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Flink H, Hedenbjörk-Lager A, Liljeström S, Nohlert E, Tegelberg Å. Identification of Swedish caries active individuals aged 30-90 years using a life course perspective and SKaPa longitudinal national registry data over a 10-year period. Acta Odontol Scand 2024; 83:412-418. [PMID: 38899384 DOI: 10.2340/aos.v83.40955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVE To describe the occurrence of caries disease from a life course perspective using longitudinal data from the Swedish Quality Registry for Caries and Periodontal Disease (SKaPa). Material and Methods: Data from seven age cohorts (ages 30-90 years), each followed over 10 years, were retrieved from the SKaPa. Using a three-trajectory model, individuals were divided into three trajectories according to their caries development over time: high (15%), moderate (45%), or low (40%). Caries experience was expressed as the mean decayed, missing, and filled surfaces (DMFS) index. RESULTS Significant differences were found for all three trajectories and in all age groups over the 10 years. The mean DMFS index increase was significantly larger for the high trajectory group than for the moderate and low trajectory groups across all age cohorts. An increase in caries experience was observed for the older cohorts across all trajectories. CONCLUSIONS A three-trajectory model appears useful for identifying and quantifying caries experiences in longitudinal studies. Increased caries disease occurs over time, especially in the highest trajectory group and among older cohorts. These findings emphasise the need for greater attention and more efficient caries prevention methods.
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Affiliation(s)
- Håkan Flink
- Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden.
| | | | - Simon Liljeström
- Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden
| | - Eva Nohlert
- Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden
| | - Åke Tegelberg
- Centre for Clinical Research Västerås, Uppsala University, Västerås, Sweden; Faculty of Odontology, Malmö University, Malmö, Sweden
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Moore D, Nyakutsikwa B, Allen T, Lam E, Birch S, Tickle M, Pretty IA, Walsh T. Effect of fluoridated water on invasive NHS dental treatments for adults: the LOTUS retrospective cohort study and economic evaluation. PUBLIC HEALTH RESEARCH 2024; 12:1-147. [PMID: 38785327 DOI: 10.3310/rfqa3841] [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] [Indexed: 05/25/2024] Open
Abstract
Background Most water fluoridation studies were conducted on children before the widespread introduction of fluoride toothpastes. There is a lack of evidence that can be applied to contemporary populations, particularly adolescents and adults. Objective To pragmatically assess the clinical and cost effectiveness of water fluoridation for preventing dental treatment and improving oral health in a contemporary population of adults, using a natural experiment design. Design Retrospective cohort study using routinely collected National Health Service dental claims (FP17) data. Setting National Health Service primary dental care: general dental practices, prisons, community dental services, domiciliary settings, urgent/out-of-hours and specialised referral-only services. Participants Dental patients aged 12 years and over living in England (n = 6,370,280). Intervention and comparison Individuals exposed to drinking water with a fluoride concentration ≥ 0.7 mg F/l between 2010 and 2020 were matched to non-exposed individuals on key characteristics using propensity scores. Outcome measures Primary: number of National Health Service invasive dental treatments (restorations/'fillings' and extractions) received per person between 2010 and 2020. Secondary: decayed, missing and filled teeth, missing teeth, inequalities, cost effectiveness and return on investment. Data sources National Health Service Business Services Authority dental claims data. Water quality monitoring data. Primary outcome Predicted mean number of invasive dental treatments was 3% lower in the optimally fluoridated group than in the sub/non-optimally fluoridated group (incidence rate ratio 0.969, 95% CI 0.967 to 0.971), a difference of -0.173 invasive dental treatments (95% CI -0.185 to -0.161). This magnitude of effect is smaller than what most stakeholders we engaged with (n = 50/54) considered meaningful. Secondary outcomes Mean decayed, missing and filled teeth were 2% lower in the optimally fluoridated group, with a difference of -0.212 decayed, missing and filled teeth (95% CI -0.229 to -0.194). There was no statistically significant difference in the mean number of missing teeth per person (0.006, 95% CI -0.008 to 0.021). There was no compelling evidence that water fluoridation reduced social inequalities in treatments received or missing teeth; however, decayed, missing and filled teeth data did not demonstrate a typical inequalities gradient. Optimal water fluoridation in England in 2010-20 was estimated to cost £10.30 per person (excluding original setup costs). Mean National Health Service treatment costs for fluoridated patients 2010-20 were 5.5% lower per person, by £22.26 (95% CI -£23.09 to -£21.43), and patients paid £7.64 less in National Health Service dental charges per person (2020 prices). Limitations Pragmatic, observational study with potential for non-differential errors of misclassification in fluoridation assignment and outcome measurement and residual and/or unmeasured confounding. Decayed, missing and filled teeth data have not been validated. Water fluoridation cost estimates are based on existing programmes between 2010 and 2020, and therefore do not include the potentially significant capital investment required for new programmes. Conclusions Receipt of optimal water fluoridation between 2010 and 2020 resulted in very small health effects, which may not be meaningful for individuals, and we could find no evidence of a reduction in social inequalities. Existing water fluoridation programmes in England produced a positive return on investment between 2010 and 2020 due to slightly lower National Health Service treatment costs. These relatively small savings should be evaluated against the projected costs and lifespan of any proposed capital investment in water fluoridation, including new programmes. Future work National Health Service dental data are a valuable resource for research. Further validation and measures to improve quality and completeness are warranted. Trial registrations This trial is registered as ISRCTN96479279, CAG: 20/CAG/0072, IRAS: 20/NE/0144. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR128533) and is published in full in Public Health Research; Vol. 12, No. 5. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Deborah Moore
- Division of Dentistry, The University of Manchester, Manchester, UK
| | | | - Thomas Allen
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Emily Lam
- Independent Patient and Public Engagement Representative
| | - Stephen Birch
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Martin Tickle
- Division of Dentistry, The University of Manchester, Manchester, UK
| | - Iain A Pretty
- Division of Dentistry, The University of Manchester, Manchester, UK
| | - Tanya Walsh
- Division of Dentistry, The University of Manchester, Manchester, UK
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Souza JAS, do Amaral JG, Monteiro DR, Fernandes RA, Fernandes GL, Gorup LF, de Souza Neto FN, de Camargo ER, Agostinho AM, Barbosa DB, Delbem ACB. 'Green' silver nanoparticles combined with tyrosol as potential oral antimicrobial therapy. J Dent 2024; 143:104867. [PMID: 38286192 DOI: 10.1016/j.jdent.2024.104867] [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: 11/17/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 01/31/2024] Open
Abstract
OBJECTIVES This study aimed to evaluate silver nanoparticles (AgNPs) obtained by a 'green' route associated or not to tyrosol (TYR) against Streptococcus mutans and Candida albicans in planktonic and biofilms states. METHODS AgNPs were obtained by a 'green' route using pomegranate extract. The minimum inhibitory concentration (MIC) against S. mutans and C. albicans was determined for AgNPs and TYR combined and alone, and fractional inhibitory concentration index (FICI) was calculated. Single biofilms of C. albicans and S. mutans were cultivated for 24 h and then treated with drugs alone or in combination for 24 h. RESULTS AgNPs and TYR were effective against C. albicans and S. mutans considering planktonic cells alone and combined. The MIC values obtained for C. albicans was 312.5 µg/mL (AgNPs) and 50 mM (TYR) and for S. mutans was 78.1 µg/mL (AgNPs) and 90 mM (TYR). The combination of these antimicrobial agents was also effective against both microorganisms: 2.44 µg/mL/0.08 mM (AgNPs/TYR) for C. albicans and 39.05 µg/mL /1.25 mM (AgNPs/TYR) for S. mutans. However, synergism was observed only for C. albicans (FICI 0.008). When biofilm was evaluated, a reduction of 4.62 log10 was observed for S. mutans biofilm cells treated with AgNPs (p < 0.05, Tukey test). However, the addition of TYR to AgNPs did not improve their action against biofilm cells (p > 0.05). AgNPs combined with TYR demonstrated a synergistic effect against C. albicans biofilms. CONCLUSIONS These findings suggest the potential use of AgNPs with or without TYR against C. albicans and S. mutans, important oral pathogens. CLINICAL SIGNIFICANCE AgNPs obtained by a 'green' route combined or not with TYR can be an alternative to develop several types of oral antimicrobial therapies and biomaterials.
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Affiliation(s)
- José Antonio Santos Souza
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Jackeline Gallo do Amaral
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Douglas Roberto Monteiro
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Renan Aparecido Fernandes
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Gabriela Lopes Fernandes
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Luiz Fernando Gorup
- Department of Chemistry, Federal University of São Carlos, São Carlos 13565-905, São Paulo, Brazil
| | | | | | | | - Debora Barros Barbosa
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil
| | - Alberto Carlos Botazzo Delbem
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araçatuba 16015-050, SP, Brazil.
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Hummel R, den Boer J, van der Heijden G, van der Sanden W, Bruers J. Longitudinal patterns of provided oral healthcare services to Dutch young patients: An observational study. PLoS One 2024; 19:e0299470. [PMID: 38394277 PMCID: PMC10890770 DOI: 10.1371/journal.pone.0299470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 02/09/2024] [Indexed: 02/25/2024] Open
Abstract
General dental practitioners (GDPs) differ in the preventive and curative care they provide to their young patients. This may be related to variation in the caries risk of patients, but also to differing opinions among GDPs about 'proper care'. Longitudinal data offers the possibility to make care patterns of GDPs comparable and to reveal possible treatment variation between GDPs. GDPs who participated in this study delivered data on the oral healthcare services (OHS) they provided to young patients during the period 2013-2017. Subsequently, data from patients who received regular OHS for 4 to 5 years were used in the analyses. Based on this, longitudinal preventive and curative care patterns were distinguished. Patients were divided into 3 preventive care patterns: no prevention, occasional prevention, and regular prevention. Furthermore, 3 curative care patterns were distinguished: no curation, curation in 1 year, and curation in several years. These care patterns were then combined. In addition, patients were classified into caries risk categories based on the caries-related treatments they received over a 2-year period: low (no procedures), elevated (1 procedure), and high (2 or more procedures). The caries risk based on the first 2 years and the last 2 years in the dataset were combined into a longitudinal caries risk profile. The most frequent combined care pattern (35.8%) was no curation and occasional or regular prevention. The most common longitudinal caries risk profile was low at beginning and end (45.2%). Dental practices varied considerably in the distribution of curative and preventive care patterns. Thereby, no relationship was shown between curative care patterns and provided preventive care. There was also a large spread in the provided OHS within the various caries risk profiles. These diversities indicated treatment variation between GDPs, which is unwarranted if less or more care is provided than necessary.
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Affiliation(s)
- Riët Hummel
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Zilveren Kruis, Zeist, The Netherlands
| | - Joost den Boer
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- KNMT, Royal Dutch Dental Association, Utrecht, The Netherlands
| | - Geert van der Heijden
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wil van der Sanden
- Department of Dentistry—Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Josef Bruers
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- KNMT, Royal Dutch Dental Association, Utrecht, The Netherlands
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5
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Sibanda L, Ghotane SG, Bernabe E, Challacombe SJ, Pitts NB, Gallagher JE. Caries clusters at lesion-severity thresholds: A Sierra Leone case study. Community Dent Oral Epidemiol 2024; 52:76-83. [PMID: 37622680 DOI: 10.1111/cdoe.12903] [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: 11/15/2022] [Revised: 06/30/2023] [Accepted: 07/28/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVES Despite being almost entirely preventable, globally, dental caries is extremely prevalent. Moreover, dental caries will continue to present an even larger challenge for lower income countries, particularly those in the African context, as they transition to a more Western diet. Hence, epidemiological data providing insight into disease patterns and trends is critical to inform public health action. The purpose of this study was to examine dental caries clusters by caries detection threshold among 15-year-old adolescents in Sierra Leone, using data from the latest national survey, and to explore associated sociodemographic factors. METHODS This paper presents a secondary analysis of oral health data on 490 15-year-olds from the Sierra Leone national oral health survey of schoolchildren. Hierarchical cluster analysis of dental caries experience was conducted across all surfaces at four decay detection thresholds using the International Caries Detection and Assessment System (ICDAS) (clinical: ICDAS 2-6, cavitated: ICDAS 3-6, obvious: ICDAS 4-6 and extensive obvious: ICDAS 5-6 decay) across the four regions of Sierra Leone. Ordered logistic regression was used to estimate the association of sociodemographic factors with generated clusters relating to clinical and obvious decay experience. These are of both clinical and epidemiological relevance. RESULTS A 3-cluster decay pattern representing a 'low' to 'high' decay experience distribution was observed under each decay detection threshold across surfaces. For clinical decay (including visual enamel caries), 28.8% had low, 55.1% medium and 15.9% high caries status. In the adjusted model, the only significant risk factor across obvious and clinical decay thresholds was region, with adolescents outside the Western region more likely to experience decay. CONCLUSION This study suggests that adolescents in Sierra Leone fall into three distinct caries clusters: low, medium to high decay experience distribution, regardless of decay threshold. It reinforces the importance of recognizing dental caries detection thresholds and the use of contemporary epidemiological methodology. This suggests that adolescents outside the Western region are likely to have higher caries experience. The data also provides insight to the nature of adolescents in each cluster and should help to inform policy and planning of the integration of oral health into primary care and school systems.
