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Abdellatif EB, El Kashlan MK, El Tantawi M. Silver diamine fluoride with sodium fluoride varnish versus silver diamine fluoride in arresting early childhood caries: a 6-months follow up of a randomized field trial. BMC Oral Health 2023; 23:875. [PMID: 37978488 PMCID: PMC10656986 DOI: 10.1186/s12903-023-03597-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 10/30/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Early childhood caries (ECC) is the most prevalent chronic health problem in young children, and it can be arrested using professionally applied fluoride such as Sodium fluoride (NaF) varnish and Silver Diamine Fluoride (SDF). This trial compared two interventions to arrest ECC lesions: 38% SDF combined with 5% NaF varnish versus 38% SDF and assessed whether the arrest rate was affected by baseline lesion severity measured by ICDAS. METHODS Children aged ≤ 4 years from 4 nurseries in a rural area in Alexandria, Egypt joined the study in March 2022. They were included if they had at least one active carious lesion with ICDAS codes ≥ 3. They were randomized to receive either 38% SDF with 5% NaF varnish or 38% SDF alone. In both groups, the agents were applied at baseline and after 6 months on the caries lesions. NaF was additionally applied on all teeth in the oral cavity, and it was also applied after three months. The primary outcome was lesion arrest status after six months. Parents' satisfaction with their children's appearance was the secondary outcome. Pearson Chi-Square test was used for bivariate comparison and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest controlling for confounders. The interaction between the intervention and baseline lesion severity (categorized into moderate and severe lesions) was assessed and the p value was calculated. RESULTS The study included 1606 lesions in 220 children, median (IQR) age = 48(9) months. The percentages of arrested lesions after the application of SDF + NaF and SDF only were 77.7% and 73.2% (p = 0.035). In multivariable analysis, SDF + NaF had significantly greater caries arrest effect than SDF alone (AOR = 2.12, p = 0.03) with significant difference (p = 0.03) between moderate (AOR = 4.10, p = 0.005) and advanced (AOR = 1.92, p = 0.08) lesions. Most parents were satisfied with their children's appearance with no significant difference between groups (SDF + NaF = 84.5%, SDF = 78.18%, p = 0.23). CONCLUSION SDF + NaF had a higher arrest rate than SDF alone and this difference was significant in moderate but not advanced lesions. The findings have implications for the non-invasive management of ECC. TRIAL REGISTRATION This trial was registered in the clinicaltrials.gov registry (#NCT05642494).
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Affiliation(s)
- Enas B Abdellatif
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt.
| | - Mona K El Kashlan
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt
| | - Maha El Tantawi
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Champolion St, Azarita, 21527, Alexandria, Egypt
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Elkhodary HM, Abdelnabi MH, Swelem AA, Sabbagh HJ, El Meligy OAES, Talaat IM, Abdellatif EB, Khader Y, Al-Batayneh OB, Al-Khanati NM, Nurelhuda NM, Alhabli S, Mostafa MH, Qureshi S, Qureshi N, Yousaf MA, Taha D, Marafi YF, Al Harrasi SN, Al-Rai S, Gomaa N, Mattar H, Bakhaider HA, Samodien B, Lố H, El Tantawi M. Individual, familial and country-level factors associated with oral hygiene practices in children: an international survey. BMC Oral Health 2023; 23:50. [PMID: 36710323 PMCID: PMC9885580 DOI: 10.1186/s12903-023-02746-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/16/2023] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Maintaining good oral hygiene is key to preventing dental caries and periodontal disease. Children and adolescents with good oral hygiene behaviours are likely to grow into adults with the same behaviours. This study assessed the frequency of using various oral hygiene methods among children and adolescents from different countries and individual, familial and country-level factors associated with the use of these methods. METHODS A multi-country online survey collected data from caregivers of children in 2020-21 about children's use of oral hygiene methods including toothbrush, fluoridated toothpaste, mouthwash, dental floss and miswak using self-administered, close-ended questions. Adjusted multilevel logistic regression models were used to assess the relationship between each of the five oral hygiene methods (dependent variables) and the independent factors: sex, age, and history of dental visits (individual factors), mother's education and area of residence (familial factors) as well as country income and region (country-level factors). RESULTS A total of 4766 parents/caregivers were included from 20 countries (77.4% Eastern Mediterranean-region and 41.6% lower middle income countries). The most frequent oral hygiene methods were using toothbrush and toothpaste (90% and 60.3%). The use of oral hygiene methods differed by age, sex and history of dental visits as well as mother's education and area of residence (P < 0.05). In addition, children from low income countries had significantly lower odds of using mouthwashes and dental floss than those from high income countries (AOR = 0.55, 95% CI 0.31, 0.98 and AOR = 0.34, 95% CI 0.12, 0.97) whereas children from the European region had higher odds of using mouthwash (AOR = 2.82, 95% CI 1.27, 6.26) and those from the region of the Americas had higher odds of using dental floss (AOR = 3.84, 95% CI 1.28, 11.52) than those from the Eastern Mediterranean region. CONCLUSIONS The use of various oral hygiene methods is associated with individual, familial and country-level factors. Oral health promotion programs should be developed taking into account these influences.
