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DeWitte SN. Assessing the existence of the male-female health-survival paradox in the past: Dental caries in medieval London. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 185:e24990. [PMID: 38923302 DOI: 10.1002/ajpa.24990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/20/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES This study seeks to identify signals of the male-female health-survival paradox in medieval London. MATERIALS AND METHODS This study uses skeletal data on age, sex, dental caries (n = 592) and antemortem tooth loss (n = 819) from adult individuals from medieval London cemeteries (c. 1200-1540 CE). The association between age and dental caries was assessed using binary logistic regression. The associations among age, time period (pre- vs. post-Black Death), oral biomarker (dental caries or antemortem tooth loss), and sex were tested using hierarchical log-linear analysis. RESULTS The analyses reveal significantly higher odds of dental caries with increasing adult ages, more older adults after the Black Death, different age distributions of dental caries between the sexes, and a greater decrease in the prevalence of dental caries for females after the Black Death. These results appear not to be an artifact of trends in AMTL. However, this study does not yield evidence suggesting that females experienced both a survival advantage and a decline in oral health at late adult ages after the Black Death relative to males. CONCLUSIONS These results do not provide evidence of the existence of a male-female health-survival paradox, but they do corroborate existing evidence of improvements in health in general in the aftermath of the Black Death. The decreased prevalence of dental caries after the Black Death may reflect dietary improvements or the effects of selective mortality during the epidemic.
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Affiliation(s)
- Sharon N DeWitte
- Institute of Behavioral Science, University of Colorado, Boulder, Colorado, USA
- Department of Anthropology, University of Colorado, Boulder, Colorado, USA
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2
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Vieira BR, de Freitas Ferreira L, de Abreu NMR, de Sousa FB. Enamel caries lesions, with and without initial cavitation, in relation to anatomical areas of the proximal surface in deciduous molars. Arch Oral Biol 2024; 169:106081. [PMID: 39236414 DOI: 10.1016/j.archoralbio.2024.106081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/20/2024] [Accepted: 08/27/2024] [Indexed: 09/07/2024]
Abstract
OBJECTIVE proximal enamel caries lesions (PEC) are believed to initiate and progress to cavitation below the proximal contact area (PCA), but no evidence exists on the location of initial carious cavitation on the proximal surface with functional PCA. This study aimed to test the association of anatomical areas of the proximal surface with the severity of PEC and the frequency of cavitation in PEC in primary molars DESIGN: laboratory, observational, transversal study. Exfoliated primary molars (n = 33) with functional PCA (biofilm-free PCA surrounded by biofilm) had their proximal surfaces (one/tooth) divided anatomically into up to nine areas: 3 areas based on the occlusal/cervical PCA boundaries (areas I, II, and III; occluso-cervically) and 3 areas based on the bucco/lingual PCA boundaries (A, B, and C), with area IIB representing the PCA and area IIIB as the sub-PCA (below the PCA). PEC (ICDAS scores 1 and 2-3) and cavitation in PEC were quantified in all areas using stereomicroscopy and microCT. PEC volume was quantified in areas IIB and IIIB under microCT RESULTS: PEC severity increased occluso-cervically. PCA and sub-PCA presented different PEC severities (higher in sub-PCA) and similar PCE volumes, but the odds of carious cavitation were much higher (Odds ratio = 197.4; 95 % CI: 8.7/4480.7) in the PCA than in the sub-PCA (no cavitation). CONCLUSION PCA presented lower PEC severity and similar PEC volume compared to sub-PCA, but PCA concentrated all cavitations in PEC, supporting a new model for the pathogenesis of PEC.
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Affiliation(s)
- Basílio Rodrigues Vieira
- Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, João Pessoa, Paraiba, Brazil, and Faculty of Dentistry, University of Pernambuco, Arcoverde, Pernambuco, Brazil
| | - Leonardo de Freitas Ferreira
- Undergraduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, João Pessoa, Paraiba, Brazil
| | | | - Frederico Barbosa de Sousa
- Department of Morphology, Health Sciences Center, Federal University of Paraiba, João Pessoa, Paraiba, Brazil.
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3
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Glessner C, Desai B, Looney S, Choi BN, Lewis M, Farmaha J, Bloomquist R. The associations between dental disease and systemic health. Odontology 2024; 112:264-271. [PMID: 37261608 DOI: 10.1007/s10266-023-00823-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 05/19/2023] [Indexed: 06/02/2023]
Abstract
Understanding the relationship between a patient's systemic and oral health is key for clinicians. The aim of this study was to determine if there is an association between specific findings in a dental exam, such as class V carious lesions, and the American Society of Anesthesiologists (ASA) classification as a proxy for systemic health. A retrospective chart review was performed on all patient charts that met inclusion criteria including detailed, complete, and vetted charts obtained over a three-year period in the predoctoral clinic of a United States dental college. Findings recorded at the initial exam included the decayed, missing or filled teeth (DMFT) score, the location of carious lesions and restorations, the presence of periodontal disease, the number of endodontically treated teeth and the number of fractured teeth or restorations. We found no association found between DMFT score and ASA status but did find that ASA I patients had a higher degree of occlusal carious lesions and that ASA III patients were more likely to have interproximal restorations and fractured teeth. We found associations between a greater number of missing teeth and the presence of periodontal disease with worsening ASA status. Our data suggest that ASA classification cannot be used as a reliable predictor for the health of a patient's dentition or the number of cervical caries. However, the data does demonstrate a positive correlation between the number of missing teeth and ASA status, promoting the idea that the number of missing teeth is a crude prognosticator of systemic health. This information can be used by physicians and dentists to help understand the relationships between a patient's dental and systemic health.
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Affiliation(s)
- Caroline Glessner
- Dental College of Georgia, 1430 John Wesley Gilbert Drive, Augusta, GA, 30912, USA
| | - Bhavik Desai
- Dental College of Georgia, 1430 John Wesley Gilbert Drive, Augusta, GA, 30912, USA
- TMJ and Orofacial Pain Treatment Centers of Wisconsin, 2626 N Wauwatosa Ave 101, Milwaukee, WI, 53213, USA
| | - Stephen Looney
- Medical College of Georgia, Population Health Sciences, 1120 15th Street, AE‑1014, Augusta, GA, 30912‑4900, USA
| | - Bich Na Choi
- Medical College of Georgia, Population Health Sciences, 1120 15th Street, AE‑1014, Augusta, GA, 30912‑4900, USA
| | - Maurice Lewis
- Dental College of Georgia, 1430 John Wesley Gilbert Drive, Augusta, GA, 30912, USA
| | - Jaspreet Farmaha
- Dental College of Georgia, 1430 John Wesley Gilbert Drive, Augusta, GA, 30912, USA
| | - Ryan Bloomquist
- Dental College of Georgia, 1430 John Wesley Gilbert Drive, Augusta, GA, 30912, USA.
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4
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Senevirathna L, Ratnayake HE, Jayasinghe N, Gao J, Zhou X, Nanayakkara S. Water fluoridation in Australia: A systematic review. ENVIRONMENTAL RESEARCH 2023; 237:116915. [PMID: 37598841 DOI: 10.1016/j.envres.2023.116915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/03/2023] [Accepted: 08/16/2023] [Indexed: 08/22/2023]
Abstract
Water fluoridation is considered a safe and effective public health strategy to improve oral health. This review aimed to systematically summarize the available evidence of water fluoridation in Australia, focusing on the history, health impacts, cost effectiveness, challenges, and limitations. A systematic search was conducted on the Ovid Medline, Web of Science, Scopus, ProQuest Central, Cinahl, and Informit databases to identify literature on water fluoridation in Australia. A grey literature search and backward snowballing were used to capture additional literature. Primary studies, reviews, letters, and opinion papers were included in the quantitative analysis and summarized based on the year of publication and geographical location. The data were extracted from primary studies and summarized under three subheadings: history, community health impacts and the limitations and challenges. Water fluoridation in Australia was first implemented in 1953 in Tasmania. Most states and territories in Australia embraced water fluoridation by 1977 and currently, 89% of the Australian population has access to fluoridated drinking water. Studies report that water fluoridation has reduced dental caries by 26-44% in children, teenagers, and adults, benefiting everyone regardless of age, income, or access to dental care. It has been recognized as a cost-effective intervention to prevent dental caries, especially in rural and low-income areas. Water fluoridation as a public health measure has faced challenges, including political and public opposition, implementation and maintenance costs, access and equity, communication and education, and ethical concerns. Variations in research activities on water fluoridation across Australian states and territories over the last seven decades can be due to several factors, including the time of implementation, funding, and support. Ongoing monitoring and research to review and update optimal fluoride levels in drinking water in Australia is warranted to ensure sustainable benefits on oral health while preventing any adverse impacts.
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Affiliation(s)
- Lalantha Senevirathna
- CSU Engineering, School of Computing, Mathematics and Engineering, Charles Sturt University, Bathurst, Australia; Gulbali Institute for Agriculture, Water and Environment, Charles Sturt University, Albury, Australia
| | | | - Nadeeka Jayasinghe
- CSU Engineering, School of Computing, Mathematics and Engineering, Charles Sturt University, Bathurst, Australia
| | - Jinlong Gao
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Institute of Dental Research, Westmead Centre for Oral health, Westmead Hospital, Westmead, Australia
| | - Xiaoyan Zhou
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Institute of Dental Research, Westmead Centre for Oral health, Westmead Hospital, Westmead, Australia
| | - Shanika Nanayakkara
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia; Institute of Dental Research, Westmead Centre for Oral health, Westmead Hospital, Westmead, Australia.
