Dental caries prevalence and risk factors among 12-year old schoolchildren from Baghdad, Iraq: a post-war survey

Impact of war on oral health: a systematic review

AIM

To systematically review the evidence from published literature about the impact of war on oral health among children and adults.

METHODOLOGY

The electronic search was carried out in the following databases Pubmed, Cochrane, Scopus, Embase, Google Scholar. In vitro studies, cross-sectional, case control studies, and randomized controlled trials conducted during the war time were included. Cross-sectional and case control studies were assessed based on the Newcastle-Ottawa Scale, whereas randomized controlled trials were assessed based on the ROBINS-I tool. In-vitro studies included in this review were assessed using the United States national toxicology program tool.

RESULTS

The search strategy yielded a total of 5126 articles and finally 21 articles were included in the review. The influence of war on oral health was categorized among both the children and adult population. A total of 14 studies were carried out in children whereas the remaining seven studies were carried out in adults. A decrease in dental caries was observed in more war-prone areas due to the limited availability of carbohydrates and sugar. Severe periodontal disease in the adult population, mainly due to less availability of food and diminished oral hygiene habits, was also reported.

CONCLUSIONS

This review underscores the multifaceted impact of war on oral health, revealing a notable prevalence of periodontal problems, craniofacial injuries and varying rates of dental caries across affected populations.

Dental treatment of children under general anesthesia during the period of matrial law

OBJECTIVE

Aim: To summarize the experience of providing dental medical care under general anesthesia to children from different regions of Ukraine during the martial law, taking into account the factors affecting the choice of optimal conditions for dental treatment.

PATIENTS AND METHODS

Materials and Methods: Dental treatment under general anesthesia of 1,258 children from different regions of Ukraine has been performed since March 2022. The condition of the teeth (df, df+DMF, DMF) and hygienic state of the oral cavity (OHI-S) were determined. The level of awareness of parents regarding the preservation of children's dental health was studied through a questionnaire.

RESULTS

Results: An unsatisfactory oral hygiene, a high level of caries were found in the vast majority of children. The highest df was observed in the group of children aged 3 to 6 years (7.14±0.33), which is significantly higher than in the group of children under 3 years of age (4.32±1.04, p≤0.05). The worst oral hygiene was observed in children aged 6-12 years (OHI-S 2.62±0.32). An insufficient level of awareness of parents and children regarding dental health was revealed. A total of 1,712 operations under general anesthesia were performed. The majority of patients could not regularly appear for follow-up examinations due to the forced departure from the country.

CONCLUSION

Conclusions: The organization of dental treatment under general anesthesia allows solving a number of problems of dental care for children during the war.

The Violence of Non-Violence: A Systematic Mixed-Studies Review on the Health Effects of Sanctions

The use of sanctions as a policy tool to affect change in the political behavior of target states has increased over the past 30 years, along with a concern about their impact on civilian health. Some researchers have proposed that targeting sanctions can avoid their moral costs, yet others have challenged this claim. This systematic mixed-studies review explored the debate about targeted sanctions by appraising their health effects as reported in the medical and public health literature, with a global focus and through the COVID-19 era.We searched three electronic databases without temporal or geographical restrictions and identified 50 studies spanning three decades (1992-2021) meeting our inclusion criteria. Using a piloted form, we extracted quotations addressing our research questions and identified themes that we grouped according to the effects of sanctions on health or its determinants, generating frequency distributions to assess the strength of support for each theme. While no study posited a causal relationship between sanctions and health, or engaged the morality of sanctions, most implied that when sanctions were present, health was inevitably impacted, even for sanctions ostensibly targeted to minimize civilian harm. Our findings suggest that given the integrated nature of the global economy, it is all but impossible to design sanctions that will achieve their stated goals without inflicting significant harm on civilians. We conclude that the use of sanctions as a policy tool threatens global health and human rights, especially in times of crises.

Presentations of Routine Dental Interventions in Children over a Six-Year Period

Aim

To evaluate over a six-year period, the prevalence of the dental procedures in primary and mixed dentitions, in males and females.

Materials and Methods

A retrospective descriptive study on dental treatments in primary and mixed dentitions was conducted in the Department of Pediatric Dentistry at the Faculty of Dental Medicine, Lebanese University, from 2015 to 2020. The total number of children was 1291. Data were classified and reviewed according to the dentition type, gender, and type of dental treatment.

Results

The number of children decreased from 741 for the period 2015–2017 to 550 during the period 2018–2020 (279 males and 271 females). No significant association was found between the admission periods and the genders. A significant relationship was found between the number of treatments performed in both genders and the dentition types (p value = 0,015). Males were slightly more likely than females to present for the treatment in mixed dentition (54.58% versus 45.2%, respectively). Results portrayed a significant relationship between surgical treatment and gender (p value = 0.049). However, no significant relationship between gender and other treatment types was noted. The comparison between the 2 time frames and the types of treatments showed a significant association in composite fillings (p value = 0.043), extractions (p value < 0.0001), sealants (p value = 0.039), preventive resin restoration (p=0.011), pulp therapies (p value < 0.0001), pediatric crowns (p value < 0.0001), and surgical interventions (p value = 0.013). A nonsignificant relationship was recorded for the appliances and composite crowns (p value = 0.45 and 0.14, respectively).

