The impact of oral health literacy and family cohesion on dental caries in early adolescence

An Assessment of Oral-Health-Related Quality of Life and Anxiety in Early Adolescents (11-14 Years) at Their First Dental Visit: A Cross-Sectional Study

Background: Knowing the oral-health-related quality of life (OHRQoL) status of pediatric patients would be helpful in analyzing their level of dental anxiety before their first visit to a pediatric dentist. However, few studies have analyzed OHRQoL and anxiety in early adolescent patients. The aim of this study was to describe the OHRQoL and anxiety levels of early adolescents, according to age and sex, at their first dental examination. Methods: A cross-sectional study was conducted on early adolescents (11-14 years old) attending their first dental examination in 2023-2024. OHRQoL was assessed using the Spanish version of the Child Perceptions Questionnaire 11-14 (CPQ-Esp11-14) and anxiety using the State-Trait Anxiety Inventory in Children (STAIC). Results: A total of 130 early adolescents were assessed, with an average age of 12.6 years (±1.06) and an equal sex distribution (65 boys and 65 girls). Among the analyzed sample, the OHRQoL dimension with the highest score was social well-being (15.01 ± 10.7), whereas the oral symptoms dimension (8.6 ± 4.25) had the lowest impact. There were no statistically significant differences between female and male early adolescents in the anxiety state or anxiety-trait dimensions or in the dimension of OHRQoL, except for oral symptoms, which were higher in boys (9.48 ± 4.51 versus 7.72 ± 3.81). Similarly, no significant differences were found based on age regarding anxiety or OHRQoL. Conclusions: Considering the limitations of this study, it can be concluded that higher levels of anxiety negatively impacted the OHRQoL of the early adolescent population studied.

Oral health care knowledge among Phenylketonuria patients in the Latvian population

Background

Phenylketonuria (PKU) is an autosomal recessive inherited disorder of phenylalanine (Phe) metabolism that results from a deficiency of phenylalanine hydroxylase (PAH). Patients with PKU rely on amino acid mixtures and low-protein diets, which often exhibit an acidic nature and pose various challenges to oral health. The objective of the study was to evaluate oral care habits of PKU patients in Latvia and the impact of the recommendations developed on improving oral care.

Materials and methods

In this study, during a one-month interval before and after the implementation of oral hygiene recommendations, questionnaires were distributed to all patients with PKU diagnosed in Latvia, with a response rate of 78 % (79 of 101).

Results

The group older and 18 years of age showed a poorer understanding of oral care even after receiving recommendations, 82 % brushing their teeth twice a day (92 % in the group <18 years of age), continuing 57 % rinsing their mouth after using amino acid formula (75 % in the younger group). Significant improvements were observed only in the respondent group younger than 18 years of age - including increases in toothbrushing twice a day by 25 % (p = 0.001), dental flossing by 23 % (p = 0.001), mouth rinsing after amino acid-based formula by 13 % (p = 0.020).

Conclusion

This study concludes that PKU patients older and 18 years of age have a poor understanding of maintaining oral hygiene and the use of the necessary supplements to improve it. Activities are needed in the future that would regularly remind and motivate PKU patients to take care of their oral health.

Oral health manifestations and the perceived quality of life among Saudi children: a cross-sectional study

Background

This cross-sectional study addresses scarcity of evidence on oral health issues among Saudi children and their impact on quality of life (OHRQL). We aimed to investigate parental reports of oral health problems in children and their effect on their OHQRL.

Methods

Parents of children aged 2-11-years from Five-Saudi regions participated from February 2021 to July 2021 by completing an electronic, self-administered questionnaire structured according to World Health Organization-Oral Health Questionnaire for children. It comprises questions on children experiencing oral pain/discomfort, oral lesions/manifestations and reduction in their OHRQL.

Results

Among 1,516 responders, 1,107 (73.0%) reported that their children experienced toothache/discomfort. The possibility of parents reporting toothache/discomfort or oral manifestations decreased with younger children. For children aged 2-5 years, the odds ratio (AOR) was 0.18 (95% CI [0.13-0.24], P < 0.001) for toothache and 0.58 (95% CI [0.45-0.74], P < 0.001) for oral manifestations. For children aged 6-8 years, the AOR was 0.57 (95% CI [0.4-0.81], P = 0.002) for toothache. Additionally, parents of younger children less frequently reported reduced OHRQL with AORs of 0.58 (95% CI [0.45-0.73], P < 0.001) for children aged 2-5 years and 0.64 (95% CI [0.49-0.83], P < 0.001) for those aged 6-8 years. Lower parental education increased AORs, with values of 1.575 (95% CI [1.196-2.074], P = 0.001) and 1.505 (95% CI [1.208-1.876], P < 0.001) for younger and 6-8-year-old children, respectively.

