Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia

Socioeconomic Status and Toothbrushing in Indigenous and Non-Indigenous Australian Children

INTRODUCTION

Dental caries in children is a multifactorial and complex condition. Toothbrushing helps maintain good oral hygiene and delivers fluoride. However, determinants of toothbrushing could vary based on Indigenous status.

OBJECTIVE

This study aimed to assess the association between socioeconomic status and adequate toothbrushing practice (brushing twice or more a day) in Indigenous and non-Indigenous Australian children.

METHODS

Data were acquired from the National Child Oral Health Survey (NCOHS) 2012 to 2014. NCOHS administered questionnaires to parents of a representative sample of 24,215 Australian children aged 5 to 14 y recruited using a complex sampling method. Data on the frequency of toothbrushing and socioeconomic status were collected through the questionnaires. Statistical analysis was conducted progressively from bivariate to multivariable regression modeling, stratified by Indigenous status.

RESULTS

Just over half of Indigenous children and over two-thirds of non-Indigenous children reported adequate toothbrushing. The prevalence of adequate brushing (twice or more a day) was 42% (95% confidence interval [CI], 1.10-1.84) higher among children with an overseas-born parent than those with Australian-born parents. Among non-Indigenous children, sex and age, parents' country of birth, number of children in the family, and other family socioeconomic indicators (education, income, private health insurance) were associated with adequate toothbrushing. The prevalence of adequate brushing was 1.09 (95% CI, 1.03-1.15) and 1.15 (95% CI, 1.10-1.21) times higher when their parent possessed vocational training and tertiary education, respectively, compared to those children whose parents had school-level education.

CONCLUSIONS

There were differences in patterns of socioeconomic disparities for toothbrushing practices between Indigenous and non-Indigenous Australian children.

KNOWLEDGE TRANSFER STATEMENT

To promote positive toothbrushing practices in children, dental clinicians and public health professionals must be aware of the determinants of toothbrushing practices. Socioeconomic disparities in toothbrushing frequency were more apparent in non-Indigenous children. These results will help develop population-specific interventions that tackle the determinants to help improve oral hygiene behavior in Indigenous and non-Indigenous children.

Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis

This study summarised the association between ultra-processed food (UPF) consumption and dental caries in children and adolescents through a systematic review and meta-analysis. The search of PubMed, Cochrane, Web of Science and Scopus databases using the 'PECOS' strategy retrieved 1462 eligible articles. Only studies with humans aged ≤ 19 years; that assessed groups of any UPF or specific UPF items; that measured dental caries as the decayed, filled and missing surfaces or teeth indexes, based on the WHO criteria; cross-sectional, case-control, cohort and all types of interventions that examined the adjusted association between UPF consumption and dental caries were included. All studies received qualitative evaluation. Meta-analysis using random-effects models combined multivariable-adjusted OR for case-control and cross-sectional studies and risk ratio (RR) for longitudinal studies of the highest v. lowest category of UPF consumption. Forty-two studies were included in the qualitative synthesis and twenty-seven in the meta-analysis. The pooled RR was 1·71 (95 % CI 1·31, 2·24), and the pooled OR was 1·55 (95 % CI 1·37, 1·75). The highest OR was found among participants who had dental caries prevalence >70 % (OR = 3·67, 95 % CI 2·16, 6·23). Better evidence quality was found among cohort studies that evaluated children <6 years old. The findings suggest that higher UPF consumption is associated with greater dental caries in children and adolescents. Public health efforts to reduce UPF consumption are needed to improve the oral health of children and adolescents.

Nanotechnology-based therapies for the prevention and treatment of Streptococcus mutans-derived dental caries

BACKGROUND

Dental caries results from long-term acid production when sugar is metabolized by a bacterial biofilm, resulting in a loss of calcium and phosphate from the enamel. Streptococcus mutans is a type of acid-producing bacteria and a virulent contributor to oral biofilms. Conventional treatment options, such as cefazolin and ampicillin, have significant levels of bacterial resistance. Other topical agents, such as fluoride, tend to be washed away by saliva, resulting in low therapeutic efficacy.

HIGHLIGHT

This review aims to highlight the solubility issues that plague poorly water-soluble therapeutic agents, various novel polymeric, and lipid-based nanotechnology systems that aim to improve the retention of therapeutic agents in the oral cavity.

CONCLUSION

In this review, different formulation types demonstrated improved therapeutic outcomes by enhancing drug solubility, promoting penetration into the deep layers of the biofilm, facilitating prolonged residence time in the buccal cavity, and reducing the emergence of drug-resistant phenotypes. These formulations have a strong potential to give new life to therapeutic agents that have limited physicochemical characteristics.

