Influence of socioeconomic inequalities on levels of dental caries in adolescents: A cohort study

Ion Release and Apatite Formation of Resin Based Pit and Fissure Sealants Containing 45S5 Bioactive Glass

The purpose of this study was to evaluate a resin based pit and fissure sealant containing 45S5 bioactive glass (BAG) by examining its ion release, pH variation, and apatite-forming properties. To prepare the experimental materials, 45S5 BAG, used as a filler, was incorporated into the light curable resin matrix at concentrations of 0 (control), 12.5, 37.5, and 50.0 wt.%. Ion release, pH variation, and apatite formation (Raman spectrometer and scanning electron microscopy-energy-dispersive X-ray spectrometry measurements) were performed. While no ions were released from the control group, the experimental groups containing 45S5 BAG showed an increased release of Ca and P ions with increasing amounts of 45S5 BAG (p < 0.05). The pH of the experimental group remained high and was significantly different from the control group (p < 0.05). Unlike the control group, it was confirmed that the apatite peak was formed in the 50.0 wt.% BAG group for 90 days, and the apatite layer consisting of Ca and P was deposited on the surface. Thus, a resin based pit and fissure sealant containing 45S5 BAG is a promising material for preventing secondary caries by releasing ions and forming apatite.

Risk Factors Associated with Children's Behavior in Dental Clinics: A Cross-Sectional Study

One of the most crucial tasks of pediatric dentists is to control children's negative behaviors. This study aimed to assess dental behavior and the associated risk factors among children aged 4-12. This cross-sectional study recruited healthy, unaffected children aged 4 to 12 years. Parents were interviewed regarding the sociodemographic details and characteristics of their children's dental visits. Two collaborative dentists examined the children for dental caries (DMFT/DMFT) and behavioral status (Frankl's behavior rating scale). This study included 439 children: 27.3% exhibited uncooperative behavior, and the mean DMFT/dmft was 8.46 ± 3.530. Uncooperative behavior significantly increased when the dental visit was scheduled as an emergency treatment (p = 0.134; Adjusted Odds Ratio (AOR): 1.530) and when there was an elevated DMFT/DMFT ratio (p < 0.001; AOR: 1.308). This study revealed a significant association between children's uncooperative behavior and their first dental visit, emphasizing the need for tailored strategies to address behavioral challenges when scheduling pediatric dental care. The proactive measures included controlling caries and avoiding emergencies.

Impact of licit and illicit substances on the oral health-related quality of life in adolescents

OBJECTIVE

To assess the impact of the consumption of licit and illicit substances on the oral health-related quality of life (OHRQoL) of adolescents from public schools in the south of Brazil.

METHODS

This cross-sectional study was carried out with a random sample of adolescents aged between 17 and 18 years old from Santa Maria, Brazil. The consumption of licit and illicit substances was measured through a self-administered questionnaire with questions from the National Survey of Scholar Health. The OHRQoL was collected using the Brazilian short version of Child Perceptions Questionnaire 11-14 (CPQ11-14). Multilevel Poisson regression models were used to estimate the association between the outcome and the explanatory variables where the adolescents (first level) were nested in their schools (second level).

RESULTS

A total of 768 adolescents were evaluated. Of these, about 15.6% have already used illegal substances. Adolescents who reported the use of illicit substances had 28% higher CPQ11-14 scores when compared to their counterparts. Alcohol use was also related to worse levels of OHRQoL, while the consumption of cigarettes acted as a protective factor.

CONCLUSIONS

This study found an association between the use of alcohol and illicit drugs with worse levels of OHRQoL.

The Impact of Socioeconomic Factors on Pediatric Oral Health: A Review

This narrative review examines the impact of socioeconomic status (SES) on pediatric oral health, emphasizing disparities in dental caries prevalence and oral health-related quality of life (OHRQoL) among children from different socioeconomic backgrounds. Utilizing an extensive literature search through PubMed, Google Scholar, and the chat.consensus.app plugin, we synthesized findings from studies published up to December 2023. The review highlights a consistent association between lower SES and adverse pediatric oral health outcomes, influenced by parental education, household income, food security, and neighborhood conditions. It also underscores the importance of the life-course perspective, showing how early-life socioeconomic disadvantages can have long-lasting effects on oral health. Furthermore, the review points to the critical role of school-based oral health education programs and the complex interplay between mental health, SES, and pediatric oral health. By examining the impact of socioeconomic factors across different childhood stages and the effectiveness of educational interventions, this review calls for targeted interventions and policy initiatives aimed at reducing socioeconomic inequalities in pediatric oral health. The findings advocate for a multifaceted approach to improve oral health outcomes for children across socioeconomic backgrounds, ensuring equitable access to oral health care and promoting overall well-being.

