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Velasco SRM, Pistelli GC, Razera FPM, Menezes-Silva R, Bastos RS, Navarro MFDL. Dental caries spectrum profile in Brazilian public school children and adolescents. Braz Oral Res 2021; 35:e067. [PMID: 34133580 DOI: 10.1590/1807-3107bor-2021.vol35.0067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 12/07/2020] [Indexed: 11/22/2022] Open
Abstract
Dental caries remains a major public health problem, with a higher prevalence among in adolescence. The present study aimed to assess the dental caries spectrum profile in children and adolescents in Brazilian public schools. A cross-sectional study was performed in two public schools in Brazil to examine the permanent teeth of children and adolescents. The dental caries were assessed by applying the Caries Assessment Spectrum and Treatment (CAST) instrument, and the results were distributed as per disease status (healthy/codes 0-2; pre-morbidity/code 3; morbidity/code 4-5; severe morbidity/codes 6-7; mortality/code 8) and by severity as per the CAST-F1 formula (no severity, mild, moderate, and severe). The CAST data were described by age groups (8-9 y, 10-11 y, 12-13 y, 14-15 y, 16-17 y, and 18-19 y). The Kruskal-Wallis test was used to investigate differences in CAST prevalence and severity among the groups (p < 0.05). Total 598 students were enrolled. Most of the subjects were male (53.34%) and belonged to the age group of 12-13 y (34.95%). The variables CAST 0/1 (p = 0.024), CAST (p = 0.024), and CAST-F1 (p = 0.029) showed significant differences among age groups, and the post hoc test showed the differences in these variables as per the age groups of 14-15 y and 16-17 y (CAST 0/1, p = 0.047; CAST, p = 0.047; CAST-F1, p = 0.033). The dental caries spectrum increased from 8 to 19 y with a peak in the prevalence and severity in the middle of adolescence.
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Affiliation(s)
- Sofia Rafaela Maito Velasco
- Universidade de São Paulo - USP, Faculty of Public Health, Department of Epidemiology, São Paulo, SP, Brazil
| | - Gustavo Chab Pistelli
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatrics Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil
| | - Fernanda Pátaro Marsola Razera
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatrics Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil
| | - Rafael Menezes-Silva
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Bauru, SP, Brazil
| | - Roosevelt Silva Bastos
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Pediatrics Dentistry, Orthodontics and Public Health, Bauru, SP, Brazil
| | - Maria Fidela de Lima Navarro
- Universidade de São Paulo - USP, Bauru School of Dentistry, Department of Operative Dentistry, Bauru, SP, Brazil
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Sullivan ZC, Van Eeden S, May J, Flannigan N, Seshu M, Dominguez-Gonzalez S. Identifying associations between dental arch relationship scores, relative deprivation and other cleft audit outcomes. Part 2. Orthod Craniofac Res 2021; 25:103-111. [PMID: 34056824 DOI: 10.1111/ocr.12504] [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: 11/28/2020] [Revised: 05/23/2021] [Accepted: 05/24/2021] [Indexed: 11/30/2022]
Abstract
Identify associations between dental arch relationship scores, oral health status and deprivation index in patients with complete unilateral cleft lip and palate (UCLP) and bilateral cleft lip and palate (BCLP). Ninety-two 5-year-old children with non-syndromic complete UCLP and thirty-nine 5-year-old children with non-syndromic complete BCLP from the United Kingdom. Data were collected from the 5-year audit outcomes submitted to the Cleft Registry and Audit Network (CRANE). The index of multiple deprivation (IMD) and Welsh index of deprivation were used to assess a relative measure of deprivation. Comparisons of 5-year-old index/BCLP Deciduous Dentition Yardstick outcome against IMD and dmft are performed using multivariable linear regression models. Both UCLP and BCLP had a high percentage of children with dmft >0 (47% and 49%, respectively). The mean dmft for the UCLP cohort was 2.8 and 2.6 for the BCLP cohort. In the UCLP group, a poorer 5-year-old index was associated with an increased dmft score (P = .023) and higher level of deprivation (P = .010). In the BCLP group, there was no significant associations between BCLP Deciduous Dentition Yardstick, dmft and IMD. A poorer dental arch relationship outcome may be associated with higher level of area deprivation and oral health status, in children with UCLP. Those with a poor outcome for the 5-year-old Index are more likely to have increased caries experience.
