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Fontana M, Eckert G, Katz B, Keels M, Levy B, Levy S, Kemper A, Yanca E, Jackson R, Warren J, Kolker J, Daly J, Kelly S, Talbert J, McKnight P. Predicting Dental Caries in Young Children in Primary Health Care Settings. J Dent Res 2023; 102:988-998. [PMID: 37329133 PMCID: PMC10477774 DOI: 10.1177/00220345231173585] [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] [Indexed: 06/18/2023] Open
Abstract
Young children need increased access to dental prevention and care. Targeting high caries risk children first helps meet this need. The objective of this study was to develop a parent-completed, easy-to-score, short, accurate caries risk tool for screening in primary health care settings to identify children at increased risk for cavities. A longitudinal, prospective, multisite, cohort study enrolled (primarily through primary health care settings) and followed 985 (out of 1,326) 1-y-old children and their primary caregivers (PCGs) until age 4. The PCG completed a 52-item self-administered questionnaire, and children were examined using the International Caries Detection and Assessment Criteria (ICDAS) at 12 ± 3 mo (baseline), 30 ± 3 mo (80% retention), and 48 ± 3 mo of age (74% retention). Cavitated caries lesion (dmfs = decayed, missing, and filled surfaces; d = ICDAS ≥3) experience at 4 y of age was assessed and tested for associations with questionnaire items using generalized estimating equation models applied to logistic regression. Multivariable analysis used backward model selection, with a limit of 10 items. At age 4, 24% of children had cavitated-level caries experience; 49% were female; 14% were Hispanic, 41% were White, 33% were Black, 2% were other, and 10% were multiracial; 58% enrolled in Medicaid; and 95% lived in urban communities. The age 4 multivariable prediction model, using age 1 responses (area under the receiver operating characteristic curve = 0.73), included the following significant (P < 0.001) variables (odds ratios): child participating in public assistance programs such as Medicaid (1.74), being non-White (1.80-1.96), born premature (1.48), not born by caesarean section (1.28), snacking on sugary snacks (3 or more/d, 2.22; 1-2/d or weekly, 1.55), PCG cleaning the pacifier with juice/soda/honey or sweet drink (2.17), PCG daily sharing/tasting food with child using same spoon/fork/glass (1.32), PCG brushing their teeth less than daily (2.72), PCG's gums bleeding daily when brushing or PCG having no teeth (1.83-2.00), and PCG having cavities/fillings/extractions in past 2 y (1.55). A 10-item caries risk tool at age 1 shows good agreement with cavitated-level caries experience by age 4.
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Affiliation(s)
- M. Fontana
- University of Michigan, Ann Arbor, MI, USA
| | | | | | | | - B.T. Levy
- University of Iowa, Iowa City, IA, USA
| | - S.M. Levy
- University of Iowa, Iowa City, IA, USA
| | - A.R. Kemper
- Division of Primary Care Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | - E. Yanca
- University of Michigan, Ann Arbor, MI, USA
| | - R. Jackson
- Indiana University, Indianapolis, IN, USA
| | - J. Warren
- University of Iowa, Iowa City, IA, USA
| | | | - J.M. Daly
- University of Iowa, Iowa City, IA, USA
| | - S. Kelly
- Duke University, Durham, NC, USA
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Mathew MG, Jeevanandan G, Vishwanathaiah S, Hamzi KA, Depsh MAN, Maganur PC. Parental and Child Outlook on the Impact of ECC on Oral Health-related Quality of Life: A Prospective Interventional Study. J Contemp Dent Pract 2022; 23:877-882. [PMID: 37282993 DOI: 10.5005/jp-journals-10024-3397] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
AIM To evaluate the perspectives of parents and children on the impact of early childhood caries (ECC) on the oral health-related quality of life (OHQoF). MATERIALS AND METHODS About 400 children aged 3-5 years were recruited for the study. About 200 children who were caries-free were the controls for the study. The remaining 200 consisted of children who were diagnosed with ECC and required dental rehabilitation under general anesthesia. Oral health-related quality of life was recorded at baseline and 6 months after intervention using the Michigan oral health-related quality of life scale. Data were analyzed and evaluated using Statistical Package for Social Sciences (SPSS) Version 25.0. RESULTS Children with ECC were found to have a significantly lower oral health-related quality of life compared with caries-free children, and a statistically significant difference was seen between both groups. The main concern for both parents and children at baseline was pain at the first visit when the evaluation was done. After the intervention, a significant improvement in the oral health-related quality of life was seen. CONCLUSION Early childhood caries was found to have detrimental effects on the oral health-related quality of life. Full-mouth rehabilitation under general anesthesia was found to bring a significant improvement in the oral health-related quality of life. The perspectives of both parents and children were found to be similar. CLINICAL SIGNIFICANCE Early childhood caries has an impact on the lives of children and their parents. Oral health-related quality of life was low with children suffering from ECC. Full-mouth rehabilitation under general anesthesia can significantly improve the OHRQoL of children. Continuous monitoring of the children with regular follow-ups and parental education should be enforced to prevent the relapse of ECC.
