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Gomersall JC, Slack-Smith L, Kilpatrick N, Muthu MS, Riggs E. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2024; 5:CD012155. [PMID: 38753314 PMCID: PMC11098061 DOI: 10.1002/14651858.cd012155.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Dental caries, a common chronic disease of childhood, is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). This review updates one published in 2019. OBJECTIVES To assess the effects of interventions undertaken with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years). SEARCH METHODS We searched Cochrane Oral Health's Trials Register, Cochrane Pregnancy and Childbirth's Trials Register, CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL EBSCO, the US National Institutes of Health Ongoing Trials Register (clinicaltrials.gov) and WHO International Clinical Trials Registry Platform (apps.who.int/trialsearch). The latest searches were run on 3 January, 2023. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing interventions with pregnant women, or new mothers and other primary caregivers of infants in the first year of life, against standard care, placebo or another intervention, reporting on a primary outcome: caries presence in primary teeth, dmfs (decayed, missing, filled primary surfaces index), or dmft (decayed, missing, filled teeth index), in children up to six years of age. Intervention types include clinical, oral health promotion/education (hygiene education, breastfeeding and other dietary advice) and policy or service. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence (GRADE). MAIN RESULTS We included 23 RCTs (5 cluster-randomised), involving 25,953 caregivers (mainly mothers) and their children. Fifteen trials assessed oral health education/promotion interventions against standard care. Six trials assessed a clinical intervention for mother dentition, against placebo, or a different type of clinical intervention. Two trials assessed oral health/education promotion plus clinical intervention (for mother's dentition) against standard care. At most, five trials (maximum of 1326 children and 130 mothers) contributed data to any comparison. Enamel-only caries were included in the diagnosis of caries in some studies. For many trials, the risk of bias was unclear due to lack of methodological details reported. In thirteen trials, participants were socioeconomically disadvantaged. No trial indicated receiving funding that was likely to have influenced their results. Oral health education/promotion interventions Child diet and feeding practice advice versus standard care: We observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a slightly lower mean dmfs (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, the evidence is very uncertain regarding the difference between groups in mean dmft (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). Breastfeeding promotion and support versus standard care: We observed little or no difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence) and in mean dmft (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). dmfs was not reported. Child diet advice compared with standard care: We are very uncertain about the effect on the risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). dmfs and dmft were not reported. Oral hygiene, child diet and feeding practice advice versus standard care: The evidence is very uncertain about the effect on the risk of caries presence in primary teeth (RR 0.73, 95% CI 0.50 to 1.07; 5 trials; 1326 participants; very low-certainty evidence) and there maybe little to no difference in mean dmfs (MD -0.87, 95% CI -2.18 to 0.43; 2 trials; 657 participants; low-certainty evidence) and mean dmft (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; low-certainty evidence). High-dose versus low-dose vitamin D supplementation during pregnancy: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.99, 95% CI 0.70 to 1.41; 1 trial; 496 participants; very low-certainty evidence). dmfs and dmft were not reported. Clinical interventions (for mother dentition) Chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo: We are very uncertain regarding the difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment for mother dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trial reported dmfs or dmft. Xylitol compared with CHX antimicrobial treatment: We are very uncertain about the effect on caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence), but we observed there may be a lower mean dmft with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence). No trial reported dmfs. Oral health education/promotion plus clinical interventions (for mother dentition) Diet and feeding practice advice for infants and young children plus basic dental care for mothers compared with standard care: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.44, 95% CI 0.05 to 3.95; 2 trials, 324 participants; very low-certainty evidence) or on mean dmft (1 study, not estimable). No trial reported dmfs. No trials evaluated policy or health service interventions. AUTHORS' CONCLUSIONS There is moderate-certainty evidence that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very-low certainty and is insufficient for determining which, if any, other intervention types and features may be effective for preventing ECC, and in which settings. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine the effects and relative effects of different interventions and inform practice. We have identified 13 ongoing studies. Future studies should consider if and how effects are modified by intervention features and participant characteristics (including socioeconomic status).
