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Mohammed Al-Dahan H, Ali Ismael S. Early childhood caries: parents' knowledge, attitude and practice towards its prevention in refugee camps in Erbil, Iraq. BMC Oral Health 2023; 23:792. [PMID: 37875915 PMCID: PMC10599036 DOI: 10.1186/s12903-023-03516-8] [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: 07/24/2023] [Accepted: 10/10/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Early childhood caries is a significant oral health issue in socially deprived communities, including refugees, where prevention plays a crucial role in minimizing the challenges and costs associated with treating early childhood caries. To improve oral health outcomes, it is important to understand parents' knowledge, attitudes, and practices. This study aims to assess the oral health knowledge, practices, and attitudes of refugee parents. METHODS This cross-sectional study included 503 parents/caregivers residing in Erbil's refugee camps in Iraq, with healthy preschool children aged one to six years. Structured questionnaire was utilized in conducting individual interviews with parents to evaluate their knowledge, attitudes, and practices. The questionnaire collected demographic information and data on access to oral health services. RESULTS A total of 503 out of 505 households actively participated in the study, resulting in a high response rate of 99.6%. Demographic analysis revealed that the majority of respondents were female parents, constituting 92.05% of the sample. Within the participant pool, the primary age groups were 26-35 years (55.3%) and 18-25 years (26.2%). Educational background analysis revealed that a significant proportion of parents had attained a secondary school education (29.6%) or primary school education (27.4%). Statistical analysis further established a noteworthy association between educational background and knowledge level. The investigation of participants' knowledge uncovered notable gaps and misconceptions pertaining to early childhood caries, with an overall mean score of 5.1. Assessing the overall attitude of parents, a mean score of 3.87 (SD = 1.29) suggested a generally unfavorable attitude towards oral hygiene practices and prevention of early childhood caries. In terms of actual practices, parents demonstrated a mean practice score of 5.7. CONCLUSIONS This study emphasizes knowledge gaps and misconceptions among parents in refugee camps regarding early childhood caries in preschool children. Findings revealed low knowledge scores, limited understanding of hidden sugars, delayed oral hygiene practices, and limited knowledge about fluoride.
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Affiliation(s)
| | - Sherzad Ali Ismael
- Public Health Faculty, Kurdistan Board of Medical Specialties, Runaki, Erbil, Iraq.
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Fenning RM, Butter EM, Norris M, Chan J, Macklin EA, McKinnon-Bermingham K, Albright C, Stephenson KG, Scherr J, Moffitt J, Hess A, Steinberg-Epstein R, Kuhlthau KA. Optimizing Parent Training to Improve Oral Health Behavior and Outcomes in Underserved Children with Autism Spectrum Disorder. J Autism Dev Disord 2023; 53:3683-3699. [PMID: 35831693 DOI: 10.1007/s10803-022-05660-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2022] [Indexed: 10/17/2022]
Abstract
A randomized controlled trial established initial efficacy of a novel parent training (PT) intervention for improving oral hygiene and oral health in underserved children with ASD (Fenning et al., 2022), a population at risk for unmet dental needs. The present study describes our emic approach to PT development alongside treatment outcome data examining feasibility, acceptability, and engagement. Families with Medicaid-eligible children with ASD ages 3 to 13 years (85% male, 62% with intellectual disability) were assigned to receive PT (n = 60) or a psychoeducational toolkit (n = 59). Results indicate strong retention, fidelity, and adherence, with quantitative and qualitative metrics revealing high treatment satisfaction and utilization. Discussion focuses on implications for individualizing treatment to optimize engagement of underrepresented families.
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Affiliation(s)
- Rachel M Fenning
- Department of Psychological Science and Claremont Autism Center, Claremont McKenna College, 850 Columbia Avenue, Seaman Hall 235, Claremont, CA, 91711, USA.
- Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, Fullerton, CA, USA.
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA.
| | - Eric M Butter
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Megan Norris
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - James Chan
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
| | - Eric A Macklin
- Biostatistics Center, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Kelly McKinnon-Bermingham
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA
| | - Charles Albright
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Kevin G Stephenson
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jessica Scherr
- Department of Pediatrics, The Ohio State University, Columbus, OH, USA
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Jacquelyn Moffitt
- Department of Child and Adolescent Studies and Center for Autism, California State University, Fullerton, Fullerton, CA, USA
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA
| | - Amy Hess
- Child Development Center, Nationwide Children's Hospital, Columbus, OH, USA
| | - Robin Steinberg-Epstein
- The Center for Autism and Neurodevelopmental Disorders, Department of Pediatrics, University of California, Irvine, Santa Ana, CA, USA
| | - Karen A Kuhlthau
- Department of Pediatrics, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA
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Khairinisa S, Setiawati F, Maharani DA, Darwita RR. Validity of mother-child self-perceived oral health for the assessment of 5 years old children's oral health in Indonesia. BMC Oral Health 2023; 23:172. [PMID: 36966296 PMCID: PMC10039489 DOI: 10.1186/s12903-023-02876-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/13/2023] [Indexed: 03/27/2023] Open
Abstract
BACKGROUND Early childhood caries (ECC) is a serious condition that has a negative impact on young children's quality of life. Mothers' perceived need for oral health care plays an important role in their children's oral health behavior. This study aimed to compare mother and child self-perceived and dentist-evaluated needs for oral health care. METHODS This cross-sectional study included 266 preschool children aged 5 years old and their mothers. A self-administered questionnaire to the mothers and interviews with the children were used to assess the perceived needs of oral health care. The mothers were asked to rate their children's oral health and determine if they needed dental treatment. The children were also asked how they felt about their oral health and whether they had any tooth decay. Agreement between mother and child regarding the child's oral health was assessed. The evaluated needs were assessed clinically using the dmft (decayed, missing, and filled teeth [primary dentition]) and pufa (pulpal involvement, ulceration, fistula, and abscess [primary dentition]) indices. The perceived and evaluated needs were compared using spearman analysis to determine their correlations and the validity of the perceived needs compared to the clinical examination was assessed using the area under the curve (AUC), sensitivity (Sn), specificity (Sp), and likelihood ratio (LR). RESULTS The prevalence rate of ECC was 89.4%, with 35% having at least one condition from untreated caries (pufa > 0). Mothers and children have a fair agreement regarding the child's oral health (ICC = 0.335). When comparisons were conducted between perceived and evaluated conditions, Mother's rating about their child's oral health showed the strongest correlation to dmft index (r = 0.372; p < 0.001). Several accuracy parameters done in this study (AUC, Sn, and Sp) did not meet the acceptable threshold. The sensitivity and specificity were the highest when comparing mothers' perceived need for their child's dental treatment to the dmft index (Sn = 96.7%) and pufa index (Sp = 88.1%), respectively. CONCLUSION Compared to the dentist's assessment, the mother and child self-reported oral health statuses showed lower accuracy in assessing the child's condition. But, the mothers in this study were better than their 5-year-old children at perceiving their child's oral health care needs. As a result, these subjective assessments can be used as a complement, but not as a substitute, to the actual clinical evaluation.
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Affiliation(s)
- Safira Khairinisa
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - Febriana Setiawati
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - Diah Ayu Maharani
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, 10430, Jakarta, Indonesia
| | - Risqa Rina Darwita
- Department of Preventive and Public Health Dentistry, Faculty of Dentistry, Universitas Indonesia, 10430, Jakarta, Indonesia.
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Crouch E, Nelson J, Radcliff E, Merrell MA, Martin A. Safe, supportive neighborhoods: Are they associated with childhood oral health? J Public Health Dent 2023; 83:9-17. [PMID: 36257835 DOI: 10.1111/jphd.12541] [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: 02/23/2022] [Revised: 05/06/2022] [Accepted: 09/28/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE There has been limited examination of how community-level supports may influence oral health metrics among children. The purpose of our study is to examine the association between two types of community-level positive childhood experiences and oral healthcare and oral health outcomes among children ages 6 to 17 years of age. METHODS This study uses a cross-sectional data set from the 2018-2019 National Survey of Children's Health. Two oral health metrics were used: preventive dental care, measured as one or more preventive dental visits in the past 12 months, and tooth decay, measured as tooth decay or cavities in the last 12 months. To quantify living in safe, stable, equitable environments, questions on residing in a safe and supportive neighborhood were used. Descriptive statistics and bivariate analyses were used to calculate frequencies, proportions, and unadjusted associations for each variable (n = 40,290). Multivariable logistic regression models were used. RESULTS In an adjusted analysis, children who lived in a supportive neighborhood had a higher likelihood of receiving a preventive dental visit than children who did not live in a supportive neighborhood (aOR 1.41; 95% CI 1.21-1.65). Children who lived in a safe neighborhood were less likely to have tooth decay than children who did not live in a safe neighborhood (aOR 0.75; 95% CI 0.65-0.86). CONCLUSIONS The findings from this study highlight the role of social structures in tightening the safety net for oral healthcare in children.
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Affiliation(s)
- Elizabeth Crouch
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Joni Nelson
- Department of Stomatology, Division of Population Oral Health, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elizabeth Radcliff
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Melinda A Merrell
- Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Amy Martin
- Department of Stomatology, Division of Population Oral Health, Medical University of South Carolina, Charleston, South Carolina, USA
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Lopez DJ, Hegde S, Whelan M, Dashper S, Tsakos G, Singh A. Trends in social inequalities in early childhood caries using population‐based clinical data. Community Dent Oral Epidemiol 2022. [PMID: 36424707 DOI: 10.1111/cdoe.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 11/07/2022] [Accepted: 11/09/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the longitudinal trends in social inequalities in early childhood caries (ECC) using collected population-based data. METHODS Clinical data on children were routinely collected from 2008 to 2019 in Victoria, Australia. ECC prevalence and severity (dmft) were quantified according to Indigenous status, culturally and linguistically diverse (CALD) status, concession cardholder status, geographic remoteness and area deprivation. The inverse probability weighting was used to quantify social inequalities in ECC. The weighted prevalence differences, and the ratio between the weighted prevalence of ECC and mean dmft and their 95% confidence interval, were then plotted. RESULTS Absolute inequalities in ECC prevalence increased for children by 7% for CALD status and cardholder status between 2008 and 2019. Likewise, absolute inequalities in ECC severity in this time period increased by 0.6 for CALD status and by 0.4 for cardholder status. Relative inequalities in ECC increased by CALD (ratio: 1.3 to 2.0), cardholder status (1.3 to 2.0) and area deprivation (1.1 to 1.3). Relative inequalities in severity increased by CALD (1.5 to 2.8), cardholder (1.4 to 2.5) or area deprivation (1.3 to 1.5). Although children with Indigenous status experienced inequalities in ECC prevalence and severity, these did not increase on the absolute (ECC: 0.1-0.1 Severity: 1.0-0.1) or relative scale (ECC ratio: 1.3-1.3 Severity ratio: 1.6-1.1). CONCLUSIONS Trends in inequalities in ECC were different according to sociodemographic measures. Oral health policies and interventions must be evaluated on the basis of reducing the prevalence of oral diseases and oral health inequalities between population sub-groups.
