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Chrisopoulos S, AlKhtib AO, Al Darwish MS, Mohamed HGS, Mathew T, Al Mannai GA, Abdulmalik M, Al Thani M, de Vries J, Do LG, Spencer AJ. Correlates of childhood caries: A study in Qatar. Int J Paediatr Dent 2024; 34:179-189. [PMID: 37908038 DOI: 10.1111/ipd.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/09/2023] [Accepted: 09/07/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND The prevalance of dental caries in children in Qatar is high, which necessitates preventive efforts. AIM To identify the sociodemographic and behavioural correlates of dental caries in the primary dentition of children 4- to 8-year-olds in Qatar. DESIGN Weighted data from the Qatar Child Oral Health Survey 2017 were analysed for caries prevalence (dmft>0) and experience (dmft). Sociodemographic and behavioural variables were also drawn from the survey. RESULTS AND CONCLUSION Among the 1154 children, caries prevalence was 69.3% (95%CI [63.4, 74.5]) and experience at 3.8 dmft (95%CI [3.3, 4.2]). The prevalence ratio (PR) 0.82 (0.72, 0.94) was lower among younger than in older children; those for non-Qatari nationality Arabic PR 0.91 (0.82, 1.00) and Other PR 0.75 (0.57, 0.99) than for Qatari nationality; those attending international kindergartens/schools PR 0.89 (0.80, 0.99) than independent schools; and whose parents had university-level education PR 0.85 (0.75,0.95) than did not. Caries prevalence was lower among those toothbrushing by age 3 years PR 0.88 (0.80,0.99) than later; children with low/intermediate sugar exposures PR 0.85 (0.74,0.97) and 0.89 (0.79,1.00) than those with high exposures; children with a dental check-up PR 0.68 (0.53,0.87) than those without; and children who drank bottled water with some fluoride PR 0.89 (0.80,0.99) than those who did not. Findings were similar for dmft. In conclusion caries prevalence varied but was high across sociodemographic correlates indicating vulnerablity. Interventions focusing on behaviours - such as toothbrushing, reducing sugar intake, check-up and encouraging intake of water with fluoride - are needed.
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Affiliation(s)
- Sergio Chrisopoulos
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | | | | | - Hasaan Gassim Saad Mohamed
- Primary Health Care Corporation (PHCC), Doha, Qatar
- College of Dental Medicine, Qatar University, Doha, Qatar
| | - Tintu Mathew
- Primary Health Care Corporation (PHCC), Doha, Qatar
| | | | | | | | | | - Loc Giang Do
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Andrew John Spencer
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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Verlinden DA, Schuller AA, Vermaire JHE, Reijneveld SA. Referral from well-child care clinics to dental clinics leads to earlier initiation of preventive dental visits: A quasi-experimental study. Int J Paediatr Dent 2024; 34:190-197. [PMID: 37747061 DOI: 10.1111/ipd.13124] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/15/2023] [Accepted: 09/04/2023] [Indexed: 09/26/2023]
Abstract
BACKGROUND An ealy first preventive dental visit for children is recommended no later than twelve months. However, still many children have their first dental visit relatively late. AIM To evaluate whether active or passive referral by a well-child care (WCC) physician of babies for a first preventive dental visit leads to earlier initiation of dental care. DESIGN From WCC clinics in two Dutch regions, 629 parents of babies participated. Parents received an active referral from a WCC physician for a dental visit for their babies (n = 204) or received care as usual (CAU) (n = 136) in one region and a passive referral (n = 143) or CAU (n = 146) in the other region. Active referral involved parents receiving a scheduled appointment at the dental practice, and passive referral involved parents making an appointment themselves. During the WCC visit, parents completed a baseline questionnaire. At age 2.5 years, parents received a follow-up questionnaire about dental attendance. RESULTS Of the active referral intervention group, 59.3% had their first preventive dental visit in their first year compared with 3.7% in the CAU group (p < .001); for the passive referral group, 46.9% compared with 9.6% (p < .001). CONCLUSION Referral of babies by WCC for their first preventive dental visit leads to earlier initiation of dental care. An active referral had a larger effect than passive referral.
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Affiliation(s)
- Deborah Ashley Verlinden
- Center for Dentistry and Oral Hygiene, University Medical Center, Groningen, The Netherlands
- TNO Child Health, Leiden, The Netherlands
| | - Annemarie A Schuller
- Center for Dentistry and Oral Hygiene, University Medical Center, Groningen, The Netherlands
- TNO Child Health, Leiden, The Netherlands
| | - J H Erik Vermaire
- Center for Dentistry and Oral Hygiene, University Medical Center, Groningen, The Netherlands
- TNO Child Health, Leiden, The Netherlands
| | - Sijmen A Reijneveld
- TNO Child Health, Leiden, The Netherlands
- Department of Health Sciences, University Medical Center, Groningen, The Netherlands
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Tooth loss over 13 years of follow-up: can regular dental visits reduce racial and socioeconomic inequalities? J Dent 2022; 122:104110. [DOI: 10.1016/j.jdent.2022.104110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 03/16/2022] [Accepted: 03/24/2022] [Indexed: 11/22/2022] Open
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Yan S, Huang S, Yang Z, Luo S, Yang X, He L, Li J, Que G. Factors Affecting Future Caries Occurrence Among Preschoolers in Northern Guangdong: A Longitudinal Study. Clin Epidemiol 2021; 13:345-355. [PMID: 34079377 PMCID: PMC8164668 DOI: 10.2147/clep.s312132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 05/06/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to investigate the new development of caries among preschoolers in northern Guangdong and to assess caries-related factors to distinguish groups with different caries risk levels. Methods Baseline data were recorded for participants from September to November 2019, and participants were reexamined from September to November 2020. A longitudinal observation of 11,973 preschoolers was conducted. The simplified debris index (DI-S) and decayed-missing-filled tooth (dmft) index values were obtained for each participant. Results Factors associated with whether caries would occur in the future and one-year increase in dmft (Δdmft) included baseline dmft, baseline DI-S, and baseline age. The risk ratio (RR) of caries occurrence and the number of teeth with new-onset caries were 4.482 (95% confidence interval, 4.056-4.957) and 2.945 (2.742-3.165) in the participants with baseline dmft ≥3, which were higher than those with baseline dmft =1 or 2. In the baseline caries-free group, whether caries would occur in the future was related to the baseline DI-S (95% confidence interval, 0.022-0.062). The caries incidence of maxillary central incisors (27.9%) was the highest among teeth of preschoolers without caries at baseline, whereas the caries incidence of mandibular first deciduous molars (42.7%) was the highest among teeth of preschoolers with caries at baseline. Conclusion Baseline dmft is a good predictor of future caries. Children with baseline caries-free status, baseline dmft >0, and baseline dmft ≥3 should be treated with preventive interventions of different intensities and frequencies. The occurrence of future caries in baseline caries-free participants is related to oral hygiene status. Measures to prevent caries on smooth surfaces, such as topical fluoridation, should be applied to all preschoolers. Preschoolers with caries at baseline may be given priority for pit and fissure sealing.
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Affiliation(s)
- Siqi Yan
- Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Shaohong Huang
- Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Zijing Yang
- Department of Biostatistics, School of Public Health, Guangdong Provincial Key Laboratory of Tropical Disease Research, Southern Medical University, Guangzhou, People's Republic of China
| | - Song Luo
- Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Xiaoxia Yang
- Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Lidan He
- Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Jianbo Li
- Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
| | - Guoying Que
- Stomatological Hospital, Southern Medical University, Guangzhou, People's Republic of China
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Kusama T, Todoriki H, Osaka K, Aida J. Majority of New Onset of Dental Caries Occurred from Caries-Free Students: A Longitudinal Study in Primary School Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228476. [PMID: 33207679 PMCID: PMC7698044 DOI: 10.3390/ijerph17228476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/12/2020] [Accepted: 11/14/2020] [Indexed: 12/19/2022]
Abstract
We examined Rose's axiom that a large number of people exposed to a small risk may generate more cases than a small number exposed to a high risk, using data on caries incidence. This longitudinal study was based on the records of annual dental checks conducted in primary schools in Okinawa, Japan. Participants were students aged 6-11 years at baseline in 2014, and a follow-up survey was conducted after one-year. The outcome variable was the increased number of decayed, missing, and filled teeth (DMFT). The predictor variable was the baseline DMFT score. Gender, grade, and affiliated school variables were adjusted. A negative binomial regression model was used to obtain the estimated increase of DMFT score. Among 1542 students, 1138 (73.8%) were caries-free at baseline. A total of 317 (20.6%) developed new caries during the follow-up. The predicted number of new carious teeth in a caries-free students and students with DMFT = 1 at baseline were 0.26 (95% CI, 0.22-0.31) and 0.45 teeth (95% CI, 0.33-0.56), respectively. However, among the total of 502 newly onset of carious teeth, 300 teeth (59.7%) occurred from the caries-free students at baseline. Hence, prevention strategies should target the low-risk group because they comprise the majority of the population.
