Clinical Consequences of Dental Caries, Parents' Perception of Child's Oral Health and Attitudes towards Dental Visits in a Population of 7-Year-Old Children

Matrix Metalloproteinases in the Periodontium-Vital in Tissue Turnover and Unfortunate in Periodontitis

The extracellular matrix (ECM) is a complex non-cellular three-dimensional macromolecular network present within all tissues and organs, forming the foundation on which cells sit, and composed of proteins (such as collagen), glycosaminoglycans, proteoglycans, minerals, and water. The ECM provides a fundamental framework for the cellular constituents of tissue and biochemical support to surrounding cells. The ECM is a highly dynamic structure that is constantly being remodeled. Matrix metalloproteinases (MMPs) are among the most important proteolytic enzymes of the ECM and are capable of degrading all ECM molecules. MMPs play a relevant role in physiological as well as pathological processes; MMPs participate in embryogenesis, morphogenesis, wound healing, and tissue remodeling, and therefore, their impaired activity may result in several problems. MMP activity is also associated with chronic inflammation, tissue breakdown, fibrosis, and cancer invasion and metastasis. The periodontium is a unique anatomical site, composed of a variety of connective tissues, created by the ECM. During periodontitis, a chronic inflammation affecting the periodontium, increased presence and activity of MMPs is observed, resulting in irreversible losses of periodontal tissues. MMP expression and activity may be controlled in various ways, one of which is the inhibition of their activity by an endogenous group of tissue inhibitors of metalloproteinases (TIMPs), as well as reversion-inducing cysteine-rich protein with Kazal motifs (RECK).

Knowledge and Attitudes of Parents about Oral Health in the Primary Dentition Stage in a Peruvian High Andean City

Children's oral health depends on parents' knowledge and attitudes. The primary dentition stage, in particular, plays a crucial role in the comprehensive development of children. Therefore, the objective was to evaluate parents' knowledge and attitudes about oral health in the primary dentition stage in Chachapoyas (Amazonas, NW Peru). A questionnaire was administered to 409 parents from 15 educational institutions, and the data were analyzed using multinomial logistic regression. Among the surveyed parents, 75.3% could identify at least one habit harmful to their children's teeth (such as excessive sugar consumption) and one of its effects (such as dental caries). Additionally, 77.5% reported that their children presented some dental problem, more frequent in the peripheral areas than in the city's center. Gender (odd ratio, OR = 0.484; p = 0.037), educational level (OR = 2.144; p = 0.043), and type of health insurance (OR = 2.627; p = 0.044) of the parents influenced awareness of taking care of their children's primary dental health. The geographic location of the school (1.729 < OR < 2.079; p ≤ 0.011) and family income (OR = 3.504; p = 0.028) influenced parents' identification of the different harmful effects of children's habits. Factors such as low socioeconomic status and never taking the child to the dentist increased the risk of dental problems (p < 0.05). It is suggested that peripheral areas, like rural areas, lack the same oral health programs and access to treatment as central urban areas, leading to disparities in parental knowledge and attitudes.

Dentist Mothers' Attitudes, Challenges and Facilitators in the Oral Health Promotion of Their Young Children

Twice daily parental supervised brushing (PSB) is recommended for the effective oral hygiene of children with toothpaste including fluoride. This cross-sectional study aimed to identify dentist mothers' attitudes, challenges, and facilitators in the oral health promotion of their young children. An online questionnaire was prepared and distributed to dentists via e-mail with a link to the form. Of all the mothers, 46.50% started brushing their children's teeth after the eruption of the first primary teeth. Nearly 50% of the mothers thought that they should brush their children's teeth until at least the age of 7-8 years old. In terms of the main barriers to toothbrushing, 52.9% said children could fall asleep at home or in the car, while 27.5% of all mothers reported being tired as the main barrier to toothbrushing. Although dentist mothers have sufficient knowledge to promote oral and dental health, they do not always have ideal attitudes and behaviors and they may encounter various barriers regarding themselves and their children in practical applications. Providing oral care for young children goes beyond 'knowledge' and is sometimes 'challenging'; however, it could be 'possible' by developing and implementing the most appropriate solution strategies suitable for each unique family and child.

Diet, Oral Hygiene Habits, and Approach to Dental Visits of Early School-Aged Children during the COVID-19 Pandemic and Possible Long-Term Health Consequences

INTRODUCTION

Early school-aged children are in a transitional phase from primary to permanent dentition. Established dietary and oral hygiene habits will influence the condition of the oral cavity in the future.

AIM

This study aimed to evaluate alterations in early school children's dietary and oral hygiene practices during the COVID-19 pandemic and to anticipate potential long-term health implications.

