Dental caries experience and use of dental services among preschool children in Ajman, UAE

Dental pain in Brazilian preschool children: association with the severity of dental caries and impact on oral health-related quality of life

PURPOSE

This study aimed to verify the association between dental pain and severity of dental caries (caries morbidity stages) and the impact on oral health-related quality of life (OHRQoL) in preschool children.

METHODS

A cross-sectional study with 199 children (2-5 years old) enrolled at preschools in Capão do Leão-RS, Brazil. The self-report of mothers of children with a history of dental pain in the last 6 months and perception of their child's OHRQoL (ECOHIS) were obtained through a structured questionnaire. This questionnaire also collected independent variables. Children's oral examination was performed using the CAST instrument to determine caries morbidity stage. Crude and adjusted Poisson regression analysis was performed.

RESULTS

The prevalence of dental pain was 14.57%. The chance of the occurrence of dental pain was higher among children diagnosed in morbidity [Prevalence ratio-PR: 5.29 (95% confidence interval-95% CI 1.91-14.61); p = 0.001] and severe morbidity [RP = 6.12 (95 CI% 2.25-16.64); p < 0.001] stages. Children with dental pain presented higher scores in the total ECOHIS [rate ratio = 7.11 (95% CI 4.55-11.09); p < 0.001] and in all of the domains of this instrument. Furthermore, children with a history of dental trauma [PR = 2.41 (95% CI 1.15-5.04); p < 0.001] and those whose reason for last visit to the dental office was for restorative/endodontic/extraction treatment [PR = 1.29 (95% CI 1.01-6.19); p = 0.049] had a higher prevalence of dental pain.

CONCLUSION

A substantial prevalence of dental pain in the last 6 months and negative impact on children's OHRQoL was identified in this sample. Children diagnosed with carious dentin lesions and abscess and fistula were more likely to have dental pain.

Trends and age-period-cohort effect on dental caries prevalence from 2008 to 2019 among Brazilian preschoolers

This study aimed to evaluate trends in the prevalence of dental caries in preschool children and associated factors considering different time variations. This is a time series study performed using data from three cross-sectional studies with pre-school children from southern Brazil in 2008, 2013 and 2019. This children group was born between the years of 2003 to 2018. Dental caries was evaluated by decayed, missing and filled deciduous teeth (dmft index). Demographic, socioeconomic, behavioural and psychosocial variables were also collected. Chi-square test for trends and a hierarchical age-period-cohort (HAPC) analysis using multilevel Poisson regression model for testing the associations between predictor variables and dental caries experience were used. A total of 1,644 pre-school children participated in all surveys. There was a significant difference in caries experience considering all APC effects. The prevalence of dental caries was 25.0% in 2008, 16.3% in 2013, and 19.4% in 2019 (p < 0.01) and no statistical difference was observed. An age effect showed that older children were more likely to experience dental caries. Considering the cohort effect, there is a significant difference between the generations, mainly between 2003 and 2018. Household income, use of dental services, and parent's perception of child oral health were associated with dental caries experience no matter the time variation. Despite recent declines in dental caries prevalence among preschool children, caries levels increased with age and social inequalities persisted through the years, indicating a need of reviewing the policies to reduce the burden of this oral disease.

Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010-2021)

Early childhood caries (ECC) is one of the most prevalent chronic childhood diseases affecting the primary teeth of children younger than 6 years of age. The disease etiology is complex and includes social, biological, and dietary factors. This review aims to explore the knowledge of ECC prevalence globally and locally within the Gulf Cooperation Council (GCC) countries during the years 2010-2021. Another aim is to explore oral health promotion programs with more focus on the GCC region. A search was conducted in PubMed, Medline, Scopus, the Cochrane Collaboration database, and Google Scholar to identify relevant studies published between 2010 and 2021 using specific keywords. Studies that utilized both the World Health Organization criteria and International Caries Detection and Assessment System for dental caries assessment were included. The included studies indicated considerable variation in the reported prevalence of ECC. While developed countries show low prevalence, countries in the GCC and other Arab countries show a high prevalence of ECC. Many oral health promotion programs were identified globally including oral health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-professional population-based oral health promotion and prevention programs such as school-based oral health programs, motivational interviewing, and anticipatory guidance. ECC remains a significant problem in many parts of the world including the GCC region. Oral health prevention programs have been established within the GCC region. Nevertheless, the GCC region has some unique characteristics that need to be investigated to contextualize the western model of the dynamics of ECC prevention and promotion programs locally.

