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Mathew MG, Jeevanandan G. Evaluation of Factors Affecting Clinical Outcomes of Full Mouth Rehabilitation Under General Anaesthesia for Children With Early Childhood Caries: A Prospective Cohort Study. Cureus 2023; 15:e46778. [PMID: 37954807 PMCID: PMC10632821 DOI: 10.7759/cureus.46778] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2023] [Indexed: 11/14/2023] Open
Abstract
AIM This study was designed to evaluate the factors affecting the clinical outcomes of full mouth rehabilitation under general anaesthesia for children with early childhood caries (ECCs). MATERIALS AND METHODS A prospective cohort of 200 children with early childhood caries and requiring dental rehabilitation under general anaesthesia was evaluated and treated. Children were recalled at six-month intervals for a period of two years and evaluated for the recurrence of caries and the need for repeat treatment of failed cases. RESULTS 86.5% of the patients adhered to the six-month recall visits for 24 months. An overall caries recurrence rate of 14.5% was seen. Children who did not adhere to the follow-up plan and visited ad hoc had the highest caries recurrence rate (88%). CONCLUSION Good compliance with postoperative instructions after full mouth rehabilitation resulted in good oral hygiene and a limited recurrence of caries. Patients with poor compliance with recall visits and postoperative instructions had high rates of caries recurrence. Rehabilitation under general anaesthesia can be considered a viable treatment option for children diagnosed with early childhood caries.
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Affiliation(s)
- Mebin George Mathew
- Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Chennai, IND
| | - Ganesh Jeevanandan
- Pediatric and Preventive Dentisty, Saveetha Dental College, Saveetha University, Chennai, IND
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Manchanda S, Liu P, Lee GHM, Lo ECM, Yiu CKY. Risk Indicators for Noncavitated and Cavitated Carious Lesions in Preschool Children. Int Dent J 2023; 73:738-745. [PMID: 37085388 PMCID: PMC10509421 DOI: 10.1016/j.identj.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 03/22/2023] [Accepted: 03/24/2023] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the risk indicators associated with noncavitated and cavitated lesions in preschool children. METHODS The cross-sectional study included 3- to 4-year-old healthy children (N = 741) recruited in a randomised controlled clinical trial. After obtaining written informed consent, parents completed a questionnaire about their child's sociodemographic background and oral health-related behaviours and parents' oral health-related knowledge and attitude. Caries and plaque were evaluated using International Caries Detection and Assessment System-II and Visible Plaque Index (VPI), respectively. Children were grouped according to their oral health status as being caries-free (CF), having only noncavitated lesions (NC), or having cavitated lesions (CL). The least absolute shrinkage and selection operator (LASSO) sparse multinomial regression was used to study the variables using 1 standard error above the minimum criterion set at P < .05. RESULTS The prevalence of children with NC and CL was 29.1% and 49.4%, respectively, with a prevalence of early childhood caries being 78.5%. The proportion of children who brushed twice or more than twice a day was highest in CF (71.7%), followed by NC (58.3%), and was least in CL (57.7%). A higher percentage of CL children (56.2%) had twice or more than twice the frequency of between-meal snacking than CF (41.7%) and NC (41.1%) (P < .001) children. The variables included with non-zero coefficients in the model were mean parental oral health knowledge, attitude score, and children's mean VPI score, and all were significant for CL; however, in NC, only VPI score was found to be significant. CONCLUSIONS Poor oral hygiene is the risk indicator associated with the presence of NC in preschool children, whilst poor oral hygiene and poor parental oral health knowledge and attitude are associated with the presence of cavitated lesions.
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Affiliation(s)
- Sheetal Manchanda
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Pei Liu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Gillian Hiu Man Lee
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Edward Chin Man Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Cynthia Kar Yung Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.
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3
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He S, Choong EKM, Duangthip D, Chu CH, Lo ECM. Clinical interventions with various agents to prevent early childhood caries: A systematic review with network meta-analysis. Int J Paediatr Dent 2023; 33:507-520. [PMID: 36718540 DOI: 10.1111/ipd.13055] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 01/16/2023] [Accepted: 01/21/2023] [Indexed: 02/01/2023]
Abstract
BACKGROUND Dental caries is one of the most prevalent chronic diseases among preschool children globally. Different preventive agents and combinations have been studied. However, the rank of the effectiveness of clinical interventions is equivocal. AIM To summarize and rank the effectiveness of clinical interventions using different agents for primary prevention of early childhood caries (ECC). DESIGN Two reviewers independently searched PubMed, Embase, and Cochrane Library to identify randomized controlled trials with at least 12-month follow-up. The network meta-analysis (NMA) on different agents was based on a random-effects model and frequentist approach. Standardized mean differences (SMD) with 95% CI of the caries increment were calculated in terms of either dmft or dmfs and used in the NMA. Caries incidences at the child level were compared using odds ratios (ORs) with 95% CI. The effectiveness of the agents was ranked using the surface under the cumulative ranking curve (SUCRA). RESULTS After screening 3807 publications and selection, the NMA finally included 33 trials. These trials used either a single or combination of agents such as fluorides, chlorhexidine, casein phosphopeptide-amorphous calcium phosphate, probiotics, xylitol, and triclosan. Compared with control, fluoride foam (FF; SMD -0.69, 95% CI: -1.06, -0.32) and fluoride salt (F salt; SMD -0.66, 95% CI: -1.20, -0.13) were effective in preventing caries increment. Probiotic milk plus low fluoride toothpaste (PMLFTP; OR 0.34, 95% CI: 0.15, 0.77), FF (OR 0.48, 95% CI: 0.37, 0.63), fluoride varnish (FV; OR 0.63, 95% CI: 0.48, 0.81), and fluoride varnish plus high fluoride toothpaste (FVHFTP; OR 0.73, 95% CI: 0.57, 0.93) were effectively preventing caries incidence. According to the SUCRA, FF ranked first in preventing caries increment, whereas PMLFTP ranked first in preventing caries incidence. CONCLUSION Fluoride foam, F salt, PMLFTP, FV, and FVHFTP all effectively reduce caries increment or caries incidence in preschool children, but the evidence indicates low degree of certainty. Considering the relatively small number of studies, confidence in the findings, and limitations in the study, clinical practitioners and readers should exercise caution when interpreting the NMA results.
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Affiliation(s)
- Shuyang He
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Elaine Kar Man Choong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
- Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Chun Hung Chu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
| | - Edward Chin Man Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong City, Hong Kong
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4
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Manchanda S, Cheung BPK, Lee GHM, Lo ECM, Yiu CKY. Quantitative analysis of salivary and biofilm bacteria associated with cavitated and non-cavitated carious lesions in pre-school children. Arch Oral Biol 2023; 146:105607. [PMID: 36543040 DOI: 10.1016/j.archoralbio.2022.105607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/08/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To quantify and compare Streptococcus mutans (S. mutans) and Lactobacillus fermentum (L. fermentum) in saliva and biofilm of caries-free children to those with cavitated and non-cavitated lesions. DESIGN One hundred and thirty-five 3-4 years old children were grouped (n = 45 in each group) according to their caries status: Clinical examination was done by a calibrated examiner. Biofilm and saliva were collected to quantify the microorganisms using qRT-PCR. The decayed-missing-filled surfaces (dmfs) was calculated by adding the number of decayed (ICDAS-II score 3-6), filled (ICDAS-II score 7 and 8) and missing (ICDAS-II score 9) surfaces due to caries. The correlation between the bacterial amounts and the number of carious surfaces was evaluated using Spearman's correlation coefficient. The levels and proportions of the microorganisms were compared using the Kruskal-Wallis test at an α-level of 0.05. RESULTS The quantity of S. mutans and L. fermentum was significantly higher in saliva and biofilm of children with cavitated lesions, followed by those with non-cavitated lesions and the lowest in caries-free children. Also, salivary and biofilm S. mutans, along with biofilm L. fermentum levels, significantly correlated with the number of non-cavitated surfaces; while salivary and biofilm S. mutans and L. fermentum levels significantly correlated with the number of cavitated surfaces. Additionally, dmfs scores significantly correlated with the salivary and biofilm S. mutans and L. fermentum levels. CONCLUSIONS S. mutans and L. fermentum in saliva and biofilm samples are associated with caries lesion severity.
