Use of caries prevention tools and associated caries risk in a suburban population of children in Nigeria

Risk indicators for dental caries, and gingivitis among 6-11-year-old children in Nigeria: a household-based survey

Background

There is little is known about the factors associated with caries experience and gingivitis among 6–11-year-old children in Nigeria. The aim of the study was to determine the prevalence and preventive oral health behaviors associated with caries and gingivitis among 6–11-year-old children in Nigeria.

Methods

A cross-sectional questionnaire-based survey was conducted in Ile-Ife, Nigeria. The dependent variables were caries and gingivitis. The dmft/DMFT index was used to assess dental caries experience (present or absent) and caries severity. The gingival index was used to assess the prevalence (present or absent) and severity of gingivitis (healthy gingiva/mild gingivitis versus moderate/severe gingivitis). The independent variables were preventive oral health behaviors (frequency of daily tooth brushing, frequency of consumption of refined carbohydrates in-between-meals, use of fluoridated toothpaste, and use of dental floss, history of dental service utilization). A series of logistic regression analysis models were constructed to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, and socioeconomic status).

Results

There were 69 (5.2%) children with caries. The mean (standard deviation) dmft was 0.08 (0.457) and the mean DMFT was 0.02 (0.159). There were 839 (63.3%) children with gingivitis with a mean (SD) gingival index score of 0.503 (0.453). Children who seldom or never used fluoride toothpaste had significantly higher odds of developing moderate to severe gingivitis (AOR; 1.671; 95% CI: 1.003–2.786; p = 0.049). Children with middle socio-economic status had significantly lower odds of developing moderate to severe gingivitis (AOR: 0.573; 95%CI: 0.330–0.994; p = 0.048). There were no risk indicators identified for caries.

Conclusion

The prevalence of dental caries was low while the prevalence of gingivitis was high in the study population. The daily used of fluoridated toothpaste seem to reduce the risk for moderate/severe gingivitis. Further studies are needed to understand these findings.

Epidemiological profile of early childhood caries in a sub-urban population in Nigeria

Background

The aim of the study was to determine the prevalence and severity of early childhood caries (ECC) in children 6–71-months; identify the teeth most at risk for ECC; and identify risk indicators associated with significant caries index (SiC) score in different age groups.

Methods

This was a cross-sectional study that collected data (using a household survey) on the ECC risk indicators (frequency of tooth brushing, consumption of refined carbohydrate in-between-meals, daily use of fluoridated toothpaste, and dental service utilization in the 12 months) in Ile-Ife, Nigeria. We computed the prevalence of ECC using the International Caries Detection and Assessment System (ICDASI (d^1–6)) index; caries severity using the ICDAS-2(d^1–2) and ICDAS-3(d^3–6) for non-cavitated and cavitated lesions respectively, decayed missing, filled teeth (dmft), and surfaces (dmfs) and SiC indices; and caries complications using the pulp (p), ulceration (u), fistula (f) and abscesses (a) (pufa) index, for children 6–11-months-old, 12–23-months-old, 23–35-months-old, 35–47-months-old; 48–59-months-old and 60–71-months-old. The differences in the mean dmft, dmfs, pufa scores, and ICDAS 1, 2, and 3 scores, and proportion of children with each ECC risk indicator were computed. Logistic regression analysis was conducted to identify risk indicators for the ECC SiC index score for each age group.

Results

The prevalence of ECC was 4.7%: 2.9% had non-cavitated lesions and 2.8% had cavitated lesions. The mean (SD) dmft, dmfs and pufa scores were 0.13 (0.92), 0.24 (1.91) and 0.04 (0.46) respectively. The dmft and dmfs scores were highest among the 24–35-months-olds while the SiC score was highest among the 12–23-months-olds. There were no significant differences in dmft, dmfs, and pufa scores between the different age groups. Toothbrushing more than once a day was the only factor associated with the SiC score: it decreases the odds for the SiC score in children 48–59-months-old. The teeth worst affected by ECC were #85 and #61.

Conclusion

The prevalence, severity and risk indicator for ECC seems to differ for each age group. The granular details on the risk profile of children with ECC in this population with a low ECC prevalence and burden can allow for the planning of age-targeted interventions.

