Occlusal Features and Caries Experience of Hong Kong Chinese Preschool Children: A Cross-Sectional Study

Malocclusion in deciduous dentition: a cross-sectional study in a Portuguese preschool population

PURPOSE

To determine the prevalence of malocclusion in Portuguese preschool children, to characterise occlusion in the deciduous dentition, and to study the relationship between malocclusion, sex, and age.

METHODS

This cross-sectional study included 3-6 years old children, from 25 randomly selected kindergartens from the Lisbon district. Data were collected through an oral examination. Malocclusion was defined as the presence of any type of occlusion anomaly (anterior crossbite, edge-to-edge, increased overjet, open bite, deep overbite, posterior crossbite, scissor bite), spacing anomaly (crowding), or dentition anomaly (supernumerary teeth, agenesis, malformations). Canine class, terminal plane of the deciduous second molars and type of Baume arch were also recorded. Statistical analysis included descriptive and chi-squared test (α = 0.05).

RESULTS

The sample included 426 children with a global prevalence of malocclusion of 60.6%. Occlusion anomalies were the most prevalent (59.2%), the most frequent being deep overbite (27%), increased overjet (22.1%) and posterior crossbite (14.1%). Crowding had a prevalence of 1.6% and agenesis of 1.4%. Class I canine (57.3%), straight second molar terminal plane (60.1%) and type I Baume arch (53.3%) were the most common. The mean overjet was 2.6 mm (sd = 2.1) and the mean overbite was 2.2 mm (sd = 2.1). Age was associated with the presence of occlusion anomalies (p = 0.03), and increased overjet prevalence was found to be higher in girls (p = 0.03).

CONCLUSIONS

The prevalence of malocclusion was high, with occlusion anomalies being the most prevalent. It is important to identify modifiable risk factors associated with malocclusion to prevent this condition in both the deciduous and permanent dentitions.

Prevalence of Malocclusion Traits in Primary Dentition, 2010-2024: A Systematic Review

The present review was aimed to describe the prevalence and the regional distribution of malocclusion among preschool children worldwide. Two independent reviewers performed a systematic literature search to identify English publications from January 2010 to May 2024 using PubMed, ISI Web of Science and Embase. Search MeSH key words were "malocclusion", "primary dentition" and "child, preschool". The reporting quality was assessed by the modified Newcastle-Ottawa Quality Assessment Scale. We identified 2599 publications and recruited 47 articles. Fourteen of the included studies were conducted in Asia, four in Europe, twenty-eight in South America and one in Africa. The prevalence of malocclusion ranged from 28.4% to 83.9%, and half of the reported prevalences were higher than 50%. The highest percentage was in Asia (61.81%), followed by Europe (61.50%), South America (52.69%) and Africa (32.50%). Statistically significant differences existed in deep overbite, anterior open bite, posterior crossbite, edge-to-edge incisor relationship and distal step between continents (p < 0.05). Europe showed the highest prevalence (33.08%) of deep overbite. Africa showed the highest prevalence (18.60%) of anterior open bite. Europe showed the highest prevalence (15.38%) of posterior crossbite. The most common malocclusion traits were increased overjet and deep overbite. To conclude, malocclusion remained prevalent in the primary dentition and varied between countries.

Prevalence and Associated Factors of Malocclusion among Preschool Children in Huizhou, China: A Cross-Sectional Study

This survey examined the prevalence of malocclusion and its associated factors in 3- to 5-year-old children in Huizhou, China. Children were recruited from 21 kindergartens using a multistage sampling method. Two examiners performed oral examinations on the children, assessing occlusal traits, including primary molar and canine relationship, overjet, crossbite, overbite, anterior open bite, scissor bite, midline deviation, crowding, and spacing. Caries experience was recorded. Self-administered questionnaires were distributed to collect background information and oral health-related habits. Chi-square test, Mann-Whitney U test, and binary logistic regression were conducted. The study invited 1485 children and eventually recruited 1454 (52.9% boys; response rate: 97.9%). The prevalence of malocclusion was 68.3%, and deep overbite was found in 48.6% of the children. Children who had lip-biting habits had a higher prevalence of deep overbite than those who did not (OR = 2.36, p < 0.05). Children who had digit-sucking habits and dental caries in anterior maxillary teeth had a lower prevalence of deep overbite than those who did not (OR = 0.73 and 0.70, respectively, p < 0.05). In conclusion, over half of the children in Huizhou who participated in the study had malocclusion. Dental caries in anterior maxillary teeth, digit-sucking, and lip-biting were the associated factors of deep overbite.

