Can type of school be used as an alternative indicator of socioeconomic status in dental caries studies? A cross-sectional study

A scoping review on early childhood caries and inequalities using the Sustainable Development Goal 10 framework

BACKGROUND

Social inequalities contribute to health disparities. This study aimed to map evidence on early childhood caries (ECC) related to the United Nations' Sustainable Development Goal 10 (SDG 10).

METHODS

A scoping review was conducted in May 2024 following the PRISMA-ScR guidelines. A literature search was performed in PubMed, Web of Science, and CINAHL for studies published in English and addressing population level social inequalities. Studies measuring individual level of social inequalities were excluded as they were covered by other SDGs. However, studies incorporating individual measures as additional measures of population level social inequality were included. Retrieved papers were summarized, inductively analysed and a conceptual framework linking SDG 10 was developed.

RESULTS

Of 452 studies retrieved, 42 met the inclusion criteria. Studies measured inequality among groups (deprivation, family income, indigenous communities, ethnicity, minority status) [14 studies], institutions (type of school, nursery or school facility, school poverty index, public primary health care units) [five studies], and inequality in communities (neighbourhood socio-economic status, Human Development Index, employment rate, income inequality, sanitary sewer and water supply, residents/household ratio, urban vs rural vs remote rural, accessibility index, location index, the slope index of inequality) [24 studies]. These levels of social inequalities were linked to higher prevalence of ECC; social and economic policies contributed to widening inequalities in ECC severity; and although effective interventions targeted at at-risk populations could reduce dental health disparities, study interventions differed by deprivation status. Six studies (14.3%) addressed SDG 10.1, 33 (78.6%) addressed SDG 10.2, 11 (26.2%) addressed SDG 10.3, and three (7.1%) addressed SDG 10.4. Fourteen studies (33.3%) addressed a combination of SDGs. The conceptual framework highlights the role of structural inequalities stemming from the cumulative impact of institutional decisions and systemic inequalities.

CONCLUSION

This scoping review underscores the profound influence of social inequality on ECC through interactions between multi-level factors. Further research is needed to explore the links between ECC and other SDG 10 targets, especially in low- and lower-middle-income countries.

The impact of distraction, masticatory performance and sex on food intake of school children from public and private schools: a randomized trial

Recent research highlights the influence of distraction on caloric intake in adults. This study investigated the impact of smartphone use and reading comic book on food intake of schoolchildren aged 10 to 12 years. One hundred and twenty students from public and private schools participated in experimental meal sessions. Individual parameters such as sex, age, body mass index (BMI), and eating preferences were assessed during the first session. In subsequent appointments, participants consumed standardized meals without distraction, while using a smartphone, or reading comic books in a random order. Child Three-Factor Eating Questionnaire (CTFEQr-21) was administered to assess eating behavior, and total caloric intake (kcal), total amount (g) and medium/high-energy-dense amount (g) were measured in each session. No significant difference was observed in food intake among the three experimental meals (without distractor, using smartphone and reading comic book). Masticatory performance, number of chewing cycles, and time until swallow were similar between sexes and school types (p>0.05). Regression models showed that meal duration was dependent on school type, number of teeth, time until swallow and absence of distractor, while total caloric intake was dependent on school type (public), sex (male), time until swallow, and number of cycles. Besides, total amount ingested, and medium/high-energy-dense amount were dependent on school type (public), sex (male), age, size of the particles and time until swallowing, uncontrolled eating and body mass index (p<0.05). In conclusion, the primary factors affecting food/caloric ingestion were sex, school type, and masticatory parameters, while the absence of distractor had an influence on meal duration.

Prevalence of Obesity and Dental Caries in Kindergarten Children During the First Decade of Saudi Vision 2030: A Cross-Sectional Study

BACKGROUND/OBJECTIVES

Obesity and dental caries are significant health issues affecting children worldwide. This study aims to investigate the prevalence of obesity and dental caries among kindergarten children in Saudi Arabia during the early implementation years of the Vision 2030 initiative. Specifically, it examines the obesity rates between public and private kindergartens and assesses the correlation between obesity and caries risk.

METHODS

We conducted a cross-sectional study involving a stratified sample of 347 kindergarten children in Jeddah, Saudi Arabia, from September 2022 to March 2023, as part of a larger project assessing the obesity and dental caries prevalence in school-aged children. Their body mass index (BMI) was computed after their weight and height were measured. Following an oral examination, the decayed, missing, and filled teeth (dmft) scores were noted. The relationships between dmft and BMI, sex, and school type were studied using non-parametric tests, and its predictors were assessed as well.

RESULTS

Our findings indicate that 15.3% of the children were classified as obese based on the BMI measurements, while 9.8% were categorized as overweight. The prevalence of obesity did not show significant differences by school type when classified by BMI. The mean dmft score was 2.8 ± 3.6, with those children in public kindergartens demonstrating significantly higher dmft scores compared to their private counterparts (p < 0.001). Notably, there was no observed relationship between obesity and caries activity.

CONCLUSIONS

Despite the implementation of Saudi Vision 2030, the high prevalence of obesity and dental caries among kindergarten children suggests that the current health initiatives may be insufficient. The lack of a relationship between obesity and caries activity highlights the complexity of these health issues and the need for targeted interventions. To improve the health outcomes, it is recommended to enhance the awareness campaigns regarding oral health and nutrition, increase access to preventive dental care, and integrate nutrition education into kindergarten curricula.

Caries prevalence among children at public and private primary schools in Riyadh: a retrospective study

Dental caries is a global oral health issue, especially critical in children, affecting their growth, nutrition, and education due to school absences or distractions from dental pain. The aim of the study was to investigate the correlation between school types (indicative of socioeconomic conditions) and dental caries prevalence among primary school children in Riyadh, alongside assessing the overall caries prevalence among schoolchildren in Riyadh. Retrospective study on 28,343 first and fourth-grade students from 960 public and private schools in Riyadh, using data from the Saudi Ministry of Health (Feb-April 2019). Utilized the DMFT/dmft index for assessment and collected demographic data. Most of the schools were public (76.1%), private national (17.1%), and private international (6.8%). Overall, the mean DMFT index for permanent teeth and the dmft index for primary teeth were 1.78 and 1.94, respectively. 58% of school children had no dental caries, 25% had mild caries, and 17% had moderate to severe caries. Public school children showed a higher caries prevalence than private schools. Oral disease rates were higher in girls than in boys, and grade four students had a higher prevalence than grade one students. Saudi Arabia, a developing nation, faces challenges in addressing oral health, especially in public schools. Targeted initiatives are crucial for awareness, preventive measures, and meeting oral health needs.

Individual and contextual determinants associated with traumatic dental injuries in children eight to ten years of age: a multilevel analysis

OBJECTIVE

Investigate individual and contextual determinants associated with traumatic dental injuries in schoolchildren.

METHODS

A cross-sectional study with 739 pairs of parents and children. Parents answered a sociodemographic questionnaire, the Family Adaptability and Cohesion Evaluation Scale and a questionnaire on the child's use of electronic devices. Examinations of the children were conducted at the school by calibrated examiners using the diagnostic criteria proposed by Andreasen. Contextual variables of the school were also collected. Multilevel Poisson regression for complex samples was performed (p < 0.05).

RESULTS

The individual factors associated with the outcome were children of single parents (PR = 2.33; 95% CI: 1.79-2.66), practice of sports (PR = 2.46; 95% CI: 1.70-3.22), the daily use of electronic devices (PR = 1.78; 95% CI: 1.31-1.81), more than 2 h per day of screen time (PR = 3.84; 95% CI: 1.94-4.28) and chaotic family adaptability (PR = 4.22; 95% CI: 3.44-4.99). The contextual variables were studying at a public school (PR = 1.77; 95% CI: 1.02-3.05) and the presence of rigid floor in the school courtyard (PR = 1.99; 95% CI: 1.15-3.15).

CONCLUSION

Individual determinants, studying at a public school and the presence of rigid floor in the school courtyard were associated with traumatic dental.

Effect of weight satisfaction on adolescent facial and dental satisfaction

PURPOSE

To investigate if facial and dental satisfaction is related to body fat percentage and body weight satisfaction.

