Caries Assessment Spectrum And Treatment Research Articles

Agrawal and Shah Modified Cast Index - A Novel Index Assessing Prevalence of Dental Caries and Treatment Needs of the Adult Indian Population.

Agrawal and Shah modified CAST (Caries Assessment Spectrum and Treatment) is the novel index prepared specifically for the Indian population for the complete evaluation of the spectrum/range of dental caries described hierarchically. To assess the prevalence of dental caries and treatment needs in an adult Indian population using Agrawal and Shah modified CAST index. A cross-sectional transverse study was performed on 2000 adult patients in the age range of 19-70 years. All the adult patients were scored for caries presence by Agrawal and Shah modified CAST codes on a structured proforma. SPSS version 20 was used to analyze the data. The prevalence of dental caries calculated using Agrawal and Shah modified CAST index was 85.6%. 5.2% (104) adults had sound dentition, 4.1% (82) adults had restorations, 2.1% (42) adults had non-cavitated lesions, 13.7% (274) adults had the presence of caries in the enamel, 19% (380) adults had the presence of caries in dentine, and pulpal involvement was observed in 27.7% (554) adults. 10.3% (206) adults had presented with a root surface and cervical caries. 13.6% (272) adults had lost at least one tooth due to caries, and 3% (60) adults had lost teeth due to any other reason except dental caries. 1.3% (26) adult patients do not show any caries-related diagnosis but were having predisposing conditions. Agrawal and Shah modified CAST index proved to be simple, useful, and appropriate in assessing dental caries prevalence in the Indian population along with the treatment needs of the Indian population.

Comparison of Oral Health and Salivary Biomarkers in Children with Juvenile Idiopathic Arthritis and Healthy Individuals.

This study examines the effects of juvenile idiopathic arthritis (JIA) on the oral health and detectability of inflammatory biomarkers IL-17, tumour necrosis factor-alpha (TNF-α) and total antioxidant status (TAS) in the saliva of children with JIA. This study included 117 participants (39 patients with JIA and 78 systemically healthy subjects aged 8-12 years). Demographic data, responses to an oral health-related questionnaire, saliva samples, periodontal parameters [plaque index (PI), gingival index (GI) and bleeding on probing (BOP)] and dental recordings [facial profile (FP) and dental occlusion relationship (DOR)] were obtained. Enzyme-linked immunosorbent assays were used to determine the levels of salivary IL-17, TNF-α and TAS. The Caries Assessment Spectrum and Treatment (CAST) index, FP and DOR distributions did not change between groups (P > 0.05). JIA patients had more temporomandibular joint (TMJ) discomfort than gingivitis patients and healthy subjects (P < 0.05). JIA patients had greater salivary IL-17 levels than healthy subjects (P < 0.05). The healthy group's TAS was higher than that of the JIA and gingivitis groups (P < 0.05). Saliva TNF-α levels were similar between groups (P > 0.05). PI, GI, BOP and TNF-α were positively associated with salivary IL-17 (P < 0.001). Elevated salivary IL-17 and TAS levels could be used as biological markers for discriminating the clinical health status of children with JIA and gingivitis.

Relationship between psychological distress with self-rated oral health and dental caries status among dental patients

BackgroundThe present study aimed to determine relationship between psychological distress with self-rated oral health and dental caries status among dental patients. Materials and methodsA cross-sectional study was designed to explore the relationship between psychological distress using Kessler Psychological Distress (K6) Scale with self-rated oral health and dental caries among dental patients in Hyderabad city. Clinical examination was done using Caries Assessment Spectrum and Treatment (CAST) index. P < 0.05 was considered to be statistically significant. ResultsSubjects aged over 32 years and females had higher mean scores of psychological distress (6.64 ± 3.90 and 5.90 ± 3.80, respectively). The overall prevalence of caries was 69.1%. Moderate psychological distress remained significantly associated with higher odds of poor self-rated oral health (OR = 1.33). The presence of dental caries, combined with moderate psychological distress, also increased the odds of poor self-rated oral health (OR = 1.18, OR = 1.76). Furthermore, subjects aged under 32 years and males had higher odds of poor self-rated oral health (OR = 2.07, OR = 2.15) (P < 0.05) (Model 3). ConclusionIn conclusion, the present study indicated that individuals with moderate psychological distress had an increased likelihood of reporting poor self-rated oral health and higher odds of dental caries. Additionally, subjects who were younger than 32 years and males had higher odds of poor self-rated oral health.

