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

Effectiveness of a School-Based Oral Health Promotion Program on Dental Caries Among Iraqi School Children: A Cluster Randomised Controlled Trial

AIM

To assess the effectiveness of a school-based oral health promotion program on dental caries of permanent dentition among Iraqi children.

METHODS

A cluster randomised controlled trial was conducted with a parallel study group, comprising 8-10-year-old schoolchildren, 186 in each group. At the beginning of the study, subjects in the intervention group received oral health education and a single dose of 5% sodium fluoride varnish for all teeth surfaces while the control group only received oral health education. The primary outcome data in this study were caries increment and incidence after six months. The secondary outcome data was any change in oral health behaviors in the students of both groups after 3 months. The caries status was recorded according to International Caries Detection and Assessment System (ICDAS). Statistical analyses included the Chi-square test, McNemar test, independent t-test, simple and multiple logistic regression models.

RESULTS

Study participants included 372 children with no significant difference in baseline characteristics between intervention and control groups. An increase was evident in the mean scores of DMFS, DMFT, number of children with DMFT > 0, and DS > 0 for both control and intervention groups at six-month follow-up but this increase was significantly higher for the control than intervention group (P < .001). Among all variables included in the multiple logistic regression model, just being in the intervention group showed a significant effect in which children in the control group had a 4.2-fold (95% CI: 2.36-7.54) greater chance for developing new caries than children in the intervention group. There was a statistically significant increase in the percentage of children with favourable levels of behaviors between baseline and 3-month follow-up (P < .05, P < .001).

CONCLUSION

Providing access to oral health services such as oral examination, fluoride varnish application, and oral health education to reduce dental caries and improve oral health practices seems to be effective among primary schoolchildren.

Diagnostic accuracy of tele-dentistry in screening children for dental caries by community health workers in a lower-middle-income country

BACKGROUND

Tele-dentistry can be useful for dental caries screening of children, especially in lower-middle-income countries (LMICs).

AIM

To evaluate the diagnostic accuracy of mobile phone photographs taken by a community health worker (CHW) for caries detection in Iran.

DESIGN

Children aged 6-12 years were visually examined by a paediatric dentist. Following dental examinations, intraoral photographs were taken by a trained CHW. Two remote dentists assessed intraoral photographs for dental caries. Diagnostic accuracy of tele-dentistry for caries detection was evaluated. In addition, the questionnaire about oral health and parents' views towards tele-dentistry was prepared.

RESULTS

One hundred thirty-one children aged 8.74 ± 1.62 years participated. The caries prevalence was 30% for the whole dentition. Tele-dentistry demonstrated high accuracy, with a sensitivity exceeding 80% and specificity exceeding 90%. The inter-rater reliability for remote dentists' assessments to the gold standard dental examination ranged from substantial to almost perfect (kappa: 75%-93%). Additionally, 80% of parents whose children participated in this study had positive views towards tele-dentistry.

CONCLUSION

Tele-dentistry was shown to be an alternative approach to clinical examinations for caries detection among school children. Employing non-dental care professionals in tele-dentistry has been emerged as a reliable and cost-effective approach, especially in LMICs.

Association between dental caries and adherence to the Mediterranean diet, dietary intake, and body mass index in children

BACKGROUND

Children with healthier nutritional status are less likely to develop severe caries than those with a high-sugar content diet. Studies evaluating dental caries and nutritional status in school-age children have generally focused on dietary intake, diet quality, or anthropometric measures, and the number of studies evaluating them together is limited.

OBJECTIVE

It was aimed to evaluate the relationship between dental caries adherence to the Mediterranean Diet (MD), dietary intake, and Body Mass Index (BMI) in school-age children.

MATERIALS AND METHODS

This study was conducted with 300 healthy children (52.0% boys, 48.0% girls) aged between 6 and 12 years. The data collection forms included sociodemographic characteristics, oral health practices of children, Mediterranean Diet Quality Index for children and adolescents (KIDMED), and food consumption records. Anthropometric measurements (body weight and height) of the children were taken. Dental examinations were performed by a pediatric dentist.

