1
|
Koizumi Y, Kunimatsu R, Kado I, Yoshimi Y, Yamada S, Ogasawara T, Tanimoto K. Maxillofacial Morphology as a Predictive Factor for Caries Risk in Orthodontic Patients: A Cross-Sectional Study. J Clin Med 2024; 13:622. [PMID: 38276128 PMCID: PMC10816193 DOI: 10.3390/jcm13020622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/17/2024] [Accepted: 01/20/2024] [Indexed: 01/27/2024] Open
Abstract
This cross-sectional study aimed to explore the correlation between maxillofacial morphology and caries risk, assessed using salivary tests, in orthodontic patients. Despite enhancing the oral health-related quality of life, orthodontic treatment may adversely affect oral hygiene and increase caries risk. This study included 1071 patients all of whom underwent orthodontic examinations and salivary tests before starting orthodontic treatment at a hospital. Salivary tests were performed to assess the secretion rate, pH, buffering capacity, and counts of cariogenic bacteria. The maxillofacial morphology was evaluated using cephalometric X-rays and dental models. Statistical analyses revealed significant correlations among salivary characteristics, bacterial scores, and maxillofacial morphology. Notably, the facial angle and Y-axis values were associated with salivary secretion (p < 0.001), pH (p < 0.001), buffering capacity (p < 0.05), and cariogenic bacterial scores (p < 0.01), respectably. In conclusion, assessing the maxillofacial morphology before orthodontic treatment may aid in predicting the risk of bacterial oral diseases, offering valuable insights into personalized preventive measures. These findings underscore the potential for comprehensive evaluations to enhance caries risk assessment in orthodontic patients.
Collapse
Affiliation(s)
- Yuma Koizumi
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima City 734-8554, Japan; (Y.K.); (Y.Y.); (S.Y.); (T.O.)
| | - Ryo Kunimatsu
- Department of Orthodontics, Graduate School of Biochemical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City 734-8554, Japan; (I.K.); (K.T.)
| | - Isamu Kado
- Department of Orthodontics, Graduate School of Biochemical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City 734-8554, Japan; (I.K.); (K.T.)
| | - Yuki Yoshimi
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima City 734-8554, Japan; (Y.K.); (Y.Y.); (S.Y.); (T.O.)
| | - Sakura Yamada
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima City 734-8554, Japan; (Y.K.); (Y.Y.); (S.Y.); (T.O.)
| | - Tomohiro Ogasawara
- Department of Orthodontics, Division of Oral Health and Development, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima City 734-8554, Japan; (Y.K.); (Y.Y.); (S.Y.); (T.O.)
| | - Kotaro Tanimoto
- Department of Orthodontics, Graduate School of Biochemical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima City 734-8554, Japan; (I.K.); (K.T.)
| |
Collapse
|
2
|
Schroth RJ, Rothney J, Sturym M, Dabiri D, Dabiri D, Dong CC, Grant CG, Kennedy T, Sihra R. A systematic review to inform the development of a Canadian caries risk assessment tool for use by primary healthcare providers. Int J Paediatr Dent 2021; 31:767-791. [PMID: 33497015 DOI: 10.1111/ipd.12776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/06/2021] [Accepted: 01/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Caries risk assessment (CRA) tools may assist in identifying children at risk of early childhood caries. AIM To complete a systematic review of CRA and develop a Canadian CRA tool for preschool children for use in non-dental clinical settings. DESIGN Systematic searches of relevant databases were conducted. Potential variables were based on strength of associations (odd ratios, relative risk, hazard ratios, etc), frequency of occurrence, and existing CRA tools. Quality of the evidence assessments were performed by at least two review teams through consensus following GRADE. RESULTS Overall, 25 publications met the inclusion criteria, all prospective in design. Based on this review, variables to be considered when developing a new CRA tool for use with preschool children are as follows: age, socioeconomic status, family toothbrushing habits, fluoride exposure, infant feeding practices, dietary habits/behaviours, dental home, caries experience, visible plaque, and enamel defects. The environmental scan identified 22 CRA tools suggesting other additional variables to consider including in a CRA tool, including special healthcare needs, enamel defects, and dental attendance. CONCLUSIONS This review informed the development of a Canadian CRA tool for use by primary healthcare professionals, which may improve access to oral health assessments and increase interprofessional collaboration.
