Oral health survey of preschool children in Iceland

Clinical Orodental Anomalies in Taiwanese Children under Age Six: a Study Based on the 1995-1997 National Dental Survey

There are few published studies that report the prevalence of intraoral anomalies for young children. The purpose of this study was to investigate the prevalence and distribution of several congenital oral and paraoral anomalies in Taiwanese children under age six. Twenty-five cities and townships were randomly sampled in different areas of Taiwan using the stratified method. These cities and townships represent cross-sectional samples of geographic locations and socioeconomic levels. A total of 981 Taiwanese children under age six were examined with dental mirrors and explorers as part of the national dental survey. The results of this survey indicated an 11.31% prevalence of geographic tongue. This number is higher than that reported in studies previously performed in different countries. The occurrence of double teeth in primary dentition was found to be 2.14%. Ankyloglossia had a frequency of 1.22%, and primary talon cusp a frequency of 0.61%. Seven (0.71%) children exhibited fissured tongues. Thirteen (1.33%) cases of hypodontia were found. These values were different from those reported in several other countries, which may be attributed to differences in the ethnic and racial composition of the population studied.

Caries prevalence of permanent teeth: a national survey of children in Iceland using ICDAS

OBJECTIVES

The Icelandic Oral Health Survey aimed to obtain new national data on the oral health of Icelandic children and teenagers.

METHODS

A representative stratified random cluster sample of 2251 Icelandic children in first, seventh and 10th grade, aged approximately 6-, 12- and 15-years old was examined for caries prevalence using the ICDAS criteria. Bite-wing digital radiographs were obtained for the children in 7th and 10th grade.

RESULTS

D(3)MFT scores by visual examination of 6-, 12- and 15-year olds were 0.12, 1.43 and 2.78 respectively but when including radiographs, the D(3)MFT rose to 2.11 at 12 years and 4.25 at 15 years. The Significant Caries Index, SiC, by visual examination for 12 and 15 y was 3.7 and 6.7 respectively but was 4.7 for 12 y and 8.9 for 15 y with radiographs. In all age groups and at most disease levels, caries was active in the majority of the lesions (58-100%). The percentage of children with no visually detectable caries at D(3)/D(1) level was 93%/74% for 6 years, 48%/22% for 12 years and 35%/16% for 15 years. When radiographs were included the percentage reduced to 34%/15% for 12 years and 20%/6% for 15 years. Approximately 80% of 12- and 15-year-olds had at least one of their first molars sealed, with the mean number of sealed first molars being 2.2 among 12 y and 2.0 among 15 y.

CONCLUSIONS

Caries levels were higher than expected in this national survey and further away from the goals of the National Health Plan for 2010 than anticipated. Caries distribution was skewed with more than half of the children having low caries scores but a wide distribution of caries experience was seen among the remaining population.

Idiopathic oligodontia in primary dentition: case report and review of literature

Idiopathic oligodontia of the primary dentition is very rare. This is a case report of a 2 year and 6 month old boy, who presented with fourteen missing primary teeth. Review of previous case reports is done and the management of these cases is discussed.

Prevalence of gingivitis in 6-year-olds in Reykjavik, Iceland

As part of a wider investigation of malocclusion, the aim of this study was to determine the prevalence of gingivitis in 6-year-olds in Reykjavik. Parents and guardians of the 401 children in 8 schools were invited by letter to have their children take part. There were 230 positive replies (57%). The Gingival Bleeding Index was used to determine the condition of the gingiva on mesiobuccal and buccal surfaces of 6 selected teeth (totaling 12 surfaces). The results showed that 26% had healthy gingivae, 23% showed bleeding from one surface, 20% from two, 17% from three, and 15% from four to eight surfaces. There were no statistically significant differences in the number of bleeding surfaces between boys and girls. The mean GBI for the whole group was 16%. Gingivitis in this group was therefore prevalent but usually slight.