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5
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Donnell CC, Johnston MJ, Foley JI. The Six-Year-Old 'Adult'. Prim Dent J 2022; 10:74-82. [PMID: 35088635 DOI: 10.1177/20501684211065326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Children are not miniature adults, yet when a child celebrates their sixth birthday, little do they know that, with the arrival of their first 'adult' tooth, they are about to gain their first real experience of being a 'grown-up'. The age of six is a key milestone in the mental, physical and emotional wellbeing of children, with most children in the UK having commenced primary school education by their fifth birthday. Six-year-olds are about to enter the most critical period in their dental development, the mixed-dentition phase, where their mouths are in a near continuous state of flux. This pivotal age in their dental development should not be undervalued; the dental decisions we make at this age means childhood lasts a lifetime. Caries is the most prevalent, preventable global disease, and with one in four children suffering from dental caries in the primary dentition by the time they start school, the foundations we lay down at the age of six translate into lifelong benefits for the permanent dentition. In this paper, the aim is to demonstrate that at the age of six we get a second chance to get things right. From caries risk factors and tailoring the five pillars of prevention by educating parents on the developing dentition, to reinforcing the importance of habit-breaking, developmental anomalies of enamel and early orthodontic intervention, this paper describes the importance of the age of six, never before so exclusively expressed in a dental sense.
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Affiliation(s)
- Christopher C Donnell
- Specialty Registrar in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Matthew J Johnston
- Dental Core Trainee, Oral and Maxillofacial Surgery, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
| | - Jennifer I Foley
- Deputy Director / Honorary Consultant in Paediatric Dentistry Edinburgh Dental Institute; Senior Clinical Lecturer in Paediatric Dentistry, University of Edinburgh, Edinburgh, UK
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6
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Progress in Oral Microbiome Related to Oral and Systemic Diseases: An Update. Diagnostics (Basel) 2021; 11:diagnostics11071283. [PMID: 34359364 PMCID: PMC8306157 DOI: 10.3390/diagnostics11071283] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/09/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
The human oral microbiome refers to an ecological community of symbiotic and pathogenic microorganisms found in the oral cavity. The oral cavity is an environment that provides various biological niches, such as the teeth, tongue, and oral mucosa. The oral cavity is the gateway between the external environment and the human body, maintaining oral homeostasis, protecting the mouth, and preventing disease. On the flip side, the oral microbiome also plays an important role in the triggering, development, and progression of oral and systemic diseases. In recent years, disease diagnosis through the analysis of the human oral microbiome has been realized with the recent development of innovative detection technology and is overwhelmingly promising compared to the previous era. It has been found that patients with oral and systemic diseases have variations in their oral microbiome compared to normal subjects. This narrative review provides insight into the pathophysiological role that the oral microbiome plays in influencing oral and systemic diseases and furthers the knowledge related to the oral microbiome produced over the past 30 years. A wide range of updates were provided with the latest knowledge of the oral microbiome to help researchers and clinicians in both academic and clinical aspects. The microbial community information can be utilized in non-invasive diagnosis and can help to develop a new paradigm in precision medicine, which will benefit human health in the era of post-metagenomics.
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Proctor DM, Shelef KM, Gonzalez A, Davis CL, Dethlefsen L, Burns AR, Loomer PM, Armitage GC, Ryder MI, Millman ME, Knight R, Holmes SP, Relman DA. Microbial biogeography and ecology of the mouth and implications for periodontal diseases. Periodontol 2000 2020; 82:26-41. [PMID: 31850642 DOI: 10.1111/prd.12268] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In humans, the composition of microbial communities differs among body sites and between habitats within a single site. Patterns of variation in the distribution of organisms across time and space are referred to as "biogeography." The human oral cavity is a critical observatory for exploring microbial biogeography because it is spatially structured, easily accessible, and its microbiota has been linked to the promotion of both health and disease. The biogeographic features of microbial communities residing in spatially distinct, but ecologically similar, environments on the human body, including the subgingival crevice, have not yet been adequately explored. The purpose of this paper is twofold. First, we seek to provide the dental community with a primer on biogeographic theory, highlighting its relevance to the study of the human oral cavity. We summarize what is known about the biogeographic variation of dental caries and periodontitis and postulate that disease occurrence reflects spatial patterning in the composition and structure of oral microbial communities. Second, we present a number of methods that investigators can use to test specific hypotheses using biogeographic theory. To anchor our discussion, we apply each method to a case study and examine the spatial variation of the human subgingival microbiota in 2 individuals. Our case study suggests that the composition of subgingival communities may conform to an anterior-to-posterior gradient within the oral cavity. The gradient appears to be structured by both deterministic and nondeterministic processes, although additional work is needed to confirm these findings. A better understanding of biogeographic patterns and processes will lead to improved efficacy of dental interventions targeting the oral microbiota.
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Affiliation(s)
- Diana M Proctor
- Division of Infectious Diseases & Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.,National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Katie M Shelef
- Department of Biology, Stanford University, Stanford, California, USA
| | - Antonio Gonzalez
- Departments of Pediatrics and Computer Science and Engineering, University of California at San Diego, La Jolla, California, USA
| | - Clara L Davis
- Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, California, USA
| | - Les Dethlefsen
- Division of Infectious Diseases & Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Adam R Burns
- Division of Infectious Diseases & Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Peter M Loomer
- Ashman Department of Periodontology & Implant Dentistry, New York University College of Dentistry, New York, New York, USA
| | - Gary C Armitage
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - Mark I Ryder
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - Meredith E Millman
- Division of Periodontology, Department of Orofacial Sciences, School of Dentistry, University of California, San Francisco, California, USA
| | - Rob Knight
- Departments of Pediatrics and Computer Science and Engineering, University of California at San Diego, La Jolla, California, USA
| | - Susan P Holmes
- Department of Statistics, Stanford University, Stanford, California, USA
| | - David A Relman
- Division of Infectious Diseases & Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.,Department of Microbiology & Immunology, Stanford University School of Medicine, Stanford, California, USA.,Infectious Diseases Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
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8
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Lakshmanan L, Gurunathan D. Parents' knowledge, attitude, and practice regarding the pit and fissure sealant therapy. J Family Med Prim Care 2020; 9:385-389. [PMID: 32110623 PMCID: PMC7014849 DOI: 10.4103/jfmpc.jfmpc_881_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 12/02/2019] [Accepted: 12/13/2019] [Indexed: 11/04/2022] Open
Abstract
Context Parents' interpretation on children's oral health care practices plays a vital role in improving children's oral health. Aim This study sought to evaluate parents' knowledge, attitude, and practice regarding dental sealants. Materials and Methods A cross-sectional study was conducted among parents of school-going children in Chennai, India. Knowledge, attitude, and practice toward sealant therapy were assessed through a questionnaire survey among 250 parents (45% fathers and 55% mothers). Results A statistically significant difference was noted in the knowledge and attitude scores at various age groups; 71% of the participants agreed that pit and fissure sealants are effective in preventing dental caries. Only 34% of the study participants' children had received dental sealants. Conclusion The parental knowledge and awareness of preventive practices appear to support dental sealants as a preventive strategy for dental caries. But most parents did not practice the preventive measures despite knowing its effectiveness and benefits. Greater efforts should be made to encourage the parents to provide their children with primary care.
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Affiliation(s)
- Lakshimi Lakshmanan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Deepa Gurunathan
- Department of Pediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
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Haricharan PB, Barad N, Patil CR, Voruganti S, Mudrakola DP, Turagam N. Dawn of a New Age Fissure Sealant? A Study Evaluating the Clinical Performance of Embrace WetBond and ART Sealants: Results from a Randomized Controlled Clinical Trial. Eur J Dent 2019; 13:503-509. [PMID: 31891967 PMCID: PMC6938448 DOI: 10.1055/s-0039-1696894] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The main purpose of this article is to evaluate the clinical performance of atraumatic restorative treatment (ART) sealant versus Embrace WetBond sealant in terms of retention and fissure caries prevention among a section of school children in the southern Indian state of Karnataka (ClinicalTrials.gov NCT02716558). MATERIALS AND METHODS After obtaining consent from the parents and screening the children against the inclusion cum exclusion criteria, 90 school children whose mandibular first molars were caries free and with a well-defined pit and fissure system were recruited for this spilt mouth trial. The respective molars were allocated either to the ART sealant or the embrace group after the randomization process. The sealants were applied according to the manufacturer's instructions and followed up at the end of 3rd, 6th, and 12th month, respectively. The outcome measures assessed were the retention and the caries preventive effects of the materials. RESULTS At the end of the 6th month, about one-fourth of the sealants in either group remained totally intact, without evidence of caries. No significant differences were seen between the sealants either in terms of retention or caries preventive benefits at the end of 12 months. STATISTICAL ANALYSIS The chi-squared test was used to check differences in proportions. The significance value was set at <0.05. Kappa test was performed to assess the intraexaminer reproducibility with respect to retention and caries status. CONCLUSION The moisture-tolerant resin sealant could not replicate the physical properties usually associated with conventional resin sealants. The usage of ART sealants was deemed to be less cumbersome in an outreach setting as observed in this trial.