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Affiliation(s)
- Sheetal Manchanda
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - B P K Cheung
- Centralized Research Laboratories, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Gillian H M Lee
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Edward C M Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong
| | - Cynthia K Y Yiu
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong.
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Duque C, Chrisostomo DA, Souza ACA, de Almeida Braga GP, Dos Santos VR, Caiaffa KS, Pereira JA, de Oliveira WC, de Aguiar Ribeiro A, Parisotto TM. Understanding the Predictive Potential of the Oral Microbiome in the Development and Progression of Early Childhood Caries. Curr Pediatr Rev 2023; 19:121-138. [PMID: 35959611 DOI: 10.2174/1573396318666220811124848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/24/2022] [Accepted: 04/22/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Early childhood caries (ECC) is the most common chronic disease in young children and a public health problem worldwide. It is characterized by the presence of atypical and fast progressive caries lesions. The aggressive form of ECC, severe early childhood caries (S-ECC), can lead to the destruction of the whole crown of most of the deciduous teeth and cause pain and sepsis, affecting the child's quality of life. Although the multifactorial etiology of ECC is known, including social, environmental, behavioral, and genetic determinants, there is a consensus that this disease is driven by an imbalance between the oral microbiome and host, or dysbiosis, mediated by high sugar consumption and poor oral hygiene. Knowledge of the microbiome in healthy and caries status is crucial for risk monitoring, prevention, and development of therapies to revert dysbiosis and restore oral health. Molecular biology tools, including next-generation sequencing methods and proteomic approaches, have led to the discovery of new species and microbial biomarkers that could reveal potential risk profiles for the development of ECC and new targets for anti-caries therapies. This narrative review summarized some general aspects of ECC, such as definition, epidemiology, and etiology, the influence of oral microbiota in the development and progression of ECC based on the current evidence from genomics, transcriptomic, proteomic, and metabolomic studies and the effect of antimicrobial intervention on oral microbiota associated with ECC. CONCLUSION The evaluation of genetic and proteomic markers represents a promising approach to predict the risk of ECC before its clinical manifestation and plan efficient therapeutic interventions for ECC in its initial stages, avoiding irreversible dental cavitation.
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Affiliation(s)
- Cristiane Duque
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Daniela Alvim Chrisostomo
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Amanda Caselato Andolfatto Souza
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Gabriela Pacheco de Almeida Braga
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Vanessa Rodrigues Dos Santos
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Karina Sampaio Caiaffa
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Jesse Augusto Pereira
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Warlley Campos de Oliveira
- Department of Preventive and Restorative Dentistry, Araçatuba Dental School, State University of São Paulo (UNESP), Araçatuba, Brazil
| | - Apoena de Aguiar Ribeiro
- Division of Diagnostic Sciences, University of North Carolina at Chapel Hill - Adams School of Dentistry, Chapel Hill, North Carolina, United State
| | - Thaís Manzano Parisotto
- Laboratory of Clinical and Molecular Microbiology, São Francisco University, Bragança Paulista, Brazil
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Jain A, Deshpande AN, Shah YS, Jaiswal V, Tailor B. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023; 16:1-8. [PMID: 37020768 PMCID: PMC10067996 DOI: 10.5005/jp-journals-10005-2488] [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] [Indexed: 04/07/2023] Open
Abstract
Introduction Dental caries is a site-specific, multifactorial chronic disease affected globally. The prevalence of dental caries is strongly associated with social and economic disadvantage, and also the susceptibility of children to dental caries. Dental caries prevention can be achieved with topical fluoride agents. Topical fluoride promotes the remineralization of early carious lesions and reduces the demineralization of healthy enamel. Aim The aim of this randomized clinical trial was to compare the effectiveness of silver diamine fluoride (SDF) and sodium fluoride varnish (FV) in preventing new carious lesions in preschoolers. Materials and methods This randomized clinical trial was conducted on 285 children aged 3-6 years. Children were randomly allocated into three groups namely, group I-deionized distilled water (DIW), group II-sodium FV, and group III-SDF. The biannual application was performed at an interval of 6 months. New carious lesions were recorded using defs and International Caries Detection and Assessment System (ICDAS II) under LED magnifying loupes. Descriptive and inferential statistics were applied and tabulated using Statistical Package for the Social Sciences (SPSS) 23.0 software. Result There was a significant difference seen in the mean values of group III (SDF) when compared with group II (FV) and also between group III (SDF) and group I (DIW) when defs index was used. The mean score of ICDAS II after 12 months in group I (DIW) was -1.171, group II (FV) was -0.690, and group III (SDF) was -0.374. Conclusion silver diamine fluoride (SDF) was found to be most effective in preventing dental caries and also it appears to be the most cost-saving fluoride therapy. How to cite this article Jain A, Deshpande AN, Shah YS, et al. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(1):1-8.
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Affiliation(s)
- Aishwarya Jain
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Anshula N Deshpande
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Yash S Shah
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Vidhi Jaiswal
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
| | - Brijesh Tailor
- Department of Pediatric and Preventive Dentistry, K. M. Shah Dental College and Hospital, Sumandeep Vidyapeeth (Deemed to be University), Vadodara, Gujarat, India
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Pithpornchaiyakul S, Naorungroj S, Pupong K, Hunsrisakhun J. Using Chatbot as an Alternative Approach for In-Person Tooth Brushing Training During the COVID-19 Pandemic. J Med Internet Res 2022; 24:e39218. [PMID: 36179147 PMCID: PMC9591704 DOI: 10.2196/39218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/02/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pandemic, practical experience was difficult to implement. Therefore, the 30-Day FunDee chatbot was created to extend the coverage of chatbots from 21 days to 30 days by incorporating more videos on toothbrushing demonstrations and dialogue. This was a secondary data comparison of 2 chatbots in similar rural areas of Pattani province: Maikan district (Study I) and Maelan district (Study II). Objective This study aimed to evaluate the effectiveness and usability of 2 chatbots, 21-Day FunDee (Study I) and 30-Day FunDee (Study II), based on the protection motivation theory (PMT). This study explored the feasibility of using the 30-Day FunDee chatbot to increase toothbrushing behaviors for caregivers in oral hygiene care for children aged 6 months to 36 months without in-person training during the COVID-19 pandemic. Methods A pre-post design was used in both studies. The effectiveness was evaluated among caregivers in terms of oral hygiene practices, knowledge, and oral health care perceptions based on PMT. In Study I, participants received in-person training and a 21-day chatbot course during October 2018 to February 2019. In Study II, participants received only daily chatbot programming for 30 days during December 2021 to February 2022. Data were gathered at baseline of each study and at 30 days and 60 days after the start of Study I and Study II, respectively. After completing their interventions, the chatbot's usability was assessed using open-ended questions. Study I evaluated the plaque score, whereas Study II included an in-depth interview. The 2 studies were compared to determine the feasibility of using the 30-Day FunDee chatbot as an alternative to in-person training. Results There were 71 pairs of participants: 37 in Study I and 34 in Study II. Both chatbots significantly improved overall knowledge (Study I: P<.001; Study II: P=.001), overall oral health care perceptions based on PMT (Study I: P<.001; Study II: P<.001), and toothbrushing for children by caregivers (Study I: P=.02; Study II: P=.04). Only Study I had statistically significant differences in toothbrushing at least twice a day (P=.002) and perceived vulnerability (P=.003). The highest overall chatbot satisfaction was 9.2 (SD 0.9) in Study I and 8.6 (SD 1.2) in Study II. In Study I, plaque levels differed significantly (P<.001). Conclusions This was the first study using a chatbot in oral health education. We established the effectiveness and usability of 2 chatbot programs for promoting oral hygiene care of young children by caregivers. The 30-Day FunDee chatbot showed the possibility of improving toothbrushing skills without requiring in-person training. Trial Registration Thai Clinical Trials Registry TCTR20191223005; http://www.thaiclinicaltrials.org/show/TCTR20191223005 and TCTR20210927004; https://www.thaiclinicaltrials.org/show/TCTR20210927004
