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Ogwo C, Brown G, Warren J, Caplan D, Levy S. Dental caries incidence and associated factors in young adults. J Public Health Dent 2023; 83:347-354. [PMID: 37776306 DOI: 10.1111/jphd.12586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/28/2023] [Accepted: 09/15/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES To assess the caries incidence from late adolescence to early adulthood and to identify the factors associated with caries incidence. METHODS This is a secondary analysis of longitudinal caries data of young adults aged 17-23 from the Iowa Fluoride Study cohort. The inclusion criteria required completion of dental exams at both ages 17 and 23 and having cumulative exposure (AUC) variables data for at least 8 out of the 11 time periods between ages 17 and 23. Mean imputation was used to handle the missing explanatory variable data. Multiple linear regressions were conducted using a generalized linear model to assess the effects of sociodemographic and behavioral/dietary variables on the age 17-23 adjusted cavitated caries (D2+ MFS) increment (AdjCI17-23 ). Multicollinearity was assessed using the variance inflation factor (VIF) and the final model was selected based on the Akaike Information Criterion (AIC) using backward selection and the net effects calculated. RESULTS The mean AdjCI17-23 was 2.08 (SD = 4.02). The net effects (main effect plus interactions) of higher composite socioeconomic status, higher combined daily fluoride intake, higher frequency of milk intake, lower amount of sugar-sweetened beverages intake, and lower age 17 dental caries counts were associated with lower mean AdjCI17-23 . CONCLUSION The incidence of caries from age 17 to 23 in this study was low. This study suggests and reinforces the need to continue to advocate for caries preventive strategies such as fluoride use, encouraging milk intake, and reducing sugar-sweetened beverage intakes.
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Affiliation(s)
- Chukwuebuka Ogwo
- Oral Health Sciences, Temple University Kornberg School of Dentistry, Philadelphia, Pennsylvania, USA
| | - Grant Brown
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - John Warren
- Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Daniel Caplan
- Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
| | - Steven Levy
- Department of Preventive & Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA
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Babar MG, Andiesta NS, Bilal S, Yusof ZYM, Doss JG, Pau A. A randomized controlled trial of 6-month dental home visits on 24-month caries incidence in preschool children. Community Dent Oral Epidemiol 2022; 50:559-569. [PMID: 35138648 DOI: 10.1111/cdoe.12710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES This paper reports on the effect of 6-month dental home visits compared to no dental home visits on 24-month caries incidence in 5- to 6-year-olds. METHODS 5- to 6-year-olds attending kindergartens were randomized to receive either 6-month dental home visits and education leaflets (Intervention group) or education leaflets alone (Control group) over 24 months. To detect a 15% difference in caries incidence with a significance level of 5% and power of 80%, 88 children were calculated to be needed in the Intervention group and 88 in the Control. Baseline clinical data included oral examinations at the kindergartens. Follow-up visits were made on the 6th, 12th and 18th month. At the end of the 24 months, both the Intervention and Control groups were visited for oral examinations. The primary outcome was caries incidence, measured by the number and proportion of children who developed new caries in the primary molars after 24 months. The secondary outcome was the number of primary molars that developed new caries (d-pms). Frequency distributions of participants by baseline socio-demographic characteristics and caries experience were calculated. The chi-square test was used to test differences between the caries experience in the Intervention and Control groups. The t test was used to compare the mean number of primary molars developing new caries between the Intervention Group and the Control Group. The number of children needed to treat (NNT) was also calculated. RESULTS At the 24-month follow-up, 19 (14.4%) developed new caries in the Intervention Group, compared to 60 (60.0%) in the Control Group (p = .001). On average, 0.2 (95% CI = 0.1-0.3) tooth per child in the Intervention Group was observed to have developed new caries compared to 1.1 (95% CI = 0.8-1.3) tooth per child in the Control Group (p = .001). The number of children needed to treat (NNT) to prevent one child from developing new caries was 2.2. CONCLUSIONS The present study has demonstrated that 6-month home visits to families of 5- to 6-year-olds are effective in caries prevention in 5- to 6-year-olds of low-income families in a middle-income country where access to health services, including oral health promotion services, is limited.
