Caries reductions between 1995, 1997 and 1999 in preschool children in Diadema, Brazil

AIMS

This study aimed to assess changes in caries prevalence and severity in preschool children in Diadema, Brazil.

METHODS

Three cross-sectional surveys were conducted, using the same protocol, in 1995, 1997 and 1999. The first survey included children aged 5-35 months, and the second and third, children aged 5-59 months. Participants were selected from all children attending a National Day of Children's Vaccination; 548, 992 and 690 in 1995, 1997 and 1999, respectively. This approach was sound as uptake rates for all years studied were above 90% for children aged between 1 and 59 months in all three surveys. Caries experience was measured using the World Health Organization (WHO) def index. Time-lag and quasi-longitudinal analysis were carried out.

RESULTS

Time-lag analysis showed a marked and statistically significant decline in the prevalence and severity of coronal and rampant caries between 1995 and 1999. There were reductions of 36.5% in the prevalence of caries in 2-year-olds between 1995 and 1997 (P < 0.002) and 36.0% between 1997 and 1999 (P = 0.041). The mean def-s at the same age decreased from 2.0 in 1995 to 1.1 in 1997 (P < 0.001) and to 1.0 in 1999 (P > 0.05). The quasi-longitudinal analysis showed a statistically significantly increase in the percentage of children with caries between 1995 and 1997 and 1997 and 1999 (P < 0.001), but not for 2-year-old children between 1995 and 1997 (P > 0.05). The same pattern was observed for severity of dental caries.

CONCLUSION

Oral health in preschool children in Diadema improved markedly during 1995-99.

[Prevalence and severity of dental caries and treatment needs in small Brazilian counties]

The aim of this study was to assess the prevalence and severity of dental caries and the need for dental treatment among schoolchildren in two small Brazilian counties. WHO criteria (1986) for the diagnosis of dental caries and treatment needs were adopted. All 6 to 12-year-old schoolchildren in both São João do Sul (n = 803) and Treviso (n = 382), both in the State of Santa Catarina, were invited to participate in the study. The response rate was 96% and 91% respectively. All kappa values for inter- and intra-examiner agreement were greater than 0.62. Prevalence of caries among 6 to 12-year-old children was 62.1% in São João do Sul and 63.6% in Treviso. Mean DMF-T for the same age group was 1.91 and 1.84 respectively. Need for treatment was high in both counties, however it was mainly related to simple clinical procedures. In conclusion, prevalence of dental caries among 6 to 12-year-old schoolchildren was lower in the two small counties studied than in other small communities in Brazil. The need for treatment was great, but it was related to simple clinical procedures. In addition, there is a need to collect further data from small towns to develop an oral health strategy appropriate to such areas.

[Dental caries and socioeconomic conditions: a cross-sectional study among 18 years-old male in Florianópolis, Santa Catarina State, Brazil]

The aim of this study was to assess the prevalence and severity of dental caries and need for treatment among 18 years-old males in Florianópolis, Southern Brazil. In addition, the associations between dental caries and socioeconomic conditions were tested. A cross sectional study was carried out. A random sample of 300, was selected from a list of Brazilian Army conscripts. Clinical data were collected according to World Health Organization criteria. Socioeconomic data (years of education of the subjects, their fathers and mothers and family income) were collected through interviews. The statistical significance of associations between socioeconomic indicators and dental caries prevalence were tested using the chi-square test whilst for severity of dental caries Mann-Whitney test was used. The prevalence of dental caries was 81% and the mean DMF-T was 4.5. The mean number of teeth that needed treatment was 1.2. Both dental status and treatment need were statistically significantly associated with socioeconomic indicators. Those with low levels of education and income experienced more disease and needed more treatment than those from high levels of education and income.

[Differences between normative criteria and self-perception in the assessment of malocclusion]

OBJECTIVE

To evaluate the impact of objectively defined orthodontic needs (normative criteria) on the external aspect and mastigation's satisfaction, and to compare these needs to self-perceived ones (subjective criteria) among adolescents.

