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Brondani B, Knorst JK, Emmanuelli B, Gasperini MRC, Braga MM, Ardenghi TM, Mendes FM. Do progression rates of initial and moderate caries lesions and sound surfaces of primary teeth increase significantly after 7 years? Int J Paediatr Dent 2024. [PMID: 38741210 DOI: 10.1111/ipd.13202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 04/11/2024] [Accepted: 04/25/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Initial caries lesions in primary teeth have presented a low progression rate after 2 years, but it could be higher in longer follow-ups. AIM To evaluate the progression rates of sound surfaces and initial and moderate caries lesions after 7 years. DESIGN This prospective 7-year cohort study included 639 preschool children aged 1-5 years in 2010. In 2017, 449 children were reassessed (70.3% retention rate). Dental caries was collected using the International Caries Detection and Assessment System (ICDAS) in both assessments. Incidence rate (IR) per 100 surface-years estimated the progression rates of sound surfaces and initial and moderate lesions for worse conditions. Cox regression with shared frailty evaluated the possible risk factors. RESULTS IR was 1.0% for sound surfaces, 2.8% and 4.2% for ICDAS scores 1 and 2, respectively, and about 17.0% for moderate lesions. The most significant risk factor for the progression was the presence of cavitated lesions in other teeth. The type of surface and tooth also influenced the outcome. CONCLUSION The progression rate of initial caries lesions in primary teeth remains low even after 7 years, but cavitated caries lesions in other teeth increase this risk. Moderate lesions demonstrate a higher risk of progression when compared to sound surfaces and initial caries lesions.
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Affiliation(s)
- Bruna Brondani
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Jessica K Knorst
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Mariana R C Gasperini
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Mariana M Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, School of Dentistry, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
- Department of Dentistry, Research Institute for Medical Innovation, Radboud University Medical Center, Nijmegen, The Netherlands
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Sakulratchata R, Saelow D, Banyat S, Wongto S, Sappracha A, Kriangkrai R, Norchai P, Tohnak S. Progression of proximal caries in primary molars using the radiographic ICDAS: a retrospective cohort study. Eur Arch Paediatr Dent 2024:10.1007/s40368-024-00886-7. [PMID: 38625491 DOI: 10.1007/s40368-024-00886-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 03/04/2024] [Indexed: 04/17/2024]
Abstract
PURPOSE To evaluate the proximal caries progression in primary molars using the radiographic International Caries Detection and Assessment System (ICDAS). METHODS A study was conducted on 196 children aged 3-9 years old who underwent the clinical examination and bitewing radiography during baseline and 6-month (and over) follow-up visits. The primary molars bitewing radiographs with initial enamel caries (RA1 and RA2) or outer dentine caries (RA3) of proximal surfaces were included. Caries advancement was scored using ICDAS criteria and statistical analyses with the chi-square test. Median survival time was evaluated using Kaplan-Meier survival curves and log-rank tests. RESULTS A total of 439 surfaces of primary molars were included in this study and an averaged follow-up period of enamel and dentine caries group were 18.3 ± 9.6 months and 16.5 ± 9.5 months respectively. The progression of proximal enamel lesions significantly differed between primary maxillary and mandibular molars (p = 0.002) and among each patient's primary mandibular second molar and the others (p = 0.002). On the contrary, the outer dentine caries of each group of primary molars was not different. The median survival time of the initial enamel proximal caries (23.30 months) was non-significantly longer than that of the dentine (20.80 months). CONCLUSIONS Progressions of the initial enamel proximal caries were significantly different among primary molars at the average 18.3-month follow-up. The median survival period of the enamel proximal caries was more extended than that of dentine but without statistical difference. These results provide essential information for dentists regarding an appropriate appointment for bitewing examinations.
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Affiliation(s)
- R Sakulratchata
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand.
| | - D Saelow
- Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
| | - S Banyat
- Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
| | - S Wongto
- Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
| | - A Sappracha
- Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
| | - R Kriangkrai
- Department of Oral Biology, Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
| | - P Norchai
- Department of Preventive Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
| | - S Tohnak
- Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, 65000, Thailand
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Gimenez T, Estevam LR, de Oliveira Ponte Y, Dalboni A, Calvo AFB, Tedesco TK, Pontes LRA, Moro BLP, Raggio DP, Braga MM, Mendes FM. Is there an acceptable surrogate for caries clinical trials? Evidence from a systematic review of primary studies. Community Dent Oral Epidemiol 2023; 51:1057-1064. [PMID: 37246464 DOI: 10.1111/cdoe.12861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND There is currently a lack of evidence supporting the use of valid surrogates in caries clinical trials. This study aimed at examining the validity of two surrogate outcomes used in randomized clinical trials for caries prevention, pit and fissure sealants and fluoridated dentifrices, according to the Prentice criteria. METHODS A systematic review was conducted in MEDLINE (PubMed), LILACS and Scopus databases up to 05 October 2022. The grey literature and the list of eligible studies' references were also screened. The search was conducted, selecting randomized clinical trials focussed on dental caries prevention using pit and fissure sealants or fluoridated dentifrices and with at least one surrogate endpoint for cavitated caries lesions. The risk of each surrogate endpoint and for the occurrence of cavitated caries lesions was calculated and compared. The association between each surrogate and the presence of cavitation was quantified, and each outcome was assessed graphically for validity according to the Prentice criteria. RESULTS For pit and fissure sealants, from 1696 potentially eligible studies, 51 were included; while for fluoridated dentifrices, of 3887 potentially eligible studies, four were included. Possible surrogates assessed were retention of sealants, presence of white spot lesions, presence of plaque or marginal discoloration around the sealants, oral hygiene index, radiographic and fluorescence caries lesion assessments. However, only the retention of sealants and the presence of white spot lesions could be evaluated for their validity according to the Prentice criteria. CONCLUSION Loss of retention of sealants and the presence of white spot lesions do not fulfil all of the Prentice criteria. Therefore, they cannot be considered valid surrogates for caries prevention.
