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Bombarde M, Chau K, Droz D, Hernandez M. Comparative study of the dental health of 4-year-old children in north-eastern France between 2001 and 2018. Eur Arch Paediatr Dent 2024; 25:375-383. [PMID: 38743213 DOI: 10.1007/s40368-024-00893-8] [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: 06/15/2023] [Accepted: 03/07/2024] [Indexed: 05/16/2024]
Abstract
PURPOSE To analyse the evolution of the oral health of 4-year-old children in nursery school between 2001 and 2018 as well as the early predictor and associated risk factors, in different school areas. METHODS We compared (1) the prevalence of ECC (4 ≥ dmft ≥ 1) and S-ECC (dmft ≥ 5) of 4-year-old children and (2) data obtained by a structured questionnaire completed by their parents from two studies performed in 2001 and 2018. Data were analysed using the Chi2 test and odds ratio (OR). RESULTS A total of 322 children and of 425 children randomly selected among Moselle's public nursery schools in north-eastern France were, respectively, included in the study in 2001 and 2018. The prevalence of ECC was respectively 40.70% and 21.65% in 2001 and 2018 (p < 0.001; OR = 2.48; 95% CI = 1.78-3.47). We also observed a decrease of S-ECC prevalence (10.56% in 2001 vs 5.90% in 2018, p < 0.05, OR = 1.89; 95% CI = 1.07-3.38). The intake of cariogenic food (sweet drink, biscuits, candies, milk, baby bottle) decreased but the knowledge of parents concerning cariogenic food did not improve. The proportion of parents helping their child has not changed in 17 years (82.33% vs 86.52%, p > 0.1) but tooth brushing was initiated earlier in 2018 than in 2001 (p < 0.01). Prescription of systemic fluoride decreased (39.14% vs 3.62%; p < 0.001). CONCLUSION The identification of the food consumption habits and the knowledge of parents concerning oral health should enable strengthening of preventive measures and the initiation of an oral health education programme for children and their family.
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Affiliation(s)
- M Bombarde
- Odontology Faculty, University of Lorraine, Nancy, France
| | - K Chau
- Maternal and Child Protection Department and Health Direction, Metz, France
- General Medicine Department, University of Lorraine, Nancy, France
- INSERM, Plurithematic Clinical Investigation Center 1433, UMR 1116, University of Lorraine, CHRU Nancy, Nancy, France
| | - D Droz
- Odontology Faculty, University of Lorraine, Nancy, France
| | - M Hernandez
- Pediatric Dentistry Department, CHRU Nancy, Nancy, France.
- Odontology Faculty, University of Lorraine, Nancy, France.
- Laboratory of Stress, Immunity, Pathogens (EA7300), Medicine Faculty, University of Lorraine, Nancy, France.
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Folayan MO, Coelho EMRDB, Ayouni I, Nguweneza A, Al-Batayneh OB, Daryanavard H, Duangthip D, Sun IG, Arheiam A, Virtanen JI, Gaffar B, El Tantawi M, Schroth RJ, Feldens CA. Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review. BMC Oral Health 2024; 24:517. [PMID: 38698356 PMCID: PMC11064360 DOI: 10.1186/s12903-024-04291-w] [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: 03/22/2023] [Accepted: 04/24/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND The goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC. METHODS The two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework. RESULTS In total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4-12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services. CONCLUSION The study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.
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Affiliation(s)
- Morenike Oluwatoyin Folayan
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada.
- Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
| | - Elisa Maria Rosa de Barros Coelho
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
- Department of Pediatric Dentistry, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - 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
| | - Ola Barakat Al-Batayneh
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Preventive Dentistry Department, Jordan University of Science and Technology, Irbid, Jordan
| | - Hamideh Daryanavard
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dubai Health Authority, Dubai, United Arab Emirates
| | - Duangporn Duangthip
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
- College of Dentistry, The Ohio State University, Columbus, OH, USA
| | - Ivy Guofang Sun
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Arheiam Arheiam
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Community and Preventive Dentistry, University of Benghazi, Benghazi, Libya
| | - Jorma I Virtanen
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Balgis Gaffar
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia
| | - 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
| | - Robert J Schroth
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Dr. Gerald Niznick College of Dentistry, University of Manitoba, Winnipeg, Canada
| | - Carlos Alberto Feldens
- Early Childhood Caries Advocacy Group, Winnipeg, MB, Canada
- Department of Pediatric Dentistry, Lutheran University of Brazil, Canoas, Brazil
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Thearawiboon S, Rojanaworarit C. Risk of Early Childhood Caries Estimated by Maternal Dental Caries during Pregnancy: A Retrospective Cohort Study. Eur J Dent 2024; 18:329-340. [PMID: 38518798 PMCID: PMC10959609 DOI: 10.1055/s-0043-1769896] [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: 03/24/2024] Open
Abstract
OBJECTIVE Public policy promoting prenatal dental care to provide long-term prevention of early childhood caries (ECC) in offspring would require evidence regarding the ECC risk associated with maternal dental caries during pregnancy. This study evaluated that association using a design capable of assessing temporal relationships and considered a directed acyclic graph to guide the adjustment of pertinent confounders. MATERIALS AND METHODS This retrospective cohort study analyzed data from 158 mother-child dyads attending care at Prachathipat Hospital, Pathum Thani, Thailand. Maternal dental caries data at their first visits to prenatal oral care from February 2012 to May 2017 were traced forwardly to match the oral health data of offspring who visited the hospital from May 2013 to March 2018. RESULTS Univariable and multivariable fractional logit regression models along with the calculation of average marginal effects revealed that children born to two categories of mothers with 1 to 5 and ≥6 carious teeth during pregnancy would averagely develop 4.5 to 5 and 7.9 to 8.8 more carious teeth per 100 teeth than dental caries would occur in offspring of caries-free mothers. CONCLUSION This evidence identified the role of maternal dental caries during pregnancy as a significant clinical risk indicator for ECC and supported the provision of prenatal dental care for mothers to prevent ECC in offspring.
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Affiliation(s)
| | - Chanapong Rojanaworarit
- Department of Population Health, School of Health Professions and Human Services, Hofstra University, Hempstead, New York, United States
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Min SN, Duangthip D, Gao SS, Detsomboonrat P. Early childhood caries and its associated factors among 5-years-old Myanmar children. FRONTIERS IN ORAL HEALTH 2024; 5:1278972. [PMID: 38333563 PMCID: PMC10850244 DOI: 10.3389/froh.2024.1278972] [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: 08/17/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Children's oral health plays a crucial role in their overall well-being and there is a significant gap in our understanding of early childhood caries (ECC) in Myanmar. This study aims to bridge this knowledge deficit by investigating the prevalence, causes, and potential interventions for ECC in the Myanmar population, providing crucial insights for future dental health policies and practices. Methods Generally healthy 5-year-old kindergarten children from 7 districts in city were recruited. ECC was assessed through clinical examinations using decayed, missed, filled teeth (dmft). Additionally, demographic data of the children and their caregivers, along with information about the children's oral health-related behaviors, were gathered using a structured questionnaire. Results Out of the 496 children, the overall prevalence of dental caries was 87.1% (mean dmft score: 5.57, SD: 4.6). Caries experience was categorized as severe (45.8%) and non-severe (41.3%). Decayed teeth constituted the major component of the dmft index (97.8%). Multiple logistic regression analysis revealed two significant factors associated with ECC prevalence: late toothbrushing initiation (OR: 2.54, p = 0.001) and dental visit experience (OR: 2.46, p = 0.010). Discussion The study highlights the alarming ECC prevalence in 5-year-old children in Mandalay, Myanmar, with mostly untreated decayed teeth. The findings emphasize early preventive oral health measures for young children to reduce ECC burden in Myanmar.
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Affiliation(s)
- Saw Nay Min
- Postdoctoral Researcher Program in Dental Public Health, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | - Duangporn Duangthip
- Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sherry Shiqian Gao
- Department of Stomatology, School of Medicine, Xiamen University, Xiamen, China
| | - Palinee Detsomboonrat
- Department of Community Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Attia D, ElKashlan MK, Saleh SM. Early childhood caries risk indicators among preschool children in rural Egypt: a case control study. BMC Oral Health 2024; 24:10. [PMID: 38172841 PMCID: PMC10765893 DOI: 10.1186/s12903-023-03771-9] [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: 08/24/2023] [Accepted: 12/13/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Early childhood caries (ECC) is a public health problem, especially in developing countries like Egypt which has an ECC prevalence of 74%. This research aimed to assess the risk indicators associated with ECC in a rural, socially-disadvantaged population in Alexandria, Egypt. METHODS A case-control study was conducted in 8 nurseries of preschool children aged 3 to 5 years in rural, deprived areas in Alexandria, Egypt, from October 2019 till January 2020. Two groups, 93 with ECC and 93 without ECC. A validated questionnaire was used to collect sociodemographic data including age, sex, number of siblings, socioeconomic status, oral health practices including toothbrushing frequency, pattern of dental visits, daily frequency of sugary snacks. Also, salivary pH and buffering capacity were assessed. A trained and calibrated dentist assessed caries status clinically according to the World Health Organization (WHO) criteria using the dmft index and oral hygiene status using Silness and Loe Plaque Index. Chi-squared test, followed by multivariable logistic regression were performed to assess the relation between independent variables and ECC, P < 0.05 was considered to be statistically significant. RESULTS Bivariate analysis showed that age, mother's education, dental visits, dietary habits, Plaque index, salivary pH and buffering capacity were significantly associated with ECC. The significant risk indicators for ECC in multivariable regression were age (AOR = 4.73, 95% CI: 2.76-7.83), mother's education (illiterate vs. university educated, AOR = 28.36, 95% CI: 8.51-112.92), frequency of daily sugary snacks (twice vs. once, AOR = 2.00, 95% CI: 1.29-3.49, and three or more vs. once, AOR = 2.67, 95% CI: 1.72-3.27), night feeding (AOR = 1.89, 95% CI: 1.38-10.21), Plaque index (AOR = 21.34, 95% CI: 5.56-81.99), and salivary pH (AOR = 0.16, 95% CI: 0.05-0.58). CONCLUSION This study suggests that sociodemographic indicators, dietary habits, plaque accumulation and salivary pH are risk indicators for ECC in the studied population.
