Dietary Determinants of Dental Caries Prevalence and Experience in Saudi Schoolchildren: Frequency versus Quantity

Background. Sugar-added diet has been associated with increased risk of developing dental caries. Objective. To investigate the dietary determinants of caries prevalence and experience based on the frequency versus the quantity of consumption among Saudi schoolchildren. Methods. This is a cross-sectional study that invited 12- to 15-year-old intermediate school students (N = 3000) in four cities in the Eastern Province of Saudi Arabia. Data collection comprised a pretested questionnaire and clinical examination. Caries was diagnosed based on the World Health Organization (WHO) criteria and was recorded as a decayed, missing, filled tooth (DMFT). The questionnaire included questions regarding the consumption of different quantities and frequencies of multiple sugar-containing food items. Multiple logistic and linear regression models were used to assess the influence of sugar-containing food on the dental caries experience (DMFT) and prevalence of decayed teeth. SPSS version 20.0 was used to analyze the data at 5% significance level. Results. Of 3000 invited students, 2262 participated with a participation rate of 75.4%. Our study found that the frequency of soft drink consumption was significantly associated with increased caries prevalence (adjusted OR = 1.33, 95% CI 1.07–1.65) and experience (adjusted B = 0.46, 95% CI 0.16–0.76). The frequency of consumption of fruit juice was statistically significantly associated with increased caries experience (adjusted B = 0.48, 95% CI 0.16–0.79). The interaction terms between the frequency and the quantity of consumption of energy drinks, soft drinks, and sweetened milk were statistically significantly related to caries experience and prevalence. Conclusion. Although the frequency of consumption of sugar-containing drinks was more associated with caries experience and prevalence, the interaction between frequency and quantity was highly related to the prevalence and experience of dental caries.

Dental Caries Prevalence among 3 - 14 Year Old School Children of Chitwan

Introduction: Dental caries, an infectious microbiologic disease of dental hard tissues is a global public health problem. It affects people of all ages with the highest priority risk group being school-going children. Objective: This study was done to assess the prevalence of dental caries in the 3-14 years old school children of Chitwan and to compare it across genders, age groups and school groups. Methods: This was a cross-sectional study conducted from January 2018 to May 2018 where WHO criteria was used to examine and calculate DMFT and dft (decayed filled teeth) indices among 360 school children. Statistical analysis was done with SPSS 20. Statistical significance was determined using independent t-test and ANOVA test. Results: The prevalence of the dental caries was found to be 85.83% with mean DMFT of 3.01 ± 2.24 among school children of Chitwan. Caries prevalence was higher in females compared to males, and in government schools compared to private school. Caries experience was highest in middle childhood group 7-12 years (89.20%, mean “DMFT+dft” 3.56 ± 2.33) followed by late childhood group of 13-14 years (84.72%, mean DMFT 2.68 ± 1.95) and early childhood group of 3-6 years (77.33%, mean dft 1.76 ± 1.60) and the differences were statistically significant. The difference in caries experience between private and government school groups as well as in male and female children was not statistically significant. 82.7% of the children had untreated caries while only 5.83% had filled teeth in their mouth. Conclusions: The prevalence of dental caries was higher in middle childhood group and higher percentage of untreated decays, calls for the need of immediate preventive as well as curative interventions.

Dental Caries Prevalence and Experience (ICDAS II Criteria) of 5-, 12- and 15-Year-Old Children and Adolescents with an Immigrant Background in Greece, Compared with the Host Population: A Cross-Sectional Study

Evidence regarding disparities in oral health among native and immigrant child and adolescent populations in Europe is scarce. The present study aimed to determine the caries status of 5-, 12-, and 15-year-olds with an immigrant background in Greece in relation to their sociodemographic characteristics and compare their caries levels with those of their native Greek peers. A sample of 707 immigrants underwent clinical examination for caries (ICDAS II criteria), followed by a calculation of caries prevalence and experience estimates (2013–2014). Multivariable regression models assessed the effect of ethnic background on the caries experience (d3–6mfs/D3–6MFS) of the total (707 immigrants and 3702 Greeks) population, and the association between parental education level and the immigrants’ d3–6mfs/D3–6MFS. Among the 5- and 12-year-olds, those with an immigrant background demonstrated higher caries rates and had unfulfilled treatment needs at higher proportions. Among 15-year-old adolescents, no considerable differences in caries status were observed according to ethnic background (native Greek or immigrant). The strength of the association between immigrant background and caries experience levels attenuated gradually with increasing age (IRR = 1.61, 1.27 and 1.10, and p = 0.001, p = 0.006 and p = 0.331 for 5-, 12- and 15-year-olds, respectively). Among the immigrants, adolescents with less educated mothers exhibited elevated caries levels. Public health strategies should prioritize immigrant children and early adolescents in order to reduce the existing ethnic disparities in oral health.