METHODS

A cross-sectional study was carried out among all 315 students aged 14-18 years who attended a highschool in Florianópolis, Brazil. A single dentist collected clinical data about malocclusion (Dental Aesthetic Index) and a questionnaire was applied to assess perceived aesthetic and masticatory satisfaction and need for orthodontic treatment. Data analysis included frequency distribution calculation and multiple logistic regression modeling.

RESULTS

There were high participation of 95% (n=300) and intra-examiner agreement (Kappa 0.6-1.0). The prevalence of one form of malocclusion was 71.3%. Crowding in one or two incisal segments [OR=2.8 (1.6-4.9)] and overjet [OR=2,4 (1.4-4.3)] were risk factors associated with perceived aesthetic dissatisfaction. Adolescents who had anterior mandibular irregularity [OR=3.3 (1.6-6.9)], overjet [OR=1.7 (1.1-3.0)] and anterior diastema [OR=3.1 (1.4-6.9)] revealed the highest self-perceived need for orthodontic treatment.

CONCLUSIONS

There are different degrees of objectively defined occlusal problems acceptable in the population which interfere with their decision to seek treatment and have a direct impact on the need of care. Subjective measures should be incorporated to clinical criteria currently used.

[Bambuí Project: an evaluation of private, public and unionized dental services]

OBJECTIVE

Since one of the goals of dental services is to reduce the effects of social inequality on dental health, it was assessed whether there are inequalities among those seeking dental care from private, public and unionized services.

METHODS

The study population consisted of adults aged 18 years or more living in the city of Bambuí, Brazil. Participants were interviewed using a structured questionnaire. Data analysis was carried out using Pearson's chi-square test, odds ratio and 95% confidence intervals (Woolf's method).

RESULTS

There were included 656 subjects who met the study's inclusion criteria. Adjusted results using multiple logistic regression showed that those using private services were more likely to be satisfied with their teeth's looks (OR=3.03; 95%CI =1.70-5.39) and chewing ability (OR=2.27; 95%CI=1.17-4.40) compared to those using public services. Also, they were less likely to perceive their need for dental treatment (OR=0.39; 95%CI=0.18-0.86) and were more likely to have had restorative (OR=9.57; 95%CI=4.72 - 19.43) and/or preventive (OR=5.57; 95%CI=2.31 - 13.40) treatment in their last visit to the dentist's. Those using unionized services were more likely to have had restorative (OR=8.51; 95%CI=2.80 - 25.92) and/or preventive treatment (OR=11.42; 95%CI=3.49 - 37.43) in their last visit to the dentist's when compared to those using public services. However, there were no differences regarding satisfaction with their teeth's looks, chewing ability, and perceived treatment needs.

CONCLUSION

Public dental care services have not been able to reduce social inequalities related to oral health care.

Cross-cultural differences in oral impacts on daily performance between Greek and British older adults

OBJECTIVE

To examine whether there are significant cross-cultural differences in oral health-related quality of life and perceived treatment need between older people of similar clinical oral status living in Greece and Britain.

BASIC RESEARCH DESIGN

Cross-sectional surveys of adults living independently aged 65 years or older. In Britain, data from the national diet and nutrition survey were used, while the Greek sample was drawn from two municipalities in Athens. Participants 753 in Britain and 681 in Greece.

MAIN OUTCOME MEASURES

Oral health-related quality of life, assessed through the modified Oral Impacts on Daily Performance (OIDP) indicator, and perceived need for dental treatment.

RESULTS

Thirty-nine per cent of Greek and 12.3% of British dentate and 47.6% of Greek and 16.3% of British edentulous participants had experienced oral impacts affecting their daily life in the last six months. The most prevalent impact was difficulty eating. Apart from that, 56.3% of Greek and 37.1% of British dentate and 33.5% of Greek and 25.3% of British edentulous participants perceived dental treatment need. After controlling for sociodemographic variables, perceived general health and clinical oral status, Greek dentate and edentulous participants were significantly more likely to experience oral impacts than their British counterparts, while in relation to perceived treatment need significant cross-cultural differences existed only between dentate respondents.