Correlation of Ora Test and Caries Assessment Spectrum and Treatment Index (CAST) to Evaluate Caries Activity in 5-to-8-Year-Old Children.

Objectives: Dental caries is a common chronic disease amongst children and are typically evaluated using the DMFT/deft index (decayed, missing, and filled teeth for permanent dentition/decayed, extracted, and filled teeth for primary dentition). To address the limitations associated with these indices, alternative assessment tools such as the Caries Assessment Spectrum and Treatment (CAST) index and Ora test have been developed. These methods aim to estimate caries activity within the oral cavity more accurately. The objective of our study was to evaluate and correlate caries activity in 5-to-8-year-old children using Ora test and CAST index. Materials and Methods: Thirty schoolchildren between the ages of 5 and 8 years were selected and allocated into two groups (n=15) with DMFT/deft scores of <5 (group A) and >5 (group B). Two separate blinded examiners administered the assessments by first determining CAST scoring, which was followed by Ora test. Statistical analysis was performed using Pearson correlation test and significance was set at P≤0.05. Results: The mean time for color change of Ora test, was 118.53±23.28 minutes in group A and 53.33±15.07 minutes in group B. CAST severity scores were 3.67±2.08 and 15.7±9.70 for groups A and B, respectively. Time taken for color change in Ora test and CAST scores showed a significant negative linear relationship (P=0.039). Conclusion: Based on the negative correlation between CAST scores and Ora test, it may be postulated that microbial activity is directly related to caries activity in 5-to-8-year-old children.

One-year oral health outcome of a community-based trial in schoolchildren aged 6-7 years old in Tehran, Iran.

Promoting schoolchildren's oral health is important, particularly in developing countries. This study was conducted to monitor the oral health of schoolchildren aged 6-7 years old following the implementation of an oral health promotion program in Tehran, Iran. The protocol was registered in the Iranian Registry of Clinical Trials (Code: IRCT20090307001749N4). A cluster random sampling method was applied, and the schools were randomly allocated to intervention and control groups. An intervention package consisting of a one-day workshop for parents and supervised toothbrushing for children was employed. In both groups, the Caries Assessment Spectrum and Treatment (CAST) and Oral Hygiene Index Simplified (OHI-S) were evaluated at baseline and at one-year follow-up in addition to the questionnaire data. Clinical data were collected by calibrated examiners at both intervals (Kappa = 89.8%, 87.68%) and analyzed using the SPSS software ver. 22.0. Of 739 children included at baseline, 593 were re-examined after one year (response rate = 74%). According to the Generalized Estimating Equation (GEE) analysis, considering the confounding effect of time, significantly more children in the control group had deciduous molars with a score of 3 and higher compared to the intervention group (OR = 1.79; 95% CI:1.17-2.73, p = 0.007). The oral hygiene status of the children significantly improved in the intervention group compared to the controls (B = -0.27; 95% CI: -0.45 --0.08, p = 0.005). After one year, the improvement in the oral health-related attitude of parents and children's oral health behavior was marginally significant in the intervention group compared to the control group [0.2 (0.17) vs. -0.13 (0.05), p = 0.096] and [0.06 (0.06) vs. -0.05 (0.04), p = 0.09], respectively. However, the impact on the oral health-related knowledge and self-reported behavior of the parents was not significant. In the intervention group, children had less caries and a better oral hygiene status compared to the controls after one year.

Comparative evaluation of dental caries experience using CAST index and WHO criteria among 5 and 15-year-old schoolchildren.

CAST (Caries Assessment Spectrum and Treatment) index is a relatively new caries assessment tool that hierarchically describes the entire caries spectrum. Its comparability with WHO (World Health Organization) criteria in different populations and age groups needs to be investigated. The objective of this study was to assess caries among 5 and 15-year-old schoolchildren using the CAST index and WHO criteria and to compare both indices on the basis of caries experience and examination time. A cross-sectional study was conducted among 553 schoolchildren aged 5 and 15 years in the North zone of Bengaluru city, India. Examiners underwent training and calibration for performing the CAST index. The first examination was performed using the CAST index followed by a second examination using the WHO criteria 2013, after some days. Time taken for examination was also recorded. The study sample consisted of 279 five-year-old and 274 fifteen-year-old schoolchildren. The difference in caries experience among 5 and 15-year-old children assessed using the CAST index (52%, 45.6%) and WHO criteria (42.3%, 24.5%) were found to be statistically significant (p < 0.05). The average examination time was longer for the CAST index (93.77±24.77 seconds and 105.04±9.49 seconds) when compared to WHO criteria (61.05±15.91 seconds and 58.72±9.42 seconds) for primary and permanent dentition (p < 0.05). Though the CAST index took a longer examination time, the information obtained was more precise and facilitated researchers in treatment planning encompassing prevention of initial lesions, restoration, and rehabilitation.