MATERIAL AND METHODS

This cross-sectional online study involved guardians of Polish children aged 6-10 years, living in Western Poland, who were socially isolated at home during the COVID-19 pandemic. A total of 180 guardians were invited to participate in this study. The questionnaire included 17 questions divided into four different sections-the child's anthropometric data, dietary habits, oral health, and attitude to dental visits.

RESULTS

The survey was completed by 106 guardians. The mean (standard deviation) age of the children was 8.12 (0.93) years (range 6-10 years). Overall, 24.5% of the surveyed individuals reported buying healthy products (fresh vegetables, fruit) more frequently during the pandemic. Furthermore, 35.8% admitted to snacking between meals more frequently and 16.0% less frequently. Almost one-quarter of the parents acknowledged that their children were less motivated to maintain oral hygiene during the pandemic and 28.3% declared a lower frequency of visits to the dentist from the outbreak of the pandemic for two main reasons: a fear of coronavirus transmission and economic reasons.

CONCLUSIONS

In the group studied, the results of the assessment indicate that the COVID-19 pandemic had some effects on oral health that may lead to an increased risk of oral disease development, such as tooth decay in children. None of the respondents noticed an increase in their child's motivation about good oral hygiene despite spending more time at home. The irregularity of follow-up visits for one-third of the respondents hindered preventive measures and the continuation of dental treatment.

COVID-19 Related Information on Pediatric Dental Care including the Use of Teledentistry: A Narrative Review

In addition to the direct impact of the SARS-CoV-2 infection, the COVID-19 pandemic reports multiple effects on people's health and psycho-physical well-being. In the dental field, oral hygiene sessions, regular dental check-ups, and aerosol-generating procedures were commonly postponed, thus resulting in repercussions on oral health also favored by the changing eating and oral hygiene habits during the multiple lockdowns. Furthermore, dental settings and practices were generally perceived as at high risk for SARS-CoV-2 transmission, thus unsafe, and by general and pediatric dentists themselves. Last, the consequences of stress related to deprivation of social life and playful activities should not be underestimated in children, exposing them to the deleterious effects of bad oral habits, with repercussions on the balanced growth and development of the stomatognathic system. The present work intends to analyze the medium-term and long-term impact of COVID-19 on pediatric oral and dental care provision, reviewing pediatric dentistry practice and oral and dental needs of pedodontics patients during the first peak and the various waves of the COVID-19 pandemic, and lessons learned.

Oral Health in Patients with Inflammatory Bowel Diseases Qualified for Biologic Treatment

Oral health is closely linked to general health status in the form of a bidirectional relationship [...].

Caries Experience and Treatment Needs in Urban and Rural Environments in School-Age Children from Three Provinces of Ecuador: A Cross-Sectional Study

In Ecuador, national epidemiological surveys have not been updated; however, some regional studies in the northern areas of the country still report a high prevalence of dental caries. The aim of this study was to determine the experience, severity, and need for treatment of dental caries in school children aged 6 to 12 years in urban and rural settings in three provinces of southern Ecuador. This cross-sectional, relational study examined 1938 schoolchildren in the provinces of Azuay, Cañar, and Morona Santiago. The survey instruments were based mainly on the WHO manual Methods of Oral Health Surveys (dmft) for primary and permanent dentition (DMFT), as well as the prevalence, severity, and Significant Caries Index (SCI). The parametric Student’s t-test was used to compare two groups, and the Spearman’s Rho and Tau-c Kendall correlation coefficients were used to associate the categorical variables. Results: The prevalence of caries in the primary dentition was 78% and 89.2% in the permanent dentition. The dmft (M = 4.12, SD = 2.86) and DMFT (M = 3.62: SD = 3.07) placed the general group in a moderate caries index. The need for treatment was 90.68% in the primary dentition, while it was 87.99% in the permanent dentition. Caries severity in both dentitions was high (M = 7.74; SD = 3.42). Conclusions. Alarming indicators of caries experience and the need for treatment were observed in the population studied.

Exploring the Relationships between Children's Oral Health and Parents' Oral Health Knowledge, Literacy, Behaviours and Adherence to Recommendations: A Cross-Sectional Survey

Although preventable, early childhood caries (ECC) is a burdening condition in all WHO regions, with Poland being one of the most affected countries in Europe. Effective home-based prevention of ECC is available and recommended by several expert bodies. Therefore, we wanted to determine how well parents were following selected oral health recommendations in preschool children. Additionally, we wanted to determine which socioeconomic factors influenced such practices the most, and how parents' oral health literacy and behaviours affected the oral hygiene and oral health status of their children. A cross-sectional survey involving 2338 parents and caregivers of children from 167 kindergartens was performed. Children's oral hygiene and oral health status were found to be associated with parents' education and economic status. They were also strongly influenced by parental health literacy and behaviours. With respect to recommendations for preschoolers, the lowest adherence was found in the use of fluoride toothpaste and its age-appropriate amount, supervision of toothbrushing, and refraining from eating after last toothbrushing. The improvement in these areas could be achieved thanks to the involvement of health professionals such as gynaecologists, midwives, and primary care personnel in efforts aimed at increasing parents' oral health knowledge and literacy.

