Malocclusion: Prevalence and Determinants among Adolescents of Karachi, Pakistan

OBJECTIVES

 The aim of this study was to determine the prevalence of malocclusion and its associated demographic and clinical factors in young adolescents (13-15 years) of Karachi, Pakistan.

MATERIALS AND METHODS

 An epidemiological survey included 500 young adolescents of registered schools, madrassas (Islamic education system), and shop workers of Gulshan-e-Iqbal Town. It was a cross-sectional analytical study design. Multistage random sampling technique was used to enroll participants. The pattern of occlusion was recorded with other related features using Angle's classification. Health status was recorded through World Health Organization-guided indices (decayed, missing, and filled permanent teeth [DMFT], community periodontal index of treatment needs [CPITN], and body mass index [BMI]). The information, thus, obtained was analyzed through SPSS using the chi-squared test and regression models.

RESULTS

 Forty four percent of the participants were female, while overall estimated prevalence of malocclusion in young adolescents of Karachi was 57.4%. After adjustments, participants going to any kind of education system had less malocclusion in comparison to those who were not going to any education system (adjusted odds ratio [aOR] = 0.305, 95% confidence interval [CI] = 0.12-0.73); mother's education especially higher level (aOR = 2.02, 95% CI = 1.08-3.75) and presence of periodontal disease (aOR = 1.57, 95% CI = 1.06-2.33) were significantly associated with malocclusion.

CONCLUSION

 This study showed that the class I malocclusion is prevalent in the local community. Demographic factors like gender, age, self-reported ethnicity, and BMI did not show any significant role. Education or knowledge of parents and young adolescents does play an influential role in decreasing malocclusion. Young adolescents, who are more prone to oral health problems at an early age, would have more chances to develop occlusal discrepancies.

The Assessment of Early Server Childhood Caries Status in Abandoned Institutionalized Children

Oral health is a critical indicator of children’s quality of life, which at this early age, depends exclusively on the attention, involvement, and guidance of parents or caregivers. Assessing carious damage and measuring the prevalence of early severe tooth decay in temporary teeth in children is obtained by calculating the dmft index, giving the sum of an individual’s decayed, missing, and filled teeth. The aim of our study was to conduct a clinical examination of the oral status of institutionalized children from Romania. We selected and included in the study 144 children, both boys and girls in equal number, with ages of five or six years old, from which 110 were eligible for the study and met the inclusion criteria. Of all children, 20.90% were five years old girls, 27.27% five years old boys, 26.36% six years old girls, and 25.46% six years old boys. Of all, 10,45% had more than three incisors presenting decays, equally affected by gender. Of the boys’ group, 20% of age six had more de two canines affected, and 26.7% of five years old girls had more than three affected canines. Of the five years boys’ group, 24.3% had more than three affected temporary molars, 44.9% of six years boys had more than five. Of the five years old girls, 33.3% had more than four temporary molars affected and, 56.6% of the six years old girls’ group had more than five molars presenting carious lesions. The dental status and dmft values were similar for five years old and six years old children and similar boys and girls. Due to the vulnerability of young children that consists not only in their inability to identify, express, and address their own needs but also the lack of parental support, lack of an optimal diet for age, and proper hygiene, they reach adolescence with an impaired dental status, inappropriate for their age.

Association of oral hygiene practices with the outcome of untreated dental caries and its clinical consequences in pre- and primary school children: A cross-sectional study in a northern province of Saudi Arabia

Objectives

To assess the association amongst oral hygiene practices, untreated dental caries (UDC) and clinical consequences of UDC in pre‐ and primary school children aged 3–5 and 6–7 years.

Materials and methods

A total of 250 subjects were recruited. The demographic and oral hygiene data were collected using a closed‐ended questionnaire. The UDC was measured using the ‘d/D' component of the decayed, missing, filled teeth (dmft/DMFT) index, and its clinical consequences were recorded using the ‘p/P' component of the pulpal involvement, ulceration, fistula and abscess (pufa/PUFA) index. The data were analyzed by multiple logistic regression.