RESULTS

While the DMFT mean score of the children was 1.7 ± 2.09, the mean dft score was 2.9 ± 3.29. The mean of KIDMED scores was 5.9 ± 3.32. DMFT and dft scores decreased statistically as maternal education increased (p < 0.05). DMFT and dft scores were not statistically different between BMI groups according to gender and age (p > 0.05). DMFT scores differed statistically between KIDMED groups (p < 0.05). This difference was between low-optimal and low-improvement-needed groups. While there was a low negative correlation (r=-0.169) between calcium intake and DMFT score, a low positive correlation was found between glucose (r = 0.172) and fructose (r = 0.149) intake and dft score (p < 0.05). In regression analysis, while the children's age related DMFT scores positively, maternal education and KIDMED scores related DMFT scores negatively. Also, children's age and maternal education related dft scores negatively.

CONCLUSION

In this study, adherence to the MD rather than nutrients was found to be important in dental caries. Also maternal education level was also found to be a determinant factor in dental caries in children. DMFT and dft did not differ between BMI groups.Further studies should be conducted to assess the impact of the MD on dental caries in children to develop dietary interventions for preventative purposes.

Anticandidal Efficacy of Oral Probiont Limosilactobacillus fermentum Against Dental Caries Pathogens in Children, Tamil Nadu, India

Dental caries remains a prevalent concern among children globally and is associated with Candida sp. Some researchers have suggested probiotic supplements as a possible solution for reducing dental caries. A study conducted in Tamil Nadu focused on collecting 80 dental caries samples from both males and females, obtained from two different locations. The samples underwent processing using the spread plate technique, followed by anticandidal activity assessments. Through ITS sequence analysis, candida strains were identified, including C. albicans (DDGRPO1, DDGRPO2). The study specifically investigated the ability of the probiotic bacterial strain Lb. fermentum cell-free filtrate to inhibit C. albicans. The research revealed that Lb. fermentum probiotics effectively inhibited the growth of C. albicans DDGRP01, displaying strong antifungal activity against Candida sp. (98%). While these results are promising, it is worth mentioning the increasing interest in exploring innovative alternatives to probiotic-based treatments. This avenue of research offers potential for a more comprehensive approach to addressing this issue. Notably, Lb. fermentum, derived from the human oral cavity, emerges as a significant postbiotic candidate for dental prophylaxis, indicating a hopeful direction for future studies.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12088-023-01175-5.

Influence of gender and oral health knowledge on DMFT index: a cross sectional study among school children in Kaski District, Nepal

BACKGROUND

Oral health problems are highly prevalent among school children in Nepal. Poor oral health condition may be influenced by various factors. However, little is known about the sociodemographic and awareness related factors on oral health problems among school children in Nepal. Therefore, this study aimed to assess the association of gender and knowledge on DMFT index among school children.

METHODS

A cross-sectional study was conducted among school children of Grade Seven in 12 schools of Kaski district in Nepal. Schools were randomly selected from the urban and semi-urban areas in the district. Data were collected covering oral health knowledge, socio-demographic characteristics, oral health condition and practices. The factors of poor oral health condition and practices were examined using t-test, one-way ANOVA, and multiple linear regression.

RESULTS

Of the total participants (n = 669), 54.9% were females and their mean DMFT score was 1.82 (SD = 1.07). Total decayed score was higher among those who did not have knowledge that fluoride prevents decay compared to those who had knowledge about it (Being aware of fluoride prevents decay: Mean = 1.21 (SD = 1.54) versus not being aware of that: mean = 2.13 (SD = 2.13); p = 0.029). Females were more likely to have higher DMFT scores compared to males (β-coefficient = 0.43, 95% CI 0.13, 0.73, p = 0.005). In addition, higher knowledge score was negatively associated with higher DMFT score (β-coefficient = - 0.09, 95% CI - 0.20, -0.01, p = 0.047).

CONCLUSION

Being female students and those having lower level of knowledge on oral health attributed to higher DMFT index. Periodic dental check-up coupled with oral health education on regular brushing, use of fluoridated paste, tongue cleaning and care of gum diseases are recommended in schools.