METHODS

A self-administered questionnaire was applied to adolescents from a Private School in Southern Brazil containing sociodemographic (sex and age) and self-perception variables. Adolescents were asked about their perceptions concerning dental problems. Body fat percentage was collected using bioelectrical impedance analysis.

RESULTS

A total of 372 adolescents were examined. Most adolescents were satisfied with their dental (81.7%) and facial appearance (87.6%), while 39% of adolescents were satisfied with their body weight. Poisson regression model showed that adolescents who expressed satisfaction with their body weight (PR = 1.12, 95%CI 1.06-1.19) and were satisfied with their dental appearance (PR = 1.24, 95% CI 1.08-1.41) exhibited a positive association with facial satisfaction. Adolescents dissatisfied with dental color (PR = 0.88, 95%CI 0.80-0.97), those reporting dental pain (PR = 0.88, 95%CI 0.80-0.97), and individuals with obesity (PR = 0.91, 95%CI 0.83-0.99) demonstrated a decrease in facial satisfaction. Adolescents aged 16 to 19 years (PR = 1.08, 95% CI 1.01-1.15) and those satisfied with their facial appearance (PR = 1.20, 95%CI 1.01-1.43) exhibited a higher prevalence of dental satisfaction. Conversely, adolescents dissatisfied with dental color (PR = 0.74, 95% CI 0.66-0.82) and those with misaligned teeth (PR = 0.63, 95%CI 0.55-0.73) reported lower levels of dental satisfaction. Parametric g-formula analysis found that the association between body fat and facial satisfaction was mediated by body weight satisfaction (p = 0.001).

CONCLUSIONS

While dental satisfaction was not influenced by corporeal characteristics, facial satisfaction was influenced by dental and body weight satisfaction. Obese adolescents had low facial satisfaction.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Association between toothbrushing frequency and dental caries and tooth loss in adolescents: a cohort study

This cohort study assessed the association between toothbrushing frequency and the increment of dental caries and tooth loss in a population-based sample of southern Brazilian adolescents, to investigate whether there is any additional benefit in performing a third daily brushing. At baseline, 1,528 12-year-old schoolchildren attending 42 schools were examined for gingivitis and dental caries, and answered a questionnaire. After a mean period of 2.5 years, 801 schoolchildren were re-examined. Dental caries and tooth loss increment were outcomes of the study. The main predictor variable was toothbrushing frequency (≥3 times/day vs. twice/day or ≤1 time/day). Poisson regression models were used to estimate the risk for caries and tooth loss increment. Incidence risk ratios (IRR) and 95% confidence intervals (CI) were estimated. The final model adjusted for sociodemographic, behavioral, and clinical variables showed that brushing twice/day afforded 40% greater risk (IRR = 1.40; 95%CI: 1.02-1.92) for caries increment than ≥3 times/day. Regarding the tooth loss increment, adolescents who brushed their teeth twice/day had a fourfold greater risk (IRR = 3.92; 95%CI: 1.23-12.49) than those who brushed ≥ 3 times/day. Sex, school type, and gingivitis were found to act as effect modifiers, inasmuch as a third daily brushing presented advantages against tooth loss only for girls, public school attendees, and those with ≥ 50% of bleeding sites. This study suggests that adolescents benefit from a third daily toothbrushing. Increasing brushing frequency to 3 times/day may be a suitable strategy to control dental caries and tooth loss among high-risk adolescents.

White blood cells in a healthy adolescent population according to social and health characteristics

BACKGROUND

The immune system constitutes a sensory system both for heritable and non-heritable factors. Among the latter, social and environmental determinants of health may influence and shape the immune system in early life. To study the relationship between leukocytes and determinants of health in adolescence, we assessed total and differential white blood cells (WBC) according to social and environmental determinants of health in a healthy adolescent population.

METHODS

As part of the population-based cohort Epidemiological Health Investigation of Teenagers in Porto (EPITeen), 1213 adolescents were evaluated at the age of 13. Total and differential WBC were evaluated through a venous blood sample using an automated blood counter (Sysmex®XE-5000, Hyogo, Japan). Sociodemographic, behavioral, and clinical data were collected through self-administered questionnaires.

RESULTS

Participants with better socioeconomic conditions (enrolled at private schools or higher parental education) had significantly lower total WBC levels, and the latter showed a lower percentage of neutrophils and higher percentage of lymphocytes. Those who practiced sports had significantly lower total WBC levels and neutrophil percentage, as well as a significantly higher percentage of eosinophils and lymphocytes. Adolescents with chronic disease, chronic medication, or allergic diseases had a significantly higher percentage of eosinophils and a lower percentage of monocytes. With increasing body mass index and systemic inflammation, we found a significant increase in total WBC levels.

CONCLUSION

WBC linked to different immune response patterns are associated with several social and environmental determinants of health in adolescence.

Prevalence, extent, risk indicators, and intraoral distribution of underlying dentin shadows (ICDAS 4) among 15-19-year-old South Brazilian adolescents

Background and Objective

This study aimed to assess the prevalence, extent, risk indicators, and intraoral distribution of underlying dentin shadows (UDS) in the occlusal surfaces of the permanent posterior teeth.

Subjects and Methods

A total of 1197 adolescents were included in the study (participation rate of 72.3%). The association between the independent variables, on the one hand, and the prevalence and extent of UDS were assessed using multilevel Poisson regression models. The prevalence ratios (PR), rate ratios (RR), and 95% confidence intervals (95% CIs) were estimated. The overall prevalence of UDS was 8.8% (95% CI = 6.0-11.5), with an overall mean of 0.13 (95% CI = 0.08-0.17) lesions per individual. Those with UDS exhibited a mean of 1.45 (95% CI = 1.28-1.62) lesions.

Results

Lower family income (PR = 1.58; 95% CI = 1.03-2.41) and caries activity (PR = 1.53; 95% CI = 1.01-2.31) were significantly associated with UDS prevalence, while age ≥17 years (RR = 1.43; 95% CI = 1.03-1.99) and caries activity (RR = 1.63; 95% CI = 1.55-2.30) were significantly associated with caries extent. The most commonly affected teeth were lower first molars, followed by upper first molars and lower second molars.

Conclusion

This study found a low prevalence and extent of UDS in the occlusal surface. Sociodemographic variables and caries activity were associated with the occurrence of UDS.

Premature Primary Tooth Loss and Oral Health-Related Quality of Life in Preschool Children

The present study aimed to evaluate the association between premature primary tooth loss and oral health-related quality of life (OHRQoL) in preschool children. A cross-sectional study was conducted in 769 5-year-old preschool children. The children and their parents or guardians answered the Brazilian version of the Scale of Oral Health Outcomes for 5-Year-Old Children for the assessment of OHRQoL. Meanwhile, clinical examinations were performed for the assessment of premature primary tooth loss. Unadjusted and adjusted multilevel Poisson regression models were utilized to investigate the associations between the variables. In the parental version of the scale, premature posterior primary tooth loss (rate ratio [RR] = 2.65; 95% confidence interval [CI] = 1.51-4.68), weak sense of coherence (RR = 2.25; 95% CI = 1.62-3.11), and visit to a dentist (RR = 1.61; 95% CI = 1.04-2.52) were associated with OHRQoL. Based on the children's perceptions, only the preschool type was associated with OHRQoL (RR = 1.92; 95% CI = 1.21-3.05). Premature posterior primary tooth loss had a greater impact on OHRQoL based on the parents' perception, whereas only the preschool type was associated with OHRQoL based on the children's perception.

Does the school environment exert influence on quality of life related to traumatic dental injury in children?

The aim of this cross-sectional study was to assess whether favorable factors related to school characteristics have a positive effect on the impact of traumatic dental injury (TDI) on oral health-related quality of life (OHRQoL). An epidemiological survey of oral health was conducted with 12-year-old schoolchildren from Quito, Ecuador. Children were examined for TDI, dental caries, and malocclusion. Individual socioeconomic data were also collected. Information on the physical environment, health practices, and occurrence of negative episodes at school was collected from the school coordinators. The Child Perceptions Questionnaire 11-14 (CPQ11-14) was used to evaluate the OHRQoL (outcome variable). Multilevel Poisson regression analysis was conducted. Severe TDI was associated with higher CPQ11-14 scores, even in the multiple model adjusted for oral health conditions, sex, individual socioeconomic variables, and school-related variables. Children from schools that had an appropriate tooth-brushing environment for their students exhibited a lower impact on OHRQoL, even after adjustment for the occurrence of TDI and other variables. A favorable school environment may exert a positive effect on OHRQoL, independent of the occurrence of TDI.

