scholarly journals Caries severity and socioeconomic inequalities in a nationwide setting: data from the Italian National pathfinder in 12-years children

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Guglielmo Campus ◽  
Fabio Cocco ◽  
Laura Strohmenger ◽  
Maria Grazia Cagetti
Keyword(s):  
Oral Health ◽  
Unemployment Rate ◽  
Gini Index ◽  
Negative Binomial ◽  
Smoking Habit ◽  
Socioeconomic Inequalities ◽  
Assessment System ◽  
Caries Detection ◽  
Per Capita ◽  
Cavitated Lesions

Abstract This study presents the result of the second National pathfinder conducted in Italy on children’s oral health, reporting the prevalence and severity of caries in 12-year old children and describing the caries figure related to the socioeconomic inequalities, both at individual level and macroeconomic level. The two-digit codes related to ICDAS (International Caries Detection and Assessment System) for each tooth and the gingival bleeding score were recorded at school on 7,064 children (48.97% males and 51.03% females). The Gross National Product (GNP) per capita, the Gini Index and Unemployment rate in each Italian section, parents’ educational levels, working status, smoking habit and their ethnic background were recorded. Zero-inflated-negative-binomial (ZINB) models were run, using caries-free teeth, teeth with enamel lesions, cavitated lesions and restorations as functions of socioeconomic explanatory variables, to evaluate the effects of justifiable economic factors of geographical distribution. The mean number of enamel lesions, cavitated lesions and filled per teeth were statistically significant (p < 0.01) dissimilar among the Italian section. GNP per capita, Gini Index and Unemployment rate were significantly correlated to ICDAS scores and filled teeth. Important differences in ICDAS score values remain among children from different socioeconomic backgrounds. Efforts should be made to improve awareness and knowledge regarding oral health practice and to implement preventive programs and access to dental services in Southern Italy where the disease is still unresolved.

scholarly journals Inequalities In Caries Among Pre-School Italian Children With Different Background

2021 ◽  
Author(s):  
Guglielmo Campus ◽  
Fabio Cocco ◽  
Laura Strohmenger ◽  
Thomas Gerhard Wolf ◽  
Araxi Balian ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Preschool Children ◽  
Negative Binomial ◽  
Public Health Problem ◽  
Assessment System ◽  
Social Gradient ◽  
Caries Detection ◽  
Caries Prevalence ◽  
Explanatory Variables ◽  
Immigrant Background

Abstract Background: The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient. Methods: The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.76% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) and behavioral habits of children/parents/caregivers were estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated as the weighted sum of the worst circumstances deriving from social explanatory variables. Children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic regression in children with European background and a logistic regression in children with non-European background) were used to elucidate the associations between all explanatory variables and health outcome (namely the caries prevalence). Mantel Haenszel trend of odds adjusted by immigrant background and area of living were calculated to study the existence, dimensions and direction of a social gradient in oral health. Results: Overall, 54.37% (95%CI 46.71–58.28%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.59% vs 41.62% p<0.01). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z=5.24, p<0.01). Conclusions: Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background. The proposed gradient was clearly able to identify children with the worst dental conditions.

scholarly journals Modifiable Factors Explain Socioeconomic Inequalities in Children’s Dental Caries

2019 ◽  
Vol 98 (11) ◽  
pp. 1211-1218 ◽  
Author(s):  
M.A. Peres ◽  
X. Ju ◽  
M. Mittinty ◽  
A.J. Spencer ◽  
L.G. Do
Keyword(s):  
Oral Health ◽  
Dental Caries ◽  
Negative Binomial ◽  
Socioeconomic Inequalities ◽  
Permanent Dentition ◽  
Caries Experience ◽  
Water Fluoridation ◽  
Sugar Consumption ◽  
Dental Visits ◽  
Modifiable Factors