Collapse
Affiliation(s)
- Robert J Schroth
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,Section of Pediatric Dentistry, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Janet Rothney
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Melina Sturym
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Darya Dabiri
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Donya Dabiri
- University of Toledo Medical Center, University of Toledo, Toledo, OH, USA
| | - Cecilia C Dong
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Cameron G Grant
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Tara Kennedy
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Rena Sihra
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
3
|
Hultquist AI, Brudin L, Bågesund M. Early childhood caries risk assessment in 1-year-olds evaluated at 6-years of age. Acta Odontol Scand 2021; 79:103-111. [PMID: 32697607 DOI: 10.1080/00016357.2020.1795247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim was to identify caries risk factors in 1-year-olds predicting dentine caries in 6-year-olds. MATERIALS AND METHODS Caries risk assessment was performed in 804 one-year-olds. Their parents answered a questionnaire, regarding family factors, general health, food habits and oral hygiene. Clinical examinations and caries risk assessments at 1, 3 and 6 years of age were performed. Simple and multiple regression analyses were used for identification of caries-associated factors. RESULTS Caries risk was found in 5% of the 1-year-olds, and 12% of the 3-year-olds. Dentine caries was found in 3% of the 3-year-olds and in 16% of the 6-year-olds. Caries risk assessment was associated with caries at 6 years of age (OR = 5.1, p < .001). Multiple logistic regression analysis found the following variables associated with caries at 6 years of age: Caries in sibling (OR = 2.1, p = .012), Beverage other than water (OR = 2.1, p < .001), Night meal (OR = 1.9, p = .002), Presence of mutans streptococci (MS) (OR = 1.6, p = .033) and Male gender (OR = 1.5, p = .053). An overall caries risk assessment was more reliable than any single caries risk factor. CONCLUSIONS Caries risk assessment for 1-year-olds in a region with low caries prevalence has limited accuracy to predict dental caries at 6 years of age. Caries risk often changes over time and should be reassessed on a regularly basis. The presence of MS in 1-year-olds did not increase the prognostic accuracy at 6 years of age.
Collapse
Affiliation(s)
- Ann Ingemansson Hultquist
- Västervik Public Dental Service, Kalmar County Council, Kalmar, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lars Brudin
- Department of Clinical Physiology, Region Kalmar Council, Kalmar, Sweden
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Mats Bågesund
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Orthodontics and Pediatric Dentistry, Norrköping, Sweden
| |
Collapse
|
4
|
Hummel R, Akveld NAE, Bruers JJM, van der Sanden WJM, Su N, van der Heijden GJMG. Caries Progression Rates Revisited: A Systematic Review. J Dent Res 2019; 98:746-754. [PMID: 31070943 PMCID: PMC6591514 DOI: 10.1177/0022034519847953] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Caries progression seems to follow universal, predictable rates, depending largely on the caries severity in populations: the higher the caries severity, the higher the progression rates. Quantification of these rates would allow prediction of future caries increments. Our aim was to describe caries progression rates in the primary and permanent dentition in Western populations (not in lesions) of children and adolescents. Therefore, we systematically searched MEDLINE-PubMed, Embase, CINAHL, and the Cochrane library for studies reporting caries progression data. Eligibility criteria were reporting empirical data from at least 2 full-mouth dental caries examinations in a closed cohort during a follow-up of at least 3 y, a first examination after 1974, a second examination before the age of 22 y, caries assessed as dentine caries (d3/D3), and caries reported in dmfs/DMFS (decayed, missing, and filled surfaces), dmft/DMFT (decayed, missing, and filled teeth), or caries-free participants. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, we described the results for the primary and permanent dentition in a systematic review, performed a meta-analysis for the caries incidence rate in the permanent dentition, and conducted multivariate, hierarchical meta-regression analyses for the caries incidence rate and the increments in DMFS and DMFT. Of the 6,343 unique studies retrieved, 43 studies (56,376 participants) were included for systematic review and 32 for meta-analyses (39,429 participants). The annual decline in caries-free children in the permanent dentition ranged from 0.8% to 10.2%. The annual increment ranged from 0.07 to 1.77 in DMFS and from 0.06 to 0.73 in DMFT. The pooled caries incidence rate was 0.11 (0.09–0.13) per person-year at risk. Meta-regression analyses showed that the methods of individual studies influenced pooled caries incidence rates and increments in DMFS and DMFT. This should be taken into account in planning and evaluation of oral health care services. However, the caries incidence rate is promising for prediction of future caries increments in populations.