Using the Caries Assessment Spectrum and Treatment Index to Determine the Caries Incidence in Primary and Permanent Molars Among School Children of Kolkata: A Cross-Sectional Study.

Caries in their early stages cannot be properly classified using the decayed, missing, and filled teeth (DMFT) index because it does not record precavitated lesions. Thus, the caries assessment spectrum and treatment (CAST) index is a good alternative as it is equipped to record the whole range of dental illnesses and count restored teeth as healthy ones. The participants in this cross-sectional study included 300 children who were seven-to-eight years of age. We used the CAST index to assess the extent of caries in the deciduous and permanent molars of these children. For this, all the permanent and baby teeth, the primary and secondary permanent molars, as well as the first and second deciduous molars were examined to determine the prevalence of each carious stage. The correlation of the distribution of the CAST codes between the first and second molars, the second and first molars, the right and left sides of the dental bend, and the opposing jaws was analyzed using Spearman's rank correlation coefficient, while the cut-off for statistical significance was a p-value of 0.05. The quantitative analysis was conducted using IBM SPSS Experiences Version 20 for Windows. By comparing CAST codes in the right and left molars, we were able to observe how the development of caries in paired teeth might affect one another. The rank correlation value was found to be less than 0.5 only in the primary second molars (55/65 and 85/75), which were found exclusively in the deciduous first molars. Moreover, the r values for the neighboring deciduous and permanent molars were found to be below 0.3, i.e., 65/64 (0.497), 74/75 (0.327), and 84/85 (0.411), which indicated a weak connection between them. When comparing the teeth in different jaws, we found reasonable correlations (r = 0.33-0.49), with only 64/74 outliers (0.501). We found that, in the examined population, there was a well-established correlation between the stages of caries development in the deciduous molars on the left side of the mouth.

Assessment of caries diagnostic thresholds of DMFT, ICDAS II and CAST in the estimation of caries prevalence rate in first permanent molars in early permanent dentition\u2014a cross-sectional study

BackgroundThe actual burden of dental caries prevalence varies with the caries assessment tool used. Therefore, the present study evaluated the caries diagnostic potentials of Decayed, Missing and Filled Teeth (DMFT); International Caries Detection and Assessment System (ICDAS) II and Caries Assessment Spectrum and Treatment (CAST) indices in estimating the caries prevalence rate of first permanent molar (FPM) in Saudi male children aged 7–9 years.MethodsThis descriptive, cross-sectional study included 390 children by multistage stratified cluster sampling method in Al-Jouf Province, Saudi Arabia. The prevalence rates of FPM caries were determined by DMFT, ICDAS II and CAST indices at various diagnostic cut-off points. Intra- and inter-examiner reliability was determined.ResultsThe prevalence rates of FPM caries determined by DMFT (decayed), ICDAS II (codes 1–6) and CAST (codes 3–7) were 64.4% (61.6–67.2), 71.5% (69.2–73.2) and 71.0% (68.7–73.3), respectively. The prevalence rates of FPM caries determined by ICDAS II at various diagnostic cut-offs were as follows: ‘sound’ (code ‘0’), 28.5% (26.3–30.8); ‘enamel caries’ (codes 1–3), 57.2% (54.7–59.7) and ‘dentinal caries’ (codes 4–6), 14.3% (12.6–16.1). Similarly, the prevalence rates estimated by CAST at different diagnostic cut-off points were: ‘healthy’ (scores 0–2), 28.1% (25.9–30.4); ‘premorbid’ (score 3, enamel carious), 56.5% (54.0–59.0); ‘morbid’ (scores 4–5, cavitated carious dentin), 7.9% (6.6–9.3); ‘severe morbidity’ (scores 6–7, pulp exposure/fistula/abscess), 6.6% (5.4–8.1) and ‘mortality’ (score 8, lost), 0.8% (0.4–1.4).ConclusionEnamel caries lesions were found in more than half of the FPMs investigated in the current study. CAST index is preferable because it detects the complete spectrum of caries. ICDAS II at codes 1–6 and CAST at codes 3–7 projected similar caries prevalence rates in FPMs.