Conclusion

Results revealed notable prevalence of toothache/discomfort and oral manifestations in children reported by parents, which was related to age and parental education; ultimately leading to reduction in their OHRQL.

Factors Associated with Dental Care Utilization for Oral Disease Prevention Among Adolescents in Multicultural Families in Republic of Korea

OBJECTIVES

This study utilized data from the 2022 Korea Youth Risk Behavior Survey to examine the utilization of preventive dental care among adolescents from multicultural families and analyze the associated factors.

METHODS

The number of adolescents from multicultural families, based on parental nationality, was 1361. The dependent variables were asymptomatic dental visits, sealant experience, and scaling experience. The independent variables included health perception factors (subjective health status, subjective oral health status), health behaviors (fruit consumption frequency, vegetable consumption frequency, sugary drink consumption frequency, drinking experience, smoking experience), and oral health behaviors (daily tooth-brushing frequency, tooth brushing after lunch, use of oral care products, oral symptom experience). Confounding variables included demographic variables (age, grade) and socioeconomic variables (academic performance, economic level, parental education level, mother's nationality). Statistical analyses were conducted using a complex samples cross-tabulation and complex samples logistic regression.

RESULTS

Asymptomatic dental visits were significantly associated with subjective oral health status and sugary drink consumption. Those who perceived their oral health as "Healthy" had an odds ratio (OR) of 3.34 (CI = 1.76-6.32; p < 0.001), and those who perceived themselves "Normal" had an OR of 2.03 (CI = 1.08-3.82; p = 0.029). A sugary drink consumption of less than three times per week was linked with an OR of 1.68 (CI = 1.05-2.70; p = 0.031). Sealant experience was associated with brushing before bedtime (OR = 2.27, CI = 1.18-4.35; p = 0.014) and using more than one oral care product (OR = 1.97, CI = 1.27-3.07; p = 0.003). Scaling experience associated with oral symptoms (OR = 1.94, CI = 1.21-3.11; p = 0.006).

CONCLUSIONS

To enhance access to preventive dental care utilization for adolescents from multicultural families, efforts are needed to raise subjective oral health awareness, improve oral health behaviors, and develop strategies that ensure timely preventive dental care.

Perception of parents and caregivers about the need for dental appointments for adolescents from a Brazilian birth cohort

OBJECTIVE

To investigate the perception of parents or caregivers regarding the need for dental appointments for adolescents aged 12-13 years and associated factors.

METHODS

Data from the Pelotas 2004 Birth Cohort were used. The outcome variable was the need for dental appointments for young adolescents perceived by parents or caregivers. Demographic and economic exposure variables were obtained from the first (2004) and sixth general follow-up (2015), respectively. The exposure variables 'previous history of dental pain', 'self-rated oral health', clinical variables and the outcome variable were obtained from the second oral health follow-up (2017). Unadjusted and adjusted multivariate Poisson regression analyses provided prevalence ratios (PR) and respective 95% confidence intervals (CI).

RESULTS

At the first oral health follow-up (2009), 1303 five-year-old children were recruited, 996 of whom were reassessed and underwent oral health examinations at 12 and 13 years of age (response rate: 76.4%). The findings showed that 72.4% of parents/caregivers perceived that the adolescents needed dental appointments. No associations were found between the outcome and sociodemographic or economic variables. After adjustments, the outcome remained positively associated with previous history of toothache (PR 1.22; 95% CI 1.14-1.32), self-rated oral health as fair or poor (PR 1.26; 95% CI 1.15-1.39), the presence of dental caries (PR 1.27; 95% CI 1.20-1.38) and severe or disabling malocclusion (PR 1.14; 95% CI 1.05-1.25).

CONCLUSIONS

The perception of parents/caregivers regarding the need for dental appointments on the part of their adolescent sons and daughters was associated with oral health problems, and these findings can serve as the basis for creating and improving oral health programmes that seek a better understanding on the part of parents and caregivers regarding the importance of integral care for their adolescent children.

