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Mourão PS, Coelho VS, Souto-Souza D, Machado GF, Moreira LV, Duarte-Rodrigues L, Ramos-Jorge J, Ramos-Jorge ML. Association between child's behaviour during first dental appointment and effectiveness of dental plaque removal by caregivers. Int J Dent Hyg 2022. [PMID: 36544268 DOI: 10.1111/idh.12653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/07/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the association between the behaviour of children aged 1 to 4 years during their dental appointment and the effectiveness of dental plaque removal by caregivers. METHODS This longitudinal study with intervention had the participation of 146 children (mean age = 34.89 months), 75 of whom (51.4%) showed positive behaviour (+ and ++) and 71 (48.6%), negative behaviour (- and - -). The children were evaluated at the first dental appointment, according to the Frankl scale. They were subjected to an assessment of oral conditions, and their plaque level was recorded (Quigley-Hein Index modified by Turesky) using the Evince® device. Caregivers received oral hygiene guidance. The dental plaque assessment was performed before giving the oral hygiene guidance and 14 days later. The statistical analysis included a descriptive assessment and the Wilcoxon test (p < 0.05). RESULTS Mean dental plaque levels dropped significantly from the first to the second assessment (p < 0.001). The sample was divided according to the child's behaviour, observing that only the group of children with positive behaviour showed significantly less dental plaque in the second assessment (p < 0.001). CONCLUSION The positive behaviour of children aged 1 to 4 years during the first dental appointments is associated with more effective dental plaque removal by caregivers.
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Affiliation(s)
- Priscila Seixas Mourão
- Department of Pediatric Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Valéria Silveira Coelho
- Department of Pediatric Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Débora Souto-Souza
- Department of Pediatric Dentistry, Centro Universitário do Triângulo (UNITRI), Uberlândia, Brazil.,Department of Pediatric Dentistry, Universidade Federal de Uberlândia (UFU), Uberlândia, Brazil
| | - Gabrielly Fernandes Machado
- Department of Pediatric Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Luana Viviam Moreira
- Department of Pediatric Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Lucas Duarte-Rodrigues
- Department of Pediatric Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
| | - Joana Ramos-Jorge
- Department of Pediatric Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Maria Letícia Ramos-Jorge
- Department of Pediatric Dentistry, Universidade Federal dos Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina, Brazil
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Zou J, Du Q, Ge L, Wang J, Wang X, Li Y, Song G, Zhao W, Chen X, Jiang B, Mei Y, Huang Y, Deng S, Zhang H, Li Y, Zhou X. Expert consensus on early childhood caries management. Int J Oral Sci 2022; 14:35. [PMID: 35835750 PMCID: PMC9283525 DOI: 10.1038/s41368-022-00186-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 06/15/2022] [Accepted: 06/15/2022] [Indexed: 02/05/2023] Open
Abstract
Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.
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Affiliation(s)
- Jing Zou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qin Du
- Department of Stomatology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Lihong Ge
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jun Wang
- Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Department of Pediatric Dentistry, Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Xiaojing Wang
- State Key Laboratory of Military Stomatology, National Clinical Research Center for Oral Diseases, Shanxi Key Laboratory of Military Stomatology, Department of Pediatric Dentistry, School of Stomatology, Fourth Military Medical University, Xi'an, China
| | - Yuqing Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Guangtai Song
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhao
- Department of Pediatric Dentistry, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat‑Sen University, Guangzhou, China
| | - Xu Chen
- Department of Pediatric Dentistry, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Beizhan Jiang
- Department of Pediatric Dentistry, School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Yufeng Mei
- Department of Pediatric Dentistry, Affiliated Stomatological Hospital, Nanjing Medical University, Nanjing, China
| | - Yang Huang
- Department of Pediatric Dentistry, Hospital of Stomatology, Jilin University, Changchun, China
| | - Shuli Deng
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - Hongmei Zhang