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Affiliation(s)
| | - Naveen Barad
- Department of Conservative Dentistry and Endodontics, Nanded Rural Dental College & Research Center, Nanded, Maharashtra, India
| | - Chetan R Patil
- Department of Conservative Dentistry and Endodontics, Maratha Mandal Dental College, Belgaum, Karnataka, India
| | - Sreenivas Voruganti
- Department of Community Dentistry, Kamineni Institute of Dental Sciences, Nalgonda district, Telangana, India
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10
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Laajala A, Pesonen P, Anttonen V, Laitala ML. Association of Enamel Caries Lesions with Oral Hygiene and DMFT among Adults. Caries Res 2019; 53:475-481. [PMID: 30917373 DOI: 10.1159/000497358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 01/29/2019] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the prevalence of enamel caries lesions and their association with tooth brushing frequency, tooth brushing quality, and past caries experience among Finnish adults. The study population comprised 46-year-old members of the Northern Finland Birth Cohort 1966 (n = 1,961). Caries lesions were examined and recorded at surface level using the International Caries Detection and Assessment System (ICDAS). The cut-off point for enamel caries was set to ICDAS score 3. The cut-off point for brushing frequency was twice daily. Visible plaque on buccal tooth surfaces represented brushing quality. Using enamel caries lesions (ICDAS1-3) as a dependent variable, an adjusted logistic regression model was conducted to investigate the association with gender, brushing frequency, visible plaque, dentin caries lesions (ICDAS4-6), teeth with restorations, extractions and fractures. Almost all participants (99%) had enamel and 40% had dentin caries lesions; the mean number of teeth with enamel caries lesions was 13.8 (SD 4.6). According to the adjusted logistic regression model, the high prevalence of ICDAS1-3 lesions was associated with having visible plaque on more than 20% of teeth and having more than 13 restored teeth. In conclusion, the prevalence of enamel caries lesions is high among the Finnish adult population. The results of this study suggest that in addition to tooth brushing frequency, the presence of visible plaque seems to be critical when evaluating the association between tooth brushing and enamel caries.
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Affiliation(s)
- Anne Laajala
- Department of Cariology, Endodontology and Pediatric Dentistry, Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland,
| | - Paula Pesonen
- Northern Finland Birth Cohorts, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Vuokko Anttonen
- Department of Cariology, Endodontology and Pediatric Dentistry, Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Marja-Liisa Laitala
- Department of Cariology, Endodontology and Pediatric Dentistry, Research Unit of Oral Health Sciences, Faculty of Medicine, University of Oulu, Oulu, Finland
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11
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Effectiveness of different preventive agents on initial occlusal and proximal caries lesions: A follow-up study. J Dent Sci 2019; 13:109-115. [PMID: 30895105 PMCID: PMC6388825 DOI: 10.1016/j.jds.2017.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 05/15/2017] [Indexed: 11/22/2022] Open
Abstract
Background/purpose Monitoring the effects of different caries-preventive agents on initial caries lesions in orthodontic patients is important. Therefore, the purpose of this study is to investigate the efficacy of different preventive methods in preventing occlusal and proximal incipient lesions (ILs) during fixed orthodontic treatment. Materials and methods Forty-eight subjects at the beginning of fixed orthodontic treatment were included. All subjects were well educated and motivated to use the fluoride toothpaste (Colgate Total, 1450 ppm F) three times a day during the study period. Four different groups were created with a split-mouth design: placebo, fluoride gel, fluoride varnish, and chlorhexidine varnish. The occlusal surfaces of the second molar teeth were assessed with DIAGNOdent pen (DD) during the first 12 months (6th and 12th), and the proximal surfaces of each quadrant were monitored using bitewing radiographs until the 24th month (baseline and 24th month). Results The mean DD values increased in each group during the first 6 months compared to the baseline, but a significant increment was only obtained in the control and fluoride gel groups (p < 0.05). Fluoride and chlorhexidine varnish had significantly more preventive effects than the control and the fluoride gel for occlusal surfaces at the 6th and 12th month and for intact proximal surfaces at the 24th month, but no significant differences were found between the two varnish groups (p > 0.05). No significant differences were found between the four methods in terms of caries progression for proximal ILs after 24 months. Conclusion Effective toothbrushing with 1450 ppm fluoridated toothpaste and topical fluoride gel application seems to be inadequate for prevention of new proximal ILs during fixed orthodontic treatment. Fluoride and chlorhexidine varnish showed more protection in relation to occlusal surfaces.
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12
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Emerald NSS, Reddy VC, Sudhir KM, Kumar RVSK. Dental caries experience using the international caries detection and assessment system among adults, Nellore District, Andhra Pradesh, India: An epidemiological survey. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2019. [DOI: 10.4103/jiaphd.jiaphd_189_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Zilberman U, Milevski I, Yegorov D, Smith P. A 3000 year old case of an unusual dental lesion: Pre-eruptive intracoronal resorption. Arch Oral Biol 2018; 97:97-101. [PMID: 30368203 DOI: 10.1016/j.archoralbio.2018.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2018] [Revised: 10/14/2018] [Accepted: 10/15/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To determine the cause of a large dental lesion, tentatively identified as a case of pre-eruptive intra-coronal resorption (PEIR), in the permanent second mandibular molar of a young individual from an Iron Age cemetery at Tel Erani (Israel), dated to ca. 3000 years B.P. The provisional diagnosis was based on the massive size of the lesion in a young individual in whom the adjacent teeth were caries-free and showed no visible enamel defects. DESIGN The lower molars of Tel Erani on the affected side were radiographed and compared to radiographs of a modern clinical case of PEIR treated by one of us (U.Z) and the internal structure and mineral content of the lesion examined in detail using energy-dispersive X-ray spectroscopy (EDS). RESULTS The Tel Erani specimen closely resembled the modern clinical case of PEIR. Moreover, both cases occurred in young individuals in whom the adjacent teeth were caries-free. Examination with SEM revealed absence of dentine in the affected tooth from Tel Erani, together with changes in structure and mineral content characteristic of resorption. CONCLUSIONS Our study shows that the changes found in the lower second molar of the 3000 year old mandible from Tel Erani are characteristic of PEIR and demonstrate the antiquity of this condition.
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Affiliation(s)
- Uri Zilberman
- Head of Pediatric Dental Clinic, Barzilai Medical University Center, Ashkelon, Israel.
| | - Ianir Milevski
- Head of the Prehistoric Branch, Israel Antiquities Authority Jerusalem, Israel; Program "Raíces", Ministry of Science and Technology, Argentina
| | - Dimitry Yegorov
- Israel Antiquities Authority, Southern District, Omer, Israel; Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Patricia Smith
- Laboratory of Bioarchaeology and Ancient DNA, Faculties of Medicine and Dental Medicine, The Hebrew University of Jerusalem, Israel
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14
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The Effects of Endodontic Access Cavity Preparation Design on the Fracture Strength of Endodontically Treated Teeth: Traditional Versus Conservative Preparation. J Endod 2018; 44:800-805. [DOI: 10.1016/j.joen.2018.01.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/23/2018] [Accepted: 01/31/2018] [Indexed: 11/18/2022]
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15
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Raphael SL, Foster Page LA, Hopcraft MS, Dennison PJ, Widmer RP, Evans RW. A survey of cariology teaching in Australia and New Zealand. BMC MEDICAL EDUCATION 2018; 18:75. [PMID: 29631580 PMCID: PMC5892021 DOI: 10.1186/s12909-018-1176-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2017] [Accepted: 03/21/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND The Australian and New Zealand chapter of the Alliance for a Cavity Free Future was launched in 2013 and one of its primary aims was to conduct a survey of the local learning and teaching of cariology in dentistry and oral health therapy programs. METHODS A questionnaire was developed using the framework of the European Organisation for Caries Research (ORCA)/Association of Dental Education in Europe (ADEE) cariology survey conducted in Europe in 2009. The questionnaire was comprised of multiple choice and open-ended questions exploring many aspects of the cariology teaching. The survey was distributed to the cariology curriculum coordinator of each of the 21 programs across Australia and New Zealand via Survey Monkey in January 2015. Simple analysis of results was carried out with frequencies and average numbers of hours collated and open-ended responses collected and compiled into tables. RESULTS Seventeen responses from a total of 21 programs had been received including 7 Dentistry and 10 Oral Health programs. Key findings from the survey were - one quarter of respondents indicated that cariology was identified as a specific discipline with their course and 41% had a cariology curriculum in written format. With regard to lesion detection and caries diagnosis, all of the program coordinators who responded indicated that visual/tactile methods and radiographic interpretation were recommended with ICDAS also being used by over half them. Despite all respondents teaching early caries lesion management centred on prevention and remineralisation, many taught operative intervention at an earlier stage of lesion depth than current evidence supports. Findings showed over 40% of respondents still teach operative intervention for lesions confined to enamel. CONCLUSION Despite modern theoretical concepts of cariology being taught in Australia and New Zealand, they do not appear to be fully translated into clinical teaching at the present time.