Individual and Contextual Factors Associated with Adolescents' Self-Perceived Need for Treatment

The present study aimed to investigate associations between the self-perceived dental treatment need and clinical factors, familial characteristics, and school context in adolescents. A cross-sectional study was conducted with a representative sample of 746 students aged 15 to 19 years in a medium-sized city in Brazil. Data collection involved the use of a sociodemographic questionnaire, an oral health questionnaire, and the Family Adaptability and Cohesion Scales (FACES III) instrument. Clinical examinations were performed by two trained and calibrated examiners (Kappa > 0.80) using the Nyvad criteria. A robust logistic regression analysis for complex samples was performed using a multilevel approach (α = 5%). The individual factors associated with the self-perceived treatment need were dental pain (OR = 1.08; 95% CI: 1.01-1.16), the loss of the first molars (OR = 1.09; 95% CI: 1.03-1.15), and disengaged family cohesion (OR = 1.15; 95% CI: 1.01-1.31). In terms of context, attending a public school was associated with the self-perceived treatment need (OR = 1.17; 95% CI: 1.02-1.33). Thus, the individual factors of toothache, tooth loss, and a disengaged family, as well as the school context, exerted an influence on the self-perceived treatment need.

Systems mapping of multilevel factors contributing to dental caries in adolescents

Dental caries is a prevalent chronic disease among adolescents. Caries activity increases significantly during adolescence due to an increase in susceptible tooth surfaces, immature permanent tooth enamel, independence in pursuing self-care, and a tendency toward poor diet and oral hygiene. Dental caries in permanent teeth is more prevalent among adolescents in low-income families and racial/ethnic minority groups, and these disparities in adolescent dental caries experience have persisted for decades. Several conceptual and data-driven models have proposed unidirectional mechanisms that contribute to the extant disparities in adolescent dental caries experience. Our objective, using a literature review, is to provide an overview of risk factors contributing to adolescent dental caries. Specifically, we map the interactive relationships of multilevel factors that influence dental caries among adolescents. Such interactive multilevel relationships more closely reflect the complex nature of dental caries experience among the adolescent population. The methods that we use are two-fold: (1) a literature review using PubMed and Cochrane databases to find contributing factors; and (2) the system dynamics approach for mapping feedback mechanisms underlying adolescent dental caries through causal loop diagramming. The results of this study, based on the review of 138 articles, identified individual, family and community-level factors and their interactions contributing to dental caries experience in adolescents. Our results also provide hypotheses about the mechanisms underlying persistence of dental caries among adolescents.

Conclusions

Our findings may contribute to a deeper understanding of the multilevel and interconnected factors that shape the persistence of dental caries experience among adolescents.

Predictors associated with malocclusion in children with and without sleep disorders: a cross-sectional study

The aim of the present study was to investigate predictors of malocclusion in Brazilian schoolchildren eight to ten years of age based on a causal directed acyclic graph model. A cross-sectional study was conducted with 739 schoolchildren eight to ten years of age. Parents/guardians provided information on sleep disorders of the child (Sleep Disturbance Scale for Children) and family characteristics (Family Adaptability and Cohesion Evaluation Scale). The diagnosis of malocclusion was performed by four trained examiners using the Dental Aesthetic Index. Control variables were selected using a directed acyclic graph. Descriptive analysis was performed, followed by robust logistic regression analysis for complex samples (α = 5%). The following variables were associated with malocclusion in the final model: sleep disorders (OR = 2.61; 95%CI: 2.43-2.86), mouth breathing (OR = 1.04; 95%CI: 1.02-1.99), non-nutritive sucking habits (OR = 2.45; 95%CI: 2.37-4.85), and obesity (OR = 1.54; 95%CI: 1.02-2.33). Sociodemographic characteristics, family functioning, and premature tooth loss did not remain associated with malocclusion. Sleep disorders, mouth breathing, sucking habits, and obesity are predictors of malocclusion in schoolchildren eight to ten years of age.

Socioecological determinants of child oral health-A scoping review

OBJECTIVES

Child oral health is a result of interactions between multilevel influences within a complex system. Understanding those interactions informs conceptualizing a socioecological framework of important influences on oral health. This paper aimed to present a scoping review on the determinants of dental caries and their interactions in childhood and adolescence.