Application of caries assessment spectrum and treatment instrument for staging and evaluating treatment needs of an adult population - A hospital based cross-sectional study.

Application of caries assessment spectrum and treatment (CAST) instrument for staging and evaluating treatment needs of an adult population suffering from dental carious lesion. Study was conducted with aim of applying CAST instrument for staging adult urban Indian population according to severity of carious lesion and treatment needs required. Cross-sectional descriptive study was conducted on 300 adult patients. After training session and calibration of examiner, all patients were examined for the caries experience and CAST codes were recorded on a structured proforma. Of 300 adult patients, 18% (54) adults have healthy dentition denoted by codes 0,1, and 2. 12 % and 15.3% adults were in reversible premorbidity stage (code 3) and morbidity stage (codes 4 and 5) respectively. The largest number of adults 29.7% were seen in serious morbidity stage (codes 6 and 7) followed by 21.3% adults in mortality stage (code 8) requiring either root canal treatment or extraction and replacement of teeth as treatment needs. CAST instrument has been found useful in staging adult population suffering with dental carious lesion and evaluating their treatment needs. Moreover, CAST is easy to apply for staging the carious lesion due its hierarchical structure and reporting results in an understandable manner.

Caries incidence of the first permanent molars according to the Caries Assessment Spectrum and Treatment (CAST) index and its determinants in children: a cohort study

BackgroundThere are limited information on caries incidence, especially from developing countries, the aim of the present study was to explore caries incidence in the first permanent molar teeth according to the CAST index in 7- to 8-year-old-children and its socio-demographic, oral health related and diet determinants.MethodsA multi-stage cluster random sample of 7–8 years old children was applied in Tehran, Iran. The oral examination using the CAST index and the Oral Hygiene Index-Simplified (OHI-S) performed by trained dentists in 2017 and 2019 calibrated with an expert (Kappa of 0.89 and 0.76, respectively). A 3-day food record was used to record sugary snacks consumption. Oral health related knowledge of the parents was assessed using a valid and reliable self-administered questionnaire. The data were analyzed using the SPSS software version 23.0 and descriptive and analytical statistics including the negative binomial regression was applied.ResultsTwo hundred and ninety schoolchildren aged 7–8 years old were followed up for two years. All of them had complete data obtained via oral examination and questionnaires. The annual caries incidence rate was 0.16 and 53% (95% CI 47.4–58.9) of the children developed at least one new dental caries (enamel or dentine) during two years. Multi-variate analysis revealed that the children of mothers with high school education or diploma (IRR = 1.47, 95% CI 1.02–2.12; p = 0.04) and those with low socio-economic status (IRR = 1.86, 95% CI 1.27–2.73; p < 0.001) were more likely to develop caries. There was no significant association between gender, father’s educational level, child birth order, housing area per person, OHI-S score, oral health knowledge of parents, and sugary snacks consumption per day and caries increment at an individual level.ConclusionThis 2-year longitudinal study on 7- to 8-year-old children showed that caries incidence according to the CAST index was associated with socio-economic status and mother education but not associated with having 2 or more sugary snack per day and oral hygiene status.

Prevalence of Dental Caries Among a Group of Egyptian Children Using Caries Assessment Spectrum and Treatment Index:A Cross Sectional Study

Background: No studies were found on a caries pattern using Caries Assessment Spectrum and Treatment (CAST) index in the literature in Egypt. The aim of this study was to evaluate caries using CAST index in primary dentition in a group of Egyptian children.Methods: A total of 201 children with age range from three to six years old were selected from outpatients’ clinic of two educational universities. A specially designed assessment chart was filled for each patient using caries assessment spectrum and treatment index. Categorical data were analyzed utilizing fisher exact test. p values were adjusted (p-value > 0.05 is considered significant) for multiple comparisons using benforroni correction. Results: Among total 201 children, 70% of the children had healthy primary teeth (code 0-2), 18.7% of the children had non cavitated dentine with visual changes in enamel and discoloration in dentine with code (3-4), 6.4% had cavitated dentin with intact pulp chamber (code 5), 0.6% had cavitated dentin involved pulp chamber (code 6), 1.5% had pus containing swelling (code 7) and 2.8% of the children had lost their teeth due to caries (code 8). No teeth were scored with code 9.Conclusion: The study proved the usefulness of the CAST index in epidemiological surveys. Based on the results of the current study, CAST index can be suggested to be used as an alternative to DMFT index due to its’ accuracy in scoring the entire spectrum of dental caries and its’ reliability.