CONCLUSIONS

The results indicated an independent cultural influence in the perception of oral impacts in older people.

Evaluation of a modified version of the index of Oral Impacts On Daily Performances (OIDP) in elderly populations in two European countries

OBJECTIVE

To examine the psychometric properties of a modified version of the index of Oral Impacts on Daily Performance (OIDP) in elderly populations in two European countries, namely Great Britain and Greece. The psychometric properties examined in this study refer to internal consistency and face, content, criterion and construct validity.

DESIGN AND SETTING

Cross-sectional epidemiologic surveys of independently living people aged 65 years or older. Data were collected by interviewers through structured questionnaires. The British sample consisted of the randomly selected independently living persons that participated in the dental component of the National Diet and Nutrition Survey (NDNS) of adults aged 65 years or over. The Greek sample is an opportunity sample drawn from eligible people living in two municipalities of the Athens region.

SUBJECTS

753 people participated in the British and 681 in the Greek sample.

RESULTS

Through pilot work in both countries, the OIDP index was modified and both Greek and British modified versions demonstrated satisfactory face and content validity. In the main studies, Cronbach's alpha of the modified OIDP was 0.77 for the Greek and 0.69 for the British sample. In both samples, the index showed very significant associations with perceived dental treatment need (p<0.001), perceived general health (p<0.001 in Greek, p=0.002 in British) and intermediate oral impacts (p<0.001), as well as with satisfaction with oral health in the Greek sample (p<0.001).

CONCLUSIONS

Overall, this study has demonstrated that the modified OIDP is a valid and reliable measure of oral health related quality of life in elderly people in Great Britain and Greece.

Clinical and behavioural risk indicators for root caries in older people

OBJECTIVE

To investigate the clinical and behavioural factors indicating root caries risk among older people.

DESIGN

Cross-sectional clinical and interview data from the National Diet and Nutrition Survey (aged 65 years and over) in Great Britain. Logistic regression models of the prevalence of root caries and linear regression models of the extent of root caries were constructed to quantify the role of a range of clinical and behavioural risk indicators, including sugars intake.

SETTING

A national sample of older British adults, free-living and institutionalised.

PARTICIPANTS

462 dentate adults aged 65 years or over.

RESULTS

Nine or more intakes of sugars per day more than doubled the odds of root caries being present (OR 2.2-2.4). Other clinical and behavioural factors affecting root caries included wearing a partial denture in the presence of heavy plaque deposits (OR 2.1-2.6) and infrequent tooth brushing (OR 2.8-4.1). Linear regression models showed that, amongst those that had root caries, sucking sweets in the presence of a dry mouth, poor hygiene, partial dentures and living in an institution contributed to the extent of root caries, as measured by the RCI(d).

CONCLUSIONS

Of the factors open to possible clinical or behavioural intervention, frequent sugars intake, poor hygiene and partial dentures were all associated with large increases in risk.

Contribution of changing diagnostic criteria toward reduction of caries between 1971 and 1997 in children attending the same school in Florianopolis, Brazil

AIM

To assess the relative impact of changing diagnostic criteria on changes in the prevalence and severity of caries between 1971 and 1997.

MATERIAL AND METHODS

All 12- and 13-year-old children attending the same school, "Padre Anchieta Primary School", in Brazil in 1971 (n=202) and 1997 (n=175) were examined by a single dentist. The criteria for the diagnosis of caries proposed by Radike in 1968 were used in both 1971 and 1997. In 1997, a second clinical examination was conducted and the WHO criteria proposed in 1987 were used.

RESULTS

Comparison of caries experience expressed as changes in the mean DMFT scores indicated a 67.7% reduction between 1971 and 1997 from 9.2 to 3.0 when Radike's criteria were used in 1971 and the WHO criteria were used in 1997. The reduction in caries was independent of the diagnostic criteria adopted in the 1997 dental examination, but the reduction of caries was smaller, from 9.2 to 6.2 (31.8%), when caries experience in 1971 and 1997 was measured using Radike's criteria.