The aim of this article was to quantify socioeconomic inequalities in dental caries experience among Australian children and to identify factors that explain area-level socioeconomic inequalities in children’s dental caries. We used data from the National Child Oral Health Survey conducted in Australia between 2012 and 2014 ( n = 24,664). Absolute and relative indices of socioeconomic inequalities in the dental caries experience in primary and permanent dentition (decayed, missing, and filled surfaces [dmfs] and DMFS, respectively) were estimated. In the first stage, we conducted multilevel negative binomial regressions to test the association between area-level Index of Relative Socioeconomic Advantage and Disadvantage (IRSAD) and dental caries experience (dmfs for 5- to 8-y-olds and DMFS for 9- to 14-y-olds) after adjustment for water fluoridation status, sociodemographics, oral health behaviors, pattern of dental visits, and sugar consumption. In the second stage, we performed Blinder-Oaxaca and Neumark decomposition analyses to identify factors that explain most of the area-level socioeconomic inequalities in dental caries. Children had a mean dmfs of 3.14 and a mean DMFS of 0.98 surfaces. Children living in the most disadvantaged and intermediately disadvantaged areas had 1.96 (95% confidence interval, 1.69–2.27) and 1.45 (1.26–1.68) times higher mean dmfs and 1.53 (1.36–1.72) and 1.43 (1.27–1.60) times higher mean DMFS than those living in the most advantaged areas, respectively. Water fluoridation status (33.6%), sugar consumption (22.1%), parental educational level (14.2%), and dental visit patterns (12.7%) were the main factors explaining area-level socioeconomic inequalities in dental caries in permanent dentition. Among all the factors considered, the factors that contributed most in explaining inequalities in primary dental caries were dental visits (30.3%), sugar consumption (20.7%), household income (20.0%), and water fluoridation status (15.9%). The inverse area-level socioeconomic inequality in dental caries was mainly explained by modifiable risk factors, such as lack of fluoridated water, high sugar consumption, and an unfavorable pattern of dental visits.

scholarly journals Association between root/coronal caries and individual factors in institutionalised elderly using ICDAS severity and activity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Margarita Usuga-Vacca ◽  
Dairo Javier Marin-Zuluaga ◽  
Jaime Eduardo Castellanos ◽  
Stefania Martignon
Keyword(s):  
Oral Health ◽  
Health Knowledge ◽  
Assessment System ◽  
Caries Detection ◽  
Caries Experience ◽  
Individual Factors ◽  
Root Caries ◽  
Cross Sectional ◽  
Root Surfaces ◽  
Exposed Root

Abstract Background Caries in the elderly has been associated with dependence, oral-health status and -care practices. This cross-sectional study aimed to investigate the association between root/coronal caries and individual factors among institutionalised elderly people in Bogotá, Colombia, using the International Caries Detection and Assessment System severity and activity criteria (ICDAS). Methods A total of 226 institutionalised elderly were clinically examined for root and coronal caries in 40 institutions. Caries risk was assessed with Cariogram, and demographics, oral health knowledge and practices, oral health-related quality of life and denture-use habits using a questionnaire. Results Participants (mean age: 80.1 ± 9.3 years; 63.7% female) presented a mean number of 10.8 ± 7.3 teeth and 19.4 ± 18.8 exposed root surfaces. Prevalence of Coronal-ICDAS caries experience (C-ICDAS DF) was of 100% and of 54.4% for C-ICDAS D; mean number of C-ICDAS DFS was 16.76 ± 27.36, with 50.9% of subjects having ≥ one active C-ICDAS DS. Prevalence of Root Caries Index was of 49.1% and of R-ICDAS DF of 46%; mean number of R-ICDAS DFS was 2.03 ± 2.78, with 40.3% of subjects having ≥ one active R-ICDAS DS. Most individuals had a systemic condition (94.2%) and required oral-hygiene assistance (58%). Logistic regression analyses showed significant associations (p < 0.05): for coronal active caries when having over six teeth (OR: 2.7), and for root caries, when having coronal caries (OR: 2.41), being a man (OR: 1.95), and having over 14 teeth (OR: 0.30). Those presenting with > eight exposed root surfaces were 4.04 more likely to have root caries and 2.4 times more likely to have active root caries. Conclusion In the institutionalised elderly population in Bogotá significant associations were found, both for the presence as for the activity status of root and coronal caries, with individual clinical factors including coronal caries, exposed root surfaces and number of teeth.

scholarly journals Do combinations of clinical parameters related to caries activity status predict progression more accurately than individual parameters?