Psychological Impact of the COVID-19 Pandemic on Children and Adolescents With and Without Mental Disorders

Background: The previous and current studies highlight the psychological distress caused by coronavirus disease 2019 (COVID-19)-associated restrictions among the general population, especially among children and adolescents; however, few studies have examined children and adolescents with a mental disorder. The current study aimed to explore whether youth with mental disorders show a higher pandemic-associated psychological burden than healthy children and adolescents and to determine which psychiatric diagnoses are particularly associated with a higher distress level. Methods: In this study, 144 children and adolescents between the ages of 6 and 18 years with a mental disorder and 48 children and adolescents within the same age range without a mental disorder, and their caregivers, completed questionnaires assessing the pandemic-associated trauma symptoms (the Child Report of Post-Traumatic Symptoms [CROPS] and the Parents Report of Post-Traumatic Symptoms [PROPS]). Additionally, we asked specific questions about the pandemic-associated stress factors, such as financial problems, prolonged screen times, or loneliness. Results: Children and adolescents with a mental illness showed a significantly higher psychological burden than their mentally healthy peers. Female gender was a risk factor for a higher self-reported psychological burden, and younger age was associated with a more extensive parent-reported psychological burden. The patients with a depressive disorder showed significantly higher levels of psychological distress associated with the COVID-19 pandemic than the patients with an attention deficit and/or a conduct disorder. Conclusions: Children and adolescents with a mental illness, particularly, female children and individuals with a depressive disorder, are at an increased risk of suffering from pandemic-associated psychological distress. Adequate mental health care options, such as telepsychiatry, are indispensable.

Who gets to learn in a pandemic? Exploring the digital divide in remote learning during the COVID-19 pandemic in Nigeria

This study investigates the digital divide in access to remote learning for children in Nigeria, as a result of the COVID-19 pandemic. The data used in this study is from a survey conducted by The Education Partnership (TEP) Centre and the Nigerian Economic Summit Group (NESG), which sampled 557 students and 626 parents living in Nigeria. From the survey, we found: a relationship between the socioeconomic status and the digital divide in accessing remote learning, significant differences in students' access to remote learning opportunities during the pandemic, and significant differences in access to digital tools between students in government schools and their private school counterparts. We also found a statistically significant association between parental level of education and the ability to support children's remote learning during the pandemic.

Dental Caries in Relation to Socioeconomic Factors of 6 and 12-year-old Schoolchildren of Paonta Sahib, Himachal Pradesh, India: An Epidemiological Study

Aims and objectives

Determination of prevalence of dental caries in 6 and 12-year-old schoolchildren, dental caries prevalence between government and private schoolchildren, and the influence of socioeconomic factors on dental caries on children of Paonta Sahib, Himachal Pradesh, India.

Materials and methods

In the government and private schools at Paonta Sahib of Sirmour district, Himachal Pradesh, India, a cross-sectional study was carried out. The study population comprised schoolchildren of 6 and 12 years. A total of 1,004 children of both genders were surveyed for dental caries status. The decayed, missing, filled teeth (DMFT) index was used for clinical examination of caries. Prior collection of sociodemographic information was done in addition to information on oral health behavior by personal interview.

Results

In the present study, dental caries prevalence was found to be higher in children of 6 years of age (63.6%) than that of 12 years (53.6%) (p = 0.001). The mean DMFT was 2.47 ± 2.75 for 6–year-old children and 1.18 ± 1.33 for 12–year-old children. No significant difference was observed in dental caries prevalence among children of government and private school (p = 0.167). Moreover, dental caries frequency was highest in children belonging to upper-middle (38.14%) class followed by lower-middle (32.32%), upper-lower (25.42%), and upper class (4.12%). The obtained data were analyzed using the chi-square test and one-way ANOVA test.

Conclusion

Dental caries prevalence was high in children of 6 years of age in the study. The dental caries frequency was more in upper-middle-class children. These results suggest that emphasis should be given to scientific monitoring, effective implementation, and evaluation of school-based oral health promotion and preventive programs to increase the dental awareness and oral hygiene practices, in Paonta Sahib, Sirmour district.

How to cite this article

Jindal L, Dua P, Mangla R, et al. Dental Caries in Relation to Socioeconomic Factors of 6 and 12-year-old Schoolchildren of Paonta Sahib, Himachal Pradesh, India: An Epidemiological Study. Int J Clin Pediatr Dent 2020;13(4):395–398.

Effectiveness of Community-Based Interventions Programs in Childhood Obesity Prevention in a Spanish Population According to Different Socioeconomic School Settings

Overweight and obesity amongst childhood are currently global health issues. However, this is the best stage of life to prevent diseases and to promote healthy habits. In our study, we evaluate the effectiveness of the THAO Salud Infantil, a community-based intervention program, by means of a cross-sectional study carried out from 2009 to 2019 surveying children aged 3 to 12 years old (n = 27,686). During the study timeframe, overweight and obesity prevalence, according to both the International Obesity Task Force and Orbegozo Foundation criteria, showed a downward trend. Differences in the anthropometric variables were observed from the beginning to the end of the study, mainly in girls. Analysis of the influence of the socioeconomic status revealed that children from families with lower incomes are in greater risk of suffering from overweight and obesity and showed lower effectiveness of the actions proposed by the program. The overall results of the study confirmed the effectiveness of community-based interventions in terms of childhood overweight/obesity prevention.

Can the school environment influence oral health-related behaviours? A multilevel analysis of the Brazilian National Adolescent School-Based Health Survey 2015

OBJECTIVE

To investigate the association between the potential support of schools for oral health promotion and a set of oral health-related behaviours among adolescent students in Brazilian state capitals.

METHODS

A cross-sectional study using individual and school environment data from the 2015 Brazilian National Adolescent School-Based Health Survey (PeNSE) was conducted. The sample consisted of 51 192 students from 1339 public and private schools in the 27 Brazilian State Capitals, aged 11-19 years old. The outcomes were six oral health-related behaviours: dental visits; toothbrushing frequency; soft drink and sweets consumption; smoking and alcohol consumption. The explanatory variable was the Oral Health Promotion School Environment index (OHPSE). Covariates were the adolescents' sociodemographic characteristics and organizational aspects of the schools. A two-level multilevel mixed-effects Poisson regression analysis with fixed slopes and random intercepts was performed, considering the complex sample design.

RESULTS

The prevalence of risk behaviours was 28.0% for 'low frequency of annual dental visits', 6.9% for 'low daily toothbrushing frequency', 28.8% for 'high weekly soft drink consumption', 41.7% for 'high weekly sweet consumption', 18.9% for 'cigarette experimentation' and 52.6% for 'alcoholic beverage experimentation'. The schools were classified as low (36.3%), intermediate (30.4%) and high (33.3%) OHPSE. In the adjusted model, schools with 'high OHPSE' had lower prevalence of 'low frequency of annual dental visits' (PR = 0.94 [95% CI 0.90; 0.99]), 'high weekly frequency of soft drink consumption' (PR = 0.94 [95% CI 0.89; 0.99]) and 'sweet consumption' (PR = 0.96 [95% CI 0.93; 1.00]) than those with 'low OHPSE'. In addition, schools with 'intermediate OHPSE' had higher prevalence's of 'low daily toothbrushing frequency' (PR = 1.12 [95% CI 1.03; 1.23]) and 'cigarette experimentation' (PR = 1.08 [95% CI 1.01; 1.16]) than those with 'low OHPSE'. 'Alcoholic beverage experimentation' was not associated with OHPSE.