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Affiliation(s)
- Taro Kusama
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (T.K.); (K.O.)
| | - Hidemi Todoriki
- Tropical Biosphere Research Center, University of the Ryukyus, Okinawa 903-0213, Japan;
| | - Ken Osaka
- Department of International and Community Oral Health, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (T.K.); (K.O.)
| | - Jun Aida
- Department of Oral Health Promotion, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo 113-8549, Japan
- Division for Regional Community Development, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan
- Correspondence: ; Tel.: +81-3-5803-5475; Fax: +81-3-5803-0194
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Madera M, Bernabé E. Estimating the prevalence of untreated caries in permanent teeth from the DMF index and lifetime caries prevalence. J Public Health Dent 2020; 81:143-149. [PMID: 33146408 DOI: 10.1111/jphd.12425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 10/14/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
AIM To derive formulas to estimate the prevalence of untreated dental caries in permanent teeth based on the DMF index and lifetime caries prevalence. METHODS Data from participants, aged 5 years or older, in the National Health and Nutrition Examination Survey 2011-2016 were analyzed. Dental caries was assessed at surface level with the Radike criteria, which matches the case definition of the Global Burden of Disease study. Participants' data were aggregated into 438 groups, based on survey strata and 5-year age brackets, to produce population estimates for the prevalence of untreated caries (DT > 0), DMFT, DMFS, DT, DS, and lifetime caries prevalence (DMFT>0). Conversion formulas were derived using fractional polynomials to characterize the association of each caries indicator with the prevalence of untreated caries. RESULTS The mean prevalence of untreated caries was 23.5 percent (SD: 12.9 percent, range: 1.0-72.3 percent). After adjustment for age, the prevalence of untreated caries was correlated with DMFT (r = 0.23), DMFS (r = 0.25), DT (r = 0.74), DS (r = 0.65) and lifetime caries prevalence (r = 0.18). Using fractional polynomial models adjusted for categorical age, the prevalence of untreated caries at population level could be estimated from DMFT with power 1 (linear form), DMFS with power 0.5, DT with power 0.5, DS with powers (0.5; 1) and lifetime caries prevalence with power 1. CONCLUSION The prevalence of untreated caries in permanent teeth can be estimated from the DMF index and lifetime caries prevalence. These conversion formulas can facilitate the inclusion of more studies in estimation of the global burden of untreated caries in permanent teeth.
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Affiliation(s)
- Meisser Madera
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.,Department of Research, Faculty of Dentistry, University of Cartagena, Cartagena, Colombia
| | - Eduardo Bernabé
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK
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7
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Comparison of two caries prevention programs among Thai kindergarten: a randomized controlled trial. BMC Oral Health 2020; 20:119. [PMID: 32306953 PMCID: PMC7168866 DOI: 10.1186/s12903-020-01107-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 04/05/2020] [Indexed: 11/12/2022] Open
Abstract
Background Intensified preventive regimen based on a ‘high-risk’ approach has been proposed instead the routine prevention that is generally given to the whole population. The effectiveness of these regimens may still be an issue. Therefore, the aim of this study was to compare two preventive programs carried out in a Public School for kindergarten children. Methods The data from clinical examinations were used to assess the caries risk for 121 children. Children with at least 2 carious lesions were considered as high risk for dental caries development. These children were randomized into two groups. Half (High risk basic-HRB group) were provided the basic prevention regimen (oral-hygiene instruction and hands-on brushing practice for teachers and caregivers, daytime tooth brushing supervised by teachers at least once a week, newly erupted first permanent molar sealant, provision of toothbrush, fluoride-containing dentifrice, and a guidebook), which was also given to low-risk children (Low risk basic-LRB group). The other half (High risk intensive-HRI group) were additionally given an intensified preventive regimen (F-varnish application, primary molar sealant, and silver diamine fluoride (SDF) application on carious lesions). Clinical examinations were performed semiannually to determine the dmfs caries increment of the three groups. Results The 89 children completed the 24-month examination were 3- to 5-year-old with 19, 35, and 35 children in the LRB, HRB, and HRI group, respectively. The new caries development at 24 months of the HRB group (75%) was higher than that of the HRI group (65.7%) and the LRB group (21.1%). One-way analysis of variance (ANOVA) indicated no significant differences of caries increment between the HRB and HRI groups at the end of our study (p = 0.709). Conclusions The negligible difference in caries increment between the HRI and HRB groups implies that intensified prevention produced minimal additional benefit. Offering all children only basic prevention could have obtained virtually the same preventive effect with substantially less effort and lower cost. Trial registration Thai Clinical Trials Registry (TCTR), TCTR20180124001. Registered 24 January 2018 - Retrospectively registered.
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Hiratsuka VY, Robinson JM, Greenlee R, Refaat A. Oral health beliefs and oral hygiene behaviours among parents of urban Alaska Native children. Int J Circumpolar Health 2019; 78:1586274. [PMID: 30857502 PMCID: PMC6419661 DOI: 10.1080/22423982.2019.1586274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 01/28/2019] [Accepted: 02/13/2019] [Indexed: 11/06/2022] Open
Abstract
American Indian/Alaska Native (AI/AN) children have a prevalence rate of early childhood caries 5 times that of the overall US population. Oral hygiene and oral health beliefs have not been described among AI/AN parents. This study explored constructs of the health belief model informing oral health beliefs and oral hygiene behaviours of parents of AI/AN children ages 0-6 years. The study aimed to determine the toothbrushing behaviour in parents of AI/AN childrenand the relationship between parent oral health beliefs and toothbrushing frequency. A cross-sectional survey which included the Oral Hygiene Scale, Oral Health Belief Questionnaire and the Early Childhood Oral Health Impact Scale was administered to a convenience sample of parents of AI/AN children 71 months or younger attending outpatient paediatric primary care appointments (N=100). Analyses were conducted to determine parent toothbrushing and the relationship between parent health beliefs and child toothbrushing. The odds of regular child toothbrushing were 49.10 times higher when the parent brushed their own teeth regularly (confidence interval (CI)=11.46-188.14; p<0.001). Parental toothbrushing had a strong positive association with the belief that oral health is as important as physical health. This research endorses parent-focused toothbrushing interventions to reduce AI/AN early childhood caries rates.
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Affiliation(s)
| | | | | | - Amany Refaat
- School of Health Sciences, Walden University, Minneapolis, MN, USA
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Faustino‐Silva DD, Colvara BC, Meyer E, Hugo FN, Celeste RK, Hilgert JB. Motivational interviewing effects on caries prevention in children differ by income: A randomized cluster trial. Community Dent Oral Epidemiol 2019; 47:477-484. [DOI: 10.1111/cdoe.12488] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 07/09/2019] [Accepted: 07/09/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Daniel Demétrio Faustino‐Silva
- Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC) Porto Alegre Brazil
| | | | - Elisabeth Meyer
- Graduate Program in Health Sciences Instituto de Cardiologia (IC/FUC) Porto Alegre Brazil
| | - Fernando Neves Hugo
- Graduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Roger Keller Celeste
- Graduate Program in Assessment Technology for the National Health System (SUS), Grupo Hospitalar Conceição (GHC) Porto Alegre Brazil
- Graduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
| | - Juliana Balbinot Hilgert
- Graduate Program in Dentistry Federal University of Rio Grande do Sul Porto Alegre Brazil
- Graduate Program in Epidemiology Federal University of Rio Grande do Sul Porto Alegre Brazil
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Abstract
In the new era of global health, a closer integration of oral health with the wider body of medicine and health systems will be essential. This will ensure that oral diseases are addressed alongside the other non-communicable diseases. Mainstreaming patient-centred primary prevention, underpinned by transforming educational and workforce systems to create future leaders in global oral health, is vital if the challenge of reducing inequalities in oral health and the aspiration of universal coverage of oral health services are to be realised.
