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Gupta RD, Haider SS, Jahan SS, Islam MI, Mazumder A, Zafar MS, Siddika N, Apu EH. Prevalence and associated factors of last dental visit and teeth cleaning frequency in Bangladesh, Bhutan, and Nepal: Findings from nationally representative surveys. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003511. [PMID: 39028749 PMCID: PMC11259307 DOI: 10.1371/journal.pgph.0003511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 06/28/2024] [Indexed: 07/21/2024]
Abstract
This study evaluated the prevalence and frequency of teeth cleaning and last dental visits, along with associated socio-demographic factors, among residents of Bangladesh, Bhutan, and Nepal. The World Health Organization (WHO) STEPwise approach to surveillance (STEPS) survey data from Bangladesh (N = 8,164), Bhutan (N = 5,374) and Nepal (N = 5,371) were analyzed. After descriptive analysis, a multivariable multilevel logistic regression was conducted to identify the factors associated with oral hygiene. The following variables were considered as outcomes of interest: daily teeth cleaning frequency and visitation to the oral healthcare providers in the last six/twelve months at the time of data collection. Bangladesh had the highest proportion of respondents who cleaned their teeth at least once or twice a day, while Nepal had the lowest. Bhutan had the highest proportion of respondents who visited a dentist within the last six months (10.5%) or 12 months (16.0%). Almost 94.5% of Nepalese participants never visited a dentist. Participants of older age, who were females and had increased educational attainment, were more likely to follow oral hygiene measures. The populations of all the countries included in the study show poor adherence to oral hygiene practices. Health promotion programs should raise awareness regarding the advantages of regular teeth cleaning and dental check-ups.
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Affiliation(s)
- Rajat Das Gupta
- BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | | | - Shah Saif Jahan
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka, Bangladesh
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford, United Kingdom
| | - Md. Irteja Islam
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka, Bangladesh
- Research, Innovation and Grants, Spreeha Bangladesh, Dhaka, Bangladesh
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Health Research and Faculty of Health, Engineering and Sciences, The University of Southern Queensland, Toowoomba, Queensland, Australia
| | - Ananna Mazumder
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka, Bangladesh
- Jahurul Islam Medical College, Bajitpur, Kishoreganj, Bangladesh
| | - Muhammad Sohail Zafar
- Department of Restorative Dentistry, College of Dentistry, Taibah University, Al Madinah Al Munawwarah, Saudi Arabia
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- School of Dentistry, University of Jordan, Amman, Jordan
- Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, Pakistan
| | - Nazeeba Siddika
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka, Bangladesh
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
- College of Dental Medicine, Lincoln Memorial University, Knoxville, Tennessee, United States of America
| | - Ehsanul Hoque Apu
- Centre for International Public Health and Environmental Research, Bangladesh (CIPHER,B), Dhaka, Bangladesh
- College of Dental Medicine, Lincoln Memorial University, Knoxville, Tennessee, United States of America
- Department of Biomedical Engineering, Institute of Quantitative Health Science and Engineering, Michigan State University, East Lansing, Michigan, United States of America
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Best AM, Lang TA, Greenberg BL, Gunsolley JC, Ioannidou E. The Oral Health Statistics Guidelines for Reporting Observational Studies and Clinical Trials in Oral Health Research: Explanation and Elaboration. J Oral Maxillofac Surg 2024:S0278-2391(24)00584-6. [PMID: 39032518 DOI: 10.1016/j.joms.2024.06.174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024]
Abstract
Adequate and transparent reporting is necessary for critically appraising research. Yet, evidence suggests that the design, conduct, analysis, interpretation, and reporting of oral health research could be greatly improved. Accordingly, the Task Force on Design and Analysis in Oral Health Research-statisticians and trialists from academia and industry-empaneled a group of authors to develop methodological and statistical reporting guidelines identifying the minimum information needed to document and evaluate observational studies and clinical trials in oral health: the Oral Health Statistics Guidelines. Drafts were circulated to the editors of 85 oral health journals and to task force members and sponsors and discussed at a December 2020 workshop attended by 49 researchers. The final version was subsequently approved by the task force in September 2021, submitted for journal review in 2022, and revised in 2023. The checklist consists of 48 guidelines: 5 for introductory information, 17 for methods, 13 for statistical analysis, 6 for results, and 7 for interpretation; 7 are specific to clinical trials. Each of these guidelines identifies relevant information, explains its importance, and often describes best practices. The checklist was published in multiple journals. The article was published simultaneously in JDR Clinical and Translational Research, the Journal of the American Dental Association, and the Journal of Oral and Maxillofacial Surgery. Completed checklists should accompany manuscripts submitted for publication to these and other oral health journals to help authors, journal editors, and reviewers verify that the manuscript provides the information necessary to adequately document and evaluate the research.
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Affiliation(s)
- Al M Best
- Professor Emeritus, School of Dentistry and Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Thomas A Lang
- Adjunct Faculty, University of Chicago Medical Writing Program
| | - Barbara L Greenberg
- Adjunct Professor, Epidemiology and Biostatistics, Touro College of Dental Medicine at New York Medical College, Valhalla, NY
| | - John C Gunsolley
- Professor Emeritus, School of Dentistry, Virginia Commonwealth University, Richmond, VA
| | - E Ioannidou
- Professor and Chair of Orofacial Sciences, UCSF School of Dentistry, San Francisco, CA.
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Best AM, Lang TA, Greenberg BL, Gunsolley JC, Ioannidou E. The OHStat Guidelines for Reporting Observational Studies and Clinical Trials in Oral Health Research: Explanation and Elaboration. JDR Clin Trans Res 2024:23800844241247029. [PMID: 38993046 DOI: 10.1177/23800844241247029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Abstract
Adequate and transparent reporting is necessary for critically appraising research. Yet, evidence suggests that the design, conduct, analysis, interpretation, and reporting of oral health research could be greatly improved. Accordingly, the Task Force on Design and Analysis in Oral Health Research-statisticians and trialists from academia and industry-empaneled a group of authors to develop methodological and statistical reporting guidelines identifying the minimum information needed to document and evaluate observational studies and clinical trials in oral health: the OHstat Guidelines. Drafts were circulated to the editors of 85 oral health journals and to Task Force members and sponsors and discussed at a December 2020 workshop attended by 49 researchers. The final version was subsequently approved by the Task Force in September 2021, submitted for journal review in 2022, and revised in 2023. The checklist consists of 48 guidelines: 5 for introductory information, 17 for methods, 13 for statistical analysis, 6 for results, and 7 for interpretation; 7 are specific to clinical trials. Each of these guidelines identifies relevant information, explains its importance, and often describes best practices. The checklist was published in multiple journals. The article was published simultaneously in JDR Clinical and Translational Research, the Journal of the American Dental Association, and the Journal of Oral and Maxillofacial Surgery. Completed checklists should accompany manuscripts submitted for publication to these and other oral health journals to help authors, journal editors, and reviewers verify that the manuscript provides the information necessary to adequately document and evaluate the research.
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Affiliation(s)
- A M Best
- School of Dentistry and Department of Biostatistics, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - T A Lang
- University of Chicago Medical Writing Program, Chicago, IL, USA
| | - B L Greenberg
- Epidemiology and Biostatistics, Touro College of Dental Medicine at New York Medical College, Valhalla, NY, USA
| | - J C Gunsolley
- School of Dentistry, Virginia Commonwealth University, Richmond, VA, USA
| | - E Ioannidou
- UCSF School of Dentistry, San Francisco, CA, USA
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Silva LTD, Frusca-DO-Monte CM, Almeida GS, Silva VCD, Lorenzato CS, Bendo CB, Menezes JVNB, Torres-Pereira CC, Fraiz FC. Quality of life in children and adolescents with blood coagulation disorders and hemoglobinopathies. Braz Oral Res 2024; 38:e052. [PMID: 38922212 DOI: 10.1590/1807-3107bor-2024.vol38.0052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/29/2024] [Indexed: 06/27/2024] Open
Abstract
The aim of this study was to evaluate the impact of oral conditions and health-related quality of life (HRQoL) on oral health-related quality of life (OHRQoL) in children and adolescents with blood coagulation disorders and hemoglobinopathies (BCDH). The study was cross-sectional and included 61 individuals aged 2 to 18 years with BCDH. Exams for dental caries (dmft/DMFT index), oral hygiene (simplified oral hygiene index - OHI-S), and gingival health (modified gingival index - MGI) were performed. The pediatric quality of life inventory™ (PedsQL™) generic core scale and oral health scale were used to measure HRQoL and OHRQoL. Spearman's correlation coefficient (ρ) and the Mann-Whitney test (α = 0.05) were conducted to assess the relationship between covariates and the PedsQL™ oral health scale. The mean PedsQL™ oral health scale score was 76.66 (SD = 21.36). Worse OHRQoL was correlated with poor oral hygiene (ρ = -0.383; p: 0.004), poor gingival health (ρ = -0.327; p = 0.014), and better HRQoL (ρ = 0.488; p < 0.001). Greater untreated dental caries experience was associated with worse OHRQoL (p = 0.009). Worse oral health status in children and adolescents with BCDH negatively impacts OHRQoL, and OHRQoL and quality of life analyzed from a generic perspective are positively correlated constructs in this population.
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Affiliation(s)
- Leandro Tavares da Silva
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | | | - Gabriela Silva Almeida
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | - Victor Cordeiro da Silva
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
| | | | - Cristiane Baccin Bendo
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brazil
| | | | | | - Fabian Calixto Fraiz
- Universidade Federal do Paraná - UFPR, School of Dentistry, Department of Stomatology, Curitiba, PR, Brazil
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Timms L, Rodd H, Deery C, Brocklehurst P, Marshman Z. Silver diamine fluoride for the management of dental caries in children in primary dental care: protocol for a feasibility study. Pilot Feasibility Stud 2024; 10:95. [PMID: 38915111 PMCID: PMC11194932 DOI: 10.1186/s40814-024-01519-y] [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: 10/23/2023] [Accepted: 06/12/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Dental caries remains a significant problem in England, affecting 11% of 3-year-olds and 23% of 5-year-olds. While current approaches have been extensively investigated, their ability to (1) control pain and infection; (2) prevent hospital admissions, and (3) be implemented within the National Health Service (NHS) contractual arrangements, remains unsatisfactory. Silver diamine fluoride (SDF) is an alternative, non-invasive approach that has proven efficacy in arresting caries progression in primary teeth, principally from studies conducted outside of Europe. Its use in primary dental care in the UK is limited, despite the acknowledged need. The clinical and cost-effectiveness of SDF has not been compared to usual care in the UK. Before a pragmatic randomised controlled trial (RCT) can be conducted to compare SDF to usual care for caries management in young children, there are several uncertainties that require investigation. This study aims to establish whether such an RCT is feasible. METHODS This mixed-method parallel design study is a feasibility study with an embedded process evaluation, to compare SDF with usual treatment in primary dental care in the UK. It will be individually randomised, with 13 dentists and therapists, in 8 different dental primary care sites with a sample size of 80 child participants aged 1-8 years old. The aim will be to recruit ten participants per site with equal arm allocation. Follow-up will be for 1 year. The study will inform whether an RCT is feasible by resolving several key uncertainties. The acceptability and implementation of SDF and the research processes will be explored. Patient and Public Involvement and Engagement representatives will be involved throughout recruitment and retention strategies, participant documentation, analysis, engagement and dissemination. DISCUSSION The ability to conduct an RCT will be evaluated. If feasible, this RCT has the potential to evaluate the effectiveness of a non-invasive approach for the management of untreated caries in young children. A feasibility study also offers the opportunity to consider factors associated with the implementation of SDF at an early stage through a process evaluation that will inform the definitive trial and an implementation strategy for SDF by identifying relevant barriers and facilitators. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT06092151. Date: 19/10/2023.
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Affiliation(s)
- Laura Timms
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
| | - Helen Rodd
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Chris Deery
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Paul Brocklehurst
- Dental Public Health, Primary Care Division, Public Health Wales, 10 Llys Castan Parc Menai, Bangor, Wales, UK
| | - Zoe Marshman
- School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Fenwicke A, George A, Blythe S, Prabhu N. Knowledge, Attitudes, and Practices of Dental Practitioners in Providing Care to Children in Out-of-Home Care: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:802. [PMID: 38929048 PMCID: PMC11204082 DOI: 10.3390/ijerph21060802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/11/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
A scoping review was conducted to synthesize available evidence of knowledge, attitudes, and practices of dental practitioners in providing care to children in out-of-home care (OOHC). Scientific databases and the grey literature were searched: 855 studies were screened after removing duplicates; 800 studies were excluded based on the title and/or abstract, and the full text of 55 studies was reviewed, with 7 included in the analysis. These included three peer-reviewed articles regarding the knowledge, attitudes, and practices of dental practitioners in providing care to children in OOHC, as well as four guidelines. Dental practitioners had some knowledge of the high health care needs of OOHC children, but knowledge regarding when children entering care received dental assessment and about OOHC dental care pathways was low. Practices of dental practitioners were varied, most gave oral hygiene instructions, but there was inconsistency in practices regarding continuity of care following placement changes and failure to attend policies. There was more consensus with dental practitioner attitudes, with practitioners in private settings seeming to prefer not to treat children in OOHC. Three of the identified guidelines provided logistical information about OOHC and consent. The final guideline gave practical information on treating children with a background of adverse childhood events (ACEs), including children in OOHC. Further research and education is warranted to aid dental practitioners in providing care to children in OOHC.
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Affiliation(s)
- Andrea Fenwicke
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia; (A.F.); (A.G.)
- Westmead Centre for Oral Health, Western Sydney Local Health District, New South Wales Health, Westmead, NSW 2145, Australia
| | - Ajesh George
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia; (A.F.); (A.G.)
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Liverpool, NSW 2750, Australia;
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW 2522, Australia
- Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia
| | - Stacy Blythe
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Liverpool, NSW 2750, Australia;
- School of Nursing and Midwifery, University of Technology Sydney, Ultimo, NSW 2007, Australia
| | - Neeta Prabhu
- School of Dentistry, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia; (A.F.); (A.G.)
- Westmead Centre for Oral Health, Western Sydney Local Health District, New South Wales Health, Westmead, NSW 2145, Australia
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Velliyagounder K, Chavan K, Markowitz K. Iron Deficiency Anemia and Its Impact on Oral Health-A Literature Review. Dent J (Basel) 2024; 12:176. [PMID: 38920877 PMCID: PMC11202564 DOI: 10.3390/dj12060176] [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: 01/10/2024] [Revised: 05/06/2024] [Accepted: 05/15/2024] [Indexed: 06/27/2024] Open
Abstract
Oral disease interventions primarily focus on behavioral changes like dietary improvements and ensuring better oral hygiene. However, recognizing the influence of biological factors, including genetics and early-life nutrition, is crucial. Iron deficiency (ID) and its advanced form, iron deficiency anemia (IDA), affect nearly two billion people globally, especially children and pregnant women. We conducted a comprehensive search using Medline via EndNote and Web of Science, employing keywords related to iron deficiency anemia (IDA), and we identified 36 studies deemed relevant for inclusion in this literature review. IDA prevalence is notably high among pregnant women and young children. Both IDA and early-childhood caries (ECC) disproportionately affect impoverished populations, highlighting the socioeconomic dimension of this issue. IDA presents with various oral mucosal changes and is closely linked to candidiasis. Additionally, IDA can hinder tooth development and weaken the immune response. Multiple population surveys have revealed a significant association between ECC and IDA. While some studies have explored the IDA-periodontal disease link, the current evidence is relatively limited in its robustness. In conclusion, more comprehensive longitudinal studies are essential to deepen our understanding of the IDA-oral disease connection. Investigating the underlying biological mechanisms is critical to developing effective interventions, particularly for vulnerable populations affected by IDA.
