Self-Reported Dental Caries by Mexican Elementary and Middle-School Schoolchildren in the Context of Socioeconomic Indicators: A National Ecological Study

Clinical Success of Pulpotomies Using Intermediate Restorations and Preformed Metal Crowns in the Context of a Developing Country: A Retrospective Questionnaire-Based Investigation

Background: Dental caries is one of the most prevalent dental illnesses in children. Untreated severe caries can damage teeth, requiring pulpotomy to save them. Objective: To evaluate the clinical success rate of treatments involving pulpotomies + IRM (Intermediate Restorative Material, composed of reinforced zinc oxide-eugenol polymers) + preformed metal crowns (PMCs) in primary teeth of children treated at a public university in Mexico. Materials and Methods: A cross-sectional ambispective study was conducted on children aged 10 years or younger, treated at a public university in Mexico. A total of 1281 medical records from February 2018 to June 2023 were reviewed, yielding a sample of 199 children treated with pulpotomy + IRM + PMC. Information was collected via telephone interviews with parents/caregivers to inquire about any symptoms following the pulpotomy and metal crown treatments. Success was defined as the absence of pain, inflammation, or infection. Results: During the study period, the number of teeth treated with pulpotomy + IRM + PMC was 414, with follow-ups ranging from 6 to 69 months. Most participants were girls (54.3%), while 45.7% were boys. Out of the 167 pulpotomy + IRM + PMC treatments included in the study, the clinical success rate was 98.2%. Conclusions: The clinical success rate of primary teeth treated with pulpotomy + IRM + PMCs was high, close to 100%, based on evidence and symptom reports from parents/caregivers. It would be beneficial to implement its use in public health institutions in countries such as Mexico.

Prevalence of Dental Pain in Schoolchildren Aged 6 to 12 Years and Clinical, Sociodemographic, and Socioeconomic Risk Indicators: A Multicenter Study of Four Mexican Cities

Background: Dental pain is a significant public health issue globally and in Mexico, with substantial negative impacts on affected individuals. Objective: The objective of this study was to evaluate the prevalence of dental pain and its association with clinical, sociodemographic, and socioeconomic risk indicators in schoolchildren aged 6 to 12 years in four cities in Mexico. Material and Methods: A cross-sectional study was conducted on 500 children attending public schools in the cities of Pachuca, Tepatitlán, Toluca, and San Luis Potosí. A questionnaire was applied, and a clinical examination was performed on the schoolchildren. Self-reported dental pain within the 12 months preceding the study, categorized as 0 (no pain) and 1 (pain), was used as the dependent variable. For the statistical analysis, the Stata program was used, where a multivariate binary logistic regression model was applied. Results: The mean age was 8.92 ± 1.99 years; 50% were girls. The prevalence of dental pain was 34.0%. Independent variables associated (p < 0.05) with the experience of dental pain were as follows: age (OR = 0.81), having a car at home (OR = 0.77), a lower socioeconomic position (OR = 2.03), curative or specialized dental care (OR = 8.40), and self-reported dental and/or gingival disease (OR = 5.39). Conclusions: Dental pain is a significant health problem in schoolchildren aged 6 to 12 years in Mexico, with a prevalence of 34% in this study. Sociodemographic and socioeconomic factors, as well as clinical indicators, play an important role in the experience of dental pain. Inequalities in oral health were observed. There is a need for public health interventions to reduce this problem in vulnerable populations.

High Correlation of the Decayed, Missing, and Filled Teeth (DMFT) Index With Caries Experience in First Permanent Molars: Perspectives and Implications in Oral Epidemiology From a Cross-Sectional Study