Conclusion

The present study points out the implications of the COVID-19 outbreak and Lebanon's economic collapse on children's dental status, with the number of children receiving dental care dropping remarkably. A decrease in all types of dental procedures was noted in mixed dentition, whereas an increase in dental treatments related to aggravated carious lesions was reported in primary dentition. More medical and financial aids are required to encourage and support parents' attitude towards children dental care during unprecedented crises.

Histopathological Records of Oral and Maxillofacial Lesions among Pediatric and Adolescent Patients in Sulaimani Governorate

Oral and maxillofacial lesions (OMFLs) in pediatrics differ markedly from their adult counterparts in terms of clinical conduct, pathological behavior, and management. This study aims to determine the frequency of OMFLs among pediatric and adolescent patients and to correlate the demographics information to the site, and histopathological findings. Pathological records of pediatric and adolescent patients were retrieved from three major pathological centers in Sulaimani city of Iraq. Demographic information, surgical procedure, anatomical sites, and histopathological diagnosis were recorded. Furthermore, The World Health Organization (WHO) International Statistical Classification of Diseases and Related Health Problems (ICD-10) was used for coding. A Chi-square test was used to find the relation between different variables, and a p-value < 0.05 was considered statistically significant. This study archived 309 (13.3%) out of 2319 pediatric and adolescent patients, with a mean age of 11.04 ± 4.62. Females were more commonly detected (52.8%). The most frequently diagnosed lesions were salivary gland diseases (20.7%), followed by reactive hyperplastic connective tissue (18.4%). A significant relation was found between age groups and diagnostic categories (p = 0.001). The lips were the most commonly detected sites (20.7%). Mucocele was the most frequently seen non-neoplastic lesions (19.4%), followed by pyogenic granuloma (8.7%). Neoplastic lesions revealed predominant hemangioma (3.2%), followed by peripheral ossifying fibroma (1.9%). Traumatic and or reactive lesions were the most commonly reported lesions. Malignant neoplasms can be identified. The current study enabled systematic data recording of pediatric and adolescent patients, encouraging the importance of the oral healthcare system in identifying and managing the problem early in this critical age in this region.

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

Background

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

Methods

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

Results

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

Conclusions

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

Comparison of Some Salivary Characteristics in Iraqi Children with Early Childhood Caries (ECC) and Children without Early Childhood Caries

Background

Early Childhood Caries (ECC) is a unique form of caries that develops in temporary dentition. It has a multifactorial infectious disease. Saliva is one of the most important factors, which has an important protective effect against tooth decay when its multiple characteristics and functions are normal. The study aimed to compare some salivary characteristics in children with ECC and children without ECC.

Materials and Methods

Case-control, cross-sectional observational study. The 77 pre-schoolers aged 37 to 72 months (12 with ECC, 26 with ECC-S, and 39 without ECC) examined and we collected the stimulated saliva. The pH microelectrode was used to determine pH and buffer capacity; a formula that involves volume, collection time, and specific saliva weight was used to test the salivary flow rate. The potentiometric and phosphate methods were used to determine fluoride through spectrophotometric, colorimetric absorption techniques.

Results

The results got to show that there are no statistically significant differences in pH, buffer capacity, salivary flow rate, and levels of fluoride and phosphate, in children with ECC, ECC-S, and without ECC. The risk factors, such as mother's education, bottle use, brushing frequency, and previous dental care of the child are more important at the time of developing ECC than some salivary variables.

Conclusion

The risk factors, such as mother's education, bottle use, brushing frequency, and previous dental care of the child are more important at the time of developing ECC than some salivary variables such as pH, buffer capacity, salivary flow rate, and levels of fluoride and phosphate.

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

Background

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

Methods

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

Results

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

Conclusions

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

Prevalence and Associated Factors of Dental Caries in Primary Schoolchildren: An Iranian Setting

Introduction

Dental caries is the most common oral health disease of school-aged children around the world. In this study, we aimed to assess the prevalence and associated factors of dental caries in primary schoolchildren in Yasuj township, Iran.

Methods

In this cross-sectional study, a total of 460 children aged 7-12 years were investigated. Dental examination was performed at school according to the World Health Organization criteria. Sociodemographic data were collected using a structured questionnaire, and caries statuses of children's teeth were recorded through a dental chart. Data were analyzed using summary statistics, chi-square test, and logistic regression model with odds ratio.

Results

The prevalence of dental caries in primary, permanent, and whole dentition among children was 75.3%, 41.1%, and 89.8%, respectively. Among all considered factors, the caries presence in primary teeth was inversely (p < 0.001) and in permanent teeth was positively (p < 0.001) associated with the children's age. Moreover, the odds of decaying permanent teeth were significantly higher in girls, in rural children, and in children whose fathers were not an employee compared to their counterparts (p=0.04, p < 0.001, and p=0.02, respectively).