- Department of Pediatric Dentistry, The Affiliated Stomatological Hospital of Chongqing Medical University, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Yanhong Li
- Department of Pediatric and Preventive Dentistry, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Clinical Research Centre for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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3
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Davidson T, Blomma C, Bågesund M, Krevers B, Vall M, Wärnberg Gerdin E, Tranæus S. Cost-effectiveness of caries preventive interventions - a systematic review. Acta Odontol Scand 2021; 79:309-320. [PMID: 33370544 DOI: 10.1080/00016357.2020.1862293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The primary purpose of this study was to assess the cost-effectiveness of caries preventive interventions. MATERIAL AND METHODS A systematic review was conducted, following the PRISMA Statement. Four electronic databases were searched (final search 16 March 2020). Studies fulfilling the inclusion criteria were independently critically appraised, by two reviewers in parallel. Data from each included study were extracted and tabulated: the analysis used a narrative approach to present the results of the estimated cost-effectiveness. RESULTS AND CONCLUSIONS Twenty-six publications fulfilled the inclusion criteria and were of low or moderate risk of bias. Ten publications were economic evaluations, directly based on empirical studies, and the other 16 were modelling studies. Most of the studies concerned interventions for children and the most common were analyses of fluoride varnish and risk-based programs. Some of the studies showed both reduced cost and improved outcomes, but most studies reported that the improved outcome came with an additional cost. The results disclosed several cost-effectiveness evaluations of caries preventive interventions in the literature, but these target primarily children at high risk. There is a scarcity of studies specifically targeting adults and especially the elderly.
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Affiliation(s)
- Thomas Davidson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Health Technology Assessment - Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Caroline Blomma
- Public Dental Service Östergötland, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Mats Bågesund
- Center for Orthodontics and Pediatric Dentistry, Norrköping, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Barbro Krevers
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Martina Vall
- Malmö University Library, Malmö University, Malmö, Sweden
| | - Elisabeth Wärnberg Gerdin
- Odontological Research Unit, Public Dental Service, Region Örebro County, Örebro, Sweden
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Sofia Tranæus
- Health Technology Assessment - Odontology (HTA-O), Faculty of Odontology, Malmö University, Malmö, Sweden
- Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Mohamed N, Barnes JM. Early childhood caries and dental treatment need in low socio-economic communities in Cape Town, South Africa. Health SA 2018; 23:1039. [PMID: 31934368 PMCID: PMC6917374 DOI: 10.4102/hsag.v23i0.1039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 03/22/2018] [Indexed: 11/01/2022] Open
Abstract
Background Early childhood caries (ECC) is a particularly severe problem in low socio-economic communities which impacts the overall health and well-being of children. The extensive waiting lists for general anaesthesia and sedation services at the only tertiary dental care centre in the study area for the treatment of children with ECC were an indication of the extent of the problem. The true extent of the problem in this area was, however, not known. This information is crucial in order to plan and execute remedial measures. Aim To assess the prevalence of oral and dental problems, especially ECC, in children under six years of age in the study population, and ascertain their need for dental treatment. Methods A cross-sectional survey of 659 children from selected schools and clinics in the study area was carried out between 2010 and 2013. Results A caries prevalence of 71.6% (472/659) was recorded. Of these, 67.5% (445/659) of children were in need of dental treatment. Conclusion Over the last decade, there has been no improvement in the caries status of children in the study population, and no organised measures have been put in place to address this problem. Awareness needs to be raised so that governments, especially in developing countries, can take appropriate measures to alleviate this public health problem. Time and resources have to be invested in the education of all health professionals dealing with children, by raising their awareness of the early stages of the disease so that timeous referrals can be made.