CONCLUSIONS

The potential support of schools for oral health promotion was associated with most of the oral health-related behaviours among adolescent students. Those attending schools with higher OHPSE scores reported a higher annual frequency of dental visits and a lower weekly frequency of soft drink and sweet consumption, while those in schools with intermediate OHPSE had a lower daily toothbrushing frequency and a higher rate of cigarette experimentation.

A digital movement in the world of inactive children: favourable outcomes of playing active video games in a pilot randomized trial

This parallel randomized controlled trial was aimed to evaluate whether parameters as physical fitness, reaction times, self-perception and enjoyment levels, as well as parental and children perspectives, were affected by active video games in inactive and technologically preoccupied children. Data were collected in a laboratory setting from four randomly selected urban public schools. All 1300 children in grades 3-6 were surveyed for the study. Among the 918 responders, 106 children were determined to be inactive and preoccupied with technology. Children in 3 schools (n = 53) allocated to active video game and in one school (n = 53) allocated to control group were compared by univariate covariance analyses for primary outcomes such as weight, body mass index and fat ratios at the end of 12 weeks. Active video game group significantly showed favourable responses for weight, body mass index and corresponding z scores as well as reaction times and self-perception controlling for age and baseline scores. In addition, enjoyment of the children in the game group by qualitative analysis was high indicating a motivational aspect for the continuation of the games. Diverse contributions of games to physical, social, intellectual and personal development were revealed.Conclusion: Active video games by promoting enjoyment levels and physical activity, as well as contributing to agility, alertness, socializing, and striving, led to a reduction in weight gain. They may be used as beneficial tools diverting children from inactivity and subsequent obesity.Trial registration: This study called AVGAME is registered with the number NCT03720938 in Clinicaltrials.gov . The trial protocol can also be retrieved from the archives of Abant Izzet Baysal University. What is Known: • Nowadays, children prefer sedentary video games that are known to induce weight gain and obesity-related comorbidities. • Active video games were shown to decrease weight in overweight and obese children. What is New: • Active video games decrease weight increment and reaction times, thus could be used to prevent obesity in inactive non-obese children. • Active video games raise self-esteem, induce enjoyment, improve the personal and intellectual development of children in addition to socializing and is a safe alternative to indoor sedentary video games.

Increase in dental caries and change in the socioeconomic profile of families in a child cohort of the primary health care in Northeast Brazil

Background

Factors associated with increases in dental caries and changes in the family socioeconomic profile were investigated in a paediatric primary health care (PHC) cohort in Northeast Brazil during the implementation of social and income transfer programmes.

Method

A prospective analytical study compared data from two surveys on caries in primary dentition conducted in 2006 (age: 18–36 months, n = 1045) and 2010 (age: 5–7 years). Data from the sample recruited and re-examined in 2010 (n = 469) were analysed. Prevalences (P) and the mean primary decayed, missing and filled teeth (dmft) index, cumulative incidence and mean increase were calculated. Differences (p ≤ 0.05 and 95% CI) in dmft ≥1 were identified via McNemar’s test. Differences in the mean dmft were evaluated according to socioeconomic variables (Kruskal-Wallis test and p ≤ 0.05). Multivariate analysis with a negative binomial model was used for the risk factors associated with increasing dmft. In the univariate analyses, nonparametric methods (Kruskal-Wallis test) were used to compare subsamples. Variables with p ≤ 0.20 were included in the multivariate model and retained when p ≤ 0.05.

Results

The prevalence and mean dmft (18–36 months and 5–7 years: p = 28.6 and 68.9%, mean = 1.01 and 3.46, respectively) and variation in mean dmft changed significantly (p < 0.005) with the education level and occupation of the mother; the prevalence and mean dmft were lower for higher maternal education level and maternal participation in the labour market. The cumulative incidence and mean increase in dmft were 8.71% and 2.45, respectively. Common risk predictors for increases in caries were consumption of sweets (RR = 1.53, 95% CI 1.09–2.14) and attendance at public schools (RR = 1.49, 95% CI: 1.81–1.89). Use of private clinical services was a protective factor (RR = 0.68, 95% CI 0.54–0.87).

Conclusion

Increases in caries were observed despite positive changes in the distribution of socioeconomic indicators for the analysed children’s families. The risk factors identified for the increase in caries suggest ongoing problems regarding the effectiveness of intersectoral and health measures for controlling caries in populations exposed to PHC programmes.

Impact of molar incisor hypomineralization on quality of life in children with early mixed dentition: A hierarchical approach

BACKGROUND

Molar incisor hypomineralization (MIH) is associated with unfavourable dental conditions such as dental caries and may consequently impact oral health-related quality of life (OHRQoL).

OBJECTIVE

To assess the impact of MIH on OHRQoL in children with early mixed dentition.

METHOD

A population-based cross-sectional study of 728 8-year-old children from the public school system in Curitiba, Brazil, was conducted. The Child Perception Questionnaire for 8- to 10-year-olds (CPQ_8-10 ) was used to evaluate OHRQoL. MIH was diagnosed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The assessments of MIH, dental caries, and malocclusion were performed by four calibrated examiners (κ ≥ 0.80). Demographic and socioeconomic data (DSE) were obtained from the children's parents/caregivers using a structured questionnaire. The analysis of OHRQoL determinants was performed through a three-level hierarchical approach: mesial (DSE), intermediate (clinical conditions), and distal (child's oral self-perception), using Poisson regression with robust variance (α = 0.05).

RESULTS

The prevalence of MIH was 12.1% (95% CI: 10-15). An association was found between MIH and OHRQoL in the "oral symptoms" domain of the CPQ_8-10 (PR: 1.07, 95% CI: 1.03-1.11, P < 0.001) after adjusting for other clinical variables and DSE.

CONCLUSION

Molar incisor hypomineralization was associated with a greater impact on OHRQoL in children's oral symptoms.

Negative effect of malocclusion on the emotional and social well-being of Brazilian adolescents: a population-based study

Background/objectives

The aesthetic impact of malocclusion can have negative repercussions on quality of life, social interaction, interpersonal relationships, and psychological well-being. The aim of this study was to evaluate the impact of malocclusion on the quality of life of Brazilian adolescents.

Methods

A representative cross-sectional study of 1612 adolescents from Belo Horizonte, Minas Gerais was conducted. The adolescents responded to the Brazilian version of the Child Perception Questionnaire (CPQ11-14-ISF:16) to assess the impact of the condition on quality of life. Cases of malocclusion were diagnosed using the Dental Aesthetic Index while clinical examination was performed by three calibrated examiners. Data regarding traumatic dental injuries, dental caries, gender, type of school, age and social vulnerability was collected. Data analysis was performed using bivariate and multivariate Poisson regression with robust variance (P < 0.05).

Results

The prevalence of malocclusion was 31.3%. The presence of definite malocclusion (PR = 1.28; CI = 1.13-1.45), severe malocclusion (PR = 1.24; CI = 1.04-1.47) and handicapping malocclusion (PR = 1.55; CI = 1.31-1.84) was associated with a greater negative impact on Emotional Well-Being. The presence of definite malocclusion (PR = 1.18; CI = 1.02-1.36), severe malocclusion (PR = 1.46; CI = 1.21-1.76) and handicapping malocclusion (PR = 1.61; CI = 1.35-1.94) was also associated with a greater negative impact on Social Well-Being.

Conclusions

Adolescents with handicapping malocclusion, where the need for treatment was mandatory, suffered from a greater negative impact on quality of life, with emotional and social aspects most affected.

Prevalence of early loss of primary molar and its impact in schoolchildren's quality of life

BACKGROUND

Evidence regarding the impact of premature loss of primary molars on oral health-related quality of life (OHRQoL) is lacking.

AIM

To evaluate the prevalence of premature loss of primary molars in schoolchildren and its impact on OHRQoL.

DESIGN

We randomly selected 667 children aged 8-9 years enrolled in public and private schools from Aracaju (Brazil). The presence of untreated dental caries and early loss of primary molars were recorded, and its impacts on OHRQoL evaluated using Child Perceptions Questionnaire (CPQ_8-10 ). Influence of some variables on tooth loss and OHRQoL was assessed by multilevel Poisson's regression analysis (P < 0.05).