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Affiliation(s)
- Judith C Gomersall
- Life Course and Intergenerational Health Research Group, Robinson Research Institute and School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Nicky Kilpatrick
- Vascular Biology, Murdoch Children's Research Institute, Melbourne, Australia
- Plastic and Maxillofacial Surgery, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Carlton, Australia
| | - M S Muthu
- Centre for Early Childhood Caries Research, Department of Pediatric and Preventive Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Australia
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Oreano MD, Santos PS, Borgatto AF, Bolan M, Cardoso M. Association between dental caries and molar‐incisor hypomineralisation in first permanent molars: A hierarchical model. Community Dent Oral Epidemiol 2022; 51:436-442. [DOI: 10.1111/cdoe.12778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/22/2022] [Accepted: 07/15/2022] [Indexed: 11/29/2022]
Affiliation(s)
| | - Pablo Silveira Santos
- Postgraduate Program of Dentistry Federal University of Santa Catarina Florianopolis Brazil
| | - Adriano Ferreti Borgatto
- Department of Informatics and Statistics Federal University of Santa Catarina Florianopolis Brazil
| | - Michele Bolan
- Department of Dentistry Federal University of Santa Catarina Florianopolis Brazil
| | - Mariane Cardoso
- Department of Dentistry Federal University of Santa Catarina Florianopolis Brazil
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Liu M, Xu X, Song Q, Zhang H, Zhang F, Lai G. Caries prevalence of the first permanent molar and associated factors among second-grade students in Xiangyun of Yunnan, China: A cross-sectional study. Front Pediatr 2022; 10:946176. [PMID: 36245725 PMCID: PMC9558722 DOI: 10.3389/fped.2022.946176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 09/12/2022] [Indexed: 12/02/2022] Open
Abstract
PURPOSE This study aimed to explore the caries prevalence of the first permanent molar (FPM) and the associated factors among second-grade students in Xiangyun of Yunnan, China. MATERIALS AND METHODS A cross-sectional survey was conducted in Xiangcheng Town, Xiangyun County, China, from September to November 2020. The methodology recommended by WHO was used for the dental examination. All the parents were required to complete a questionnaire to collect information on children's family background, dietary habits, oral health behaviors and parental oral health-related knowledge. The tests of significance used were the chi-square test. The association between dental caries prevalence and its associated factors was investigated using logistic regression analysis. Statistical significance was set at P < 0.05. RESULTS Data of 1,295 second graders consisting of 665 males and 630 females were analyzed. The caries prevalence of FPM was 47.6%, and the mean DMFT was 1.11 ± 1.394 in this sample. Among all the children with caries, the filling rate is meager, 2.6%. There were statistically significant differences in the caries prevalence of FPM among age groups. No significant difference existed between the sexes. Logistic regression analysis showed that the most significantly associated factors were: consuming desserts at least once a day, no fluoride varnish application experience, worse parental perception of children's oral health status, and incorrect parental knowledge of whether decayed primary teeth need treatment. CONCLUSION Caries prevalence of FPM among second-grade schoolchildren in Xiangyun was considerably higher than the average prevalence nationwide in China. As China aims to reduce dental caries to <25% of 12-year-old children in 2030, the local government of remote regions like Xiangyun needs to do much more to achieve this goal. Results of this study could provide a framework for ongoing and future public oral health programs and policy planning in Xiangyun, with particular attention to early preventive and therapeutic measures.
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Affiliation(s)
- Mingshan Liu
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Xiaoqin Xu
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Qianqian Song
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Hongmei Zhang
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Fang Zhang
- Department of Stomatology, People's Hospital of Xiangyun Affiliated to Dali University, Dali, China
| | - Guangyun Lai
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai, China
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ABANTO J, OLIVEIRA LB, PAIVA SM, GUARNIZO-HERREÑO C, SAMPAIO FC, BÖNECKER M. Impact of the first thousand days of life on dental caries through the life course: a transdisciplinary approach. Braz Oral Res 2022; 36:e113. [DOI: 10.1590/1807-3107bor-2022.vol36.0113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 04/04/2022] [Indexed: 12/23/2022] Open
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Zhou X, Li H, Zhu C, Yuan C, Meng C, Feng S, Sun X, Zheng S. Analysis of salivary proteomic biomarkers for the surveillance of changes in high-risk status of early childhood caries. BMC Oral Health 2021; 21:572. [PMID: 34749719 PMCID: PMC8573911 DOI: 10.1186/s12903-021-01930-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/25/2021] [Indexed: 11/10/2022] Open
Abstract
Background Early childhood caries is an urgent public health concern. The aim of this study was to investigate salivary proteomic biomarkers for the surveillance of changes in the high-risk status of early childhood caries. The process involves the screening of specific salivary peptides that were differentially expressed only under dynamic changes in individual caries status. Methods Stimulated whole saliva samples were collected from 28 kindergarten children aged 3–4 years in Beijing at baseline and 3 months and 6 months after baseline. A total of 68 samples were collected. In terms of their caries status and progress during the observation period, participants were divided into 3 groups; 7 in the non-caries recurrence group, 6 in the caries recurrence group, and 15 in the healthy control group. Salivary peptides that exhibited no significant differences in cross-sectional comparisons between different groups of caries status but only expressed differentially along with dynamic changes of individual caries were screened using the technique of magnetic beads combined with matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS). The technique of liquid chromatography-electrospray ionization-tandem mass spectrometry (LC-ESI-MS/MS) was employed to identify the proteins from which these peptides were derived. Results We found two salivary peptides differentially expressed only under dynamic changes in individual caries status in the above comparisons; mass-to-charge ratio (m/z) values of the two peptides were 1045.9 and 2517.6, respectively (P < 0.05). Principal component analysis (PCA) and the decision tree model based on these two peptides showed an acceptable distinguishing ability for changes in the high-risk status of early childhood caries. The source proteins of the two peptides with m/z values of 1045.9 and 2517.6 were identified as submandibular gland androgen regulatory protein 3B (SMR-3B) and mucin-7, respectively. Conclusions Two proteins in children’s saliva, namely SMR-3B and mucin-7, have the potentiality to serve as candidate biomarkers for dynamic surveillance of changes in high-risk status of early childhood caries.
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Affiliation(s)
- Xinzhu Zhou
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, PR China
| | - Haozhe Li
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, PR China
| | - Ce Zhu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, PR China.,Department of Preventive Dentistry, Shanghai Jiao Tong University School of Dentistry, Shanghai Ninth People's Hospital, Shanghai, 200011, PR China
| | - Chao Yuan
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, PR China
| | - Chunhua Meng
- Second Kindergarten in Asian Games Village, Chaoyang Disctrict, Beijing, Beijing, 100101, PR China
| | - Shulan Feng
- Second Kindergarten in Asian Games Village, Chaoyang Disctrict, Beijing, Beijing, 100101, PR China
| | - Xiangyu Sun
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, PR China.