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Affiliation(s)
- Dina Attia
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Mona K ElKashlan
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Susan M Saleh
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Javadzadeh E, Razeghi S, Shamshiri A, Miri HH, Moghaddam F, Schroth RJ, Mohebbi SZ. Prevalence and socio-behavioral determinants of early childhood caries in children 1-5- year- old in Iran. PLoS One 2023; 18:e0293428. [PMID: 38011147 PMCID: PMC10681183 DOI: 10.1371/journal.pone.0293428] [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: 07/24/2023] [Accepted: 10/11/2023] [Indexed: 11/29/2023] Open
Abstract
AIM According to the World Health Organization (WHO), early childhood caries (ECC) is still considered a major global health problem despite the general improvement in oral health practice. This study aimed to assess ECC's prevalence, severity, and key social and behavioral determinants in Iranian children 1-5- years of age. METHOD This cross-sectional study recruited Iranian 1-5-year-olds with a three-stage stratified clustered sampling method. After providing consent, parents were interviewed using a validated questionnaire, including questions on child characteristics and behavioral factors. Each child underwent a dental examination by one of four trained and calibrated dentists. Associations between key covariates of interest and primary outcome measures were assessed by multivariable logistic regression modeling and multivariate generalized negative binomial regression modeling after weightings were applied. Statistical analysis was performed using SPSS V25 and Stata V14.2 software packages. A p-value ≤ 0.05 was considered significant. RESULTS The mean age of 909 participants was 41.1±1.2 months, 48.6% were male, and 38.1% lived in rural areas. The overall prevalence of ECC was 53.2% and mean dmft score was 2.7± 0.3. Key determinants associated with ECC included living rurally (p = 0.009, OR = 2.13), consuming sweet drinks, sugary snacks, or both [p-value = 0.02 (OR = 2.53), and p-value<0.001 (OR = 4.96), respectively], and visible plaque (p<0.001, OR = 3.41). Covariates associated with dmft scores included residing in rural regions (p = 0.02, IRR = 1.31), having both sugary snacks and sweet drinks (p = 0.02, IRR = 1.85) compared to those had none, and visible dental plaque (p<0.001, IRR = 2.06). CONCLUSIONS The prevalence of dental caries in children is high in Iran. The increase of ECC prevalence and severity from toddlers to preschoolers emphasizes on the critical importance of early interventions in toddlers. Improving access to care for rural children is essential along with the need to change dietary and self-care behaviors through multilevel efforts.