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Affiliation(s)
- Kabilan Velliyagounder
- Department of Oral Biology, Rutgers School of Dental Medicine, 110 Bergen Street, Newark, NJ 07103, USA; (K.C.); (K.M.)
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Gomersall JC, Slack-Smith L, Kilpatrick N, Muthu MS, Riggs E. Interventions with pregnant women, new mothers and other primary caregivers for preventing early childhood caries. Cochrane Database Syst Rev 2024; 5:CD012155. [PMID: 38753314 PMCID: PMC11098061 DOI: 10.1002/14651858.cd012155.pub3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND Dental caries, a common chronic disease of childhood, is associated with adverse health and economic consequences for infants and their families. Socioeconomically disadvantaged children have a higher risk of early childhood caries (ECC). This review updates one published in 2019. OBJECTIVES To assess the effects of interventions undertaken with pregnant women, new mothers or other primary caregivers of infants in the first year of life, for preventing ECC (from birth to six years). SEARCH METHODS We searched Cochrane Oral Health's Trials Register, Cochrane Pregnancy and Childbirth's Trials Register, CENTRAL, MEDLINE (Ovid), Embase (Ovid), CINAHL EBSCO, the US National Institutes of Health Ongoing Trials Register (clinicaltrials.gov) and WHO International Clinical Trials Registry Platform (apps.who.int/trialsearch). The latest searches were run on 3 January, 2023. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing interventions with pregnant women, or new mothers and other primary caregivers of infants in the first year of life, against standard care, placebo or another intervention, reporting on a primary outcome: caries presence in primary teeth, dmfs (decayed, missing, filled primary surfaces index), or dmft (decayed, missing, filled teeth index), in children up to six years of age. Intervention types include clinical, oral health promotion/education (hygiene education, breastfeeding and other dietary advice) and policy or service. DATA COLLECTION AND ANALYSIS Two review authors independently assessed study eligibility, extracted data, assessed risk of bias, and assessed certainty of evidence (GRADE). MAIN RESULTS We included 23 RCTs (5 cluster-randomised), involving 25,953 caregivers (mainly mothers) and their children. Fifteen trials assessed oral health education/promotion interventions against standard care. Six trials assessed a clinical intervention for mother dentition, against placebo, or a different type of clinical intervention. Two trials assessed oral health/education promotion plus clinical intervention (for mother's dentition) against standard care. At most, five trials (maximum of 1326 children and 130 mothers) contributed data to any comparison. Enamel-only caries were included in the diagnosis of caries in some studies. For many trials, the risk of bias was unclear due to lack of methodological details reported. In thirteen trials, participants were socioeconomically disadvantaged. No trial indicated receiving funding that was likely to have influenced their results. Oral health education/promotion interventions Child diet and feeding practice advice versus standard care: We observed a probable 15 per cent reduced risk of caries presence in primary teeth with the intervention (RR 0.85, 95% CI 0.75 to 0.97; 3 trials; 782 participants; moderate-certainty evidence), and there may be a slightly lower mean dmfs (MD -0.29, 95% CI -0.58 to 0; 2 trials; 757 participants; low-certainty evidence); however, the evidence is very uncertain regarding the difference between groups in mean dmft (MD -0.90, 95% CI -1.85 to 0.05; 1 trial; 340 participants; very low-certainty evidence). Breastfeeding promotion and support versus standard care: We observed little or no difference between groups in the risk of caries presence in primary teeth (RR 0.96, 95% CI 0.89 to 1.03; 2 trials; 1148 participants; low-certainty evidence) and in mean dmft (MD -0.12, 95% CI -0.59 to 0.36; 2 trials; 652 participants; low-certainty evidence). dmfs was not reported. Child diet advice compared with standard care: We are very uncertain about the effect on the risk of caries presence in primary teeth (RR 1.08, 95% CI 0.34 to 3.37; 1 trial; 148 participants; very low-certainty evidence). dmfs and dmft were not reported. Oral hygiene, child diet and feeding practice advice versus standard care: The evidence is very uncertain about the effect on the risk of caries presence in primary teeth (RR 0.73, 95% CI 0.50 to 1.07; 5 trials; 1326 participants; very low-certainty evidence) and there maybe little to no difference in mean dmfs (MD -0.87, 95% CI -2.18 to 0.43; 2 trials; 657 participants; low-certainty evidence) and mean dmft (MD -0.30, 95% CI -0.96 to 0.36; 1 trial; 187 participants; low-certainty evidence). High-dose versus low-dose vitamin D supplementation during pregnancy: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.99, 95% CI 0.70 to 1.41; 1 trial; 496 participants; very low-certainty evidence). dmfs and dmft were not reported. Clinical interventions (for mother dentition) Chlorhexidine (CHX, a commonly prescribed antiseptic agent) or iodine-NaF application and prophylaxis versus placebo: We are very uncertain regarding the difference in risk of caries presence in primary teeth between antimicrobial and placebo treatment for mother dentition (RR 0.97, 95% CI 0.80 to 1.19; 3 trials; 479 participants; very low-certainty evidence). No trial reported dmfs or dmft. Xylitol compared with CHX antimicrobial treatment: We are very uncertain about the effect on caries presence in primary teeth (RR 0.62, 95% CI 0.27 to 1.39; 1 trial, 96 participants; very low-certainty evidence), but we observed there may be a lower mean dmft with xylitol (MD -2.39; 95% CI -4.10 to -0.68; 1 trial, 113 participants; low-certainty evidence). No trial reported dmfs. Oral health education/promotion plus clinical interventions (for mother dentition) Diet and feeding practice advice for infants and young children plus basic dental care for mothers compared with standard care: We are very uncertain about the effect on risk of caries presence in primary teeth (RR 0.44, 95% CI 0.05 to 3.95; 2 trials, 324 participants; very low-certainty evidence) or on mean dmft (1 study, not estimable). No trial reported dmfs. No trials evaluated policy or health service interventions. AUTHORS' CONCLUSIONS There is moderate-certainty evidence that providing advice on diet and feeding to pregnant women, mothers or other caregivers with children up to the age of one year probably leads to a slightly reduced risk of early childhood caries (ECC). The remaining evidence is low to very-low certainty and is insufficient for determining which, if any, other intervention types and features may be effective for preventing ECC, and in which settings. Large, high-quality RCTs of oral health education/promotion, clinical, and policy and service access interventions, are warranted to determine the effects and relative effects of different interventions and inform practice. We have identified 13 ongoing studies. Future studies should consider if and how effects are modified by intervention features and participant characteristics (including socioeconomic status).
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Affiliation(s)
- Judith C Gomersall
- Life Course and Intergenerational Health Research Group, Robinson Research Institute and School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Nicky Kilpatrick
- Vascular Biology, Murdoch Children's Research Institute, Melbourne, Australia
- Plastic and Maxillofacial Surgery, Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Carlton, Australia
| | - M S Muthu
- Centre for Early Childhood Caries Research, Department of Pediatric and Preventive Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Elisha Riggs
- Intergenerational Health, Murdoch Children's Research Institute, Parkville, Australia
- Department of General Practice, The University of Melbourne, Melbourne, Australia
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Sritangsirikul S, Kitsahawong K, Matangkasombut O, Seminario AL, Pitiphat W. A longitudinal study on the impact of breastfeeding with or without formula milk on dental caries. Sci Rep 2024; 14:10384. [PMID: 38710791 DOI: 10.1038/s41598-024-60582-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 04/24/2024] [Indexed: 05/08/2024] Open
Abstract
Concerns exist about prolonged breastfeeding increasing dental caries risk, but evidence is mixed. This 2-year cohort study followed 486 toddlers, to examine the association between breastfeeding duration and caries at age 3. Caregivers reported feeding practices and potential confounders every 6 months. "Full breastfeeding" was defined as feeding breastmilk without formula milk regardless of other foods/liquids, whereas "any breastfeeding" was feeding breastmilk with/without formula milk. A calibrated dentist performed dental examinations. We used multivariable log-binomial and negative binomial regressions to estimate relative risks (RRs) and 95% confidence intervals (CIs) for caries prevalence and severity, adjusted for confounders. At 3-year-old, 60.3% of children exhibited caries (mean decayed-and-filled-teeth, dft: 3.3). Notably, full breastfeeding for 6-17 months reduced caries prevalence (RR = 0.84, 95%CI 0.73-0.98 for 6-11 months; RR = 0.78, 95%CI 0.63-0.96 for 12-17 months). Conversely, any breastfeeding ≥ 18 months significantly increased caries risk (RR = 1.45, 95%CI 1.31-1.60). Full breastfeeding ≥ 6 months or any breastfeeding 6-17 months was associated with lower dft scores in children. Our findings suggest a complex relationship between breastfeeding duration and caries. Full breastfeeding for moderate durations (6-17 months) offers protective benefits, while any breastfeeding ≥ 18 months increases risk in this population.
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Affiliation(s)
- Sirima Sritangsirikul
- Faculty of Dentistry, PhD Program in Oral Sciences, Khon Kaen University, Muang District, Khon Kaen, 40002, Thailand
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Henri Dunant, Bangkok, 10330, Thailand
| | - Kemporn Kitsahawong
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Muang District, Khon Kaen, 40002, Thailand
| | - Oranart Matangkasombut
- Department of Microbiology and Center of Excellence On Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Henri Dunant, Bangkok, 10330, Thailand
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, Laksi, Bangkok, 10210, Thailand
| | - Ana Lucia Seminario
- Timothy A. DeRouen Center for Global Oral Health, School of Dentistry, University of Washington, Seattle, WA, 98195, USA
| | - Waranuch Pitiphat
- Division of Dental Public Health, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Muang District, Khon Kaen, 40002, Thailand.
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Sulyanto RM, Beall CJ, Ha K, Montesano J, Juang J, Dickson JR, Hashmi SB, Bradbury S, Leys EJ, Edgerton M, Ho SP, Griffen AL. Fungi and bacteria occupy distinct spatial niches within carious dentin. PLoS Pathog 2024; 20:e1011865. [PMID: 38805482 PMCID: PMC11161102 DOI: 10.1371/journal.ppat.1011865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 06/07/2024] [Accepted: 05/09/2024] [Indexed: 05/30/2024] Open
Abstract
The role of bacteria in the etiology of dental caries is long established, while the role of fungi has only recently gained more attention. The microbial invasion of dentin in advanced caries especially merits additional research. We evaluated the fungal and bacterial community composition and spatial distribution within carious dentin. Amplicon 16S rRNA gene sequencing together with quantitative PCR was used to profile bacterial and fungal species in caries-free children (n = 43) and 4 stages of caries progression from children with severe early childhood caries (n = 32). Additionally, healthy (n = 10) and carious (n = 10) primary teeth were decalcified, sectioned, and stained with Grocott's methenamine silver, periodic acid Schiff (PAS) and calcofluor white (CW) for fungi. Immunolocalization was also performed using antibodies against fungal β-D-glucan, gram-positive bacterial lipoteichoic acid, gram-negative endotoxin, Streptococcus mutans, and Candida albicans. We also performed field emission scanning electron microscopy (FESEM) to visualize fungi and bacteria within carious dentinal tubules. Bacterial communities observed included a high abundance of S. mutans and the Veillonella parvula group, as expected. There was a higher ratio of fungi to bacteria in dentin-involved lesions compared to less severe lesions with frequent preponderance of C. albicans, C. dubliniensis, and in one case C. tropicalis. Grocott's silver, PAS, CW and immunohistochemistry (IHC) demonstrated the presence of fungi within carious dentinal tubules. Multiplex IHC revealed that fungi, gram-negative, and gram-positive bacteria primarily occupied separate dentinal tubules, with rare instances of colocalization. Similar findings were observed with multiplex immunofluorescence using anti-S. mutans and anti-C. albicans antibodies. Electron microscopy showed monomorphic bacterial and fungal biofilms within distinct dentin tubules. We demonstrate a previously unrecognized phenomenon in which fungi and bacteria occupy distinct spatial niches within carious dentin and seldom co-colonize. The potential significance of this phenomenon in caries progression warrants further exploration.
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Affiliation(s)
- Rosalyn M. Sulyanto
- Department of Dentistry, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Clifford J. Beall
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, Ohio, United States of America
| | - Kasey Ha
- Department of Dentistry, Boston Children’s Hospital, Boston, Massachusetts, United States of America
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Joseph Montesano
- Harvard School of Dental Medicine, Boston, Massachusetts, United States of America
| | - Jason Juang
- Harvard School of Dental Medicine, Boston, Massachusetts, United States of America
| | - John R. Dickson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Shahr B. Hashmi
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, Ohio, United States of America
| | - Seth Bradbury
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, Ohio, United States of America
- Division of Pediatric Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, United States of America
| | - Eugene J. Leys
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, Ohio, United States of America
| | - Mira Edgerton
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, Buffalo, New York, United States of America
| | - Sunita P. Ho
- Preventive and Restorative Dental Sciences, School of Dentistry, University of California, San Francisco, San Francisco, California, United States of America
| | - Ann L. Griffen
- Division of Biosciences, College of Dentistry, The Ohio State University, Columbus, Ohio, United States of America
- Division of Pediatric Dentistry, College of Dentistry, The Ohio State University, Columbus, Ohio, United States of America
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11
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Lumsden CL, Edelstein BL, Leu CS, Zhang J, Rubin MS, Andrews H. Change in parental knowledge and beliefs about early childhood dental caries following a pragmatic community-based trial. J Public Health Dent 2024. [PMID: 38684426 DOI: 10.1111/jphd.12620] [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: 08/09/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES To evaluate parent knowledge and belief changes following the MySmileBuddy (MSB) early childhood caries (ECC) intervention. METHODS Pre- and post-intervention surveys were completed by 669 parents of children with visually-evident ECC from among 977 participants in a 6-12-month pragmatic community-based caries management trial administered by community health workers (CHWs). Six domains of knowledge about caries and motivating and facilitating determinants were assessed via 26 survey items. Principal components analysis and reliability testing reduced dataset dimensionality. Parent and CHW characteristics were analyzed as potential moderators. Paired T-tests measured pre-to-post-intervention changes. Generalized estimating equations accounted for within-participant correlation with significance set at p < 0.05. RESULTS Twenty items consolidated into five factors (saliva, hygiene, diet, seriousness/susceptibility, and outcome expectations). Six additional items were evaluated individually. Positive post-intervention changes (p < 0.0001) were observed across all factors and all but one individual item (tooth decay is very common). Greatest knowledge increases related to caries as a bacterial disease in two measures, the saliva factor and a single caries belief item tooth decay is an infectious disease (0.59 unit increase, 95% CI [0.55, 0.64] and 0.46 unit increase, 95% CI [0.4, 0.51], respectively), and in the value of fluoridated water over bottled (0.46 unit increase, 95% CI [0.39-0.53]). Most parents improved knowledge of ECC salivary (72%) and dietary risks (57%), and preventative hygiene behaviors (59%). CONCLUSIONS MSB enhanced knowledge and beliefs about caries and confirmed hypothesized mediators of behavior change among parents of high-risk children. Engaging peer-like CHW interventionists may have moderated intervention effects, warranting further exploration.