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, 100081, PR China.
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The ADEPT study: a comparative study of dentists' ability to detect enamel-only proximal caries in bitewing radiographs with and without the use of AssistDent artificial intelligence software. Br Dent J 2021; 231:481-485. [PMID: 34686815 PMCID: PMC8536492 DOI: 10.1038/s41415-021-3526-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 12/16/2020] [Indexed: 11/08/2022]
Abstract
Introduction Reversal of enamel-only proximal caries by non-invasive treatments is important in preventive dentistry. However, detecting such caries using bitewing radiography is difficult and the subtle patterns are often missed by dental practitioners. Aims To investigate whether the ability of dentists to detect enamel-only proximal caries is enhanced by the use of AssistDent artificial intelligence (AI) software. Materials and methods In the ADEPT (AssistDent Enamel-only Proximal caries assessmenT) study, 23 dentists were randomly divided into a control arm, without AI assistance, and an experimental arm, in which AI assistance provided on-screen prompts indicating potential enamel-only proximal caries. All participants analysed a set of 24 bitewings in which an expert panel had previously identified 65 enamel-only carious lesions and 241 healthy proximal surfaces. Results The control group found 44.3% of the caries, whereas the experimental group found 75.8%. The experimental group incorrectly identified caries in 14.6% of the healthy surfaces compared to 3.7% in the control group. The increase in sensitivity of 71% and decrease in specificity of 11% are statistically significant (p <0.01). Conclusions AssistDent AI software significantly improves dentists' ability to detect enamel-only proximal caries and could be considered as a tool to support preventive dentistry in general practice. Enamel-only proximal caries is often missed by dentists when examining bitewing radiographs. The use of AssistDent artificial intelligence software results in a 71% increase in ability to detect enamel-only proximal caries accompanied by a 11% decrease in specificity. Artificial intelligence software could be considered as a tool to support preventive dentistry in general practice.
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Mahboobi Z, Pakdaman A, Yazdani R, Azadbakht L, Montazeri A. Dietary free sugar and dental caries in children: A systematic review on longitudinal studies. Health Promot Perspect 2021; 11:271-280. [PMID: 34660221 PMCID: PMC8501477 DOI: 10.34172/hpp.2021.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/11/2021] [Indexed: 01/11/2023] Open
Abstract
Background: Dental caries, as a multi-factorial problem, is prevalent among children. The aim of this review was to assess the association between dietary free sugars (DFS) consumption and dental caries in 6- to 12-year-old children in the recent longitudinal e vidence. Methods: In this systematic review, database search was performed in PubMed, Embase, ISI Web of Science and Scopus using the keywords "diet", "dental caries" and "school children".We considered the articles published in English from 2004 to 2019. After duplicate removal,title, abstract data basell text of all included papers were assessed by two independent reviewers. The quality of included papers was assessed using the Newcastle-Ottawa scale. Results: From 2122 papers, ten longitudinal studies were included. In the included studies, the consumption of 100% juice (daily), candy (more than once a week), and soft drink and sweet drinks (at bedtime) were highly associated with caries in children. In few studies, daily consumption of water and dairy products was reported to be protective. However, some studies reported non-significant association between consumption of different sugary items and dental caries. The quality of included studies was moderate. Heterogeneity was observed in the measurement of caries outcome, and data collection tool for diet assessment, and statistical measure, which impeded the meta-analysis of data. Conclusion: The methodology and results in the longitudinal studies on the association of dietary free sugar consumption and dental caries in schoolchildren were heterogeneous, which urge the need for further standard research protocols in this area.
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Affiliation(s)
- Zeinab Mahboobi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Afsaneh Pakdaman
- Research Centre for Caries Prevention, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Yazdani
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Montazeri
- Health Metrics Research Center, Institute for Health Sciences Research, ACECR, Tehran, Iran
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Zhang K, Li J, Lu Z. Oral health status and knowledge of only and non-only children in China. Br Dent J 2021:10.1038/s41415-021-3477-y. [PMID: 34616027 DOI: 10.1038/s41415-021-3477-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 12/07/2020] [Indexed: 11/09/2022]
Abstract
Objectives To evaluate the oral health status and knowledge of only children (OC) and non-only children (NOC), and to explore potential reasons for the differences.Materials and methods This cross-sectional sampling survey included 3,731 children between the ages of 12 and 15 years. The oral health of the subjects was examined, according to the Basic Methods of Oral Health Survey (fifth edition) recommended by the World Health Organisation, and their eating habits, oral health knowledge and oral habits were recorded. EpiData software was used to input data, and SPSS version 19.0 software was used for analysis and comparison.Results The incidence of dental caries and the decayed, missing and filled teeth index (DMFT) in OC (53.2% and 1.53, respectively) were significantly lower than those in NOC (56.2% and 1.86, respectively) (P <0.05). These values were highest in female NOC (63.7%). Gingival bleeding in NOC (78.9%) was significantly higher than that in OC (74.1%) and the difference was statistically significant (P <0.05). The pit and fissure sealant rate of the OC (17.9%) was better than that of the NOC (11.0%), and the difference was statistically significant (P <0.05). There were no significant differences in the oral health attitudes between the two groups, while the scores of the OC were higher than that of the NOC on eight questions of oral health knowledge and awareness, with statistically significant differences for five of the questions (P <0.05). In terms of oral behavioural habits and related factors, the OC scored better than the NOC.Conclusions Our results show that the oral health status of NOC, especially female children, is worrying. When formulating health-related policies, it is necessary to consider these inequalities in adolescents and to provide more resources to the relatively vulnerable adolescents.
