Oral health status and oral health behaviors in Chinese Children

Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial

Aim and objective

To compare the arresting caries effectiveness of two different silver nanoparticle (AgNP) concentrations of nano-silver fluoride (NSF), namely 400 and 600 ppm. The hypothesis is that in posterior primary teeth with occlusal and approximal active dentin carious lesions, NSF 600's effectiveness will be higher than that of the NSF 400 solution over a 6-month follow-up period.

Materials and methods

This was a double-blind randomized clinical trial (RCT) conducted in the city of Recife, Brazil. A total of 337 children aged 5–7 years who attended the University of Pernambuco Dental School's clinics were examined. A single-blinded investigator conducted the examinations and treatment of the children. After baseline examination and recording of the dmft index, children were allocated to one of two study groups (NSF 600—intervention and NSF 400—positive control). In both groups, each tooth received two drops of NSF and treatments were performed only once in 6 months. The follow-up examinations were visual and tactile, performed in 30, 90, and 180 days to determine the activity of caries. The carious lesions that were not arrested in 30 days were recorded and referred for restorative treatment.

Results

The NSF 600 showed higher rate of success in arresting caries (72.7%, p = 0.025) compared with NSF 400 (56.5%).

Conclusion

The higher rate of success of NSF 600 can be explained by the higher concentration of AgNPs.

Clinical significance

Nano-silver fluoride has emerged as an excellent alternative to silver diamine fluoride (SDF), as it adds a high antibacterial effect to better esthetic results. Treatment is simple, non-invasive, and incurs low cost. It is ideal for use in community-based programs to increase the access to dental care without staining teeth black like other silver products.

How to cite this article

Arnaud M, Junior PCM, Lima MGS, et al. Nano-silver Fluoride at Higher Concentration for Caries Arrest in Primary Molars: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2021;14(2):207–211.

Dental caries and associated factors among adolescents aged 12 to 15 in Jiangxi Province, China

BACKGROUND

The purpose of this survey was to examine the association of general characteristics, oral health knowledge, attitudes, behavior, and dental caries status among adolescents in Jiangxi Province and to provide a basis for future prevention of dental caries among middle school students.

METHODS

A total of 8,160 adolescents aged 12 to 15 years were invited to participate in this survey by a stratified random cluster sampling method from 30 schools in five counties in Jiangxi Province. A self-administered questionnaire was used to understand their basic characteristics, including oral health behaviors, knowledge, and attitudes. Chi-square tests were used to compare dental caries status and general characteristics. Univariate and multivariate logistic regression analyses were used to study the effects of oral health knowledge, attitudes, and behavior on dental caries.

RESULTS

The prevalence of dental caries in permanent teeth was 25.8 percent, and the mean DMFT score of 12- to 15-year-old adolescents was 0.48 ± 1.04. The prevalence in rural areas was higher than that in urban areas (P < 0.001). The prevalence was higher in girls than in boys (P < 0.001). No significant age differences were observed (P > 0.05) in the prevalence of dental caries. The multivariate logistic regression analysis indicated that the variables associated with dental caries were tooth brushing frequency, use of toothpaste, frequency of sugary milk intake, smoking, and oral health attitudes.

CONCLUSIONS

This study revealed that adolescent oral health behaviors and attitudes were associated with dental caries. It is important to implement targeted oral disease prevention and control measures among adolescents.

Exploring an Association of Demographic, Oral, and Systemic Health Factors Among Patients Attending a Teaching Dental Center

Background:

Updated information on oral health status could be used to monitor oral disease patterns, as widespread variations in oral health outcomes within and between different countries are reported.

Aim:

The objective was to examine the status of oral and systemic health and their association with demographic characteristics of the population attending a public dental center.

Methods:

A cross-sectional secondary analysis of the patients’ record was conducted during June 2017 attending the dental center of Madina Teaching hospital Faisalabad, Pakistan. Study variables were analyzed using the t test and the c2 test with a significance level of P ≤ .050.

Results:

The mean age of the study sample was 31.9 ± 14.5 years; 56% were females; 48% had primary or higher education; 9% were hypertensive; 5% had hepatitis; and 5% diabetes mellitus; 52% were with poor oral hygiene, 68% had dental caries, 84% had no fillings, 27% had tooth loss, and 99% functional dentition; 74% patients had calculus, 67% had gingivitis, and 5% had periodontitis. Age was the strongest risk indicator. Dental caries, tooth loss, poor oral hygiene, gingivitis, periodontitis, and tooth mobility were significantly associated with diabetes mellitus; tooth loss and tooth mobility were associated with cardiac disease; tooth loss, periodontitis, and tooth mobility were associated with hypertension, whereas tooth loss and calculus were associated with hepatitis. Higher age and lower income were positively associated with poor oral hygiene.

Conclusion:

Age and gender remain to be the strongest predictors for both oral and systemic conditions. Poor oral health and tooth loss showed a strong relationship with chronic systemic conditions.

Utilization of a Mobile Dental Vehicle for Oral Healthcare in Rural Areas

Oral diseases remain one of the major global public health challenges, and the worldwide urban–rural disparities in oral health are significant. Residents in rural areas generally suffer from a higher prevalence and severity of dental caries and periodontal disease, yet they face numerous difficulties and barriers in accessing oral healthcare. Conventional strategies, such as building of dental clinics or, hospitals, or the provision of outreach services by using disposable materials, are neither practical nor effective in rural settings. Mobile dental vehicles (MDVs) have been proposed as an alternative strategy to supplement the traditional oral healthcare in many regions. They have usually been utilized in school-based oral health programs, providing dental care to the homeless or migrants, and screening programs for the population for various oral diseases. Due to their high mobility, MDVs are particularly valuable for the underserved populations living in rural areas. The advance of dental devices enables MDVs to be operated in a self-sufficient manner. This allows the MDV to function almost as well as a conventional dental clinic, providing a variety of dental treatments, including scaling, restoration, and oral surgery. This article discusses the use of MDVs as a solution to urban–rural inequality in receiving oral healthcare.

Socio-demographic determinants as predictors of oral hygiene status and gingivitis in schoolchildren aged 7-12 years old: A cross-sectional study

OBJECTIVE

Gingivitis and poor oral hygiene status are the most prevalent oral diseases among primary school students. Poor oral hygiene status, gingivitis and socio-demographic determinants have been shown to be associated with periodontal diseases. There is limited information on the gingivitis and oral hygiene status among Iranian children. In the present study, the status of gingivitis, oral hygiene status, and their association with socio-demographic determinants among schoolchildren aged 7-12 years old in Hamadan were investigated.