RESULTS

The prevalence for early tooth loss was 65.4% (95% confidence interval 51.1%-77.3%). Children with untreated dental caries and attending public schools presented higher prevalence of early tooth loss. Moreover, early loss of primary molars provoked negative impact on OHRQoL considering total score of CPQ_8-10 and domains "oral symptoms," "functional limitations" and "emotional well-being." Children presenting early teeth loss presented significantly higher scores of CPQ_8-10 , as well as females and children with dental caries in other teeth.

CONCLUSIONS

The prevalence of early loss of primary molars is high, and it impacts the OHRQoL of children aged 8-9 years.

Do Children of Working Mothers Experience More Dental Caries?

BACKGROUND

Pain and discomfort due to untreated dental caries lead to eating and sleep disruptions, behavioral changes, and poor quality of life. Among adolescents, severe dental caries may lead to activity restriction, school absenteeism, and poor academic performance. Dietary factors, parent's socioeconomic status, and family income have been associated with dental caries experience. The employment status of the mother is a measure of socioeconomic status of the family.

AIMS

This study aims to estimate the prevalence of dental caries and to find out its sociodemographic, oral health behavioral, and clinical determinants among older adolescent (15-18 years) students in Kerala.

SETTINGS AND DESIGN

This was a cross-sectional study conducted at higher secondary schools.

METHODS

Oral examination and sociodemographic and oral health behavioral data collection were done among 1065 older adolescent students in the age group 15-18 across five districts of Kerala by a multistage cluster sampling design. Decayed, missing, and filled teeth (DMFT) and Significant Caries (SiC) index were taken.

STATISTICAL ANALYSIS USED

SPSS version 16 software was employed. Multiple regression analysis was done to estimate adjusted odds ratios (OR) of predictors of dental caries experience.

RESULTS

The overall dental caries experience for the group was 59.8% (95% confidence interval [CI]: 56.9-62.7). About 40% of students had no caries experience, 43% had DMFT score 1-3, and only 16.8% had DMFT score 4 and more. Mean DMFT was 1.67 (95% CI: 1.56-1.79). Diet preference, timing of sugar intake, and sugar form were not significantly associated with caries. Mean SiC index was 3.90 (95% CI, 3.75-4.05). In the unadjusted analysis, age, gender, place of residence, mother's employment status, school type, frequency of sugar intake, oral hygiene status, and timing of last dental visit were significant. In the adjusted analysis, however, age, male gender, government schools, timing of last dental visit, and employed mothers were significant predictors for higher dental caries experience.

CONCLUSIONS

Mother's employment was the strongest predictor (OR 2.82, 95% CI: 2.15-3.69) for dental caries experience among adolescents when adjusted to other variables in the final multivariate model.

Contextual and individual determinants of oral health-related quality of life among five-year-old children: a multilevel analysis

Background

Contextual factors may influence oral health-related quality of life (OHRQoL) in children. The aim of the present study was to evaluate the influence of individual and contextual determinants of OHRQoL based on the perceptions of children.

Methods

A cross-sectional study was conducted with a representative sample of 769 five-year-old children from public and private preschools in a city in the countryside of northeast Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, sociodemographic data and aspects of the child’s oral health. The children answered the child version of the Scale of Oral Health Outcomes for five-year-old children and were submitted to oral examinations. Variables related to the context were obtained from the schools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models were used to investigate associations between variables.

Results

In the adjusted analysis, parent’s/caregiver’s schooling, household income, parent’s/caregiver’s age, a history of dental pain, dental caries and its consequences and traumatic dental injury were considered individual determinants of OHRQoL according to the children’s self-reports. After the incorporation of the contextual determinants, the association between parent’s/caregiver’s schooling and OHRQoL lost its significance. Type of school was the context variable that remained associated with OHRQoL.

Discussion

Besides the clinical and sociodemographic individual characteristics, characteristics of the school environment in which the child studies are associated with self-reported impacts on OHRQoL.

Oral Problems and Self-Confidence in Preschool Children

The aim of the present study was to evaluate the impact of clinical oral factors, socioeconomic factors and parental sense of coherence on affected self-confidence in preschool children due to oral problems. A cross-sectional study with probabilistic sampling was conducted at public and private preschools with 769 five-year-old children and their parents/caretakers. A questionnaire addressing socio-demographic characteristics as well as the Scale of Oral Health Outcomes for Five-Year-Old Children (SOHO-5) and the Sense of Coherence Scale (SOC-13) were administered. The dependent variable was self-confidence and was determined using the SOHO-5 tool. Dental caries (ICDAS II), malocclusion and traumatic dental injury (TDI) were recorded during the clinical exam. Clinical examinations were performed by examiners who had undergone training and calibration exercises (intra-examiner agreement: 0.82-1.00 and inter-examiner agreement: 0.80-1.00). Descriptive statistics and Poisson regression analysis were performed (a=5%). Among the children, 91.3% had dental caries, 57.7% had malocclusion, 52.8% had signs of traumatic dental injury and 26.9% had bruxism. The following variables exerted a greater negative impact on the self-confidence of the preschool children due to oral problems: attending public school (PR=2.26; 95% CI: 1.09-4.68), a history of toothache (PR=4.45; 95% CI: 2.00-9.91) and weak parental sense of coherence (PR=2.27; 95% CI: 1.03-5.01). Based on the present findings, clinical variables (dental pain), socio-demographic characteristics and parental sense of coherence can exert a negative impact on self-confidence in preschool children due to oral problems.

Impact of untreated dental caries on the quality of life of Brazilian children: population-based study

BACKGROUND

The assessment of oral health should consider clinical and biopsychosocial aspects.

AIM

To evaluate the impact of untreated dental caries on the quality of life of children.

DESIGN

A cross-sectional study was conducted with 647 Brazilian children. The Child Perceptions Questionnaire (CPQ_8-10 ) and the 'oral health' global indicator were administered to the children and used as the outcomes. Parents answered a general questionnaire, and oral clinical examinations were performed. Data analysis involved descriptive statistics, chi-squared test, Mann-Whitney test, and Poisson's regression analysis (α = 5%). The psychometric properties of the CPQ_8-10 were tested for younger age group (6/7 years).

RESULTS

Untreated caries was a predictor of impact on quality of life for the following items: 'pain in teeth/mouth' (PR = 1.69; 95% CI: 1.41-2.04), 'difficulty biting/chewing hard foods' (PR = 1.28; 95% CI: 1.05-1.56), 'difficulty eating what you wanted to eat' (PR = 1.61; 95% CI: 1.29-2.02), 'trouble sleeping' (PR = 1.64; 95% CI: 1.27-2.13), 'missed school' (PR = 1.62; 95% CI: 1.24-2.12), 'trouble doing homework' (PR = 1.61; 95% CI: 1.12-2.31), and 'difficulty paying attention in class' (PR = 1.41; 95% CI: 1.01-1.96).

CONCLUSION

Children with untreated dental caries feel greater negative impacts on quality of life than children without untreated caries.

Importance of contextual variables related to cavitated lesions in 5-year-old children

BACKGROUND

Dental caries have a high prevalence in children and need to evaluate their individual and contextual determinants.

AIM

To evaluate the importance of individual and contextual determinants on the occurrence of cavitated lesions in 5-year-old children.

DESIGN

A cross-sectional study was conducted with 769 preschoolers in a city in northeastern Brazil. Parents/caregivers answered questionnaires addressing psychological aspects, socio-demographic characteristics and the child's oral health. The diagnosis of dental caries (cavitated lesion) was performed using the ICDAS-II. Variables related to the context were collected at the preschools and official municipal publications. Unadjusted and adjusted multilevel Poisson regression models with robust variance correction were used.

RESULTS

The prevalence of cavitated lesions was 58.8%. In the analysis adjusted by individual determinants, low household income (PR = 1.61; 95%CI:1.27-2.05), lower parent's/caregiver's schooling (PR = 1.57; 95%CI:1.20-2.05), not visited to the dentist (PR = 0.77; 95%CI:0.62-0.94), brushing frequency under 2 times per day (PR = 2.17; 95%CI:1.35-3.51) and weak parent's/caregiver's SOC (PR = 1.30; 95%CI:1.09-1.56) were associated with cavitated lesions. However, after the incorporation of the contextual determinants, parent's/caregiver's schooling and SOC lost their association. Considering contextual factors, children attending public preschools (PR = 1.66; 95%CI:1.34-2.05) and/or smaller preschools (PR = 1.001; 95%CI:1.001-1.002) had a greater probability of exhibiting cavitated lesions.