METHODS

The two review questions were as follows: Which factors are determinants of child dental caries? and, How do determinants interact within and across socioecological levels? The three main electronic databases for biomedical records, PubMed, Web of Science and Scopus were searched, followed by reference check. The search and screening/selection procedures followed an a priori strategy and inclusion/exclusion criteria were specified in advance. The main components of the strategy were participants, concept and context. Following the final selection, eligible studies were assessed with quality appraisal tools for the risk of methodologic biases. Determinants reported in the included studies were then assigned to the micro-, meso-, exo- or macro-systems levels in a socioecological framework. Interactions between determinants were also identified and reported.

RESULTS

A total of 100 studies were included after removal of duplicates, screening on the title/abstracts and full-text assessment among 3313 records initially identified. A higher number of studies included were cross-sectional studies published in recent years. The majority of determinants found to influence child dental health were assigned to microsystem level within the framework. However, determinants were found at all levels and interactions were reported within and between socioecological levels. Determinants identified in the scoping review represent factors at different socioecological levels that influence child oral health.

CONCLUSION

Application of a socioecological model through a complex systems approach should lead to valid and robust progress towards practical solutions for better child oral health globally.

Longitudinal study for dental caries calibration of dentists unexperienced in epidemiological surveys

This study aimed to make a longitudinal analysis of interexaminer calibration reproducibility in diagnosing dental caries in posterior teeth, by examiners without previous experience in epidemiological studies. A group of 11 inexperienced examiners underwent theoretical-practical training and calibration assessments, assisted by a standard examiner. An examiner who did not participate directly in the research selected 5-year-old children with and without caries. The D3 diagnostic threshold was used to evaluate dental caries, based on the World Health Organization (WHO) criteria. The initial calibration (baseline) was performed after the theoretical-practical training session, and consisted of examining 20 children; the second calibration occurred three months later, and involved evaluating another 18 children. The interexaminer agreement was obtained by kappa statistics, and by overall percentage agreement. The paired t-test was applied to compare the values for kappa means and overall percentage agreement between the time points studied. At baseline, the values for kappa (> 0.81) and overall percentage agreement (> 95.63%) were considered high. At the 3-month calibration assessment, all the examiners showed some decrease in both kappa (p < 0.0001) and overall percentage agreement (p = 0.0102). The calibration process currently proposed by the WHO is effective. However, reproducibility was not maintained over time for inexperienced examiners evaluating the posterior teeth of 5-year-old children, under epidemiological conditions.

Relation between caries experience and the consumption of sweetened drinks and processed food in children: A population-based study

OBJECTIVES

Diet can play a role in caries disease and the consumption of ultra-processed foods has increased over the years. The purpose was to propose predictive models on the relation between caries experience, diet, sex, and oral health aspects.

METHODS

This cross-sectional study included 5213 schoolchildren aged 2-11 years and a questionnaire based on WHO Oral Health Survey was applied to assess the intake of sugary foods, oral hygiene practices, access to health services and parents' perception; dmft/DMFT index, biofilm accumulation and orthodontic treatment need were assessed by 6 calibrated dentists.

RESULTS

The logistic model showed that female sex and presence of biofilm increased the chance of having early childhood caries; besides, this chance increased by 17% for each additional day of sweetened drink intake. In children aged 6-11 years, a negative binomial regression model showed that the absence of biofilm and frequency of toothbrushing were related to lower caries index, while male sex and the consumption of salty snacks and cake/cookies were related to higher dmft+DMFT index. Disagreement or weak agreement between caregivers' perception of the presence of dental caries and children's need for dental treatment was found.

CONCLUSION

Early childhood caries was dependent on the consumption of sweetened drinks and the presence of biofilm, while in older children the caries experience was predicted by the consumption of snacks, cakes and biscuits, biofilm accumulation and toothbrushing frequency, emphasizing the need of health education to encourage healthy eating habits and oral care with an approach to parents/caregivers to prevent dental caries development.

Orofacial dysfunction, nonnutritive sucking habits, and dental caries influence malocclusion in children aged 8-10 years

INTRODUCTION

Malocclusion is one of the most prevalent oral health problems and can affect self-esteem, social relations, and oral health-related quality of life. The present study aimed to evaluate associations between malocclusion and orofacial dysfunction, nonnutritive sucking habits, cavitated carious lesions, and anxiety in Brazilian children.

METHODS

An analytical cross-sectional study was conducted with a representative sample of 739 children aged 8-10 years. Parents or guardians provided sociodemographic data and information on the nonnutritive sucking habits of the children. The children answered the Revised Children's Manifest Anxiety Scale. Four trained examiners examined the children for the diagnosis of malocclusion (dental aesthetic index), dental caries (International Caries Detection and Assessment System), and orofacial dysfunction (Nordic Orofacial Test-Screening). The control variables were selected using a directed acyclic graph. Descriptive statistics were performed, followed by unadjusted and adjusted robust logistic regression analysis (P <0.05).

