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Sabbagh HJ, Alzain IO. Oral health care among children in Saudi Arabia: a cross-sectional study. BMC Oral Health 2024; 24:1118. [PMID: 39300481 DOI: 10.1186/s12903-024-04818-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 08/27/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Oral health is crucial for caries prevention. Research reported variations in oral health practices among countries and individuals. Therefore, this study aims to examine and compare oral hygiene practices among children aged 3 to 11 years old across five areas of Saudi Arabia. METHODS This cross-sectional study includes healthy children aged 3 to 11 from five areas/regions of Saudi Arabia. A self-administered, validated parental questionnaire was constructed according to the WHO Oral Health Questionnaire for children, which inquires about the child's socio-demographic factors, oral health evaluation, and oral hygiene practice. RESULTS Out of the 1516 parents who participated, 21.2% reported their children brushing twice a day. Regression analysis found that the first-born children and those who visited a dentist displayed a significantly higher adjusted odds ratio (AOR) for parents reporting that their child practices oral health care compared to only children (AOR: 2.837; P = 0.016) and to those who did not visit a dentist in the last 12 months (AOR: 2.989; P < 0.001). CONCLUSION This study highlights that only 21.2% of parents reported their children practicing excellent oral hygiene by brushing twice a day. This underscores the importance of early dental visits, customized interventions, and prevention programs that account for regional and demographic factors, such as birth order, to effectively promote oral health.
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Affiliation(s)
- Heba Jafar Sabbagh
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box: 80200, Jeddah, 21589, Saudi Arabia.
| | - Ibtesam Omar Alzain
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, P.O. Box: 80200, Jeddah, 21589, Saudi Arabia
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Gunay B, Kaya MS, Ozgen IT, Guler EM, Kocyigit A. Evaluation of the relationship between pain inflammation due to dental caries and growth parameters in preschool children. Clin Oral Investig 2023:10.1007/s00784-023-04988-2. [PMID: 37036512 PMCID: PMC10088690 DOI: 10.1007/s00784-023-04988-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 03/28/2023] [Indexed: 04/11/2023]
Abstract
OBJECTIVES To evaluate the relationship between pain inflammation due to dental caries and growth parameters, sleep disturbances, and oral health-related quality of life (OHRQoL) in preschool children before/after dental treatment and compare the results with the control group. MATERIALS AND METHODS Study (pain inflammation due to caries) and control groups were included in this prospective clinical trial. The Child Sleep Habits Questionnaire (CSHQ) assessing sleep disturbances and the Early Childhood Oral Health Impact Scale (ECOHIS) assessing OHRQoL were applied in the corresponding time intervals to the study and control groups, respectively: baseline (T0study), 7 days after treatment (T1study), and following 6 months (T2study); baseline (T0control), and the following 6 months (T2control). Biochemical growth parameters (insulin-like growth factor-1 and insulin-like growth factor binding protein-3) and anthropometric measurements (standard deviation score of height, weight, and body mass index) were obtained at T0study, T2study, and T0control. Mann-Whitney U and the Student t-tests were used for statistical analyses. The significance level was set at p < 0.05. RESULTS Data on 45 children (mean age: 55.6 ± 10.37 months) were analyzed. T2study was statistically higher than T0study for the anthropometric measurements and biochemical growth parameters (p < 0.05). T0study was statistically higher than T0control for biochemical growth parameters (p < 0.05). CSHQ and ECOHIS scores were found statistically significant at T0study than T0control (p < 0.05). Statistical scores of CSHQ and ECOHIS in T2study were significantly reduced compared to T0study (p < 0.05). CONCLUSION Children's growth parameters, sleep disturbances, and OHRQoL improved after the elimination of pain and inflammation. CLINICAL RELEVANCE This study's novelty is the observation of drastically increased growth parameters and reduced sleep disturbances following dental treatment.