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Affiliation(s)
- Sarah L. Raphael
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
| | | | | | | | - Richard P. Widmer
- Department of Dentistry, Children’s Hospital at Westmead, Westmead, Australia
| | - R. Wendell Evans
- Department of Population Oral Health, Faculty of Dentistry, The University of Sydney, Westmead, Australia
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16
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Chestnutt IG, Hutchings S, Playle R, Morgan-Trimmer S, Fitzsimmons D, Aawar N, Angel L, Derrick S, Drew C, Hoddell C, Hood K, Humphreys I, Kirby N, Lau TMM, Lisles C, Morgan MZ, Murphy S, Nuttall J, Onishchenko K, Phillips C, Pickles T, Scoble C, Townson J, Withers B, Chadwick BL. Seal or Varnish? A randomised controlled trial to determine the relative cost and effectiveness of pit and fissure sealant and fluoride varnish in preventing dental decay. Health Technol Assess 2018; 21:1-256. [PMID: 28613154 DOI: 10.3310/hta21210] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Fissure sealant (FS) and fluoride varnish (FV) have been shown to be effective in preventing dental caries when tested against a no-treatment control. However, the relative clinical effectiveness and cost-effectiveness of these interventions is unknown. OBJECTIVE To compare the clinical effectiveness and cost-effectiveness of FS and FV in preventing dental caries in first permanent molars (FPMs) in 6- and 7-year-olds and to determine their acceptability. DESIGN A randomised controlled allocation-blinded clinical trial with two parallel arms. SETTING A targeted population programme using mobile dental clinics (MDCs) in schools located in areas of high social and economic deprivation in South Wales. PARTICIPANTS In total, 1016 children were randomised, but one parent subsequently withdrew permission and so the analysis was based on 1015 children. The randomisation of participants was stratified by school and balanced for sex and primary dentition baseline caries levels using minimisation in a 1 : 1 ratio for treatments. A random component was added to the minimisation algorithm, such that it was not completely deterministic. Of the participants, 514 were randomised to receive FS and 502 were randomised to receive FV. INTERVENTIONS Resin-based FS was applied to caries-free FPMs and maintained at 6-monthly intervals. FV was applied at baseline and at 6-month intervals over the course of 3 years. MAIN OUTCOME MEASURES The proportion of children developing caries into dentine (decayed, missing, filled teeth in permanent dentition, i.e. D4-6MFT) on any one of up to four treated FPMs after 36 months. The assessors were blinded to treatment allocation; however, the presence or absence of FS at assessment would obviously indicate the probable treatment received. Economic measures established the costs and budget impact of FS and FV and the relative cost-effectiveness of these technologies. Qualitative interviews determined the acceptability of the interventions. RESULTS At 36 months, 835 (82%) children remained in the trial: 417 in the FS arm and 418 in the FV arm. The proportion of children who developed caries into dentine on a least one FPM was lower in the FV arm (73; 17.5%) than in the FS arm (82, 19.6%) [odds ratio (OR) 0.84, 95% confidence interval (CI) 0.59 to 1.21; p = 0.35] but the difference was not statistically significant. The results were similar when the numbers of newly decayed teeth (OR 0.86, 95% CI 0.60 to 1.22) and tooth surfaces (OR 0.85, 95% CI 0.59 to 1.21) were examined. Trial fidelity was high: 95% of participants received five or six of the six scheduled treatments. Between 74% and 93% of sealants (upper and lower teeth) were intact at 36 months. The costs of the two technologies showed a small but statistically significant difference; the mean cost to the NHS (including intervention costs) per child was £500 for FS, compared with £432 for FV, a difference of £68.13 (95% CI £5.63 to £130.63; p = 0.033) in favour of FV. The budget impact analysis suggests that there is a cost saving of £68.13 (95% CI £5.63 to £130.63; p = 0.033) per child treated if using FV compared with the application of FS over this time period. An acceptability score completed by the children immediately after treatment and subsequent interviews demonstrated that both interventions were acceptable to the children. No adverse effects were reported. LIMITATIONS There are no important limitations to this study. CONCLUSIONS In a community oral health programme utilising MDCs and targeted at children with high caries risk, the twice-yearly application of FV resulted in caries prevention that is not significantly different from that obtained by applying and maintaining FSs after 36 months. FV proved less expensive. FUTURE WORK The clinical effectiveness and cost-effectiveness of FS and FV following the cessation of active intervention merits investigation. TRIAL REGISTRATION EudraCT number 2010-023476-23, Current Controlled Trials ISRCTN17029222 and UKCRN reference 9273. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 21. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Ivor Gordon Chestnutt
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Cardiff, UK
| | - Simon Hutchings
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Rebecca Playle
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Cardiff, UK.,South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | | | - Deborah Fitzsimmons
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Nadine Aawar
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Lianna Angel
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Sharron Derrick
- Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, UK
| | - Cheney Drew
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ceri Hoddell
- Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, UK
| | - Kerenza Hood
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Ioan Humphreys
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Nigel Kirby
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Tin Man Mandy Lau
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Catherine Lisles
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Maria Zeta Morgan
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Cardiff, UK
| | - Simon Murphy
- DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - Jacqueline Nuttall
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Kateryna Onishchenko
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Ceri Phillips
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Timothy Pickles
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Charlotte Scoble
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Julia Townson
- South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Cardiff, UK
| | - Beverley Withers
- Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, UK
| | - Barbara Lesley Chadwick
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Cardiff, UK
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17
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Yong R, Ranjitkar S, Lekkas D, Halazonetis D, Evans A, Brook A, Townsend G. Three‐dimensional (3D) geometric morphometric analysis of human premolars to assess sexual dimorphism and biological ancestry in Australian populations. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:373-385. [DOI: 10.1002/ajpa.23438] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 01/28/2018] [Accepted: 01/29/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Robin Yong
- Adelaide Dental SchoolUniversity of AdelaideAdelaide South Australia 5005 Australia
| | - Sarbin Ranjitkar
- Adelaide Dental SchoolUniversity of AdelaideAdelaide South Australia 5005 Australia
| | - Dimitra Lekkas
- Adelaide Dental SchoolUniversity of AdelaideAdelaide South Australia 5005 Australia
| | - Demetrios Halazonetis
- School of DentistryNational and Kapodistrian University of AthensAthens 11527 Greece
| | - Alistair Evans
- School of Biological SciencesMonash UniversityClayton Victoria 3800 Australia
| | - Alan Brook
- Adelaide Dental SchoolUniversity of AdelaideAdelaide South Australia 5005 Australia
- Institute of DentistryQueen Mary University of LondonLondon E1 4NS United Kingdom
| | - Grant Townsend
- Adelaide Dental SchoolUniversity of AdelaideAdelaide South Australia 5005 Australia
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18
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Proctor DM, Fukuyama JA, Loomer PM, Armitage GC, Lee SA, Davis NM, Ryder MI, Holmes SP, Relman DA. A spatial gradient of bacterial diversity in the human oral cavity shaped by salivary flow. Nat Commun 2018; 9:681. [PMID: 29445174 PMCID: PMC5813034 DOI: 10.1038/s41467-018-02900-1] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 01/08/2018] [Indexed: 01/03/2023] Open
Abstract
Spatial and temporal patterns in microbial communities provide insights into the forces that shape them, their functions and roles in health and disease. Here, we used spatial and ecological statistics to analyze the role that saliva plays in structuring bacterial communities of the human mouth using >9000 dental and mucosal samples. We show that regardless of tissue type (teeth, alveolar mucosa, keratinized gingiva, or buccal mucosa), surface-associated bacterial communities vary along an ecological gradient from the front to the back of the mouth, and that on exposed tooth surfaces, the gradient is pronounced on lingual compared to buccal surfaces. Furthermore, our data suggest that this gradient is attenuated in individuals with low salivary flow due to Sjögren's syndrome. Taken together, our findings imply that salivary flow influences the spatial organization of microbial communities and that biogeographical patterns may be useful for understanding host physiological processes and for predicting disease.
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Affiliation(s)
- Diana M Proctor
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, 94305, USA
- Infectious Diseases Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA
- Division of Periodontology, University of California, San Francisco School of Dentistry, San Francisco, CA, 94143, USA
| | - Julia A Fukuyama
- Department of Computational Biology, Fred Hutchinson Cancer Research Institute, Seattle, WA, 98109, USA
| | - Peter M Loomer
- Division of Periodontology, University of California, San Francisco School of Dentistry, San Francisco, CA, 94143, USA
- Ashman's Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY, 10010, USA
| | - Gary C Armitage
- Division of Periodontology, University of California, San Francisco School of Dentistry, San Francisco, CA, 94143, USA
| | - Stacey A Lee
- Division of Periodontology, University of California, San Francisco School of Dentistry, San Francisco, CA, 94143, USA
| | - Nicole M Davis
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, 94305, USA
| | - Mark I Ryder
- Division of Periodontology, University of California, San Francisco School of Dentistry, San Francisco, CA, 94143, USA
| | - Susan P Holmes
- Department of Statistics, Stanford University, Stanford, CA, 94305, USA
| | - David A Relman
- Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, CA, 94305, USA.
- Infectious Diseases Section, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, 94304, USA.
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, 94305, USA.