CONCLUSION

The observed reduction of caries is not a statistical artifact. However, while 47.2% of this reduction is real, 52.8% of it is a statistical artifact due to changes in the criteria for measuring caries used by epidemiologists.

Socio-economic correlates of traumatic injuries to the permanent incisors in schoolchildren aged 12 years in Blumenau, Brazil

This study aimed to assess the prevalence of injuries to the permanent incisors in Blumenau, Brazil. In addition, the relationship between dental injuries and socio-economic indicators was examined. A cross-sectional survey was carried out. It included a random sample of 652 children aged 12 years, from both sexes, attending public and private primary schools in Blumenau, Brazil. Multi-stage sampling technique and proportional representation were adopted. A trained and calibrated dentist collected the data through clinical examinations and interviews. Clinical examination included type of damage, treatment provided and needed, size of incisal overjet and type of lip coverage. The response rate was 82.5%. The prevalence of dental injuries was 58.6%. Boys experienced more injuries than girls, 67.2% and 50.2% (P=0.001), respectively. Children from mothers with higher schooling experienced more dental injuries than those from of mothers with lower schooling, 68.2% and 56.6% (P=0.03). Father's level of education, parents' employment status and family income were not statistically significantly associated with dental injuries (P>0.05). There was a tendency for children with incisal overjet greater than 5 mm (P=0.2) and inadequate lip coverage (P=0.1) to have more dental injuries, but differences were not statistically significant. Nearly all (97.3%) children who had dental injuries needed treatment. In conclusion, the prevalence of dental injuries in Blumenau, Brazil, was very high, treatment of dental injuries was severely neglected, and boys and children from mothers with high schooling were more likely to have experienced dental injuries.

Social deprivation, income inequality, social cohesion and dental caries in Brazilian school children

This ecological study investigated the associations between social deprivation, income inequality and social cohesion and dental caries levels in school children of the Distrito Federal, Brazil. Three sources of data were used: (1) area-based data from a 1997 social survey carried out on 13,000 families, (2) 1995 census data collected for the Government of the Distrito Federal (GDF), and (3) dental caries data from a 1997 oral health survey on 7296 6-12-year-old school children. Results of simple linear regression showed that percent with less than eight years of education (P = 0.03) and percent who did not have a maid (P = 0.009), were negatively statistically significantly associated with the percent of children free of caries. None of the deprivation measures were statistically significantly associated with mean DMF-T scores (P > 0.05). GINI coefficient, an indicator of social inequalities, was negatively statistically significantly associated with both measures of dental caries experience, percent of caries free (P = 0.003) and mean DMF-T scores (P = 0.01). Per thousand number of homicides or attempted homicides, an indicator of social cohesion was of marginal statistical significance associated with caries experience. Results of multiple linear regression analyses showed that only the Gini coefficient remained statistically significantly associated with both dental clinical measures used, after adjusting for potential confounding. In conclusion, relative rather than absolute levels of income were stronger determinants of the onset of caries in this study.

Prevalence, causes and correlates of traumatic dental injuries among 13-year-olds in Brazil

A cross-sectional survey was carried out. This involved 652 out of a total of 764 (85%) 13-year-old adolescents enrolled in private and public schools located in urban areas in Cianorte, Brazil. They were interviewed and examined for traumatic dental injuries by one trained examiner (B.N.) using validated criteria. Sociodemographic data included sex, family structure (nuclear families, single parents and step-parents) and socio-economic indicators. Anthropometric measures included height and weight. The body mass index (BMI) was calculated (mean=20.1; SD=3.7). Those who had BMI scores equal or above the 85% percentile were considered overweight (BMI >23). The prevalence of traumatic injuries to the permanent incisors was 20.4%. The most common reported cause of injuries to the permanent incisors was falls (24.1%) followed by collisions with people or inanimate objects (15%), traffic accidents (10.5%), misuse of the teeth (6%), sports (2.3%) and violence (1.5%). Unknown causes accounted for 40.6%. Children from non-nuclear families, overweight children and boys were 2.18, 1.93 and 2.19 times respectively more likely to have dental injuries than children from nuclear families, non-overweight children and girls (P<0.01) after adjusting for family structure, BMI, sex, family income and level of education of the parents. The relationship between dental injuries and socioeconomic indicators was not statistically significant. In conclusion, being from a non-nuclear family, overweight and a boy increased the risk of having traumatic dental injury, but the relationship with socio-economic indicators was not statistically significant.