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Affiliation(s)
| | | | - Joanna May
- Alder Hey Hospital Children's Hospital, Liverpool, UK
| | - Norah Flannigan
- Orthodontic department, Liverpool University Dental Hospital, Liverpool, UK
| | - Madhavi Seshu
- Alder Hey Hospital Children's Hospital, Liverpool, UK
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van Meijeren-van Lunteren AW, Oude Groeniger J, Wolvius EB, Kragt L. Neighbourhood characteristics and children's oral health: a multilevel population-based cohort study. Eur J Public Health 2021; 31:742-748. [PMID: 33624096 PMCID: PMC8514066 DOI: 10.1093/eurpub/ckab013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background To understand determinants of oral health inequalities, multilevel modelling is a useful manner to study contextual factors in relation to individual oral health. Several studies outside Europe have been performed so far, however, contextual variables used are diverse and results conflicting. Therefore, this study investigated whether neighbourhood level differences in oral health exist, and whether any of the neighbourhood characteristics used were associated with oral health. Methods This study is embedded in The Generation R Study, a prospective cohort study conducted in The Netherlands. In total, 5 960 6-year-old children, representing 158 neighbourhoods in the area of Rotterdam, were included. Data on individual and neighbourhood characteristics were derived from questionnaires, and via open data resources. Caries was assessed via intraoral photographs, and defined as decayed, missing and filled teeth (dmft). Results Differences between neighbourhoods explained 13.3% of the risk of getting severe caries, and 2% of the chance of visiting the dentist yearly. After adjustments for neighbourhood and individual characteristics, neighbourhood deprivation was significantly associated with severe dental caries (OR: 1.48, 95% CI: 1.02–2.15), and suggestive of a low odds of visiting the dentist yearly (OR: 0.81, 95% CI: 0.56–1.18). Conclusions Childhood caries and use of dental services differs between neighbourhoods and living in a deprived neighbourhood is associated with increased dental caries and decreased yearly use of dental services. This highlights the importance of neighbourhoods for understanding differences in children’s oral health, and for targeted policies and interventions to improve the oral health of children living in deprived neighbourhoods.
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Affiliation(s)
- Agatha W van Meijeren-van Lunteren
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Joost Oude Groeniger
- Department of Public Health, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Public Administration and Sociology, Erasmus University, Rotterdam, The Netherlands
| | - Eppo B Wolvius
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Lea Kragt
- The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.,Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus University Medical Centre, Rotterdam, The Netherlands
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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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Janus M, Reid-Westoby C, Lee C, Brownell M, Maguire JL. Association between severe unaddressed dental needs and developmental health at school entry in Canada: a cross-sectional study. BMC Pediatr 2019; 19:481. [PMID: 31810457 PMCID: PMC6898915 DOI: 10.1186/s12887-019-1868-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 12/02/2019] [Indexed: 11/24/2022] Open
Abstract
Background Dental problems are the most prevalent chronic disease worldwide, with up to half of all kindergarten children having tooth decay. However, there is a lack of evidence of whether unaddressed dental needs (UDNs) are associated with children’s developmental health, a concept reflecting holistic child development - encompassing physical, emotional, and cognitive development. The objective of the current study was to evaluate the relationship between UDNs and developmental health among kindergarten children using the Early Development Instrument (EDI). Methods We examined associations between teacher reported UDNs and developmental vulnerability on the EDI. Children were included in the study if they were enrolled in kindergarten in publicly-funded schools in Canada between 2010 and 2015, had been in the classroom for at least one month, and had no more than 25% of missing items on the questionnaire. Results Among 576,264 children who met inclusion criteria (95.4% of eligible children), 2465 (0.4%) were identified as having UDNs by their teachers. Children with UDNs had 4.58 to 8.27 times higher odds of being vulnerable on any of the five developmental domains (physical health and well-being, social competence, emotional maturity, language and cognitive development, communication skills and general knowledge), compared to children without UDNs. Conclusion In this study, teacher-reported UDNs were associated with developmental vulnerability in kindergarten children. Teacher reported unmet dental needs in kindergarten children may be a proxy for poor developmental health at school entry, and thus a marker for supporting both children’s oral health and early developmental needs.