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Affiliation(s)
- Samerchit Pithpornchaiyakul
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Prince of Songkla University, Hatyai, Songkhla, TH.,Improvement of Oral Health Care Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, TH
| | - Supawadee Naorungroj
- Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University,, Hatyai, Songkhla, TH
| | | | - Jaranya Hunsrisakhun
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Prince of Songkla University, Hatyai, Songkhla, TH.,Improvement of Oral Health Care Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, TH
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Wang Q, Qu X, Houser SH, Zhang Y, Tian M, Zhang Q, Zhang W. Caries Risk Assessment and Dental Referral by Paediatric Primary Care Physicians in Sichuan Province, China: A Cross-Sectional Study. Risk Manag Healthc Policy 2022; 15:1641-1650. [PMID: 36092548 PMCID: PMC9450904 DOI: 10.2147/rmhp.s362004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 08/08/2022] [Indexed: 11/30/2022] Open
Abstract
Background Limited information is known about dental implementation by pediatric primary care physicians (PCPs) at the primary care level in China. This study aimed to explore the current status of primary oral care implementation and related influencing factors. Methods A cross-sectional survey was conducted among PCPs in Sichuan Province, China. Multivariable logistic regression was used to analyse factors associated with CRA and dental referral for high caries-risk children. Results A total of 504 out of 524 questionnaires remained for analysis. In all, 93.8% of PCPs reported that they usually or sometimes performed dental screening for children, 31.3% performed CRA, and 49.0% referred high caries-risk children to dentists. More CRA activities were associated with PCPs who encountered a greater number of children with caries during systematic care (adjusted OR: 2.37, 95% CI:[1.08,5.18], had dental knowledge training by pediatric dentists (aOR: 2.26, 95% CI:[1.36, 3.75], and learned pediatric dental knowledge on their own (aOR: 2.87, 95% CI: [1.51, 5.45]). In addition to the above associators, a higher rate of dental referrals for high caries-risk children was associated with having a dental department in the same work institute (aOR: 1.72, 95% CI: [1.09, 2.70] and having more confidence in their dental knowledge (aOR: 1.29, 95% CI: [1.04, 1.61]). Conclusion Paediatric PCPs commonly implement dental screening but perform fewer CRAs and dental referrals for high caries-risk children during systematic health management in western China. To increase CRA activities and dental referral by paediatric PCPs, health policymakers could encourage interdisciplinary cooperation between dental professionals and paediatric PCPs.
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Affiliation(s)
- Qingyu Wang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, People’s Republic of China
- HEOA Group, Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, Chengdu, People’s Republic of China
| | - Xing Qu
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
- Correspondence: Xing Qu, Institute of Hospital Management, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, People’s Republic of China, +86 13880713452, Email
| | - Shannon H Houser
- Department of Health Services Administration, the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yan Zhang
- Department of Maternity and Child Health Management, Sichuan Provincial Maternity and Child Health Care Hospital, Chengdu, People’s Republic of China
| | - Meirong Tian
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
| | - Qiong Zhang
- Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, People’s Republic of China
- State Key Laboratory of Oral Diseases & National Clinical Research, Sichuan University, Chengdu, People’s Republic of China
| | - Wei Zhang
- Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu, People’s Republic of China
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Sousa GPD, Lima CCB, Braga MM, Moura LDFADD, Lima MDDMD, Moura MSD. Early childhood caries management using fluoride varnish and neutral fluoride gel: a randomized clinical trial. Braz Oral Res 2022; 36:e099. [PMID: 35830143 DOI: 10.1590/1807-3107bor-2022.vol36.0099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 04/04/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the clinical efficacy of varnish and neutral fluoride gel in the management of early childhood caries (ECC). A randomized clinical trial was conducted to compare two strategies for ECC management: topical application of neutral fluoride gel (NFG group) and varnish (FV group) every four months for a period of one year. The sample consisted of children between the ages of three and four years, enrolled in public daycare centers. The incidence of ECC between the groups was compared by assessing values (new dmfs) at two levels: d2 when enamel/dentin were affected and d3 when dentin affected. Pearson's Chi-square, Fisher's Exact, Kolmogorov-Smirnov and Mann-Whitney tests were used to compare the incidence and increment of caries between the NFG and FV groups (p<0.05). A total of 240 children were included in this study and 213 children (88.7%) were followed up for 12 months. The incidence of ECC was 24.1% in the GF and 21.0% in the FV groups (p=0.586). The increment of caries in d2mfs was 1.36 (95% CI = 0.83 - 1.89) in the NFG and 1.33 (95% CI = 0.75 - 1.89) in FV (p=0.756) groups. Increment of caries in d3mfs was 1.60 (95% CI = 0.95 - 2.25) in NFG and 1.40 (95% CI = 0.75 - 2.04) in FV (p=0.468). Neutral fluoride gel and fluoride varnish exhibited similar efficacy in the management of ECC after 12 months of follow-up.
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Affiliation(s)
- Geovanna Peres de Sousa
- Universidade Federal do Piauí - UFPI, Department of Pathology and Dental Clinics, Teresina, PI, Brazil
| | | | - Mariana Minatel Braga
- Universidade de São Paulo - USP, School of Dentistry, Department of Pediatric Dentistry, São Paulo, SP, Brazil
| | | | | | - Marcoeli Silva de Moura
- Universidade Federal do Piauí - UFPI, Department of Pathology and Dental Clinics, Teresina, PI, Brazil
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Souza BMD, Silva MDS, Braga AS, Santos DMSD, Carvalho TDS, Santos NMD, Rios D, Buzalaf MAR, Magalhães AC. Acceptability and effect of TiF4 on dental caries: a randomized controlled clinical trial. Braz Oral Res 2021; 35:e121. [PMID: 34878076 DOI: 10.1590/1807-3107bor-2021.vol35.0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 03/18/2021] [Indexed: 11/22/2022] Open
Abstract
This randomized three-armed controlled clinical trial compared the effect of titanium tetrafluoride (TiF4) and sodium fluoride (NaF) varnishes on caries control in smooth surfaces of permanent dentition and children's acceptability. Sixty children (6-8 y/o) were randomly divided into TiF4 (2.45% F-), NaF (2.26% F-) or placebo (control) groups. Varnishes were applied on permanent teeth once a week for the first 4 weeks and after the 6th and 12th months of the study. The variables were as follows: International Caries Detection and Assessment System (ICDAS) scores, quantitative fluorescence changes, visual plaque index (VPI) and degree of acceptability. Two-way RM-ANOVA, ANOVA/Tukey and χ2 tests were performed (p < 0.05). No differences were found between the treatments with respect to ICDAS scores (p = 0.32). Only TiF4 reduced the mean fluorescence loss significantly at 18 months compared to the baseline (p = 0.003). TiF4 showed a lower percentage of new caries lesions by tooth surface than the placebo, while NaF did not induce such a change (p < 0.014). Regardless of the treatment, more than 95% of the participants reported being satisfied. For all groups, the VPI decreased significantly at 3 months compared to the baseline value (p < 0.001), with no differences between the treatments (p = 0.17). TiF4 had a similar ability to control caries lesions as NaF; however, only TiF4 differed from the placebo (p = 0.004). The acceptability of TiF4 varnish was similar to that of NaF varnish.