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Affiliation(s)
- L Sibanda
- Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, Denmark Hill Campus, London, UK
- NHS England London Region, Wellington House, London, UK
| | - S G Ghotane
- Department of Women & Children's Health, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - E Bernabe
- Centre of Dental Public Health and Primary Care, Institute of Dentistry, Queen Mary University of London, London, UK
| | - S J Challacombe
- Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, Tower Wing, Guys Hospital, London, UK
| | - N B Pitts
- Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Oral, Clinical and Translational Sciences, King's College London, Tower Wing, Guys Hospital, London, UK
| | - J E Gallagher
- Faculty of Dentistry, Oral & Craniofacial Sciences, Centre for Host Microbiome Interactions, King's College London, Denmark Hill Campus, London, UK
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Moore D, Nyakutsikwa B, Allen T, Lam E, Birch S, Tickle M, Pretty IA, Walsh T. How effective and cost-effective is water fluoridation for adults and adolescents? The LOTUS 10-year retrospective cohort study. Community Dent Oral Epidemiol 2024. [PMID: 38191778 DOI: 10.1111/cdoe.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/10/2023] [Accepted: 11/19/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVE To pragmatically assess the clinical and cost-effectiveness of water fluoridation for preventing dental treatment and improving oral health in a contemporary population of adults and adolescents, using a natural experiment design. METHODS A 10-year retrospective cohort study (2010-2020) using routinely collected NHS dental treatment claims data. Participants were patients aged 12 years and over, attending NHS primary dental care services in England (17.8 million patients). Using recorded residential locations, individuals exposed to drinking water with an optimal fluoride concentration (≥0.7 mg F/L) were matched to non-exposed individuals using propensity scores. Number of NHS invasive dental treatments, DMFT and missing teeth were compared between groups using negative binomial regression. Total NHS dental treatment costs and cost per invasive dental treatment avoided were calculated. RESULTS Matching resulted in an analytical sample of 6.4 million patients. Predicted mean number of invasive NHS dental treatments (restorations 'fillings'/extractions) was 3% lower in the optimally fluoridated group (5.4) than the non-optimally fluoridated group (5.6) (IRR 0.969, 95% CI 0.967, 0.971). Predicted mean DMFT was 2% lower in the optimally fluoridated group (IRR 0.984, 95% CI 0.983, 0.985). There was no difference in the predicted mean number of missing teeth per person (IRR 1.001, 95% CI 0.999, 1.003) and no compelling evidence that water fluoridation reduced social inequalities in dental health. Optimal water fluoridation in England 2010-2020 was estimated to cost £10.30 per person (excludes initial set-up costs). NHS dental treatment costs for optimally fluoridated patients 2010-2020 were 5.5% lower, by £22.26 per person (95% CI -£21.43, -£23.09). CONCLUSIONS Receipt of optimal water fluoridation 2010-2020 resulted in very small positive health effects which may not be meaningful for individuals. Existing fluoridation programmes in England produced a positive return on investment between 2010 and 2020 due to slightly lower NHS dental care utilization. This return should be evaluated against the projected costs and lifespan of any proposed capital investment in water fluoridation, including new programmes.
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Affiliation(s)
- Deborah Moore
- Faculty of Biology, Medicine and Health, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Blessing Nyakutsikwa
- Faculty of Biology, Medicine and Health, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Thomas Allen
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | | | - Stephen Birch
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Martin Tickle
- Faculty of Biology, Medicine and Health, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Iain A Pretty
- Faculty of Biology, Medicine and Health, Division of Dentistry, The University of Manchester, Manchester, UK
| | - Tanya Walsh
- Faculty of Biology, Medicine and Health, Division of Dentistry, The University of Manchester, Manchester, UK
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7
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Javed K, Nasir MZ, Jalees M, Manzoor MA. Role of diet and dietary habits in causing dental caries among adults reporting to a tertiary care hospital in Pakistan; a case-control study. Heliyon 2023; 9:e23117. [PMID: 38144297 PMCID: PMC10746458 DOI: 10.1016/j.heliyon.2023.e23117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/21/2023] [Accepted: 11/27/2023] [Indexed: 12/26/2023] Open
Abstract
Objective To determine the association of diet and dietary practices with dental caries among adults. Design A case-control study. Setting Operative Department, Rawal Institute of Health Sciences, Islamabad, Pakistan. Participants 300 participants of both genders, aged 25-50 years. Interventions A food frequency questionnaire and a patient proforma were used to determine the frequency and preferences of diet and dietary habits that may be associated with dental caries among adults, respectively. The diet and dietary habits of 150 adults with caries (cases) were compared with those of 150 adults without dental caries (control). An independent sample T-test was applied to determine the difference in mean age. Mann-Whitney and Chi-Square tests were applied to determine the significance of diet and dietary habits respectively. Multivariate logistic regression analysis determined the odd ratio change in significant variables. P-value ≤0.05 was considered significant. Results Refined sugar (p-value = 0.69), fruit juices (p-value = 0.45), carbonated beverages (p-value = 0.91), duration of consumption of sugary food (p-value = 0.07), and frequency of brushing (p-value = 0.15) were not found to be significantly associated with dental caries in adults. The gender (p-value = 0.02), preferred time for eating sugary foods (p-value <0.001), smoking (p-value <0.001), and tea consumption (p-value = 0.02) were found to be significantly associated with dental caries. Conclusion Adults who regularly consumed sugar as a snack other than regular mealtimes were more likely to be associated with dental caries. Men, smokers, and adults who frequently took shots of sugar with their tea were more likely to be associated with dental caries.
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Affiliation(s)
- Kiran Javed
- Rawal Institute of Health Sciences, Islamabad, Pakistan
| | | | - Maham Jalees
- Rawal Institute of Health Sciences, Islamabad, Pakistan
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Flink H, Hedenbjörk-Lager A, Liljeström S, Nohlert E, Tegelberg Å. Identification of caries-active individuals in longitudinal data a methodological study using a national registry. Acta Odontol Scand 2023:1-6. [PMID: 37831434 DOI: 10.1080/00016357.2023.2265474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 09/27/2023] [Indexed: 10/14/2023]
Abstract
OBJECTIVE The aim was to identify caries active individuals among adults by using a trajectory model of longitudinal data from the Swedish national registry (SKaPa) and comparing them with published data from the Dunedin cohort. MATERIALS AND METHODS Data from two different age groups (30- and 40-year-olds) followed for 10 years were retrieved from SKaPa and were compared with published longitudinal birth-cohort data from the Dunedin study. Using the trajectory model, the subjects were divided into three different trajectories according to their caries development over time (i.e. high, 15%; moderate, 45%; low, 40%). RESULTS Caries experience, as measured by mean decayed, missing, and filled surfaces (DMFS) index, revealed significant differences among the three trajectories in both age groups. The patterns were similar to those observed in the Dunedin cohort. The mean increase in DMFS during the 10-year follow-up period from SKaPa was significantly higher for the high trajectories in both age groups compared with the moderate and low trajectories. CONCLUSIONS The method using three trajectories for presentation of caries experience over time, may be a useful tool to identify subjects with different disease activities. Identification of subjects in the high caries experience trajectory may increase the possibility to explore and evaluate more effective caries prevention for this group in the future.
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Affiliation(s)
- Håkan Flink
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Simon Liljeström
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden
| | - Eva Nohlert
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden
| | - Åke Tegelberg
- Region Vastmanland, Uppsala University, Centre for Clinical Research, Vastmanland Hospital Vasteras, Vasteras, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
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Fagbule OF, Emenyonu UK, Idiga E, Oni OO, Ijarogbe OA, Osuh ME, Lawal FB, Owoaje TO, Ibiyemi O. Using traditional rhyme (folk song) as a tool for oral hygiene promotion (UTRATOHP) among children in rural communities in Nigeria: A protocol for a randomised controlled trial. PLoS One 2023; 18:e0280856. [PMID: 37267257 DOI: 10.1371/journal.pone.0280856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 05/09/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Most oral diseases are caused by poor oral hygiene, and with adequate oral hygiene measures, they are easily preventable. The use of folk songs to deliver oral health education may likely hold a huge potential for success and an increased likelihood of acceptability and sustainability among school children. Therefore, an investigation into the effectiveness of methods that would be culturally appropriate and sustainable, such as folk songs, is essential. AIM To determine the effect of traditional rhyme (folk song) as a tool for oral hygiene education among children in rural communities in Nigeria. MATERIALS AND METHODS This is a school-based, assessor-blinded, two-arm cluster-randomised controlled trial that will assess the effectiveness of oral hygiene messages delivered through traditional rhyme (folk song) on children's oral hygiene knowledge, attitude, practices, and oral hygiene status in two rural communities (Igboora and Idere) in Nigeria. The study will involve a minimum of 424 participants (aged 7-9 years) selected from eight primary schools using the cluster sampling technique. Four schools will be randomised into the test group to receive oral hygiene messages through folk songs, and the participants will sing the song for two weeks. The other four schools will be assigned to the control group, and the participants will receive the usual oral health talk on oral hygiene practices by a dentist. The participants' oral hygiene knowledge, attitude, practice and status will be assessed at baseline, immediate, six, and twelve-month post-intervention. A modified World Health Organization (WHO) Children's oral health survey questionnaire will be utilised for data collection. Oral examinations will be conducted to assess the participants' dental caries experience and oral hygiene status using the dmft/DMFT and simplified oral hygiene indices, respectively. DISCUSSION Folk songs are popular means of conveying messages in Nigeria, and using them to deliver oral health messages may be an effective, acceptable, and sustainable method among children. This study will provide empirical information about this innovative intervention to guide policy development, dental public health practice, and future studies. TRIAL REGISTRATION Pan African Clinical Trial Registry-PACTR202010863892797 (October 2020).
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Affiliation(s)
- Omotayo Francis Fagbule
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria
- Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Urenna Karen Emenyonu
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Ejiro Idiga
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Olubunmi Oluseun Oni
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria
| | - Olabode Adeyemi Ijarogbe
- Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Akoka, Lagos State, Nigeria
| | - Mary Ebelechukwu Osuh
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria
- Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Folake Barakat Lawal
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria
- Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
| | | | - Olushola Ibiyemi
- Department of Periodontology and Community Dentistry, University College Hospital, Ibadan, Oyo State, Nigeria
- Department of Periodontology and Community Dentistry, Faculty of Dentistry, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria
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Ruiz B, Broadbent JM, Thomson WM, Ramrakha S, Hong CL, Poulton R. Differential Unmet Needs and Experience of Restorative Dental Care in Trajectories of Dental Caries Experience: A Birth Cohort Study. Caries Res 2023; 57:524-535. [PMID: 37231938 DOI: 10.1159/000530378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/13/2023] [Indexed: 05/27/2023] Open
Abstract
Dental caries is a chronic and cumulative disease but little has been reported on the continuity of the disease and its treatment through life. Group-based multi-trajectory modeling was used to identify developmental trajectories of untreated carious tooth surfaces (DS), restored tooth surfaces (FS), and teeth extracted due to caries (MT) from ages 9 to 45 years in a New Zealand longitudinal birth cohort, the Dunedin Multidisciplinary Health and Development Study (n = 975). Associations between early-life risk factors and trajectory group membership were examined by specifying the probability of group membership according to a multinomial logit model. Six trajectory groups were identified and labeled: "low caries rate"; "moderate caries rate, maintained"; "moderate caries rate, unmaintained"; "high caries rate, restored"; "high caries rate, tooth loss"; and "high caries rate, untreated caries". The two moderate-caries-rate groups differed in count of FS. The three high-caries-rate groups differed in the relative proportion of accumulated DS, FS, and MT. Early childhood risk factors associated with less favorable trajectories included higher dmfs scores at age 5, lack of exposure to community water fluoridation during the first 5 years of life, lower childhood IQ, and low childhood socioeconomic status. Parent self-ratings of their own or their child's oral health as "poor" were associated with less favorable caries experience trajectories. Children who had clinical signs of dental caries together with a parent rating of child's oral health as poor were more likely to follow a less favorable caries trajectory. Higher deciduous dentition caries experience at age 5 years was associated with less favorable caries trajectories, as were children whose parents gave "poor" ratings of their own or their child's oral health. These findings highlight the considerable intergenerational continuity in dental caries experience from early childhood to midlife. Subjective measures of child oral health are informative and might aid as predictors of adult caries experience in cases where childhood dental clinical data were not available.