Dental caries and associated factors among diabetic and nondiabetic adult patients attending Bichena Primary Hospital’s Outpatient Department

Purpose

Dental caries is a significant public health issue affecting both the diabetic and nondiabetic populations. However, the problem and associated factors of dental caries among diabetics and nondiabetics patients are not well-known in Ethiopia. This study aims to compare the prevalence of dental caries and associated factors among diabetic and nondiabetic patients at the Outpatient Department of Bichena Primary Hospital in Northwest, Ethiopia.

Methods

Institutional based, comparative cross-sectional study was conducted from October 7 to December 6, 2019, among 200 diabetes and 400 nondiabetic adult patients. A consecutive sampling technique was implemented to recruit study participants. Data were collected by a pretested structured questionnaire and analysis was performed in Statistical Package for Social Science version 20. Bivariable and multivariable logistic regressions were employed and variables with a p-value &lt; 0.05 were declared statistically significant.

Results

A total of 582 patients were involved in the study with a response rate of 97.0%. The prevalence of dental caries was 67.9% [95% confidence interval (CI): 63.2%–72.8%] and 79.6% (95% CI: 74.0%–85.70%) in nondiabetic and diabetic group, respectively. Females gender [adjusted odds ratio (AOR) = 1.79, 95% CI: 1.15–2.77], poor oral hygiene (AOR = 2.95, 95% CI: 1.71–5.11), lack of regular teeth cleaning habits (AOR = 3.26, 95% CI: 2.13–4.97), feeling dry mouth (AOR = 2.31, 95% CI: 1.11–4.81), sugared tea drinking (AOR = 2.00, 95% CI: 1.18–3.38), inadequate oral health knowledge (AOR = 3.51, 95% CI: 2.19–5.62), and khat chewing (AOR = 2.14, 95% CI: 1.24–3.71) were significantly associated factors with high prevalence of dental caries.

Conclusion

The prevalence of caries was significantly higher among diabetics than nondiabetics. Oral health education with preventive measures such as improving teeth cleaning practice, reducing sugary foods and drinks intake, and improving oral hygiene practice of patients should be mainstreamed along with diabetic follow-up care.

Antibacterial Efficacy of Walnut Green Husk (WGH) Extract with Zinc Oxide Nanoparticles on Streptococcus Mutans

Background

Chemical agents, such as Chlorhexidine are used as one of dental plaque control strategy. Researchers are looking for a natural and economic substitute with same antibacterial efficacy and less complications. The aim of this study was to evaluate the antimicrobial efficacy of the Khorasan Razavi walnut green husk (WGH) extract with and without adding ZnO nanoparticles (nZnO) on Streptococcus mutans (S. mutans).

Methods

In this in vitro study, antimicrobial effect of the Hydro-ethanolic extract of WGH, was evaluated against S. mutans. Broth Dilution and Agar diffusion methods were used with 90 tubes containing different dilutions of WGH extract (100 to 0.006 mg/ml). ZnO nanoparticles (nZnO) were added to 45 tubes. Streptococcus mutans was exposed to 15 different serial concentrations of study extracts, from 100 mg/ml to 0.006 mg/ml. Minimum inhibitory concentration (MIC) of the study extracts were determined and zone of inhibition diameter was compared to positive controls (chlorhexidine 0.2%, nZnO), and negative control (sterile distilled water). The differences between the mean diameters, were analyzed by independent sample T- teS.

Results

Minimum inhibitory concentration (MIC) of study extract was found to be 50mg/mL, with adding nZnO, MIC was reduced to 3.12mg/mL. Mean diameter of inhibition zone at 3.12 mg/ml with and without adding ZnO nanoparticles were 17.67±0.57 mm and 8±0.001 mm, respectively, (p-value< 0.001).

Discussion

Adding nZnO could be enhanced antimicrobial efficacy of the WGH extract against S. mutants, while it was still less effective than chlorhexidine.

