Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam

Introduction

One of the most prevalent oral diseases affecting preschoolers, early childhood caries (ECC), can significantly lower a child's quality of life. The pain and discomfort that ECC causes will alter the child's eating habits, which will have an impact on both their physical and mental health, as shown by the deviation from the body mass index (BMI). Dental caries and deviation from the normal BMI are both significantly influenced by children's eating habits and socioeconomic status (SES).

Aim

To determine the association of ECC with BMI, dietary habits, and SES among 3-6-year-old preschool children.

Materials and methods

A cross-sectional study was conducted among 375 preschool children of 3-6 years of age. The decayed, missing, or filled teeth (deft) index was used to determine the caries status. Measurement of height (m) and weight (kg) was done using a stadiometer and electronic weighing machine. For each child, the BMI (kg/m2) was calculated, and the child's body weight status was assessed using Centers for Disease Control and Prevention (CDC)-based classification. Questionnaires were collected with demographic details, 3 days diet diary, and the SES of parents. The dietary habit and SES were obtained from the healthy eating index-2005 (HEI-2005) score and Modified Kuppuswamy's Scale 2018. All the data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) software V 20.0.

Result

The prevalence of ECC was 44.8%. On comparison of mean height, weight, and BMI scores, there was a significant difference in mean weight (p = 0.006) and BMI (p = 0.001) among the two study groups. Children with ECC had a lower HEI-2005 score and belonged to a lower social class compared to caries-free children (p = 0.001).

Conclusion

Children with ECC are significantly associated with BMI being overweight, or risk of being overweight; lower grades of SES and lower total score of HEI-2005 with poor diet and diet that needs improvement.

How to cite this article

Suresh A, Srinivasan D, AR SE, et al. Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam. Int J Clin Pediatr Dent 2023;16(4):565-571.

Geospatial Hotspot Analysis and Endemicity Trends of Missing and Unrecovered Children in India

BACKGROUND

Children constitute a nation's true asset. A country's future relies upon the proper development of its children, which necessitates a supportive environment and sufficient opportunities. Children, under the age of 18 years form a considerable percentage of India's population which imparts a huge responsibility for the nation. Everyday we come across news about a child going missing. The National Crime Record Bureau (NCRB) states that 73,138 children were reported missing overall in 2018. The prevalence increased by 8.9% in 2019, a worrisome situation. The cause behind children going missing is multi-dimensional like poverty, unemployment, loss of livelihood, natural calamities, social conflicts, and migration to urban areas. At present, missing children remain a neglected and non-urgent intervention area for everyone. Only the parents whose children are missing can feel the vacuum and sorrow of the situation. The sociologies of India's missing children merit dimensional and circumstantial examination. The sociological space into which a child goes missing is highly under-researched in India. This study helped in understanding the magnitude of missing cases across India based on existing literature and secondary sources. It also identified the potentially safe and worst areas with regard to missing children. The endemicity helped in identifying the changing trends in each of these areas of interest, which could serve as baseline data for policymakers and law enforcement alike.

MATERIALS AND METHODS

This is a cross-sectional analytical type of study. The data of missing and unrecovered children for the past five years (2021-2017) were obtained from open government data portal (https://data.gov.in) and geospatial hotspot analysis was done using the Getis-Order-G statistics on the same using GeoPandas and PySAL libraries of python. The endemicity of missing cases was studied using hierarchical cluster analysis and self-organizing maps using Python.

RESULTS

For boys, Uttar Pradesh, Rajasthan, and Madhya Pradesh remained consistent hotspots (high risk of missing cases) across all five years of study whereas Karnataka became a hotspot for 2020 and 2021. Among the cold spots (low risk of missing cases), Andaman and Nicobar Islands remained consistent cold spot across all five years of study and has emerged as a safe haven for boys. The missing girls' data reveals that Uttar Pradesh has consistently been the worst state for girls (along with their neighbors) as it possess the risk of girls going missing all through the study period with Chhattisgarh being included from 2019 onwards. Jharkhand, Gujarat, Sikkim, and Andaman and Nicobar Islands have consistently been cold spots across the board and have emerged as areas with low risk for missing girls.

CONCLUSION

This study helps us in understanding the magnitude of missing cases across India and it also identifies which are potentially safe areas as well as worst areas with regard to missing children. The endemicity also helps us in identifying the changing trends in each of these areas of interest. This will serve as a great resource for policy makers and law enforcement alike.

Exploratory study on the factors related with the early detection of missing older persons with dementia living alone in Japan

AIM

To clarify the factors related to the early detection of missing older persons with dementia (PwD) who lived alone in Japan.

METHODS

We carried out a multiple regression analysis with data from 88 missing PwD.

RESULTS

The location of the discovery was within the municipality where the missing PwD lived. Furthermore, the use of long-term care insurance services was significantly associated with early detection.

CONCLUSION

Missing PwD were located within the municipality in which they lived, which meant that the individual was found before they went far. In addition, with the long-term care insurance services, professionals should regularly visit the home of PwD according to a care plan. Planned regular visits might trigger the early recognition of a missing person with dementia and enable early search activities. Therefore, use of long-term care insurance services might lead to the early detection of missing PwD living alone. Geriatr Gerontol Int 2023; ••: ••-••.

