Video game playing and oral health in school-age children: A cross-sectional study in Turkey

AIM

The aim of this study is to evaluate the relationship of video game playing with oral/dental health and harmful oral habits in school-age children.

METHODS

The daily video gamer (n = 77) and occasional video gamer (n = 77) children between 6 and 12 years old were included in the study. A questionnaire inquiring socio-demographic characteristics, video gaming and abnormal oral habits of the children was filled by parents. The children were examined intraorally and decayed-missing-filled tooth, the International Caries Detection and the Assessment-II System scores, dental plaque and gingival indices were recorded.

RESULTS

Of the children; 42.9% daily video gamers played video games for between 1 and 2 h and 57.1% played for ≥2 h while all of the occasional video gamers spent for between 1 and 2 h on video game per day. The daily video gamer and occasional video gamer children were not different in terms of socio-demographic characteristics, frequency of having daily tooth brushing habit, using children's toothpaste and having regular dental checkup (P > 0.05). No statistically significant difference was present between the groups in terms of frequencies of abnormal oral habits and having at least one abnormal oral habit (P > 0.05). Severe gingivitis and advanced caries lesions were more common in daily video gamer group (14.2% vs. 3.9%, P = 0.025 and 90.9% vs. 70.9%, P = 0.026, respectively). Daily video gaming time was weakly correlated with plaque index (r = 0.26, n = 77, P = 0.024). Daily video gaming for ≥2 h increased the risk for severe gingivitis (odds (95% confidence interval) = 4.53 (1.07-19.23), P = 0.041) while daily video gaming for between 1 and 2 h decreased the risk for having abnormal oral habit (odds (95% confidence interval) = 0.39 (0.16-0.93), P = 0.034).

CONCLUSION

In school age, daily video gaming may worsen oral and dental health compared with occasional video gaming. Particularly, an excessive video gaming time seems to be associated with poor oral health in school children.

Problematic media use is associated with poor oral health in Turkish school-age children: a pilot cross-sectional study

OBJECTIVES

In the recent years, problematic media use (PMU) has become a serious health concern for children. The precisely defined effects of PMU on children's oral health are unknown. It was aimed to investigate the relationship between the PMU and oral health and oral habits in school-age children.

METHODS

In this cross-sectional study, mothers and their healthy children aged 6-11 years who applied to pediatric dentistry outpatient clinic were enrolled. PMU was assessed using the parent-reported Problematic Media Use Measure Short Form (PMUM-SF). PMUM-SF scores were divided into 3 groups from the lowest to the highest tertile. Multivariable logistic regressions for PMU (moderate-high vs. low) were used to predict the odds of having good and parafunctional oral habits, poor oral hygiene, gingivitis and caries.

RESULTS

Totally 153 mother-child pairs participated in this study. Plaque index, gingival index, ICDAS-II (International Caries Detection and Evaluation System), DMFT and DMFS [decayed (D), missing (M), filled (F) tooth (T) /surfaces (S)] scores were significantly higher in children with moderate-high PMU (P < 0.05). After adjusting for potential confounders, moderate-high PMU decreased the probability of good oral habit of daily toothbrushing [Odds (95% CI) = 0.43 (0.20-0.94)] while it increased the risk of oral parafunctional habit of object sucking/biting [Odds (95% CI) = 3.34 (1.27-8.74)]. Moderate-high PMU increased the risk of moderate-severe gingivitis, moderate-extensive caries and the presence of DMFT [Odds (95% CI) = 2.13 (1.01-4.50); 4.54 (1.11-18.54) and 2.16 (1.07-4.36), respectively].

CONCLUSIONS

Turkish school-age children with a remarkable PMU were significantly more likely to have poor oral health and exhibit oral parafunctional habits Oral health screening seems to be needed for Turkish children experiencing PMU.

Childhood obesity risk increases with increased screen time: a systematic review and dose-response meta-analysis

BACKGROUND

The role of screen time in promoting obesity among children has been reported in previous studies. However, the effects of different screen types and the dose-response association between screen time and obesity among children is not summarized yet. In the current meta-analysis we systematically summarized the association between obesity and screen time of different screen types in a dose-response analysis.

METHODS

A systematic search from Scopus, PubMed and Embase electronic databases was performed. Studies that evaluated the association between screen time and obesity up to September 2021 were retrieved. We included 45 individual studies that were drawn from nine qualified studies into meta-analysis.