Collapse
Affiliation(s)
- R Hummel
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,2 Zilveren Kruis Achmea, Leusden, The Netherlands
| | - N A E Akveld
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - J J M Bruers
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,3 KNMT, Royal Dutch Dental Association, Utrecht, The Netherlands
| | - W J M van der Sanden
- 4 College of Oral Science, Department of Quality and Safety of Oral Health Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - N Su
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,5 State Key Laboratory of Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,6 Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - G J M G van der Heijden
- 1 Department of Social Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
5
|
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.
Collapse
Affiliation(s)
- Renata S Guedes
- Department of Pediatric Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | | |
Collapse
|
6
|
Mortazavi S, Enshaei Z, Farajzadegan Z. Development of Caries Risk Assessment Tool for Iranian Preschoolers: A Primary Validation Study. Int J Prev Med 2017; 8:92. [PMID: 29184643 PMCID: PMC5686924 DOI: 10.4103/ijpvm.ijpvm_256_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 08/27/2017] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The aim of the present study was to develop a dental caries risk assessment tool for Iranian preschoolers. METHODS In a validation and cross-sectional study, a random sample of 150 preschool children was involved. This study was conducted in three phases: questionnaire design (expert panel and peer evaluation), questionnaire testing (pilot evaluation and field testing), and validation study. The initial assessments include interview, dental examination, and laboratory investigations. Validity and reliability indices, content validity index (CVI), content validity ratio (CVR), impact score, and test-retest and Cronbach's alpha were measured. Decayed, missing, filled teeth (dmft) scores were calculated according to the WHO guidelines. RESULTS The Iranian version of caries risk assessment (CRA) questionnaire contained 17 items. Cronbach's alpha coefficient (0.86) indicated a suitable internal consistency. The mean scores for the CVI and the CVR were 0.87 and 0.78, respectively. The prevalence rate of dental caries in the study group was 69.3%, and the mean dmft was 4.57 (range 0-19). CONCLUSIONS The Persian version of CRA questionnaire was adapted to the Iranian population. The findings demonstrated overall acceptable validity and also reliability in the application of test-retest. The results of the present study provide initial evidence that the designed CRA form could be a useful tool for CRA in the Iranian preschoolers.
Collapse
Affiliation(s)
- Shiva Mortazavi
- Dental Research Centre, Department of Pediatric Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Enshaei
- Dental Research Centre, Department of Pediatric Dentistry, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ziba Farajzadegan
- Department of Community Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
7
|
Dias KR, Andrade CBD, Wait TTDA, Chamon RC, dos Santos KRN, Soviero VM, Maia LC, Fonseca-Gonçalves A. Influence of the microbiological component of Cariogram ® for evaluating the risk of caries in children. Acta Odontol Scand 2017; 75:446-452. [PMID: 28585889 DOI: 10.1080/00016357.2017.1334960] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To compare the risk for caries in children as determined by Cariogram® software (CS; Stockholm, Sweden) with and without its microbiological component and by a form based on Cariogram® (FBC). METHODS Children (n = 28) aged 3-9 years were included. Data were collected clinically and from anamnesis. The salivary levels of Streptococcus mutans (SM) were evaluated. A linear regression model was used to determine which variables were predictive for each type of risk analysis. Caries risk was the dependent variable and the independent variables were caries experience, related disease, plaque amount, diet frequency, salivary levels of SM, fluoride sources and clinical judgment. A paired Student t-test was used for the following comparisons: (a) CS with and without SM; (b) CS without SM and FBC; (c) CS with SM and FBC. RESULTS The mean dmft/DMFT was 5.56 ± 2.51. There was no difference between the methods (p < .05). Regardless of caries risk, the children presented the same levels of SM (p = .889). Caries experience, plaque amount, diet frequency and fluoride sources were predictors of caries risk in all assessment methods. Clinical judgment was a significant predictor in CS. CONCLUSIONS Caries experience, plaque amount, diet frequency and fluoride sources are valuable predictors of caries risk; microbiological tests are not necessary for evaluating caries risk in children, which can be assessed similarly by CS without SM and FBC.
