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Kimmie-Dhansay F, Bhayat A. Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa: a systematic review and meta-analysis. BMC Oral Health 2022; 22:453. [PMID: 36280818 PMCID: PMC9594869 DOI: 10.1186/s12903-022-02489-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dental caries (DC) is highly prevalent condition affecting mostly young children. There has been no systematic review done on the prevalence of DC amongst 12-year -olds in Africa. Although some African countries have reported a decrease in DC prevalence, others have shown an increase and it is essential to measure current trends in order to identify strategies and programmes that could assist in reducing DC in Africa. The aim of this systematic review was to determine the prevalence of DC (condition) amongst the permanent dentition of 12-year-old children (population) in Africa (context). METHODS A systematic review and meta-analysis was performed. Peer reviewed cross-sectional articles from January 2000 until December 2021 was searched and this included the following databases: Pubmed (Medline); SCOPUS; CINAHL (via EBSCOhost); Academic Search Complete (via EBSCOhost); Dentistry and Oral Sciences Sources (via EBSCOhost); and Science Direct. The search was last updated on the 10th January 2022. Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Prevalence figures were stratified by Urban/Rural status, country and time using a random-effects model. All studies performed on children 12-year-olds on the African continent were included. The prevalence of DC and the DMFT scores were the primary and secondary outcome measures, respectively. Only articles consisting of 12-year-old children who reside in Africa were included in this study. The systematic review was registered with Prospero CRD42021293666. RESULTS 18,080 participants were included in this review. A total of thirty studies were included in the review. The pooled effect size of dental caries severity was 1.09 (CI 0.91-1.27) and the overall prevalence was 36% (CI 29.4-41.7%). Eritrea (78%) had the highest prevalence of DC while Zambia had the lowest (11%); Eritrea also had the highest DMFT score (2.5) with Sudan having the lowest score (0.49). Urban cities had the highest DMFT score (1.32, CI 0.97-1.68), compared to rural cities (1.13, CI 0.86-1.4) and there was an increasing trend in DC prevalence over time from 28% (CI 23-34%) in 2000 to 2005 to 57% (CI 43-72%) in studies conducted after 2015. The risk of bias was very low where majority of the studies scored more than 50% in the JBI critical appraisal tool. CONCLUSIONS There was a wide discrepancy in the DC prevalence and scores across the different countries, settings (rural versus urban) and there was an increase in the prevalence over time. This review was self-funded.
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Affiliation(s)
- F. Kimmie-Dhansay
- grid.8974.20000 0001 2156 8226Department of Community Oral Health, University of the Western Cape, Cape Town, South Africa
| | - A. Bhayat
- grid.49697.350000 0001 2107 2298Department of Community Dentistry, University of Pretoria, Pretoria, South Africa
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Trombley TM, Agarwal SC, Beauchesne PD, Goodson C, Candilio F, Coppa A, Rubini M. Making sense of medieval mouths: Investigating sex differences of dental pathological lesions in a late medieval Italian community. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 169:253-269. [PMID: 30924143 DOI: 10.1002/ajpa.23821] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 02/21/2019] [Accepted: 03/02/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Bioarchaeological investigations of sex-based differences in the prevalence of dental pathological lesions, particularly caries, have drawn considerable attention, and out of this work, two dominant models have emerged. Traditionally, the first model interprets sex-related patterns in caries as a product of gendered differences in diet. A more recent model interprets a generally higher propensity for caries prevalence in females in light of reproductive ecology. To test the hypothesis that females have higher risk of caries in accordance with reproductive ecology, we examined and analyzed caries prevalence and other potentially synergistic oral pathological lesions in a late medieval (A.D. 1300-1500) Italian archaeological sample. MATERIALS AND METHODS We examined sex- and age-related prevalence in caries and other oral pathological lesions in a late medieval Italian skeletal assemblage excavated from Villamagna consisting of 38 females and 37 males (n = 1,534 teeth). We examined age- and sex-related patterns in six dental traits: antemortem tooth loss, caries, calculus, periapical inflammation, tooth wear, and periodontitis. RESULTS Significant age-related increases in antemortem tooth loss, caries, calculus, and tooth wear were observed in both males and females. However, there was a lack of expected sex differences in oral pathological lesions, with instead older males exhibiting significantly more antemortem tooth loss and corrected caries than females. DISCUSSION Results are discussed in relation to the ethnohistoric context of medieval rural dietary practices as well as biomedical salivary literature, which suggest that dietary changes throughout the life course may have facilitated trade-offs that buffered females from higher rates of dental pathological lesions.
