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Ruff RR, Barry Godín TJ, Small TM, Niederman R. Silver diamine fluoride, atraumatic restorations, and oral health-related quality of life in children aged 5-13 years: results from the CariedAway school-based cluster randomized trial. BMC Oral Health 2022; 22:125. [PMID: 35413873 PMCID: PMC9005017 DOI: 10.1186/s12903-022-02159-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/06/2022] [Indexed: 11/10/2022] Open
Abstract
Objective Silver diamine fluoride (SDF) is a non-surgical treatment for the arrest and prevention of dental caries that results in irreversible black staining of dental decay. The objective of this study was to evaluate the short-term impact of SDF treatment on oral health-related quality of life (OHRQoL) relative to a standard package of glass ionomer sealants and atraumatic restorative treatment (ART) in children aged 5–13 years. Methods CariedAway is a pragmatic, longitudinal, cluster-randomized non-inferiority trial of non-surgical interventions for caries. Secondary study outcomes included OHRQoL and academic performance. Oral health-related quality of life was measured at each study visit using the Child Oral Health Impact Profile. Change in OHRQoL was assessed using linear regression and non-inferiority was determined using t tests. Results 160 children with an average age of 8.7 years completed quality of life assessments. Untreated decay at baseline (approximately 25%) was associated with significantly worse OHRQoL and treatment in both groups resulted in incremental improvement: children receiving SDF improved their OHRQoL scores from 16.44 (SD = 11.12) to 14.62 (SD = 11.90), and those receiving traditional sealants and atraumatic restorations slightly improved from 16.65 (SD = 10.56) to 16.47 (SD = 11.09). Quality of life in children receiving silver diamine fluoride was non-inferior to those receiving sealants and ART at least 6 months post-treatment (mean difference = 1.85, 95% CI = − 2.10, 5.80), and change in OHRQoL did not depend on the severity of baseline decay. Conclusions OHRQoL is related to untreated dental caries, and observed changes following SDF treatment were non-inferior relative to standard preventive therapies.
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Affiliation(s)
- Ryan Richard Ruff
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, USA.
| | - Tamarinda J Barry Godín
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, USA
| | - Topaz Murray Small
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, USA
| | - Richard Niederman
- Department of Epidemiology & Health Promotion, New York University College of Dentistry, New York, USA
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Clarke R, Shaw-Ridley M. Parental Attitudes and Beliefs About Preschooler Preventive Oral Health Behaviors: Implications for Health Promotion. J Immigr Minor Health 2018; 21:731-736. [DOI: 10.1007/s10903-018-0812-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Joshi A, Ocanto R, Jacobs RJ, Bhoopathi V. Florida child care center directors' intention to implement oral health promotion practices in licensed child care centers. BMC Oral Health 2016; 16:100. [PMID: 27659715 PMCID: PMC5034571 DOI: 10.1186/s12903-016-0298-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Accepted: 09/16/2016] [Indexed: 11/24/2022] Open
Abstract
Background To determine the factors associated with child care center directors’ (CCCDs) intention to implement oral health promotion practices (OHPPs) in licensed childcare centers (CCCs) within the next year, and their self-perceived barriers in successfully implementing those practices. Methods For this cross-sectional study, a pretested 45-item online survey was sent to 5142 CCCDs assessing pediatric oral health knowledge, attitudes towards oral health, intention to implement OHPPs, and self-perceived barriers to implementing OHPPs. An adjusted logistic regression model determined the factors associated with CCCDs intention to implement OHPPs within the next year. Results Participants were 877 CCCDs, with mean age of 48.5 ± 10.5 years, of whom 96 % were women, and 74 % were whites (Response rate = 19.4 %). The majority (67 %) of respondents reported that they intended to implement OHPPs in their center within a year. Insufficient funding, lack of enough training in oral health, and limited time to promote oral health were the most frequently cited barriers to implementing OHPPs. CCCDs of non-White race (p = 0.02), with a college degree or above (p = 0.05), and with positive attitudes (p < 0.0001), were more likely to report that they will implement OHPPs within the next year compared to their counterparts. Conclusions CCCDs reported fewer barriers to implementing OHPPs within the next year, indicating that CCCs can be a suitable setting to promote oral health. CCCDs race, educational status and attitudes towards oral health strongly predicted their intention to implement OHPPs. Though this study assessed the intention of CCCDs to implement OHPPs in CCCs, it did not access the actual implementation of OHPPs by them. Therefore future research could longitudinally assess predictors for true implementation of OHPPs. In addition, researchers should adopt a more comprehensive, multi-level approach to assess the actual dental health needs of children attending these centers, along with parental, staff and center level characteristics, and other relevant factors related to implementing OHPPs.
