Persistent oral health disparity in 12-year-old Hispanics: a cross-sectional study

Exploring Jordanian children and parents' awareness, behavior, and perception of pediatric oral health

BACKGROUND

To evaluate children's and parents' practice and attitude toward oral hygiene and their knowledge about oral hygiene.

METHODS

This cross-sectional questionnaire-based study was conducted on randomly selected children who were seen in the Pediatric dentistry clinic in different Royal Medical Services hospitals. A modified questionnaire was used to gather information from the child or parents to gather the child's demographic data and evaluate the children's and parents' practice and attitude toward oral hygiene, their knowledge about oral hygiene, information about the parent and family, and oral examination, the questionnaire questions' reliability and validity were assessed by test-retest and Cronbach's Alpha test.

RESULTS

Three hundred seventy four patients were included, and the average age was 5.06 ± 3.58 SD years. Children's and parents' practice toward oral hygiene was inadequate where the majority (83.3%) brush their teeth occasionally, change their toothbrushes infrequently, apply toothpaste inappropriately, and less than half (47.2%) clean their tongue after teeth brushing. A significant number (73%) of candidates were aware that oral health has a significant role in their general health and can prevent dental problems. Participants agreed that maintaining a healthy mouth is an individual responsibility. The majority of participants came from large family size (the average family members 6.1 ± 1.7 SD) who live below the poverty line.

CONCLUSION

Our study demonstrated that awareness of oral health status in children below the age of 12 was poor. Although their oral knowledge was good their attitude and behavior were inadequate. These findings urge the need for expanded, well-organized, preventive educational programs that include school's syllabus, house visits, and hospitals for parents and children alike.

Socioecological determinants of child oral health-A scoping review

OBJECTIVES

Child oral health is a result of interactions between multilevel influences within a complex system. Understanding those interactions informs conceptualizing a socioecological framework of important influences on oral health. This paper aimed to present a scoping review on the determinants of dental caries and their interactions in childhood and adolescence.

METHODS

The two review questions were as follows: Which factors are determinants of child dental caries? and, How do determinants interact within and across socioecological levels? The three main electronic databases for biomedical records, PubMed, Web of Science and Scopus were searched, followed by reference check. The search and screening/selection procedures followed an a priori strategy and inclusion/exclusion criteria were specified in advance. The main components of the strategy were participants, concept and context. Following the final selection, eligible studies were assessed with quality appraisal tools for the risk of methodologic biases. Determinants reported in the included studies were then assigned to the micro-, meso-, exo- or macro-systems levels in a socioecological framework. Interactions between determinants were also identified and reported.

RESULTS

A total of 100 studies were included after removal of duplicates, screening on the title/abstracts and full-text assessment among 3313 records initially identified. A higher number of studies included were cross-sectional studies published in recent years. The majority of determinants found to influence child dental health were assigned to microsystem level within the framework. However, determinants were found at all levels and interactions were reported within and between socioecological levels. Determinants identified in the scoping review represent factors at different socioecological levels that influence child oral health.

CONCLUSION

Application of a socioecological model through a complex systems approach should lead to valid and robust progress towards practical solutions for better child oral health globally.

Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review and meta-analysis

BACKGROUND

Dental caries (DC) is highly prevalent condition affecting mostly young children. There has been no systematic review done on the prevalence of DC amongst 12-year -olds in Africa. Although some African countries have reported a decrease in DC prevalence, others have shown an increase and it is essential to measure current trends in order to identify strategies and programmes that could assist in reducing DC in Africa. The aim of this systematic review was to determine the prevalence of DC (condition) amongst the permanent dentition of 12-year-old children (population) in Africa (context).

METHODS

A systematic review and meta-analysis was performed. Peer reviewed cross-sectional articles from January 2000 until December 2021 was searched and this included the following databases: Pubmed (Medline); SCOPUS; CINAHL (via EBSCOhost); Academic Search Complete (via EBSCOhost); Dentistry and Oral Sciences Sources (via EBSCOhost); and Science Direct. The search was last updated on the 10th January 2022. Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Prevalence figures were stratified by Urban/Rural status, country and time using a random-effects model. All studies performed on children 12-year-olds on the African continent were included. The prevalence of DC and the DMFT scores were the primary and secondary outcome measures, respectively. Only articles consisting of 12-year-old children who reside in Africa were included in this study. The systematic review was registered with Prospero CRD42021293666.