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Affiliation(s)
- David M Williams
- Bart's and the London School of Medicine and Dentistry, Queen Mary, University of London, United Kingdom.
| | - Peter A Mossey
- University of Dundee, School of Dentistry, Dundee, United Kingdom
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11
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Soares GH, Pereira NF, Biazevic MGH, Braga MM, Michel-Crosato E. Dental caries in South American Indigenous peoples: A systematic review. Community Dent Oral Epidemiol 2018; 47:142-152. [DOI: 10.1111/cdoe.12436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 08/30/2018] [Accepted: 10/25/2018] [Indexed: 10/27/2022]
Affiliation(s)
- Gustavo Hermes Soares
- Community Dentistry Department; School of Dentistry; Universidade de São Paulo - USP; São Paulo Brazil
| | - Nayara Fernanda Pereira
- Community Dentistry Department; School of Dentistry; Universidade de São Paulo - USP; São Paulo Brazil
| | | | - Mariana Minatel Braga
- Pediatric Dentistry Department; School of Dentistry; Universidade de São Paulo - USP; São Paulo Brazil
| | - Edgard Michel-Crosato
- Community Dentistry Department; School of Dentistry; Universidade de São Paulo - USP; São Paulo Brazil
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Razak F, Subramanian SV, Sarma S, Kawachi I, Berkman L, Davey Smith G, Corsi DJ. Association between population mean and distribution of deviance in demographic surveys from 65 countries: cross sectional study. BMJ 2018; 362:k3147. [PMID: 30076132 PMCID: PMC6073428 DOI: 10.1136/bmj.k3147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To examine whether conditions related to scarcity at the left side of the distribution (anaemia, severe chronic energy deficiency, and underweight) are as strongly related to population means as conditions of excess at the right side of the distribution (overweight and obesity). DESIGN Observational study. SETTING 65 countries, with nationally representative cross sectional data from 1994 to 2014 obtained from the Demographic Health Surveys. PARTICIPANTS Non-pregnant women aged 20-49. Sample of 65 countries and n=524 380 for analysis of BMI; sample of 44 countries and n=316 465 for analysis of haemoglobin. MAIN OUTCOME MEASURES The association between mean and prevalence of each category. For BMI, prevalence of severe chronic energy deficiency (SCED, BMI <16.0), underweight (BMI <18.5), overweight (BMI >25) and obese (BMI >30.) were measured; for haemoglobin, prevalence of anaemia (haemoglobin <12.0 g/dL) and severe anaemia (haemoglobin <8.0 g/dL) were examined. RESULTS There was a strong association between mean BMI and prevalence of overweight (r2=0.98; r=0.99; β=8.3 (8.0 to 8.6)) and obesity (r2=0.93; r=0.97; β=4.2 (3.9 to 4.5)). For left sided conditions, a moderate to strong association was found between mean BMI and prevalence of underweight (r2=0.67; r=-0.82; β=-2.7 (-3.1 to -2.2)), and a weaker association for SCED (r2=0.38; r=-0.61; β=-0.32 (-0.43 to -0.22)). There was a moderate association between mean haemoglobin and prevalence of anaemia (r2=0.46; r=-0.68; β=-10.8 (-14.5 to -7.1)) and a weaker association with severe anaemia (r2=0.30; r=-0.55; β=-0.55 (-0.81 to -0.29)). CONCLUSIONS The associations between population means and prevalence of conditions of scarcity such as low BMI and anaemia were substantially weaker than the associations of mean BMI with conditions of excesses such as overweight and obesity.
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Affiliation(s)
- Fahad Razak
- Division of General Internal Medicine, Li Ka Shing Knowledge Institute, St Michael's Hospital, 209 Victoria Street, Toronto, ON M5B 1W8, Canada
| | - S V Subramanian
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Kresge Building 7th Floor, 716, Boston, MA 02115-6096, USA
| | | | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, 677 Huntington Avenue, Kresge Building 7th Floor, 716, Boston, MA 02115-6096, USA
| | - Lisa Berkman
- Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA 02138, USA
| | - George Davey Smith
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 2BN, UK
| | - Daniel J Corsi
- OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON K1Y 4E9, Canada
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Chong L, Clarkson JE, Dobbyn‐Ross L, Bhakta S. Slow-release fluoride devices for the control of dental decay. Cochrane Database Syst Rev 2018; 3:CD005101. [PMID: 29495063 PMCID: PMC6494221 DOI: 10.1002/14651858.cd005101.pub4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Slow-release fluoride devices have been investigated as a potentially cost-effective method of reducing dental caries in people with high risk of disease. This is the second update of the Cochrane Review first published in 2006 and previously updated in 2014. OBJECTIVES To evaluate the effectiveness and safety of different types of slow-release fluoride devices on preventing, arresting, or reversing the progression of carious lesions on all surface types of primary (deciduous) and permanent teeth. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following electronic databases: Cochrane Oral Health's Trials Register (to 23 January 2018); the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 12) in the Cochrane Library (searched 23 January 2018); MEDLINE Ovid (1946 to 23 January 2018); and Embase Ovid (1980 to 23 January 2018). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials (23 January 2018). We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Parallel randomised controlled trials (RCTs) comparing slow-release fluoride devices with an alternative fluoride treatment, placebo, or no intervention in all age groups. The main outcome measures sought were changes in numbers of decayed, missing, and filled teeth or surfaces (DMFT/DMFS in permanent teeth or dmft/dmfs in primary teeth), and progression of carious lesions through enamel and into dentine. DATA COLLECTION AND ANALYSIS We conducted data collection and analysis using standard Cochrane review methods. At least two review authors independently performed all the key steps in the review such as screening of abstracts, application of inclusion criteria, data extraction, and risk of bias assessment. We resolved discrepancies through discussions or arbitration by a third or fourth review author. MAIN RESULTS We found no evidence comparing slow-release fluoride devices against other types of fluoride therapy.We found only one double-blind RCT involving 174 children comparing a slow-release fluoride device (glass beads with fluoride were attached to buccal surfaces of right maxillary first permanent molar teeth) against control (glass beads without fluoride were attached to buccal surfaces of right maxillary first permanent molar teeth). This study was assessed to be at high risk of bias. The study recruited children from seven schools in an area of deprivation that had low levels of fluoride in the water. The mean age at the beginning of the study was 8.8 years and at the termination was 10.9 years. DMFT in permanent teeth or dmft in primary teeth was greater than one at the start of the study and greater than one million colony-forming units of Streptococcus mutans per millilitre of saliva.Although 132 children were still included in the trial at the two-year completion point, examination and statistical analysis was performed on only the 63 children (31 in intervention group, 32 in control group) who had retained the beads (retention rate was 47.7% at 2 years). Among these 63 children, caries increment was reported to be statistically significantly lower in the intervention group than in the control group (DMFT: mean difference -0.72, 95% confidence interval (CI) -1.23 to -0.21; DMFS: mean difference -1.52, 95% CI -2.68 to -0.36 (very low-quality evidence)). Although this difference was clinically significant, it only holds true for those children who maintain the fluoride beads; over 50% of children did not retain the beads.Harms were not reported within the trial report. Evidence for other outcomes sought in this review (progression to of caries lesion, dental pain, healthcare utilisation data) were also not reported. AUTHORS' CONCLUSIONS There is insufficient evidence to determine the caries-inhibiting effect of slow-release fluoride glass beads. The body of evidence available is of very low quality and there is a potential overestimation of benefit to the average child. The applicability of the findings to the wider population is unclear; the study had included children from a deprived area that had low levels of fluoride in drinking water, and were considered at high risk of caries. In addition, the evidence was only obtained from children who still had the bead attached at 2 years (48% of all available children); children who had lost their slow-release fluoride devices earlier might not have benefited as much from the devices.
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Affiliation(s)
| | - Janet E Clarkson
- University of DundeeDivision of Oral Health SciencesDental Hospital & SchoolPark PlaceDundeeScotlandUKDD1 4HR
| | - Lorna Dobbyn‐Ross
- College of Medicine, Dentistry & Nursing, University of DundeeDundeeUK
| | - Smriti Bhakta
- Morley Dental Centre12 Corporation StreetMorleyLeedsUKLS27 9NB
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Reda SF, Reda SM, Thomson WM, Schwendicke F. Inequality in Utilization of Dental Services: A Systematic Review and Meta-analysis. Am J Public Health 2017; 108:e1-e7. [PMID: 29267052 DOI: 10.2105/ajph.2017.304180] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Dental diseases are among the most prevalent conditions worldwide, with universal access to dental care being one key to tackling them. Systematic quantification of inequalities in dental service utilization is needed to identify where these are most pronounced, assess factors underlying the inequalities, and evaluate changes in inequalities with time. OBJECTIVES To evaluate the presence and extent of inequalities in dental services utilization. SEARCH METHODS We performed a systematic review and meta-analysis by searching 3 electronic databases (MEDLINE, Embase, Cochrane Central Database), covering the period from January 2005 to April 2017. SELECTION CRITERIA We included observational studies investigating the association between regular dental service utilization and sex, ethnicity, place of living, educational or income or occupational position, or insurance coverage status. Two reviewers undertook independent screening of studies and made decisions by consensus. DATA COLLECTION AND ANALYSIS Our primary outcome was the presence and extent of inequalities in dental service utilization, measured as relative estimates (usually odds ratios [ORs]) comparing different (high and low utilization) groups. We performed random effects meta-analysis and subgroup analyses by region, and we used meta-regression to assess whether and how associations changed with time. MAIN RESULTS A total of 117 studies met the inclusion criteria. On the basis of 7 830 810 participants, dental services utilization was lower in male than female participants (OR = 0.85; 95% confidence interval [CI] = 0.74, 0.95; P < .001); ethnic minorities or immigrants than ethnic majorities or natives (OR = 0.71; 95% CI = 0.59, 0.82; P < .001); those living in rural than those living in urban places (OR = 0.87; 95% CI = 0.76, 0.97; P = .011); those with lower than higher educational position (OR = 0.61; 95% CI = 0.55, 0.68; P < .001) or income (OR = 0.66; 95% CI = 0.54, 0.79; P < .001); and among those without insurance coverage status than those with such status (OR = 0.58; 95% CI = 0.49, 0.68; P < .001). Occupational status (OR = 0.95; 95% CI = 0.81, 1.09; P = .356) had no significant impact on utilization. The observed inequalities did not significantly change over the assessed 12-year period and were universally present. AUTHORS' CONCLUSIONS Inequalities in dental service utilization are both considerable and globally consistent. Public Health Implications. The observed inequalities in dental services utilization can be assumed to significantly cause or aggravate existing dental health inequalities. Policymakers should address the physical, socioeconomic, or psychological causes underlying the inequalities in utilization.