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Affiliation(s)
- Begoña Ruiz
- Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Jonathan M Broadbent
- Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W Murray Thomson
- Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Chuen Lin Hong
- Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
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11
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Poulton R, Guiney H, Ramrakha S, Moffitt TE. The Dunedin study after half a century: reflections on the past, and course for the future. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2114508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Hayley Guiney
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Terrie E. Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, NC, USA
- SGDP Centre, Kings College London, London, UK
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12
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Lawal FB, Fagbule OF, Lawal TA, Oke GA. “Oral health as an important milieu for social and mental health”: Perspectives of adolescents emerging from a qualitative study. FRONTIERS IN ORAL HEALTH 2022; 3:879144. [PMID: 36060114 PMCID: PMC9433566 DOI: 10.3389/froh.2022.879144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background Recent evidence showed that the prevalence of oral diseases is still high among adolescents in many developing countries, including Nigeria. It therefore has becomes pertinent to focus on appropriate oral health interventions to promote oral health among them. This necessitates investigating the perspectives of adolescents, who are the major stakeholders, on the importance of oral health as baseline data needed in planning appropriate primary interventions. Aim The aim of the study was to explore the perspectives of adolescents on the importance of oral health. Methods An explorative qualitative study was conducted among adolescents attending senior secondary school I (grade 10) in the metropolis of Ibadan, Nigeria. A total of 12 focus group discussions were conducted among 120 adolescents aged 14 to 19 years. The discussions were transcribed verbatim, and triangulation and organization, as well as thematic analysis, of data were carried out. Results Some adolescents had positive perceptions of oral health and valued it as highly important, although some had contrary views and believed oral health was unimportant. Oral health is described as being integral to general health, is associated with eating and communication, is a means of survival and confidence building, and is a prelude to attract the opposite gender. Adolescents perceived the need for oral health education and dental treatment. Conclusion Adolescents have mixed perspectives on the importance of oral health; while some valued it as highly important, others believed it was of no significance. Those who valued oral health as important described it as a milieu for general health, human survival, and social and mental health and thus requested for oral health promotion in schools.
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Affiliation(s)
- Folake Barakat Lawal
- Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
- Fellow of the Consortium for Advanced Research Training in Africa, African Population and Health Research Center (APHRC), Nairobi, Kenya
- *Correspondence: Folake Barakat Lawal
| | - Omotayo Francis Fagbule
- Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Taiwo Akeem Lawal
- Division of Paediatric Surgery, Department of Surgery, University of Ibadan and University College Hospital, Ibadan, Nigeria
| | - Gbemisola Aderemi Oke
- Department of Periodontology and Community Dentistry, University of Ibadan and University College Hospital, Ibadan, Nigeria
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13
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Factors Affecting Dental Caries Experience in 12-Year-Olds, Based on Data from Two Polish Provinces. Nutrients 2022; 14:nu14091948. [PMID: 35565915 PMCID: PMC9104912 DOI: 10.3390/nu14091948] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 12/22/2022] Open
Abstract
(1) Background: Dental caries is a chronic disease that affects a child’s dentition from the first stages of life. Several factors contribute to the development of the disease, including an improper diet. This cross-sectional study aimed to identify risk factors of dental caries in 12-year-old adolescents from Greater Poland and Lubusz Provinces (Poland). (2) Material and methods: The research was conducted in adolescents from five primary schools. A questionnaire consisted of close-ended questions on socioeconomic characteristics on family, diet, and oral hygiene habits. An assessment of the dentition was carried out in accordance with World Health Organization (WHO) recommendations. In addition to cavitated carious lesions, incipient caries lesions were noted according to the International Caries Detection and Assessment System, adapted for epidemiological studies (ICDASepiDMFt). (3) Results: The mean number of teeth with untreated caries; removed due to caries; and restored because of caries (DMFt) was 1.52 ± 1.90, while the ICDASepiDMFt index amounted to 2.64 ± 2.55, respectively. Children who did not brush every day had significantly higher odds of having ICDASepiDMFt > 0 than children brushing at least once daily (OR = 10.32, 95% CI = 1.36−78.32, p = 0.0240). Adolescents who drank sweet carbonated drinks every day had significantly higher ICDASepiDMTt than children who drank sweet carbonated drinks less frequently (p = 0.0477). (4) Conclusions: The research revealed that dental caries indices of 12-year-old adolescents from Greater Poland and Lubusz Provinces depend mainly on oral hygiene behaviors. The only significant nutritional factor that differentiated the caries intensity was the daily consumption of sweet carbonated drinks.
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14
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Ruiz B, Broadbent JM, Thomson WM, Ramrakha S, Boden J, John Horwood L, Poulton R. Childhood caries experience in two Aotearoa New Zealand birth cohorts: implications for research, policy and practice. J R Soc N Z 2022. [DOI: 10.1080/03036758.2022.2061018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Begoña Ruiz
- Sir John Walsh Research Institute, Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Jonathan M. Broadbent
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - W. Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Sandhya Ramrakha
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
| | - Joe Boden
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - L. John Horwood
- Christchurch Health and Development Study, Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, Division of Sciences, University of Otago, Dunedin, New Zealand
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15
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Gougeon K, Yasukawa K, Baudet A. Barodontalgia and Dental Barotrauma Among Scuba Divers. Aerosp Med Hum Perform 2022; 93:539. [PMID: 35551726 DOI: 10.3357/amhp.6045.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
INTRODUCTION: Barometric pressure variation during dives may induce barodontalgia and barotrauma. Barodontalgia refers to oral pain resulting from a change in ambient pressure. The aim of this study was to investigate the occurrence of barodontalgia and dental barotrauma among French civilian scuba divers.METHODS: A nationwide cross-sectional internet-based survey was conducted among French scuba divers over 18 yr of age registered by the French Federation of Underwater Sports (FFESSM). The online questionnaire was distributed from October to December 2020. It contained questions regarding general characteristics of participants, barodontalgia and dental barotrauma occurrences, and relationship of the diver with his/her dentist.RESULTS: There were 684 scuba divers (65.4% men; aged 48 ± 12 yr) who participated in the study. Barodontalgia was reported by 18.7%, with some respondents reporting more than one episode. Most barodontalgia affected posterior (81.2%) and upper teeth (55.2%) with dental filling (50.0%). At least one dental barotrauma was reported by 10.1% of respondents, including mainly loss or fracture of a dental filling (4.2%). The occurrence of dental barotrauma was significantly higher among men (12.3%) than women (5.9%) and increased significantly with the age, the years of diving and the diving qualification.CONCLUSION: Information should be provided to divers on the importance of routine dental checkups.Kougeon K, Yasukawa K, Baudet A. Barodontalgia and dental barotrauma among scuba divers. Aerosp Med Hum Perform. 2022; 93(5):421-425.
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Affiliation(s)
| | | | - Alexandre Baudet
- Université de Lorraine, Faculté d’odontologie, F-54505 Vandœuvre-lès-Nancy, France
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16
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Donnell CC, Johnston MJ, Foley JI. The Six-Year-Old 'Adult'. Prim Dent J 2022; 10:74-82. [PMID: 35088635 DOI: 10.1177/20501684211065326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children are not miniature adults, yet when a child celebrates their sixth birthday, little do they know that, with the arrival of their first 'adult' tooth, they are about to gain their first real experience of being a 'grown-up'. The age of six is a key milestone in the mental, physical and emotional wellbeing of children, with most children in the UK having commenced primary school education by their fifth birthday. Six-year-olds are about to enter the most critical period in their dental development, the mixed-dentition phase, where their mouths are in a near continuous state of flux. This pivotal age in their dental development should not be undervalued; the dental decisions we make at this age means childhood lasts a lifetime. Caries is the most prevalent, preventable global disease, and with one in four children suffering from dental caries in the primary dentition by the time they start school, the foundations we lay down at the age of six translate into lifelong benefits for the permanent dentition. In this paper, the aim is to demonstrate that at the age of six we get a second chance to get things right. From caries risk factors and tailoring the five pillars of prevention by educating parents on the developing dentition, to reinforcing the importance of habit-breaking, developmental anomalies of enamel and early orthodontic intervention, this paper describes the importance of the age of six, never before so exclusively expressed in a dental sense.
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Affiliation(s)
- Christopher C Donnell
- Specialty Registrar in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Matthew J Johnston
- Dental Core Trainee, Oral and Maxillofacial Surgery, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Jennifer I Foley
- Deputy Director / Honorary Consultant in Paediatric Dentistry Edinburgh Dental Institute; Senior Clinical Lecturer in Paediatric Dentistry, University of Edinburgh, Edinburgh, UK
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17
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Morelli E, Broadbent J, Knight E, Leichter J, Thomson W. Does having children affect women's oral health? A longitudinal study. J Public Health Dent 2022; 82:31-39. [PMID: 34124780 PMCID: PMC8669016 DOI: 10.1111/jphd.12466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 05/16/2021] [Accepted: 06/02/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Many believe women's oral health deteriorates as a result of having children. If so, such associations should exist among women but not among men. The aims of this study were to investigate whether number of children is associated with experience of dental disease and tooth loss among both men and women and to examine whether this association is affected by other variables of interest. METHODS This study used data from the Dunedin Multidisciplinary Health and Development study, a longitudinal study of 1037 individuals (48.4% female) born from April 1972 to March 1973 in Dunedin, New Zealand, who have been examined repeatedly from birth to age 45 years. RESULTS Data were available for 437 women and 431 men. Those with low educational attainment were more likely to have more children and began having children earlier in life. Having more children was associated with experiencing more dental caries and tooth loss by age 45, but this association was dependent on the age at which the children were had. Those entering parenthood earlier in life (by age 26) had poorer dental health than those entering parenthood later in life, or those without children. There was no association between number of children and periodontal attachment loss (PAL). Low educational attainment, poor plaque control, never routine dental attendance, and smoking (for PAL) were associated with PAL, caries experience, and tooth loss. CONCLUSIONS Social factors associated with both the timing of reproductive patterns and health behaviors influence the risk of dental disease and its management.
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Affiliation(s)
- E. Morelli
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - J.M. Broadbent
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - E. Knight
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - J. Leichter
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
| | - W.M. Thomson
- University of Otago – Sir John Walsh Research Institute, Dunedin, New Zealand
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18
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Hummel R, van der Sanden W, Bruers J, van der Heijden G. The relationship between claimed restorations and future restorations in children and adolescents: An observational follow-up study on risk categories for dental caries. PLoS One 2021; 16:e0259495. [PMID: 34767565 PMCID: PMC8589182 DOI: 10.1371/journal.pone.0259495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 10/20/2021] [Indexed: 11/25/2022] Open
Abstract
Various models are available to assess caries risk in individuals. In general past caries experience is considered as the best single predictor for future caries development in populations. Likewise, recent restorations have been used to predict future restorations. We aimed to evaluate a classification model for risk categories for dental caries in children based on claims data from Dutch healthcare insurance company Zilveren Kruis. The baseline caries risk categories were derived from the number of claimed restorations in two baseline years (2010 through 2011). These categories were defined as low (no new restorations), moderate (1 new restoration), and high (2 or more new restorations). First, we analyzed the relationship between baseline caries risk categories and the number of new restorations during 3 years of follow-up (2012 through 2014). Secondly, we used negative binominal two-level analyses to determine the accuracy of our classification model in predicting new restorations during follow-up. Thirdly, we reclassified the participants after 3 years and determined the changes in the categorization. We included insurance claims data for the oral healthcare services in 28,305 children and adolescents from 334 dental practices for the period 2010–2014. At baseline, 68% of the participants were in risk category low, 13% in moderate and 19% in high. The mean number of new restorations during follow-up was 0.81 (SD 1.72) in baseline risk category low, 1.61 (SD 2.35) in moderate, and 2.65 (SD 3.32) in high. The accuracy of the multivariate model for predicting 0/>0 restorations was 50%. After 3 years, 60% of the study participants were in the same risk category, 20% were in a lower, and 21% in a higher risk category. Risk categories based on claimed restorations were related to the number of new restorations in groups. As such, they could support planning and evaluation of oral healthcare services.
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Affiliation(s)
- Riët Hummel
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Zilveren Kruis Achmea, Zeist, The Netherlands
- * E-mail:
| | - Wil van der Sanden
- Department of Dentistry, Quality and Safety of Oral Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Josef Bruers
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- KNMT, Royal Dutch Dental Association, Utrecht, The Netherlands
| | - Geert van der Heijden
- Department of Oral Public Health (OPH), Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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19
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Parents' Willingness to Invest in Primary Oral Health Prevention for Their Preschool Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111437. [PMID: 34769953 PMCID: PMC8582652 DOI: 10.3390/ijerph182111437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/21/2021] [Accepted: 10/26/2021] [Indexed: 11/17/2022]
Abstract
There is growing evidence for the beneficial effects of starting oral health prevention early in life. Preventing dental caries in very young children requires considerable investment from parents. Therefore, this cross-sectional study aimed to explore parents' willingness to pay (WTP) and willingness to invest in time (WTIT) for primary oral health prevention in preschool children and describe whether these are related to the parents' demographic, socio-economic and behavioural characteristics. In a convenience sample of parents of preschool children aged six months to four years (n = 142), data were collected with questionnaires. On average, parents were willing to pay EUR15.84 per month, invest time for 1.9 dental visits per year, and spend 2.4 min per day brushing their child's teeth. A higher education level of the mother and having a child older than two were associated with a higher WTIT in brushing minutes per day (p = 0.03). In addition, parents who brushed their child's teeth more frequently were also more willing to invest in brushing minutes (p < 0.01) and money (p < 0.01). Findings emphasise the importance of early oral health interventions and the need to increase awareness of primary prevention's importance in maintaining healthy teeth and reducing possibly oral health inequalities.