Association of clinical, social and environmental variables with dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water

Background Although a trend towards dental caries reduction has been observed, further investigations on its pattern and development are still needed. Objective To investigate the influence of clinical, social and environmental variables on dental caries prevalence in adolescents from a Brazilian municipality supplied with fluoridated water in 2018. Method This study was conducted with a non-probabilistic sample of 277 adolescents aged 12 years of public schools in Nova Friburgo, state of Rio de Janeiro, Brazil. Clinical examinations were carried out by calibrated examiners to assess caries, periodontal disease, and fluorosis according to criteria of the World Health Organization (WHO). Semi-structured questionnaires were applied to record socio-environmental information. Results Individuals living in regions supplied with fluoridated water below the minimum required levels (OR=3.60, p=0.0006), with low income (OR=1.90, p=0.0444), presence of gingivitis (OR=3.36; p=0.0016), and whose reason for visiting the dentist was dental treatment (OR=2.41; p=0.0203) were more likely to have dental caries. A significant reduction (p<0.0001) in dental caries indexes was observed between 2012 and 2018. Conclusion Fluoridation of public water supply at unsuitable levels, as well as other social and clinical variables can influence the caries pattern in adolescents.

Global Burden and Inequality of Dental Caries, 1990 to 2019

Previous studies on the global burden of caries primarily focused on simple descriptive statistics. We aimed to characterize the burden, trends, and inequalities of untreated caries of permanent and deciduous teeth from 1990 to 2019 at the global, regional, and national levels through an array of analytic approaches. Estimates of caries burden were extracted from the Global Burden of Disease Study 2019. Decomposition analysis was performed to examine the contribution of demographic and epidemiologic factors to the evolving number of prevalent caries cases. In portfolio analysis, the caries epidemiologic profile of each country was categorized by terciles of age-standardized prevalence in 2019 and average annual percentage change from 1990 to 2019. Sociodemographic attribution analysis was performed to reveal the scale of inequality in burden of caries. Age-standardized prevalence of caries in permanent and deciduous teeth decreased 3.6% (95% uncertainty interval, 2.6% to 4.5%) and 3.0% (1.3% to 4.9%), respectively. Population growth was the key driver of the changes in the number of caries cases, especially in sub-Saharan Africa (percentage contribution: 126.6%, permanent teeth; 103.0%, deciduous teeth). Caries prevalence in the permanent dentition was lower in more developed countries, whereas a reverse trend was noted in the deciduous dentition, except for the highest sociodemographic quintile where caries prevalence was the lowest. Globally, 64.6 million (95% CI, 64.4 to 64.9 million) and 62.9 million (62.8 to 63.1 million) prevalent cases of caries in permanent and deciduous teeth were attributable to sociodemographic inequality in 2019. This amounted to 3.2% (3.2% to 3.2%) and 12.1% (12.1% to 12.1%) of the global number of prevalent cases of caries in permanent and deciduous teeth. Burden of dental caries remains a global public health challenge. A systemwide reform of the global oral health care system is needed to tackle the causes of the burden and inequality of dental caries.

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

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.

TOOTH WEAR IN CHILDREN - PREVALENCE, CLINICAL FEATURES AND RISK FACTORS

Introduction: Pathological tooth wear in children with primary dentition can be a result of various harmful habits, risk factors and nocturnal bruxism. It is difficult to be distinguished from physiological tooth wear. Aim:To study caries prevalence, tooth wear prevalence, its clinical characteristics and its relationship with bruxism in children aged 3 - 7 years. Materials and methods: The object of the study are 222 children, divided into 5 age groups - from 3 to 7 years. The examined children underwent a clinical examination, during which the following were registered: dental status, caries prevalence, the type, degree and prevalence of tooth wear. Information on the presence and characteristics of nocturnal bruxism in the examined children was obtained from the parents. The results were statistically processed with SPSS-19. Results: Tooth wear is found in more than 2/3 of the examined children (P<0.05). The highest average number of abraded teeth is present in 6- and 7-year-old children - about 7. Tooth abrasion affects 75% of canine teeth, 37.6% of incisors and 11.8% of molars in children aged 3-7 years. The predominant severity of wear is that in the inner ½ of the enamel (degree 1b) and occurs in 41.7% of children (P<0.05). 1/3 of the examined children have nocturnal bruxism (P<0.05). In almost 90% of them, tooth wear was found (P<0.05). Conclusions: There is an increase in the severity of tooth abrasion with age in children between 3-7 years. Nocturnal bruxism is almost always accompanied by tooth wear.