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Affiliation(s)
- Trent M Trombley
- Department of Anthropology, University of California, Berkeley, Berkeley, California
| | - Sabrina C Agarwal
- Department of Anthropology, University of California, Berkeley, Berkeley, California
| | - Patrick D Beauchesne
- Department of Behavioral Sciences, University of Michigan, Dearborn, Dearborn, Michigan
| | - Caroline Goodson
- Faculty of History, University of Cambridge, King's College, Cambridge, United Kingdom
| | - Francesca Candilio
- Anthropological Service, Soprintendenza Archeologia, Belle Arti e Paesaggio per la città metropolitana di Cagliari e le province di Oristano e Sud Sardegna, Cagliari, Italy.,Physical Anthropology Section, University of Pennsylvania Museum of Archaeology and Anthropology, Philadelphia, Pennsylvania
| | - Alfredo Coppa
- Department of Environmental Biology, Sapienza University of Rome, Rome, Italy
| | - Mauro Rubini
- Department of Archaeology, Foggia University, Foggia, Italy.,Anthropological Service, S.A.B.A.P.-LAZ, Rome, Italy
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Antonijevic E, Mandinic Z, Curcic M, Djukic-Cosic D, Milicevic N, Ivanovic M, Carevic M, Antonijevic B. "Borderline" fluorotic region in Serbia: correlations among fluoride in drinking water, biomarkers of exposure and dental fluorosis in schoolchildren. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2016; 38:885-896. [PMID: 26423526 DOI: 10.1007/s10653-015-9769-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 09/23/2015] [Indexed: 06/05/2023]
Abstract
This study explores relation between dental fluorosis occurrence in schoolchildren, residents of Ritopek, a small local community near Belgrade, and fluoride exposure via drinking water. Additionally, fluoride levels were determined in children's urine and hair samples, and efforts were made to correlate them with dental fluorosis. Dental fluorosis and caries prevalence were examined in a total of 52 schoolchildren aged 7-15 years (29 boys and 23 girls). Fluoride levels in three types of samples were analyzed using composite fluoride ion-selective electrode. Results showed high prevalence of dental fluorosis (34.6 %) and low prevalence of dental caries (23.1 %, mean DMFT 0.96) among children exposed to wide range of water fluoride levels (0.11-4.14 mg/L, n = 27). About 11 % of water samples exceeded 1.5 mg/L, a drinking-water quality guideline value for fluoride given by the World Health Organization (2006). Fluoride levels in urine and hair samples ranged between 0.07-2.59 (n = 48) and 1.07-19.83 mg/L (n = 33), respectively. Severity of dental fluorosis was positively and linearly correlated with fluoride levels in drinking water (r = 0.79). Fluoride levels in urine and hair were strongly and positively correlated with levels in drinking water (r = 0.92 and 0.94, respectively). Fluoride levels in hair samples appeared to be a potentially promising biomarker of fluoride intake via drinking water on one hand, and severity of dental fluorosis on the other hand. Based on community fluorosis index value of 0.58, dental fluorosis revealed in Ritopek can be considered as "borderline" public health issue.