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Affiliation(s)
- Muneer Gohar Babar
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
| | - Niekla Survia Andiesta
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
| | - Sobia Bilal
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
| | - Zamros Yuzadi Mohd Yusof
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Jennifer Geraldine Doss
- Department of Community Oral Health & Clinical Prevention, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Allan Pau
- Clinical Oral Health Sciences Division, School of Dentistry, International Medical University, Kuala Lumpur, 57000, Malaysia
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Guracho TT, Atomssa EM, Megersa OA, Tolossa T. Determinants of dental caries among adolescent patients attending Hospitals in West Wollega Zone, Western Ethiopia: A case-control study. PLoS One 2021; 16:e0260427. [PMID: 34855813 PMCID: PMC8639066 DOI: 10.1371/journal.pone.0260427] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Background Dental caries is a prevalent disease in both developed and developing countries and is a public health problem among adolescents. This study aimed to assess the determinants of dental caries among adolescent patients in the west Wollega Zone, Western Ethiopia. Methods A hospital-based unmatched case-control study design was conducted in West Wollega Zone, West Ethiopia. A total of 133 cases and 266 controls participated in this study. Data were collected using pre-tested questionnaires from three hospitals. Epi-info version 7 was used for data entry and was analyzed using SPSS version 20. Frequency, proportion, mean and standard deviation were computed to summarize the data. Statistics are presented using tables and bar graphs. Multivariable binary logistic regression analysis was used to identify the determinants of dental caries at P < 0.05. The adjusted odds ratio with 95% confidence interval (CI) was used to show the strength of association between the predictors and dental caries. Results A total of 399 adolescents were enrolled in this study, yielding a response rate of 100%. The study found that, daily consumption of sugared coffee (AOR = 2.91, 95% CI:1.62, 5.23), khat chewing (AOR = 2.90, 95%CI: 1.46, 3.15), daily consumption of bread (AOR = 2.65, 95%CI: 1.44, 4.89), daily consumption of sweet foods (AOR = 2.04, 95%CI:1.19, 3.48), living in urban areas (AOR = 1.86, 95%CI:1.09, 3.15), and daily tooth brushing using toothpaste or stick (AOR = 0.48;95%CI, 0.28, 0.81) were significantly associated with dental caries among adolescents. Conclusions and recommendations In this study, drinking sugared coffee, daily consumption of bread, khat chewing, sugary food consumption, living in urban areas, and daily tooth brushing using toothpaste were significantly associated with dental caries. Therefore, improving dietary and drinking habits and strengthening regular tooth brushing are important for reducing dental caries among adolescents.
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Affiliation(s)
| | - Emiru Merdassa Atomssa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Obsa Amante Megersa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
| | - Tadesse Tolossa
- Department of Public Health, Institute of Health Sciences, Wollega University, Nekemte, Ethiopia
- * E-mail:
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Nery NG, Antunes JLF, Jordão LMR, Freire MDCM. Can the school environment influence oral health-related behaviours? A multilevel analysis of the Brazilian National Adolescent School-Based Health Survey 2015. Community Dent Oral Epidemiol 2020; 49:23-32. [PMID: 32815223 DOI: 10.1111/cdoe.12569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 06/06/2020] [Accepted: 07/29/2020] [Indexed: 11/30/2022]
Abstract
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.
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Pilecco RO, Godois LDS, Maroneze MC, Ortiz FR, Ardenghi TM. Factors associated with the number of filled teeth in adolescents from public schools: a cohort study. Braz Oral Res 2020; 33:e124. [PMID: 31994597 DOI: 10.1590/1807-3107bor-2019.vol33.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Accepted: 11/06/2019] [Indexed: 11/22/2022] Open
Abstract
This study aimed to assess the association of demographic conditions, socioeconomic status, clinical variables, and psychosocial factors with the number of filled teeth in adolescents from public schools. This cohort study comprised 1,134 12-year-old adolescents enrolled in public schools in Santa Maria, Brazil, in 2012. They were followed-up in 2014, where 743 individuals were reassessed (follow-up rate of 65.52%) for the number of filled teeth. Data were collected via dental examinations and structured interviews. Demographic and socioeconomic characteristics were collected from parents or legal guardians. The psychosocial factor comprised students' subjective measurement of happiness (Brazilian version of the Subjective Happiness Scale - SHS). Dental examinations were performed to assess the number of filled teeth through decay, missing, and filled teeth index (DMF-T). Unadjusted and adjusted Poisson regression analyses were performed to assess the association between baseline variables and filled teeth at follow-up. The number of filled teeth in 2012 and 2014 were 193 (17.02%) and 235 (31.63%), respectively. The incidence of filled teeth in 2014 was 42 (5.65%). Adolescents with untreated dental caries, those who visited the dentist in the last 6 months, those that exhibited being happier, and those who had filled teeth at baseline were associated with a higher number of filled teeth at follow-up. We conclude that the number of filled teeth in adolescents was influenced by clinical and psychosocial factors, emphasizing the need to focus on oral health policies in individuals with higher disease burden and those who feel psychologically inferior.
