A descriptive study on oral hygiene practice and caries increment in children with growth stunting

Introduction

Stunting is a condition of malnutrition in children from the womb to the early life stage that causes growth failure in the body and brain. Stunting influences the development and integrity of the oral cavity and increases the risk of developing diseases in the oral cavity, such as dental caries. The growth barriers in stunting children and parental knowledge can affect maintaining oral hygiene. This study aims to determine the description of oral hygiene practice and caries increment in children with growth stunting.

Methods

This type of research is a quantitative descriptive with a Secondary Data Analysis approach in the form of examination results for the presence or absence of caries through the ICDAS index and the results of the oral hygiene practice questionnaire on 113 children with growth stunting in Sukajadi district, Bandung.

Results

Most stunting children (60.2%) experienced increased caries rates classified as low, and 70.8% had poor oral hygiene practices. There were 50 children (44.3%) with poor oral hygiene practice with low caries increment, while 18 children (15.9%) had good oral hygiene practice with low caries increment.

Conclusion

Oral hygiene practice is classified as poor, but caries increment is still relatively low in most stunting children in Sukajadi district, Bandung.

The Effect of MI Varnish™ on Caries Increment and Dietary Habits among 6- and 12-Year-Old Children in Riga, Latvia: A 3-Year Randomized Controlled Trial

Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-year-old children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia.

Caries Experience and Increment in Children Attending Kindergartens with an Early Childhood Caries Preventive Program Compared to Basic Prophylaxis Measures-A Retrospective Cohort Study

Dental caries constitutes a public health challenge. As preventive strategies are desirable, this retrospective cohort study aimed to assess the caries experience and increment in children attending kindergartens with an early childhood caries (ECC) preventive program (intervention group, IG) compared to basic prophylaxis measures (control group, CG) located in areas of different socioeconomic status (SES) within Marburg (Germany). The long-term caries experience (2009−2019) of these 3−5-year-old kindergarten children was evaluated. For the caries increment, dental records of 2019 were screened for the availability of a minimum of two dental examinations at least 8 months apart. Caries was scored according to the WHO criteria (dmf−t). The data were split by observation period (300−550 and >550 days). Overall, 135 children (Ø 3.7 years) attended IG, and 132 children (Ø 3.6 years) attended CG. After 300−550 days, no significant differences were found between both groups regarding mean caries increment and experience (p > 0.05). After >550 days, IG with low SES exhibited a high caries experience. Fluoride varnish applications could not reduce the caries increment compared to CG in the short-term but slightly decreased the long-term caries experience. Comprehensive ECC prevention measures actively involving parents are needed to overcome the caries burden.

Effectiveness of pit and fissure sealants on primary molars: A 2-yr split-mouth randomized clinical trial

The primary objective of this study was to evaluate the effects of sealants in preventing pit and fissure caries in primary molars. The secondary objective was to assess the sealant retention during a 2-yr study period. A 2-yr split-mouth randomized clinical trial including 90 3-7-yr-old children was conducted in the paediatric dental department of Montpellier hospital. The dentition of each included patient was divided into an experimental side and a control side, with annual follow-up visits. Caries increments, measured as the number of new occlusal cavitated lesions, were not different between the sealed (mean 0.23) and the control primary molars (mean 0.29). A multiple mixed-effects logistic regression showed that male gender, moderate/high caries risk, and a higher oral hygiene index score, had a statistically significant effect resulting in higher caries increments in the primary molars, than did female gender, low caries risk, and lower oral hygiene index scores. Sealing showed no statistically significant influence on the development of new caries lesions. After 2 yr, the percentages of partially or totally lost sealants were 22.7% and 32.0%, respectively. In this sample of children, the caries increment was not significantly different between the sealed and the unsealed molars. At the end of this 2-yr study, more than half of the sealants were totally or partially lost, which could explain the low sealant effectiveness.

The Association of Caries Increment Dynamics in Preschool Children with Risk Factors: The 3-Year Prospective Study

This prospective study monitored the dental status, the presence of plaque, and cariogenic microorganism levels of identical children over three years. The aim was to determine the dynamics of caries increment as well as the relationship between risk factors and caries prevalence. A total number of 125 children (72 boys and 53 girls) was included in the study, with an average age of 3.95 ± 0.06 years at the baseline. During the clinical examination at the nursery schools, the presence of dental plaque was recorded, and saliva samples were collected from the tongue of children for the DentoCult SM test providing easy detection of mutans streptococci from saliva samples. At baseline, 65.6% of the children had no caries, 4% had restored teeth with fillings or crowns or missing teeth due to caries, and 30.4% had at least one untreated caries. The percentages of intact teeth, restored or missing teeth, and untreated caries were 52.8%, 8.8%, 38.4% in the second year and 49.1%, 13.8%, and 31.1% in the third year. The dmft index value was 1.41 ± 0.24 in the first year, 2.29 ± 0.30 in the second year, and 2.33 ± 0.31 in the third year. There was a significant correlation between plaque presence and dt and dmft values (p < 0.05; the statistical analyses were performed using the Kolmogorov-Smirnov test). This 3-year longitudinal study highlighted the importance of examining both the oral hygiene and the level of cariogenic microorganisms when undertaking the evaluation of caries risk evaluation in preschool children.

