Abstract
This paper describes the results of a cross-sectional study conducted with a randomized sample of 447 low-income children between 2.5 and 4 years of age selected from the files of a health institution in Medellin, Colombia. The patients were examined in 2007 using the modified criteria of the International Caries Detection and Assessment System (ICDAS); the first caries code was not used. Clinical examination was carried out by three examiners previously trained in the ICDAS. The inter-examiner agreement was rated as good (kappa 0.73 - 0.82). The prevalence of untreated caries was 74.7% (335) with a mean of 9.7 +/- 9.4 affected surfaces. The prevalence of caries (treated and untreated) was 74.9% (335). The mean dmf-s was 7.6 +/- 9.7. The prevalence of non-cavitated lesions on at least one tooth surface was 73.4%. Cavitated lesions were more frequent on smooth surfaces than on occlusal surfaces (respectively 64.7% and 46.8%; p value < 0.001). Only 25.1% (112.5) of the children had no clinical signs of caries according to the ICDAS criteria. It was concluded that dental caries is a highly prevalent condition in this Colombian population, the main contributor being non-cavitated lesions. There was an association between caries and oral hygiene practices, such as the amount of toothpaste used, and also between caries and the occurrence of a previous dental visit (p value < 0.00). Eating habits constituted no statistically significant association.
Highlights
During the last decades, there have been changes in the prevalence of dental caries, and in the distribution and pattern of the disease.[1]
According to The World Health Organization (WHO), a dental health program should include dental education in conjunction with other activities related to prevention, restoration and emergency attention.[6,7,8]
Dental caries were measured with the criteria of the International Caries Detection and Assessment System (ICDAS)
Summary
There have been changes in the prevalence of dental caries, and in the distribution and pattern of the disease.[1] Oral health inequalities have emerged as a major public health issue as low income and socially disadvantaged groups experience disproportionately high levels of oral disease.[2] Detection of lesions during the early non-cavitated stage among these groups is an important challenge in the diagnostic process. Given the dynamic nature of dental caries, it is possible to arrest and control disease progression through the remineralization of lesions before they progress to a cavity.[3]. When white spot lesion detection as well as early identification of non-cavitated lesions are included in the clinical diagnostic process, the prevention of primary dental caries and a timely non-operative treatment become possible, effectively averting the progression towards cavitated lesions and allowing a short-term control of the disease, with long-term effects. It is currently well known that a single preventive measure in itself is not enough to reduce dental caries; it is best combined with other preventive and curative actions.[4,5] According to The World Health Organization (WHO), a dental health program should include dental education in conjunction with other activities related to prevention, restoration and emergency attention.[6,7,8]
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