Systems mapping of multilevel factors contributing to dental caries in adolescents

Dental caries is a prevalent chronic disease among adolescents. Caries activity increases significantly during adolescence due to an increase in susceptible tooth surfaces, immature permanent tooth enamel, independence in pursuing self-care, and a tendency toward poor diet and oral hygiene. Dental caries in permanent teeth is more prevalent among adolescents in low-income families and racial/ethnic minority groups, and these disparities in adolescent dental caries experience have persisted for decades. Several conceptual and data-driven models have proposed unidirectional mechanisms that contribute to the extant disparities in adolescent dental caries experience. Our objective, using a literature review, is to provide an overview of risk factors contributing to adolescent dental caries. Specifically, we map the interactive relationships of multilevel factors that influence dental caries among adolescents. Such interactive multilevel relationships more closely reflect the complex nature of dental caries experience among the adolescent population. The methods that we use are two-fold: (1) a literature review using PubMed and Cochrane databases to find contributing factors; and (2) the system dynamics approach for mapping feedback mechanisms underlying adolescent dental caries through causal loop diagramming. The results of this study, based on the review of 138 articles, identified individual, family and community-level factors and their interactions contributing to dental caries experience in adolescents. Our results also provide hypotheses about the mechanisms underlying persistence of dental caries among adolescents.

Conclusions

Our findings may contribute to a deeper understanding of the multilevel and interconnected factors that shape the persistence of dental caries experience among adolescents.

Examining Myeloperoxidase (MPO) biomarker in the saliva of patients with Lactobacillus-associated caries in Hilla City

This study aimed to evaluate the levels of myeloperoxidase (MPO) biomarkers in the saliva of individuals with Lactobacillus spp.-related caries in Hilla City. A total of 115 samples were collected, including 90 (78.26%) from patients with severe dental caries and 25 (21.74%) from healthy subjects as a control group. The age range was between 20 and 45 years, with a mean age of 33.76±2.01 for patients with severe dental caries and 24.15±0.44 for healthy subjects. Female participants constituted the majority of the study sample, with 77 (85.5%) females and 13 (14.5%) males. Pathogenic bacteria were isolated and identified using gram staining, biochemical tests, and the VITEK 2 compact system. Of the 90 clinical samples, 65 (72.2%) showed positive bacterial culture, while 25 (27.7%) samples had no bacterial growth. Lactobacillus spp. accounted for 25/65 (38.4%) of the total isolates, making it the predominant etiological agent compared to other types of bacteria, constituting 40/65 (61.5%). There was a significant decrease (p≤0.05) in myeloperoxidase levels in patients with severe dental caries and positive Lactobacillus culture compared to the control group.

Geo-Mapping of the Spatial Accessibility to Public Oral Health Facilities among Schoolchildren in Selangor, Malaysia

Spatial accessibility to health services influences service utilisation and eventually impacts the disease burden. This cross-sectional study analysed the spatial accessibility of schoolchildren to public oral health facilities and school dental services (SDS) and vice versa in Selangor. Overlay and proximity analysis from geo-mapping software was employed to map the primary dental clinics with SDS, the public schools, and the proximity between primary dental clinics with SDS and public schools by travelling distance (5 km, 10 km, 20 km) and travelling time (15 min, 30 min). Over half of the schoolchildren in Selangor are within 5 km of accessibility to primary dental clinics and SDS teams. Meanwhile, nearly half of the primary and secondary schools, particularly in rural areas, are located within a more than 5 km service area of public oral health facilities. The SDS teams have a travel burden of more than 20 km to the public schools in Selangor's northern and north-western districts of large geographical areas. Simultaneously, most public primary and secondary schools are within 15 min of driving time from primary dental clinics. Geo-mapping highlights the inequalities in spatial accessibility to public oral health facilities with SDS among schoolchildren in Selangor. It is time to prioritise the resources, SDS, and preventive programmes to reduce inequalities in oral health accessibility among schoolchildren in Selangor.

Parental stress and dental caries experience in adolescents: analysis of data from a birth cohort study in Pelotas, Southern Brazil

PURPOSE

Analyze the association between parental stress and dental caries experience in adolescents in southern Brazil using data from the Pelotas 2004 Birth Cohort.