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Affiliation(s)
- Ehsan Javadzadeh
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Razeghi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmadreza Shamshiri
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Fatemeh Moghaddam
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Robert J. Schroth
- Rady Faculty of Health Sciences, Department of Preventive Dental Sciences, Dr. Gerald Niznick College of Dentistry and Department of Pediatric and Child Health and Community Health Sciences, Max Rady, College of Medicine, Children’s Hospital Research Institute of University of Manitoba, Winnipeg, Canada
| | - Simin Z. Mohebbi
- Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
- Professor and Head of Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Yang L, Zhao S, Zhu Y, Lai G, Wang J. Oral health-related quality of life and associated factors among a sample from East China with severe early childhood caries: a cross-sectional study. BMC Oral Health 2023; 23:837. [PMID: 37936111 PMCID: PMC10629075 DOI: 10.1186/s12903-023-03560-4] [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: 06/07/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND To investigate the oral health-related quality of life (OHRQoL) and associated factors among a sample from East China with severe early childhood caries (S-ECC). METHODS A total of 316 children with S-ECC and their parents were recruited to participate in a cross-sectional study. Children were examined for caries status using criteria proposed by World Health Organization (WHO). The accompanying parent was required to provide demographic information and complete two validated questionnaires in Chinese: the early childhood oral health impact scale (ECOHIS) and the 5-item oral health impact profile (OHIP). RESULTS The study had a 98.1% response rate. Finally, the data of 300 children and their parents were analyzed. Mothers cared for their children far more than fathers in the included family (78.7% mother, 21.3% father). The mean age of children was 4.1 ± 0.7 years, ranging from 3 to 5. The mean dmft score was 13.8 ± 3.8. Few (13.7%) children never had a toothache. ECOHIS scores ranged from 0 to 38, with a mean score of 16.2 ± 7.2. The mean OHIP score was 2.9 ± 2.7. The parental age, family income, residence, history of pain, the dmft scores and parents' OHIP showed associations with ECOHIS scores or domain scores (P < 0.05). The multiple regression analysis showed that the history of pain, accompanying parents' OHIP, and the dmft scores were mainly associated with ECOHIS and child impact (P < 0.05); parental age was associated with family impact (P = 0.024). CONCLUSIONS The parent's OHRQoL was associated with the children's OHRQoL, indicating that policymakers and clinical practitioners should improve both children's and their parents' oral health. Furthermore, the caries severity and the history of dental pain impacted children's OHRQoL.
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Affiliation(s)
- Lianyi Yang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, No. 500 Quxi Road, Huangpu District, Shanghai, China
| | - Shimin Zhao
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, No. 500 Quxi Road, Huangpu District, Shanghai, China
| | - Yuanbing Zhu
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, No. 500 Quxi Road, Huangpu District, Shanghai, China
| | - Guangyun Lai
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, No. 500 Quxi Road, Huangpu District, Shanghai, China.
| | - Jun Wang
- Department of Pediatric Dentistry, Shanghai Ninth People's Hospital, College of Stomatology, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, No. 500 Quxi Road, Huangpu District, Shanghai, China.
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Wilson NJ, Lin Z, Pithouse M, Morrison B, Sumar B, George A. Qualitative Insights from A Novel Staff-Led Oral Health Champions Program Within a Residential Service For People With Intellectual and Developmental Disability. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:728-745. [PMID: 35549753 DOI: 10.1177/17446295221095654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The oral health of people with intellectual and developmental disability is poorer than that of the general community. Any solution for people with intellectual and developmental disability living in residential services needs to include disability support workers (DSWs). Previous studies have used either didactic or train-the-trainer approaches to enhance DSW knowledge and skills. Taking a different approach, a novel program used DSWs as embedded oral health champions. This model provided educational opportunities for DSWs to learn about good oral health and then share with peers and provide benefits to people with intellectual and developmental disability that they support. Interviews with a sample of these champions were conducted and analysed using content analysis. Findings suggest that DSWs are capable of affecting change with the right type and depth of training, management and organisational support. A DSW-led champions model has merit, however requires ongoing expert support to help maintain and sustain benefits over time.
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Affiliation(s)
- Nathan J Wilson
- Associate Professor, Australian Centre for Integration of Oral Health (ACIOH), School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
| | - Zhen Lin
- Research Assistant, School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
| | | | - Bonnie Morrison
- Health Promotion Officer, Dental Health Services Victoria, Carlton, VIC, Australia
| | - Bashir Sumar
- Lecturer, School of Nursing and Midwifery, Western Sydney University, Richmond, NSW, Australia
| | - Ajesh George
- Professor, Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University. Ingham Institute for Applied Medical Research. Sydney Dental School, University of Sydney, Liverpool, NSW, Australia
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Marqués-Martínez L, Pérez-Bermejo M, Lairón-Peris AR, Guinot-Barona C, Borrell-García C, García-Miralles E. Association between the Severity of Dental Caries and the Degree of Adherence to the Mediterranean Diet in the Pediatric Population. Nutrients 2022; 14:nu14173622. [PMID: 36079878 PMCID: PMC9460314 DOI: 10.3390/nu14173622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/16/2022] Open
Abstract
Children who show better eating practices are less likely to suffer from severe caries than those who eat a diet rich in sugars. In the present study, we aimed to establish the relationship between the severity of dental caries and adherence to the Mediterranean diet. A cross-sectional study was carried out in which 263 children aged 2 to 14 years old were examined intraorally to analyze the presence and severity of caries. Children’s parents/caregivers completed the KIDMED questionnaire to determine their degree of adherence to the Mediterranean diet. The results showed that the prevalence of caries is greater than 80% in children with medium or low adherence to the Mediterranean diet, and remains significant at 67% in the high adherence group (p = 0.010). A statistically significant negative correlation of weak magnitude (r = −0.29; p < 0.001) was found between adherence and the number of carious teeth. Caries severity in the first molars is also influenced by adherence to the diet in a statistically significant way. In conclusion, there is an association between adherence to the Mediterranean diet and the prevalence, extension, and severity of caries in the pediatric population.
