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Du S, Cheng M, Cui Z, Wang X, Feng X, Tai B, Hu D, Lin H, Wang B, Wang C, Zheng S, Liu X, Rong W, Wang W, Si Y. Decomposing Socioeconomic Inequality in Early Childhood Caries Among 3 to 5-Year-Old Children in China. Int Dent J 2024:S0020-6539(24)00106-0. [PMID: 38821780 DOI: 10.1016/j.identj.2024.04.001] [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: 02/20/2024] [Revised: 03/20/2024] [Accepted: 04/02/2024] [Indexed: 06/02/2024] Open
Abstract
INTRODUCTION AND AIMS Early childhood caries (ECC) is a widespread oral disease that harms children's health in China. Although previous studies have linked ECC prevalence to socioeconomic status, few have measured the degree of socioeconomic inequality. This study aimed to evaluate the socioeconomic inequality of ECC in children aged 3 to 5 years in China and identify the contributor to the inequality. METHODS We extracted data on 3 to 5-year-old children from the fourth National Oral Health Survey. We measured the inequality of ECC by the average household income per capita. We used the average household income per capita to measure the inequality of ECC. To describe inequality both qualitatively and quantitatively, we used the following methods: concentration curve, Erreygers-corrected concentration index, relative index of inequality and slope index of inequality. We also applied a decomposition based on the probit model to identify the factors that contributed to inequality. RESULTS The prevalence of ECC in Chinese preschool children was 63.11% (95% CIs: 60.54%, 65.61%). The negative value of the Erreygers-corrected concentration index (-0.0459; 95% CIs: -0.0594, -0.0324), slope index of inequality (-0.0674; 95% CIs: -0.0876, -0.0471) and the positive value of relative index of inequality (0.7484; 95% CIs: 0.6856, 0.8169) all indicated that ECC prevalence was higher among children from low-income families. The main factors contributing to inequality were average household income, parents' educational level and living areas. CONCLUSION There is a pro-poor inequality in ECC among 3 to 5-year-old children in China. CLINICAL RELEVANCE To improve oral health equality, policymakers should focus more on children from low-income families, with less educated parents and living in rural areas.
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Affiliation(s)
- Shuo Du
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Menglin Cheng
- Department of Stomatology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhiying Cui
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xing Wang
- Chinese Stomatological Association, Beijing, China
| | - Xiping Feng
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Baojun Tai
- School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Deyu Hu
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Huancai Lin
- Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, China
| | - Bo Wang
- Chinese Stomatological Association, Beijing, China
| | - Chunxiao Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Shuguo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Xuenan Liu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Wensheng Rong
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Weijian Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yan Si
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, & Beijing Key Laboratory of Digital Stomatology & NHC Key Laboratory of Digital Stomatology & NMPA Key Laboratory for Dental Materials, Beijing, China.
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Lieneck C, Connelly E, Ireland D, Jefferson A, Jones J, Breidel N. Facilitators and Barriers to Oral Healthcare for Women and Children with Low Socioeconomic Status in the United States: A Narrative Review. Healthcare (Basel) 2023; 11:2248. [PMID: 37628445 PMCID: PMC10454235 DOI: 10.3390/healthcare11162248] [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: 06/30/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
This rapid review examined facilitators and barriers affecting oral healthcare access and utilization among women and children with a low socioeconomic status (SES) in the United States from 2019 to the present. A comprehensive search was conducted across multiple electronic databases, yielding a total of 30 relevant studies for inclusion. The findings highlight various facilitators that positively impact oral healthcare outcomes, including targeted educational programs, access to non-dental care healthcare services, community-based initiatives, and increased access to affordable oral health services. Conversely, barriers such as financial constraints, lack of access to food program social assistance, access to care difficulties, and limited oral health literacy were identified as major challenges faced by this population. Understanding these facilitators and barriers during the COVID-19 global pandemic can inform the development of tailored interventions and policies aimed at improving oral healthcare outcomes for women and children with a low SES in the United States.