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Affiliation(s)
- Sophie F Reda
- Sophie F. Reda, Seif M. Reda, and Falk Schwendicke are with Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin, Berlin, Germany. W. Murray Thomson is with the Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Seif M Reda
- Sophie F. Reda, Seif M. Reda, and Falk Schwendicke are with Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin, Berlin, Germany. W. Murray Thomson is with the Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
| | - W Murray Thomson
- Sophie F. Reda, Seif M. Reda, and Falk Schwendicke are with Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin, Berlin, Germany. W. Murray Thomson is with the Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
| | - Falk Schwendicke
- Sophie F. Reda, Seif M. Reda, and Falk Schwendicke are with Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin, Berlin, Germany. W. Murray Thomson is with the Sir John Walsh Research Institute, Faculty of Dentistry, The University of Otago, Dunedin, New Zealand
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15
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Aguiar VR, Pattussi MP, Celeste RK. The role of municipal public policies in oral health socioeconomic inequalities in Brazil: A multilevel study. Community Dent Oral Epidemiol 2017; 46:245-250. [DOI: 10.1111/cdoe.12356] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 11/07/2017] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Roger Keller Celeste
- Department of Social and Preventive Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
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16
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Cappelli DP, Mobley CC. Association between Sugar Intake, Oral Health, and the Impact on Overall Health: Raising Public Awareness. ACTA ACUST UNITED AC 2017. [DOI: 10.1007/s40496-017-0142-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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17
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Sheiham A, Williams DM, Weyant RJ, Glick M, Naidoo S, Eiselé JL, Selikowitz HS. Billions with oral disease: A global health crisis--a call to action. J Am Dent Assoc 2017; 146:861-4. [PMID: 26610819 DOI: 10.1016/j.adaj.2015.09.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 09/22/2015] [Indexed: 11/26/2022]
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18
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Nimako-Boateng J, Owusu-Antwi M, Nortey P. Factors affecting dental diseases presenting at the University of Ghana Hospital. SPRINGERPLUS 2016; 5:1709. [PMID: 27757378 PMCID: PMC5050172 DOI: 10.1186/s40064-016-3391-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Accepted: 09/26/2016] [Indexed: 11/29/2022]
Abstract
Dental diseases are common in man and range from a toothache to cancers of the head and neck. Dental conditions can affect our capacity to function effectively in areas such as smiling, chewing and speaking. The objective of this study was to describe the main types of dental conditions presenting at the University Hospital between January 2006 and December 2011 and to determine factors associated with the top five diagnosed conditions as well as the acute and chronic conditions. A retrospective review of all 5012 clinical records of dental patients visiting the dental unit within the period stated was carried out. A total of 4196 records which passed the inclusion/exclusion criteria were analysed. Most of the patients who presented were adults. The top 5 dental conditions were apical periodontitis (50.4 %), reversible pulpitis (23.3 %), Gingivitis (11.4 %), Periodontitis (6.2 %) and Halitosis/bad breadth (8.8 %). The top 5 conditions constituted over 75 % of the cases seen. About 84 % of the presentation was acute whilst 16 % was chronic. For the entire dataset and also the top five conditions, approximately 53.0 % were males and 47.0 %. Males outnumbered females on all occasions except for halitosis and most patients presented within 1 month of experiencing symptoms of dental disease. Some significant association was found between the presence of multiple chronic conditions and reversible/irreversible pulpitis. The main dental conditions presenting at the University Hospital during the stated period (i.e. between January 2006 and December 2011) were: apical periodontitis (50.4 %), reversible pulpitis (23.3 %), gingivitis (11.4 %), periodontitis (6.2 %) and halitosis/bad breadth (8.8 %).
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Affiliation(s)
- Joseph Nimako-Boateng
- University of Ghana Hospital, Legon, Ghana ; University of Ghana School of Public Health, Legon, Ghana
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19
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Watt RG, Heilmann A, Rouxel P, Williams DM, Tsakos G. Aubrey Sheiham: Iconoclast and Dental Public Health Pioneer. J Dent Res 2016; 95:1441-1444. [PMID: 27625356 DOI: 10.1177/0022034516664478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- R G Watt
- Department of Epidemiology and Public Health, University College London, London, UK
| | - A Heilmann
- Department of Epidemiology and Public Health, University College London, London, UK
| | - P Rouxel
- Department of Epidemiology and Public Health, University College London, London, UK.,UCL Eastman Dental Institute, London, UK
| | - D M Williams
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, London, UK
| | - G Tsakos
- Department of Epidemiology and Public Health, University College London, London, UK
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20
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Poon BT, Holley PC, Louie AM, Springinotic CM. Dental caries disparities in early childhood: A study of kindergarten children in British Columbia. Canadian Journal of Public Health 2015; 106:e308-14. [PMID: 26451993 DOI: 10.17269/cjph.106.4918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 06/25/2015] [Accepted: 05/02/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The objective of this paper was to describe results of a public health-administered, provincial dental survey of children aged 4-6 years old in British Columbia, and assess the changes in rates of dental caries geographically and by neighbourhood socio-economic status between baseline (2006/07) and follow-up data collection (2009/10). METHOD The study design involved two retrospective cohorts of kindergarten children who received a public health-administered dental assessment in the years 2006/07 and 2009/10. Neighbourhood socio-economic status was measured by an index created from Canadian Census and Tax Filer data sets. The dental outcomes included previous decay experience, untreated visible decay, and urgent treatment needs. RESULTS The analysis comprised dental outcomes for 35,602 kindergarten children in 2006/07 and 35,215 children in 2009/10. There was a modest decrease in dental decay rates between surveys, with rates of decay experience - previous and untreated - of 38.9% and 36.7% respectively. However, there were disparities, with almost 50% of children with dental decay in the most socio-economically disadvantaged neighbourhoods, and approximately 30% with dental decay in the least disadvantaged areas. CONCLUSION The kindergarten dental survey had extensive coverage, was at the population level, and enabled analysis of change in early childhood dental decay rates over time and by geography. Although overall rates improved, dental health inequalities persisted in both survey years at both regional and neighbourhood levels.
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Affiliation(s)
- Brenda T Poon
- Human Early Learning Partnership University of British Columbia.