RESULTS

The following variables remained associated with the occurrence of malocclusion in the final model: nonnutritive sucking habits (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.25-4.08), orofacial dysfunction (OR, 1.56; 95% CI, 1.13-2.17), and cavitated carious lesion (OR, 1.39; 95% CI, 1.03-1.89).

CONCLUSIONS

Nonnutritive sucking habits, orofacial dysfunction, and cavitated carious lesions were associated with the presence of malocclusion in children aged 8-10 years.

Validity of data collection methods for time spent, professional involvement and treatment volume for the purpose of cost-effectiveness studies in dentistry

OBJECTIVES

Economic evaluations can support provision of adequate and affordable oral care, requiring valid information on costs. The aim was to assess the validity of (a) patients' self-report (PS) and routine electronic patient records (EPR) regarding time spent per visit and (b) PS regarding types of treatment and type of dental professionals involved.

METHODS

Data were collected in four dental clinics regarding time spent using PS and EPR, on types of treatment and dental professionals involved using PS. As reference standard for time spent, independent research assistants (RA) collected data on time per visit using stopwatches. As reference standard for types of treatment and of dental professionals involved, we used the dental clinic's Electronic Patient Files (DEPF). The two one-sided tests (TOST) equivalence procedure for the difference between paired means for time and kappa statistics for treatment and professional were used to assess agreement of data collection methods with the reference standards.

RESULTS

Equivalence and agreement was good between (a) PS and RA registration concerning waiting time, appointment time and total time spent and (b) EPR and DEPF concerning appointment time. Agreement between PS and DEPF concerning types of treatment was moderate to fair (kappa values between 0.49 and 0.56 for preventive consultation, restoration, radiographs and extractions and between 0.15 and 0.26 for fluoride applications and sealants). Agreement between PS and DEPF for dental professional involved was fair (kappa = 0.41).

CONCLUSIONS

Data collection regarding time using PS and EPR was valid. Data collection via PS on treatment and professionals involved were not sufficiently valid and should occur via DEPF.

Factors associated with awake bruxism according to perceptions of parents/guardians and self-reports of children

BACKGROUND

Bruxism is a repetitive activity of the masticatory muscles that has been associated with orofacial disorders and psychosocial factors AIM: The aim of this study was to investigate associations between possible awake bruxism (PAB) and family functioning, bullying, and dental caries in children 8-10 years of age.

DESIGN

A school-based study was conducted with 739 pairs of parents/guardians and children. The parents/guardians answered the Family Adaptability and Cohesion Evaluation Scales for the establishment of family functioning. Information on bullying due to dental conditions was collected from the children. Dental caries in the children was evaluated using International Caries Detection and Assessment System criteria. A directed acyclic graph was used to define the theoretical model and select control factors. Descriptive analysis was performed, followed by multivariate logistic regression for complex samples.

RESULTS

Considering the parental reports, fewer years of mother's schooling, a low family income, very flexible family adaptability, and cavitated dental caries were associated with PAB. The female sex, bullying, and orofacial dysfunction were associated with self-reported PAB.

CONCLUSIONS

Therefore, the factors associated with PAB differ according to the reports of parents/guardians or self-reports of children. Healthcare providers should consider both reports for a more effective intervention addressing PAB.

Contributions of school context to caries on anterior teeth: a multilevel analysis

OBJECTIVE

To investigate whether oral health literacy (OHL) and school context are associated with untreated dental caries on the anterior teeth of adolescents.

METHODS

A representative cross-sectional study was conducted with 746 students aging 15 to 19 in the city of Campina Grande, Brazil. The guardians answered a questionnaire addressing sociodemographic data and the absence/presence of private health insurance. Two examiners were trained for the diagnosis of dental caries using the Nyvad criteria and the measurement of OHL using the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) (Kappa > 0.80). Contextual aspects of the schools were obtained from the 2017 National School Census. Descriptive statistics were conducted, followed by unadjusted and adjusted robust negative binomial regression for complex samples (p < 0.05).