Missing Cases of Bacteriologically Confirmed TB/DR-TB from the National Treatment Registers in West and North Sumatra Provinces, Indonesia

This study aimed to assess the percentage of confirmed drug-sensitive (DS) TB and drug-resistant (DR) TB patients who were missing in the national treatment registration in North Sumatra and West Sumatra, where treatment services for DR-TB in North Sumatra are relatively well established compared with West Sumatra, where the system recently started. Confirmed DS/DR-TB records in the laboratory register at 40 government health facilities in 2017 and 2018 were traced to determine whether they were in the treatment register databases. A Jaro-Winkler soundexed string distance analysis enhanced by socio-demographic information matching had sensitivity and specificity over 98% in identifying the same person in the same or different databases. The laboratory data contained 5885 newly diagnosed records of bacteriologically confirmed TB cases. Of the 5885 cases, 1424 of 5353 (26.6%) DS-TB cases and 133 of 532 (25.0%) DR-TB cases were missing in the treatment notification database. The odds of missing treatment for DS-TB was similar for both provinces (AOR = 1.0 (0.9, 1.2), but for DR-TB, North Sumatra had a significantly lower missing odds ratio (AOR = 0.4 (0.2, 0.7). The system must be improved to reduce this missing rate, especially for DR-TB in West Sumatra.

Radiographic Assessment of Permanent First Molars Among Adults in Riyadh: A Retrospective Study

Introduction The first permanent molars (FPMs) are the first permanent teeth to emerge in the oral cavity, which have an important role in dentition, dental development, and occlusion. FPMs are the most susceptible teeth to caries due to early eruption. There are many adverse consequences related to losing FPMs. Many of the previous studies focused on younger age groups. To the best of our knowledge, there needs to be more newly updated data reported in the literature regarding the status of FPMs in adults in Saudi Arabia. The study aimed to assess the status of permanent first molars among adults in a sample of patients in Riyadh. Methods A cross-sectional retrospective study was conducted from the records of patients in the Dental University Hospital, College of Dentistry, King Saud University (KSU), after obtaining ethical approval. Panoramic images of 810 patients ages 18 and above who were seen at KSU, College of Dentistry, were examined to assess the status of FPMs. A panoramic examination was undertaken for various dental reasons in the time between the years 2017 and 2022. Patients were divided into three age groups: 18-30, 31-50, and >50 years. Data were collected in a particular form and analyzed. The prevalence of missing teeth, as well as restored and carious teeth, were recorded. In addition, further information regarding the type of restoration was recorded. Correlations of the findings regarding age, gender, side, and jaw were determined for all cases and were performed using the chi-square test. P-values less than 0.05 were considered statistically significant. Results A total of 810 patients' panoramic radiographs were studied. Panoramic male study subjects were 382 (47.2%), and females were 427 (52.8%). Three-hundred thirty-nine (339; 41.9%) of them were of less than 30 years of age, 327 (40.4%) were in the age group of 31-50 years, and the remaining 144 (17.8%) were above 50 years of age. The prevalence of missing first molar teeth was 145 (17.9%) for teeth 16, 147 (18.1%) for teeth 26, 207 (25.5%) for teeth 36, and 188 (23.2%) for teeth 46. No statistically significant association was found between the age groups and gender and the first molar missing teeth (p=0.848 & p=0.159). Nineteen point thirteen percent (19.13%) of patients had only one missing FPM, 12.3% of patients had two, and 6.29% of them had three missing FPM teeth. Five point fifty-five percent (5.55%) of patients had four missing FPMs. A total of 56.8% (242) radiographs in the overall sample did not show any missing teeth. The mandibular FPMs (35.2%) were found missing more frequently than their maxillary counterparts (14.8%), and the left mandibular quadrant showed a slightly higher rate of missing FPM (25.55%). Statistically, a significant association was seen between the number of missing FPM among different age groups, p-value <0.0001. The most restored, carious, and replaced tooth was the mandibular left molar, and tooth-color restoration was the most commonly used restoration. Conclusion A high prevalence rate of missing first permanent molars (FPMs) was found in this study population. This calls for more awareness and preventive measures to preserve such significant teeth, therefore reducing the need for complex procedures. Further prospective studies on a larger population are needed to comprehensively evaluate the status of FPMs.

Determinants of oral-health-related quality of life among adult people in Iran

BACKGROUND

Oral health-related quality of life (OHRQoL) assesses the subjective perception of oral health and its impact on the quality of life. The aim of this study is to measure the OHRQoL and its determinants among adult people living in Kerman, Iran.

MATERIALS AND METHODS

In this cross-sectional study, a total of 5657 adult people (18-64 years) residing in the Kerman district, both in the rural and urban areas, were enrolled in the study between September 2014 and April 2018. The Oral Health Impact Profile (OHIP-14) and the oral health indices, such as the total decayed, missing, filled teeth (DMFT), community periodontal index (CPI), gingival index (GI), and xerostomia, were measured by an experienced dentist. The demographic variables of gender, age, educational status, and marital status were also recorded. The impact of the studied variables on OHRQoL was evaluated with multiple logistic regression.

RESULTS

Participants were 2239 (39.58%) men, and average age was 45.39. The mean scores for OHRQoL, DMFT, CPI and GI were respectively: 24.07 (7.76), 10.7 (6.86), 0.76 (0.96), 0.63 (0.8). The frequency of people with xerostomia was 37.4. 301 (53.3%) of people had poor quality of life related to oral health. In multivariable analysis, there was a statistically significant increase in OHRQoL with an increase in the DMFT (P < 0.001), xerostomia (P < 0.001), CPI, (P < 0.001). Men had a significantly higher OHIP score than women (P < 0.001).

CONCLUSION

According to the results of this study, DMFT, xerostomia, and CPI scores are strongly related to OHIP scores. In addition, between CPI and GI scores, the CPI score is the better predictor.

Assessing consequences of untreated dental caries using pufa/PUFA index among 6-12 years old schoolchildren in a rural population of Kerala

CONTEXT

Dental caries is the most common dental disease of childhood. India with a population of more than 135 crores accounts for a high proportion of dental morbidity. Poor oral health has a significant impact on quality of life, especially in rural areas. The consequences of untreated dental caries include pain, abscess, and space infections which may lead to loss of function and school hours. These consequences are of utmost important while planning a community dental care program.