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Affiliation(s)
- Laura Marqués-Martínez
- Dentistry Department, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - Marcelino Pérez-Bermejo
- SONEV Research Group, School of Medicine and Health Sciences, Catholic University of Valencia, C/Quevedo n° 2, 46001 Valencia, Spain
- Correspondence: ; Tel.: +34-620984639
| | - Ana Rosa Lairón-Peris
- Dentistry Department, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - Clara Guinot-Barona
- Dentistry Department, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - Carla Borrell-García
- Dentistry Department, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
| | - Esther García-Miralles
- Dentistry Department, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain
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A Conceptual Framework for Food Sharing as Collaborative Consumption. Foods 2022; 11:foods11101422. [PMID: 35626993 PMCID: PMC9141114 DOI: 10.3390/foods11101422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 11/30/2022] Open
Abstract
Food waste has increased significantly and become a global issue amidst a growing concern regarding famine in several countries. Food sharing constitutes the solution to the problem provided an appropriate framework is developed that guides its application. The sharing economy was touted as the appropriate framework, yet it is excessively macroscopic to be able to capture the dynamics of food sharing activities. A microscopic framework is required to overcome this problem, the concept of collaborative consumption with its focus on activity level being one potential solution. However, an investigation into how food sharing activities can be viewed as collaborative consumption should be completed. This paper presents an analysis of the relationship between food sharing activities and collaborative consumption. The authors employed a systematic literature review conducted by meta-analysis and content analysis to identify the commonalities between the two and the theories underlying them. The result is a conceptual framework of food sharing activities as a collaborative consumption practice. The framework highlights eight propositions that can explain the intention, performance, and continuity of food sharing activities. At the end of the paper, the authors outline the theoretical and managerial contributions and recommend future research activities.
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Tenelanda López D, Alban Hurtado C, Castelo Reyna M, Vinueza OF. Oral health status and sociofamiliar aspects among 12-year-old schoolchildren: A correlational study. J Int Oral Health 2022. [DOI: 10.4103/jioh.jioh_66_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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12
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Early predictors of childhood caries among 4-year-old children: a population-based study in north-eastern France. Eur Arch Paediatr Dent 2021; 22:833-842. [PMID: 34089514 DOI: 10.1007/s40368-021-00627-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/17/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Untreated early childhood caries (ECC) can trigger a number of negative consequences, including pain, chewing difficulties, insufficient physical development and low academic performance. Therefore, ECC impacts the oral health-related to quality of life. That is why it is important to assess the ECC prevalence and to determine the associated risk factors. AIM The aim of this study was to investigate the relationship between early predictor factors and dental caries among 4-year-old French children, considering the socioeconomic factors, dietary and oral hygiene practices, the access and the follow-up by paediatric dentist. DESIGN The study was a cross-sectional observation. A random sample of 4-year-old children was selected among 596 Moselle's public nursery schools in north-eastern France. Data were gathered from clinical dental examinations and a structured questionnaire completed by parents. RESULTS In total, 425 subjects with completed questionnaires and clinical examinations were included. The prevalence of ECC and S-ECC (Severe-ECC), including only cavitated lesions, d3mft, were 15.8% and 5.9%, respectively. Multivariable logistic regression modelling identified four main factors associated with a high risk of ECC that were sweet intake (adjusted odds ratio ORadjusted = 3.43, 95% CI = 1.57-7.53), brushing habits (ORadjusted = 2.25, 95% CI = 1.23-4.21), childcare arrangement (ORadjusted = 2.27, 95% CI = 1.23-4.21) and maternal educational level (ORadjusted = 1.87, 95% CI = 1.06-3.31). These four factors have a cumulative effect. Only 4% of children presented teeth restoration. CONCLUSIONS This study highlighted the impact of the family environment on the oral health status of the preschool children. The identification of the risk factors should allow to strengthen preventive measures and initiate oral health education program for children and their family.