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Affiliation(s)
- Christie L Lumsden
- Section of Oral, Diagnostic, and Rehabilitation Sciences, Columbia University College of Dental Medicine, New York, New York, USA
| | - Burton L Edelstein
- Department of Health Policy and Management, Professor Emeritus of Dental Medicine (in Pediatric Dentistry) and Health Policy & Management at Columbia University Irving Medical Center, Columbia University College of Dental Medicine and Mailman School of Public Health, New York, New York, USA
| | - Cheng-Shiun Leu
- Department of Biostatistics, Mailman School of Public Health, New York, New York, USA
| | - Jiaqing Zhang
- Department of Human Development, Teachers College Columbia University, New York, New York, USA
| | - Marcie S Rubin
- Section of Growth and Development, Columbia University College of Dental Medicine, New York, New York, USA
| | - Howard Andrews
- Columbia Data Coordinating Center, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York, USA
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12
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Endrighi R, Henshaw M, Adams WG, Montion E, Park H, Borrelli B. The Longitudinal Reciprocal Relationships of Tooth Brushing Behaviors Between Underserved Children and Their Caregivers. Ann Behav Med 2024; 58:353-362. [PMID: 38489828 DOI: 10.1093/abm/kaae010] [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] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Tooth brushing is effective in preventing early childhood caries. However, it is unclear how children's and caregiver's tooth brushing are reciprocally related. PURPOSE The current study investigated whether the longitudinal relationships between children and caregiver tooth brushing are moderated by a caregiver-targeted child oral health intervention and caregiver depression. METHODS Secondary analysis of a randomized clinical trial that tested whether caregiver-targeted oral health text messages (OHT) outperformed child wellness text messages (CWT) on pediatric dental caries and oral health behaviors (n = 754, mean child age = 2.9 years, 56.2% Black, 68.3% RESULTS Within-participants analyses revealed that caregiver tooth brushing at Months 4 and 12 positively predicted their child's tooth brushing at Months 12 and 24 for caregivers in the OHT condition with low depressive symptoms (i.e., moderation by depressive symptoms and condition). Similarly, children's tooth brushing at Month 4 positively predicted caregiver tooth brushing at Month 12 for caregivers in the OHT condition with low depressive symptoms. There were no significant associations among participants in the CWT condition, regardless of depressive symptoms. CONCLUSIONS Child and caregiver tooth brushing have reciprocal influences, but only for those in the OHT condition with low depressive symptoms.
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Affiliation(s)
- Romano Endrighi
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Michelle Henshaw
- Office of Global & Population Health and Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - William G Adams
- Department of Pediatrics, Boston Medical Center, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Erin Montion
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Hannah Park
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
| | - Belinda Borrelli
- Center for Behavioral Science Research, Department of Health Policy & Health Services Research, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA, USA
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Huang HY, Yang YT, Chuang CC, Shen YK, Chen MH, Lin WC. Evaluation of the clinical application of personalized 3D printing and CAD/CAM resin crowns to replace stainless steel crowns in paediatric dentistry. Int J Paediatr Dent 2024. [PMID: 38570933 DOI: 10.1111/ipd.13182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 11/23/2023] [Accepted: 01/04/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Children with dental caries are treated with stainless steel metal crowns (SSC), but the aesthetics and precision still need to be improved. Currently, both 3D-printed resin crowns (PRC) and computer-aided design/computer-aided manufacture (CAD/CAM) resin crowns (CRC) meet the clinical requirements for crown applications in terms of strength, production time, cost, and aesthetics. AIM This study replaced SSC with customized resin crowns by 3D printing and CAD/CAM. DESIGN In this study, PRC, CRC, and SSC were used for incisor and molar restorations, and 60 crowns were made with 10 for each group. The fabrication efficiency, surface characteristics, marginal fit, and stability of the two different crowns were evaluated. RESULTS PRC and CRC show superior color and surface characteristics, though production times are longer (5.3-12.4 times and 3.3-9.1 times, respectively) than for SSC (p < .05). They, however, can be completed within 80 min. Edge gaps for PRC and CRC are significantly lower (13.0-19.2 times and 13.0-13.7 times) than for SSC (p < .05). All materials exhibit good stability. CONCLUSION The 3D-PRCs and CAD/CAM resin crowns may replace SSCs as a potential choice for clinical child caries.
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Affiliation(s)
- Huei-Yu Huang
- Department of Pediatric Dentistry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Ya-Ting Yang
- Department of Pediatric Dentistry, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
| | - Chun-Chao Chuang
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University, Taichung, Taiwan
- Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yung-Kang Shen
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Mu-Hsiung Chen
- Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Wei-Chun Lin
- School of Dental Technology, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Center for Tooth Bank and Dental Stem Cell Technology, Taipei Medical University, Taipei, Taiwan
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Parmar JS, Sanagavarapu P, Micheal S, Chandio N, Cartwright S, Arora A. A Qualitative Study of Preschool Children's Perspectives on an Oral Health Promotion Program in New South Wales, Australia. CHILDREN (BASEL, SWITZERLAND) 2024; 11:415. [PMID: 38671632 PMCID: PMC11049284 DOI: 10.3390/children11040415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024]
Abstract
In Australia, dental caries are observed in almost half of children starting school. Oral health promotion programs are being implemented in early childhood education and care (ECEC) settings to promote oral health. This study examined children's perceptions of one such program, the Bright Smiles Bright Futures (BSBF) program in ECEC settings in New South Wales, Australia. Data were collected using focus group discussions from 15 children aged 3-5 years, transcribed verbatim, and analysed through inductive thematic analysis. Three themes were identified as follows: (i) oral health knowledge of children, (ii) oral hygiene practices routine and skills development, and (iii) evaluation of the oral health promotion kit and opportunities for improvement. Children's perspectives highlight the BSBF program's success in communicating key messages to promote oral health. The integration of family-centric approaches, acknowledgement of children's preferences, and the use of interactive tools collectively enhance the overall effectiveness of the oral health promotion program.
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Affiliation(s)
- Jinal Shashin Parmar
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (J.S.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
| | - Prathyusha Sanagavarapu
- School of Education, Western Sydney University, Bankstown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia;
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia;
| | - Sowbhagya Micheal
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia;
- School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia
| | - Navira Chandio
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (J.S.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia;
| | - Susan Cartwright
- Colgate-Palmolive Pty Ltd., 420 George St., Sydney, NSW 2000, Australia;
| | - Amit Arora
- School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia; (J.S.P.); (N.C.)
- Health Equity Laboratory, Campbelltown, NSW 2560, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown Campus, Locked Bag 1797, Penrith, NSW 2751, Australia;
- Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW 2010, Australia
- Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW 2145, Australia
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15
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Lumsden CL, Edelstein BL, Leu CS, Zhang J, Levine J, Andrews H. Behavioral Outcomes of a Pragmatic Early Childhood Caries Management Trial. JDR Clin Trans Res 2024; 9:140-149. [PMID: 37553996 DOI: 10.1177/23800844231189483] [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] [Indexed: 08/10/2023] Open
Abstract
OBJECTIVES To evaluate a preventative behavioral intervention for managing early childhood caries (ECC) in a cohort of high-risk children. METHODS This pragmatic trial of the MySmileBuddy Program (MSB) evaluated preventive behavioral outcomes in a 1-y community health worker-delivered intervention to prevent ECC progression. Pre-/postintervention surveys assessed parent-reported child engagement in therapeutic toothbrushing (i.e., adult-assisted brushing with fluoridated toothpaste twice daily) and caries-related dietary behaviors and barriers. Generalized linear model with identity link for continuous variables and logit link for dichotomous outcomes evaluated pre-/postintervention comparisons and generalized estimating equations accounted for within-participant correlation (α = 0.05). RESULTS Among 1,130 children with postintervention data, the average age was 3.97 y, 99% were Medicaid insured, and 88% were Hispanic. Most parents (95%) were mothers/grandmothers, married or in a committed partnership (75%), unemployed (62%), and with modest education (80% high school degree or less). The odds of reported therapeutic brushing nearly doubled (n = 864; odds ratio [OR] = 1.79, 95% confidence interval [CI] = 1.46, 2.20, P < 0.001); day and night bottle/sippy cup frequencies dropped 0.29 units (n = 871; 95% CI = -0.37, -0.33, P < 0.001) and 0.22 units (n = 1,130; 95% CI = -0.30, -0.15, P < 0.001); nighttime breastfeeding reduced 0.15 units (n = 870; 95% CI = -0.21, -0.10, P < 0.001); sharing utensils reduced 0.30 units (n = 572; 95% CI = -0.39, -0.21, P < 0.001); not using sugary foods to calm child improved 0.37 units (n = 664; 95% CI = 0.31, 0.44, P < 0.001); odds of eating meals and snacks at a table increased (n = 572; OR = 1.57, 95% CI = 1.28, 1.93, P < 0.001; n = 572; OR = 1.80, 95% CI = 1.50, 2.15, P < 0.001) respectively; and reducing barriers to behaviors improved 0.38 units for toothbrushing (n = 666; 95% CI = 0.31, 0.44, P < 0.001) and 0.33 units for diet (n = 668; 95% CI = 0.29, 0.38, P < 0.001). CONCLUSION Despite limitations inherent to pragmatic trials, significant behavioral changes suggest that MSB yielded an important salutary impact. Forthcoming mediation analyses will explore causal pathways. Findings support integration of MSB's behavior change program in caries management initiatives. KNOWLEDGE TRANSFER STATEMENT The results of this study can be used by clinicians, public health leaders, and researchers to inform the development and implementation of community-based, preventative behaviorally focused early childhood caries prevention programs. Study findings may enhance the understanding of the impact of behavioral interventions that engage parents of young children and could lead to more effective prevention for populations at high-risk of caries.
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Affiliation(s)
- C L Lumsden
- Columbia University Irving Medical Center, Columbia University College of Dental Medicine, Section of Oral, Diagnostic, and Rehabilitation Sciences, New York, NY, USA
| | - B L Edelstein
- Columbia University Irving Medical Center, Columbia University College of Dental Medicine, and Mailman School of Public Health, Department of Health Policy and Management, New York, NY, USA
| | - C S Leu
- Teachers College Columbia University, Department of Human Development, New York, NY, USA
| | - J Zhang
- Teachers College Columbia University, Department of Human Development, New York, NY, USA
| | - J Levine
- Columbia University College of Dental Medicine, Section of Oral, Diagnostic, and Rehabilitation Sciences, New York, NY, USA
| | - H Andrews
- Columbia Data Coordinating Center, Mailman School of Public Health, Columbia University Irving Medical Center, New York, NY, USA
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16
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Akinkugbe AA, Midya V, Duffy J, Landero J, Wright RO, Wright RJ. Metal mixtures and oral health among children and adolescents in the National Health and Nutrition Examination Survey (NHANES), 2017-2020. Int J Hyg Environ Health 2024; 257:114335. [PMID: 38330728 PMCID: PMC10939733 DOI: 10.1016/j.ijheh.2024.114335] [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] [Received: 10/23/2023] [Revised: 01/30/2024] [Accepted: 02/04/2024] [Indexed: 02/10/2024]
Abstract
INTRODUCTION Dental caries is the most common non-communicable human disease, yet little is known about the role of environmental metals, despite teeth consisting of a hard matrix of trace elements. We conducted a cross-sectional study of associations between environmental metals and objective assessment of dental caries and subjective assessments of oral health among a representative sample of U.S. children and adolescents. METHODS Data were from the 2017-March 2020 pre-pandemic data file of the National Health and Nutrition Examination Survey (NHANES). To account for metal mixtures, we used weighted quantile sum (WQS) regression to estimate the joint impact of multiple trace elements assessed in blood and urine with oral disease outcomes. RESULTS The blood metal mixture index was associated with a 32% (95% CI: 1.11, 1.56) increased risk of decayed surfaces while the urine metal mixture index was associated with a 106%, RR (95% CI = 2.06 (1.58, 2.70) increased caries risk. For both blood and urine, Mercury (Hg) had the largest contribution to the mixture index followed by Lead (Pb). The WQS blood metal mixture index was also significantly associated with poorer self-rated oral health, although the magnitude of the association was not as strong as for the objective oral disease measures, RR (95% CI) = 1.04 (1.02, 1.07). DISCUSSION Increased exposure to a metal mixture was significantly related to poorer objective and subjective oral health outcomes among U.S. children and adolescents. These are among the first findings showing that metal mixtures are a significant contributor to poor oral health.
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Affiliation(s)
- A A Akinkugbe
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - V Midya
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Duffy
- Tufts University School of Medicine, Boston, MA, USA
| | - J Landero
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Climate Change, Environmental Health and Exposomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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17
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Park SA, Lim JN, Lee JY. Evaluation of the Effectiveness of Children's Dental Care Programs: A Retrospective Study. Healthcare (Basel) 2024; 12:721. [PMID: 38610144 PMCID: PMC11011933 DOI: 10.3390/healthcare12070721] [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: 02/08/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 04/14/2024] Open
Abstract
This study aimed to evaluate the long-term impact of children's dental care programs on children and adolescents to reduce oral health inequalities. It measured and assessed the improvement effects of children's dental care programs on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and children's dental care program between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. A frequency analysis was conducted for demographic characteristics, and a binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. The data were analyzed using PASW Statistics with the statistical significance level set at α = 0.05. Regarding oral health status based on the frequency of participation in children's dental care program for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health status in children's dental care program between primary and adolescent age groups, individuals under continuous oral health care showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, a binary logistic regression analysis revealed significant influences (p < 0.05) of the developmental stage and frequency of program participation on dental caries prevalence. Children's dental care programs are essential for alleviating oral health inequalities among children and adolescents and preventing oral diseases. Furthermore, the developmental stage of children and the frequency of program participation are crucial factors in preventing oral conditions, such as dental caries.
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Affiliation(s)
- Soo-Auk Park
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan 31116, Republic of Korea;
| | - Ji-Na Lim
- Department of Public Health Science, Graduate School, Dankook University, Cheonan 31116, Republic of Korea;
| | - Jae-Young Lee
- Department of Dental Hygiene, College of Health Science, Dankook University, Cheonan 31116, Republic of Korea;
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18
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Foláyan MO, Amalia R, Kemoli A, Ayouni I, Nguweneza A, Duangthip D, Sun IG, Virtanen JI, Masumo RM, Vukovic A, Al-Batayneh OB, Gaffar B, Mfolo T, Schroth RJ, El Tantawi M. Scoping review on the link between economic growth, decent work, and early childhood caries. BMC Oral Health 2024; 24:77. [PMID: 38218865 PMCID: PMC10787988 DOI: 10.1186/s12903-023-03766-6] [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: 09/14/2023] [Accepted: 12/12/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Early Childhood Caries (ECC) is a prevalent chronic non-communicable disease that affects millions of young children globally, with profound implications for their well-being and oral health. This paper explores the associations between ECC and the targets of the Sustainable Development Goal 8 (SDG 8). METHODS The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to economic growth, decent work sustained economic growth, higher levels of productivity and technological innovation, entrepreneurship, job creation, and efforts to eradicate forced labor, slavery, and human trafficking and ECC all of which are the targets of the SDG8. Only English language publications, and publications that were analytical in design were included. Studies that solely examined ECC prevalence without reference to SDG8 goals were excluded. RESULTS The initial search yielded 761 articles. After removing duplicates and ineligible manuscripts, 84 were screened. However, none of the identified studies provided data on the association between decent work, economic growth-related factors, and ECC. CONCLUSIONS This scoping review found no English publication on the associations between SDG8 and ECC despite the plausibility for this link. This data gap can hinder policymaking and resource allocation for oral health programs. Further research should explore the complex relationship between economic growth, decent work and ECC to provide additional evidence for better policy formulation and ECC control globally.