CONCLUSION

Contextual variables were more important to the occurrence cavitated lesions than individual socioeconomic variables.

Comparison of Oral Health Status and Knowledge on Oral Health in Two Age Groups of Schoolchildren: A Cross-sectional Study

INTRODUCTION

Oral health plays a pivotal role in the overall wellbeing of children. As children grow, there is a variation in their oral health status due to the changing trends and lifestyle.

AIM

To evaluate and compare the factors related to oral health status in two age groups of school going children.

MATERIALS AND METHODS

A total of 582 children aged 8 to 11 years from 3 schools were included. Based on their school grade, they were grouped as younger (third grade) and older (fifth grade) children. Their dental caries status, caries treatment needs, oral hygiene status were assessed. A questionnaire was given to them to assess their knowledge on oral health.

RESULTS

Both third and fifth grade children had similar caries status. The caries treatment needs was significantly higher (p = 0.02) in fifth grade children of school III. The oral hygiene status was significantly better (p = 0.004) in fifth grade children of school I and third grade children (p < 0.001) of school III. Fifth grade children were found to have more knowledge on oral health and it was statistically significant in school II (p = 0.001). In school III, as caries status increased, the oral hygiene index score significantly increased (p = 0.001).

CONCLUSION

Age did not have any influence on the oral health status of children. The older children had better knowledge on oral health, but the oral hygiene practices were not followed effectivelyHow to cite this article: Geethapriya PR, Asokan S, Kandaswamy D. Comparison of Oral Health Status and Knowledge on Oral Health in Two Age Groups of Schoolchildren: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(4): 340-345.

Risk of alcohol dependence: prevalence, related problems and socioeconomic factors

The present study evaluated the possible alcohol dependence and related problems among adolescents and determined possible associations with socioeconomic factors and gender. A cross-sectional study was conducted with a representative sample of 936 adolescents aged 15 to 19 years enrolled at public and private schools in the city of Belo Horizonte, Brazil. Data related to alcohol consumption and associated problems were collected using the Alcohol Use Disorder Identification Test (AUDIT). The Social Vulnerability Index (SVI), mother's schooling and type of school were used to assess socioeconomic factors. Statistical analysis involved the chi-square test (p < 0.05) and Poisson regression. The prevalence of possible dependence was 16.4%, 52.1% reported concern of a family member regarding the adolescent's alcohol consumption. Female adolescents were less likely to exhibit possible dependence in comparison to males. Participants with living in a low vulnerability area were more likely to consume alcohol in comparison to those living in underprivileged areas. The results of the present study demonstrate that possible dependence was significantly associated with the male gender and low social vulnerability.

Association between Optimism, Psychosocial Well Being and Oral Health: A Cross-Sectional Study

OBJECTIVE

The aim of the study was to assess the association of optimism and psychosocial well being of school going children on their oral health status.

STUDY DESIGN

The study included 12- to 15-year-old school going children (N = 2014) from Tamilnadu, India. Optimism was measured using the revised version of the Life Orientation Test (LOT-R). A questionnaire was sent to the parents regarding their child's psychosocial behavior which included shyness, feeling inferiority, unhappiness and friendliness. Clinical examination for each child was done to assess the DMFT score and OHI-S score. The data obtained were statistically analyzed using Pearson Chi-Square test, Mann-Whitney test and Kruskal-Wallis test with the aid of SPSS software (version 17). Odds Ratio (OR) was calculated with 95% Confidence Interval (CI). The p value ≤ 0.05 was considered statistically significant.

RESULTS

Boys with high optimism had significantly lesser DMFT score than the boys with low optimism (p=0.001). Girls with high optimism had significantly higher DMFT score (p=0.001). In psychosocial outcomes, inferiority (p=0.002) and friendliness (p=0.001) showed significant association with DMFT score. Among the boys, children who felt less inferior (p=0.001), less unhappy (p=0.029) and more friendly (p=0.001) had lesser DMFT score.

CONCLUSION

Among the psychosocial outcomes assessed, inferiority and friendliness had significant association with oral health of the children and hence, can be used as a proxy measures oral health.

Factors related to the dental caries incidence in youth: a cohort study in Brazilian Northeastern

Abstract The conceptual model of the life course considers that health-disease is a dynamic process that is also affected by previous and current lifelong experiences. The aim of the study was to investigate the incidence of caries and its determinants in young people in Sobral-Ceará, Brazil. This was a cohort study of oral health started in 2000, with waves in 2006 and 2012. 482 young people aged 17-21 years were examined and interviewed. The incidence of caries between 2006 and 2012 was the outcome analyzed and the independent variables were socioeconomic conditions and use of oral health actions and services. The average incidence of caries was 2.95 teeth from the adolescence to the youth. It was found that social deprivation throughout life and deny access to the dentist during infancy implies a greater incidence of caries in youth, therefore, the use of services and oral health actions during the adolescence and youth have not been sufficient to reduce inequities in oral health.

Factors associated with malocclusion in youth in a municipality of Northeastern Brazil

The aim of the study was to identify factors associated with severe malocclusion in young people in Sobral, Ceará, Northeastern Brazil. This is cross-sectional study nested in a cohort study with a sample of 569 young people aged from 17 - 21 years who participated in the survey on oral health. The rate of categorized dental aesthetics of Dental Aesthetic Index < 31 and Dental Aesthetic Index ≥ 31 was used. The independent variables were: data from the beginning of the cohort (socioeconomic conditions in childhood and exposure factors) and the last survey (sociodemographic data, use of dental services and self-perceived oral health). Poisson regression was performed to determine the best explanatory model of related factors. The prevalence of severe malocclusion was 20.0%. Private school was a protective factor, while the use of a pacifier for more than 36 months was a risk factor. Malocclusion was associated with all measures of self-perception and dental trauma. Socioeconomic factors in childhood stimulated prolonged use of harmful habits and these were risks for the components of Dental Aesthetic Index factors. Socioeconomic conditions were associated with occlusal condition of the youth.

Neighbourhood Determinants of Caries Experience in Preschool Children: A Multilevel Study

OBJECTIVES

To investigate the association between neighbourhood factors and decayed, missing, and filled teeth (dmft) index among preschool children.

METHODS

The sample of this cross-sectional study comprised 1,110 children (0-5 years old) clustered in 16 official neighbourhoods of Canoas city, southern Brazil. Multilevel binomial models were used to estimate the association of contextual variables at neighbourhood level (Human Development Index, average income, and public primary health care units) with two oral health outcomes: decayed teeth (dt) and missing or filled teeth (mft), after adjusting for individual variables (gender, age, maternal education, equivalent household income logarithm, household, and point of care).

RESULTS

Overall, 24.9% of the sample had dental caries experience (dmft >0), and 92.3% of the dmft was untreated caries. There was no statistical significant association (p > 0.05) of contextual characteristics with the decay component. The teeth of children living in richer areas had 2.87 (95% CI: 1.05-7.86) times more chances of being treated (mft component). Variance attributed to neighbourhood level was estimated as 5.9% (p < 0.01) and 4.1% (p = 0.17) for dt and mft, respectively, in adjusted models.

CONCLUSIONS

Intra-urban areas seem homogeneous, with small variability between neighbourhoods, having no contextual effect on untreated dental caries (dt). Contextual variables may influence treatment access (mft) through the use of dental services in preschool children.

Influence of the socioeconomic status on the prevalence of malocclusion in the primary dentition

OBJECTIVE:

To assess the influence of socioeconomic background on malocclusion prevalence in primary dentition in a population from the Brazilian Amazon.

METHODS:

This cross-sectional study comprised 652 children (males and females) aged between 3 to 6 years old. Subjects were enrolled in private preschools (higher socioeconomic status - HSS, n = 312) or public preschools (lower socioeconomic status - LSS, n = 340) in Belém, Pará, Brazil. Chi-square and binomial statistics were used to assess differences between both socioeconomic groups, with significance level set at P < 0.05.