METHODS

Interviews and oral health examinations for the determination of the main exposure and outcome of the study were performed in the homes of the adolescents. The outcome was dental caries experience in the permanent dentition analyzed using the Decayed, Missing and Filling Surfaces (DMFS) index. The main exposure was parental stress measured using the Parenting Stress Index-Short Form administered to the parents of the adolescents. Demographic/socioeconomic characteristics, oral health characteristics and oral health-related quality of life were considered potential confounding factors. Negative binomial regressions estimated mean ratios (MR) and 95% confidence intervals (CI).

RESULTS

Nine hundred ninety-six adolescents were evaluated at 12 and 13 years of age. The prevalence of dental caries experience in the adolescents was 36.9% (95% CI: 33.8-40.0) and 15.1% (95% CI: 12.8-17.3) of the parents had parental stress. After adjusting for confounding factors, parental stress was associated with a higher mean number of decayed, missing and filling surfaces in the adolescents (MR = 1.10; 95% CI: 1.01-1.26; p = 0.045).

CONCLUSION

Adolescents of parents with parental stress have more dental caries experience compared to those whose parents do not have parental stress.

Prevalence of Dental Caries in Children in Mymensingh and Its Associated Risk Factors: A Cross-Sectional Study

Background: Children suffer from various oral and periodontal diseases. Dental caries is one of the most prevalent oral diseases among children in the world. This study was conducted to identify the prevalence and risk factors of dental caries in children in Mymensingh, Bangladesh. Methods: A cross-sectional study was conducted on 362 pediatric patients who attended the Dental Unit of Mymensingh Medical College from March to September 2019. The sample size was calculated using a statistical formula and the children were selected using a systematic random sampling technique. Children and their guardians were interviewed and data were recorded using a structured questionnaire. Risk factors were analyzed using multivariate logistic regression. Results: The overall prevalence of dental caries was 82.7%. The prevalence of caries was significantly higher in aged children (8–10 years) and also in rural, low-income, and illiterate families. Seven significant risk factors were identified that included residence in the rural area (OR: 7.31 [1.73–30.83]), a parental income of BDT ≤ 20,000 per month (OR: 4.75 [1.49–15.05]), reduced duration (≤1 min) of teeth cleaning (OR: 18.54 [2.05–168.17]), teeth cleaning before breakfast (OR: 93.30 [10.95–795.32]), the spoon-feeding method (OR: 12.57 [2.09–75.61]), long-term (37–48 months) breastfeeding (OR: 212.53 [8.69–5195.25]), and family oral problem (OR: 8.20 [2.57–26.16]). Conclusions: The prevalence of dental caries among the children in Mymensingh is very high and was associated with residence in rural areas, parental income, reduced duration of teeth cleaning, teeth cleaning before breakfast, the spoon-feeding method, long-term breastfeeding, and family oral problems.

Number of dentists in the neighborhood and incidence of dental caries in the children permanent dentition

This study aimed to evaluate the influence of the number of dentists in the neighborhood on the incidence of dental caries in the children permanent dentition. This cohort began in 2010 (T1) with a random sample of 639 children (1 to 5 years-old) followed for 7 years, in southern Brazil. The follow-up reassessment (T2) took place in 2017. Untreated dental caries was evaluated at T2 through the Decayed, Missing, and Filled surfaces index (DMF-S). The number of dentists in the neighborhood was obtained from the city's official database and used as a contextual variable. Socioeconomic, demographic, and oral health variables at the individual level were evaluated at T1. A multilevel Poisson regression was performed to evaluate the influence of the predictor variables in the incidence of untreated dental caries. From 639 children at T1, 449 were reassessed at T2 (a 70.3% retention rate). The mean of decayed surfaces at T2 was 0.92 (SE 0.01). The greater the number of dentists in the neighborhoods where the children lived, the lower the incidence of dental caries. Children with low socioeconomic status, who have not routinely visited the dentist in the last 6 months, who presented a experience of dental caries, and whose parents perceived their oral health as fair/poor showed a higher incidence of surfaces with untreated dental caries. As conclusion, children who live in neighborhoods with fewer dentists have a higher incidence of untreated dental caries in permanent dentition.