Health Literacy in Early Childhood: A Systematic Review of Empirical Studies

Early childhood plays a key role in the formation of healthy habits and the establishment of health literacy. Nonetheless, there are only a few research studies focusing on the health literacy level of children under the age of eight. The aim of our systematic review is to explore empirical research on health literacy related to early childhood. The research was conducted in accordance with the PRISMA protocol. This systematic review examines 12 studies published between 2013–2022. Results show that research focuses on different domains of health literacy for children. In relation to children’s food literacy, children understand the relationship between health and nutrition and they realize the health impact of obesity. The habits connected to oral health are strongly associated with parents’ knowledge of and behaviours around oral health. Results related to health care situations show that children are able to be actively involved in decision-making processes in connection with their health. Exploring young children’s health literacy is essential in order to be able to plan health promotion interventions, embedded into early childhood education. Picture-based messages or story-based messages supported by illustrations can help measure health literacy in early childhood and can support the formation of health literacy.

Factors Affecting Dental Caries Experience in 12-Year-Olds, Based on Data from Two Polish Provinces

(1) Background: Dental caries is a chronic disease that affects a child’s dentition from the first stages of life. Several factors contribute to the development of the disease, including an improper diet. This cross-sectional study aimed to identify risk factors of dental caries in 12-year-old adolescents from Greater Poland and Lubusz Provinces (Poland). (2) Material and methods: The research was conducted in adolescents from five primary schools. A questionnaire consisted of close-ended questions on socioeconomic characteristics on family, diet, and oral hygiene habits. An assessment of the dentition was carried out in accordance with World Health Organization (WHO) recommendations. In addition to cavitated carious lesions, incipient caries lesions were noted according to the International Caries Detection and Assessment System, adapted for epidemiological studies (ICDASepiDMFt). (3) Results: The mean number of teeth with untreated caries; removed due to caries; and restored because of caries (DMFt) was 1.52 ± 1.90, while the ICDASepiDMFt index amounted to 2.64 ± 2.55, respectively. Children who did not brush every day had significantly higher odds of having ICDASepiDMFt > 0 than children brushing at least once daily (OR = 10.32, 95% CI = 1.36−78.32, p = 0.0240). Adolescents who drank sweet carbonated drinks every day had significantly higher ICDASepiDMTt than children who drank sweet carbonated drinks less frequently (p = 0.0477). (4) Conclusions: The research revealed that dental caries indices of 12-year-old adolescents from Greater Poland and Lubusz Provinces depend mainly on oral hygiene behaviors. The only significant nutritional factor that differentiated the caries intensity was the daily consumption of sweet carbonated drinks.

Bibliometric Analysis of the Current Landscape of Global Scientific Production on the Development of Vaccines against Dental Caries

Objective. To perform a bibliometric analysis of the scientific research on the development of vaccines against dental caries. Methods. An extraction of the scientific production published on the development of vaccines against dental caries between 2011 and 2020 was carried out from the Scopus database. Microsoft Excel was used for the elaboration of tables and SciVal for the bibliometric analysis of the data, which were divided into indicators of production, impact, and collaboration. Finally, VOSviewer was used for co-occurrence analysis of keywords and collaborative networks. Results. 106 studies were retrieved from the Scopus database, which were conducted on the development of dental caries vaccines within the years 2011–2020. Wuhan University, in China, was the university with the highest scientific production on the subject, with 4 publications. Regarding the most productive journals, the first place was occupied by the Journal of Dental Research with 7 publications. Regarding the most productive journals, the first place was occupied by the Journal of Dental Research with 7 publications. The highest percentage of the documents analyzed was in quartile 1 journals and in the national collaboration pattern. Conclusion. Most of the manuscripts regarding the development of vaccines against dental caries were published in China and in Q1 quartile journals. In addition, Yan Huimin, Yang Jingyi, Zhou Dihan, Yang Yi, Li Yuhong and Fan Mingwen were found to top the list of most productive authors. The Journal of Dental Research was also identified as the most productive and cited journal.