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20
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Su N, Lagerweij MD, van der Heijden GJMG. Assessment of predictive performance of caries risk assessment models based on a systematic review and meta-analysis. J Dent 2021; 110:103664. [PMID: 33984413 DOI: 10.1016/j.jdent.2021.103664] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/05/2021] [Accepted: 04/09/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES To assess the predictive performance of caries risk assessment (CRA) models for prediction of caries increment for individuals based on a systematic review and meta-analyses. DATA/SOURCES We included external validation studies assessing the predictive performance of CRA models for prediction of caries increment for individuals, using discrimination and calibration as the outcome parameters. PubMed, EMBASE, and CINAHL were searched electronically on 10th September 2020 to identify prediction modeling studies on external validation of CRA models. The risk of bias of the included studies was assessed using the Prediction model Risk Of Bias ASsessment Tool (PROBAST). STUDY SELECTION A total of 22 studies with seven different CRA models were included. As for full Cariogram, the pooled area under the receiver operating characteristic curve (AUC) was 0.78 (95 %CI: 0.68; 0.85) based on eight studies regardless of the risk of bias levels, and 0.82 (95 %CI: 0.58; 0.93) based on four studies with low risk of bias only. The pooled observed: expected ratio (O:E ratio) of full Cariogram was 0.91 (95 %CI: 0.72; 1.14) based on 12 studies regardless of the risk of bias levels, and 0.89 (95 %CI: 0.71; 1.12) based on five studies with low risk of bias only. As for reduced Cariogram, the pooled AUC was 0.72 (95 %CI: 0.67; 0.77) based on six studies regardless of the risk of bias levels, and 0.74 (95 %CI: 0.45; 0.91) based on two studies with low risk of bias only. The pooled O:E ratio of reduced Cariogram was 0.84 (95 %CI: 0.59; 1.18) based on six studies regardless of the risk of bias levels, and 1.05 (95 %CI: 0.43; 2.59) based on two studies with low risk of bias only. Based on an insufficient number of studies for the other CRA models, the pooled AUCs ranged from 0.50 to 0.88, while the pooled O:E ratio ranged from 0.38 to 1.00. CONCLUSION The average predictive performance of both full and reduced Cariogram seems to be acceptable. However, the evidence from research does not allow a firm conclusion on the performance of the other included CRA models, due to the insufficient number of high-quality studies. CLINICAL SIGNIFICANCE Both full and reduced Cariogram were found to be reliable CRA models for prediction of caries increment in clinical practices for dental patients and communities for general populations. The reduced Cariogram showed better predictive performance and less burden in terms of time and resources to individuals than the full Cariogram. Therefore, the reduced Cariogram could be more recommended than the full Cariogram.
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Affiliation(s)
- Naichuan Su
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amasterdam and VU University, the Netherlands.
| | - Maxim D Lagerweij
- Department of Cariology, Endodontology and Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amasterdam and VU University, the Netherlands
| | - Geert J M G van der Heijden
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amasterdam and VU University, the Netherlands
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21
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Stona P, Kramer PF, Vargas-Ferreira F, Amorim LMD, Coelho EMDRB, Feldens CA. Socioeconomic and intraoral polarization of untreated caries and tooth loss among male adolescents. Braz Oral Res 2021; 35:e031. [PMID: 33729276 DOI: 10.1590/1807-3107bor-2021.vol35.0031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 10/22/2020] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to investigate the intraoral distribution of untreated caries and tooth loss and estimate the impact of different socioeconomic factors on the occurrence of these outcomes. A cross-sectional study was conducted with 652 18-year-old male adolescents from the city of Sapucaia do Sul, Brazil, who conscripted for military service. The participants answered a questionnaire addressing sociodemographic variables. Two trained and calibrated examiners performed the clinical examinations for the diagnosis of dental caries using the criteria of the World Health Organization. Tooth group and adolescent were the units of analysis for the primary outcomes of the study. Poisson regression analysis with robust variance was performed, with the calculation of crude and adjusted prevalence ratios (PR) and 95% confidence intervals (CI). The prevalence of caries experience and untreated caries was 70.2% and 39.3%, respectively, and 9.4% of the adolescents had missing teeth. Sixty-seven percent of the untreated caries and 98.8% of missing teeth were in first molars. The probability of dental caries and tooth loss was significantly higher among adolescents with less schooling (PR = 2.56; 95%CI: 1.97-3.32 and PR = 3.28; 95%CI: 1.61-6.65, respectively) and those whose mothers had less schooling (PR = 1.31; 95%CI: 1.03-1.67 and PR = 2.30; 95%CI: 1.18-4.50, respectively). In conclusion, the occurrence of untreated dental caries and tooth loss was concentrated in the first molars of adolescents. Moreover, the prevalence of both conditions was higher among adolescents with low schooling and whose mothers had low schooling, reflecting the strong intraoral and socioeconomic polarization of these outcomes.
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Affiliation(s)
- Priscila Stona
- Faculdade da Serra Gaúcha - FSG, School of Dentistry, Department of Pediatric Dentistry. Caxias do Sul, RS, Brazil
| | - Paulo Floriani Kramer
- Universidade Luterana do Brasil - Ulbra, School of Dentistry, Department of Pediatric Dentistry. Porto Alegre, RS, Brazil
| | - Fabiana Vargas-Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry. Belo Horizonte, MG, Brazil
| | - Lívia Mund de Amorim
- Universidade Luterana do Brasil - Ulbra, School of Dentistry, Department of Pediatric Dentistry. Porto Alegre, RS, Brazil
| | | | - Carlos Alberto Feldens
- Universidade Luterana do Brasil - Ulbra, School of Dentistry, Department of Pediatric Dentistry. Porto Alegre, RS, Brazil
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22
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Reasons for Permanent Teeth Extractions and Related Factors among Adult Patients in the Eastern Province of Saudi Arabia. ScientificWorldJournal 2021; 2021:5534455. [PMID: 33688305 PMCID: PMC7920728 DOI: 10.1155/2021/5534455] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/22/2021] [Accepted: 02/10/2021] [Indexed: 12/17/2022] Open
Abstract
Objective To evaluate the reasons for permanent teeth extractions and related factors among adult patients visiting dental clinics in the Eastern Province of Saudi Arabia. Materials and Methods This retrospective cross-sectional study included data of patients who underwent teeth extractions. Data were collected from public and private dental clinics in different cities of the Eastern Province of Saudi Arabia (January-March 2020). The demographic information of patients and their reasons for teeth extractions were obtained from participating dentists. Results The study included data of 696 patients with 55.9% of males and 44.1% of females. The mean number of teeth extractions in the sample was 1.86 ± 1.8, and it increased significantly with advancing age (P ≤ 0.001). Saudi (1.97 ± 1.98) versus non-Saudi patients (1.55 ± 1.11) (P=0.02) and patients in public practice (2.03 ± 1.95) versus patients in private practice (1.50 ± 1.38) (P ≤ 0.001) showed significantly higher teeth extractions. Dental caries was the most common reason for teeth extractions (49.1%), followed by remaining roots (18.5%), periodontal disease (18.4%), and impactions (7.2%). Most commonly extracted teeth included tooth # 30 (9.8%), followed by tooth #16 (9.6%), tooth # 1 (8.8%), tooth # 19 (8.3%), and tooth # 4 (8.3%). On the other hand, upper incisors were the least commonly extracted teeth. Conclusions Dental caries, remaining roots, periodontal disease, and impactions were the most common reasons for teeth extractions in our sample of patients. The extractions increased significantly with increasing age. Saudis and patients in public clinics underwent significantly higher teeth extractions. Measures aimed at the prevention and treatment of oral conditions can help reduce teeth extractions and improve the quality of life of patients.
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Moore D, Allen T, Birch S, Tickle M, Walsh T, Pretty IA. How effective and cost-effective is water fluoridation for adults? Protocol for a 10-year retrospective cohort study. BDJ Open 2021; 7:3. [PMID: 33479223 PMCID: PMC7820470 DOI: 10.1038/s41405-021-00062-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Tooth decay can cause pain, sleepless nights and loss of productive workdays. Fluoridation of drinking water was identified in the 1940s as a cost-effective method of prevention. In the mid-1970s, fluoride toothpastes became widely available. Since then, in high-income countries the prevalence of tooth decay in children has reduced whilst natural tooth retention in older age groups has increased. Most water fluoridation research was carried out before these dramatic changes in fluoride availability and oral health. Furthermore, there is a paucity of evidence in adults. The aim of this study is to assess the clinical and cost-effectiveness of water fluoridation in preventing invasive dental treatment in adults and adolescents aged over 12. METHODS/DESIGN Retrospective cohort study using 10 years of routinely available dental treatment data. Individuals exposed to water fluoridation will be identified by sampled water fluoride concentration linked to place of residence. Outcomes will be based on the number of invasive dental treatments received per participant (fillings, extractions, root canal treatments). A generalised linear model with clustering by local authority area will be used for analysis. The model will include area level propensity scores and individual-level covariates. The economic evaluation will focus on (1) cost-effectiveness as assessed by the water fluoridation mean cost per invasive treatment avoided and (2) a return on investment from the public sector perspective, capturing the change in cost of dental service utilisation resulting from investment in water fluoridation. DISCUSSIONS There is a well-recognised need for contemporary evidence regarding the effectiveness and cost-effectiveness of water fluoridation, particularly for adults. The absence of such evidence for all age groups may lead to an underestimation of the potential benefits of a population-wide, rather than targeted, fluoride delivery programme. This study will utilise a pragmatic design to address the information needs of policy makers in a timely manner.
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Affiliation(s)
- Deborah Moore
- grid.5379.80000000121662407Dental Public Health, Division of Dentistry, Dental Health Unit, The University of Manchester, Lloyd Street North Manchester Science Park, Manchester, M15 6SE UK
| | - Thomas Allen
- Director, Centre for the Business and Economics of Health, University of Queensland, St Lucia, Queensland, 4072 UK
| | - Stephen Birch
- Director, Centre for the Business and Economics of Health, University of Queensland, St Lucia, Queensland, 4072 UK ,grid.5379.80000000121662407Health Economics, Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building Oxford Road, Manchester, M13 9PL UK
| | - Martin Tickle
- grid.5379.80000000121662407Dental Public Health & Primary Care, Division of Dentistry, The University of Manchester, Coupland 3, Manchester, M13 9PL UK
| | - Tanya Walsh
- grid.5379.80000000121662407Healthcare Evaluation, Division of Dentistry, The University of Manchester, Coupland 3, Manchester, M139PL UK
| | - Iain A. Pretty
- grid.5379.80000000121662407Public Health Dentistry, Division of Dentistry, Dental Health Unit, The University of Manchester, Lloyd Street North Manchester Science Park, Manchester, M15 6SE UK
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Abstract
This paper concerns the assessment of the current state of dentistry in the world and the prospects of its sustainable development. A traditional Chinese censer was adopted as the pattern, with a strong and stable support on three legs. The dominant diseases of the oral cavity are caries and periodontal diseases, with the inevitable consequence of toothlessness. From the caries 3.5–5 billion people suffer. Moreover, each of these diseases has a wide influence on the development of systemic complications. The territorial range of these diseases and their significant differentiation in severity in different countries and their impact on disability-adjusted life years index are presented (DALY). Edentulousness has a significant impact on the oral health-related quality of life (OHRQoL). The etiology of these diseases is presented, as well as the preventive and therapeutic strategies undertaken as a result of modifying the Deming circle through the fives’ rules idea. The state of development of Dentistry 4.0 is an element of the current stage of the industrial revolution Industry 4.0 and the great achievements of modern dental engineering. Dental treatment examples from the authors’ own clinical practice are given. The systemic safety of a huge number of dentists in the world is discussed, in place of the passive strategy of using more and more advanced personal protective equipment (PPE), introducing our own strategy for the active prevention of the spread of pathogenic microorganisms, including SARS-CoV-2. The ethical aspects of dentists’ activity towards their own patients and the ethical obligations of the dentist community towards society are discussed in detail. This paper is a polemic arguing against the view presented by a group of eminent specialists in the middle of last year in The Lancet. It is impossible to disagree with these views when it comes to waiting for egalitarianism in dental care, increasing the scope of prevention and eliminating discrimination in this area on the basis of scarcity and poverty. The views on the discrimination of dentistry in relation to other branches of medicine are far more debatable. Therefore, relevant world statistics for other branches of medicine are presented. The authors of this paper do not agree with the thesis that interventional dental treatment can be replaced with properly implemented prophylaxis. The final remarks, therefore, present a discussion of the prospects for the development of dentistry based on three pillars, analogous to the traditional Chinese censer obtaining a stable balance thanks to its three legs. The Dentistry Sustainable Development (DSD) > 2020 model, consisting of Global Dental Prevention (GDP), Advanced Interventionist Dentistry 4.0 (AID 4.0), and Dentistry Safety System (DSS), is presented.