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Affiliation(s)
- Ajay Joshi
- Pediatric Dentistry Department, Indiana University School of Dentistry, 1121 W. Michigan Street, Indianapolis, IN, 46202, USA
| | - Romer Ocanto
- Department of Pediatric Dentistry, Nova Southeastern University College of Dental Medicine, 3200 S University Drive, Fort Lauderdale, FL, 33328, USA
| | - Robin J Jacobs
- Psychiatry and Behavioral Medicine, College of Osteopathic Medicine, Nova Southeastern University, 3200 S. University Drive, Fort Lauderdale, FL, 33328, USA
| | - Vinodh Bhoopathi
- Department of Pediatric Dentistry and Community Oral Health Sciences, Temple University Maurice H. Kornberg School of Dentistry, 3223 N Broad Street, Philadelphia, PA, 19140, USA.
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Abstract
This article provides a brief introduction to various aspects of oral health care in children, with emphasis on the epidemiology, risk assessment, prevention, and treatment modalities for dental caries. In addition, barriers to dental care and the involvement of pediatricians in advocating for and providing preventive dental care for children are reviewed. Oral health care is one of the most prevalent unmet needs among infants, toddlers, and adolescents in the United States. Routine or preventive dental visits are important for early diagnosis, prevention, and treatment of oral diseases, and for establishing and maintaining good oral health and overall well-being.
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Affiliation(s)
- Christopher Okunseri
- Department of Clinical Services, School of Dentistry, Marquette University, Room 356, PO Box 1881, Milwaukee, WI 53201-1881, USA.
| | - Cesar Gonzalez
- Department of Developmental Sciences, School of Dentistry, Marquette University, PO Box 1881, Milwaukee, WI 53201, USA
| | - Brian Hodgson
- Department of Developmental Sciences, School of Dentistry, Marquette University, PO Box 1881, Milwaukee, WI 53201, USA
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Gorsuch MM, Sanders SG, Wu B. Tooth loss in Appalachia and the Mississippi delta relative to other regions in the United States, 1999-2010. Am J Public Health 2014; 104:e85-91. [PMID: 24524527 DOI: 10.2105/ajph.2013.301641] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES We examined regional variation in tooth loss in the United States from 1999 to 2010. METHODS We used 6 waves of the Behavioral Risk Factor Surveillance System and data on county characteristics to describe regional trends in tooth loss and decompose diverging trends into the parts explained by individual and county components. RESULTS Appalachia and the Mississippi Delta had higher levels of tooth loss than the rest of the country in 1999. From 1999 to 2010, tooth loss declined in the United States. However, Appalachia did not converge toward the US average, and the Mississippi Delta worsened relative to the United States. Socioeconomic status explained the largest portion of differences between regions in 1999, but a smaller portion of the trends. The Mississippi Delta is aging more quickly than the rest of the country, which explains 17% of the disparity in the time trend. CONCLUSIONS The disadvantage in tooth loss is persistent in Appalachia and growing in the Mississippi Delta. The increasing disparity is partly explained by changes in the age structure but is also associated with behavioral and environmental factors.