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19
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Chestnutt IG, Playle R, Hutchings S, Morgan-Trimmer S, Fitzsimmons D, Aawar N, Angel L, Derrick S, Drew C, Hoddell C, Hood K, Humphreys I, Kirby N, Lau TMM, Lisles C, Morgan MZ, Murphy S, Nuttall J, Onishchenko K, Phillips C, Pickles T, Scoble C, Townson J, Withers B, Chadwick BL. Fissure Seal or Fluoride Varnish? A Randomized Trial of Relative Effectiveness. J Dent Res 2017; 96:754-761. [PMID: 28394709 DOI: 10.1177/0022034517702094] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Fissure sealant (FS) and fluoride varnish (FV) are effective in preventing dental caries when compared with a no-treatment control. However, the relative clinical effectiveness of these interventions is uncertain. The objective of the study was to compare the clinical effectiveness of FS and FV in preventing dental caries in first permanent molars (FPMs) in 6- to 7-y-olds. The study design was a randomized clinical trial, with 2 parallel arms. The setting was a targeted-population program that used mobile dental clinics in schools located within areas of high social and economic deprivation in South Wales. A total of 1,016 children were randomized 1:1 to receive either FS or FV. Resin-based FS was applied to caries-free FPMs and maintained at 6-mo intervals. FV was applied at baseline and at 6-mo intervals for 3 y. The main outcome measures were the proportion of children developing caries into dentine (D4-6MFT) on any 1 of up to 4 treated FPMs after 36 mo. At 36 mo, 835 (82%) children remained: 417 in the FS arm and 418 in the FV arm. A smaller proportion of children who received FV ( n = 73, 17.5%) versus FS ( n = 82, 19.6%) developed caries into dentine on at least 1 FPM (odds ratio [OR] = 0.84; 95% CI, 0.59 to 1.21; P = 0.35), a nonstatistically significant difference between FS and FV treatments. The results were similar when the number of newly decayed teeth (OR = 0.86; 95% CI, 0.60 to 1.22) and tooth surfaces (OR = 0.85; 95% CI, 0.59 to 1.21) were examined. In a community oral health program, semiannual application of FV resulted in caries prevention that was not significantly different from that obtained by applying and maintaining FS after 36 mo (EudraCT: 2010-023476-23; ISRCTN: ISRCTN17029222).
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Affiliation(s)
- I G Chestnutt
- 1 Applied Clinical Research and Public Health, School of Dentistry, Cardiff University, Cardiff, UK
| | - R Playle
- 1 Applied Clinical Research and Public Health, School of Dentistry, Cardiff University, Cardiff, UK.,2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - S Hutchings
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - S Morgan-Trimmer
- 3 DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - D Fitzsimmons
- 4 Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - N Aawar
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - L Angel
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - S Derrick
- 5 Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, UK
| | - C Drew
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - C Hoddell
- 5 Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, UK
| | - K Hood
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - I Humphreys
- 4 Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - N Kirby
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - T M M Lau
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - C Lisles
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - M Z Morgan
- 1 Applied Clinical Research and Public Health, School of Dentistry, Cardiff University, Cardiff, UK
| | - S Murphy
- 3 DECIPHer, School of Social Sciences, Cardiff University, Cardiff, UK
| | - J Nuttall
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - K Onishchenko
- 4 Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - C Phillips
- 4 Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - T Pickles
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - C Scoble
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - J Townson
- 2 South East Wales Trials Unit, Centre for Trials Research, Cardiff University, Neuadd Meirionnydd, Cardiff, UK
| | - B Withers
- 5 Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, UK
| | - B L Chadwick
- 1 Applied Clinical Research and Public Health, School of Dentistry, Cardiff University, Cardiff, UK
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20
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Yeh DY, Kuo HC, Yang YH, Ho PS. The Responsiveness of Patients' Quality of Life to Dental Caries Treatment-A Prospective Study. PLoS One 2016; 11:e0164707. [PMID: 27776148 PMCID: PMC5077135 DOI: 10.1371/journal.pone.0164707] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Accepted: 09/29/2016] [Indexed: 11/19/2022] Open
Abstract
The objective of this study was to determine the responsiveness of oral health-related quality of life (OHRQoL) (oral health impact profile [OHIP] and oral impact on daily performance [OIDP]) and health-related quality of life (HRQoL) (World Health Organization quality of life scale, brief [WHOQOL-BREF]) in dental caries restoration treatment. The study also aimed to assess the influence of treatment on the responsiveness of patients' quality of life (QoL). A total of 126 patients (aged 16-40 years) received dental caries restoration treatment with a 2-week follow-up and pre- and posttreatment interviews by questionnaire. Patients were assessed for their perceptions of OHRQoL and HRQoL by using the OHIP, OIDP, and WHOQOL-BREF measures. The responsiveness of all outcome measurements was assessed by effect size (ES). Stepwise multiple regression analysis was used to examine the association with the responsiveness of all outcome measurements. Significant differences were found between OIDP (ES = 0.39), OHIP (ES = 0.54), and WHOQOL-BREF (ES = 0.13) with regard to pretreatment and posttreatment (p-values: <0.0001, <0.0001, and 0.0120, respectively). Sex and dental caries status at baseline were significantly associated with responsiveness by all measurements. This study suggests that dental caries treatment moderately improves OHRQoL, but is less related to HRQoL. Furthermore, the number of dental caries and restoration are important factors affecting the improvement of patients' perceived OHRQoL.
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Affiliation(s)
- Ding-Yu Yeh
- Department of Dentistry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
| | - Hsiao-Ching Kuo
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hsin Yang
- School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pei-Shan Ho
- Department of Oral Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan
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21
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Mamai-Homata E, Koletsi-Kounari H, Margaritis V. Gender differences in oral health status and behavior of Greek dental students: A meta-analysis of 1981, 2000, and 2010 data. J Int Soc Prev Community Dent 2016; 6:60-8. [PMID: 27011935 PMCID: PMC4784066 DOI: 10.4103/2231-0762.175411] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the oral health status and behavior of Greek dental students over time, and to meta-analyze these findings to test the widely documented hypothesis that women have better oral health behavior, oral hygiene, and periodontal status but higher dental caries rates than men. MATERIALS AND METHODS A total sample of 385 students was examined using identical indices to assess oral health and behavioral data initially in 1981 while the years 2000 and 2010 were selected due to significant changes that took place in the dental curriculum in the 1990s and 2000s. Data by gender concerning the outcome variables recorded in every one of the three surveys were analyzed using Mantel-Haenszel and continuous outcomes methods. RESULTS A significant improvement in the oral health status and behavior of students was observed over time. The meta-analysis of data by gender showed that females brushed their teeth significantly more often than males [summary odds ratio (OR): 1.95 and 95% confidence interval (CI): 1.08-3.54]. Males and females were found to have a similar risk of developing dental caries. CONCLUSION The hypothesis that young women have better oral hygiene habits compared to men was confirmed. However, the hypothesis that women have better oral hygiene and periodontal status but exhibit higher dental caries experience than men was not supported by the findings of the study.
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Affiliation(s)
- Eleni Mamai-Homata
- Department of Preventive and Community Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Haroula Koletsi-Kounari
- Department of Preventive and Community Dentistry, Dental School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vasileios Margaritis
- Department of Public Health, College of Health Sciences, Walden University, Minneapolis, Minnesota, USA
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22
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Schwendicke F, Tu YK, Blunck U, Paris S, Göstemeyer G. Effect of Industry Sponsorship on Dental Restorative Trials. J Dent Res 2015; 95:9-16. [DOI: 10.1177/0022034515609270] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Industry sponsorship was found to potentially introduce bias into clinical trials. We assessed the effects of industry sponsorship on the design, comparator choice, and findings of randomized controlled trials on dental restorative materials. A systematic review was performed via MEDLINE, CENTRAL, and EMBASE. Randomized trials on dental restorative and adhesive materials published 2005 to 2015 were included. The design of sponsored and nonsponsored trials was compared statistically (risk of bias, treatment indication, setting, transferability, sample size). Comparator choice and network geometry of sponsored and nonsponsored trials were assessed via network analysis. Material performance rankings in different trial types were estimated via Bayesian network meta-analysis. Overall, 114 studies were included (15,321 restorations in 5,232 patients). We found 21 and 41 (18% and 36%) trials being clearly or possibly industry sponsored, respectively. Trial design of sponsored and nonsponsored trials did not significantly differ for most assessed items. Sponsored trials evaluated restorations of load-bearing cavities significantly more often than nonsponsored trials, had longer follow-up periods, and showed significantly increased risk of detection bias. Regardless of sponsorship status, comparisons were mainly performed within material classes. The proportion of trials comparing against gold standard restorative or adhesive materials did not differ between trial types. If ranked for performance according to the need to re-treat (best: least re-treatments), most material combinations were ranked similarly in sponsored and nonsponsored trials. The effect of industry sponsorship on dental restorative trials seems limited.
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Affiliation(s)
- F. Schwendicke
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - Y.-K. Tu
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - U. Blunck
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - S. Paris
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
| | - G. Göstemeyer
- Department of Operative and Preventive Dentistry, Charité–Universitätsmedizin, Berlin, Germany
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Abstract
AIM To describe the occurrence of dental caries at the person, tooth and tooth surface level from childhood to early mid-life. BACKGROUND No studies have reported on age and caries experience in a population-based sample through the first half of life. METHODS Prospective cohort study of a complete birth cohort (n = 1,037) born in 1972/73 in Dunedin, New Zealand. Dental examinations were conducted at ages 5, 9, 15, 18, 26, 32 and 38, and participation rates remained high. Surface-level caries data were collected at each age (WHO basic methods). Statistical analyses and graphing of data were undertaken using Intercooled Stata Version 10. RESULTS Data are presented on dental caries experience in the permanent dentition at ages 9, 15, 18, 26, 32 and 38. Percentile curves are charted and reported for person-level caries experience. Data are also presented on the number of decayed teeth and tooth surfaces, (including root surfaces at age 38), as a function of the number of teeth and surfaces present, respectively. Across the cohort, the number of tooth surfaces affected by dental caries increased by approximately 0.8 surfaces per year (on average), while the percentage of at-risk tooth surfaces affected by caries increased by approximately 0.5% per year, with negligible variation in that rate throughout the observation period. CONCLUSION These unique data show clearly that dental caries continues as a disease of adulthood, remaining important beyond childhood and adolescence and that rates of dental caries over time remain relatively constant.