Conclusions

The prevalence of dental caries among the studied primary schoolchildren in mixed dentition was high and associated with their sociodemographic factors. Providing and implementing preventive, therapeutic, and informative programs for controlling dental caries at individual, family, and school levels are necessary for local health policymakers.

Knowledge and Practice of Preventive Measures for Oral Health Care among Male Intermediate Schoolchildren in Abha, Saudi Arabia

The aims of this study were to evaluate oral health knowledge and assess the practice of preventive measures for oral health care among intermediate schoolchildren in Abha, Saudi Arabia. Information about oral health was collected through a questionnaire containing closed-ended questions, which was distributed to children of six randomly selected intermediate schools. Most (82.3%) of the schoolchildren were aware that good oral health is important for general health. The priority for oral health information was given to dentists (31.6%), whereas teachers were given the least priority (19.1%). About half (53.5%) of the schoolchildren reported that sweets are the cause of dental caries, and 47.1% of them related pain with dental caries. More than half (58.8%) took sweets between meals. Most of them (69.6%) visited a dentist because of pain. Two-thirds (66.9%) of the children did not brush their teeth daily, and most (78%) did not use dental floss. A large number (62.7%) of the schoolchildren stated that rinsing with water after each meal is the best way to keep their gums healthy. For boys in intermediate schools, properly designed oral health educational programs should be implemented to improve their knowledge and behavior toward oral health.

Oral health and socio-economic status among children during Syrian crisis: a cross-sectional study

BACKGROUND

The Syrian crisis has started eight years ago and has, directly and indirectly, affected all the aspects of the Syrians lives. A lot of new war-related factors contributed to change the socio-economic status, the demographical distribution and the ability to access the public health services. Moreover, the crisis created the biggest displacement crisis both inside and outside Syria. Therefore, it is important to study the prevalence of dental caries and oral health in these specific circumstances in order to build a database to assess and compare future results of preventive programs and to assess health and social needs of the communities affected by war or crisis. The aim of this research is to Study the level of oral health among children during the Syrian crisis, as well as the relation between oral health and socioeconomic status (SES).

METHODS

A cross-sectional study to assess the oral health of children in Damascus city by using DMFT index and other dental indices. The data were collected from ten randomly selected schools covering all the areas of Damascus city, and the final sample size was 811 children.

RESULTS

DMFT index was used to assess the oral health of the children. The average number was (3.36) among all children; 14% of the sample size had a good oral health, while 86% had at least one decayed, missed, or filled tooth. There was also a strong association between SES of the child and the oral health represented as DMFT Index (P = 0.03), Pearson's correlation test displayed an inverse association between the SES and oral health (P = - 0.074).

CONCLUSION

This study highlights the impact of the Syrian crisis on the SES of the Syrian children and their oral health. Bad oral health has been recorded and it has a significant relation with the SES of the children.

Factors related to dental caries in 10-year-old Vietnamese schoolchildren

BACKGROUND

In Vietnam, research is required to provide a clearer understanding of the factors associated with dental caries. This will allow paediatric dentists and physicians to provide appropriate care to children.

AIM

To determine the factors related to dental caries and to evaluate the association between dental caries and nutritional status in 10-year-old schoolchildren.

METHOD

In 2015, 1,079 10-year-old children were randomly selected from 16 public schools in Ho Chi Minh City. Information on self-reported oral health, dental habits, eating, drinking and physical activity behaviours was obtained via a questionnaire. Anthropometric measurements (height and weight) were also taken. Body mass index (BMI) was calculated, and nutritional classification of children was conducted using the BMI-for-age percentile. Dental plaque and dental caries (decayed and filled teeth) were recorded for both primary and permanent teeth.

RESULTS

Dental caries was experienced on primary and permanent teeth by 60.7% and 39.6%, respectively, of subjects. The factors significantly related to primary tooth decay were school location [odds ratio (OR) = 1.78], self-reported dental caries (OR = 1.36), frequency of tooth self-checking (OR = 1.32), toothbrushing habits (OR = 1.31) and nutritional status (OR = 1.77); however, the factors associated with permanent tooth decay were school location (OR = 2.66), self-reported dental caries (OR = 1.34), frequency of tooth self-checking (OR = 1.37), frequency of dental check-ups (OR = 1.35), toothbrushing habits (OR = 1.31) and nutritional status (OR = 1.39 and 1.74) (P < 0.05).

CONCLUSION

Dental caries was associated with school location, dental-related behaviours and nutritional status in 10-year-old schoolchildren in Ho Chi Minh City, Vietnam.