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Affiliation(s)
- Morẹ́nikẹ́ Oluwátóyìn Foláyan
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Rosa Amalia
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive and Community Dentistry, Faculty of Dentistry, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Arthur Kemoli
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Paediatric Dentistry and Orthodontics, University of Nairobi, Nairobi, Kenya
| | - Imen Ayouni
- Department of Pediatrics and Child Health, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Arthemon Nguweneza
- Division of Human Genetics, Department of Pathology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Duangporn Duangthip
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, SAR, China
| | - Jorma I Virtanen
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway
| | - Ray M Masumo
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Community Health and Nutrition, Tanzania Food and Nutrition Centre, Dar es Salaam, Tanzania
| | - Ana Vukovic
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Clinic for Pediatric and Preventive Dentistry, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Ola B Al-Batayneh
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Balgis Gaffar
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Tshepiso Mfolo
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Community Dentistry, University of Pretoria, Pretoria, South Africa
| | - Robert J Schroth
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Canada
| | - Maha El Tantawi
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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19
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Bakar M, Johnston B, Fitzgerald K, Casby C, Duane B. Environmental impact of the supervised toothbrushing programme amongst children in Scotland. J Dent 2023; 139:104773. [PMID: 37931697 DOI: 10.1016/j.jdent.2023.104773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/01/2023] [Accepted: 11/02/2023] [Indexed: 11/08/2023] Open
Abstract
OBJECTIVES To understand the environmental impact of providing a nationwide supervised toothbrushing programme (Childsmile) for 5-year-old children in Scotland. METHODS A life cycle assessment was conducted to assess the annual environmental effects of the supervised toothbrushing programme in early years childcare, as well as each dental procedure (dental restoration under local anaesthesia (LA), single tooth extraction under LA, and multiple teeth extraction under general anaesthesia) spanning from 2001/02 to 2009/10. The expected savings in annual carbon dioxide equivalent (CO2e) emissions for all combined dental treatments in subsequent years were calculated compared to those in 2001/02. RESULTS An overall decrease in CO2e emissions was evident in the Childsmile programme and across all dental procedures. The estimated reduction in emissions across all procedures varied from 102.5 tonnes in 2002/03 to 461.1 tonnes in 2009/10 when compared to 2001/02. Within three years, the expected emissions savings from all combined dental procedures surpassed the emissions generated by implementing the Childsmile programme. CONCLUSIONS Over time, there was a significant reduction in annual CO2e emissions for all combined dental treatments in children. In the eighth year of the Childsmile, emissions savings were more than 4.5 times greater than the emissions generated during its implementation. CLINICAL SIGNIFICANCE The study highlights the importance of educating public by individual dentists about the environmental impact of caries prevention programmes and paediatric dental treatments as this may influence patient choice. It also encourages commissioners of community dental programmes to support the implementation of supervised toothbrushing programmes in early years childcare.
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Affiliation(s)
- Majidi Bakar
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland.
| | - Bridget Johnston
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland
| | - Kirsten Fitzgerald
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland
| | - Caoimhe Casby
- Children's Health Ireland, Crumlin, Dublin D12 N512, Ireland
| | - Brett Duane
- Dublin Dental University Hospital, Trinity College Dublin, Dublin D02 F859, Ireland
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20
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Samuel SR, Lai CWM, Khan MM, Mathew MG, Kramer MS, Hsu CYS. Gestational Serum Retinol Deficiency Is Associated with Enamel Hypoplasia. J Dent Res 2023; 102:1417-1424. [PMID: 37899507 DOI: 10.1177/00220345231200788] [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] [Indexed: 10/31/2023] Open
Abstract
Enamel hypoplasia (EH) is a prevalent developmental defect of teeth that can result from various insults, including prenatal nutrient deficiencies. This study aimed to evaluate the association between prenatal serum retinol deficiency and EH in the deciduous teeth of offspring at 2-y of age. A cohort of 1,450 pregnant women was enrolled, and their prenatal nutritional status was assessed between 12 and 14 wk of gestation. Maternal serum retinol, serum 25-hydroxyvitamin D (25OHD), hemoglobin, body mass index, and birth outcomes, infant feeding practices, family socioeconomic status, and demographic information were recorded. Oral health examinations were conducted for the children semiannually, and EH was diagnosed using the Modified DDE index on all the surfaces of erupted teeth. A modified Poisson regression analysis was used to assess the cumulative risk of EH over a period of 2-y. A total of 920 (63.4%) mother-child pairs completed the study, and the cumulative EH prevalence among offspring after 2-y of follow-up was 16.5% (N = 152; 87/1,114 children in the first year and 132/920 in the second year, with 20/920 having EH only in the first year). After adjusting for potential confounders, maternal serum retinol deficiency significantly increased the risk of deciduous EH (risk ratio [RR], 2.0; 95% confidence interval [CI], 1.1-3.7). In addition, deficient serum 25OHD (RR, 6.5; 95% CI, 4.0-10.7), caesarean delivery (RR, 1.6; 95% CI, 1.0-2.4), Muslim (RR, 2.9; 95% CI, 2.0-4.1) and Christian (RR, 2.4; 95% CI, 1.6-3.5) versus Hindu religions, and very preterm birth (RR, 1.7; 95% CI, 1.1-2.9) increased the risk of EH. Children presenting with EH had 2 or more teeth affected, and the maxillary incisors were the most frequently affected, followed by the first primary molars and canines. In conclusion, maternal serum retinol deficiency during the 12 to 14 wk of gestation may increase the risk of deciduous EH, besides the well-established 25OHD deficiency.
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Affiliation(s)
- S R Samuel
- The Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
| | - C W M Lai
- Faculty of Dentistry, National University of Singapore, Singapore
| | - M M Khan
- Department of Pediatric Dentistry, Taif University, Taif, Saudi Arabia
| | - M G Mathew
- Pediatric and Preventive Dentistry, Christian Dental College, Ludhiana, Punjab, India
| | - M S Kramer
- Departments of Pediatrics and of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University Faculty of Medicine, Montreal, Canada
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - C-Y S Hsu
- Faculty of Dentistry, National University of Singapore, Singapore
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21
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Ramage G, Borghi E, Rodrigues CF, Kean R, Williams C, Lopez-Ribot J. Our current clinical understanding of Candida biofilms: where are we two decades on? APMIS 2023; 131:636-653. [PMID: 36932821 DOI: 10.1111/apm.13310] [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: 02/27/2023] [Accepted: 03/12/2023] [Indexed: 03/19/2023]
Abstract
Clinically we have been aware of the concept of Candida biofilms for many decades, though perhaps without the formal designation. Just over 20 years ago the subject emerged on the back of progress made from the bacterial biofilms, and academic progress pace has continued to mirror the bacterial biofilm community, albeit at a decreased volume. It is apparent that Candida species have a considerable capacity to colonize surfaces and interfaces and form tenacious biofilm structures, either alone or in mixed species communities. From the oral cavity, to the respiratory and genitourinary tracts, wounds, or in and around a plethora of biomedical devices, the scope of these infections is vast. These are highly tolerant to antifungal therapies that has a measurable impact on clinical management. This review aims to provide a comprehensive overight of our current clinical understanding of where these biofilms cause infections, and we discuss existing and emerging antifungal therapies and strategies.
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Affiliation(s)
- Gordon Ramage
- School of Medicine, Dentistry and Nursing, University of Glasgow, Glasgow, UK
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
| | - Elisa Borghi
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- Department of Health Sciences, San Paolo Medical School, Università Degli Studi di Milano, Milan, Italy
| | - Célia Fortuna Rodrigues
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- LEPABE-Department of Chemical Engineering, Faculty of Engineering, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, Gandra, Portugal
- ALiCE-Associate Laboratory in Chemical Engineering, Faculty of Engineering, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, Gandra, Portugal
- TOXRUN-Toxicology Research Unit, Cooperativa de Ensino Superior Politécnico e Universitário-CESPU, Gandra, Portugal
| | - Ryan Kean
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- Department of Biological Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Craig Williams
- Study Group for Biofilms (ESGB), European Society for Clinical Microbiology and Infectious Disease, Basel, Switzerland
- Microbiology Department, Morecambe Bay NHS Trust, Lancaster, UK
| | - Jose Lopez-Ribot
- Department of Biology and the South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, Texas, USA
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22
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Feldens CA, Alvarez L, Acevedo AM, Cepeda V, Chirife MT, Gálvez CA, Dezan-Garbelini C, Gudiño-Fernández S, Martignon S, Pérez V, Paiva SM, Zambrano O, Zelada D, Villena R. Early-life sugar consumption and breastfeeding practices: a multicenter initiative in Latin America. Braz Oral Res 2023; 37:e104. [PMID: 38055522 DOI: 10.1590/1807-3107bor-2023.vol37.0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 06/03/2023] [Indexed: 12/08/2023] Open
Abstract
The aim of this multicenter study was to explore the early-life sugar consumption and dietary practices in Latin America as well as to investigate the association between breastfeeding duration and the age at which foods and beverages with added sugars are introduced. A cross-sectional study was conducted with 805 1- to 3-year-old children from 10 Latin American countries, as a complementary study to the Research Observatory for Dental Caries of the Latin American Region (OICAL). A Food Frequency Questionnaire previously tested in different countries was applied to children's mothers and data on breastfeeding and age at introduction of sugary foods and beverages was collected. Statistical analysis included the Kruskal-Wallis test and Poisson regression with robust variance, with the calculation of crude and adjusted mean ratios (MR) and 95% of confidence intervals (CI). The average age at introduction of sugary foods and beverages was 10.1 months (95%CI 9.7-10.4) and 9.6 (95%CI 9.2-9.9) months, respectively, with a significant variation between countries (p < 0.001). The average daily frequency of sugary foods-beverages was 3.3 times per day (95%CI 3.1-3.5) and varied significantly between countries (p = 0.004). Breastfeeding duration of over six months was associated with an increase in the age of introduction of sweet drinks (16%; MR 1.16; 95%CI 1.05-1.28) and foods (21%; MR 1.21; 95%CI 1.10-1.33). In conclusion, most children from vulnerable settings in Latin America start consuming sugary products in the first year of life and a high frequency of consumption was reported through early childhood. Additionally, breastfeeding contributes to a delay in the introduction of sugary products.
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Affiliation(s)
- Carlos Alberto Feldens
- Universidade Luterana do Brasil - Ulbra, Department of Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Licet Alvarez
- Universidad de la República Uruguay - Udelar, Department of Pediatric Dentistry, Montevideo, Uruguay
| | - Ana María Acevedo
- Universidad Central de Venezuela, Faculty of Dentistry, Institute of Dental Research, Caracas, Venezuela
| | - Veronica Cepeda
- Universidad Internacional del Ecuador - Uide, Faculty of Dentistry, Quito, Ecuador
| | - Maria Teresa Chirife
- Universidad Autónoma del Paraguay, Department of Pediatric Dentistry, Asunción, Paraguay
| | | | | | - Sylvia Gudiño-Fernández
- Universidad de Costa Rica, Pediatric Dentistry Master, San José Postgraduate Study Sistem, San José, Costa Rica
| | | | - Vidal Pérez
- Universidad de Talca, Department of Pediatric Dentistry, Talca, Chile
| | - Saul Martins Paiva
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Pediatric Dentistry, Belo Horizonte, MG, Brasil
| | - Olga Zambrano
- Universidad del Zulia, Institute of Dental Research, Maracaibo, Zulia, Venezuela
| | - Diana Zelada
- Universidad San Martin de Porres - USMP, Department of Pediatric Dentistry. Lima, Perú
| | - Rita Villena
- Universidad San Martin de Porres - USMP, Department of Pediatric Dentistry, Lima, Perú
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23
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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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24
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Do LG, Song YH, Du M, Spencer AJ, Ha DH. Socioecological determinants of child oral health-A scoping review. Community Dent Oral Epidemiol 2023; 51:1024-1036. [PMID: 36440603 DOI: 10.1111/cdoe.12819] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Abstract
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.
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Affiliation(s)
- Loc G Do
- Population Oral Health, School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
| | - Young Ha Song
- Department of Preventive and Social Dentistry, School of Dentistry, Seoul National University, Seoul, Korea
- Dental Research Institute, Seoul National University, Seoul, Korea
| | - Mi Du
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - A John Spencer
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Diep H Ha
- Population Oral Health, School of Dentistry, The University of Queensland, Brisbane, Queensland, Australia
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25
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Cohen-Cline H, Ahmed J, Holtorf M, McKeane L, Bartelmann S. Impact of oral health integration training on children's receipt of oral assessment, fluoride varnish and dental services. Community Dent Oral Epidemiol 2023; 51:1017-1023. [PMID: 36345788 DOI: 10.1111/cdoe.12810] [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: 12/29/2021] [Revised: 09/30/2022] [Accepted: 10/21/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To evaluate the impact of an oral health integration training program on children's receipt of oral health and dental services in Southern Oregon. METHODS Children under 19 years with at least 6 months of Medicaid enrolment and at least one healthcare visit from 2014 to 2018 were included. The treatment group included children with at least one visit with a trained provider (n = 5541); children with no visits with trained providers (n = 8273) were the control group. The percentage of the treatment group who received oral health assessments was calculated, and regression models were developed to estimate the difference in likelihood of receiving fluoride varnish and dental services between treatment and control groups. RESULTS The percentage of children receiving oral health assessments increased over time. Visiting a trained provider was consistently associated, each year, with a greater likelihood of receipt of fluoride varnish and preventive and diagnostic dental services but was not associated with treatment dental services or dental sealants. CONCLUSIONS This study reports evidence for the overall impact of an oral health integration training on children's receipt of oral and dental services. Health systems implementing these types of training strategies should consider how to reach specific underserved subgroups, increase paediatric dentists, and expand efforts to include older children.