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Blinkhorn AS, Byun R, Mehta P, Kay M. A 4-year assessment of a new water-fluoridation scheme in New South Wales, Australia. Int Dent J 2015; 65:156-63. [PMID: 25913418 DOI: 10.1111/idj.12166] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To monitor the changes in dental caries prevalence of 5- to 7-year-old children living in a fluoridated area, a newly fluoridated area and in an area without water fluoridation, in NSW, Australia. METHODS Dental caries prevalence was recorded for 5- to 7-year-old children, living in the three study locations, by six trained and calibrated examiners in 2008, 2010 and 2012. A questionnaire recorded demographic data, toothbrushing behaviour and sugary drink consumption. Caries experience was measured using the decayed, missing, and filled teeth (dmft) index for primary teeth, the percentage of children who were caries free and the significant caries index. Univariate analysis was undertaken to determine independent predictors of caries. RESULTS The caries prevalence changed over time. In 2008, the mean dmft index was 1.40 for the fluoridated area, 2.02 for the area about to fluoridate and 2.09 for the unfluoridated control. By 2012, these mean dmft scores were 0.69, 0.72 and 1.21, respectively. In the two areas where children received fluoridated water, the significant caries index was 2.30 for the fluoridated area and 2.40 for the newly fluoridated area. The significant caries score for children in the unfluoridated location was 3.93. Multivariate analysis showed that over time the differences in dental caries prevalence between the established fluoride area and the newly fluoridated area diminished. However, children in the unfluoridated control area continued to demonstrate significant differences in the mean number of decayed teeth compared with children in the fluoridated comparator sites, and the proportions of children free from decay were significantly higher in the fluoridated areas than in the unfluoridated area. CONCLUSION Fluoridation of public water supplies in Gosford and Wyong offers young children better dental health than those children who do not have access to this public health measure.
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Affiliation(s)
| | - Roy Byun
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia.,South Western Local Health District, Sydney, NSW, Australia
| | - Pathik Mehta
- Faculty of Dentistry, University of Sydney, Sydney, NSW, Australia
| | - Meredith Kay
- Breast Screen NSW, Northern Sydney and Central Coast Local Health Districts, St Leonards, NSW, Australia
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Olabisi AA, Udo UA, Ehimen UG, Bashiru BO, Gbenga OO, Adeniyi AO. Prevalence of dental caries and oral hygiene status of a screened population in Port Harcourt, Rivers State, Nigeria. J Int Soc Prev Community Dent 2015; 5:59-63. [PMID: 25767769 PMCID: PMC4355852 DOI: 10.4103/2231-0762.151979] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Objectives: The study was designed to determine the prevalence of dental caries and partial edentulism, in addition to assessing the oral hygiene status and restorative care among adults in a community-based outreach program in Port Harcourt. Materials and Methods: A cross-sectional study was conducted among adults who participated in oral health screening program, which took place in Alakahia and Obigbo rural communities in Port Harcourt, Rivers State, Nigeria. After a brief oral health education, clinical examination was conducted and the diagnosis of caries was made based on the guidelines laid down by World Health Organization. Prevalence of caries was measured using decayed missing and filled teeth (DMFT) index, and oral hygiene status was assessed using the OHI-S. The restorative index [(F/F + D) ×100] was also calculated and the sociodemographic factors of the subjects were noted. Chi-square test, independent t-test and descriptive statistic were employed for analysis. Results: One fifty-five females (53.8%) and 133 males (46.2%) attended the events and their mean age was 29.3 ± 10.5 years. About one-third of the participants (35.1%) presented with dental caries. The mean DMFT for the whole group was 0.67 ± 2.0. The restorative index for the subjects was 26.8%. The oral hygiene status of most of the participants was fair. This was significantly better in females than in males (P = 0.002). Conclusion: Although about one-third of the participants had dental caries, only a quarter of them had received restorative care. Most of the respondents had fair and poor oral hygiene, this suggests the need to educate and motivate the community toward adopting and maintaining positive oral health attitudes and practices.
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Affiliation(s)
- Arigbede Abiodun Olabisi
- Department of Restorative Dentistry, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Umanah Ayamma Udo
- Department of Restorative Dentistry, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Ukegheson Gabriel Ehimen
- Department of Child Dental Health, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria
| | | | - Omitola Olufemi Gbenga
- Department of Oral Pathology and Oral Biology, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
| | - Akadiri Oladimeji Adeniyi
- Department of Oral and Maxillofacial Surgery, University of Port Harcourt, Port Harcourt, Rivers State, Nigeria
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Cochrane NJ, Hopcraft MS, Tong AC, Thean HL, Thum YS, Tong DE, Wen J, Zhao SC, Stanton DP, Yuan Y, Shen P, Reynolds EC. Fluoride content of tank water in Australia. Aust Dent J 2014; 59:180-6. [PMID: 24861392 DOI: 10.1111/adj.12163] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND The aims of this study were to: (1) analyse the fluoride content of tank water; (2) determine whether the method of water collection or storage influenced fluoride content; and (3) survey participant attitudes towards water fluoridation. METHODS Plastic tubes and a questionnaire were distributed through dentists to households with water tanks in Victoria. A midstream tank water sample was collected and fluoride analysed in triplicate using ion chromatography RESULTS All samples (n = 123) contained negligible amounts of fluoride, with a mean fluoride concentration of <0.01 ppm (range: <0.01-0.18 ppm). No statistically significant association was found between fluoride content and variables investigated such as tank material, tank age, roof material and gutter material. Most people did not know whether their tank water contained fluoride and 40.8% preferred to have access to fluoridated water. The majority thought fluoride was safe and more than half of the respondents supported fluoridation. Fluoride content of tank water was well below the optimal levels for caries prevention. CONCLUSIONS People who rely solely on tank water for drinking may require additional exposure to fluoride for optimal caries prevention.
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Affiliation(s)
- N J Cochrane
- Oral Health CRC, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Victoria
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Martinez-Mier EA, Zandona AF. The impact of gender on caries prevalence and risk assessment. Dent Clin North Am 2013; 57:301-315. [PMID: 23570807 DOI: 10.1016/j.cden.2013.01.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Dental caries remains a common disease worldwide. There is evidence indicating that many caries risk factors provide a gender bias, placing women at a higher caries risk. Generally, dental caries disproportionally affects the poor and racial or ethnic minorities worldwide, with women suffering more from the disease. Differences in access to care as reflected by untreated caries rates also reflect gender disparities. There is a lack of evidence in regard to gender differences and dental caries. Therefore, there is an urgent need to develop the evidence necessary to meet the oral health needs of both women and men worldwide.
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Chestnutt IG, Chadwick BL, Hutchings S, Playle R, Pickles T, Lisles C, Kirkby N, Morgan MZ, Hunter L, Hodell C, Withers B, Murphy S, Morgan-Trimmer S, Fitzsimmons D, Phillips C, Nuttall J, Hood K. Protocol for "Seal or Varnish?" (SoV) trial: a randomised controlled trial to measure the relative cost and effectiveness of pit and fissure sealants and fluoride varnish in preventing dental decay. BMC Oral Health 2012; 12:51. [PMID: 23167481 PMCID: PMC3534529 DOI: 10.1186/1472-6831-12-51] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 11/09/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental caries remains a significant public health problem, prevalence being linked to social and economic deprivation. Occlusal surfaces of first permanent molars are the most susceptible site in the developing permanent dentition. Cochrane reviews have shown pit and fissure sealants (PFS) and fluoride varnish (FV) to be effective over no intervention in preventing caries. However, the comparative cost and effectiveness of these treatments is uncertain. The primary aim of the trial described in this protocol is to compare the clinical effectiveness of PFS and FV in preventing dental caries in first permanent molars in 6-7 year-olds. Secondary aims include: establishing the costs and the relative cost-effectiveness of PFS and FV delivered in a community/school setting; examining the impact of PFS and FV on children and their parents/carers in terms of quality of life/treatment acceptability measures; and examining the implementation of treatment in a community setting. METHODS/DESIGN The trial design comprises a randomised, assessor-blinded, two-arm, parallel group trial in 6-7 year old schoolchildren. Clinical procedures and assessments will be performed at 66 primary schools, in deprived areas in South Wales. Treatments will be delivered via a mobile dental clinic. In total, 920 children will be recruited (460 per trial arm). At baseline and annually for 36 months dental caries will be recorded using the International Caries Detection and Assessment System (ICDAS) by trained and calibrated dentists. PFS and FV will be applied by trained dental hygienists. The FV will be applied at baseline, 6, 12, 18, 24 and 30 months. The PFS will be applied at baseline and re-examined at 6, 12, 18, 24, and 30 months, and will be re-applied if the existing sealant has become detached/is insufficient. The economic analysis will estimate the costs of providing the PFS versus FV. The process evaluation will assess implementation and acceptability through acceptability scales, a schools questionnaire and interviews with children, parents, dentists, dental nurses and school staff. The primary outcome measure will be the proportion of children developing new caries on any one of up to four treated first permanent molars. DISCUSSION The objectives of this study have been identified by the National Institute for Health Research as one of importance to the National Health Service in the UK. The results of this trial will provide guidance on which of these technologies should be adopted for the prevention of dental decay in the most susceptible tooth-surface in the most at risk children. TRIAL REGISTRATIONS ISRCTN ref: ISRCTN17029222 EudraCT: 2010-023476-23 UKCRN ref: 9273.