RESULTS

The results of the two-class meta-analysis showed that those at the highest category of screen time were 1.2 times more likely to develop obesity [odds ratio (OR) = 1.21; confidence interval (CI) = 1.113, 1.317; I2 = 60.4%; P < 0.001). The results of subgrouping identified that setting, obesity status and age group were possible heterogeneity sources. No evidence of non-linear association between increased screen time and obesity risk among children was observed (P-nonlinearity = 0.310).

CONCLUSION

In the current systematic review and meta-analysis we revealed a positive association between screen time and obesity among children without any evidence of non-linear association. Due to the cross-sectional design of included studies, we suggest further studies with longitudinal or interventional design to better elucidate the observed associations.

Exposure to screen time and dental neglect

AIM

Dental neglect is the failure of parents to meet a child's basic oral health needs and causes complications. Long screen time, and its health impact, is an important public health issue. This study is aimed at determining whether there is a relationship between screen time of children and parents and dental neglect.

METHODS

Two hundred and fifteen patients were included in this cross-sectional observational study. A questionnaire including questions exploring demographic data, children's life-styles and, screen time of both parents and children. A dental neglect scale was administered to the parents. The children's intraoral examinations were evaluated using the decayed, missing, filled teeth (dmft) and pulp, ulcers, fistula, abscess (pufa) indices.

RESULTS

Multivariable linear regression analysis showed that dental neglect was statistically significantly associated with brushing teeth unsupervised and infrequently, frequent snacking, rarely doing exercise, screen exposure at an early age and presence of dental plaque (P < 0.05). Long screen time was statistically significantly associated with high dmft scores, reflecting poor oral health. It was found that children who did not attend daycare, had statistically significantly longer exposure to screens, compared to those who attended daycare.

CONCLUSIONS

Early exposure to screens and long-term screen use are associated with adverse outcomes pertaining to children's oral health.

Screen Time and Body Mass Index Among Children and Adolescents: A Systematic Review and Meta-Analysis

Background

There is no summative quantitative study that report the difference in BMI in high screen user children and adolescents or give a difference in screen time in children and adolescents with obesity vs. children and adolescents without obesity. In the current meta-analysis we systematically summarized the association between obesity and screen time and meta-analyzed the results.

Methods

A systematic search from Scopus, PubMed and Embase electronic databases. Studies that evaluated the association between screen time and obesity up to June 2021.

Results

Results revealed that those at the highest screen time category had 0.7 kg/m2 higher BMI (WMD = 0.703; CI = 0.128, 1.278; P < 0.016; I 2 = 95.8%). Moreover, children and adolescents with obesity had a mean value of 0.313 h higher screen time compared with children and adolescents without obesity (WMD: 0.313; OR = 0.219, 0.407; P < 0.001; I 2 = 96%). The results of subgrouping showed that study quality, continent and sample size could reduce the heterogeneity values. No evidence of publication bias was reported according to visual asymmetry of funnel plots and the results of Begg's and Egger's tests.

Conclusion

For the first time, the current systematic review and meta-analysis revealed a positive association between screen time and obesity among children and adolescents. Due to the cross-sectional design of the included studies, causal inference is impossible, therefore, further studies in separate analysis of both genders are suggested to better elucidate gender-specific results.

Systematic Review Registration

[www.ClinicalTrials.gov], identifier [CRD4202123 3899].

Association between Insufficient Sleep and Dental Caries among Preschoolers in Japan: A Cross-Sectional Multicentre Study

Recently, sleeping status has attracted attention for its relationship with oral health. In the present study, we have investigated the association between early childhood caries and sleeping status. A multicentre observational cross-sectional study was conducted among 332 preschoolers (aged 3–6 years) and their parents in Chitose, Japan. Dental caries and sleeping status were assessed in the children and the sleep quality and health literacy of the parents were also assessed. Univariate and multivariate regression analyses were used in order to investigate the effect of the sleeping status of the parents and their children on dental caries. Among the children, the prevalence of dental caries experience was 12.7%. The children without caries slept significantly longer and their parents had a better Pittsburgh Sleep Quality Index (PSQI) score than those with caries experience. The sleeping status and the numbers of caries in the children were significantly correlated. Health literacy was better in those without caries experience. Parents’ PSQI was significantly positively correlated with the numbers of caries in the children (r = 0.19, p = 0.0004). The children’s sleep durations, screen time, and parental smoking status were independently associated with early childhood caries. Poor sleeping status of children and their parents is related to dental caries among preschoolers.