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Affiliation(s)
- Kaiqiang Zhang
- Department of Preventive Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang, 110002, China
| | - Jian Li
- Department of Preventive Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang, 110002, China
| | - Zhenfu Lu
- Department of Preventive Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang, 110002, China; Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, 110002, China.
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Gao Y, Ju X, Jamieson L. Associations between dental care approachability and dental attendance among women pregnant with an Indigenous child: a cross-sectional study. BMC Oral Health 2021; 21:451. [PMID: 34535100 PMCID: PMC8446472 DOI: 10.1186/s12903-021-01816-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background Oral health during pregnancy is vital for both mother and child. Indigenous Australians face many barriers in accessing dental care. Service approachability is one of the key domains in accessing health services. There is little empirical evidence of the association between service approachability and dental care attendance or oral health outcome. The aim of this study is to examine the relationship between dental service approachability on dental care attendance and self-reported gum disease among South Australian women pregnant with an Aboriginal child. Methods Four hundred and twenty-seven women pregnant with an Aboriginal child completed questionnaires in both metropolitan and regional health settings in South Australia in 2011. Four variables related to approachability of dental services: (1) perception of need; (2) service-related health literacy; (3) oral health beliefs and; (4) trust and expectation of dental service. The association between service approachability-related factors, dental utilisation and self-reported gum disease during pregnancy were assessed using Generalised Poisson regression models, after adjusting for age, remoteness, employment status and education. Estimates were presented as adjusted prevalence ratios (APR). Results Most participants (85.8%) reported a need for dental care, had positive oral health beliefs (88.3%) and had expectations towards dental care (86.2%). Dental service utilisation during pregnancy was low (35.7%). Many participants (78.0%) expressed knowing what to do if they needed dental care, while most (39.8%) doubted that dental care would be available the next day. Poor health service literacy was identified as a risk factor for non-optimal dental attendance (APR = 0.86, 95%CI 0.74–0.99). Perceived need for dental care was positively associated with self-reported gum disease (APR = 1.24, 95%CI 1.06–1.45). Conclusion Inability to navigate the dental care system was a risk factor for poor dental attendance among South Australian women pregnant with an Aboriginal child. Perceived need for dental care was associated with gum disease. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01816-5.
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Affiliation(s)
- Yuan Gao
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia.
| | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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Carvalho Silva C, Gavinha S, Vilela S, Rodrigues R, Manso MC, Severo M, Lopes C, Melo P. Dietary Patterns and Oral Health Behaviours Associated with Caries Development from 4 to 7 Years of Age. Life (Basel) 2021; 11:609. [PMID: 34202656 PMCID: PMC8305377 DOI: 10.3390/life11070609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/20/2021] [Accepted: 06/20/2021] [Indexed: 11/17/2022] Open
Abstract
The association between modifiable risk factors and caries in children has been documented; however, most studies have been cross-sectional and have not considered the complexity of dietary factors and oral health habits. This study aimed to investigate the prospective association between dietary patterns and oral health behaviours at 4 years of age and the development of new decayed, missing, and filled teeth (d3-6mft/D3-6MFT) over a period of three years. Participants were children from the Generation XXI population-based birth cohort. At 4 years of age, diet patterns were assessed using a food frequency questionnaire, with three dietary patterns being identified. For the purpose of capturing the new development of caries between 4 and 7 years of age, two dental outcomes were defined in the mixed dentition: "dental caries development" and "severe dental caries development" in the mixed dentition. Bivariate analysis and multivariate logistic regression were used. From 4 to 7 years of age, 51.2% of the children had at least one new d3-6mft/D3-6MFT and 27.4% had more than two new d3-6mft/D3-6MFT. Children belonging to the "energy-dense foods" (OR = 2.19; 95% CI: 1.20-4.00) and "snacking" (OR = 2.19; 95% CI: 1.41-3.41) dietary patterns at 4 years old were associated with severe dental caries development three years later. Preventive strategies should be implemented in an attempt to reduce snacking and the consumption of energy-dense, micronutrient-poor foods to promote children's oral health.
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Affiliation(s)
- Cátia Carvalho Silva
- Faculdade de Medicina Dentária, Universidade do Porto (U. Porto), Rua Dr. Manuel Pereira da Silva, 93, 4200-393 Porto, Portugal;
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
| | - Sandra Gavinha
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
| | - Sofia Vilela
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
| | - Rita Rodrigues
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
| | - Maria Conceição Manso
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
- Environmental and Health Research Unit (FP-ENAS), Universidade Fernando Pessoa Energy, 4249-004 Porto, Portugal
- Associated Laboratory for Green Chemistry (LAQV/REQUIMTE), Universidade do Porto, 4050-313 Porto, Portugal
| | - Milton Severo
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
- Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Carla Lopes
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
- Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Paulo Melo
- Faculdade de Medicina Dentária, Universidade do Porto (U. Porto), Rua Dr. Manuel Pereira da Silva, 93, 4200-393 Porto, Portugal;
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
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11
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Mahboobi Z, Pakdaman A, Yazdani R, Azadbakht L, Shamshiri AR, Babaei A. Caries incidence of the first permanent molars according to the Caries Assessment Spectrum and Treatment (CAST) index and its determinants in children: a cohort study. BMC Oral Health 2021; 21:259. [PMID: 33985489 PMCID: PMC8120821 DOI: 10.1186/s12903-021-01612-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 05/06/2021] [Indexed: 01/22/2023] Open
Abstract
Background There are limited information on caries incidence, especially from developing countries, the aim of the present study was to explore caries incidence in the first permanent molar teeth according to the CAST index in 7- to 8-year-old-children and its socio-demographic, oral health related and diet determinants.