Association between coronal caries and malocclusion in an adult population

Purpose

Only a few but conflicting results have been reported on the association between malocclusions and caries. We investigated this association using data from the population-based cross-sectional Study of Health in Pomerania (SHIP).

Methods

Sagittal, vertical and transversal intermaxillary relationship, space conditions and sociodemographic parameters of 1210 dentate subjects (median age 30 years, interquartile range 25–35 years) were collected. Caries was assessed with the Decayed-Missing-Filled Surfaces index but analyzed as ordered outcome (four levels: sound, enamel caries, caries, tooth loss) in ordinal multilevel models, taking into account subject, jaw, and tooth level simultaneously.

Results

Anterior open bite ≤3 mm (odds ratio [OR] = 2.08, 95% confidence interval [CI]: 1.19–3.61), increased sagittal overjet of 4–6 mm (OR = 1.31, CI: 1.05–1.64), distal occlusion of ½ premolar width (OR = 1.27, CI: 1.05–1.53) and distal 1 premolar width (OR = 1.31, CI: 1.06–1.63) were associated with adjusted increased odds for a higher outcome level (caries). Anterior spacing (OR = 0.24, CI: 0.17–0.33), posterior spacing, (OR = 0.69, CI: 0.5–0.95), posterior crowding (OR = 0.57, CI: 0.49–0.66) and buccal nonocclusion (OR = 0.54, CI: 0.33–0.87) were associated with a lower outcome level (caries).

Conclusion

The results from this population-based study suggest that a connection between caries and malocclusion exists to a limited extent in young adults. The associations with caries are contradictory for several malocclusion variables. Distal occlusion (OR = 1.31, CI: 1.06–1.63) and related skeletal anomalies displayed positive associations with caries whereas crowding did not. Orthodontic treatment of anterior crowding would probably not interfere with caries experience. These aspects should be considered for patient information and in treatment decisions.

Do malocclusion and orthodontic treatment impact oral health? A systematic review and meta-analysis

INTRODUCTION

Currently, there is limited evidence on the effects of malocclusion on oral health and whether the correction of malocclusion results in an improvement in oral health. In this review, we examined the evidence from randomized controlled trials and prospective cohort studies to provide information on any association between malocclusion and oral health and the effects of orthodontic treatment.

METHODS

We conducted this review in 2 parts: (1) we looked at the impact of malocclusion on oral health, and (2) we reviewed the evidence on the effect of orthodontic treatment on oral health. We searched for randomized controlled trials and prospective cohort studies. The searches were completed for articles published between January 1, 1990 and October 8, 2018 and covered Medline via Ovid, Embase, and the Cochrane Database of Systematic Reviews. References of included articles and previous systematic reviews were hand-searched. No language restrictions were applied. Two members of the study team assessed the quality of the studies using the Appraisal Tool for Cross-Sectional Studies to appraise the quality of studies in part 1. The assessment was performed at the study level. Two authors assessed each study independently, with a third author consulted when a disagreement occurred. For studies in part 2, we used the Newcastle-Ottawa scale to assess the risk of bias. When studies were included in a Cochrane review, we incorporated the risk of bias assessment. We developed data extraction forms for each area of oral health under investigation (trauma, quality of life, caries, and periodontal disease). Each author piloted the form, and we held discussions to inform any necessary refinements. We extracted data from studies into 2 × 2 tables, which provided a binary analysis of malocclusion vs the outcome of interest. If these data were not available from the published paper, then studies were not included in the meta-analysis. The authors were contacted when possible to request data in this format.

RESULTS

For part 1 of the study, we identified 87 studies. The overall quality was low. We could not include any of the data into an analysis because of a large variation in the nature of the studies, data collected, and outcome measures that were selected. For part 2 of the study, we found 7 studies; however, there were similar deficiencies in the data as in part 1, and thus, we could not reach any strong conclusions.

CONCLUSIONS

Overall, there is an absence of published evidence regarding the effects of malocclusion on oral health and the impact of orthodontic treatment on oral health.