METHODS

In this cross-sectional study, 988 primary school students aged 7-12 years old were selected. The oral hygiene status was measured through Simplified Oral Hygiene Index (OHI-S) and Community Periodontal Index (CPI) was used to evaluate gingival bleeding and calculus. CPI was measured using a standardized protocol to investigate gum bleeding and calculus. The oral hygiene was classified as good, fair or poor based on calculus and debris measurements. Age, gender, educational level, occupation and residence district of parents, dental pain experience in the last year and whether parents supervised their children while brushing were assessed by the questionnaires. The collected data were analyzed using descriptive statistics and logistic regression analysis.

RESULTS

The oral hygiene status was good in 644 students (65.20%), fair in 341 (34.50%) and poor in three (0.30%). Moreover, the results of CPI depicted that 639 students (64.07%) had healthy periodontium, 320 (32.40%) had periodontal bleeding and 29 (2.9%) were with calculus. Higher percentage of the boys in the age group of 12 years old had periodontal bleeding and fewer good oral hygiene. The results of CPI and OHI-S scores depicted that more than half of the primary school students had healthy gums and periodontium (64.1%) and good oral hygiene status (65.2%). There were significant statistical associations between age and residence district with calculus measured by the CPI, also between gender, age, residence district, and mother's occupation with the gingival bleeding measured by the CPI. Furthermore, age and mother's occupation were significantly associated with OHI-S index.

CONCLUSIONS

In general, the periodontal health status is poorer in students attending suburban schools compared to those in urban schools in Hamadan. Since there are significant associations between gender, school districts and mother's occupation with oral hygiene index among schoolchildren in primary schools, considering them in schools' oral health program design might be useful.

Managing Early Childhood Caries for Young Children in China

The latest national survey found that 70% of 5-year-old children in China had dental caries. The prevalence of early childhood caries (ECC) may not only be attributed to poor oral hygiene and unhealthy diet, but also to limited access to and availability of dental care. The prevailing preventive measures adopted by industrialised countries for ECC management are neither practical nor affordable in China. Hence, an alternative approach to ECC management is necessary. Atraumatic restorative treatment (ART) has been advocated because the simple and short operative time renders ART affordable. However, the success rate of ART in restoring anterior primary teeth is unfavourable. Although there is no water fluoridation in China, topical fluorides may be used to manage ECC. Tooth brushing with fluoride toothpaste is effective for caries control, but not all toothpastes in China are fluoridated. Professionally applied fluorides such as sodium fluoride varnish can be a cost-effective treatment for managing the high prevalence of ECC in China. Silver diamine fluoride (SDF) at 38% is suggested to be effective in arresting ECC in China. It can be a simple, non-invasive and low-cost treatment. However, it stains caries black. Children and their parents must be well informed before SDF treatment.

Oral health knowledge, behaviors and parental practices among rural-urban migrant children in Guangzhou: a follow-up study

BACKGROUND

Despite the growing number of rural-urban migrant children in China, follow-up observation on the oral health of migrant children is still scarce. This study described the changes of oral health knowledge, behaviors and parental practices in migrant children over a period of one year. Possible factors affecting changes were also investigated.

METHODS

The study used purposive sampling to select five private schools of migrant children in Guangzhou. A total of 1900 students in Grades 3 and 4 were recruited. A self-administered questionnaire was used in November 2011 to understand their basic situations, including oral health knowledge, behaviors and parental practices. A final survey was conducted in April 2013 to detect any changes.

RESULTS

The mean accuracy of oral health knowledge was 53.17% and 59.42% in 2011 and 2013, respectively (p < 0.001). For migrant children, the total score of oral hygiene, dietary habits and parental practices increased at the follow-up evaluation (p < 0.05). Children with less oral health knowledge were more likely to achieve significantly positive changes in score of knowledge (p < 0.001) in the final survey. Migrant children who had worse performance on oral hygiene (beta estimate = 0.68, p < 0.001), dietary habits (beta estimate = 0.58, p < 0.001) and good parental practices in the baseline survey were more likely to obtain beneficial changes. No significant associations between demographic characteristics and changes of oral health knowledge and behaviors (p > 0.05) were observed.

CONCLUSION

Oral health knowledge, behaviors and parental practices among migrant children significantly improved at the follow-up assessment. However, the overall situation was still poor. Positive and effective health education and prevention programs tailored to rural-urban migrant children with varying levels of oral health knowledge, behaviors and parental practices will be needed.

A randomized controlled trial of home bleaching of tetracycline-stained teeth

OBJECTIVES

To investigate the effectiveness of two home bleaching modalities on whitening of tetracycline-stained teeth (TST).

METHODS

A randomized controlled trial on the bleaching effect of 15% carbamide peroxide gel loaded in tray and 6.5% hydrogen peroxide strip in subjects with TST was performed. Eligible subjects were judged independently by two assessors, and randomly assigned into the tray or the strip group. Lightness (L*), redness (a*) and yellowness (b*) were measured with colorimeter at baseline, one, two and three months. Any adverse reaction associated with bleaching were also recorded. Overall colour changes (ΔE) were analysed by one-sample and independent t-test/Wilcoxon test at significance level α=0.05.

RESULT

Twelve and fourteen participants were allocated to the tray and the strip group respectively. Both groups experienced noticeable and significant L*a*b* improvement at the end of the trial in comparison to the baseline (p<0.05). Significant improvement was observed in the first month for the tray group (p<0.05) and in the first two months for the strip group (p<0.05). While greater lightness improvement was observed in the tray group over the strip group in the first month (p=0.02), the reverse was noticed in the second month (p=0.01). There was no difference between two groups at the end of this trial (p<0.05) and no significant adverse reactions were observed.

CONCLUSION

Over a three-month period, 6.0% hydrogen peroxide strip performed equally well as the 15% carbamide peroxide tray delivery system in TST.

CLINICAL SIGNIFICANCE

Home bleaching systems produce noticeable tooth whitening effect in subjects with tetracycline-stained teeth.