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Affiliation(s)
- Evica Antonijevic
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia.
| | - Zoran Mandinic
- Clinic for Preventive and Paediatric Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia
| | - Marijana Curcic
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
| | - Danijela Djukic-Cosic
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
| | - Nemanja Milicevic
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
| | - Mirjana Ivanovic
- Clinic for Preventive and Paediatric Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia
| | - Momir Carevic
- Clinic for Preventive and Paediatric Dentistry, School of Dental Medicine, University of Belgrade, Dr Subotica 11, Belgrade, 11000, Serbia
| | - Biljana Antonijevic
- Department of Toxicology "Akademik Danilo Soldatović", Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, Belgrade, 11221, Serbia
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Iheozor‐Ejiofor Z, Worthington HV, Walsh T, O'Malley L, Clarkson JE, Macey R, Alam R, Tugwell P, Welch V, Glenny A. Water fluoridation for the prevention of dental caries. Cochrane Database Syst Rev 2015; 2015:CD010856. [PMID: 26092033 PMCID: PMC6953324 DOI: 10.1002/14651858.cd010856.pub2] [Citation(s) in RCA: 146] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Dental caries is a major public health problem in most industrialised countries, affecting 60% to 90% of school children. Community water fluoridation was initiated in the USA in 1945 and is currently practised in about 25 countries around the world; health authorities consider it to be a key strategy for preventing dental caries. Given the continued interest in this topic from health professionals, policy makers and the public, it is important to update and maintain a systematic review that reflects contemporary evidence. OBJECTIVES To evaluate the effects of water fluoridation (artificial or natural) on the prevention of dental caries.To evaluate the effects of water fluoridation (artificial or natural) on dental fluorosis. SEARCH METHODS We searched the following electronic databases: The Cochrane Oral Health Group's Trials Register (to 19 February 2015); The Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2015); MEDLINE via OVID (1946 to 19 February 2015); EMBASE via OVID (1980 to 19 February 2015); Proquest (to 19 February 2015); Web of Science Conference Proceedings (1990 to 19 February 2015); ZETOC Conference Proceedings (1993 to 19 February 2015). We searched the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization's WHO International Clinical Trials Registry Platform for ongoing trials. There were no restrictions on language of publication or publication status in the searches of the electronic databases. SELECTION CRITERIA For caries data, we included only prospective studies with a concurrent control that compared at least two populations - one receiving fluoridated water and the other non-fluoridated water - with outcome(s) evaluated at at least two points in time. For the assessment of fluorosis, we included any type of study design, with concurrent control, that compared populations exposed to different water fluoride concentrations. We included populations of all ages that received fluoridated water (naturally or artificially fluoridated) or non-fluoridated water. DATA COLLECTION AND ANALYSIS We used an adaptation of the Cochrane 'Risk of bias' tool to assess risk of bias in the included studies.We included the following caries indices in the analyses: decayed, missing and filled teeth (dmft (deciduous dentition) and DMFT (permanent dentition)), and proportion caries free in both dentitions. For dmft and DMFT analyses we calculated the difference in mean change scores between the fluoridated and control groups. For the proportion caries free we calculated the difference in the proportion caries free between the fluoridated and control groups.For fluorosis data we calculated the log odds and presented them as probabilities for interpretation. MAIN RESULTS A total of 155 studies met the inclusion criteria; 107 studies provided sufficient data for quantitative synthesis.The results from the caries severity data indicate that the initiation of water fluoridation results in reductions in dmft of 1.81 (95% CI 1.31 to 2.31; 9 studies at high risk of bias, 44,268 participants) and in DMFT of 1.16 (95% CI 0.72 to 1.61; 10 studies at high risk of bias, 78,764 participants). This translates to a 35% reduction in dmft and a 26% reduction in DMFT compared to the median control group mean values. There were also increases in the percentage of caries free children of 15% (95% CI 11% to 19%; 10 studies, 39,966 participants) in deciduous dentition and 14% (95% CI 5% to 23%; 8 studies, 53,538 participants) in permanent dentition. The majority of studies (71%) were conducted prior to 1975 and the widespread introduction of the use of fluoride toothpaste.There is insufficient information to determine whether initiation of a water fluoridation programme results in a change in disparities in caries across socioeconomic status (SES) levels.There is insufficient information to determine the effect of stopping water fluoridation programmes on caries levels.No studies that aimed to determine the effectiveness of water