A longitudinal study of early childhood caries incidence in Wenzhou preschool children

Prevalence of dental neglect and associated risk factors in children and adolescents-A systematic review

BACKGROUND

Dental neglect (DN) is characterized within the wider framework of child neglect, though it is under-recognized by professionals.

AIM

To get an overview of the prevalence of DN worldwide and highlight the possible risk factors associated with it.

METHODS

A systematic review was conducted according to PRISMA guidelines. Studies on children and adolescents aged 0-19 years were included. Studies were identified by searching in the various scientific databases up to 14 January 2020.

RESULTS

Ten primary studies were included in which DN or indicators of DN were examined. The prevalence estimate range of DN reported by seven of the included studies after removing the outliers is from 34% to 56%. The prevalence of untreated caries reported by three of the included studies ranged from 38.9% to 99%. The education level and SES of parents and parental attitudes towards dental health affect children's oral health. Moreover, looked-after children and children of refugees are at higher risk of DN.

CONCLUSION

The study showed a high prevalence of DN and untreated caries. Due to the under-reporting of DN and a limited number of included studies, the results cannot be generalized worldwide. There is a need to make policies that include reporting of DN to higher authorities by dental professionals.

Effects of early preventive dental visits and its associations with dental caries experience: a cross-sectional study

Objectives

Limited information is known about preventive dental visits (PDVs) before seven years of age among children in China. This study aimed to examine the early PDV rate, identify the impact of PDV on dental caries and untreated dental caries, and explore the factors related to PDV among Chinese sampled children under seven years old.

Methods

A cross-sectional survey was conducted in five selected primary health care facilities in Chengdu, China, from May to August 2021. Parent–child dyads during regular systematic medical management were recruited to participate. Children's dental caries were identified through dental examinations and documented as decayed, missing and filled teeth index (dmft) by trained primary care physicians. Dental-related information was collected through a questionnaire. Zero-inflated negative binomial (ZINB) regression was used to test the effect of early PDV on the dmft value, and logistic regression was used to analyse impact factors on the early PDV.

Results

A total of 2028 out of 2377 parent–child dyads were qualified for analysis. Half of the children (50.4%) were male, with a mean age of 4.8 years. Among all the children, 12.1% had their first dental visit for preventive purposes, 34.4% had their first dental visit for symptomatic purposes, and more than half had never visited a dentist. The results showed that a lower dmft value (adjusted OR: 0.69, 95% CI: 0.48–0.84), a higher rate of caries-free (aOR: 6.5, 95% CI: 3.93–10.58), and a lower rate of untreated dental caries (aOR: 0.40, 95% CI: 0.21–0.76) were associated with early PDV utilization. Children who had a higher rate of PDV were positively associated with living in a family with better parental behaviours (aOR: 2.30, 95% CI: 1.71–3.08), better parental oral health perception (aOR: 1.23, 95% CI: 1.06–1.32), fathers who had no untreated caries (aOR: 0.68, 95% CI: 0.47–0.97), families with higher socioeconomic status (aOR: 1.09, 95% CI: 1.04–1.16), and dental health advice received from well-child care physicians (aOR: 1.47, 95% CI: 1.08–2.00).

Conclusions

Early PDV was associated with a lower rate of dental caries prevalence and untreated dental caries among sampled children younger than seven in Western China. Underutilization and social inequities existed in PDV utilization. Public health strategies should be developed to increase preventive dental visits and eliminate social disparities that prevent dental care utilization.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12903-022-02190-6.

Effectiveness of Silver Diamine Fluoride in Preventing Occlusal Caries in Primary Teeth of Preschool Children: a Study Protocol for a Randomized Clinical Trial (Preprint)

Background

Tooth decay is a significant public health problem globally. The caries-arrest effectiveness of 38% silver diamine fluoride (SDF) has been well documented. However, information on the caries-preventive effect of SDF on primary teeth is insufficient.

Objective

The aim of this trial is to investigate the effectiveness of semiannual application of 38% SDF and that of 5% sodium fluoride (NaF) varnish when compared with placebo control for preventing occlusal caries in the primary molars of preschool children over 30 months.

Methods

This 3-arm, parallel design, double-blind, randomized controlled trial involves 791 preschool children. Children are randomly allocated to receive 1 of 3 interventions as follows: Group 1, 38% SDF; Group 2, 5% NaF varnish; and Group 3, placebo control (tonic water). The intervention and dental examination will be carried out every 6 months. A parent-administered questionnaire, including the children’s demographic background and oral health–related behaviors, has been collected at baseline. Follow-up examinations to detect new caries development will be conducted every 6 months by a masked examiner. Caries development will be diagnosed at the cavitation level. Chi-square tests and logistic regression analyses will be adopted. A 2-level logistic regression analysis will be performed to investigate the effects of the study interventions and other potential confounding factors on the development of occlusal caries.

Results

This study was started on September 1, 2020, and the recruitment process ended on September 30, 2021. At present, a total of 791 children are participating in the study. This 30-month clinical trial is expected to be completed in March 2024.

Conclusions

If SDF application is more effective than NaF varnish for preventing caries on occlusal surfaces of primary teeth, it can be a preferred choice for caries prevention in a kindergarten-based program. Results of this trial will provide valuable clinical evidence for the development of oral health strategies and policies on the promotion of child oral health.

Trial Registration

HKU Clinical Registry HKUCTR-2844, https://tinyurl.com/bdhz9yuk; ClinicalTrials.gov NCT05084001, https://clinicaltrials.gov/ct2/show/NCT05084001

International Registered Report Identifier (IRRID)

DERR1-10.2196/35145

Risk factors of early childhood caries (ECC) among children in Beijing - a prospective cohort study

BACKGROUND

Early childhood caries (ECC) was a serious oral health concern with high prevalence and a low treatment rate in China, and few researches have focused on preschool children. This study aimed to explore the risk factors of ECC in Beijing, China.

METHODS

Totle of 712 children (mean age: 46.37 ± 5.44 months) participated in this prospective cohort study. Questionnaires and the levels of mutans streptococci in dental plaques and non-stimulated saliva, assessed using Dentocult SM strips, were collected at baseline, respectively. Two calibrated examiners checked for dental caries according to the WHO 1997 criteria at baseline and 1-year follow-up. Negative binomial regression was used for multivariate analysis of factors related to caries development.

RESULTS

For caries-free children at baseline, only plaque mutans streptococci (PMS) levels were associated with caries development (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.08-2.61, P = 0.02). Children with high PMS levels (scored 2 and 3) had higher caries incidence (46.2% vs. 33.8%) and more caries increment (1.87 ± 3.17 vs. 0.90 ± 1.89) than those with low levels (scored 0 and 1). Among all participants, PMS (OR = 1.69, 95% CI: 1.32-2.23, P < 0.001) and previous caries experience (OR = 2.80, 95% CI: 2.20-3.56, P < 0.001) were related to caries increment.

CONCLUSIONS

For caries-free children, the only significant risk factor for ECC was high PMS levels. For all participants, besides high PMS levels, previous caries experience was another significant risk factor for caries development.

TRIAL REGISTRATION

The study design, protocol, and informed consent forms were undertaken with the understanding of Declaration of Helsinki and were approved by the Human Research Ethics Committee of the School of Stomatology, Peking University, China (PKUSSIRB-2012042).