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Affiliation(s)
- Hannah Cohen-Cline
- Center for Outcomes Research and Education (CORE), Providence Health & Services, Portland, Oregon, USA
| | - Jannate Ahmed
- Center for Outcomes Research and Education (CORE), Providence Health & Services, Portland, Oregon, USA
| | - Megan Holtorf
- Center for Outcomes Research and Education (CORE), Providence Health & Services, Portland, Oregon, USA
| | | | - Sarah Bartelmann
- Center for Outcomes Research and Education (CORE), Providence Health & Services, Portland, Oregon, USA
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26
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Lembacher S, Hofer V, Bekes K. The Impact of Dental Pain on the Oral Health-Related Quality of Life (OHRQoL) of Preschool Children in Austria. J Clin Med 2023; 12:5906. [PMID: 37762847 PMCID: PMC10532059 DOI: 10.3390/jcm12185906] [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: 07/10/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
Dental pain in children is a global public health burden with psychosocial and economic implications, challenging families and pediatric dentists in daily clinical practice. Previous studies have addressed the exclusive impact of either caries, dental trauma, malocclusion, or socioeconomic status on OHRQoL. Even though such examples can surely cause dental pain in children, so far only little research on the correlation of dental pain as a general symptom of different underlying causes and OHRQoL has been published. The aim of this study was to evaluate the impact of dental pain on the oral health-related quality of life (OHRQoL) of children between the ages of 0 and 6 years old and subsequently compare the results to a control group free of tooth ache. Children and their adult caregivers were recruited from the Emergency unit of the Department of Pediatric Dentistry at the University Clinic of Dentistry in Vienna. The caregivers completed the German version of the Early Childhood Oral Health Impact Scale (ECOHIS-G). Afterwards, the children were clinically examined. The cause for dental pain, dmf-t index, and plaque accumulation were collected. In total, 259 children with a mean age of 4.2 years (SD ± 1.5 years) were included in the study group. Their mean ECOHIS-G score was 9.0 (SD ± 7.4), while the control group only amounted to a score of 4.9 (SD ± 5.6). The difference between the two groups was statistically significant in both ECOHIS-G subsections, the child impact scale (CIS) and the family impact scale (FIS) as well as the ECOHIS-G sum score (p < 0.05). Dmf-t index and plaque accumulation significantly correlated with CIS and ECOHIS sum score (p ≤ 0.05). The reduction in quality of life was nearly twice as great in the children with dental pain as in the control children. The ECOHIS-G is a valid instrument for measuring the OHRQoL of children with dental pain between the ages of 0 to 6.
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Affiliation(s)
| | | | - Katrin Bekes
- Department of Paediatric Dentistry, University Clinic of Dentistry, Medical University Vienna, Sensengasse 2a, 1090 Vienna, Austria; (S.L.); (V.H.)
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Dhyppolito IM, Nadanovsky P, Cruz LR, de Oliveira BH, Dos Santos APP. Economic evaluation of fluoride varnish application in preschoolers: A systematic review. Int J Paediatr Dent 2023; 33:431-449. [PMID: 36695007 DOI: 10.1111/ipd.13049] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 10/20/2022] [Accepted: 01/12/2023] [Indexed: 01/26/2023]
Abstract
BACKGROUND Fluoride varnish (FV) is a convenient way of professionally applying fluoride in preschoolers. However, its modest anticaries effect highlights the need for economic evaluations. AIM To assess economic evaluations reporting applications of FV to reduce caries incidence in preschoolers. DESIGN We included full economic evaluations with preschool participants, in which the intervention was FV and the outcome was related to dentin caries. We searched in CENTRAL; MEDLINE via PubMed; WEB OF SCIENCE; EMBASE; SCOPUS; LILACS; BBO; and BVS Economia em saúde, OpenGrey, and EconoLit. Clinical trial registers, thesis and dissertations, and meeting abstracts were hand searched, as well as 11 dental journals. Risk of bias in the included studies was assessed using the Philips' and Drummond's (full and simplified) tools. RESULTS Titles and abstracts of 2871 articles were evaluated, and 200 were read in full. Eight cost-effectiveness studies were included: five modeling and three within-trial evaluations. None of the studies gave sufficient information to allow a thorough assessment using the bias tools. We did not combine the results of the studies due to the great heterogeneity among them. Four studies reported that FV in preschool children was a cost-effective measure, but in one of these studies, sealants and fluoride toothpaste were more cost-effective measures than the varnish, and three studies used limited data that compromised the generalizability of their results. The other four studies showed a large increase in costs due to the application of varnish and/or low cost-effectiveness. CONCLUSION We did not find convincing overall evidence that applying FV in preschoolers is an anticaries cost-effective measure. The protocol of this systematic review is available at Open Science Framework (https://osf.io/xw5va/).
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Affiliation(s)
- Izabel Monteiro Dhyppolito
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Paulo Nadanovsky
- Department of Epidemiology, Institute of Social Medicine, Rio de Janeiro State University, Rio de Janeiro, Brazil
- Department of Epidemiology, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Laís Rueda Cruz
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Branca Heloisa de Oliveira
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - Ana Paula Pires Dos Santos
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
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28
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Uthayakumar T, Bennett JX, Cartas HL, Brunet M, Vo KL, Kroon J. Passive Smoking and Oral Health of Infants, Preschoolers, and Children: A Systematic Review. Nicotine Tob Res 2023; 25:1625-1632. [PMID: 37311007 PMCID: PMC10445258 DOI: 10.1093/ntr/ntad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 06/02/2023] [Accepted: 06/09/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Almost half of the world's children experience passive smoking, which is linked to numerous oral health conditions. The aim is to synthesize data on the impact of passive smoking on oral health of infants, preschoolers, and children. AIMS AND METHODS A search was conducted across Medline (via EBSCOhost), PubMed, and Scopus up to February 2023. Risk of bias was assessed according to the Newcastle-Ottawa Scale (NOS). RESULTS The initial search produced 1221 records and after removal of duplicates, screening by title and abstract, and full-text assessment, 25 studies were eligible for review and data extraction. The majority of studies (94.4%) found a correlation between passive smoking and increased prevalence of dental caries with three studies suggesting a dose-response relationship. Prenatal passive smoking exposure in 81.8% of studies indicated an increased dental caries experience compared to postnatal exposure. Low parental education, socioeconomic status, dietary habits, oral hygiene, and gender affected the level of environmental tobacco smoke (ETS) exposure and dental caries risk. CONCLUSIONS The results of this systematic review strongly suggest a significant association between dental caries in the deciduous dentition and passive smoking. Early intervention and education on the effects of passive smoking on infants and children will allow for the improvement in oral health outcomes and reduction in smoking-associated systemic conditions. The results justify all health professionals paying more attention to passive smoking when conducting pediatric patient histories, contributing to improved diagnosis and appropriate treatment planning with more suitable follow-up schedules. IMPLICATIONS The evidence from this review that environmental tobacco smoke and passive smoking is a risk factor for oral health conditions, both prenatally and postnatally during early childhood, justifies all health professionals paying more attention to passive smoking when conducting pediatric patient histories. Early intervention and appropriate parental education regarding the effects of secondhand smoke on infants and children will allow for the minimization of dental caries, improvement in oral health outcomes and overall reduction in smoking-associated systemic conditions for the children exposed.
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Affiliation(s)
- Thusheka Uthayakumar
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | | | - Hazel Leah Cartas
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Mylène Brunet
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Kim Loan Vo
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
| | - Jeroen Kroon
- School of Medicine and Dentistry, Griffith University, Gold Coast, Queensland, Australia
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Mann AE, O'Connell LM, Osagie E, Akhigbe P, Obuekwe O, Omoigberale A, Kelly C, Coker MO, Richards VP. Impact of HIV on the Oral Microbiome of Children Living in Sub-Saharan Africa, Determined by Using an rpoC Gene Fragment Metataxonomic Approach. Microbiol Spectr 2023; 11:e0087123. [PMID: 37428077 PMCID: PMC10434123 DOI: 10.1128/spectrum.00871-23] [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] [Received: 02/27/2023] [Accepted: 06/11/2023] [Indexed: 07/11/2023] Open
Abstract
Children living with HIV have a higher prevalence of oral diseases, including caries, but the mechanisms underlying this higher prevalence are not well understood. Here, we test the hypothesis that HIV infection is associated with a more cariogenic oral microbiome, characterized by an increase in bacteria involved in the pathogenesis of caries. We present data generated from supragingival plaques collected from 484 children representing three exposure groups: (i) children living with HIV (HI), (ii) children who were perinatally exposed but uninfected (HEU), and (iii) unexposed and therefore uninfected children (HUU). We found that the microbiome of HI children is distinct from those of HEU and HUU children and that this distinction is more pronounced in diseased teeth than healthy teeth, suggesting that the impact of HIV is more severe as caries progresses. Moreover, we report both an increase in bacterial diversity and a decrease in community similarity in our older HI cohort compared to our younger HI cohort, which may in part be a prolonged effect of HIV and/or its treatment. Finally, while Streptococcus mutans is often a dominant species in late-stage caries, it tended to be found at lower frequency in our HI cohort than in other groups. Our results highlight the taxonomic diversity of the supragingival plaque microbiome and suggest that broad and increasingly individualistic ecological shifts are responsible for the pathogenesis of caries in children living with HIV, coupled with a diverse and possibly severe impact on known cariogenic taxa that potentially exacerbates caries. IMPORTANCE Since its recognition as a global epidemic in the early 1980s, approximately 84.2 million people have been diagnosed with HIV and 40.1 million people have died from AIDS-related illnesses. The development and increased global availability of antiretroviral treatment (ART) regimens have dramatically reduced the mortality rate of HIV and AIDS, yet approximately 1.5 million new infections were reported in 2021, 51% of which are in sub-Saharan Africa. People living with HIV have a higher prevalence of caries and other chronic oral diseases, the mechanisms of which are not well understood. Here, we used a novel genetic approach to characterize the supragingival plaque microbiome of children living with HIV and compared it to the microbiomes of uninfected and perinatally exposed children to better understand the role of oral bacteria in the etiology of tooth decay in the context of HIV exposure and infection.
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Affiliation(s)
- Allison E. Mann
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
| | - Lauren M. O'Connell
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
| | - Esosa Osagie
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Paul Akhigbe
- Institute of Human Virology Nigeria, Abuja, Nigeria
| | - Ozoemene Obuekwe
- University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | | | - Colton Kelly
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
- School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - the DOMHaIN Study Team
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
- Institute of Human Virology Nigeria, Abuja, Nigeria
- University of Benin Teaching Hospital, Benin, Edo State, Nigeria
- Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers University, Newark, New Jersey, USA
- School of Dentistry, University of the Pacific, San Francisco, California, USA
| | - Modupe O. Coker
- Institute of Human Virology Nigeria, Abuja, Nigeria
- Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers University, Newark, New Jersey, USA
| | - Vincent P. Richards
- Department of Biological Sciences, Clemson University, Clemson, South Carolina, USA
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Raksakmanut R, Thanyasrisung P, Sritangsirikul S, Kitsahawong K, Seminario A, Pitiphat W, Matangkasombut O. Prediction of Future Caries in 1-Year-Old Children via the Salivary Microbiome. J Dent Res 2023; 102:626-635. [PMID: 36919874 PMCID: PMC10399075 DOI: 10.1177/00220345231152802] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
Dental caries is the most common chronic disease in children that causes negative effects on their health, development, and well-being. Early preventive interventions are key to reduce early childhood caries prevalence. An efficient strategy is to provide risk-based targeted prevention; however, this requires an accurate caries risk predictor, which is still lacking for infants before caries onset. We aimed to develop a caries prediction model based on the salivary microbiome of caries-free 1-y-old children. Using a nested case-control design within a prospective cohort study, we selected 30 children based on their caries status at 1-y follow-up (at 2 y old): 10 children who remained caries-free, 10 who developed noncavitated caries, and 10 who developed cavitated caries. Saliva samples collected at baseline before caries onset were analyzed through 16S rRNA gene sequencing. The results of β diversity analysis showed a significant difference in salivary microbiome composition between children who remained caries-free and those who developed cavitated caries at 2 y old (analysis of similarities, Benjamini-Hochberg corrected, P = 0.042). The relative abundance of Prevotella nanceiensis, Leptotrichia sp. HMT 215, Prevotella melaninogenica, and Campylobacter concisus in children who remained caries-free was significantly higher than in children who developed cavitated caries (Wilcoxon rank sum test, P = 0.024, 0.040, 0.049, and 0.049, respectively). These taxa were also identified as biomarkers for children who remained caries-free (linear discriminant analysis effect size, linear discriminant analysis score = 3.69, 3.74, 3.53, and 3.46). A machine learning model based on these 4 species distinguished between 1-y-old children who did and did not develop cavitated caries at 2 y old, with an accuracy of 80%, sensitivity of 80%, and specificity of 80% (area under the curve, 0.8; 95% CI, 44.4 to 97.5). Our findings suggest that these salivary microbial biomarkers could assist in predicting future caries in caries-free 1-y-old children and, upon validation, are promising for development into an adjunctive tool for caries risk prediction for prevention and monitoring.
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Affiliation(s)
- R. Raksakmanut
- Graduate Program in Oral Biology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Wang-Mai, Pathumwan, Bangkok, Thailand
| | - P. Thanyasrisung
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Wang-Mai, Pathumwan, Bangkok, Thailand
| | - S. Sritangsirikul
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Wang-Mai, Pathumwan, Bangkok, Thailand
- PhD Program in Oral Sciences, Faculty of Dentistry, Khon Kaen University, Muang District, Khon Kaen, Thailand
| | - K. Kitsahawong
- Division of Pediatric Dentistry, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Muang District, Khon Kaen, Thailand
| | - A.L. Seminario
- Department of Pediatric Dentistry, School of Dentistry, University of Washington, WA, USA
| | - W. Pitiphat
- Division of Dental Public Health, Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Muang District, Khon Kaen, Thailand
| | - O. Matangkasombut
- Department of Microbiology and Center of Excellence on Oral Microbiology and Immunology, Faculty of Dentistry, Chulalongkorn University, Wang-Mai, Pathumwan, Bangkok, Thailand
- Research Laboratory of Biotechnology, Chulabhorn Research Institute, Laksi, Bangkok, Thailand
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Martin MA, Avenetti D, Lee HH, Nordgren R, Berbaum ML, Edomwande Y, Cui L, Sandoval A. Community health worker intervention to improve tooth brushing in young children: Results from a cluster randomized controlled trial. Community Dent Oral Epidemiol 2023; 51:503-511. [PMID: 35766288 PMCID: PMC9797618 DOI: 10.1111/cdoe.12768] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 05/22/2022] [Accepted: 05/27/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Coordinated Oral health Promotion (CO-OP) Chicago is a cluster randomized controlled trial testing the efficacy of a community health worker (CHW) intervention to improve tooth brushing in low-income children. METHODS Four hundred twenty children under 3 years old (mean 21.5 months) were recruited from 20 sites in or near Chicago, IL. Children were identified mainly as Black race (41.9%) or Hispanic ethnicity (53.8%) and most (85.2%) had Medicaid. Intervention families were offered four CHW home visits over 1 year. Brushing frequency was self-reported. Plaque score was determined from images collected in homes using disclosing solution. Analyses used GEE logistic models with variable selection at p < .05. RESULTS At enrolment, 45.0% of families reported twice a day or more child brushing frequency, and child plaque scores were poor (mean of 1.9, SD: 0.6). Data were obtained from 87.1% of children at 6 months and 86.2% at 12 months. In the CHW intervention arm (10 sites, N = 211), 23.7% received 4 visits, 12.8% 3 visits, 21.3% 2 visits, 23.2% 1 visit and 19% no visits from CHWs. No intervention effect was seen for brushing frequency or plaque score. Child brushing frequency improvement over time was associated with a range of child and caregiver factors. The only factor associated with a change in plaque score over time was parent involvement in brushing. CONCLUSIONS Oral-health-specific CHW services were not associated with improved brushing behaviours in these young children. However, caregiver involvement with brushing supported more quality brushing. More robust interventions are needed to support families during this critical developmental period.
