The Impact of Early Childhood Factors on Dental Caries Incidence in First Permanent Molars: A 7-Year Follow-Up Study

Trends and age-period-cohort effect on dental caries prevalence from 2008 to 2019 among Brazilian preschoolers

This study aimed to evaluate trends in the prevalence of dental caries in preschool children and associated factors considering different time variations. This is a time series study performed using data from three cross-sectional studies with pre-school children from southern Brazil in 2008, 2013 and 2019. This children group was born between the years of 2003 to 2018. Dental caries was evaluated by decayed, missing and filled deciduous teeth (dmft index). Demographic, socioeconomic, behavioural and psychosocial variables were also collected. Chi-square test for trends and a hierarchical age-period-cohort (HAPC) analysis using multilevel Poisson regression model for testing the associations between predictor variables and dental caries experience were used. A total of 1,644 pre-school children participated in all surveys. There was a significant difference in caries experience considering all APC effects. The prevalence of dental caries was 25.0% in 2008, 16.3% in 2013, and 19.4% in 2019 (p < 0.01) and no statistical difference was observed. An age effect showed that older children were more likely to experience dental caries. Considering the cohort effect, there is a significant difference between the generations, mainly between 2003 and 2018. Household income, use of dental services, and parent's perception of child oral health were associated with dental caries experience no matter the time variation. Despite recent declines in dental caries prevalence among preschool children, caries levels increased with age and social inequalities persisted through the years, indicating a need of reviewing the policies to reduce the burden of this oral disease.

Persistent poverty and child dental caries: time-varying exposure analysis

BACKGROUND

This study investigated the cumulative impact of persistent poverty on dental caries among elementary schoolchildren in Japan.

METHODS

Data were derived from four-wave longitudinal data of children in all public elementary schools in Adachi City, Tokyo, Japan, from 2015 to 2020 (n=4291, response rate: 80.1%-83.8%). Poverty status, defined as annual household income

RESULTS

Children with persistent poverty experienced more dental caries (mean: 3.81, SD: 3.73) than children who had never experienced poverty (mean: 2.39, SD: 3.27). After controlling for confounders, being in persistent poverty was significantly associated with having more dental caries than never being in poverty (mean difference: 1.54, 95% CI 0.60, 2.48). The magnitude of the association was greater than that of poverty assessed at first grade only (mean difference: 0.75, 95% CI 0.35, 1.16) or experience of poverty at any of the four waves (mean difference: 0.69, 95% CI 0.39, 0.99).

CONCLUSION

The cumulative impact of persistent poverty could be larger than the poverty assessed at a single time point.

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Key Words

• BIOSTATISTICS
• DENTISTRY
• EPIDEMIOLOGY

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MESH Headings

• Humans
• Child
• Dental Caries/epidemiology
• Poverty
• Japan/epidemiology
• Schools
• Surveys and Questionnaires

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Affiliation(s)

Yusuke Matsuyama Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan Department of Oral Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Aya Isumi Department of Health Policy, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Satomi Doi Department of Health Policy, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
Takeo Fujiwara Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan

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Impact of community and individual social capital during early childhood on oral health-related quality of life: A 10-year prospective cohort study

AIM

To evaluate the impact of community and individual social capital during early childhood on oral health-related quality of life (OHRQoL) over a 10-year follow-up period.

METHODS

A prospective cohort study was conducted in the southern Brazil. Baseline (T1) data collection occurred in 2010 with preschool children aged 1-5 years. Participants were assessed in 2012 (T2), 2017 (T3), and 2020 (T4). OHRQoL was assessed using the B-ECOHIS at T1 and T2 and through CPQ8-10 at T3 and CPQ11-14 at T4. Community social capital was evaluated through the presence of formal institutions in the neighbourhood and individual social capital by social networks, both at T1. Demographic and socioeconomic characteristics were also evaluated. Multilevel Poisson regression analysis was performed to estimate the impact of social capital measures on OHRQoL.

RESULTS

Of the 639 children assessed at T1, 469 were followed at T2 (73.3% response rate), 449 at T3 (70.3% response rate), and 429 at T4 (67.1% response rate). Individuals living in neighbourhoods with the presence of social class associations at T1 had higher OHRQoL at T3 and T4. Individuals whose families visit friends and neighbours less than once a month or never at T1 had lower OHRQoL at T1, T3 and T4. Attending religious meetings less than once a month or never at T1 was associated with lower OHRQoL at T2 and T4.

CONCLUSION

Social capital at the community level had a long-term effect on OHRQoL, especially during adolescence, while individual social capital levels impacted OHRQoL across the assessments.

CLINICAL SIGNIFICANCE

The findings indicate that psychosocial variables can impact OHRQoL, a fundamental aspect of clinical practice.

Effectiveness of Three Agents in Pulpotomy Treatment of Permanent Molars with Incomplete Root Development: A Randomized Controlled Trial

The aim of this study was to investigate and compare, radiographically and clinically, the impacts of calcium-silicate based-cement (CSBC), nano-hydroxyapatite and platelet-rich fibrin (PRF) as pulpotomy agents in permanent immature molars with incomplete root development. Sixty-three participants (63 permanent immature molars) were included in this study. The patients were randomly divided into three equal groups. Fast setting MTA (MM-MTA), nano-hydroxyapatite and platelet-rich fibrin were used as pulpotomy agents. The teeth were evaluated clinically and radiographically after 6 and 12 months by two blinded examiners. Apical closure and pulp canal obliteration percentages were recorded. The in vitro reaction of the tested materials after a 7-day immersion period of the different materials in phosphate-buffered solution was analyzed using scanning electron microscopy to associate the in vitro mineralization with in vivo pulp canal obliteration percentages. Data were analyzed using Chi-square and ANOVA tests (α = 0.05). No significant difference was found between the three tested groups in terms of clinical and radiographic success (p > 0.05). All cases demonstrated evidence of root growth, including complete apical closure or continued apical closure. At 12 months, complete apical closure was found among the MM-MTA group (50%), nano-hydroxyapatite group (55%) and platelet-rich fibrin group (60%) (p > 0.05). After 12 months, pulp canal obliteration was more observed in the MM-MTA and nano-hydroxyapatite groups than in the PRF group (p < 0.05). MM-MTA (auto-mixed), NHA (hand-mixed) and PRF (autologous) could be used as pulpotomy agents since they exhibit comparable high clinical and radiographic success rates. However, the fact that the groups managed with MM-MTA and NHA have a higher tendency to canal obliteration might indicate that PRF should be considered the first choice material as pulpotomy agent, as it would make retreatment considerably easier.