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Affiliation(s)
- Basak Gunay
- Department of Pedodontics, School of Dentistry, Bezmialem Vakif University, 34093, Istanbul, Turkey.
| | - Mustafa Sarp Kaya
- Department of Pedodontics, School of Dentistry, Bezmialem Vakif University, 34093, Istanbul, Turkey
| | - Ilker Tolga Ozgen
- Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Eray Metin Guler
- Department of Medical Biochemistry, Hamidiye School of Medicine, University of Health Sciences Turkey, Istanbul, Turkey
- Department of Medical Biochemistry, Haydarpasa Numune Health Application and Research Center, Hamidiye Faculty of Medicine, University of Health Sciences Turkey, Istanbul, Turkey
| | - Abdurrahim Kocyigit
- Department of Clinical Biochemistry, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
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Mishu MP, Tsakos G, Heilmann A, Watt RG. The role of oral health-related quality of life in the association between dental caries and height, weight and BMI among children in Bangladesh. Community Dent Oral Epidemiol 2022; 50:529-538. [PMID: 34837423 DOI: 10.1111/cdoe.12707] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES To examine whether oral health-related quality of life (OHRQoL) explained the negative associations between dental caries and anthropometric measures of child growth among a sample of 5- to 9-year-old children in Dhaka, Bangladesh, while taking potential confounding factors (maternal education, family income, study setting, child's birth weight and childhood diseases) into account. In addition, to test whether specific oral impacts had a role in explaining these associations. METHODS Data collection was conducted via a cross-sectional survey among children and their parents from both hospital and school settings in Dhaka. Dental caries and severe consequences of dental caries (defined here as dental sepsis) were the exposure variables, and age- and sex-adjusted height-z-scores (HAZ), weight-z-scores (WAZ) and BMI-z-scores (BAZ) were the outcome variables. OHRQoL was measured using the Bengali version of the Scale of Oral Health Outcomes for 5-year-old children (SOHO-5). First, associations between oral impacts (prevalence of overall impacts and specific items of the SOHO-5) and outcome measures were assessed. Multiple linear regression was used to assess associations between caries and anthropometric measures, adjusted for potential confounders. Oral impacts were then added to test whether their inclusion attenuated the associations between exposures and outcomes. To further investigate potential mediating role of oral impacts, structural equation modelling (SEM) was used to test the hypothesis that dental caries and sepsis were associated with the outcomes directly and also indirectly via oral impacts in general. A similar approach was used to investigate mediation by specific SOHO-5 items. RESULTS The sample consisted of 715 children, 73.1% of whom had dental caries, 37.5% presented with sepsis, and 57.3% reported at least one oral impact (SOHO-5 score ≥1). Prevalence of overall oral impacts and also the impact on 'eating difficulty' (a specific item of SOHO-5) were negatively associated with all three outcomes. Dental caries and sepsis was associated with lower HAZ, WAZ and BAZ, and adjustment for overall oral impacts considerably attenuated the associations between 'severe dental caries' and outcomes, and dental sepsis and outcomes. Using SEM, we found significant indirect associations between caries and sepsis and anthropometric measures via oral impacts (except for dental caries and HAZ). Considering specific oral impacts, eating difficulties explained about 44% and 65% of the associations between caries and anthropometric outcomes, and dental sepsis and anthropometric outcomes, respectively. CONCLUSIONS Oral impacts, in particular eating difficulties, appear to mediate associations between caries and markers of child growth among this population.
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Affiliation(s)
- Masuma Pervin Mishu
- Department of Health Sciences, Faculty of Sciences, University of York, Heslington, UK
| | - Georgios Tsakos
- Research Department of Epidemiology and Public Health, University College London (UCL), London, UK
| | - Anja Heilmann
- Research Department of Epidemiology and Public Health, University College London (UCL), London, UK
| | - Richard G Watt
- Research Department of Epidemiology and Public Health, University College London (UCL), London, UK
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Association of Dental Caries and Anthropometric Measures among Primary School Children. CHILDREN-BASEL 2021; 8:children8030223. [PMID: 33805733 PMCID: PMC8001750 DOI: 10.3390/children8030223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 11/24/2022]
Abstract
Aim: This study aimed to investigate an association between dental caries status and anthropometric measures in primary school children. Methods and Materials: An analytical cross-sectional study (n = 376) was conducted among primary school children (age range = 6–9 years) registered in private schools. Non-clinical data was gathered from parents of participating children through a self-administered structured questionnaire as well as from the children through an interviewer-administered questionnaire. Clinical data included the examination of dental caries using dmft/DMFT index and anthropometric measures including calculated z-scores of height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BAZ), and physical examination. Inferential statistics included Kruskal Wallis and linear regression for univariate and multivariate analysis respectively. Results: The proportion of dental caries in primary and secondary dentition was 67.6% and 8.2% respectively. A significant association was observed between dental caries status and HAZ, WAZ, and BAZ (p < 0.001). An inverse relation was found between low, medium, and high dental caries categories and anthropometric measures. Conclusions: In the primary dentition, dental caries were significantly and inversely related to weight-for-age, height-for-age, and BMI-for-age. Hence, it can be concluded that among the low-income population dental caries is associated with lower anthropometric outcomes in children and therefore caries management should be considered an approach impacting overall health and quality of life.