Assessment of electrophysiological changes in the heart by analysing resting electrocardiografic recording and comparison with Seattle criteria in trained male 14-19 years aged volleyball players

Background: Cardiovascular arrest among athletes is prevalent in today's competitive world. As a result, a thorough and routine assessment is advised. The Seattle Criteria are one of the most widely accepted standards in the electrophysiological diagnosis and can reveal possible aberrant findings based on ECG values. Aim of the study: This study aims to investigate the heart's electrophysiological adaptations in trained male volleyball players. This comparison study used the Seattle Criteria to evaluate whether training has a beneficial or negative impact on the heart. Material and methods: In this study, 41 trained male volleyball players aged 14 to 19 were divided into three groups (14–15, 16–17, and 18–19). Each player's resting ECG was recorded and compared to the Seattle criteria. The Kruskal-Wallis nonparametric ANOVA was used, followed by the Mann-Whitney U test for significant outcomes. Results: The Q-T interval differed significantly between the three groups (p < 0.05). In Groups 2 and 3, ST depression was identified using ECG 23% and 8% of the time, respectively. In Groups 1, 2, and 3, ST elevation was detected in 60%, 62%, and 83% of ECGs, respectively. Group 1 had much longer ventricular depolarization and repolarization times. Sinus bradycardia, sinus arrhythmia, and early repolarization (ST elevation) are considered normal ECG findings in athletes, while a ST-segment depression (0.5 mm) is abnormal. Conclusions: It can be inferred that the adaptive aspects of the electrophysiological alterations in the heart as a result of training may help justify the effective workload and prevent cardiac failure in athletes.

Pathways between Social Capital and Oral Health from Childhood to Adolescence

This study aimed to evaluate the theoretical pathways by which social capital can influence dental caries and oral health-related quality of life (OHRQoL) of children over time. This 10-y prospective cohort started in 2010 with a sample of 639 preschoolers aged 1 to 5 y from the southern Brazil. Community and individual social capital were assessed at baseline through the presence of formal institutions in the neighborhood and social networks, respectively. In the 10-y follow-up, the individual social capital was evaluated by social trust and social networks. Dental caries was measured by the International Caries Detection and Assessment System (ICDAS), and the short version of the Child Perception Questionnaire (CPQ11-14) was used to assess OHRQoL. Demographic, socioeconomic, behavioral (frequency of toothbrushing and use of dental services), and psychosocial (sense of coherence) characteristics were also assessed. Structural equation modeling was used to evaluate the associations between variables over time. About 429 children were reassessed at 10-y follow-up (67.1% cohort retention rate). High community social capital at baseline directly predicted lower occurrence of dental caries and better OHRQoL after 10 y. Social capital at community level also indirectly predicted lower occurrence of dental caries through sense of coherence, frequency of toothbrushing, and use of dental services. Individual social capital at follow-up was indirectly linked to OHRQoL via the psychosocial pathway (sense of coherence). Community-level social capital was associated with dental caries and OHRQoL over time. The relationship between individual social capital and oral health was mediated through the psychosocial pathway.

Determinants of dental caries in children in the Middle East and North Africa region: a systematic review based on literature published from 2000 to 2019

Background

Dental caries risk factors have been expanded to not only emphasize biology, dietary and oral habits but also broader social determinants such as socioeconomic factors and the utilization of health services. The aim was to review sociobehavioural/cultural and socioeconomic determinants of dental caries in children residing in the Middle East and North Africa (MENA) region.

Methods

A search was conducted in the PubMed/Medline database and Google Scholar to identify studies published from 2000 to 2019 covering children using key search terms. In the initial stages, titles, abstracts and, if needed, full articles were screened for eligibility. In the final stage, all included articles were reassessed and read, and relevant data were extracted.

Results

Out of 600 initial articles, a total of 77 were included in this review, of which 74 were cross-sectional, 2 were longitudinal and one was a case–control study. The studies included a total of 94,491 participants in 14 countries across the MENA region. A majority used the World Health Organization scoring system to assess dental caries. The caries prevalence ranged between 17.2% and 88.8%, early childhood caries between 3% and 57% and decayed missing filled teeth (dmft) varied between 0.6 and 8.5 across the various age groups. Increased age, low maternal education, low overall socioeconomic status, decreased frequency of tooth brushing, low parental involvement, poor oral habits, infant feeding practices and sugar consumption were among the most prevalent determinants for increased risk of caries in the reviewed studies.

Conclusions

Dental caries was found to be high among children in many of the studies published from MENA. The key determinants of dental caries were found to include factors related to child characteristics, family background, oral hygiene and infant feeding and eating habits. The high dental caries prevalence emphasises the need to address the prevailing modifiable sociobehavioural and socioeconomic determinants by translating them into effective oral health prevention policies and programmes.

Oral status of HIV-infected children aged 12 years or younger who attended a Paediatric Infectious Diseases Clinic in Cape Town

BACKGROUND

Children continue to suffer from the impact of the human immunodeficiency virus-acquired immunodeficiency syndrome (HIV/AIDS) pandemic. In Cape Town, these children receive medical care including antiretroviral therapy from facilities like Tygerberg Hospital's Paediatric Infectious Diseases Clinic. HIV-infected children may experience an increased caries experience when compared with their healthy peers.

AIM

The aim of this study was to determine the oral health status of HIV-infected children younger than 12 years receiving antiviral drugs at the Paediatric Infectious Diseases Clinic.

DESIGN

A cross-sectional survey was conducted among children aged between 2 and 12 years presenting at this clinic. Caregivers were interviewed to obtain information regarding health seeking behaviour, oral hygiene practices and dietary habits. A single clinician undertook a standardized clinical intraoral examination according to the World Health Organization guidelines, with modifications.

RESULTS

Sixty-six children were recruited. A high prevalence of dental caries (78.8%) and an unmet treatment need of 90.4% were recorded among the participants. Most children had never visited the dentist, and those who did had mainly received emergency dental care.

