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Kassebaum N, Smith A, Bernabé E, Fleming T, Reynolds A, Vos T, Murray C, Marcenes W. Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990-2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors. J Dent Res 2017; 96:380-387. [PMID: 28792274 PMCID: PMC5912207 DOI: 10.1177/0022034517693566] [Citation(s) in RCA: 989] [Impact Index Per Article: 141.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Global Burden of Disease 2015 study aims to use all available data of
sufficient quality to generate reliable and valid prevalence, incidence, and
disability-adjusted life year (DALY) estimates of oral conditions for the period
of 1990 to 2015. Since death as a direct result of oral diseases is rare, DALY
estimates were based on years lived with disability, which are estimated only on
those persons with unmet need for dental care. We used our data to assess
progress toward the Federation Dental International, World Health Organization,
and International Association for Dental Research’s oral health goals of
reducing the level of oral diseases and minimizing their impact by 2020. Oral
health has not improved in the last 25 y, and oral conditions remained a major
public health challenge all over the world in 2015. Due to demographic changes,
including population growth and aging, the cumulative burden of oral conditions
dramatically increased between 1990 and 2015. The number of people with
untreated oral conditions rose from 2.5 billion in 1990 to 3.5 billion in 2015,
with a 64% increase in DALYs due to oral conditions throughout the world.
Clearly, oral diseases are highly prevalent in the globe, posing a very serious
public health challenge to policy makers. Greater efforts and potentially
different approaches are needed if the oral health goal of reducing the level of
oral diseases and minimizing their impact is to be achieved by 2020. Despite
some challenges with current measurement methodologies for oral diseases,
measurable specific oral health goals should be developed to advance global
public health.
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Affiliation(s)
- N.J. Kassebaum
- Department of Anesthesiology and
Pain Medicine, University of Washington, Seattle, WA, USA
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - A.G.C. Smith
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - E. Bernabé
- Division of Population and Patient
Health, King’s College London Dental Institute, London, UK
| | - T.D. Fleming
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - A.E. Reynolds
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - T. Vos
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - C.J.L. Murray
- Institute for Health Metrics and
Evaluation, University of Washington, Seattle, WA, USA
| | - W. Marcenes
- Division of Population and Patient
Health, King’s College London Dental Institute, London, UK
- W. Marcenes, Division of Population and
Patient Health, King’s College London Dental Institute, Bessemer Road, Demark
Hill, London SE5 9RW, UK.
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52
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Schwendicke F, Splieth CH, Thomson WM, Reda S, Stolpe M, Foster Page L. Cost-effectiveness of caries-preventive fluoride varnish applications in clinic settings among patients of low, moderate and high risk. Community Dent Oral Epidemiol 2017; 46:8-16. [DOI: 10.1111/cdoe.12320] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 06/05/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Christian H. Splieth
- Department of Preventive and Pediatric Dentistry; Universitätsmedizin Greifswald; Greifswald Germany
| | - William Murray Thomson
- Department of Oral Sciences; Faculty of Dentistry; University of Otago; Otago New Zealand
| | - Seif Reda
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | | | - Lyndie Foster Page
- Department of Oral Sciences; Faculty of Dentistry; University of Otago; Otago New Zealand
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53
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Song IS, Han K, Ryu JJ, Park JB. Obesity is inversely related to the risks of dental caries in Korean adults. Oral Dis 2017; 23:1080-1086. [DOI: 10.1111/odi.12693] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 05/06/2017] [Accepted: 05/15/2017] [Indexed: 01/08/2023]
Affiliation(s)
- I-S Song
- Department of Oral and Maxillofacial Surgery; Korea University Anam Hospital; Seoul Korea
| | - K Han
- Department of Biostatistics; College of Medicine; The Catholic University of Korea; Seoul Korea
| | - J-J Ryu
- Department of Prosthodontics; Korea University Anam Hospital; Seoul Korea
| | - J-B Park
- Department of Periodontics; College of Medicine; The Catholic University of Korea; Seoul Korea
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54
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Schwendicke F, Stolpe M. In-Office Application of Fluoride Gel or Varnish: Cost-Effectiveness and Expected Value of Perfect Information Analysis. Caries Res 2017; 51:231-239. [DOI: 10.1159/000458729] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 01/30/2017] [Indexed: 11/19/2022] Open
Abstract
Application of fluoride gel/varnish (FG/FV) reduces caries increments but generates costs. Avoiding restorative treatments by preventing caries might compensate for these costs. We assessed the cost-effectiveness of dentists applying FG/FV in office and the expected value of perfect information (EVPI). EVPI analyses estimate the economic value of having perfect knowledge, assisting research resource allocation. A mixed public-private-payer perspective in Germany was adopted. A population of 12-year-olds was followed over their lifetime, with caries increments modelled using wide intervals to reflect the uncertainty of caries risk. Biannual application of FV/FG until age 18 years was compared to no fluoride application. Effectiveness parameters and their uncertainty were derived from systematic reviews. The health outcome was caries increment (decayed, missing, or filled teeth; DMFT). Cost calculations were based on fee catalogs or microcosting, including costs for individual-prophylactic fluoridation and, for FG, an individualized tray, plus material costs. Microsimulations, sensitivity, and EVPI analyses were performed. On average and applied to a largely low-risk population, no application of fluoride was least costly but also least effective (EUR 230; 11 DMFT). FV was more costly and effective (EUR 357; 7 DMFT). FG was less effective than FV and also more costly when using individualized trays. FV was the best choice for payers willing to invest EUR 39 or more per avoided DMFT. This cost-effectiveness will differ in different settings/countries or if FG/FV is applied by other care professionals. The EVPI was mainly driven by the individual's caries risk, as FV/FG were significantly more cost-effective in high-risk populations than in low-risk ones. Future studies should focus on caries risk prediction.