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Affiliation(s)
| | | | - Helen H Lee
- University of Illinois Chicago, Chicago, Illinois, USA
| | | | | | | | - Liyong Cui
- University of Illinois Chicago, Chicago, Illinois, USA
| | - Anna Sandoval
- University of Illinois Chicago, Chicago, Illinois, USA
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Full Mouth Treatment of Early Childhood Caries with Zirconia Dental Crowns: A Case Report. CHILDREN 2023; 10:children10030488. [PMID: 36980045 PMCID: PMC10047684 DOI: 10.3390/children10030488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/06/2023]
Abstract
Pediatric dentists should always strive for cosmetic and functional rehabilitation when treating decaying or injured primary teeth. The most popular restoration technique for such teeth is “strip crowns” made of composite materials, but more recently, zirconia and preveneered stainless steel crowns have gained popularity. Moreover, zirconia crowns are usually preferred over stainless steel crowns for aesthetic reasons. The aim of this case report is to present a 4-year-old patient with a high caries risk who underwent a full-mouth pediatric zirconia crown treatment. The operation was performed under general anesthesia. This article describes the restoration of all primary teeth and the follow-up 6 months after the parents’ request to improve the aesthetics. The gingival health and the adaptation of the zirconia crown were evaluated both clinically and radiologically. In this case, the preformed pediatric zirconia crowns provided functional and durable restoration while restoring the natural appearance of the teeth. However, primary dental prevention, including education on oral hygiene and dietary habits, remains the cornerstone in preventing early childhood caries and promoting oral health in pediatric patients. It is important to note that dental intervention under general anesthesia should only be considered as a last resort after all other options have been exhausted, due to the potential risks associated with the use of general anesthesia.
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Danesh DO, Peng J, Hammersmith KJ, Gowda C, Maciejewski H, Amini H, Wapner AW, Meyer BD. Impact on Dental Utilization of the Integration of Oral Health in Pediatric Primary Care Through Quality Improvement. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2023; 29:186-195. [PMID: 36459615 DOI: 10.1097/phh.0000000000001689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
OBJECTIVES To evaluate child-level dental utilization and expenditure outcomes based on if and where children received fluoride varnish (FV) at quality improvement (QI) medical practices, at non-QI medical practices, at dental practices, or those who never received FV from any practice. DESIGN Retrospective claims-based analysis cohort study. SETTING Children with Medicaid insurance through an Ohio pediatric accountable care organization. PARTICIPANTS Children aged 1 to 5 years with 1 or more well-child visits between 2015 and 2017. INTERVENTION FV receipt versus no FV. Among children who received FV, categorized if FV delivered by a QI-participating medical provider, a non-QI-participating medical provider, and a dental provider. MAIN OUTCOME MEASURE Dental claims from 2014 to 2019 were collected for preventive dental visits, caries-related treatment visits, dental general anesthesia (GA) visit, and emergency department visit for a dental problem to examine utilization patterns, expenditures, and dental outcomes. RESULTS The QI group had a significantly higher incidence of preventive dental visits than the dental (incidence rate ratio [IRR] = 0.93; 95% confidence interval [CI], 0.91-0.96) or non-QI groups (IRR = 0.86; 95% CI, 0.84-0.88). Compared with the QI group, the non-QI (adjusted odds ratio [aOR] = 2.6; 95% CI, 2.4-2.9) and dental (aOR = 2.9; 95% CI, 2.6-3.3) groups were significantly more likely to have caries-related treatment visits. The dental group children were significantly more likely to have dental treatment under GA than the QI group (aOR = 5.3; 95% CI, 2.0-14.4). CONCLUSIONS Children seen at QI practices appear to have an increased uptake of preventive dental services, which may explain the lower incidence of dental caries visits and GA treatment.
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Affiliation(s)
- David O Danesh
- Division of Pediatric Dentistry, College of Dentistry (Drs Danesh, Hammersmith, Amini, and Meyer), Department of Pediatrics, College of Medicine (Dr Gowda), and Division of Health Services Management and Policy, College of Public Health (Dr Wapner), The Ohio State University, Columbus, Ohio; Department of Dentistry (Drs Danesh, Peng, Hammersmith, Amini, and Meyer), Partners For Kids (Dr Gowda and Ms Maciejewski), Center for Clinical Excellence (Ms Maciejewski), Division of Emergency Medicine (Dr Wapner), and Information Technology Research and Innovation (Dr Peng), Nationwide Children's Hospital, Columbus, Ohio
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Almuqrin A, Kaur IP, Walsh LJ, Seneviratne CJ, Zafar S. Amelioration Strategies for Silver Diamine Fluoride: Moving from Black to White. Antibiotics (Basel) 2023; 12:antibiotics12020298. [PMID: 36830209 PMCID: PMC9951939 DOI: 10.3390/antibiotics12020298] [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: 01/18/2023] [Revised: 01/30/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Topical cariostatic agents have become a reasonable alternative for managing dental caries in young children. Silver diamine fluoride (SDF) is a practical topical approach to arrest caries and avoid extensive and risky dental treatment. However, the literature demonstrates a parental hesitation towards accepting SDF because of black unaesthetic tooth discolouration following application. The rapid oxidation of ionic silver darkens demineralised tooth structure permanently. In this regard, nano-metallic antimicrobials could augment or substitute for silver, and thereby enhance SDF aesthetic performance. Recently, biomedical research has drawn attention to selenium nanoparticles (SeNPs) due to their antimicrobial, antioxidant, and antiviral potencies. Various in vitro studies have examined the effect of SeNPs on the virulence of bacteria. This narrative review explores practical issues when using SDF and suggests future directions to develop it, focusing on antimicrobial metals. Several methods are described that could be followed to reduce the discolouration concern, including the use of nanoparticles of silver, of silver fluoride, or of selenium or other metals with antimicrobial actions. There could also be value in using remineralising agents other than fluoride, such as NPs of hydroxyapatite. There could be variations made to formulations in order to lower the levels of silver and fluoride in the SDF or even to replace one or both of the silver and fluoride components completely. Moreover, since oxidation processes appear central to the chemistry of the staining, adding SeNPs which have antioxidant actions could have an anti-staining benefit; SeNPs could be used for their antimicrobial actions as well. Future research should address the topic of selenium chemistry to optimise how SeNPs would be used with or in place of ionic silver. Incorporating other antimicrobial metals as nanoparticles should also be explored, taking into account the optimal physicochemical parameters for each of these.
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Alkhtib AO, Mohamed HG. Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010-2021). PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001228. [PMID: 36962836 PMCID: PMC10021236 DOI: 10.1371/journal.pgph.0001228] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 12/19/2022] [Indexed: 01/13/2023]
Abstract
Early childhood caries (ECC) is one of the most prevalent chronic childhood diseases affecting the primary teeth of children younger than 6 years of age. The disease etiology is complex and includes social, biological, and dietary factors. This review aims to explore the knowledge of ECC prevalence globally and locally within the Gulf Cooperation Council (GCC) countries during the years 2010-2021. Another aim is to explore oral health promotion programs with more focus on the GCC region. A search was conducted in PubMed, Medline, Scopus, the Cochrane Collaboration database, and Google Scholar to identify relevant studies published between 2010 and 2021 using specific keywords. Studies that utilized both the World Health Organization criteria and International Caries Detection and Assessment System for dental caries assessment were included. The included studies indicated considerable variation in the reported prevalence of ECC. While developed countries show low prevalence, countries in the GCC and other Arab countries show a high prevalence of ECC. Many oral health promotion programs were identified globally including oral health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-professional population-based oral health promotion and prevention programs such as school-based oral health programs, motivational interviewing, and anticipatory guidance. ECC remains a significant problem in many parts of the world including the GCC region. Oral health prevention programs have been established within the GCC region. Nevertheless, the GCC region has some unique characteristics that need to be investigated to contextualize the western model of the dynamics of ECC prevention and promotion programs locally.
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Do LG, Spencer AJ, Sawyer A, Jones A, Leary S, Roberts R, Ha DH. Early Childhood Exposures to Fluorides and Child Behavioral Development and Executive Function: A Population-Based Longitudinal Study. J Dent Res 2023; 102:28-36. [PMID: 36214232 DOI: 10.1177/00220345221119431] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It is important to both protect the healthy development and maintain the oral health of the child population. The study examined the effect of early childhood exposures to water fluoridation on measures of school-age executive functioning and emotional and behavioral development in a population-based sample. This longitudinal follow-up study used information from Australia's National Child Oral Health Study 2012-14. Children aged 5 to 10 y at baseline were contacted again after 7 to 8 y, before they had turned 18 y of age. Percent lifetime exposed to fluoridated water (%LEFW) from birth to the age 5 y was estimated from residential history and postcode-level fluoride levels in public tap water. Measures of children's emotional and behavioral development were assessed by the Strength and Difficulties Questionnaire (SDQ), and executive functioning was measured by the Behavior Rating Inventory of Executive Function (BRIEF). Multivariable regression models were generated to compare the associations between the exposure and the primary outcomes and controlled for covariates. An equivalence test was also conducted to compare the primary outcomes of those who had 100% LEFW against those with 0% LEFW. Sensitivity analysis was also conducted. A total of 2,682 children completed the SDQ and BRIEF, with mean scores of 7.0 (95% confidence interval, 6.6-7.4) and 45.3 (44.7-45.8), respectively. Those with lower %LEFW tended to have poorer scores of the SDQ and BRIEF. Multivariable regression models reported no association between exposure to fluoridated water and the SDQ and BRIEF scores. Low household income, identifying as Indigenous, and having a neurodevelopmental diagnosis were associated with poorer SDQ/BRIEF scores. An equivalence test confirmed that the SDQ/BRIEF scores among those with 100% LEFW were equivalent to that of those who had 0% LEFW. Exposure to fluoridated water during the first 5 y of life was not associated with altered measures of child emotional and behavioral development and executive functioning.
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Affiliation(s)
- L G Do
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia
| | - A J Spencer
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - A Sawyer
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - A Jones
- School of Population and Global Health, Population and Public Health, The University of Western Australia, WA, Australia
| | - S Leary
- Bristol Dental School, University of Bristol, Bristol, UK
| | - R Roberts
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - D H Ha
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Herston, Queensland, Australia
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Sharma A, Patil SS, Muthu MS, Venkatesan V, Kirubakaran R, Nuvvula S, Arockiam S. Single nucleotide polymorphisms of enamel formation genes and early childhood caries - systematic review, gene-based, gene cluster and meta-analysis. J Indian Soc Pedod Prev Dent 2023; 41:3-15. [PMID: 37282406 DOI: 10.4103/jisppd.jisppd_78_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Introduction Genetic polymorphisms of genes regulating amelogenesis can alter susceptibility to Early Childhood Caries (ECC). This systematic review aims to analyze associations between single-nucleotide polymorphisms of enamel formation genes and ECC. Methods Search was conducted across PUBMED, CINAHL, LILACS, SCOPUS, EMBASE, Web of Science, Genome-Wide Association Studies databases from January 2003 to September 2022. This was supplemented by hand search. Totally 7124 articles were identified and 21 articles that satisfied the inclusion criteria proceeded to data extraction. Quality assessment was done using the Q-Genie tool. Results Quantitative synthesis revealed that homozygous genotype AA of rs12640848 was significantly higher in children with ECC with an odds ratio of 2.36. Gene-based analysis revealed significant association between six variants of AMBN, four variants of KLK4, two variants of MMP20, and a single variant of each of MMP9 and MMP13 genes and ECC. The Bonferroni corrected-log10 P value of amelogenesis gene Cluster was 2.25 (0.05/88 = 5.6 × 10-4). Search Tool for Retrieval of Interacting Genes and Proteins plot constructed to comprehend the protein-protein interaction revealed the presence of four functional clusters. Gene function prediction using Multiple Association Network Integration Algorithm revealed that physical interaction between these genes was 69.3%. Conclusion Polymorphisms of genes regulating amelogenesis can influence the susceptibility to ECC. AA genotype of rs12640848 may increase the susceptibility to ECC. Gene-based analysis revealed a significant association between multiple polymorphisms of genes regulating amelogenesis and ECC.
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Affiliation(s)
- Aruna Sharma
- Department of Pediatric and Preventive Dentistry, Centre for Early Childhood Caries and Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu; Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India
| | - Sneha S Patil
- Department of Environmental Health Engineering, Faculty of Public Health, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu; Department of Pediatric and Preventive Dentistry, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - M S Muthu
- Department of Pediatric and Preventive Dentistry, Centre for Early Childhood Caries and Research, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India; Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Vettriselvi Venkatesan
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| | - Richard Kirubakaran
- South Asian Cochrane Network and Centre, Christian Medical College, Vellore, Tamil Nadu, India
| | - Sivakumar Nuvvula
- Department of Paediatric and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Selva Arockiam
- Department of Orthodontics, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu, India
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Jones KE, Simancas-Pallares MA, Ginnis J, Shrestha P, Divaris K. Guardians' Self-Reported Fair/Poor Oral Health Is Associated with Their Young Children's Fair/Poor Oral Health and Clinically Determined Dental Caries Experience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:632. [PMID: 36612952 PMCID: PMC9819637 DOI: 10.3390/ijerph20010632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/18/2022] [Accepted: 12/28/2022] [Indexed: 06/17/2023]
Abstract
In this cross-sectional, community-based study among a multi-ethnic sample of preschool-age children in North Carolina, United States, we sought to quantify the association between guardians' self-reported oral health and their children's oral health and determine whether race/ethnicity and education level modify these associations. We used questionnaire (n = 7852) responses about caregivers' and their children's oral health and clinical examination-derived (n = 6243) early childhood caries (ECC) status defined at the ICDAS ≥ 3 caries lesion detection threshold. We used multi-level mixed-effects generalized linear models to examine the associations between the guardians' reported oral health and their children's reported and clinically determined oral health among the entire sample and within strata of race/ethnicity, guardians' education, and children's dental home. The guardians' and their children's reported fair/poor oral health (FPOH) were 32% and 15%, respectively, whereas 54% of the children had ECC and 36% had unrestored disease. The guardians' FPOH was strongly associated with their children's FPOH (average marginal effect (AME) = +19 percentage points (p.p.); 95% CI = 17-21), and this association was most pronounced among Hispanics, lower-educated guardians, and children without a dental home. Similar patterns, but smaller-in-magnitude associations, were found for the guardians' FPOH and their children's clinically determined ECC (AME = +9 p.p.; 95% CI = 6-12) and unrestored disease (AME = +7 p.p.; 95% CI = 4-9). The study's findings support a strong association between guardians' and their children's reported and clinically determined oral health and implicate ethnicity, education, and having a dental home as factors possibly modifying the magnitude of these associations.