Penetration and Adaptation of the Highly Viscous Zinc-Reinforced Glass Ionomer Cement on Contaminated Fissures: An In Vitro Study with SEM Analysis

Objective: To evaluate the penetration and adaptation of highly viscous zinc-reinforced glass ionomer cement (ZRGIC), using a scanning electron microscope (SEM), when applied under various contaminated conditions on grooves and fissures of primary second molars. Materials and Methods: A total of 40 extracted human primary second molars were randomly assigned into five groups (8 teeth each), with different surface conditions (conditioned with 40% polyacrylic acid, dry condition, water contamination, saliva contamination, or saliva contamination and air-drying) on the occlusal surface before placement of zinc-reinforced highly viscous glass ionomer cement with the finger-press technique. After sectioning the teeth, they were subjected to SEM analysis, where four in each group underwent aging by thermocycling and the other four were without aging. ANOVA tests, post hoc analysis, and unpaired t-tests were used for statistical analyses. Results: There was a significant statistical difference in the sealant penetration in the non-aging group, but in the aging group, there was no significant statistical difference in the sealant penetration. On other hand, a significant statistical difference was found in the adaptation between all the groups (p < 0.05). Highly viscous zinc-reinforced glass ionomer fissure sealants have better fissure penetration and more intimate adaptation under fissures conditioned with 40% polyacrylic acid and dry surface fissures with no contamination. However, the best penetration and retention after aging were under contaminated fissures with a shiny layer of saliva. Conclusions: The ZRGIC is a highly viscous fluoride-releasing cement, effectively seals fissures by interfering with food lodgment and protecting teeth from caries. It is advisable to restore the fissures with the minimal technique of sensitive fluoride-releasing GIC, particularly in young, uncooperative children, rather than leaving a caries-prone environment.

An educational intervention using the health belief model for improvement of oral health behavior in grade-schoolers: a randomized controlled trial

Background

Oral health problems especially dental caries are common in school children, and education programs may help to prevent these conditions. The aim of current study was to examine the effects of an educational program based on a Health Belief Model (HBM) to improve oral health behaviors of elementary school children.

Methods

A total of 112 children ages 6–12 years old accompanied by one of their parents were randomly assigned to intervention/test and control groups. In the intervention group, five consecutive weekly educational sessions based on the HBM were provided, while the control group received only routine education delivered by the dental clinic. The Decayed, Missing, and Filled Teeth (DMFT) score, papillary bleeding index, and responses to the HBM questionnaire were assessed in the intervention and control groups at baseline and three-month follow-up after the intervention was completed. Within-group and between-group differences were examined using the Student’s t-test and analysis of covariance.

Results

All HBM domains were improved at follow-up in the intervention group compared to the control group (p < 0.001). The largest change was in perceived susceptibility, whereas the smallest changes were in perceived severity and perceived benefits. The papillary bleeding index demonstrated a significant change from baseline to follow-up in the intervention group (reduction of 0.7, 95% CI = − 0.9 to − 0.5). All components of the DMFT score except missing teeth also improved in the intervention group compared to controls. However, no significant difference was found in total DMFT score between intervention and control groups.

Conclusion

An education program based on HBM may be more effective than current methods used to educate children and their parents on optimal oral health behaviors. Administration of interventions of this type along with other school-based programs to prevent dental caries may be helpful in grade-school children.

The Effect of Parental Education and Socioeconomic Status on Dental Caries among Saudi Children

Parental attitudes toward the importance of oral hygiene have an impact on the formation of their children’s oral habits and the prevalence of oral diseases. Our aim was to assess the association between parents’ education and socioeconomic status and their children’s oral health. A cross-sectional study was conducted between the years of 2018 and 2020 in the eastern province of Saudi Arabia among primary school children. Two pre-calibrated dentists performed the clinical examination of the children, and a self-administered validated questionnaire was obtained from their parents. Clinical examination was performed on 589 children with an age range of 3 to 14 years, where 47% were males and 53% were females, 70% with dental caries. Both parents with higher education and a high monthly income were significantly associated with lower prevalence of decayed teeth in their children, respectively. Mother’s education, age, gender and application of sealant were found significantly associated with the high prevalence of caries. High prevalence of tooth decay was reported among school children in the eastern province of Saudi Arabia. A high educational level of parents and high income were correlated with a lower prevalence of decayed teeth, similarly to the situation in the case of presence of medical insurance.