fluoridation for preventing caries in adults met the review's inclusion criteria.With regard to dental fluorosis, we estimated that for a fluoride level of 0.7 ppm the percentage of participants with fluorosis of aesthetic concern was approximately 12% (95% CI 8% to 17%; 40 studies, 59,630 participants). This increases to 40% (95% CI 35% to 44%) when considering fluorosis of any level (detected under highly controlled, clinical conditions; 90 studies, 180,530 participants). Over 97% of the studies were at high risk of bias and there was substantial between-study variation. AUTHORS' CONCLUSIONS There is very little contemporary evidence, meeting the review's inclusion criteria, that has evaluated the effectiveness of water fluoridation for the prevention of caries.The available data come predominantly from studies conducted prior to 1975, and indicate that water fluoridation is effective at reducing caries levels in both deciduous and permanent dentition in children. Our confidence in the size of the effect estimates is limited by the observational nature of the study designs, the high risk of bias within the studies and, importantly, the applicability of the evidence to current lifestyles. The decision to implement a water fluoridation programme relies upon an understanding of the population's oral health behaviour (e.g. use of fluoride toothpaste), the availability and uptake of other caries prevention strategies, their diet and consumption of tap water and the movement/migration of the population. There is insufficient evidence to determine whether water fluoridation results in a change in disparities in caries levels across SES. We did not identify any evidence, meeting the review's inclusion criteria, to determine the effectiveness of water fluoridation for preventing caries in adults.There is insufficient information to determine the effect on caries levels of stopping water fluoridation programmes.There is a significant association between dental fluorosis (of aesthetic concern or all levels of dental fluorosis) and fluoride level. The evidence is limited due to high risk of bias within the studies and substantial between-study variation.
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Affiliation(s)
- Zipporah Iheozor‐Ejiofor
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Helen V Worthington
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Tanya Walsh
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Lucy O'Malley
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Jan E Clarkson
- University of DundeeDivision of Oral Health SciencesDental Hospital & SchoolPark PlaceDundeeUKDD1 4HR
| | - Richard Macey
- School of Dentistry, The University of ManchesterJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Rahul Alam
- The University of ManchesterInstitute of Population Health, Centre for Primary CareOxford RoadManchesterUKM13 9PL
| | - Peter Tugwell
- Faculty of Medicine, University of OttawaDepartment of MedicineOttawaCanadaK1H 8M5
| | - Vivian Welch
- University of OttawaBruyère Research Institute85 Primrose StreetOttawaCanadaK1N 5C8
| | - Anne‐Marie Glenny
- School of Dentistry, The University of ManchesterCochrane Oral Health GroupJR Moore BuildingOxford RoadManchesterUKM13 9PL
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García-Pérez A, Irigoyen-Camacho M, Borges-Yáñez A. Fluorosis and Dental Caries in Mexican Schoolchildren Residing in Areas with Different Water Fluoride Concentrations and Receiving Fluoridated Salt. Caries Res 2013; 47:299-308. [DOI: 10.1159/000346616] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 12/17/2012] [Indexed: 11/19/2022] Open
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van der Veen MH, Attin R, Schwestka-Polly R, Wiechmann D. Caries outcomes after orthodontic treatment with fixed appliances: do lingual brackets make a difference? Eur J Oral Sci 2010; 118:298-303. [PMID: 20572865 DOI: 10.1111/j.1600-0722.2010.00733.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Orthodontic treatment with fixed appliances is considered a risk factor for the development of white spot caries lesions (WSL). Traditionally, brackets are bonded to the buccal surfaces. Lingual brackets are developing rapidly and have become more readily available. Buccal surfaces are considered to be more caries prone than lingual surfaces. Furthermore, lingual brackets are shaped to fit the morphology of the teeth and seal almost the entire surface. In the present study we tested the hypothesis that lingual brackets result in a lower caries incidence than buccal brackets. We tested this hypothesis using a split-mouth design where subjects were allocated randomly to a group receiving either buccal or lingual brackets on the maxillary teeth and the alternative bracket type in the mandible. The results indicate that buccal surfaces are more prone to WSL development, especially when WSL existed before treatment. The number of WSL that developed or progressed on buccal surfaces was 4.8 times higher than the number of WSL that developed or progressed on lingual surfaces. When measured using quantitative light-induced fluorescence (QLF), the increase in integrated fluorescence loss was 10.6 times higher buccally than lingually. We conclude that lingual brackets make a difference when caries lesion incidence is concerned.