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21
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Desai P, Kruger E, Trolio R, Tennant M. Western Australian schools access to dentally optimal fluoridated water. Aust Dent J 2015; 60:112-8. [DOI: 10.1111/adj.12260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2014] [Indexed: 12/01/2022]
Affiliation(s)
- P Desai
- Department of Anatomy, Physiology and Human Biology; International Research Collaborative - Oral Health and Equity; The University of Western Australia; Nedlands Western Australia
| | - E Kruger
- Department of Anatomy, Physiology and Human Biology; International Research Collaborative - Oral Health and Equity; The University of Western Australia; Nedlands Western Australia
| | - R Trolio
- Department of Anatomy, Physiology and Human Biology; International Research Collaborative - Oral Health and Equity; The University of Western Australia; Nedlands Western Australia
| | - M Tennant
- Department of Anatomy, Physiology and Human Biology; International Research Collaborative - Oral Health and Equity; The University of Western Australia; Nedlands Western Australia
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22
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Roncalli AG, Sheiham A, Tsakos G, Watt RG. Socially unequal improvements in dental caries levels in Brazilian adolescents between 2003 and 2010. Community Dent Oral Epidemiol 2015; 43:317-24. [DOI: 10.1111/cdoe.12156] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 01/13/2015] [Indexed: 01/28/2023]
Affiliation(s)
- Angelo G. Roncalli
- Department of Dentistry; Federal University of Rio Grande do Norte; Natal RN Brazil
- Department of Epidemiology and Public Health; University College London; London UK
| | - Aubrey Sheiham
- Department of Epidemiology and Public Health; University College London; London UK
| | - Georgios Tsakos
- Department of Epidemiology and Public Health; University College London; London UK
| | - Richard G. Watt
- Department of Epidemiology and Public Health; University College London; London UK
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23
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Lim S, Tellez M, Ismail AI. Dental caries development among African American children: results from a 4-year longitudinal study. Community Dent Oral Epidemiol 2014; 43:200-7. [PMID: 25441657 DOI: 10.1111/cdoe.12140] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 11/01/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine dental caries development and caries risk factors among preschool African American children from low-income families in Detroit, Michigan, over a 4-year window. METHODS Data came from a representative sample of 1021 children (0-5 years) and their caregivers in Detroit. The baseline participants in 2002-2003 (W1) were re-examined in 2004-2005 (W2) and 2007 (W3). Caries was measured using the International Caries Detection and Assessment System. Bivariate and multivariate analyses for repeated data were conducted to explore associations between caries increment outcomes and demographics, access to dental care, oral health-related behaviours, and social and physical environments. RESULTS The mean number of new noncavitated caries lesions (NCCL) was 2.8 between W1 and W2 and 2.6 between W2 and W3, while the mean number of new cavitated caries lesions (CCL) was 2.0 and 2.0, respectively, during the same time periods. In younger children (<3 years old in W1), higher number of new NCCL than new CCL was observed in both W1-W2 and W2-W3. The risk of new NCCL was associated with child's soda intake and caregiver's age. For the risk of new CCL, significant risk factors included baseline NCCL, baseline CCL, as well as child's age. Baseline caries and child's soda intake were also associated with the risk of developing new decayed, missing and filled tooth surfaces. CONCLUSIONS Higher number of new NCCL relative to CCL was developed among low-income African American children during early childhood. New caries development was associated with baseline caries and child's soda intake.
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Affiliation(s)
- Sungwoo Lim
- Kornberg School of Dentistry, Temple University, Philadelphia, PA, USA
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24
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Chong LY, Clarkson JE, Dobbyn-Ross L, Bhakta S. Slow-release fluoride devices for the control of dental decay. Cochrane Database Syst Rev 2014:CD005101. [PMID: 25432017 DOI: 10.1002/14651858.cd005101.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Slow-release fluoride devices have been investigated as a potentially cost-effective method of reducing dental caries in people with high risk of disease. OBJECTIVES To evaluate the effectiveness and safety of different types of slow-release fluoride devices on preventing, arresting, or reversing the progression of carious lesions on all surface types of primary (deciduous) and permanent teeth. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group Trials Register (to 13 August 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (2014, Issue 7), MEDLINE via Ovid (1946 to 13 August 2014), and EMBASE via Ovid (1980 to 13 August 2014). We searched the US National Institutes of Health Trials Register and the World Health Organization (WHO) International Clinical Trials Registry Platform. We placed no restrictions on the language or date of publication when searching the electronic databases.We first published the review in 2006. The update in 2013 found 302 abstracts, but none of these met the inclusion criteria of the review. SELECTION CRITERIA Parallel randomised controlled trials (RCTs) comparing slow-release fluoride devices with an alternative fluoride treatment, placebo, or no intervention in all age groups. The main outcomes measures sought were changes in numbers of decayed, missing, and filled teeth or surfaces (DMFT/DMFS in permanent teeth or dmft/dmfs in primary teeth), and progression of carious lesions through enamel and into dentine. DATA COLLECTION AND ANALYSIS We conducted data collection and analysis using standard Cochrane review methods. At least two review authors independently performed all the key steps in the review such as screening of abstracts, application of inclusion criteria, data extraction, and risk of bias assessment. We resolved discrepancies through discussions or arbitration by a third or fourth review author. MAIN RESULTS We found no evidence comparing slow-release fluoride devices against other types of fluoride therapy.We found only one double-blind RCT involving 174 children comparing a slow-release fluoride device (glass beads with fluoride were attached to buccal surfaces of right maxillary first permanent molar teeth) against control (glass beads without fluoride were attached to buccal surfaces of right maxillary first permanent molar teeth). This study was assessed to be at high risk of bias. The study recruited children from seven schools in an area of deprivation that had low levels of fluoride in the water. The mean age at the beginning of the study was 8.8 years and at the termination was 10.9 years. DMFT in permanent teeth or dmft in primary teeth was greater than one at the start of the study and greater than one million colony-forming units of Streptococcus mutans per millilitre of saliva.Although 132 children were still included in the trial at the two-year completion point, examination and statistical analysis was performed on only the 63 children (31 in intervention group, 32 in control group) who had retained the beads (retention rate was 47.7% at two years). Among these 63 children, caries increment was reported to be statistically significantly lower in the intervention group than in the control group (DMFT: mean difference -0.72, 95% confidence interval (CI) -1.23 to -0.21; DMFS: mean difference -1.52, 95% CI -2.68 to -0.36 (very low quality evidence)). Although this difference was clinically significant, it only holds true for those children who maintain the fluoride beads; over 50% of children did not retain the beads.Harms were not reported within the trial report. Evidence for other outcomes sought in this review (progression to of caries lesion, dental pain, healthcare utilisation data) were also not reported. AUTHORS' CONCLUSIONS There is insufficeint evidence to determine the caries-inhibiting effect of slow-release fluoride glass beads. The body of evidence available is of very low quality and there is a potential overestimation of benefit to the average child. The applicability of the findings to the wider population is unclear; the study had included children from a deprived area that had low levels of fluoride in drinking water, and were considered at high risk of carries. In addition, the evidence was only obtained from children who still had the bead attached at two years (48% of all available children); children who had lost their slow-release fluoride devices earlier might not have benefited as much from the devices.
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25
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Bergström EK, Birkhed D, Granlund C, Moberg Sköld U. Approximal caries increment in adolescents in a low caries prevalence area in Sweden after a 3.5-year school-based fluoride varnish programme with Bifluorid 12 and Duraphat. Community Dent Oral Epidemiol 2014; 42:404-11. [DOI: 10.1111/cdoe.12108] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 04/17/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Eva-Karin Bergström
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
- Department of Preventive and Community Dentistry; Public Dental Health Service; Västra Götaland Region; Gothenburg Sweden
| | - Dowen Birkhed
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
| | - Christina Granlund
- Specialist Clinic of Oral and Maxillofacial Radiology; Public Dental Health Service; Västra Götaland Region; Gothenburg Sweden
| | - Ulla Moberg Sköld
- Department of Cariology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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26
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Maupome G, Isyutina O. Dental Students’ and Faculty Members’ Concepts and Emotions Associated with a Caries Risk Assessment Program. J Dent Educ 2013. [DOI: 10.1002/j.0022-0337.2013.77.11.tb05624.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Gerardo Maupome
- Department of Preventive and Community Dentistry; Indiana University School of Dentistry
| | - Olga Isyutina
- Department of Preventive and Community Dentistry; Indiana University School of Dentistry
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27
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Piovesan C, Tomazoni F, Del Fabro J, Buzzati BCS, Mendes FM, Antunes JLF, Ardenghi TM. Inequality in dental caries distribution at noncavitated and cavitated thresholds in preschool children. J Public Health Dent 2013; 74:120-6. [PMID: 24020651 DOI: 10.1111/jphd.12035] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 08/02/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the inequality in dental caries distribution according to different thresholds assessed using the International Caries Detection and Assessment System (ICDAS) and to investigate the associations of socioeconomic factors with caries lesions at both noncavitated and cavitated thresholds. METHODS Study subjects were recruited in Santa Maria, Brazil, during the National Day of Children's Vaccination, and 639 children aged 12-59 months were included. Fifteen calibrated examiners performed the examinations using ICDAS criteria. Inequality in dental caries distribution was measured using the Gini coefficient, and the Significant Caries Index was calculated for several thresholds of ICDAS. Poisson regression analysis was used to assess the associations of socioeconomic factors with the highest caries scores. RESULTS The inequality in the distribution of dental caries was lower when precavitated caries were included; the Gini coefficient decreased from 0.77 to 0.60 when noncavitated caries lesions were included in the analyses. Moreover, the inequalities were higher in the younger than in the older children for all thresholds. Socioeconomic factors were significantly (P < 0.001) associated with caries when an ICDAS score of 3 was considered as the cut-off point. Children whose mothers did not complete primary education (P < 0.001) and those with low household income (P < 0.001) were more likely to have increased dental caries. CONCLUSION Caries lesions were more equally distributed when noncavitated lesions were included in the dental survey. Socioeconomic factors are found to be associated with the inequalities in caries distribution in this age group.