CONCLUSION

The high prevalence of severe dental caries in this population highlights the need for oral health awareness and the inclusion of oral health care in the comprehensive care of children with HIV.

WHY THIS PAPER IS IMPORTANT TO PAEDIATRIC DENTISTS

The study highlights the importance of collaborating with health professions outside of dentistry. Doctors and nurses are often the first health professionals to come into contact with children with special needs. They should therefore be made aware of the early signs of decay so that these patients can be referred for dental treatment timeously. Holistic management of children with special healthcare needs is essential to improve their overall well-being.

Oral Health Status among Children with Down Syndrome in Dubai, United Arab Emirates

Objectives:

The purpose of this study was to assess the oral health status in Down syndrome (DS) children in Dubai, United Arab Emirates.

Materials and Methods:

A total of 106 DS children (mean age = 9.3 ± 2.8) and 125 healthy children (mean age = 11.7 ± 4.4) were recruited from both special needs centers and private/public schools in Dubai. A dental examination for decayed-missing-filled teeth (DMFT) in deciduous dentition/DMFT in permanent dentition indices, simplified oral hygiene index, calculus index (CI), were carried out. In addition, occlusal, dentofacial, soft-tissue abnormalities, and erosion were assessed. Statistical analysis was conducted using SPSS for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA).

Results:

The mean number of DMFT in DS children was significantly higher than that in healthy children. DS children in the primary dentition group had higher restorative index and Met Need Index scores than the control group. On the other hand, CI was found to be significantly higher among children with DS compared to healthy controls (P < 0.004). DS children had a significantly higher proportion of open bite and other occlusal problems. Class III molar angle malocclusion was significantly higher in DS (66%) compared to controls (11.2%). Erosion was significantly higher among DS children compared to healthy control (34% vs. 15.3%).

Conclusions:

DS children in Dubai had higher caries rate compared to healthy children. DS group received more restorations and dental treatment compared to the control group. More to add, DS children had significantly more calculus, erosion, and malocclusion problems.

Anti-caries vaccine based on clinical cold-adapted influenza vaccine: A promising alternative for scientific and public-health protection against dental caries

Dental caries remains one of the most pervasive infectious disease around the world. Protection against dental caries can be achieved experimentally by eliciting salivary IgA targeting surficial antigens of S. mutans, however, no such a vaccine has been launched for human use yet. Live vectored vaccines hold the greatest feasibility to induce potent and long-lasting immunity in the host. The FDA approved intranasal cold-adapted influenza vaccine has been used in clinical settings for many years. The vaccine can not only induce broad adaptive immune responses especially mucosal immunity, but the member strains can also circumvent existing immunity, presenting promising candidates for live vectored anti-caries vaccine. Moreover, the genetic techniques for modification of cold-adapted influenza viruses are well developed and widely applicable. Thus, we hypothesize that effective anti-caries vaccine can be developed with the backbone of cold-adapted influenza viruses by inserting specific antigenic identifier sequences of S. mutans into the viral genome, which is anticipated to protect against dental caries in humans with easy inoculation. The immune efficacies of recombinant cold-adapted influenza viruses expressing exogenous antigens have been verified by in vivo experiments for multiple infectious diseases, giving us great confidence to validate the safety properties and protection effect with this chimeric vaccine in animals or even humans. Existing data suggests that the live anti-caries vaccine may help improve public oral health by controlling the caries disease itself.

Children’s meals at restaurants in Abu Dhabi, United Arab Emirates, have poor nutritional quality

BACKGROUND: Many people in the UAE eat out frequently, but there is limited knowledge about the nutritional quality of the consumed meals. OBJECTIVE: The aim of this study was to assess the nutritional quality of children’s meals in Abu Dhabi restaurants, considering deep-frying and food group content. METHODS: In this cross-sectional pilot study, popular food outlets were identified using an online customer rating application. Children menus were collected and the meal quality was assessed. A healthy meal should not be deep-fried and contain at least 2 of the following food groups: low-fat dairy/lean protein/whole grain/fruits/vegetables (criteria adapted from the “Kids Live Well Nutritional Criteria” by the National Restaurant Association, US). RESULTS: 58 restaurants were included, of which 29 had children menus, offering a total of 209 meals. 60% of the meals had beverages included in the price: 13% being water or milk. Overall, 78.9% of the assessed meals did not meet the cut-offs for healthy meals. CONCLUSIONS: In this pilot study, a majority of children’s meals in Abu Dhabi’s food outlets had poor nutritional quality. The findings suggest a need for more extensive studies around meal offerings at restaurants.

Oral Health Knowledge, Attitude, and Practices of Sharjah Mothers of Preschool Children, United Arab Emirates

Objective:

The improvement of children's oral health, a world global health target, is essential to general health and quality of life. Hence, the aim of this study was to assess the knowledge, attitude, and practices of mothers toward their children's oral health in Sharjah, United Arab Emirates (UAE).

Materials and Methods:

A cross-sectional interview-based study was conducted among 383 mothers of preschool children (average age 3.49 [+1.63 years]) attending Sharjah Dental Center, UAE. Statistical analysis was performed using SPSS software for Windows, version 20.0 (SPSS Inc., Chicago, IL, USA).