Results

Overall, 94.2% and 56.5% of the participants had one or more UDC and pulp involvement (p ≥ 1), respectively in 3–5‐year‐old age group. In the 6‐7‐year‐ age group the prevalence of UDC was 26.7% and the pulp involvement was 11.6%. Children who brushed with their fingers were 4.7 times more likely to have UDC (crude odds ratio [COR] = 4.71; 95% CI: 1.21–18.40). Twice‐daily brushing resulted in a 39% (p = 0.732) lower likelihood of having UDC compared with once‐daily brushing (COR = 0.61; 95% CI: 0.04, 10.09). Children with irregular brushing frequency were 3.2 times more likely to have pulpal involvement (COR = 3.21; 95% CI: 1.74–5.93).

Conclusion

Finger brushing, irregular frequency of brushing and lack of parental supervision whilst brushing were associated with UDC and its consequences.

Oral health status of 6- and 12-year-old children of Roma origin from Eastern Slovakia: a pilot study

OBJECTIVE

The purpose of this study was to determine the prevalence and clinical effect of untreated dental caries in Roma children from eastern Slovakia using dmft/DMFT index and SiC index, association between dental caries development and oral hygiene, dietary habits and preventive dental care.

METHODS

Dental caries were assessed by recording the dmft index (for primary dentition) and the DMFT index (for permanent dentition) that are used to assess the state of teeth, which expresses the current state of teeth or its development in an individual or the entire population. The SiC index was calculated as the mean dmft of one-third of the population with highest caries scores. The normality of data distribution was tested by Shapiro-Wilk test. P-value < 0.05 was considered statistically significant. Chi-square test was used to compare proportions (oral hygiene, dietary habits and preventive dental visit). Data were analysed using ordered logistic regression and t-test. The study includes questionnaire containing 5 questions about dietary habits, oral hygiene and preventive dental visit.

RESULTS

The results of presented study confirmed higher average values of DMFT (3.24) in the population of 12-year-old Roma children and lower average values of dmft (2.5) in the second group (p < 0.05). The value of SiC index represented 6.10 in the group of six-year-old and 7.66 in twelve-year-old children. Logistic regression was performed to test the magnitude of the association between dental caries and related factors. There was statistically significant association between average value dmft/DMFT and dietary habits, oral hygiene, and preventive dental visit in both study groups.

CONCLUSION

The study revealed insufficient oral hygiene of the Roma children population. Systematic implementation of preventive examinations for oral hygiene and health programmes are needed to promote oral health. The study represents a pilot study of the SiC index values in Roma minority population from eastern Slovakia.

Caries Status and Salivary Alterations of Type-1 Diabetes Mellitus in Children and Adolescents: A Systematic Review and Meta-analysis

INTRODUCTION

The association between dental caries, salivary alterations, and type-1 diabetes mellitus (D1TM) remains inconclusive in children and adolescents. This systematic review evaluated the caries status and salivary alterations of children and adolescents suffering from D1TM.

METHODS

Meta-analysis searched from 5 electronic databases was performed considering the decay-missing-filled teeth (DMFT), decay-missing-filled surfaces, and decay-missing-filled primary teeth (dmft) index for caries and the stimulated flow rate, unstimulated flow rate, and buffering capacity for salivary alterations. Quality assessments were performed using the Healthcare Research and Quality Agency.

RESULTS

Eleven studies satisfied the eligibility criteria. The meta-analysis revealed that DMF(T) (0.61; 95% confidence interval [CI], 0.14-1.08, P = .01) and dmft (-0.43; 95% CI, -0.71 to -0.15, P = .002) were significantly higher in D1TM group than the non-D1TM group. Stimulated flow rate (-0.40; 95% CI, -0.57 to -0.23, P < .00001) was significantly lower in D1TM group than in the non-D1TM group. No significant differences in decay-missing-filled surfaces and the buffering capacity were observed between the D1TM and the non-D1TM groups.

CONCLUSIONS

The level of DMF(T) and dmft was higher in children/adolescents with D1TM than that with non-D1TM, and the salivary flow could be considered decreased with D1TM. The strength of the evidence of the studies analyzed, however, was deemed to be moderate and low.