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Affiliation(s)
- Cristian Lieneck
- School of Health Administration, Texas State University, San Marcos, TX 78666, USA
| | - Erin Connelly
- School of Health Sciences, Southern Illinois University-Carbondale, Carbondale, IL 62901, USA; (E.C.); (D.I.); (A.J.); (J.J.); (N.B.)
| | - Daryah Ireland
- School of Health Sciences, Southern Illinois University-Carbondale, Carbondale, IL 62901, USA; (E.C.); (D.I.); (A.J.); (J.J.); (N.B.)
| | - Alexandra Jefferson
- School of Health Sciences, Southern Illinois University-Carbondale, Carbondale, IL 62901, USA; (E.C.); (D.I.); (A.J.); (J.J.); (N.B.)
| | - Jesikuh Jones
- School of Health Sciences, Southern Illinois University-Carbondale, Carbondale, IL 62901, USA; (E.C.); (D.I.); (A.J.); (J.J.); (N.B.)
| | - Nicole Breidel
- School of Health Sciences, Southern Illinois University-Carbondale, Carbondale, IL 62901, USA; (E.C.); (D.I.); (A.J.); (J.J.); (N.B.)
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Zaidi S, Ali K, Chawla YM, Khan AU. mltG gene deletion mitigated virulence potential of Streptococcus mutans: An in-vitro, ex-situ and in-vivo study. AMB Express 2023; 13:19. [PMID: 36806997 PMCID: PMC9941400 DOI: 10.1186/s13568-023-01526-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/22/2023] Open
Abstract
Bacterial cells are surrounded by a peptidoglycan (PG) cell wall, which is essential for cell integrity and intrinsic biogenesis pathways; hence, the cell wall is a potential target for several antibiotics. Among several lytic transglycosylases (LTs), the mltG gene plays a crucial role in the synthesis of peripheral PG. It localises the re-modelled PGs for septum formation and cleavage across the bacterial cell wall during daughter cells separation. However, the role of mltG gene in bacterial virulence, particularly in Gram-positive bacteria during dentine biofilm and caries development, has remained unexplored. Hence, we exploited Gram-positive Streptococcus mutans cells for the very first time to construct a mltG knock-out bacterial strain, e.g., ΔmltG S. mutans. Systematic comparative investigations revealed that doubling time (Td), survival, enzymatic efficiencies, pH tolerance, bio-synthesise of lipid, proteins and DNA, biofilm formation and dentine lesions were significantly (p < 0.001) compromised in case of ΔmltG S. mutans than wild type strain. The qRT-PCR based gene expression profiling revealed that transcriptional expression of critically important genes involved in biofilm, metabolism, and stress response were dysregulated in the mutant. Besides, an incredible reduction in dentine caries development was found in the molar teeth of Wistar rats and also in human extracted teeth. Concisely, these trends obtained evidently advocated the fact that the deletion of mltG gene can be a potential target to impair the S. mutans virulence through severe growth retardation, thereby reducing the virulence potential of S. mutans.
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Affiliation(s)
- Sahar Zaidi
- grid.411340.30000 0004 1937 0765Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary, Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 UP India
| | - Khursheed Ali
- grid.411340.30000 0004 1937 0765Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary, Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 UP India
| | - Yadya M. Chawla
- grid.425195.e0000 0004 0498 7682ICGEB-Emory Vaccine Center, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| | - Asad U. Khan
- grid.411340.30000 0004 1937 0765Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary, Biotechnology Unit, Aligarh Muslim University, Aligarh, 202002 UP India
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The Link between Stroke Risk and Orodental Status-A Comprehensive Review. J Clin Med 2022; 11:jcm11195854. [PMID: 36233721 PMCID: PMC9572898 DOI: 10.3390/jcm11195854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022] Open
Abstract
One of the primary causes of disability and mortality in the adult population worldwide is stroke. A person's general health is significantly impacted by their oral and dental health. People who have poor oral health are more susceptible to conditions such as stroke. Stroke risk has long been linked to oral and dental conditions. The risk of stroke and its cost impact on the healthcare systems appear to be significantly reduced as a result of the decline in the incidence and prevalence of oral and dental illnesses. Hypothetically, better management of oral hygiene and dental health lead to reduced stroke risk. To the authors' best knowledge, for the first time, the potential link between dental health and stroke were cross-examined. The most typical stroke symptoms, oral and dental illnesses linked to stroke, and the role of oral healthcare professionals in stroke prevention are revealed. The potential mediating processes and subsequent long-term cognitive and functional neurological outcomes are based on the available literature. It must be noted that periodontal diseases and tooth loss are two common oral health measures. Lack of knowledge on the effects of poor oral health on systemic health together with limited access to primary medical or dental care are considered to be partially responsible for the elevated risk of stroke. Concrete evidence confirming the associations between oral inflammatory conditions and stroke in large cohort prospective studies, stratifying association between oral disease severity and stroke risk and disease effects on stroke survival will be desirable. In terms of clinical pathology, a predictive model of stroke as a function of oral health status, and biomarkers of systemic inflammation could be useful for both cardiologists and dentists.
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