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Affiliation(s)
- Diego J. Lopez
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, University of Melbourne Melbourne Victoria Australia
| | - Shalika Hegde
- Dental Health Services Victoria Melbourne Victoria Australia
| | - Martin Whelan
- Dental Health Services Victoria Melbourne Victoria Australia
| | - Stuart Dashper
- Melbourne Dental School University of Melbourne Melbourne Victoria Australia
| | - Georgios Tsakos
- Department of Epidemiology and Public Health University College London London UK
| | - Ankur Singh
- Centre for Epidemiology and Biostatistics Melbourne School of Population and Global Health, University of Melbourne Melbourne Victoria Australia
- Melbourne Dental School University of Melbourne Melbourne Victoria Australia
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Lara JS, Romano A, Murisi PU, Tedesco TK, Mendes FM, Soto-Rojas AE, Alonso C, Campus G. Impact of early childhood caries severity on oral health-related quality of life among preschool children in Mexico: A cross-sectional study. Int J Paediatr Dent 2022; 32:334-343. [PMID: 34358390 DOI: 10.1111/ipd.12889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 06/15/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Information is scarce on Early Childhood Caries (ECC) in Mexican preschool children and its impact on quality of life. AIM To evaluate the ECC prevalence and its impact on OHRQoL in 3-5 years-old Mexican children according to disease severity. DESIGN Caries was determined at two thresholds: (1) children with at least one caries lesion (ICDAS-1-6) and (2) children with at least one lesion in dentin (ICDAS-3-6). OHRQoL was assessed through the Mexican Early Childhood Oral Health Impact Scale (M-ECOHIS). Associations among caries severity, M-ECOHIS, and other variables were assessed by ordinal logistic regression. RESULTS A total of 409 children participated (53.8% girls, 46.2% boys). Caries prevalence was 82.2% considering all lesions, and 45.0% for dentinal lesions. Significant linear trends (p < .05) among caries levels and categories of exposure were found for socioeconomic variables, dietary habits, and toothbrushing habits. Attending rural private schools (OR = 1.39, 95%CI = 1.11-1.72; p < .01), two main meals/day (OR = 2.75, 95%CI = 1.26-6.03; p = .01) and unsupervised toothbrushing (OR = 3.20, 95%CI = 1.96-5.24; p < .01) increased the risk to have high caries severity levels. M-ECOHIS scores were statistically significant associated with caries levels (χ2 (4) = 175.85, p < .01; trend across groups z = 12.63 Prob > |z| < 0.01). CONCLUSIONS M-ECOHIS was significantly associated with caries severity. Type of school, age groups, parents' educational level, family income, and living conditions were correlated with caries, showing how distinctive risk indicators were associated with different caries stages.
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Affiliation(s)
- Juan Sebastian Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Ariadna Romano
- Department of Pediatric Dentistry, Dental School, Los Altos Campus, University of Guadalajara, Tepatitlan de Morelos, Mexico
| | - Pedroza Uribe Murisi
- Department of Pediatric Dentistry, Dental School, Los Altos Campus, University of Guadalajara, Tepatitlan de Morelos, Mexico
| | | | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of Sao Paulo, Sao Paulo, Brazil
| | - Armando E Soto-Rojas
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Celina Alonso
- Department of Pediatric Dentistry, Dental School, Los Altos Campus, University of Guadalajara, Tepatitlan de Morelos, Mexico
| | - Guglielmo Campus
- Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
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Imes EP, Ginnis J, Shrestha P, Simancas-Pallares MA, Divaris K. Guardian Reports of Children's Sub-optimal Oral Health Are Associated With Clinically Determined Early Childhood Caries, Unrestored Caries Lesions, and History of Toothaches. Front Public Health 2022; 9:751733. [PMID: 35004573 PMCID: PMC8739514 DOI: 10.3389/fpubh.2021.751733] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Parents'/guardians' perceptions of their children's oral health are useful proxies of their clinically determined caries status and are known to influence dental care-seeking behavior. In this study, we sought to examine (1) the social and behavioral correlates of fair/poor child oral health reported by guardians and (2) quantify the association of these reports with the prevalence of early childhood caries (ECC), unrestored caries lesions and toothaches. Methods: We used guardian-reported child oral health information (dichotomized as fair/poor vs. excellent/very good/good) obtained via a parent questionnaire that was completed for n = 7,965 participants (mean age = 52 months; range = 36-71 months) of a community-based, cross-sectional epidemiologic study of early childhood oral health in North Carolina between 2016 and 2019. Social, demographic, oral health-related behavioral data, and reports on children's history of toothaches (excluding teething) were collected in the same questionnaire. Unrestored ECC (i.e., caries lesions) was measured via clinical examinations in a subset of n = 6,328 children and was defined as the presence of one or more tooth surfaces with an ICDAS ≥ 3 caries lesion. Analyses relied on descriptive and bivariate methods, and multivariate modeling with average marginal effect (A.M.E.) estimation accounting for the clustered nature of the data. Estimates of association [prevalence ratios (PR) and adjusted marginal effects (AME) with 95% confidence intervals (CI)] were obtained via multilevel generalized linear models using Stata's svy function and accounting for the clustered nature of the data. Results: The prevalence of fair/poor oral health in this sample was 15%-it increased monotonically with children's age, was inversely associated with parents' educational attainment, and was higher among Hispanics (21%) and African Americans (15%) compared to non-Hispanic whites (11%). Brushing less than twice a day, not having a dental home, and frequently consuming sugar-containing snacks and beverages were significantly associated with worse reports (P < 0.0005). Children with fair/poor reported oral health were twice as likely to have unrestored caries lesions [prevalence ratio (PR) = 2.0; 95% confidence interval (CI) = 1.8-2.1] and 3.5 times as likely to have experienced toothaches [PR = 3.5; 95% CI = 3.1-3.9] compared to those with better reported oral health. Conclusions: Guardian reports of their children's oral health are valuable indicators of clinical and public health-important child oral health status. Those with fair/poor guardian-reported child oral health have distinguishing characteristics spanning socio-demographics, oral-health related practices, diet, and presence of a dental home.
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Affiliation(s)
- Emily P Imes
- Doctor of Dental Surgery (DSS) Curriculum, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Jeannie Ginnis
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Poojan Shrestha
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Miguel A Simancas-Pallares
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Kundabala M, Shenoy R, D'Souza V, Jain A, Suprabha B. Preventing early childhood caries through oral health promotion and a basic package for oral care: A pragmatic trial. Contemp Clin Dent 2022; 13:162-168. [PMID: 35846578 PMCID: PMC9285834 DOI: 10.4103/ccd.ccd_873_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/17/2020] [Accepted: 01/19/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction: Untreated caries in mothers is one of the common risk factors for early childhood caries (ECC). Aim: The aim of the study was to investigate the impact of an oral health promotion program on ECC. Methodology: We conducted a pragmatic trial at 12 primary health centers in a rural community of India with 311 pregnant women using fluoride toothpaste, oral health information through pamphlets, and referral to urgent dental care or atraumatic dental treatment as the test intervention. Data were collected through structured interviews at baseline and oral examination of the children at 2 years of age. Results: Of the 311 women who participated, 274 children were followed up with at 2 years of age. ECC was low and comparable in both groups. When compared with the control group, significantly, more children from the intervention group were breastfed for over 6 months of age (P = 0.012) and consumed less sugar (P < 0.001). The number of mothers’ decayed teeth (P = 0.01), children's sweet scores (P < 0.001), and the age at which brushing commenced for children (P = 0.04) increased the likelihood of tooth decay in children. Conclusion: The oral health promotion program had some beneficial effects in preventing caries in children when provided to pregnant women.
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Vasireddy D, Sathiyakumar T, Mondal S, Sur S. Socioeconomic Factors Associated With the Risk and Prevalence of Dental Caries and Dental Treatment Trends in Children: A Cross-Sectional Analysis of National Survey of Children's Health (NSCH) Data, 2016-2019. Cureus 2021; 13:e19184. [PMID: 34873524 PMCID: PMC8635037 DOI: 10.7759/cureus.19184] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction In the United States of America, early childhood caries (ECC) is the most common chronic childhood disease of early onset, with dental caries being the most prevalent chronic disease among children aged 6-19 years. Children without an established medical home, from low-income households, and who are uninsured have historically shown to be prone to dental caries and attribute to higher health care costs. Early recognition of these risk factors by a pediatrician helps prevent the development of medical and psychosocial complications in the child. Methods The cross-sectional data of the prevalence of dental caries and dental treatment trends in children and three socioeconomic risk factors, namely establishment of a medical home, household income, and child's health insurance, were accessed from the National Survey of Children's Health (NSCH) for the years 2016-2019. The association of the risk factors with the prevalence of dental caries and with the prevalence of dental treatment were analyzed using two-sample proportion tests and chi-square (χ2) tests for dichotomous categorical variables and non-dichotomous categorical variables, respectively. Standardized residuals were calculated and analyzed as well. Furthermore, the odds ratios were calculated and utilized to quantify the influence of each category on the highly associated category with having teeth decay and not receiving dental treatment under each socioeconomic risk factor. Results The results of this study revealed that the three socioeconomic factors considered have statistically significant associations with tooth decay and dental treatment. The prevalence and associative risk of tooth decay and untreated caries were the highest in the children without a medical home. Additionally, the odds of having tooth decay was >50% higher for the children from the lowest household income category (0-99% federal poverty level [FPL]) compared to those from the high household income categories (200-399% FPL and >400% FPL). Public insurance coverage was associated with the highest prevalence of dental caries and not receiving fluoride treatment. Furthermore, the likelihood of not availing dental treatment is nearly two times or more higher for the uninsured children than children having public insurance, or private insurance, or a combination of both. Conclusion Our study findings reveal that children belonging to certain socioeconomic risk categories are at a higher risk of developing dental caries and not receiving dental treatment. As a consequence, the study implies that increased support and expansion of public health insurance will benefit oral health care for the children. Pediatricians play an integral part in developing a medical home for the child by providing preventative dental care and establishing continued care through dental referrals.
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Guan M, Nada OA, Wu JJ, Sun JL, Li N, Chen LM, Dai TM. Dental Caries and Associated Factors in 3-5-Year-Old Children in Guizhou Province, China: An Epidemiological Survey (2015-2016). Front Public Health 2021; 9:747371. [PMID: 34660522 PMCID: PMC8514823 DOI: 10.3389/fpubh.2021.747371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective: This study aimed to explore the factors influencing dental caries among 3–5-year-old children in Guizhou Province and the interrelationship between these factors using structural equation modeling, while providing theoretical references to improve the prevention and control strategy. Materials and Methods: A total of 1,291 children aged 3–5 years in Guizhou Province were selected by a multistage stratified and whole group random sampling to examine the caries prevalence in whole-mouth deciduous teeth crowns, and parents were surveyed with questionnaires to analyze the caries-related factors. IBM SPSS Statistics v 23.0 software (IBM, Armonk, NY, USA) was used for statistical analysis. Results: The caries prevalence of children aged 3–5 years in Guizhou Province was 63.1%, the mean decayed-missing-filled teeth was 3.32, the caries filling rate was 0.5%, and there was no statistically significant difference between urban and rural areas and among genders in each age group; results of logistic regression analysis showed that the caries risk increased with the following factors: age, brushing frequency <2 times per day when parents did not take their children to the dentist, and with parents poor evaluation of the oral condition of their children. The higher the education of the parent, the lower the risk of children suffering from caries in deciduous teeth. Conclusions: With an overall poor situation about oral hygiene habits, oral healthcare attitude of the parents, and behavior transformation, the prevalence of dental caries in the deciduous teeth of children aged 3–5 years in Guizhou Province is high, and their caries status was severe, with more than 99% of the caries cases that were untreated. Therefore, prevention and treatment measures of caries in preschool children need strengthening through the improvement of public awareness and the enhancement of the management of oral health habits of their children.