Dental caries spectrum profile in Brazilian public school children and adolescents

Dental caries remains a major public health problem, with a higher prevalence among in adolescence. The present study aimed to assess the dental caries spectrum profile in children and adolescents in Brazilian public schools. A cross-sectional study was performed in two public schools in Brazil to examine the permanent teeth of children and adolescents. The dental caries were assessed by applying the Caries Assessment Spectrum and Treatment (CAST) instrument, and the results were distributed as per disease status (healthy/codes 0-2; pre-morbidity/code 3; morbidity/code 4-5; severe morbidity/codes 6-7; mortality/code 8) and by severity as per the CAST-F1 formula (no severity, mild, moderate, and severe). The CAST data were described by age groups (8-9 y, 10-11 y, 12-13 y, 14-15 y, 16-17 y, and 18-19 y). The Kruskal-Wallis test was used to investigate differences in CAST prevalence and severity among the groups (p < 0.05). Total 598 students were enrolled. Most of the subjects were male (53.34%) and belonged to the age group of 12-13 y (34.95%). The variables CAST 0/1 (p = 0.024), CAST (p = 0.024), and CAST-F1 (p = 0.029) showed significant differences among age groups, and the post hoc test showed the differences in these variables as per the age groups of 14-15 y and 16-17 y (CAST 0/1, p = 0.047; CAST, p = 0.047; CAST-F1, p = 0.033). The dental caries spectrum increased from 8 to 19 y with a peak in the prevalence and severity in the middle of adolescence.

Discriminant validity of the CAST instrument compared to the dmf index in the deciduous dentition: a cross sectional study.

This study aimed to assess the discriminant validity of the Caries Assessment Spectrum and Treatment (CAST) at different thresholds, compared with the Decayed, Missing, and Filled Teeth Index (dmf) instrument, to discriminate caries risk factors. A cross-sectional study was conducted including children aged 2-5 years from preschools in Southern Brazil. Parents answered a questionnaire, and children were clinically examined using the CAST instrument and, in the following weeks, using the dmf index. Two caries thresholds were adopted for CAST: caries in dentin (CAST4-7/CAST2,4-8) and enamel caries (CAST3-7/CAST2-8). Poisson regression was used in the analysis (p < 0.05). A total of 200 children were included. The prevalence of caries was 47.0% with dmf, 42.5% with CAST4-7, and 77.5% with CAST3-7. When the outcome was caries prevalence, CAST4-7 discriminated between sexes, household crowding, and dental pain, and CAST3-7 discriminated age and family income, while the dmf was associated with dental pain. When experience of caries was the outcome, all the criteria discriminated between sexes, age, family income, household overcrowding, visible dental plaque, and dental pain, while dmf and CAST2-8 also discriminated maternal schooling. The CAST discriminated caries risk factors similar to the dmf index when caries experience was the outcome. When prevalence was considered, CAST was able to discriminate for more individual characteristics than dmf.

Delivering dental health promotion in developing countries: should this be carried out by non-dental professionals?

Design Three-armed randomised clinical trial.Study selection The study's aim was to examine the effectiveness of providing oral health promotion, prevention and a restorative programme at mother and child health clinics (MCHs) through a multidisciplinary team. This was studied by collecting data on the participants' caries rates. The study sample consisted of 368 Peruvian children, aged 0-3 years, who were from low socioeconomic areas of Peru and were studied over three different MCHs. The interventions used in this study are split into active intervention group (AG), passive intervention group (PG) and control group (CG). The AG group had multiple interventions, such as multiple training courses for nurses on dental health, oral health-related information cards (OHICs) and atraumatic restorative treatment (ART)-trained dentists. The PG implemented OHICs and ART-trained dentists, and the CG nurses received a 45-minute lecture on the importance of oral health and regular protocols followed.Data analysis/data extraction and synthesis Caries Assessment Spectrum and Treatment (CAST) scores were used to measure the participants' caries rates. The CAST scores were collected over a three-year period by two calibrated and trained dentists. The CAST scores ranged from 0 (no caries) to 8 (loss of tooth due to caries), although the authors only collected data from scores 3-8 as this was indicating disease presence.Results The results were gathered for each arm of the study and compared using analysis of variance. The results showed that it was statistically significant (P <0.001) that the AG group had a lower rate of carious dentine compared to the PG and CG groups. The percentage of carious dentine prevalence was 10%, 60.5% and 63.0%, respectively.Conclusion The conclusion of the paper is that using a multidisciplinary approach - with trained nurses, delivery of oral health inspection and advice - can reduce the rate of caries in 0-3-year-olds.