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Affiliation(s)
- Nadia Mohamed
- Department of Paediatric Dentistry, Faculty of Dentistry, University of the Western Cape, South Africa
| | - Jo M Barnes
- Division of Community Health, Faculty of Medicine and Health Sciences, University of Stellenbosch, South Africa
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de Silva AM, Hegde S, Akudo Nwagbara B, Calache H, Gussy MG, Nasser M, Morrice HR, Riggs E, Leong PM, Meyenn LK, Yousefi-Nooraie R. WITHDRAWN: Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev 2016; 12:CD009837. [PMID: 28004389 PMCID: PMC6463845 DOI: 10.1002/14651858.cd009837.pub3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. SEARCH METHODS We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. SELECTION CRITERIA Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for both intervention and control groups. Interventions were excluded if they were solely of a chemical nature (e.g. chlorhexidine, fluoride varnish), were delivered primarily in a dental clinical setting or comprised solely fluoridation. DATA COLLECTION AND ANALYSIS Two review authors independently performed screening, data extraction and assessment of risk of bias of included studies (a team of six review authors - four review authors and two research assistants - assessed all studies). We calculated mean differences with 95% confidence intervals for continuous data. When data permitted, we undertook meta-analysis of primary outcome measures using a fixed-effect model to summarise results across studies. We used the I2 statistic as a measure of statistical heterogeneity. MAIN RESULTS This review includes findings from 38 studies (total n = 119,789 children, including one national study of 99,071 children, which contributed 80% of total participants) on community-based oral health promotion interventions delivered in a variety of settings and incorporating a range of health promotion strategies (e.g. policy, educational activities, professional oral health care, supervised toothbrushing programmes, motivational interviewing). We categorised interventions as dietary interventions (n = 3), oral health education (OHE) alone (n = 17), OHE in combination with supervised toothbrushing with fluoridated toothpaste (n = 8) and OHE in combination with a variety of other interventions (including professional preventive oral health care, n = 10). Interventions generally were implemented for less than one year (n = 26), and only 11 studies were RCTs. We graded the evidence as having moderate to very low quality.We conducted meta-analyses examining impact on dental caries of each intervention type, although not all studies provided sufficient data to allow pooling of effects across similar interventions. Meta-analyses of the effects of OHE alone on caries may show little or no effect on DMFT (two studies, mean difference (MD) 0.12, 95% confidence interval (CI) -0.11 to 0.36, low-quality evidence), dmft (three studies, MD -0.3, 95% CI -1.11 to 0.52, low-quality evidence) and DMFS (one study, MD -0.01, 95% CI -0.24 to 0.22, very low-quality evidence). Analysis of studies testing OHE in combination with supervised toothbrushing with fluoridated toothpaste may show a beneficial effect on dmfs (three studies, MD -1.59, 95% CI -2.67 to -0.52, low-quality evidence) and dmft (two studies, MD -0.97, 95% CI -1.06 to -0.89, low-quality evidence) but may show little effect on DMFS (two studies, MD -0.02, 95% CI -0.13 to 0.10, low-quality evidence) and DMFT (three studies, MD -0.02, 95% CI -0.11 to 0.07, moderate-quality evidence). Meta-analyses of two studies of OHE in an educational setting combined with professional preventive oral care in a dental clinic setting probably show a very small effect on DMFT (-0.09 weighted mean difference (WMD), 95% CI -0.1 to -0.08, moderate-quality evidence). Data were inadequate for meta-analyses on gingival health, although positive impact was reported. AUTHORS' CONCLUSIONS This review provides evidence of low certainty suggesting that community-based oral health promotion interventions that combine oral health education with supervised toothbrushing or professional preventive oral care can reduce dental caries in children. Other interventions, such as those that aim to promote access to fluoride, improve children's diets or provide oral health education alone, show only limited impact. We found no clear indication of when is the most effective time to intervene during childhood. Cost-effectiveness, long-term sustainability and equity of impacts and adverse outcomes were not widely reported by study authors, limiting our ability to make inferences on these aspects. More rigorous measurement and reporting of study results would improve the quality of the evidence.