Oral health impact on daily performance in patients with implant-stabilized overdentures and patients with conventional complete dentures

This cohort study (n = 83) investigated whether patients with implant-stabilized overdentures would demonstrate less impact on daily life, would have less difficulty in the mastication of different types of food, and would generally be more satisfied than patients with conventional complete dentures. The groups were comparable for gender, age of dentures, and duration of edentulism. The patients were interviewed using a questionnaire, which included the Oral Impacts on Daily Performances (OIDP) sociodental indicator. Patients with implant-stabilized overdentures were more satisfied with the comfort of their dentures, could eat a wide range of food items with less difficulty, and experienced less impact on daily life than patients with conventional complete dentures. The findings of this study support the need to consider implant-stabilized overdentures in the treatment of edentulous patients.

Prevalence of impacts of dental and oral disorders and their effects on eating among older people; a national survey in Great Britain

OBJECTIVE

The objective was to assess the prevalence, in a British population aged 65 years and older, of oral health related impacts and the effects they had on the quality of daily life and in particular on eating.

METHODS

753 free living and 202 institutionalised subjects aged 65 years and over, participating in the oral health survey of the British National Diet and Nutrition Survey (NDNS), had a dental examination and interview. Data on the impact of dental and oral disorders on the activities of daily living based upon the modified Oral Impacts on Daily Performance (OIDP) indicator were collected.

RESULTS

17% of the free living edentate participants reported that their mouth affected their pattern of daily living on a regular basis. Oral impacts levels were lowest in dentate subjects with the greatest number of teeth. For the dentate, the most common oral impacts were on eating and speaking. Impacts relating to emotional stability, sleeping, relaxing, carrying out physical activity and social contact were very infrequent, but were severe when they did occur. Among those with an impact on eating, 25% said it was severe and 42% had the impact nearly every day or in a spell of 3 or more months. Oral impacts were more prevalent among the institution sample, particularly the dentate. The impacts were associated with the inability or difficulty to eat a range of 16 common foods.

CONCLUSION

This survey has shown that the oral status of older people fairly frequently affects the quality of life of older people, and in particular, the ability to eat several common types of foods.

[Prevalence and severity of dental caries among schoolchildren aged six and twelve]

OBJECTIVE

To determine the prevalence and severity of dental caries and to assess treatment needs among schoolchildren aged 6 and 12 in Blumenau, Brazil, and to compare the results found for private and public schools.

METHODS

A schoolchildren population of Blumenau, SC, Brazil, was studied. A random sample of 1,473 schoolchildren from Blumenau, Brazil, was obtained. Four strata were studied: 6 and 12 years old schoolchildren attending public and private schools. WHO (1997) criteria for caries diagnosis and treatment needs were used.

RESULTS

The prevalence of caries in the primary dentition of 6-years-old children was 60.9% and 34.9% in public and private schools (p<0.0001), respectively. The mean DMF-T for children aged 6 was 2.98 and 1.32 for public and private schools, respectively, (p<0.0001), and 2.42 for the whole sample. The prevalence of caries in the permanent dentition of 12-years-old children was 54.7% and the mean DMF-T was 1.46 for public schools. The response rate for private schools was low and the results could not be analyzed. Forty-two percent and 77.0% of children aged six of public and private schools, respectively, had no treatment needs. For those aged 12, the percentage was 53.0% for public schools.

CONCLUSIONS

The prevalence of caries and the treatment needs among schoolchildren in Blumenau was low, but there was a statistically significant higher prevalence and higher severity in public school children aged six. The prevalence of caries and treatment needs at the age of 12 in public schools were also low.