AIMS

To assess the prevalence of dental caries, caries experience, and severity of dental caries among 6-12 years old schoolchildren in the rural areas of Kollam District, Kerala State.

SETTINGS AND DESIGN

A community school-based, descriptive, cross-sectional study in the rural areas of Kollam District.

MATERIALS AND METHODS

A cross-sectional study was carried among 2194 schoolchildren in the rural areas of Kollam District in the age group of 6-12 years. Children from eight randomly selected schools were examined for pufa/PUFA and dmf/DMF indices.

STATISTICAL ANALYSIS USED

SPSS version 17.0, Mann-Whitney, t-test, KruskalWallis test. P < 0.05 was considered statistically significant.

RESULTS AND CONCLUSIONS

Overall caries prevalence among the total population was found to be 74%. The prevalence of caries in the deciduous dentition was 61% and a mean decayed, missing, filled teeth value of 2.74 ± 3.200 and for the permanent dentition the caries prevalence of 26.8% and a mean Decayed, Missing, Filled Teeth of 0.66 ± 1.360 were observed. The prevalence of untreated dental caries (pufa/PUFA) was 40.8%. The pufa prevalence in deciduous dentition was 38.3% with a mean pufa of 0.99 ± 1.679. Moreover, the PUFA prevalence in permanent dentition was 4.1% with a mean PUFA of 0.06 ± 0.349. The highest prevalence of untreated dental caries (pufa/PUFA) was found in the 7 years' age group (52%) and the lowest in 12 years' age group (22.4%).

Oral health in patients with dementia: A meta-analysis of comparative and observational studies

OBJECTIVE

Poor oral health is common in dementia, but findings of epidemiological studies have been inconsistent. This meta-analysis examined oral health in patients with dementia diagnosed according to standardized diagnostic criteria.

METHODS

Six international databases (PubMed, EMBASE, PsycINFO, Medline, Cochrane Library, and Web of Science) were searched from their commencement date until 8 November 2018. Oral health was measured by the Remaining Teeth (RT) and Decayed, Missing, and Filled Teeth (DMFT) Index. The mean differences (MD) and 95% confidence intervals (CI) of DMFT Index total and component scores were calculated using a random-effect model.

RESULTS

Twenty-four studies were included for analyses. The pooled DMFT Index was 23.48 (95% CI: 22.34, 24.62), while the pooled score for each component was 2.38 (95% CI: 1.56, 3.20) in decayed teeth (DT), 18.39 (95% CI: 15.92, 20.87) in missing teeth (MT), 2.29 (95% CI: 0.62, 3.95) in filled teeth (FT), and 11.59 (95% CI: 9.14, 14.05) in RT. Compared to controls, people with dementia had significantly a higher DMFT Index total score (MD = 3.80, 95% CI: 2.21, 5.39, p < 0.00,001), and significantly lower number of RT (MD = -3.15, 95% CI: -4.23, -2.06, p < 0.00,001). Subgroup analyses revealed that higher DMFT Index score was significantly associated with year of survey (>2010), study design (case-control study), percentage of females (≤54.3), and the Mini Mental State Examination score (≤18.2). Higher MT score was significantly associated with study design (cross-sectional study), and lower FT score was significantly associated with year of survey (>2010).

CONCLUSIONS

Oral health was significantly poorer in people with dementia compared with controls. Regular screening and effective treatment should be implemented for this population.

Feasibility of oral health evaluation by intraoral digital photography: a pilot study

Objectives

This study investigated the accuracy and duration of intraoral digital photograph examination (IDPE) for evaluating oral health status and explored the feasibility of remote oral health assessment.

Methods

Thirty-one healthy college students underwent evaluations of oral health status via clinical examination (CE) combined with panoramic X-ray assessment at baseline, followed by IDPE 1 month later using photos taken at baseline. Methods for evaluation of gingival health included the Modified Gingival Index (MGI) and Plaque Index (PI). Examinations of caries status included the decayed, missing, and filled teeth and surfaces indexes (DMFT and DMFS indexes, respectively). The duration of each evaluation was also recorded.

Results

There were significant differences in MGI and PI between CE and IDPE. There were no significant differences in DMFT and DMFS indexes between CE and IDPE, and there were positive correlations between CE and IDPE for each of the two indexes (DMFT index: r=0.56; DMFS index: r=0.69). The IDPE duration was shorter than the CE duration.

Conclusions

The feasibility of caries status assessment via IDPE is promising. Digital oral health evaluation merits further clinical consideration.

Trial registration

Xiamen University Training Program of Innovation and Entrepreneurship for Undergraduates, project number: 2018X0583. Registered 1 April 2018; http://cxw.xmu.edu.cn/admin/Innovation/NewInnovationDetail?id=6ce0a415-6131-496b-891a-6a1ae44e556d

Pre-Operative Oral Health-Related Quality of Life in Patients Attending Surgical Removal of Mandibular Third Molar Teeth

The study aimed to measure the pre-operative oral health-related quality of life (OHRQoL) and to identify patient and teeth pathologies associated with worse OHRQoL among patients attending mandibular third molar tooth extraction. Data were collected preoperatively from 199 patients attending surgical removal of their mandibular third molar. To that end, we measured the Oral Health Impact Profile-14 (OHIP-14) and analyzed its association with: (1) demographics; (2) health-related behaviors such as smoking, alcohol consumption, physical activity, and dietary habits; (3) Plaque Index (PI); (4) Decay, Missing, and Filled Teeth (DMFT); and (5) clinical characteristics related to third molar extraction, such as the indication for extraction, tooth angulations, and radiographic pathology. The mean age of the study population was 21.5 ± 3.2 years and the mean OHIP-14 global score was 22.5 ± 8.3. The present study identified patient and teeth profiles that are associated with worse pre-operative OHRQoL in patients attending mandibular third molar extraction. The “vulnerable patient” profile includes poor health-related behaviors, particularly the performance of physical activity less than once a week (p = 0.028). The “disturbing teeth” profile includes higher plaque scores (p = 0.023) and specific characteristics of the third molar teeth, such as pericoronitis (p = 0.027) and radiolucency around third molars in panoramic radiography (p < 0.001). These findings support the hypothesis that OHRQoL is a complex phenomenon which is associated with the patient’s health-related behaviors as well as with specific tooth pathologies.