The Effect of a Bi-annual Professional Application of APF Foam on Dental Caries Increment in Primary Teeth: 24-month Clinical Trial

The purpose of this study was to evaluate the effect of a bi-annual professional application of acidulated phosphate fluoride (APF) foam on caries increment in the primary dentition over a two-year period in the People’s Republic of China. In a double-blind, cluster-randomized, placebo-controlled trial, 392 children aged 3–4 years from 15 classes were randomly assigned to two groups on a school class basis. The experimental group (8 classes) received a bi-annual APF foam application, and the control group (7 classes) received the placebo. The mean increment of dmfs in the experimental group was 24.2% lower than that in the control group (p < 0.05). The significant caries reduction was observed on approximal surfaces in the experimental group compared with the control group (p < 0.01), but there were no differences on occlusal surfaces (p > 0.05). A bi-annual professional application of APF foam was effective in reducing the increment of dental caries in the primary teeth.

Prevalence of Dental Caries Among Primary School Children of India - A Cross-Sectional Study

INTRODUCTION

In India, the trend indicates an increase in oral health problems especially dental caries, which has been consistently increasing both in prevalence and in severity. Children of all age groups are affected by dental caries. It becomes imperative to collect the data on prevalence of dental caries and treatment needs to provide preventive care.

AIM

To assess the prevalence of dental caries and treatment needs of 6-11years old Indian school children.

MATERIALS AND METHODS

This was a cross-sectional study. Sampling frame consisted of 6-11years old primary school children. Study sample consisted of 13,200 children selected from 10 talukas of Belgavi District, Karnataka, India. Clinical examination for dmft and DMFT was carried out in the school premises by five teams, each consisting of one faculty, three postgraduate students and five interns from the KLE VK Institute of Dental Sciences, Belagavi, Karnataka, India. The examiners were trained and calibrated by the principal investigator. Statistical analysis was done using Chi-square and t-test.

RESULTS

The overall caries prevalence was 78.9%, mean dmft was 2.97±2.62 and mean DMFT was 0.17±0.53. The decayed teeth component was the principal component in both dmft and DMFT indices. The mean dmft in boys was higher compared to girls and it was found to be statistically significant (p<0.05).

CONCLUSION

This study provided us with the baseline data, using which treatment was provided to all the children screened. The children were provided treatment at the camp site/dental hospital/satellite centers and primary health care centers according to the facilities available.

Comparison of two preventive interventions on dental caries among children in Democratic People's Republic of Korea

OBJECTIVES

The aim was to compare the change in dental caries status in two different intervention groups of the Children's Oral Health Promotion Programme (COHPP).

METHODS

A longitudinal study among 500 children who had participated into the COHPP for 6 years was conducted in Pyongyang, Democratic People's Republic of Korea (DPRK). Children in Group I received intensified school-based intervention and were clinically examined at the age of 7 years in 2007 (n = 250), 10 years in 2010 (n = 250) and 13 years in 2013 (n = 242). Children in Group II (n = 250) joined the programme at the age of 4 years in kindergarten in 2007, were provided with early preschool-based intervention and were clinically examined at the age of 7 years in 2010 and 10 years in 2013.

RESULTS

Both the prevalence and the mean number of dt + DT decreased significantly in both groups during the follow-up. This was due to decrease in the number of dt, whereas the number of DT remained relatively constant. Poisson regression showed that the association between the group status and the change in the number of dt + DT was statistically significant when adjusted for gender but disappeared when the school was included in the analysis.

CONCLUSIONS

The decrease in dental caries may be partly due to the exfoliation of deciduous teeth and dental treatment received. However, the study gave some reference emphasizing the early starting of the prevention.

Oral health knowledge and practice of 12 to 14-year-old Almajaris in Nigeria: A problem of definition and a call to action

We studied oral health knowledge and practices of 12 to 14-year-old Almajiri boys in northern Nigeria because we found few studies on their health, and none on their oral health. We present our study after explaining the desperate life circumstances and context of Nigeria's approximately 10 million Almajiri youth. Our results, when compared with those of previously studied populations (those most similar in terms of environment, age range, and oral health characteristics) show that the Almajiris fare poorly. Although the international community has paid some attention to the Nigerian Almajiri children's educational needs, there has been little support for health, and none for oral health. We argue that the World Health Organization could better assist Nigeria and these children by assuring that the Almajiris are not excluded from programs targeting children classified as 'street children', and make specific recommendations.

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 and periodontal status of 12-year-old Dai school children in Yunnan Province, China: a cross-sectional study

BACKGROUND

The Dai people are one of the ethnic minorities in China and have a population of 1,260,000. They have the same origin as one of the main ethnic groups in Laos and Thailand. The study aims to describe the dental caries and gingival status of 12-year-old Dai children in China and to study the factors affecting their oral-health status.

METHODS

This cross-sectional oral-health survey was conducted from 2011-2012 with ethics approval. A sample of 12-year-old Dai children living in Yunnan, China, was selected using a multistage and cluster sampling method. One trained examiner performed the clinical examination. Caries experience was measured using DMFT index, and gingival status was assessed with CPI index. A self-completed questionnaire was sent to the children, and they were asked about their backgrounds and oral-health-related behaviors and oral-health knowledge. Binary logistic regression analysis was performed to investigate the factors that affected the caries status.

RESULTS

A total of 875 children were invited, and 823 (94 %) joined the survey. The prevalence of caries experience among the participants was 40 %. The mean DMFT and DT scores were 0.9 and 0.8, respectively. Most children (93 %) had gingivitis, and many (46 %) had calculus. Girls and those who had visited a dentist during the previous year had a higher prevalence of caries.

CONCLUSION

Dental caries were prevalent among 12-year-old Dai children in China. The periodontal condition of most of the children was poor. Caries were associated with gender and dental attendance.

Oral health status and oral health knowledge, attitudes and behavior among rural children in Shaanxi, western China: a cross-sectional survey

BACKGROUND

The current oral health status and possible dental risk factors among children in rural Shaanxi Province, western China are unreported. This study aimed to describe the oral health status and to analyze the possible risk factors for the oral health status in this population.

METHODS

A multi-stage cluster sampling method was used to survey 12- to 15-year-olds and 4- to 6-year-olds in villages in Shaanxi Province. The structured questionnaires were provided to the 12- to 15-year-olds and to the caregivers of the 4- to 6-year-olds to collect information on the subjects' oral health knowledge, attitudes and behavior. A clinical examination was performed to assess dental caries and gingival bleeding (only 12- to 15-year-olds). SPSS 17.0 statistical software was used to analyze the data.