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55
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Foster Page LA, Beckett D, Ahmadi R, Schwass DR, Leon de la Barra S, Moffat SM, Meldrum A, Thomson WM. Resin Infiltration of Caries in Primary Molars in a Community Setting: 24-Month Randomized Controlled Trial Findings. JDR Clin Trans Res 2017; 2:287-294. [PMID: 30938631 DOI: 10.1177/2380084417699400] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to assess whether resin infiltration of primary molar proximal lesions is more effective than noninvasive measures in radiographically controlling carious lesion progression into the dentin. A split-mouth randomized controlled trial included 90 children, each with 2 proximal lesions confined to the inner half of the enamel or ≤0.5 mm into the dentin. For each child, lesions were randomly allocated to test (infiltration: DMG Icon preproduct and fluoride varnish) or control (fluoride varnish) status. The primary outcome measure was 24-mo radiographic lesion progression. Placement of a restoration during the study period was counted as lesion progression. Proportions of teeth with progressed lesions were compared using the McNemar test. Children also reported on the treatment's acceptability to them. Children (46% female) ranged in age from 6 to 9 y. Their mean number of decayed, missing, and filled teeth (d3mft) was 2.8 (SD 2.6). At baseline, 58% and 42% of children were at moderate and low risk, respectively. Test and control lesions presented with similar radiographic lesions at baseline. At the 24-mo follow-up, 6 children had moved and 30 teeth had exfoliated. In the test and control groups, 15 of 66 lesions (22.7%) and 30 of 69 lesions (43.5%) had progressed, respectively (P < 0.05). The 2-y therapeutic effect (based on pairwise radiographic readings) of infiltration over fluoride varnish was 20.8% (95% confidence interval, 10.6%-30.2%). Nearly all children (96.7%) had enjoyed their visit to the clinic, and more than two-thirds (72.2%) were not worried about returning for treatment. Infiltration is more efficacious than fluoride varnish for controlling carious lesion progression in proximal lesions in primary molars, and most children find the treatment acceptable (Australian New Zealand Clinical Trials Registry ANZCTR.org.au ACTRN12611000827932). Knowledge Transfer Statement: These study findings can help clinicians decide which caries management approach they wish to use to prevent progression of proximal lesions in primary molars. With consideration of cost and patient preference, this information could lead to more appropriate therapeutic decisions.
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Affiliation(s)
- L A Foster Page
- 1 Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - D Beckett
- 1 Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - R Ahmadi
- 1 Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - D R Schwass
- 2 Department of Oral Rehabilitation, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - S Leon de la Barra
- 1 Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - S M Moffat
- 1 Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - A Meldrum
- 1 Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W M Thomson
- 1 Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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56
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López R, Smith PC, Göstemeyer G, Schwendicke F. Ageing, dental caries and periodontal diseases. J Clin Periodontol 2017; 44 Suppl 18:S145-S152. [DOI: 10.1111/jcpe.12683] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2016] [Indexed: 12/30/2022]
Affiliation(s)
- Rodrigo López
- Section of Periodontology; Department of Dentistry and Oral Health; Aarhus University; Aarhus Denmark
| | - Patricio C Smith
- Dentistry Academic Unit; Faculty of Medicine; Pontificia Universidad Católica de Chile; Santiago Chile
| | - Gerd Göstemeyer
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
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57
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Rosier BT, van Loveren C, Zaura E, Loos BG, Keijser BJF, Crielaard W, Lagerweij MD. Caries Incidence in a Healthy Young Adult Population in Relation to Diet. JDR Clin Trans Res 2016; 2:142-150. [PMID: 30931779 DOI: 10.1177/2380084416683340] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In the past, epidemiological studies focused on cavitated stages of caries. The arrival of the International Caries Detection and Assessment System (ICDAS) in 2004 allowed for clinical measurements of the initial stages of enamel caries. However, since the introduction, most studies applying the ICDAS still have studied the diseased population. The objective of this cross-sectional observational study was to describe early enamel caries in a large healthy young adult population and determine the relationship with diet and oral hygiene measures. The study population consisted of 268 healthy participants without frank cavitation. The examinations were done visually and radiographically using ICDAS on all tooth surfaces. In total, 8.6% of the surfaces (occlusal > approximal > smooth) had caries, of which 92.0% were confined to enamel (28.5% ICDAS score 1, 54.0% score 2, 8.6% score 3). Thirteen percent of the occlusal and 63% of the approximal caries were found with radiography. Thus, radiography is quintessential for the diagnosis of approximal enamel lesions. We found a positive correlation between enamel caries (ICDAS 1 to 3) and the consumption of mono- and disaccharides and carbohydrates ( r = 0.226 and r = 0.188, respectively, both P < 0.01), as well as a negative correlation with alcohol consumption ( r = -0.202, P < 0.01). There was also a positive correlation between enamel caries and the energy intake from mono- and disaccharides (sugar kJ, r = 0.206, P < 0.01), which was independent of body mass index. Only 11 participants consumed less than 10% of total energy as sugar kJ, which is the recommended percentage of kJ from free sugar by the World Health Organization. No clear correlation was found with oral hygiene. In conclusion, in this healthy young adult population, caries was found in 97.8% of the subjects, mostly initial enamel caries (ICDAS 1 to 2) in the occlusal surface of molars, and was related with dietary factors.