Results:

Adequate knowledge was found among 58.2% of mothers, 99% exhibited excellent attitude, and only 20% followed good practices toward their children's oral health. Poor knowledge and practice of mothers were significantly associated with mothers' occupation and education. Employed mothers had a significantly higher score of knowledge. Mothers with secondary education and university qualifications had significantly higher scores of practice compared with mothers with primary education.

Conclusions:

Although mothers had better than average knowledge and excellent attitude toward their children's oral health issues; most of them carried out improper practices. Mothers’ educational and employment backgrounds were significant influencing factors.

Early childhood caries and associated risk factors among preschool children in Ras Al-Khaimah, United Arab Emirates

AIM

To investigate the prevalence and contributing factors of early childhood caries (ECC) in preschool children of Ras Al-Khaimah (RAK), United Arab Emirates (UAE).

STUDY DESIGN

Cross-sectional.

METHODS

The sample consisted of 540 healthy preschool children between four and six years of age attending 10 nursery schools in RAK, UAE. A structured questionnaire was distributed to the mothers of children who gave consent for their children to be included in the study. The questionnaire was used to collect information regarding child and mother's demographic data, children's feeding and dietary habits, oral hygiene practices and frequency of dental visits. The dental examination of children was conducted by one investigator using a mouth mirror and a torch light source.

RESULTS

Five hundred and forty children with a mean age of 5.1 (SD = 0.71) years were included in the study. The prevalence of ECC was 74.1%, the mean dmft was 3.07 ± 0.135. The significant caries index (SiC) was very high (13.3) and the care index was very low (3.8%). A high proportion of caries-free children and those with ECC were either never or only visited dentists when in pain. However, the difference in frequency of dental visits was statistically highly significant (p < 0.001). There was also a statistically significant difference in frequency of tooth brushing between children with and without caries and more than two-thirds of children with ECC spent less than two minutes when brushing their teeth. The difference in sweet consumption was not statistically significant.

CONCLUSION

The prevalence of dental decay and the mean dmft were high and the care index was extremely low. There is a great need for prospective studies and community preventive programs to solve the problem of ECC and set plans to treat open cavities in RAK preschool children.

Prevalence of early childhood caries and enamel defects in four and five-year old Qatari preschool children

Background

Dental caries is the most prevalent chronic disease in early childhood in most communities worldwide. Several studies conducted in the Gulf Cooperation Council countries have documented a high prevalence of early childhood caries (ECC). To date, no studies have been conducted in Qatar to examine the prevalence of ECC and enamel developmental defects in preschool children. The present study aimed to determine the prevalence of ECC and enamel defects in preschool children aged four and five years attending kindergartens in Qatar.

Methods

A descriptive cross-sectional study was performed among 250 children randomly selected from 16 public kindergartens. Caries experience was measured using the World Health Organization caries criteria (dmft) for tooth rather than surface; enamel defects were scored by the modified developmental defects of enamel index. Descriptive statistics and Chi-Square test of relatedness were used.

Results

A response rate of 63 % was reported. The overall caries prevalence of the study sample was 89.2 %; 15.6 % of the examined children had ECC and 73.6 % had severe ECC. Developmental enamel defects were present in 39 % of children and 27 % had demarcated enamel opacities.

Conclusion

The high rate of dental caries and enamel defects recorded in this study for this young age group has strongly emphasized the necessity of community-based preventive programs and professional care that should begin during pregnancy and in early childhood.

The prevalence of dental erosion in 5-year-old preschoolers in Sharjah, United Arab Emirates

Objective:

The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors.

Materials and Methods:

A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria.

Results:

In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P < 0.05). Children with caries experience have 0.28 times the odds (95% CI = 0.16–0.51) of having tooth erosion compared to children with no caries experience (P < 0.05). Children who drink sugary or carbonated beverages have 0.30 times the odds (95% CI = 0.19–0.41) of having dental erosion compared to children who drink water (P < 0.05).

Conclusions:

The findings of this study indicate that 58.80% of 5-year-old preschoolers in Sharjah, United Arab Emirates, were affected by dental erosion. Caries experience and consumption of acidic drinks were associated with dental erosion.

Dental caries and their treatment needs in 3-5 year old preschool children in a rural district of India

Background:

Dental problems in the preschool children are neglected by their parents as the deciduous teeth are going to shed off, and hence considered to be of no importance and more of economic burden if attended to them.

Aims:

This study was to determine the caries prevalence in preschool children (3-5-year-old) of rural Moradabad district, to analyze the specific pattern of dental caries experience in this population and to assess the treatment needs among them.

Material and Methods:

Children within the age group of 3-5 years attending Anganwadi centers of rural Moradabad district were included in the study. Caries diagnosis was based on decayed, extracted, filled surface (defs) and the treatment needs were recorded using World Health Organization (WHO) oral health assessment form 1997.

Results:

Out of 1,500 children examined, 48.7% males and 52.6% females did not require any treatment. The mean decayed, extracted, filled teeth (deft) value was found to be significantly high in 5-year-old participants when compared to 3-year-old participants (P < 0.01). Majority of the children required one surface filling followed by two surface fillings, caries arresting sealant care, extraction, crown bridge element, pulp care, and space maintainer.