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Barbosa MCF, Reis CLB, Lopes CMCF, Madalena IR, Küchler EC, Baratto-Filho F, Storrer CLM, Lima DC, Oliveira DSB. Assessing the Association Between Nutritional Status, Caries, and Gingivitis in Schoolchildren: A Cross-Sectional Study. Glob Pediatr Health 2021; 8:2333794X211001237. [PMID: 33786340 PMCID: PMC7961701 DOI: 10.1177/2333794x211001237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 02/10/2021] [Accepted: 02/11/2021] [Indexed: 12/12/2022] Open
Abstract
Objective. To evaluate if nutritional status is associated with caries and gingivitis in Brazilian schoolchildren. Material and methods. Children of both genders, age ranging from 8 to 11 years old, were included in this study. Caries was diagnosed using ICDAS (International System for Detection and Assessment of Carious Lesions) and gingivitis was diagnosed using the Community Periodontal Index. The nutritional status of each child was defined by BMI Z-score calculation. Data on oral health behavior and dietary habit were collected through parent's questionnaires. Parametric analyzes were performed to compare the groups. The established alpha was 5%. Results. The sample consisted of 353 schoolchildren: 16 underweight children, 247 eutrophic children, 64 overweight children, and 26 were obese children. Overweight, Obese and Overweight + Obese children presented less cavitated caries lesion than Eutrophic children (P < .05). Gingivitis was not associated with nutritional status (P > .05). Conclusion. Caries was associated with overweight and obesity in Brazilian schoolchildren.
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Biscaglia L, di Caccamo P, Terrenato I, Arrica MA, Seita A, Campus G. Oral health status and caries trend among 12-year old Palestine refugee students: results from the UNRWA's oral health surveys 2011 and 2016. BMC Oral Health 2019; 19:157. [PMID: 31319840 PMCID: PMC6639937 DOI: 10.1186/s12903-019-0844-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 07/01/2019] [Indexed: 11/24/2022] Open
Abstract
Background In 2016 the United Nation Relief and Work Agency for Palestine refugees in the Near East (UNRWA) commissioned a survey on oral health among 12-year-old students at UNRWA schools in five fields of operation (Jordan, Lebanon, Syria, Gaza Strip and West Bank), following World Health Organization guidelines. The survey aimed to determine the prevalence of dental caries and periodontal diseases among Palestine students attending UNRWA schools and how this has changed over time. Methods A two-stage stratified cluster sample design was used. For each Field of operation, the sample size was calculated based on 95% confidence level, 80% power and margin of error of 4%. Clinical examination was carried out by trained Field Oral Health services Officers (FOHSOs) from the 5 fields. Teeth presence and condition, gingival bleeding and calculus and the presence of dental sealants in occlusal surfaces of permanent molars were recorded. Behavior information of students/parents were collected using a questionnaire that was self-completed by the child/parent under supervision. Results were compared with those from a previous survey carried out in 2011 with the same methodology. Results In the two surveys the distributions of students who had caries experience in their permanent teeth were similar (73.1% in 2011 vs 72.8% in 2016, p = 0.83). In 2016 a significant increase of missing teeth (p < 0.01) and sealants (p < 0.01) was observed. Both surveys have identified behavioral determinants for dental caries, particularly dietary habits such as soft drinks consumption. Gingival health also showed statistical differences among the fields. Conclusions The prevalence of caries experience was very high in all fields and, with regard to main oral health indices, no trend of improvement was observed through 2011 and 2016. Surveys’ results advocates the need of a large-scale integrated preventive approach toward oral health and the emerging growth of Noncommunicable Diseases (NCDs), in line with the WHO recommendations.
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Affiliation(s)
- Lilia Biscaglia
- COI Cooperazione Odontoiatrica Internazionale NGO, Turin, Italy
| | | | - Irene Terrenato
- Biostatistics and Bioinformatic Unit- Scientific Direction, IRCCS - Regina Elena National Cancer Institute, Rome, Italy
| | - Maria Antonietta Arrica
- Department of Surgery, Medicine and Experimental Sciences, School of Dentistry, University of Sassari, Sassari, Italy
| | - Akihiro Seita
- Department of Health, UNRWA Headquarters Amman, Amman, Jordan
| | - Guglielmo Campus
- Biostatistics and Bioinformatic Unit- Scientific Direction, IRCCS - Regina Elena National Cancer Institute, Rome, Italy. .,Klinik für Zahnerhaltung, Präventiv- und Kinderzahnmedizin Zahnmedizinische Kliniken (ZMK), University of Bern, Freiburgstrasse 7, Bern, Switzerland.