Correlation between the caries status of the first permanent molars and the overall DMFT Index: A cross-sectional study

To analyze whether a correlation exists between the caries status (Decayed, Missing and Filled Teeth, DMFT Index) of the first permanent molars (FPMs) and that of the full permanent dentition of Mexican adolescents, and to propose its use in large epidemiological studies of dental caries.We conducted a cross-sectional study of 1538 adolescents from 12 to 15 years old. Based on a clinical oral examination, we determined the DMFT Indices of their FPMs (FPM-DMFT) and of their full permanent dentition (comprehensive DMFT Index). We explored each FPM to determine whether it was with or without caries, filled, missing or sealed. For our statistical analysis, we used Fisher exact test and Spearman correlation in Stata software.After examining a total of 6157 FPMs, we found that 56.8% of our sample of adolescents had no caries in their 4 FPMs whereas 4.9% experienced caries in all 4. No significant differences emerged by sex (P > .05); however, by age, the older adolescents experienced greater FPM-DMFT (P < .05). Analysis yielded a correlation of r = 0.8693 between the FPM-DMFT and comprehensive DMFT scores (P < .0001) of participants. The underestimation of caries prevalence (DMFT > 0) was 5.4% (48.6% vs 43.2%), while the DMFT Index was underestimated at 0.34 (1.15 vs 0.81).The strong correlation between the FPM-DMFT and comprehensive DMFT Indices suggests that overall caries status can be inferred on the basis of FPM caries status. This evidence is useful when conducting large epidemiological studies such as national surveys.

Early occurrence of childhood dental caries among low literate families

OBJECTIVE

The purpose of this cross-sectional study was to identify the oral health status and influencing factors in preschool children in Tabriz, Iran. A total of 756 children from 20% of the total district preschools were selected using a two-step random sampling procedure. Questionnaires were used to collect demographic and socio-economic data. Oral exams were conducted by a single pediatric dentist to assess the children's oral health, and to determine the number of decayed, missing, and filled teeth (dmft) according to the World Health Organization's (WHO) definition of caries.

RESULTS

Out of 756 preschool children, 51.5% boys with mean age of years 5.76 (SD = 0.78) were enrolled. The median (25th-75th Pertcentile) of dmft index in boys and girls was 4 (2-9) and 5 (2-8), respectively. Only 15.1% children had decay-free teeth. The results of univariate analysis showed a significant relationship between dmft index and child age (P < 0.001), mother's years of education (P = 0.001), mother's employment status (P < 0.001), and family socio-economic status (P < 0.001). On multivariate analysis, statistical significance was found in sex (P = 0.007), age groups except for 5 years (P = 0.210), mother's education status (P < 0.001) as well as in families with intermediate (P = 0.024), and high (P = 0.072) socio-economic status.

Risk of Dental Caries for Children Aged 4 to 6 in Craiova

Dental caries represent a chronic disease of high prevalence for the human body and is produced by the interaction of a number of predisposing factors throughout the time. Specialized studies in recent years have made some progress with regard of complex interacting factors in the process of developing dental caries in children, but due to the plurifactorial nature of the disease it seems that there is still much to be studied regarding the start, progress and prevention of tooth decay.The aim of the study was to determine the risk of tooth decay in children aged 4 to 6 years in Craiova and the relationship of the main etiopathogenic cariogenic factors.

MATERIAL AND METHODS

The study included a total of 101 children of both sexes, aged 4-6 years, from two kindergartens in Craiova. They filled out questionnaires about food and oral hygiene habits and after that the study protocol included visual clinical examination in according to WHO methodology; determination of dmft index with the analysis of dt, mt and ft component The results were recorded in personal files and were analyzed statistically.

RESULTS

The results of our study were consistent with data from the literature of recent years. So, the highest value of the dmft index (2.52) was at the age group of 6.

CONCLUSIONS

The most significant contribution to the values of carious experience is the number of teeth affected by caries at the expense of obturated ones.