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Affiliation(s)
- Andrea M de Silva
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Carlton, Victoria, Australia, 3053
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
| | - Shalika Hegde
- Centre for Applied Oral Health Research (Corporate Level), Dental Health Services Victoria, The Royal Dental Hospital of Melbourne, Carlton, Melbourne, Victoria, Australia, 3053
- School of Health & Social Development, Faculty of Health, Melbourne Burwood Campus, Deakin University, Burwood, Victoria, Australia
| | - Bridget Akudo Nwagbara
- Independent consultant, Abuja, Nigeria
- Nigerian Branch of the South African Cochrane Centre, Calabar, Nigeria
| | - Hanny Calache
- Melbourne Dental School, University of Melbourne, Carlton, Victoria, Australia
- Clinical Leadership, Dental Health Services Victoria, 720 Swanston Sreet, Carlton, Victoria, Australia
- School of Dentistry and Oral Health, La Trobe University, Bendigo, Victoria, Australia
| | - Mark G Gussy
- Dept of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, PO Box 199, Bendigo, Victoria, Australia, 3552
| | - Mona Nasser
- Peninsula Dental School, Plymouth University Peninsula Schools of Medicine and Dentistry, The John Bull Building, Tamar Science Park,, Plymouth, UK, PL6 8BU
| | - Hannah R Morrice
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
| | - Elisha Riggs
- Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria, Australia, 3052
- General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Pamela M Leong
- Early Life Epigenetics, Murdoch Childrens Research Institute, Flemington Road, Carlton, Victoria, Australia, 3053
| | - Lisa K Meyenn
- Centre for Applied Oral Health Research, Dental Health Services Victoria, Carlton, Victoria, Australia, 3053
| | - Reza Yousefi-Nooraie
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, ON, Canada, M5T 3M6
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de Silva AM, Hegde S, Akudo Nwagbara B, Calache H, Gussy MG, Nasser M, Morrice HR, Riggs E, Leong PM, Meyenn LK, Yousefi‐Nooraie R. Community-based population-level interventions for promoting child oral health. Cochrane Database Syst Rev 2016; 9:CD009837. [PMID: 27629283 PMCID: PMC6457580 DOI: 10.1002/14651858.cd009837.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Dental caries and gingival and periodontal disease are commonly occurring, preventable chronic conditions. Even though much is known about how to treat oral disease, currently we do not know which community-based population-level interventions are most effective and equitable in preventing poor oral health. OBJECTIVES Primary • To determine the effectiveness of community-based population-level oral health promotion interventions in preventing dental caries and gingival and periodontal disease among children from birth to 18 years of age. Secondary • To determine the most effective types of interventions (environmental, social, community and multi-component) and guiding theoretical frameworks.• To identify interventions that reduce inequality in oral health outcomes.• To examine the influence of context in the design, delivery and outcomes of interventions. SEARCH METHODS We searched the following databases from January 1996 to April 2014: MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), the Cumulative Index to Nursing and Allied Health Literature (CINAHL), the Education Resource Information Center (ERIC), BIOSIS Previews, Web of Science, the Database of Abstracts of Reviews of Effects (DARE), ScienceDirect, Sociological Abstracts, Social Science Citation Index, PsycINFO, SCOPUS, ProQuest Dissertations & Theses and Conference Proceedings Citation Index - Science. SELECTION CRITERIA Included studies were individual- and cluster-randomised controlled trials (RCTs), controlled before-and-after studies and quasi-experimental and interrupted time series. To be included, interventions had to target the primary outcomes: dental caries (measured as decayed, missing and filled deciduous teeth/surfaces, dmft/s; Decayed, Missing and Filled permanent teeth/surfaces, DMFT/S) and gingival or periodontal disease among children from birth to 18 years of age. Studies had to report on one or more of the primary outcomes at baseline and post intervention, or had to provide change scores for both intervention and control groups. Interventions were excluded if they were solely of a chemical nature (e.g. chlorhexidine, fluoride varnish), were delivered primarily in a dental clinical setting or comprised solely fluoridation. DATA COLLECTION AND ANALYSIS Two review authors independently performed screening, data extraction and assessment of risk of bias of included studies (a team of six review authors - four review authors and two research assistants - assessed all studies). We calculated mean differences with 95% confidence intervals for continuous data. When data permitted, we undertook meta-analysis of primary outcome measures using a fixed-effect model to summarise results across studies. We