evidence of the effectiveness of both educational interventions in improving OSE and the TPB constructs after three months. Therefore, both TPB-based educational methods can be recommended for designing and implementing interventions aimed at preventing oral cancer. Trial registration The trial protocol was registered in the Iranian Registry of Clinical Trials (IRCT) on 04/03/2022 (registration number: IRCT20220221054086N1).
Introduction : Despite recent advances in treatment of oral cancer, it still causes high rates of mortality and morbidity worldwide. Delays in diagnosis and treatment of these cancers greatly affect the prognosis. This study aimed to assess the treatment delay and its relation to diagnostic delay among oral cancer patients in Tehran, Iran. Materials and Methods : We studied 100 patients with primary oral squamous cell carcinoma who were admitted to three teaching hospitals between 2004 and 2006. Treatment delay was defined as the time from diagnosis to the beginning of treatment. Diagnostic delay is considered as the time elapsed between the onset of symptoms and diagnosis. Results : Of all the patients 53% were male with the mean age of 61.5 (SD 15.8 years; range 24-100 years) at diagnosis. The majority of tumors (61%) were at advanced stages when diagnosed (stages III or IV). The mean diagnostic delay was 7.2 months (SD 7.5) and the mean treatment delay was 33.16 days (SD14.1). Patients who were diagnosed at earlier stages had longer treatment delays (p<0.05), and those who had longer diagnostic delay had shorter treatment delay (p<0.05). Conclusions : Our findings indicated a need for oral cancer prevention campaigns, focused on reducing the delays between the appearance of signs and symptoms, and final diagnosis and treatment to ensure better prognosis and higher quality of life for patients.
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