Prevalence of Caries among Schoolchildren in the Interior of Suriname

The aim of this study was to determine the prevalence of caries among children living in the interior of Suriname and to investigate the influence of the reachability of their habitats and different ethnicities on the prevalence of caries. As part of children's regular dental check-ups, data on the prevalence of caries were registered for schoolchildren (n = 1,309) living in four different regions. Prevalence of caries was expressed by the number of decayed, missing, and filled teeth (DMFT index). Consequences of severe caries were recorded by counting the number of teeth with pulp involvement, ulcerations, fistulas, and abscesses. Depending on the habitat, the number of children with caries in their primary dentition varied between 68% and 100%, in the mixed dentition between 79% and 98%, and in their permanent dentition between 54% and 94%. After the World Health Organization criteria, the average scores of dmft were high in children with primary teeth (except for Brokopondo), moderate to high in children with mixed dentition and low to moderate in children with permanent teeth. Children in more remote areas had a greater prevalence of caries than children in less remote regions. Severe consequences of caries were seen in 14-75% of the children. Treatments were rarely performed. Children in the interior of Suriname are in great need of preventive and curative dental treatments.

Dental caries prevalence and its association with fluoride level in drinking water in Sana'a, Yemen

Objectives:

Dental caries is the most prevalent chronic condition affecting schoolchildren worldwide. This study is aimed to assess the prevalence of dental caries among schoolchildren in urban and rural districts of Sana'a governorate, Yemen, and to investigate the correlation between caries experience and level of fluoride in drinking water, age, gender, and residence.

Materials and Methods:

This school-based survey involved 17,599 schoolchildren (aged 6–12 years), of whom 9623 were boys and 7976 were girls. We used decay-missing-filled teeth/decay-filled teeth (DMFT/dft) indices to evaluate dental caries experience. In addition, fluoride concentration in drinking water was investigated.

Results:

Around 67.6% of children had dental caries. Children residing in urban districts had significantly higher mean scores of DMFT/dft than those in rural areas (P < 0.05). A significant negative correlation between caries experience and fluoride level was found (P < 0.05), with the lowest dft/DMFT scores at the optimum fluoride level of 0.61–2 ppm and the highest at two extremes, 0.0–0.4 ppm and >2 ppm.

Conclusion:

This survey found a very high prevalence of caries among schoolchildren in Yemen. There was also an inverse relation between dental caries experience and fluoride levels.

Prevalence of dental caries and associated factors among 12 years old students in Eritrea

BACKGROUND

Dental caries is one of the most prevalent diseases of childhood in developing countries. However, there is a paucity of epidemiological data on the prevalence and associated factors of dental caries in Eritrea. The objective of this study was to assess the prevalence and associated factors of dental caries among 12 years old school children in Eritrea.

METHODS

A school based cross sectional study was conducted among 225 twelve years old students in two selected schools. One school from randomly selected urban and rural subzones of the country were selected. WHO adopted questionnaire and a standard checklist were used to collect relevant data. To assess dental caries, two examiners were calibrated by a certified dentist and inter observer agreement was calculated using the Cohen's Kappa statistic (0.82). All data analysis was done using SPSS version 20.

RESULTS

The prevalence of dental caries was 78%, without significant difference between males (78%) and females (79%).The mean DMFT value was 2.50 (±2.21). The decayed component contributed 98.3% of the score as it had 2.44 (±1.2) share to the mean DMFT value. The first molar was the most affected tooth with a DMFT value of 1.55 (±1.36). The mean significant caries index score (SiC) was 4.97 (±1.9) which is higher than the upper limit of SiC value of 3 set by the WHO as a global average. More than half of the respondents had never visited a dentist and out of the students who had utilized a dental health facility, 82% of visits were due to dental pain while visits for regular checkups were cited by only 6.6% of the respondents.

CONCLUSION

Dental caries was found to be a common public health problem among 12 years old Eritrean students. The prevalence of dental caries, mean DMFT and SiC scores were higher than the average score of other developing countries. Gaps in dental health service utilization, dental health practices and suboptimal water fluoride levels contribute to poor dental health among school children in Eritrea.

Oral health status among children and adolescents in governmental and private schools of the Palestinian Territories

BACKGROUND

Political conflicts in the Palestinian Territories (PT) have resulted in systematic deterioration of socio-economic conditions and health. The World Health Organization (WHO) has emphasised the negative impacts of social crisis on children' oral health and quality of life.

OBJECTIVES

To assess the prevalence and trends in dental caries and poor gingival health of schoolchildren in the PT through the scholastic years 1998/1999 to 2012/2013.

METHODS

This is a retrospective study. Prevalence data on dental caries of primary and permanent dentitions among children 6, 12 and 16 years of age were gathered from annual oral health reports of the School Dental Health Programme (SDHP)-Ministry of Health. Caries was recorded according to WHO methods and criteria. Decayed, missing and filled teeth indices for primary (dmft) and permanent (DMFT) teeth were calculated. Gingival health status was examined according to the Community Periodontal Index (scores 1 and 2). Statistical analysis used SPSS.

RESULTS

In 2012/2013, dental caries prevalence rates and the index scores among schoolchildren were as follows, respectively: 56.4% and 2.7 dmft at age 6; 42.0% and 1.4 DMFT at age 12; and 38.7% and 1.7 DMFT at age 16. For all age groups, the d/D-component of the caries indices was high. Trends of dental-caries prevalence, caries experience and gingival bleeding were fairly constant over time from 1998/1999.