RESULTS

The decayed, missing, filled teeth (DMFT) index scores of 12- to 15-year-olds and 4-to 6-year-olds averaged 0.45 and 3.05, respectively. The caries prevalence was 23.9% in 12- to 15-year-olds and 67% in 4-to 6-year-olds. Additionally, 45.2% of the 12- to 15-year-olds had gingival bleeding and 62.8% had calculus. The oral health knowledge of the subjects was generally poor, whereas they held very positive attitudes toward oral health. A low number of participants reported that they brushed their teeth at least twice daily. Moreover, a statistically significant relationship was found between oral health knowledge scores, tooth brushing frequency and DMFT scores as well as gingival bleeding in the 12- to 15-year-olds. Frequency of sweets consumption was strongly related to dmft scores in the 4- to 6-year-olds.

CONCLUSION

The oral health status, oral health knowledge and behaviors among village children in Shaanxi Province are poor. Oral health education to improve oral health knowledge and to increase the frequency of tooth brushing should be undertaken in the rural schools in western China.

A new "silver-bullet" to treat caries in children--nano silver fluoride: a randomised clinical trial

BACKGROUND

Untreated dental caries in children remains a public health challenge in poor communities.

OBJECTIVES

This prospective controlled clinical trial investigated the effectiveness of a new anti-caries agent, Nano Silver Fluoride (NSF), applied once a year to arrest caries in children.

METHODS

One hundred thirty decayed primary teeth were randomly divided into two groups: NSF as the experimental agent and water as the control group. Teeth were clinically diagnosed and treated by one masked examiner and followed up at seven days and five and 12 months by another calibrated examiner who was blinded to the type of treatment. The criteria of the ICDAS II were followed to determine the activity of lesion and the diagnosis of caries. The Pearson's chi-square test was used to compare the groups during different follow-up exams.

RESULTS

At seven days, 81% of teeth in the NSF group exhibited arrested caries, whereas in controls, no teeth had arrested decay (p<0.001) [PF, prevented fraction=81%]. After five months, the NSF group had 72.7% with arrested decay, and the control group had 27.4% (p<0.001) [PF=62.5%]. At 12 months, 66.7% of the lesions treated with NSF were still arrested, while the control group had 34.7% remaining arrested (p=0.003) [PF=50%]. The number need to treat (NNT) at five months was two, and at 12 months, the number was three.

CLINICAL SIGNIFICANCE

The NSF formulation is effective to arrest active dentine caries and not stain teeth.

CONCLUSIONS

NSF was demonstrated to be effective in arresting caries in children in poor communities.

Intranasal co-delivery of IL-6 gene enhances the immunogenicity of anti-caries DNA vaccine

AIM

To investigate the effects of co-delivering IL-6 expressing plasmid pCI-IL-6 on the immunogenicity of the anti-caries DNA vaccine pCIA-P, which encodes the surface protein antigen PAc of Streptococcus mutans.

METHODS

Plasmid pCI-IL-6 was constructed by inserting the murine IL-6 gene into the pCI vector. Expression of IL-6 in vitro was assessed using Western blot analysis. BALB/c mice were intranasally co-immunized with pCIA-P plus pCI-IL-6 on d 0 and 14. Anti-PAc IgG and secretory IgA (sIgA) were assessed by ELISA. Splenocytes from the mice were re-stimulated with the PAc protein, and IFN-γ and IL-4 production was measured using ELISA. Splenocyte proliferation was analyzed with flow cytometry. Rats were similarly immunized, and dental caries scores were determined using the Keyes method.

RESULTS

Marked expression of IL-6 was found in COS-7 cells transfected with pCI-IL-6. In the pCI-IL-6 co-immunized mice, the specific IgG antibodies in serum and sIgA antibodies in saliva were significantly higher than those in the control mice at weeks 4 and 8. Moreover, the secretion of IFN-γ from splenocytes in response to re-stimulation with PAc protein was significantly higher in the pCI-IL-6 co-immunized mice than that in the control mice, whereas the secretion of IL-4 had no significant difference. The proliferation of splenocytes from the pCI-IL-6 co-immunized mice was significantly higher than that from the mice immunized with pCIA-P and pCI vector. In the rat caries model, the pCI-IL-6 co-immunization rats displayed lower caries scores than the control rats.

CONCLUSION

Intranasal co-delivery of IL-6 gene significantly enhances the immunogenicity of the anti-caries DNA vaccine.

Dental and periodontal status of 12-year-old Bulang children in China

BACKGROUND

Bulang is an ethnic minority group living in Yunnan in the southwestern part of China. There is little information pertaining to the oral health of Bulang children. This study aims to examine the dental caries and periodontal status of 12-year-old Bulang children in China and the factors affecting their oral-health status.

METHODS

12-year-old Bulang school children in Yunnan, China, were recruited through a multi-stage cluster sampling method. Following the recommendation of the World Health Organization, caries experiences were recorded using the DMFT index and periodontal status with the CPI index. A self-completed questionnaire was used to collect information on the background and oral health-related behaviours of the children.

RESULTS

A total of 900 children in primary schools were invited, and 873 (97%) joined the survey. Their caries prevalence was 35%. Their caries experience in mean DMFT (±SD) score was 0.6 ± 1.1, and 94% of the carious teeth had no treatment. Most children (71%) had bleeding gums, and 58% of them had calculus. Girls and those who had visited a dentist in the previous year had higher caries risk.

CONCLUSIONS

Dental caries was common among the 12-year-old Bulang children in China. Most of the carious teeth were left untreated. Caries prevalence was associated with gender and dental attendance. Their periodontal condition was poor, and more than half of them had calculus.

Dental caries status of Bulang preschool children in Southwest China

BACKGROUND

Bulang is one of the 55 ethnic minorities in China with a population of around 120,000. They live mainly in Yunnan, which is a less-developed province in southwestern China. Many Bulang people live in remote villages and have little access to dental care. They like hot and sour food and chew betel nut. This study examines the caries status of 5-year-old Bulang children and factors that influence their caries status.