RESULTS:

A high prevalence of malocclusion (81.44%) was found in the sample. LSS females exhibited significantly lower prevalence (72.1%) in comparison to HSS females (84.7%), particularly with regard to Class II (P < 0.0001), posterior crossbite (P = 0.006), increased overbite (P = 0.005) and overjet (P < 0.0001). Overall, malocclusion prevalence was similar between HSS and LSS male children (P = 0.36). Early loss of primary teeth was significantly more prevalent in the LSS group (20.9%) in comparison to children in the HSS group (0.9%), for both males and females (P < 0.0001).

CONCLUSION:

Socioeconomic background influences the occurrence of malocclusion in the primary dentition. In the largest metropolitan area of the Amazon, one in every five LSS children has lost at least one primary tooth before the age of seven.

Oral health-related quality of life of children seeking orthodontic treatment based on child oral health impact profile: A cross-sectional study

Aims:

The aim of this study was to assess oral health-related quality of life (OHRQoL) using short form (SF) of child oral health impact profile (COHIP) in children aged 11–15 years who sought orthodontic treatment. A comparison was done between these children and age-matched peers who never had or sought orthodontic treatment.

Methodology:

This cross-sectional study included 227 children aged 11–15 years. A total of 110 participants had sought orthodontic treatment at KSR Institute of Dental Science and Research (orthodontic group) and 117 participants from a nearby school who had never undergone or sought orthodontic treatment (comparison group). OHRQoL was assessed with the SF of the COHIP, and malocclusion severity was assessed with the index of orthodontic treatment needs. Data presentation and statistical analysis were performed with the Statistical Package for the Social Sciences Software (Version 19, SPSS, Chicago, IL, USA). The Chi-square test and Fischer exact tests were used to analyze the qualitative data.

Results:

Children with little to borderline treatment needs have a better quality of life when compared to children with definitive treatment needs (P = 0.049). No statistically significant difference in COHIP-SF scores was found between boys and girls (P > 1.000). In the orthodontic group, children with little to borderline treatment needs were 4.8 times (P = 0.037) more likely to report better OHRQoL when compared to children with definitive treatment needs.

Conclusion:

Children who sought orthodontic treatment had lower quality of life scores than those who never had or never sought treatment.

Dental caries in 12-year-old schoolchildren: multilevel analysis of individual and school environment factors in Goiânia

The aim of this study was to investigate the association between dental caries index among 12-year-old schoolchildren and individual and contextual factors related to the schools in the city of Goiânia, Goiás, Brazil. A cross-sectional study was carried out with 2,075 schoolchildren using the 2010 National Survey of Oral Health methodology. The dependent variable was the decayed, missing, and filled teeth (DMFT) index and the independent variables were individual (sex, race, and maternal education) and contextual ones (type of school, health district, and the presence of oral programs). Multilevel analysis and log-linear negative binominal regression were performed, considering the complex sampling design. Mean DMFT index was 1.51. Female students, whose mothers had lower schooling, those attending public schools, located in districts with the worst socioeconomic indicators, and covered by the Family Health Strategy had higher caries levels. The dental caries index was low and associated with the schoolchildren sociodemographic characteristics and factors related to the schools, showing inequalities in distribution.

Oral Health-Related Quality of Life and Traumatic Dental Injuries in Young Permanent Incisors in Brazilian Schoolchildren: A Multilevel Approach

BACKGROUND

Traumatic dental injury (TDI) during childhood may negatively impact the quality of life of children.

OBJECTIVE

To describe the association of oral health-related quality of life (OHRQoL) and domains (oral symptons, functional limitation, emotional- and social-well-being) of children with individual and contextual variables.

METHODS

A cross-sectional study was performed using a representative sample of 1,201 schoolchildren, 8-10 years-old, from public and private schools of Belo Horizonte, Brazil. The CPQ8-10 was used to assess OHRQoL, dichotomized in low and high impact. Sociodemographic information was collected through questionnaires to parents. Children were examined at schools, using the Andreasen criteria. Individual variables were gender, age, number of residents in home, parents/caregivers' level of education, family income, and TDI (dichotomized into without trauma/mild trauma and severe trauma). Dental caries and malocclusion were considered co-variables. Contextual variables were the Social Vulnerability Index and type of school. Ethical approval and consent forms were obtained. Data were analyzed using SPSS for Windows 19.0 and HLM 6.06, including frequency distribution, chi-squared test and multilevel approach (p < 0.05).

RESULTS

The prevalence of a negative impact on OHRQoL in children with severe trauma was 55.9%. The TDI negatively impacted emotional and social domains of OHRQoL. A multilevel analysis revealed a significant difference in OHRQoL according to the type of school and showed that 16% of the total variance was due to contextual characteristics (p < 0.001; ICC = 0.16). The negative impact on OHRQoL was higher in girls (p = 0.009), younger children (p = 0.023), with severe TDI (p = 0.014), those from public schools (p = 0.017) and whose parents had a lower education level (p = 0.001).

CONCLUSION

Severe trauma impacts OHRQoL on emotional and social domains. Contextual dimensions add information to individual variability to explain higher impact, emphasizing socioeconomic inequalities.

Dental caries in Uruguayan adults and elders: findings from the first Uruguayan National Oral Health Survey

This study aimed to assess dental caries status and associated factors in Uruguayan adults and elders using data from the first Uruguayan National Oral Health Survey. Data were representative of the country as a whole. Socio-demographic information was collected with a closed questionnaire. Dental caries was assessed by clinical examination using the DMFT index. The final sample consisted of 769 participants. Mean DMFT was 15.20 and 24.12 for the 35-44 and 65-74-year age groups, respectively. Mean number of decayed teeth was 1.70 in adults and 0.66 in elders. Multivariate analyses showed higher prevalence of dental caries associated with age 65-74 years, low socioeconomic status, use of public dental services, presence of gingivitis; for decayed teeth, age 35-44 years, low socioeconomic status, use of public dental services, infrequent tooth brushing, need for oral health care, and presence of root caries showed higher severity. Uruguayan adults and elders from disadvantaged backgrounds concentrated a heavier burden of dental caries.

Impact of wearing fixed orthodontic appliances on quality of life among adolescents: Case-control study

OBJECTIVE

To investigate the impact of wearing a fixed orthodontic appliance on oral health-related quality of life (OHRQoL) among adolescents.

MATERIALS AND METHODS

A case-control study (1 ∶ 2) was carried out with a population-based randomized sample of 327 adolescents aged 11 to 14 years enrolled at public and private schools in the City of Brumadinho, southeast of Brazil. The case group (n  =  109) was made up of adolescents with a high negative impact on OHRQoL, and the control group (n  =  218) was made up of adolescents with a low negative impact. The outcome variable was the impact on OHRQoL measured by the Brazilian version of the Child Perceptions Questionnaire (CPQ 11-14) - Impact Short Form (ISF:16). The main independent variable was wearing fixed orthodontic appliances. Malocclusion and the type of school were identified as possible confounding variables. Bivariate and multiple conditional logistic regressions were employed in the statistical analysis.

RESULTS

A multiple conditional logistic regression model demonstrated that adolescents wearing fixed orthodontic appliances had a 4.88-fold greater chance of presenting high negative impact on OHRQoL (95% CI: 2.93-8.13; P < .001) than those who did not wear fixed orthodontic appliances. A bivariate conditional logistic regression demonstrated that malocclusion was significantly associated with OHRQoL (P  =  .017), whereas no statistically significant association was found between the type of school and OHRQoL (P  =  .108).

CONCLUSIONS

Adolescents who wore fixed orthodontic appliances had a greater chance of reporting a negative impact on OHRQoL than those who did not wear such appliances.

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression

The aim of this cross-sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3-5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health-related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio-economic characteristics of the family. Statistical analyses were performed using the chi-square test, Kruskal-Wallis test, Mann-Whitney U-test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children.