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Affiliation(s)
- Chaiana Piovesan
- Centro Universitário Franciscano, Santa Maria, Rio Grande do Sul, Brazil
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Cagetti MG, Campus G, Milia E, Lingström P. A systematic review on fluoridated food in caries prevention. Acta Odontol Scand 2013; 71:381-7. [PMID: 22827733 DOI: 10.3109/00016357.2012.690447] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This paper aims to provide a systematic review of the caries-prevention effect of fluoridated food, excluding water. The main aim of this review was to evaluate the presence of scientific evidence relating to the effects of fluoride intake via food on the occurrence of carious lesions. The outcome was defined as a clinical outcome, so only papers evaluating a decrease in caries indices were included. MATERIALS AND METHODS Relevant databases (Medline®, Embase®, The Cochrane Library) were searched. The date range was set from 01.01.1966 to 03.31.2011. One hundred and thirty-nine reports were identified and assessed. Only three papers fulfilled the inclusion criteria and were discussed in detail. RESULTS No paper related to the use of fluoridated salt in caries prevention fulfilled the inclusion criteria. The use of milk as a vehicle for providing additional fluoride in a dental public health programme was evaluated in two papers. The consumption of fluoridated milk was an effective measure to prevent caries in the primary teeth. The use of fluoridated sugar demonstrated a reduction in caries increment in the permanent dentition in one paper. CONCLUSIONS Literature on the effectiveness of fluoridation in foods in caries prevention is scant and almost all the studies have been conducted in children. There is low evidence that the use of milk fluoridation is effective in reducing the caries increment.
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Affiliation(s)
- Maria Grazia Cagetti
- WHO Collaborating Centre of Milan for Epidemiology and Community Dentistry, University of Milan, S. Paolo Hospital, Milan, Italy
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Abstract
The term 'population health' is part of the natural evolution of the science of epidemiology. With the recognition of the importance of a life-course approach to help understand health along with the recognition of the importance of the wider determinants of health, epidemiology requires new techniques and thinking. 'Population health' recognizes that to improve oral health, then the determinants have to be tackled. These include both those that may be described as belonging to the environment and those influenced by the care system. The key issue for policy development is the need to recognize that with globalization and the extended time frame to undertake research, partnerships will be a key necessity to help ensure success in addressing inequalities and overall levels of health.
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Affiliation(s)
- Paul Batchelor
- Dental Health Services Leadership and Management Programme, Faculty of General Dental Practice (UK), Royal College of Surgeons, London, UK.
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30
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Abstract
Periodontal diseases are highly prevalent, particularly amongst socially disadvantaged populations, impact on quality of life and are costly to treat. Clinical treatments and chairside preventive approaches alone will never adequately address this problem. Indeed in many parts of the developing world clinical care and chairside prevention are both unaffordable and inappropriate for the control of periodontal diseases. A paradigm shift away from the individualized treatment approach to a population public health model is needed to promote periodontal health and, in particular to address social inequalities in periodontal status. Public health measures need to focus on the underlying determinants of periodontal diseases. Poor hygiene, tobacco use, psychosocial factors and related systemic diseases are the main risk factors for periodontal diseases. Public health interventions need to tackle these factors but also must recognize and act upon the distal underlying influences that determine and pattern these identified risks. Recognition also needs to be placed on the interlinking and common risk factors shared by periodontal diseases and other chronic conditions. A complementary range of public health policies acting at local, regional, national and international levels need to be implemented to achieve sustainable improvements in oral health. To be effective these policies need to link across the broader public health agenda and require public engagement and support. Clinicians, public health practitioners, commercial organizations and professional groups all have an important role to play in promoting periodontal health.
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Krisdapong S, Prasertsom P, Rattanarangsima K, Adulyanon S, Sheiham A. Using associations between oral diseases and oral health-related quality of life in a nationally representative sample to propose oral health goals for 12-year-old children in Thailand. Int Dent J 2012; 62:320-30. [DOI: 10.1111/j.1875-595x.2012.00130.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Affiliation(s)
- Kaye Roberts-Thomson
- Australian Research Centre for Population Oral Health (ARCPOH); School of Dentistry; The University of Adelaide; SA; Australia
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Baelum V. Dentistry and population approaches for preventing dental diseases. J Dent 2011; 39 Suppl 2:S9-19. [PMID: 22079282 DOI: 10.1016/j.jdent.2011.10.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 10/18/2011] [Accepted: 10/24/2011] [Indexed: 12/13/2022] Open
Abstract
Dental professionals are expected to engage in oral disease prevention, but their tools limit the approach to chair side activities based on the common notion that the major dental diseases, dental caries, gingivitis and periodontitis, are behavioural diseases shaped by individual lifestyles. However, lifestyles also have causes and individual behaviours reflect cultural norms, expectations and opportunities that are socio-economically determined and structurally maintained. Importantly, the effects of the societal and socio-economic determinants reach way above their influences as individual attributes, and effective approaches to the prevention and control of oral diseases are aligned with this causal chain. Unfortunately, the ethos and philosophy of dentistry is focused to a downstream, patient-centred, curative and rehabilitative approach to oral diseases. Whilst such services are needed to care for those who have already suffered the consequences of oral diseases, they do not influence population oral health. A more balanced distribution of efforts and resources along the whole range of intervention points from the downstream curative to the upstream structural healthy policy approaches is required if appropriate, evidence-based, effective, cost-effective, sustainable, equitable, universal, comprehensive and ethical delivery of health care, including oral health care, is the goal. The implementation of healthy policies and sound approaches to population oral health will require substantial commitment and political will on the part of the public and their elected officials.
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Affiliation(s)
- Vibeke Baelum
- School of Dentistry, Aarhus University Faculty of Health Sciences, Aarhus, Denmark.
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Sheiham A, Alexander D, Cohen L, Marinho V, Moysés S, Petersen PE, Spencer J, Watt RG, Weyant R. Global oral health inequalities: task group--implementation and delivery of oral health strategies. Adv Dent Res 2011; 23:259-67. [PMID: 21490238 DOI: 10.1177/0022034511402084] [Citation(s) in RCA: 132] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This paper reviews the shortcomings of present approaches to reduce oral diseases and inequalities, details the importance of social determinants, and links that to research needs and policies on implementation of strategies to reduce oral health inequalities. Inequalities in health are not narrowing. Attention is therefore being directed at determinants of major health conditions and the extent to which those common determinants vary within, between, and among groups, because if inequalities in health vary across groups, then so must underlying causes. Tackling inequalities in health requires strategies tailored to determinants and needs of each group along the social gradient. Approaches focusing mainly on downstream lifestyle and behavioral factors have limited success in reducing health inequalities. They fail to address social determinants, for changing people's behaviors requires changing their environment. There is a dearth of oral health research on social determinants that cause health-compromising behaviors and on risk factors common to some chronic diseases. The gap between what is known and implemented by other health disciplines and the dental fraternity needs addressing. To re-orient oral health research, practice, and policy toward a 'social determinants' model, a closer collaboration between and integration of dental and general health research is needed. Here, we suggest a research agenda that should lead to reductions in global inequalities in oral health.
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Affiliation(s)
- A Sheiham
- Department of Epidemiology and Public Health, Dental Public Health Unit, London, UK.
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MacRitchie HMB, Longbottom C, Robertson M, Nugent Z, Chan K, Radford JR, Pitts NB. Development of the Dundee Caries Risk Assessment Model (DCRAM) - risk model development using a novel application of CHAID analysis. Community Dent Oral Epidemiol 2011; 40:37-45. [DOI: 10.1111/j.1600-0528.2011.00630.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Frazão P. Effectiveness of the bucco-lingual technique within a school-based supervised toothbrushing program on preventing caries: a randomized controlled trial. BMC Oral Health 2011; 11:11. [PMID: 21426572 PMCID: PMC3068992 DOI: 10.1186/1472-6831-11-11] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Accepted: 03/22/2011] [Indexed: 05/26/2023] Open
Abstract
Background Supervised toothbrushing programs using fluoride dentifrice have reduced caries increment. However there is no information about the effectiveness of the professional cross-brushing technique within a community intervention. The aim was to assess if the bucco-lingual technique can increase the effectiveness of a school-based supervised toothbrushing program on preventing caries. Methods A randomized double-blinded controlled community intervention trial to be analyzed at an individual level was conducted in a Brazilian low-income fluoridated area. Six preschools were randomly assigned to the test and control groups and 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice supervised directly by a dental assistant, was developed four times per year. At the remaining school days the children brushed their teeth under indirect supervising of the teachers. In test group, children also underwent a professional cross-brushing on surfaces of first permanent molar rendered by a specially trained dental assistant five times per year. Enamel and dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars during 18-month follow-up. Exposure time of surfaces was calculated and incidence density ratio was estimated using Poisson regression model. Results Difference of 21.6 lesions per 1,000 children between control and test groups was observed. Among boys whose caries risk was higher compared to girls, incidence density was 50% lower in test group (p = 0.016). Conclusion Modified program was effective among the boys. It is licit to project a relevant effect in a larger period suggesting in a broader population substantial reduction of dental care needs. Trial registration ISRCTN18548869.