36 Months' Clinical Performance of Primary Incisors Restorations Depending on the Type of Restorative Technique Used: A Randomized Controlled Trial

Background: Depending on the stage of the disease and the child’s age, different types of interventions can be used to treat early childhood caries. As a result, there is not enough clinical evidence to show that one kind of restoration is better than another. The objective of this longitudinal study was to compare the results of 36 months of clinical performance of primary incisors restorations using an incremental layering technique with the ceram.x^® SphereTECTM nanoceramic composite (Dentsply) or a full coverage technique with transparent strip crowns (Frasaco GmbH) with the same composite in children with or without biological caries risk factors. Methods: 80 patients (females 42/52.5%) were included in the study. A total of 160 restorations were performed. Restorations were evaluated at baseline and at 6, 12, 24, and 36 months, according to modified Ryge criteria. Conclusion: Restorations with both techniques were clinically highly successful and showed similar clinical performance at postoperatively regardless of the presence of biological factors of caries risk.

The prevalence of dental caries and associated factors among secondary school children in rural highland Vietnam

BACKGROUND

To determine the prevalence of dental caries in primary and permanent teeth and identify factors associated with dental caries among secondary school children in rural highland Vietnam.

METHODS

This was a cross-sectional study that included 1985 secondary schoolchildren. Dental examination was performed at school using World Health Organization criteria. Data collection on demographic characteristics and knowledge, attitude, and practices related to dental caries was conducted by interviewing children. Descriptive and inferential statistics using a multivariate logistic regression model were applied.

RESULTS

Prevalence of caries in primary and permanent teeth was 41.1 and 68.9 %, respectively. Prevalence of caries in primary teeth in the age group 11-12 years old (59.4 %) was significantly higher than in children in the age group of 13-14 years (27.8 %; p < 0.01). Factors associated with dental caries in primary teeth were age group of 11-12 years, belonging to the Jarai ethnic group, and having inadequate knowledge or attitude related to dental caries. Factors associated with dental caries in permanent teeth were having insufficient knowledge, attitude, and practices related to dental caries.

CONCLUSIONS

The prevalence of dental caries in primary and permanent teeth was high among secondary school children in Vietnam's rural highlands. It is recommended that interventions focus on younger secondary school children and the Jarai minority ethnic group, and that interventions should emphasize improving knowledge, attitudes, and practices related to dental caries.

Varying Manpower Alters Dental Health in a Developing Health Care System

OBJECTIVES

This study assessed relationships between oral health care workforce and dental health in 12-year-olds in a developing health care system in Iran from 1992 to 2014 and compared these findings with the most recent corresponding findings in selected countries.

METHODS

Data regarding oral health care workers from 1962 to 2014 were extracted from the comprehensive human resource data bank of the Shahid Beheshti Research Institute of Dental Sciences. Data regarding decayed, missing, and filled permanent teeth (DMFT) of 12-year-olds, extracted from official statistics, described dental health. Comparisons with other countries utilised the database of the World Health Organization. Changes in the DMFT index with fluctuations in the number of oral health care workers were investigated using exploratory data analysis methods. Associations of DMFT with the density of the oral health care workforce were evaluated using a multiple linear regression model.

RESULTS

The trend in supply of dental workforce in Iran began to expand in the 1970s and, after a reduction in 2003 to 2007, reached a peak by 2014. Means of DMFT indices of 12-year-olds in Iran fluctuated between 1.50 and 2.40 from 1992 to 2014. The relationship between the dentist to population ratio and the DMFT index of 12-year-olds showed a downwards trend (r = -0.994; P < .001) until 1998 and afterwards an upwards trend (r = 0.887; P < .001). Globally, the DMFT index decreased in countries with a preventively-oriented oral health care workforce.