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Affiliation(s)
- Marina Mileo Gorsuch
- Marina Mileo Gorsuch and Seth G. Sanders are with the Sanford School of Public Policy, Duke University, Durham, NC. Seth G. Sanders is also with the Department of Economics, Duke University. Bei Wu is with the School of Nursing and Global Health Institute, Duke University
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Hong CHL, Bagramian RA, Hashim Nainar SM, Straffon LH, Shen L, Hsu CYS. High caries prevalence and risk factors among young preschool children in an urban community with water fluoridation. Int J Paediatr Dent 2014; 24:32-42. [PMID: 23373970 DOI: 10.1111/ipd.12023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Singapore is unique in that it is a 100% urban community with majority of the population living in a homogeneous physical environment. She, however, has diverse ethnicities and cultures as such; there may be caries risk factors that are unique to this population. AIM The aims were to assess the oral health of preschool children and to identify the associated caries risk factors. DESIGN An oral examination and a questionnaire were completed for each consenting child-parent pair. RESULTS One hundred and ninety children (mean age: 36.3 ± 6.9 months) were recruited from six community medical clinics. Ninety-two children (48.4%) were caries active. The mean d123 t and d123 s scores were 2.2 ± 3.3 and 3.0 ± 5.6, respectively. Higher plaque scores were significantly (P < 0.0005) associated with all measures of decay (presence of decay, dt, ds). The risk factors for severity of decay (i.e., dt and ds) include child's age, breastfeeding duration, and parents' ability to withhold cariogenic snacks from their child. CONCLUSIONS The high caries rate suggests that current preventive methods to reduce caries in Singapore may have reached their maximum effectiveness, and other risk factors such as child's race, and dietary and breastfeeding habits need to be addressed.
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Affiliation(s)
- Catherine H L Hong
- Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore
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Abstract
The first ICNARA conference (International Conference on Novel Anticaries and Remineralizing Agents) was held in Chile in January, 2008, and the proceedings were published in Advances in Dental Research (Volume 21, 2009). That issue of Advances summarized the state of the science and set a research agenda for the future for two key components of caries management, namely, antibacterial agents and remineralizing agents. The second conference (ICNARA 2, January 2012) provided an update on science and new directions for research and clinical practice. Over the past decade, renewed efforts have been made across the world to establish proven methods of caries risk assessment and to provide direction for improved methods of caries management based upon risk levels. Evidence-based caries risk assessment tools are now available. The need for improved therapy to reduce the bacterial challenge that initiates the caries process, and to enhance remineralization, is now very clear. Fluoride therapy alone is insufficient to control the caries process in high-risk individuals. New remineralizing and anticaries products and new delivery systems are in development, and ICNARA 2 presents future technology for the management of dental caries.
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Long CM, Quinonez RB, Beil HA, Close K, Myers LP, Vann WF, Rozier RG. Pediatricians' assessments of caries risk and need for a dental evaluation in preschool aged children. BMC Pediatr 2012; 12:49. [PMID: 22559270 PMCID: PMC3394214 DOI: 10.1186/1471-2431-12-49] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2012] [Accepted: 05/04/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Risk-based prioritization of dental referrals during well-child visits might improve dental access for infants and toddlers. This study identifies pediatrician-assessed risk factors for early childhood caries (ECC) and their association with the need for a dentist's evaluation. METHODS A priority oral health risk assessment and referral tool (PORRT) for children < 36 months was developed collaboratively by physicians and dentists and used by 10 pediatricians during well-child visits. PORRT documented behavioral, clinical, and child health risks for ECC. Pediatricians also assessed overall ECC risk on an 11-point scale and determined the need for a dental evaluation. Logistic regression models calculated the odds for evaluation need for each risk factor and according to a 3-level risk classification. RESULTS In total 1,288 PORRT forms were completed; 6.8% of children were identified as needing a dentist evaluation. Behavioral risk factors were prevalent but not strong predictors of the need for an evaluation. The child's overall caries risk was the strongest predictor of the need for an evaluation. Cavitated (OR = 17.5; 95% CI = 8.08, 37.97) and non-cavitated (OR = 6.9; 95% CI = 4.47, 10.82) lesions were the strongest predictors when the caries risk scale was excluded from the analysis. Few patients (6.3%) were classified as high risk, but their probability of needing an evaluation was only 0.36. CONCLUSIONS Low referral rates for children with disease and prior to disease onset but at elevated risk, indicate interventions are needed to help improve the dental referral rates of physicians.