METHODS

A sample of 5-year-old Bulang children in Yunnan was selected using a multi-stage cluster sampling method. One trained dentist examined the children using dental mirrors with intra-oral LED light and CPI probes. Caries experience was measured according to the dmft index. Oral hygiene status was recorded according to the visible plaque index (VPI). A parental questionnaire was used to study the children's oral health-related behaviours.

RESULTS

A total of 775 children were invited and 723 joined the survey. The caries prevalence was 85%, and 38% of them had caries involved in pulp. The mean dmft and dt score were 5.8 ± 4.9 and 5.6 ± 4.8, respectively. Visible plaque was found on 636 children (88%). Multi-factor ANCOVA analysis found that higher dmft scores were found among the children who snacked on sweets daily, had visited a dentist within the last year and had higher VPI scores.

CONCLUSIONS

The caries prevalence and experience among 5-year-old Bulang children in Yunnan was high, and most of the caries were left untreated. The caries experience was associated with snacking habits, dental visit habits and oral hygiene.

Dental caries and erosion status of 12-year-old Hong Kong children

Background

This study aimed to assess the dental caries and erosion status of 12-year-old Hong Kong children and study the determinants of dental caries and dental erosion of these children.

Methods

The survey was performed from 2011 to 2012 with ethics approval. Stratified random sampling was adopted to select 12-year-old children in 7 primary schools in Hong Kong. The participating parents were asked to complete a self-administered questionnaire concerning their children’s diet and oral health habits. The children were examined for caries status with WHO criteria by 3 calibrated examiners. Detection of dental erosion followed Basic Erosive Wear Examination (BEWE) criteria.

Results

A total of 704 children were recruited and 600 (316 boys, 53%) participated in the survey. There were 124 children (21%) with caries experience (DMFT > 0) and their DMFT was 0.34 ± 0.76. About half of their decay was unfilled (DT = 0.16 ± 0.52) The DMFT of girls and boys were 0.45 ± 0.89 and 0.23 ± 0.61, respectively (p = 0.001). Girls also had a higher DT (0.21 ± 0.62 compared with 0.11 ± 0.41, p = 0.013) and FT than boys (0.23 ± 0.63 compared with 0.12 ± 0.44, p = 0.016). Most children (75%) had at least some sign of erosion (BEWE > 0), but no severe erosion (BEWE = 3). Logistic regression showed girls who consumed soft drinks and took vitamin C supplements had higher caries risk. Dental erosion was more severe among the children who had caries experience and consumed fruit juice.

Conclusions

The 12-year-old Hong Kong children had low caries experience, and almost half of the decay was left untreated. Although severe erosion was not found, many children had early signs of erosion.

Randomized clinical trial on effectiveness of silver diamine fluoride and glass ionomer in arresting dentine caries in preschool children

OBJECTIVE

To compare the effectiveness of annual topical application of silver diamine fluoride (SDF) solution, semi-annual topical application of SDF solution, and annual application of a flowable high fluoride-releasing glass ionomer in arresting active dentine caries in primary teeth.

METHODS

A total of 212 children, aged 3-4 years, were randomly allocated to one of three groups for treatment of carious dentine cavities in their primary teeth: Gp1-annual application of SDF, Gp2-semi-annual application of SDF, and Gp3-annual application of glass ionomer. Follow-up examinations were carried out every six months to assess whether the treated caries lesions had become arrested.

RESULTS

After 24 months, 181 (85%) children remained in the study. The caries arrest rates were 79%, 91% and 82% for Gp1, Gp2 and Gp3, respectively (p=0.007). In the logistic regression model using GEE to adjust for clustering effect, higher caries arrest rates were found in lesions treated in Gp2 (OR=2.98, p=0.007), those in anterior teeth (OR=5.55, p<0.001), and those in buccal/lingual smooth surfaces (OR=15.6, p=0.004).

CONCLUSION

Annual application of either SDF solution or high fluoride-releasing glass ionomer can arrest active dentine caries. Increasing the frequency of application to every 6 months can increase the caries arrest rate of SDF application.

CLINICAL SIGNIFICANCE

Arrest of active dentine caries in primary teeth by topical application of SDF solution can be enhanced by increasing the frequency of application from annually to every 6 months, whereas annual paint-on of a flowable glass ionomer can also arrest active dentine caries and may provide a more aesthetic outcome.

The Prevalence and Severity of Dental Caries and Oral Hygiene Status of Asthmatic Children between the Age Group of 6 and 12 Years: A Cross-Sectional Study

Aim

To assess the prevalence and severity of dental caries and oral hygiene status of 6 to 12 years old children with bronchial asthma.

Materials and methods

The study population consisted of 500 children between the age group of 6 and 12 years old, who were diagnosed with bronchial asthma and were under medication. DMFT score was assessed by WHO criteria (1997) and oral hygiene status was assessed by simplified oral hygiene index (OHI-S) by Greene and Vermillion (1964).

Results

The data was collected and analyzed using the SPSS package.15.6% of females had good oral hygiene status when compared to males who almost had 12.6 and 20.8% of children who were in the category of moderate persistent asthma had decayed teeth whereas only 4% of children in severe persistent asthma category had experienced with decayed teeth.

Conclusion

Moderate persistent group of asthmatic children who were consuming orobronchodilator form of medication are found to have high prevalence of dental caries than dry powder and metered dose inhaler.

How to cite this article

Anandhan V, Bharathan R, Venkataraghavan K, Reddy NV. The Prevalence and Severity of Dental Caries and Oral Hygiene Status of Asthmatic Children between the Age Group of 6 and 12 Years: A Cross-Sectional Study. World J Dent 2012;3(3):250-254.

Severe early childhood caries and behavioural risk indicators among young children in Ajman, United Arab Emirates

AIM

To estimate the prevalence of severe early childhood caries (s-ECC) in the primary dentition of young children in Ajman, UAE, and investigate its association with child and family characteristics, dietary habits, oral hygiene practices and dental services utilisation.

METHODS

A one-stage cluster sample was used to randomly select children aged five or six years old who were enrolled in public or private schools in Ajman, UAE. Clinical examinations for caries were conducted by a single examiner using WHO criteria. Parents completed questionnaires seeking information on child and family characteristics, dietary habits, oral hygiene, and dental service utilisation. Bivariate and multivariate analyses were used to identify risk markers and risk indicators for s-ECC experience.