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Matsuyama Y, Isumi A, Doi S, Fujiwara T. Poor parenting behaviours and dental caries experience in 6- To 7-year-old children. Community Dent Oral Epidemiol 2020; 48:493-500. [PMID: 32750206 PMCID: PMC7689935 DOI: 10.1111/cdoe.12561] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/12/2020] [Accepted: 06/16/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVES The association between poor parenting and dental caries in children remains unclear. We investigated the association of poor parenting with dental caries and oral health behaviour among children aged 6-7 years in Japan. METHODS Two waves of repeated cross-sectional surveys on children and their caregivers in Adachi City, Tokyo, were analysed. Questionnaires on parenting behaviour and the child's oral health behaviour were distributed through schools and completed by 8499 caregivers (response rate = 80.8%). The number of decayed or filled primary teeth (dft) at school dental health check-ups was linked to the survey data (N for complete case analysis = 6309). Factor analysis was performed to identify types of poor parenting: poor involvement, child abuse and lack of supervision of a child's health behaviours. The association between factor scores (z-score), the number of dft and oral health behaviour (not brushing teeth twice a day, not controlling snack eating habits and drinking juice every day) was evaluated by Poisson's regressions adjusted for covariates, including caregiver's socioeconomic status. RESULTS Poor involvement and lack of supervision of a child's health behaviours were positively associated with dft (mean ratio, MR [95% confidence interval, CI] =1.05 [1.03, 1.07] and 1.18 [1.16, 1.21], respectively) and unhealthy oral health behaviours. Child abuse was not associated with dft (MR = 0.99 [0.96, 1.01]) but was associated with all three unhealthy oral health behaviours (prevalence ratio, PR [95% CI] were 1.11 [1.06, 1.16], 1.11 [1.06, 1.16] and 1.06 [1.00, 1.11] for not brushing teeth, not controlling snack eating and drinking juice, respectively). CONCLUSIONS Poor involvement and lack of supervision of a child's health behaviours were associated with dental caries, and any type of poor parenting was associated with poor oral health behaviour among children.
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Affiliation(s)
- Yusuke Matsuyama
- Department of Global Health PromotionTokyo Medical and Dental UniversityBunkyo‐kuTokyoJapan
| | - Aya Isumi
- Department of Global Health PromotionTokyo Medical and Dental UniversityBunkyo‐kuTokyoJapan
- Japan Society for the Promotion of ScienceChiyoda‐kuTokyoJapan
| | - Satomi Doi
- Department of Global Health PromotionTokyo Medical and Dental UniversityBunkyo‐kuTokyoJapan
- Japan Society for the Promotion of ScienceChiyoda‐kuTokyoJapan
| | - Takeo Fujiwara
- Department of Global Health PromotionTokyo Medical and Dental UniversityBunkyo‐kuTokyoJapan
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Madera M, Bernabé E. Estimating the prevalence of untreated caries in permanent teeth from the DMF index and lifetime caries prevalence. J Public Health Dent 2020; 81:143-149. [PMID: 33146408 DOI: 10.1111/jphd.12425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/14/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
AIM To derive formulas to estimate the prevalence of untreated dental caries in permanent teeth based on the DMF index and lifetime caries prevalence. METHODS Data from participants, aged 5 years or older, in the National Health and Nutrition Examination Survey 2011-2016 were analyzed. Dental caries was assessed at surface level with the Radike criteria, which matches the case definition of the Global Burden of Disease study. Participants' data were aggregated into 438 groups, based on survey strata and 5-year age brackets, to produce population estimates for the prevalence of untreated caries (DT > 0), DMFT, DMFS, DT, DS, and lifetime caries prevalence (DMFT>0). Conversion formulas were derived using fractional polynomials to characterize the association of each caries indicator with the prevalence of untreated caries. RESULTS The mean prevalence of untreated caries was 23.5 percent (SD: 12.9 percent, range: 1.0-72.3 percent). After adjustment for age, the prevalence of untreated caries was correlated with DMFT (r = 0.23), DMFS (r = 0.25), DT (r = 0.74), DS (r = 0.65) and lifetime caries prevalence (r = 0.18). Using fractional polynomial models adjusted for categorical age, the prevalence of untreated caries at population level could be estimated from DMFT with power 1 (linear form), DMFS with power 0.5, DT with power 0.5, DS with powers (0.5; 1) and lifetime caries prevalence with power 1. CONCLUSION The prevalence of untreated caries in permanent teeth can be estimated from the DMF index and lifetime caries prevalence. These conversion formulas can facilitate the inclusion of more studies in estimation of the global burden of untreated caries in permanent teeth.
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Affiliation(s)
- Meisser Madera
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.,Department of Research, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Abstract
Objectives To define an expert Delphi consensus on when to intervene in the caries process and existing carious lesions.Methods Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference.Results Lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations may be placed for form, function, aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated lesions which are cleansable. Cavitated lesions which are not cleansable usually require minimally invasive management. In specific circumstances, mixed interventions may be applicable. Occlusally, cavitated lesions confined to enamel/non-cavitated lesions extending radiographically into deep dentine may be exceptions. Proximally, cavitation is hard to assess tactile-visually. Most lesions extending radiographically into the middle/inner third of dentine are assumed to be cavitated. Those restricted to the enamel are not cavitated. For lesions extending radiographically into the outer third of dentine, cavitation is unlikely. These lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds.Conclusions Comprehensive diagnosis is the basis for systematic decision-making on when to intervene in the caries process and existing lesions.
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Tribst JPM, Dal Piva AMDO, de Jager N, Bottino MA, de Kok P, Kleverlaan CJ. Full-Crown Versus Endocrown Approach: A 3D-Analysis of Both Restorations and the Effect of Ferrule and Restoration Material. J Prosthodont 2020; 30:335-344. [PMID: 32856743 DOI: 10.1111/jopr.13244] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2020] [Indexed: 01/18/2023] Open
Abstract
PURPOSE To assess stress distribution in full-crowns with a composite buildup and endocrowns under axial or oblique loads, both with different ferrules (1 or 2 mm) and ceramic materials (glass ceramic or hybrid ceramic). MATERIALS AND METHODS Sixteen models were analyzed with finite element analysis. No-separation contacts were considered between restoration/resin cement and resin cement/tooth. The contact between the fixation cylinder and the root was considered perfectly bonded. The axial load was applied to the occlusal surface and the oblique load was applied to the buccal cusp. The resulting tensile stresses were shown for the crown, the cement layer and the tooth. RESULTS Almost all factors influenced the stress distribution significantly in the crown and the cement layer, as well as the tooth. The only exception was found under oblique loading by the restoration material and the type of crown that were of no significant influence on the stress distribution in the tooth. CONCLUSIONS Under axial load, the endocrown showed the least tensile stresses in the tooth, but under oblique loads, the full-crown showed less tensile stresses than the endocrown. With the hybrid ceramic material, lower stresses were found in the crown, but higher stresses were present in the cement layer. The 2 mm ferrule is beneficial for reducing the resulting tensile stresses in all modalities.
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Affiliation(s)
- João Paulo Mendes Tribst
- Department of Dental Materials and Prosthetics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil
| | - Amanda Maria de Oliveira Dal Piva
- Department of Dental Materials and Prosthetics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil
| | - Niek de Jager
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Marco Antonio Bottino
- Department of Dental Materials and Prosthetics, São Paulo State University (UNESP), Institute of Science and Technology, São José dos Campos, Brazil
| | - Paul de Kok
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Cornelis Johannes Kleverlaan
- Department of Dental Materials Science, Academic Centre for Dentistry Amsterdam (ACTA), Universiteit van Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
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Haukka A, Heikkinen AM, Haukka J, Kaila M. Oral health indices predict individualised recall interval. Clin Exp Dent Res 2020; 6:585-595. [PMID: 32776480 PMCID: PMC7745075 DOI: 10.1002/cre2.319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 06/18/2020] [Accepted: 06/20/2020] [Indexed: 01/22/2023] Open
Abstract
Objectives The individualised recall interval (IRI) is part of the oral health examination. This observational, register‐based study aimed to explore how oral health indices DMFT (decayed, missing, filled teeth), DT (decayed teeth), CPI (Community Periodontal Index, maximum value of individual was used) and number of teeth are associated with IRI for adults. Methods Oral health examination includes an assessment of all oral tissues, diagnosis, a treatment plan and assessment and a determination of the interval before the next assessment. It is called the IRI. This cross‐sectional study population included 42,533 adults (age range 18–89 years), who had visited for an oral health examination during 2009, provided by the Helsinki City Social Services and Health Care. The recall interval was categorised into an ordinal scale (0–12, 13–24, 25–36 and 37–60 months) and was modelled using a proportional odds model. ORs less than one indicated a shorter recall interval. Results Recall interval categories in the study population were 0–12 months (n = 4,569; 11%), 13–24 months (n = 23,732; 56%), 25–36 months (n = 12,049; 28%), and 37–60 months (n = 2,183; 5%). The results of statistical models clearly showed an association between the length of recall intervals and oral health indices. In all models, higher values of DMFT, DT and CPI indicated a shorter recall interval. The number of teeth were not so relevant. The association was not influenced when different combinations of other predictors (age, gender, socioeconomic status, chronic diseases) were included in the model. The severity of periodontitis predicted a short recall interval, for example, in the Model 1, CPI maximum value 4 was OR = 0.35 (95% confidence interval 0.31–0.40). Conclusions The oral health indices showed a clear association with the length of the IRI. Poor oral health reduced IRI. The indices provide information about the amount of oral health prevention required and are useful to health organisations.
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Affiliation(s)
- Anna Haukka
- Dental Care, Health Services, The Social Services and Health care, Helsinki, Finland.,Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Jari Haukka
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Minna Kaila
- Public Health Medicine, Department of Public Health, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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30
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Innes NPT, Chu CH, Fontana M, Lo ECM, Thomson WM, Uribe S, Heiland M, Jepsen S, Schwendicke F. A Century of Change towards Prevention and Minimal Intervention in Cariology. J Dent Res 2020; 98:611-617. [PMID: 31107140 DOI: 10.1177/0022034519837252] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Better understanding of dental caries and other oral conditions has guided new strategies to prevent disease and manage its consequences at individual and public health levels. This article discusses advances in prevention and minimal intervention dentistry over the last century by focusing on some milestones within scientific, clinical, and public health arenas, mainly in cariology but also beyond, highlighting current understanding and evidence with future prospects. Dentistry was initially established as a surgical specialty. Dental caries (similar to periodontitis) was considered to be an infectious disease 100 years ago. Its ubiquitous presence and rampant nature-coupled with limited diagnostic tools and therapeutic treatment options-meant that these dental diseases were managed mainly by excising affected tissue. The understanding of the diseases and a change in their prevalence, extent, and severity, with evolutions in operative techniques, technologies, and materials, have enabled a shift from surgical to preventive and minimal intervention dentistry approaches. Future challenges to embrace include continuing the dental profession's move toward a more patient-centered, evidence-based, less invasive management of these diseases, focused on promoting and maintaining oral health in partnership with patients. In parallel, public health needs to continue to, for example, tackle social inequalities in dental health, develop better preventive and management options for existing disease risk groups (e.g., the growing aging population), and the development of reimbursement and health outcome models that facilitate implementation of these evolving strategies. A century ago, almost every treatment involved injections, a drill or scalpel, or a pair of forceps. Today, dentists have more options than ever before available to them. These are supported by evidence, have a minimal intervention focus, and result in better outcomes for patients. The profession's greatest challenge is moving this evidence into practice.
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Affiliation(s)
- N P T Innes
- 1 School of Dentistry, University of Dundee, Dundee, UK
| | - C H Chu
- 2 Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - M Fontana
- 3 Cariology and Restorative Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - E C M Lo
- 2 Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - W M Thomson
- 4 Department of Oral Sciences, School of Dentistry, University of Otago, Dunedin, New Zealand
| | - S Uribe
- 5 School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
| | - M Heiland
- 6 Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S Jepsen
- 7 Periodontology, Operative, and Preventive Dentistry, University of Bonn, Bonn, Germany
| | - F Schwendicke
- 8 Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Schwendicke F, Splieth CH, Bottenberg P, Breschi L, Campus G, Doméjean S, Ekstrand K, Giacaman RA, Haak R, Hannig M, Hickel R, Juric H, Lussi A, Machiulskiene V, Manton D, Jablonski-Momeni A, Opdam N, Paris S, Santamaria R, Tassery H, Zandona A, Zero D, Zimmer S, Banerjee A. How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement. Clin Oral Investig 2020; 24:3315-3321. [PMID: 32643090 DOI: 10.1007/s00784-020-03431-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 06/23/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. METHODS Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. RESULTS Managing an individual's caries risk using non-invasive means (oral hygiene measures including flossing/interdental brushes, fluoride application) is recommended, as both proximal and secondary carious lesions may be prevented or their activity reduced. For proximal lesions, only cavitated lesions (confirmed by visual-tactile, or radiographically extending into the middle/inner dentine third) should be treated invasively/restoratively. Non-cavitated lesions may be successfully arrested using non-invasive measures in low-risk individuals or if radiographically confined to the enamel. In high-risk individuals or if radiographically extended into dentine, for these lesions, additional micro-invasive (lesion sealing and infiltration) treatment should be considered. For restoring proximal lesions, adhesive direct restorations allow minimally invasive, tooth-preserving preparations. Amalgams come with a lower risk of secondary lesions and may be preferable in more clinically complex scenarios, dependent on specific national guidelines. In structurally compromised (especially endodontically treated) teeth, indirect cuspal coverage restorations may be indicated. Detection methods for secondary lesions should be tailored according to the individual's caries risk. Avoiding false positive detection and over-treatment is a priority. Bitewing radiographs should be combined with visual-tactile assessment to confirm secondary caries detections. Review/refurbishing/resealing/repairing instead of replacing partially defective restorations should be considered for managing secondary caries, if possible. CONCLUSIONS An individualized and lesion-specific approach is recommended for intervening in the caries process in adults. CLINICAL SIGNIFICANCE Dental clinicians have an increasing number of interventions available for the management of dental caries. Many of them are grounded in the growing understanding of the disease. The best evidence, patients' expectations, clinicians' expertise, and the individual clinical scenario all need to be considered during the decision-making process.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative Dentistry, Charité - Universitätsmedizin, Berlin, Germany.
