Guardian Reports of Children's Sub-optimal Oral Health Are Associated With Clinically Determined Early Childhood Caries, Unrestored Caries Lesions, and History of Toothaches

Prevalence of dental caries among children in Indonesia: A systematic review and meta-analysis of observational studies

Objective

The prevalence of dental caries among children in Indonesia remains unclear. Therefore, we aimed to provide an updated assessment of this prevalence while also investigating the influence of patient characteristics and methodological factors.

Design

We performed a systematic review and meta-analysis, including searches of PubMed, Cochrane Library, and Embase from inception to August 24, 2023. We included 8840 participants in 27 studies reporting the prevalence of dental caries among Indonesian children.

Results

The overall prevalence of dental caries was 76 % (95 % confidence interval: 71%-81 %). Studies in which decay-missing-filled teeth (DMFT) criteria were used to diagnose dental caries were significantly more prevalent than studies using non-DMFT criteria (78 % vs. 64 %, P < 0.05). No significant moderators were identified for the study subgroup based on study origin (Jakarta vs. non-Jakarta) or comorbidity status (comorbidity vs. no comorbidity). Owing to incomplete reporting of variables, metaregression analysis could not be conducted for continuous variables, such as age and male percentage.

Conclusions

The prevalence of dental caries among Indonesian children remains notably high, showing consistency across Jakarta-based studies and non-Jakarta studies. Initiating dental caries prevention and health promotion campaigns is imperative, focusing on the critical importance of early detection.

Socio-behavioural determinants associated with the first dental visit in Saudi children: A cross-sectional study

BACKGROUD

Oral health is an integral component of overall well-being, understanding the age at which children have their first dental visit (FDV) and the socio-behavioural factors influencing these visits is essential for improving oral health outcomes in children.

AIM

This study aimed to determine the age at which Saudi children had their FDV and the socio-behavioural predictors associated with these visits in Al Jouf Province, Kingdom of Saudi Arabia.

DESIGN

This cross-sectional study used a multistage stratified random sampling technique to invite 566 parents/guardians of schoolchildren aged 12 years or younger. Multinomial logistic regression analysis was used to identify socio-behavioural variables that predict children's FDV. p < 0.05 was considered statistically significant.

RESULTS

Most FDVs in children occurred between the ages of 6 and 10 years. More than half of the participants stated that FDVs occurred primarily because of dental pain. Furthermore, educated mothers reported a higher frequency of dental visits for their children. Children with a low family income were 63% (95% confidence interval 0.16-0.83; p = .015) less likely to visit a dentist between the ages of 1 and 5 years.

CONCLUSION

First dental visits in children in Al Jouf Province typically occurred between the ages of 6 and 10 years, with dental pain being the main reason. Parents' or caregiver's relationships with children, parental age and familial income were identified as predictors of the FDV.

Correlation between caries activity and salivary microbiota in preschool children

Early childhood caries (ECC) is the most common chronic infectious oral disease in preschool children worldwide. It is closely related to the caries activity (CA) of children. However, the distribution characteristics of oral saliva microbiomes in children with different CA are largely underexplored. The aim of this study was to investigate the microbial community in saliva of preschool children with different CA and caries status, and to analyze the difference of microbial community in saliva of children with different CA and its correlation with ECC. Subjects were divided into 3 groups based on the Cariostat caries activity test: Group H, high CA (n=30); Group M, medium CA (n = 30); Group L, low CA (n=30). Questionnaire survey was used to explore the related influencing factors of CA. According to the caries status (on the basis of decayed mising filled teeth), these subjects were divided into caries-free group (dmft=0, n=19), caries-low group (0 < dmft ≤ 4, n=27) and caries-high group (dmft > 4, n=44). Microbial profiles of oral saliva were analyzed using 16S rRNA gene sequencing. There were significant differences in the microbial structure (P < 0.05). Scardovia and Selenomonas were the biomarkers of both H group and high caries group. The genus Abiotrophia and Lautropia were the biomarkers of both the L group and the low caries group, while the Lactobacillus and Arthrospira spp. were significantly enriched in the M group. The area under the ROC curve of the combined application of dmft score, age, frequency of sugary beverage intake, and the genus Scardovia, Selenomonas, and Campylobacter in screening children with high CA was 0.842. Moreover, function prediction using the MetaCyc database showed that there were significant differences in 11 metabolic pathways of salivary microbiota among different CA groups. Certain bacteria genera in saliva such as Scardovia and Selenomonas may be helpful in screening children with high CA.

Guardians' Self-Reported Fair/Poor Oral Health Is Associated with Their Young Children's Fair/Poor Oral Health and Clinically Determined Dental Caries Experience

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.

Expert consensus on early childhood caries management

Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.