Conclusion:

The most common pattern was pit and fissure, then maxillary anterior pattern, posterior proximal pattern, and posterior buccal lingual smooth surface pattern. The mean deft value was higher in males as compared to females. There is a greater need for oral health education among parents and teachers.

Severity of early childhood caries in preschool children attending Al-Ain Dental Centre, United Arab Emirates

AIM

To investigate the severity of and contributing factors of early childhood caries (ECC) in preschool children presented to a paediatric dentistry department in Al-Ain Dental Centre, United Arab Emirates; to study the level of any previous dental care provided to these children and to establish a baseline database for further research and the resources required for serving preschool children in Al-Ain (UAE).

STUDY DESIGN

Cross-sectional prospective.

METHODS

The sample consisted of all healthy children below 5 years of age who presented for their initial visits to the Department of Paediatric Dentistry during a 3-month period. A structured questionnaire was used to obtain information regarding demographic data, feeding history and dietary habits, and oral hygiene practices. The dental examination of children was conducted by the investigator with the help of a mouth mirror and Sirona dental unit light source.

RESULTS

One hundred and seventy six children with a mean age of 3.7 years were included in the study and 78 (44 %) children were still bottle-fed on demand at the time of examination. More than half of the children consumed sweets more than once/day and 58 % either never or rarely brushed their teeth. Only one child was given fluoride. Two-thirds of children had never visited a dentist before and 63 % had poor oral hygiene. The mean dmft and dmfs scores were 10.9 and 32.1, respectively. The care index was very low (6.4 %).

CONCLUSION

The high level of dental decay could be attributed to on-demand bottle feeding, high sweet consumption, poor oral hygiene, lack of use of fluoride prevention and lack of regular dental visits. There is a great need for prospective studies and community preventive programmes to solve the continuing problem of ECC.

Parental Attitudes and Tooth Brushing Habits in Preschool Children in Mangalore, Karnataka: A Cross-sectional Study

Background: Adoption of consistent behavioral habits in childhood takes place at home, with the parents especially the mother, being the primary model for behavior. Tooth brushing habits which is learnt during early years of life, is deeply ingrained in the child's mind and it is expected that this leads to an adaptation of good oral hygiene in their later life.

Objectives: To assess the tooth brushing habits of preschool children and to determine the role and amount of supervision given to them by parents.

Study design: A pretested self-designed questionnaire was used to collect information from parents of 130 preschool children in Anganwadi and Kindergarten in Mangalore. Statistical analysis was done and Chi-square test was used.

Results: Tooth brushing habits in these children was started at a mean age of 22.4 months (SD 8.4).62% of the preschool children used toothbrush and toothpaste for cleaning teeth and brushing habits were mainly (84%) introduced by mothers. Seventy-one percent of the children were cooperative when they were introduced to tooth brushing.

Conclusion: Preschool children of Mangalore were introduced to tooth brushing at a mean age of 22.4 months. Mothers played a vital role in introducing and teaching the child how to brush. In children less than 10 months of age tooth brushing was not started at all.

How to cite this article: Pullishery F, Panchmal GS, Shenoy R. Parental Attitudes and Tooth Brushing Habits in Preschool Children in Mangalore, Karnataka: A Cross-sectional Study. Int J Clin Pediatr Dent 2013;6(3):156-160.

Epidemiology of dental caries in children in the United Arab Emirates

Dental caries has a significant impact on the general health and development of children. Understanding caries epidemiology is an essential task for the United Arab Emirates (UAE) policymakers to evaluate preventive programmes and to improve oral health. The purpose of this review is to collect and summarise all data available in the published literature on the epidemiology of dental caries in the UAE in children aged under 13 years. This will provide dental health planners with a comprehensive data summary, which will help in the planning for and evaluation of dental caries prevention programmes. Data were collected from the various published studies in PubMed, Academic Search Complete, Google, and the reference lists in relevant articles. Four keywords were used in the search: 'dental caries,' 'epidemiology,' 'prevalence,' and 'UAE'. All studies conducted in the UAE in general or any single emirate that sheds light on the prevalence of dental caries of children under 13 years were included in this literature review. Studies on early childhood caries and factors associated with dental caries were also included. The review comprises 11 published surveys of childhood caries in UAE. The earliest study was published in 1991 and the most recent was published in 2011. The range of decayed, missing and filled primary teeth (dmft) in UAE children (age between 4 years and 6 years) was 5.1-8.4. For the 12-year-old group the decayed missing and filled permanent teeth (DMFT) ranged from 1.6 to 3.24. Baseline data on oral health and a good understanding of dental caries determinants are necessary for setting appropriate goals and planning for preventive oral health programmes. The current data available on the dmft and DMFT indicate that childhood dental caries is still a serious dental public health problem in the UAE that warrants immediate attention by the government and policy makers.

Dental caries in Arab League countries: a systematic review and meta-analysis

OBJECTIVE

The aim of this review was to determine prevalence of dental caries in primary and permanent teeth in the 2-20-year-old population of the Arab league.

METHODS

A literature search was performed on Pubmed, Summon and Google Scholar using the key words 'Dental caries', 'dmft' and 'DMFT'. A total of 293 articles were found, of which 35 passed our inclusion criteria and were included in analysis. Tables were made separately for primary and permanent teeth; the age group for primary teeth was 2-12 years and for permanent teeth 6-20 years.