Influence of maternal postpartum depression on children's toothbrushing frequency

OBJECTIVES

Daily toothbrushing behaviour is very effective for the prevention of early childhood dental caries (ECC), but is mostly dependent upon parental management. Intrapersonal association between lower toothbrushing frequency and depression is well known; however, the impact of maternal postpartum depression on child toothbrushing behaviour within the mother-child dyad remains unknown. The aim of this study was to determine the association between the prevalence of maternal postpartum depression and lower toothbrushing frequency in children aged two years.

METHODS

A secondary analysis of a data set from the Japan Environment and Children's Study was performed. A total of 104 062 fetuses were enrolled after obtaining informed written parental consent, in which 84 533 mother-infant pairs were included after applying exclusion criteria. The Edinburgh Postpartum Depression Scale (EPDS) was used to evaluate maternal postpartum depression (a total score of ≥9 in EPDS) at one and six months postpartum. Indeed, the participants were classified based on the persistence of postpartum depression: 'Resilient' (no prevalence); 'Improving' (prevalence only at one month postpartum); 'Emergent' (prevalence only at six months postpartum); and 'Chronic' (prevalence at both time points). The association between postpartum depression and a toothbrushing frequency in children (the reference group: more than once per day, the low group: once per day, and the very-low group: less than once per day) was examined using Poisson regression models with adjustments for maternal and child characteristics after multiple imputations for missing data.

RESULTS

The prevalence of maternal postpartum depression at one and six months postpartum was 13.9% and 11.4%, respectively; the proportions of each persistence group were 81.1% ('Resilient'), 7.5% ('Improving'), 5.0% ('Emergent') and 6.4% ('Chronic'). Concerning children's toothbrushing frequency, 51.6% and 0.5% of participants self-reported frequencies of once per day and less than once per day, respectively. The association of maternal postpartum depression with a lower toothbrushing frequency in children consistently had higher relative risks (RRs). However, these associations were weakened when adjusting for whether the child could self-perform toothbrushing or whether this was done under parental supervision. A key result is that participants with persistent postpartum depression at both one and six month(s) postpartum showed the highest adjusted RRs (95% CI) for lower toothbrushing frequency in children (1.08 [1.04-1.12] with a decrease in children's toothbrushing frequency).

CONCLUSION

Maternal mental health provides valuable screening information for children with lower toothbrushing frequency for the purpose of preventing ECC.

Lifestyle and psychosocial correlates of oral hygiene practice among Indonesian adolescents

Poor oral hygiene leads to poor oral health, which in turn has negative impacts on overall health and quality of life. This study aimed to evaluate the prevalence and associated factors of oral hygiene practice among school-going adolescents in Indonesia. Secondary analysis of cross-sectional, nationally representative data from the 2015 Indonesia Global School-based Health Survey, covering 11,142 students aged 11-18 years, was performed. Multiple logistic regression was employed to explore associations between lifestyle, psychosocial factors, and tooth-brushing frequency. Around 10.8% of the students brushed their teeth less frequently than the recommended twice-daily regimen. Male gender, lower socio-economic status, poor dietary practice, longer sedentary time, drug use, psychological distress, less peer support, and no parental support were associated with infrequent tooth brushing. The findings support the need to integrate oral health promotion into general health actions that target families, schools, and social environments of adolescents to develop healthier habits.

Gamified Mobile Computerized Cognitive Behavioral Therapy for Japanese University Students With Depressive Symptoms: Protocol for a Randomized Controlled Trial

BACKGROUND

Evidence shows that computerized self-help interventions are effective for reducing symptoms of depression. One such intervention, SPARX, is a gamified mobile computerized cognitive behavioral therapy (cCBT) developed for adolescents in New Zealand, which was shown to be as effective as usual care for young people with mild-to-moderate symptoms of depression. However, gamified cCBT has not yet been tested in Japan.

OBJECTIVE

This trial is designed to investigate whether a Japanese-adapted version of SPARX improves depressive symptoms in Japanese university students with mild-to-moderate depressive symptoms.

METHODS

In this 7-week, multicenter, stratified, parallel-group, superiority randomized trial, participants will be allocated to either a treatment condition (SPARX) or a wait-list control condition. SPARX is a fully automated program, which will be delivered to the mobile phone or tablet device of the participants. SPARX is designed as an interactive fantasy game to guide the user through seven modules that teach key CBT strategies. All participants will be recruited from universities via advertisements on online bulletin boards, the campus newspaper, and posters. Participants in the treatment condition will use the SPARX program weekly. The primary outcome is the reduction of depressive symptoms (using Patient Health Questionnaires-9) measured at baseline and weekly: once after the 7-week intervention and once at a 1-month follow-up. Secondary outcomes include satisfaction with the program and satisfaction with life, measured by the Satisfaction With Life Scale; positive and negative moods, measured by the Profile of Mood States Second Edition; social functioning, measured by the EuroQol Instrument; rumination, measured by the Ruminative Responses Scale; and coping, measured by the Brief Coping Orientation to Problem Experienced Inventory.