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Affiliation(s)
- Beatriz Martines de Souza
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Mayara de Souza Silva
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Aline Silva Braga
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | | | - Thamyris de Souza Carvalho
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
| | - Natália Mello Dos Santos
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru, SP, Brazil
| | - Daniela Rios
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatric Dentistry, Orthodontic and Public Health, Bauru, SP, Brazil
| | | | - Ana Carolina Magalhães
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Biological Sciences, Bauru, SP, Brazil
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11
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Chou R, Pappas M, Dana T, Selph S, Hart E, Fu RF, Schwarz E. Screening and Interventions to Prevent Dental Caries in Children Younger Than 5 Years: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA 2021; 326:2179-2192. [PMID: 34874413 DOI: 10.1001/jama.2021.15658] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE A 2014 review for the US Preventive Services Task Force (USPSTF) found that oral fluoride supplementation and topical fluoride use were associated with reduced caries incidence in children younger than 5 years. OBJECTIVE To update the 2014 review on dental caries screening and preventive interventions to inform the USPSTF. DATA SOURCES Ovid MEDLINE, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to September 2020); surveillance through July 23, 2021. STUDY SELECTION Randomized clinical trials (RCTs) on screening, preventive interventions, referral to dental care; cohort studies on screening and referral; studies on diagnostic accuracy of primary care oral examination or risk assessment; and a systematic review on risk of fluorosis included in prior USPSTF reviews. DATA EXTRACTION AND SYNTHESIS One investigator abstracted data; a second checked accuracy. Two investigators independently rated study quality. RESULTS Thirty-two studies (19 trials, 9 observational studies, and 4 nonrandomized clinical intervention studies [total 106 694 participants] and 1 systematic review [19 studies]) were included. No study evaluated effects of primary care screening on clinical outcomes. One study (n = 258) found primary care pediatrician examination associated with a sensitivity of 0.76 (95% CI, 0.55 to 0.91) and specificity of 0.95 (95% CI, 0.92 to 0.98) for identifying a child with cavities, and 1 study found a risk assessment tool associated with sensitivity of 0.53 and specificity of 0.77 (n = 697, CIs not reported) for a child with future caries. No new trials of dietary fluoride supplementation were identified. For prevention, topical fluoride compared with placebo or no topical fluoride was associated with decreased caries burden (13 trials, n = 5733; mean caries increment [difference in decayed, missing, and filled teeth or surfaces], -0.94 [95% CI, -1.74 to -0.34]) and likelihood of incident caries (12 trials, n = 8177; RR, 0.80 [95% CI, 0.66 to 0.95]; absolute risk difference, -7%) in higher-risk populations or settings, with no increased fluorosis risk. Evidence on other preventive interventions was limited (education, xylitol) or unavailable (silver diamine fluoride), and no study directly evaluated primary care dentistry referral vs no referral. CONCLUSIONS AND RELEVANCE There was no direct evidence on benefits and harms of primary care oral health screening or referral to dentist. Dietary fluoride supplementation and fluoride varnish were associated with improved caries outcomes in higher-risk children and settings.
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Affiliation(s)
- Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland
- Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland
| | - Miranda Pappas
- Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland
| | - Tracy Dana
- Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland
| | - Shelley Selph
- Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland
| | - Erica Hart
- Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland
| | - Rongwei F Fu
- Department of Medical Informatics and Clinical Epidemiology, Pacific Northwest Evidence-based Practice Center, Oregon Health & Science University, Portland
- School of Public Health, Oregon Health & Science University-Portland State University, Portland
| | - Eli Schwarz
- School of Public Health, Oregon Health & Science University-Portland State University, Portland
- School of Dentistry, Oregon Health & Science University, Portland
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12
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Yu KF, Wen W, Liu P, Gao X, Lo ECM, Wong MCM. Effectiveness of Family-Centered Oral Health Promotion on Toddler Oral Health in Hong Kong. J Dent Res 2021; 101:286-294. [PMID: 34515552 DOI: 10.1177/00220345211036663] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Early childhood caries is common in Hong Kong, and parental practices on maintaining good oral health of their young children are far from satisfactory. This article reports on the effectiveness of a randomized controlled trial on family-centered oral health promotion to new parents in establishing proper feeding habits and oral hygiene practices and in reducing caries risk among 3-y-old toddlers. At baseline, pregnant mothers and their husbands were recruited and randomly allocated into 2 groups. The test group received individualized oral health education (OHE) via a behavioral and educational counseling approach while the control group received the OHE pamphlets only. Information related to the feeding habits, oral hygiene practices, and oral health of the toddlers was collected by parent-completed questionnaires and oral examination annually via home visits. A total of 580 families were recruited at baseline, and 436 toddlers were followed up when they reached 3 y old (test, n = 228; control, n = 208; follow-up rate, 75.2%). The proportions of toddlers who held food in the mouth, fell asleep when milk feeding, had prolonged use of the nursing bottle, ate before bed, and consumed a sweet snack daily were significantly lower in the test group than in the control group (all P < 0.05). Significantly higher proportions of toddlers brushed their own teeth twice daily, were brushed by their parents twice daily, and used fluoride toothpaste than in the control group (all P < 0.001). Toddlers in the test group had better oral health status with a lower level of visible plaque, Streptococcus mutans, white spot lesion, and cavitated lesion (all P < 0.05). Family-centered oral health promotion and individualized OHE for parents via a behavioral and educational counseling approach are more effective in establishing good feeding habits and parental toothbrushing practices and in decreasing the caries risk of their toddlers than the distribution of OHE pamphlets alone (ClinicalTrials.gov NCT02937194).
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Affiliation(s)
- K F Yu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - W Wen
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Xicheng District, Beijing, China
| | - P Liu
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - X Gao
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.,Faculty of Dentistry, National University of Singapore, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - E C M Lo
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - M C M Wong
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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13
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Aliakbari E, Gray-Burrows KA, Vinall-Collier KA, Edwebi S, Marshman Z, McEachan RRC, Day PF. Home-based toothbrushing interventions for parents of young children to reduce dental caries: A systematic review. Int J Paediatr Dent 2021; 31:37-79. [PMID: 32333706 DOI: 10.1111/ipd.12658] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dental caries is the most prevalent preventable condition in children. A key preventive home-based oral health behaviour is the adoption and maintenance of parental supervised toothbrushing until 8 years of age. AIM To examine interventions promoting parental supervised toothbrushing practices to reduce dental caries in young children (<8 years old). DESIGN Interventions promoting parental involvement in home-based toothbrushing in children under 8 years old and their impact on caries were subjected to review. Electronic databases (MEDLINE, EMBASE, PubMed, Web of Science, PsycINFO, Scopus, and the Cochrane Library), references, and unpublished literature databases were searched for relevant literature. RESULTS Of the 10 176 articles retrieved, forty-two articles were included. The Theoretical Domains Framework was used to code intervention content, with the main domains addressed being knowledge (41/42), skills (35/42), and environmental context and resources (22/42). Sufficient descriptions of the intervention development, delivery, and evaluation were lacking, with only 18 studies being underpinned by theory. Twenty-nine studies explored the impact on caries yielding mixed results. CONCLUSIONS There are few interventions targeting home-based oral health behaviours underpinned by theory and methodological rigour in their development and evaluation. This demonstrates a clear need for future interventions to be guided by complex intervention methodology.