Long-Term Results of Tinnitus Retraining Therapy in Patients Who Failed to Complete the Program

Purpose: We aimed to evaluate the results of Tinnitus Retraining Therapy (TRT) in patients who did not complete the program. Methods: We divided 90 patients who failed to complete the TRT program were into 3 groups: 36 patients who only completed the first phase of the TRT program (Missing group; M), 34 patients who attended counselling for less than 6 months (Noncompliant group; NC) and 20 patients who attended counselling for more than 6 months but did not complete the TRT program (Compliant group; C). The Tinnitus Handicap Inventory (THI), tinnitus Visual Analogue Scales (VAS) and a questionnaire regarding the reasons for dropout were obtained through a telephone survey. Results: Telephonic THI and VAS scores were significantly lower than the initial scores in the M and C groups but not in the NC group. Patients who were unsure about the effectiveness of TRT were prevalent in the NC group, and the poorest long-term THI results were registered in those patients. Conclusions: A fundamental cause of very poor TRT results was when patients were unsure about TRT. On the other hand, a single counselling session could be effective in reducing tinnitus annoyance in patients who accepted the TRT approach and trusted its efficacy.

Retention of Alzheimer Disease Research Participants

INTRODUCTION

Participant retention is important to maintaining statistical power, minimizing bias, and preventing scientific error in Alzheimer disease and related dementias research.

METHODS

We surveyed representative investigators from NIH-funded Alzheimer's Disease Research Centers (ADRC), querying their use of retention tactics across 12 strategies. We compared survey results to data from the National Alzheimer's Coordinating Center for each center. We used a generalized estimating equation with independent working covariance model and empirical standard errors to assess relationships between survey results and rates of retention, controlling for participant characteristics.

RESULTS

Twenty-five (83%) responding ADRCs employed an average 42 (SD=7) retention tactics. In a multivariable model that accounted for participant characteristics, the number of retention tactics used by a center was associated with participant retention (odds ratio=1.68, 95% confidence interval: 1.42, 1.98; P<0.001 for the middle compared with the lowest tertile survey scores; odds ratio=1.59, 95% confidence interval: 1.30, 1.94; P<0.001 for the highest compared with the lowest tertile survey scores) at the first follow-up visit. Participant characteristics such as normal cognition diagnosis, older age, higher education, and Caucasian race were also associated with higher retention.

CONCLUSIONS

Retention in clinical research is more likely to be achieved by employing a variety of tactics.

Prevalence of dental caries, oral health awareness and treatment-seeking behavior of elderly population in rural Maharashtra

Background and Objective

There have been numerous studies of oral health status of school children and young population; however, similar studies in elderly population in India are lacking. With advances in medical science and consequent increase in life expectancy, elderly population is on the rise and is a subject of growing concern for public health policy. Hence, an attempt was made to study factors influencing decayed, missing, and filled teeth (DMFT) index, oral health awareness, and dental treatment-seeking behavior of elderly population.

Methods

A cross-sectional community-based survey was conducted between September 2014 and December 2014 in villages in rural Maharashtra. Sociodemographic and health-related information were collected from 352 participants 60 years of age and above in 10 villages.

Results

Prevalence of dental caries was 76.4% in a study population with median DMFT score of 12 with interquartile range of 7-22. The majority of the participants cleaned their teeth with fingers using charcoal and mishri. Only 17.2% participants used toothbrush. About 39% participants had experienced dental pain, of which majority did not visit dentist. The median DMFT index who used toothbrush and toothpaste was significantly less when compared with participants who did not use tooth brush and tooth paste. The majority of the participants had one or more missing teeth, but only 2.2% were using dentures.

Conclusion

There is an urgent need for comprehensive oral health educational programs, and accessible and affordable oral health services to be provided to rural community.

Exploratory research on outcomes for individuals missing through dementia wandering in Japan

AIM

To clarify the factors related to outcomes of individuals missing through dementia wandering.

METHODS

We carried out binary logistic regression analysis with 160 family members of missing persons (88 survivors, 72 decedents).

RESULTS

Living alone at the point of going missing (OR 13.45, 95% CI 1.12-161.56), being found within the local area (OR 6.36, 95% CI 2.26-17.88), and a long period between going missing and being found (OR 6.14, 95% CI 3.14-12.00) were significantly related with death.

CONCLUSIONS

Early detection of missing persons is essential in preventing dementia wandering-related deaths. The time taken to locate missing dementia patients who lived alone was longer, relative to that of those who lived with others, and this increased the risk of death. Furthermore, the locations where the deceased were located tended to be local, rather than distant areas. Geriatr Gerontol Int 2019; 19: 902-906.

Patterns of oral hygiene behaviors, daily habits, and caries prevalence in India and dominican republic: A comparative study

Background

The purpose of the study was to gain integrative knowledge on oral hygiene behaviors and daily habits affecting caries experience among rural people in India and Dominican Republic (DR).

Materials and Methods

Participants were recruited in two countries: La Esquina community, Province Maria Trinidad Sanchez in DR and in Ramgarh, district Chhindwara in the state of Madhya Pradesh in India. A total of 104 participants (18-80 years) were in the DR sample while 202 participants (18-85 years) were in the Indian sample. Face-to-face interviews collected information on oral hygiene behaviors, daily habits, and dental care. The caries experience was quantified using decayed, missing, and filled teeth (DMFT) index.