Methods A multi-stage cluster random sample of 7–8 years old children was applied in Tehran, Iran. The oral examination using the CAST index and the Oral Hygiene Index-Simplified (OHI-S) performed by trained dentists in 2017 and 2019 calibrated with an expert (Kappa of 0.89 and 0.76, respectively). A 3-day food record was used to record sugary snacks consumption. Oral health related knowledge of the parents was assessed using a valid and reliable self-administered questionnaire. The data were analyzed using the SPSS software version 23.0 and descriptive and analytical statistics including the negative binomial regression was applied. Results Two hundred and ninety schoolchildren aged 7–8 years old were followed up for two years. All of them had complete data obtained via oral examination and questionnaires. The annual caries incidence rate was 0.16 and 53% (95% CI 47.4–58.9) of the children developed at least one new dental caries (enamel or dentine) during two years. Multi-variate analysis revealed that the children of mothers with high school education or diploma (IRR = 1.47, 95% CI 1.02–2.12; p = 0.04) and those with low socio-economic status (IRR = 1.86, 95% CI 1.27–2.73; p < 0.001) were more likely to develop caries. There was no significant association between gender, father’s educational level, child birth order, housing area per person, OHI-S score, oral health knowledge of parents, and sugary snacks consumption per day and caries increment at an individual level. Conclusion This 2-year longitudinal study on 7- to 8-year-old children showed that caries incidence according to the CAST index was associated with socio-economic status and mother education but not associated with having 2 or more sugary snack per day and oral hygiene status.
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Affiliation(s)
- Zeinab Mahboobi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, P.O. Box 1439955991, Tehran, Iran
| | - Afsaneh Pakdaman
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, P.O. Box 1439955991, Tehran, Iran. .,Department of Community Oral Health, Research Centre for Caries Prevention, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
| | - Reza Yazdani
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, P.O. Box 1439955991, Tehran, Iran.,Department of Community Oral Health, Research Centre for Caries Prevention, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad R Shamshiri
- Department of Community Oral Health, Research Centre for Caries Prevention, Dental Research Institute, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Azadeh Babaei
- Department of Community Oral Health, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
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Hultquist AI, Brudin L, Bågesund M. Early childhood caries risk assessment in 1-year-olds evaluated at 6-years of age. Acta Odontol Scand 2021; 79:103-111. [PMID: 32697607 DOI: 10.1080/00016357.2020.1795247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim was to identify caries risk factors in 1-year-olds predicting dentine caries in 6-year-olds. MATERIALS AND METHODS Caries risk assessment was performed in 804 one-year-olds. Their parents answered a questionnaire, regarding family factors, general health, food habits and oral hygiene. Clinical examinations and caries risk assessments at 1, 3 and 6 years of age were performed. Simple and multiple regression analyses were used for identification of caries-associated factors. RESULTS Caries risk was found in 5% of the 1-year-olds, and 12% of the 3-year-olds. Dentine caries was found in 3% of the 3-year-olds and in 16% of the 6-year-olds. Caries risk assessment was associated with caries at 6 years of age (OR = 5.1, p < .001). Multiple logistic regression analysis found the following variables associated with caries at 6 years of age: Caries in sibling (OR = 2.1, p = .012), Beverage other than water (OR = 2.1, p < .001), Night meal (OR = 1.9, p = .002), Presence of mutans streptococci (MS) (OR = 1.6, p = .033) and Male gender (OR = 1.5, p = .053). An overall caries risk assessment was more reliable than any single caries risk factor. CONCLUSIONS Caries risk assessment for 1-year-olds in a region with low caries prevalence has limited accuracy to predict dental caries at 6 years of age. Caries risk often changes over time and should be reassessed on a regularly basis. The presence of MS in 1-year-olds did not increase the prognostic accuracy at 6 years of age.