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Determinants of dental caries in children in the Middle East and North Africa region: a systematic review based on literature published from 2000 to 2019. BMC Oral Health 2021; 21:237. [PMID: 33947387 PMCID: PMC8097819 DOI: 10.1186/s12903-021-01482-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 03/03/2021] [Indexed: 12/22/2022] Open
Abstract
Background Dental caries risk factors have been expanded to not only emphasize biology, dietary and oral habits but also broader social determinants such as socioeconomic factors and the utilization of health services. The aim was to review sociobehavioural/cultural and socioeconomic determinants of dental caries in children residing in the Middle East and North Africa (MENA) region. Methods A search was conducted in the PubMed/Medline database and Google Scholar to identify studies published from 2000 to 2019 covering children using key search terms. In the initial stages, titles, abstracts and, if needed, full articles were screened for eligibility. In the final stage, all included articles were reassessed and read, and relevant data were extracted. Results Out of 600 initial articles, a total of 77 were included in this review, of which 74 were cross-sectional, 2 were longitudinal and one was a case–control study. The studies included a total of 94,491 participants in 14 countries across the MENA region. A majority used the World Health Organization scoring system to assess dental caries. The caries prevalence ranged between 17.2% and 88.8%, early childhood caries between 3% and 57% and decayed missing filled teeth (dmft) varied between 0.6 and 8.5 across the various age groups. Increased age, low maternal education, low overall socioeconomic status, decreased frequency of tooth brushing, low parental involvement, poor oral habits, infant feeding practices and sugar consumption were among the most prevalent determinants for increased risk of caries in the reviewed studies. Conclusions Dental caries was found to be high among children in many of the studies published from MENA. The key determinants of dental caries were found to include factors related to child characteristics, family background, oral hygiene and infant feeding and eating habits. The high dental caries prevalence emphasises the need to address the prevailing modifiable sociobehavioural and socioeconomic determinants by translating them into effective oral health prevention policies and programmes.
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Reyes LT, Knorst JK, Ortiz FR, Mendes FM, Ardenghi TM. Pathways influencing dental caries increment among children: A cohort study. Int J Paediatr Dent 2021; 31:422-432. [PMID: 32965714 DOI: 10.1111/ipd.12730] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 08/25/2020] [Accepted: 09/03/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Dentists should assess pathways influencing the increment of dental caries among children to guide the prevention and treatment of the disease. AIM Evaluate the pathways that influence the increment of carious lesions in pre-school children. DESIGN This is a 2-year cohort study was conducted with a random sample of 639 pre-school children in southern Brazil. Caries experience, socioeconomic status (SES), social capital, and psychosocial characteristics were obtained at baseline. Increment of dental caries was assessed at 2 years follow-up in 467 children (cohort retention rate of 73.1%). Previously calibrated examiners assess the caries through the International Caries Detection and Assessment System (ICDAS). Structural equation modeling (SEM) was performed to test the pathways influencing dental caries increment. RESULTS Dental caries at baseline was heavily influenced by children's age (SC: 0.381, P < .01), tooth plaque (SC: 0.077, P = .02), parent's perception child oral health (SC: 0.295, P < .01), and household (SC: 0.148, P < .01). Increment of dental caries was directly affected by dental caries at baseline (Standardized Coefficients [SC]: 0.377, P < .01). Indirect paths were not significant. CONCLUSIONS Dental caries experience was the main factor of direct influence on the increment of caries, reinforcing the theory of risk accumulation over time.
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Affiliation(s)
- Lilian Toledo Reyes
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fernanda Ruffo Ortiz
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | | | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
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Dixit UB, Sehgal PR, Moorthy L, Iyer H. Does maternal tooth brushing-related sef-efficacy predict child's brushing adherence? J Indian Soc Pedod Prev Dent 2021; 39:164-170. [PMID: 34341236 DOI: 10.4103/jisppd.jisppd_370_20] [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: 11/04/2022] Open
Abstract
BACKGROUND Dental plaque is a root cause of dental caries. Effective plaque control in young children can be achieved with twice-daily assisted tooth brushing. Self-efficacy relates to one's confidence in performing a task. Self-efficacy is shown to facilitate the behavior change in treatments for lifestyle diseases. The influence of maternal self-efficacy in children's oral health behaviors is less studied. AIM The aim of this study is to evaluate an association between maternal tooth brushing-related self-efficacy (MTBSE) and child's brushing adherence. SETTINGS AND DESIGN This cross-sectional study was conducted in schools and included 781 mother-child dyads with children between the age group of 2 and 6 years. METHODS Selected mothers were asked to complete the questionnaires on sociodemographic data, mother's oral health knowledge (MOHK), tooth-brushing practices, and MTBSE. Brushing adherence was evaluated as complete adherence if the child followed twice daily assisted brushing using the toothbrush and toothpaste. STATISTICAL ANALYSIS Nonparametric tests were used to compare the variables. Binary logistic regression was used to evaluate the predictors of brushing adherence. RESULTS Complete brushing adherence (assisted brushing with toothbrush and toothpaste at least twice per day) was seen only in 26.9% children. More children with complete brushing adherence were single children (P < 0.001). Children with complete brushing adherence had mothers with significantly higher MTBSE (P < 0.001). The presence/absence of siblings, MOHK, and MTBSE were found to be strong and significant predictors of brushing adherence in children. CONCLUSIONS MTBSE plays a significant role in complete adherence to toothbrushing in children aged 2-6 years.