Background Dental caries is identified as one of the most prevalent chronic pathologies among the pediatric population on a global scale, constituting a public health problem. Within the permanent dentition, the first molars play a fundamental and critical role both in masticatory functionality and in the development of occlusion and the overall oral health of the patient. Previous research has shown that permanent molars tend to show significantly high levels of caries incidence, and a correlation has been detected between the status of the first permanent molars and the overall caries rate. Objective To investigate the correlation between the overall DMFT index (Decayed, Missing, and Filled Teeth Index in the permanent dentition) and the DMFT calculated from the status of the first permanent molars (FPMs) in a sample of Mexican school-aged children, and to discuss the implications for oral epidemiology. Material and methods A cross-sectional study was conducted on 107 children aged 5 to 12 years at a pediatric dentistry clinic of a public university in Mexico. All data were obtained from medical records. The DMFT index was calculated for the entire dentition, and a separate DMFT index was determined for the first permanent molars. Nonparametric tests were used in the analyses. Analyses were performed in Stata 14 (StataCorp, College Station, USA). Results The mean age was 8.52±1.36 years, and 50.5% were boys. The mean overall DMFT index was 1.90±2.01 and the DMFT-FPM index was 1.71±1.74, a difference of 0.19 (10%) (Wilcoxon: DMFT vs DMFT-FPM, p=0.0009). The correlation between caries indices was very strong (Spearman r=0.9803; p<0.0001). The overall caries prevalence was 58.9% for DMFT>0 and for the DMFT-FPM>0, 57.0%, a difference of 1.9 percentage points (3.2%). The results show an association of experience and caries prevalence by age (p<0.05), but not by sex (p>0.05). Conclusions There is a very strong correlation between the overall DMFT index and the DMFT calculated exclusively for the first permanent molars in this sample of Mexican schoolchildren. This suggests that the FPMs contribute significantly to the overall caries experience and could be a key indicator in the diagnosis and monitoring of oral health, taking into account the percentage of underestimation.

The Psychological Impact of Anterior Teeth Caries and Treatment Needs Among Adults at King Saud University Clinics in Riyadh, Saudi Arabia

Introduction Aesthetic dentistry has become increasingly important, as a smile is key to social and emotional well-being. Dental caries can greatly and persistently diminish overall oral health-related quality of life, impacting one's capacity to engage socially and maintain emotional health. The study aims to assess the psychological impact of anterior teeth caries and restorative treatment needs. Methodology A cross-sectional study was conducted at King Saud University clinics. The questionnaire used in this study was developed based on previous research and structured into three main domains: demographic data, psychosocial impact of dental aesthetics, and restorative treatment needs assessment. The statistical analysis of the study's Inter-rater reliability was assessed using the Fleiss kappa coefficient. The intra-rater reliability was evaluated for all raters using Cohen's kappa, with each rater showing almost perfect agreement in dental caries and treatment option measures (p < 0.001). Results The participants who perceived the presence of anterior caries had significantly worse overall psychological impact scores than those who did not perceive having anterior caries. The overall Psychosocial Impact of the Dental Aesthetics Questionnaire (PIDAQ) score shows a more negative psychosocial impact of dental aesthetics on those needing indirect restoration than those needing direct restorations. Conclusions Anterior teeth caries significantly impacts individuals' psychological well-being, particularly in emotional and social aspects. Those perceiving the presence of anterior caries experience more significant emotional distress and social implications. The need for restorative treatment, especially indirect restoration, is associated with higher psychosocial impact and lower dental self-confidence.

Experience, Prevalence, and Severity of Dental Caries in Mexican Preschool and School-Aged Children

Objective Dental caries in Mexico continues to be a public health problem, indicated by it is high prevalence and incidence in children. This disease is associated with pain in preschool and school children, with large-scale consequences for the individual, society, and health systems. The objective of the present study was to determine the experience (mean of caries indices), prevalence, and severity of caries in children 2-12 years of age who sought dental care at a dental school in Mexico. Material and methods A cross-sectional study was carried out on 826 clinical records of patients ages 2-12 years. The dependent variable was caries, in terms of experience (mean primary teeth (dmft) and permanent teeth (DMFT) indices), prevalence (dmft and DMFT greater than 0), and severity (cutoffs of caries indices at various levels). The independent variables were age and sex. The data were analyzed in Stata 14 (StataCorp LLC, College Station, Texas). Results The average age was 7.2±2.3; 52.4% were boys. In the primary dentition, the caries experience (mean dmft) was 3.01±3.30, the prevalence of caries was 65.8%, and the severity dmft>3=37.3% and dmft>6=15.6%. In the permanent dentition, the caries experience (mean DMFT) was 0.99±1.88, the prevalence of caries was 31.5%, and the severity DMFT>3=12.5% ​​and DMFT>6=1.6%. The percentage of caries-free children in both dentitions was 26.1% (n=216/826). The experience, prevalence, and severity of caries were statistically different by age (p<0.001). Only in the severity of dmft>3 were differences observed across sex (p<0.05). Among children with mixed dentition, primary teeth were more affected than permanent teeth (2.46±2.87 vs 0.88±1.61; p<0.0001). Conclusions About seven out of 10 children were affected by cavities in either or both dentitions. It was observed that age was positively associated with dental caries, equally affecting girls and boys. In this sample, the primary dentition was impacted more than the permanent dentition. Despite being preventable, dental caries continues to be a health problem in children.