RESULTS

This study received funding from The Research Institute of Personalized Health Sciences, Health Sciences University of Hokkaido, and obtained institutional review board approval in September 2019. Data collection began in April 2019.

CONCLUSIONS

Results of this trial may provide further evidence for the efficacy of gamified cCBT for the treatment of depression and, specifically, provide support for using SPARX with Japanese university students.

TRIAL REGISTRATION

Japan Primary Registries Network UMIN000034354; https://tinyurl.com/uu7xd77.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/15164.

Association of short sleep duration and long media use with caries in school children

BACKGROUND

Individual lifestyle factors are associated with dental caries in children. The aim of this study was to investigate comprehensively the association between dental caries in elementary school children and lifestyle factors of the children and their parents.

METHODS

Children from five elementary schools in Takaoka city, Toyama Prefecture, Japan (1,699: 848 boys, 851 girls, age range 6-12 years) participated in a survey conducted in March 2016. Questions on socioeconomic status (SES) and lifestyle factors in the children and their parents were included. Children who received treatment for three or more dental caries were defined as having many caries. Logistic regression analysis was performed to evaluate whether these factors were associated with the number of caries.

RESULTS

The percentage of children with many caries (≥3) was 38.4%. In univariate analysis, being in 5^th or 6^th grade, frequent snacking, short sleep duration, long hours of media use, paternal smoking, and parental skipping of breakfast were significantly associated with many caries. Lack of affluence was marginally significant. In multivariate analysis, the association of short hours of sleep and long hours of media use remained significant. The adjusted odds ratio (OR) for media use of 1-2 h and more than 2 h were 1.79 (95% confidence interval [CI]: 1.30-2.46) and 2.24 (95% CI: 1.61-3.11) respectively. The adjusted OR for less than 8 h of sleep was 1.49 (95% CI: 1.07-2.06).

CONCLUSIONS

Long duration of media use and short duration of sleep were associated with dental caries. Establishing a healthy lifestyle is necessary for preventing dental caries in children.

Factors associated with sports-related dental injuries among young athletes: a cross-sectional study in Miyagi prefecture

BACKGROUND

Sports-related dental injuries, such as tooth fracture, loosening, and avulsion, are a major concern among young athletes because they directly impair oral function. Although the preventive efficacy of mouthguards has been well established, the prevalence of sports-related dental injuries remains high among young athletes. The aim of this study is to identify the variables contributing to the risk of sports-related dental injuries by conducting a survey on large population of young athletes in Miyagi prefecture.

METHODS

A cross-sectional study was conducted with school-aged athletes (aged 6-15 years, n = 5735) using a self-reported questionnaire. The questionnaire examined general variables, including sex, age, and body mass index; sports-related variables, including sports-type, team level, activity schedule, break time, and verbal/physical abuse by coaches; and lifestyle variables related to free time, including screen-time and sleep duration. Their associations with sports-related dental injuries were examined using multivariate logistic regression models.

RESULTS

The prevalence of sports-related dental injuries was 13.3% (763 of 5735 young athletes) and was higher in males (14.3%, 592 of 4132) than in females (10.7%, 171 of 1603; adjusted odds ratios [ORs] and 95% confidence intervals [CIs]: 1.48 [1.22-1.79], p < 0.001). After stratification according to sex, significant associations with the prevalence of sports-related dental injuries were evident for three variables-insufficient break time, verbal abuse, and physical punishment-in males (adjusted ORs [95% CI]: 1.35 [1.03-1.77], p = 0.032; 1.31 [1.05-1.62], p = 0.015; and 1.36 [1.06-1.75], p = 0.016, respectively) but not in females (adjusted ORs [95% CI]: 0.88 [0.53-1.47], p = 0.623; 1.29 [0.87-1.91], p = 0.206; and 0.97 [0.57-1.63], p = 0.894, respectively).

CONCLUSIONS

Although our results might be based on the individual athlete's self-perception to the sports-related variables, our results suggest that insufficient break time, verbal abuse, and physical punishment from coaches are positively associated with the prevalence of sports-related dental injuries in young male athletes.