Results

There were significant differences in a few oral hygiene behaviors, daily habits, and levels of caries experience between the Dominican and Indian subgroups. Use of toothbrush (χ² = 65.2; P < 0.001), self-reported use of fluoridated toothpaste (χ² = 94.04; P < 0.001), use of tobacco (χ² = 32.4; P < 0.001), dental visit (χ² = 24.84; P < 0.001), attitude toward seeking professional dental care (χ² = 85.07; P < 0.001), and DMFT scores (F = 13.3; P < 0.001) were significantly different between the two countries. The caries experience was higher in the Dominicans (9.6 ± 8.0 vs. 4.0 ± 5.7) than India's rural.

Conclusions

Oral health practices varied considerably between rural populations in these two countries. Caries prevalence was significantly higher in Dominicans despite higher consumption of tobacco and lesser use of toothbrush among rural Indians in the subcontinent.

Evaluation of Caries Prevalence and Decayed-, Missing-, and Filled-teeth Values in Permanent Dentition in Children 7 to 10 Years Old-A Longitudinal Study

AIM

To evaluate the correlation between age and caries development in permanent teeth, as well as to show the trends of decayed, missing, and filled teeth (DMFT) index in Albania.

MATERIALS AND METHODS

Subsequent observations hold from July 2016-July 2018. Our study included 393 children of the age range of 7-10 years old. The children in the survey were divided into four groups according to their ages 7, 8, 9 and 10 years and these groups were considered separately. For the age group 7 years old we observed 110 children (28.13%), for the age group 8 years old we observed 106 children (27.11%), while for the age groups 9 years and 10 years old we observed 88 (22.35%) and 89 (22.41%) children, respectively.

RESULTS

In our study, 393 children were selected and a total of 3128 molars were observed during 2 years time period. The strong influence on caries of the age group 9-10 years old is confirmed by p value 0.002. The results of our study show that the influence in caries manifestation decreases more at the age of 8-9 years old with a p = 0.014. Caries prevalence was 28.3% in permanent dentition in children 7-10 years old, while the DMFT index of our results was 3.46.

CONCLUSION

Our results showed a prevalence of carious teeth at the age group 9-10 years old compared with the age group 8-9 years old. To reduce dental caries development and its increment in children of the age class 7-10 years old we recommend the use of fluoride, a healthy non-cariogenic diet, and dental routine check-ups.

CLINICAL SIGNIFICANCE

Age has an important role in evaluating caries prevalence and DMFT index. Based on age, caries is more prevalent in children 9-10 years old, and the DMFT index resulted to be in high values equal to 3.46.

Salivary lead concentration in dental caries among normal and children with cerebral palsy

INTRODUCTION

Cerebral palsy (CP) is a neurological disability the exact cause of which is not known. Exposure to toxic elements, environmental pollutants, and various teratogens such as lead, either prenatal or postnatal, can be a risk factor for this neurologic disability. CP children have poor neuromuscular coordination, exposing them to increased risk of oral diseases such as drooling of saliva, periodontal diseases, dental caries, and malocclusion. There are less studies comparing lead concentration in CP children, as it can be one of the contributing factors to dental caries.

AIMS AND OBJECTIVES

The present study was to estimate and compare the salivary lead level in normal and neurologically disabled children and to correlate salivary lead level with dental caries in both normal and neurologically disabled children.

MATERIALS AND METHODS

A study on 45 children reporting to CP rehabilitation center and 41 normal children taken from the Outpatient Department of the Pediatric and Preventive Dentistry. P.M.N.M. Dental College and Hospital, Bagalkot, Karnataka. All children were between the age group of 5-12 years. In all individuals, a thorough medical history and dental examination were done. The age, state of dentition, and the level of caries in all individuals were determined by the same examiner, and salivary lead concentrations were determined using atomic absorption spectrophotometer. All children were divided into four groups depending on the presence or absence of dental caries. Group 1 consisted of 20 normal children with dental caries, Group 2 consisted of 21 normal children without dental caries, Group 3 consisted of 25 CP children with dental caries, and Group 4 consisted of 20 CP children without dental caries.

RESULTS

Were recorded tabulated and statistically analyzed. CP children had high decayed, missing, and filled teeth/def scores, dental caries, and salivary lead concentration as compared to normal children. Statistically significant correlation was obtained between the dental caries and saliva lead concentration. The lead concentration was directly proportional to the carious status.

CONCLUSION

CP children are more prone to dental caries and increased salivary lead concentration which could be a cause as well as the effect of CP.

Do Children of Working Mothers Experience More Dental Caries?

BACKGROUND

Pain and discomfort due to untreated dental caries lead to eating and sleep disruptions, behavioral changes, and poor quality of life. Among adolescents, severe dental caries may lead to activity restriction, school absenteeism, and poor academic performance. Dietary factors, parent's socioeconomic status, and family income have been associated with dental caries experience. The employment status of the mother is a measure of socioeconomic status of the family.

AIMS

This study aims to estimate the prevalence of dental caries and to find out its sociodemographic, oral health behavioral, and clinical determinants among older adolescent (15-18 years) students in Kerala.

SETTINGS AND DESIGN

This was a cross-sectional study conducted at higher secondary schools.

METHODS

Oral examination and sociodemographic and oral health behavioral data collection were done among 1065 older adolescent students in the age group 15-18 across five districts of Kerala by a multistage cluster sampling design. Decayed, missing, and filled teeth (DMFT) and Significant Caries (SiC) index were taken.

STATISTICAL ANALYSIS USED

SPSS version 16 software was employed. Multiple regression analysis was done to estimate adjusted odds ratios (OR) of predictors of dental caries experience.