Socioeconomic Inequalities in Alcohol and Tobacco Consumption: A National Ecological Study in Mexican Adolescents

Alcohol and cigarettes are the psychoactive substances that adolescents use most frequently. When both addictions are combined, they carry the worst burden of disease globally. The objective of this study was to identify whether socioeconomic factors correlate with alcohol and tobacco consumption in Mexican adolescents aged 10 years or more and to establish the relationship in the consumption between the two substances. This ecological study utilized data describing alcohol and tobacco consumption among adolescents aged 10-16 years (n = 48,837 ≈ N = 11,621,100). Having ever consumed any alcohol-containing beverage constituted alcohol consumption. Smoking a cigarette within 30 days constituted cigarette consumption. For both variables, the state-level percentages reported in the survey were used. Diverse socioeconomic variables were collected from official sources. Data on the prevalence of tobacco use and alcohol consumption were entered into an Excel database estimated for each of the states of the Mexican Republic, as well as the socioeconomic variables. We performed the analysis using Stata 14. Consumption prevalence was 15.0% for alcohol and 4.2% for tobacco. Alcohol consumption was not correlated with any studied socioeconomic variable (p > 0.05). The prevalence of tobacco consumption among elementary school students correlated (p < 0.05) with the portion of the population living in private dwellings without sewage, drainage, or sanitation (r = 0.3853). The prevalence of tobacco consumption among middle-school adolescents correlated with the portion of the employed population that earned up to two minimum wages (r = 0.3960), the percentage in poverty by income 2008 (r = 0.4754) and 2010 (r = 0.4531), and the percentage in extreme poverty by income 2008 (r = 0.4612) and 2010 (r = 0.4291). Positive correlations were found between tobacco consumption and alcohol consumption among both elementary (r = 0.5762, p=0.0006) and middle-school children (r = 0.7016, p=0.0000). These results suggest that certain socioeconomic factors correlate with tobacco consumption but not alcohol consumption. A correlation between alcohol consumption and tobacco consumption was observed. The results can be used for developing interventions in adolescents.

Validity of mother-child self-perceived oral health for the assessment of 5 years old children's oral health in Indonesia

BACKGROUND

Early childhood caries (ECC) is a serious condition that has a negative impact on young children's quality of life. Mothers' perceived need for oral health care plays an important role in their children's oral health behavior. This study aimed to compare mother and child self-perceived and dentist-evaluated needs for oral health care.

METHODS

This cross-sectional study included 266 preschool children aged 5 years old and their mothers. A self-administered questionnaire to the mothers and interviews with the children were used to assess the perceived needs of oral health care. The mothers were asked to rate their children's oral health and determine if they needed dental treatment. The children were also asked how they felt about their oral health and whether they had any tooth decay. Agreement between mother and child regarding the child's oral health was assessed. The evaluated needs were assessed clinically using the dmft (decayed, missing, and filled teeth [primary dentition]) and pufa (pulpal involvement, ulceration, fistula, and abscess [primary dentition]) indices. The perceived and evaluated needs were compared using spearman analysis to determine their correlations and the validity of the perceived needs compared to the clinical examination was assessed using the area under the curve (AUC), sensitivity (Sn), specificity (Sp), and likelihood ratio (LR).

RESULTS

The prevalence rate of ECC was 89.4%, with 35% having at least one condition from untreated caries (pufa > 0). Mothers and children have a fair agreement regarding the child's oral health (ICC = 0.335). When comparisons were conducted between perceived and evaluated conditions, Mother's rating about their child's oral health showed the strongest correlation to dmft index (r = 0.372; p < 0.001). Several accuracy parameters done in this study (AUC, Sn, and Sp) did not meet the acceptable threshold. The sensitivity and specificity were the highest when comparing mothers' perceived need for their child's dental treatment to the dmft index (Sn = 96.7%) and pufa index (Sp = 88.1%), respectively.