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Affiliation(s)
- Paulo Frazão
- Public Health School, University of São Paulo, São Paulo, Brazil.
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The dental health of three-year-old children in Greater Glasgow, Scotland. Br Dent J 2010; 209:E5. [DOI: 10.1038/sj.bdj.2010.723] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2010] [Indexed: 11/08/2022]
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Abstract
BACKGROUND The aim of this study was to assess the correlates of income and income inequality with dental caries in a sample of all countries, as well as in rich countries alone. METHODS In this ecological study, the authors analyzed national data on income, income inequality and dental caries from 48 countries. Of them, 22 were rich countries (according to World Bank criteria). The authors determined income by gross national income (GNI) per capita (formerly known as gross national product) and income inequality by the Gini coefficient (a measure of income inequality on a scale between 0 and 1). They assessed dental caries according to the decayed, missing, filled teeth (dmft) index in 5- to 6-year-old children. The authors used Pearson and partial correlation coefficients to examine the linear associations of income and income inequality with dental caries. RESULTS GNI per capita, but not the Gini coefficient, was inversely correlated with the dmft index in the 48 countries. However, the results showed an opposite pattern when analyses were restricted to rich countries (that is, the dmft index was significantly correlated with the Gini coefficient but not with GNI per capita). CONCLUSION These findings support the income inequality hypothesis that beyond a certain level of national income, the relationship between income and the population's health is weak. Income inequality was correlated more strongly with dental caries than was income in rich countries. CLINICAL IMPLICATIONS Among rich countries, income inequality is a stronger determinant of childhood dental caries than is absolute income.
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Carvalho DM, Salazar M, Oliveira BHD, Coutinho ESF. O uso de vernizes fluoretados e a redução da incidência de cárie dentária em pré-escolares: uma revisão sistemática. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2010; 13:139-49. [DOI: 10.1590/s1415-790x2010000100013] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2009] [Accepted: 12/17/2009] [Indexed: 11/22/2022] Open
Abstract
O objetivo desta revisão sistemática foi verificar se existe evidência conclusiva de que o verniz fluoretado reduz a incidência de cárie dentária em pré-escolares. Foram feitas buscas nas bases eletrônicas BBO, LILACS, MEDLINE e Cochrane para identificar ensaios clínicos controlados que avaliassem o desenvolvimento de lesões cavitadas de cárie em crianças com até seis anos de idade. Dois pesquisadores analisaram criticamente os trabalhos selecionados para inclusão. Foram encontrados 513 artigos e oito foram incluídos. Esses estudos apresentaram problemas quanto ao desenho e, além disso, eram heterogêneos quanto à experiência prévia de cárie dos participantes, ao tipo de intervenção administrada ao grupo controle, à exposição das crianças a outras fontes de fluoretos, e ao intervalo entre as aplicações de verniz. As diferenças absolutas entre as incidências de cárie nos grupos controle e teste e as frações prevenidas variaram de 0,30 a 1,64 e de 5 a 63%, respectivamente. O verniz fluoretado parece ser efetivo para reduzir a incidência de cárie dentária em pré-escolares, mas outros ensaios clínicos de melhor qualidade metodológica são necessários para se obter evidência conclusiva a esse respeito.
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Dental caries risk studies revisited: causal approaches needed for future inquiries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2009; 6:2992-3009. [PMID: 20049240 PMCID: PMC2800328 DOI: 10.3390/ijerph6122992] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Accepted: 11/25/2009] [Indexed: 11/17/2022]
Abstract
Prediction of high-risk individuals and the multi-risk approach are common inquiries in caries risk epidemiology. These studies prepared the ground for future studies; specific hypotheses about causal patterns can now be formulated and tested applying advanced statistical methods designed for causal studies, such as structural equation modeling, path analysis and multilevel modeling. Causal studies should employ measurements, analyses and interpretation of findings, which are in accordance to causal aims. Examples of causal empirical studies from medical and oral research are presented.
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Campus G, Cagetti MG, Sacco G, Benedetti G, Strohmenger L, Lingström P. Caries risk profiles in Sardinian schoolchildren using Cariogram. Acta Odontol Scand 2009; 67:146-52. [PMID: 19253062 DOI: 10.1080/00016350902740498] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The aim of our study was to assess the caries risk profile in a group of Sardinian schoolchildren and to compare the outcome with their history of caries. MATERIAL AND METHODS Using the computer-based program "Cariogram", 957 subjects aged 7, 8, and 9 years were enrolled in this cross-sectional study. The children were examined to evaluate dmfs/DMFS and gingival conditions. Data on dietary and oral hygiene habits were collected and saliva was analyzed, including levels of mutans streptococci (MS) and lactobacilli (Lb). Based on the Cariogram profiles, the children were divided into five risk groups in accordance with "chance of avoiding caries". RESULTS Almost 50% of the children had a low caries risk, while more than a quarter had less than 40% "chance of avoiding caries". A significant linear trend between the five Cariogram categories and dmfs/DMFS was observed in the three age groups (p<0.001). CONCLUSIONS The Cariogram risk profile showed strong correlations to the caries experience of Sardinian schoolchildren and that efforts to reduce caries risk are necessary.
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Sánchez-Pérez L, Golubov J, Irigoyen-Camacho ME, Moctezuma PA, Acosta-Gio E. Clinical, salivary, and bacterial markers for caries risk assessment in schoolchildren: a 4-year follow-up. Int J Paediatr Dent 2009; 19:186-92. [PMID: 19399983 DOI: 10.1111/j.1365-263x.2008.00941.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND In Mexico, there is a high prevalence of dental caries and large groups of children still show extensive untreated dental damage. AIM This study aims to evaluate, in a cohort of 6-year-old Mexican children, the relationship between caries increment at 4 years and the following caries risk markers: fissure morphology, caries experience, salivary flow rate, Snyder test results, and mutans and lactobacilli counts. DESIGN To predict new caries lesions in 110 schoolchildren, clinical, salivary, and bacteriological caries risk markers were used, including fissure morphology, caries experience, salivary flow rate, Snyder test, and Streptococcus mutans and lactobacilli counts. To determine the validity of these markers, the baseline data were compared with the caries increment after 4 years. RESULTS The risk model's capacity to predict caries was moderate (specificity 79.6% and sensitivity 78.6%). Caries experience (P = 0.0001), Snyder test (P = 0.002), and fissure morphology (P = 0.024) had the strongest association with caries increment. Salivary flow rate, lactobacilli, and S. mutans counts did not contribute significantly to the prediction of caries lesions in these children. CONCLUSION In addition to the initial caries experience, tooth morphology and Snyder test proved to be useful predictors for caries. These three risk markers may be particularly useful in targeting caries prevention efforts in developing countries.
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Affiliation(s)
- Leonor Sánchez-Pérez
- Area for Research in Clinical Sciences, Health Care Department, Metropolitan Autonomous University, Mexico.
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Peres MA, Barros AJ, Peres KG, Araújo CLP, Menezes AMB. Life course dental caries determinants and predictors in children aged 12 years: a population-based birth cohort. Community Dent Oral Epidemiol 2009; 37:123-33. [DOI: 10.1111/j.1600-0528.2009.00460.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Sarmadi R, Gabre P, Gahnberg L. Strategies for caries risk assessment in children and adolescents at public dental clinics in a Swedish county. Int J Paediatr Dent 2009; 19:135-40. [PMID: 19178606 DOI: 10.1111/j.1365-263x.2008.00947.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Since caries prevalence has decreased and become polarized, high-risk preventive strategies have been widely adopted. The underlying factors leading to assessment and management of caries risk are poorly understood. AIM The aim of this study was to identify the factors forming the basis for dentist's caries risk assessment in dental care for children and adolescents. DESIGN From all 3372 children in a Swedish county identified as at high risk for developing caries, a sample of dental records from 432 children, aged 3-19 years, were randomly selected to be analysed in the study. Information about medical and social history, dental status, dietary habits, oral hygiene, and salivary data was obtained from the records. RESULTS The results show that the only data registered in the majority of the dental records were dental status from the clinical examination and bitewing radiographs. In approximately half of the dental records, medical history and data concerning oral hygiene were registered. Dental history and dietary habits were noted in approximately 25% of the dental records, whereas other risk factors/indicators were occasionally registered. CONCLUSIONS Dentists mainly base their caries risk assessments on past caries experience, a reliable risk indicator for assessing the risk of being affected by caries again. In children with no experience of caries, knowledge of other risk factors/indicators needs to be available to perform a caries risk assessment. In this study, documentation of such knowledge was strongly limited.