RESULTS

The total number of children sampled was 1297. Dental examination and questionnaire data were obtained for 1036 (79.9%), of whom 50.0% were female. The overall prevalence of s-ECC was 31.1% (95% CI, 23.6, 38.9). The prevalence of s-ECC was higher among children of low-income families, those who had a high snack consumption level, and those who utilised dental services only when they had a problem.

CONCLUSIONS

The prevalence of s-ECC in young children in Ajman is high, and socio-economic characteristics, dietary habits, and dental utilisation are important determinants of their dental caries experience. There is an urgent need for oral health programs targeted at the treatment and underlying causes of dental caries in these children.

Why Iranian adolescents do not brush their teeth: a qualitative study

OBJECTIVES

To explore and describe attitudes towards tooth-brushing among Iranian adolescents.

METHODS

A series of focus-group sessions were held with 37 Iranian adolescents in schools. The groups comprised five to eight adolescents. All focus-group discussions were tape-recorded and then transcribed verbatim. All transcripts, codes and categories were read several times to extract a theme. Data were analysed using a qualitative content analysis approach.

RESULTS

Four major categories emerged from the analysis: brushing teeth is a necessary evil, parental influence on not brushing teeth, brushing teeth is insignificant, and brushing teeth is a health hazard. The theme identified in the latent content described that tooth-brushing is not part of the adolescents' activities of daily living.

CONCLUSIONS

Health educators should stress on the engagement of parents, awareness of the adolescents on brushing techniques and causes of toothache, and address any misconceptions regarding tooth-brushing.

Assessing the effectiveness of a school-based oral health promotion programme in Yichang City, China

OBJECTIVES

To assess the outcome of oral health promotion in schoolchildren over a 3-year period in Yichang City, Hubei, China.

METHODS

In a cluster randomized controlled trial, the concept of the World Health Organization Health Promoting Schools Project was applied to primary schoolchildren. Seven intervention schools and eight control schools were randomly selected from one district by stratified cluster sampling. The study was conducted as a 3-year follow-up study. After 3 years, 661 children remained in the intervention group and 697 children in the control group. Data on dental caries, plaque accumulation, and sulcus bleeding were collected by clinical examination, while behavioural data were gathered by self-administered questionnaires.

RESULTS

The 3-year net mean DMFS increment score was 0.22 in the intervention schools and 0.35 in the control schools (P < 0.013). A statistically significant difference in mean plaque (P < 0.013) and sulcus bleeding (P < 0.005) increment scores after 3 years was found between the two groups. Statistically significant higher scores were observed in restorations received and sealants placed, and a lower score in untreated dental caries, in children from the intervention group than the control group after 3 years (P < 0.01). In addition, more children in the intervention schools adopted regular oral health behavioural practices such as brushing their teeth at least twice a day, visiting the dentist within the past calendar year, and using fluoride toothpaste.

CONCLUSION

The study suggests that the school-based oral health promotion was an effective way to reduce new caries incidence, improve oral hygiene and establish positive oral health behavioural practices in the targeted schoolchildren.

Dental caries in 12-year-old suburban Nigerian school children

BACKGROUND

Dental caries is one of the commonest oral diseases in children. Despite this fact, not much attention has been given to studies on this issue among suburban Nigerian children.

OBJECTIVE

To investigate the prevalence of dental caries, dental attendance and oral health behaviours among the 12- year-old suburban Nigerian children.

SUBJECTS AND METHODS

Four hundred and two schoolchildren (349 boys, 153 girls) from both private and public schools age 12-year-old participated in the study in 2003. One examiner was calibrated and performed the screening procedures using standard method of WHO diagnostic criteria.

RESULTS

The prevalence of caries was 13.9 % and mean DMFT was 0.14. The decayed component accounted for 77.2 % of the DMFT while filling and missing teeth accounted for 15.8% and 7% respectively. Over 85 % of the children examined were caries free. Seventy seven per cent of the teeth affected by caries were untreated. The probability of having caries experience DMFT> 0 was significantly associated with the type of school and regular sweet consumption p < 0.05. The children who had not visited the dentist had higher caries prevalence than other children. This was statistically significant p < 0.05. Dental attendance was generally poor in both public (90.6%) and private (83.1%) school children.

CONCLUSION

The findings in this study for the caries prevalence in 12 year-old suburban Nigerian schoolchildren was as low as in developed countries of central Europe and lower than the global standard according to WHO references for the year 2000.

Oral health-related cultural beliefs for four racial/ethnic groups: Assessment of the literature

BACKGROUND

The purpose of this study was to assess information available in the dental literature on oral health-related cultural beliefs. In the US, as elsewhere, many racial/ethnic minority groups shoulder a disproportionate burden of oral disease. Cultural beliefs, values and practices are often implicated as causes of oral health disparities, yet little is known about the breadth or adequacy of literature about cultural issues that could support these assertions. Hence, this rigorous assessment was conducted of work published in English on cultural beliefs and values in relation to oral health status and dental practice. Four racial/ethnic groups in the US (African-American, Chinese, Filipino and Hispanic/Latino) were chosen as exemplar populations.

METHODS

The dental literature published in English for the period 1980-2006 noted in the electronic database PUBMED was searched, using keywords and MeSH headings in different combinations for each racial/ethnic group to identify eligible articles. To be eligible the title and abstract when available had to describe the oral health-related cultural knowledge or orientation of the populations studied.

RESULTS

Overall, the majority of the literature on racial/ethnic groups was epidemiologic in nature, mainly demonstrating disparities in oral health rather than the oral beliefs or practices of these groups. A total of 60 relevant articles were found: 16 for African-American, 30 for Chinese, 2 for Filipino and 12 for Hispanic/Latino populations. Data on beliefs and practices from these studies has been abstracted, compiled and assessed. Few research-based studies were located. Articles lacked adequate identification of groups studied, used limited methods and had poor conceptual base.

CONCLUSION

The scant information available from the published dental and medical literature provides at best a rudimentary framework of oral health related ideas and beliefs for specific populations.

Enhanced efficacy of CTLA-4 fusion anti-caries DNA vaccines in gnotobiotic hamsters

AIM

To evaluate the comparative immunogenicity and protective efficacy of the cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) fusion anti-caries DNA vaccines pGJA-P/VAX1, pGJA-P, and non-fusion anti-caries DNA construct pGLUA-P in hamsters. In addition, the ability of CTLA-4 to target pGJA-P/VAX1-encoding antigen to dendritic cells was tested in vitro.