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Paisi M, Kay E, Bennett C, Kaimi I, Witton R, Nelder R, Lapthorne D. Body mass index and dental caries in young people: a systematic review. BMC Pediatr 2019; 19:122. [PMID: 31014292 PMCID: PMC6480798 DOI: 10.1186/s12887-019-1511-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 04/12/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity and caries in young people are issues of public health concern. Even though research into the relationship between the two conditions has been conducted for many years, to date the results remain equivocal. The aim of this paper was to determine the nature of the relationship between Body Mass Index (BMI) and caries in children and adolescents, by conducting a systematic review of the published literature. METHODS A systematic search of studies examining the association between BMI and caries in individuals younger than 18 years old was conducted. The electronic bibliographic databases PubMed, MEDLINE, Embase, CINAHL, CENTRAL and Google Scholar were searched. References of included studies were checked to identify further potential studies. Internal and external validity as well as reporting quality were assessed using the validated Methodological Evaluation of Observational Research checklist. Results were stratified based on the risk of flaws in 14 domains 10 of which were considered major and four minor. RESULTS Of the 4208 initially identified studies, 84 papers met the inclusion criteria and were included in the review; conclusions were mainly drawn from 7 studies at lower risk of flaws. Three main types of association between BMI and caries were found: 26 studies showed a positive relationship, 19 showed a negative association, and 43 found no association between the variables of interest. Some studies showed more than one pattern of association. Assessment of confounders was the domain most commonly found to be flawed, followed by sampling and research specific bias. Among the seven studies which were found to be at lower risk of being flawed, five found no association between BMI and caries and two showed a positive association between these two variables. CONCLUSIONS Evidence of an association between BMI and caries was inconsistent. Based on the studies with a low risk lower risk of being flawed, a positive association between the variables of interest was found mainly in older children. In younger children, the evidence was equivocal. Longitudinal studies examining the association between different indicators of obesity and caries over the life course will help shed light in their complex relationship.
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Affiliation(s)
- Martha Paisi
- Faculty of Medicine and Dentistry, University of Plymouth, Peninsula Dental School, room C507, Portland Square, Plymouth, Plymouth, Devon PL4 8AA UK
| | - Elizabeth Kay
- Faculty of Medicine and Dentistry, University of Plymouth, Peninsula Dental School, room C507, Portland Square, Plymouth, Plymouth, Devon PL4 8AA UK
| | - Cathy Bennett
- Office of Research and Innovation, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Irene Kaimi
- School of Computing, Electronics and Mathematics, Plymouth University, Plymouth, PL4 8AA UK
| | - Robert Witton
- Faculty of Medicine and Dentistry, University of Plymouth, Peninsula Dental School, room C507, Portland Square, Plymouth, Plymouth, Devon PL4 8AA UK
| | - Robert Nelder
- Office of the Director of Public Health, Plymouth City Council, Plymouth, PL6 5UF UK
| | - Debra Lapthorne
- Public Health England, South West, Follaton House, Plymouth Road, Totnes, Devon TQ9 5NE UK
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Eichner FA, Groenwold RHH, Grobbee DE, Oude Rengerink K. Systematic review showed that stepped-wedge cluster randomized trials often did not reach their planned sample size. J Clin Epidemiol 2018; 107:89-100. [PMID: 30458261 DOI: 10.1016/j.jclinepi.2018.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/15/2018] [Accepted: 11/14/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To determine how often stepped-wedge cluster randomized controlled trials reach their planned sample size, and what reasons are reported for choosing a stepped-wedge trial design. STUDY DESIGN AND SETTING We conducted a PubMed literature search (period 2012 to 2017) and included articles describing the results of a stepped-wedge cluster randomized trial. We calculated the percentage of studies reaching their prespecified number of participants and clusters, and we summarized the reasons for choosing the stepped-wedge trial design as well as difficulties during enrollment. RESULTS Forty-six individual stepped-wedge studies from a total of 53 articles were included in our review. Of the 35 studies, for which recruitment rate could be calculated, 69% recruited their planned number of participants, with 80% having recruited the planned number of clusters. Ethical reasons were the most common motivation for choosing the stepped-wedge trial design. Most important difficulties during study conduct were dropout of clusters and delayed implementation of the intervention. CONCLUSION About half of recently published stepped-wedge trials reached their planned sample size indicating that recruitment is also a major problem in these trials. Still, the stepped-wedge trial design can yield practical, ethical, and methodological advantages.