Collapse
Affiliation(s)
- Kairon Ribeiro Dias
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Carolina Barbosa de Andrade
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Taíssa Tomaz de Almeida Wait
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Raiane Cardoso Chamon
- Department of Medical Microbiology, Prof. Paulo de Góes Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Kátia Regina Netto dos Santos
- Department of Medical Microbiology, Prof. Paulo de Góes Institute, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Vera Mendes Soviero
- Department of Preventive and Community Dentistry, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Andréa Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
8
|
Senneby A, Mejàre I, Sahlin NE, Svensäter G, Rohlin M. Diagnostic accuracy of different caries risk assessment methods. A systematic review. J Dent 2015; 43:1385-93. [PMID: 26493112 DOI: 10.1016/j.jdent.2015.10.011] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To evaluate the accuracy of different methods used to identify individuals with increased risk of developing dental coronal caries. DATA Studies on following methods were included: previous caries experience, tests using microbiota, buffering capacity, salivary flow rate, oral hygiene, dietary habits and sociodemographic variables. QUADAS-2 was used to assess risk of bias. Sensitivity, specificity, predictive values, and likelihood ratios (LR) were calculated. Quality of evidence based on ≥3 studies of a method was rated according to GRADE. SOURCES PubMed, Cochrane Library, Web of Science and reference lists of included publications were searched up to January 2015. STUDY SELECTION From 5776 identified articles, 18 were included. Assessment of study quality identified methodological limitations concerning study design, test technology and reporting. No study presented low risk of bias in all domains. Three or more studies were found only for previous caries experience and salivary mutans streptococci and quality of evidence for these methods was low. Evidence regarding other methods was lacking. For previous caries experience, sensitivity ranged between 0.21 and 0.94 and specificity between 0.20 and 1. Tests using salivary mutans streptococci resulted in low sensitivity and high specificity. For children with primary teeth at baseline, pooled LR for a positive test was 3 for previous caries experience and 4 for salivary mutans streptococci, given a threshold ≥10(5) CFU/ml. CONCLUSIONS Evidence on the validity of analysed methods used for caries risk assessment is limited. As methodological quality was low, there is a need to improve study design. CLINICAL SIGNIFICANCE Low validity for the analysed methods may lead to patients with increased risk not being identified, whereas some are falsely identified as being at risk. As caries risk assessment guides individualized decisions on interventions and intervals for patient recall, improved performance based on best evidence is greatly needed.