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Affiliation(s)
- Thais Gimenez
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, Brazil
| | - Luana Rodrigues Estevam
- Graduate Program in Dentistry, Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Campinas, Brazil
| | - Yohana de Oliveira Ponte
- Graduate Program in Dentistry, Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Campinas, Brazil
| | - Adriana Dalboni
- Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, Brazil
| | - Ana Flávia Bissoto Calvo
- Graduate Program in Dentistry, Faculdade São Leopoldo Mandic, Instituto de Pesquisa São Leopoldo Mandic, Campinas, Brazil
| | | | | | | | - Daniela Prócida Raggio
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
- School of Dentistry, Cardiff University, Cardiff, UK
| | - Mariana Minatel Braga
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
| | - Fausto Medeiros Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, Sao Paulo, Brazil
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Arduim ADS, Gonçalves DP, Scherer MM, Araújo FBD, Lenzi TL, Casagrande L. Effectiveness of non-operative approaches in active enamel carious lesions: a retrospective longitudinal study. Braz Oral Res 2023; 37:e057. [PMID: 37255077 DOI: 10.1590/1807-3107bor-2023.vol37.0057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 11/03/2022] [Indexed: 06/01/2023] Open
Abstract
The aim of the study was to investigate the effectiveness of non-invasive and micro-invasive treatments in active enamel carious lesions in high-caries-risk children. Clinical records of children treated in a dental school setting were retrospectively screened for active enamel carious lesions treated non-invasively (topical fluoride applications, oral hygiene instruction, or dietary guidance) or micro-invasively (sealant). The control of active carious lesions was set as the main outcome established by the combination of inactivation and non-progression of the lesions based on Nyvad and ICDAS criteria, respectively. Individual and clinical factors associated with the outcome were analyzed by Poisson regression. The sample consisted of 105 high-caries-risk children with a mean age of 8.3 (± 2.4) years. From a total of 365 active enamel carious lesions, most lesions (84.1%) were active non-cavitated carious lesions (ICDAS scores 1 and 2) and only 15.9% presented localized enamel breakdown (ICDAS score 3). Of these, 72.6% were inactivated and 92.1% did not progress (mean time of 6.5 ± 4.1 months). The prevalence of controlled carious lesions was higher among children older than 6 years (PR:1.43; 95%CI:1.00-2.03; p = 0.04) and in those with better biofilm control (PR:0.99; 95%CI: 0.98-0.99; p = 0.03). Non-operative approaches are effective for controlling active enamel carious lesions. The majority of active enamel carious lesions became inactive and did not progress after treatment. Caries control was associated with older children and better biofilm control.
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Affiliation(s)
- Andressa da Silva Arduim
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Debora Plotnik Gonçalves
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Maitê Munhoz Scherer
- Universidade Federal do Rio Grande do Sul - UFRS, Dental Graduate Program, Porto Alegre, RS, Brazil
| | - Fernando Borba de Araújo
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Tathiane Larissa Lenzi
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Luciano Casagrande
- Universidade Federal do Rio Grande do Sul - UFRS, School of Dentistry, Post-Graduate Program in Pediatric Dentistry, Porto Alegre, RS, Brazil
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Noronha TG, Knorst JK, Godois LDS, Emmanuelli B, Ardenghi TM, Tomazoni F. Sense of coherence moderates the relationship between perceived racial discrimination and oral health-related quality of life in schoolchildren. J Dent 2023; 131:104432. [PMID: 36709840 DOI: 10.1016/j.jdent.2023.104432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/10/2023] [Accepted: 01/19/2023] [Indexed: 01/27/2023] Open
Abstract
AIM To evaluate the moderating effect of the sense of coherence (SOC) in the relationship between racial discrimination and oral health-related quality of life (OHRQoL) in schoolchildren. METHODS This is a cross-sectional study nested in a cohort performed in southern Brazil. OHRQoL was assessed using the short version of the Child Perceptions Questionnaire 11-14 (CPQ11-14). The perception of racial discrimination was measured using a question contained in the Bullying Questionnaire by Olweus, and SOC through the shortened version of the 13-item Sense of Coherence Scale. Sociodemographic and dental caries following the International Caries Detection and Assessment System (ICDAS) characteristics were also collected. A simple slop test and Poisson regression analysis were performed to test the interaction effects of the predictors on OHRQoL. RESULTS A total of 429 schoolchildren were included in this study. About 6.7% reported had perceived racial discrimination. The simple slope test indicated that the negative effects of racial discrimination on OHRQoL were significant under different SOC levels. Among schoolchildren who suffered racial discrimination, those who had higher SOC reported lower impact on OHRQoL when compared to those with low SOC. CONCLUSION SOC can be considered a moderating variable in the relationship between racial discrimination and OHRQoL. CLINICAL SIGNIFICANCE These findings highlight that psychosocial factors such as SOC could attenuate the impact of perceived discrimination on OHRQoL in adolescence.
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Affiliation(s)
- Thaís Gioda Noronha
- Post Graduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Curso de Odontologia, Federal University of Santa Maria, Av. Roraima, 1000, Cidade Universitária - 26F, Santa Maria, RS 97015-372, Brazil
| | - Leonardo da Silva Godois
- Post Graduate Program in Dental Sciences, Federal University of Santa Maria, Santa Maria, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, School of Dentistry, Curso de Odontologia, Federal University of Santa Maria, Av. Roraima, 1000, Cidade Universitária - 26F, Santa Maria, RS 97015-372, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Curso de Odontologia, Federal University of Santa Maria, Av. Roraima, 1000, Cidade Universitária - 26F, Santa Maria, RS 97015-372, Brazil
| | - Fernanda Tomazoni
- Department of Stomatology, School of Dentistry, Curso de Odontologia, Federal University of Santa Maria, Av. Roraima, 1000, Cidade Universitária - 26F, Santa Maria, RS 97015-372, Brazil.