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Affiliation(s)
- Ivor Gordon Chestnutt
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY, UK
| | - Barbara Lesley Chadwick
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY, UK
| | - Simon Hutchings
- South East Wales Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - Rebecca Playle
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY, UK
- South East Wales Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - Timothy Pickles
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY, UK
- South East Wales Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - Catherine Lisles
- South East Wales Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - Nigel Kirkby
- South East Wales Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - Maria Zeta Morgan
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY, UK
| | - Lindsay Hunter
- Applied Clinical Research and Public Health, Cardiff University School of Dentistry, Heath Park, Cardiff, CF14 4XY, UK
| | - Ceri Hodell
- Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, CF14 7XB, UK
| | - Beverely Withers
- Community Dental Service, Cardiff and Vale University Health Board, Whitchurch Hospital, Cardiff, CF14 7XB, UK
| | - Simon Murphy
- DECIPHer, School of Social Sciences, Cardiff University, 1–3 Museum Place, Cardiff, CF10 3BD, UK
| | - Sarah Morgan-Trimmer
- DECIPHer, School of Social Sciences, Cardiff University, 1–3 Museum Place, Cardiff, CF10 3BD, UK
| | - Deborah Fitzsimmons
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Ceri Phillips
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Swansea University, Singleton Park, Swansea, SA2 8PP, UK
| | - Jacqueline Nuttall
- South East Wales Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
| | - Kerenza Hood
- South East Wales Trials Unit, School of Medicine, Cardiff University, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS, UK
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Costa SM, Martins CC, Bonfim MDLC, Zina LG, Paiva SM, Pordeus IA, Abreu MHNG. A systematic review of socioeconomic indicators and dental caries in adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2012; 9:3540-74. [PMID: 23202762 PMCID: PMC3509471 DOI: 10.3390/ijerph9103540] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 09/10/2012] [Accepted: 10/02/2012] [Indexed: 11/16/2022]
Abstract
Increasing evidence suggests that socioeconomic factors may be associated with an increased risk of dental caries. To provide better evidence of the association between dental caries in adults and socioeconomic indicators, we evaluated the relation between these two conditions in a thorough review of the literature. Seven databases were systematically searched: Pubmed, Cochrane, Web of Science, Bireme, Controlled Trials, Clinical Trials and the National Institute for Health and Clinical Excellence. No restrictions were placed on the language or year of publication. The search yielded 41 studies for systematic review. Two independent reviewers screened the studies for inclusion, extracted data and evaluated quality using the Newcastle-Ottawa scale. The following socioeconomic indicators were found: educational level, income, occupation, socio-economic status and the community index. These indicators were significantly associated with a greater occurrence of dental caries: the subject's education, subject's income, subject's occupation and the Gini coefficient. A high degree of heterogeneity was found among the methods. Quality varied across studies. The criteria employed for socioeconomic indicators and dental caries should be standardized in future studies. The scientific evidence reveals that educational level, income, occupation and the Gini coefficient are associated with dental caries.
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Affiliation(s)
- Simone M. Costa
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (S.M.C.); (C.C.M.); (M.L.C.B.); (S.M.P.);
(I.A.P.)
| | - Carolina C. Martins
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (S.M.C.); (C.C.M.); (M.L.C.B.); (S.M.P.);
(I.A.P.)
| | - Maria de Lourdes C. Bonfim
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (S.M.C.); (C.C.M.); (M.L.C.B.); (S.M.P.);
(I.A.P.)
| | - Lívia G. Zina
- Minas Gerais State Public Health School, Avenida Augusto de Lima, 2061-Barro Preto, Belo Horizonte MG 30190-002, Brazil;
| | - Saul M. Paiva
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (S.M.C.); (C.C.M.); (M.L.C.B.); (S.M.P.);
(I.A.P.)
| | - Isabela A. Pordeus
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (S.M.C.); (C.C.M.); (M.L.C.B.); (S.M.P.);
(I.A.P.)
| | - Mauro H. N. G. Abreu
- School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte 31270-901, Brazil; (S.M.C.); (C.C.M.); (M.L.C.B.); (S.M.P.);
(I.A.P.)
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30
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Stephenson J. A model for the analysis of caries occurrence in primary molar tooth surfaces. Caries Res 2012; 46:452-9. [PMID: 22739707 DOI: 10.1159/000339390] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 04/17/2012] [Indexed: 11/19/2022] Open
Abstract
Recently methods of caries quantification in the primary dentition have moved away from summary 'whole mouth' measures at the individual level to methods based on generalised linear modelling (GLM) approaches or survival analysis approaches. However, GLM approaches based on logistic transformation fail to take into account the time-dependent process of tooth/surface survival to caries. There may also be practical difficulties associated with casting parametric survival-based approaches in a complex multilevel hierarchy and the selection of an optimal survival distribution, while non-parametric survival methods are not generally suitable for the assessment of supplementary information recorded on study participants. In the current investigation, a hybrid semi-parametric approach comprising elements of survival-based and GLM methodologies suitable for modelling of caries occurrence within fixed time periods is assessed, using an illustrative multilevel data set of caries occurrence in primary molars from a cohort study, with clustering of data assumed to occur at surface and tooth levels. Inferences of parameter significance were found to be consistent with previous parametric survival-based analyses of the same data set, with gender, socio-economic status, fluoridation status, tooth location, surface type and fluoridation status-surface type interaction significantly associated with caries occurrence. The appropriateness of the hierarchical structure facilitated by the hybrid approach was also confirmed. Hence the hybrid approach is proposed as a more appropriate alternative to primary caries modelling than non-parametric survival methods or other GLM-based models, and as a practical alternative to more rigorous survival-based methods unlikely to be fully accessible to most researchers.
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Affiliation(s)
- J Stephenson
- School of Human & Health Sciences, University of Huddersfield, Huddersfield, UK.
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31
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Shearer DM, Thomson WM, Caspi A, Moffitt TE, Broadbent JM, Poulton R. Family history and oral health: findings from the Dunedin Study. Community Dent Oral Epidemiol 2012; 40:105-15. [PMID: 22022823 PMCID: PMC3270204 DOI: 10.1111/j.1600-0528.2011.00641.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
CONTEXT The effects of the oral health status of one generation on that of the next within families are unclear. OBJECTIVES To determine whether parental oral health history is a risk factor for oral disease. METHODS Oral examination and interview data were collected during the age-32 assessments in the Dunedin Study. Parental data were also collected on this occasion. The sample was divided into two familial-risk groups for caries/tooth loss (high risk and low risk) based on parents' self-reported history of tooth loss at the age-32 assessment interview. MAIN OUTCOME MEASURES Probands' dental caries and tooth loss status at age 32, together with lifelong dental caries trajectory (age 5-32). RESULTS Caries/tooth loss risk analysis was conducted for 640 proband-parent groups. Reference groups were the low-familial-risk groups. After controlling for confounding factors (sex, episodic use of dental services, socio-economic status and plaque trajectory), the prevalence ratio (PR) for having lost 1+ teeth by age 32 for the high-familial-risk group was 1.41 [95% confidence interval (CI) 1.05, 1.88] and the rate ratio for DMFS at age 32 was 1.41 (95% CI 1.24, 1.60). In the high-familial-risk group, the PR of following a high caries trajectory was 2.05 (95% CI 1.37, 3.06). Associations were strongest when information was available about both parents' oral health. Nonetheless, when information was available for one parent only, associations were significant for some outcomes. CONCLUSIONS People with poor oral health tend to have parents with poor oral health. Family/parental history of oral health is a valid representation of the intricacies of the shared genetic and environmental factors that contribute to an individual's oral health status. Associations are strongest when data from both parents can be obtained.
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Affiliation(s)
- Dara M Shearer
- Department of Oral Sciences, School of Dentistry, Dunedin, New Zealand.
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Kirkevang LL, Væth M, Wenzel A. Incidence of caries lesions in approximal surfaces: a radiographic study of a general adult Danish population. Caries Res 2011; 45:538-46. [PMID: 22024792 DOI: 10.1159/000331932] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2011] [Accepted: 08/16/2011] [Indexed: 12/26/2022] Open
Abstract
The aim was to describe the incidence of caries lesions in a randomly selected adult population, and to identify risk factors related to the incidence of caries lesions in approximal surfaces. In 1997, 616 adults participated in a study including a radiographic survey. In 2003 these individuals were contacted again and offered a second radiographic survey; 473 consented and attended this examination. In approximal surfaces, presence/absence of caries lesions and presence and type of coronal fillings were recorded. The incidence of caries lesions in surfaces with no caries lesions in 1997 was studied. Potential risk factors included information at three levels: (1) person, (2) tooth, and (3) surface. The analysis was carried out by multilevel logistic regression. For the analyses 23,701 approximal surfaces were eligible. In 23,243 approximal surfaces no caries lesions were detected in 1997, 17,007 of these were surfaces without fillings, and 6,236 were filled surfaces. In unfilled surfaces several factors affected the risk for development of a caries lesion: young age, high number of fillings, number of teeth and status of the adjacent surface. In filled surfaces few factors affected the incidence of caries lesions: status of the adjacent surface, smoking and distal surfaces. Differences in risk factor patterns for the incidence of caries lesions were found for unfilled and filled surfaces. The study emphasizes the importance of assessing factors related to the incidence of caries lesions in adults. Further it underlines the need to analyse the fate of filled surfaces separately, because once a surface has received a filling it needs continuous attendance.