Molar-incisor hypomineralization and dental caries: A hierarchical approach in a populational-based study

The last couple of decades has seen an increasing interest in molar-incisor hypomineralization (MIH) studies. Hypomineralized defects can have several consequences such as hypersensitivity, increased dental plaque accumulation, and consequently higher caries risk. This cross-sectional study aimed to investigate the prevalence of MIH and its association with dental caries in schoolchildren from a city in southern Brazil. A random cluster sample of schoolchildren was selected. Clinical examinations were carried out to collect information on MIH (following the European Academy of Pediatric Dentistry criteria), dental caries (using the DMF-T index) and gingivitis. Socioeconomic, demographic and behavior variables were collected using a standardized questionnaire answered by the children's parents/caregivers. Prevalence ratios (PR) were estimated using Poisson regression analysis with robust variance through a hierarchical approach (p<0.05). A total of 513 schoolchildren were included in the study. MIH and caries prevalence was 19.7% and 31.6%, respectively. The mean age was 11.6 (+1.9) years. Dental caries was more prevalent in children with MIH (PR 1.39; 95% CI 1.05 - 1.85). Older children and children whose families were enrolled in conditional cash transference programs (PR 1.97 95% CI 1.47 - 2.64), and children who did not have their mother or father as the head of the family (PR 1.56 95% CI 1.06 - 2.30) presented a higher prevalence of dental caries. Our findings suggest that children with MIH are more likely to have dental caries.

Contributions of school context to caries on anterior teeth: a multilevel analysis

OBJECTIVE

To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents.

METHODS

A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05).

RESULTS

The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24–2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13–1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05–3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07–1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78–3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05–0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98–0.99) were associated with the outcome.

CONCLUSIONS

Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19.

Toothbrushing and related factors among high school students in the Southeast of Iran: A cross-sectional study

INTRODUCTION

Dental caries is one of the most common problems in student, and tooth brushing at least twice a day is one of the preventive measures of dental caries. This study aimed to determine the frequency of daily brushing and its related factors among high school students in the southeast of Iran based on the Health Action Process Approach (HAPA).

METHODS

In this cross-sectional study, 2045 high school students of 13-15 years from urban areas of Zahedan in the southeast of Iran with multistage random sampling were selected. A self-administered questionnaire was used to assess demographic background, psychosocial constructs of the HAPA and daily brushing frequency. Binary logistic regression analysis was performed to determine predictors of daily brushing.

RESULTS

Only 18% of participants reported tooth brushing at least twice a day, which is the desired brushing behaviour. Multivariate regression showed that increased odds of daily brushing associated with gender (OR = 2.38, 95% CI 1.84-3.08), mother education (OR = 2.27, 95% CI 1.62-3.18), father job (OR = 2.24, 95% CI 1.20-4.19), task self-efficacy (OR = 1.24, 95% CI 1.08-1.42), action planning (OR = 1.10, 95% CI 1.02-1.19) and maintenance self-efficacy (OR = 1.20, 95% CI 1.13- 1.27).

CONCLUSION

The brushing behaviour of students needs to be taken seriously in Zahedan. Motivational and volitional constructs of the HAPA include task self-efficacy, action planning, and maintenance self-efficacy could be considered in intervention programmes targeting increase adolescent brushing.

Caries incidence of the first permanent molars according to the Caries Assessment Spectrum and Treatment (CAST) index and its determinants in children: a cohort study

Background

There are limited information on caries incidence, especially from developing countries, the aim of the present study was to explore caries incidence in the first permanent molar teeth according to the CAST index in 7- to 8-year-old-children and its socio-demographic, oral health related and diet determinants.

Methods

A multi-stage cluster random sample of 7–8 years old children was applied in Tehran, Iran. The oral examination using the CAST index and the Oral Hygiene Index-Simplified (OHI-S) performed by trained dentists in 2017 and 2019 calibrated with an expert (Kappa of 0.89 and 0.76, respectively). A 3-day food record was used to record sugary snacks consumption. Oral health related knowledge of the parents was assessed using a valid and reliable self-administered questionnaire. The data were analyzed using the SPSS software version 23.0 and descriptive and analytical statistics including the negative binomial regression was applied.

Results

Two hundred and ninety schoolchildren aged 7–8 years old were followed up for two years. All of them had complete data obtained via oral examination and questionnaires. The annual caries incidence rate was 0.16 and 53% (95% CI 47.4–58.9) of the children developed at least one new dental caries (enamel or dentine) during two years. Multi-variate analysis revealed that the children of mothers with high school education or diploma (IRR = 1.47, 95% CI 1.02–2.12; p = 0.04) and those with low socio-economic status (IRR = 1.86, 95% CI 1.27–2.73; p < 0.001) were more likely to develop caries. There was no significant association between gender, father’s educational level, child birth order, housing area per person, OHI-S score, oral health knowledge of parents, and sugary snacks consumption per day and caries increment at an individual level.