RESULTS

The average number of anterior teeth with untreated caries was 0.95 (SD = 1.77). Among individual factors, the male sex (RR = 1.64; 95%CI: 1.24–2.16), inadequate level of OHL (RR = 2.03; 95%CI: 1.13–1.63), marginal level of OHL (RR = 1.87; 95%CI: 1.05–3.33) and not having private health insurance (RR = 1.34; 95%CI: 1.07–1.68) were associated with untreated caries on anterior teeth. Among school contextual factors, the number of students in the classroom (RR = 2.64; 95%CI: 1.78–3.93), number of public oral health services in the district (RR = 0.14; 95%CI: 0.05–0.39) and average income of the district in which the school is located (RR = 0.99; 95%CI: 0.98–0.99) were associated with the outcome.

CONCLUSIONS

Sociodemographic factors, having private health insurance, OHL, and school context exerted an influence on the occurrence of untreated dental caries on anterior teeth in adolescents aging 15 to 19.

The impact on the quality of life caused by the early loss of primary molars

INTRODUCTION

Evidence regarding the impact of early loss of primary molars (ELPM) on Oral Health-Related Quality of Life (OHRQoL) is lacking. The aim of the present study was evaluating the impact of ELPM on OHRQoL of Brazilian schoolchildren aged 6-10 years.

METHODS

This observational prospective cohort study was conducted with 163 schoolchildren, assigned in the primary tooth loss group (PTLG), in which all tooth loss was caused by carious lesions, and in a control group without tooth loss (CG). Two calibrated examiners conducted the clinical oral assessments to determine caries experience and tooth loss. OHRQoL was assessed using the Child Perception Questionnaire 8-10 years (CPQ8-10) instrument administered at baseline and at 10-12 months of follow-up.

RESULTS

Children in PTLG exhibited significantly more negative impact on OHRQoL at baseline (p < 0.01) than CG, and also after the follow-up period (p < 0.01). It was also possible to observe a significant reduction in the negative impact on OHRQoL in both CG and PTLG in the longitudinal analysis (p < 0.01). Nevertheless, there was an even more substantial reduction in the negative impact on OHRQoL in children in PTLG.

CONCLUSIONS

This study provides evidence that early tooth loss is associated with negative impact on OHRQoL. Moreover, it indicates that access to dental treatment can have a positive impact on the OHRQoL of children with dental caries and ELPM.

Analysis of the correlation between malocclusion, bad oral habits, and the caries rate in adolescents

BACKGROUND

Malocclusion deformity and caries are common oral diseases in adolescents. In order to explore the correlation between malocclusion deformity and caries prevalence in adolescents, this study analyzed the influence of factors such as poor oral habits on caries in adolescents.

METHODS

In this study, 1,093 adolescents aged 11 to 14 enrolled in 2-3 schools in Zhangjiakou area from September 2020 to June 2021 were selected as the research subjects. The basic data of these adolescents were collected by questionnaires. Malocclusion and caries were examined by on-site inspection. Their bad oral habits were also investigated. After data collection, the chi-square test, logistic regression, the Mann-Whitney U test, and the Kruskal-Wallis H test were used for multivariate analysis.

RESULTS

The results showed that the incidence of malocclusion was 72.66% and the caries rate was 68.8% among adolescents aged 11-14 in this area. The 4 bad oral habits of biting, mandibular protrusion, lateral chewing, and mouth breathing were the influencing factors of malocclusion in adolescents. Bad oral habits, malocclusion, and frequent consumption of sugary beverages were independent risk factors for caries in adolescents, and significantly positively correlated with the caries rate.

CONCLUSIONS

Malocclusion and the four bad oral habits were independent risk factors of caries in adolescents.

Attention-deficit/hyperactivity disorder and oral health literacy exert an influence on the occurrence of dental caries in early adolescence

Little is known regarding the influence of psychosocial factors on dental caries at early adolescence. The study aimed to investigate associations between family environment, attention-deficit/hyperactivity disorder (ADHD) and oral health literacy (OHL) with dental caries experience in early adolescence. A cross-sectional study was conducted with a representative sample of 448 12-year-old adolescents at public and private schools in North-eastern Brazil. Parents/guardians and teachers answered the Brazilian version of the inattention and hyperactivity/impulsivity subscales (SNAP- IV) for the evaluation of ADHD and a sociodemographic questionnaire. An OHL instrument (BREALD-30) and the Family Adaptability and Cohesion Scales (FACES III) were administered to the adolescents. Caries experience (DMFT) was the dependent variable. Data analysis involved Poisson regression with robust variance (α = 5%). Adolescents with more symptoms of ADHD (teachers' reports) (RR: 1.73; 95% CI: 1.31-2.28), those with lower OHL (RR: 1.59; 95% CI: 1.01-2.51), those with a lower family income (RR: 1.38; 95% CI: 1.03-1.83), and those from families with a greater number of residents in the home (RR: 1.18; 95% CI: 1.06-1.31) had greater caries experience. Family adaptability and cohesion were not associated with caries experience. Dental caries experience in early adolescence was influenced by symptoms of ADHD, OHL, and sociodemographic factors.