METHODS

All DNA constructs contain genes encoding the A-P regions of a cell surface protein (PAc) and the glucan binding (GLU) domain of glucosyltransferases (GTFs) of cariogenic organism Streptococcus mutans. Human dendritic cells were mixed with the CTLA-4-Ig-GLU-A-P protein expressed by pGJA-P/VAX1-transfected cells and analyzed by flow cytometry. Gnotobiotic hamsters were immunized with anti-caries DNA vaccines by intramuscular injection or intranasal administration. Antibody responses to a representative antigen PAc were assayed by ELISA, and caries protection was evaluated by Keyes caries scores.

RESULTS

A flow cytometric analysis demonstrated that CTLA-4-Ig-GLU-A-P protein was capable of binding to human dendritic cells. pGJA-P/VAX1 and pGJA-P induced significantly higher specific salivary and serum anti-PAc antibody responses than pGLUA-P. Significantly fewer caries lesions were also observed in hamsters immunized with pGJA-P/VAX1 and pGJA-P. There was no significant difference in the anti-PAc antibody level or caries scores between pGJA-P/VAX1 and pGJA-P-immunized groups.

CONCLUSION

Antigen encoded by CTLA-4 fusion anti-caries DNA vaccine pGJA-P/VAX1 could specifically bind to human dendritic cells through the interaction of CTLA-4 and B7 molecules. Fusing antigen to CTLA-4 has been proven to greatly enhance the immunogenicity and protective efficacy of anti-caries DNA vaccines.

Caries experience variables as indicators in caries risk assessment in 6–7-year-old Chinese children

OBJECTIVES

The aim of the present study is to investigate variables of the past caries experience as indicators of future caries in a Chinese child population.

METHODS

Caries was recorded at baseline and 2 years later in 433, 6-7-year-old Chinese children. Correlation coefficients between variables of the past caries experience and caries increment were calculated. Stepwise logistic regression analyses provided predictor variables. ROC curves presenting sensitivity as function of (100-specificity) were employed to summarize the obtained information. The area under the ROC curves was used as a measure of predictive accuracy.

RESULTS

Twelve variables of baseline caries experience had a significant (p<or=0.05) correlation with caries increment in the permanent dentition. Among the variables, the number of primary molars with enamel or dentine caries, fillings or missings due to caries (d(12)mftmol), the number of fissures of the first permanent molar with enamel caries (D(1)fis) and the number of pits and fissures of the first permanent molar with dentine caries (D(2)pitfis) were the most powerful caries predictors, which resulted in a value of 0.74 under the ROC.

CONCLUSIONS

By including non-cavitated caries in the past caries experience of primary molars and permanent first molars, it was possible to construct a screening criterion (d(12)mftmol+D(1)fis+D(2)pitfis), which enabled the selection of true negative children and the selection of a high caries risk group in a 6-7-year-old Chinese child population.

Dental caries experience and use of dental services among preschool children in Ajman, UAE

OBJECTIVE

The aim of this study was to estimate the prevalence and severity of dental caries in the primary dentition of young children in Ajman, UAE, and investigate its association with sociodemographic characteristics and use of dental services.

METHODS

A cluster-sampling approach was used to randomly select children aged 5 or 6 years who were enrolled in public or private schools. Clinical examinations for caries were conducted by a single examiner using World Health Organization criteria. Parents completed questionnaires seeking information on socioeconomic background and dental service utilization. Zero-inflated negative binomial (ZINB) regression modelling was used to identify risk markers and risk indicators for caries experience.

RESULTS

The prevalence of dental caries in the sample was high 76.1%. The average dmfs score 10.2. Caries severity was greater among older children and among male children of less educated mothers. Emirati (local) children had higher caries severity than others. Children who had higher level of caries visited the dentist more frequently than other children whose visits were for check-up only.

CONCLUSIONS

Dental caries prevalence and severity in young children in Ajman are high, and socioeconomic characteristics and dental utilization are important determinants of their dental caries experience. There is an urgent need for oral health programmes targeted at the treatment and underlying causes of dental caries in these children.

Oral health knowledge, attitudes and behaviour of children and adolescents in China

OBJECTIVES

A national representative study to describe oral health behaviour, illness behaviour, oral health knowledge and attitudes among 12-year-old and 18-year-old Chinese, to analyse the oral health behaviour profile of the two age groups in relation to province and urbanisation, and to assess the relative effect of socio-behavioural risk factors on dental caries experience.

METHODS

The total number of 4,400 of each age group were selected and data were collected by clinical examinations (WHO criteria) and self-administered structured questionnaires.

RESULTS

44.4% of the respondents brushed their teeth at least twice a day but only 17% used fluoridated toothpaste. Subjects who saw a dentist during the previous 12 months or two years were 31.3% and 35.3% for 12-year-olds and 22.5% and 20.2% for 18-year-olds, respectively. Nearly one third (29%) of 12 year-olds and 40.5% of 18-year-olds would visit a dentist in case of signs of caries but only when in pain. Nearly half of the participants (47.2%) had never received any oral health care instruction. Significant variations in oral health practices were found according to province and regular dental care habits were more frequent in urban than in rural areas. The risk of dental caries was high in the case of frequent consumption of sweets and dental caries risk was low for participants with use of fluoridated toothpaste.

CONCLUSION

Systematic community-oriented oral health promotion programmes are needed to target lifestyles and the needs of children, particularly for those living in rural areas. A prevention-oriented oral health care policy would seem more advantageous than the present curative approach.

Dental caries and periodontal status of 12-year-old school children in rural Qinghai, China

OBJECTIVES

To describe the dental caries and periodontal status of 12-year-old children in rural Qinghai and to compare the oral health status between the Han and ethnic minority children.

METHOD

Children aged 12-years in three primary schools in Hexi Townships, Guide County, Hainan Tibetan Autonomous State, Qinghai Province, China, were invited to participate in the survey conducted during July 2001. Each child was interviewed and clinically examined in the schools, using portable equipment. World Health Organization (WHO) examination procedures and diagnostic criteria were used. SPSS 11.0 was used for data compilation and statistical analysis.