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Affiliation(s)
- Kaitlin E. Jones
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
| | - Miguel A. Simancas-Pallares
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jeannie Ginnis
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
| | - Poojan Shrestha
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
| | - Kimon Divaris
- Division of Pediatric and Public Health, Adams School of Dentistry, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, NC 27599, USA
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Chinnakotla B, Susarla SM, Mohan DC, Turton B, Husby HM, Morales CP, Sokal-Gutierrez K. Associations between Maternal Education and Child Nutrition and Oral Health in an Indigenous Population in Ecuador. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:473. [PMID: 36612796 PMCID: PMC9819843 DOI: 10.3390/ijerph20010473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
The global nutrition transition has increased the prevalence of childhood dental caries. Greater understanding is needed of the impact of social determinants—including maternal education—on child oral health. This is a cross-sectional analysis of a convenience sample of families of 458 indigenous Ecuadorian children aged 6 months through 6 years from 2011−2013. Data was collected by mother interviews and child dental and anthropometric examinations. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between years of maternal education and maternal-child oral health practices and child oral health outcomes. Each additional year of maternal education was significantly (p < 0.05) associated with some healthier practices including greater likelihood of mothers and children drinking milk daily (OR 1.20; 95% CI 1.08, 1.34); and less healthy practices including greater likelihood of bottle-feeding children with sugary liquids (OR 1.14; 95% CI 1.06, 1.22) and to older age, giving children sweets daily, calming children with a bottle or sweets, and less likelihood of helping brush their children’s teeth (OR 0.93; 95% CI 0.88, 0.98). Each year of maternal education had a small but statistically non-significant influence on increasing the odds of children being among those who are cavity-free (OR 1.03; 95% CI 0.92, 1.16). Interventions to improve health outcomes should focus not just on maternal education but also address social and commercial determinants of health through nutrition and oral health education, as well as policies to reduce sugar and ensure universal access to oral health care.
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Affiliation(s)
| | | | | | - Bathsheba Turton
- Henry M. Goldman School of Dental Medicine, Boston University, Boston, MA 02118, USA
| | - Hannah M. Husby
- School of Public Health, University of California, Berkeley, CA 94704, USA
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Shoaee S, Saeedi Moghaddam S, Masinaei M, Sofi-Mahmudi A, Hessari H, Heydari MH, Shamsoddin E, Parsaeian M, Ghasemian A, Larijani B, Fakhrzadeh H, Farzadfar F. Trends in dental caries of deciduous teeth in Iran: a systematic analysis of the national and sub-national data from 1990 to 2017. BMC Oral Health 2022; 22:634. [PMID: 36564764 PMCID: PMC9789600 DOI: 10.1186/s12903-022-02634-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dental caries is the most prevalent child affliction in the world and can be reduced through effective preventive interventions. To plan cost-effective interventions, clear and integrated data are needed. This study has been designed to overcome the lack of national trend in deciduous dental caries in Iran. OBJECTIVE To estimate the dental caries trend in deciduous teeth in the Iranian population at different ages from 1990 to 2017. METHODS From 1990 to 2017 a literature search about dmf and its components (decayed, missed, and filled tooth, abbreviated as dt, mt, and ft) as well as dental caries was done in the Iranian population in three English (PubMed, Web of Science, and Scopus) and three national databases (in Persian). All eligible national oral health surveys in these 28 years were included. National dmft data were categorised based on age (1-4, 5-9, and 10-14), sex, province and year. The final trends were estimated using an age-spatio-temporal hierarchical model. We used the bootstrap method in multilevel models to predict the uncertainty interval (UI) of the modelled results. Finally, the estimations of dmft, dt, mt, and ft with a 95% UI were reported from 1990 to 2017. RESULTS Almost 22% of the Iranian deciduous teeth were involved with dental caries in 1990 [dmft = 4.37; (95% UI 2.23, 6.62)] which more than 83% of it was dt [3.64 (1.53, 5.88)] and less than 7% was ft [0.30 (0.06, 0.65)]. During 1990-2017, dmft increased by more than 15% [in 2017, dmft = 5.03 (2.82, 7.29)]. The highest increase was seen in dt which was more than 17% [in 2017, dt = 4.27 (1.96, 6.57)]. CONCLUSION Increasing dental caries among Iranian children over 28 years shows that oral health policies in Iran need critical evaluation. We need cost-effective nationwide interventions (e.g., supervised tooth brushing and improving dietary habits) and training well-experienced intermediate manpower (e.g., dental hygienists) to reduce dental caries.
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Affiliation(s)
- Shervan Shoaee
- grid.411705.60000 0001 0166 0922Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran ,grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran ,grid.412105.30000 0001 2092 9755Kerman Oral and Dental Diseases Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sahar Saeedi Moghaddam
- grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran
| | - Masoud Masinaei
- grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran
| | - Ahmad Sofi-Mahmudi
- grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran ,Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Hossein Hessari
- grid.411705.60000 0001 0166 0922Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Hossein Heydari
- grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran ,grid.411600.2School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Erfan Shamsoddin
- grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran ,Cochrane Iran Associate Centre, National Institute for Medical Research Development (NIMAD), Tehran, Iran
| | - Mahboubeh Parsaeian
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Anooshe Ghasemian
- grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran
| | - Bagher Larijani
- grid.411705.60000 0001 0166 0922Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713111 Iran
| | - Hossein Fakhrzadeh
- grid.411705.60000 0001 0166 0922Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713111 Iran
| | - Farshad Farzadfar
- grid.411705.60000 0001 0166 0922Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713136 Iran ,grid.411705.60000 0001 0166 0922Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, 10, Al-e-Ahmad and Chamran Highway Intersection, Tehran, 1411713111 Iran
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Kranz AM, Opper IM, Stein BD, Ruder T, Gahlon G, Sorbero M, Dick AW. Medicaid Payment and Fluoride Varnish Application During Pediatric Medical Visits. Med Care Res Rev 2022; 79:834-843. [PMID: 35130771 PMCID: PMC9357861 DOI: 10.1177/10775587221074766] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
All Medicaid programs pay for fluoride varnish applications during medical visits for infants and toddlers, but receipt of care varies considerably across states. Using 2006-2014 Medicaid data from 22 states, this study examined the association between Medicaid payment and receipt of fluoride varnish during pediatric medical visits. Among 3,393,638 medical visits, fewer than one in 10 visits included fluoride varnish. Higher Medicaid payment was positively associated with receipt of fluoride varnish during pediatric medical visits. As policymakers consider strategies for increasing young children's access to preventive oral health services, as well as consider strategies for balancing budgets, attention should be paid to the effects of provider payment on access to pediatric oral health services.
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Staszczyk M, Jamka-Kasprzyk M, Kościelniak D, Cienkosz-Stepańczak B, Krzyściak W, Jurczak A. Effect of a Short-Term Intervention with Lactobacillus salivarius Probiotic on Early Childhood Caries-An Open Label Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912447. [PMID: 36231747 PMCID: PMC9566377 DOI: 10.3390/ijerph191912447] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/26/2022] [Accepted: 09/27/2022] [Indexed: 05/31/2023]
Abstract
ECC is a significant therapeutic and social problem and a global burden on public health. The aim of this clinical trial was to test whether a 2-week daily consumption of chewing tablets containing thermally inactivated L. salivarius reduces the 12-month caries increment compared to the control group. The investigation was a single-center, randomized, controlled open-label, blinded end-point evaluation trial in two parallel groups. At baseline, 140 generally healthy children between 3 and 6 years of age with or without ECC were randomly assigned to the probiotic test group (n = 70) or to the treatment as the usual control group (n = 70). The primary outcome measure was the 1-year increment in caries incidence and prevalence. Secondary endpoints assessed were the initial, cavitated and obvious dentinal caries increment as well as the measurement of dental plaque accumulation, as an indicator of the ECC risk. Data were collected through the clinical assessment of the children's caries (dmft and ICDAS II) and oral hygiene status (DI-S of OHI-S index). Caries incidence and prevalence were statistically significantly lower in the probiotic group versus the control group (p < 0.001 and p = 0.0075). The initial and final mean OHI-S scores in the probiotic group did not show any significant differences. In conclusion, the regular short-term intake of probiotics may reduce caries development. Our findings suggest that self-administered probiotic therapy may provide a good complement to increase the effectiveness of individual preventive home care in preschool children. This is the first clinical study evaluating the effect of a short-term probiotic intervention on reducing early childhood caries with 12 months of follow-up.
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Affiliation(s)
- Małgorzata Staszczyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Małgorzata Jamka-Kasprzyk
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Dorota Kościelniak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
| | - Beata Cienkosz-Stepańczak
- Laboratory of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, 30-387 Krakow, Poland
| | - Wirginia Krzyściak
- Department of Medical Diagnostics, Faculty of Pharmacy, Jagiellonian University Medical College, 30-688 Krakow, Poland
| | - Anna Jurczak
- Department of Pediatric Dentistry, Institute of Dentistry, Jagiellonian University Medical College, 31-155 Krakow, Poland
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Pithpornchaiyakul S, Naorungroj S, Pupong K, Hunsrisakhun J. Using Chatbot as an Alternative Approach for In-Person Tooth Brushing Training During the COVID-19 Pandemic. J Med Internet Res 2022; 24:e39218. [PMID: 36179147 PMCID: PMC9591704 DOI: 10.2196/39218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 09/02/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
Background It is recommended that caregivers receive oral health education and in-person training to improve toothbrushing for young children. To strengthen oral health education before COVID-19, the 21-Day FunDee chatbot with in-person toothbrushing training for caregivers was used. During the pandemic, practical experience was difficult to implement. Therefore, the 30-Day FunDee chatbot was created to extend the coverage of chatbots from 21 days to 30 days by incorporating more videos on toothbrushing demonstrations and dialogue. This was a secondary data comparison of 2 chatbots in similar rural areas of Pattani province: Maikan district (Study I) and Maelan district (Study II). Objective This study aimed to evaluate the effectiveness and usability of 2 chatbots, 21-Day FunDee (Study I) and 30-Day FunDee (Study II), based on the protection motivation theory (PMT). This study explored the feasibility of using the 30-Day FunDee chatbot to increase toothbrushing behaviors for caregivers in oral hygiene care for children aged 6 months to 36 months without in-person training during the COVID-19 pandemic. Methods A pre-post design was used in both studies. The effectiveness was evaluated among caregivers in terms of oral hygiene practices, knowledge, and oral health care perceptions based on PMT. In Study I, participants received in-person training and a 21-day chatbot course during October 2018 to February 2019. In Study II, participants received only daily chatbot programming for 30 days during December 2021 to February 2022. Data were gathered at baseline of each study and at 30 days and 60 days after the start of Study I and Study II, respectively. After completing their interventions, the chatbot's usability was assessed using open-ended questions. Study I evaluated the plaque score, whereas Study II included an in-depth interview. The 2 studies were compared to determine the feasibility of using the 30-Day FunDee chatbot as an alternative to in-person training. Results There were 71 pairs of participants: 37 in Study I and 34 in Study II. Both chatbots significantly improved overall knowledge (Study I: P<.001; Study II: P=.001), overall oral health care perceptions based on PMT (Study I: P<.001; Study II: P<.001), and toothbrushing for children by caregivers (Study I: P=.02; Study II: P=.04). Only Study I had statistically significant differences in toothbrushing at least twice a day (P=.002) and perceived vulnerability (P=.003). The highest overall chatbot satisfaction was 9.2 (SD 0.9) in Study I and 8.6 (SD 1.2) in Study II. In Study I, plaque levels differed significantly (P<.001). Conclusions This was the first study using a chatbot in oral health education. We established the effectiveness and usability of 2 chatbot programs for promoting oral hygiene care of young children by caregivers. The 30-Day FunDee chatbot showed the possibility of improving toothbrushing skills without requiring in-person training. Trial Registration Thai Clinical Trials Registry TCTR20191223005; http://www.thaiclinicaltrials.org/show/TCTR20191223005 and TCTR20210927004; https://www.thaiclinicaltrials.org/show/TCTR20210927004
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Affiliation(s)
- Samerchit Pithpornchaiyakul
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Prince of Songkla University, Hatyai, Songkhla, TH.,Improvement of Oral Health Care Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, TH
| | - Supawadee Naorungroj
- Department of Conservative Dentistry, Faculty of Dentistry, Prince of Songkla University,, Hatyai, Songkhla, TH
| | | | - Jaranya Hunsrisakhun
- Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Prince of Songkla University, Hatyai, Songkhla, TH.,Improvement of Oral Health Care Research Unit, Faculty of Dentistry, Prince of Songkla University, Hatyai, Songkhla, TH
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Goldfeld S, Francis KL, O’Connor E, Ludvigsson J, Faresjö T, Nikiema B, Gauvin L, Yang-Huang J, Abu Awad Y, McGrath JJ, Goldhaber-Fiebert JD, Faresjo Å, Raat H, Kragt L, Mensah FK. Comparative inequalities in child dental caries across four countries: Examination of international birth cohorts and implications for oral health policy. PLoS One 2022; 17:e0268899. [PMID: 36044409 PMCID: PMC9432734 DOI: 10.1371/journal.pone.0268899] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 05/10/2022] [Indexed: 11/19/2022] Open
Abstract
Child dental caries (i.e., cavities) are a major preventable health problem in most high-income countries. The aim of this study was to compare the extent of inequalities in child dental caries across four high-income countries alongside their child oral health policies. Coordinated analyses of data were conducted across four prospective population-based birth cohorts (Australia, n = 4085, born 2004; Québec, Canada, n = 1253, born 1997; Rotterdam, the Netherlands, n = 6690, born 2002; Southeast Sweden, n = 7445, born 1997), which enabled a high degree of harmonization. Risk ratios (adjusted) and slope indexes of inequality were estimated to quantify social gradients in child dental caries according to maternal education and household income. Children in the least advantaged quintile for income were at greater risk of caries, compared to the most advantaged quintile: Australia: AdjRR = 1.18, 95%CI = 1.04–1.34; Québec: AdjRR = 1.69, 95%CI = 1.36–2.10; Rotterdam: AdjRR = 1.67, 95%CI = 1.36–2.04; Southeast Sweden: AdjRR = 1.37, 95%CI = 1.10–1.71). There was a higher risk of caries for children of mothers with the lowest level of education, compared to the highest: Australia: AdjRR = 1.18, 95%CI = 1.01–1.38; Southeast Sweden: AdjRR = 2.31, 95%CI = 1.81–2.96; Rotterdam: AdjRR = 1.98, 95%CI = 1.71–2.30; Québec: AdjRR = 1.16, 95%CI = 0.98–1.37. The extent of inequalities varied in line with jurisdictional policies for provision of child oral health services and preventive public health measures. Clear gradients of social inequalities in child dental caries are evident in high-income countries. Policy related mechanisms may contribute to the differences in the extent of these inequalities. Lesser gradients in settings with combinations of universal dental coverage and/or fluoridation suggest these provisions may ameliorate inequalities through additional benefits for socio-economically disadvantaged groups of children.
