Dental caries prevalence of 6-14-year-old children in Guangdong, China

Caries experience variables as indicators in caries risk assessment in 6–7-year-old Chinese children

OBJECTIVES

The aim of the present study is to investigate variables of the past caries experience as indicators of future caries in a Chinese child population.

METHODS

Caries was recorded at baseline and 2 years later in 433, 6-7-year-old Chinese children. Correlation coefficients between variables of the past caries experience and caries increment were calculated. Stepwise logistic regression analyses provided predictor variables. ROC curves presenting sensitivity as function of (100-specificity) were employed to summarize the obtained information. The area under the ROC curves was used as a measure of predictive accuracy.

RESULTS

Twelve variables of baseline caries experience had a significant (p<or=0.05) correlation with caries increment in the permanent dentition. Among the variables, the number of primary molars with enamel or dentine caries, fillings or missings due to caries (d(12)mftmol), the number of fissures of the first permanent molar with enamel caries (D(1)fis) and the number of pits and fissures of the first permanent molar with dentine caries (D(2)pitfis) were the most powerful caries predictors, which resulted in a value of 0.74 under the ROC.

CONCLUSIONS

By including non-cavitated caries in the past caries experience of primary molars and permanent first molars, it was possible to construct a screening criterion (d(12)mftmol+D(1)fis+D(2)pitfis), which enabled the selection of true negative children and the selection of a high caries risk group in a 6-7-year-old Chinese child population.

Influence of diagnostic adjuncts to the measurement of caries prevalence at different caries thresholds

OBJECTIVES

To determine the influence of diagnostic adjuncts (dental brushing and drying) in dental caries diagnosis. To analyse the underestimation levels in epidemiological examinations when compared to traditional dental setting examinations. To evaluate the influence of including noncavitated (NC) carious lesions in the estimation of the disease.

PARTICIPANTS

51, 12-year-old children.

INTERVENTIONS/METHODS

Four epidemiological exams performed in an outdoor setting and one performed in a traditional dental setting (visual-tactile method associated or not with diagnostic adjuncts).

MAIN OUTCOME MEASURES

DMFS (Decayed, Missing and Filled Surfaces) index, according to the WHO criteria.

RESULTS

When compared to exams carried out in a traditional dental setting, the epidemiological examinations showed no significant statistical differences for the DMFS score (p>0.05), presenting underestimation levels lower than 10% (except for the low prevalence caries group in the WHO exam). For the DMFS, previous dental brushing was more relevant than previous dental drying, although drying was the most important resource for NC diagnosis (p<0.05).

CONCLUSION

The visual/tactile method, with or without diagnostic adjuncts, can diagnose cavitated lesions efficiently, but not NC lesions. However, for the low caries prevalence group, the implementation of dental brushing prior to an exam could be suggested.

Predicting caries in permanent teeth from caries in primary teeth: an eight-year cohort study

Several cross-sectional studies report that caries in primary teeth is correlated with caries in permanent teeth. This eight-year cohort study sought to determine if caries in the primary dentition can predict caries in the permanent dentition of the same individuals and, if so, with what degree of prediction accuracy. A total of 362 Chinese children, from 3 to 5 years old at the time of the 1992 baseline study, were re-examined in 2000. The study found statistically significant associations between caries prevalence in primary and permanent dentitions (p < 0.01). Children having caries in their primary teeth were three times more likely to develop caries in their permanent teeth (relative ratio = 2.6, 95% CI = 1.4-4.7; p < 0.001). Caries on primary molars had the highest predictive value (85.4%). This study demonstrates that caries status in the primary teeth can be used as a risk indicator for predicting caries in the permanent teeth.

The second national survey of oral health status of children and adults in China

OBJECTIVES

To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience.

DESIGN

Cross-sectional study, oral epidemiological survey based on WHO methodology, clinical examinations.

SETTING

National survey by National Committee for Oral Health.

SUBJECTS

Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5,12,15,18, 35-44 and 65-74. Each age group consisted of 23,452 participants, i.e. total of 140,712 individuals.

RESULTS

At age 5, 76.6% were affected by dental caries and mean dmft was 4.5. Mean DMFT varied from 1.0 in 12-year-olds, 1.4 in 15-year-olds, 1.6 in 18-year-olds, 2.1 in 35-44-year-olds to 12.4 in 65-74-year-olds. In adults, caries experience was higher in females than in males. The effect of urbanisation on caries prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old-age people of rural areas. At national level, changes in dental caries prevalence of 12- and 15-year-olds were small. However, some provinces with extensive oral health programmes (e.g. Love Teeth Day) showed declining caries experience whereas provinces with limited preventive activities had increasing levels of caries. For all age groups, gingival bleeding and calculus were most frequent. Severe periodontal conditions were relatively rare.

CONCLUSION

The systematic implementation of preventive oral care and community-oriented health programmes are needed for the continuous promotion of oral health in China.

Oral health status and oral health behaviors in Chinese Children

The objectives of the study were to describe the oral health status and treatment needs of the 5- to 6-year-old and 12-year-old children in Southern China; to describe the patterns of oral health behaviors, knowledge, and attitudes among the 12-year-olds; and to assess the effects of socio-behavioral factors on the 12-year-old children's dental caries experiences. The study sample was comprised of 1,587 5- to 6-year-old and 1,576 12-year-old urban and rural schoolchildren living in Guangdong Province. Three calibrated dentists clinically examined the children, and trained interviewers interviewed the 12-year-olds. Caries prevalence of the 5- to 6-year-old children was high (urban 78% vs. rural 86%); the mean dmft of the urban and rural children was 4.8 and 7.0, respectively. The caries prevalence and mean DMFT score of the 12-year-olds were 41% and 0.9 (urban) and 42% and 0.9 (rural). Only 2% of the 12-year-olds exhibited no calculus or gingival bleeding, while more than 70% had calculus. In conclusion, there is an urgent need for establishing caries-preventive activities for preschool children. The prevalence of caries among the 12-year-olds was not high, but their periodontal condition was unsatisfactory. Knowledge about gum bleeding and the use of fluoride was low. More oral health education activities should be organized, especially for the rural children.

Arresting dentine caries in Chinese preschool children

OBJECTIVES

To investigate the incidence of rehardening of caries lesions in children in Southern China taking part in a preventive programme.

DESIGN

Longitudinal study.

SAMPLE AND METHODS

A prevention programme was established for 168 3-6-year-old children in a kindergarten (KG1), which included regular oral health education sessions and a daily toothbrushing exercise using fluoridated toothpaste (1000 ppm F). A group of 121 children studying in two other kindergartens without a preventive programme formed the controls. Due to lack of resources and dental personnel, restorative and other curative treatments were not provided.

RESULTS

Rehardening of dentine caries (arrested caries) was found in children in both test and control groups. At the third annual examination, 45% of the caries lesions on the proximal surfaces of primary anterior teeth in KG1 children found at the baseline and previous annual examinations had become arrested. A multiple linear regression analysis indicated that baseline ds score and its interactions with the prevention programme, gender and the child's oral hygiene all had significant effect on the number of tooth surfaces with arrested caries at the third annual examination.

CONCLUSION

Results from this study support the use of simple prevention programmes to stabilize the caries situation in communities where intensive use of trained dental personnel is not feasible.