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Fernandes IB, Ramos Jorge J, Mourão PS, Rodrigues AB, Coelho VS, Vettore MV, Ramos-Jorge ML. The Impact of Socio-Environmental, Individual, and Biological Factors on Oral Health-Related Quality of Life among Preschool Children: A Cohort Study with 3-Year Follow-Up. Caries Res 2023; 57:470-484. [PMID: 36889286 DOI: 10.1159/000529908] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 02/23/2023] [Indexed: 03/10/2023] Open
Abstract
This study assessed impact of socio-environmental, individual, and biological factors on the worsening and severe worsening of oral health-related quality of life (OHRQoL) among preschoolers and their families. A cohort study was conducted in Diamantina, Brazil, with 151 children between 1 and 3 years of age and their mothers, who were evaluated at baseline (2014) and re-evaluated after 3 years (2017). The children were clinically examined to assess the presence of dental caries, malocclusion, dental trauma, and enamel defects. The mothers answered the Early Childhood Oral Health Impact Scale (B-ECOHIS) and a questionnaire addressing individual characteristics of the child and socio-environmental factors. Extensive caries found in the follow-up (relative risk [RR] = 1.91; 95% confidence interval [CI] = 1.26-2.91) and failure to undergo the dental treatment recommended at baseline (RR = 2.49; 95% CI = 1.62-3.81) were associated with worsening of OHRQoL over 3 years. An increase in the number of children in the household (RR = 2.95; 95% CI = 1.06-8.25), occurrence of extensive caries in the follow-up (RR = 2.06; 95% CI = 1.05-4.07), and failure to undergo the dental treatment recommended at baseline (RR = 3.68; 95% CI = 1.96-6.89) were associated with a severe worsening of OHRQoL. In conclusion, the risk of worsening and severe worsening of OHRQoL was higher in preschoolers with extensive caries at follow-up and among those who did not undergo dental treatment. Furthermore, severe worsening of OHRQoL was also impacted by an increase in the number of children in the household.
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Affiliation(s)
- Izabella Barbosa Fernandes
- Department of Pediatric Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Joana Ramos Jorge
- Department of Pediatric Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Priscila Seixas Mourão
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | | | - Valéria Silveira Coelho
- Department of Pediatric Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Mario Vianna Vettore
- Department of Health and Nursing Sciences, University of Agder, Kristiansand, Norway
| | - Maria Letícia Ramos-Jorge
- Department of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
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da Rocha Gomes Benelli K, Chaffee BW, Kramer PF, Knorst JK, Ardenghi TM, Feldens CA. Pattern of caries lesions and oral health-related quality of life throughout early childhood: A birth cohort study. Eur J Oral Sci 2022; 130:e12889. [PMID: 35917322 PMCID: PMC9845073 DOI: 10.1111/eos.12889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 07/17/2022] [Indexed: 01/21/2023]
Abstract
The aim of this study was to evaluate the impact of different patterns of dental caries on oral health-related quality of life (OHRQoL) throughout early childhood. This birth cohort study followed 277 children from southern Brazil for 6 years. Demographic and socioeconomic variables were collected at birth. At age 3 years, children's dental caries experience was quantified by the decayed, missing, or filled teeth (dmft) index. At age 6 years, parents answered the Early Childhood Oral Health Impact Scale (ECOHIS). Poisson regression models were used to estimate associations between caries experience and later OHRQoL, presented as the ratio of ECOHIS scores between the groups. The prevalence of dental caries at 3 years of age was 37.5%. In children with caries, lesions only in anterior teeth, only in posterior teeth, and in both dental segments at age 3 were associated with age 6 ECOHIS scores that were 2.7, 7.8, and 6.2 times higher, respectively, than in children without dental caries experience. OHRQoL was worse among children with higher dmft scores. Dental caries lesions in posterior teeth by age 3 years was strongly predictive of adverse impacts on later OHRQoL, presumably as an indicator of continued disease experience in the intervening years.
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Affiliation(s)
| | - Benjamin W. Chaffee
- Division of Oral Epidemiology and Dental Public Health, University of California San Francisco, San Francisco, USA
| | - Paulo Floriani Kramer
- Department of Pediatric Dentistry, Universidade Luterana do Brasil, Canoas, Brazil
- Department of Pediatric Dentistry, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Jessica Klöckner Knorst
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil
| | - Thiago Machado Ardenghi
- Department of Stomatology, School of Dentistry, Universidade Federal de Santa Maria, Santa Maria, Brazil
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Castañeda-Sarmiento S, Uchima Koecklin KH, Barahona Hernandez MB, Santos GP, Bruno Luyo JC, Sánchez Sotomayor JC, Ruiz-Yasuda C, Apaza ZR, Adasme DP, Torres Ricse DA, Mendoza Ballena ME, Salcedo A, Ramirez-Sotelo LR, Blanco-Victorio DJ, Arieta-Miranda J, Torres-Ramos G. Association between developmental defects of enamel and early childhood caries in children under 6 years old: A systematic review and meta-analysis. Heliyon 2022; 8:e10479. [PMID: 36110226 PMCID: PMC9469663 DOI: 10.1016/j.heliyon.2022.e10479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/01/2021] [Accepted: 08/23/2022] [Indexed: 12/02/2022] Open
Abstract
Early childhood caries (ECC) are an oral health problem worldwide in children under 6 years of age. This disease of rapid development has a multifactorial etiology, and one of the possible risk factors is developmental defects of enamel (DDE), such as hypoplasia and opacities. The aim of this systematic review was to evaluate the association between DDE and ECC in children under 6 years of age. An electronic search was conducted until March 2022 using Medline (PubMed), Scopus, Science-Direct, LILACS, Web of Science, Cochrane Library, EBSCO-Host, EMBASE, and Google Scholar and complemented with a manual search, with no restrictions on language or date of publication. Longitudinal studies of children under 6 years of age with primary dentition were included. A total of 1158 studies were found, of which 651 records were reviewed by title and abstract, and 24 articles were selected for full-text evaluation. Finally, nine studies that met the selection criteria were included in the qualitative synthesis. Study quality and certainty were assessed using the Newcastle-Ottawa scale and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Three cohort studies of good quality were included in the meta-analysis. A risk associated with DDE (RR = 1.94; 95% CI: 1.52–2.49) and a risk associated with enamel hypoplasia (RR = 5.45; 95% CI: 1.84–16.14) were found. The results for diffuse opacity (RR = 1.21; 95% CI: 0.18–8.15) and demarcated opacity (RR = 1.26; 95% CI: 0.43–3.65) were not significant. GRADE analysis presented low and very low certainty of evidence. It was concluded that there is an association between DDE and ECC. However, the results should be interpreted with caution because of the limitations of the study. The protocol for this study has been registered in PROSPERO under identification number CRD42021238919.