Assessment of dental caries using caries assessment spectrum and treatment index in children of age 5-10 years

Introduction: Dental caries is the most prevalent disease of oral health in school-aged children around the world. Although different caries detection/diagnosis criteria are available, none of them includes the total spectrum of dental caries (which ranges from a sound tooth to tooth loss due to caries) other than caries assessment spectrum and treatment (CAST) Index. CAST index covers the total dental caries spectrum from no carious lesion through caries protection (sealant) and caries cure (restoration) to carious lesions in enamel and dentin, and the advanced stages of carious lesion progression in pulp and tooth surrounding tissue. Methodology: A cross-sectional study was conducted among children of age 5–10 years to detect the prevalence of dental caries using CAST index in Panchayat Union Primary School in Sundharipalayam and Koot-road (east), Villupuram. A total of 100 samples were selected based on inclusion criteria. Results: Only 33% had sound dentition, 0% had sealant and restoration, presence of caries in enamel and/or dentine ranged from 9% to 33%. Pulpal involvement was observed in 13% and abscess/fistula was present in 7% of participants in at least one tooth. 5% had lost at least one tooth due to caries. Conclusion: CAST index has been found useful in epidemiological surveys, especially in recording early carious lesions. Developers of the CAST index should throw more light on the treatment needs part of the index as well as how each code of this index can be utilized in controlling dental caries in a community.

Impact of dental treatment on the oral health-related quality of life of Brazilian schoolchildren.

This before-after experimental study evaluated the impact of dental treatment on the oral health-related quality of life (OHRQoL) in children aged 6-8 years from Paranoá, DF, considering the presence or absence of cavitated dentin carious lesions pre- and post-treatment. The responsiveness and sensitivity of the questionnaires were also investigated. Caries was detected by using the Caries Assessment Spectrum and Treatment (CAST) instrument, while the impact of oral health on the children's health-related quality of life was assessed using the Brazilian version of the Child Perceptions Questionnaire (CPQ8-10), which was completed by the children and the Brazilian version of the Early Childhood Oral Health Impact Scale (B-ECOHIS), which was completed by their parents. Sociodemographic characteristics were also assessed. After the examinations, the children were categorized into two groups according to the presence (treatment/n = 34) or absence (control/n = 34) of cavitated dentin carious lesions. Restorative/curative care was provided to the treatment group, while the control group received preventive measures. OHRQoL was assessed at baseline and at four weeks post-treatment. No significant sociodemographic differences were observed between the groups. In the treatment group, the children and their families reported a greater impact of oral health on their OHRQoL in both questionnaires (p < 0.05). However, there was a significant reduction in the impact of oral health, with differences between the pre-treatment and post-treatment phases (p = 0.001). Good sensitivity and responsiveness were observed for both questionnaires. Dental treatment was found to reduce the negative impact of dental caries on OHRQoL in 6-8-year-old children, which was detected by both questionnaires (B-ECOHIS and CPQ8-10).

Is there an association between dental caries, fluorosis, and molar-incisor hypomineralization?