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Affiliation(s)
- Felizitas A Eichner
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
| | - Rolf H H Groenwold
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Diederick E Grobbee
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Katrien Oude Rengerink
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Dimaisip-Nabuab J, Duijster D, Benzian H, Heinrich-Weltzien R, Homsavath A, Monse B, Sithan H, Stauf N, Susilawati S, Kromeyer-Hauschild K. Nutritional status, dental caries and tooth eruption in children: a longitudinal study in Cambodia, Indonesia and Lao PDR. BMC Pediatr 2018; 18:300. [PMID: 30217185 PMCID: PMC6137874 DOI: 10.1186/s12887-018-1277-6] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 09/05/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Untreated dental caries is reported to affect children's nutritional status and growth, yet evidence on this relationship is conflicting. The aim of this study was to assess the association between dental caries in both the primary and permanent dentition and nutritional status (including underweight, normal weight, overweight and stunting) in children from Cambodia, Indonesia and Lao PDR over a period of 2 years. A second objective was to assess whether nutritional status affects the eruption of permanent teeth. METHODS Data were used from the Fit for School - Health Outcome Study: a cohort study with a follow-up period of 2 years, consisting of children from 82 elementary schools in Cambodia, Indonesia and Lao PDR. From each school, a random sample of six to seven-year-old children was selected. Dental caries and odontogenic infections were assessed using the World Health Organization (WHO) criteria and the pufa-index. Weight and height measurements were converted to BMI-for-age and height-for-age z-scores and categorized into weight status and stunting following WHO standardised procedures. Cross-sectional and longitudinal associations were analysed using the Kruskal Wallis test, Mann Whitney U-test and multivariate logistic and linear regression. RESULTS Data of 1499 children (mean age at baseline = 6.7 years) were analyzed. Levels of dental caries and odontogenic infections in the primary dentition were significantly highest in underweight children, as well as in stunted children, and lowest in overweight children. Dental caries in six to seven-year old children was also significantly associated with increased odds of being underweight and stunted 2 years later. These associations were not consistently found for dental caries and odontogenic infections in the permanent dentition. Underweight and stunting was significantly associated with a lower number of erupted permanent teeth in children at the age of six to seven-years-old and 2 years later. CONCLUSIONS Underweight and stunted growth are associated with untreated dental caries and a delayed eruption of permanent teeth in children from Cambodia, Indonesia and Lao PDR. Findings suggest that oral health may play an important role in children's growth and general development. TRIAL REGISTRATION The study was restrospectively registered with the German Clinical Trials Register, University of Freiburg (trial registration number: DRKS00004485 ; date of registration: 26th of February, 2013).
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Affiliation(s)
- Jed Dimaisip-Nabuab
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), L.P. Leviste corner Rufino Street, Makati City, Metro Manila, Philippines.,Department of Epidemiology and Biostatistics, College of Public Health, University of the Philippines, 625 Pedro Gil St, Ermita, Manila, Philippines
| | - Denise Duijster
- Department of Social Dentistry, Academic Centre for Dentistry Amsterdam, Gustav Mahlerlaan 3004, 1081LA, Amsterdam, The Netherlands. .,Department of Epidemiology and Public Health, University College London, Torrington Place 1-19, London, WC1E 6BT, UK.