RESULTS

The overall dental caries experience for the group was 59.8% (95% confidence interval [CI]: 56.9-62.7). About 40% of students had no caries experience, 43% had DMFT score 1-3, and only 16.8% had DMFT score 4 and more. Mean DMFT was 1.67 (95% CI: 1.56-1.79). Diet preference, timing of sugar intake, and sugar form were not significantly associated with caries. Mean SiC index was 3.90 (95% CI, 3.75-4.05). In the unadjusted analysis, age, gender, place of residence, mother's employment status, school type, frequency of sugar intake, oral hygiene status, and timing of last dental visit were significant. In the adjusted analysis, however, age, male gender, government schools, timing of last dental visit, and employed mothers were significant predictors for higher dental caries experience.

CONCLUSIONS

Mother's employment was the strongest predictor (OR 2.82, 95% CI: 2.15-3.69) for dental caries experience among adolescents when adjusted to other variables in the final multivariate model.

Speech evaluation in children with missing anterior teeth and after prosthetic rehabilitation with fixed functional space maintainer

INTRODUCTION

Speech and language development in children is a dynamic process. Development of vocal sound into meaningful speech was one of the major discoveries which have made the human beings to reach the pinnacle of the animal kingdom. The ability to speak is determined by the flow of air into the mouth which affects pronunciation of various words and phrases.

AIM

This study aimed to evaluate speech changes before and after prosthetic rehabilitation with fixed functional space maintainer in children with missing maxillary anterior teeth.

MATERIALS AND METHODS

The study sample comprised of 25 children in the age range of 3-6 years having at least two maxillary anterior teeth indicated for extraction or had already got extracted. Speech therapist evaluated articulation of [v], [ph], [n], [d], [dh], [th], [t], [s.],[s], and [l] speech sounds of patients preoperatively (T0), postoperatively after the appliance insertion (T1), and postoperatively after 7 days (T2) using Weiss Comprehensive Articulation Test. The data obtained were analyzed using Chi-square and Mcnemar's test.

RESULTS

There was statistically significant (P < 0.05) correction in [v], [ph], [d], [dh], [th], [t], [s.], and [s] speech sounds immediately after prosthetic rehabilitation (T1). While, the assessment of speech sounds after 7 days of appliance insertion (T2) showed statistically nonsignificant differences.

CONCLUSIONS

The results suggested that treatment of a patient with missing anterior teeth should not be restricted to esthetic and functional oral rehabilitation, but also comprehend with the speech, as premature loss of the primary maxillary incisor appears to have long-term effect on the speech development.

Comparison of Efficiency GEE and QIF Methods for Predicting Factors Affecting on Bipolar I Disorder Under Complete-case in a Longitudinal Studies

BACKGROUND

Mood variation in manic and depression phases during time is common in type I of Bipolar disorder. Analyzing recurrence require to the related statistical methods. In this paper, we compare the two methods of estimating the GEE and the QIF in recurrence data.

METHODS

In this study, data of 255 patients with Bipolar I disorder hospitalized during years of 2007-2011. Recurrence in Bipolar I disorder was as outcome. Patients' characteristics were gender, age of onset, recurrence history in first degree family, and economic status. Under simulation, percentage of missing were generated to vary and handled by complete-case(cc) strategy. Data were analyzed using GEE and QIF methods. Performance of the methods was assessed using Relative Efficiency.

RESULTS

QIF method had more efficiency than GEE method in the data with missing /without missing. Odds of recurrence in a first-degree family history was 30% more than those without a family history (p=0.009). Also, odds of recurrence in high/moderate level of economic status was 23% more than low level status (p=0.014).

CONCLUSION

QIF method was more appropriated for modeling recurrence during time with the structure of more correlation and low dropout rate in data. Family history and economic status were more affected recurrence in type I of Bipolar disorder.

Search Methods Used to Locate Missing Cats and Locations Where Missing Cats Are Found

Simple Summary

A least 15% of cat owners lose their pet in a five-year period and some are never found. This paper reports on data gathered from an online questionnaire that asked questions regarding search methods used to locate missing cats and locations where missing cats were found. The most important finding from this retrospective case series was that approximately one third of cats were recovered within 7 days. Secondly, a physical search increased the chances of finding cats alive and 75% of cats were found within a 500 m radius of their point of escape. Thirdly, those cats that were indoor-outdoor and allowed outside unsupervised traveled longer distances compared with indoor cats that were never allowed outside. Lastly, cats considered to be highly curious in nature were more likely to be found inside someone else’s house compared to other personality types. These findings suggest that a physical search within the first week of a cat going missing could be a useful strategy. In light of these findings, further research into this field may show whether programs such as shelter, neuter and return would improve the chances of owners searching and finding their missing cats as well as decreasing euthanasia rates in shelters.

Abstract

Missing pet cats are often not found by their owners, with many being euthanized at shelters. This study aimed to describe times that lost cats were missing for, search methods associated with their recovery, locations where found and distances travelled. A retrospective case series was conducted where self-selected participants whose cat had gone missing provided data in an online questionnaire. Of the 1210 study cats, only 61% were found within one year, with 34% recovered alive by the owner within 7 days. Few cats were found alive after 90 days. There was evidence that physical searching increased the chance of finding the cat alive (p = 0.073), and 75% of cats were found within 500 m of the point of escape. Up to 75% of cats with outdoor access traveled 1609 m, further than the distance traveled by indoor-only cats (137 m; p ≤ 0.001). Cats considered to be highly curious were more likely to be found inside someone else’s house compared to other personality types. These findings suggest that thorough physical searching is a useful strategy, and should be conducted within the first week after cats go missing. They also support further investigation into whether shelter, neuter and return programs improve the chance of owners recovering missing cats and decrease numbers of cats euthanized in shelters.