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Affiliation(s)
- C Marshall Long
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Rocio B Quinonez
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Heather A Beil
- School of Nursing, University of North Carolina, Chapel Hill, NC, USA
| | - Kelly Close
- North Carolina Department of Health and Human Services, Division of Public Health, Oral Health Section, Raleigh, NC, USA
| | - Larry P Myers
- North Carolina Department of Health and Human Services, Division of Public Health, Oral Health Section, Raleigh, NC, USA
- North Carolina Department of Health and Human Services, Division of Medical Assistance, Raleigh, NC, USA
| | - William F Vann
- Department of Pediatric Dentistry, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - R Gary Rozier
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Vázquez EM, Vázquez F, Barrientos MC, Córdova JA, Lin D, Beltrán FJ, Vázquez CF. Association between asthma and dental caries in the primary dentition of Mexican children. World J Pediatr 2011; 7:344-9. [PMID: 21633854 DOI: 10.1007/s12519-011-0300-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 06/09/2010] [Indexed: 11/28/2022]
Abstract
BACKGROUND Asthma has been associated with a great number of negative health outcomes. This study was undertaken to detect the association between asthma and dental caries in the primary dentition. METHODS Data were obtained from a cohort of 1160 Mexican children aged 4-5 years. We used the questionnaire of the International Study of Asthma and Allergies Diseases in Childhood. Asthma was classified according to parents' reports. Caries indexes were measured as the number of decayed (d), missing (m), and filled (f), teeth (t) (dmft) or surfaces (dmfs). Decayed teeth included initial caries in this study. Adjusted odds ratios (adjusted ORs) were determined for asthma using logistic regression model. Gender, sugary products consumption, and oral hygiene habits were utilized as covariates. RESULTS The prevalence of dental caries was 17.9% in the 1160 children. Approximately 226 (19.5%) children were identified with asthma. Among them, 166 (73.5%) presented with symptoms during the day and 60 (26.5%) during the day and night. The prevalence of caries in children with asthma was 19.9%; it was higher in children with nocturnal asthma symptoms than in those with asthma symptoms only during the day. Logistic regression model showed that asthma (adjusted OR=1.24; 95% confidence interval [95% CI]=0.84-1.81) was not associated with caries. A significant association was found between nocturnal asthma symptoms (adjusted OR=1.85; 95% CI=1.00-3.44) and dental caries. CONCLUSIONS Asthma is not associated with dental caries. Nocturnal asthma symptoms appear to be associated with dental caries in the primary dentition.
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Affiliation(s)
- Eliza M Vázquez
- University Center Tampico-Madero, Autonomous University of Tamaulipas (UAT), Tamaulipas, México.
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Li Y, Zhang Y, Yang R, Zhang Q, Zou J, Kang D. Associations of social and behavioural factors with early childhood caries in Xiamen city in China. Int J Paediatr Dent 2011; 21:103-11. [PMID: 21121987 DOI: 10.1111/j.1365-263x.2010.01093.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early childhood caries (ECC) is the presence of caries in primary teeth in children 71 months of age or younger. Despite a decreasing prevalence of caries in China, ECC and related risk factors in China have not been well studied. AIMS This study aimed to investigate the status of ECC in children living in Xiamen city in China and to analyse the associated social and behaviour determinants. DESIGN A stratified random sample consisted of 1523 children with normal birth records. Clinical examination was performed to record caries at the surface level. Parents filled in questionnaires regarding eating habits, family status, childcare provider, and oral intervention. RESULTS Prevalence of ECC in studied child population was 56.8-78.31%, with an increasing tendency with age. The following factors were found to be significantly associated with ECC: age, candy, carbonated drink, bedtime eating, late start of brushing, low education of parents, private childcare, increased number of siblings, rural residence, and lack of oral health knowledge. Using a stepwise forward logistic regression analysis, a prediction model was established. CONCLUSION Early childhood caries in children living in Xiamen city was strongly associated with eating habits, family- and childcare-related factors and tooth-brushing. The ECC-high-risk group is children in rural private childcare facilities.
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Affiliation(s)
- Yang Li
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, China
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