Longitudinal study of caries, cariogenic bacteria and diet in children just before and after starting school

Fifty 5-yr-old preschool children living in Akranes, a small community in West Iceland known to have a high caries prevalence, were investigated with respect to caries, salivary counts of mutans streptococci and lactobacilli, and consumption of cariogenic foods. Fifteen months later, after being in school for half a year, 43 of the 50 children were reexamined and investigated as before. Mean dmfs scores rose from 7.1 to 9.0, but the scores including initial caries rose from 9.7 to 15.3. Mutans streptococci were carried by 84% of children on both occasions with a mean count 2.1 and 3.6 x 10(5) cfu/ml. Lactobacillus carriage increased from 29 to 38% and the mean count from 5.1 to 13 x 10(3) cfu/ml at 6 yr. The frequency of consumption of sugar-containing foods increased from 4.2 to 5.2 intakes per day and between-meal snacks rose from 3.0 to 3.7 per day. Children classified as "misusing" sugar were 59% at 5 yr and 83% at 6 yr. The mean caries score at 6 yr for children "misusing" sugar was 10.7 but only 2.0 for those not misusing sugar. Thus the deterioration in dental health appears, in these children, to be associated with the increased consumption of sweets and other cariogenic between-meal snacks after starting school.

Dental caries and Streptococcus mutans in a rural child population in Iceland

In spite of having a high socioeconomic standing, in Iceland caries prevalence has remained stubbornly high. This study reports findings from a mixed fishing and farming community in East Iceland that has traditionally been associated with the highest prevalence of caries. A total of 188 children aged 3-16 yr (96.4% of residents of that age group) were examined. At 6 yr the mean dmfs score was 4.1, DMFS 0 and 48% were caries-free. The mean DMFS score at 12 yr was 4.7 and 22.6% remained caries-free but at 16 yr the DMFS score was 11.6 and no children were caries-free. Caries was unevenly distributed within each age group and was more prevalent among residents of the fishing town than the surrounding farming district. In a pilot study conducted in 1989 mean counts of Streptococcus mutans for children aged 4-7 yr were 2.6 x 10(5) cfu/ml and declined to 4.6 x 10(4) cfu/ml in 1990 after a program of chlorhexidine brushing had been added to the routine caries preventive measures adopted in this community. It may therefore be possible to screen Icelandic children for caries risk and apply preventive measures to those demonstrated to be most in need.

Caries prevalence, Streptococcus mutans and sugar intake among 4-year-old urban children in Iceland

Concern at the high prevalence of dental caries in Iceland prompted this survey of 158 preschool children in Reykjavik. On initial examination in 1987 45.8% of the children were caries-free and the prevalence of caries was a mean dmft 2.4 and a mean dmfs 3.3. A dietary questionnaire aimed at discovering the frequency of sugar consumption per week revealed a threshold value of 30 instances of sugar intake per week above which caries prevalence increased markedly. Some of this sugar is consumed in paediatric medicines, particularly antibiotics and anti-asthmatics, which are widely used in Iceland. Caries prevalence (dmft) for children taking such medicines regularly was 3.0 compared with 2.1 for remaining children (P less than 0.05). Those children who took fluoride tablets regularly had less caries (mean dmft 1.1) than those who used fluoride tablets irregularly or not at all (mean dmft 2.8; P less than 0.001). Samples of saliva from the dorsum of the tongue were taken for determination of numbers of Streptococcus mutans and lactobacilli. High bacterial counts were strongly associated with caries. Only 5% of children with more than 5 x 10(5 S. mutans cfu per ml were caries free but 27% of subjects had 67% of the total amount of caries for the group and all of these would have been detected by the bacterial test.