RESULTS

A meta-analysis was run by using data extracted from the studies included. Heterogeneity was tested by forest plot and chi-square test, and considerable heterogeneity was found. Mean decayed, missing and filled teeth (dmft) was 4.341 (95% CI 3.714, 4.969) and in permanent teeth (DMFT) was 2.469 (95% CI 2.019, 2.919) from a random effect model. Publication bias diagnostics suggested missing of four studies of primary teeth caries data and eight studies of permanent teeth caries data to obtain symmetry in the funnel plot.

CONCLUSION

The incidence of caries in primary teeth was found to be high compared with caries in permanent teeth in the Arab League. This study does not provide a comprehensive picture of caries prevalence in the Arab League because in many of these countries only a few studies were performed. Therefore, these data cannot provide a complete picture of the prevalence of caries in those countries. Additional studies are needed to better evaluate the prevalence of caries in children and young adults in Arab League countries.

Ethnic and socio-economic disparities in oral health outcomes and quality of life among Sri Lankan preschoolers: a cross-sectional study

Introduction

The distribution and severity of dental caries among preschool children vary according to the socio-economic and ethnic differences within and between countries. Understanding socio-economic influences on child oral health could inform early interventions to reduce the oral health burden throughout the life-cycle. The aim of this study is to examine the socio-economic and ethnic influences on oral health among preschoolers in Kegalle, Sri Lanka.

Methods

The study involved 784 children aged between 48–72 months recruited from 84 pre-schools in the Kegalle district in Sri Lanka. Cross-sectional data were collected by means of an oral examination of the children and a self-administered questionnaire to their parents/caregivers. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess Oral Health related Quality of Life (OHQoL). Univariate and multivariate models of Poisson regression were used to investigate the associations between the variables.

Results

Compared to children whose fathers had tertiary education, those whose fathers did not study beyond grade 5, had more caries measured in terms of decayed, missing and filled surfaces (dmfs) (IRR = 2.30; 95% CI: 1.30, 4.06; p < 0.01) and experienced poor OHQoL at child (IRR = 2.52; 95% CI: 1.20, 5.31; p < 0.05) and family (IRR = 1.59; 95% CI: 1.11, 2.27; p < 0.05) levels. However, lower educational attainment among mothers was associated with better OHQoL among children. Compared to the Sinhalese ethnic group, Tamils had more gingival bleeding (bleeding surfaces) (IRR = 3.04; 95% CI: 1.92, 4.81; p < 0.001) and poor OHQoL at child level (IRR = 2.07; 95% CI: 1.19, 3.60; p < 0.01), whereas Muslims had poor OHQoL at family level (IRR = 1.42; 95% CI: 1.10, 1.84; p < 0.01). Children of low-income families had more gum bleeding (IRR = 1.00; 95% CI: 0.99, 1.00; p < 0.05) compared to children of high-income families.

Conclusions

Socio-economic and ethnic differences in oral health outcomes exist among this population of preschoolers. Interventions targeting children of fathers with low educational levels and ethnic minority groups are required to reduce inequalities in oral health in Sri Lanka and other similar countries.

Avaliação da participação de mães em um programa de prevenção e controle de cáries e doenças periodontais para lactentes

OBJETIVO: Avaliar o conhecimento sobre saúde bucal de mães participantes de um programa educativo-preventivo para lactentes. MÉTODOS: Estudo de coorte com 112 mães e seus bebês de 0 a 18 meses, cadastrados no projeto "Promoção de Saúde Bucal na Primeira Infância", da Universidade Federal do Maranhão. Inicialmente, entrevistas semiestruturadas que contemplavam o nível de conhecimento das mães sobre a saúde bucal dos bebês foram realizadas. Também foi examinada a cavidade bucal dos bebês a fim de detectar o nível de placa bacteriana, sangramento gengival e presença de cárie. Em seguida, palestras educativo-preventivas foram ministradas e, após um ano de acompanhamento, novas entrevistas foram realizadas, bem como o exame clínico. Para analisar os dados, foram utilizados os testes de qui-quadrado e exato de Fisher com nível de significância de 5%. RESULTADOS: Antes das palestras educativas, 93% das mães executavam a higiene bucal de seus bebês e 57,3% a realizavam nos períodos diurno e noturno. Após as palestras, todas responderam executar os cuidados (p=0,02), sendo 74,7% nos períodos diurno e noturno (p=0,01). Não houve diferença quanto ao consumo de alimentos cariogênicos nos questionários inicial e final. Notou-se que, inicialmente, 5,6% das faces dentais apresentaram cárie; 29,7%, placa bacteriana; e 11,9%, sangramento gengival. Após as palestras, apenas 0,4% das faces dentais apresentaram cárie (p<0,0001); 2,4%, placa bacteriana (p<0,0001); e 10,6%, sangramento gengival (p<0,0001). CONCLUSÕES: A aquisição de conhecimentos é fundamental para melhorar as condições de saúde.

Mode of delivery, mutans streptococci colonization, and early childhood caries in three- to five-year-old Thai children

OBJECTIVE

To investigate whether mode of delivery is associated with mutans streptococci (MS) colonization and early childhood caries (ECC) in preschool Thai children.