Family Cohesion Is Associated with the Self-Perceived Need for Dental Treatment among Adolescents

This study explored the association between family cohesion and self-perceived need for dental treatment among adolescents. A school-based representative cross-sectional study was conducted with 746 students aged 15 to 19 randomly selected from schools in Campina Grande, Brazil. Parents/guardians provided information on sociodemographic data, and students completed questionnaires about the self-perceived need for dental treatment, dental pain, and family cohesion and adaptability (FACES III). Two dentists were trained (kappa >0.80) to diagnosis dental caries using the Nyvad criteria and assess adolescents' level of functional oral health literacy (BREALD-30). Descriptive analysis was performed, followed by nonadjusted and adjusted robust binary logistic regression for complex samples (α = 5%). The prevalence of self-perceived need for dental treatment was 88.6%. The presence of dental caries (OR = 2.10; IC 95%: 1.22-3.61), tooth loss (OR = 15.81; IC 95%: 2.14-116.56), dental pain in the last six months (OR = 1.87; IC 95%: 1.06-3.31), and enmeshed family cohesion type (OR = 10.23; IC 95%: 3.96-26.4) remained associated with the self-perceived need for dental treatment in the final model. In conclusion, dental caries, dental pain, tooth loss, and family cohesion influenced the self-perceived need for dental treatment in adolescents.

Do social inequalities persist in the distribution of dental caries in adolescents from Maranhão? Contributions of a population-based study

This study aimed to analyze the association of socioeconomic factors with the prevalence of dental caries in adolescents from São Luís, Maranhão, Brazil, to answer whether social inequalities persist in distributing this disease. This is a cross-sectional study nested in a prospective cohort. We included 2,413 adolescents aged 18-19 years evaluated in the 2016 second follow-up. The outcome was teeth with untreated dental caries (yes or no) assessed by the DMFT index. Socioeconomic and demographic characteristics were the independent variables. Descriptive statistical and Poisson regression analyses were performed, calculating crude and adjusted prevalence ratios (PRs) (alpha=5%). Belonging to economic classes C (PR=1.23; 95% CI: 1.11-1.37) or D-E (PR=1.48; 95% CI: 1.32-1.65), being married/living with a partner (PR=1.22; 95% CI: 1.07-1.39), having separated parents (PR=1.11; 95% CI 1.03-1.19) and a greater number of people in the household (PR=1.05; 95% CI: 1.03-1.07) were associated with a higher prevalence of dental caries. Social inequalities in adolescent oral health persist despite the implementation of the National Oral Health Policy. The current health care model should seek to reorient health education strategies, targeting them at vulnerable populations.

Assessment of Parents' Oral Health Literacy and Its Association with Caries Experience of Their Preschool Children