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Affiliation(s)
- Roxana Sarmadi
- Department of Paediatric Dentistry, Public Dental Health, Uppsala County Council, Uppsala, Sweden. roxana.sarmadi @lul.se
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Vered Y, Zini A, Livny A, Mann J, Sgan-Cohen HD. Changing dental caries and periodontal disease patterns among a cohort of Ethiopian immigrants to Israel: 1999-2005. BMC Public Health 2008; 8:345. [PMID: 18828927 PMCID: PMC2565680 DOI: 10.1186/1471-2458-8-345] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Accepted: 10/02/2008] [Indexed: 11/05/2022] Open
Abstract
Background Dental epidemiology has indicated that immigrants and minority ethnic groups should be regarded as high risk populations on the verge of oral health deterioration. The objectives of this study were to measure the changing pattern of dental caries, periodontal health status and tooth cleaning behaviour among a cohort of Ethiopian immigrants to Israel between the years 1999–2005. Methods Increment of dental caries and periodontal health status was recorded among a cohort of 672 Ethiopian immigrants, utilizing the DMFT and CPI indices. Data were gathered during 1999–2000 and five years later, during 2004–2005. Participants were asked about their oral hygiene habits in Ethiopia and in Israel five years since their immigration. Results Regarding dental caries, at baseline 70.1% of the examinees were caries-free, as compared to 57.3% after five years. DMFT had increased from 1.48 to 2.31. For periodontal health status, at baseline, 94.7% demonstrated no periodontal pockets (CPI scores 0–2) and 5.3% revealed periodontal pockets (CPI scores 3&4), compared to 75.6% and 24.4%, respectively after five years. At baseline, 74% reported cleaning their teeth exclusively utilizing chewing and cleaning sticks common in Ethiopia. After five years, 97% reported cleaning their teeth exclusively utilizing toothbrushes. Conclusion The deterioration in the oral health status, especially the alarming and significant worsening of periodontal health status, among this immigrant group, emphasizes the need for health promotion and maintenance among immigrants and minority groups in changing societies. An "acclimatizing and integrating" model of oral health promotion among minority and immigrant groups is suggested.
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Affiliation(s)
- Yuval Vered
- Department of Community Dentistry, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel.
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Cypriano S, Hoffmann RHS, de Sousa MDLR, Wada RS. Dental caries experience in 12-year-old schoolchildren in southeastern Brazil. J Appl Oral Sci 2008; 16:286-92. [PMID: 19089262 PMCID: PMC4327539 DOI: 10.1590/s1678-77572008000400011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Revised: 01/24/2008] [Accepted: 03/03/2008] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the prevalence of caries-free children using DMFT and significant caries (SiC) indexes in different caries prevalence groups in cities of the region of Campinas, São Paulo State, Brazil. The methodology proposed by the World Health Organization (1997) was used for caries diagnosis in 2,378 individuals. According to the DMFT index obtained in each evaluated city, 3 prevalence groups with representative samples were formed, being classified as low, moderate and high. SiC index was used to classify the one third of the population with the highest caries prevalence. In the low prevalence group, 32.4% of the children were caries free (DMFT=0), with mean DMFT of 2.29 and SiC index of 4.93. In the moderate prevalence group, 21.8% of the children were caries free, with mean DMFT of 3.36 and SiC of 6.74. Only 6.9% of the children in the high prevalence group were caries free and the mean DMFT was 5.54 (SiC=9.62). There was a great heterogeneity in dental caries distribution within the studied population, as well as a high caries prevalence considering the 3 classifications. Other indexes besides DMFT could be used to improve oral health assessment during establishment of the treatment plan and intervention.
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Affiliation(s)
- Silvia Cypriano
- DDS, PhD, Professor, Department of Preventive Dentistry, Pontifical Catholic University, Campinas, SP, Brazil
| | - Rosana H. S. Hoffmann
- DDS, MSc, PhD Student, Department of Cariology, Dental School of Piracicaba, State University of Campinas, Piracicaba, SP, Brazil
| | - Maria da Luz R. de Sousa
- DDS, MSc, PhD, Chair Professor, Department of Community and Preventive Dentistry, Public Health Area, Dental School of Piracicaba, State University of Campinas, Piracicaba, SP, Brazil
| | - Ronaldo S. Wada
- DDS, MSc, PhD, Professor, Department of Social Dentistry, Biostatics Area, Dental School of Piracicaba, State University of Campinas, Piracicaba, SP, Brazil
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Aida J, Ando Y, Oosaka M, Niimi K, Morita M. Contributions of social context to inequality in dental caries: a multilevel analysis of Japanese 3-year-old children. Community Dent Oral Epidemiol 2008; 36:149-56. [DOI: 10.1111/j.1600-0528.2007.00380.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Silva AND, Mendonça MHMD, Vettore MV. A salutogenic approach to oral health promotion. CAD SAUDE PUBLICA 2008; 24 Suppl 4:s521-30. [DOI: 10.1590/s0102-311x2008001600005] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Accepted: 08/07/2008] [Indexed: 11/22/2022] Open
Abstract
Theoretical frameworks on health promotion focusing on social determinants of oral health have highlighted promising approaches for improving the oral health of populations and reducing inequities in oral health. In the last two decades the salutogenic theory has gained ground in the field of health promotion, but not in oral health promotion. Instead of focusing on risk factors and behavior change, the theory highlights the importance of resources and the ability to use them. The model's central construct, sense of coherence (SOC), suggests explanations of the relationship between life stressors and health status. The stronger the SOC, the more successfully people will cope with stressors and thus maintain their health. This paper discusses the potential of the salutogenic theory to guide the development of actions in the five fields of oral health promotion: creating supportive environments; promoting health through public policy; strengthening community action; developing personal skills; and reorienting health services. The theory can serve as a framework for oral health promotion measures that strengthen the available resources, create better ones, and enable people to identify and benefit from them.
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van Palenstein Helderman WH, Van't Hof MA, van Loveren C, Bronkhorst E. Utility Technology in the Assessment of the Cut-Off between a Negative and a Positive Test in a Caries Prediction Model. Caries Res 2007; 41:165-9. [PMID: 17426394 DOI: 10.1159/000099313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2005] [Accepted: 10/02/2006] [Indexed: 11/19/2022] Open
Abstract
The methodology for the assessment of a negative or positive test in caries prediction models has not received much attention. This study aims to explain how utility technology could be applied in a caries prediction model for the assessment of the cut-off between a negative and a positive test. In this study loss of utilities was assigned to false outcomes of the prediction test. A regression equation with past caries experience variables of 11-year-old children and caries increment in the 11- to 15-year forecast period as outcome was computed. The adjusted explained variance for caries increment was 0.45. Formulas were constructed for the loss of utilities for false-negative tests whereas false-positive tests were corrected with a fixed loss of utilities. Each 11-year-old child of the 252 children was screened at various points of the regression equation. Loss of utilities was calculated for each child on the basis of the validation criterion, the outcome of the test and the actual caries increment of the child. The point on the regression equation with the least loss of utilities for the whole group was taken as the cut-off between a negative and a positive test. If the validation criterion for the prediction period was set on no caries, the prediction model resulted in a sensitivity of 84% and a specificity of 73%. This prediction model has potential when caries incidence is low and resources limited.
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Watt RG. From victim blaming to upstream action: tackling the social determinants of oral health inequalities. Community Dent Oral Epidemiol 2007; 35:1-11. [PMID: 17244132 DOI: 10.1111/j.1600-0528.2007.00348.x] [Citation(s) in RCA: 313] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The persistent and universal nature of oral health inequalities presents a significant challenge to oral health policy makers. Inequalities in oral health mirror those in general health. The universal social gradient in both general and oral health highlights the underlying influence of psychosocial, economic, environmental and political determinants. The dominant preventive approach in dentistry, i.e. narrowly focusing on changing the behaviours of high-risk individuals, has failed to effectively reduce oral health inequalities, and may indeed have increased the oral health equity gap. A conceptual shift is needed away from this biomedical/behavioural 'downstream' approach, to one addressing the 'upstream' underlying social determinants of population oral health. Failure to change our preventive approach is a dereliction of ethical and scientific integrity. A range of complementary public health actions may be implemented at local, national and international levels to promote sustainable oral health improvements and reduce inequalities. The aim of this article is to stimulate discussion and debate on the future development of oral health improvement strategies.
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Affiliation(s)
- Richard Geddie Watt
- Department of Epidemiology and Public Health, University College London, London, UK.
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