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Affiliation(s)
- Uma B Dixit
- Department of Pedodontics and Preventive Dentistry, DY Patil University-School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Priyanka R Sehgal
- Department of Pedodontics and Preventive Dentistry, DY Patil University-School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Lakshmi Moorthy
- Department of Pedodontics and Preventive Dentistry, DY Patil University-School of Dentistry, Navi Mumbai, Maharashtra, India
| | - Harikesavan Iyer
- Department of Pedodontics and Preventive Dentistry, DY Patil University-School of Dentistry, Navi Mumbai, Maharashtra, India
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Tenelanda-López D, Valdivia-Moral P, Castro-Sánchez M. Eating Habits and Their Relationship to Oral Health. Nutrients 2020; 12:nu12092619. [PMID: 32867393 PMCID: PMC7551577 DOI: 10.3390/nu12092619] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
The objective of this research was to compare the healthy behaviors and caries index of young people in school to obtain an overview of their lifestyles, which would enable the development of educational programs for the promotion of oral health. The study design was carried out using a descriptive, cross-sectional, and observational methodology with a mixed approach. 380 twelve-year-old students participated in this research conducted in the city of Riobamba-Ecuador. The techniques used were observational and surveys with their respective instruments, the Dental Clinical History, and the Health Behavior in School-aged Children 2014-Spain questionnaire. The community index of the Decayed, Missing due to caries, and Filled Teeth (DMFT) reflected a high level (6.47) in the study subjects. A variety of foods such as fruits, chips, vegetables, candy, sugar-containing drinks, meat, fish, dairy, and cereals were consumed at least once a week by most students. Two statistically significant associations were demonstrated in this investigation. The first one was between fruit consumption and the DMFT index, the second one was between vegetable consumption and the DMFT index. Both associations showed significant values (p) of 0.049 and 0.028, respectively; these were not determining indicators since caries is a multifactorial pathology, which can develop not only as a product of poor eating habits.
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Affiliation(s)
- Dennys Tenelanda-López
- Faculty of Natural Resources, Escuela Superior Politécnica de Chimborazo, Riobamba EC060155, Ecuador
- School of Dentistry, Universidad Nacional de Chimborazo, Riobamba 060150, Ecuador
- Correspondence: ; Tel.: +593-9-9258-3944
| | - Pedro Valdivia-Moral
- Faculty of Education, Universidad de Granada, 18011 Granada, Spain; (P.V.-M.); (M.C.-S.)
| | - Manuel Castro-Sánchez
- Faculty of Education, Universidad de Granada, 18011 Granada, Spain; (P.V.-M.); (M.C.-S.)
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Yazdani R, Mohebbi SZ, Fazli M, Peighoun M. Evaluation of protective factors in caries free preschool children: a case-control study. BMC Oral Health 2020; 20:177. [PMID: 32586302 PMCID: PMC7318423 DOI: 10.1186/s12903-020-01154-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 06/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing the proportion of caries-free children following the WHO's global target has led to more desirable welfare and a higher level of quality of life for children. In the present study, we aimed to evaluate the factors contributing to a caries-free condition in preschool children as a basic action towards the global goals of children's oral health. METHODS This was a case-control study evaluating the protective factors contributing to dental caries free in 4-6-year-old children in Tehran/Iran in 2017. 500 preschool children and their mothers were selected from 22 randomly selected preschools and were enrolled in the study. The participants were divided into two case (caries-free) and control (with dental caries) groups. The data were collected using two data gathering tools; the child oral examination form and the mother's valid questionnaire. The latter included three domains; socio-demographic factors, behavioral oral health measures, and feeding practices and dietary habits. The criteria for caries detection were cavities in the enamel and dentine. A logistic regression model was applied to identify caries-free protective factors (P < 0.05). RESULTS Among 230 caries-free and 270 non-caries-free children who participated in the study, boys were more caries-free (P = 0.001). The protective factors against dental caries that were identified in the study were dental check-up as the cause of dental visit, being the first child in the family, the fewer sessions night feeding of the child's, family's house ownership, and parent's university education (P < 0.05). CONCLUSIONS Dental health can be achieved by considering protective factors like the regular dental check-up and socio-economic factors. Communities are invited to pay close attention to these important protective factors as far as they can increase the proportion of caries-free among preschool children especially in countries with developing oral health care systems.