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Affiliation(s)
- Elnaz Aliakbari
- Specialist in Paediatric Dentistry, Clarendon Dental Spa, Leeds, UK
| | - Kara A Gray-Burrows
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sakina Edwebi
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
| | - Zoe Marshman
- Faculty of Medicine, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Peter F Day
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
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14
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Turton B, Durward C, Crombie F, Sokal-Gutierrez K, Soeurn S, Manton DJ. Evaluation of a community-based early childhood caries (ECC) intervention in Cambodia. Community Dent Oral Epidemiol 2020; 49:275-283. [PMID: 33200439 DOI: 10.1111/cdoe.12599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 09/28/2020] [Accepted: 10/30/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To critically evaluate an early childhood caries (ECC) intervention performed by non-dental primary healthcare providers. METHODS This mixed-methods investigation includes data from three sources: (a) a pilot non-randomized controlled trial to examine clinical outcomes at four health centres; (b) stakeholder focus group interviews; and (c) a survey of parents whose children were exposed to the intervention. The pilot study involved four Community Health Centres in rural Cambodia whereby mother-child (6-24 months of age)dyads received oral health education (OHE), toothbrushes, fluoride toothpaste and fluoride varnish on up to six occasions as part of the routine vaccination schedule. Outcomes were as follows: presence of ECC; impacts on oral health-related quality of life (OHRQoL); stakeholder perceptions of intervention delivery; and parental perceptions of fluoride varnish. RESULTS Participants in the intervention group had six times lower odds of developing ECC than those in the comparison group after controlling for socio-economic status (OR 0.13). Those in the intervention group also had a large reduction OHRQoL scale scores. Key knowledge and practice gaps were identified among stakeholders. Surveyed parents had favourable views of the fluoride varnish placement by medical professionals, and four out of five stated that they would recommend fluoride varnish for other children. Primary healthcare providers, commune council representatives and community health promoters supported oral health interventions being provided in CHCs. CONCLUSIONS OHE and fluoride varnish interventions provided by non-dental primary health workers were feasible and acceptable for stakeholders in a Cambodian setting. The intervention group had lower ECC experience and better OHRQoL at 2 years of age.
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Affiliation(s)
- Bathsheba Turton
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - Callum Durward
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - Felicity Crombie
- Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | | | - Sopharith Soeurn
- Faculty of Dentistry, University of Puthisastra, Phnom Penh, Cambodia
| | - David J Manton
- Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, Groningen, The Netherlands
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15
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Associations between Child Snack and Beverage Consumption, Severe Dental Caries, and Malnutrition in Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217911. [PMID: 33126647 PMCID: PMC7672540 DOI: 10.3390/ijerph17217911] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 10/16/2020] [Accepted: 10/26/2020] [Indexed: 12/01/2022]
Abstract
The global nutrition transition and increased consumption of sugar-sweetened beverages and ultra-processed snacks have contributed to increasing rates of child obesity and dental caries in developing countries. In Nepal, where child malnutrition rates are high, the relationship between malnutrition and dental caries is poorly understood. This cross-sectional study aims to assess this relationship among a convenience sample of 273 children age six months to less than 12 years in three communities in Nepal, using parent/caregiver interviews, child dental exams, and anthropometric measurements. Fisher’s exact test and independent t-tests examined associations between dietary practices and severe caries and between severe caries and malnutrition, respectively. Children consumed sugar-sweetened beverages and processed snacks frequently: 80% consumed tea with sugar, 60% consumed sweet snacks, and 65% consumed processed savory snacks daily. Overall, 74% of children had untreated tooth decay, and 21% exhibited stunting malnutrition, 14% were underweight, and 6% presented wasting. Significant associations were found between daily consumption of sweets and processed snacks with severe caries and between severe caries and poorer nutritional status. These findings underscore the need to incorporate nutrition and oral health promotion and dental treatment into maternal–child health services and schools and to strengthen policies to reduce children’s access to junk food.
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16
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Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study. BMC Oral Health 2020; 20:139. [PMID: 32398067 PMCID: PMC7218629 DOI: 10.1186/s12903-020-01104-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 04/02/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The high prevalence of early childhood caries (ECC) is widespread around the world, and oral health education (OHE) plays a vital role in preventing ECC. Numerous studies on ECC risk factor assessment have assisted us in enriching the content of OHE. The objective of this study was to further assess independent risk factors for ECC at different ages to provide evidence and insights for OHE. METHODS Children aged 3-5 years old (N = 1301) in Shandong Province were enrolled in this cross-sectional study. Data about oral health status and caregivers' oral health knowledge, attitude, and practice (KAP) were extracted from the 4th National Oral Health Survey of China. The associations between ECC prevalence and various KAP variables were tested with chi-square tests, bivariate analysis and multivariable logistic regression analyses. RESULTS The ECC prevalence in Shandong Province was 64.6%, and the dmft mean was 3.15. The independent variables with an increased risk for ECC were age, feeding method within 6 months of birth, bedtime sugar frequency, experience of toothache over the past year and dental visits (P < 0.05, chi-square tests). Complete breastfeeding within 6 months of birth primarily contributed to the high ECC risk of the 3-year-old group (OR: 3.39, 95% CI: 1.41-8.17), while high frequency bedtime sweet consumption mainly contributed to that of the 5-year-old group (OR: 3.22, 95% CI: 1.03-10.06; logistic regression analysis). Tooth brushing was not associated with ECC in this study, and some positive knowledge and attitude variables were positively correlated with a high risk of ECC. CONCLUSION These data provide evidence to suggest that the ECC-related risk factors at different ages are inconsistent, which provides some insights for OHE. We should highlight the effects of feeding methods in the early stages of deciduous dentition and sugar habits in the late stages of deciduous dentition on ECC, as well as encourage preventive dental visit and supplemental training for oral health practices.
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17
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Bakhurji E, Hoaglin Cooper L. School-based fluoride varnish programs: a national survey. J Public Health Dent 2019; 79:279-285. [PMID: 31479531 DOI: 10.1111/jphd.12337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2018] [Revised: 05/20/2019] [Accepted: 07/22/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE To identify and describe school-based fluoride varnish (FV) programs in K-12 grades children in the United States. METHODS This cross-sectional study utilized an online, self-administered survey to identify and describe school-based FV programs in 2016. Several public health directories, mainly The Association of States and Territorial Dental Directors directory, were contacted to identify FV programs. The survey's questionnaire included 23 closed-ended questions regarding program description, assessment, and process. RESULTS Of 85 identified programs, 52 responded (response rate = 61 percent) with 40 school-based FV programs in operation in 27 states. About 85 percent of responding programs apply FV as part of an existing school-based program. Dental sealants on permanent teeth are the most common procedure provided in addition to FV (92 percent). One-third of programs apply FV once a year versus 28 percent that apply FV twice a year. CONCLUSIONS Evidence-based guidelines for FV in school-based programs are needed to ensure cost-effectiveness and continuity.
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Affiliation(s)
- Eman Bakhurji
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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18
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de Sousa F, dos Santos A, Nadanovsky P, Hujoel P, Cunha-Cruz J, de Oliveira B. Fluoride Varnish and Dental Caries in Preschoolers: A Systematic Review and Meta-Analysis. Caries Res 2019; 53:502-513. [DOI: 10.1159/000499639] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 12/06/2018] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to assess the effectiveness of fluoride varnish (FV) in reducing dentine caries at the patient, tooth, and surface levels as well as caries-related hospitalizations in preschoolers. We performed a systematic review of clinical trials of FV, alone or associated with an oral health program, compared with placebo, usual care, or no intervention. Bibliographical search included electronic searches of seven databases, registers of ongoing trials, and meeting abstracts, as well as hand searching. We performed random-effects meta-analyses and calculated confidence and prediction intervals. The search yielded 2,441 records; 20 trials were included in the review and 17 in at least one meta-analysis. Only one study had low risk of bias in all domains. We found no study reporting on caries-related hospitalizations. At the individual level, the pooled relative risk was 0.88 (95% confidence interval [CI] 0.81, 0.95); this means that in a population of preschool children with 50% caries incidence, we need to apply fluoride varnish in 17 children to avoid new caries in one child. At the tooth level, the pooled weighted mean difference was –0.30 (95% CI –0.69, 0.09) and at the surface level –0.77 (95% CI –1.23, –0.31). Considering the prediction intervals, none of the pooled estimates were statistically significant. We conclude that FV showed a modest and uncertain anticaries effect in preschoolers. Cost-effectiveness analyses are needed to assess whether FV should be adopted or abandoned by dental services.