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Affiliation(s)
- Monique H van der Veen
- Department of Cariology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam, Amsterdam, the Netherlands.
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Almerich-Silla JM, Montiel-Company JM, Ruiz-Miravet A. Caries and dental fluorosis in a western Saharan population of refugee children. Eur J Oral Sci 2009; 116:512-7. [PMID: 19049520 DOI: 10.1111/j.1600-0722.2008.00583.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of this study was to investigate the relationship between dental fluorosis and dental caries among western Saharan refugee children. The western Saharan child population is characterized by adverse living conditions, an unbalanced diet, poor oral hygiene habits, and a concentration of fluoride in the drinking water of around 2 p.p.m. (2 mg l(-1)). A sample consisting of 360 children, 6-7 yr of age, and 212 children, 11-13 yr of age, was obtained from four refugee camps (Smara, Awsard, El-Aaiun, and 27-February) situated in the vicinity of Tindouf (southern Algeria). The children were examined using the World Health Organization criteria for caries diagnosis and Dean's index for fluorosis. The decayed, missing or filled teeth (DMFT) score was 0.48 in the 6-7-yr-old children and 1.69 in the 11-13-yr-old children, with a caries prevalence (DMFT > 0 or decayed and filled primary teeth (dft) > 0) of 47.2% and 63.2%, respectively. Among the 6-7 yr-old children examined, 36.9% were free of fluorosis, 15.6% presented moderate fluorosis, and 7.8% presented severe fluorosis. Among 11-13 yr-old children, only 4.2% were free of fluorosis, 30.2% exhibited moderate fluorosis, and 27.4% presented severe fluorosis. The mean DMFT, decayed permanent teeth (DT), and caries prevalence (DMFT > 0 and DMFT or dft > 0) scores were significantly higher among the children affected by severe fluorosis, suggesting that severe fluorosis might increase the susceptibility to dental caries.
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Narbutaité J, Vehkalahti MM, Milciuviené S. Dental fluorosis and dental caries among 12-yr-old children from high- and low-fluoride areas in Lithuania. Eur J Oral Sci 2007; 115:137-42. [PMID: 17451504 DOI: 10.1111/j.1600-0722.2007.00434.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We investigated the prevalence and severity of dental fluorosis, and the occurrence of dental caries, among 12-yr-old children from high- and low-fluoride areas in a country with high caries figures and a developing oral healthcare system. The sample included a total of 600 lifetime residents from high-fluoride (HF; 1.7-2.2 ppm) and low-fluoride (LF; 0.2 ppm) areas in Lithuania. The diagnoses of dental fluorosis followed the Thylstrup-Fejerskov Index (TF), and a diagnosis of dental caries followed the World Health Organization criteria. In the HF area, 66% of the 12-yr-old children had dental fluorosis (TF score > 0) compared with 4% in the LF area. The maximum TF severity scores were 7 and 3, respectively. The mean number of teeth with fluorosis was 4.5 [95% confidence interval (CI) = 4.0, 5.0] for the HF group and 0.2 (95% CI = 0.1, 0.2) for the LF group. In the HF group, 72% had a decayed, missing or filled teeth (DMFT) score of > 0, compared with 87% in the LF group. The mean DMFT was 2.0 (95% CI = 1.8, 2.3) in the HF group and 3.5 (95% CI = 3.2, 3.8) in the LF group. Current untreated caries (DT) occurred (DT >0) in half of both the HF and LF groups. Regardless of the concentration of fluoride in the drinking water, the prevalence of past (DMFT > 0) and present (DT > 0) caries was high, calling for more emphasis on the prevention of tooth decay in countries, such as Lithuania, with high caries figures and a developing oral healthcare system.