Collapse
Affiliation(s)
- Anna Senneby
- Faculty of Odontology, Malmö University, 205 06 Malmö, Sweden
| | - Ingegerd Mejàre
- The Swedish Council on Technology Assessment in Health Care, Box 3657, 103 59 Stockholm, Sweden
| | - Nils-Eric Sahlin
- Department of Medical Ethics, Lund University, 221 84 Lund, Sweden
| | | | | |
Collapse
|
9
|
Mejàre I, Axelsson S, Dahlén G, Espelid I, Norlund A, Tranæus S, Twetman S. Caries risk assessment. A systematic review. Acta Odontol Scand 2014; 72:81-91. [PMID: 23998481 DOI: 10.3109/00016357.2013.822548] [Citation(s) in RCA: 149] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the ability of multivariate models and single factors to correctly identify future caries development in pre-school children and schoolchildren/adolescents. STUDY DESIGN A systematic literature search for relevant papers was conducted with pre-determined inclusion criteria. Abstracts and full-text articles were assessed independently by two reviewers. The quality of studies was graded according to the QUADAS tool. The quality of evidence of models and single predictors was assessed using the GRADE approach. RESULTS Ninety original articles fulfilled the inclusion criteria. Seven studies had high quality, 35 moderate and the rest poor quality. The accuracy of multivariate models was higher for pre-school children than for schoolchildren/adolescents. However, the models had seldom been validated in independent populations, making their accuracy uncertain. Of the single predictors, baseline caries experience had moderate/good accuracy in pre-school children and limited accuracy in schoolchildren/adolescents. The period of highest risk for caries incidence in permanent teeth was the first few years after tooth eruption. In general, the quality of evidence was limited. CONCLUSIONS Multivariate models and baseline caries prevalence performed better in pre-school children than in schoolchildren/adolescents. Baseline caries prevalence was the most accurate single predictor in all age groups. The heterogeneity of populations, models, outcome criteria, measures and reporting hampered the synthesis of results. There is a great need to standardize study design, outcome measures and reporting of data in studies on caries risk assessment. The accuracy of prediction models should be validated in at least one independent population.
Collapse
Affiliation(s)
- I Mejàre
- Swedish Council on Health Technology Assessment , Stockholm , Sweden
| | | | | | | | | | | | | |
Collapse
|
10
|
Mäkinen KK, Järvinen KL, Anttila CH, Luntamo LM, Vahlberg T. Topical xylitol administration by parents for the promotion of oral health in infants: a caries prevention experiment at a Finnish Public Health Centre. Int Dent J 2013; 63:210-24. [PMID: 23879257 DOI: 10.1111/idj.12038] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This demonstration programme tested topical use of xylitol as a possible oral health promoting regimen in infants at a Finnish Public Health Centre in 2002-2011. METHODS Parents (usually mothers) began once- or twice-daily administration of a 45% solution of xylitol (2.96 m) onto all available deciduous teeth of their children at the age of approximately 6-8 months. The treatment (xylitol swabbing), which continued till the age of approximately 36 months (total duration 26-28 months), was carried out using cotton swabs or a children's toothbrush; the approximate daily xylitol usage was 13.5 mg per each deciduous tooth. RESULTS At the age of 7 years, caries data on the deciduous dentition of 80 children were compared with those obtained from similar, untreated children (n = 90). Xylitol swabbing resulted in a significant (P < 0.001) reduction in the incidence of enamel and dentine caries compared with the comparison subjects (relative risk 2.1 and 4.0, respectively; 95% confidence intervals 1.42-3.09 and 2.01-7.98, respectively). Similar findings were obtained when the children were 5 or 6 years old. The treatment reduced the need of tooth filling relative risk and 95% confidence intervals at 7 years: 11.86 and 6.36-22.10, respectively; P < 0.001). Compared with untreated subjects, the oral counts of mutans streptococci were reduced significantly (P < 0.001). CONCLUSIONS Considerable improvement in dental health was accomplished in infants participating in a topical at-home xylitol administration experiment, which was offered to families in the area by the Public Health Centre as a supplement to standard oral health care. Caregiver assessment of the programme was mostly rated as high or satisfactory.
Collapse
Affiliation(s)
- Kauko K Mäkinen
- Institute of Dentistry, University of Turku, Turku, Finland.
| | | | | | | | | |
Collapse
|
11
|
Comparing Health Promotion Programs in Public Dental Service of Vantaa, Finland: A Clinical Trial in 6–36-Month-Old Children. Int J Dent 2013; 2013:757938. [PMID: 24348559 PMCID: PMC3852318 DOI: 10.1155/2013/757938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Revised: 09/22/2013] [Accepted: 10/03/2013] [Indexed: 11/17/2022] Open
Abstract
Objective. The study assessed whether the new family-based programs in health promotion or the training of dental professionals had an impact on the colonization of mutans streptococci (MS) in young children. Material and Methods. The participants were children born in 2008 and inhabitants of Vantaa aged 24–36 months. The families with first-born children were invited to a questionnaire study. Vantaa was categorized into three matching areas, which were randomly assigned to different programs. New counseling methods were trained. The routine program used earlier served as the control group. The children born in 2006 served as a historic control. The outcome measure was the presence of MS. Statistical method was logistic regression. Results. Colonization of MS was found only in few children born in 2006 or 2008; 15% and 11%, respectively. Within the 2008 birth cohort, the addition of parental counseling did not improve the routine program. Instead, the father's advanced level of education (P = 0.044) and the child's reported the use of xylitol at least three times a day (P = 0.014) associated with negative MS scores. Conclusions. The routine program and training of the professionals seem to reduce the proportion of children with MS more than adding parental self-care to oral health programs.