[Gingival and periodontal conditions associated with socioeconomic factors]

OBJECTIVE

To assess the prevalence of gingival bleeding, calculus and periodontal pockets among 18-year-old males. In addition, to verify whether these conditions are associated with years of education and family income.

METHODS

A cross sectional survey was carried out. A representative sample of 18-year-old males living in Florianópolis, Brazil, was selected from the Brazilian Army applicant list. Clinical and socioeconomic data were collected through dental examinations and interviews, respectively. Socioeconomic data included the subjects and their parents' years of education, and family income. A single dentist carried out the dental examinations looking for gingival bleedings after probing, calculus and shallow and deep periodontal pockets (3.5 mm to 5.5 mm and 5.5 mm and over). The associations between periodontal conditions and socioeconomic variables were analyzed using the qui-square test.

RESULTS

A total of 286 people participated in the study. Intra-examiner agreement was high. All kappa values were above 0.7. The prevalence of gingival bleeding, calculus, shallow and deep periodontal pockets were 86%, 50.7%, 7.7% and 0.3% respectively. There were associations between gingival bleeding and all socioeconomic variables (p<0.001). Calculus were associated with the subject's and their father's low educational level (p<0.05) and with their mother's low educational level (p<0.01). Periodontal pockets were associated with their father's low educational level (p<0.05).

CONCLUSIONS

The prevalence of periodontal pockets was very low, while gingival bleeding and calculus were high. General periodontal health of the studied population was good.

[The Bambuí Project: a population-based study of factors associated with regular utilization of dental services in adults]

A cross-sectional study was conducted in Bambuí, Minas Gerais, to identify factors associated with regular use of dental services. Participants were interviewed with a structured questionnaire and previously validated questions. 999/1,221 (81.8%) randomly selected individuals aged > 18 years participated in the Bambuí dental survey. Of these, 654 out of 656 individuals who had at least one natural tooth and had visited a dentist during their lifetime participated in the study. Results adjusted by multiple logistic regression showed that regular use of dental services was significantly related to having > 8 and 4-7 years of schooling (OR = 9.90; 95% CI = 2.90-33.77 and OR = 3.87; 95% CI = 1.11-13.51, respectively), having a preference for restorative treatment rather than extraction (OR = 4.91; 95% CI = 2.23-10.79), having no present need of dental treatment (OR = 4.87; 95% CI = 3.17-7.49), and belief that visiting the dentist prevents tooth decay and gum disease (OR = 1.73; 95% CI = 1.13-2.65). The results show that regular use of dental services was related to factors distributed in the Andersen and Newman model (1973) explaining use of dentistry services.

Oral health and nutrition in older people

The theoretical link between foods choice and masticatory efficiency has long been established. Recent evidence has confirmed this association, demonstrating a progressive alteration in food choice with decreasing numbers of teeth, with the greatest effect being among those who are edentulous. This altered food selection results in significant differences in the hematological status for some key nutrients in the one study in which this association was investigated. This paper summarizes some of the literature relevant to diet as a risk factor for systemic disease and identifies areas where altered food choice as a consequence of reduced masticatory efficiency might be placing individuals at increased risk of life-threatening conditions, such as atherosclerosis and cancer.

The relationship between sweetness preference and dental caries in mother/child pairs from Maringá-Pr, Brazil

AIM

Children's patterns of sugar consumption and dental health status have been associated to their mothers' patterns. As a liking for sweetness has been related to caries levels, this study was carried out to analyse the relationship between sweetness preference and caries experience in mother/child pairs.

PARTICIPANTS AND METHODS

A cross-sectional survey was conducted on a sample of low socio-economic mothers and their 4-5-year-olds from Maringá-Pr, Brazil. Mothers' and children's preference for sugar was measured using the Sweet Preference Inventory. Their caries experience was assessed according to World Health Organization (WHO) guidelines.

RESULTS

High levels of sweetness preference and caries experience were found in the sample studied. Although not strong, a significant correlation in patterns of sweetness preference (r=0.12, P<0.05) and caries experience (r=0.14, P<0.05) between mother/child pairs was identified. Among the social-demographic variables, only family income was statistically associated with the children's preference for sweetness (P<0.05). No significant association between sweetness preference and caries experience could be established.