METHODS

Three hundred and fifty mothers and their 3- to 5-year-old children (184 born vaginally and 166 born by Caesarean section) participated in the study. Data included a dental examination, MS colonization assessed by the Dentocult(®) SM Strip Mutans method, and a questionnaire survey of family socio-demographic information, as well as children's birth history, dietary habits, and oral health practices.

RESULTS

Overall, ECC prevalence was 56% in 3-year-old and 78% in 5-year-old Thai children. Compared to children delivered by C-section, vaginally born children experienced increased ECC prevalence (73.8% versus 59.6%; P = 0.009) and were more likely to have higher MS scores (OR = 1.8, 95% CI = 1.1-2.9), adjusting for mother's gestational age, MS score, feeding practice habits; child's age and tooth brushing habits. Children's MS scores were highly correlated with their mothers' MS scores (P < 0.001). Additionally, children's age, MS colonization, and mothers' prechewing feeding habits were the most significant risk indicators for ECC in Thai children.

CONCLUSION

Our findings suggest that mode of delivery is significantly correlated with MS colonization and caries outcomes in young Thai children. Future studies are needed to further understand the possible biological mechanisms linking mode of child delivery to the colonization of cariogenic microbiota and development of ECC.

Review and recommendations for zero-inflated count regression modeling of dental caries indices in epidemiological studies

Over the past 5-10 years, zero-inflated (ZI) count regression models have been increasingly applied to the analysis of dental caries indices (e.g. DMFT, dfms). The main reason for that is linked to the broad decline in children's caries experience, such that dmf and DMF indices more frequently generate low or even zero counts. This article specifically reviews the application of ZI Poisson and ZI negative binomial regression models to dental caries, with emphasis on the description of the models and the interpretation of fitted model results given the study goals. The review finds that interpretations provided in the published caries research are often imprecise or inadvertently misleading, particularly with respect to failing to discriminate between inference for the class of susceptible persons defined by such models and inference for the sampled population in terms of overall exposure effects. Recommendations are provided to enhance the use as well as the interpretation and reporting of results of count regression models when applied to epidemiological studies of dental caries.

Preditores da realização de consultas odontológicas de rotina e por problema em pré-escolares

OBJETIVO: Estimar a prevalência do uso de serviços odontológicos por pré-escolares e fatores associados. MÉTODOS: Estudo transversal com 1.129 crianças de cinco anos de idade da Coorte de Nascimentos de Pelotas 2004, RS, de setembro de 2009 a janeiro de 2010. Registrou-se o uso de serviço odontológico pelo menos uma vez na vida e o motivo para a primeira consulta odontológica da criança. As categorias do desfecho foram: ter feito a primeira consulta por rotina, para resolver um problema ou nunca ter ido ao dentista. Os exames bucais e as entrevistas foram realizados nos domicílios. Aspectos socioeconômicos e variáveis independentes ligadas à mãe e à criança foram analisados por meio de regressão logística multinomial. RESULTADOS: A prevalência de uso por qualquer motivo foi 37,0%. Os principais preditores para consulta de rotina foram nível econômico mais elevado, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Principais preditores para consulta por problema foram ter sentido dor nos últimos seis meses, mãe com maior escolaridade e ter recebido orientação sobre prevenção. Cerca de 45,0% das mães receberam orientação de como prevenir cárie, principalmente fornecida por dentistas. Filhos de mães com história de maior aderência a programas de saúde tiveram maior probabilidade de ter feito uma consulta odontológica de rotina. CONCLUSÕES: A taxa de utilização dos serviços odontológicos por pré-escolares foi inferior às de consultas médicas (puericultura). Além da renda e da escolaridade, comportamentos maternos têm papel importante no uso por rotina. Relato de dor nos últimos seis meses e número elevado de dentes afetados por cárie, independentemente dos demais fatores, estiveram associados ao uso para resolver problema. É necessária a integração de ações de saúde bucal nos programas materno-infantis.

[Factors associated with dental caries in preschoolers in Recife, Pernambuco State, Brazil]

To investigate factors associated with dental caries in deciduous dentition, a nested case-control study was conducted in a prevalence survey of preschool children (n = 1,690) aged 18 to 36 months and 5 years of age, treated under the Family Health Program in Recife, Pernambuco State, Brazil, in 2006. Cases were children with dmft > 1 and controls with dmft = 0. The independent variables were analyzed in blocks: demographic, environmental, family structure, health care, and dental services use. OR and 95%CI were estimated. Variables associated with the outcome at p < 0.20 in the univariate analysis were included in a multivariate logistic regression model. The cutoff for remaining in the final model was p < 0.10. Larger households (more members), lack of running supply, time of residence, maternal (or caregiver's) schooling, attendance in public preschool, demand for dental services, and sugar intake patterns were associated factors. Variables related to social context were the main predictors of caries, thus highlighting the need for comprehensive measures to address other common childhood health problems.

Dental caries experience, oral health status and treatment needs of dental patients with autism

Objectives

Autism is a lifelong neurodevelopmental disorder. The aims of this study were to investigate whether children with autism have higher caries prevalence, higher periodontal problems, or more treatment needs than children of a control group of non-autistic patients, and to provide baseline data to enable comparison and future planning of dental services to autistic children.