Collapse
|
12
|
dos Santos APP, Soviero VM. Comparison between a simplified and a conventional biofilm index in relation to caries activity and gingivitis in the primary dentition. Eur Arch Paediatr Dent 2012; 8:201-5. [DOI: 10.1007/bf03262597] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
13
|
Tellez M, Gomez J, Pretty I, Ellwood R, Ismail AI. Evidence on existing caries risk assessment systems: are they predictive of future caries? Community Dent Oral Epidemiol 2012; 41:67-78. [DOI: 10.1111/cdoe.12003] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M Tellez
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
| | | | - I Pretty
- Colgate Palmolive Dental Health Unit; School of Dentistry, University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - R Ellwood
- Colgate Palmolive Dental Health Unit; School of Dentistry, University of Manchester; Manchester Academic Health Sciences Centre; Manchester; UK
| | - AI Ismail
- Maurice H Kornberg School of Dentistry; Temple University; Philadelphia; PA; USA
| |
Collapse
|
14
|
Peters MC, Tallman JA, Braun TM, Jacobson JJ. Clinical reduction of S. mutans in pre-school children using a novel liquorice root extract lollipop: a pilot study. Eur Arch Paediatr Dent 2011; 11:274-8. [PMID: 21108917 DOI: 10.1007/bf03262762] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIM To determine the clinical effect of a simple herbal caries-prevention protocol aimed at reduction of Streptococcus mutans (SM) in young children in a pre-school setting. STUDY DESIGN Proof-of-principle pilot study. METHODS To prove the concept this pilot study delivered a clinical intervention using sugar-free lollipops containing liquorice root extract. Regimen: Supervised herbal lollipops, twice daily for 3 weeks. Species-specific monoclonal antibody testing of saliva provided SM counts. Children were grouped in high, medium and low caries-risk using baseline SM-levels as risk-indicator. Bacterial numbers at baseline, during intervention, and for 9 weeks post-intervention were compared. STATISTICS SM levels were analysed using GEE modelling. RESULTS High-risk children showed the steepest early decrease in mean log-SM (P<.001). At end of a follow-up period, the log-SM decrease moved the high-risk group down to moderate-risk level. High-risk children showed a decrease in fitted mean SM% not seen in other groups (P<.001). The decrease reached a nadir around 22-days post-intervention. Twice-daily use of herbal lollipop significantly reduced both number and relative percent of SM in high-risk children. SM numbers were reduced for 22 days after the last lollipop, stabilized and then began to rebound. CONCLUSION A potential for simple effective caries-prevention for high-risk children has been demonstrated. Encouraging results warrant randomised clinical trials (RCT) of liquorice root in herbal lollipops or alternative modes of delivery.
Collapse
Affiliation(s)
- M C Peters
- Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan, 1100 N University, Ann Arbor, MI 48109, USA.
| | | | | | | |
Collapse
|
15
|
Fontana M, Jackson R, Eckert G, Swigonski N, Chin J, Zandona AF, Ando M, Stookey GK, Downs S, Zero DT. Identification of caries risk factors in toddlers. J Dent Res 2011; 90:209-14. [PMID: 21173434 PMCID: PMC3144099 DOI: 10.1177/0022034510385458] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Revised: 05/24/2010] [Accepted: 06/17/2010] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to identify risk factors to predict caries progression in toddlers in primary-healthcare settings for the cost-effective targeting of preventive and referral strategies. We examined 329 children (26 ± 6 mos old) twice, one year apart, in Indiana, USA. A 107-item structured interview was used to collect information from the primary caregiver and child on factors/beliefs/perceptions/behaviors that could affect caries development, transmission of bacteria, medical-dental health, and access to care. Bacterial levels, gingivitis, dental plaque, and caries experience were assessed. Multiple-variable logistic regression models of caries progression toward cavitation included family caries experience, transmission-related behaviors, dietary factors, health beliefs, and lower income, but differed in selected predictors/predictive power by race/ethnicity. Addition of clinical variables did not significantly improve the prediction.