used the I2 statistic as a measure of statistical heterogeneity. MAIN RESULTS This review includes findings from 38 studies (total n = 119,789 children, including one national study of 99,071 children, which contributed 80% of total participants) on community-based oral health promotion interventions delivered in a variety of settings and incorporating a range of health promotion strategies (e.g. policy, educational activities, professional oral health care, supervised toothbrushing programmes, motivational interviewing). We categorised interventions as dietary interventions (n = 3), oral health education (OHE) alone (n = 17), OHE in combination with supervised toothbrushing with fluoridated toothpaste (n = 8) and OHE in combination with a variety of other interventions (including professional preventive oral health care, n = 10). Interventions generally were implemented for less than one year (n = 26), and only 11 studies were RCTs. We graded the evidence as having moderate to very low quality.We conducted meta-analyses examining impact on dental caries of each intervention type, although not all studies provided sufficient data to allow pooling of effects across similar interventions. Meta-analyses of the effects of OHE alone on caries may show little or no effect on DMFT (two studies, mean difference (MD) 0.12, 95% confidence interval (CI) -0.11 to 0.36, low-quality evidence), dmft (three studies, MD -0.3, 95% CI -1.11 to 0.52, low-quality evidence) and DMFS (one study, MD -0.01, 95% CI -0.24 to 0.22, very low-quality evidence). Analysis of studies testing OHE in combination with supervised toothbrushing with fluoridated toothpaste may show a beneficial effect on dmfs (three studies, MD -1.59, 95% CI -2.67 to -0.52, low-quality evidence) and dmft (two studies, MD -0.97, 95% CI -1.06 to -0.89, low-quality evidence) but may show little effect on DMFS (two studies, MD -0.02, 95% CI -0.13 to 0.10, low-quality evidence) and DMFT (three studies, MD -0.02, 95% CI -0.11 to 0.07, moderate-quality evidence). Meta-analyses of two studies of OHE in an educational setting combined with professional preventive oral care in a dental clinic setting probably show a very small effect on DMFT (-0.09 weighted mean difference (WMD), 95% CI -0.1 to -0.08, moderate-quality evidence). Data were inadequate for meta-analyses on gingival health, although positive impact was reported. AUTHORS' CONCLUSIONS This review provides evidence of low certainty suggesting that community-based oral health promotion interventions that combine oral health education with supervised toothbrushing or professional preventive oral care can reduce dental caries in children. Other interventions, such as those that aim to promote access to fluoride, improve children's diets or provide oral health education alone, show only limited impact. We found no clear indication of when is the most effective time to intervene during childhood. Cost-effectiveness, long-term sustainability and equity of impacts and adverse outcomes were not widely reported by study authors, limiting our ability to make inferences on these aspects. More rigorous measurement and reporting of study results would improve the quality of the evidence.
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Affiliation(s)
| | | | | | | | - Mark G Gussy
- La Trobe UniversityDept of Dentistry and Oral Health, La Trobe Rural Health SchoolPO Box 199BendigoAustralia3552
| | - Mona Nasser
- Plymouth University Peninsula Schools of Medicine and DentistryPeninsula Dental SchoolThe John Bull Building, Tamar Science Park,PlymouthUKPL6 8BU
| | - Hannah R Morrice
- University of MelbourneJack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global HealthCarltonAustralia
| | | | - Pamela M Leong
- Murdoch Childrens Research InstituteEarly Life EpigeneticsFlemington RoadCarltonAustralia3053
| | - Lisa K Meyenn
- Dental Health Services VictoriaCentre for Applied Oral Health ResearchCarltonAustralia3053
| | - Reza Yousefi‐Nooraie
- University of TorontoInstitute of Health Policy, Management and Evaluation155 College StreetTorontoCanadaM5T 3M6
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Alsharif AT, Kruger E, Tennant M. A population-based cost description study of oral treatment of hospitalized Western Australian children aged younger than 15 years. J Public Health Dent 2015; 75:202-9. [DOI: 10.1111/jphd.12088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 01/05/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Alla Talal Alsharif
- International Research Collaborative - Oral Health and Equity; The University of Western Australia; Perth Western Australia Australia
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity; The University of Western Australia; Perth Western Australia Australia
| | - Marc Tennant
- School of Anatomy, Physiology and Human Biology; The University of Western Australia (M309); Perth Western Australia Australia
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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.