| | - Habib Benzian
- Department of Epidemiology and Health Promotion, WHO Collaborating Center for Quality Improvement and Evidence-based Dentistry, College of Dentistry, New York University, 433 First Avenue, New York, NY, 10010, USA
| | - Roswitha Heinrich-Weltzien
- Department of Preventive Dentistry and Pediatric Dentistry, University Hospital Jena, Friedrich Schiller University Jena, Bachstraße 18, 07743, Jena, Germany
| | - Amphayvan Homsavath
- Faculty of Dentistry, University of Health Sciences Ministry of Health, 7444 Mahosot Rd, Vientiane, Lao People's Democratic Republic
| | - Bella Monse
- Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), L.P. Leviste corner Rufino Street, Makati City, Metro Manila, Philippines
| | - Hak Sithan
- Department of Preventive Medicine, Ministry of Health, 151-153 Kampuchea Krom Avenue, Phnom Penh, Cambodia
| | - Nicole Stauf
- The Health Bureau Ltd., Whiteleaf Business Center, 11 Little Balmer, Buckingham, MK18 1TF, UK
| | - Sri Susilawati
- Department of Dental Public Health, Faculty of Dentistry, Padjadjaran University, Sekelda Selatan I, Bandung, Indonesia
| | - Katrin Kromeyer-Hauschild
- Institute of Human Genetics, University Hospital Jena, Friedrich Schiller University Jena, Am Klinikum 1, 07740, Jena, Germany
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Vendrame É, Goulart MDA, Hilgert JB, Hugo FN, Celeste RK. Decomposing early and adult life social position effects on oral health and chronic diseases in a cross-sectional study of Southern Brazil. Community Dent Oral Epidemiol 2018; 46:601-607. [DOI: 10.1111/cdoe.12410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Accepted: 07/05/2018] [Indexed: 12/27/2022]
Affiliation(s)
- Édina Vendrame
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Mariél de Aquino Goulart
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Juliana B. Hilgert
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Graduate Program in Epidemiology; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Fernando N. Hugo
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Research Center in Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Roger Keller Celeste
- Graduate Program in Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
- Department of Preventive and Social Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
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Dietary diversity and nutritional adequacy of under-fives in a fishing community in the central region of Ghana. BMC Nutr 2017. [DOI: 10.1186/s40795-016-0120-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
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Barker D, McElduff P, D'Este C, Campbell MJ. Stepped wedge cluster randomised trials: a review of the statistical methodology used and available. BMC Med Res Methodol 2016; 16:69. [PMID: 27267471 PMCID: PMC4895892 DOI: 10.1186/s12874-016-0176-5] [Citation(s) in RCA: 100] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 05/28/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous reviews have focussed on the rationale for employing the stepped wedge design (SWD), the areas of research to which the design has been applied and the general characteristics of the design. However these did not focus on the statistical methods nor addressed the appropriateness of sample size methods used.This was a review of the literature of the statistical methodology used in stepped wedge cluster randomised trials. METHODS Literature Review. The Medline, Embase, PsycINFO, CINAHL and Cochrane databases were searched for methodological guides and RCTs which employed the stepped wedge design. RESULTS This review identified 102 trials which employed the stepped wedge design compared to 37 from the most recent review by Beard et al. 2015. Forty six trials were cohort designs and 45 % (n = 46) had fewer than 10 clusters. Of the 42 articles discussing the design methodology 10 covered analysis and seven covered sample size. For cohort stepped wedge designs there was only one paper considering analysis and one considering sample size methods. Most trials employed either a GEE or mixed model approach to analysis (n = 77) but only 22 trials (22 %) estimated sample size in a way which accounted for the stepped wedge design that was subsequently used. CONCLUSIONS Many studies which employ the stepped wedge design have few clusters but use methods of analysis which may require more clusters for unbiased and efficient intervention effect estimates. There is the need for research on the minimum number of clusters required for both types of stepped wedge design. Researchers should distinguish in the sample size calculation between cohort and cross sectional stepped wedge designs. Further research is needed on the effect of adjusting for the potential confounding of time on the study power.
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Affiliation(s)
- D Barker
- School of Medicine and Public Health, Faculty of Health, CCEB, HMRI Building, Level 4 West, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
| | - P McElduff
- School of Medicine and Public Health, Faculty of Health, CCEB, HMRI Building, Level 4 West, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia
| | - C D'Este
- School of Medicine and Public Health, Faculty of Health, CCEB, HMRI Building, Level 4 West, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.,National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, 0200, Australia
| | - M J Campbell