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Affiliation(s)
- Min Guan
- Department of Conservative Dentistry and Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Ola A Nada
- Oral Biology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Juan-Juan Wu
- Department of Conservative Dentistry and Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Jiang-Ling Sun
- Department of Conservative Dentistry and Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Na Li
- Department of Medicine, Faculty of Medicine, Guizhou University, Guiyang, China
| | - Li-Ming Chen
- Department of Conservative Dentistry and Endodontics, Guiyang Stomatological Hospital, Guiyang, China
| | - Tai-Ming Dai
- Department of Conservative Dentistry and Endodontics, Guiyang Stomatological Hospital, Guiyang, China
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Association between first oral examination characteristics and dental treatment needs in privately insured children: A claims data analysis. J Am Dent Assoc 2021; 152:936-942.e1. [PMID: 34521538 DOI: 10.1016/j.adaj.2021.05.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 05/21/2021] [Accepted: 05/27/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND Early childhood caries (ECC) remains the most common, preventable infectious disease among children in the United States. Screening is recommended after the eruption of the first tooth, but it is unclear how the age at first dental examination is associated with eventual restorative treatment needs. The authors of this study sought to determine how provider type and age at first dental examination are associated longitudinally with caries experience among children in the United States. METHODS Deidentified claims data were included for 706,636 privately insured children aged 0 through 6 years as part of the nationwide IBM Watson Health Market Scan (2012-2017). The authors used Kaplan-Meier survival analysis to describe the association between the age of first visit and restorative treatment needs. RESULTS A total of 21% of this population required restorative treatment, and the average age at first dental examination was 3.6 years. A multivariable Cox proportional hazards model showed increased hazard for restorative treatment with age at first dental visit at 3 years (hazard ratio, 2.05; 95% CI, 1.97 to 2.13) and 4 years (hazard ratio, 3.99; 95% CI, 3.84 to 4.16). CONCLUSION The high proportion of children requiring restorative treatment and late age at first dental screening show needed investments in educating general dentists, medical students, and pediatricians about oral health guidelines for pediatric patients. PRACTICAL IMPLICATIONS Communicating the importance of children establishing a dental home by age 1 year to parents and health care professionals may help reduce disease burden in children younger than 6 years.
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12
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Folayan MO, Tantawi ME, Virtanen JI, Feldens CA, Rashwan M, Kemoli AM, Villena R, Al-Batayneh OB, Amalia R, Gaffar B, Mohebbi SZ, Arheiam A, Daryanavard H, Vukovic A, Schroth RJ. An ecological study on the association between universal health service coverage index, health expenditures, and early childhood caries. BMC Oral Health 2021; 21:126. [PMID: 33731081 PMCID: PMC7968322 DOI: 10.1186/s12903-021-01500-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Accepted: 03/08/2021] [Indexed: 11/11/2022] Open
Abstract
Background Universal health care (UHC) may assist families whose children are most prone to early childhood caries (ECC) in accessing dental treatment and prevention. The purpose of this study was to determine the association between UHC, health expenditure and the global prevalence of ECC. Methods Health expenditure as percentage of gross domestic product, UHC service coverage index, and the percentage of 3–5-year-old children with ECC were compared among countries with various income levels using one-way analysis of variance (ANOVA). Three linear regression models were developed, and each was adjusted for the country income level with the prevalence of ECC in 3–5-year-old children being the dependent variable. In model 1, UHC service coverage index was the independent variable whereas in model 2, the independent variable was the health expenditure as percentage of GDP. Model 3 included both independent variables together. Regression coefficients (B), 95% confidence intervals (CIs), P values, and partial eta squared (ƞ2) as measure of effect size were calculated. Results Linear regression including both independent factors revealed that health expenditure as percentage of GDP (P < 0.0001) was significantly associated with the percentage of ECC in 3–5-year-old children while UHC service coverage index was not significantly associated with the prevalence of ECC (P = 0.05). Every 1% increase in GDP allocated to health expenditure was associated with a 3.7% lower percentage of children with ECC (B = − 3.71, 95% CI: − 5.51, − 1.91). UHC service coverage index was not associated with the percentage of children with ECC (B = 0.61, 95% CI: − 0.01, 1.23). The impact of health expenditure on the prevalence of ECC was stronger than that of UHC coverage on the prevalence of ECC (ƞ2 = 0.18 vs. 0.05). Conclusions Higher expenditure on health care may be associated with lower prevalence of ECC and may be a more viable approach to reducing early childhood oral health disparities than UHC alone. The findings suggest that currently, UHC is weakly associated with lower global prevalence of ECC. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01500-8.
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Affiliation(s)
| | | | - Jorma I Virtanen
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | | | - Maher Rashwan
- Centre for Oral Bioengineering, Barts and the London, School of Medicine and Dentistry, Queen Mary University of London, Mile End Road, London, E1 4NS, UK.,Department of Conservative Dentistry, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Arthur M Kemoli
- Department of Paediatric Dentistry and Orthodontics, University of Nairobi, Nairobi, Kenya
| | - Rita Villena
- Department of Pediatric Dentistry, San Martin de Porres University, Lima, Peru
| | - Ola B Al-Batayneh
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Rosa Amalia
- Preventive and Community Dentistry Department, Faculty of Dentistry, Universitas Gadjah Mada Yogyakarta, Yogyakarta, Indonesia
| | - Balgis Gaffar
- Preventive Dental Sciences Department, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Simin Z Mohebbi
- Department of Community Oral Health, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Arheiam Arheiam
- Department of Community and Preventive Dentistry, University of Benghazi, Benghazi, Libya
| | | | - Ana Vukovic
- Department of Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Robert J Schroth
- Department of Preventive Dental Science, Dr. Gerald Niznick College of Dentistry, and Departments of Pediatrics and Child Health and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
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13
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Brännemo I, Dahllöf G, Cunha Soares F, Tsilingaridis G. Impact of an extended postnatal home visiting programme on oral health among children in a disadvantaged area of Stockholm, Sweden. Acta Paediatr 2021; 110:230-236. [PMID: 32623798 DOI: 10.1111/apa.15457] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/24/2020] [Accepted: 06/29/2020] [Indexed: 12/21/2022]
Abstract
AIM To evaluate oral health outcomes and early oral health promotion of children in a Swedish, parental support programme conducted in a collaboration between Child Health Services and Social Services. METHODS The intervention offered first-time parents six home visits from a paediatric nurse and a parental advisor with Social Services. On the fourth visit (infant age 6-8 months), parents received a toothbrush and fluoride toothpaste from non-dental staff. Twice, at child ages 18 and 36 months, a dentist used the International Caries Detection and Assessment System to record caries and conducted a structured interview with the parents on oral health habits. The intervention group (n = 72) was compared to a reference group (n = 100) from the standard child healthcare programme, which included one home visit. RESULTS Significantly, caries prevalence was lower and tooth brushing habits more consistent in the intervention group compared to the reference group in the standard child health programme. The difference was most pronounced at 18 months and had decreased at the 36-month follow-up. CONCLUSION The extended postnatal home visiting programme had a positive impact on oral health. Early oral health promotion delivered by non-dental professionals could be a beneficial approach to early caries prevention.
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Affiliation(s)
- Ida Brännemo
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Stockholm Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Göran Dahllöf
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Stockholm Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
- TkMidt–Center for Oral Health Services and Research, Mid‐Norway Trondheim Norway
| | - Fernanda Cunha Soares
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Stockholm Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
| | - Georgios Tsilingaridis
- Division of Orthodontics and Pediatric Dentistry Department of Dental Medicine Karolinska Institutet Stockholm Sweden
- Center for Pediatric Oral Health Research Stockholm Sweden
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14
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Pereira FADO, Assunção LRDS, Ferreira FM, Fraiz FC. Urgency and discontinuity of oral health care in children and adolescents. CIENCIA & SAUDE COLETIVA 2020; 25:3677-3684. [PMID: 32876268 DOI: 10.1590/1413-81232020259.33232018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/19/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to investigate the discontinuity of oral health care among children and adolescents who accessed emergency services at primary care units and urgent care units. Records were reviewed of patients aged 0 to 17 years treated in the public healthcare system in city of Curitiba, Brazil. Discontinuity was considered when elective treatment was not registered at the primary care unit within six months after urgent care. The sample was stratified based on the Municipal Human Development Index (MHDI) (≤0.799 or ≥0.800). The association between discontinuity and covariables was assessed using univariate and multivariate Poisson regression models with robust variance (α=0.05). The incidence of discontinuity was 42.2%. In the MHDI≤0.799 stratum, the risk of discontinuity was greater among children younger than five years of age and individuals who had not had a dental appointment in the previous year. In both MHDI strata, the risk of discontinuity was higher in patients who received urgent care at an urgent care unit than those treated at a primary care unit. The incidence of the discontinuity of oral health care was high and was strongly influenced by the characteristics of dental service utilization among individuals living in regions with a lower MHDI.
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Affiliation(s)
| | | | - Fernanda Morais Ferreira
- Departamento de Pediatria e Ortodontia, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fabian Calixto Fraiz
- Departamento de Estomatologia, Universidade Federal do Paraná, Curitiba, PR, Brazil,
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15
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Shen A, Bernabé E, Sabbah W. The Socioeconomic Inequality in Increment of Caries and Growth among Chinese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4234. [PMID: 32545837 PMCID: PMC7345061 DOI: 10.3390/ijerph17124234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/28/2020] [Accepted: 06/03/2020] [Indexed: 11/16/2022]
Abstract
BACKGROUND This study aimed at assessing socioeconomic inequalities in the increment of dental caries and growth among preschool Chinese children, and to assess the best predictor of socioeconomic inequality for each of these conditions. METHODS This is a longitudinal population-based study. The sample data included preschool children living in three cities of the Liaoning Province, China. At baseline, 15 kindergartens with 1111 participants were included and dropped to 772 with a response rate of 70% at follow-up. Mean ages at baseline and follow-up were 50.82 and 60.55 months, respectively. Median follow-up time was 10.12 months. Data were collected through structured questionnaire, oral examination and anthropometric measurement. The questionnaire collected information on sex, age, family income, mother's education and children's dietary habits. The numbers of decayed, missing and filled teeth (DMFT) was used to indicate dental caries. Weight- and height-for-age z-scores were calculated using the WHO Growth Standard. Multilevel analysis was used to assess the association between baseline socioeconomic position and each of dental caries and child's growth. RESULTS Mother's education was negatively associated with increments of DMFT. Family income was not significantly associated with DMFT in the fully adjusted model. The association persisted after accounting for other socioeconomic and dietary factors. Higher income was positively related to an increase in the weight-for-age z-score. The relationship between income and changes in the height-for-age z-score was positive and significant in the second highest income group. CONCLUSIONS Mother's education appeared to be the strongest predictor of increments of dental caries. Only income was significantly associated with an increase in children's weight and height.
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Affiliation(s)
- Anqi Shen
- Department of Preventive Dentistry, Beijing Stomatology Hospital, Capital Medical University, 4th Tiantanxili, Dongcheng District, Beijing 100050, China
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (E.B.); (W.S.)
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (E.B.); (W.S.)
| | - Wael Sabbah
- Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE5 9RS, UK; (E.B.); (W.S.)
