The accuracy of caries risk assessment in children attending South Australian School Dental Service: a longitudinal study

Dental caries prediction and the indication of pit and fissure sealant in children first permanent molars: a prospective study

OBJECTIVES

To evaluate predictors for caries incidence on first permanent molars and to assess the accuracy and efficiency of these predictors for the indication of pit and fissure sealants.

METHODS

This 7-y cohort study started in 2010 with a sample of 639 children (1-5 years) from Southern Brazil. Dental caries was assessed using the ICDAS. Maternal education, family income, parental perception on child oral health and severe dental caries experience were collected at baseline and used to test the prediction of dental caries. Predictive values, accuracy and efficiency were estimated for each possible predictor.

RESULTS

About 449 children were re-assessed at follow-up (70.3% retention rate). The baseline characteristics showed similar risks for dental caries incidence in first permanent molars. Low family income and poor parental perception of child oral health were moderately accurate in correctly identifying sound children who would not need to receive pit and fissure sealant. However, all the adopted criteria have lower accuracy incorrectly identifying children who later developed dental caries in first permanent molars.

CONCLUSIONS

Distal and intermediate factors were relatively accurate in determining caries risk incidence on children's first permanent molars. The criteria adopted were more accurate in identifying sound children than those who need to receive pit and fissure sealant.

CLINICAL RELEVANCE

Our findings reinforce the idea that investing in strategies that take into account common risk factors still represents the best option for dental caries prevention. However, adopting only these parameters is not enough to indicate pit and fissure sealants.

Testing the efficacy of a brief-caries risk assessment form to evaluate the dental health status among preschool children, Bangkok, Thailand

Purpose

The study aims to test the efficacy of brief-caries risk assessment form with standard caries risk assessment form and to evaluate the application of caries risk assessment following American Academy of Pediatric Dentistry (AAPD) between brief and standard caries risk assessment on dental health status among preschool children.

Design/methodology/approach

Brief-caries risk assessment form was developed. Then, experimental study was conducted in public health center 54 among 70 patients (35 test and 35 control) from January to July 2019. Test group used brief-caries assessment form, and control group used standard form. Both groups received the same caries risk assessment criteria and management protocol from AAPD. At baseline, 3-month and 6-month follow-up, caries risk and dental health status (plaque index, cavitated caries lesion and non-cavitated caries lesion) were assessed. Data were analyzed by descriptive statistic, t-test, chi-square test, Fisher's exact test and repeated measures ANOVA.

Findings

Percentage of high caries risk decreased from baseline (93.9%: test and 96.9%: control) to 6-month follow-up (66.7%: test and 65.6%: control) in both groups, with no statistically significant differences between groups. Plaque index, cavitated caries lesion and non-cavitated caries lesion were not statistically significant differences between groups. Brief-caries assessment decreased times/visit from 10-15 minutes to 5 minutes.

Originality/value

Brief-caries assessment form decreased caries risk and prevented dental caries as the standard form. Using brief-caries assessment form could save time, is cost-effective and is appropriate for use in public health centers. However, a short follow-up time might have insufficient power to detect the differences between groups.

Salivary 1,5-Anhydroglucitol and Vitamin Levels in Relation to Caries Risk in Children

The objective of this study was to evaluate the association between salivary 1,5-anhydroglucitol (AG), vitamins A (VA), C (VC), and E (VE), and caries risk in children. 100 healthy children aged between 6 and 13 years were divided into two equal groups of caries-free (DMFS/dmfs=0) and caries active (DMFS/dmfs>3). Unstimulated midmorning saliva was collected from all the children and the levels of salivary AG and vitamins A, C, and E were measured. Caries risk assessment was done using American Academy of Pediatric Dentistry Caries Assessment Tool. Analysis of salivary AG and vitamins was performed using a commercially available ELISA kit. Low levels of AG were present in caries active and high caries risk groups compared to caries-free and low/medium caries risk groups. This difference is statistically significant (p < 0.05). A strong negative correlation between AG and caries activity was observed in the caries active group. VA was not related to caries activity, while VC and VE displayed a statistically significant correlation (p < 0.05). Similarly, a strong negative correlation was observed between the levels of AG and high caries risk group. Salivary AG, VC, and VE together are related to caries risk in caries active children. These salivary parameters can act as indicator of caries status in children.

Prediction of Early Childhood Caries via Spatial-Temporal Variations of Oral Microbiota

Microbiota-based prediction of chronic infections is promising yet not well established. Early childhood caries (ECC) is the most common infection in children. Here we simultaneously tracked microbiota development at plaque and saliva in 50 4-year-old preschoolers for 2 years; children either stayed healthy, transitioned into cariogenesis, or experienced caries exacerbation. Caries onset delayed microbiota development, which is otherwise correlated with aging in healthy children. Both plaque and saliva microbiota are more correlated with changes in ECC severity (dmfs) during onset than progression. By distinguishing between aging- and disease-associated taxa and exploiting the distinct microbiota dynamics between onset and progression, we developed a model, Microbial Indicators of Caries, to diagnose ECC from healthy samples with 70% accuracy and predict, with 81% accuracy, future ECC onsets for samples clinically perceived as healthy. Thus, caries onset in apparently healthy teeth can be predicted using microbiota, when appropriately de-trended for age.

Longitudinal study of caries progression in 2- and 3-year-old German children

OBJECTIVE

This 2-year longitudinal study in 2- and 3-year-old kindergarten children investigated lesion progression on different surfaces of primary teeth.

METHODS

The study was conducted between September 2008 and September 2010 on a sample of 400 children from the Kyffhäuser district (Thuringia, Germany). A calibrated investigator recorded (non)cavitated caries lesions according to World Health Organization (WHO), International Caries Detection and Assessment System (ICDAS) and Universal Visual Scoring System (UniViSS) criteria. Nonparametric methods and linear regression using a mixed-effects model with an unbalanced design were used for data analysis.

RESULTS

There was a significant increase in the prevalence of noncavitated caries lesions during the 2-year period, with the highest chance for change on all surfaces compared to cavitated lesions. First visible sign lesions on occlusal surfaces had the highest chance for change (estimate 0.38), whereas established lesions revealed the highest chance for change on proximal (estimate 1.05) and smooth surfaces (estimate 0.62). Proximal lesions exhibited the greatest chance for change irrespective of severity level.

CONCLUSION

Our study demonstrated that each type of carious lesion had different changing rates. Greater lesion severity correlated with greater chances to change and receive treatment. This information is crucial for dental practitioners in decision-making processes.