- Medical Statistics Group, ScHARR, University of Sheffield, Sheffield, UK
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Grund K, Goddon I, Schüler IM, Lehmann T, Heinrich-Weltzien R. Clinical consequences of untreated dental caries in German 5- and 8-year-olds. BMC Oral Health 2015; 15:140. [PMID: 26538196 PMCID: PMC4634920 DOI: 10.1186/s12903-015-0121-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 10/19/2015] [Indexed: 11/10/2022] Open
Abstract
Background About half of all carious lesions in primary teeth of German 6- to 7-year-old children remain untreated, but no data regarding the clinical consequences of untreated dental caries are available. Therefore, this cross-sectional observational study aimed to assess the prevalence and experience of caries and odontogenic infections in the primary dentition of 5- and 8-year-old German children. Methods Dental examinations were performed in 5-year-old pre-school children (n = 496) and in 8-year-old primary school children (n = 608) living in the Westphalian Ennepe-Ruhr district. Schools and preschools were selected by sociodemographic criteria including size, area, ownership, socio-economic status. Caries was recorded according to WHO criteria (1997). The Lorenz curves were used to display the polarisation of dental caries. Caries pattern in 5-year-olds was categorized by Wyne’s (1997) definition of early childhood caries (ECC). Odontogenic infections as clinical consequence of untreated dental caries were assessed by the pufa index. The ‘untreated caries-pufa ratio’ was calculated, and the Spearman’s rank correlation coefficient (ρ) was used for evaluating the correlation between dmft and pufa scores. Categorical data were compared between groups using the chi-square test and continuous data were analysed by t-test. Results Caries prevalence and experience in the primary dentition was 26.2 %/0.9 ± 2.0 dmft in 5-year-olds and 48.8 %/2.1 ± 2.8 dmft in 8-year-olds. ECC type I (22 %) was the prevalent caries pattern in 5-year-olds. About 30 % of the tooth decay was treated (5y: 29.7 %/8y: 39.3 %). The Lorenz curves showed a strong caries polarisation on 20 % of the children. Pufa prevalence and experience was 4.4 %/0.1 ± 0.5 pufa in 5-year-olds and 16.6 %/0.3 ± 0.9 pufa in 8-year-olds. In 5-year-olds 14.2 % and in 8-year-olds 34.2 % of the d-component had progressed mainly to the pulp. A significant correlation between dmft and pufa scores exists in both age groups (5y: ρ = 0.399; 8y: ρ = 0.499). First deciduous molars were most frequently affected by odontogenic infections, presenting virtually all pufa scores (>95 %). Conclusions Prevalence and experience of odontogenic infections and the untreated caries-pufa ratio were increasing from the younger to the elder children. Dmft and pufa scores in primary teeth predict a higher caries risk in permanent teeth. The pufa index highlights relevant information for decision makers to develop effective oral health care programs for children at high risk for caries.
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Affiliation(s)
- Katrin Grund
- Department of Preventive and Paediatric Dentistry, Jena University Hospital, Bachstr. 18, D-07743, Jena, Germany.
| | - Inka Goddon
- Department of Social Services and Health, Health Services for Children and Adolescents Schwelm, Hauptstr. 92, D-58332, Schwelm, Germany.
| | - Ina M Schüler
- Department of Preventive and Paediatric Dentistry, Jena University Hospital, Bachstr. 18, D-07743, Jena, Germany.
| | - Thomas Lehmann
- Department of Medical Statistics and Epidemiology, Jena University Hospital, Bachstr. 18, D-07743, Jena, Germany.
| | - Roswitha Heinrich-Weltzien
- Department of Preventive and Paediatric Dentistry, Jena University Hospital, Bachstr. 18, D-07743, Jena, Germany.
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Khanh LN, Ivey SL, Sokal-Gutierrez K, Barkan H, Ngo KM, Hoang HT, Vuong I, Thai N. Early Childhood Caries, Mouth Pain, and Nutritional Threats in Vietnam. Am J Public Health 2015; 105:2510-7. [PMID: 26469655 DOI: 10.2105/ajph.2015.302798] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We investigated the relationships among early childhood caries (ECC), mouth pain, and nutritional status in children aged 1 to 6 years in Southern and Central Vietnam. METHODS A total of 593 parent-child pairs were recruited from 5 kindergartens or preschools in Ho-Chi Minh City and Da Nang. Parents completed surveys about dietary habits, oral health practices, and children's mouth pain experience; children received anthropometric assessment and dental examinations. RESULTS There was a high prevalence of dental caries (74.4%), mostly untreated, and mouth pain (47.1%). Moderate correlations were found between parents' and children's consumption of soda (ρ = 0.361; P < .001) and salty snacks (ρ = 0.292; P < .001). Severity of ECC was associated with decreased weight- and body mass index-for-age z-scores. Presence of pulp-involved caries was associated with strikingly lower height-for-age (mean difference = 0.66; P = .001), weight-for-age (mean difference = 1.17; P < .001), and body mass index-for-age (mean difference = 1.18; P < .001) z-scores. Mouth pain was associated with lower body mass index-for-age z-scores (mean difference = 0.29; P = .013). CONCLUSIONS ECC might negatively affect children's nutritional status, which might be mediated by the depth of decay, chronic inflammation, and mouth pain. Family-based and prevention-oriented nutrition and oral health programs are needed and should start during pregnancy and infancy.