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Affiliation(s)
- Ann Ingemansson Hultquist
- Västervik Public Dental Service, Kalmar County Council, Kalmar, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lars Brudin
- Department of Clinical Physiology, Region Kalmar Council, Kalmar, Sweden
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Mats Bågesund
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Orthodontics and Pediatric Dentistry, Norrköping, Sweden
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13
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Serum Levels of Vitamin D and Dental Caries in 7-Year-Old Children in Porto Metropolitan Area. Nutrients 2021; 13:nu13010166. [PMID: 33430295 PMCID: PMC7825719 DOI: 10.3390/nu13010166] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 01/01/2021] [Accepted: 01/04/2021] [Indexed: 12/15/2022] Open
Abstract
Vitamin D deficiency has been associated with significant changes in dental structures. In children, it can induce enamel and dentin defects, which have been identified as risk factors for caries. This study aimed to assess the association between low serum 25-hydroxyvitamin D (25(OH) D) levels (<30 ng/mL) and the prevalence of caries in the permanent teeth and mixed dentition of 7-year-old children. A sample of 335 children from the population-based birth cohort Generation XXI (Porto, Portugal) was included. Data on children’s demographic and social conditions, health status, dental health behaviours, dental examination including erupted permanent first molars, and blood samples available for vitamin D analysis were collected. Dental outcomes included the presence of caries, including non-cavitated lesions (d1–6mft/D1–6MFT > 0), and advanced caries (d3–6mft/D3–6MF > 0). Serum 25(OH) D was measured using a competitive electrochemiluminescence immunoassay protein-binding assay. Bivariate analysis and multivariate logistic regression were used. Advanced caries in permanent teeth was significantly associated with children’s vitamin D levels <30 ng/mL, gastrointestinal disorders, higher daily intake of cariogenic food, and having had a dental appointment at ≤7 years old. Optimal childhood levels of vitamin D may be considered an additional preventive measure for dental caries in the permanent dentition.
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14
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Hamasha AAH, Alfadhel AA, Alshareef AA, ALjamal MM, Albesher NB, Alaqaili NM, Kinani TS. The Effect of Secondhand Smoking on Dental Caries among Schoolchildren in Riyadh, Saudi Arabia: A Cross-sectional Study. J Int Soc Prev Community Dent 2020; 10:69-75. [PMID: 32181223 PMCID: PMC7055338 DOI: 10.4103/jispcd.jispcd_400_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Accepted: 12/18/2019] [Indexed: 12/02/2022] Open
Abstract
Aim: The aim of this study was to explore the relationship between dental caries and exposure to secondhand smoking in mixed teeth among Saudi children. Materials and Methods: A cross-sectional study was designed to target schoolchildren aged between 6 and 13 years in their mixed dentition stage. A cluster random sample of schools teaching first to sixth grades from different regions in Riyadh city was used. Data were obtained by self-reported questionnaires and clinical dental examinations. Questionnaires comprised sections related to sociodemographic, behavioral, health characteristics, and questions related to mother and father smoking status, type, and duration of smoking, and whether parents smoked inside homes or not. The clinical dental examination was based on the basic methods of the World Health Organization criteria for decayed, missing, and filled teeth (DMFT) (1997). Statistical analyses included descriptive statistics, t test, and one-way analysis of variance. Results: Of the 302 participating schoolchildren, 56% were females, 72% were Saudi nationals, and 84% were of normal weight. Of the total 3246 teeth examined, DMFT was found in 1922 teeth (mean DMFT = 6.36). Only eight mothers (2.7%) were smokers, seven of them smoked inside their homes. Majority of fathers were smokers (110, 37%) and 82% smoked inside their houses. It had been found that 26% of schoolchildren were exposed to secondhand smoking. The mean DMF scores were higher among schoolchildren with smoking fathers and mothers, and the difference was statistically significant (P = 0.05). Conclusion: The DMFT among Saudi schoolchildren was 6.36. Children, who are exposed to secondhand smoking by their family members, are more likely to have dental caries in their mixed dentitions.
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Affiliation(s)
- Abed Al-Hadi Hamasha
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Ashwaq A Alfadhel
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Asma A Alshareef
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Manal M ALjamal
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Nouf B Albesher
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Nourah M Alaqaili
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Thoraya S Kinani
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
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Risk Factors Associated with Carious Lesions in Permanent First Molars in Children: A Seven-Year Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17041421. [PMID: 32098396 PMCID: PMC7068253 DOI: 10.3390/ijerph17041421] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/19/2020] [Accepted: 02/20/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to evaluate the risk factors associated with the occurrence of caries in permanent teeth (PT) and in the permanent first molar (PFM) seven years after their eruption. Children born in 2005 who were enrolled in a Community Dental Program were included. A total of 278 children were enrolled. Evaluated risk factors were parental caries experience, educational level of the mother, routine medications, systemic diseases, dietary habits, toothbrushing frequency, existence of molar incisor hypomineralization (MIH) in the PT, and caries in the temporary teeth (TT). Associations between independent variables and the DMF-T (decayed, missing, and filled teeth in PT) and DMF-M (DMF in PFM) indices, only considering cavitated and non-cavitated carious lesions or cavitated carious lesions as outcomes, were evaluated by Poisson regression with robust variance analysis. A cariogenic diet (sweets and soft drinks), toothbrushing frequency of <1 a day, a presence of df-t (decayed and filled temporary teeth) score of >0, low educational level of the mother, and existence of MIH were associated with high DMF-T or DMF-M values (p < 0.05). We can conclude that the intake of sweets and soft drinks, toothbrushing frequency, the presence of caries in TT, and MIH in PT were the best predictors of the occurrence of caries in PT and PFM.