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16
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Lumsden C, Andrews H, Leu CS, Edelstein B. Changes in knowledge and beliefs of community health workers following an oral health intervention training program. J Prev Interv Community 2020; 47:54-65. [PMID: 30806193 DOI: 10.1080/10852352.2018.1547309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Greater acknowledgement of the ways in which social determinants influence health has led to increased engagement of Community Health Workers (CHWs) in health promotion activities. This study sought to evaluate changes in CHW knowledge and beliefs via pre-/post-training surveys immediately following a four-day (∼20 hour) oral health intervention training and to gather CHW feedback on training. Significant increases in summary scores for 19 knowledge (t(9) = -6.715, p < .001) and four belief (t(9) = -2.994, p = .015) measures, using four-point Likert scales, were observed post-training. Feedback was overwhelmingly positive, with the majority of CHWs reporting confidence in understanding the material and study purpose. Findings support the effectiveness and acceptability of a brief training program to prepare CHWs to deliver an oral health intervention. CHWs hold promise to effectively engage populations in which the impact of interventions delivered by traditional oral healthcare team members has shown limited success.
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Affiliation(s)
- Christie Lumsden
- a Section of Population Oral Health , Columbia University College of Dental Medicine , New York , NY , USA
| | - Howard Andrews
- b Department of Neurobiology (in Psychiatry and in Biostatistics), Columbia University Medical Center , New York , NY , USA
| | - Cheng-Shiun Leu
- c Department of Biostatistics (in Psychiatry) , Columbia University Medical Center , New York , NY , USA
| | - Burton Edelstein
- d Section of Population Oral Health , Columbia University College of Dental Medicine , New York , NY , USA
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17
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Fakhruddin KS, Egusa H, Ngo HC, Panduwawala C, Pesee S, Venkatachalam T, Samaranayake LP. Silver diamine fluoride (SDF) used in childhood caries management has potent antifungal activity against oral Candida species. BMC Microbiol 2020; 20:95. [PMID: 32295517 PMCID: PMC7161255 DOI: 10.1186/s12866-020-01776-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 03/30/2020] [Indexed: 12/24/2022] Open
Abstract
Background The microbiome of Severe-Early Childhood Caries (S-ECC), is characterized by an ecosystem comprising bacterial and fungal species, with a predominance of Candida species. Hence, an anti-cariogen effective against both bacteria and fungi would be valuable in the management of S-ECC. Here we evaluate the antifungal effect of silver diamine fluoride (SDF) against 35-clinical yeast isolates (Ten-each of C. albicans, C. krusei, C. tropicalis and five C. glabrata strains) from dentinal caries-lesions from S-ECC. Results Disc-diffusion and time-kill assays as well as MIC50 and MIC90 evaluations against therapeutic concentrations confirmed the broad-spectrum anti-candidal potency of SDF. Ultrastructural images revealed morphologic aberrations of yeast-cell walls on exposure to SDF. All C. krusei and C. glabrata isolates were significantly more sensitive to SDF, relative to the standard antifungal fluconazole. Further, SDF appears to effectively abrogate filamentation of C. albicans even at very low concentrations. Conclusions Our data, for the first time, elucidate the antifungal potency of SDF, in addition to its known antibacterial activity, in the management of S-ECC.
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Affiliation(s)
- Kausar Sadia Fakhruddin
- Department of Preventive and Restorative Dentistry, University City- Sharjah, University of Sharjah, 27272, United Arab Emirates.,Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai-city, Miyagi, 980-8575, Japan
| | - Hiroshi Egusa
- Division of Molecular and Regenerative Prosthodontics, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai-city, Miyagi, 980-8575, Japan.
| | - Hien Chi Ngo
- Department of Preventive and Restorative Dentistry, University City- Sharjah, University of Sharjah, 27272, United Arab Emirates
| | - Chamila Panduwawala
- Department of Preventive and Restorative Dentistry, University City- Sharjah, University of Sharjah, 27272, United Arab Emirates
| | - Siripen Pesee
- Faculty of Dentistry, Department of Oral Diagnostic Science, Faculty of Dentistry, Thammasat University, Pathum Thani, Thailand
| | - Thenmozhi Venkatachalam
- Sharjah Institute of Medical Research, University City- Sharjah, University of Sharjah, 27272, United Arab Emirates
| | - Lakshman Perera Samaranayake
- Department of Preventive and Restorative Dentistry, University City- Sharjah, University of Sharjah, 27272, United Arab Emirates. .,The University of Hong Kong, Hong Kong, Special Administrative Region, China.
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18
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Beharry MS, Christensen R. Homelessness in Pediatric Populations: Strategies for Prevention, Assistance, and Advocacy. Pediatr Clin North Am 2020; 67:357-372. [PMID: 32122565 DOI: 10.1016/j.pcl.2019.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recent data indicate that homelessness among pediatric and adolescent populations is significantly higher than previous studies and point-in-time counts indicate. Pediatricians and other health care providers often see children and youth who are at risk of or are currently experiencing homelessness, but may not be aware of their status. This article summarizes current definitions of homelessness and data on common health issues for pediatric patients. Information on how to recognize and help those experiencing homelessness as well as areas for continued advocacy is shared.
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Affiliation(s)
- Meera S Beharry
- Adolescent Medicine, McLane Children's Medical Center, McLane Children's Specialty Clinic, Baylor Scott and White, 1901 SW H.K. Dodgen Loop, MS-CK-300, Building 300, Temple, TX 76502, USA; Texas A&M Health Science Center (Affiliate), Temple, TX, USA.
| | - Randal Christensen
- Randal Christensen Consulting, LLC, 2654 W Horizon Ridge Parkway Suite B5-113, Henderson, NV 89052, USA. https://twitter.com/AskMeWhyIHurt
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19
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Yavagal P, Velangi C, Singh I, Desai P, Sunny C. Prevalence of early childhood caries among children attending anganwadis in Davangere City: A cross sectional survey. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2020. [DOI: 10.4103/jiaphd.jiaphd_129_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Feasibility and usability of measuring receipt of sealants in 2 states. J Am Dent Assoc 2019; 150:839-845. [PMID: 31561760 DOI: 10.1016/j.adaj.2019.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 11/21/2022]
Abstract
BACKGROUND The authors examined the reliability and validity of the Dental Quality Alliance childhood sealant measure under actual use conditions in Texas and Florida. The 2 states provide care for almost 20% of children in Medicaid nationally. METHODS The authors used dental claims data to examine the reliability of the caries risk assessment component of the measure. They examined validity using a 3-year look-back period to identify children who were inaccurately included in the measure denominator as sealant eligible when they were not owing to already sealed, missing, or restored teeth. RESULTS The children identified at elevated risk varied between the states, with 85% at elevated risk in Texas and 39% in Florida in 2017. Different methods can be used to calculate risk, raising questions about reliability. In Texas, 31% of children included in the denominator were not eligible to receive sealants owing to already sealed, missing, or restored teeth. The magnitude of the underestimation increased with age, so by the time children were 9 years old, 40% were not measure eligible yet included in the denominator. Similar results were observed for Florida. CONCLUSIONS The authors propose eliminating the caries risk assessment requirement and incorporating a 3-year look-back period to identify already sealed, missing, or restored molars. PRACTICAL IMPLICATIONS The reliability and validity of the sealant measure needs to be enhanced. Measure misspecification in which children are not correctly identified as needing sealants can contribute to inaccurate development of quality improvement goals, performance improvement projects, or pay-for-quality programs.
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21
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Mosharrafian S, Shafizadeh M, Sharifi Z. Fracture Resistance of a Bulk-Fill and a Conventional Composite and the Combination of Both for Coronal Restoration of Severely Damaged Primary Anterior Teeth. Front Dent 2019; 16:69-77. [PMID: 31608339 PMCID: PMC6778610 DOI: 10.18502/fid.v16i1.1112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 08/04/2018] [Indexed: 11/24/2022] Open
Abstract
Objectives: This study aimed to compare the fracture resistance of a bulk-fill and a conventional composite and a combination of both for coronal restoration of severely damaged primary anterior teeth. Materials and Methods: In this in vitro experimental study, 45 primary anterior teeth were randomly divided into three groups. After root canal preparation, the canals were filled with Metapex paste such that after the application of 1 mm of light-cure liner, 3 mm of the coronal third of the canal remained empty for composite post fabrication. Filtek Z250 conventional composite was used in group 1, Sonic-Fill bulk-fill composite was used in group 2 and Sonic-Fill with one layer of Filtek Z250 as the veneering were used in group 3. Adper Single Bond 2 was used in all groups. The teeth were thermocycled, and fracture resistance was measured by a universal testing machine. The mode of fracture was categorized as repairable or irreparable. Data were analyzed using one-way ANOVA. Results: The mean fracture resistance was 307.00±74.72, 323.31±84.28 and 333.30±63.96 N in groups 1 to 3, respectively (P=0.55). The mean fracture strength was 14.53±2.98, 15.08±2.82 and 15.26±3.02 MPa in groups 1 to 3, respectively (P=0.77). The frequency of repairable mode of failure was 80% for the conventional, 73.6% for the bulk-fill and 80% for the bulk-fill plus conventional group, with no significant difference (P>0.05). Conclusion: Bulk-fill composites can be used for coronal reconstruction of severely damaged primary anterior teeth similar to conventional composites to decrease the treatment time in pediatric patients.
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Affiliation(s)
- Shahram Mosharrafian
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.,Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shafizadeh
- Department of Pediatric Dentistry, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Sharifi
- Department of Pediatric Dentistry, School of Dentistry, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
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22
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Ellepola K, Truong T, Liu Y, Lin Q, Lim TK, Lee YM, Cao T, Koo H, Seneviratne CJ. Multi-omics Analyses Reveal Synergistic Carbohydrate Metabolism in Streptococcus mutans-Candida albicans Mixed-Species Biofilms. Infect Immun 2019; 87:e00339-19. [PMID: 31383746 PMCID: PMC6759298 DOI: 10.1128/iai.00339-19] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/26/2019] [Indexed: 12/25/2022] Open
Abstract
Candida albicans, a major opportunistic fungal pathogen, is frequently found together with Streptococcus mutans in dental biofilms associated with severe childhood caries (tooth decay), a prevalent pediatric oral disease. However, the impact of this cross-kingdom relationship on C. albicans remains largely uncharacterized. Here, we employed a novel quantitative proteomics approach in conjunction with transcriptomic profiling to unravel molecular pathways of C. albicans when cocultured with S. mutans in mixed biofilms. RNA sequencing and iTRAQ (isobaric tags for relative and absolute quantitation)-based quantitative proteomics revealed that C. albicans genes and proteins associated with carbohydrate metabolism were significantly enhanced, including sugar transport, aerobic respiration, pyruvate breakdown, and the glyoxylate cycle. Other C. albicans genes and proteins directly and indirectly related to cell morphogenesis and cell wall components such as mannan and glucan were also upregulated, indicating enhanced fungal activity in mixed-species biofilm. Further analyses revealed that S. mutans-derived exoenzyme glucosyltransferase B (GtfB), which binds to the fungal cell surface to promote coadhesion, can break down sucrose into glucose and fructose that can be readily metabolized by C. albicans, enhancing growth and acid production. Altogether, we identified key pathways used by C. albicans in the mixed biofilm, indicating an active fungal role in the sugar metabolism and environmental acidification (key virulence traits associated with caries onset) when interacting with S. mutans, and a new cross-feeding mechanism mediated by GtfB that enhances C. albicans carbohydrate utilization. In addition, we demonstrate that comprehensive transcriptomics and quantitative proteomics can be powerful tools to study microbial contributions which remain underexplored in cross-kingdom biofilms.