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Affiliation(s)
- B T Rosier
- 1 Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands.,2 Department of Genomics and Health, FISABIO Foundation, Center for Advanced Research in Public Health, Valencia, Spain
| | - C van Loveren
- 1 Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - E Zaura
- 1 Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands.,3 Top Institute Food and Nutrition, Wageningen, the Netherlands
| | - B G Loos
- 4 Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
| | - B J F Keijser
- 1 Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands.,3 Top Institute Food and Nutrition, Wageningen, the Netherlands.,5 Microbiology and Systems Biology, TNO Earth, 10 Environmental and Life Sciences, Zeist, the Netherlands
| | - W Crielaard
- 1 Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands.,3 Top Institute Food and Nutrition, Wageningen, the Netherlands
| | - M D Lagerweij
- 6 Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije University Amsterdam, Amsterdam, the Netherlands
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58
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Navarra CO, Robino A, Pirastu N, Bevilacqua L, Gasparini P, Di Lenarda R, Crovella S. Caries and Innate Immunity: DEFB1 Gene Polymorphisms and Caries Susceptibility in Genetic Isolates from North-Eastern Italy. Caries Res 2016; 50:589-594. [DOI: 10.1159/000450965] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/20/2016] [Indexed: 11/19/2022] Open
Abstract
Background: The DEFB1 gene, encoding for the constitutively expressed human β-defensin 1 (hBD1) antimicrobial peptide is a potential candidate when studying genetic susceptibility to caries. DEFB1 genetic variations have been reported as contributing to hBD1 production impairment, leading to a greater susceptibility to be infected by oral pathogens, also leading to periodontitis. Methods: We analysed 5 DEFB1 polymorphisms, namely 3 functional single-nucleotide polymorphisms (SNPs) at the 5′-untranslated region (UTR), -52G>A (rs1799946), -44C>G (rs1800972), and -20G>A (rs11362), 2 SNPs at the 3′-UTR, c*5G>A (rs1047031) and c*87A>G (rs1800971) SNP located in potential miRNA binding sites, looking for possible correlations with the risk to develop caries in 654 adult subjects from isolated populations of north-eastern Italy. Dental caries prevalence was evaluated with the DMFT (decayed, missing, filled teeth) index, calculated after an accurate oral examination. DEFB1 SNP genotyping was performed with an Illumina 370k high-density SNP array. Results: Two DEFB1 SNPs were significantly associated with the DMFT index: the strongest association emerged from rs11362 SNP (p = 0.008). In particular G/G homozygous individuals showed a higher DMFT index compared to both G/A heterozygous and A/A homozygous individuals; rs1799946 SNP was also significantly associated with DMFT (p = 0.030), and individuals homozygous for the T allele had a higher DMFT value compared to heterozygous C/T and homozygous C/C individuals. Conclusions: Our study replicated, on a larger number of individuals, previous findings showing the association between two 5′-UTR SNPs in the DEFB1 gene and DMFT, suggesting that these polymorphisms could be considered as potential markers for assessing the risk to develop caries.
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59
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Schwendicke F, Thomson WM, Broadbent JM, Stolpe M. Effects of Taxing Sugar-Sweetened Beverages on Caries and Treatment Costs. J Dent Res 2016; 95:1327-1332. [PMID: 27671690 DOI: 10.1177/0022034516660278] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Caries increment is affected by sugar-sweetened beverage (SSB) consumption. Taxing SSBs could reduce sugar consumption and caries increment. The authors aimed to estimate the impact of a 20% SSB sales tax on caries increment and associated treatment costs (as well as the resulting tax revenue) in the context of Germany. A model-based approach was taken, estimating the effects for the German population aged 14 to 79 y over a 10-y period. Taxation was assumed to affect beverage-associated sugar consumption via empirical demand elasticities. Altered consumption affected caries increments and treatment costs, with cost estimates being calculated under the perspective of the statutory health insurance. National representative consumption and price data were used to estimate tax revenue. Microsimulations were performed to estimate health outcomes, costs, and revenue impact in different age, sex, and income groups. Implementing a 20% SSB sales tax reduced sugar consumption in nearly all male groups but in fewer female groups. The reduction was larger among younger than older individuals and among those with low income. Taxation reduced caries increment and treatment costs especially in younger (rather than older) individuals and those with low income. Over 10 y, mean (SD) net caries increments at the population level were 82.27 (1.15) million and 83.02 (1.08) million teeth at 20% and 0% SSB tax, respectively. These generated treatment costs of 2.64 (0.39) billion and 2.72 (0.35) billion euro, respectively. Additional tax revenue was 37.99 (3.41) billion euro over the 10 y. In conclusion and within the limitations of this study's perspective, database, and underlying assumptions, implementing a 20% sales tax on SSBs is likely to reduce caries increment, especially in young low-income males, thereby also reducing inequalities in the distribution of caries experience. Taxation would also reduce treatment costs. However, these reductions might be limited in the total population.