CONCLUSIONS

Increased numbers of dentists have no significant impact on improving dental health in 12-year-olds. To promote dental health, the system providing health services should implement a preventively-oriented approach when planning for the oral health workforce.

Prevalence of Dental Caries and Its Associated Factors among Primary School Children in Ethiopia

Background. Dental caries (decay or cavities) is a breakdown of teeth as a result of bacteria. Dental caries is one of the preventable oral health problems and the most common chronic diseases in childhood. Poor dental and oral health affect the quality of children’s life. Objectives. To estimate the prevalence of dental caries and its associated factors among primary school children in Alem Ketema, North Showa, Ethiopia. Methodology. An institution-based quantitative cross-sectional study was conducted on 422 primary school children, from February 9 to March 8, 2020. Pretested structured questionnaire and oral examinations were conducted by using the WHO criteria (DMFT) index to collect the data. The data were entered into Epi-Data 3.1 software, and analysis was carried out using SPSS version 23 and variables with $P$ value ≤0.05 in the multivariable binary logistic analysis were considered as a cut-point to declare statistical significance. Result. The prevalence of dental caries was 46.9% (95% CI: 42.1, 51.7). The mean Decayed, Missing, and Filled Teeth (DMFT) index was 1.28 (±1.21). Being male (AOR = 1.975, 95% CI = 1.067–3.66), lack of parents’ insistence (AOR = 2.052, 95% CI = 1.079–3.902), lack of oral health education program (AOR = 4.753, 95% CI = 1.69–13.38), history of dental aches (AOR = 2.88, 95% CI = 1.55–5.32), and poor habit of mouth wash (AOR = 4.74, 95% CI = 2.55–8.79) were found significantly associated with dental caries. Conclusion. The prevalence of dental caries was higher and a common public health problem among school children. Lack of parent’s insistence, sex, dental ache history, poor practices of mouth wash, and lack of oral health education were significant predictors of dental caries. Therefore, oral health education program and parents encouraging their children to practice oral hygiene are important to prevent dental caries.

Dental caries and associated factors in Ethiopia: systematic review and meta-analysis

BACKGROUND

Globally, dental caries may be a major public health issue which may be preventable. Many studies have been conducted on dental caries in Ethiopia which present inconsistent results.

OBJECTIVE

This meta-analysis was expected to consolidate the findings conducted in various regions of the country and generate country representative information on the burden and its associated factors of dental caries in Ethiopia.

METHODS

Our systematic review and meta-analysis was carried out to estimate the pooled prevalence of dental caries and its associated factors in the Federal Democratic Republic of Ethiopia. Medical specialty databases like ScienceDirect, HINARI, Embase, PubMed, Google Scholar, and Cochrane Library were consistently and exhaustively searched. To determine the aggregate prevalence, studies delineating the prevalence of dental caries and associated factors were included. Important data were extracted employing a standardized data extraction tool ready in Microsoft Excel and imported to the STATA version-13 statistical software package for analyses. To assess non-uniformity, the Cochrane Q test statistics and I2 test were performed respectively. A random effects model meta-analysis was accustomed to estimate the pooled burden of dental caries.

RESULTS

The result of thirteen studies disclosed that the overall prevalence of dental caries in the Federal Democratic Republic of Ethiopia was found to be 40.98 (31.62, 50.34). Within the subgroup analysis, the uppermost prevalence was determined in Tigray region (46.59% (24.64, 68.54)) whereas the bottom prevalence was determined in Addis Ababa (34.20% (8.42, 59.97)). Dental caries prevalence was considerably high among study subjects who consumed sweet food (OR= 2.4 (95% CI (1.91, 3.01))). But the presence of dental plaque (OR = 5.14 (95% CI (0.67, 39.39))) and habit of tooth- cleaning (OR = 0.71 (95% CI (0.17, 2.96))) were not statistically significant with the outcome of interest.

CONCLUSION

Our meta-analysis found that the prevalence of dental caries was comparatively high, and sweet food consumption was the most risk issue for dental caries in Ethiopia. The Ethiopian Federal Ministry of Health ought to offer a lot of attention to strengthen the oral health care system and also the implementation of community-level interference programs.