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Affiliation(s)
- K Ellepola
- Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore
- Center of Oral and Craniofacial Biology, School of Dentistry, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - T Truong
- Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore
| | - Y Liu
- Biofilm Research Labs, Levy Center for Oral Health, Department of Orthodontics and Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Q Lin
- Protein and Proteomic Centre, Department of Biological Sciences, National University of Singapore, Singapore
| | - T K Lim
- Protein and Proteomic Centre, Department of Biological Sciences, National University of Singapore, Singapore
| | - Y M Lee
- Protein and Proteomic Centre, Department of Biological Sciences, National University of Singapore, Singapore
| | - T Cao
- Oral Sciences, Faculty of Dentistry, National University of Singapore, Singapore
| | - H Koo
- Biofilm Research Labs, Levy Center for Oral Health, Department of Orthodontics and Divisions of Pediatric Dentistry & Community Oral Health, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - C J Seneviratne
- National Dental Centre Singapore, Oral Health ACP, SingHealth Duke NUS, Singapore
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Application of the Theory of Planned Behavior to Predict Dental Attendance and Caries Experience among Children of Newcomers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193661. [PMID: 31569485 PMCID: PMC6801792 DOI: 10.3390/ijerph16193661] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 09/24/2019] [Accepted: 09/25/2019] [Indexed: 11/17/2022]
Abstract
Background: This study aimed to explore the predictors of regular dental attendance behavior and caries experience among children of newcomers to Canada using the Theory of Planned Behavior (TPB). Methods: A total of 274 newcomer parents with a child aged 1 to 12 years old who had lived in Canada for 10 years or less participated in this cross-sectional study. Children underwent a dental examination to measure their deft/DEFT, and parents completed a self-administered questionnaire. Parental attitudes, subjective norms, perceived behavioral control (PBC), and intention were examined using Structural Equation Modeling (SEM) as predictors of dental attendance behavior and caries experience using the TPB model. Results: Out of all the components of the model, attitude and PBC significantly predicted the intention (p < 0.05) while the subjective norm had no statistical effects on the loading of the model (p > 0.05). Intention significantly predicted behavior, but behavior could not predict caries experience. Although 51.6% of the variance of intention was predicted by this model, only 0.2% of the variance for dental attendance behavior was explained. Conclusions: The theory of planned behavior was successful in predicting dental attendance intention and behavior for children among newcomers, but this behavior could not predict caries experience in children.
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Crouch E, Nelson J, Radcliff E, Martin A. Exploring associations between adverse childhood experiences and oral health among children and adolescents. J Public Health Dent 2019; 79:352-360. [DOI: 10.1111/jphd.12341] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 06/17/2019] [Accepted: 08/08/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Elizabeth Crouch
- Rural and Minority Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health University of South Carolina Columbia SC USA
| | - Joni Nelson
- Division of Population Oral Health, Department of Stomatology Medical University of South Carolina Charleston SC USA
| | - Elizabeth Radcliff
- Rural and Minority Health Research Center, Department of Health Services Policy and Management, Arnold School of Public Health University of South Carolina Columbia SC USA
| | - Amy Martin
- Division of Population Oral Health, Department of Stomatology Medical University of South Carolina Charleston SC USA
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Effect of Layering Technique on Push-Out Bond Strength of Composite Resin to Intracanal Dentin of Primary Anterior Teeth. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2018; 15:300-308. [PMID: 30833976 PMCID: PMC6397734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES This in-vitro study aimed to compare the push-out bond strength of composite resin posts packed into the root canal of primary anterior teeth using two different layering techniques. MATERIALS AND METHODS Thirty-two primary anterior teeth were randomly divided into two groups. In group 1, after the preparation of post spaces, a posterior composite resin (Filtek P60) was packed in three horizontal layers by a composite condenser instrument with a cylindrical tip using the horizontal layering technique (HLT). In group 2, this was done using a condenser with a conical tip in three funnel-shaped layers according to the funnel-shaped layering technique (FSLT). Next, the specimens were subjected to push-out bond strength testing. Data were analyzed using t-test and the Kaplan-Meier curves. RESULTS The mean±standard deviation (SD) bond strengths of composite resin posts were 8.46±3.45 MPa and 7.7±2.24 MPa for the HLT and FSLT, respectively; the difference was not statistically significant (P=0.46). CONCLUSIONS The layering technique by which composite resin was packed into the root canal of primary anterior teeth (HLT versus FSLT) had no significant effect on the push-out bond strength of composite resin posts.
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Mota-Veloso I, Ramos-Jorge ML, Homem MA, Pordeus IA, Paiva SM, Oliveira-Ferreira F. Dental caries in schoolchildren: influence of inattention, hyperactivity and executive functions. Braz Oral Res 2018; 32:e52. [PMID: 29898021 DOI: 10.1590/1807-3107bor-2018.vol32.0052] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 05/03/2018] [Indexed: 11/22/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by inappropriate levels of hyperactivity, impulsivity, and/or inattention. Individuals with ADHD may present limitations with regard to executive functions and performing activities that involve planning and/or attention/concentration. The aim of the study was to investigate the association between dental caries and signs of ADHD in a representative sample of schoolchildren. A representative sample of 851 schoolchildren aged seven to 12 years was randomly selected from public and private schools. Data acquisition involved a clinical dental examination for cavitated permanent and deciduous teeth using the DMFT/dmft indices. Neuropsychological evaluations, including the assessment of intelligence (Raven's Colored Progressive Matrix Test) and executive functions (Corsi Tapping Blocks tests and Digit Span test) were also performed. Parents/caregivers and teachers answered the SNAP-IV Questionnaire for the investigation of signs of inattention and hyperactivity in the family and school environment. Parents/caregivers also answered questionnaires addressing socioeconomic and socio-demographic characteristics. Descriptive analysis of the variables and Poisson regression with robust variance were performed. Parental reports of signs of inattention (PR: 1.28; p < 0.05) and hyperactivity (PR: 1.15; p < 0.05) were associated with a greater occurrence of caries. A better performance on the backward order of the Corsi Tapping Blocks tests (PR: 0.94; p < 0.05) and higher level of mother's schooling were associated with a lower frequency of caries. A better performance on executive function tasks was a protective factor against dental caries, whereas children considered inattentive and/or hyperactive by their parents had a higher prevalence rate of dental caries.
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Affiliation(s)
- Isabella Mota-Veloso
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Maria Letícia Ramos-Jorge
- Universidade Federal dos Vales do Jequitinhonha e Mucuri - UFVJM, School of Dentistry, Department of Pediatric Dentistry and Orthodontics, Diamantina, MG, Brazil
| | - Marcio Alexandre Homem
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Isabela Almeida Pordeus
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Saul Martins Paiva
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | - Fernanda Oliveira-Ferreira
- Universidade Federal de Juiz de Fora (UFJF), Department of Basic Sciences, Governador Valadares, MG, Brazil
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Crouch E, Radcliff E, Nelson J, Strompolis M, Martin A. The experience of adverse childhood experiences and dental care in childhood. Community Dent Oral Epidemiol 2018; 46:442-448. [DOI: 10.1111/cdoe.12389] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/08/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Elizabeth Crouch
- Department of Health Services Policy and Management; South Carolina Rural Health Research Center; Arnold School of Public Health; University of South Carolina; Columbia SC USA
| | - Elizabeth Radcliff
- Department of Health Services Policy and Management; South Carolina Rural Health Research Center; Arnold School of Public Health; University of South Carolina; Columbia SC USA
| | - Joni Nelson
- Department of Stomatology; Division of Population Oral Health; Medical University of South Carolina; Charleston SC USA
| | | | - Amy Martin
- Department of Stomatology; Division of Population Oral Health; Medical University of South Carolina; Charleston SC USA
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What should we expect from Switzerland's compulsory dental insurance reform? BMC Health Serv Res 2018; 18:272. [PMID: 29636053 PMCID: PMC5894163 DOI: 10.1186/s12913-018-3065-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 03/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A vast and heated debate is arising in Switzerland as a result of some recent citizens' initiatives aimed at introducing compulsory dental health care insurance. The Grand Conseils of the Vaud, Geneva, and Neuchâtel cantons recently approved three public initiatives and their citizens are expected to vote on the proposal in 2018. The process of collecting signatures has begun in several other cantons and the discussion has now moved to a national level. DISCUSSION At present, there is no scientific research that can help policy-makers and citizens to understand the main economic implications of such reform. We attempt to fill this gap by analysing three critical issues: the level and determinants of unmet needs for dental care in Switzerland; the protection of vulnerable individuals; and the economic sustainability of reform. RESULTS AND SHORT CONCLUSIONS The results show that income is not a unique determinant of barriers to access to dental care but rather, cultural and socio-demographic factors impact the perceived level of unmet dental care needs. The reform might only partially, if at all, improve the equity of the current system. In addition, the results show that the 1% wage-based contribution that the reform promoters suggest should finance the insurance is inadequate to provide full and free dental care to Swiss residents, but is merely sufficient to guarantee basic preventive care, whereas this could be provided by dental hygienists for less.
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Disparities in untreated caries among children and adults in the U.S., 2011-2014. BMC Oral Health 2018; 18:30. [PMID: 29510696 PMCID: PMC5840689 DOI: 10.1186/s12903-018-0493-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 03/01/2018] [Indexed: 11/17/2022] Open
Abstract
Background The Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults. Few studies in current scholarship make use of up-to-date, nationally representative data to examine oral health disparities in the U.S. population. The purpose of this study is to use nationally representative data to determine the prevalence of untreated caries among children and adults of different socioeconomic and racial/ethnic groups and to examine the factors associated with untreated caries among children and adults. Methods This study used the 2011–2014 National Health and Nutrition Examination Survey (NHANES) demographic, oral health questionnaire, and oral health dentition examination data (n = 7008 for children; n = 9673 for adults). Participants that had a standardized oral health examination and at least one natural primary or permanent tooth considering 28 tooth spaces were included in this study. Our main outcome measure was untreated coronal caries defined as decay on the crown or enamel surface of a tooth that had not been treated or filled. Population estimates were calculated to determine the prevalence of untreated caries among children and adults in the United States. Frequencies and Pearson’s chi-square tests were used to compare those with and without untreated caries. Multivariate logistic regression models were used to evaluate the factors associated with untreated caries. We conducted analyses among children and adults separately. Results From 2011 to 2014, 12.4 million children and 57.6 million adults in the United States had untreated caries. Age, family income level, recent dental visit, and financial and non-financial barriers were significantly associated with untreated caries in both children and adults. Race/ethnicity, gender and education level were also significantly associated with untreated caries among adults. The odds of untreated caries associated with financial barriers were 2.06 for children and 2.84 for adults while the odds of untreated caries associated with non-financial barriers were 2.86 for children and 1.67 for adults. Conclusions Demographic and socio-economic disparities in untreated caries exist among children and adults.