CONCLUSION

The findings of this study suggest that mothers may play an important role on the establishment of their children dietary preferences and patterns of dental health. Also, that the socio-economic status may influence children's preference for sugar.

Epidemiology of traumatic injuries to the permanant incisors of 9-12-years-old school children in Damascus, Syria

This cross-sectional survey was carried out to assess epidemiological data concerning dental injuries to the permanent incisors of Syrian children. It included 1087 children aged 9 to 12 years, of both sexes, randomly selected from public and private primary schools in Damascus. The response rate was 100%. The prevalence of traumatic injuries to the permanent incisors rose from 5.2% at the age of 9 years to 11.7% at the age of 12 years [P = 0.007]. The difference in prevalence between boys and girls was not statistically significant [P > 0.05]. The majority [59.8%] of children who had experienced injuries to the permanent incisors reported that they were not taken to the dentist for evaluation or treatment of the damage. Among those children who had experienced traumatic injuries to the teeth 93.1% presented with untreated damage. Because some injuries were minor, such as small enamel fractures, the proportion of children who needed treatment was 63.2%. There was a tendency for children with an incisal overjet greater than 5 mm to have experienced dental injuries [P = 0.06]. Children with inadequate lip covcmgc were more likely to have experienced dental injuries than those with adequate lip coverage [P = 0.000]. The most common reported cause of iniuries to the permanent incisors was violence [42.5%], followed by traffic accidents [24.1%] collisions with people or inanimate objects [16.0%] and falls [9.1%]. In conclusion, traumatic dental injury may pose a serious dental public health problem.

The relationship between sweetness preference, levels of salivary mutans streptococci and caries experience in Brazilian pre-school children

AIM

To analyse the relationship between preference for sweetness, levels of salivary mutans streptococci and levels of caries in low socio-economic 4-5-year-old Brazilian children.

DESIGN

A cross-sectional survey.

SUBJECTS AND METHODS

298 children of both sexes, who, in 1998, were regularly attending public nurseries were randomly selected. Caries experience was assessed according to WHO guidelines. Saliva samples were analysed for mutans streptococci using the spatula method. Children's preference for sugar was measured using the 'Sweet Preference Inventory'. Personal interviews with the mothers were conducted.

RESULTS

255 children completed all aspects of the research, a response rate of 85.6%. 34.9% of them were caries-free. The mean dmf-s was 4.25 (SD 6.16), the decayed component being 3.56 (SD 5.82) and the filled surfaces, 0.69 (SD 1.85). For these pre-school children; male sex (P < 0.01), single parent (P < 0.01), habit of eating or drinking items that contained non-milk extrinsic sugar between meal times (P < 0.05) and high levels of salivary mutans streptococci (P < 0.001) were significantly associated with higher dmfs scores. There was no statistical relationship between sweetness preference and dental caries and with mutans streptococci levels.

CONCLUSION

Levels of salivary mutans streptococci but not sweetness preference were potential good predictors of caries experience among 4-5 year-old-children living in urban area of Brazil.

Prevalence and correlates of traumatic injuries to the permanent teeth of schoolchildren aged 9-14 years in Belo Horizonte, Brazil

A cross-sectional survey was carried out on 3702 boys and girls aged 9-14 years, attending public and private primary schools in Belo Horizonte, Brazil. A multi-stage sampling technique using an equal probability scheme was adopted to select the children. The response rate for the total sample was 97%. Dental examinations were carried out by one dentist (MISC). Intra-examiner agreement was very good. The prevalence of dental injuries increased from 8% at the age of 9 years to 13.6% at 12 and 16.1% at 14 years. Adjusted results showed that children from high socio-economic backgrounds were 1.4 (95% CI = 1.15-1.79) times more likely to present with a dental injury than children with low SES. Boys were 1.7 times (95% CI = 1.41-2.16) more likely to have dental injuries than girls. Children with an overjet size greater than 5.0 mm were 1.37 times (95% CI = 1.06-1.80) more likely to have a dental injury than children with an overjet size equal or lower than 5.0 mm. Finally, children with an adequate lip coverage were 0.56 times (95% CI = 0.44-0.72) less likely to have a traumatic dental injury than those with inadequate lip coverage.

