Treating High-Caries Risk Occlusal Surfaces in First Permanent Molars through Sealants and Supervised Toothbrushing: A 3-Year Cost-Effective Analysis

2017 ◽  
Vol 51 (5) ◽  
pp. 489-499 ◽  
Author(s):  
Ann Goldman ◽  
Soraya C. Leal ◽  
Rodrigo G. de Amorim ◽  
Jo E. Frencken
Keyword(s):  
High Risk ◽  
School Children ◽  
Cost Effective ◽  
Atraumatic Restorative Treatment ◽  
Carious Lesion ◽  
School Year ◽  
High Caries Risk ◽  
Sample Data ◽  
Permanent Molars ◽  
First Permanent Molars

We conducted a 3-year cost-effectiveness analysis on the cavitated dentine carious lesion preventive capabilities of composite resin (CR) (reference group) and atraumatic restorative treatment (ART) high-viscosity glass-ionomer cement (HVGIC) sealants compared to supervised toothbrushing (STB) in high-risk first permanent molars. School children aged 6-7 years in 6 schools (2 per group) received CR and ART/HVGIC sealants or STB daily for 180 days each school year. Data were collected prospectively and cost estimates were made for sample data and a projection of 1,000 sealants/STB high-risk permanent molars. Although STB had the best outcome, its high implementation cost (95% of cost for supervisors visiting schools 180 days/school year) affected the results. ART/HVGIC was cost-effective compared to CR for the sample data (savings of USD 37 per cavitated dentine carious lesion prevented), while CR was cost-effective compared to ART/HVGIC for the projection (savings of USD 17 per cavitated dentine carious lesion prevented), and both were cost-saving compared to STB. Two STB scenarios were tested in sensitivity analyses with variations in caries incidence and number of supervision days; results showed STB had lower costs and higher savings per cavitated dentine carious lesion prevented than CR and ART/HVGIC. A major assumption is that both scenarios have the same high effectiveness rate experienced by STB under study conditions; however, they point to the value of further research on the benefits of adopting STB as a long-term venture in a general population of school children.

A differentiated approach to the dental caries prevention in children with different levels of caries risk

2020 ◽  
Vol 20 (3) ◽  
pp. 211-215
Author(s):  
T. N. Tserakhava ◽  
N. V. Shakavets ◽  
E. I. Melnikava ◽  
M. I. Klenovskaya ◽  
D. N. Naumovich ◽  
...  
Keyword(s):  
Oral Hygiene ◽  
Calcium Phosphates ◽  
Clinical Effectiveness ◽  
Control Group ◽  
Caries Risk ◽  
Health Group ◽  
High Caries Risk ◽  
Permanent Molars ◽  
Different Levels ◽  
First Permanent Molars

Relevance. Prevention of caries of the first permanent molars is one of the most relevant problems in pediatricdentistry.Purpose – to develop an algorithm for prevention of first permanent molars caries in children with differentlevels of caries risk.Materials and methods. The article presents the results of the implementation of the algorithm for prevention of first permanent molars caries in children with different levels of caries risk. This algorithm includes a comprehensive assessment of the values of indices dmft, DMFT, OHI-S, and the patient's health group is also taken into account. The study involved 253 children aged 6-7 years divided into 4 groups: 3 groups of children depending on the health group and the control group. 3 subgroups were identified in each group – with a low, medium, and high caries risk. We developed preventive measures schemes were for children of each group including training in oral hygiene; controlled and home toothbrushing using fluoride-containing toothpastes; applications of varnishes containing fluoride, calcium, phosphates from 2 to 3 times a year; fissure sealing of the first permanent molars. We carried out these activities were for 24 months, and then evaluated theirs effectiveness. Children in the control group were trained in oral hygiene. The clinical effectiveness of medical prophylaxis was evaluated by changes in the above clinical indicators.Results. In group of children with medium caries risk the increase in caries was 0.09, and the reduction in caries was 89.65%. In children with a low and high caries risk no increase in caries was observed; the reduction in the intensity of caries was 100%. A significant decrease in OHI-S oral hygiene index values was noted in all groups (p < 0.05). We noted high preventive efficacy of fissures sealing in the first permanent molars. No occlusal surface caries developed in sealed fissures.Conclusions. The application of the proposed preventive schemes in patients demonstrates high efficacy of fluoride and calcium-containing varnishes and sealing the fissures of the first permanent molars. 

scholarly journals Atraumatic Restorative Treatment-Sealed versus Nonsealed First Permanent Molars: A 3-Year Split-Mouth Clinical Trial

2020 ◽  
Vol 55 (1) ◽  
pp. 12-20
Author(s):  
Daniela Hesse ◽  
Camila de Almeida Brandão Guglielmi ◽  
Daniela Prócida Raggio ◽  
Marcelo José Strazzeri Bönecker ◽  
Fausto Medeiros Mendes ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Low Income ◽  
Cox Regression ◽  
Caries Experience ◽  
Rank Test ◽  
Atraumatic Restorative Treatment ◽  
Restorative Treatment ◽  
Permanent Molars ◽  
Caries Lesions ◽  
First Permanent Molars