Conclusion

This 2-year longitudinal study on 7- to 8-year-old children showed that caries incidence according to the CAST index was associated with socio-economic status and mother education but not associated with having 2 or more sugary snack per day and oral hygiene status.

Pathways influencing dental caries increment among children: A cohort study

BACKGROUND

Dentists should assess pathways influencing the increment of dental caries among children to guide the prevention and treatment of the disease.

AIM

Evaluate the pathways that influence the increment of carious lesions in pre-school children.

DESIGN

This is a 2-year cohort study was conducted with a random sample of 639 pre-school children in southern Brazil. Caries experience, socioeconomic status (SES), social capital, and psychosocial characteristics were obtained at baseline. Increment of dental caries was assessed at 2 years follow-up in 467 children (cohort retention rate of 73.1%). Previously calibrated examiners assess the caries through the International Caries Detection and Assessment System (ICDAS). Structural equation modeling (SEM) was performed to test the pathways influencing dental caries increment.

RESULTS

Dental caries at baseline was heavily influenced by children's age (SC: 0.381, P < .01), tooth plaque (SC: 0.077, P = .02), parent's perception child oral health (SC: 0.295, P < .01), and household (SC: 0.148, P < .01). Increment of dental caries was directly affected by dental caries at baseline (Standardized Coefficients [SC]: 0.377, P < .01). Indirect paths were not significant.

CONCLUSIONS

Dental caries experience was the main factor of direct influence on the increment of caries, reinforcing the theory of risk accumulation over time.

Dental Fluorosis: the Risk of Misdiagnosis-a Review

Fluoride has been considered as the single factor most frequently responsible for causing enamel mottling. However, in humans, either endogenous and/or exogenous factors not related to fluoride exposure may also cause enamel mottling. In this sense, various studies in the international literature have reported severe mottling of the teeth that could not be attributed to fluoride exposure. Thus, misdiagnosis of non-fluoride-induced enamel defects may occur frequently. Reports of unexpectedly high population prevalence and individual cases of fluorosis, where such diagnoses are irreconcilable with the identified fluoride history, highlight the necessity for a more precise definition and diagnosis of dental fluorosis. Also, a more discriminating diagnostic procedure is suggested. Particularly, positive identification of environmental fluoride levels to which the communities and individuals are exposed shall be developed before the confirmation of a diagnosis of fluorosis. It is considered that a more critical methodology for the diagnosis of fluorosis will be helpful in the rational use and control of fluorides for dental health, and in the identification of factors that may induce enamel defects.

Knowledge synthesis: How to improve the use of evidence from clinical trials?

BACKGROUND

The value of systematic reviews (SRs) is determined by methodology and reporting quality of primary studies and how the SR is conducted and reported.

AIM

This study discusses key aspects of clinical trials (CTs) that might affect the value of SRs.

DESIGN

Narrative review.

RESULTS

We highlighted the following CT factors that could affect SR value: Defining the purpose of CTs is important because it could directly impact whether an SR question is appropriately answered and formulated; choose the most appropriate intervention to answer a proposed SR question is critical because we can exclude or include different studies, directly influencing selection bias; when conducting SRs, the study's search must be restricted to equal or highly similar comparison groups, allowing suitable comparisons of the outcomes' estimates; in SRs, it may be interesting to explore the effect of the most common definition of the disease used in clinical practice, being useful in evidence-based dentistry and easily translated to daily practitioners; and deficiencies in CT reporting can lead to unusable reports, biased results, and conclusions.

CONCLUSION

All aspects discussed were found to be important for improving the use of evidence from CTs.

Factors associated with dental caries in adolescents: a cross-sectional study, São Paulo State, Brazil, 2015

OBJECTIVE

To analyze association between prevalence and severity of dental caries and demographic, socioeconomic, behavioral and oral health status in adolescents.

METHODS

This was a cross-sectional study with secondary data on 5,558 adolescents examined in the São Paulo State Oral Health Survey in 2015. The zero-inflated negative binomial regression model was used, considering sample weights. Prevalence ratios (PR), ratios of mean (RM) and confidence intervals (CI) were estimated.