Guardian Reports of Children's Sub-optimal Oral Health Are Associated With Clinically Determined Early Childhood Caries, Unrestored Caries Lesions, and History of Toothaches

Background: Parents'/guardians' perceptions of their children's oral health are useful proxies of their clinically determined caries status and are known to influence dental care-seeking behavior. In this study, we sought to examine (1) the social and behavioral correlates of fair/poor child oral health reported by guardians and (2) quantify the association of these reports with the prevalence of early childhood caries (ECC), unrestored caries lesions and toothaches. Methods: We used guardian-reported child oral health information (dichotomized as fair/poor vs. excellent/very good/good) obtained via a parent questionnaire that was completed for n = 7,965 participants (mean age = 52 months; range = 36-71 months) of a community-based, cross-sectional epidemiologic study of early childhood oral health in North Carolina between 2016 and 2019. Social, demographic, oral health-related behavioral data, and reports on children's history of toothaches (excluding teething) were collected in the same questionnaire. Unrestored ECC (i.e., caries lesions) was measured via clinical examinations in a subset of n = 6,328 children and was defined as the presence of one or more tooth surfaces with an ICDAS ≥ 3 caries lesion. Analyses relied on descriptive and bivariate methods, and multivariate modeling with average marginal effect (A.M.E.) estimation accounting for the clustered nature of the data. Estimates of association [prevalence ratios (PR) and adjusted marginal effects (AME) with 95% confidence intervals (CI)] were obtained via multilevel generalized linear models using Stata's svy function and accounting for the clustered nature of the data. Results: The prevalence of fair/poor oral health in this sample was 15%-it increased monotonically with children's age, was inversely associated with parents' educational attainment, and was higher among Hispanics (21%) and African Americans (15%) compared to non-Hispanic whites (11%). Brushing less than twice a day, not having a dental home, and frequently consuming sugar-containing snacks and beverages were significantly associated with worse reports (P < 0.0005). Children with fair/poor reported oral health were twice as likely to have unrestored caries lesions [prevalence ratio (PR) = 2.0; 95% confidence interval (CI) = 1.8-2.1] and 3.5 times as likely to have experienced toothaches [PR = 3.5; 95% CI = 3.1-3.9] compared to those with better reported oral health. Conclusions: Guardian reports of their children's oral health are valuable indicators of clinical and public health-important child oral health status. Those with fair/poor guardian-reported child oral health have distinguishing characteristics spanning socio-demographics, oral-health related practices, diet, and presence of a dental home.

Association between Insufficient Sleep and Dental Caries among Preschoolers in Japan: A Cross-Sectional Multicentre Study

Recently, sleeping status has attracted attention for its relationship with oral health. In the present study, we have investigated the association between early childhood caries and sleeping status. A multicentre observational cross-sectional study was conducted among 332 preschoolers (aged 3–6 years) and their parents in Chitose, Japan. Dental caries and sleeping status were assessed in the children and the sleep quality and health literacy of the parents were also assessed. Univariate and multivariate regression analyses were used in order to investigate the effect of the sleeping status of the parents and their children on dental caries. Among the children, the prevalence of dental caries experience was 12.7%. The children without caries slept significantly longer and their parents had a better Pittsburgh Sleep Quality Index (PSQI) score than those with caries experience. The sleeping status and the numbers of caries in the children were significantly correlated. Health literacy was better in those without caries experience. Parents’ PSQI was significantly positively correlated with the numbers of caries in the children (r = 0.19, p = 0.0004). The children’s sleep durations, screen time, and parental smoking status were independently associated with early childhood caries. Poor sleeping status of children and their parents is related to dental caries among preschoolers.

Nomogram prediction of caries risk among schoolchildren age 7 years based on a cohort study in Shanghai

Objective

Caries risk assessment tools are essential for identifying and providing treatment for individuals at high risk of developing caries. We aimed to develop a nomogram for the assessment and evaluation of caries risk among Chinese children.

Methods

We enrolled schoolchildren age 7 years from a primary school in Shanghai. Baseline information of participants was collected using a questionnaire completed by children’s caregivers. A nomogram of a novel prediction scoring model was established based on predictors detected in univariate and multivariate analyses. Predictive accuracy and discriminative ability of the nomogram were calculated using the concordance index (C index). The bootstrap method (1000 samples) was used to decrease overfitting. The net benefit of the model was validated using decision curve analysis.

Results

Overall, 406 children with complete information and two completed dental examinations were included in the final analysis. The nomogram based on logistic regression model coefficients demonstrated a C index of 0.766 (95% confidence interval: 0.761–0.771) for caries risk. The net benefit of the decision curve analysis was 38.6% at 55% threshold probability.

Conclusion

This nomogram model, derived using dietary habits, oral hygiene status, and caries experience, showed promising predictive ability to assess the caries risk among Chinese children.