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Affiliation(s)
- F Schwendicke
- 1 Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - W M Thomson
- 2 Department of Oral Sciences, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - J M Broadbent
- 3 Department of Oral Rehabilitation, Sir John Walsh Research Institute, School of Dentistry, The University of Otago, Dunedin, New Zealand
| | - M Stolpe
- 4 Kiel Institute for the World Economy, Kiel, Germany
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60
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Ferraz EG, Silva LR, Sarmento VA, de Jesus Campos E, de Oliveira TFL, Magalhães JC, Paraguassú GM, Boa-Sorte N. Comparison of two visual methods for detecting caries among obese and non-obese children. Acta Odontol Scand 2016; 74:405-10. [PMID: 27098286 DOI: 10.3109/00016357.2016.1169555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The study aimed to compare two visual methods for detecting caries among obese and non-obese children in Salvador, Brazil. MATERIALS AND METHODS A cross-sectional study was conducted from 2011-2012, which evaluated 180 paediatric patients, 6-14 years old, girls and boys, categorized into two groups: obese and non-obese (healthy weight), according to the body mass index. For the evaluation of dental caries, the decayed, missing or filled teeth index (DMFT/dmft) and International Caries Detection and Assessment System II (ICDAS II) visual criteria were used. RESULTS The mean DMFT value was 0.98 in obese children and 0.57 in the non-obese children, without significant differences between groups (p = 0.206). The mean dmft value in the non-obese children (1.66) was higher than in obese children (0.95), with significant differences between groups (p = 0.021). According to ICDAS II criteria, there was a higher prevalence of non-cavitated enamel lesions (D1-3) in obese children (n = 156, 10.5%) compared to the non-obese children (n = 55, 1.9%), with significant differences between the groups (p < 0.001). CONCLUSIONS The inclusion of non-cavitated lesions during the caries evaluation represents a challenge in diagnosis, which allows for control of this process before the evolution of these lesions to cavitation.
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Affiliation(s)
- Eduardo Gomes Ferraz
- School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Pediatric Gastroenterology and Hepatology of the Professor Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Luciana Rodrigues Silva
- Department of Pediatric Gastroenterology and Hepatology of the Professor Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Viviane Almeida Sarmento
- School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Propedeutics and Integrated Clinic, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Elisângela de Jesus Campos
- Department of Pediatric Gastroenterology and Hepatology of the Professor Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
- Institute of Health Sciences, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Thaís Feitosa Leitão de Oliveira
- School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Pediatric Gastroenterology and Hepatology of the Professor Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Juliana Cunha Magalhães
- School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Pediatric Gastroenterology and Hepatology of the Professor Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Gardênia Matos Paraguassú
- School of Dentistry, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Pediatric Gastroenterology and Hepatology of the Professor Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
| | - Ney Boa-Sorte
- School of Medicine, Federal University of Bahia, Salvador, Bahia, Brazil
- Department of Nutrology of the Professor Edgard Santos Teaching Hospital, Federal University of Bahia, Salvador, Bahia, Brazil
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61
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Broadbent JM, Zeng J, Foster Page LA, Baker SR, Ramrakha S, Thomson WM. Oral Health-related Beliefs, Behaviors, and Outcomes through the Life Course. J Dent Res 2016; 95:808-13. [PMID: 26936215 DOI: 10.1177/0022034516634663] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Complex associations exist among socioeconomic status (SES) in early life, beliefs about oral health care (held by individuals and their parents), and oral health-related behaviors. The pathways to poor adult oral health are difficult to model and describe, especially due to a lack of longitudinal data. The study aim was to explore possible pathways of oral health from birth to adulthood (age 38 y). We hypothesized that higher socioeconomic position in childhood would predict favorable oral health beliefs in adolescence and early adulthood, which in turn would predict favorable self-care and dental attendance behaviors; those would lead to lower dental caries experience and better self-reported oral health by age 38 y. A generalized structural equation modeling approach was used to investigate the relationship among oral health-related beliefs, behaviors in early adulthood, and dental health outcomes and quality of life in adulthood (age, 38 y), based on longitudinal data from a population-based birth cohort. The current investigation utilized prospectively collected data on early (up to 15 y) and adult (26 and 32 y) SES, oral health-related beliefs (15, 26, and 32 y), self-care behaviors (15, 28, and 32 y), oral health outcomes (e.g., number of carious and missing tooth surfaces), and oral health-related quality of life (38 y). Early SES and parental oral health-related beliefs were associated with the study members' oral health-related beliefs, which in turn predicted toothbrushing and dental service use. Toothbrushing and dental service use were associated with the number of untreated carious and missing tooth surfaces in adulthood. The number of untreated carious and missing tooth surfaces were associated with oral health-related quality of life. Oral health toward the end of the fourth decade of life is associated with intergenerational factors and various aspects of people's beliefs, SES, dental attendance, and self-care operating since the childhood years.