CONCLUSION

Compared to the dentist's assessment, the mother and child self-reported oral health statuses showed lower accuracy in assessing the child's condition. But, the mothers in this study were better than their 5-year-old children at perceiving their child's oral health care needs. As a result, these subjective assessments can be used as a complement, but not as a substitute, to the actual clinical evaluation.

Comparative Analysis of Edentulism in a Sample of Mexican Adults with and without Type 2 Diabetes

The objective of the present study was to compare the prevalence of edentulism in Mexican adults with and without a diagnosis of type 2 diabetes mellitus (T2DM) when they are seeking dental care. A cross-sectional study was conducted on 1921 medical records of Mexican adults 40 years of age and older who sought dental care at clinics of a public university in Mexico. The dependent variable was edentulism, clinically determined through an oral examination. The main independent variable was the self-report of previous T2DM diagnosis made by a physician. Sociodemographic, socioeconomic and behavioral covariates were included in a multivariate binary logistic regression model. Overall edentulism prevalence was 8.4% (95% CI = 7.1-9.6). The prevalence of T2DM was 14.3% (n = 274). The prevalence of edentulism among individuals with T2DM was 13.1%, but only 7.6% among individuals without T2DM. In the multivariate binary logistic regression model, a previous T2DM diagnosis increased the probability of being edentulous 1.61 times (95% CI = 1.03-2.50). For each year a person's age increased, the likelihood of being edentulous increased by 12% (95% CI = 10-14%). In summary, a higher prevalence of edentulism was present in Mexican adults with T2DM and in those of older age. This information may be used by dental care providers and health policymakers to improve approaches to preventive care, as well as to characterize and anticipate care needs more accurately for the adult and older adult populations.

The Assessment of Early Server Childhood Caries Status in Abandoned Institutionalized Children

Oral health is a critical indicator of children’s quality of life, which at this early age, depends exclusively on the attention, involvement, and guidance of parents or caregivers. Assessing carious damage and measuring the prevalence of early severe tooth decay in temporary teeth in children is obtained by calculating the dmft index, giving the sum of an individual’s decayed, missing, and filled teeth. The aim of our study was to conduct a clinical examination of the oral status of institutionalized children from Romania. We selected and included in the study 144 children, both boys and girls in equal number, with ages of five or six years old, from which 110 were eligible for the study and met the inclusion criteria. Of all children, 20.90% were five years old girls, 27.27% five years old boys, 26.36% six years old girls, and 25.46% six years old boys. Of all, 10,45% had more than three incisors presenting decays, equally affected by gender. Of the boys’ group, 20% of age six had more de two canines affected, and 26.7% of five years old girls had more than three affected canines. Of the five years boys’ group, 24.3% had more than three affected temporary molars, 44.9% of six years boys had more than five. Of the five years old girls, 33.3% had more than four temporary molars affected and, 56.6% of the six years old girls’ group had more than five molars presenting carious lesions. The dental status and dmft values were similar for five years old and six years old children and similar boys and girls. Due to the vulnerability of young children that consists not only in their inability to identify, express, and address their own needs but also the lack of parental support, lack of an optimal diet for age, and proper hygiene, they reach adolescence with an impaired dental status, inappropriate for their age.

Nomogram prediction of caries risk among schoolchildren age 7 years based on a cohort study in Shanghai

Objective

Caries risk assessment tools are essential for identifying and providing treatment for individuals at high risk of developing caries. We aimed to develop a nomogram for the assessment and evaluation of caries risk among Chinese children.

Methods

We enrolled schoolchildren age 7 years from a primary school in Shanghai. Baseline information of participants was collected using a questionnaire completed by children’s caregivers. A nomogram of a novel prediction scoring model was established based on predictors detected in univariate and multivariate analyses. Predictive accuracy and discriminative ability of the nomogram were calculated using the concordance index (C index). The bootstrap method (1000 samples) was used to decrease overfitting. The net benefit of the model was validated using decision curve analysis.

Results

Overall, 406 children with complete information and two completed dental examinations were included in the final analysis. The nomogram based on logistic regression model coefficients demonstrated a C index of 0.766 (95% confidence interval: 0.761–0.771) for caries risk. The net benefit of the decision curve analysis was 38.6% at 55% threshold probability.

Conclusion

This nomogram model, derived using dietary habits, oral hygiene status, and caries experience, showed promising predictive ability to assess the caries risk among Chinese children.