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Affiliation(s)
- Heba Mohamed Elkhodary
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.411303.40000 0001 2155 6022Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Mohamed Hussein Abdelnabi
- grid.412125.10000 0001 0619 1117Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.411806.a0000 0000 8999 4945Department of Removable Prosthodontics, Faculty of Dentistry, Minia University, Minia, Egypt
| | - Amal Ali Swelem
- grid.7776.10000 0004 0639 9286Department of Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Heba Jafar Sabbagh
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar Abd El Sadek El Meligy
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia ,grid.7155.60000 0001 2260 6941Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Iman Mamdouh Talaat
- grid.412789.10000 0004 4686 5317Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE ,grid.7155.60000 0001 2260 6941Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Enas B. Abdellatif
- grid.7155.60000 0001 2260 6941Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Yousef Khader
- grid.37553.370000 0001 0097 5797Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Ola B. Al-Batayneh
- grid.37553.370000 0001 0097 5797Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Nuraldeen Maher Al-Khanati
- grid.449576.d0000 0004 5895 8692Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Nazik M. Nurelhuda
- grid.9763.b0000 0001 0674 6207Dental Public Health Division, Faculty of Dentistry, University of Khartoum, Khartoum, Sudan
| | - Sara Alhabli
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohamed Hassan Mostafa
- grid.411303.40000 0001 2155 6022Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Shabnum Qureshi
- grid.412997.00000 0001 2294 5433Department of Education, University of Kashmir, Srinagar, India
| | - Nafeesa Qureshi
- grid.412273.10000 0001 0304 3856NHS Tayside Scotland, Dundee, DD2 2RZ UK
| | - Muhammad Abrar Yousaf
- grid.444943.a0000 0004 0609 0887Department of Biology, Faculty of Science and Technology, Virtual University of Pakistan, Lahore, Pakistan
| | - Dunia Taha
- grid.8192.20000 0001 2353 3326Department of Pediatric Dentistry, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Yousef Falah Marafi
- grid.7155.60000 0001 2260 6941Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | | | - Sarah Al-Rai
- grid.444919.50000 0004 1777 7537Department of Conservative and Preventive Dentistry, Faculty of Dentistry, Saba University, Sana’a, Yemen
| | - Noha Gomaa
- grid.39381.300000 0004 1936 8884Oral Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON Canada ,grid.413953.90000 0004 5906 3102Department of Oral Medicine, Children’s Health Research Institute, London, ON Canada
| | - Hala Mattar
- grid.7155.60000 0001 2260 6941Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Hanin A. Bakhaider
- grid.412125.10000 0001 0619 1117Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, South Africa
| | - Hanane Lố
- Department of Pediatric Dentistry, Clinique Dentaire D’Agadir, Agadir, Morocco
| | - Maha El Tantawi
- grid.7155.60000 0001 2260 6941Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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Elkhodary HM, Sabbagh HJ, El Meligy OAES, Talaat IM, Abdellatif EB, Mostafa MH, Khader Y, Al-Batayneh OB, Alhabli S, Al-Khanati NM, Qureshi S, Qureshi N, Yousaf MA, Marafi YF, Al Harrasi SN, Al-Rai S, Gomaa N, Mattar H, Bakhaider HA, Samodien B, Lố H, El Tantawi M. Children’s access to dental care during the COVID-19 pandemic: a multi-country survey. Children's Health Care 2022. [DOI: 10.1080/02739615.2022.2114478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Heba Mohamed Elkhodary
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Heba Jafar Sabbagh
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar Abd El Sadek El Meligy
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Iman Mamdouh Talaat
- Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE
- Pathology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Enas B. Abdellatif
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Mohamed Hassan Mostafa
- Department of Pedodontics and Oral Health, Faculty of Dental Medicine for Girls, Al Azhar University, Cairo, Egypt
| | - Yousef Khader
- Department of Public Health, Faculty of Medicine, Jordan University of Science and Technology, Jordan
| | - Ola B. Al-Batayneh
- Preventive Dentistry Department, Faculty of Dentistry, Jordan University of Science and Technology, Jordan
| | - Sara Alhabli
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nuraldeen Maher Al-Khanati
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Shabnum Qureshi
- Department of Education, University of Kashmir, Srinagar, India
| | - Nafeesa Qureshi
- General Dental services NHS Tayside, NHS Tayside Scotland, DD2 2RZ, Dundee, United Kingdom
| | - Muhammad Abrar Yousaf
- Department of Biology, Faculty of Science and Technology, Virtual University of Pakistan, Lahore, Pakistan
| | | | | | - Sarah Al-Rai
- Department of Conservative and Preventive Dentistry, Faculty of Dentistry, Saba University, Yemen
| | - Noha Gomaa
- Oral Medicine, Schulich School of Medicine and Dentistry, University of Western Ontario, London, ON, Canada
- Department of Oral Medicine, Children’s Health Research Institute, London, ON, Canada
| | - Hala Mattar
- Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Hanin A. Bakhaider
- Pediatric Dentistry Department, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bahia Samodien
- Western Cape Education Department, Cape Town, South Africa
| | - Hanane Lố
- Department of Pediatric Dentistry, Clinique Dentaire D’Agadir, Morocco
| | - Maha El Tantawi
- Pediatric Dentistry and Dental Public Health Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
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