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Affiliation(s)
- J M Broadbent
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - J Zeng
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - L A Foster Page
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - S R Baker
- Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - S Ramrakha
- Department of Psychology, University of Otago, Dunedin, New Zealand
| | - W M Thomson
- Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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62
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Kühnisch J, Ekstrand KR, Pretty I, Twetman S, van Loveren C, Gizani S, Spyridonos Loizidou M. Best clinical practice guidance for management of early caries lesions in children and young adults: an EAPD policy document. Eur Arch Paediatr Dent 2016; 17:3-12. [DOI: 10.1007/s40368-015-0218-4] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 11/14/2015] [Indexed: 11/29/2022]
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63
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Spencer AJ, Do LG. Caution needed in altering the ‘optimum’ fluoride concentration in drinking water. Community Dent Oral Epidemiol 2015; 44:101-8. [DOI: 10.1111/cdoe.12205] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/09/2015] [Indexed: 11/28/2022]
Affiliation(s)
- A. John Spencer
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide SA Australia
| | - Loc G. Do
- Australian Research Centre for Population Oral Health; The University of Adelaide; Adelaide SA Australia
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64
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Stock C, Jürges H, Shen J, Bozorgmehr K, Listl S. A comparison of tooth retention and replacement across 15 countries in the over-50s. Community Dent Oral Epidemiol 2015; 44:223-31. [PMID: 26706945 DOI: 10.1111/cdoe.12209] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/20/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Oral diseases are still among the most common chronic diseases globally with substantial detrimental impact especially on elderly people's health and well-being. However, limited evidence exists on international variation in the oral health status of the older population. We aimed to examine international variation in tooth loss and tooth replacement in the general population aged between 50 and 90 years. METHODS A cross-sectional analysis of data from the fifth wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) was conducted. The data cover 14 European countries (Austria, Belgium, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, the Netherlands, Slovenia, Spain, Sweden, and Switzerland) and Israel, and they were collected during the year 2013. Age-specific percentages of the population having all natural teeth, the age-specific numbers of natural (and artificial) teeth, and the age-specific percentages of full, partial, or no replacement of missing teeth were assessed with stratification by country. It was further evaluated to which extent proposed oral health goals concerning tooth loss at higher ages had been achieved. RESULTS In total, 62,763 individuals were included in the study. Age-standardized mean numbers of natural teeth exhibited substantial variation, ranging from 14.3 (Estonia) to 24.5 (Sweden). The oral health goal of retaining at least 20 teeth at age 80 years was achieved by 25% of the population or less in most countries. A target concerning edentulism (≤15% in population aged 65-74 years) was reached in Sweden, Switzerland, Denmark, France, and Germany. Tooth replacement practices varied especially for a number of up to five missing teeth which were more likely to be replaced in Austria, Germany, Luxembourg, and Switzerland than in Israel, Denmark, Estonia, Spain, and Sweden. CONCLUSIONS This study suggests that the age-specific number of natural teeth and the practice of tooth replacement in the over 50s differ substantially among the included countries. The present results may be helpful in the formulation and evaluation of oral health goals in the older population.
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Affiliation(s)
- Christian Stock
- Institute of Medical Biometry and Informatics (IMBI), Heidelberg University, Heidelberg, Germany
| | - Hendrik Jürges
- Schumpeter School of Business and Economics, University of Wuppertal, Wuppertal, Germany
| | - Jing Shen
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Kayvan Bozorgmehr
- Department of General Practice and Health Services Research, University Hospital Heidelberg, Heidelberg, Germany
| | - Stefan Listl
- Department of Conservative Dentistry, Heidelberg University, Heidelberg, Germany.,Max Planck Institute for Social Law and Social Policy, Munich Center for the Economics of Aging, Munich, Germany
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Schwendicke F, Tu YK, Blunck U, Paris S, Göstemeyer G. Effect of Industry Sponsorship on Dental Restorative Trials. J Dent Res 2015; 95:9-16. [DOI: 10.1177/0022034515609270] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Industry sponsorship was found to potentially introduce bias into clinical trials. We assessed the effects of industry sponsorship on the design, comparator choice, and findings of randomized controlled trials on dental restorative materials. A systematic review was performed via MEDLINE, CENTRAL, and EMBASE. Randomized trials on dental restorative and adhesive materials published 2005 to 2015 were included. The design of sponsored and nonsponsored trials was compared statistically (risk of bias, treatment indication, setting, transferability, sample size). Comparator choice and network geometry of sponsored and nonsponsored trials were assessed via network analysis. Material performance rankings in different trial types were estimated via Bayesian network meta-analysis. Overall, 114 studies were included (15,321 restorations in 5,232 patients). We found 21 and 41 (18% and 36%) trials being clearly or possibly industry sponsored, respectively. Trial design of sponsored and nonsponsored trials did not significantly differ for most assessed items. Sponsored trials evaluated restorations of load-bearing cavities significantly more often than nonsponsored trials, had longer follow-up periods, and showed significantly increased risk of detection bias. Regardless of sponsorship status, comparisons were mainly performed within material classes. The proportion of trials comparing against gold standard restorative or adhesive materials did not differ between trial types. If ranked for performance according to the need to re-treat (best: least re-treatments), most material combinations were ranked similarly in sponsored and nonsponsored trials. The effect of industry sponsorship on dental restorative trials seems limited.
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Affiliation(s)
- F. Schwendicke
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - Y.-K. Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - U. Blunck
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - S. Paris
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - G. Göstemeyer
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
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Abstract
WHO data suggest that all over the world the prevalence of caries has declined at the end of the previous and in the first decade of the present century. This decline started wherever the use of effective fluoride toothpaste became commonplace. Even though the decline is considerable with a 90 % reduction in DMFT for 12-year-olds in Western Europe and the USA, caries still affects 60-90 % of the children throughout the world. In the high- and middle-income countries, the nature of caries has changed from a rapid progressing disease of childhood to a slowly progressing disease throughout adulthood and even old age. However, throughout the world, the circumstances for caries differ, e.g., low-income countries experience more caries with higher sugar consumption, while between high-income countries this correlation is reversed. In high-income countries, fluoride is widely used and preventive programs in dental offices are in place. These programs, if effective, may not be a realistic option in low-income countries. In order to reduce caries in the world even further, the use of effective and affordable fluoride toothpaste should be encouraged and enabled.