RESULTS

Caries prevalence was 71.7%, and was higher in females (PR=1.09 - 95%CI 1.04;1.15), associated with being behind at school (PR=1.11 - 95%CI 1.03;1.18), dental calculus (PR=1.10 - 95%CI 1.01;1.20) and no access to fluoridated water (PR=1.21 - 95%CI 1.01;1.45).

CONCLUSION

Identification of factors associated with dental caries can instruct the programming of health services aimed at controlling the disease.

Perception of Dental Caries and Parental Difficulties in Implementing Oral Hygiene for Children Aged Less Than 6 Years: A Qualitative Study

BACKGROUND

Despite extensive prevention programs, dental hygiene remains inadequate, particularly among children under the age of six, and early childhood caries (ECC) are still a concern. Oral hygiene behavior and preventive practices seem difficult to change at a family level.

AIM

The present study aimed to better understand the reasons behind this behavior and to identify the different barriers to the implementation of adequate preventive measures.

METHODS

A qualitative study was conducted in the pediatric dentistry service of the Montpellier University Hospital (France) in 2019. A thematic analysis concerning three domains was performed: family environment, dental literacy, and oral hygiene.

RESULTS

The main barriers encountered by the parents were, respectively, (1) a weakness in the organization of familial life, together with a low-medium family income and a lack of authority, (2) ignorance of the necessity of treating carious primary teeth, and (3) a lack of time for brushing or supervising their children's teeth.

CONCLUSION

These results showed that oral hygiene and primary teeth care could not be easily achieved in the family environment of the participants, and oral health strategies should be focused not only on children but also on their parents.

School academic climate and oral health (tooth loss) in adolescents

Background

Preventing tooth loss depends on oral health maintenance behaviors. This study hypothesized that adolescents with educational aspirations have greater motivation to invest in the future, including maintenance of oral health status.

Aim

To analyze the association between a school academic climate of educational aspirations and tooth loss (first permanent molars) among adolescents.

Methods

A cross-sectional study was designed to include 2,500 adolescents (aged 14–19 years) enrolled in public high schools of Olinda located in Northeast Brazil. Multilevel Poisson regression random intercept models were conducted with tooth loss (first permanent molars) as the outcome. The primary cohort of interest was school academic climate, as measured by the proportion of students taking the national high school exams.

Results

Tooth loss of the first permanent molars (assessed by clinical exam) was more prevalent in adolescents from more disadvantaged backgrounds (receiving family allowance, low maternal education). However, after controlling for a wide range of individual characteristics, adolescents enrolled in schools with lower academic climate had a higher prevalence of tooth loss (PR 1.42, 95%CI: 1.09,1.85).

Conclusion

The school academic climate is associated with tooth loss, suggesting that educational aspirations are linked to adolescent oral health maintenance behaviors.

Untreated dental caries prevalence and impact on the quality of life among 11 to14-year-old Egyptian schoolchildren: a cross-sectional study

Background

This study aimed to assess caries prevalence and experience among 11 to 14 years, school children, analyze demographic, socioeconomic, personal and professional dental care in relation to untreated carious lesions, and evaluates the effect of decayed teeth on early adolescents’ oral health-related quality of life (OHRQoL).

Methods

A cross-sectional analytical investigation was conducted on 1020 preparatory schoolchildren selected on the basis of a multistage sampling technique. Caries status of the participants detected via recording their caries experience and untreated cavities using DMFT and DT indices. OHRQoL was determined using a validated Arabic CPQ_11–14 short-form questionnaire. Statistical methods for descriptive analysis, chi-square test, Independent-Samples t test and one-way analysis of variance (ANOVA) were used. Multivariate Poisson regression analysis through a hierarchical approach was used to detect the influence of independent variables on DT scores. To declare the association between independent variables and QoL, a step-by-step, multivariate regression analysis was conducted.

Results

The average scores of DMFT and DT in this study were 2.97 ± 1.29 and 1.66 ± 1.24. Poisson regression analysis demonstrated that early adolescents whom their mothers with a lower level of education and of low socioeconomic status were 1.41 and 1.27 times respectively had higher DT scores when compared with their peers. Untreated cavities affected mainly by mother education, school type, family income, and regular dental appointments. Children with DMFT≤3) or DT = 0 recorded a statistically significant lower CPQ_11–14 average score (p<0.01) and (p<0.0001) respectively.

Conclusions

Untreated carious cavities and caries experience were associated with lower socioeconomic, maternal education andl ess frequent tooth brushing. Untreated carious cavities have a significant negative impact on schoolchildren’s QoL.