CONCLUSION

The SDHP was established in order to prevent and control oral diseases among schoolchildren in the PT. The Programme is fairly passive and the survey indicates an urgent need for reorientation of activities towards population-based prevention and health promotion. The application of the WHO Health Promoting Schools concept is highly recommended.

Associations of Community Water Fluoridation with Caries Prevalence and Oral Health Inequality in Children

This study aimed to confirm the association between the community water fluoridation (CWF) programme and dental caries prevention on permanent teeth, comparing to a control area, neighbouring population without the programme, and verifying whether the programme can reduce the socio-economic inequality related to the oral health of children in Korea. Evaluation surveys were conducted among 6-, 8-, and 11-year-old children living in Okcheon (CWF) and neighbouring Yeongdong (non-CWF, control area) towns in South Korea. Data on monthly family income, caregiver educational level, and Family Affluence Scale scores were evaluated using questionnaires that were distributed to the parents. The effectiveness of CWF in caries reduction was calculated based on the differences in decayed, missing, and filled teeth and decayed, missing, and filled tooth surfaces indices between the two towns. The data were analysed using logistic regression and univariate analysis of variance. Both 8- and 11-year-old children living in the CWF area had lower dental caries prevalence than those living in the non-CWF community. Differences in dental caries prevalence based on educational level were found in the control area but not in the CWF area. Socio-economic factor-related inequality in oral health were observed in the non-CWF community. Additionally, 8- and 11-year-old children living in the CWF area displayed lower dental caries prevalence in the pit-and-fissure and smooth surfaces than those living in the non-CWF community. These results suggest that CWF programmes are effective in the prevention of caries on permanent teeth and can reduce oral health inequalities among children. The implementation of CWF programmes should be sustained to overcome oral health inequalities due to socio-economic factors and improve children's overall oral health.

Awareness of and compliance with healthy oral habits reported by children and their parents in Democratic People's Republic of Korea after a preventive programme

OBJECTIVE

The study aimed to examine awareness of and compliance with healthy oral habits reported by children and their parents in Pyongyang, Democratic People's Republic of Korea (DPRK), after a preventive programme.

MATERIALS AND METHODS

The data were collected in 2013 with self-completed, partly structured questionnaires from 1994 children aged 10 and 13 years and from 200 parents. Association between awareness of and compliance with healthy oral habits reported by the children and their parents was evaluated using Chi square tests and multivariate logistic regression analyses, children's oral health habits according to themselves and their parents were analysed using McNemar's test.

RESULTS

Both children and their parents seemed to be familiar with healthy oral habits, although the awareness was not directly related to the reports of the children's oral practices. Most of the children reported brushing their teeth at least twice a day, using fluoride toothpaste and drinking water for thirst but frequent sweet snacking was common. Children's and their parents' reports were consistent with regard to sweet snacking frequency (p = 0.736) and the main thirst quencher (p = 0.349).

CONCLUSIONS

Awareness of healthy oral habits appeared to be good among children and their parents. Unhealthy oral habits seemed to coincide with one another.

Spatial distribution mapping of drinking water fluoride levels in Karnataka, India: fluoride-related health effects

Objectives:

(1) To estimate the concentrations of fluoride in drinking water throughout different zones and districts of the state of Karnataka. (2) To investigate the variation of fluoride concentration in drinking water from different sources, and its relationships to daily temperature and rainfall status in the regional districts. (3) To develop an updated fluoride concentration intensity map of the state of Karnataka, and to evaluate these data in the context of fluoride-related health effects such as fluorosis and their prevalence.

Materials and Methods:

Aqueous standard solutions of 10, 100 and 1,000 ppm fluoride (F−) were prepared with analytical grade Na+/F− and a buffer; TISAB II was incorporated in both calibration standard and analysis solutions in order to remove the potentially interfering effects of trace metal ions. This analysis was performed using an ion-selective electrode (ISE), and mean determination readings for n = 5 samples collected at each Karnataka water source were recorded.

Results:

The F− concentration in drinking water in Karnataka state was found to vary substantially, with the highest mean values recorded being in the north-eastern zone (1.61 ppm), and the lowest in the south-western one (only 0.41 ppm). Analysis of variance (ANOVA) demonstrated that there were very highly significant ‘between-zone’ and ‘between-districts-within-zones’ sources of variation ( p < 10−5–10−9), results consistent with a substantial spatial variance of water source F− levels within this state.

Conclusions:

The southern part of Karnataka has low levels of F− in its drinking water, and may require fluoridation treatment in order to mitigate for dental caries and further ailments related to fluoride deficiency. However, districts within the north-eastern region have contrastingly high levels of fluoride, an observation which has been linked to dental and skeletal fluorosis. This highlights a major requirement for interventional actions in order to ensure maintenance of the recommended range of fluoride concentrations (0.8–1.5 ppm) in Karnataka’s drinking water sources.