| | - Christian H Splieth
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Peter Bottenberg
- Oral Health Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna - Alma Mater Studiorum, Bologna, Italy
| | - Guglielmo Campus
- Department of Restorative, Preventive and Paediatric Dentistry, Zahnmedizinische Kliniken (ZMK), University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Sophie Doméjean
- Département d'Odontologie Conservatrice, Univ Clermont Auvergne, UFR d'Odontologie; Centre de Recherche en Odontologie Clinique EA 4847, F-63100, Clermont-Ferrand, France
- CHU Estaing Clermont-Ferrand, Service d'Odontologie, F-63001, Clermont-Ferrand, France
| | - Kim Ekstrand
- Cariology and Endodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rodrigo A Giacaman
- Cariology Unit, Department of Oral Rehabilitation, Faculty of Health Sciences, University of Talca, Talca, Chile
| | - Rainer Haak
- Department of Cariology, Endodontology and Periodontology, University Leipzig, Leipzig, Germany
| | - Matthias Hannig
- Clinic of Operative Dentistry and Periodontology, Saarland University, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | - Hrvoje Juric
- Department of Paediatric and Preventive Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Adrian Lussi
- School of Dental Medicine, University of Bern, Bern, Switzerland and Department of Operative Dentistry and Periodontology, Faculty of Dentistry, University Medical Centre, Freiburg, Germany
| | - Vita Machiulskiene
- Clinic of Dental and Oral Pathology, Faculty of odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - David Manton
- Centrum van Tandheelkunde en Mondzorgkunde, UMCG, Groningen, Netherlands
| | | | - Niek Opdam
- Radboud University Medical Centre, Department of Dentistry, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Sebastian Paris
- Department of Operative Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Ruth Santamaria
- Preventive and Pediatric Dentistry, Center for Oral Health, Universitätsmedizin Greifswald, Greifswald, Germany
| | - Hervé Tassery
- Faculté d'Odontologie Marseille, Preventive and Restorative Department, Marseille cedex, Aix-Marseille-Université, Marseille, France
- EA 4203 Laboratory, Université de Montpellier, Montpellier, France
| | - Andrea Zandona
- Department of Comprehensive Care, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
| | - Domenick Zero
- Department of Cariology, Operative Dentistry and Dental Public Health, Oral Health Research Institute, School of Dentistry Indiana University, Indianapolis, IN, USA
| | - Stefan Zimmer
- Department of Operative and Preventive Dentistry, Faculty of Health, Dental School, Witten/Herdecke University, Witten, Germany
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Raphael D. Narrative review of affinities and differences between the social determinants of oral and general health in Canada: establishing a common agenda. J Public Health (Oxf) 2020; 41:e218-e225. [PMID: 30165524 DOI: 10.1093/pubmed/fdy152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 07/24/2018] [Accepted: 08/03/2018] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND This article overviews Canadian work on the social determinants of oral and general health noting their affinities and differences. METHODS A literature search identified Canadian journal articles addressing the social determinants of oral health and/or oral health inequalities. Analysis identified affinities and differences with six themes in the general social determinants of health literature. RESULTS While most Canadian social determinants activity focuses on physical and mental health there is a growing literature on oral health-literature reviews, empirical studies and policy analyses-with many affinities to the broader literature. In addition, since Canada provides physical and mental health services on a universal basis, but does not do so for dental care, there is a special concern with the reasons behind, and the health effects-oral, physical and mental-of the absence of publicly financed dental care. CONCLUSIONS The affinities between the social determinants of oral health and the broader social determinants of health literature suggests the value of establishing a common research and action agenda. This would involve collaborative research into common social determinants of oral and general health and combined policy advocacy efforts to improve Canadians' living and working conditions as means of achieving health for all.
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Affiliation(s)
- Dennis Raphael
- School of Health Policy and Management, York University, Toronto 4700 Keele Street, Toronto, Ontario, Canada
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González-Aragón Pineda AE, García Pérez A, García-Godoy F. Salivary parameters and oral health status amongst adolescents in Mexico. BMC Oral Health 2020; 20:190. [PMID: 32631313 PMCID: PMC7339390 DOI: 10.1186/s12903-020-01182-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/29/2020] [Indexed: 11/10/2022] Open
Abstract
Background In the last years an increased interest in the use of salivary parameters in connection with caries experience and caries prediction has been shown. In schoolchildren investigations are known, where the relationship between caries prevalence and salivary parameters has been assessed, but in the adolescent population studies are scarce. The aim of the study was evaluate of the association among salivary parameters, oral health status and caries experience in adolescents in Mexico. Methods A cross-sectional study was conducted on 256 (DMFT≥5) and 165 (DMFT< 5) 12-to- 14-year-old adolescents. From all the adolescents, unstimulated mid-morning saliva samples were collected, after which the salivary flow rate was calculated, and the salivary pH and buffer capacity was measured. The caries was evaluated via the application of the DMFT score. Clinical variables such as oral hygiene and dental calculus were examined in the adolescent’s oral cavity. The adolescents provided data on their personal characteristics by completing a questionnaire, while socioeconomic data were collected from their parents. Descriptive, bivariate and logistic regression model analyses were performed. Results The prevalence of caries was 61.1% (DMFT≥5) in permanent dentition, with 72.7% of subjects presenting poor oral hygiene. The mean levels of salivary flow rate, pH, and buffer capacity was significantly lower (p < 0.05) in adolescents with caries score of DMFT≥5 than in those with caries score of DMFT < 5. Salivary flow and buffer capacity were higher in boys than in girls. The logistic regression model applied showed that adolescents with a salivary flow rate < 1 ml per min were more likely to present caries [OR = 1.58 (CI95% 1.04–2.40); p = 0.033] than adolescents with a flow rate ≥ 1 ml per-min, and that, for each unit of increased pH, the probability of presenting caries reduced by 76% [OR = 0.24 (CI95% 0.10–0.55); p = 0.001]. Conclusion Significant association was found in salivary flow rate, pH and buffer capacity in adolescents with caries (DMFT≥5). In addition to differences of these parameters by sex, the results suggest saliva parameters may act as indicators of caries in adolescents.
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Affiliation(s)
- A E González-Aragón Pineda
- Faculty of Higher Studies (FES), Iztacala, National Autonomous University of Mexico (UNAM), Avenida de los Barrios Número 1, Colonia Los Reyes Ixtacala, C.P. 54090, Tlalnepantla, Estado de México, Mexico
| | - A García Pérez
- Faculty of Higher Studies (FES), Iztacala, National Autonomous University of Mexico (UNAM), Avenida de los Barrios Número 1, Colonia Los Reyes Ixtacala, C.P. 54090, Tlalnepantla, Estado de México, Mexico.
| | - F García-Godoy
- Bioscience Research Center, College of Dentistry, University of Tennessee Health Science Center, Memphis, TN, USA
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Phillips M, Bernabé E, Mustakis A. Radiographic assessment of proximal surface carious lesion progression in Chilean young adults. Community Dent Oral Epidemiol 2020; 48:409-414. [PMID: 32524660 DOI: 10.1111/cdoe.12552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To investigate the rate and associations of interproximal carious lesion progression. METHODS Retrospective data were analysed from 125 young adults (age range: 18-29 years) with repeated bitewing radiographs collected over a 6-year period. Participants were submitted to different protocols of radiographic examination frequency. Transitions from outer enamel to outer dentine (OE-to-OD) and from outer dentine to dentine (OD-to-D) were selected because of their clinical relevance. Factors associated with each transition were assessed in Cox regression models. RESULTS One hundred seven (85.6%) and 52 (41.6%) participants experienced OE-to-OD and OD-to-D transitions, respectively. In addition, 16.8% of 537 eligible surfaces progressed from OE-to-OD whereas 59.4% of 128 eligible surfaces progressed from OD-to-D. Incidence rates were 6.6 and 44.1 per 100 tooth surface-years, respectively. Mean survival time for OE-to-OD transition was 6.4 years (95% confidence interval: 6.0-6.9) and the median survival time for OD-to-D transition was 1.6 years (95%CI: 1.3-1.7). In adjusted Cox regression models, location in the lower jaw (hazard ratio: 0.34; 95% CI: 0.21-0.57) was inversely associated with OE-to-OD progression. In addition, proximal DMFS at baseline (HR: 0.93; 95%CI: 0.87-0.99) and location in the lower jaw (HR: 0.51; 95%CI: 0.26-0.99) were inversely associated with OD-to-D progression. CONCLUSIONS This group of Chilean young adults has a high progression rate of proximal caries lesions. Location of the caries lesion and proximal DMFS were the only factors associated with caries progression.
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Affiliation(s)
- Melania Phillips
- Faculty of Health Sciences, School of Dentistry, Universidad Autónoma de Chile, Santiago, Chile
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King´s College London, London, UK
| | - Alexandra Mustakis
- School of Dentistry, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
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Östberg AL, Petzold M. A longitudinal study of the impact of change in socioeconomic status on dental caries in the permanent dentition of Swedish children and adolescents. Community Dent Oral Epidemiol 2020; 48:271-279. [PMID: 32337750 DOI: 10.1111/cdoe.12529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 02/14/2020] [Accepted: 02/25/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The overall aim was to analyse longitudinally the development of dental caries in the permanent dentition of children and adolescents in a Swedish region, in relation to possible change in socioeconomic status (SES). METHODS A total of 259 448 individuals in western Sweden were followed over a 3-year period, through dental journal records at baseline (3-19-year-olds) and 1-3 dental check-ups during the follow-up period. Official socioeconomic register information (ethnicity, wealth, parental education and employment) was available at both baseline and follow-up. Data were used both as independent single variables and combined in an index. Gender, age and caries status at baseline and the examination years were included as covariates in the regression models. RESULTS Associations over time were found between SES and dental caries in young people. A persistently low SES was associated with the greatest risk of both new and accumulated (decayed plus filled teeth/approximal surfaces) caries; however, any change in SES, whether improved or worsened, led to a greater risk. An increased risk of new caries events was identified for those who were older at baseline and by examination year. On average, the increase per year in decayed and/or filled teeth and in approximal surfaces was 0.23 and 0.12, respectively. CONCLUSION SES was shown to be an important risk factor for dental caries over time in young Swedish people. Prevention programmes should pay particular attention to the needs of socioeconomically vulnerable individuals and groups.
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Affiliation(s)
- Anna-Lena Östberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Max Petzold
- Health Metrics Unit, The Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
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Flink H, Tegelberg Å, Arnetz JE, Birkhed D. Self-reported oral and general health related to xerostomia, hyposalivation, and quality of life among caries active younger adults. Acta Odontol Scand 2020; 78:229-235. [PMID: 31729277 DOI: 10.1080/00016357.2019.1690677] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Objective: The aim was to study prevalence of xerostomia, hyposalivation and quality of life among caries active younger adults.Materials and methods: A questionnaire regarding oral and general health, xerostomia and quality of life was mailed to 134 caries active (CA) and 40 caries inactive (CI) patients, 25-50 years of age (mean age 39.9 ± 6.2 years) treated at a Swedish Public Dental Service clinic, regarding oral and general health, xerostomia and quality of life. Caries data and unstimulated whole salivary flow rates were obtained from dental records.Results: The overall response rate was 69%. Dental records confirmed that CA patients had more decayed teeth over time than CI patients (p < .001). The CA group reported worse oral health (p < .001) and general health (p < .01), more xerostomia (p < .001) and lower salivary flow rate (p < .01) compared to CI patients. Xerostomia was inversely related to unstimulated whole salivary flow rates as well as to oral and general health (p < .01). There were no differences between groups in quality of life.Conclusion: Younger caries active adult patients reported significantly more xerostomia and hyposalivation compared to caries inactive patients. Xerostomia and hyposalivation were inversely related to perceptions of oral and general health, but not to quality of life.