Social deprivation and traumatic dental injuries among 14-year-old schoolchildren in Newham, London

AIMS

To assess the epidemiology of dental injuries among schoolchildren in Newham, London.

MATERIAL AND METHODS

This study was carried out as part of the annual Community Dental Service's School Dental Inspection (SDI) programme in Newham. All schoolchildren aged 14 years were invited to participate in the study. Dental examinations were carried out by one trained examiner (SM) and included presence of clinical evidence of dental injuries, treatment provided and needed in the upper and lower permanent incisors, size of incisal overjet and type of lip coverage. The postcode was recorded to assess the levels of social deprivation.

FINDINGS

2242 out of 2684 children were examined. The prevalence of dental injuries was 23.7%. Treatment of dental injuries was neglected. Being male, having an incisal overjet greater than 5 mm and living in an overcrowded household increased the risk of having dental injuries.

CONCLUSIONS

The prevalence of dental injuries in Newham (23.7%), which is a deprived area of London, was much higher than the overall prevalence in the UK (17%). Traumatic dental injuries seem to be a serious dental public health problem among children in deprived areas. Thus, there is an urgent need to collect local data on dental injuries in order to obtain a more comprehensive picture of the dental health.

Prevalence of oral lesions among a sample of Bangladeshi medical users aged 40 years and over living in Tower Hamlets, UK

AIM

To collect data on the prevalence of oral mucosal lesions among Bangladeshi medical care users aged 40 years and over and to explore the relationship of oral disease status and tobacco smoking and paan (betel quid) chewing.

DESIGN

Multi-centre cross-sectional study.

SETTING

General medical practitioners' waiting areas in Tower Hamlets, UK.

SUBJECTS

185 Bangladeshi adults aged 40 years old and over.

METHOD

An oral mucosal examination, based on WHO criteria and an interview. Information on tobacco smoking and paan chewing behaviour was collected during the interview.

RESULTS

Out of 185 adults there was a response rate of 74%. Oral mucosal lesions were observed in 40% of participants. The most common lesion was found to be leukoplakia with a prevalence of 25%. Significant relationships were found between smoking and the presence of oral pathology and between paan chewing with tobacco and the presence of leukoplakia.

CONCLUSION

In this study of older Bangladeshi medical care users there was a high prevalence of oral mucosal lesions. Sensitively tailored health promotion interventions, which aim to reduce tobacco use, should be developed for this population.

Dental health and treatment needs among a sample of Bangladeshi medical users aged 40 years and over living in Tower Hamlets, UK

AIM

To assess the dental health status and treatment needs of Bangladeshi medical care users aged 40 years and over and to explore the relationship of oral disease status, tobacco usage and paan (betel quid) chewing.

DESIGN

Multi-centre cross-sectional study.

SETTING

General medical practitioners' waiting areas in Tower Hamlets, UK.

SUBJECTS

185 Bangladeshi adults aged 40 years and over.

INTERVENTION

A clinical examination and an interview schedule.

MEASURES

Dental status, periodontal status, dental plaque, calculus and denture status. Tobacco smoking and paan chewing behaviour.

RESULTS

The response rate was 74%. 85% of participants were dentate with an average number of 24 (SD +/- 5.4) standing teeth. The mean DMFT score was 5.38, with missing teeth (3.81) being the major component. The decayed component was 0.43 and the filled was 1.14. 46% of participants were assessed as being free from gingivitis. Significant relationships between chewing paan and aspects of dental and periodontal status were found. Impacts of oral health were reported by 45% of the respondents. The normative need for dental treatment was 96% with a perceived need of 48%.

CONCLUSION

There was considerable normative dental need. Whilst caries experience was low, there were high levels of periodontal treatment needs. Paan chewing was related to aspects of dental and periodontal status.