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Affiliation(s)
- M. D. Lagerweij
- Department of Cariology Endodontology Pedodontology, ACTA, Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
| | - C. van Loveren
- Department of Cariology Endodontology Pedodontology, ACTA, Amsterdam, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands
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Polymorphisms in sweet taste genes (TAS1R2 and GLUT2), sweet liking, and dental caries prevalence in an adult Italian population. GENES AND NUTRITION 2015; 10:485. [PMID: 26268603 DOI: 10.1007/s12263-015-0485-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 08/04/2015] [Indexed: 10/23/2022]
Abstract
The aim of the study was to assess the relationship between sweet taste genes and dental caries prevalence in a large sample of adults. In addition, the association between sweet liking and sugar intake with dental caries was investigated. Caries was measured by the decayed, missing, filled teeth (DMFT) index in 647 Caucasian subjects (285 males and 362 females, aged 18-65 years), coming from six villages in northeastern Italy. Sweet liking was assessed using a 9-point scale, and the mean of the liking given by each individual to specific sweet food and beverages was used to create a sweet liking score. Simple sugar consumption was estimated by a dietary history interview, considering both added sugars and sugar present naturally in foods. Our study confirmed that polymorphisms in TAS1R2 and GLUT2 genes are related to DMFT index. In particular, GG homozygous individuals for rs3935570 in TAS1R2 gene (p value = 0.0117) and GG homozygous individuals for rs1499821 in GLUT2 gene (p value = 0.0273) showed higher DMFT levels compared to both heterozygous and homozygous for the alternative allele. Furthermore, while the relationship sugar intake-DMFT did not achieve statistical significance (p value = 0.075), a significant association was identified between sweet liking and DMFT (p value = 0.004), independent of other variables. Our study showed that sweet taste genetic factors contribute to caries prevalence and highlighted the role of sweet liking as a predictor of caries risk. Therefore, these results may open new perspectives for individual risk identification and implementation of target preventive strategies, such as identifying high-risk patients before caries development.
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Abstract
During the last century, dental research has focused on unraveling the mechanisms behind various oral pathologies, while oral health was typically described as the mere absence of oral diseases. The term 'oral microbial homeostasis' is used to describe the capacity of the oral ecosystem to maintain microbial community stability in health. However, the oral ecosystem itself is not stable: throughout life an individual undergoes multiple physiological changes while progressing through infancy, childhood, adolescence, adulthood and old age. Recent discussions on the definition of general health have led to the proposal that health is the ability of the individual to adapt to physiological changes, a condition known as allostasis. In this paper the allostasis principle is applied to the oral ecosystem. The multidimensionality of the host factors contributing to allostasis in the oral cavity is illustrated with an example on changes occurring in puberty. The complex phenomenon of oral health and the processes that prevent the ecosystem from collapsing during allostatic changes in the entire body are far from being understood. As yet individual components (e.g. hard tissues, microbiome, saliva, host response) have been investigated, while only by consolidating these and assessing their multidimensional interactions should we be able to obtain a comprehensive understanding of the ecosystem, which in turn could serve to develop rational schemes to maintain health. Adapting such a 'system approach' comes with major practical challenges for the entire research field and will require vast resources and large-scale multidisciplinary collaborations.
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Affiliation(s)
- Egija Zaura
- Department of Preventive Dentistry Amsterdam, Academic Center for Dentistry Amsterdam, Amsterdam, The Netherlands
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69
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Schwendicke F, Paris S, Stolpe M. Detection and treatment of proximal caries lesions: Milieu-specific cost-effectiveness analysis. J Dent 2015; 43:647-55. [PMID: 25862278 DOI: 10.1016/j.jdent.2015.03.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 03/06/2015] [Accepted: 03/27/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Dental caries lesions are highly prevalent, concentrated in high-risk groups, and often affect proximal tooth surfaces. Choosing a caries detection method determines the available treatment options: radiographically detected early lesion stages might receive non-, micro-, or invasive treatments, whilst visually tactile detected lesions are often advanced and mostly require invasive treatment. Thus, the choice of detection method impacts on patients via the applied treatment. We compared the cost-effectiveness of combinations of detections and treatments of proximal lesions in different populations which did or did not receive prevention during adolescence. These cost-effectiveness comparisons of different detection-treatment combinations should aid clinical decision making and improve resource allocation. METHODS A Markov-model was constructed to follow a proximal posterior surface in a 12-year-old German over his lifetime. Prevalence, validity and transition probabilities were extracted from the literature. Microsimulations were performed to evaluate costs (Euro) per tooth-retention-time (years). RESULTS For populations with low risk, radiographic detection plus non-invasive treatment without (270 Euro, 61.5 years) and with prevention (312 Euro, 63.0 years), as well as radiographic detection plus micro-invasive treatment and prevention (373 Euro, 64.0 years) were cost-effective. For populations with high risk, radiographic detection plus micro-invasive treatment without (427 Euro, 58.5 years) and with prevention (436 Euro, 61.0 years) were cost-effective. Combinations involving invasive treatments had limited cost-effectiveness. CONCLUSIONS Caries detection methods should be evaluated regarding the cost-effectiveness resulting from their use in different populations. CLINICAL SIGNIFICANCE Caries detection methods are usually evaluated regarding their validity compared to a gold standard. We demonstrate that the cost-effectiveness stemming from using different detection methods additionally depends on the treatment options determined by different methods, and the examined population. Dentists' choice of a detection method should not only be guided by its validity, but also by its specific benefits in different populations.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14199 Berlin, Germany.