RESULTS

All 196 12-year-olds (118 Han and 78 from ethnic minorities, i.e. Muslims and Tibetans) were surveyed. 48% of the children reported never brushing their teeth, while 12% brushed only every 2-3 days. Over ninety per cent (n=182) of the children had never visited a dentist. The DMFT scores in Han and in minority groups were found to be 0.12 and 0.23 respectively. A larger proportion of children in Han group (94%) had no caries experience (DMFT = 0) than that of Muslim and Tibetan (82%) groups (p<0.01). None of the children had healthy gingiva (i.e. highest CPI score=0) and 85% had calculus.

CONCLUSION

The prevalence of caries experience in Han children is significantly lower than that in Muslim and Tibetan children in rural Qinghai. Dental caries and caries treatment needs of Han and minority rural schoolchildren in Qinghai are low but their periodontal health status is unsatisfactory. Basic dental health care and preventive education for the children in this part of China is needed.

Caries experience of 5-6-year-old and 12-13-year-old schoolchildren in central and western Nepal

OBJECTIVE

To describe and analyse the caries experience and caries prevalence in the deciduous dentition of 5-6-year-old schoolchildren and in the permanent dentition of 12-13-year-old schoolchildren in western and central Nepal.

DESIGN

Non-randomised cross-sectional surveys conducted by trained and calibrated examiners.

SETTING

Surveys were conducted in private and government rural and urban schools at 10 sites along the Terai and the foothills in eight districts of western and central Nepal.

SUBJECTS

A total of 2,177, 5-6-year-old and 3,323, 12-13-year-old schoolchildren from urban and rural areas were examined under WHO Pathfinder methodology.

OUTCOME MEASURES

Prevalence of caries and dental caries experience (dmft/DMFT).

RESULTS

The caries prevalence and mean dmft score of 5-6-year-olds was 67% and 3.3 (urban 64% and 2.9; rural 78% and 4.0). The caries prevalence and mean DMFT score of 12-13-year-olds was 41% and 1.1 (urban 35% and 0.9; rural 54% and 1.5). The d/D-component constituted almost the entire dmft/DMFT index.

CONCLUSION

The recorded prevalence of untreated dental caries in schoolchildren requires an appropriate oral health response based primarily on prevention and health promotion. Foremost in this regime would be the promotion and use of accessible and affordable fluoridated toothpaste.

Dental caries vaccines: prospects and concerns

Dental caries remains one of the most common infectious diseases of mankind. Cariogenic micro-organisms enter the dental biofilm early in life and can subsequently emerge, under favorable environmental conditions, to cause disease. In oral fluids, adaptive host defenses aroused by these infections are expressed in the saliva and gingival crevicular fluid. This review will focus on methods by which mucosal host defenses can be induced by immunization to interfere with dental caries caused by mutans streptococci. The natural history of mutans streptococcal colonization is described in the context of the ontogeny of mucosal immunity to these and other indigenous oral streptococci. Molecular targets for dental caries vaccines are explored for their effectiveness in intact protein and subunit (synthetic peptide, recombinant and conjugate) vaccines in pre-clinical studies. Recent progress in the development of mucosal adjuvants and viable and non-viable delivery systems for dental caries vaccines is described. Finally, the results of clinical trials are reviewed, followed by a discussion of the prospects and concerns of human application of the principles presented.

Effectiveness of silver diamine fluoride and sodium fluoride varnish in arresting dentin caries in Chinese pre-school children

Untreated dental caries in Chinese pre-school children is common. This prospective controlled clinical trial investigated the effectiveness of topical fluoride applications in arresting dentin caries. Three hundred seventy-five children, aged 3-5 years, with carious upper anterior teeth were divided into five groups. Children in the first and second groups received annual applications of silver diamine fluoride solution (44,800 ppm F). Sodium fluoride varnish (22,600 ppm F) was applied every three months to the lesions of children in the third and fourth groups. For children in the first and third groups, soft carious tissues were removed prior to fluoride application. The fifth group was the control. Three hundred eight children were followed for 30 months. The respective mean numbers of arrested carious tooth surfaces in the five groups were 2.5, 2.8, 1.5, 1.5, and 1.3 (p < 0.001). Silver diamine fluoride was found to be effective in arresting dentin caries in primary anterior teeth in pre-school children.

Predicting caries in permanent teeth from caries in primary teeth: an eight-year cohort study

Several cross-sectional studies report that caries in primary teeth is correlated with caries in permanent teeth. This eight-year cohort study sought to determine if caries in the primary dentition can predict caries in the permanent dentition of the same individuals and, if so, with what degree of prediction accuracy. A total of 362 Chinese children, from 3 to 5 years old at the time of the 1992 baseline study, were re-examined in 2000. The study found statistically significant associations between caries prevalence in primary and permanent dentitions (p < 0.01). Children having caries in their primary teeth were three times more likely to develop caries in their permanent teeth (relative ratio = 2.6, 95% CI = 1.4-4.7; p < 0.001). Caries on primary molars had the highest predictive value (85.4%). This study demonstrates that caries status in the primary teeth can be used as a risk indicator for predicting caries in the permanent teeth.

The second national survey of oral health status of children and adults in China

OBJECTIVES

To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience.

DESIGN

Cross-sectional study, oral epidemiological survey based on WHO methodology, clinical examinations.

SETTING

National survey by National Committee for Oral Health.

SUBJECTS

Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5,12,15,18, 35-44 and 65-74. Each age group consisted of 23,452 participants, i.e. total of 140,712 individuals.

RESULTS

At age 5, 76.6% were affected by dental caries and mean dmft was 4.5. Mean DMFT varied from 1.0 in 12-year-olds, 1.4 in 15-year-olds, 1.6 in 18-year-olds, 2.1 in 35-44-year-olds to 12.4 in 65-74-year-olds. In adults, caries experience was higher in females than in males. The effect of urbanisation on caries prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old-age people of rural areas. At national level, changes in dental caries prevalence of 12- and 15-year-olds were small. However, some provinces with extensive oral health programmes (e.g. Love Teeth Day) showed declining caries experience whereas provinces with limited preventive activities had increasing levels of caries. For all age groups, gingival bleeding and calculus were most frequent. Severe periodontal conditions were relatively rare.

CONCLUSION

The systematic implementation of preventive oral care and community-oriented health programmes are needed for the continuous promotion of oral health in China.