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Riggs E, Kilpatrick N, Slack‐Smith L, Chadwick B, Yelland J, Muthu MS, Gomersall JC. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2019; 2019:CD012155. [PMID: 31745970 PMCID: PMC6864402 DOI: 10.1002/14651858.cd012155.pub2] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Dental caries is one of the most common chronic diseases of childhood and is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). OBJECTIVES To assess the effects of interventions with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years of age). SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 14 January 2019), Cochrane Pregnancy and Childbirth Group's Trials Register (to 22 January 2019), Cochrane Central Register of Controlled Trials (CENTRAL) (Cochrane Register of Studies, to 14 January 2019), MEDLINE Ovid (1946 to 14 January 2019), Embase Ovid (1980 to 14 January 2019) and CINAHL EBSCO (1937 to 14 January 2019). The US National Institutes of Health Trials Registry (ClinicalTrials.gov) and World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on language or publication status. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing one or more interventions with pregnant women, mothers, or other caregivers of infants in the first year of life (intervention types included clinical, oral health education/promotion such as hygiene education, breastfeeding and other dietary advice, and policy or health service), versus standard care or placebo or another intervention. For inclusion, trials had to report at least one caries outcome. DATA COLLECTION AND ANALYSIS Two review authors independently assessed trial eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence using the GRADE approach. MAIN RESULTS We included 17 RCTs (4 cluster-randomised), involving 23,732 caregivers (mainly mothers) and their children. Eleven RCTs assessed four oral health education/promotion interventions against standard care: child diet advice, child diet and feeding practice advice, breastfeeding promotion and support, and oral hygiene with child diet and feeding practice advice. Six trials assessed clinical interventions in mother's dentition, four trials chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo, and two trials xylitol against CHX or CHX + xylitol. At most, three trials (maximum of 1148 children and 130 mothers) contributed data to any comparison. For many trials, risk of bias was judged unclear due to lack of methodological details reported, and there was high risk of attrition bias in some trials. None of the included trials indicated receiving funding that is likely to have influenced their results. The trials were performed in high-, middle- and low-income countries. In nine trials, participants were socioeconomically disadvantaged. For child diet and feeding practice advice versus standard care, we observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a lower mean dmfs (decayed, missing, filled primary surfaces) score (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, we are uncertain regarding the difference between the groups in mean dmft (decayed, missing, filled teeth) score (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). For breastfeeding promotion and support versus standard care, we observed that there may be little or no a difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence), or mean dmft score (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). Dmfs was not reported for this comparison. We are uncertain whether child diet advice only compared with standard care reduces risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). Dmfs and dmft were not reported for this comparison. For oral hygiene, child diet and feeding practice advice versus standard care, we observed little or no reduced risk of caries presence in primary teeth (RR 0.91, 95% CI 0.75 to 1.10; 2 trials; 365 participants; low-certainty evidence), and are uncertain regarding difference between the groups in mean dmfs score (MD -0.99, 95% CI -2.45 to 0.47; 1 trial; 187 participants; very low-certainty evidence) and dmft score (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; very low-certainty evidence). We observed there may be little or no difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment in mother's dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trials assessing this comparison reported dmfs or dmft. For xylitol compared with CHX antimicrobial treatment, we observed there may be a lower mean dmft score with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence); however, we are uncertain regarding the difference between groups in caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence). Neither trial evaluating this comparison reported dmfs. No trials assessed a health policy or service intervention. AUTHORS' CONCLUSIONS Moderate-certainty evidence suggests that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very low certainty and is insufficient for determining which, if any, other interventions types and features may be effective for preventing ECC. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine effects and relative effects of different interventions and inform practice. We have identified 12 studies currently in progress. Those designing future studies should describe the intervention components, setting and participants, consider if and how effects are modified by intervention features and participant characteristics, and adopt a consistent approach to measuring and reporting ECC.
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Affiliation(s)
- Elisha Riggs
- Murdoch Children's Research InstituteIntergenerational HealthFlemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of General PracticeBerkeley StreetMelbourneVictoriaAustralia3000
| | - Nicky Kilpatrick
- Murdoch Children's Research InstituteVascular BiologyFlemington RoadParkvilleMelbourneVictoriaAustralia3052
- Royal Children's HospitalPlastic and Maxillofacial Surgery50 Flemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of PaediatricsBerkeley StreetCarltonVictoriaAustralia3010
| | - Linda Slack‐Smith
- The University of Western AustraliaSchool of Population and Global Health35 Sterling Highway, CrawleyPerthWestern AustraliaAustralia6009
| | - Barbara Chadwick
- Cardiff UniversitySchool of DentistryHeath ParkCardiffUKCF14 4XY
| | - Jane Yelland
- Murdoch Children's Research InstituteIntergenerational HealthFlemington RoadParkvilleVictoriaAustralia3052
- The University of MelbourneDepartment of General PracticeBerkeley StreetMelbourneVictoriaAustralia3000
| | - M S Muthu
- Pedo Planet ‐ Children Dental CentersPediatric Dentistry161/62 A Mount Poonamallee RoadPorurChennaiIndia600116
- Sri Ramachandra Institute of Higher Education and ResearchCentre for Early Childhood Caries Research, Department of Pediatric and Preventive DentistryChennaiIndia
| | - Judith C Gomersall
- Women and Kids, South Australian Health and Medical Research InstituteWomen’s and Children’s Hospital7th Floor, 72 King William RoadAdelaideSouth AustraliaAustralia5006
- School of Public Health, University of AdelaideAdelaideAustralia
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17
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Goldfeld S, Francis KL, Hoq M, Do L, O'Connor E, Mensah F. The Impact of Policy Modifiable Factors on Inequalities in Rates of Child Dental Caries in Australia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16111970. [PMID: 31163687 PMCID: PMC6604007 DOI: 10.3390/ijerph16111970] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 05/14/2019] [Accepted: 05/21/2019] [Indexed: 11/28/2022]
Abstract
Background: Poor oral health in childhood can lead to adverse impacts later in life. We aimed to estimate the prevalence and population distribution of childhood dental caries in Australia and investigate factors that might ameliorate inequalities. Methods: Data from the nationally representative birth cohort Longitudinal Study of Australian Children (N = 5107), using questions assessing: The experience of dental caries during each biennial follow-up period (2–3 years to 10–11 years), socioeconomic position (SEP), and policy modifiable oral health factors. Results: The odds of dental caries were higher for children with lowest vs. highest SEP (adjusted OR (adjOR) 1.92, 95% CI 1.49–2.46), and lower where water was fluoridated to recommended levels (adjOR 0.53, 95% CI 0.43–0.64). There was no evidence of an association between caries experience and either reported sugary diet or tooth brushing. When SEP and fluoridation were considered in conjunction, compared to the highest SEP group with water fluoridation children in the lowest SEP with fluoridation had adjOR 1.54 for caries, (95% CI 1.14–2.07), and children in the lowest SEP without fluoridation had adjOR 4.06 (95% CI 2.88–5.42). For patterns of service use: The highest SEP group reported a greater percentage of service use in the absence of caries. Conclusions: Dental caries appears prevalent and is socially distributed in Australia. Policy efforts should consider how to ensure that children with dental caries receive adequate prevention and early care with equitable uptake.