2019 ◽  
Author(s):  
I Floriano ◽  
R Matos ◽  
J Mattos-Silveira ◽  
ES Rocha ◽  
KR Ekstrand ◽  
...  
Keyword(s):  
Predictive Power ◽  
Assessment System ◽  
Caries Detection ◽  
Clinical Parameters ◽  
Caries Lesion ◽  
Occlusal Surfaces ◽  
Risk Of Progression ◽  
Caries Progression ◽  
Cavitated Lesions

AbstractFew studies have addressed the predictive power of the clinical parameters used in assessing caries lesion activity. This study assessed the predictive validity of evaluating clinical parameters that are related to caries lesion activity status, individually and combined, in a long-term analysis. The occlusal surfaces of primary molars (1361 surfaces) were examined in 205 children according to the following clinical features: potential for plaque stagnation, colour, luster, cavitation, texture, and clinical depth. Cavities with frankly exposed dentine were excluded from this sample. After 1 year, 148 children (828 surfaces) were re-evaluated using the International Caries Detection and Assessment System to assess caries lesion progression. Progression was set as an outcome to verify the predictive power of the initially assessed clinical parameters. Different combinations of two or more parameters were also tested to check for any association with caries progression. Multilevel Poisson regression analyses were performed and the relative risk for each parameter/combination tested was calculated by considering a confidence interval of 95%. Forty percent of the reassessed surfaces presented caries progression after 1 year. Despite their surface integrity, dentine caries lesions were approximately 10-fold more likely and enamel lesions were approximately three-fold more likely to progress than sound surfaces. Similarly, cavitated lesions showed the highest risk of progression compared to sound/non-cavitated lesions. When only non-cavitated surfaces were considered, roughness proved to be a risk factor for caries progression. In conclusion, the lesions presenting clinical involvement of the dentine and even those cavitations clinically involving only the enamel had a higher risk of progression compared to sound or non-cavitated surfaces. For these lesions, the evaluation of other conjoint parameters seems unnecessary. Nevertheless, surface roughness can be a useful feature in predicting the risk of non-cavitated caries lesion progression.

scholarly journals Dental Caries in 12-Year-Old Schoolchildren who Participate in a Preventive and Restorative Dentistry Program

2021 ◽  
pp. 405-413
Author(s):  
Karol Ramírez ◽  
Adrián Gómez-Fernández
Keyword(s):  
Oral Health ◽  
Costa Rica ◽  
Dental Caries ◽  
Health Program ◽  
Positive Impact ◽  
Assessment System ◽  
Caries Detection ◽  
Occlusal Surfaces ◽  
Dmft Index ◽  
The University