Oral hygiene behavior and periodontal status in European adolescents: an overview

The object of this review is to examine toothbrushing as a health behavior in European adolescents. The aims are to investigate the role of environmental and social factors on toothbrushing as a health behavior, to illustrate the importance of such factors in the prevention of periodontal diseases and to demonstrate how a knowledge of these factors can aid the development of specific health education programs. In order to do this the results of many studies concerned with oral hygiene behavior from different European countries have been examined. It is from the detailed study of these various European investigations that the results section is composed. The findings from this review demonstrate that toothbrushing as a health behavior is influenced by both environmental and social factors, that both of these factors affect the incidence of gingivitis and periodontal disease in the countries examined, and that when they are incorporated into health education programs based on the community development approach they can aid behavior change.

Bilateral fusion and gemination: a literature analysis and case report

The dental literature concerning the bilateral presentation of fusion and gemination is reviewed and analyzed. Tables are presented to show the prevalence and distribution of these anomalies in both the primary and permanent dentitions. In addition, the first prevalence statistics for the bilateral occurrence of fusion and gemination in the primary and permanent dentitions are determined. The first case of bilateral fusion of mandibular primary incisors to be reported in 13 years is presented. The presence of all four succedaneous incisors and the diagnosis of bilateral fusion are confirmed radiographically. The developmental concerns and possible sequelae of bilateral fusion and gemination are also discussed.

Caries prevalence in Icelandic children in 1970 and 1983

In the autumn of 1983 a clinical survey was carried out on 756 children aged 6-14 yr, residing in three non-fluoridated communities in Iceland. The aim of the survey was to assess what changes, if any, in caries prevalence may have taken place as a result of the provision of free dental restorative services for these children since 1974. The 1983 prevalence data were compared with data obtained from a caries survey conducted in 1970 in the same areas in Iceland. The same examiner performed all examinations in both studies. Although considerable increase was noted in number of filled teeth with a corresponding decrease in carious and missing teeth, a statistically significant change in caries prevalence, (dft, dfs, DMFT, DMFS) did not manifest itself. The dfs and DMFS in 1983 was 8.9 and 9.5, respectively, compared to 8.5 and 10.4 in 1970. Over 90% of the toothpaste used in Iceland during the 1970's contained fluoride. The children in the three study areas had not been provided with any public preventive programs.

Hypodontia, hyperodontia, and double formation of primary teeth in Iceland. An epidemiological study

The aim of this study was to determine the prevalence of hypodontia, hyperodontia, and double formation of primary teeth in Icelandic children in the dental stage DS 02 (primary dentition complete). The study group comprised 927 children (498 boys and 429 girls). This was about 9% of all children aged 0-83 months in Reykjavik at the time of the registration of these anomalies, during the winter of 1978-1979. The children included those presenting for regular examinations in two health centers, children from three kindergartens, and seven pre-school classes from two schools in Reykjavik. Of these children 61.9% were selected for this study as they proved to be in dental stage DS 02 (primary teeth fully erupted). The prevalences were hypodontia, 0.5%; hyperodontia, 0.5%; and double formation, 0.7%. Comparison was made with earlier results from Iceland and with results from several other nations.

Epidemiology of dental caries in 5-year-old children in Israel

The objective of this study was to assess the prevalence of dental caries in the earliest age at which children were organized as a group in the national education system and to find possible associations with variables that may help to identify "groups at risk" in this population. A total of 965 children, 5 years old, were examined. They were selected by a method to form a representative sample of all West Jerusalem compulsory kindergarten classes in 1971. Caries, gingivitis and oral hygiene were assessed and demogrphic data were collected. It was found that 84% of the children were affected with mean dif value of 4.7 (+/- 3.6). Association was found between caries and social class. The high morbidity suggests that organized services should be planned for this age group. Since the resources are limited, efforts should be directed mainly towards "groups at risk".