Collapse
Affiliation(s)
- M Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University Ave., Room 2029B, Ann Arbor, MI 48109 USA.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Eckert GJ, Jackson R, Fontana M. Sociodemographic variation of caries risk factors in toddlers and caregivers. Int J Dent 2010; 2010:593487. [PMID: 20953367 PMCID: PMC2952902 DOI: 10.1155/2010/593487] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 05/05/2010] [Accepted: 07/29/2010] [Indexed: 11/18/2022] Open
Abstract
Objectives. Dental caries is the most common chronic childhood disease, with numerous identified risk factors. Risk factor differences could indicate the need to target caregiver/patient education/preventive care intervention strategies based on population and/or individual characteristics. The purpose of this study was to evaluate caries risk factors differences by race/ethnicity, income, and education. Methods. We enrolled 396 caregiver-toddler pairs and administered a 105-item questionnaire addressing demographics, access to care, oral bacteria transmission, caregiver's/toddler's dental and medical health practices, caregiver's dental beliefs, and caregiver's/toddler's snacking/drinking habits. Logistic regressions and ANOVAs were used to evaluate the associations of questionnaire responses with caregiver's race/ethnicity, income, and education. Results. Caregivers self-identified as Non-Hispanic African-American (44%), Non-Hispanic White (36%), Hispanic (19%), and "other" (1%). Differences related to race/ethnicity, income, and education were found in all risk factor categories. Conclusions. Planning of caregiver/patient education/preventive care intervention strategies should be undertaken with these caries risk factor differences kept in mind.
Collapse
Affiliation(s)
- G. J. Eckert
- Division of Biostatistics, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - R. Jackson
- Department of Preventive and Community Dentistry, Indiana University School of Dentistry, Indianapolis, IN 46202, USA
| | - M. Fontana
- Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI 48109-1078, USA
| |
Collapse
|
17
|
Holgerson PL, Twetman S, Stecksèn-Blicks C. Validation of an age-modified caries risk assessment program (Cariogram) in preschool children. Acta Odontol Scand 2009; 67:106-12. [PMID: 19152150 DOI: 10.1080/00016350802714734] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES (i) To validate caries risk profiles assessed with a computer program against actual caries development in preschool children, (ii) to study the possible impact of a preventive program on the risk profiles, and (iii) to compare the individual risk profiles longitudinally. MATERIAL AND METHODS Caries risk was assessed in 125 two-year-old children invited to participate in a 2-year caries-preventive trial with xylitol tablets. At 7 years of age, 103 were available for follow-up, 48 from the former intervention group and 55 from the control group. At baseline and after 5 years, 7 variables associated with caries were collected through clinical examinations and questionnaires, and scored and computed with a risk assessment program (Cariogram). RESULTS Children assessed as having a "low chance (0-20%) of avoiding caries" had significantly higher caries at 7 years of age compared to children with a lower risk in the control group (p<0.05) but not in the intervention group. Overall predictive accuracy and precision, however, were moderate in both groups. Less than half of the children remained in the same risk category at both ages, despite a largely unchanged consumption pattern of sugar. The majority of the children who changed category displayed a lowered risk at 7 years. The intervention program seemed to impair the predictive abilities of Cariogram. CONCLUSION A modified Cariogram applied on preschool children was not particularly useful in identifying high caries risk patients in a low-caries community.