Association between oral health habits and dental caries among children in Pyongyang, Democratic People's Republic of Korea

AIM

To evaluate the self-reported oral health habits and their association with the occurrence of dental caries among children in Pyongyang, Democratic People's Republic of Korea (DPRK), after 6 years of activities under the auspices of the Children's Oral Health Promotion Programme (COHPP).

METHODS

The data were collected in September 2013 in two of the most central districts of Pyongyang City, DPRK. The sample consisted of 492 children aged 10 and 13 years who had participated in the COHPP for 6 years. The children filled in a self-completed, structured questionnaire on oral health habits and were examined clinically by a dentist. The differences in mean (SD) number of decayed primary (dt) and permanent teeth (DT) and their sum (dt + DT) subdivided according to genders, age groups, districts and self-reported oral health habits were evaluated using Mann-Whitney U-test. The associations between self-reported oral health habits and the occurrence of dental caries were evaluated with chi-square test and logistic regression analyses.

RESULTS

The school-aged children commonly reported healthy oral hygiene habits but sweet snacks were commonly used. The occurrence of dental caries associated statistically significantly with the frequency of sweet snacking (p=0.011) but not with the frequency of tooth brushing (p=0.725) or the use of water for thirst instead of sugary beverages (p=0.189).

CONCLUSION

A more effective promotion of healthy dietary habits with innovative approaches and close collaboration with different social actors will be needed in future.

Impact of parent-related factors on dental caries in the permanent dentition of 6-12-year-old children: A systematic review

OBJECTIVE

To synthesise data from the literature on the effects of various parent-related characteristics (socio-demographic, behavioural and family environment) on dental caries in the permanent dentition of children.

DATA

Available studies in which the effects of parent-related characteristics on dental caries experience in the permanent dentition of children aged 6-12 years were evaluated.

SOURCES

PubMed, Medline via OVID and CINAHL Plus via EBSCO, restricted to scientific articles, were searched in April 2015. English language and time filters (articles published from 2000) were used.

STUDY SELECTION

A total of 4162 titles were retrieved, of which 2578 remained after duplicates were removed. After review of titles and their abstracts by two independent reviewers, 114 articles were considered relevant for full text review. Of these, 48 were considered for final inclusion. Data extraction was performed by two authors using piloted data extraction sheets.

CONCLUSIONS

Most of the literature on determinants of dental caries has been limited to socio-economic and behavioural aspects: we found few studies evaluating the effects of family environment and parental oral hygiene behaviour. Children belonging to lower socio-economic classes experienced more caries. In more than half the studies, children of highly educated, professional and high income parents were at lower risk for dental caries. There were conflicting results from studies on the effect of variables related to family environment, parents' oral hygiene behaviour and parent's disease status on dental caries in their children.

Oral health knowledge, attitude, and practice in 12-year-old schoolchildren in Iran

Objective:

The knowledge, attitude, practice (KAP) studies play an important role in promotion of oral health. The aim of this study was to assess oral health KAP in 12-year-old schoolchildren in Iran.

Materials and Methods:

In a cross-sectional study on 1554 students aged 12 years from the rural and urban areas of five provinces, KAP of subjects was assessed using a culturally adapted questionnaire. Data were analyzed using Chi-squared test, t-test, correlation coefficient, analysis of variance (ANOVA), and linear regression. Statistical significance was set at P < 0.05.

Results:

In general, the scores of students in knowledge, attitude, and practice were 74.1 ± 21.1%, 72.6 ± 21.1%, and 51.8 ± 12%, respectively. Urban students had significantly higher scores in KAP (P = 0.0001). Female students got higher scores in all the three dimensions, but the difference was significant only in brushing practice (P = 0.006). Students in Tehran (the capital city) had significantly higher scores in all fields (P = 0.0001). Parents’ education and mothers’ job had a significant relationship with KAP of children.

Conclusion:

The results of this study showed that 12-year-old schoolchildren in Iran had good knowledge and positive attitude. But oral health practice was not satisfactory.

Dental Caries Prevalence among 12-15 Year Old Palestinian Children

Objective. To measure the distribution of dental caries in a group of Palestinian adolescents. Material and Methods. A sample of 677 individuals of both sexes (411 were females and 266 were males) their ages ranged from 12 to 15 year old randomly selected from schools in northern west bank in Palestine. Clinical examination was performed on all the subjects focusing on the index DMFT, representing the number of teeth that were either decayed, missing or with extraction indicated, or restored. Results. The prevalence of dental caries in the permanent dentition was 54.35% and was the highest in 15 age 75.75% in comparison to the other ages (12, 13, and 14) (40.57%, 41.76%, and 60.47%), respectively. The mean DMFT for the sample was 5.39 ± 2.85525 while the mean DMFT for different age groups (12–15) was 5.52 ± 2.766, 5.58 ± 2.745, 5.23 ± 3.304, and 5.23 ± 2.606, respectively. The prevalence of dental caries was higher in females with DMFT 5.39 ± 2.854 than males with DMFT 5.26 ± 2.891. Conclusion. High prevalent dental caries was found among Palestinian adolescents and higher in females than males. Strict preventive programs should be implemented. Further research with large samples required to include all adolescents from Palestine.