Association between early childhood caries and malnutrition in a sub-urban population in Nigeria

Background

To determine the association between malnutrition and early childhood caries (ECC) in children resident in sub-urban, Nigeria.

Methods

This study was a subset of a larger cross-sectional study the data of which was generated through a household survey conducted in Ile-Ife, Nigeria. The study’s explanatory variable was malnutrition (underweight, overweight, wasting and stunting) and the outcome variable was ECC. Poisson regression analysis was used to determine the association between ECC and malnutrition. Variables (sex, frequency of sugar consumption, maternal knowledge of oral hygiene, oral hygiene status) associated with ECC in the primary study were adjusted for to obtain the adjusted prevalence ratio (APR).

Results

Of the 370 children, 20 (5.41%) were underweight, 20 (5.41%) were overweight, 67 (18.11%) were wasting, 120 (32.43%) were stunted and 18 (4.86%) had ECC. Factors associated with ECC were being stunted, underweight, overweight and fair oral hygiene. The prevalence of ECC was lower in children who were stunted (APR: 0.14; 95% CI: 0.03–0.69; p = 0.02), almost seven times higher in children who were overweight (APR: 6.88; 95% CI: 1.83–25.85; p < 0.001), and predictively absent in children who were underweight (APR: 0; 95% CI: 0–0; p < 0.001) when compared with children who had normal weight. Non-significant risk indicators for ECC included consuming sugar between meals three times a day or more, having low socioeconomic status and being female.

Conclusions

For this study population, the indicators of malnutrition – being stunted, underweight, overweight - and fair oral hygiene were risk indicators for ECC. The frequency of sugar consumption was not a significant risk indicator when malnutrition was included as an explanatory variable for ECC in the study population.

Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis

The objective of this study was to evaluate the clinical effectiveness and cost-effectiveness of oral-health promotion programs (OHPPs) aiming to improve children’s knowledge of favorable oral health behavior to lower decayed/-missing/-filled teeth (DMFT) while reducing the financial cost on health institutions. An electronic search was performed in seven databases. Studies were restricted to human interventions published in English. The search study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the risk of bias was assessed based on the Drummonds Checklist. A total of 1072 references were found. Among these, 19 full texts were included. Most studies had a strong quality. The overall pooled impact of OHPPs estimates children suffering from DMFT/S to have 81% lower odds of participating in OHPP (95% CI 61–90%, I²: 98.3%, p = 0). Furthermore, the program was shown to be effective at lowering the cost in 97 out of 100 OHPPs (95% CI 89–99%, I²: 99%, p = 0). Three subgroups analyses (age groups, study countries, studies of the last five years) were performed to evaluate the influence modification on the pooled effect. A comprehensive analysis of the OHPPs confirmed a reduction effect on child DMFT, hence, lowering the financial burden of dental-care treatment on health institutions.

Contribution of preventive methods in controlling caries among Saudi primary schoolchildren: a population-based cross-sectional study

OBJECTIVE

This study assessed the association between caries preventive measures including regular dental checkups, twice a day tooth brushing using fluoridated toothpaste and pit and fissure sealants on one side and the presence of caries among primary schoolchildren in the Eastern Province of Saudi Arabia.

MATERIALS AND METHODS

A cross-sectional study was conducted in 2016 including 1198, 6-12-year-old children from 13 randomly selected schools. The outcome variable was caries presence. The explanatory variables were brushing twice a day using fluoridated toothpaste, the presence of sealant and regular dental checkups. Multivariable logistic regression model was conducted to assess the associations controlling for confounders (age, gender, ability to get treatment, being health insured and school) using SPSS version 20.0.

RESULTS

Data of 921 participants (83.8%) were available. The prevalence of caries was 63.5%, whereas 67.6% brushed their teeth twice a day, 28.3% visited the dentist for regular checkups and 7.6% had sealant. In multivariable regression, out of the three main explanatory variables, only having regular checkups was significantly associated with caries presence (OR = 0.65, 95% CI = 0.48, 0.88).

CONCLUSIONS

Lower odds of caries presence were associated with regular dental checkups but not with regular brushing or having sealant.