Impact of Dental Caries on the Quality of Life of Preschool Children in Salvador, Bahia

Dental caries affects most of preschoolers and has important consequences for the development and quality of life of affected children. Aim: To describe the epidemiological status of dental caries in preschoolers in Salvador-BA- Brazil and evaluate the impact of this oral disease on the oral health-related quality of life (OHRQoL), considering sociodemographic characteristics. Methodology: This is a cross-sectional study in a representative sample of preschool children in Salvador-BA- Brazil. Caries was assessed using dmft and the impact on quality of life used the B-ECOHIS (Brazilian version of the Early Childhood Oral Health Impact Scale). Data collection took place in 2018 through, thorough clinical examination and questionnaire application. Descriptive, univariate, and multivariate analyzes were performed using robust Poisson regression, with a significance level of 5%. Results: 1591 children were examined, and the prevalence of caries was 36.46%. The presence of early caries (adjusted PR = 2.07; 1.82-2.34 95% CI), severe caries (PR = 2.07; 1.84-2.33 95% CI) and child oldest age (adjusted PR = 1.55; 1.36-1.77 95% CI) were associated with children's OHRQoL; child oldest age (adjusted PR = 1.42; 1.19-1.69 95% CI), the presence of early caries (adjusted PR = 2.65; 2.22-3.16 95% CI), severe caries (PR = 3.07; 2.63-3.60 CI 95%) and the number of people in the household (PR = 1.46; 1.22-1.73 CI 95%) were associated with Family OHRQoL. Conclusion: The children evaluated had a high prevalence and severity of early caries. Worst oral health and sociodemographic conditions had a negative impact on the OHRQoL of children and their families.

Which determinants should be considered to reduce social inequalities in paediatric dental care access? A cross-sectional study in France

Better access to dental care through systemic and educational strategies is needed to lessen the burden of disease due to severe early caries. Our study aims to describe family characteristics associated with severe early caries: parental knowledge, attitudes, practices in oral health and socio-demographic factors. For this cross-sectional study, 102 parents of children aged under 6 years with severe early caries and attending paediatric dentistry service in France completed a questionnaire during face-to-face interviews. Caries were diagnosed clinically by calibrated investigators, using the American Academy of Paediatric Dentistry criteria, and dental status was recorded using the decayed, missing, and filled teeth index. The majority of children were from underprivileged backgrounds and had poor oral health status, with a median dmft index of 10. Parents highlighted the difficulty of finding suitable dental care in private practices. Parents appeared to have good oral health knowledge and engaged in adapted behaviours but showed a low sense of self-efficacy. They perceived the severity of early caries as important but the susceptibility of their child as moderate. The study affirmed the importance of improving the accessibility of paediatric dental care and developing educational strategies to enhance the knowledge, skills, and oral health practices of families.

Detection Methods for Early Caries Diagnosis: A Systematic Review and Meta-Analysis

The aim was to appraise the evidence on the performance of various means for the detection of incipient caries in vivo. Five databases of published and unpublished research were searched for studies from January 2000 to October 2019. Search terms included “early caries” and “caries detection.” Inclusion criteria involved diagnostic test accuracy studies for early caries detection in permanent and primary teeth. A risk-of-bias assessment was performed using the QUADAS-2 tool. We performed the study selection, data extraction, and risk-of-bias assessment in duplicate. The review protocol was a priori registered in the Open Science Framework. Of the initially 22,964 search results, 51 articles were included. For permanent teeth, when histologic examination was considered as the reference for occlusal surfaces, the sensitivity (Se) range appeared high for the DIAGNOdent Pen (DD Pen) at 0.81–0.89, followed by ICDAS-II at 0.62–1, DIAGNOdent (DD) at 0.48–1, and bitewing radiography (BW) at 0–0.29. The corresponding specificity (Sp) range was: DD Pen 0.71–0.8, ICDAS-II 0.5–0.84, DD 0.54–1, and BW 0.96–1. When operative intervention served as the reference for occlusal surfaces, again, the DD means valued the most promising results on Se: DD 0.7–0.96 and DD Pen 0.55–0.90, followed by ICDAS-II 0.25–0.93, and BW 0–0.83. The Sp range was: DD 0.54–1, DD Pen 0.71–1, ICDAS-II 0.44–1, and BW 0.6–1. For approximal surfaces, the Se was: BW 0.75–0.83, DD Pen 0.6, and ICDAS-II 0.54; the Sp was: BW 0.6–0.9, DD Pen 0.2, and ICDAS-II 1. For primary teeth, under the reference of histologic assessment, the Se range for occlusal surfaces was: DD 0.55–1, DD Pen 0.63–1, ICDAS-II 0.42–1, and BW 0.31–0.96; the respective Sp was: DD 0.5–1, DD Pen 0.44–1, ICDAS-II 0.61–1, and BW 0.79–0.98. For approximal surfaces, the Se range was: DD Pen 0.58–0.63, ICDAS-II 0.42–0.55, and BW 0.14–0.71. The corresponding Sp range was: DD Pen 0.85–0.87, ICDAS-II 0.73–0.93, and BW 0.79–0.98. Se and Sp values varied, due to the heterogeneity regarding the setting of individual studies. Evidently, robust conclusions cannot be drawn, and different diagnostic means should be used as adjuncts to clinical examination. In permanent teeth, visual examination may be enhanced by DD on occlusal surfaces and BW on approximal surfaces. In primary teeth, DD Pen may serve as a supplementary tool across all surfaces.

Lesion Activity Assessment of Early Caries Using Dye-enhanced Quantitative Light- Induced Fluorescence

We aimed to determine whether dye-ehanced quantitative light-induced fluorescence (DEQLF), wherein the porous structure of carious lesions is filled in with a fluorescent dye, can be used to quantitatively and intuitively distinguish between active and inactive carious lesions. To simulate active and inactive caries, lesions were artificially formed on 126 bovine specimens. They were demineralized with 1% carbopol solution for 3 (A3), 5 (A5), and 10 days (A10). Half the specimens in each group were remineralized with 2% NaF (I3, I5, and I10). The specimens were dehydrated for 10 s and dyed with 100-µM sodium fluorescein for 10 s. Images were captured with a QLF-digital 2+ Biluminator. Fluorescence intensity of the lesions (ΔG) between the groups and absolute changes in ΔG (|ΔΔG|) between dehydration and dye penetration were compared using the independent t-test. ΔG in A3, A5, and A10 were higher than those in I3, I5, and I10 (P<0.001). In |ΔΔG| comparisons, dye penetration was 3.1-3.7 times higher than dehydration in the active group (P<0.001), and was 1.7-2.2 times lower than dehydration in I3 and I5 (P<0.05), with no significant difference in I10. DEQLF may be used to clinically evaluate early caries activity, and longitudnally monitor changes in lesion activity.