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14199 Berlin, Germany.
| | - Michael Stolpe
- Health Economy Unit, Kiel Institute for the World Economy, Kiellinie 66, 21405 Kiel, Germany.
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Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. J Dent Res 2015; 94:650-8. [PMID: 25740856 DOI: 10.1177/0022034515573272] [Citation(s) in RCA: 921] [Impact Index Per Article: 102.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We aimed to consolidate all epidemiologic data about untreated caries and subsequently generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 18,311 unique citations. After screening titles and abstracts, we excluded 10,461 citations as clearly irrelevant to this systematic review, leaving 1,682 for full-text review. Furthermore, 1,373 publications were excluded following the validity assessment. Overall, 192 studies of 1,502,260 children aged 1 to 14 y in 74 countries and 186 studies of 3,265,546 individuals aged 5 y or older in 67 countries were included in separate metaregressions for untreated caries in deciduous and permanent teeth, respectively, using modeling resources from the Global Burden of Disease 2010 study. In 2010, untreated caries in permanent teeth was the most prevalent condition worldwide, affecting 2.4 billion people, and untreated caries in deciduous teeth was the 10th-most prevalent condition, affecting 621 million children worldwide. The global age-standardized prevalence and incidence of untreated caries remained static between 1990 and 2010. There is evidence that the burden of untreated caries is shifting from children to adults, with 3 peaks in prevalence at ages 6, 25, and 70 y. Also, there were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of untreated caries due to population growth and longevity and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
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Affiliation(s)
- N J Kassebaum
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA Department of Anesthesiology and Pain Medicine, University of Washington and Seattle Children's Hospital, Seattle, WA, USA
| | - E Bernabé
- Division of Population and Patient Health, King's College London Dental Institute, London, UK
| | - M Dahiya
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - B Bhandari
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - C J L Murray
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - W Marcenes
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
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van Palenstein Helderman WH, Groeneveld A, van der Heijden GJ, van Loveren C, Holmgren CJ, Benzian H. Adequate evidence to challenge the paradigm of dental caries prevention in early age? Am J Public Health 2015; 105:e5-6. [PMID: 25713944 DOI: 10.2105/ajph.2015.302601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Wim H van Palenstein Helderman
- At the time of writing, Wim H. van Palenstein Helderman was with University of Dar es Salaam, Tanzania, Africa, and Radboud University, Nijmegen, The Netherlands. Arie Groeneveld was with the Caries Research Unit, Organization of Health Research TNO, Utrecht, The Netherlands. Geert J. van der Heijden and Cor van Loveren are with the Academic Center for Dentistry, University of Amsterdam, The Netherlands, and VU University Amsterdam, The Netherlands. Christopher J. Holmgren is with Aide Odontologique Internationale, Montrouge, France. Habib Benzian is with the Department of Epidemiology and Health Promotion, New York University College of Dentistry, New York
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Schwendicke F, Paris S, Stolpe M. Cost-effectiveness of caries excavations in different risk groups - a micro-simulation study. BMC Oral Health 2014; 14:153. [PMID: 25511906 PMCID: PMC4279684 DOI: 10.1186/1472-6831-14-153] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/11/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Whilst being the most prevalent disease worldwide, dental caries is increasingly concentrated in high-risk populations. New caries treatments should therefore be evaluated not only in terms of their cost-effectiveness in individuals, but also their effects on the distribution of costs and benefits across different populations. To treat deep caries, there are currently three strategies: selective (one-step incomplete), stepwise (two-step incomplete) and complete excavation. Building on prior research that found selective excavation generally cost-effective, we compared the costs-effectiveness of different excavations in low- and high-risk patients, hypothesizing that selective excavation had greater cost-effectiveness-advantages in patients with high compared with low risk. METHODS An average tooth-level Markov-model was constructed following the posterior teeth in an initially 18-year old male individual, either with low or high risk, over his lifetime. Risk was assumed to be predicted by several parameters (oral hygiene, social position, dental service utilization), with evidence-based transition probabilities or hazard functions being adjusted for different risk status where applicable. Total lifetime treatment costs were estimated for German healthcare, with both mixed public-private and only private out-of-pocket costs being calculated. For cost-effectiveness-analysis, micro-simulations were performed and joint parameter uncertainty introduced by random sampling of probabilities. Cohort analyses were used for assessing the underlying reasons for potential differences between strategies and populations. RESULTS Selective excavation was more effective and less costly than both alternatives regardless of an individual's risk. All three strategies were less effective and more costly in patients with high compared with low risk, whilst the differences between risk groups were smallest for selective excavation. Thus, the cost-effectiveness-advantages of selective excavation were more pronounced in high-risk groups, who also benefitted the most from reduced private out-of-pocket treatment costs. CONCLUSIONS Whilst caries excavation does not tackle the underlying sources for both the development of caries lesions and the potential differences of individuals' risk status, selective excavation seems most suitable to treat deep lesions, especially in patients with high risk, who over-proportionally benefit from the resulting health-gains and cost-savings.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Aßmannshauser Str, 4-6, 14197 Berlin, Germany.