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Bağ İ. The attitudes of parents toward the oral health of children and their reflection on the non-cavitated caries lesions. PEDIATRIC DENTAL JOURNAL 2022. [DOI: 10.1016/j.pdj.2021.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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10
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Tedesco TK, Calvo AFB, Pássaro AL, Araujo MP, Ladewig NM, Scarpini S, Lara JS, Braga MM, Gimenez T, Raggio DP. Nonrestorative treatment of initial caries lesion in primary teeth: a systematic review and network meta-analysis. Acta Odontol Scand 2022; 80:1-8. [PMID: 34102948 DOI: 10.1080/00016357.2021.1928748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To identify the best available approach to avoid initial caries lesions progression in primary teeth. MATERIALS AND METHODS Search was performed in MEDLINE/Pubmed, Web of Science, Embase and CENTRAL databases until March 2021. Studies compared treatment options to avoid the initial caries lesion progression with at least 12 months of follow-up were included. Network meta-analyses were conducted considering the non-progression of caries lesions as an outcome. RESULTS Potentially eligible studies were screened (n = 2820) and eleven were included. Six studies evaluated the use of fluoride varnish, resin infiltration, sealing, and toothbrushing/flossing on proximal initial caries lesions. When considering occlusal surfaces, only two studies evaluating the ozone gas, fluoride varnish, resin infiltration, and sealants were included. For buccal/lingual surfaces, three studies evaluating toothbrushing, CPP-ACP paste, fluoride varnish, and resin infiltration were included. For all types of surfaces, the resin infiltration showed the best probability to avoid the progression of initial caries lesions. CONCLUSION The limited number of included studies, most with a high risk of bias and lack of hard outcomes, such as frank cavitation, makes it not feasible to recommend a specific management approach for initial caries lesion control in primary teeth with a high certainty of evidence. PROSPERO: #CRD42016037781.
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Affiliation(s)
- Tamara Kerber Tedesco
- Graduate Program in Dentistry, Ibirapuera University, São Paulo, SP, Brazil
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
| | - Ana Flávia Bissoto Calvo
- Graduate Program in Dentistry, Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas Sao Leopoldo Mandic, Campinas, SP, Brazil
| | - Ana Laura Pássaro
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
| | - Mariana Pinheiro Araujo
- Department of Child Dental and Oral Health, School of Dentistry, University of Dundee, Dundee, United Kingdom
| | - Nathalia Miranda Ladewig
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
| | - Samata Scarpini
- Graduate Program in Dentistry, Ibirapuera University, São Paulo, SP, Brazil
| | - Juan Sebastian Lara
- Department of Cariology, Operative Dentistry and Dental Public Health, School of Dentistry, Indiana University, Indianapolis, IN, USA
| | - Mariana Minatel Braga
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
| | - Thais Gimenez
- Graduate Program in Dentistry, Ibirapuera University, São Paulo, SP, Brazil
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
| | - Daniela Prócida Raggio
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Sao Paulo, São Paulo, SP, Brazil
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11
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Pauli LA, Costa VPPD, Azevedo MS, Leal SC, Goettems ML. Discriminant validity of the CAST instrument compared to the dmf index in the deciduous dentition: a cross sectional study. Braz Oral Res 2021; 35:e078. [PMID: 34161415 DOI: 10.1590/1807-3107bor-2021.vol35.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 10/30/2020] [Indexed: 11/21/2022] Open
Abstract
This study aimed to assess the discriminant validity of the Caries Assessment Spectrum and Treatment (CAST) at different thresholds, compared with the Decayed, Missing, and Filled Teeth Index (dmf) instrument, to discriminate caries risk factors. A cross-sectional study was conducted including children aged 2-5 years from preschools in Southern Brazil. Parents answered a questionnaire, and children were clinically examined using the CAST instrument and, in the following weeks, using the dmf index. Two caries thresholds were adopted for CAST: caries in dentin (CAST4-7/CAST2,4-8) and enamel caries (CAST3-7/CAST2-8). Poisson regression was used in the analysis (p < 0.05). A total of 200 children were included. The prevalence of caries was 47.0% with dmf, 42.5% with CAST4-7, and 77.5% with CAST3-7. When the outcome was caries prevalence, CAST4-7 discriminated between sexes, household crowding, and dental pain, and CAST3-7 discriminated age and family income, while the dmf was associated with dental pain. When experience of caries was the outcome, all the criteria discriminated between sexes, age, family income, household overcrowding, visible dental plaque, and dental pain, while dmf and CAST2-8 also discriminated maternal schooling. The CAST discriminated caries risk factors similar to the dmf index when caries experience was the outcome. When prevalence was considered, CAST was able to discriminate for more individual characteristics than dmf.
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Affiliation(s)
- Laís Anschau Pauli
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Post-Graduate Program in Dentistry, Pelotas, RS, Brazil
| | | | - Marina Souza Azevedo
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Post-Graduate Program in Dentistry, Pelotas, RS, Brazil
| | - Soraya Coelho Leal
- Universidade de Brasília - UnB, School of Health Sciences, Department of Dentistry, Brasília, DF, Brazil
| | - Marília Leão Goettems
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Post-Graduate Program in Dentistry, Pelotas, RS, Brazil
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12
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Floriano I, Souza Rocha E, Matos R, Mattos-Silveira J, Ekstrand KR, Mendes FM, Braga MM. How combining different caries lesions characteristics may be helpful in short-term caries progression prediction: model development on occlusal surfaces of primary teeth. BMC Oral Health 2021; 21:255. [PMID: 33980210 PMCID: PMC8117278 DOI: 10.1186/s12903-021-01568-2] [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: 06/10/2020] [Accepted: 04/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background Few studies have addressed the clinical parameters' predictive power related to caries lesion associated with their progression. This study assessed the predictive validity and proposed simplified models to predict short-term caries progression using clinical parameters related to caries lesion activity status. Methods The occlusal surfaces of primary molars, presenting no frank cavitation, were examined according to the following clinical predictors: colour, luster, cavitation, texture, and clinical depth. After one year, children were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as the outcome to be predicted. Univariate multilevel Poisson models were fitted to test each of the independent variables (clinical features) as predictors of short-term caries progression. The multimodel inference was made based on the Akaike Information Criteria and C statistic. Afterwards, plausible interactions among some of the variables were tested in the models to evaluate the benefit of combining these variables when assessing caries lesions. Results 205 children (750 surfaces) presented no frank cavitations at the baseline. After one year, 147 children were reassessed (70%). Finally, 128 children (733 surfaces) presented complete baseline data and had included primary teeth to be reassessed. Approximately 9% of the reassessed surfaces showed caries progression. Among the univariate models created with each one of these variables, the model containing the surface integrity as a predictor had the lowest AIC (364.5). Univariate predictive models tended to present better goodness-of-fit (AICs < 388) and discrimination (C:0.959–0.966) than those combining parameters (AIC:365–393, C:0.958–0.961). When only non-cavitated surfaces were considered, roughness compounded the model that better predicted the lesions' progression (AIC = 217.7, C:0.91). Conclusions Univariate model fitted considering the presence of cavitation show the best predictive goodness-of-fit and discrimination. For non-cavitated lesions, the simplest way to predict those lesions that tend to progress is by assessing enamel roughness. In general, the evaluation of other conjoint parameters seems unnecessary for all non-frankly cavitated lesions. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01568-2.
