Diagnostic efficiency of digital photography and AI-assisted image interpretation in dental caries examination: An umbrella review

A birth cohort study. Children born at Womens and Childrens Hospital of Juruá in the Western Brazilian Amazon from July 2015 to June 2016 were invited to join the study. 1246 children were invited and accepted into the study. Follow-up included visits at 6, 12 and 24 months of age, and a dental caries examination between 21 and 27months of age (n = 800). Data collected included baseline co-variables and sugar consumption. Data was collected at 6, 12 and 24months. At 24months, a 24-hour diet recall was obtained from the mother to obtain information on sugar consumption. A dental examination was carried out by two research paediatric dentists and caries was scored in accordance with the WHO criteria: decayed, missing and filled primary teeth (dmft)..Children were then categorised into absence of caries (dmft = 0) or presence of caries (dmft = >1). Follow-up interviews were carried out in 10% of cases to ensure accuracy and quality of the results. Statistical analysis was carried out using the G-formula. It was assumed breastfeeding had a direct effect on caries at 2 years and is indirectly mediated by sugar consumption. This was modified to include the presence of intermediate confounders (bottle-feeding) and time-varying confounders. Total causal effect of these confounders was calculated by the addition of natural direct effect and natural indirect effect. The odds ratio (OR) for total causal effect was estimated. In total, 800 children were followed up throughout the study; of these, the prevalence of caries was 22.8% (95% CI, 19.8%-25.8%). 14.9% (n = 114) of children were breastfed at 2 years of age and 60% of children (n = 480) were bottle-fed. Bottle-fed children were found to have an inverse relationship with caries. Children breastfed for 12-23 months (n = 439) were found to have an OR 1.13 for having caries at 2 years compared to those breastfed <12-months (n = 247), equating to a 13% higher risk. Children breastfed for ≥24-months had an even higher risk (27%) of caries at 2 years of age compared to those breast-fed to 12-months (TCE: OR = 1.27, 95% BC-CI 1.14:1.40). There is a weak association with prolonged breastfeeding and increased caries rate in children. Decreasing sugar consumption alongside prolonged breastfeeding marginally reduces the effect of breastfeeding on dental caries.

Background: Oral health status is dependent on the interplay of multiple etiological and predisposing factors, which have varying ability to cause diseases. However, little is known about maternal factors associated with the oral health of preschoolchildren at different stages of their development. Aim: To assess the association of maternal oral health-related knowledge and attitude with the preschoolchildren's dental caries status. Materials and Methods: The present study was a cross-sectional study conducted among 618 mother–child pairs. Three to 5-year-old preschoolchildren were selected from eight preprimary schools following two-stage random sampling. Responses from the mothers on oral health-related knowledge and attitude were collected through a structured questionnaire. It was followed by dental caries examination of their preschoolchildren based on the WHO criteria for dental caries examination. Chi-square test was done to find the association between the study variables. Model for the prediction of dental caries occurrence in preschoolchildren was generated following multiple logistic regression analysis. Level of significance was set at P < 0.05. Results: The mean correct oral health-related knowledge and attitude scores of mothers were 6.59 ± 2.35 and 7.28 ± 1.83, respectively. Preschoolchildren had a mean untreated dental caries score of 2.73 ± 1.63 and decayed, missing, and filled teeth score of 3.13 ± 1.79. Untreated dental caries in children was found to be statistically significantly associated with maternal oral health-related knowledge ( P = 0.021) and attitude ( P = 0.006). Mothers who were having better knowledge and favorable attitude toward oral health had significantly lower odds of developing dental caries in their children as reflected by the logistic regression analysis (odds ratio = 0.33 [0.22–0.52] and 0.36 [0.24–0.53], respectively). Conclusion: The study concluded that maternal factors were significantly related to children's dental caries status and emphasized the need of raising awareness among mothers for limiting and controlling dental caries among preschoolchildren.