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Affiliation(s)
- Julija Narbutaité
- Clinic for Preventive and Paediatric Dentistry, Kaunas University of Medicine, Kaunas, Lithuania.
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Pizzo G, Piscopo MR, Pizzo I, Giuliana G. Community water fluoridation and caries prevention: a critical review. Clin Oral Investig 2007; 11:189-93. [PMID: 17333303 DOI: 10.1007/s00784-007-0111-6] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2006] [Accepted: 02/14/2007] [Indexed: 10/23/2022]
Abstract
The aim of this paper was to critically review the current role of community water fluoridation in preventing dental caries. Original articles and reviews published in English language from January 2001 to June 2006 were selected through MEDLINE database. Other sources were taken from the references of the selected papers. For the past 50 years community water fluoridation has been considered the milestone of caries prevention and as one of the major public health measures of the 20th century. However, it is now accepted that the primary cariostatic action of fluoride occurs after tooth eruption. Moreover, the caries reduction directly attributable to water fluoridation have declined in the last decades as the use of topical fluoride had become more widespread, whereas enamel fluorosis has been reported as an emerging problem in fluoridated areas. Several studies conducted in fluoridated and nonfluoridated communities suggested that this method of delivering fluoride may be unnecessary for caries prevention, particularly in the industrialized countries where the caries level has became low. Although water fluoridation may still be a relevant public health measure in poor and disadvantaged populations, the use of topical fluoride offers an optimal opportunity to prevent caries among people living in both industrialized and developing countries.
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Affiliation(s)
- Giuseppe Pizzo
- Department of Oral Sciences, University of Palermo, Via del Vespro 129, 90127, Palermo, Italy.
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López R, Baelum V. Gender differences in tooth loss among Chilean adolescents: socio-economic and behavioral correlates. Acta Odontol Scand 2006; 64:169-76. [PMID: 16809195 DOI: 10.1080/00016350500514824] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate gender differences in tooth loss among Chilean adolescents and its association with selected socio-economic indicators and oral-health-related behaviors. MATERIAL AND METHODS Data on 9,163 Chilean adolescents obtained using multistage random cluster procedures. Clinical recordings included information on missing teeth and the participants provided information on socio-demographic factors and oral-related behaviors. Two eruption-time-adjusted logistic regression analyses were used to investigate the associations between gender, tooth loss and socio-economic position/oral-health-related behaviors. RESULTS The association between gender and tooth loss remained after adjusting for age, eruption times in both the socio-economic position regression model and the oral-health-related behaviors model. Tooth loss followed social gradients for the variables paternal income and achieved parental education, with students reporting a paternal income < 100,000 US dollars (OR = 2.0), and having a father (OR = 1.8) and a mother (OR = 2.0) who achieved only primary school education being more likely to experience tooth loss. The adjusted regression model for behavioral indicators revealed that students who reported brushing their teeth once a day (OR = 1.6) were more likely to have experienced tooth loss than those who reported more frequent toothbrushing. Students who visited a dentist rarely (OR = 0.8) or never (OR = 0.5) were less likely to have lost first molars and/or incisors. CONCLUSIONS The results demonstrate that gender differences in tooth loss among young Chileans are related to socio-economic position; and selected oral-health-related behaviors after adjusting for eruption time variation.
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Affiliation(s)
- Rodrigo López
- Faculty of Health Sciences, University of Aarhus, Aarhus, Denmark.
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