To investigate the efficacy of atraumatic restorative treatment (ART) sealants vs. no sealant in preventing the development of dentine caries lesions in first permanent molars over a period of 3 years. A total of 187 schoolchildren (aged 6–8 years) from a low-income population presenting the 4 first permanent molars without clinically detectable dentine caries lesions were selected to be part of a split-mouth clinical trial. All 4 first permanent molars were investigated in this trial and the children’s mouth was split vertically into left and right sides; therefore, 2 molars were randomly allocated to receive ART sealants, while the other 2 molars remained nonsealed. All children received toothbrushing instructions and dietary advice every 6 months for a period of 3 years. Clinical evaluations were performed after 3, 6, 12, 18, 24, and 36 months and both sealant retention and dental caries were scored. Kaplan-Meier survival analysis, log-rank test, and Cox regression with shared frailty analysis were performed. A cavitated dentine caries lesion was considered a failure. The cumulative survival rates of dentine cavity-free first permanent molars were 90% for ART-sealed molars and 90.8% for nonsealed molars, with no statistically significantly difference between sealed and nonsealed molars (<i>p</i> = 0.70). The retention of sealants was not associated with the development of cavitated dentine caries and children presenting a higher baseline caries experience had greater chances of developing dentine lesions. In conclusion, the application of ART sealants was not more efficacious than nonsealing in reducing the development of dentine cavitated lesions in first permanent molars.

scholarly journals Prevalence of Molar Incisor Hypomineralization and its Relation with Dental Caries in School Children of Udupi District, South India

2015 ◽  
Vol 6 (3) ◽  
pp. 143-146 ◽  
Author(s):  
Kalyana Chakravarthy Pentapati ◽  
Shashidhar Acharya ◽  
Abhinav N Tadikonda
Keyword(s):  
Dental Caries ◽  
School Children ◽  
South India ◽  
Pediatric Dentistry ◽  
World Health ◽  
Significant Positive Association ◽  
Molar Incisor Hypomineralization ◽  
Permanent Molars ◽  
The Mean ◽  
First Permanent Molars

ABSTRACT Aim To evaluate the prevalence of molar incisor hypomineralization (MIH) and its relationship with dental caries in school children of Udupi district. Materials and methods A total of 352 school children were recruited for this study. The European Academy of Pediatric Dentistry (EAPD) 2003, criteria were followed for diagnosis of MIH. Dental caries was recorded using World Health Organization (WHO) guidelines (1997) under natural day light. Results The prevalence of MIH was seen to be 27% (n = 95). A total of 323 teeth had hypomineralization (106 were incisors and 217 were molars). The lower molars (n = 127) were more frequently affected than the upper molars (n = 90). Overall the maxillary incisors (n = 68) were more affected than the mandibular incisors (n = 38). Amongst the children with MIH, the mean number of decayed teeth was significantly lower than mean number of hypomineralized teeth in first permanent molars and first permanent molars and incisors (p < 0.001 and < 0.001) respectively. The mean decayed teeth in first permanent molar and incisors were significantly higher in subjects with MIH than without MIH (p < 0.001). Poisson regression analysis showed a significant positive association between MIH and dental caries (B = 1.43; p < 0.001). Conclusion The prevalence of MIH was relatively high and was associated with dental caries. How to cite this article Tadikonda AN, Acharya S, Pentapati KC. Prevalence of Molar Incisor Hypomineralization and its Relation with Dental Caries in School Children of Udupi District, South India. World J Dent 2015;6(3):143-146.

scholarly journals Determination of prevalence of asymptomatic proteinuria and haematuria in 5-15 year aged school children in southern India

2021 ◽  
Vol 8 (9) ◽  
pp. 1483
Author(s):  
Rameshkumar Vadamalai
Keyword(s):  
High Risk ◽  
School Children ◽  
Urine Analysis ◽  
Cost Effective ◽  
P Value ◽  
Age Group ◽  
Persistent Proteinuria ◽  
Orthostatic Proteinuria ◽  
High Risk Screening ◽  
Asymptomatic Proteinuria

Background: Chronic renal diseases remain major cause of morbidity and mortality in young children. Although idiopathic nephrotic syndrome takes on chronic course other histopathological variants can lead to rapid progression of disease. Proteinuria in children can be physiological. Hematuria in children is always should be investigated. Persistent proteinuria in children should be investigated for any significant progressive renal disease after excluding orthostatic proteinuria. Although many countries adopt high risk screening in pediatric age group many eastern countries advocate school screening for asymptomatic proteinuria and hematuria using dipstick urine screening.Methods: A 6 month cross sectional study of asymptomatic children aged 5-15 years in metropolitan school for dipstick urine analysis for proteinuria and hematuria.Results: The ratio of male and female children in the study is 1.2:1 (total-1999, male-1056, and female-934). Age group ranged from 5 to 15 with mean 12.13 and standard deviation (SD)-2.46. Maximum number of students in the study are above 10 years of age. Children with isolated asymptomatic proteinuria have significant differences due to their sex (p value-0.005) and hematuria (p value-0.007). Prevalence of asymptomatic proteinuria is 9.8% and hematuria is 1.05%. Prevalence of persistent proteinuria is 1.35%.Conclusions: Prevalence of asymptomatic proteinuria and hematuria can be determined using dipstick urine analysis in school children. Mass screening is cost effective and feasible only if persistent cases of proteinuria are followed up, ruling out orthostatic proteinuria. Although study is feasible, it is cumbersome. High risk screening is the best cost effective method.

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