BackgroundTo evaluates the tendency of South Korean dentists to over-diagnose clinically healthy teeth in pseudo-patients.MethodsWe conducted a pseudo-patient, cross-sectional study in 196 private dental clinics with 58 pseudo-patients in South Korea between August and December 2018. Trained pseudo-patients with no previous oral diseases, including dental caries, diagnosed by two experienced dentists, were sent to each dental clinic. Before visiting each private dental clinic, participants were instructed to state, “I have no symptoms, but I would like to have a dental caries examination”. The oral examination was performed using visual and tactile inspection methods only. The interactions between the dental clinic staff and the pseudo-patient were documented on a data collection form shortly after each visit.ResultsIn 33.2% (65/196) of these interactions, the pseudo-patients were diagnosed as having no dental caries. 11.7% (23/196), 12.8% (25/196), 10.7% (21/196), and 10.7% (21/196) of the sample were diagnosed with dental caries in one, two, three, and four teeth, respectively. Dentists diagnosed five or more dental caries in 20.9% (41/196) of the sample. 196 dental clinics diagnosed a total of 503 dental caries. Of these, 392 were in molars. Small solo practice dentists diagnosed 3.54 dental caries and large group practice dentists 1.57, but the difference was not significant (p = 0.07). The recommendation rate for dental caries treatment was highest among 43 (55.1%) large solo practices, and lowest in 7 (33.3%) large group practices. However, small solo practices had the lowest rate of preventive care recommendations at 12 (30.8%) and 10 (47.6%) in large group practices. The data shows that preventive care recommendations increased as the practice size increased.ConclusionThe study findings indicate that Korean dentists tend to over-diagnose dental caries, which could pose a threat to public health both in Korea and worldwide. Therefore, it is important to carefully consider strategies to improve the correct diagnosis and standard of care for dental caries by private dentists.

The study aimed to analyze and determine the factors associated with dental caries experience contains many zeros by zero inflated models. A cross sectional design was employed using clinical examination and questionnaire with interview method. A study was conducted during March-August 2007 in Dharwad, Karnataka, India, involved a systematic random samples of 1760 individuals aged 18-40 years. The dental caries examination was carried out by using DMFT index (i.e. Decayed (D), Missing (M), Filled (F)). The DMFT index data contains many zeros were analyzed with Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. The study findings indicated, the variables such as family size, frequency of brushing and duration of change of toothbrush were positively associated with dental caries. But the variable the frequency of sweet consumption is negatively associated with dental caries experience in Zero Inflated Poisson (ZIP) and Zero Inflated Negative Binomial (ZINB) models. The ZIP model is a very good fit over the standard Poisson model and the ZINB is the better statistical fit compared to the Negative Binomial model. The Zero Inflated Negative Binomial model is better fit over the Zero Inflated Poisson model for modeling the DMF count data.

Dental caries is a multifactorial disease with varying clinical picture and its diagnostic criteria is complicated, when initial lesion is considered. Hence, there is a need for an index which measures cavitated, non-cavitated, and initial lesion in dental caries. So, the purpose of this study was to compare the of def index with Nyvad's new diagnostic criteria. A total of 249 school children in the age group of three to six years were selected for the study from Sajjan Rao School at Bangalore city. Children teeth were cleaned and dried with cotton rolls and chip blower. The dental caries examinations were conducted under standardized conditions using plane mouth mirrors and explorers with the help of artificial illumination. The diagnostic criteria used were deft and d, e, and f component of Nyvad's new caries diagnostic criteria. Mann Whitney 'U' test was used to compare the two indexes at five percent significant level. The mean value for deft was 2.48 and the mean for d, e, and f component of Nyvad's new caries diagnostic criteria was 3.18 which shows statistically significant difference with P value of <0.05. The result obtained by Nyvad's new caries diagnostic criteria produces values much higher than those with def caries index system. Hence, Nyvad's new caries diagnostic criteria can be used to diagnose dental caries at the initial stages, which in turn will reflect exact prevalence of caries.