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Affiliation(s)
- L-L Kirkevang
- Department of Dental Pathology, Operative Dentistry and Endodontics, Faculty of Health Sciences, Aarhus University, Aarhus, Denmark.
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da Silva RP, Pereira AC, de Castro Meneghim M, Mialhe FL. Development of an auxiliary resource for diagnosis of dental caries in epidemiological surveys. Int J Dent Hyg 2011; 9:250-3. [PMID: 21689374 DOI: 10.1111/j.1601-5037.2011.00518.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Early dental caries diagnosis within the changing global pattern of dental caries development requires the use of auxiliary resources and adjuncts to diagnosis. The aim of this study was to introduce an alternative resource for drying teeth to enable early diagnosis of dental caries in epidemiological surveys. METHODS Polyurethane tips and three-in-one syringes were fitted to nebulizers and non-professional portable compressors for dental surface drying. The output air pressure of these sets was compared with the output pressure from the three-in-one syringe in a dental office. RESULTS Although the output pressure from the alternative resources was lower than the output pressure from the dental office equipment, the dental surfaces were dried satisfactorily, allowing the early diagnosis of the dental caries. CONCLUSION When a dental setting is not available, these alternative resources for drying teeth can be used satisfactorily.
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Affiliation(s)
- R P da Silva
- Piracicaba Dental School, University of Campinas, Campinas, SP, Brazil
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34
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Shearer DM, Thomson WM, Broadbent JM, Poulton R. Maternal oral health predicts their children's caries experience in adulthood. J Dent Res 2011; 90:672-7. [PMID: 21248361 PMCID: PMC3144114 DOI: 10.1177/0022034510393349] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2010] [Revised: 11/07/2010] [Accepted: 11/09/2010] [Indexed: 11/17/2022] Open
Abstract
The long-term effects of poor maternal oral health are unknown. We determined whether maternal oral health when children were young was a risk indicator for caries experience in adulthood, using oral examination and interview data from age-5 and age-32 assessments in the Dunedin Study, and maternal self-rated oral health data from the age-5 assessment. The main outcome measure was probands' caries status at age 32. Analyses involved 835 individuals (82.3% of the surviving cohort) dentally examined at both ages, whose mothers were interviewed at the age-5 assessment. There was a consistent gradient in age-32 caries experience across the categories of maternal self-rated oral health status (from the age-5 assessment): it was greatest among the probands whose mothers rated their oral health as "poor" or who were edentulous, and lowest among those whose mothers rated their oral health as "excellent". Unfavorable maternal self-rated oral health when children are young should be regarded as a risk indicator for poor oral health among offspring as they reach adulthood.
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Affiliation(s)
- D M Shearer
- Department of Oral Sciences, School of Dentistry, PO Box 647, Dunedin 9054, New Zealand.
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35
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Heegaard KM, Holm-Pedersen P, Bardow A, Hvidtfeldt UA, Grønbaek M, Avlund K. The Copenhagen Oral Health Senior Cohort: design, population and dental health. Gerodontology 2010; 28:165-76. [PMID: 21138466 DOI: 10.1111/j.1741-2358.2010.00383.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND In order to study the way old age influence oral health, the Copenhagen Oral Health Senior Cohort (COHS) has been established. OBJECTIVES To describe the design, measurement procedures, and baseline values for COHS including spatial distribution of restorations and dental caries as well as reasons for non-participation. MATERIALS AND METHODS Seven hundred and eighty-three individuals aged 65 years or older, from a total of 1918 invited elderly people, underwent an interview regarding oral health-related behaviour and a clinical oral examination including measurement of unstimulated whole saliva flow rate. RESULTS Twelve percent of the COHS was edentulous. The number of dental restorations was higher for women compared to men; however, men had more caries than women. Coronal caries was most frequent on mesial and distal surfaces and on the maxillary incisors and canines; root caries was most frequent on labial surfaces and evenly distributed within the dentition. Only 41% of all invited elderly people accepted the invitation, with old age and poor health being the primary reasons for non-participation. CONCLUSION The baseline values for COHS show that a substantial proportion of the participants had retained a natural dentition and that dental caries was prevalent with the anterior maxillary teeth being most affected.
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Affiliation(s)
- Karen M Heegaard
- Copenhagen Gerontological Oral Health Research Centre, School of Dentistry, University of Copenhagen, Copenhagen, Denmark
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36
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Campain AC, Mariño RJ, Wright FAC, Harrison D, Bailey DL, Morgan MV. The impact of changing dental needs on cost savings from fluoridation. Aust Dent J 2010; 55:37-44. [PMID: 20415910 DOI: 10.1111/j.1834-7819.2010.01173.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Although community water fluoridation has been one of the cornerstone strategies for the prevention and control of dental caries, questions are still raised regarding its cost-effectiveness. This study assessed the impact of changing dental needs on the cost savings from community water fluoridation in Australia. METHODS Net costs were estimated as Costs((programme)) minus Costs((averted caries).) Averted costs were estimated as the product of caries increment in non-fluoridated community, effectiveness of fluoridation and the cost of a carious surface. Modelling considered four age-cohorts: 6-20, 21-45, 46-65 and 66+ years and three time points 1970s, 1980s, and 1990s. Cost of a carious surface was estimated by conventional and complex methods. Real discount rates (4, 7 (base) and 10%) were utilized. RESULTS With base-case assumptions, the average annual cost savings/person, using Australian dollars at the 2005 level, ranged from $56.41 (1970s) to $17.75 (1990s) (conventional method) and from $249.45 (1970s) to $69.86 (1990s) (complex method). Under worst-case assumptions fluoridation remained cost-effective with cost savings ranging from $24.15 (1970s) to $3.87 (1990s) (conventional method) and $107.85 (1970s) and $24.53 (1990s) (complex method). For 66+ years cohort (1990s) fluoridation did not show a cost saving, but costs/person were marginal. CONCLUSIONS Community water fluoridation remains a cost-effective preventive measure in Australia.
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Affiliation(s)
- A C Campain
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
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Karlsson L, Maia AMA, Kyotoku BBC, Tranaeus S, Gomes ASL, Margulis W. Near-infrared transillumination of teeth: measurement of a system performance. JOURNAL OF BIOMEDICAL OPTICS 2010; 15:036001. [PMID: 20615003 DOI: 10.1117/1.3427135] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Transillumination (TI) of dental enamel with near-infrared light is a promising nonionizing imaging method for detection of early caries lesion. Increased mineral loss (caries lesion) leads to increased scattering and absorption. Caries thus appear as dark regions because less light reaches the detector. The aim of this work was to characterize the performance of a TI system from the resolution of acquired images using the modulation transfer function at two wavelengths, 1.28 and 1.4 mum. Test charts with various values of spatial periods, mimicking a perfect caries lesion, were attached to tooth sections, followed by capture of the transmitted image, using both wavelengths. The sections were then consecutively reduced in thickness, and a sequence of all sizes of the test charts were used for repeatedly imaging procedures. The results show that the TI system can detect feature size of 250 mum with 30% modulation. From the information about how the image degrades as it propagates through enamel, we also examined the possibility of estimating the position of a simulated approximal caries lesion by comparing images obtained from the two sides of a tooth section.
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Affiliation(s)
- Lena Karlsson
- Karolinska Institutet, Department of Dental Medicine, P.O. Box 4064, SE-141 04 Huddinge, Sweden.
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Rodríguez-Vilchis LE, Contreras-Bulnes R, Sánchez-Flores I, Samano EC. Acid Resistance and Structural Changes of Human Dental Enamel Treated with Er:YAG Laser. Photomed Laser Surg 2010; 28:207-11. [PMID: 19803725 DOI: 10.1089/pho.2008.2454] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laura Emma Rodríguez-Vilchis
- Center of Research and Advanced Studies in Dentistry, School of Dentistry of the Autonomous University of the State of Mexico, Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, C.P. 50130, Toluca, Estado de México, México
| | - Rosalía Contreras-Bulnes
- Center of Research and Advanced Studies in Dentistry, School of Dentistry of the Autonomous University of the State of Mexico, Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, C.P. 50130, Toluca, Estado de México, México
| | - Ignacio Sánchez-Flores
- Center of Research and Advanced Studies in Dentistry, School of Dentistry of the Autonomous University of the State of Mexico, Jesús Carranza Esq. Paseo Tollocan, Col. Universidad, C.P. 50130, Toluca, Estado de México, México
| | - Enrique Cuauhtémoc Samano
- Center of Nanosciences and Nanotechnology of the Autonomous National University of Mexico, Km. 107 Carr. Tijuana-Ensenada, C.P. 22860, Ensenada, Baja California, México
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Collins J, Bobadilla M, Fresno M. Indicadores de Riesgo Cariogénico en Adolescentes de Santo Domingo, República Dominicana. ACTA ACUST UNITED AC 2008. [DOI: 10.1016/s0718-5391(08)70014-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Affiliation(s)
- J V Kumar
- Bureau of Dental Health, New York State Department of Health, Room 542, Empire State Plaza Tower, Albany, NY 12237, USA.
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