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Affiliation(s)
- Sharon Goldfeld
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
| | - Kate L. Francis
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Elodie O’Connor
- Centre for Community Child Health, Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Johnny Ludvigsson
- Crown Princess Victoria Children´s Hospital and Div of Pediatrics, Dept of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Tomas Faresjö
- Dept of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
| | - Beatrice Nikiema
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
- Cree Board of Health and Social Services of James Bay [CBHSSJB], Department of Program Development and Support, Mistissini, Québec, Canada
| | - Lise Gauvin
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CRCHUM), Montréal, Québec, Canada
- École de Santé Publique, Université de Montréal, Montréal, Québec, Canada
| | - Junwen Yang-Huang
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Yara Abu Awad
- PERFORM Centre & Department of Psychology, Montreal, Canada
| | | | - Jeremy D. Goldhaber-Fiebert
- Stanford Health Policy, Centers for Health Policy and Primary Care and Outcomes Research, Department of Medicine, Stanford University, Stanford, California, United States of America
| | - Åshild Faresjo
- Dept of Health, Medicine and Caring Science, Linköping University, Linköping, Sweden
| | - Hein Raat
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Lea Kragt
- The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands
- Department of Oral & Maxillofacial Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Fiona K. Mensah
- Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Victoria, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
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Mahmoud SA, El Moshy S, Rady D, Radwan IA, Abbass MMS, Al Jawaldeh A. The effect of unhealthy dietary habits on the incidence of dental caries and overweight/obesity among Egyptian school children (A cross-sectional study). Front Public Health 2022; 10:953545. [PMID: 36052005 PMCID: PMC9424618 DOI: 10.3389/fpubh.2022.953545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/11/2022] [Indexed: 01/24/2023] Open
Abstract
Background Obesity and dental caries are public health problems in Egypt. Factors such as unhealthy diet, poor oral hygiene, and physical inactivity can play a major role in both problems. This study was carried out to illuminate the mutual unhealthy dietary risk factors associated with the incidence of both health conditions. Methods Between 1 October 2020 and 1 July 2021, 369 Egyptian children (5-10 years) were examined. Dental status was assessed using decayed, missing/extracted, and filled tooth indices (dmft, deft, and DMFT) for deciduous, mixed, and permanent dentitions, respectively. Moreover, the lifestyle, food habits, and body mass index (BMI) were recorded. Results A total of 342 (93.7%) of the included subjects suffered from caries, and only 27(7.3%) were caries-free. Based on BMI percentiles, 247 (66.9%) of the youngsters were overweight/obese, while 122 (33.1%) had normal weight. The mean dmft was 6.9 (±4.6), deft 4.2 (±3.3), and DMFT 0.1 (±1.7). In the primary dentition, a significant positive correlation was detected between dmft and BMI, legumes, sweetened milk and juice, soft drinks, and desserts, while a significant negative correlation was detected between dmft/deft, meat/poultry/fish, fresh fruits, and vegetables. A significant positive correlation was detected between deft and BMI, sweetened milk and juice, ice cream, candies, and crackers. In the permanent dentition, a significant positive correlation was detected between age, soft drinks, sweetened juice, desserts, and DMFT, while a significant negative correlation was detected with fresh fruits and vegetables. BMI was significantly negatively correlated with a healthy lifestyle, meat/poultry/fish consumption, and fresh fruits and vegetables while positively correlated with legumes, ice cream, soft drinks, granulated sugars, desserts, fast food, and caffeinated drinks. Conclusion Overweight/obesity was positively correlated with primary dentition dental caries. Desserts (sweetened snacks) and soft drinks could be the common risk factors associated with high caries and overweight/obesity incidence among Egyptian school children; conversely, consumption of fruits and vegetables could hinder both health conditions. Moreover, sweetened juices were associated with primary and permanent dental caries.
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Affiliation(s)
- Sara Ahmed Mahmoud
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sara El Moshy
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Dina Rady
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Israa Ahmed Radwan
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Marwa M. S. Abbass
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt,*Correspondence: Marwa M. S. Abbass
| | - Ayoub Al Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
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Attitude of Midwives towards Fluoride Recommendations and Oral Prevention in Infants and Young Children. CHILDREN 2022; 9:children9081135. [PMID: 36010026 PMCID: PMC9406566 DOI: 10.3390/children9081135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 11/16/2022]
Abstract
Early childhood caries is a challenge. Early dental screening flanked by multidisciplinary preventions by pediatricians, dentists, and midwives (MWs) may be helpful. New recommendations for dental screening in children (FUs) and fluoride have been introduced in Germany. The aim of this study was to investigate whether midwives consider FUs useful and implement early childhood caries prevention, as well as fluoride recommendations. The survey was conducted using an online questionnaire. Demographic data, including 11 items on early childhood dental prophylaxis and fluoride, were requested. Agreement was recorded using Likert scales. The data were analyzed descriptively. Two hundred and seventeen female MWs participated (age: 44.1 (11.04) years). One hundred and four (47.9%) participants knew about the FUs. Of the MWs, 30.7% found a referral from the first tooth to be very important (important/neutral/unimportant: 27%/27.9%/14.4%), compared with 84.8% for the entire primary dentition (11.8%/2.8%/0.5%). Of the MWs, 41.7% always recommended fluoride toothpaste from the first tooth (often/occasionally/rarely/never: 22.7%/12.4%/7.9%/15.3%) and 48.1% completely rejected fluoride-free toothpaste (always/often/occasionally/rarely: 9.8%/8.9%/17.3%/15.9%). In addition, 54.8% never recommended the use of fluoride tablets (always/often/occasionally/rarely: 9.2%/7.4%/10.2%/18.4%). The FUs are not yet well-known among MWs, and only less than one-third recommended dental check-ups, starting with the first tooth. This contrasts with the high uptake of fluoridated toothpaste. More educational work should be carried out to convince more MWs of the benefits of the FUs.
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Aljafari A, ElKarmi R, Nasser O, Atef A, Hosey MT. Oral health status and practices of 6- to 7-year-old children in Amman, Jordan: a cross-sectional study. BMC Oral Health 2022; 22:307. [PMID: 35879792 PMCID: PMC9310399 DOI: 10.1186/s12903-022-02342-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Dental caries affects the majority of children in Jordan, with some evidence of its prevalence steadily increasing. Previous studies have shown that families struggle to establish good oral health practices. The aim of this study was to evaluate the current oral health status and practices of 6- to7-year-old children in Amman, Jordan.r Methods A cross-sectional cohort study. The sample consisted of 6- to 7-year-old children attending six randomly selected schools in Amman, Jordan. Measures collected were: I) Caries experience (d3mft/D3MFT), II) Oral hygiene, measured using the Simplified Oral Hygiene Index, III) Dietary, toothbrushing, and dental attendance practices, measured using diaries and parental questionnaires, IV) Participants’ basic characteristics: age, education and employment. Data were analysed using SPSS20.
Results In total, 942 children were recruited. Four hundred and fifty-seven were boys, 485 were girls. Their average age was 6.5 years. Eighty-nine percent had decay in their primary teeth. Mean d3mft was 5.1(1 (range = 0–12, SD = 2.9). Only 8% of carious teeth were restored. Mean DMFT score was 0.3 (range = 0–4, SD = 0.8). Mean debris score was 1.07 (range = 0–3, SD = 0.37). Children indicated that they brush their teeth 1.6 times a day (range = 0–3, SD = 0.6). The majority (81%) were unsupervised. Sixty-seven percent of parents did not know the appropriate fluoride toothpaste concentration. Children were having 1.5 sugary snacks in-between their meals (Range = 1–6, SD = 1.1). They scored a mean of 2.5 (Range = 0–5.87, SD = 1.7) in sweetened drinks intake (recommended ≤ 1) and 2.8 (Range = 0–18.57, SD = 1.5) in non-core food intake (recommended ≤ 2) on a dietary questionnaire. Most parents (84%) indicated that their child attends the dentist only when in pain, and 18% indicated that their child is extremely afraid of dentists. Only 32% and 18% were familiar with fluoride varnish and fissure sealants, respectively. Regression analysis revealed that debris score and dental attendance were reliable predictors of caries experience. Conclusions Six- to seven-year-old children in Amman, Jordan have a high caries experience. Most show signs of poor oral hygiene, excessive intake of cariogenic foods, and symptomatic dental attendance. Their parents lack knowledge on fluoride varnish and fissure sealants. There is a need for oral health promotion tailored to this cohort's need.
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Affiliation(s)
- Ahmad Aljafari
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan.
| | - Rawan ElKarmi
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Osama Nasser
- Department of Dentistry, Jordan University Hospital, Amman, Jordan
| | - Ala'a Atef
- Department of Dentistry, Jordan University Hospital, Amman, Jordan
| | - Marie Therese Hosey
- Centre of Oral, Clinical and Translational Science, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Effect of oral health promotion interventions on pregnant women dental caries: a field trial. BMC Oral Health 2022; 22:280. [PMID: 35804346 PMCID: PMC9270746 DOI: 10.1186/s12903-022-02292-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 06/21/2022] [Indexed: 11/20/2022] Open
Abstract
Background Dental caries is a costly and very common disease, especially in pregnant women. Reasons such as not paying attention to oral health, poor diet and also lack of adequate education in this regard cause this to happen. Performing well-designed educational interventions using primary health system’s forces, can improve oral health of pregnant women and help control this disease. We conducted this study to evaluate the effectiveness of some oral health interventions on pregnant women dental caries. Methods A field trial study was done in comprehensive Health Centers in Varamin, Tehran, Iran to assess 439 mothers’ dental health status from pregnancy up to 2 years after delivery in intervention (n = 239) and control groups (n = 200). Mothers in intervention groups received oral health-related education consisted of nutritional and behavioral messages via either of four methods: A: comprehensive method including all following methods together (n = 74), B: group discussion by dentists (n = 59), C: face to face education by primary health care providers (n = 53), and D: social network applications (n = 53); while those in control group only received routine maternal and oral health care. We used a questionnaire to collect mothers’ demographic, socioeconomic and dental care behavior data and also performed oral examinations to assess their DMFT at baseline and 24 months after delivery to evaluate the effectiveness of these educational oral health interventions. Results From 454 mothers participated the examination session, 18 pregnant women discontinued during the follow-ups and 439 were remained with mean age of 27.47. In the intervention group, the frequency of daily brushing among women increased from 64% at baseline to 85.6% at the last follow-up and the mean D significantly decreased nearly 1unit at same period (P < 0.05). Most and least dental caries changes were in comprehensive intervention group and social network intervention group compared to other intervention groups, respectively. Conclusions Performing educational interventions during and after pregnancy using various message delivery methods and messengers (oral health professionals and trained PHCPs), could improve oral health status and behaviors of pregnant and lactating mothers in a feasible and applicable manner.
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Affiliation(s)
- Marzie Deghatipour
- Department of Community Oral Health, Dental School, Zahedan University of Medical Sciences, Zahedan, Iran.,Oral and Dental Disease Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Zahra Ghorbani
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Amir Hossein Mokhlesi
- Department of Community Oral Health, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran. .,Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Shahla Ghanbari
- Deputy for Health Affairs, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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49
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Ahn E, Kim SM. The cost- effectiveness of early dental visit in infants and toddlers focused on regional deprivation in South Korea: A retrospective cohort study. PLoS One 2022; 17:e0269770. [PMID: 35696402 PMCID: PMC9191701 DOI: 10.1371/journal.pone.0269770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 05/31/2022] [Indexed: 11/18/2022] Open
Abstract
Background The aims of this study are to evaluate the cost-effectiveness of early dental visits (EDVs) and to investigate how regional deprivation impacts the economic evaluation. Methods This study used the South Korea National Health Insurance database, which included medical claim data and voluntary-based oral examination data. The subjects of this study included whole participants for oral examinations for infants and toddlers of the National Health Insurance Corporation. A retrospective cohort study was designed and measured all oral treatments, costs, and number of visits for 208,969 children (experimental group, 101,768; non- experimental group, 107,201) who underwent oral examination for infants and toddlers from 2007 to 2014. The cost-effectiveness was measured using the incremental cost-effectiveness ratio, and the T-health index was used as the measurement for effectiveness. In addition, the difference in the effect according to the level of regional deprivation was confirmed. Results The findings of this study showed that EDVs were cost-effective and that children who participated in EDVs had better oral health (T-health-2 index difference 0.32 point in most deprived regions) and needed 5 USD less costly dental treatments than those who did not have EDVs. The cost-effectiveness of EDVs varied according to the level of regional deprivation and was the highest in the most deprived regions. Conclusions The study findings suggested that the provision of oral examination for infants and toddlers was a cost-effective dental policy. Additionally, EDVs were more effective in children who resided in the most deprived regions, a finding that will lead to the development of policy intervention to improve dental care despite spatial inequality for disadvantaged population groups. Regarding the distribution of dental hospitals/clinics, incentive based dental polices for either dental providers or patients are needed that will assure the delivery of dental care despite spatial inequality.
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Affiliation(s)
- Eunsuk Ahn
- Department of Dental Hygiene, Daejeon Institute of Science and Technology, Daejeon, Republic of Korea
| | - Sun-Mi Kim
- Department of Dental Hygiene, Wonkwang Health Science University, North Jula, Republic of Korea
- * E-mail:
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Gunasekaran S, Silva M, O'Connell MA, Manton DJ, Hallett KB. Caries experience and gingival health in children and adolescents with type 1 diabetes mellitus-A cross-sectional study. Pediatr Diabetes 2022; 23:499-506. [PMID: 35138695 PMCID: PMC9311150 DOI: 10.1111/pedi.13324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 01/18/2022] [Accepted: 01/27/2022] [Indexed: 11/29/2022] Open
Abstract
AIM To investigate the oral health of children and adolescents with type 1 diabetes (T1D) and its associations with diabetes-related and lifestyle factors. DESIGN Cross-sectional study at a large tertiary hospital pediatric diabetes clinic. Oral examination determined dental caries experience and gingival health. Secondary outcome measures included salivary characteristics, oral hygiene and dietary practices, and diabetes-related factors. RESULTS Eighty children and adolescents with T1D participated; mean (SD) age and HbA1c were 13.4(2.6) years and 7.7(0.9)%, respectively. Forty-seven (59%) participants had one or more decayed, missing or filled teeth; 75 (94%) participants had gingivitis. Half (50%) reported ≥3 hypoglycemic episodes necessitating rapid-acting carbohydrate in the previous week. Sixty-two participants (78%) had normal saliva flow, however, 42 (52%) had reduced salivary buffering capacity. Glycemic control (HbA1c ) was not associated with caries experience, gingival health or salivary characteristics. Increased frequency of tooth brushing (OR, 0.11; 95%CI 0.01-0.97, p = 0.05) and interdental flossing (OR, 0.31; 95%CI 0.12-0.81, p = 0.02) were associated with lower caries experience. Interdental flossing (OR, 0.31; 95% CI 0.12-0.80, p = 0.02) and good oral hygiene (OR, 0.06; 95% CI 0.01-0.22, p < 0.001) were associated with less gingivitis. CONCLUSION Poor oral health is common in children with T1D, regardless of HbA1c. Given potential implications for short- and long-term systemic health, this study demonstrates the need for targeted strategies to improve oral health in children with T1D.
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Affiliation(s)
- Shangeetha Gunasekaran
- Royal Children's Hospital (RCH)MelbourneAustralia,Melbourne Dental SchoolUniversity of MelbourneAustralia
| | - Mihiri Silva
- Royal Children's Hospital (RCH)MelbourneAustralia,Melbourne Dental SchoolUniversity of MelbourneAustralia,Inflammatory OriginsMurdoch Children's Research InstituteMelbourneAustralia,Department of PaediatricsUniversity of MelbourneMelbourneAustralia
| | - Michele A. O'Connell
- Royal Children's Hospital (RCH)MelbourneAustralia,Department of PaediatricsUniversity of MelbourneMelbourneAustralia,Diabetes, Murdoch Children's Research InstituteMelbourneAustralia
| | - David J. Manton
- Royal Children's Hospital (RCH)MelbourneAustralia,Melbourne Dental SchoolUniversity of MelbourneAustralia,Centrum voor Tandheelkunde en MondzorgkundeUniversitair Medisch Centrum GroningenGroningenNetherlands
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