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Affiliation(s)
- Reza Yazdani
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Simin Zahra Mohebbi
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Fazli
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Peighoun
- Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Vieira KA, Rosa-Júnior LS, Souza MAV, Santos NB, Florêncio TMMT, Bussadori SK. Chronic malnutrition and oral health status in children aged 1 to 5 years: An observational study. Medicine (Baltimore) 2020; 99:e19595. [PMID: 32358344 PMCID: PMC7440136 DOI: 10.1097/md.0000000000019595] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 01/15/2020] [Accepted: 02/18/2020] [Indexed: 11/26/2022] Open
Abstract
To evaluate the effect of chronic malnutrition on the oral health of children aged 1 to 5 years.An observational, analytical, cross-sectional study was conducted and involved 82 children (12-71 months of age). Nutritional status was evaluated using anthropometric indicators and oral health status/caries prevalence was measured. Non-stimulated saliva was collected and flow rate and buffering capacity was measured.The mean dmft index was 1.38 for the adequately nourished children, 3.04 for those with mild malnutrition, 2.5 for those with moderate malnutrition and 2.4 for those with severe malnutrition. 69 of the 82 children had low to very low buffering capacity. No significant differences among the groups were found between malnutrition and age, buffering capacity or the dmft index (P > .05). However, significant differences in salivary flow were found among the different malnutrition categories (P < .05). Spearman correlation coefficient revealed a weak negative correlation between nutrition and salivary flow (r = -0.267).Malnutrition exerts a negative impact on the oral cavity of children and a reduction in salivary flow rate was observed with the increase in malnutrition. Diagnosing the effects of malnutrition in oral environment of children is important because it could improve the quality of life and give them an adequate treatment.
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Affiliation(s)
- Karlla A. Vieira
- Department of Biophotonics, Nove de Julho University (UNINOVE), São Paulo
- Centro Universitário CESMAC, Faculty of Dentistry, Maceió-AL, Brazil
| | | | - Maria A. V. Souza
- Centro Universitário CESMAC, Faculty of Dentistry, Maceió-AL, Brazil
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Ganesh A, Sampath V, Sivanandam BP, H S, Ramesh A. Risk Factors for Early Childhood Caries in Toddlers: An Institution-based Study. Cureus 2020; 12:e7516. [PMID: 32377464 PMCID: PMC7198107 DOI: 10.7759/cureus.7516] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 04/02/2020] [Indexed: 11/24/2022] Open
Abstract
Background Tooth decay experience among toddlers and preschoolers is of epidemic proportions worldwide and dental caries still remains an important childhood disease affecting a considerable part of this population. Though the prevalence of Early Childhood Caries (ECC) is associated with several risk factors such as feeding and oral hygiene practices, Streptococcus mutans levels, socioeconomic status (SES), etc., it is suggested that these factors should be studied adequately to aid in the early prevention and management of ECC. Objective The objectives of the study were to: a) evaluate the distribution of ECC, b) study the role of SES in the occurrence of ECC, c) record the variations in feeding and dietary practices along with oral hygiene practices and d) Correlate the sweet score with ECC. Materials and Methods This cross-sectional observational study was conducted over a period of 6 months among 100 toddlers (12-36 months) attending the Pediatric outpatient department of a single medical institution in Chennai, India. The study consisted of an intra-oral examination followed by a face to face interview of the mothers of the children using a validated structured oral health questionnaire. Results SES and ECC were negatively correlated with statistically significant association. Majority of the subjects did not follow any oral hygiene practices before teeth erupted; few subjects used tooth brush and tooth paste after teeth erupted and followed oral hygiene practices once a day. Statistically significant positive correlation with ICDAS scores was noted in relation to the sweet score and the frequency of intake of sweet foods, candy, etc. Cavitated lesions were more common than non-cavitated lesions and majority of the posterior teeth had ICDAS score 4. Conclusion Healthcare providers for children must be well informed on the etiology and risk factors of ECC and guide children for their first dental visit within one year of age.
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Affiliation(s)
- Akila Ganesh
- Public Health Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Vandana Sampath
- Oral Pathology, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Banu Priya Sivanandam
- Public Health Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Sangeetha H
- Dentistry, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | - Archana Ramesh
- Dentistry, Sri Ramachandra Institue of Higher Education and Research, Chennai, IND
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