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Affiliation(s)
- Isabela Floriano
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, Brazil.,Dentistry Course, University Uninovafapi Centre, Teresina, Piaui, Brazil
| | | | - Ronilza Matos
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, Brazil.,Dental School, Fundação Hermínio Ometto, Araras, Sao Paulo, Brazil
| | - Juliana Mattos-Silveira
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, Brazil
| | - Kim Rud Ekstrand
- Section of Cariology and Endodontics, Dental School of Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Fausto Medeiros Mendes
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, Brazil
| | - Mariana Minatel Braga
- Department of Orthodontics and Paediatric Dentistry, School of Dentistry, University of Sao Paulo, Avenida Professor Lineu Prestes, 2227, Cidade Universitária, São Paulo, SP, Brazil.
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13
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Untreated dental caries and visible plaque of mothers are not determinant for the incidence of caries in dentin among children: evidence from a 3-year prospective cohort study. Clin Oral Investig 2021; 25:5431-5439. [PMID: 33704570 DOI: 10.1007/s00784-021-03851-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 02/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate whether characteristics related to mother's oral health, trajectory of family income, and maternal education are associated with the incidence of caries in dentin in preschool children. MATERIALS AND METHODS One hundred fifty-eight mothers and their children were evaluated at baseline and re-evaluated after 3 years. Sociodemographic variables, dental caries, and biofilm of the mothers and children and daily sugar intake of the children were evaluated. Poisson regression was used to evaluate what factor represents risk for the incidence of caries in dentin at four to 6 years of age. RESULTS The risk of the incidence of caries in dentin was 54% higher in children whose mothers had a low level of education at both baseline and follow-up. Children from families with an income lower at baseline and follow-up (RR 2.49; 95% CI 1.62-3.83) and those whose families experienced a reduction in income in this period (RR 2.05; 95% CI 1.29-3.26) had a greater risk of the incidence of caries in dentin. Moreover, children who increased their daily sugar intake (RR 1.67; 95% CI 1.09-2.52), those that maintained high sugar intake (RR 1.81; 95% CI 1.14-2.87), and those with cavitated caries at baseline (RR 1.53; 95% CI 1.19-1.97) had a greater risk of the incidence of caries in dentin. CONCLUSIONS Low mother's education, a lower family income, a reduction in family income, a high frequency of daily sugar intake, and a history of cavitated caries were risk factors for the incidence of caries in dentin. CLINICAL RELEVANCE The results could help in the targeting of improved prevention and control strategies for dental caries.
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14
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Lopes ABS, Ramos-Jorge ML, Machado GF, Vieira-Andrade RG, Ramos-Jorge J, Fernandes IB. Longitudinal evaluation of determinants of the clinical consequences of untreated dental caries in early childhood. Community Dent Oral Epidemiol 2021; 50:91-98. [PMID: 33704820 DOI: 10.1111/cdoe.12635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 02/17/2021] [Accepted: 02/18/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study aimed to evaluate whether the trajectory of family income, parental education and clinical variables are associated with the clinical consequences of untreated dental caries among children. METHODS A prospective cohort study was conducted with 439 children between one and three years of age, evaluated at baseline and re-evaluated after three years. Sociodemographic and economic variables, untreated dental caries and biofilm were investigated both at baseline and at the 3-year follow-up. The pufa index (pulpal involvement, ulceration, fistula and abscess) was used to diagnose the clinical consequences of untreated dental caries. RESULTS The prevalence of pufa ≥1 was 18.2% in the follow-up. The following variables were associated with a higher risk of clinical consequences of untreated dental caries: mother's low schooling level at baseline and follow-up (RR = 1.51; 95% CI: 1.04-2.18), incidence or baseline presence of biofilm (RR = 4.66; 95% CI: 2.02-10.74), cavitated dental caries at baseline (RR = 3.57; 95% CI:1.86 to 6.83) and incidence of cavitated dental caries (RR = 2.04; 95% CI: 1.24-3.35). CONCLUSION Low maternal schooling level, biofilm, cavitated dental caries at baseline, and incidence of dental caries were the factors determining the consequences of untreated dental caries.