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Skeie MS, Klock KS. Dental caries prevention strategies among children and adolescents with immigrant - or low socioeconomic backgrounds- do they work? A systematic review. BMC Oral Health 2018; 18:20. [PMID: 29415706 PMCID: PMC5803902 DOI: 10.1186/s12903-018-0478-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 01/24/2018] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND This systematic review was designed to uncover the most reliable evidence about the effects of caries preventive strategies in children and adolescents of immigrant or low socioeconomic backgrounds. METHODS According to pre-determined inclusion and exclusion criteria, relevant articles focusing on underprivileged groups were electronically selected between January1995 and October 2015. The literature search was conducted in five databases; PubMed, Embase, CINAHL, SweMed+ and Cochrane Library. Accepted languages for included articles were English, German and Scandinavian languages. Abstracts and selected articles in full text were read and assessed independently by two review authors. Systematic reviews and meta-analyses were not included. Also articles with topics of water fluoridation and fluoride toothpaste were excluded, this due to all existing evidence of anti-caries effect for disadvantaged groups. The key data about the main characteristics of the study were compiled in tables and a quality grading was performed. RESULTS Thirty-seven articles were selected for further evaluation. Supervised toothbrushing for 5-year-old school children was found to be an effective prevention technique for use in underprivileged groups. Also a child/mother approach, targeting nutrition and broad oral health education of mothers showed effectiveness. For older children, a slow-release fluoride device and application of acidulated phosphate fluoride (APF) gel showed to be effective. CONCLUSION On the basis of this review, we maintain that in addition to studies of water fluoridation and fluoride toothpaste, there are other preventive intervention studies providing scientific evidence for caries reduction among children and adolescents with immigrant or low socioeconomic backgrounds.
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Affiliation(s)
- Marit S Skeie
- Department of Clinical Dentistry, Pediatric Dentistry, The Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway.
| | - Kristin S Klock
- Department of Clinical Dentistry, Community Dentistry, The Faculty of Medicine, University of Bergen, Aarstadveien 19, N-5009, Bergen, Norway.
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Abstract
Dental caries is the single most common chronic disease of childhood in the United States. Access to dental care is one of the barriers to improved oral health for children. Primary care providers who routinely treat children have an established role in prevention and early identification of health problems; thus, they are ideal front-line providers who can detect oral health discrepancies and begin the process of care and prevention.
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Affiliation(s)
- Mona M Sedrak
- Seton Hall University, School of Health and Medical Sciences, 400 South Orange Avenue, South Orange, NJ, 07079 USA.
| | - Laura M Doss
- Elizabeth Mueller and Associates, The Pediatric Dental Center, 6396 Thornberry Ct, Mason, OH 45040, USA
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Smith Slep AM, Heyman RE, Mitnick DM, Lorber MF, Beauchaine TP. Targeting couple and parent-child coercion to improve health behaviors. Behav Res Ther 2017; 101:82-91. [PMID: 29108651 DOI: 10.1016/j.brat.2017.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/29/2017] [Accepted: 10/09/2017] [Indexed: 02/07/2023]
Abstract
This phase of the NIH Science of Behavior Change program emphasizes an "experimental medicine approach to behavior change," that seeks to identify targets related to stress reactivity, self-regulation, and social processes for maximal effects on multiple health outcomes. Within this framework, our project focuses on interpersonal processes associated with health: coercive couple and parent-child conflict. Diabetes and poor oral health portend pain, distress, expense, loss of productivity, and even mortality. They share overlapping medical regimens, are driven by overlapping proximal health behaviors, and affect a wide developmental span, from early childhood to late adulthood. Coercive couple and parent-child conflict constitute potent and destructive influences on a wide range of adult and child health outcomes. Such interaction patterns give rise to disturbed environmental stress reactivity (e.g., disrupted sympathetic nervous and parasympathetic nervous systems) and a wide range of adverse health outcomes in children and adults, including dental caries, obesity, and diabetes-related metabolic markers. In this work, we seek to identify/develop/validate assays assessing coercion, identify/develop and test brief interventions to reduce coercion, and test whether changes in coercion trigger changes in health behaviors.
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di Bella E, Leporatti L, Montefiori M, Krejci I, Ardu S. Popular initiatives in 2014–2016 call for the introduction of mandatory dental care insurance in Switzerland: The contrasting positions at stake. Health Policy 2017; 121:575-581. [DOI: 10.1016/j.healthpol.2017.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 02/17/2017] [Accepted: 04/04/2017] [Indexed: 01/15/2023]
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Ramírez-Puerta BS, Escobar-Paucar G, Franco-Cortés ÁM, Ochoa-Acosta EM, Otálvaro-Castro GJ, Agudelo-Suárez AA. Caries dental en niños de 0-5 años del municipio de Andes, Colombia. Evaluación mediante el sistema internacional de detección y valoración de caries - ICDAS. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2017. [DOI: 10.17533/udea.rfnsp.v35n1a10] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Cagetti MG, Congiu G, Cocco F, Meloni G, Sale S, Campus G. Are distinctive risk indicators associated with different stages of caries in children? A cross-sectional study. BMC Public Health 2016; 16:1213. [PMID: 27905917 PMCID: PMC5134095 DOI: 10.1186/s12889-016-3865-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Accepted: 11/23/2016] [Indexed: 11/19/2022] Open
Abstract
Background Actual caries figures emphasize the need to identify the risk indicators involved in the disease’s development. The hypothesis that certain risk indicators might affect the dynamic evolution of the caries process was assessed; to clarify this premise, a cross-sectional survey was performed in school children. Methods A total of 390 subjects aged 6–8 years old were randomly selected. Caries was assessed, and the subjects were stratified as follows: i) highest caries score; ii) most prevalent caries score; and iii) number of affected teeth. Parents/guardians completed a questionnaire regarding vital statistics, socio-economic indicators, dietary habits, oral hygiene habits and oral health behaviours. Results Caries was detected in 42.31% of the subjects. Maternal nationality, parental education level, use of a sweetened pacifier at night, intake of lactose-free milk and toothbrushing frequency were statistically significant associated (p < 0.05) with subjects stratified according to the highest caries score. Parental educational level, maternal occupational status and use of a sweetened pacifier at night were associated (p < 0.05) with affected children stratified according to the most prevalent caries score. Maternal educational level and intake of lactose-free milk were associated with subjects with moderate caries stages compared to being caries-free (p = 0.01 and p = 0.02, respectively). Maternal nationality (p < 0.01) and toothbrushing frequency (p = 0.01) were associated with subjects affected by extensive lesions compared to caries-free children. In subjects affected by initial lesions as the most prevalent figure, gender (male) and paternal occupation status (unemployed) were statistically significant associated (p = 0.03 and p = 0.04, respectively) compared to those affected by highest prevalence of extensive caries lesions. In children with the highest prevalence of moderate caries lesions, maternal education level (p < 0.01), paternal occupational status (p = 0.03) and use of a sweetened pacifier at night (p < 0.01) were statistically significantly associated. Conclusions Maternal nationality, maternal low level of education, intake of lactose-free milk and low toothbrushing frequency were involved in the change from caries-free status to different caries stages. Gender, paternal unemployment, maternal low educational level and use of a sweetened pacifier were correlated with caries progression, showing how distinctive risk indicators were associated with different caries stages. Electronic supplementary material The online version of this article (doi:10.1186/s12889-016-3865-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maria Grazia Cagetti
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.,WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy
| | - Giovanna Congiu
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy
| | - Fabio Cocco
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy.,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy
| | - Gianfranco Meloni
- Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy
| | - Silvana Sale
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy
| | - Guglielmo Campus
- WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy. .,Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy.
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Abou El Fadl R, Blair M, Hassounah S. Integrating Maternal and Children's Oral Health Promotion into Nursing and Midwifery Practice- A Systematic Review. PLoS One 2016; 11:e0166760. [PMID: 27880790 PMCID: PMC5120808 DOI: 10.1371/journal.pone.0166760] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 11/03/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Globally, oral diseases contribute to major disease problems and oral health disparities persistently exist amongst vulnerable population groups. Two contributory factors to these challenges are the shortage of dental practitioners and the characteristic separation between the medical and dental professions. Nurses and midwives, in particular, are in a potentially excellent position to assist in basic oral health services such as dental health education and intraoral screening. We aimed to assess the effectiveness of integrating promotion of oral health of young children and their mothers into nursing and midwifery practice. METHODS AND FINDINGS Seven electronic databases including CENTRAL, EMBASE, MEDLINE, GLOBAL HEALTH, CINHAL, Scopus, and Web of Science were systematically searched whereas conference proceedings and theses were retrieved via PROQUEST. Only randomized, non-randomized trials and observational studies on preventive oral health programs delivered by nurses or midwives in healthcare settings or through home visits were included. Two investigators reviewed full-text articles independently to decide on eligibility for inclusion. Quality assessment was done using Cochrane tool for risk of bias for randomized trials and Downs and Black assessment tool for all other studies. Out of 3162 retrieved records, twenty one trials on oral health interventions incorporated into standard nursing practice were reviewed. Eighteen programs reported significant positive outcomes including reduction in caries experience, better oral hygiene and dietary habits and increased rates of dental visits amongst young children as reported by their caregivers. CONCLUSIONS Incorporating oral health promotion into nursing practice is a promising initiative for reducing oral health disparities by contributing to a downward trend in caries experience and increased access to dental care especially amongst the poor disadvantaged communities.
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Affiliation(s)
- Reham Abou El Fadl
- MPH, School of Public Health, Imperial College of London. Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
| | - Mitch Blair
- Department of Paediatrics, River Island Academic Centre for Paediatrics and Child Health, Imperial College London, London, United Kingdom
| | - Sondus Hassounah
- WHO Collaborating Centre for Public Health Education and Training, Department of Primary Care and Public Health, Imperial College London, London, United Kingdom
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Amin MS, Perez A, Nyachhyon P. Parental awareness and dental attendance of children among African immigrants. J Immigr Minor Health 2016; 17:132-8. [PMID: 24057752 DOI: 10.1007/s10903-013-9912-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To assess parental awareness of their child's dental status and the relationship between parental awareness and children's dental attendance. Participants were children aged 6 years or younger and their African parents who had lived in Canada for up to 10 years. Demographics and parents' perceived dental status were collected. Children's normative dental status was determined by dental examinations. 125 pairs of parents and children aged 21-72 months were included. 52% of the children never had a dental visit. Dental status of 44% of children was rated as good by parents, among them, 56% had dental decay. Parental assessments did not coincide with the clinical assessments of 62% of children. No correlation was found between parental awareness and children's dental attendance. Children of African immigrants are at high risk for developing severe dental decay because of low parental awareness and lack of regular dental visits.