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Affiliation(s)
- Magdalena Janus
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, McMaster Innovation Park, 175 Longwood Rd South, Suite 201A, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada.
| | - Caroline Reid-Westoby
- Offord Centre for Child Studies, Department of Psychiatry and Behavioural Neurosciences, McMaster University, McMaster Innovation Park, 175 Longwood Rd South, Suite 201A, 1280 Main St. West, Hamilton, ON, L8S 4K1, Canada
| | - Catherine Lee
- Bachelor of Health Sciences (Honours), Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Marni Brownell
- Manitoba Centre for Health Policy, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jonathon L Maguire
- Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Department of Nutritional Sciences, Faculty of Medicine, Universtiy of Toronto, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Department of Paediatrics, St. Michael's Hospital, Toronto, ON, Canada
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Ljung R, Lundgren F, Appelquist M, Cederlund A. The Swedish dental health register - validation study of remaining and intact teeth. BMC Oral Health 2019; 19:116. [PMID: 31208416 PMCID: PMC6580593 DOI: 10.1186/s12903-019-0804-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 05/31/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Sweden has a long tradition of nationwide registers enabling population-based research of high quality and validity. We aimed to describe the content and validity of reported number of remaining and intact teeth in the Swedish Dental Health Register and report some descriptive data on dental health care utilization. METHODS The Swedish Dental Health Register was initiated in July 1st 2008 and contains individual data on dental health care to the whole adult population of Sweden. The dental care given freely to children and young adults is not included. Descriptive data on remaining, intact teeth and dental health care utilization is presented by proportion of the population stratified by sex and age. We conducted a validation study, by manual review of randomly sampled 1500 dental health visits records, to assess reported number of teeth to the register with what was actually recorded in the dental health care record (gold standard), analyzed by positive predictive value (PPV) and Bland-Altman plots. RESULTS Of the Swedish adult population 2014, 2.6 million (69%) men and 2.9 million (76%) women had at least one visit to a dentist during a two-year period 2013 to 2014. More than half of the population up to age 64 have all remaining teeth (28 teeth or more). Of the 1500 requested dental records 1131 (75%) were received. The positive predictive value for patients reported to the register as having at least 1 tooth up to 31 intact teeth was 91.5% (95% confidence interval 89.0-93.5, 567 manually reviewed to be correct out of 620 reported). CONCLUSIONS For patients coded as having less than 32 intact teeth but not being edentulous the reported number of remaining and intact teeth is to a very high degree correct. However, the correctness for those coded as edentulous or having 32 remaining intact teeth is low and varies substantially by age.
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Affiliation(s)
- Rickard Ljung
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77, Stockholm, Sweden.
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André Kramer AC, Petzold M, Hakeberg M, Östberg AL. Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents. Caries Res 2017; 52:42-50. [DOI: 10.1159/000481411] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 09/08/2017] [Indexed: 01/26/2023] Open
Abstract
The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.
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Smallridge J, Wills AK, Mahmoud O, Chong A, Clark V, Collard M, Sandy JR, Ness AR. Centre-level variation in dental treatment and oral health and individual- and area-level predictors of oral health in 5-year-old children with non-syndromic unilateral cleft lip and palate: the Cleft Care UK study. Part 3. Orthod Craniofac Res 2017; 20 Suppl 2:19-26. [DOI: 10.1111/ocr.12185] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2017] [Indexed: 11/29/2022]
Affiliation(s)
- J. Smallridge
- Cleft.NET.East; Cambridge University Hospitals NHS Foundation trust, Addenbrooke's Hospital; Cambridge UK
| | - A. K. Wills
- National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle; University Hospitals Bristol NHS Foundation Trust and the University of Bristol; Bristol UK
- Bristol Dental School; University of Bristol; Bristol UK
| | - O. Mahmoud
- School of Social and Community Medicine; University of Bristol; Bristol UK
- Department of Applied Statistics; Helwan University; Cairo Egypt
| | - A. Chong
- National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle; University Hospitals Bristol NHS Foundation Trust and the University of Bristol; Bristol UK
| | - V. Clark
- West Midlands Regional Centre for Cleft Lip and Palate; Birmingham Children's Hospital; Birmingham UK
| | | | - J. R. Sandy
- Bristol Dental School; University of Bristol; Bristol UK
| | - A. R. Ness
- National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition, Diet and Lifestyle; University Hospitals Bristol NHS Foundation Trust and the University of Bristol; Bristol UK
- Bristol Dental School; University of Bristol; Bristol UK
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