Background: Fluoride is an inorganic element that plays a crucial role in dental health through drinking water. Variations in groundwater fluoride levels in coastal areas can affect dental health, especially dental caries. The optimal fluoride concentration to prevent caries is 0,7 mg/L, with a maximum limit of 1,5 mg/L according to Ministry of Health Regulation No. 32 of 2017.Objective: This study aimed to determine the fluoride concentration in coastal groundwater and its association with dental caries incidence in children.Methods: An analytical observational cross-sectional study was conducted using simple random sampling on 26 children aged ≥2 years residing in coastal areas who used groundwater as their drinking water source. The study was carried out in Oesapa Village, Kupang City, in May 2024. Data were collected using questionnaires and dental caries examinations with the DMF-T index. Data were analyzed using correlation tests between fluoride levels and caries incidence.Results: Groundwater fluoride levels ranged from 0,00 to 1,01 mg/L (mean 0,28 mg/L), remaining below the safe limit of 1,5 mg/L. The mean dmf-t score for primary teeth was 2,36, and the DMF-T score for permanent teeth was 0,08, indicating generally good dental status among children. Statistical analysis showed no significant correlation between fluoride concentration and caries incidence (p= 0,796). Behavioral factors such as tooth brushing habits and sugar consumption were suspected to influence caries occurrence.Conclusions: Fluoride levels in coastal groundwater of Oesapa were within normal limits and met Ministry of Health standards. Caries incidence was low, and no association was found between fluoride levels and caries prevalence.

Over the past decade, dental sealants have become recognized as an important adjunct to the use of fluorides in the prevention of dental caries. The most recent national survey of oral health in children conducted in 1986-1987 found that only 7.6% of children had any sealed teeth. As part of the oral health component of the 1988-1991 Third National Health and Examination Survey (NHANES III-Phase 1), the prevalence of dental sealants in children, adolescents, and adults was determined. The presence of dental sealants on posterior teeth (excluding third molars) and maxillary lateral incisors was recorded by visual and tactile methods during the dental caries examination. Findings in this paper are based on those examined persons having at least one sealable primary tooth for children aged 2-11 years (n=3,792); at least one sealable premanent tooth for persons aged 18 years and over (n=7,146). During 1988-1991, about 18.5% of US children and youth ages 5-17 had one or more sealed permanent teeth. A significantly higher percentage of non-Hispanic whites had sealants in comparison with their non-Hispanic black and Mexican-American counterparts (for all contrasts, p<0.001). As expected, molar teeth were the most frequently sealed tooth type. Only 1.4% of US children ages 2-11 had at least one sealed primary tooth. The prevalence of dental sealants decreased in the US adult population with increasing age; 5.5% of adults ages 18-24 had at least one sealed permanent tooth. Data collected from NHANES III-Phase 2 (1991-1994) will be analyzed to determine if the upward trend in sealant use continues.

BackgroundOral health status is associated with the overall health among people living with human immunodeficiency virus (HIV) infection. However, it is unclear whether dental caries is associated with the viral load in this population. Particularly, dental caries among children living with HIV needs better understanding as this can affect their overall health and future well-being. This study assessed the association between dental caries and viral load among children living with HIV in Phnom Penh, Cambodia.MethodsThis cross-sectional study, conducted at the National Pediatric Hospital as a baseline survey of a randomized controlled trial, included 328, 3–15-year-old children living with HIV and their primary caregivers. Calibrated and trained examiners conducted oral examinations for dental caries (DMFT/dmft index) in the children and retrieved the latest HIV viral load data from the hospital’s patient information system. On the dental examination day, the children and their caregivers were invited to answer a questionnaire-based interview. Multiple logistic regression analysis was conducted to assess the association between dental caries and viral load. The cut-off point for undetectable viral load was set at < 40 copies/mL.ResultsData from 328 children were included in the analysis; 68.3% had an undetectable viral load. The mean DMFT/dmft was 7.7 (standard deviation = 5.0). Adjusted regression analysis showed that dental caries in permanent or deciduous teeth was positively associated with detectable viral load (adjusted odds ratio [AOR]: 1.07, 95% confidence interval [CI]: 1.01–1.14). Conversely, antiretroviral therapy of ≥ 1 year and self-reported better adherence to antiretroviral drugs were negatively associated with detectable viral load. Among children with detectable viral load, dental caries in permanent or deciduous teeth was positively associated with non-suppression of viral load (> 1000 copies/mL) (AOR: 1.12, CI: 1.03–1.23).ConclusionsDental caries was associated with viral load status detection among children living with HIV. This finding suggests that dental caries may affect their immune status. The oral health of children living with HIV should be strengthened, and further research is needed to clarify the causal relationship between viral load and oral health status.