Salutogenesis: A New Approach toward Oral Health Promotion

Introduction:

Sense of coherence (SOC) is hypothesized to be an important psychological factor that enables people to cope with stressors and successfully maintain and improve health. Very few publications report on the relationship between “salutogenesis,” as measured by the concept of SOC and oral health status. However, little is known about the relationship between the mother's SOC and dental caries of their children.

Aims and Objectives:

The aim of the present study was to explore the impact of mother's SOC level on dental caries status of their children.

Materials and Methods:

A school-based cross-sectional study was conducted with the children aged 4–8 years attending public school (n = 200). Questionnaires were applied to mothers to obtain level of SOC. Dental caries status in children was assessed using decayed, missing, filled tooth surfaces (DMFS) and/or dmfs index. One-way analysis of variance F-test and post hoc Tukey test were used to assess the effect of mother's SOC level on their children's caries dmfs index.

Results:

Mean of dmfs and/or DMFS in children showed statistically significant relation with their mother's SOC level (P < 0.01). On intergroup comparison, significant (P < 0.01) difference was found when mean of dmfs and/or DMFS with mothers having low SOC and high SOC was compared. However, there was no significant relation when mean was compared to mothers with medium and low SOC.

Conclusion:

Dental caries of children gets influenced by mother's SOC level. There was an inverse relationship between mother's SOC level and their children dental caries status.

Sociodemographic profile and oral health status of thalassemic patients attending the National Thalassaemia Centre, Kurunegala, Sri Lanka

AIM

The aim of the present study was to investigate the sociodemographic profile and oral health status (Decayed, Missing, Filled Teeth [DMFT] and periodontal health) of thalassemic patients compared to healthy individuals.

METHODS

The data were collected by means of an interviewer-administered, pretested, and validated questionnaire, followed by oral examination. Patients attending the outpatient department, who were age and sex matched, but without any diagnosed or suspected long-term illnesses, were considered for the control group. Both groups were compared in terms of facial profile, skeletal pattern, facial angles, DMFT, and periodontal health (plaque index, bleeding on probing, and probing pocket depth).

RESULTS

The association of convex facial profile and class II skeletal pattern with Thalassemic status was statistically significant when compared to healthy individuals. Decayed, missing, and filled teeth in the permanent and deciduous dentition, plaque index, and probing pocket depths of the control group were significantly higher compared with the thalassemic group. Surprisingly, 67.8% of thalassemic patients did not show bleeding on probing.

CONCLUSION

Families of the thalassemic patients attending the National Thalassaemia Centre are from a low socioeconomic background. Their DMFT and periodontal health are significantly better than those of healthy individuals.

Isolation and Typing of Streptococcus mutans and Streptococcus sobrinus from Caries-active Subjects

Background

Streptococcus mutans and Streptococcus sobrinus are main etiological agents of dental caries.

Aim

The aim of the study was to isolate, identify, characterize, and determine the minimum inhibitory concentration (MIC) of S. mutans and S. sobrinus from caries-active subjects.

Materials and Methods

Sixty-five plaque samples were collected from caries-active subjects aged between 35 and 44 years, processed and cultured on mitis salivarius bacitracin agar. All the bacterial isolates were subjected to morphotyping and the suspected colonies were identified by 16S rDNA sequencing. The S. mutans and S. sobrinus strains were characterized by biotyping and phylogenetic analysis. The MIC of ampicillin and erythromycin was determined by microtiter plate method.

Results

Of the study population, 41 isolates displayed typical colony morphologies of S. mutans and S. sobrinus. The 16S rDNA sequencing results revealed that 36 isolates were S. mutans and 5 isolates were S. sobrinus. The biotyping of these isolates demonstrated three biotypes, namely, biotype I (n = 35), biotype III (n = 1), and biotype IV (n = 2). However, 3 isolates exhibited variant biotypes. The phylogenetic analysis revealed that the clinical strains of S. mutans and S. sobrinus clustered independently along with respective reference strains. The average MIC of ampicillin and erythromycin against S. mutans and S. sobrinus was 0.047 μg/ml and 0.39 μg/ml, respectively.

Conclusion

The 16S rDNA sequencing was an impeccable method for S. mutans and S. sobrinus identification when compared with morphotyping and biotyping methods. The study also suggested that nonspecific bacteria might be involved in caries formation.

Multiple imputation of completely missing repeated measures data within person from a complex sample: application to accelerometer data in the National Health and Nutrition Examination Survey

The Physical Activity Monitor component was introduced into the 2003-2004 National Health and Nutrition Examination Survey (NHANES) to collect objective information on physical activity including both movement intensity counts and ambulatory steps. Because of an error in the accelerometer device initialization process, the steps data were missing for all participants in several primary sampling units, typically a single county or group of contiguous counties, who had intensity count data from their accelerometers. To avoid potential bias and loss in efficiency in estimation and inference involving the steps data, we considered methods to accurately impute the missing values for steps collected in the 2003-2004 NHANES. The objective was to come up with an efficient imputation method that minimized model-based assumptions. We adopted a multiple imputation approach based on additive regression, bootstrapping and predictive mean matching methods. This method fits alternative conditional expectation (ace) models, which use an automated procedure to estimate optimal transformations for both the predictor and response variables. This paper describes the approaches used in this imputation and evaluates the methods by comparing the distributions of the original and the imputed data. A simulation study using the observed data is also conducted as part of the model diagnostics. Finally, some real data analyses are performed to compare the before and after imputation results. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

Inequalities in Indigenous Oral Health: Findings from Australia, New Zealand, and Canada