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Affiliation(s)
- Maryam S Amin
- Division of Pediatric Dentistry, University of Alberta, 5-513 Edmonton Clinic Health Academy, 11405-87 Avenue NW, Edmonton, AB, T6G 1C9, Canada,
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Hoeft KS, Barker JC, Shiboski S, Pantoja-Guzman E, Hiatt RA. Effectiveness evaluation of Contra Caries Oral Health Education Program for improving Spanish-speaking parents' preventive oral health knowledge and behaviors for their young children. Community Dent Oral Epidemiol 2016; 44:564-576. [PMID: 27517458 DOI: 10.1111/cdoe.12250] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2015] [Accepted: 06/30/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the effectiveness of the Contra Caries Oral Health Education Program (CCOHEP) for improving low-income, Spanish-speaking parents' oral health knowledge and behaviors for their young children. Mexican American children in the United States suffer disproportionately high prevalence and severity of early childhood caries, yet few evaluated, theory-based behavioral interventions exist for this population. CCOHEP is a theory-based curriculum consisting of four 2-h interactive classes designed for and by Spanish speakers and led by designated community health educators (promotoras). Topics included children's oral hygiene, caries etiology, dental procedures, nutrition, child behavior management, and parent skill-building activities. METHODS Low-income Spanish-speaking parents/caregivers of children aged 0-5 years were recruited through community services in an agricultural city in California. Survey questions from the Oral Health Basic Research Facts Questionnaire measuring oral health-related behaviors and knowledge were verbally administered before, immediately after, and 3 months after attendance at CCOHEP. Five questions measured aspects of parental toothbrushing for their children (frequency, using fluoridated toothpaste, brushing before bed, not drinking or eating after nighttime brushing, adult assistance), three questions measured other oral health behaviors, and 16 questions measured oral health-related knowledge. Analyses of within-person changes between pre- and post-tests and again between post-test and 3-month follow-up consisted of McNemar's test for binary outcomes and sign tests for ordinal outcomes. RESULTS Overall, 105 caregivers participated in CCOHEP (n = 105 pretest, n = 95 post-test, n = 79 second post-test). At baseline, all parents self-reported doing at least one aspect of toothbrushing correctly, but only 13% reported performing all five aspects according to professional guidelines. At post-test, 44% of parents reported completing all aspects of toothbrushing according to professional guidelines (P < .001). Statistically significant improvements were seen in 4 aspects of toothbrushing (P ≤ .008) between pretest and post-test (all but adult assistance). The second post-test showed 3 of these improvements were maintained, while adult assistance and the other reported behaviors improved (P ≤ .008). Between pretest and post-test, checking child's teeth monthly and frequency of sweet drinks consumption improved (P ≤ .008), while frequency of eating sweet foods did not change. Knowledge was high at baseline (mean 12.8 of 16), but 6 knowledge items improved significantly between pretest and post-test. Improvements were maintained at second post-test. CONCLUSIONS Contra Caries Oral Health Education Program improved low-income Spanish-speaking parents' oral hygiene knowledge and self-reported behaviors for their young children, and change was sustained 3 months after the end of the intervention. Future, more rigorous evaluation of the intervention is recommended.
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Affiliation(s)
- K S Hoeft
- Department of Epidemiology & Biostatistics, Center to Address Disparities in Children's Oral Health (CAN DO), University of California, San Francisco, San Francisco, CA, USA.
| | - J C Barker
- Department of Anthropology, History & Social Medicine, Center to Address Disparities in Children's Oral Health (CAN DO), University of California, San Francisco, San Francisco, CA, USA
| | - S Shiboski
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
| | - E Pantoja-Guzman
- Department of Anthropology, History & Social Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - R A Hiatt
- Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA
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Braun PA, Quissell DO, Henderson WG, Bryant LL, Gregorich SE, George C, Toledo N, Cudeii D, Smith V, Johs N, Cheng J, Rasmussen M, Cheng NF, Santo W, Batliner T, Wilson A, Brega A, Roan R, Lind K, Tiwari T, Shain S, Schaffer G, Harper M, Manson SM, Albino J. A Cluster-Randomized, Community-Based, Tribally Delivered Oral Health Promotion Trial in Navajo Head Start Children. J Dent Res 2016; 95:1237-44. [PMID: 27439724 DOI: 10.1177/0022034516658612] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The authors tested the effectiveness of a community-based, tribally delivered oral health promotion (OHP) intervention (INT) at reducing caries increment in Navajo children attending Head Start. In a 3-y cluster-randomized trial, we developed an OHP INT with Navajo input that was delivered by trained Navajo lay health workers to children attending 52 Navajo Head Start classrooms (26 INT, 26 usual care [UC]). The INT was designed as a highly personalized set of oral health-focused interactions (5 for children and 4 for parents), along with 4 fluoride varnish applications delivered in Head Start during academic years of 2011 to 2012 and 2012 to 2013. The authors evaluated INT impact on decayed, missing, and filled tooth surfaces (dmfs) increment compared with UC. Other outcomes included caries prevalence and caregiver oral health-related knowledge and behaviors. Modified intention-to-treat and per-protocol analyses were conducted. The authors enrolled 1,016 caregiver-child dyads. Baseline mean dmfs/caries prevalence equaled 19.9/86.5% for the INT group and 22.8/90.1% for the UC group, respectively. INT adherence was 53% (i.e., ≥3 child OHP events, ≥1 caregiver OHP events, and ≥3 fluoride varnish). After 3 y, dmfs increased in both groups (+12.9 INT vs. +10.8 UC; P = 0.216), as did caries prevalence (86.5% to 96.6% INT vs. 90.1% to 98.2% UC; P = 0.808) in a modified intention-to-treat analysis of 897 caregiver-child dyads receiving 1 y of INT. Caregiver oral health knowledge scores improved in both groups (75.1% to 81.2% INT vs. 73.6% to 79.5% UC; P = 0.369). Caregiver oral health behavior scores improved more rapidly in the INT group versus the UC group (P = 0.006). The dmfs increment was smaller among adherent INT children (+8.9) than among UC children (+10.8; P = 0.028) in a per-protocol analysis. In conclusion, the severity of dental disease in Navajo Head Start children is extreme and difficult to improve. The authors argue that successful approaches to prevention may require even more highly personalized approaches shaped by cultural perspectives and attentive to the social determinants of oral health (ClinicalTrials.gov NCT01116739).
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Affiliation(s)
- P A Braun
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D O Quissell
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W G Henderson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - L L Bryant
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S E Gregorich
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - C George
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - N Toledo
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - D Cudeii
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - V Smith
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - N Johs
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J Cheng
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Rasmussen
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - N F Cheng
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - W Santo
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - T Batliner
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - A Wilson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - A Brega
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - R Roan
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - K Lind
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - T Tiwari
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S Shain
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - G Schaffer
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - M Harper
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S M Manson
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J Albino
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Suresh KS, Kumar P, Javanaiah N, Shantappa S, Srivastava P. Primary Oral Health Care in India: Vision or Dream? Int J Clin Pediatr Dent 2016; 9:228-232. [PMID: 27843255 PMCID: PMC5086011 DOI: 10.5005/jp-journals-10005-1369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Accepted: 03/21/2016] [Indexed: 11/23/2022] Open
Abstract
The contemporary approach to dental caries management in children focuses on prevention than treatment. Pediatricians, general dentists and pediatric dentists must be involved in a detailed preventive program, which includes prenatal counselling, treatment of expectant mothers at risk for dental caries, infant oral health care and the establishment of the dental home, so that dental disease can be prevented in infants, starting at a young age. Various health care system and organizations in India must join together to promote oral health care for all the children and specially focused toward children from disadvantaged background and children with special health care needs. HOW TO CITE THIS ARTICLE Suresh KS, Kumar P, Javanaiah N, Shantappa S, Srivastava P. Primary Oral Health Care in India: Vision or Dream? Int J Clin Pediatr Dent 2016;9(3):228-232.
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Affiliation(s)
- Kotumachagi S Suresh
- Professor and Head, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Pravin Kumar
- Postgraduate, Department of Pedodontics and Preventive Dentistry Government Dental College and Research Institute, Bengaluru Karnataka, India
| | - Nagarathna Javanaiah
- Lecturer and Assistant Professor, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Shruti Shantappa
- Postgraduate Student, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
| | - Pooja Srivastava
- Postgraduate Student, Department of Pedodontics, Government Dental College and Research Institute, Bengaluru, Karnataka, India
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Factors affecting children's adherence to regular dental attendance: a systematic review. J Am Dent Assoc 2016; 145:817-28. [PMID: 25082930 DOI: 10.14219/jada.2014.49] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Parents' adherence to regular dental attendance for their young children plays an important role in improving and maintaining children's oral health. The authors conducted a systematic review to determine the factors that influence parental adherence to regular dental attendance for their children. TYPE OF STUDIES REVIEWED The authors searched nine electronic databases to May 2013. They included quantitative and qualitative studies in which researchers examined factors influencing dental attendance in children 12 years or younger. The authors considered all emergency and nonemergency visits. They appraised methodological quality through the Health Evidence Bulletins Wales methodological quality assessment tool. RESULTS The authors selected 14 studies for the systematic review. Researchers in these studies reported a variety of factors at the patient, provider and system levels that influenced dental attendance. Factors identified at the patient level included parents' education, socioeconomic status, behavioral beliefs, perceived power and subjective norms. At the provider level, the authors identified communication and professional skills. At the system level, the authors identified collaborations between communities and health care professionals, as well as a formal policy of referring patients from family physicians and pediatricians to dentists. PRACTICAL IMPLICATIONS Barriers to and facilitators of parents' adherence to regular dental attendance for their children should be identified and considered when formulating health promotion policies. Further research is needed to investigate psychosocial determinants of children's adherence to regular dental visits.
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Amin M, ElSalhy M. Factors Affecting Dental Attendance of Children of New Immigrant Parents: A Cross-Sectional Study. J Immigr Minor Health 2016; 19:1351-1361. [DOI: 10.1007/s10903-016-0441-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Anderson M, Dahllöf G, Twetman S, Jansson L, Bergenlid AC, Grindefjord M. Effectiveness of Early Preventive Intervention with Semiannual Fluoride Varnish Application in Toddlers Living in High-Risk Areas: A Stratified Cluster-Randomized Controlled Trial. Caries Res 2016; 50:17-23. [PMID: 26795957 DOI: 10.1159/000442675] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 11/16/2015] [Indexed: 11/19/2022] Open
Abstract
This study evaluated whether toddlers in an extended preventive program of semiannual fluoride varnish applications from 1 year of age had a lower incidence of caries than those undergoing a standard program. A cohort of 1-year-old children (n = 3,403) living in multicultural areas of low socioeconomic standing in Stockholm participated in a cluster-randomized controlled field trial with two parallel arms. The children attended 23 dental clinics. Using the ICDAS II criteria, the examiners recorded caries at baseline and after 1 and 2 years. The children in the reference group received a standardized oral health program once yearly between 1 and 3 years of age. The children in the test group received the same standard program supplemented with topical applications of fluoride varnish every 6 months. We compared the test group and the reference group for the prevalence and increment of caries. At baseline, 5% of the children had already developed caries (ICDAS II 1-6). We reexamined the children after 1 year (n = 2,675) and after 2 years (n = 2,536). Neither prevalence nor caries increment differed between the groups. At 3 years of age, 12% of the children had developed moderate and severe carious lesions (ICDAS II 3-6), with a mean increment of 0.5 (SD 2.4) in the test group and 0.6 (SD 2.2) in the reference group. In conclusion, semiannual professional applications of fluoride varnish, as a supplement to a standard oral health program, failed to reduce caries development in toddlers from high-risk communities.
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Affiliation(s)
- Maria Anderson
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Custodio-Lumsden CL, Wolf RL, Contento IR, Basch CE, Zybert PA, Koch PA, Edelstein BL. Validation of an early childhood caries risk assessment tool in a low-income Hispanic population. J Public Health Dent 2015; 76:136-42. [PMID: 26440728 DOI: 10.1111/jphd.12122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 08/28/2015] [Indexed: 11/28/2022]
Abstract
OBJECTIVES There is a recognized need for valid risk assessment tools for use by both dental and nondental personnel to identify young children at risk for, or with, precavitated stages of early childhood caries (i.e., early stage decalcifications or white spot lesions).The aim of this study is to establish concurrent criterion validity of "MySmileBuddy" (MSB), a novel technology-assisted ECC risk assessment and behavioral intervention tool against four measures of ECC activity: semi-quantitative assays of salivary mutans streptococci levels, visible quantity of dental plaque, visual evidence of enamel decalcifications, and cavitation status (none, ECC, severe ECC). METHODS One hundred eight children 2-6 years of age presenting to a pediatric dental clinic were recruited from a predominantly Spanish-speaking, low-income, urban population. All children received a comprehensive oral examination and saliva culture for assessment of ECC indicators. Their caregivers completed the iPad-based MSB assessment in its entirety (15-20 minutes). MSB calculated both diet and comprehensive ECC risk scores. Associations between all variables were determined using ordinal logistic regression. RESULTS MSB diet risk scores were significantly positively associated with salivary mutans (P < 0.05), and approached significance with visible plaque levels (P < 0.1). MSB comprehensive risk scores were significantly associated with both oral mutans and visible plaque (P < 0.05). Neither was associated with visually evident decalcifications or cavitations. CONCLUSIONS Findings suggest that MSB may have clinical utility as a valid risk assessment tool for identifying children with early precursors of cavitations but does not add value in identifying children with extant lesions.