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Affiliation(s)
- Sharon Goldfeld
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, Australia.
- Department of Paediatrics, University of Melbourne, Melbourne 3010, Australia.
| | - Kate Louise Francis
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, Australia.
| | - Monsurul Hoq
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, Australia.
| | - Loc Do
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide 5005, Australia.
| | - Elodie O'Connor
- Centre for Community Child Health, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, Australia.
| | - Fiona Mensah
- Department of Paediatrics, University of Melbourne, Melbourne 3010, Australia.
- Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne 3052, Australia.
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18
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Silva PFD, Oliveira LRS, Braga SSL, Signori C, Armstrong SR, Soares CJ, Cenci MS, Faria-E-Silva AL. Effect of selective carious tissue removal on biomechanical behavior of class II bulk-fill dental composite restorations. Dent Mater 2018; 34:1289-1298. [PMID: 29793795 DOI: 10.1016/j.dental.2018.05.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 04/25/2018] [Accepted: 05/10/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study aimed to develop a method to induce carious lesions in the pulpal floor dentin of a class II cavity preparation, and to determine the effects of this carious lesion on the biomechanical behavior of the dental composite restoration. METHODS The pulpal floor dentin of class I cavities in sound third molars were demineralised with acetic acid for 35days followed by a 7-day exposure to pooled human saliva biofilm and demineralization was verified by micro-CT. Subsequently, the proximal walls were removed forming a class II cavity and the caries lesion was left intact or was completely removed prior to restoration with a bulk-fill dental composite (n=10). Cuspal deflection was assessed by strain-gauge and micro-CT imaging. The presence of enamel cracks was assessed by transillumination before and after restoration, and again after 1,200,000 cycles of mechanical fatigue in a chewing simulator. Finally, resistance to fracture by axial compressive loading and failure mode was determined. Data were analyzed by 2-way repeated measures ANOVA, Fisher's exact test, and t-test (α=0.05). RESULTS The presence of carious lesions had no significant effect upon cuspal deflection, formation of enamel cracks, and fracture strength of the dental composite restorations. The restorative procedure increased the number of enamel cracks, which was not affected by mechanical cycling. SIGNIFICANCE Maintaining carious lesions does not affect the biomechanical behavior of class II restorations performed with bulk-fill dental composite.
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Affiliation(s)
- Paula Fernanda Damasceno Silva
- Graduate program in Dentistry, Federal University of Sergipe, Rua Claudio Batista s/n, Sanatorio, Aracaju, SE, 49060-100, Brazil.
| | - Lais Rani Sales Oliveira
- Graduate program in Dentistry, Dental School, Federal University of Uberlândia,Av. Pará 1720, Bloco 4LA, Campus Umuarama, Uberlândia, MG, 38400-902, Brazil.
| | - Stella Sueli Lourenço Braga
- Graduate program in Dentistry, Dental School, Federal University of Uberlândia,Av. Pará 1720, Bloco 4LA, Campus Umuarama, Uberlândia, MG, 38400-902, Brazil.
| | - Cácia Signori
- Graduate program in Dentistry, Dental School, Federal University of Pelotas, Rua Gonçalves Chaves 457, sala 505, Pelotas, RS, 96015-560, Brazil.
| | - Steve R Armstrong
- Department of Operative Dentistry, College of Dentistry and Dental Clinics, University of Iowa,S-244A Dental Science Building, Iowa City, IA, 52242, USA.
| | - Carlos José Soares
- Department of Restorative Dentistry, Dental School, Federal University of Uberlândia, Av. Pará 1720, Bloco 4LA, Campus Umuarama, Uberlândia, MG, 38400-902, Brazil.
| | - Maximiliano Sérgio Cenci
- Department of Operative Dentistry, College of Dentistry and Dental Clinics, University of Iowa,S-244A Dental Science Building, Iowa City, IA, 52242, USA.
| | - André Luis Faria-E-Silva
- Department of Dentistry, Federal University of Sergipe, Rua Claudio Batista s/n, Sanatorio, Aracaju, SE, 49060-100, Brazil.
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