The objective was to compare absolute differences in the prevalence of Indigenous-related inequalities in dental disease experience and self-rated oral health in Australia, Canada, and New Zealand. Data were sourced from national oral health surveys in Australia (2004 to 2006), Canada (2007 to 2009), and New Zealand (2009). Participants were aged ≥18 y. The authors measured age- and sex-adjusted inequalities by estimating absolute prevalence differences and their corresponding 95% confidence intervals (95% CIs). Clinical measures included the prevalence of untreated decayed teeth, missing teeth, and filled teeth; self-reported measures included the prevalence of "fair" or "poor" self-rated oral health. The overall pattern of Indigenous disadvantage was similar across all countries. The summary estimates for the adjusted prevalence differences were as follows: 16.5 (95% CI: 11.1 to 21.9) for decayed teeth (all countries combined), 18.2 (95% CI: 12.5 to 24.0) for missing teeth, 0.8 (95% CI: -1.9 to 3.5) for filled teeth, and 17.5 (95% CI: 11.3 to 23.6) for fair/poor self-rated oral health. The I² estimates were small for each outcome: 0.0% for decayed, missing, and filled teeth and 11.6% for fair/poor self-rated oral health. Irrespective of country, when compared with their non-Indigenous counterparts, Indigenous persons had more untreated dental caries and missing teeth, fewer teeth that had been restored (with the exception of Canada), and a higher proportion reporting fair/poor self-rated oral health. There were no discernible differences among the 3 countries.

The Concept of Missing Incidents in Persons with Dementia

Behavioral symptoms of dementia often present the greatest challenge for informal caregivers. One behavior, that is a constant concern for caregivers, is the person with dementia leaving a designated area such that their whereabouts become unknown to the caregiver or a missing incident. Based on an extensive literature review and published findings of their own research, members of the International Consortium on Wandering and Missing Incidents constructed a preliminary missing incidents model. Examining the evidence base, specific factors within each category of the model were further described, reviewed and modified until consensus was reached regarding the final model. The model begins to explain in particular the variety of antecedents that are related to missing incidents. The model presented in this paper is designed to be heuristic and may be used to stimulate discussion and the development of effective preventative and response strategies for missing incidents among persons with dementia.

How many injections did you miss last month? A simple question to predict interferon β-1a adherence in multiple sclerosis

OBJECTIVES

Adherence to treatment is of utmost importance in multiple sclerosis (MS) to achieve full benefits from disease-modifying treatments. Thus, we investigated predictors of adherence to interferon β-1a.

METHODS

114 relapsing-remitting MS subjects were recruited and followed-up during 1.536 ± 0.961 years. RebiSmart® (Ares Trading SA, Coinsins, Switzerland), an electronic auto-injector, allows real-time recording of adherence which was retrospectively evaluated, and subjects were categorized accordingly: fully adherent (if no doses were missed), early or late missing (if missing the first dose during the first month of observation or later). The occurrence of clinical relapses and the annualized relapse rate (ARR) were prospectively recorded.

RESULTS

Adherence was 95.0 ± 9.0%. Early missing (n = 17, 14.9%) was more likely to be associated with the occurrence of a clinical relapse (OR = 4.155; p = 0.018), but not late missing (n = 54, 47.4%) (OR = 1.454; p = 0.408), as compared to fully adherent (n = 43, 37.7%). Adherence was lower in early missing, as compared to late missing (p < 0.001). The ARR was higher in early missing, as compared to late missing and to fully adherent (p < 0.001).

CONCLUSION

MS subjects missing an injection early presented lower adherence, and a fourfold chance of having a relapse, suggesting a simple way to assess and categorize adherence in a clinical, real-life setting, where lack of time often prevents more thorough evaluations.

Dorsal dislocation of the trapezoid with carpo-metacarpal dislocations: a case report and a description of the "missing carpal sign" on radiographs

BACKGROUND

A case report of dorsal trapezoid dislocation with index and middle carpometacarpal dislocation is described.

OBJECTIVES

On review of the literature, this rare injury is often misdiagnosed on presentation, with difficulty in reviewing initial radiographs being a key factor.

CASE REPORT

We present our case report of trapezoid dislocation and describe the "missing carpal sign" on radiographs as an aid to suspicion of diagnosis.

CONCLUSION

Trapezoid dislocation is an often-overlooked diagnosis; we present a sign to increase suspicion of injury and hence promote further investigation.

Missing data sensitivity analysis for recurrent event data using controlled imputation

Statistical analyses of recurrent event data have typically been based on the missing at random assumption. One implication of this is that, if data are collected only when patients are on their randomized treatment, the resulting de jure estimator of treatment effect corresponds to the situation in which the patients adhere to this regime throughout the study. For confirmatory analysis of clinical trials, sensitivity analyses are required to investigate alternative de facto estimands that depart from this assumption. Recent publications have described the use of multiple imputation methods based on pattern mixture models for continuous outcomes, where imputation for the missing data for one treatment arm (e.g. the active arm) is based on the statistical behaviour of outcomes in another arm (e.g. the placebo arm). This has been referred to as controlled imputation or reference-based imputation. In this paper, we use the negative multinomial distribution to apply this approach to analyses of recurrent events and other similar outcomes. The methods are illustrated by a trial in severe asthma where the primary endpoint was rate of exacerbations and the primary analysis was based on the negative binomial model.

Idiopathic multiple impacted unerupted teeth: Case report and discussion

Multiple impacted permanent teeth are usually related to syndromes, metabolic and hormonal disorders. However, in some cases, impaction of multiple teeth is not associated with any syndrome. In this report, we present a case of 17-year-old male patient with missing teeth. Radiographs revealed multiple impacted permanent teeth, though medical and family history along with physical examination was not suggestive of any syndromes. If other investigations are negative, an idiopathic case of multiple impacted teeth is suggested to be the possible diagnosis. The objective of this report is to increase awareness of such cases especially in the absence of hereditary/genetic/metabolic factors usually inherent in such scenarios. The patient management in such cases needs to be planned specifically from a multidisciplinary standpoint.