The interrelationship of human immunodeficiency virus (HIV) infection and dental caries, as well as Salivary IgA (S-IgA) level, appear to remain underexplored while a manual and electronic search of the literature was made. Hence, this study was undertaken to assess the relationship of S-IgA and dental caries status in HIV +ve children. The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV +ve and HIV -ve children and to determine the dental caries status in HIV +ve and HIV -ve children, which may help in treatment planning and prevention of the same. Twenty-eight HIV +ve children aged between 6 and 14 years and 28 age matched HIV -ve children were included in this study, and both samples were randomly selected from the same nongovernmental organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. 2 cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes, and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to the WHO criteria (1997) using a flat mouth mirror and Community periodontal index (CPI) probe. In HIV +ve group, mean salivary IgA level was calculated as 81.61 ± 6.20 μg/ml, mean decayed, missing, filled teeth (DMFT) was 3.86 ± 3.37, mean decayed, extracted and filled teeth (deft) was 4.75 ± 2.86. In HIV -ve group, the mean salivary IgA level was calculated as 145.57 ±17.83 μg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong -ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, P < 0.001) and negative, but not significant correlation (r = -0.19, t = 0.99, P > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, P < 0.001), S-IgA and deft (r = -0.942, t = 14.32, P < 0.001) was found in HIV -ve group. This study suggests that the individuals, who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.

The inter-relationship of Human Immunodeficiency Virus (HIV) infection and dental caries as well as Salivary Immunoglobulin-A (S-IgA) level appear to remain under explored while a manual and electronic search of the literature was made. Hence, the present study was undertaken to assess the relationship of S-IgA and dental caries status in HIV positive children. The aim of this study was to find out the relationship of S-IgA antibody with dental caries by measuring the concentration of IgA in saliva of HIV positive and negative children and determine the dental caries status in HIV positive and HIV negative children, which may help in treatment planning and prevention of the same. A total of 28 HIV positive children aged between 6-14 years and 28 age matched HIV negative children were included in this study and both samples were randomly selected from the same Non-Governmental Organization (NGO). The HIV status of both these samples was confirmed from their medical records provided by the NGO. Only 2cc of unstimulated saliva was collected from both groups in special tubes coded numerically using the method described by Collins and Dawes and the samples were analyzed to measure the concentration of IgA using commercially available ELISA kit (DRG Diagnostics, Germany). Examination of dental caries was carried out according to WHO criteria (1997) using a flat mouth mirror and CPI probe. In HIV +ve group mean S-IgA level was calculated as 81.61 ± 6.20 μg/ml, mean DMFT was 3.86 ± 3.37, mean deft was 4.75 ± 2.86. In HIV -ve group mean S-IgA level was calculated as 145.57 ± 17.83μg/ml, mean DMFT was 2.54 ± 0.69, mean deft was 2.43 ± 2.01. Strong-ve correlation between S-IgA and DMFT (r = -0.781, t = 6.38, p < 0.001) and negative but Not Significant (N.S.) correlation (r = -0.19, t = 0.99, p > 0.05) between S-IgA and deft was found in HIV +ve group. Strong -ve correlation between S-IgA and DMFT (r = -0.655, t = 4.42, p < 0.001), S-IgA and deft (r = -0.942, t =14.32, p=<0.001) was found in HIV-ve group. This study suggests that the individuals who are suffering from IgA deficiency in general, are more susceptible to dental caries than normal individuals.

Objectives. The present study was designed to determine the prevalence of premature loss of primary teeth and its effect on malocclusion in Eastern Province, Saudi Arabia. Materials and methods. This is an observational, cross-sectional study that included 307 male children aged 9–11 years old. Clinical examinations were performed using a disposable sharp explorer, a UNC periodontal probe and a dental mirror. The samples were examined clinically to detect the following traits: Angle’s classification of malocclusion, overjet, overbite, anterior open-bite, lateral open-bite, midline shift and cross-bite. Additionally, a dental caries examination was performed using WHO methods. Questionnaires in Arabic were coded and sent to the students’ parents. Results. The mean DMFT was 5.61 (SD = 3.01). The d-component was the highest, with a mean of 4 (SD = 2.83). Of the 307 children, it was found that 204 (66.4%) had a high DMFT score, which is defined as a score above 4. It was found that 156/307 (51%) children had premature loss of deciduous teeth. Conclusion. A high prevalence of premature loss of teeth was found in this study. This finding emphasizes the importance of increasing awareness levels about this issue and focuses attention on the need for more preventive efforts to maintain healthy and normal dentitions that would improve the masticatory function and aesthetics of individuals and the whole population. In addition, the findings emphasize the importance of the early detection of premature loss of primary teeth to prevent future malocclusion.