Prevalence of Dental Caries and Its Associated Factors among Primary School Children in Ethiopia

Background. Dental caries (decay or cavities) is a breakdown of teeth as a result of bacteria. Dental caries is one of the preventable oral health problems and the most common chronic diseases in childhood. Poor dental and oral health affect the quality of children’s life. Objectives. To estimate the prevalence of dental caries and its associated factors among primary school children in Alem Ketema, North Showa, Ethiopia. Methodology. An institution-based quantitative cross-sectional study was conducted on 422 primary school children, from February 9 to March 8, 2020. Pretested structured questionnaire and oral examinations were conducted by using the WHO criteria (DMFT) index to collect the data. The data were entered into Epi-Data 3.1 software, and analysis was carried out using SPSS version 23 and variables with $P$ value ≤0.05 in the multivariable binary logistic analysis were considered as a cut-point to declare statistical significance. Result. The prevalence of dental caries was 46.9% (95% CI: 42.1, 51.7). The mean Decayed, Missing, and Filled Teeth (DMFT) index was 1.28 (±1.21). Being male (AOR = 1.975, 95% CI = 1.067–3.66), lack of parents’ insistence (AOR = 2.052, 95% CI = 1.079–3.902), lack of oral health education program (AOR = 4.753, 95% CI = 1.69–13.38), history of dental aches (AOR = 2.88, 95% CI = 1.55–5.32), and poor habit of mouth wash (AOR = 4.74, 95% CI = 2.55–8.79) were found significantly associated with dental caries. Conclusion. The prevalence of dental caries was higher and a common public health problem among school children. Lack of parent’s insistence, sex, dental ache history, poor practices of mouth wash, and lack of oral health education were significant predictors of dental caries. Therefore, oral health education program and parents encouraging their children to practice oral hygiene are important to prevent dental caries.

Social determinants and behavioural factors influencing toothbrushing frequency among primary school children in rural Australian community of Lithgow, New South Wales

Objective

This study aims to determine the social determinants and behavioural factors influencing frequency of toothbrushing among primary school children residing in the rural community of Lithgow in New South Wales, Australia. All six primary schools of Lithgow were approached to participate in a cross-sectional survey prior to implementation of water fluoridation. A validated oral health survey questionnaire was completed by 703 parents of the children. Multivariable logistic regression analysis was employed to determine significant predictors associated with frequency of toothbrushing.

Results

Parents with a positive attitude towards water fluoridation had 74% higher odds (OR = 1.74, 95% CI 1.17–2.60) of their children brushing twice or more daily. Children living in a single parent household had 34% reduced odds (OR = 0.66, 95% CI 0.43–0.99) of brushing twice daily. Poor maternal oral health was significantly associated with suboptimal dental hygiene practices in children, where mothers who had any tooth extracted had 7% reduced odds of their children brushing their teeth twice or more daily (OR = 0.93, 95% CI 0.90–0.97). Subsequently, children with increased consumption of chocolates per day were less likely to brush twice or more daily. Finally, children with dental insurance had two times higher odds (OR = 2.04, 95% CI 1.40–2.96) of brushing twice daily.

Community-level predictors of Australian children's dental caries and injury

BACKGROUND

Social determinants of oral health are complex and have been described by conceptual frameworks. A widely embraced model of children's oral health was published by Fisher-Owens et al. (2007), identifying theoretical constructs influencing oral health. The current study aimed to investigate community-level constructs described in the conceptual model.

METHODS

The Longitudinal Study of Australian Children is a cross-sequential dual cohort study, with a representative sample (n = 10090) of Australian children. Generalized estimating equations were applied to model seven waves of carer-reported oral health and community measures.

RESULTS

In the final model, children living in Queensland had a 1.48 (CI 1.35-1.62) increased odds of dental caries over time. Children in low socio-economic status (SES) areas (OR 1.32 CI 1.20-1.44) had an increased odds of caries. The state of Queensland (OR 1.24 CI 1.05-1.46) and poor neighbourhood liveability (OR 1.17 CI 1.05-1.31) were predictors of dental injury.

CONCLUSION

By modelling available community measures, this study found SES and rurality were predictors of caries over childhood. Our results highlight the difficulty of applying conceptual models to oral health. The use of qualitative studies and realist reviews should be considered to complement statistical models to provide contextualized insights into funding, policy and service delivery on children's oral health.

Fluoride Occurrence and Human Health Risk in Drinking Water Wells from Southern Edge of Chinese Loess Plateau

Fluoride hydrogeochemistry and associated human health risks implications are investigated in several aquifers along the southern edge of the Chinese Loess Plateau. Locally, 64% shallow groundwater samples in loess aquifer exceed the fluoride limit (1.5 mg/L) with the maximum of 3.8 mg/L. Presently, the shallow groundwater is the main source of private wells for domestic use, and this is clearly a potential risk for human health. Hydrogeochemistry and stable isotopes are used to elucidate the diversity of occurrence mechanisms. Enrichment of fluoride in groundwater is largely controlled by the F-containing minerals dissolution. Furthermore, alkaline condition and calcium-removing processes promote water-rock interactions. Stable isotopes of hydrogen and oxygen (δD and δ18O) in study area waters demonstrate that groundwater in loess aquifer is old, which means groundwater remains in the aquifer for a long time. Long residence time induces sufficient water-rock interactions, which play significant roles in the resolution of fluoride minerals. Samples from the shallow loess aquifer show elevated fluoride levels, which may pose human health risk for both adults (60%) and children (94%) via oral intake. To ensure drinking water safety, management measures such as popularizing fluoride-removing techniques and optimizing water supply strategies need to be implemented.