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19
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Patil S, Kulkarni V, Bhise A. Algorithmic analysis for dental caries detection using an adaptive neural network architecture. Heliyon 2019; 5:e01579. [PMID: 31080904 PMCID: PMC6506865 DOI: 10.1016/j.heliyon.2019.e01579] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 03/13/2019] [Accepted: 04/24/2019] [Indexed: 11/09/2022] Open
Abstract
Objectives AI techniques have lifelong impact in biomedics and widely accepted outcomes. The sole objective of the study is to evaluate accurate detection of caries using feature extraction and classification of the dental images along with amalgamation Adaptive Dragonfly algorithm (DA) algorithm and Neural Network (NN) classifier. Materials and methods Here proposed caries detection model is designed for detecting the tooth cavities in an accurate manner. This methodology has two main phases; feature extraction and classification. In all total 120 images database is split into three sets, randomly for evaluating the performance. Further, this categorization of the test cases aids in ensuring the enhancement of the performance. In each of the test cases, there are 40 caries images the investigation in the performance of the proposed caries detection model was done in terms of accuracy, sensitivity, specificity, and precision, FPR, FNR, NPV, FDR, F1Score and MCC. Results Here MPCA with Nonlinear Programming and Adaptive DA, the proposed model is termed as MNP-ADA. The performance of the proposed MPCA-ADA model is evaluated by comparing it over the other existing feature extraction models. MPCA–ADA over the conventional classifier models like PCA-ADA, LDA-ADA and ICA-ADA in terms of performance parameters and MCC for all the test types and have superior results than the existing ones. Conclusion The research work emphasizes the prospective efficacy of IP and NN algorithms for the detection and diagnosis of dental caries. A novel and improved model shows substantially worthy performance in distinguishing dental caries using image processing techniques.
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Affiliation(s)
| | | | - Archana Bhise
- EXTC Department, SVKMs, NMIMS, MPSTME, Mumbai, India
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20
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Jamieson LM, Smithers LG, Hedges J, Aldis J, Mills H, Kapellas K, Lawrence HP, Broughton JR, Ju X. Follow-up of an Intervention to Reduce Dental Caries in Indigenous Australian Children: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2019; 2:e190648. [PMID: 30874781 PMCID: PMC6484654 DOI: 10.1001/jamanetworkopen.2019.0648] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/17/2019] [Indexed: 02/04/2023] Open
Abstract
Importance Testing the long-term usefulness of a childhood intervention and determining the best age of implementation are important for translation and policy change. Objectives To investigate among children aged 3 years the long-term effectiveness an intervention that aimed to reduce dental caries among South Australian Aboriginal children and to assess if children in the delayed intervention (DI) group had any benefit from the intervention from ages 2 to 3 years and if the intervention usefulness was greater when delivered between pregnancy and age 2 years (immediate intervention [II] vs ages 2 to 3 years [DI]). Design, Setting, and Participants Secondary analysis of a randomized clinical trial. The study enrolled 448 pregnant women across South Australia, Australia, at baseline (February 1, 2011, to May 30, 2012), with 223 randomly allocated to the II group and 225 to the DI group. Three-year follow-up data were collected November 2014 to February 2016. Interventions The intervention comprised dental treatment to mothers, fluoride varnish application to children, and motivational interviewing delivered together with anticipatory guidance. This was delivered during pregnancy and at child ages 6, 12, and 18 months for the II group and at child ages 24, 30, and 36 months for the DI group. Main Outcomes and Measures The mean number of decayed teeth measured at child age 3 years. Results There were 324 children at age 3 years (52.3% male). The mean number of decayed teeth at age 3 years was 1.44 (95% CI, 1.38-1.50) for the II group and 1.86 (95% CI, 1.89-2.03) for the DI group (mean difference, -0.41; 95% CI, -0.52 to -0.10). The predicted mean number of decayed teeth at age 3 years for the DI group was 2.15. Between ages 2 and 3 years, the caries increment for the II group was 0.82 (95% CI, 0.75-0.89), compared with 0.97 (95% CI, 0.87-1.17) for the DI group (P = .05). Conclusions and Relevance At the 3-year follow-up, II children had less dental caries than DI children, DI children developed dental caries at a lower trajectory than predicted had the intervention not been received at ages 2 to 3 years, and the caries increment was less between ages 2 to 3 years among II children compared with DI children. This study suggests that the best time to implement the intervention is earlier rather than later infancy. Trial Registration Australian and New Zealand Clinical Trial Registry Ideintifier: ACTRN12611000111976.
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Affiliation(s)
- Lisa M. Jamieson
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia
| | - Lisa G. Smithers
- School of Public Health, The University of Adelaide, Adelaide, South Australia
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia
| | - Jacqueline Aldis
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia
| | - Helen Mills
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia
| | - Herenia P. Lawrence
- Dental Public Health, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - John R. Broughton
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
- The Ngāi Tahu Māori Health Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Xiangqun Ju
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia
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Moynihan P, Tanner LM, Holmes RD, Hillier-Brown F, Mashayekhi A, Kelly SAM, Craig D. Systematic Review of Evidence Pertaining to Factors That Modify Risk of Early Childhood Caries. JDR Clin Trans Res 2019; 4:202-216. [PMID: 30931717 DOI: 10.1177/2380084418824262] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION A systematic review of evidence on the impact of modifiable risk factors on early childhood caries (ECC) was conducted to inform recommendations in a World Health Organization manual on ECC prevention. OBJECTIVES To systematically review published evidence pertaining to the effect of modifiable risk factors on ECC. METHODS Twelve questions relating to infant feeding, diet, oral hygiene, and fluoride were addressed, as prioritized by a World Health Organization expert panel. Questions pertaining to the use of fluoride toothpaste were excluded due to its proven efficacy. The target population was children aged <72 mo. Data sources included Medline, Embase, CINAHL, and PubMed, and all human epidemiologic studies were included. The highest level of evidence was used for evidence synthesis and, where possible, meta-analysis. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement, with evidence assessed via the GRADE method. RESULTS Of the 13,831 papers identified, 627 were screened in duplicate; of these, 139 were included. The highest-level evidence indicated that breastfeeding ≤24 mo does not increase ECC risk but suggested that longer-duration breastfeeding increases risk (low-quality evidence). Low-quality evidence indicated increased risk associated with consumption of sugars in bottles. Only 1 study had data on the impact of sugars in complementary foods, which increased risk. Moderate-quality evidence showed a benefit of oral health education for caregivers (odds ratio, 0.39; 95% CI, 0.19 to 0.80, P = 0.009). Meta-analysis of data on the impact on ECC from living in a fluoridated area showed a significant effect (mean difference, -1.25; 95% CI, -1.24 to -0.36; P = 0.006). Limited moderate- and low-quality data indicated a benefit of fluoride exposure from salt and milk, respectively. CONCLUSION The best available evidence indicates that breastfeeding up to 2 y of age does not increase ECC risk. Providing access to fluoridated water and educating caregivers are justified approaches to ECC prevention. Limiting sugars in bottles and complementary foods should be part of this education. KNOWLEDGE TRANSFER STATEMENT This research is being used by the World Health Organization in developing a toolkit on the prevention and management of early childhood caries. The information will guide 1) governments in developing national oral health plans and 2) clinicians when providing preventive advice, including that regarding infant feeding practices. It will help ensure that advice is in line with current World Health Organization guidelines and the best available evidence.