RESULTS

18,080 participants were included in this review. A total of thirty studies were included in the review. The pooled effect size of dental caries severity was 1.09 (CI 0.91-1.27) and the overall prevalence was 36% (CI 29.4-41.7%). Eritrea (78%) had the highest prevalence of DC while Zambia had the lowest (11%); Eritrea also had the highest DMFT score (2.5) with Sudan having the lowest score (0.49). Urban cities had the highest DMFT score (1.32, CI 0.97-1.68), compared to rural cities (1.13, CI 0.86-1.4) and there was an increasing trend in DC prevalence over time from 28% (CI 23-34%) in 2000 to 2005 to 57% (CI 43-72%) in studies conducted after 2015. The risk of bias was very low where majority of the studies scored more than 50% in the JBI critical appraisal tool.

CONCLUSIONS

There was a wide discrepancy in the DC prevalence and scores across the different countries, settings (rural versus urban) and there was an increase in the prevalence over time. This review was self-funded.

Oral Health in 12- and 15-Year-Old Children in Serbia: A National Pathfinder Study

The aim of the paper is to present the oral health profile of 12- and 15-year-old schoolchildren in Serbia. Basic Methods for Oral Health Surveys of the WHO were implemented to record: Decayed, Missing, and Filled Teeth/Surfaces Index (DMFT/DMFS), gingival bleeding, enamel fluorosis and other structural anomalies, dental erosion, dental trauma, and oral mucosal lesions. In addition, Silness and Löe plaque index and orthodontic status were assessed. A total of 36% of 12-year-olds and 22% of 15-year-olds in Serbia were caries-free. The mean DMFT was 2.32 ± 2.69 for 12-year-olds and 4.09 ± 3.81 for 15-year-olds. DMFT was made up largely by the decayed component. Gingival bleeding was present in 26% of examined 12-year-old and 18% of 15-year-old children. Dental plaque was observed in 63% of both 12- and 15-year-olds. Fluorosis, structural anomalies, dental erosion, dental trauma, and oral mucosal lesion were rarely detected. Low prevalence of malocclusions was found. Oral disease is still a common public health problem among schoolchildren in Serbia. A significant increase in the prevalence of caries disease between 12- and 15-year-old groups implies that preventive care for adolescents requires special attention. Corrective actions and reforms to the current school-based oral health prevention program are needed to further improve oral health in Serbian children.

Tropical Oral Disease: Analysing Barriers, Burden, Nutrition, Economic Impact, and Inequalities

Traditionally, a healthy mouth is a good indicator of good general health. Poor oral hygiene reflects the health of the oral cavity and is a risk factor for overall health. Although oral diseases like dental decay and periodontitis are prevalent, awareness of oral diseases is still limited. Oral disorders include a wide range of diseases that may not be confined to the oral anatomical structures but may be manifestations of systemic diseases. Identification of the risk factors of dental and oral diseases, including socio-economic determinants, plays a major role in the type of oral health care, and in the promotion of dental health awareness. This article reviews oral diseases in the Caribbean and aims to raise awareness of this subject while suggesting a research agenda for the region.

An Assessment of Pediatric Dental Caries and Family Quality of Life in an Informal Amazonian Community

Background:

Oral diseases are among the most prevalent non-communicable diseases worldwide, disproportionally affecting vulnerable populations. The Community of Claverito is one of many informal urban floating communities located on the Amazon River in Peru.

Objectives:

To assess child and caregiver dental health status (DHS) and to measure the associations between child DHS and child and family quality of life in the informal Community of Claverito.

Methods:

DHS, as measured by decayed and filled teeth (DFT/dft), was recorded for 66 children and 35 caregivers using the WHO Oral Assessment form. Oral health-related quality of life was measured using the Parental-Caregiver Perceptions Questionnaire (P-CPQ). The family impact of child oral disorders was measured using the Family Impact Scale (FIS). Descriptive statistics, correlations, and regression analyses were used to evaluate the associations between DFT/dft, P-CPQ, and FIS scores (p < 0.05).

Findings:

The majority of children assessed were female (52%) with a mean age of 9.4 years (SD ± 4.4). The prevalence of untreated child dental caries was 97%. The child and caregiver’s mean DFT/dft scores were 6.8 (SD ± 4.5) and 8.7 (SD ± 13.3), respectively. Mean total P-CPQ and total FIS scores were 33.4 and 12.5, respectively. A significant positive association was observed between child DFT/dft scores and total FIS scores (p < 0.01). Significant associations were also observed between child DFT/dft scores and caregiver age (p < 0.01) and child DFT/dft scores and caregiver DFT scores (p < 0.01).