Since 2013, the Faculty of Dentistry of the University of Costa Rica has provided a preventive and restorative oral health program at Carmen Lyra Public School. The first generation of students that received dental care from this project were examined in 2019 for caries status.  A total of 62 twelve-year-old schoolchildren were examined (31 boys and 31 girls). First, all teeth surfaces were cleaned with a brush and then rinsed. Subsequently, examination was performed in each person by a calibrated examiner using the International Caries Detection and Assessment System (ICDAS). Prevalence of dental caries was 59.7%. ICDAS code 2 was the most prevalent (68.8%), followed by 1 (19.3%), 5 (4.5%), 3 (3.5%), 6 (2.5%), and 4 (1.4%). Regarding number of carious surfaces, the highest prevalence was observed in the occlusal surfaces (77.3%), followed by the vestibular (13.9%), mesial (4.2%), palatal/lingual (4,1%) and distal (0.5%). Of these carious surfaces, 7% were caries associated with restorations and were present only on the occlusal surfaces. Boys had more cavities than girls (54.1% compared to 45.9%), however, this difference was not significant. Regarding the condition of restorations in teeth, 92 dental restorations (resin or amalgam) were found in the population studied and were well adjusted. Most of these restorations were found on the occlusal surfaces (82.6%), followed by vestibular surfaces (8.7%,) palatal/lingual (5.4%) surfaces, mesial surfaces (3.3%), and no restorations were detected on the distal surfaces. Sealants were identified in 11.3% schoolchildren; 98% were identified on the occlusal surfaces and the other 2% were found on the palatal/lingual surfaces. DMFT Index was 1.6±0.71. The prevalence of dental caries in this sample was low compared to other studies in twelve-year-old schoolchildren in Costa Rica. This may suggest that the oral health program had a positive impact in the studied population.

scholarly journals Factors Associated with Accessing Prison Dental Services in Scotland: A Cross-Sectional Study

2019 ◽  
Vol 7 (1) ◽  
pp. 12 ◽  
Author(s):  
Ruth Freeman ◽  
Derek Richards
Keyword(s):  
Regression Analysis ◽  
Oral Health ◽  
Assessment System ◽  
Caries Detection ◽  
Psychosocial Needs ◽  
Dental Services ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Variance Model ◽  
Factors Associated

Background: Prisoners have poorer dental health than non-prison populations. It is known that the prison environment can promote health and thus, policies, including access to dental care, are in place to promote health during imprisonment. Aim: Our aim was to conduct an oral health and psychosocial needs survey to identify the factors associated with accessing prison dental services in Scotland. Methods: A convenience sample of offenders from a male maximum security prison, a women’s prison, and a young offenders’ institution was gathered. A questionnaire examined the demography, prison experience, dental anxiety, oral health-related quality of life, and reported attendance of dental services. A dental examination was conducted using the International Caries Detection and Assessment System to diagnose obvious decay. A hierarchical logistic regression analysis was performed. Results: 342 prisoners participated. When missing data were excluded, the final sample was 259. The regression analysis showed the following: Model 1 characterized the offenders by demography and prison experience, explaining 19% of the variance. Model 2 showed that an offender was 36% more likely to attend dental services for every unit change in the 5-point ranking scale of ‘feeling irritable with people because of teeth, mouth, or dentures’, explaining an additional 7% of the variance. Model 3 explained 35% of the variance, (i.e., an additional 9%) and was adopted as the final model to characterize offenders who access dental services when in prison. An offender who reported accessing prison dental services was 3.28 times more likely to be male. For each increase in the year of an offender’s age, the offender was 5% more likely to access prison dental services. An 11% greater chance of accessing prison dental services for every experience of remand was also found. An offender was 32% more likely to access prison dental services for each increased level of irritability, and there was a 2 times higher likelihood of emergency dental services’ attendance. There was a 19% lower chance of accessing prison dental services for each additional tooth affected by decay and a 13% greater chance of accessing prison dental services for each unit increase in missing teeth. Conclusions: In conclusion, this investigation identified factors associated with access to prison dental services in Scotland. The role of accessibility factors, such as the oral health impact of irritability, appeared to increase perceptions of dental need and promote dental services’ attendance

scholarly journals Comprehensive Implementation of the International Caries Detection and Assessment System (ICDAS) in a Dental School and University Oral Health Centre: A Stepwise Framework

2014 ◽  
Vol 2 (1) ◽  
pp. 41-51
Author(s):  
Priya Ahlawat ◽  
Abhishek Parolia ◽  
Zeinab Hasan ◽  
Frederick Smales ◽  
Allan Pau ◽  
...  
Keyword(s):  
Oral Health ◽  
Health Centre ◽  
Assessment System ◽  
Dental School ◽  
Caries Detection

The Use of the International Caries Detection and Assessment System (ICDAS) in a National Health Service General Dental Practice as Part of an Oral Health Assessment