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Pinto GDS, Oliveira LJC, Romano AR, Schardosim LR, Bonow MLM, Pacce M, Correa MB, Demarco FF, Torriani DD. Longevity of posterior restorations in primary teeth: Results from a paediatric dental clinic. J Dent 2014; 42:1248-54. [DOI: 10.1016/j.jdent.2014.08.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2014] [Revised: 07/09/2014] [Accepted: 08/12/2014] [Indexed: 10/24/2022] Open
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Bernabé E, Sheiham A. Age, period and cohort trends in caries of permanent teeth in four developed countries. Am J Public Health 2014; 104:e115-21. [PMID: 24832427 PMCID: PMC4056243 DOI: 10.2105/ajph.2014.301869] [Citation(s) in RCA: 91] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES We assessed the relative influences of age, period, and cohort effects on trends in caries experience of permanent teeth in 4 different populations. METHODS We used data from England and Wales, United States, Japan, and Sweden in which numerous cross-sectional, nationally representative surveys have been conducted periodically since the early 1960s. For each country, trends in caries experience (measured by DMFT index-the number of decayed, missing, and filled permanent teeth) were analyzed in an age, period, and cohort (APC) analysis using partial least square regression. RESULTS A strong effect of age manifested in caries experience, period and cohort effects aside. Caries levels increased through to adolescence; thereafter, there was a larger increase in DMFT in adulthood. Compared with the aging effect, period and cohort effects on caries experience were small. Population DMFT scores decreased over time in all countries except Japan. Cohort effects on caries experience displayed a nonlinear pattern in all 4 countries, with slightly lower caries levels among the oldest and most recent generations. CONCLUSIONS Despite marked recent declines in caries among children, caries levels increase with age and remain problematic in adults.
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Affiliation(s)
- Eduardo Bernabé
- Eduardo Bernabé is with the Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St. Thomas' Hospitals, London, UK. Aubrey Sheiham is with the Department of Epidemiology and Public Health, University College London, London, UK
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Bernabé E, Sheiham A. Extent of differences in dental caries in permanent teeth between childhood and adulthood in 26 countries. Int Dent J 2014; 64:241-5. [PMID: 24863963 DOI: 10.1111/idj.12113] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To compare levels of caries in permanent teeth between children and adults and specifically, the extent to which the decayed, missing, filled teeth (DMFT) index was greater in adults than in children. METHODS The analysis was based on published reports from 26 countries with comparable summary data on dental caries for different World Health Organisation index ages. Reports were obtained from two large electronic databases, the World Health Organisation Oral Health Country/Area Profile Programme and the Global Burden of Disease 2010 Study. RESULTS Very much higher levels of caries occurred in adults than in children in all 26 countries. For most countries, irrespective of the DMFT levels in 12-year-olds, the percentage difference in levels of DMFT between 12-year-olds and 35- to 44-year-olds was above 500% and the relative difference was 5 or more. CONCLUSION Large differences in experience of dental caries in permanent teeth were found between childhood and adulthood.
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Affiliation(s)
- Eduardo Bernabé
- Division of Population and Patient Health, King's College London Dental Institute at Guy's, King's College and St Thomas' Hospitals, London, UK
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76
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Association between developmental defects of enamel and dental caries in schoolchildren. J Dent 2014; 42:540-6. [DOI: 10.1016/j.jdent.2014.02.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 02/10/2014] [Accepted: 02/12/2014] [Indexed: 11/20/2022] Open
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Sulugodu Ramachandra S. Low levels of caries in aggressive periodontitis: A literature review. Saudi Dent J 2013; 26:47-9. [PMID: 25408595 DOI: 10.1016/j.sdentj.2013.12.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 10/30/2013] [Accepted: 12/03/2013] [Indexed: 12/20/2022] Open
Abstract
This article is a traditional literature review on caries levels in aggressive periodontitis. Aggressive periodontitis generally affects systemically healthy individuals aged <30 years (older individuals can also be affected) and is characterized by a young age of onset, rapid rate of disease progression, and familial aggregation of cases. Dental caries is caused by the dissolution of enamel by acid-producing bacteria present in the plaque biofilm, especially when the biofilm reaches critical mass due to improper oral hygiene. The association between caries level and aggressive periodontitis has long been debated. Initial research indicated that caries levels were high in patients with aggressive periodontitis, but high-quality studies have consistently shown that caries and aggressive periodontitis are inversely related. A recent in vitro study showed that Streptococcus mutans was killed more readily in the saliva of patients with aggressive periodontitis and Aggregatibacter actinomycetemcomitans positivity than in patients with A. actinomycetemcomitans negativity. Other mechanisms possibly explaining the inverse relationship between caries and aggressive periodontitis in cases of Down's syndrome are also discussed in this literature review. The usefulness of caries level in the diagnosis of aggressive periodontitis in developing countries such as India, where the disease is diagnosed primarily on the basis of clinical and radiographic features and familial history is also discussed.
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ten Cate JM. Summary of: Permanent dentition caries through the first half of life. Br Dent J 2013; 215:342-3. [DOI: 10.1038/sj.bdj.2013.956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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