(1) Purpose: To assess the oral health literacy (OHL) of parents and its association with the caries experience of their preschool children attending the Hospital University Sains Malaysia (HUSM), Kota Bharu, Kelantan, Malaysia. (2) Materials and Methods: This is a descriptive cross-sectional study involving a systematic random sampling method, using a sample of 230 parent/preschool child dyads. Among 230 parents, 24 were males and 206 were females (mean age 31.43 ± 5.82); among 230 children, 92 were boys and 138 were girls (mean age 4.82 ± 1.04) attending the pedodontics clinic, HUSM, who participated and met the inclusion criteria. A structured, self-administered oral health literacy questionnaire including sociodemographic factors was used in this study. A child's oral examination was performed to check the dmft (decayed, missing, filled teeth) status. Statistical analysis was done using descriptive and Spearman's correlation analysis and multivariate regression analysis. (3) Results: The mean dmft score of children in relation to the OHL level of parents showed a significant difference (p < 0.00). The mean dmft score of children in relation to the OHL level of parents showed the following relationships: Inadequate (7.49 ± 4.10) followed by marginal (3.28 ± 2.67) and then adequate (0.55 ± 1.55). The incidence of caries amongst children in relation to parental employment was more associated with unemployed parents (6.11 ± 4.43) than with employed parents (2.79 ± 3.65). The caries experience amongst children in relation to education of their parents revealed a significant difference (p < 0.001), and the mean dmft score was high amongst preschool children with primary school qualified parents (10.7 ± 4.10) followed by high school (7.04 ± 3.68), vocational (5.81 ± 3.57), diploma (2.61 ± 2.81), and university (1.29 ± 2.27), respectively. The results revealed a valid significant difference (negative correlation, rs = -0.753 **) between the OHL of parents with the dmft score of their preschool children. The age and gender of parents was not significantly associated with OHL, whereas ethnicity (positive correlation, rs = 0.283 **), education (positive correlation, rs = 0.865 **), and employment (negative correlation, rs = -0.490 **) were found to be significant. Conclusion: We conclude that there is a significant association between the OHL of parents with the dmft score of their preschool children. The logistic regression showed that after adjustment for sociodemographic factors, parents' gender (OR = 0.067, 95% CI: 0.012-0.360), parents' employment status (OR = 3.247, 95% CI: 0.897-11.754), parents' OHL score (OR = 0.042, 95% CI: 0.016-0.114), and child age (OR = 2.195, 95% CI: 1.249-3.857) were significantly associated with dental caries in children. Our study concluded that parents' employment status, age, gender, OHL, and child's age were significantly associated with the caries experience of their preschool children.

Perception of Dental Caries and Parental Difficulties in Implementing Oral Hygiene for Children Aged Less Than 6 Years: A Qualitative Study

BACKGROUND

Despite extensive prevention programs, dental hygiene remains inadequate, particularly among children under the age of six, and early childhood caries (ECC) are still a concern. Oral hygiene behavior and preventive practices seem difficult to change at a family level.

AIM

The present study aimed to better understand the reasons behind this behavior and to identify the different barriers to the implementation of adequate preventive measures.

METHODS

A qualitative study was conducted in the pediatric dentistry service of the Montpellier University Hospital (France) in 2019. A thematic analysis concerning three domains was performed: family environment, dental literacy, and oral hygiene.

RESULTS

The main barriers encountered by the parents were, respectively, (1) a weakness in the organization of familial life, together with a low-medium family income and a lack of authority, (2) ignorance of the necessity of treating carious primary teeth, and (3) a lack of time for brushing or supervising their children's teeth.

CONCLUSION

These results showed that oral hygiene and primary teeth care could not be easily achieved in the family environment of the participants, and oral health strategies should be focused not only on children but also on their parents.

The improvement of the providing system of dental health of teenagers

Relevance. Forming of dental health of child population is one of the key problems of stomatology at the modern stage. Purpose. To determine the efficiency of comprehensive prevention and treatment measures on dental status of teenagers being at different stages of orthodontic treatment.

Materials and methods. 68 children at the age of 15 with pathology of dentoalveolar system being at the preparation stage and at the beginning stages of the orthodontic treatment were examined. The first group included 22 patients with abnormalities of soft tissue at the surgical preparation stage; 19 patients of the second group had accompanying hearing and speech impairments in need of orthodontic treatment at the therapeutic preparation; 27 patients of the third group were at the beginning stages of orthodontic treatment with integral technique. Intensity and the rate of tooth decay intensity, indexes Silness-Loe, РМА (C. Parma, 1960), SBI, physicochemical properties of saliva (secretion speed, saliva surface tension, pH potential) as well and Tooth-Enamel Resistance test were defined.

Results. Children of 15 years old with pathology of dentition system displayed high degree of decay intensity 0,63 ± 0,05, low degree of oral hygiene (1,861 ± 0,102 points by Silness-Loe, PI index), mild degree of gingivitis by РМА index 14,22 ± 1,18% and increase degree of bleeding (SBI 0,111 ± 0,0083 points) on the background of changing of rheological properties of saliva (secretion speed, saliva surface tension) and its pH potential 6,62 ± 0,076. The efficiency of use of parodontax line of hygiene products was studied.

Conclusions. The usage of the complex of prevention and treatment measures with inclusion of parodontax toothpastes and the mouth rinses at different stages of orthodontic treatment of the teenagers normalizes hygienic condition of cavity, stabilizes parodontal indexes on the background of reliable shift of saliva pH to alkaline side and rheological characteristics of saliva.