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Affiliation(s)
| | - Randi L Wolf
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Isobel R Contento
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Charles E Basch
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Patricia A Zybert
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Pamela A Koch
- Department of Health and Behavior Studies, Teachers College Columbia University, New York, NY, USA
| | - Burton L Edelstein
- Section of Population Oral Health, Columbia University College of Dental Medicine, New York, NY, USA
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Ramírez-Puerta BS, Franco-Cortés AM, Ochoa-Acosta E, Escobar-Paucar G. Experiencia de caries en dentición primaria en niños de 5 años, Medellín, Colombia. REVISTA FACULTAD NACIONAL DE SALUD PÚBLICA 2015. [DOI: 10.17533/udea.rfnsp.v33n3a03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Hoeft KS, Rios SM, Pantoja Guzman E, Barker JC. Using community participation to assess acceptability of "Contra Caries", a theory-based, promotora-led oral health education program for rural Latino parents: a mixed methods study. BMC Oral Health 2015; 15:103. [PMID: 26335081 PMCID: PMC4558913 DOI: 10.1186/s12903-015-0089-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 08/25/2015] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Latino children experience more prevalent and severe tooth decay than non-Hispanic white and non-Hispanic black children. Few theory-based, evaluated and culturally appropriate interventions target parents of this vulnerable population. To fill this gap, the Contra Caries Oral Health Education Program, a theory-based, promotora-led education program for low-income, Spanish-speaking parents of children aged 1-5 years, was developed. This article describes qualitative findings of the acceptability of curriculum content and activities, presents the process of refinement of the curriculum through engaging the target population and promotoras, and presents results from the evaluation assessing the acceptability of the curriculum once implemented. METHODS Focus groups were conducted with low-income Spanish-speaking parents of children 1-5 years living in a city in an agricultural area of California. Interviews were digitally recorded, translated and transcribed, checked for accuracy and the resulting data was thematically coded and analyzed using a social constructionist approach. The Contra Caries Oral Health Education Program was then implemented with a separate but similar sample, and after completing the program, participants were administered surveys asking about acceptability and favorite activities of the education program. Data were entered into a database, checked for accuracy, open-ended questions were categorized, and responses to close-ended questions counted. RESULTS Twelve focus groups were conducted (N = 51), 105 parents attended the Contra Caries Oral Health Education Program, and 83 parents filled out surveys. Complete attendance and retention was high (89% and 90%, respectively). This study found that their children's oral health is a high priority. Parents were not only interested in, but actually attended classes focused on increasing their knowledge and skills with respect to early childhood oral health. The Contra Caries content and format was perceived as acceptable by parents. Strong opinions about curriculum content were expressed for including information on how caries starts and progresses, weaning from the bottle, oral health care for children and adults, motivational strategies for children's tooth brushing, dental visits and cavity restorations. CONCLUSIONS The Contra Caries Oral Health Education Program was acceptable to low-income, Spanish-speaking parents of children 1-5 years. Participating in the curriculum development and revision process likely played an important role in the parents' high acceptability of the program.
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Affiliation(s)
- Kristin S Hoeft
- Department of Epidemiology and Biostatistics, Center to Address Disparities in Children's Oral Health (CAN DO), 3333 California Street, Suite 485, San Francisco, CA, 94143, USA.
| | - Sarah M Rios
- Department of Epidemiology and Biostatistics, Center to Address Disparities in Children's Oral Health (CAN DO), 3333 California Street, Suite 485, San Francisco, CA, 94143, USA.
| | - Estela Pantoja Guzman
- Department of Epidemiology and Biostatistics, Center to Address Disparities in Children's Oral Health (CAN DO), 3333 California Street, Suite 485, San Francisco, CA, 94143, USA.
| | - Judith C Barker
- Department of Anthropology, History & Social Medicine, Center to Address Children's Oral health Disparities (CAN DO), University of California San Francisco, 3333 California Street, Suite 485, San Francisco, CA, 94143-0850, USA.
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Braun PA, Racich KW, Ling SB, Ellison MC, Savoie K, Reiner L, Westfall JM. Impact of an interprofessional oral health education program on health care professional and practice behaviors: a RE-AIM analysis. Pediatric Health Med Ther 2015; 6:101-109. [PMID: 29388574 PMCID: PMC5683258 DOI: 10.2147/phmt.s79826] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Early childhood caries is the most common chronic childhood condition and largely preventable. Access to oral health preventive services (OHPS) for children at risk for caries is suboptimal and could be expanded if they were provided by non-dental professionals. Many state Medicaid programs in the USA now reimburse non-dental professionals for OHPS but require that they receive oral health education (OHE) to be reimbursed. Few OHE programs have been evaluated. METHODS We evaluated the impact of Colorado's OHE program on professional- and practice-level behaviors regarding the provision of OHPS to children by measuring its reach, effectiveness, adoption, implementation, and maintenance (ie, using the Reach Effectiveness Adoption Implementation Maintenance [RE-AIM] framework) with Medicaid claims data, online surveys, and key informant interviews. RESULTS From 2009 to 2012, the proportion of young, low-income children receiving OHPS from a medical professional increased 16-fold. We surveyed 703 OHE participants; post-OHE response rates were 61% at 12 months, 34% at 24 months (2009 participants), and 39% at 12 months (2011 participants). Respondents reported confidence in providing OHPS; favorable oral health knowledge, attitudes, and beliefs; and were providing OHPS to most eligible children. Approximately half of the practices had initiated practice-level changes to support program implementation and maintenance. Few barriers were reported to care. Eighteen interviewees reported factors facilitating program diffusion, which included quality materials, community need, and reimbursement; barriers included lack of time to provide services, resources to purchase supplies, and referral dentists. CONCLUSION This evaluation of a state interprofessional OHE program shows evidence of program diffusion and identifies facilitating factors and barriers to having medical professionals provide OHPS.
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Affiliation(s)
| | | | - Sarah B Ling
- Department of Family Medicine, Broadlawns Medical Center, Des Moines, IA, USA
| | | | - Karen Savoie
- Area Health Education Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - John M Westfall
- Area Health Education Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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Koh R, Pukallus M, Kularatna S, Gordon LG, Barnett AG, Walsh LJ, Seow WK. Relative cost-effectiveness of home visits and telephone contacts in preventing early childhood caries. Community Dent Oral Epidemiol 2015; 43:560-8. [DOI: 10.1111/cdoe.12181] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Accepted: 06/03/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Rongzhen Koh
- Centre for Paediatric Dentistry; Oral Health Centre; The University of Queensland; Herston Qld Australia
| | - Margaret Pukallus
- Oral Health Program (Logan-Beaudesert Division); Metro South Health; Logan City Qld Australia
| | - Sanjeewa Kularatna
- Centre for Applied Health Economics; Menzies Health Institute, Queensland; School of Medicine; Griffith University; Meadowbrook Qld Australia
| | - Louisa G. Gordon
- Centre for Applied Health Economics; Menzies Health Institute, Queensland; School of Medicine; Griffith University; Meadowbrook Qld Australia
| | - Adrian G. Barnett
- Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane Qld Australia
| | - Laurence J. Walsh
- Centre for Paediatric Dentistry; Oral Health Centre; The University of Queensland; Herston Qld Australia
| | - Wan Kim Seow
- Centre for Paediatric Dentistry; Oral Health Centre; The University of Queensland; Herston Qld Australia
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Biordi DL, Heitzer M, Mundy E, DiMarco M, Thacker S, Taylor E, Huff M, Marino D, Fitzgerald K. Improving access and provision of preventive oral health care for very young, poor, and low-income children through a new interdisciplinary partnership. Am J Public Health 2015; 105 Suppl 2:e23-9. [PMID: 25689183 PMCID: PMC4355709 DOI: 10.2105/ajph.2014.302486] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES We provided oral health care services at 2 sites using a nurse practitioner-dietitian team to increase dental workforce capacity and improve access to care for low-income preschool children. METHODS Our team provided oral health assessments and education, fluoride varnish application, and dentist referrals. The primary endpoint was participants' access to oral health care. Secondary endpoints included increasing the practice scope of registered dietitians through training programs for oral health assessment and the application of fluoride varnishes for children. The oral health and hygiene and dietary habits of the participants were also determined. RESULTS From 2010 to 2013, 4360 children received fluoride varnishes in 7195 total visits. Although the proportion of children with dental caries at the first visit was greater at the urban site, both sites were similar by visits 2 and 3. The number of caries declined with increased program visits, which coincided with an increase in the proportion of participants visiting a dentist. CONCLUSIONS Progress toward eliminating dental health disparities requires addressing barriers to dental care access. We showed that expanding access to oral health services through nurse practitioner-dietitian cooperation improved access to preventive fluoride varnishing use in low-income children.
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Affiliation(s)
- Diana L Biordi
- Diana L. Biordi, Marjet Heitzer, Eric Mundy, Marguerite DiMarco, Marlene Huff, and Karen Fitzgerald are with the School of Nursing, University of Akron, Akron, OH. Sherrey Thacker is with the College of Health Professions, University of Akron, Akron. Evelyn Taylor and Deborah Marino are with the College of Nutrition and Dietetics, University of Akron, Akron
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Association of caries increment in preschool children with nutritional and preventive variables. Clin Oral Investig 2015; 19:1913-9. [PMID: 25672515 DOI: 10.1007/s00784-015-1419-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 01/29/2015] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of the present study was to evaluate the influence of various risk factors on dental caries increment in deciduous teeth of preschool children over 2.5 years. MATERIALS AND METHODS A longitudinal study was carried out in kindergartens in two German counties in Northern Hesse. At baseline examination in 2006-2007, the mean age of the children was 3.5 years. Caries experience was recorded according to WHO standards. Information about feeding practices during early childhood and preventive measures were collected by a structured questionnaire for each child. RESULTS Three hundred ninety-five (69.8%) of the 566 children showed no caries increment. A caries increase of 1 to 10 dmf-teeth was exhibited by 171 children (30.2%). The mean dmf-t increment amounted to 0.75. The bivariate analysis revealed that the consumption of sugary food and beverages had a negative impact on oral health. Early start of toothbrushing, use of fluoridated children's toothpaste, and frequent toothbrushing exerted a positive influence on dental health. Stepwise backward logistic regression analysis confirmed that a high social status has a significant positive impact on dental health (p = 0.028), whereas the consumption of sugary food and beverages was significantly associated with a higher dental caries increment (p = 0.004). CONCLUSION Obviously, it is not possible to limit the caries increment in children of low socioeconomic status as successfully as in children of high socioeconomic status. CLINICAL RELEVANCE There must be a stronger focus on families of low socioeconomic status when preventive measures are performed on groups or individuals.
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