A Two-Year Longitudinal Study of the Effectiveness of the CRT® Bacteria Test in Evaluating Caries Risk in Three-Year-Old Children

Objective. To study the correlation between the level of infection with Streptococcus mutans (SM) and lactobacilli (LB) in saliva with existing status and the development of primary dental caries in 3-year-old children and to evaluate the results of CRT® bacteria as a Caries Risk Test. Methods. A total of 140 3-year-old children were selected for the study. Oral examination was conducted and the levels of infection with SM and LB in saliva were measured using a CRT® bacteria test. Oral reexamination was conducted after two years. The prevalence rate of caries, the decayed-missing-filled tooth (dmft) and decayed-missing-filled surface (dmfs) indices, and Caries Severity Index (CSI) were calculated at the start and end of the two years. The indices were statistically analyzed. Results. The caries prevalence rate, dmft, dmfs, and CSI increased with increasing levels of CRT-SM and CRT-LB at the start and end of the two years; the increases in dmft, dmfs, and CSI over the period were consistent with the increases in CRT-SM and CRT-LB levels, with all differences being highly statistically significant. The increase in caries prevalence rate over the two years was not statistically different for different CRT-SM and CRT-LB levels. CRT-SM and CRT-LB levels were highly positively correlated with dmft, dmfs, CSI and their increases over the two years. Levels of infection with oral SM and LB were found to be independent risk factors for primary dental caries, respectively. For an SM concentration in saliva of ≥104 CFU/mL and an LB concentration of <104 CFU/mL, the risk of caries increased by approximately 2.8-fold. When the concentration of LB in saliva was ≥104 CFU/mL and that of SM <104 CFU/mL, the risk of caries increased by approximately 3.9-fold. When the concentration of both SM and LB was ≥104 CFU/mL, the risk increased by approximately 10.9-fold. Conclusions. Significant positive correlations were found between the level of infection with oral SM and LB and existing oral decay status and the trend in the development of primary dental caries. Infection with SM and LB significantly increased the risk of caries in primary teeth. The CRT® bacteria is a simple, convenient, reliable, and effective Caries Risk Test.

Dental Caries and Associated Factors in 3–5-Year-Old Children in Guizhou Province, China: An Epidemiological Survey (2015–2016)

Objective: This study aimed to explore the factors influencing dental caries among 3–5-year-old children in Guizhou Province and the interrelationship between these factors using structural equation modeling, while providing theoretical references to improve the prevention and control strategy.Materials and Methods: A total of 1,291 children aged 3–5 years in Guizhou Province were selected by a multistage stratified and whole group random sampling to examine the caries prevalence in whole-mouth deciduous teeth crowns, and parents were surveyed with questionnaires to analyze the caries-related factors. IBM SPSS Statistics v 23.0 software (IBM, Armonk, NY, USA) was used for statistical analysis.Results: The caries prevalence of children aged 3–5 years in Guizhou Province was 63.1%, the mean decayed-missing-filled teeth was 3.32, the caries filling rate was 0.5%, and there was no statistically significant difference between urban and rural areas and among genders in each age group; results of logistic regression analysis showed that the caries risk increased with the following factors: age, brushing frequency &lt;2 times per day when parents did not take their children to the dentist, and with parents poor evaluation of the oral condition of their children. The higher the education of the parent, the lower the risk of children suffering from caries in deciduous teeth.Conclusions: With an overall poor situation about oral hygiene habits, oral healthcare attitude of the parents, and behavior transformation, the prevalence of dental caries in the deciduous teeth of children aged 3–5 years in Guizhou Province is high, and their caries status was severe, with more than 99% of the caries cases that were untreated. Therefore, prevention and treatment measures of caries in preschool children need strengthening through the improvement of public awareness and the enhancement of the management of oral health habits of their children.