A tremendous variation was found in time of eruption and in duration of eruption of permanent molars. This variation highlights the importance of individualizing caries preventive strategies for children.

Accessible Summary What is known on this subject? There is a need to shed light on healthcare professionals’ reactions to the use of the Guided Self‐Determination method in a mental health hospital to better understand and adjust the implementation process of evidence‐based practice. Healthcare professionals´ values and beliefs play an important role when implementing evidence‐based practice in real‐world healthcare settings. What this paper adds to existing knowledge? The study identifies opposite positions in mental healthcare professionals: being ready or resistant to change when implementing an evidence‐based intervention. The positions are elaborated in four thematic dynamic continuums describing reactions to using the intervention. In addition, this is the first study to explore mental healthcare professionals´ reactions to using the Guided Self‐Determination method in a mental health context. What are the implications for practice? When preparing implementation of an evidence‐based intervention, it is important to consider adaptation of the intervention, the mental healthcare professionals’ acceptability, support from management and participation in supervision. In future research, it is important to consider collecting data from mental healthcare professionals trained in using an evidence‐based intervention, however not using it in clinical practice, to understand barriers towards evidence‐based practice. Abstract IntroductionEvidence‐based interventions are required in mental health nursing to improve quality and outcome for patients. However, there is a need to shed light on professionals’ reactions to the use of evidence‐based interventions to better understand and adjust the implementation process. AimTo explore mental healthcare professionals´ reactions to using the evidence‐based intervention Guided Self‐Determination method in the care of inpatients with severe mental illness. MethodA qualitative study conducted in relation to an 8 months implementation program. Data collection: 9 qualitative interviews and field notes generated from supervision of the intervention. ResultsFour themes emerged from a thematic analysis: “The expert becomes novice,” “Theory used as a looking glass,” “Guided Self‐Determination perceived as an interruption” and “Becoming an informer of the impact of GSD.” DiscussionUsing the themes may help leaders or researchers predict or discover the support needed by individual professionals. Implications for practiceWhen preparing implementation of an evidence‐based intervention, it is important to consider adaptation and acceptability, as well as support from management and participation in supervision. Finally, it is worth to consider collecting data from trained professionals, who did not use the intervention in practice to understand barriers towards evidence‐based practise.

This paper reviews the first part of the outcomes of the ORCA Saturday Afternoon Symposium 2014 dealing with ‘caries epidemiology and community dentistry: chances for future improvements in caries risk groups'. After the caries decline in many countries, there are remaining pockets of higher caries levels, mostly in the primary dentition and/or linked to a low socio-economic status (SES). The review into the evidence of caries-preventive measures clearly points to the use of fluorides, especially toothbrushing with fluoridated toothpaste and collective measures such as water fluoridation. In contrast to several unsuccessful high-risk approaches, community and public health programmes seem to be able to ensure a population-wide access and compliance in risk groups. Their simple and evidence-based measures mostly combine regular plaque removal and fluoride applications via toothbrushing, at least for children and adolescents. For the future, the common risk factor approach which addresses associations between oral health, social deprivation, diet, hygiene, smoking, alcohol use and stress should lead to combined efforts with other community health and education specialists. Further engagement with public policy, community leaders and administration is needed in order to strengthen healthy choices and behaviour, e.g. in ‘healthy' schools and kindergartens. It seems advisable that these population programmes also aim at improving upstream factors.

This paper examines the characteristics of the process of innovation as applied to provision of dental health to children. The data are from a demonstration project conducted in a Danish public child dental health clinic to evaluate the appropriateness and effectiveness of an individualized and alternative, mainly non-operative caries treatment strategy that was implemented in 1987. The aim of the strategy was to avoid operative intervention and sealants, and was based on three principles: caries is a localized disease; intensive training in home-based treatment, and individualized risk assessments and controls in conjunction with professional plaque removal. The major influence on the innovation process appeared to be personal education of the personnel, active participation in research, and feedback from clinical observations. In 1992 an additional feedback measure was introduced addressing the question: how much time does the individual child spend on treatment during one year? Mean total treatment time varied from 12 min 1- to 4-yr-olds to 44-58 min for 7- to 17-yr-olds. About 60% of the total treatment time was used on non-operative caries treatment (diagnosis, risk assessment, plaque removal, toothbrushing training) and about 25% on operative caries treatment for 3- to 17-yr-olds. The 1-2-yr-olds required only non-operative treatment. The new treatment strategy reduced operative procedures by 60%. The paper introduces an easily applicable measure of treatment outcome in terms of teeth that have not been restored or sealed as a result of regular professional treatment or care. The main conclusion drawn is that the dominant moving forces in the innovation process were professional responsibility and self-adjustment by a constant learning process involving clinical feedback measures in conjunction with modern understanding of caries as a localized disease caused by local evolution of microbial cariogenic biofilms.