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Affiliation(s)
- P Moynihan
- 1 School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.,2 Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK.,3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - L M Tanner
- 3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - R D Holmes
- 1 School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.,2 Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | - F Hillier-Brown
- 4 Faculty of Social Sciences and Health, Durham University, Durham, UK
| | - A Mashayekhi
- 3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - S A M Kelly
- 5 Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - D Craig
- 3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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22
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Soldani FA, Lamont T, Jones K, Young L, Walsh T, Lala R, Clarkson JE. One-to-one oral hygiene advice provided in a dental setting for oral health. Cochrane Database Syst Rev 2018; 10:CD007447. [PMID: 30380139 PMCID: PMC6516798 DOI: 10.1002/14651858.cd007447.pub2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Effective oral hygiene measures carried out on a regular basis are vital to maintain good oral health. One-to-one oral hygiene advice (OHA) within the dental setting is often provided as a means to motivate individuals and to help achieve improved levels of oral health. However, it is unclear if one-to-one OHA in a dental setting is effective in improving oral health and what method(s) might be most effective and efficient. OBJECTIVES To assess the effects of one-to-one OHA, provided by a member of the dental team within the dental setting, on patients' oral health, hygiene, behaviour, and attitudes compared to no advice or advice in a different format. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 10 November 2017); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 10) in the Cochrane Library (searched 10 November 2017); MEDLINE Ovid (1946 to 10 November 2017); and Embase Ovid (1980 to 10 November 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were also searched for ongoing trials (10 November 2017). No restrictions were placed on the language or date of publication when searching the electronic databases. Reference lists of relevant articles and previously published systematic reviews were handsearched. The authors of eligible trials were contacted, where feasible, to identify any unpublished work. SELECTION CRITERIA We included randomised controlled trials assessing the effects of one-to-one OHA delivered by a dental care professional in a dental care setting with a minimum of 8 weeks follow-up. We included healthy participants or participants who had a well-defined medical condition. DATA COLLECTION AND ANALYSIS At least two review authors carried out selection of studies, data extraction and risk of bias independently and in duplicate. Consensus was achieved by discussion, or involvement of a third review author if required. MAIN RESULTS Nineteen studies met the criteria for inclusion in the review with data available for a total of 4232 participants. The included studies reported a wide variety of interventions, study populations, clinical outcomes and outcome measures. There was substantial clinical heterogeneity amongst the studies and it was not deemed appropriate to pool data in a meta-analysis. We summarised data by categorising similar interventions into comparison groups.Comparison 1: Any form of one-to-one OHA versus no OHAFour studies compared any form of one-to-one OHA versus no OHA.Two studies reported the outcome of gingivitis. Although one small study had contradictory results at 3 months and 6 months, the other study showed very low-quality evidence of a benefit for OHA at all time points (very low-quality evidence).The same two studies reported the outcome of plaque. There was low-quality evidence that these interventions showed a benefit for OHA in plaque reduction at all time points.Two studies reported the outcome of dental caries at 6 months and 12 months respectively. There was very low-quality evidence of a benefit for OHA at 12 months.Comparison 2: Personalised one-to-one OHA versus routine one-to-one OHAFour studies compared personalised OHA versus routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality).Comparison 3: Self-management versus professional OHAFive trials compared some form of self-management with some form of professional OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis or plaque (very low quality). None of the studies measured dental caries.Comparison 4: Enhanced one-to-one OHA versus one-to-one OHASeven trials compared some form of enhanced OHA with some form of routine OHA.There was little evidence available that any of these interventions demonstrated a difference on the outcomes of gingivitis, plaque or dental caries (very low quality). AUTHORS' CONCLUSIONS There was insufficient high-quality evidence to recommend any specific one-to-one OHA method as being effective in improving oral health or being more effective than any other method. Further high-quality randomised controlled trials are required to determine the most effective, efficient method of one-to-one OHA for oral health maintenance and improvement. The design of such trials should be cognisant of the limitations of the available evidence presented in this Cochrane Review.
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Affiliation(s)
- Francesca A Soldani
- Bradford District Care NHS Foundation TrustCommunity Dental ServiceBradfordUK
| | - Thomas Lamont
- University of Dundee, Dental School & HospitalPark PlaceDundeeTaysideUKDD1 4HN
| | | | - Linda Young
- NHS Education for ScotlandScottish Dental Clinical Effectiveness ProgrammeDundee Dental Education CentreSmall's WyndDundeeUKDD1 4HN
| | - Tanya Walsh
- The University of ManchesterDivision of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Rizwana Lala
- School of Clinical Dentistry, University of SheffieldUnit of Dental Public HealthClaremont CrescentSheffieldUKS10 2TA
| | - Janet E Clarkson
- Dundee Dental School, University of DundeeDivision of Oral Health SciencesPark PlaceDundeeScotlandUKDD1 4HR
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23
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Decision Tree Approach to the Impact of Parents' Oral Health on Dental Caries Experience in Children: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040692. [PMID: 29642381 PMCID: PMC5923734 DOI: 10.3390/ijerph15040692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 03/21/2018] [Accepted: 04/03/2018] [Indexed: 01/20/2023]
Abstract
Decision tree (DT) analysis was applied in this cross-sectional study to investigate caries experience in children by using clinical and microbiological data obtained from parent–child pairs. Thirty pairs of parents and children were recruited from periodontal and pediatric dental clinics. All participants were clinically examined for caries and periodontitis by a calibrated examiner. Cariogenic and periodontopathic bacteria examinations were conducted. The Kendall rank correlation coefficient was used to measure the association between data variables obtained through clinical and microbiological examinations. A classificatory inductive decision tree was generated using the C4.5 algorithm with the top-down approach. The C4.5 DT analysis was applied to classify major influential factors for children dental caries experience. The DT identified parents’ periodontal health classification, decayed, missing, filled permanent teeth (DMFT) index, periodontopathic test (PerioCheck) result, and periodontal pocket depth as the classification factors for children caries experience. 13.3% of children were identified with a low decayed, missing, filled primary teeth (dmft) index (dmft < 3) whose parents had a periodontal pocket depth ≤3.7, PerioCheck score >1, DMFT index <13.5, and periodontal classification >2. The DT model for this study sample had an accuracy of 93.33%. Here, parental periodontal status and parents’ DMFT were the factors forming the DT for children’s caries experience.
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Abstract
We focus on scalable public health interventions that prevent and delay the development of caries and enhance resistance to dental caries lesions. These interventions should occur throughout the life cycle, and need to be age appropriate. Mitigating disease transmission and enhancing resistance are achieved through use of various fluorides, sugar substitutes, mechanical barriers such as pit-and-fissure sealants, and antimicrobials. A key aspect is counseling and other behavioral interventions that are designed to promote use of disease transmission-inhibiting and tooth resistance-enhancing agents. Advocacy for public water fluoridation and sugar taxes is an appropriate dental public health activity.
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Affiliation(s)
- Jeremy A Horst
- Department of Biochemistry and Biophysics, University of California San Francisco, 1700 4th Street, QB3 Room 404, San Francisco, CA 94158, USA
| | - Jason M Tanzer
- Section on Oral Medicine, Department of Oral and Maxillofacial Diagnostic Sciences, University of Connecticut Health, University of Connecticut, 263 Farmington Avenue, Farmington, CT 06030, USA
| | - Peter M Milgrom
- Department of Oral Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, USA.