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Affiliation(s)
- Rafaela Oliveira Pilecco
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Leonardo da Silva Godois
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Marília Cunha Maroneze
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
| | - Fernanda Ruffo Ortiz
- Universidade Federal de Minas Gerais -UFMG, School of Dentistry, Department of children and adolescent's oral health, Belo Horizonte, MG, Brazil
| | - Thiago Machado Ardenghi
- Universidade Federal de Santa Maria - UFSM, School of Dentistry, Department of Stomatology, Santa Maria, RS, Brazil
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Massoni ACDLT, Porto É, Ferreira LRBO, Silva HP, Gomes MDNC, Perazzo MF, D'avila S, Granville-Garcia AF. Access to oral healthcare services of adolescents of a large-size municipality in northeastern Brazil. Braz Oral Res 2020; 34:e029. [DOI: 10.1590/1807-3107bor-2020.vol34.0029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2019] [Accepted: 01/06/2020] [Indexed: 11/22/2022] Open
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de Sousa Queiroz RC, Ribeiro AGA, Tonello AS, Pinheiro ACM, Júnior JA, Rocha TAH, da Silva NC, Costa EM, Vissoci JRN, Staton C, Facchini LA, Thomaz EBAF. Is there a fair distribution of the structure of dental services in the capitals of the Brazilian Federative Units? Int J Equity Health 2019; 18:5. [PMID: 30621709 PMCID: PMC6325759 DOI: 10.1186/s12939-018-0899-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 11/28/2018] [Indexed: 11/10/2022] Open
Abstract
Background Brazilian Primary Care Facilities (PCF) provide primary care and must offer dental services for diagnosis, prevention, and treatment of diseases. According to a logic of promoting equity, PCF should be better structured in less developed places and with higher need for oral health services. Objective To analyze the structure of dental caries services in the capitals of the Brazilian Federative Units and identify whether socioeconomic factors and caries (need) are predictors of the oral health services structure. Methods This is an ecological study with variables retrieved from different secondary databases, clustered for the level of the federative capitals. Descriptive thematic maps were prepared, and structural equations were analyzed to identify oral health service structure’s predictors (Alpha = 5%). Four models with different outcomes related to dental caries treatment were tested: 1) % of PCF with a fully equipped office; 2) % of PCF with sufficient instruments, and 3) % of PCF with sufficient supplies; 4) % of PCF with total structure. Results 21.6% of the PCF of the Brazilian capitals had a fully equipped office; 46.9% had sufficient instruments, and 30.0% had sufficient supplies for caries prevention and treatment. The four models evidenced proper fit indexes. A correlation between socioeconomic factors and the structure of oral health services was only noted in model 3. The worse the socioeconomic conditions, the lower the availability of dental supplies (standard factor loading: 0.92, P = 0.012). Estimates of total, direct and indirect effects showed that dental caries experience observed in the Brazilian population by SB-Brasil in 2010 did not affect the outcomes investigated. Conclusion Material resources are not equitably distributed according to the socioeconomic conditions and oral health needs of the population of the Brazilian capitals, thus contributing to persistent oral health inequities in the country.
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Affiliation(s)
| | | | | | | | - José Aquino Júnior
- Department of Public Health, Postgraduate Program in Environmental Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - Thiago Augusto Hernandes Rocha
- Pan American Health Organization, Brasilia Federal District Brazil, Brasília, Brazil.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Núbia Cristina da Silva
- Center for Graduate Studies and Research in Administration (CEPEAD), Faculty of Economic Sciences (FACE), Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Duke Global Health Institute, Duke University, Durham, NC, USA
| | - Elisa Miranda Costa
- Graduate Program in Public Health, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | | | | | - Luiz Augusto Facchini
- Department of Social Medicine, Postgraduate Programs in Epidemiology and Nursing, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Erika Bárbara Abreu Fonseca Thomaz
- Department of Public Health, Postgraduate Program in Public Health, Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Maranhão, Brazil
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