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Hietasalo P, Seppä L, Niinimaa A, Kallio J, Lahti S, Hausen H. Post-trial costs, clinical outcomes, and dental service utilization after a randomized clinical trial for caries control among Finnish adolescents. Eur J Oral Sci 2010; 118:265-9. [DOI: 10.1111/j.1600-0722.2010.00726.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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10
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Sociodemographic determinants for oral health risk profiles. Int J Dent 2010; 2010:938936. [PMID: 20339491 PMCID: PMC2836788 DOI: 10.1155/2010/938936] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 12/10/2009] [Indexed: 11/18/2022] Open
Abstract
The present study aimed to explore the association between caries risk profiles and different sociodemographic factors .
The study sample (n = 104) was randomly selected within an urban population in Flanders, Belgium. Caries risk was assessed by anamnesis, clinical examination, salivary tests, and a questionnaire. Age, gender, and socio-economic status were extracted from social insurance data files. Social indicators were “occupational status,” “being entitled to the increased allowance for health care interventions” and having access to the “Maximum Bill” (MAF), initiatives undertaken to protect deprived families. In the bivariate analysis there were significant differences in risk profiles between occupational groups (P < .001), between entitled and non-entitled individuals to the increased allowance (P = .02), and between access or no-access to the MAF (P < .01). The multiple logistic model showed a significantly higher chance of being in the low risk group for individuals with no-access to the MAF compared to those with access (OR:14.33–95% C.I. 2.14–95.84).
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Meurman P, Pienihäkkinen K, Eriksson AL, Alanen P. Oral health programme for preschool children: a prospective, controlled study. Int J Paediatr Dent 2009; 19:263-73. [PMID: 19320915 DOI: 10.1111/j.1365-263x.2009.00967.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND New perspectives are needed for oral health programmes (OHPs). The aim was to evaluate the preventive effect of a risk-based OHP in comparison with a traditional programme. DESIGN An age cohort of 794 Finnish children, 446 in the intervention group and 348 in the control group, was followed from 18 months to 5 years of age. The children were screened for mutans streptococci (MS) in the dental biofilm. The main outcome measure was the proportion of children with dental caries (decayed, missing, or filled primary teeth > 0) at the age of 5 years. The intervention, targeted to MS-positive subjects in the intervention group only, was based on repeated health education to the caretakers and xylitol lozenges for the child. Dental hygienists carried out the programme. RESULTS OHP was effective in white-collar families [numbers needed to treat (NNT) = 3, 95% CI 2-11]. Factors significantly associated with caries at 5 years were MS colonization at 18 months, occupation of caretaker, but also gender when incipient carious lesions were included in the index. CONCLUSION Early risk-based OHP, targeted to the families of MS-positive children, can reduce the risk for caries in white-collar families. For blue-collar families, different kinds of methods in caries prevention and support are needed.
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Affiliation(s)
- Pia Meurman
- University of Turku, Institute of Dentistry, Turku, Finland.
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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]
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Kruger E, Dyson K, Tennant M. Hospitalization of Western Australian children for oral health related conditions: a 5-8 year follow-up. Aust Dent J 2006; 51:231-6. [PMID: 17037889 DOI: 10.1111/j.1834-7819.2006.tb00434.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND This study investigated in-patient oral health care provision for children under 18 years of age in Western Australia. METHODS Hospitalizations of children for oral health conditions over a four-year period were analysed using data obtained from the Western Australian Hospital Morbidity Data System (HMDS). This study followed a previously published study examining similar data for 1995. RESULTS Between 1999-2000 and 2002-2003, a total of 26 497 episodes of care were attributed to oral health conditions among children aged 0-17 years. The cost of this care exceeded $40 million. Embedded and impacted teeth accounted for 33.2 per cent of oral health episodes, dental caries 28.3 per cent, pulp and periapical tissue conditions 7.1 per cent and dentofacial anomalies 6.1 per cent. With the exception of the infant age group (0-1 years), non-Aboriginal children had higher admission rates than Aboriginal children. In the 13-17 year age group a non-Aboriginal child was 31 times more likely to be admitted to hospital for an oral condition than an Aboriginal child. CONCLUSIONS This study confirms the impact of oral health related conditions among children in Western Australia. It is also clear that there are differences between age and population groups in terms of access to in-patient dental services and exposure to risk factors for specific oral conditions.
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Affiliation(s)
- E Kruger
- The Centre for Rural and Remote Oral Health, The University of Western Australia.
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