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25
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Muñoz-Millán P, Zaror C, Espinoza-Espinoza G, Vergara-Gonzalez C, Muñoz S, Atala-Acevedo C, Martínez-Zapata MJ. Effectiveness of fluoride varnish in preventing early childhood caries in rural areas without access to fluoridated drinking water: A randomized control trial. Community Dent Oral Epidemiol 2017; 46:63-69. [PMID: 28850712 DOI: 10.1111/cdoe.12330] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 07/27/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Early childhood caries (ECC) constitutes a serious public health issue, especially in communities without water fluoridation. We assessed the effectiveness of biannual fluoride varnish applications to prevent ECC in children from nonfluoridated rural areas. METHODS A triple-blind randomized control trial with two parallel arms was conducted with 275 two- to three-year-old children without cavitated carious lesions from 28 rural public preschools in Chile. The preschools were located in areas of low socioeconomic status without access to fluoridated water. An oral health education component was administered to children, parents and educators. A new toothbrush and toothpaste for each child was delivered to the parents at baseline and at four follow-up visits. The participants were randomly allocated to receive fluoride varnish or placebo applications every six months. Trained, calibrated dentists blind to the treatment arm performed visual dental assessments at 6, 12, 18 and 24 months. The primary endpoint was the development of cavitated carious lesions in children during the 24-month follow-up period using WHO criteria, and the secondary outcomes were an increase in caries measured as a change in the index of decayed, missing or filled teeth (dmft) since the beginning of the study and the development of adverse effects. An intention-to-treat (ITT) approach was used for the primary analysis. RESULTS We included 131 participants in the intervention group and 144 participants in the placebo group; of these children, 89 (67.9%) in the intervention group and 100 (69.4%) in the control group completed the protocol. The comparative ITT analysis of caries incidence after 24 months of follow-up showed a between-group prevention fraction of 18.9% (-2.9%-36.2%). Caries incidence was 45.0% for the experiment group and 55.6% for the control group (P = .081), with a mean dmft of 1.6 (SD = 2.4) and 2.1 (SD = 2.5), respectively. No adverse effects were reported. CONCLUSIONS In conclusion, biannual fluoride varnish application is not effective in preschool children from rural nonfluoridated communities at a high risk of caries.
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Affiliation(s)
- Patricia Muñoz-Millán
- Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.,Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile
| | - Carlos Zaror
- Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.,Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile
| | - Gerardo Espinoza-Espinoza
- Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile.,Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | | | - Sergio Muñoz
- Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - Claudia Atala-Acevedo
- Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.,Faculty of Dentistry, Center for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Universidad de La Frontera, Temuco, Chile
| | - Maria José Martínez-Zapata
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
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26
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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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27
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Sälzer S, Alkilzy M, Slot DE, Dörfer CE, Schmoeckel J, Splieth CH. Socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level. J Clin Periodontol 2017; 44 Suppl 18:S106-S115. [DOI: 10.1111/jcpe.12673] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Mohammad Alkilzy
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Julian Schmoeckel
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Christian H. Splieth
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
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28
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Kabil NS, Eltawil S. Prioritizing the Risk Factors of Severe Early Childhood Caries. Dent J (Basel) 2017; 5:E4. [PMID: 29563410 PMCID: PMC5806985 DOI: 10.3390/dj5010004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 11/21/2022] Open
Abstract
Severe early childhood caries remains the most common chronic disease affecting children. The multifactorial etiology of caries has established a controversy about which risk factors were more significant to its development. Therefore, our study aimed through meticulous statistical analysis to arrange the "well agreed upon" common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program. The study prioritized or reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to three or more, night feeding, child self-employed brushing, mother's caries experience, two siblings, on demand feeding, once/day sugary food, sharing utensils, one sibling, male gender, father's education, late first dental visit, brushing time, mother's education, no dental visit, decreased brushing frequency, and no night brushing.
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Affiliation(s)
- Noha Samir Kabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt.
| | - Sherif Eltawil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Oral & Dental Medicine, Cairo University, Giza 12613, Egypt.
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29
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Mishra P, Fareed N, Battur H, Khanagar S, Bhat MA, Palaniswamy J. Role of fluoride varnish in preventing early childhood caries: A systematic review. Dent Res J (Isfahan) 2017; 14:169-176. [PMID: 28702057 PMCID: PMC5504868 DOI: 10.4103/1735-3327.208766] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Early childhood caries is a public health problem that continues to affect babies and preschool children worldwide. This untreated caries process results in progressive destruction of the crowns of the teeth, often accompanied by severe pain and suffering, affecting the quality of life. Fluoride varnish which is one of the most important materials to prevent ECC is easy to apply and well tolerated by children. This study aimed to evaluate the scientific evidence regardingthe role of fluoride varnish in preventing early childhood caries. Materials and Methods: Records were searched from various databases such as PubMed/Medline, Cochrane, and EMBASE. Articles published over the past 36 years (1979-2015) were identified using the key search terms. A total of 190 records were identified by title/abstracts/full text articles and were retrieved. Potentially relevant reports identified from the reference lists of relevant studies, review articles and chapters were hand-searched, which yielded an additional 10 articles. The main outcome of our investigation was prevention of early childhood caries following application of fluoride varnish and unavoidable fluoride exposure. Out of 190 articles originally identified, 30 records were considered potentially eligible and sought for further assessment. 17 articles met the inclusion criteria and these studies were assessed independently for methodology and performance. Results: Analysis of literature revealed that basically two concentrations of fluoride varnishes have been used: 1% and 5%, with a caries preventive fraction ranges of 6.4-30% and 5-63%, respectively. Conclusion: The results showed that fluoride varnishes have been used at concentrations of 1% and 5% in the prevention of ECC. The preventive fraction was influenced by the frequency of application, the duration of study and sample size. The evidence level of the studies was of moderate to limited value.
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Affiliation(s)
- Poulami Mishra
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Nusrath Fareed
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Hemant Battur
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Sanjeev Khanagar
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Manohar A Bhat
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
| | - Jagan Palaniswamy
- Department of Public Health Dentistry, KVG Dental College and Hospital, Sullia, Karnataka, India
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Semiannual Fluoride Applications in Low-Risk Toddlers May Not Be More Effective Than Toothbrushing Instruction and Dietary Counseling in Controlling Dental Caries. J Evid Based Dent Pract 2016; 16:246-248. [PMID: 27938699 DOI: 10.1016/j.jebdp.2016.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Effectiveness of early preventive intervention with semiannual fluoride varnish application in toddlers living in high-risk areas: A stratified cluster-randomized controlled trial. Anderson M, Dahlöf G, Twetman S, Jansson L, Bergenlid AC, Grindefjord M. Caries Res 2016;50(1):17-23. SOURCE OF FUNDING The study was commissioned and supported by Stockholm County Council and Karolinska Institutet. TYPE OF STUDY/DESIGN Non-blinded, cluster-randomized controlled field trial with two parallel arms.
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31
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Hajishengallis E, Parsaei Y, Klein MI, Koo H. Advances in the microbial etiology and pathogenesis of early childhood caries. Mol Oral Microbiol 2016; 32:24-34. [PMID: 26714612 DOI: 10.1111/omi.12152] [Citation(s) in RCA: 140] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2015] [Indexed: 01/18/2023]
Abstract
Early childhood caries (ECC) is one of the most prevalent infectious diseases affecting children worldwide. ECC is an aggressive form of dental caries, which, left untreated, can result in rapid and extensive cavitation in teeth (rampant caries) that is painful and costly to treat. Furthermore, it affects mostly children from impoverished backgrounds, and so constitutes a major challenge in public health. The disease is a prime example of the consequences arising from complex, dynamic interactions between microorganisms, host, and diet, leading to the establishment of highly pathogenic (cariogenic) biofilms. To date, there are no effective methods to identify those at risk of developing ECC or to control the disease in affected children. Recent advances in deep-sequencing technologies, novel imaging methods, and (meta)proteomics-metabolomics approaches provide an unparalleled potential to reveal new insights to illuminate our current understanding about the etiology and pathogenesis of the disease. In this concise review, we provide a broader perspective about the etiology and pathogenesis of ECC based on previous and current knowledge on biofilm matrix, microbial diversity, and host-microbe interactions, which could have direct implications for developing new approaches for improved risk assessment and prevention of this devastating and costly childhood health condition.
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Affiliation(s)
- E Hajishengallis
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Y Parsaei
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M I Klein
- Araraquara Dental School, Univ Estadual Paulista, UNESP, Araraquara, Sao Paulo, Brazil
| | - H Koo
- School of Dental Medicine, University of Pennsylvania, Philadelphia, PA, USA
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