Fissure Depth and Caries Incidence in First Permanent Molars: A Five-Year Follow-Up Study in Schoolchildren

This study aimed to evaluate the association between the fissure depth (tooth morphology) of permanent molars and dental caries incidence with a five-year follow-up period. In total, 110 Mexican schoolchildren aged seven years were recruited at baseline, of which 88 children completed the follow-up assessments. The fissure depths of the first permanent lower molars were recorded, and dental caries [decayed, missing, and filled deciduous surfaces (dmfs) and decayed, missing, and filled permanent surfaces (DMFS)] was evaluated annually. A generalized estimating equation model was constructed for evaluating the association between dental caries and fissure depth. The initial and final DMFS scores were 0.02 (±0.2) and 1.55 (±2.49), respectively. The generalized estimating equation model showed that children with deep molar fissures were more likely to develop caries lesions, (Odds Ratio OR = 3.15, p = 0.028) compared to children with shallow fissures. Moreover, dental caries in primary teeth (OR = 1.07, p = 0.005) was associated with the development of carious lesions in the permanent dentition. Fissure depth was a useful predictor of dental caries, according to this five-year follow-up study. The detection of deep occlusal fissures in the lower first permanent molars could contribute to the identification of children at high risk of dental caries. Tooth morphology may be used to identify children at a higher caries risk, particularly in settings with limited resources.

Threshold values affect predictive accuracy of caries risk assessment

OBJECTIVE

To evaluate effects of thresholds on estimates of predictive accuracy of methods for caries risk assessment.

MATERIAL AND METHODS

Adolescents, aged 12 visiting two dental clinics, were examined by visual/tactile examination and bitewing radiography at baseline and after one year. Three methods for caries risk assessment were applied: previous caries experience, dentists' risk assessment according to set criteria (presence or absence of caries lesion) and acid tolerance of dental biofilm. The measure for validity (the reference standard) comprised caries lesion progression at 1 year. Predictive accuracy estimates were calculated for several thresholds.

RESULTS

Accuracy estimates changed with threshold values of the methods and the reference standard. Patient spectrum differed between the clinics, which resulted in different accuracy estimates for the two samples. Generally, negative predictive values were high while positive ones were low indicating that these methods were more efficient in finding individuals who are at low risk of developing caries lesions than those with increased risk.

CONCLUSIONS

As thresholds and patient spectrum affected predictive accuracy, it may be difficult to design a universal model with set thresholds for caries risk assessment. Foremost, a model should consider the level of aspiration for prediction and clinical decisions that will be made based on the risk assessment in the actual clinical setting.

Identification of caries risk in 2-year-olds

OBJECTIVE

The first aim was to describe presence of plaque, caries and oral health behaviours in 2-year-old children. The second aim was to measure increments in caries experience from 2 to 5 years of age and to study whether national background, visible plaque, caries and oral health behaviour at 2 years of age were associated with increments in caries experience.

METHODS

The study population consisted of 392 children, of whom 211 were monitored from 2 to 5 years of age. At age 2 years, parents completed a questionnaire about family background and oral health behaviour. The presence of plaque and caries at tooth level was obtained from dental records. Data were tested with chi-square statistics and Mann-Whitney U test. Negative binomial regression analysis was conducted to explore the association between caries increment between 2 and 5 years of age and national background, visible plaque, caries and oral health behaviour at 2 years of age.

RESULTS

Caries was found in 4.6% of 2-year-olds, and 4.6% had visible plaque. More than half of these children (57.9%) brushed twice daily, toothbrushing was introduced when the child was 7 months or older in 61.0% of the children, and 15.6% consumed sugary snacks daily. Non-Western children more often had caries, visible plaque and unfavourable oral health behaviour than Western children (P < .05). At age 5 years, 28.9% of the children had caries experience. Non-Western background, toothbrushing less than twice daily, not using fluoridated toothpaste, not using fluoride lozenges, consuming sugary drinks at night, consuming sugary snacks daily, presence of plaque and caries at 2 years of age were associated with caries increment between 2 and 5 years of age in bivariable analyses. The results from multivariable analysis showed that children who started toothbrushing late, children who brushed less than twice daily at 2 years of age and children of non-Western background had a higher probability of having caries increment from 2 to 5 years of age than other children.

CONCLUSIONS

A small proportion of 2-year-olds had caries, but these children had several decayed teeth. Substantial differences in oral health and oral health behaviour were found between Western and non-Western children. The preventive care delivered to the studied children failed to prevent caries increment from 2 to 5 years of age.

Longitudinal study of dental caries increment in Malaysian school children: a 5-year cohort study

The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study.

Caries increment among army personnel: a 5-year longitudinal study

To assess the progression of dental caries among Malaysian infantry soldiers after 5 years in military service. A retrospective cohort study with a self-administered questionnaire and a clinical oral examination. Data were available for 173 (67.3%) soldiers. Mean decayed, missing, or filled teeth had increased significantly by 20.6% (P = .001) over 5 years. The highest increase was in the missing teeth component (+120%), followed by filled teeth (+23%). This was accompanied by a decrease in decayed teeth (-23.5%; P < .05). In terms of surfaces, mean decayed, missing, or filled surfaces, missing surfaces, and filled surfaces had increased significantly (P < .05). Caries experience was significantly associated with smoking status and rank (P < .05). Dental caries experience was worse after 5 years in military service compared with during recruitment, and there were more tooth extractions than restorations. Health promotion interventions are needed to prevent further tooth loss among soldiers.