Behavioural and socioeconomic factors associated with the simultaneous occurrence of periodontal disease and dental caries

Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study

Dental caries remains the most common chronic disease in childhood. This study aimed to identify environmental stressors in children and estimate the association between salivary cortisol level as a stress biomarker and childhood caries. We conducted a case-control study involving 80 Egyptian children. The cases were 40 children with early childhood caries (ECC). The controls included 40 caries-free children. Data were collected from the parents or caregivers of the children using a questionnaire. The clinical examination included caries experience and an oral hygiene index. Saliva samples were collected and tested for unbounded cortisol levels. The results from the current study showed that the mean age for participants was 5.09 ± 0.66 years. Twenty-one of the children with ECC were girls. In multivariate regression, there is a significant association between ECC and elevated salivary cortisol levels (> 0.57 µg/dl) with an adjusted odds ratio (AOR) of 9.649 (p = 0.003), father smoking (AOR = 5.791, p = 0.030), sleeping with a bottle or food in the mouth (AOR = 8.481, p = 0.027), and poor oral hygiene evaluated through the Silness-Löe Plaque Index (AOR = 6.681, p = 0.001). As a conclusion, the study indicates that salivary cortisol is an independent stress biomarker in relation to early childhood caries. Salivary cortisol as a stress biomarker can help clinicians provide an additional assessment tool for identifying caries risk in children.

Associations Between Socioeconomic, Spatial and Educational Factors and Midlife Periodontal Disease Risk: Evidence From 'High School and Beyond'

BACKGROUND

Periodontal disease (PD) is a prevalent, preventable and treatable oral infection associated with substantial morbidity globally. There is little information from population-representative cohort studies about the sociodemographic, educational and other early life factors that stratify PD risk.

METHODS

We used data from the U.S. 'High School and Beyond' (HS&B:80) study, which has followed a nationally representative sample of 26,820 people from high school in 1980 through midlife in 2021. Data from the 1980s include information about education, early life circumstances, spatial location and demographic attributes. Data from 13,080 sample members who responded in 2021 include indicators of self-reported PD diagnosis.

RESULTS

People with higher degrees and course grades have a lower risk of midlife PD. Rural adolescents and those who attended private schools are also at lower risk. We find little evidence of heterogeneity in correlates of midlife PD by gender or race/ethnicity.

CONCLUSIONS

The quantity and characteristics of people's schooling and their location of residence are associated with midlife PD.

Consumption of ultra-processed foods and dental caries in Brazilian adolescents

This study aimed to evaluate the association between ultra-processed food (UPF) and dental caries, considering muscle mass (MM), bone mineral density (BMD), and oral hygiene habits (OHH) as mediators. This study has an analytical cross-sectional design with 2,515 adolescents (18-19 years). The main exposure - the UPF intake ratio - was established using the food frequency questionnaire. The outcome was the number of decayed teeth, according to the DMFT index. The model adjustment included socio-economic status (SES), frequency of physical activity, and concurrent risk habits (CRH) as potential confounders. Three latent variables were considered: SES (family income, economic class, household head, and adolescent education), OHH (gingival bleeding on probing index and visible plaque index), and CRH (alcohol and tobacco dependence). The analyses used structural equation modeling, estimating the standardized coefficient (SC) in three models: lumbar BMD(1), femoral BMD(2), and total BMD(3). UPF consumption had a direct (SCmodel1=0.071, SCmodel2=0.072, SCmodel3=0.071; p < 0.05) and total (SCmodel1=0.067, SCmodel2=0.068, SCmodel3=0.068; p < 0.05) effect on the number of decayed teeth. BMD and MM did not mediate the association between UPF and dental caries, but the indirect association mediated by OHH was significant in all analyses (p < 0.05). Dental Caries was explained in other specific pathways: SES→UPF→Dental Caries (SCmodel1 = 0.009, SCmodel2 = 0.008, SCmodel3 = 0.009); SES→OHH→Dental Caries (SCmodel1 = 0.033, SCmodel2 = 0.033, SCmodel3 = 0.034); CRH→UPF→Dental Caries (SCmodel1 = 0.009, SCmodel2 = 0.008, SCmodel3 = 0.008); CRH→OHH→Dental Caries (SCmodel1 = 0.029, SCmodel2 = 0.027, SCmodel3 = 0.027). Dental caries prevention should include encouraging good OHH, healthy eating, and developing equitable public policies in middle and low-income countries like Brazil.

Nomogram prediction of caries risk among schoolchildren age 7 years based on a cohort study in Shanghai

Objective

Caries risk assessment tools are essential for identifying and providing treatment for individuals at high risk of developing caries. We aimed to develop a nomogram for the assessment and evaluation of caries risk among Chinese children.

Methods

We enrolled schoolchildren age 7 years from a primary school in Shanghai. Baseline information of participants was collected using a questionnaire completed by children’s caregivers. A nomogram of a novel prediction scoring model was established based on predictors detected in univariate and multivariate analyses. Predictive accuracy and discriminative ability of the nomogram were calculated using the concordance index (C index). The bootstrap method (1000 samples) was used to decrease overfitting. The net benefit of the model was validated using decision curve analysis.

Results

Overall, 406 children with complete information and two completed dental examinations were included in the final analysis. The nomogram based on logistic regression model coefficients demonstrated a C index of 0.766 (95% confidence interval: 0.761–0.771) for caries risk. The net benefit of the decision curve analysis was 38.6% at 55% threshold probability.