Prevalence of dental caries among school children of Bharatpur city, India

Background:

Healthy teeth and oral tissues and the need for oral health care are important for any section of society. Dental caries is an infectious microbial disease of multifactorial origin in which diet, host, and microbial flora interacts over a period of time in such a way so as to encourage demineralization of the tooth enamel with resultant caries formation. Dental caries, the product of man's progress towards civilization, has a very high morbidity potential and thus, is coming into focus of the mankind.

Aims and Objectives:

To assess the prevalence of dental caries among 12-15 year old government and private school children of Bharatpur city.

Materials and Methods:

This was a cross-sectional study carried out on total 1400 school children, of which 700 school children were from government schools and 700 were from private schools. Simple random sampling methodology was used to select the sample. The subjects were examined for dental caries according to WHO 1997 assessment form. Significant Caries Index was also used to assess the prevalence of dental caries.

Results:

The prevalence of dental caries was found higher among government school children, that is, 53%, when compared to private school children, that is, 47% and this difference was found to be statistically significant. The mean decayed, missing, and filled teeth were found to be higher in government school children (7.61 ± 2.86) as compared to private school children (4.76 ± 2.42).

Conclusion:

Dental caries was found to be the major public health problems among both the government and private school children of Bharatpur city, which need immediate attention. Regular dental checkups and practice of routine oral hygiene procedures will enable them to lead a healthier life.

Migration background is associated with caries in Viennese school children, even if parents have received a higher education

Background

A low level of education and the migration background of parents are associated with the development of caries in children. The aim of this study was to evaluate whether a higher educational level of parents can overcome risks for the development of caries in immigrants in Vienna, Austria.

Methods

The educational level of the parents, the school type, and the caries status of 736 randomly selected twelve-year-old children with and without migration background was determined in this cross sectional study. In children attending school in Vienna the decayed, missing, and filled teeth (DMFT) index was determined. For statistical analysis, a mixed negative-binomial-model was used.

Results

The caries status of the children with migration background was significantly worse compared to that of the native Viennese population. A significant interaction was found between migration background and the educational level of the parents (p = 0.045). No interaction was found between the school type and either the migration background (p = 0.220) or the education level of the parents (p = 0.08). In parents with a higher scholarly education level, migration background (p < 0.01) and school type (p = 0.018) showed an association with DMFT values. In parents with a low education level, however, migration background and school type had no significant association with DMFT values.

Conclusion

These data indicate that children with a migration background are at higher risk to acquire caries than other Viennese children, even when the parents have received a higher education.

Prevalence of dental caries among 12-14 year old children in Qatar

BACKGROUND

To ensure the oral health of a population, clinicians must deliver appropriate dental services, and local communities need to have access to dental care facilities. However, establishment of this infrastructure must be based on reliable information regarding disease prevalence and severity in the target population.

OBJECTIVES

The aims of this study were to measure the incidence of dental caries in school children aged 12-14 throughout Qatar, including the influence of socio-demographic factors.

MATERIALS AND METHODS

A cross-sectional study was conducted in Qatar from October 2011 to March 2012. A total of 2113 children aged 12-14 were randomly selected from 16 schools located in different geographic areas. Three calibrated examiners using World Health Organization (WHO) criteria to diagnose dental caries performed the clinical examinations. Data analyses were subsequently conducted.

RESULTS

The mean decayed, missing, and filled teeth index values were respectively 4.62 (±3.2), 4.79 (±3.5), and 5.5 (±3.7), for 12, 13, and 14 year-old subjects. Caries prevalence was 85%. The mandibular incisors and canines were least affected by dental caries, while maxillary and mandibular molars exhibited the highest incidence of dental caries. Dental caries were affected by socio-demographic factors; significant differences were detected between female and male children, where more female children showed dental caries than male children. In addition, children residing in semi-urban areas showed more dental caries than in urban areas.

CONCLUSION

Results indicated that dental caries prevalence among school children in Qatar has reached critical levels, and is influenced by socio-demographic factors. The mean decayed, missing, and filled teeth values obtained in this study were the second highest detected in the Eastern Mediterranean region.

The prevalence of inhalant use and associated factors among adolescents in Belo Horizonte, Brazil

The scope of this study was to establish the prevalence of inhalant use among adolescents and its association with marijuana use, alcohol consumption, socioeconomic status and gender. A cross-sectional study was performed with a representative sample of 891 adolescents from public and private schools in the city of Belo Horizonte, Brazil. Data were collected using two self-administered questionnaires: the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and the Alcohol Use Disorders Identification Test (AUDIT C). The socioeconomic status was evaluated using the Social Vulnerability Index, mother's education level and type of school (public or private). The data were analyzed using the chi-square test (p < 0.05) and logistic regression analysis. The prevalence of inhalant use was 7.9%. No significant association was found between the use of inhalants and socioeconomic status after the logistic regression analysis. Inhalant use among adolescents was associated with marijuana use (OR: 4.61; 95% CI: 2.27 - 9.36) and with binge drinking (OR: 5.02; 95% CI: 2.57 - 9.81).

Associations between specific technologies and adolescent sleep quantity, sleep quality, and parasomnias

OBJECTIVE

We tested the hypothesis that weekday bedtime use of six technologies would be significantly associated with eight sleep parameters studied relating to sleep quantity, sleep quality, and parasomnias.

METHODS

In our cross-sectional study, we previously administered validated age-appropriate questionnaires (School Sleep Habits Survey, Technology Use Questionnaire). Participating adolescents (n=738; 54.5% boys) were aged 11-13 years and were from the Midlands region of the United Kingdom in 2010.

RESULTS

Frequent use of all technology types was significantly inversely associated with weekday sleep duration (hours). Frequent music listeners and video gamers had significantly prolonged sleep onset (β=7.03 [standard error {SE}, 2.66]; P<.01 and β=6.17 [SE, 2.42]; P<.05, respectively). Frequent early awakening was significantly associated with frequent use of all technology types. The greatest effect was observed in frequent television viewers (odds ratio [OR], 4.05 [95% confidence interval {CI}, 2.06-7.98]). Difficulty falling asleep was significantly associated with frequent mobile telephone use, video gaming, and social networking, with music listeners demonstrating the greatest effect (OR, 2.85 [95%CI, 1.58-5.13]). Music listeners were at increased risk for frequent nightmares (OR, 2.02 [95% CI, 1.22-3.45]). Frequent use of all technologies except for music and mobile telephones was significantly associated with greater cognitive difficulty in shutting off. Frequent television viewers were almost four times more likely to report higher sleepwalking frequency (OR, 3.70 [95% CI, 1.89-7.27]).

CONCLUSIONS

Frequent weekday technology use at bedtime was associated with significant adverse effects on multiple sleep parameters. If confirmed in other samples and longitudinally, improving sleep hygiene through better management of technology could enhance the health and well-being of adolescent populations.

The complexity of obesity in U.K. adolescents: relationships with quantity and type of technology, sleep duration and quality, academic performance and aspiration

BACKGROUND

Contemporary technology and multiple device use may link to increased body mass index (BMI). The sleep-obesity relationship is inconsistent in adolescents. Sleep duration and quality may have crucial connections to obesity development, particularly in adolescents where sleep alterations are common. Elevated BMI in adolescents may influence academic performance and aspiration, but data are limited.

OBJECTIVES

The objectives of this study was to assess the linear associations between BMI z-score and (i) quantity/type of technology used; (ii) sleep quantity/quality and (iii) academic performance/aspiration.

METHODS

Consenting adolescents (n = 624; 64.9% girls, aged 11-18 years) were recruited. The Schools Sleep Habits Survey and Technology Use Questionnaire were administered. Objective measures of height/weight were obtained.

RESULTS

Quantity of technology was positively associated with BMI z-score β = 0.10, P < 0.01. Those who always engaged in video gaming had significantly higher BMI z-score vs. never-users, β = 1.00, P < 0.001. Weekday sleep duration and sleep onset latency were related to BMI z-score, β = -0.24, P < 0.001 and β = 0.01, P < 0.001, respectively. An inverse linear association was observed between BMI z-score and academic performance, β = -0.68, P < 0.001.

CONCLUSIONS

If confirmed prospectively, reducing bedtime use of technology and improving sleep hygiene in adolescents could be an achievable intervention for attenuating obesity with potentially positive effects on academic performance.