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Affiliation(s)
- Ana Beatriz Silva Lopes
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Maria Letícia Ramos-Jorge
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | - Gabrielly Fernandes Machado
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil
| | | | - Joana Ramos-Jorge
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Izabella Barbosa Fernandes
- Department of Pediatric Dentistry, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Brazil.,Department of Pediatric Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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15
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Inclusion of initial caries lesions in a population-based sample of Brazilian preschool children: Impact on estimates and treatment needs. PLoS One 2020; 15:e0234122. [PMID: 32559191 PMCID: PMC7304588 DOI: 10.1371/journal.pone.0234122] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/19/2020] [Indexed: 12/11/2022] Open
Abstract
This study aimed to assess changes in epidemiological estimates and treatment needed when initial caries lesions are included in a population-based survey of preschool children. A cross-sectional survey was conducted in a Brazilian municipality, collecting data of preschool children in 16 health centers. Caries detection used the merged codes (epi-codes) for ICDAS/ICCMS. An option for treatment, according to ICCMS, was chosen during the examination. Caries experience (dmft/dmfs) and prevalence were estimated considering three thresholds (A- initial, moderate, and severe lesions, B- only moderate and severe lesions and C- severe lesions). Incremental need for non-operative care was also verified. The sample consisted of 663 children aged 2–4 years (response rate of 99.85%). Including initial lesions, a 2-fold increase in dmft was observed (A: 3.36, B: 1.02, p<0.001). With the inclusion, the caries prevalence increased to 75% compared to threshold B only (28%). The majority (76%) of children who required any intervention (56%) should be scheduled for non-operative care. We suggest that including initial caries lesions in an epidemiological survey may significantly impact assessment of population caries experience.
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16
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Paixão-Gonçalves S, Corrêa-Faria P, Ferreira FM, Ramos-Jorge ML, Paiva SM, Pordeus IA. Risk of Dental Caries in Primary Teeth with Developmental Defects of Enamel: A Longitudinal Study with a Multilevel Approach. Caries Res 2019; 53:667-674. [PMID: 31291628 DOI: 10.1159/000501029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 05/19/2019] [Indexed: 02/01/2023] Open
Abstract
The risk of dental caries seems to be greater in the presence of developmental defects of enamel (DDE). The aim was to determine whether the presence of DDE in the primary teeth of preschool children increases the risk of dental caries in the primary dentition after a period of approximately 2 years. This study was conducted in two stages: baseline (T0) and follow-up (T1). At T0, examinations were conducted for the diagnosis of enamel defects using the DDE index (FDI, 1992), dental caries, and oral hygiene. The participants were allocated to two groups according to the presence (affected) or absence (unaffected) of DDE. At the second evaluation (T1), examinations were performed for the diagnosis of dental caries. Poisson regression analysis with a multilevel approach was used to determine the association between DDE and dental caries. The two levels of the analysis were tooth and child. Among the 339 children (113 affected and 226 unaffected) examined at baseline (T0), 325 were re-examined at follow-up (T1). According to the multilevel analysis, teeth with enamel hypoplasia had a greater risk of having dental caries (RR: 1.99; 95% CI: 1.19-3.33). The risk of caries was greater on posterior teeth (RR: 2.59; 95% CI: 2.18-3.07) and maxillary teeth (RR: 1.48; 95% CI: 1.26-1.75) that had DDE at T0. On the child level, dental caries at T1 was associated with having dental caries at T0 (RR: 1.38; 95% CI: 1.32-1.46). In conclusion, enamel hypoplasia and previous dental caries are risk factors for carious lesions in the primary dentition.
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Affiliation(s)
| | - Patrícia Corrêa-Faria
- Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Goiás, Goiânia, Brazil
| | - Fernanda Morais Ferreira
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Letícia Ramos-Jorge
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Belo Horizonte, Brazil
| | - Saul Martins Paiva
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Isabela Almeida Pordeus
- Department of Paediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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17
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Ribeiro APD, Maciel IP, de Souza Hilgert AL, Bronkhorst EM, Frencken JE, Leal SC. Caries assessment spectrum treatment: the severity score. Int Dent J 2018; 68:84-90. [DOI: 10.1111/idj.12331] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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18
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Ekstrand K, Gimenez T, Ferreira F, Mendes F, Braga M. The International Caries Detection and Assessment System – ICDAS: A Systematic Review. Caries Res 2018. [DOI: 10.1159/000486429] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The aims of this study were: (1) to evaluate the overall reproducibility and accuracy of the International Caries Detection and Assessment System (ICDAS) for assessing coronal caries lesions, and (2) to investigate the use of systems associated with the ICDAS for activity assessment of coronal caries lesions. Specific search strategies were adopted to identify studies published up to 2016. For the first objective, we selected studies that assessed primary coronal caries lesions using the ICDAS as a reference standard. A total of 54 studies were included. Meta-analyses summarized the results concerning reproducibility and accuracy (correlation with histology, summary ROC curves [SROC], and diagnostic odds ratio [DOR]). The latter 2 were expressed at D1/D3 levels. The heterogeneity of the studies was also assessed. Reproducibility values (pooled) were > 0.65. The ICDAS mostly presented a good overall performance as most areas under SROC were > 0.75 at D1 and > 0.90 at D3; DOR ≥6. For the second objective, we selected studies investigating activity assessment associated with the ICDAS. The meta-analyses pooled results based on the same methodology and parameters as above. Longitudinal findings regarding caries progression were described to estimate the validity of these systems. On average, the systems for activity assessment of caries lesions showed moderate values concerning reproducibility and overall performance. Active caries lesions were more prone to progress than inactive ones after 2 years. In conclusion, the ICDAS presented a substantial level of reproducibility and accuracy for assessing primary coronal caries lesions. Additional systems associated with the ICDAS that classify caries lesion activity can be useful as they are moderately reproducible and accurate.
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19
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Guedes RS, Ardenghi TM, Emmanuelli B, Piovesan C, Mendes FM. Sensitivity of an oral health-related quality-of-life questionnaire in detecting oral health impairment in preschool children. Int J Paediatr Dent 2018; 28:207-216. [PMID: 28833769 DOI: 10.1111/ipd.12328] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
AIM This two-year cohort study evaluated whether the Early Childhood Oral Health Impact Scale (ECOHIS) is responsive to detect changes related to dental caries. DESIGN Preschool children were examined in 2010 regarding dental caries, and their parents responded to the ECOHIS. After 2 years, 352 children (response rate = 73.6%) were re-examined and a new ECOHIS was responded. Children were categorized according to caries increment (no new caries, 1-3 surfaces with new lesions, and four or more decayed surfaces). The outcome variables were related to the decline of quality of life as determined via ECOHIS: decline, severe decline, and differences between baseline and follow-up scores. Effect sizes (ES) were calculated, and the associations were evaluated through Poisson regression. RESULTS ES was small for children with 1-3 new lesions (ES = 0.19) and moderate for children with four or more new carious lesions (ES = 0.61). Children who developed 1-3 new lesions were significantly associated with all outcome variables compared to children with no new lesions, but the associations were stronger for children with four or more new carious lesions. CONCLUSIONS The ECOHIS is sensitive to the deterioration of quality of life due to caries increments in preschool children.