2010 ◽  
Vol os17 (4) ◽  
pp. 153-160 ◽  
Author(s):  
Charles Ormond ◽  
Gail Douglas ◽  
Nigel Pitts
Keyword(s):  
Oral Health ◽  
National Health Service ◽  
Health Service ◽  
Health Assessment ◽  
Assessment System ◽  
Caries Detection ◽  
Dental Practice ◽  
General Dental Practice ◽  
The Mean ◽  
Mean Time

Introduction The Scottish Dental Clinical Effectiveness Programme (SDCEP) is developing guidance for oral health assessment and review that is intended for use in National Health Service (NHS) general dental practice. One section of this guidance is assessment of the teeth, including their caries status. The detailed caries assessment method identified by the guidance group is the International Caries Detection and Assessment System (ICDAS). Aim The aim of this study was to investigate the implications of using the ICDAS in an NHS general practice and, in particular, the time taken to use the system. Method After online and in-practice training and calibration, 50 adult and 50 child patients were randomly allocated for assessment using the ICDAS detection codes. The ICDAS protocol states that the teeth should be clean and dry. For this study, all patients had their teeth brushed by the dentist before the assessment and the results were recorded on draft ICDAS clinical pro forma sheets. The time taken for the assessment was assessed with a stopwatch and recorded in a spreadsheet program. Results The results showed that the mean time for the assessment of an adult was 3.80 minutes, or 4.99 minutes if the time for pre-examination cleaning and drying was included. For a child, the mean time was 2.53 minutes, or 3.99 minutes if pre-examination brushing time was included. Conclusions These results indicate that with training and experience, it is possible to carry out an ICDAS assessment in a time that is practical in general dental practice.

scholarly journals Review of the Health, Welfare and Care Workforce in Tasmania, Australia: 2011–2016

2021 ◽  
Vol 18 (13) ◽  
pp. 7014
Author(s):  
Belinda Jessup ◽  
Tony Barnett ◽  
Kehinde Obamiro ◽  
Merylin Cross ◽  
Edwin Mseke
Keyword(s):  
Oral Health ◽  
Rural Communities ◽  
Health Workforce ◽  
Census Data ◽  
Care Service ◽  
The State ◽  
Full Time ◽  
Full Time Equivalent ◽  
Diverse Range ◽  
Per Capita

Background: On a per capita basis, rural communities are underserviced by health professionals when compared to metropolitan areas of Australia. However, most studies evaluating health workforce focus on discrete professional groups rather than the collective contribution of the range of health, care and welfare workers within communities. The objective of this study was therefore to illustrate a novel approach for evaluating the broader composition of the health, welfare and care (HWC) workforce in Tasmania, Australia, and its potential to inform the delivery of healthcare services within rural communities. Methods: Census data (2011 and 2016) were obtained for all workers involved in health, welfare and care service provision in Tasmania and in each statistical level 4 area (SA4) of the state. Workers were grouped into seven categories: medicine, nursing, allied health, dentistry and oral health, health-other, welfare and carers. Data were aggregated for each category to obtain total headcount, total full time equivalent (FTE) positions and total annual hours of service per capita, with changes observed over the five-year period. Results: All categories of the Tasmanian HWC workforce except welfare grew between 2011 and 2016. While this growth occurred in all SA4 regions across the state, the HWC workforce remained maldistributed, with more annual hours of service per capita provided in the Hobart area. Although the HWC workforce remained highly feminised, a move toward gender balance was observed in some categories, including medicine, dentistry and oral health, and carers. The HWC workforce also saw an increase in part-time workers across all categories. Conclusions: Adopting a broad approach to health workforce planning can better reflect the reality of healthcare service delivery. For underserviced rural communities, recognising the diverse range of workers who can contribute to the provision of health, welfare and care services offers the opportunity to realise existing workforce capacity and explore how ‘total care’ may be delivered by different combinations of health, welfare and care workers.

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