Conclusion

This nomogram model, derived using dietary habits, oral hygiene status, and caries experience, showed promising predictive ability to assess the caries risk among Chinese children.

Regional Variation in Restorative Treatment Need among Finnish Young People

Aim

To evaluate the regional variation in restorative treatment need among Finnish young people based on the socioeconomic factors.

Materials and Methods

This cross-sectional study was conducted in 20 garrisons of the Finnish Defence Forces in January and July 2011. The study population comprised 13,819 Finnish conscripts born in the beginning of 1990s, including females. A computer-based survey was done together with clinical oral examination to gather background information, e.g., educational status. Furthermore, average annual income of the conscript's residence municipality was achieved from the Statistics of Finland. The zip code of the place of residence of each conscript was later extracted from the Mildoc^® system. Georeferenced place of residence and income status were merged as information on provinces' level in a dataset. The association between the outcome variable and explanatory variables was determined by using the generalized linear mixed model, and geomaps were constructed.

Results

Mean D value was 1.41 ranging from 0.89 (Kymenlaakso) to 2.33 (Kainuu). Higher education and high-income level were protective factors for restorative treatment need. Restorative treatment need was also low in those areas with high (OR: 0.70, 95% CI: 0.56–0.87) and medium (OR: 0.79, 95% CI: 0.70–0.89) yearly income compared to low yearly income. The high odds for the need of restorative treatment were discovered in Northern Ostrobothnia (OR: 2.26, 95% CI: 1.53–3.33) followed by Central Ostrobothnia (OR: 2.08, 95% CI: 1.17–3.70), Uusimaa (OR: 1.55, 95% CI: 1.16–2.08), and Central Finland (OR: 1.54, 95% CI: 1.10–2.16) compared to Varsinais-Suomi.

Conclusion

In conclusion, there is a significant regional variation in restorative treatment need among Finnish young people in their twenties based on the socioeconomic factors.

Relationship between Chinese Baijiu consumption and dental caries among 55- to 74-year-old adults in Guangdong, southern China: a cross-sectional survey

Background

Whether an association between alcohol consumption and dental caries exists is still unclear. Chinese Baijiu is the most common alcohol consumed by middle-aged and elderly Chinese individuals. This study aimed to assess the relationship between alcohol consumption (Chinese Baijiu) and dental caries in Guangdong Province, southern China.

Methods

A cross-sectional study was conducted in Guangdong Province using a multistage, stratified, equal-sized, random sampling strategy. In total, 576 individuals aged 55–74 were recruited to fill out a questionnaire through face-to-face and one-on-one interviews and to undergo a series of dental examinations with a Community Periodontal Index (CPI) probe. According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of dental caries was determined by the DFT/DFRoot (decayed-filled tooth/root) index. The ratios of males to females and urban people to countrymen were both 1:1. Then, the chi-square test and rank-sum tests were used to compare the differences in caries between subgroups, and multivariate logistic regression analyses, as well as negative binomial regression analyses, were executed to identify the potential relationship between alcohol consumption and caries.

Results

The prevalence of crown caries was 79.17% with a DFT index of 3.19, while that of root caries was 61.28% with a DFRoot index of 2.08. The prevalence and mean tooth of crown caries of females were higher than those of males. The prevalence and mean DFRoot of root caries in rural areas were higher than those in urban areas. The results of the multivariate logistic regression analysis and negative binomial regression analysis showed that there was a statistically significant negative correlation between the consumption frequency of Chinese Baijiu and caries (often vs. never/rarely, crown caries: odds ratio (OR) = 0.54, 95% confidence interval (CI): 0.26–1.13, P = 0.103, incidence rate ratio (IRR) = 0.63, 95% CI: 0.44–0.92, P = 0.015; root caries: OR = 0.47, 95% CI: 0.24–0.93, P = 0.030, IRR = 0.52, 95% CI: 0.32–0.54, P = 0.008).

Conclusions

Within the limitations of this study, frequent consumption of Chinese Baijiu was a protective factor for caries in middle-aged and elderly people in Guangdong Province. However, considering the harm of alcohol to one’s general health, it is recommended to drink moderately and avoid alcohol abuse.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02453-x.

Fear of COVID-19 in Madrid. Will patients avoid dental care?

Introduction

The objective of this research is to describe how perceived infectability, germ aversion, and fear of COVID-19 in adults in Madrid have changed from the beginning of the pandemic until the lockdown exit phase and their influence on dental care behaviour.

Materials and Methods

Some 961 participants were monitored in a study in Madrid at 2 time points: before lockdown (T0) and after completion of the total lockdown (T1). A questionnaire that included basic sociodemographic variables, the perceived vulnerability to disease scale (including perceived infectability and germ aversion), the fear of COVID-19 scale, and dental visiting behaviour after confinement for fear of COVID was administered.

Results

The participants had higher scores for infectability and germ aversion at T1 than at T0 (P < 0.01). Of those studied, 24.5% (235) of the participants would not go to the dentist for fear of COVID-19. Those who had a high perceived infectability scale score were at least 5 times more likely to not visit the dentist. Those with high COVID-19 fear were at least 6 times more likely to not visit the dentist, and those older than 60 years were 8 times more likely to not visit.

Conclusions

The population's high levels of vulnerability to infectability and perceived germ aversion associated with fear of COVID-19 and the resultant avoidance behaviour to dental care will remain until an effective drug or vaccine for SARS-CoV2 is found.