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Affiliation(s)
- Håkan Flink
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
- Public Dental Clinic Sala, Public Dental Health Västmanland, Sala, Sweden
| | - Åke Tegelberg
- Centre for Clinical Research, Uppsala University, Västerås, Sweden
- Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Judith E. Arnetz
- Department of Family Medicine, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Silva RDNMT, Duarte DA, de Oliveira AMG. The influence of television on the food habits of schoolchildren and its association with dental caries. Clin Exp Dent Res 2020; 6:24-32. [PMID: 32067395 PMCID: PMC7025986 DOI: 10.1002/cre2.244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 08/09/2019] [Accepted: 08/15/2019] [Indexed: 11/25/2022] Open
Abstract
Objectives The consumption of food with a high‐sugar content is encouraged by the food industry through television (TV) aimed at children and may be associated with dental caries. This study aims to evaluate the influence of TV on the food habits of schoolchildren aged years and its association with dental caries. Material and methods This was an observational, epidemiological, and cross‐sectional study. Five neighborhoods of Belem District were selected, and then two schools from each neighborhood were drawn (one private and one public). All sixth and seventh grade students were selected. Data were extracted from questionnaires completed by schoolchildren and their parents and the decayed, missing, and filled teeth (DMFT/dmft) indices of the schoolchildren. The indices were carried out by three examiners previously calibrated (κ > .80). Logistic regression analysis was performed to investigate the association of variables of study with consumption of cariogenic foods and occurrence of dental caries. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Results Schoolchildren who watched TV for >90 min were more likely to consume cariogenic foods (OR = 2.38; 95% CI [1.57, 3.60]) and have a DMFT + dmft >1 (OR = 2.10; 95% CI [1.37, 3.26]). Those who consumed cariogenic foods while watching TV were more likely to have DMFT + dmft >1 (OR = 14.75; 95% CI [8.24, 6.40]). Parents who bought foods they saw on TV contributed to a higher consumption of cariogenic foods (OR = 3.29; 95% CI [2.07, 5.24]) and DMFT + dmft >1 (OR = 3.93; 95% CI [2.09, 7.37]) among their children. Conclusions TV can influence the eating habits of schoolchildren aged 10 to 12 and the food purchases of their parents, stimulating the consumption of cariogenic foods and contributing to the development of dental caries.
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Hong C, Broadbent J, Thomson W, Poulton R. The Dunedin Multidisciplinary Health and Development Study: Oral health findings and their implications. J R Soc N Z 2020; 50:35-46. [PMID: 32226196 PMCID: PMC7100605 DOI: 10.1080/03036758.2020.1716816] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Abstract
Longitudinal research is needed to better understand the natural history of oral conditions and long-term health and social outcomes. Oral health data has been collected periodically in the Dunedin Multidisciplinary Health and Development Study for over 40 years. To date, 70+ peer-review articles on the Study's oral health-related findings have been published, providing insight into the natural history of oral conditions, risk factors, impacts on quality of life, and disparities in oral health. Some of these report new findings, while others build upon the existing body of evidence. This paper provides an overview of these findings and reflects on their public health implications and policy utility in New Zealand.
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Affiliation(s)
- C.L. Hong
- Department of Oral Sciences, University of Otago
| | | | - W.M. Thomson
- Department of Oral Sciences, University of Otago
| | - R. Poulton
- Department of Psychology, University of Otago
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Hogan R, Goodwin M, Boothman N, Iafolla T, Pretty IA. Further opportunities for digital imaging in dental epidemiology. J Dent 2019; 74 Suppl 1:S2-S9. [PMID: 29929584 DOI: 10.1016/j.jdent.2018.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 04/24/2018] [Indexed: 12/31/2022] Open
Abstract
Dental epidemiological research permits accurate tracking of the prevalence and distribution of oral disease across population groups, enabling planning and evaluation of public health interventions and healthcare service provision. This first section of this paper aimed to review traditional assessment methods in dental epidemiology and to consider the methodological and logistical benefits provided by digital imaging, both generally and specifically in relation to an established dual-camera system. The remainder of this paper describes the results of a semi-structured examination of an image archive from previous research utilising a dual-camera system, exploring whether the diagnostic yield of the images might be increased. Common oral conditions are presented alongside suggestions of the diagnostically useful data displayed in example images. Possible scoring mechanisms are discussed with consideration of the limitations that might be encountered for each condition. The retrospective examination suggests further data is obtainable from images acquired using the dual-camera system, however, consideration should be given to how best to validate this clinically. Additionally, other imaging modalities are discussed whilst taking into account the potential limitations of the dual-camera system.
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Affiliation(s)
- Richard Hogan
- Dental Health Unit, School of Dentistry, The University of Manchester, M15 6SE, UK.
| | - Michaela Goodwin
- Dental Health Unit, School of Dentistry, The University of Manchester, M15 6SE, UK
| | - Nicola Boothman
- Dental Health Unit, School of Dentistry, The University of Manchester, M15 6SE, UK
| | - Timothy Iafolla
- National Institute of Dental and Craniofacial Research, 31 Center Drive, Suite 5B55, Bethesda, MD 20892-2190, USA
| | - Iain A Pretty
- Dental Health Unit, School of Dentistry, The University of Manchester, M15 6SE, UK
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Abstract
Since the classical epidemiological studies by Dean, it has been known that there should be an optimum level of exposure to fluoride that would be able to provide the maximum protection against caries, with minimum dental fluorosis. The "optimal" daily intake of fluoride for children (0.05-0.07 mg per kilogram bodyweight) that is still accepted worldwide was empirically determined. In the present review, we discuss the appropriateness of the current guidance for fluoride intake, in light of the windows of susceptibility to caries and fluorosis, the modern trends of fluoride intake from multiple sources, individual variations in fluoride metabolism, and recent epidemiological data. The main conclusion is that it is very difficult to think about a strict recommendation for an "optimal" range of fluoride intake at the individual level in light of existing knowledge of 1) the mechanisms of action of fluoride to control caries, 2) the mechanisms involved in dental fluorosis development, 3) the distinct factors that interfere in the metabolism of fluoride, and 4) the windows of susceptibility to both dental caries and fluorosis development. An "optimal" range of fluoride intake is, however, desirable at the population level to guide programs of community fluoridation, but further research is necessary to provide additional support for future decisions on guidance in this area. This list includes the effect of factors affecting fluoride metabolism, clinical trials on the effectiveness of low-fluoride dentifrices to prevent caries in the primary dentition, and validation of biomarkers of exposure to fluoride.
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Affiliation(s)
- M A R Buzalaf
- 1 Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Brazil
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Schwendicke F, Splieth C, Breschi L, Banerjee A, Fontana M, Paris S, Burrow MF, Crombie F, Page LF, Gatón-Hernández P, Giacaman R, Gugnani N, Hickel R, Jordan RA, Leal S, Lo E, Tassery H, Thomson WM, Manton DJ. When to intervene in the caries process? An expert Delphi consensus statement. Clin Oral Investig 2019; 23:3691-3703. [PMID: 31444695 DOI: 10.1007/s00784-019-03058-w] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 08/08/2019] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To define an expert Delphi consensus on when to intervene in the caries process and on existing carious lesions using non- or micro-invasive, invasive/restorative or mixed interventions. METHODS Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference. RESULTS Carious lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations will be placed for reasons of form, function and aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated carious lesions which are cleansable. Cavitated lesions which are not cleansable usually require invasive/restorative management, to restore form, function and aesthetics. In specific circumstances, mixed interventions may be applicable. On occlusal surfaces, cavitated lesions confined to enamel and non-cavitated lesions radiographically extending deep into dentine (middle or inner dentine third, D2/3) may be exceptions to that rule. On proximal surfaces, cavitation is hard to assess visually or by using tactile methods. Hence, radiographic lesion depth is used to determine the likelihood of cavitation. Most lesions radiographically extending into the middle or inner third of the dentine (D2/3) can be assumed to be cavitated, while those restricted to the enamel (E1/2) are not cavitated. For lesions radiographically extending into the outer third of the dentine (D1), cavitation is unlikely, and these lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds. CONCLUSIONS Comprehensive diagnostics are the basis for systematic decision-making on when to intervene in the caries process and on existing carious lesions. CLINICAL RELEVANCE Carious lesion activity, cavitation and cleansability determine intervention thresholds. Invasive treatments should be applied restrictively and with these factors in mind.
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Affiliation(s)
- Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - Christian Splieth
- Preventive & Pediatric Dentistry, University of Greifswald, Greifswald, Germany
| | - Lorenzo Breschi
- Department of Biomedical and Neuromotor Sciences, DIBINEM, University of Bologna-Alma Mater Studiorum, Bologna, Italy
| | - Avijit Banerjee
- Conservative & MI Dentistry, Faculty of Dentistry, Oral & Craniofacial Sciences, King's Health Partners, King's College London, London, UK
| | - Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Sebastian Paris
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Michael F Burrow
- Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Felicity Crombie
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Lyndie Foster Page
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Patricia Gatón-Hernández
- Department of Dentistry, University of Barcelona, Barcelona, Spain
- Faculdade de Odontologia de Ribeirão Preto, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Rodrigo Giacaman
- Cariology Unit, Department of Oral Rehabilitation, University of Talca, Talca, Chile
| | - Neeraj Gugnani
- Department of Pediatric and Preventive Dentistry, DAV (C) Dental College, Yamunanagar, Haryana, India
| | - Reinhard Hickel
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Munich, Germany
| | | | - Soraya Leal
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasilia, Brazil
| | - Edward Lo
- Faculty of Dentistry, University of Hong Kong, Pokfulam, Hong Kong, SAR, China
| | - Hervé Tassery
- Faculty of Dentistry, AMU University, Marseille, France
| | - William Murray Thomson
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - David J Manton
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
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Hummel R, Akveld NAE, Bruers JJM, van der Sanden WJM, Su N, van der Heijden GJMG. Caries Progression Rates Revisited: A Systematic Review. J Dent Res 2019; 98:746-754. [PMID: 31070943 PMCID: PMC6591514 DOI: 10.1177/0022034519847953] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Caries progression seems to follow universal, predictable rates, depending largely on the caries severity in populations: the higher the caries severity, the higher the progression rates. Quantification of these rates would allow prediction of future caries increments. Our aim was to describe caries progression rates in the primary and permanent dentition in Western populations (not in lesions) of children and adolescents. Therefore, we systematically searched MEDLINE-PubMed, Embase, CINAHL, and the Cochrane library for studies reporting caries progression data. Eligibility criteria were reporting empirical data from at least 2 full-mouth dental caries examinations in a closed cohort during a follow-up of at least 3 y, a first examination after 1974, a second examination before the age of 22 y, caries assessed as dentine caries (d3/D3), and caries reported in dmfs/DMFS (decayed, missing, and filled surfaces), dmft/DMFT (decayed, missing, and filled teeth), or caries-free participants. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we described the results for the primary and permanent dentition in a systematic review, performed a meta-analysis for the caries incidence rate in the permanent dentition, and conducted multivariate, hierarchical meta-regression analyses for the caries incidence rate and the increments in DMFS and DMFT. Of the 6,343 unique studies retrieved, 43 studies (56,376 participants) were included for systematic review and 32 for meta-analyses (39,429 participants). The annual decline in caries-free children in the permanent dentition ranged from 0.8% to 10.2%. The annual increment ranged from 0.07 to 1.77 in DMFS and from 0.06 to 0.73 in DMFT. The pooled caries incidence rate was 0.11 (0.09–0.13) per person-year at risk. Meta-regression analyses showed that the methods of individual studies influenced pooled caries incidence rates and increments in DMFS and DMFT. This should be taken into account in planning and evaluation of oral health care services. However, the caries incidence rate is promising for prediction of future caries increments in populations.
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Affiliation(s)
- R Hummel
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,2 Zilveren Kruis Achmea, Leusden, The Netherlands
| | - N A E Akveld
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J J M Bruers
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,3 KNMT, Royal Dutch Dental Association, Utrecht, The Netherlands
| | - W J M van der Sanden
- 4 College of Oral Science, Department of Quality and Safety of Oral Health Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N Su
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,5 State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,6 Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - G J M G van der Heijden
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Abstract
Over the past 30 years and fueled by both a rapidly evolving understanding of dental diseases and technological advances in diagnostics and therapy, dentistry has been changing dramatically. Managing dental caries and carious lesions had, for nearly a century, encompassed only a small number of basic concepts that were applied to virtually all patients and lesions, namely, invasive removal of any carious tissue regardless of its activity or depth and its replacement with restorative materials (amalgams or crowns for most of the past) or tooth removal and prosthetic replacement. Grounded in a deeper understanding of the disease "caries," its management-aiming to control the causes of the disease, to slow down or alleviate existing disease, and, only as a last resort, to remove its symptoms using a bur or forceps-has become more complex and diverse. In parallel and at nearly unprecedented speed, our patients are changing, as mirrored by ongoing debates as to the demographic and, with it, the social future of most high-income countries. This article describes how these changes will have a profound future impact on how we practice dental medicine in the future. It will deduce, from both demographic and epidemiologic trends, why there is the need to apply not one but rather the whole range of existing evidence-based concepts in an individualized (personalized) manner, hence increasing the effectiveness and efficiency of dental management strategies, and also describe how these strategies should be tailored according not only to our patients (their age and risk profiles) but also to the specific tooth (or site or lesion).
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Chiang HM, Tranaeus S, Sunnegårdh-Grönberg K. Caries as experienced by adult caries active patients: a qualitative study. Acta Odontol Scand 2019; 77:15-21. [PMID: 30084696 DOI: 10.1080/00016357.2018.1493218] [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] [Indexed: 10/28/2022]
Abstract
Objective: In the western world, increased oral health has resulted in a skewed occurrence of caries disease where relatively few individuals now account for most caries disease. This study examines how adults with recurrent caries activity experience caries disease and treatment.Materials and methods: The study is based on qualitative data from individual interviews, which were subjected to qualitative content analysis. The interviews were semi-structured and thematic and an interview guide was used that consisted of two main areas with open ended questions. Meaning units were condensed and labelled with a code which preserved the core content of the reduced text. Codes were assigned to different subcategories according to their similarities or differences. Subcategories formed categories which describe the manifest content of the text.Results: The domain "experience with caries" consisted of four subcategories that formed the main category Caries - an unwelcomed acquaintance. The domain "experience with caries treatment" consisted of three subcategories that formed the category Caries treatment - pain for gain.Conclusion: Comprehensive non-operative treatment and close follow-ups should precede restorations; this would probably gain insight in how to avoid new cavities to a greater extent. If to be supportive, information and advice about self-care given to individuals with recurrent cavities should be delivered with respect to the patient's feelings about their experience of dental caries.