Conclusions:

Children and their caregivers living in the Community of Claverito exhibited high levels of dental caries. Children’s untreated dental caries were associated with both family’s quality of life and caregivers’ untreated dental caries. Further research is needed on how improving availability and access to oral health services have the potential to benefit the health of residents of informal communities like the one of Claverito.

Prevalence of gingivitis and calculus in 12-year-old Puerto Ricans: a cross-sectional study

Background

Gingivitis is a common oral health problem. Untreated gingivitis may progress to periodontitis, a common cause of tooth loss. The prevalence of gingivitis and calculus among Puerto Rican children is unknown. Understanding this prevalence can support early public health preventative strategies. This study aims to estimate the prevalence of gingivitis and calculus among 12-year-old Puerto Ricans by health region and to explore differences in distribution by school type (proxy for socio-economic status) and gender.

Methods

A probability-based sample of 113 schools was selected proportional to enrollment size and stratified by health region, school type, and gender. Two trained examiners evaluated the presence of gingivitis and both supragingival and subgingival dental calculus. Gingivitis was defined as the presence of gingival bleeding upon gentle probing (BOP) in at least one site, and the extent of the problem was classified according to the percentage of teeth whose gingiva presented BOP (limited: 25–49% of the teeth tested; extensive: >50% of teeth tested). Logistic and linear regression models, adjusted for health regions, were used to compare gingivitis and calculus prevalence and extent between genders and school types.

Results

Gingivitis was found in 80.41% of the 1586 children evaluated. Urban-public schoolchildren had a slightly higher prevalence (83.24%) compared to private (79.15%, p = 0.16); those in rural-public (77.59%) and private schools had similar prevalence (p = 0.15). Extensive gingivitis was present in 60.81% of all children. The mean percentage of sites presenting BOP (BOP%) was 17.79%. Rural and urban public schoolchildren presented significantly higher BOP% compared to children from private schools (p = 0.0005, p = 0.002, respectively). Dental calculus was detected in 61.59% of the sample, boys presenting significantly higher (p = 0.005) total and supragingival calculus. Rural-public schoolchildren had a significantly higher prevalence of subgingival calculus compared to private schoolchildren (p = 0.02).

Conclusions

Gingivitis prevalence is higher among 12-year-old Puerto Ricans compared to data reported for U.S. adolescents. Public schoolchildren presented significantly higher BOP% sites compared to private schoolchildren. Boys presented a significantly higher total and supragingival calculus prevalence than girls. Oral health disparities related to gender and school type were identified by this study. Studies exploring the reasons for these disparities are recommended.

Electronic supplementary material

The online version of this article (10.1186/s12903-017-0471-5) contains supplementary material, which is available to authorized users.

Association between Type, Amount, and Pattern of Carbohydrate Consumption with Dental Caries in 12-Year-Olds in Puerto Rico

OBJECTIVE

To identify the types, food sources, and pattern of carbohydrates that significantly contribute to dental caries in Puerto Rican children.

METHODS

As part of an island-wide cross-sectional oral health study in 1,587 twelve-year-olds, diet intake was assessed in a representative subset (n = 801) with a 24-hour dietary recall. Carbohydrate intake was quantified using a computer-based diet analysis program. Caries was assessed using the National Institute of Dental and Craniofacial Research diagnostic criteria. Odds ratios were used to associate carbohydrate intake quartiles with caries, after controlling for important confounders.

RESULTS

A total of 723 subjects had complete data. Most were females (54%) and attended public schools (77%). The caries prevalence was 33%. The highest quartile intake for the following sugars significantly increased the odds of caries compared to the lowest quartile: total carbohydrates (OR = 1.93, 95% CI = 1.08-3.46), total sugars (OR = 1.88, 95% CI = 1.01-351), sucrose (OR = 2.05, 95% CI = 1.13-3.70), fructose (OR = 1.95, 95% CI = 1.05-3.62), and inositol (OR = 2.52, 95% CI = 1.38-4.63). The main food sources of these sugars were juices, including natural juices with no added sugars, and sweetened beverages. The odds of caries also increased significantly in children whose 10% of total energy intake was from total sugars (OR = 3.76, 95% CI = 1.03-13.7).

CONCLUSION

After adjusting for important caries risk factors, total carbohydrates, total sugars, ≥10% kilocaloric energy from total sugars, and sucrose, fructose, and inositol intake significantly increased caries risk. Our findings can help raise awareness about the potential caries risk from the main sources of these sugars, natural fruit juices and sweetened beverages, which are consumed in great quantities in many societies.