Caries prevalence of preschoolchildren in Baja, Hungary in 1955 and 1975

In 1975 caries epidemiologic investigations were performed in 1,017 preschoolchildren of Baja, aged 3--6 years. The data were analyzed and compared with those of 620 preschoolchildren of the same city in 1955. A mean increase of 10.9% of the caries frequency (percentage of examinees with caries), and a mean increase of 43.5% of the caries intensity(dmft count per examinee) could be observed in spite of a better vitamin D prophylaxis. The possible cariogenic role of the increased surgar consumption (37.5 kg from 24.4 kg per individual during 20 years) is discussed.

An epidemiologic study of occlusal anomalies in relation to development of the dentition in Icelandic children

The purpose of the investigation was to determine the prevalence of occlusal anomalies in relation to dental stages (DS) in Icelandic schoolchildren, and to compare it with results from other Scandinavian countries and Ireland found on the basis of the same method. The material consisted of 1,641 randomly selected children, 791 boys and 850 girls, corresponding to 9.5% of the total primary and secondary school population of Reykjavík. A significant sex difference was only recorded in the frequencies of of two of the single morphologic traits of occlusal anomalies, the boys showing higher frequencies in deep bite and in scissors-bite. Significant differences in the occurrence of occlusal anomalies in Iceland and Denmark were only found in two out of 108 pairs of frequencies.

[Periodontal disease and prevention in children and adolescents]

Clinical and epidemiological studies have shown that: 1. Bacterial plaque which accumulates around the teeth is responsible for chronic periodontal inflammation. From adolescence on, this inflammation is almost universal. 2. Gingivitis prepares the periodontitis, which is characterized by a migration of the epithelial attachment, pocket formation and progressive bone loss. 3. Calculus is formed by plaque calcification. Its rough surface allows bacterial retention and proliferation in contact with the epithelial covering. 4. The mechanisms of host resistance to parasitic plaque are mostly unknown. This resistance is variable and seems to decrease with age. 5. Periodontal disease in children and adolescents is a real problem in preventive medicine, because of its immediate or remote consequences on tooth loss. Thanks to fluoride, the prevention of dental caries is quite effective; the prevention of periodontal disease is on the contrary much more difficult. Mechanical removal of plaque is tedious and must be done again and again; however, it is not logical to separate prevention of caries from that of periodontal disease. Information of the public at large on oral health is of utmost importance, as well as a good cooperation of the teachers in preventive programs for schoolchildren. Every health department or service should try to apply the following measures: -Permanent employments for "school dental nurses" should be created, on a part-time or full-time basis. They should take care of the organisation and supervision of oral health programs. -In each school dental service, a dentist should be responsible for teaching the theoretical and practical aspects of periodontal prevention. -Caries reduction obtained by fluorides is no excuse to reduce the "treatment staff". This staff should be devoted to prevention at large and to refreshing courses. In a young population with regular supervision, prevention of periodontal disease can meet with considerable success. Initial periodontal disease is reversible: it is possible to avoid the degradation of gingivitis in progressive periodontitis, and this helps maintaining dental and periodontal health throughout life.

Occlusion in the primary dentition in 3-year-old children

The material for the present study comprises plaster models of 310 Copenhagen children, impressions for which were taken during the month each child attained the age of 3 years. On the basis of fixed criteria a description is given of individual symptoms of occlusion. Using the primary canines as the guide to occlusion it was found that the same occlusion at both sides occurs in 79.7% of the overall total, the remaining 20.3% having different occlusion at each side. Approximately one-half recorded neutral occlusion at both sides, and one-third had distal occlusion at both sides. The termination pattern of the dental arches in centric occlusion were normal or straight in 68.0% and bilateral distal in 14.8%. In 82 subjects or 27% of the degree of overlapping was greater than or equal to half the height of the mandibular central incisors. The number of cross-bites constituted 11.6% of all subjects. Assessment of spacing was undertaken exclusively on the basis of whether or not a space existed. About 3.5% of all subjects had close contact between all teeth in the maxilla or crowding, and about 24% had spacing between all teeth in the maxilla. In the mandible about 5% had close contact between the teeth and only 15% had spacing between all teeth in the mandible.