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Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Chaiana Piovesan
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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20
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Guedes RS, Piovesan C, Ardenghi TM, Emmanuelli B, Braga MM, Mendes FM. Presence of Initial Caries Lesions as a Risk Factor for Caries in Preschool Children: A Cohort Study. Caries Res 2017; 52:32-41. [PMID: 29232677 DOI: 10.1159/000479824] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/26/2017] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to evaluate the influence of initial noncavitated caries lesions on cavitated caries increment in preschool children. A 2-year cohort study was designed to include the participants of a survey on dental caries performed in 2010. Preschool children (12-59 months old) were examined for dental caries and classified as children with no caries lesions, with only initial lesions, with at least 1 moderate caries lesion, and with extensive lesions. Socioeconomic data were also collected. After 2 years, 466 children were re-examined (follow-up rate of 72.9%) only for cavitated lesions. Association between caries incidence at 2 levels of severity and caries experience and other variables was evaluated using hierarchical Poisson regression analysis. The children with moderate and extensive caries lesions at baseline presented a higher risk of presenting both outcomes than the children with no caries lesions. Nevertheless, the children with only initial lesions had a higher risk of developing at least 1 new cavitated carious lesion, but not for a more severe increment in caries. Subgroup analysis stratified by the children's age showed that the influence of the presence of initial caries lesions on cavitated caries increment was only observed in children aged 12-35 months. In conclusion, although the presence of moderate and extensive lesions at baseline is a significant predictor for cavitated caries increment after 2 years in preschool children at all ages, the presence of only initial caries lesions is also associated, but with less severe caries incidence.
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Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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21
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Chi DL. Parent Refusal of Topical Fluoride for Their Children: Clinical Strategies and Future Research Priorities to Improve Evidence-Based Pediatric Dental Practice. Dent Clin North Am 2017; 61:607-617. [PMID: 28577640 DOI: 10.1016/j.cden.2017.03.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A growing number of parents are refusing topical fluoride for their children during preventive dental and medical visits. This nascent clinical and public health problem warrants attention from dental professionals and the scientific community. Clinical and community-based strategies are available to improve fluoride-related communications with parents and the public. In terms of future research priorities, there is a need to develop screening tools to identify parents who are likely to refuse topical fluoride and diagnostic instruments to uncover the reasons for topical fluoride refusal. This knowledge will lead to evidence-based strategies that can be widely disseminated into clinical practice.
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Affiliation(s)
- Donald L Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Box 357475, B509 Health Sciences Building, Seattle, WA 98195-7475, USA.
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22
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Melgar RA, Pereira JT, Luz PB, Hugo FN, Araujo FBD. Differential Impacts of Caries Classification in Children and Adults: A Comparison of ICDAS and DMF-T. Braz Dent J 2017; 27:761-766. [PMID: 27982192 DOI: 10.1590/0103-6440201600990] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 08/01/2016] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to describe and compare findings regarding the prevalence and severity of dental caries when using ICDAS and DMFT/dmft in an epidemiological study with children and their mothers. This cross-sectional study evaluated 150 preschoolers and their mothers. Data were collected with ICDAS and then transformed into DMFT/dmft. ICDAS scores related to caries were analyzed according to three different cut-off-points: CP1 (0-healthy/1-6-caries), CP2 (0-1-healthy/2-6-caries) and CP3 (0-2-healthy/3-6-caries), representing the D/d of DMFT/dmft. ICDAS codes regarding restorations, except sealants, were considered the F/f and the code 97 as the M/m of DMFT/dmft index. Prevalence of caries and its severity with ICDAS were 92%, 84% and 31.3% in children and 97.3%, 96.6% and 80% in adults according to CP1/CP2/CP3, respectively. Admitting CP3 as the standard for data transformation of ICDAS in DMFT/dmft, it was observed that DMFT/dmft index would underestimate 60% of non-cavitated lesions in children and 16.6% in adults. The DMFT/dmft underestimated the presence of disease to disregard non-cavitated lesions for the pediatric population evaluated. The choice of which is the best index for epidemiological surveys will depend on the purpose of the research and the target population: if it is to estimate the needs of the population to determine clinical care in children and adults, the DMFT/dmft may be sufficient. However, if the objective is to have a more comprehensive diagnosis of caries at the population level in order to develop preventive strategies, to halt and reverse the disease, the detection of non-cavitated-lesions becomes important, mainly in young children.
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Affiliation(s)
- Rosa Ana Melgar
- Faculty of Dentistry of Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Joanna Tatith Pereira
- University Center of Serra Gaúcha, Caxias do Sul, RS, Brazil and UFRGS - Federal University of Rio Grande do Sul; Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Patrícia Blaya Luz
- UFRGS - Federal University of Rio Grande do Sul, Pediatric Dentistry, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- UFRGS - Federal University of Rio Grande do Sul, Center of Community Dental Health Research, Porto Alegre, RS, Brazil
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Piva F, Pereira JT, Luz PB, Hashizume LN, Hugo FN, Araujo FBD. A Longitudinal Study of Early Childhood Caries and Associated Factors in Brazilian Children. Braz Dent J 2017; 28:241-248. [DOI: 10.1590/0103-6440201701237] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 12/05/2016] [Indexed: 11/21/2022] Open
Abstract
Abstract Early childhood caries (ECC) affects children all over the world and has high prevalence and severity in preschool children. Different social, biological and behavioral factors compose a network of causal factors for ECC. The aim was to evaluate the association between socioeconomic variables and caries at baseline, and the presence of Streptococcus mutans and Lactobacillus spp. microorganisms with the progression of caries lesions after two years of follow-up in a group of children. At baseline, 163 children (3-4 years old) living in the areas of 12 primary care services of the Hospital Group Conceição (GHC, Porto Alegre, RS, Brazil) were evaluated. After two years, 119 children were re-evaluated. Clinical examinations were conducted by calibrated examiners using the ICDAS criteria. A sociodemographic questionnaire was applied to the children’s parents and saliva samples were collected from the children for microbiological analysis. Descriptive statistics and multivariate Poisson regression analysis were performed in the statistical analysis. The factors associated with the caries progression were marital status of mothers (p=0.040), higher S. mutans counts (p=0.031) and the presence of cavitated lesions at baseline (p<0.001). The caries lesions progression in preschool children enrolled in primary health care was directly associated with marital status, presence of cavitated lesions at baseline and higher S. mutans counts at two-year follow-up.