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Affiliation(s)
- Mebin George Mathew
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
| | - Ganesh Jeevanandan
- Department of Pedodontics and Preventive Dentistry, Saveetha Dental College and Hospital, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India, Phone: +91 9884293869, e-mail:
| | - Satish Vishwanathaiah
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | | | | | - Prabhadevi C Maganur
- Department of Preventive Dental Sciences, Division of Pedodontics, College of Dentistry, Jazan University, Jazan, Saudi Arabia, Phone: +966505916621, e-mail:
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Rojanaworarit C, Claudio L, Howteerakul N, Siramahamongkol A, Ngernthong P, Kongtip P, Woskie S. Hydrogeogenic fluoride in groundwater and dental fluorosis in Thai agrarian communities: a prevalence survey and case-control study. BMC Oral Health 2021; 21:545. [PMID: 34686164 PMCID: PMC8532340 DOI: 10.1186/s12903-021-01902-8] [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: 07/15/2021] [Accepted: 10/12/2021] [Indexed: 11/19/2022] Open
Abstract
Background Dental fluorosis can be a disease of social inequity in access to safe drinking water. This dental public health issue becomes prominent in socially disadvantaged agrarian communities in fluoride endemic areas where the standard irrigation system is unavailable and groundwater containing natural fluoride is the major drinking water source. This study aimed to determine the prevalence and severity of dental fluorosis in children and to evaluate its association with fluoride in groundwater in the aforementioned setting in Thailand. Methods A cross-sectional survey of 289 children in Nakhon Pathom Province was conducted in 2015. Children with very mild to severe fluorosis were regarded as ‘cases’ while their counterparts were ‘controls’ for a subsequent case–control study. Records of fluoride concentrations in groundwater used for household supply corresponding to resident and number of years by age of each child during 2008–2015 were retrieved. Other exposure variables were measured using a questionnaire. Prevalence ratio (PR), a measure indicating the relative effect of different levels of fluoride on dental fluorosis, was obtained from Poisson regression with robust standard error. Result There were 157 children with very mild to moderate dental fluorosis (54.3% prevalence). The univariable analysis revealed that the prevalence of dental fluorosis among children with fluoride concentrations in water sources of 0.7–1.49 (index category 1) and ≥ 1.5 ppm (index category 2) was 1.62 (95% CI; 0.78, 3.34) and 2.75 (95% CI; 1.42, 5.31) times the prevalence among those with fluoride < 0.7 ppm (referent category). After adjusting for all covariates, the adjusted prevalence ratios in both index categories were 1.64 (95% CI; 0.24, 11.24) and 2.85 (95% CI; 0.44, 18.52) which were close to their corresponding crude estimates. Since the magnitude of confounding, measured by (PRcrude–PRadjusted)/PRadjusted, were less than 10% for both index categories; this indicated the limited confounding effect of all covariates. Conclusions In fluoride endemic areas, groundwater containing natural fluoride utilized for household consumption resulted in high dental fluorosis prevalence, particularly in the groundwater with fluoride concentrations of ≥ 1.5 ppm. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01902-8.
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Affiliation(s)
- Chanapong Rojanaworarit
- Department of Health Professions, School of Health Professions and Human Services, Hofstra University, Hempstead, NY, USA.
| | - Luz Claudio
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nopporn Howteerakul
- Department of Epidemiology, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | | | | | - Pornpimol Kongtip
- Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok, Thailand
| | - Susan Woskie
- Department of Public Health, University of Massachusetts Lowell, Lowell, MA, USA
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Smith SR, Kroon J, Schwarzer R, Hamilton K. Social-cognitive predictors of parental supervised toothbrushing: An application of the health action process approach. Br J Health Psychol 2021; 26:995-1015. [PMID: 33656231 DOI: 10.1111/bjhp.12516] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/09/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND We examined the social cognition determinants of parental supervised toothbrushing guided by the health action process approach (HAPA). METHODS In a prospective correlational survey study, participants (N = 185, 84.3% women) completed HAPA social cognition constructs at an initial time point (T1), and 12 weeks later (T2) self-reported on their parental supervised toothbrushing behaviour, toothbrushing habit, and action control. RESULTS Structural equation models exhibited adequate fit with the data when past behaviour and habit were either excluded or included. Intention, self-efficacy, planning, and action control were predictors of parental supervised toothbrushing; intention predicted action planning and coping planning; and self-efficacy and attitude were predictors of intention. Indirect effects of social cognition constructs through intentions, and intentions through planning constructs were also observed. Inclusion of past behaviour and habit attenuated model effects. CONCLUSION Results indicate that parental supervised toothbrushing is a function of motivational and volitional processes. This knowledge can be used to inform behaviour change interventions targeting parental supervised toothbrushing.
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Affiliation(s)
- Stephanie R Smith
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Queensland, Australia
| | - Jeroen Kroon
- School of Dentistry and Oral Health, Griffith University, Gold Coast Campus, Queensland, Australia
| | - Ralf Schwarzer
- Department of Psychology, Freie Universität Berlin, Germany.,SWPS University of Social Sciences and Humanities, Wroclaw, Poland
| | - Kyra Hamilton
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Mount Gravatt Campus, Queensland, Australia
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