Self-efficacy can be interpreted as a self-belief that one has successfully committed to a specific situation or maintained a specific behaviour. We aimed to test the reliability and validity of a cross-cultural adaptation of the self-efficacy oral health (SEOH) questionnaire in the Indonesian language among adolescents and to understand the diverse perspectives of oral health self-efficacy related to gender. A cross-cultural adaptation of the SEOH self-administered questionnaire was completed followed by a dental caries examination. Sample size estimation suggested 341 adolescents aged 12-13years. Eleven junior high schools were clustered and randomly selected from six districts across Jakarta, Indonesia. The SEOH was reliable with interclass correlation and Cronbach's alpha values of 0.86 and 0.86, respectively. Significant results for the construct and discriminant validity analyses were observed. There was no significant difference in terms of the total score between males and females, but there was a significant difference in terms of the psychology control domain. Our study results provide evidence supporting the reliability and validity of the Indonesian version of the SEOH questionnaire for adolescents across Indonesia.

Dental caries is the most common disease affecting oral cavity. Despite credible scientific advances and the fact that dental caries is preventable, the disease continues to be a major public health problem.AimTo assess the dental caries status and oral hygiene practices among 6–10-year-old rural and urban schoolchildren in south Bengaluru.Materials and methodsA total of 452 children from four schools which included one government school from rural and urban area and one private school from rural and urban area in south Bengaluru. Detailed pro forma was used, and information was recorded through an interview system. The examination for dental caries was made according to the dentition status and treatment needs as described by the World Health Organization (1997) using Community Periodontal Index Probe and Plane Mouth Mirror (type III examination), under natural day light in school premises. The examination was done by a single examiner and recorded by the trained personnel.ResultsPrevalence of dental caries was more in rural schoolchildren. More than five decayed teeth were documented in higher percentage of children in rural government school, while it was much less in children of other schools.ConclusionA comprehensive community-focused oral healthcare intervention that includes oral health education in elementary schools and homes is recommended to increase general oral health awareness.How to cite this articleChandregowda KY, Kumar VD, Shankarappa KB, et al. Assessment of Dental Caries Status and Oral Hygiene Practices among 6–10-year-old Rural and Urban Schoolchildren in South Bengaluru, Karnataka, India. Int J Clin Pediatr Dent 2020;13(4):348–354.

To determine the efficacy of 5% sodium fluoride (NaF) varnish application in reducing caries increments in the permanent dentition of rural Brazilian school children over the course of 12 months. A double-blind, randomized, placebo-controlled trial was conducted with 379 children aged 7-14 years who attended three schools in Brazil between January 2006 and December 2007. During this period, each school was visited four times at 6-month interval for recruitment, dental examinations, and fluoride varnish applications. Recruited children were randomly assigned to either a treatment (5% NaF varnish, n = 198) or a control group (placebo, n = 181). Trained interviewers collected data on oral health habits and sociodemographic characteristics from the children. Information on the child's diet was collected through a 7-day food frequency diary. Caries examinations were conducted using the International Caries Detection and Assessment System (ICDAS). The efficacy of fluoride varnish application on caries prevention was reported as a preventive fraction (PF). Crude caries increments of decayed and filled surfaces (DFS) were compared between fluoride varnish and placebo groups. A generalized linear model (GLM) was constructed to test the differences in DFS increments between the groups after accounting for confounding factors. Of the total sample (N = 379), 210 (55.4%) children had completed 12 months of follow-up including one or two applications of fluoride varnish or placebo. At the baseline examination, the children in the treatment and control groups presented on average 6.2 and 5.6 DFS, respectively (P < 0.001). After 12 months of follow-up, the children in the varnish group showed significantly lower DFS increments than did children in the control group (10.8 versus 13.3; P < 0.007), with PF of 40% (95% CI: 34.3-45.7%; P < 0.0001). The results of this study suggest that applications of 5% NaF varnish can be recommended as a public health measure for reducing caries incidence in this high-caries-risk population.

Caries experience between primary teeth at 3–5 years of age and future caries in the permanent first molars