Material and Methods

61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai and Sharjah Autism Centers were selected for the study. The control group consisted of 61 non-autistic patients chosen from relatives or friends of autistic patients in an attempt to have matched age, sex and socioeconomic status. Each patient received a complete oral and periodontal examination, assessment of caries prevalence, and caries severity. Other conditions assessed were dental plaque, gingivitis, restorations and treatment needs. Chi-square and Fisher's exact test of significance were used to compare groups.

Results

The autism group had a male-tofemale ratio of 2.8:1. Compared to controls, children with autism had significantly higher decayed, missing or filled teeth than unaffected patients and significantly needed more restorative dental treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic children were 0.02 and 0.3, respectively. The majority of the autistic children either having poor 59.0% (36/61) or fair 37.8% (23/61) oral hygiene compared with healthy control subjects. Likewise, 97.0% (59/61) of the autistic children had gingivitis.

Conclusions

Children with autism exhibited a higher caries prevalence, poor oral hygiene and extensive unmet needs for dental treatment than non-autistic healthy control group. Thus oral health program that emphasizes prevention should be considered of particular importance for children and young people with autism.

Associations among dental caries experience, fluorosis, and fluoride exposure from drinking water sources in Saudi Arabia

OBJECTIVES

a) To correlate fluoride levels in drinking water sources with caries experience and dental fluorosis in Saudi Arabia, and suggest appropriate fluoride concentration for drinking water in the country.

METHODS

Fluoride levels were determined from 3,629 samples obtained from drinking water sources in 11 regions of Saudi Arabia. Based on the fluoride concentrations, a stratified sample of subjects aged 6-7, 12-13, and 15-18 years was obtained from the regions. A total of 12,200 selected subjects were examined for dental caries according to the World Health Organization criteria, and dental fluorosis, using Thylstrup and Fejerskov classification.

RESULTS

There was an inverse relationship between fluoride exposure and caries experience, but the prevalence of dental fluorosis increased with increase in fluoride concentration. There was no significant difference in caries experience or in the prevalence of dental fluorosis when fluoride levels increased from 0.3 ppm to 0.6 ppm. In contrast, caries experience was lower, while severity of fluorosis was significantly higher at fluoride levels above 0.6 ppm.

CONCLUSIONS

a) Fluoride levels in drinking water sources in Saudi Arabia correlate significantly with caries experience and prevalence of dental fluorosis. b) Appropriate fluoride concentration for drinking water in Saudi Arabia may be about 0.6 ppm.

How pre-school children learn to brush their teeth in Sharjah, United Arab Emirates

OBJECTIVE

The objective of this cross-sectional study was to assess tooth brushing habits of pre-school children and to determine the role and amount of supervision given to them by their parents.

METHOD

One hundred pre-school children below 6 years were selected from Maternal and Child Health Center, Sharjah (United Arab Emirates, UAE). A standard piloted questionnaire was used to collect socio-demographic details and information on oral hygiene practise.

RESULTS

Tooth brushing was stared at a mean age of 16 months. Thirty-seven per cent of the pre-schoolers used a toothbrush for cleaning their teeth and the brushing habits were mainly (70%) introduced by mothers. The majority (80%) of children's tooth brushing at the age of 3 years and above was supervised by mothers. Younger children were frequently supervised in tooth brushing than older children (P < 0.05)

CONCLUSIONS

In summary, pre-school children of Sharjah (UAE) were introduced to tooth brushing at a mean age of 16 months. Mothers played a pivotal role in introducing and teaching the child how to brush. There was no positive correlation between the brushing behaviour of the mothers and their children. In most cases, the children's brushing was supervised by their mother when they were above 25 months of age. In children less than 12 months of age tooth brushing was not started at all.

Atividade de cárie na dentição decídua, Indaiatuba, São Paulo, Brasil, 2004

Os objetivos deste trabalho foram verificar a atividade de cárie, além de conhecer a experiência de cárie (ceod), necessidades de tratamento e defeitos de esmalte em pré-escolares de cinco anos de idade. Examinaram-se 624 crianças de Indaiatuba, São Paulo, Brasil, em 2004, selecionadas por meio de processo amostral aleatório sistemático. Para medir a experiência de cárie e necessidade de tratamento adotou-se os critérios da OMS. Para a atividade de cárie, optou-se por uma simplificação dos critérios de diagnóstico de Nyvad et al. Na análise estatística utilizaram-se os testes Mann Whitney e qui-quadrado com nível de significância de 5%. 40,5% dos pré-escolares apresentaram atividade de cárie. O ceod foi de 1,62 (IC95%: 1,35-1,89). Entre os doentes (ceod > 0) o ceod foi 3,81 (IC95%: 3,36-4,26), ainda neste grupo, 91,4% das crianças apresentaram atividade de cárie. O índice de cuidados foi de 12,3%. Sugere-se que medidas de prevenção e tratamento direcionadas a essa população continuem sendo priorizadas, uma vez que as medidas de controle e paralisação da cárie em seus estágios iniciais são bem conhecidas. Além disso, recomenda-se cuidado direcionado aos pré-escolares com maior experiência de cáries.