Collapse
|
18
|
Katsumura S, Nishikawara F, Tamaki Y, Yamada H, Nakamura Y, Sato K, Tsuge S, Nomura Y, Hanada N. Evaluation of risk factors for dental caries from 6 to 8 years old children. PEDIATRIC DENTAL JOURNAL 2008. [DOI: 10.1016/s0917-2394(08)70118-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
19
|
Affiliation(s)
| | - Stuart A. Gansky
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| | - John D. Featherstone
- Department of Preventive and Restorative Dental Sciences; School of Dentistry; University of California; San Francisco
| |
Collapse
|
20
|
Seki M, Yamashita Y, Shibata Y, Torigoe H, Tsuda H, Maeno M. Effect of mixed mutans streptococci colonization on caries development. ACTA ACUST UNITED AC 2006; 21:47-52. [PMID: 16390341 DOI: 10.1111/j.1399-302x.2005.00253.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the clinical importance of mixed mutans streptococci colonization in predicting caries in preschool children. METHODS Caries prevalence was examined twice, with a 6-month interval, in 410 preschool children aged 3-4 years at baseline. A commercial strip method was used to evaluate the mutans streptococci score in plaque collected from eight selected interdental spaces and in saliva. Mutans streptococci typing polymerase chain reaction (PCR) assays (Streptococcus sobrinus and Streptococcus mutans, including serotypes c, e, and f) were performed using colonies on the strips as template. RESULTS Twenty variables were examined in a univariate analysis to predict caries development: questionnaire variables, results of clinical examination, mutans streptococci scores, and PCR detection of S. sobrinus and S. mutans (including serotypes c, e, and f). Sixteen variables showed statistically significant associations (P < 0.04) in the univariate analysis. However, when entered into a logistic regression, only five variables remained significant (P < 0.05): caries experience at baseline; mixed colonization of S. sobrinus and S. mutans including S. mutans serotypes; high plaque mutans streptococci score; habitual use of sweet drinks; and nonuse of fluoride toothpaste. CONCLUSION 'Mixed mutans streptococci colonization' is a novel measure correlated with caries development in their primary dentition.
Collapse
Affiliation(s)
- M Seki
- Department of Oral Health Sciences, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan.
| | | | | | | | | | | |
Collapse
|
21
|
Nobre Dos Santos M, Rodrigues LKA, Peres RCR, Yokoyama RT, Gavazzi JCC, Gavião MBD. Relationships between occlusal or free-smooth and approximal caries in mixed dentition. Acta Odontol Scand 2005; 63:308-13. [PMID: 16419437 DOI: 10.1080/00016350500206702] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This cross-sectional study aimed to examine the relationships between free-smooth or occlusal surfaces and approximal caries in 104 schoolchildren between 6 and 8 years of age. Caries diagnosis was clinically and radiographically assessed, and white spot lesions, evident caries lesions or restorations, as well as radiolucence in enamel were considered to be caries. In the studied subjects, the correlations were analyzed in the 1st primary molars (Ds), the 2nd primary molars (Es), the 1st permanent molars (6s), and all molars. The data were statistically analyzed by chi-square test. Significant correlations between occlusal surface caries and approximal surface lesions were observed in Ds and Es teeth and in all molars, but not for 1st permanent molars. For free-smooth surface, these correlations were significant only for Es and all molars. Sensitivity and specificity for occlusal surface as an indicator of approximal caries in the same tooth type ranged from 73% to 83% and 51% to 58%, respectively. Similarly, for free-smooth surface the values varied from 22% to 60% and 57% to 90%, respectively. Sensitivity and specificity for occlusal surface caries in identifying subjects with approximal caries were 78% and 70%, respectively; for free-smooth surface, the corresponding values were 59% and 65%, respectively. The results suggest that visually detected caries lesions are indicative of approximal caries. Thus, if a certain risk limit is defined and the corresponding number of caries lesions in different surfaces is reached, the risk is above the threshold and could be a practical guideline on the need for radiography in this age group of patients with "moderate caries experience".
Collapse
Affiliation(s)
- Marinês Nobre Dos Santos
- Department of Paediatric Dentistry, Faculty of Dentistry of Piracicaba, State University of Campinas, Piracicaba, São Paulo, Brazil.
| | | | | | | | | | | |
Collapse
|