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Affiliation(s)
- Huei-Min Chiang
- Public Dental Service, Folktandvården Vännäs, Vännäs, Sweden
| | - Sofia Tranaeus
- Health Technology Assessment-Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
- Division of Cariology and Endodontology Department of Dental Medicine, Karolinska institutet, Huddinge, Sweden
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Haworth S, Shungin D, Kwak SY, Kim H, West NX, Thomas SJ, Franks PW, Timpson NJ, Shin M, Johansson I. Tooth loss is a complex measure of oral disease: Determinants and methodological considerations. Community Dent Oral Epidemiol 2018; 46:555-562. [PMID: 29956852 PMCID: PMC6282797 DOI: 10.1111/cdoe.12391] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 05/17/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Counts of missing teeth or measures of incident tooth loss are gaining attention as a simple way to measure dental status in large population studies. We explore the meaning of these metrics and how missing teeth might influence other measures of dental status. METHODS An observational study was performed in 2 contrasting adult populations. In total, 62 522 adult participants were available with clinically assessed caries and periodontal indices from the Swedish arm of the Gene-Lifestyle Interactions and Dental Endpoints Study (GLIDE) and the Korea National Health and Nutrition Examination Survey (KNHANES) in the Republic of Korea. Longitudinal measures of tooth loss were available for 28 244 participants in GLIDE with median follow-up of 10.6 years. RESULTS In longitudinal analysis, hazard for tooth loss was associated with baseline dental status (previous tooth loss, periodontal status and caries status) and socio-demographic variables (age, smoking status and highest educational level). Analysis of cross-sectional data suggested that indices of caries exposure were not independent of periodontal status. The strength and direction of association varied between groups, even for measures specifically intended to avoid measuring tooth loss. Individuals with impaired periodontal health (community periodontal index [CPI] 3 or higher in any sextant) had higher standardized decayed and filled surfaces (DFS; number of DFS divided by total number of tooth surfaces) in GLIDE (incidence risk ratio [IRR] 1.05 [95% CI: 1.04, 1.07], but lower standardized DFS in KNHANES (IRR: 0.95 [0.92, 0.98]) than individuals with better periodontal health (CPI <3 in all sextants). CONCLUSIONS Incident tooth loss is a complex measure of dental disease, with multiple determinants. The relative importance of dental caries and periodontal disease as drivers of tooth loss differs between age groups. Measures of dental caries exposure are associated with periodontal status in the studied populations, and these associations can be population-specific. Consideration of the study-specific properties of these metrics may be required for valid inference in large population studies.
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Affiliation(s)
- Simon Haworth
- Medical Research Council Integrative Epidemiology UnitDepartment of Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
- Bristol Dental SchoolUniversity of BristolBristolUK
| | | | - So Young Kwak
- Department of Public Health SciencesBK21PLUS Program in Embodiment: Health‐Society InteractionGraduate SchoolKorea UniversitySeoulRepublic of Korea
| | - Hae‐Young Kim
- Department of Public Health SciencesBK21PLUS Program in Embodiment: Health‐Society InteractionGraduate SchoolKorea UniversitySeoulRepublic of Korea
| | | | | | - Paul W. Franks
- Department of Clinical Sciences, Genetic and Molecular Epidemiology UnitLund UniversitySkåne University Hospital MalmöMalmöSweden
- Department of Public Health and Clinical MedicineUmeå UniversityUmeåSweden
- Department of NutritionHarvard T. H. Chan School of Public HealthBostonMAUSA
| | - Nicholas J. Timpson
- Medical Research Council Integrative Epidemiology UnitDepartment of Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Min‐Jeong Shin
- Department of Public Health SciencesBK21PLUS Program in Embodiment: Health‐Society InteractionGraduate SchoolKorea UniversitySeoulRepublic of Korea
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Fontana M, Gonzalez-Cabezas C. Evidence-Based Dentistry Caries Risk Assessment and Disease Management. Dent Clin North Am 2018; 63:119-128. [PMID: 30447787 DOI: 10.1016/j.cden.2018.08.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The objective of this article was to provide a summary of evidence-based recommendations for the assessment of caries risk and management of dental caries. The goal is to help clinicians manage the caries disease process using personalized interventions supported by the best available evidence, taking into account the clinician's expertise and the patient's needs and preferences, to maintain health and preserve tooth structure.
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Affiliation(s)
- Margherita Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Ann Arbor, MI 48109, USA.
| | - Carlos Gonzalez-Cabezas
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University, Ann Arbor, MI 48109, USA
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Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global epidemiology of dental caries and severe periodontitis - a comprehensive review. J Clin Periodontol 2018; 44 Suppl 18:S94-S105. [PMID: 28266116 DOI: 10.1111/jcpe.12677] [Citation(s) in RCA: 483] [Impact Index Per Article: 80.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2016] [Indexed: 01/03/2023]
Abstract
BACKGROUND Dental caries and periodontitis are the most common oral diseases and major causes of tooth loss. AIM To perform a review of global prevalence and incidence of dental caries and periodontitis. METHODOLOGY Inclusion and exclusion criteria were developed. MEDLINE database and EMBASE database were used to search for eligible publications using keywords and MeSH terms. Additionally, WHO databank was used for obtaining dental caries information and PUBMED for a search on trends of dental caries prevalence and severity. RESULTS Over the last four decades, the prevalence and severity of dentine carious lesions among 5- and 12-year-olds have declined; the decay-component is very high, with the lowest prevalence among 12-year-olds in high-income countries, which also had the lowest prevalence among 35- to 44-year-olds; and the number of retained teeth has increased around the globe. The prevalence of periodontitis is high, with approximately 10% of the global population affected by severe periodontitis. Study heterogeneity and methodological issues hamper comparisons across studies and over time. CONCLUSION While the prevalence of dental caries has decreased, the disease is prevalent in all age groups. The prevalence of periodontitis is high. There is insufficient evidence to conclude that the prevalence of periodontitis has changed over time.
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Affiliation(s)
- Jo E Frencken
- Department of Oral Function and Prosthetic Dentistry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Praveen Sharma
- Periodontal Research Group, College of Medical and Dental Sciences, Dental School, University of Birmingham, Birmingham, UK
| | - Laura Stenhouse
- Department of Special Care Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - David Green
- Department of Restorative Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - Dominic Laverty
- Department of Restorative Dentistry, Birmingham Dental Hospital and School of Dentistry, Birmingham, UK
| | - Thomas Dietrich
- Periodontal Research Group, College of Medical and Dental Sciences, Dental School, University of Birmingham, Birmingham, UK
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Raphael SL, Foster Page LA, Hopcraft MS, Dennison PJ, Widmer RP, Evans RW. A survey of cariology teaching in Australia and New Zealand. BMC MEDICAL EDUCATION 2018; 18:75. [PMID: 29631580 PMCID: PMC5892021 DOI: 10.1186/s12909-018-1176-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The Australian and New Zealand chapter of the Alliance for a Cavity Free Future was launched in 2013 and one of its primary aims was to conduct a survey of the local learning and teaching of cariology in dentistry and oral health therapy programs. METHODS A questionnaire was developed using the framework of the European Organisation for Caries Research (ORCA)/Association of Dental Education in Europe (ADEE) cariology survey conducted in Europe in 2009. The questionnaire was comprised of multiple choice and open-ended questions exploring many aspects of the cariology teaching. The survey was distributed to the cariology curriculum coordinator of each of the 21 programs across Australia and New Zealand via Survey Monkey in January 2015. Simple analysis of results was carried out with frequencies and average numbers of hours collated and open-ended responses collected and compiled into tables. RESULTS Seventeen responses from a total of 21 programs had been received including 7 Dentistry and 10 Oral Health programs. Key findings from the survey were - one quarter of respondents indicated that cariology was identified as a specific discipline with their course and 41% had a cariology curriculum in written format. With regard to lesion detection and caries diagnosis, all of the program coordinators who responded indicated that visual/tactile methods and radiographic interpretation were recommended with ICDAS also being used by over half them. Despite all respondents teaching early caries lesion management centred on prevention and remineralisation, many taught operative intervention at an earlier stage of lesion depth than current evidence supports. Findings showed over 40% of respondents still teach operative intervention for lesions confined to enamel. CONCLUSION Despite modern theoretical concepts of cariology being taught in Australia and New Zealand, they do not appear to be fully translated into clinical teaching at the present time.
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Affiliation(s)
- Sarah L. Raphael
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
| | | | | | | | - Richard P. Widmer
- Department of Dentistry, Children’s Hospital at Westmead, Westmead, Australia
| | - R. Wendell Evans
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
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Schwendicke F, Foster Page LA, Smith LA, Fontana M, Thomson WM, Baker SR. To fill or not to fill: a qualitative cross-country study on dentists' decisions in managing non-cavitated proximal caries lesions. Implement Sci 2018; 13:54. [PMID: 29625615 PMCID: PMC5889601 DOI: 10.1186/s13012-018-0744-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 03/26/2018] [Indexed: 12/01/2022] Open
Abstract
Background This study aimed to identify barriers and enablers for dentists managing non-cavitated proximal caries lesions using non- or micro-invasive (NI/MI) approaches rather than invasive and restorative methods in New Zealand, Germany and the USA. Methods Semi-structured interviews were conducted, focusing on non-cavitated proximal caries lesions (radiographically confined to enamel or the outer dentine). Twelve dentists from New Zealand, 12 from Germany and 20 from the state of Michigan (USA) were interviewed. Convenience and snowball sampling were used for participant recruitment. A diverse sample of dentists was recruited. Interviews were conducted by telephone, using an interview schedule based on the Theoretical Domains Framework (TDF). Results The following barriers to managing lesions non- or micro-invasively were identified: patients’ lacking adherence to oral hygiene instructions or high-caries risk, financial pressures and a lack of reimbursement for NI/MI, unsupportive colleagues and practice leaders, not undertaking professional development and basing treatment on what had been learned during training, and a sense of anticipated regret (anxiety about not restoring a proximal lesion in its early stages before it progressed). The following enablers were identified: the professional belief that remineralisation can occur in early non-cavitated proximal lesions and that these lesions can be arrested, the understanding that placing restorations weakens the tooth and inflicts a cycle of re-restoration, having up-to-date information and supportive colleagues and work environments, working as part of a team of competent and skilled dental practitioners who perform NI/MI (such as cleaning or scaling), having the necessary resources, undertaking ongoing professional development and continued education, maintaining membership of professional groups and a sense of professional and personal satisfaction from working in the patient’s best interest. Financial aspects were more commonly mentioned by the German and American participants, while continuing education was more of a focus for the New Zealand participants. Conclusions Decisions on managing non-cavitated proximal lesions were influenced by numerous factors, some of which could be targeted by interventions for implementing evidence-based management strategies in practice. Electronic supplementary material The online version of this article (10.1186/s13012-018-0744-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- F Schwendicke
- Department for Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
| | - L A Foster Page
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - L A Smith
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - M Fontana
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, Ann Arbor, USA
| | - W M Thomson
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - S R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Moore D, Poynton M, Broadbent JM, Thomson WM. The costs and benefits of water fluoridation in NZ. BMC Oral Health 2017; 17:134. [PMID: 29179712 PMCID: PMC5704512 DOI: 10.1186/s12903-017-0433-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 11/20/2017] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Implementing community water fluoridation involves costs, but these need to be considered against the likely benefits. We aimed to assess the cost-benefit and cost-effectiveness of water fluoridation in New Zealand (NZ) in terms of expenditure and quality-adjusted life years. METHODS Based on published studies, we determined the risk reduction effects of fluoridation, we quantified its health benefits using standardised dental indexes, and we calculated financial savings from averted treatment. We analysed NZ water supplies to estimate the financial costs of fluoridation. We devised a method to represent dental caries experience in quality-adjusted life years. RESULTS Over 20 years, the net discounted saving from adding fluoride to reticulated water supplies supplying populations over 500 would be NZ$1401 million, a nine times pay-off. Between 8800 and 13,700 quality-adjusted life years would be gained. While fluoridating reticulated water supplies for large communities is cost-effective, it is unlikely to be so with populations smaller than 500. CONCLUSIONS Community water fluoridation remains highly cost-effective for all but very small communities. The health benefits-while (on average) small per person-add up to a substantial reduction in the national disease burden across all ethnic and socioeconomic groups.
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Affiliation(s)
- David Moore
- Sapere Research Group Limited, PO Box 587, Wellington, New Zealand
| | - Matthew Poynton
- Sapere Research Group Limited, PO Box 587, Wellington, New Zealand
| | - Jonathan M. Broadbent
- Sir John Walsh Research Institute, School of Dentistry, The University of Otago, PO Box 56, Dunedin, New Zealand
| | - W. Murray Thomson
- Sir John Walsh Research Institute, School of Dentistry, The University of Otago, PO Box 56, Dunedin, New Zealand
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