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Jablonski-Momeni A, Heinzel-Gutenbrunner M, Vill G. Use of a fluorescence-based camera for monitoring occlusal surfaces of primary and permanent teeth. Int J Paediatr Dent 2016; 26:448-456. [PMID: 26590509 DOI: 10.1111/ipd.12216] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Sound teeth and incipient lesions require regular monitoring to detect possible progression of caries early on. AIM To evaluate the ability of the VistaProof (VP) fluorescence-based camera for monitoring occlusal surfaces. DESIGN A total of 419 posterior teeth (205 primary molars, 145 permanent molars, and 69 premolars) of 35 patients were examined (average age: 9.1 years). The occlusal surfaces were classified visually according to the criteria of the International Caries Detection and Assessment System (ICDAS). VP measurements were performed at baseline (t1), and the examinations were repeated after six (t2) and twelve month (t3). Correlation between methods was calculated using Spearman's rank correlation coefficient (rs ). Wilcoxon test was used to monitor whether VP identified changes as well as ICDAS (α = 0.05). RESULTS Correlations between ICDAS and VP were significantly positive (rs : 0.66-0.73, P < 0.001). No significant differences were found between all times for the ICDAS findings. Significant differences for the VP were ascertained for t1/t2 (P = 0.03). Results based on cluster randomization showed significant differences between ICDAS and VistaProof concerning the absence/presence of changes in the finding (P < 0.0005). CONCLUSION Correlation between ICDAS and VP was strong. The VP supported the findings of visual examination for monitoring occlusal surfaces, although not all changes could be detected with respect to the visual findings.
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Affiliation(s)
- Anahita Jablonski-Momeni
- Dental School, Department of Pediatric and Community Dentistry, Philipps University, Marburg, Germany.
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25
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Guedes RS, Ardenghi TM, Piovesan C, Emmanuelli B, Mendes FM. Influence of initial caries lesions on quality of life in preschool children: a 2-year cohort study. Community Dent Oral Epidemiol 2016; 44:292-300. [PMID: 26892250 DOI: 10.1111/cdoe.12217] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 01/13/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We aimed to assess the impact of the presence of initial and other stages of dental caries on the impairment of oral health-related quality of life in preschool children (COHRQoL) through a cohort study. METHODS During an epidemiological survey, 478 children (12-59 months old) were examined for dental caries using the International Caries and Detection Assessment System (ICDAS), and their parents answered the Early Childhood Oral Health Impact Scale (ECOHIS). Children were categorized based on the presence of dental caries as follows: children with no caries lesions, children with only initial lesions (ICDAS scores 1 and 2), children with at least one moderate lesion (ICDAS scores 3 and 4) and children with extensive lesions (ICDAS scores 5 and 6). After 2 years, 352 children were re-examined for the presence of dentine cavitations, and their parents completed a new ECOHIS questionnaire. Multilevel Poisson regression analysis was performed to evaluate the impact of the presence of different stages of caries lesions at the baseline on COHRQoL impairment at the follow-up, considering two outcome variables: worsening and severe worsening of COHRQoL. Relative risk values (RR) and respective 95% confidence intervals (95% CI) were calculated. RESULTS Worsening or severe worsening of the COHRQoL at the follow-up were observed only in children with moderate lesions (RR = 2.00; 95% CI = 1.30-3.08 and RR = 2.38; 95% CI = 1.31-4.34, respectively) or children with extensive lesions (RR = 1.59; 95% CI = 1.10-2.30 for worsening and RR = 1.88; 95% CI = 1.13-3.12 for severe worsening). On the other hand, the presence of only initial caries lesions was not a significant predictor of COHRQoL impairment. CONCLUSIONS The presence of only initial caries lesions does not impair COHRQoL of preschool children; however, moderate and extensive lesions are risk factors for worsening of the COHRQoL.
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Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,School of Dentistry, Centro Universitário Franciscano, Santa Maria, Brazil
| | - Thiago M Ardenghi
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Chaiana Piovesan
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.,Institute of Dentistry, São Lucas School, Porto Velho, Brazil
| | - Bruno Emmanuelli
- Department of Stomatology, Federal University of Santa Maria, Santa Maria, Brazil
| | - Fausto M Mendes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
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Detection and monitoring of early caries lesions: a review. Eur Arch Paediatr Dent 2015; 17:13-25. [PMID: 26514842 DOI: 10.1007/s40368-015-0208-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2015] [Accepted: 09/18/2015] [Indexed: 10/22/2022]
Abstract
AIM To review the current evidence base of detecting and monitoring early carious lesions in children and adolescents and a rationale proposed to ensure that such lesions are identified and appropriately managed. METHODS The systematic literature search identified initially a review by Gomez and co-workers from 2013 and this still represents the current state of the science in relation to caries detection and monitoring. The review described among others, visible detection systems, image-based detection systems and point-measurement approaches. RESULTS The current evidence base suggests that while there are numerous devices or technology-enabled detection systems, the use of a careful, methodical visual inspection of clean, dry teeth, supplemented where indicated by radiographic views, remains the standard of care in caries detection and diagnostics. Further, it is possible by means of existing visible and radiographical systems to monitor lesions over time. Using low-cost intra-oral cameras facilitates the recording of lesion appearance in the patient record and may be of significant benefit in monitoring early lesions over time following their detection. This benefit extends to the clinician and the patient for whom it may be a useful educational and motivational tool. CONCLUSIONS Recommendations are presented that can be adopted and adapted to local circumstances and that are both substantiated by evidence and promote a clear, simple and consistent approach to caries detection, diagnosis and monitoring in children and adolescents. The diagnoses (initial, active; moderate, active and extensive, active) are linked to appropriate management options within primary care.
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