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Affiliation(s)
- Linh Ngo Khanh
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Susan L Ivey
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Karen Sokal-Gutierrez
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Howard Barkan
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Kimberly M Ngo
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Hung T Hoang
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Ivy Vuong
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - Nam Thai
- Linh Ngo Khanh, Susan L. Ivey, Karen Sokal-Gutierrez, Howard Barkan, Kimberly M. Ngo, Ivy Vuong, and Nam Thai are with Health Research for Action, University of California, Berkeley School of Public Health. Hung T. Hoang is with University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
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Baghdadi ZD. Children's oral health-related quality of life and associated factors: Mid-term changes after dental treatment under general anesthesia. J Clin Exp Dent 2015; 7:e106-13. [PMID: 25810820 PMCID: PMC4367996 DOI: 10.4317/jced.51906] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 10/09/2014] [Indexed: 11/08/2022] Open
Abstract
Objectives: This study aimed to document the mid-term effects of comprehensive dental treatment under general anesthesia (DTGA) on parent-assessed children’s oral health-related quality of life (COHRQoL). A second aim was to examine some epidemiological factors associated with COHRQoL and treatment outcome.
Study Design: A pretest-posttest design was followed in which parents were surveyed using the Child Oral Health Quality of Life Questionnaire before and 6-9 months after their children (age ranges 3-10 years) underwent DTGA. Some clinical conditions and epidemiological factors were examined to assess their association with COHRQoL and changes resulting from treatment.
Results: The clinical sample consisted of 80 children-parent dyads. The effect sizes of change following DTGA were large for both the child impact section and family impact section of the COHRQoL. COHRQoL scores after treatment were comparable or lower than those of a cross-matched group of children with no complaints related to oral health. Child’s age, pain and number of teeth with pulpal involvement showed significant association with both pretreatment scores and change scores.
Conclusions: Children’s OHRQoL improved after DTGA as assessed by parents 6-9 months postoperatively. Child’s age, pain and number of pulpally-involved teeth can be used as predictors for COHRQoL and change scores.
Key words:Quality of life, children, oral health, reliability.
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Affiliation(s)
- Ziad D Baghdadi
- DDS, PD, MS, MPH, PhD. Department of Preventive Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia ; DDS, PD, MS, MPH, PhD. Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada S7N 5E5
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Oral Health Over the Life Course. A LIFE COURSE PERSPECTIVE ON HEALTH TRAJECTORIES AND TRANSITIONS 2015. [DOI: 10.1007/978-3-319-20484-0_3] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Baghdadi ZD, Muhajarine N. Effects of Dental Rehabilitation under General Anesthesia on Children's Oral-Health-Related Quality of Life: Saudi Arabian Parents' Perspectives. Dent J (Basel) 2014; 3:1-13. [PMID: 29567920 PMCID: PMC5851165 DOI: 10.3390/dj3010001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 12/16/2014] [Indexed: 11/16/2022] Open
Abstract
Aim: To determine whether dental treatment under general anesthesia (GA) would improve quality of life for children as reported by Saudi Arabian parents using a Parental-Caregivers Perceptions Questionnaire (P-CPQ) and a Family Impact Scale (FIS). Methods: Sixty-six parents completed P-CPQ and FIS scales four to eight weeks after their children (ages three to ten years) underwent comprehensive dental treatment under GA. Postoperative data were compared with baseline data gathered before GA using paired t-test at the 0.05 level of significance. The responsiveness of the P-CPQ and the FIS and the magnitude of changes in children’s quality of life as a result of dental treatment were determined by calculating the effect size (ES). Cross-sectional construct validity and internal consistency were also examined using the pretreatment scores of the P-CPQ and the FIS scores. Results: The overall P-CPQ and FIS scores showed a significant decrease following treatment, concomitant with large ES in both scales and all their subscales with the exception of social wellbeing, which showed moderate ES (ES 0.59). The greatest relative changes were seen in the oral symptoms (ES 1.81) and the family activity (ES 1.57) subscales. Conclusion: Dental treatment under GA is associated with considerable improvement in children’s quality of life as perceived by Saudi parents. The P-CPQ and the FIS scales are valid and responsive to changes resulting from dental treatment of young children affected by severe childhood caries.
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Affiliation(s)
- Ziad D Baghdadi
- Department of Preventive Dentistry, Riyadh Colleges of Dentistry and Pharmacy, P.O. Box 67126, Riyadh 11596, Saudi Arabia.
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada.
| | - Nazeem Muhajarine
- Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK, S7N 5E5, Canada.
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