Prevalence of dental caries among 12-14 year old children in Qatar

BACKGROUND

To ensure the oral health of a population, clinicians must deliver appropriate dental services, and local communities need to have access to dental care facilities. However, establishment of this infrastructure must be based on reliable information regarding disease prevalence and severity in the target population.

OBJECTIVES

The aims of this study were to measure the incidence of dental caries in school children aged 12-14 throughout Qatar, including the influence of socio-demographic factors.

MATERIALS AND METHODS

A cross-sectional study was conducted in Qatar from October 2011 to March 2012. A total of 2113 children aged 12-14 were randomly selected from 16 schools located in different geographic areas. Three calibrated examiners using World Health Organization (WHO) criteria to diagnose dental caries performed the clinical examinations. Data analyses were subsequently conducted.

RESULTS

The mean decayed, missing, and filled teeth index values were respectively 4.62 (±3.2), 4.79 (±3.5), and 5.5 (±3.7), for 12, 13, and 14 year-old subjects. Caries prevalence was 85%. The mandibular incisors and canines were least affected by dental caries, while maxillary and mandibular molars exhibited the highest incidence of dental caries. Dental caries were affected by socio-demographic factors; significant differences were detected between female and male children, where more female children showed dental caries than male children. In addition, children residing in semi-urban areas showed more dental caries than in urban areas.

CONCLUSION

Results indicated that dental caries prevalence among school children in Qatar has reached critical levels, and is influenced by socio-demographic factors. The mean decayed, missing, and filled teeth values obtained in this study were the second highest detected in the Eastern Mediterranean region.

Risk factors associated with deciduous tooth decay in Iraqi preschool children

Introduction:

Tooth decay (TD) is common in children with significant consequences on systemic well-being, growth and quality of life, as well as increasing the risk of decay in the permanent teeth.

Aim:

The aim of the present study is to define risk factors associated with deciduous TD (DTD) in Iraqi preschool children.

Materials and Methods:

From the 1^st June to 31^st December 2012, a case-control study was carried out on 684 children under the age of 6 years who attended Al-Aulwyiah pediatric teaching hospital in Baghdad. Clinical examination and World Health Organization caries diagnostic criteria for decayed, missing and filled teeth (DMFT) were applied. Data including gender, residence, socio-economic status (SES), parental education level, parental smoking, tooth brushing frequency, type of feeding during infancy and the presence of any systemic disease in the child were sought.

Results:

The mean DMFT score in the case group was 2.03 ± 1.39, of which decayed teeth formed 1.93. Males had a higher mean DMFT (2.10 ± 1.08) than females (1.96 ± 1.70) but with no statistically significant difference. The study revealed that residence, SES, parental education level and tooth brushing frequency were dependent risk factors significantly associated with DTD. However, gender, parental smoking and pattern of feeding during infancy were not significantly associated with DTD. Only four children with systemic disorders (1.2%), namely asthma and congenital heart diseases, were noticed to have DTD.

Conclusion:

Pediatricians and dentists could provide dental preventive and screening measures. Confronting relevant risk factors associated with DTD and improving access to oral care services are suggested. In addition, promotion of oral health programs through school curricula is needed.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Oral bacterial communities in individuals with type 2 diabetes who live in southern Thailand

Type 2 diabetes mellitus is increasingly common in Thailand and elsewhere. In the present investigation, the bacteriological composition of saliva and supragingival plaque in Thai diabetics with and without active dental caries and in nondiabetics was determined by differential culture and eubacterial DNA profiling. Potential associations between fasting blood sugar and glycosylated hemoglobin (biomarkers of current and historical glucose control, respectively) with decayed, missing, and filled teeth and with salivary Streptococcus and Lactobacillus counts were also investigated. The incidence of active dental caries was greater in the Thai diabetics than in nondiabetics, and the numbers of total streptococci and lactobacilli were significantly higher in supragingival plaque from diabetics than in nondiabetics. Lactobacillus counts in the saliva and supragingival plaque of diabetics with active caries were significantly higher than those in diabetics without active caries. Oral eubacterial DNA profiles of diabetic versus nondiabetic individuals and of diabetics with active caries versus those without active caries could not be readily differentiated through cluster analysis or multidimensional scaling. The elevated caries incidence in the Thai diabetics was positively associated with numbers of bacteria of the acidogenic/acid-tolerant genera Streptococcus and Lactobacillus. Lactobacillus bacterial numbers were further elevated in diabetics with active caries, although salivary eubacterial DNA profiles were not significantly altered.

Risk factors in the occurrence of molar-incisor hypomineralization amongst a group of Iraqi children

BACKGROUND.  Despite the worldwide increasing interest in the prevalence studies of molar-incisor hypomineralization (MIH), there is still insufficient evidence to verify the aetiological factors of this condition. AIMS.  To investigate risk factors involved in the development of MIH in a group of school-aged Iraqi children. DESIGN.  Seven- to nine-year-old school children (823 of 1000 eligible, response rate of 82.3%) had their first permanent molars and incisors evaluated using the European Academy of Paediatric Dentistry evaluation criteria for MIH. Mothers completed a medical history questionnaire-based interview performed in the schools by a trained examiner. RESULTS.  For children with MIH, 6% reported no relevant medical history; the remaining 94% reported various medical conditions putatively associated with MIH compared with 70% for the non-affected group. Post-natal medical conditions (33.3%) were most frequently reported. When data were split into the possible risk effect groups, maternal psychological stress (OR, 3.24), frequent exposure to ultrasonic scans during the last gestational trimester (OR, 2.51) and birth order as a fourth sibling or later (OR, 3.17 and 5.73, respectively) were previously unreported significant risk factors and postulated as contributing to, or causing the defect. CONCLUSIONS.  Children with MIH had experienced a greater number of medical conditions than their unaffected peers with no single health event identified as a risk factor.

Risk factors of hypomineralised second primary molars in a group of Iraqi schoolchildren

AIM

To investigate risk factor/s involved in the development of hypomineralised second primary molars and to relate the location of the affected tooth in the dental arches with the timing of the illness/condition incidence.

STUDY DESIGN

A cluster sample of 1,000, Iraqi 7-9 year-old children were invited to have their second primary molars examined for demarcated hypomineralised lesions.

METHODS

Mothers of 823 children completed a questionnaire-based interview regarding pregnancy and childhood systemic health history. In the clinical examination, the buccal, occlusal and lingual/palatal surfaces of the second primary molar were evaluated for demarcated hypomineralisation lesions by visual examination.

RESULTS

A response rate of 82.3% was obtained. Of the children examined, 53 (6.6%) had hypomineralisation defects in at least one second primary molar and were considered as the hypomineralised second primary molar-affected group. Of the total affected teeth (n=83), maxillary molars were the teeth most frequently affected by hypomineralisation throughout all developmental stages (69.9%). Demarcated opacities were the most prevalent lesion type (71.0%). Ninety-four percent of subjects diagnosed with demarcated defects reported various medical conditions possibly associated with hypomineralisation compared with 44% for their non-affected counterparts. Peri-natal medical conditions (45.3%) were the most frequently reported followed by pre-natal and post-natal conditions (24.5%, 9.4%; respectively).

STATISTICS

Ill health during pregnancy, delivery complications, neonatal complications, acute childhood illness, birth weight and duration of breast feeding were significant potential risk factors (p<0.05). The greater the number of health events reported, the higher was the chance of developing the defect. Children who experienced neonatal complications and whose mothers reported pregnancy and birth problems were approximately six times more likely to have the defect than those whose mothers had delivery complications only (80% vs 14.6%) (p<0.001). Also of those children whose mothers did not report delivery complications, but were breastfed for less than six months, of low birth weight and had history of upper respiratory tract infection, the chance of hypomineralised defects was over four times more likely to happen than in those who did not suffer any of these problems (25.8% vs 6.7%) (p<0.01). No statistically significant association was revealed between the time of the illness/condition occurrence and the location of the tooth in the dental arches.

CONCLUSIONS

Children with hypomineralised second primary molars had experienced more medical conditions than their unaffected peers particularly during the peri-natal period. No single factor was identified as a potential cause, leaving the aetiology of the defect unclear.

Caries experience of Egyptian adolescents: does the atraumatic restorative treatment approach offer a solution?

OBJECTIVES

To assess the prevalence and severity of dental caries amongst Egyptian adolescents and the prevalence of carious lesions treatable through the atraumatic restorative treatment (ART) approach.

SUBJECTS AND METHODS

Using a convenient sample procedure, two secondary schools with a dental clinic were selected (967 students, average age: 13.7 ± 0.8 years, range: 12-15). Dental caries was diagnosed using the ART caries criteria, and plaque and calculus were assessed using the Green and Vermillion criteria amongst students grades 1-3 in the dental clinic by 3 calibrated examiners. The effect of the independent variables gender, age, tooth surface, jaw side (left or right) and type of jaw (mandible/maxilla) on dependent caries experience variables and D(2) and D(3) variables were tested using ANOVA.

RESULTS

The prevalence of dental caries including enamel lesion (D(2)MFT) amongst the 967 students was 51.4% and that of dental caries excluding enamel lesions (D(3)MFT) was 38.1%. The mean D(2)MFT and D(3)MFT scores were 1.5 and 0.8, respectively. The percentage of teeth filled and extracted was low. Female students had statistically significantly higher mean D(3)MFT/S and D(2)MFT/S scores than males (p < 0.0001). The prevalence of cavitated carious lesions (D(3)) treatable through ART was 48% for score 2 and 28% for score 3.

CONCLUSIONS

Most of the cavitated lesions were found untreated despite the presence of a dental clinic and a dentist on the school premises. The majority of cavitated lesions without pulp involvement could be treated using the preventive and restorative components of the ART approach.