Objective:This cross-sectional study aimed to determine the prevalence of dental caries, dental fluorosis, and molar-incisor hypomineralization, and their associations in a group of Brazilian schoolchildren.Methodology:Adolescents (n=411) were evaluated by two calibrated examiners for dental caries (DC), dental fluorosis (DF), and molar-incisor hypomineralization (MIH) using the CAST (Caries Assessment Spectrum and Treatment) instrument, Thylstrup and Fejerskov (TF) index, and MIH Severity Scoring System (MIH-SSS), respectively. Descriptive statistics, chi-square tests, and logistic regression were used for statistical analysis.Results:The sample comprised 42.75% boys and 57.25% girls. The prevalence of DC in permanent dentition was 94.75%, of which 29% were represented by dentin lesions. For DF, a prevalence of 40.75% was observed, with 69.32% mild, 12.88% moderate, and 17.79% severe. A positive association between the source of water and fluorosis was detected (p=0.01). The prevalence of MIH was 18%. Thirty adolescents (41.7%) presented with severe MIH. No association was found between DF or MIH and dentin DC or between MIH and DF at the individual level. However, a significant negative relationship was detected between DF and dentin carious lesions ( p <0.005) and DF and MIH ( p <0.00001) at the tooth level, whereas a positive association was observed between MIH and dentin carious lesions ( p <0.00001). A positive association was also observed between the severity of both conditions ( p <0.00001). Mild DF was the most prevalent problem observed. Cases of teeth with mild MIH were the most predominant in MIH-affected teeth.Conclusions:No association was observed among the dentin carious lesions, MIH, and DF at the participant level. However, a positive association between MIH and dentin carious lesions was found at the tooth level, whereas MIH, DF, and DF and dentin carious lesions showed a negative relationship.

Dental caries in three-year-old preschool children in Lima, Peru assessed according to the CAST instrument.

The aim of this study was to determine the caries situation of three-year-old preschool children residing in low socioeconomic status districts in Lima, Peru. The study is a crosssectional analysis of the caries situation of suburban areas of Lima. A stratified sampling procedure by geographical distribution, considering healthcare centers with a motherand- child health clinic and surrounding preschools as factors, identified 45 randomly selected preschools, of which 17 accepted to participate. Children from 3-year-old classrooms were examined by two independent calibrated dentists using the Caries Assessment Spectrum and Treatment (CAST) instrument at their premises using artificial light, sterile examination mirrors and gauze for drying each tooth before evaluation. ANOVA and the Tamhane method were used to analyze the data. 308 children, mean age 3.4 years (min: 3 years; max: 3 years, 7 months), were examined. The sample prevalence of enamel and dentine carious lesions (CAST code 3-7) was 91.2% while the prevalence of dentine carious lesions (CAST code 4-7) was 58.8%. The mean number of teeth with cavities that had reached the pulp and those that had an abscess or fistula were 2.0% and 0.5% respectively. The majority of enamel and dentine carious lesions were observed in molars. The CAST severity score was 7.0. Mean examination time was 57 seconds. The burden of dental caries of the children at this young age was high.

Severe Early Childhood Caries in IVF Children: An Observational Study with Comparative Evaluation

Context: Severe early childhood caries (S-ECC) is one of the major problems affecting the tooth structure in childhood before 71 months of age. It may affect both In vitro fertilization (IVF) and spontaneously conceived children. Aims: This study was aimed to evaluate, identify, and compare the prevalence of S-ECC in the deciduous dentition of IVF and spontaneously conceived children before 71 months of age. Settings and Design: In a cross-sectional, observational, case–control study, the S-ECC status of children aged 24–71 months was assessed. The studied case group comprised term, singleton babies who were the outcome of IVF in the studied area. The control group comprised term, first child, singleton, and spontaneously conceived 24–71-month-old children who were also resident of the studied area. A sample of 103 IVF and 162 spontaneously conceived children was examined utilizing Caries Assessment Spectrum and Treatment (CAST). Statistical Analysis Used: Statistical analysis was done using Chi-square tests (c2) or Z test. Results: A statistically significant difference was found in some aspects among the studied, i.e., IVF children, and control group, i.e., spontaneously conceived children. Conclusions: IVF children are considered better than spontaneously conceived children in some aspects when studied in relation to S-ECC status evaluated through CAST.

SOS Teeth: Age and Sex Differences in the Prevalence of First Priority Teeth among a National Representative Sample of Young and Middle-Aged Adults.

Background: “SOS teeth” are defined as the first priority teeth for treatment, that have distinct cavitation reaching the pulp chamber or only root fragments are present. Objectives: To assess the prevalence and distribution of SOS teeth with regard to age and sex difference among young to middle-aged adults. Methods: This is a cross-sectional records-based study of a nationally representative sample, consisting of young to middle-aged military personnel, who attended the military dental clinics of the Israel Defense Forces (IDF) for one year. SOS teeth definition corresponds to code number 6 of the “Caries Assessment Spectrum and Treatment (CAST)” as an instrument to assess dental caries. Data pertaining to age and sex were drawn from the central demographic database and that of SOS teeth were obtained from the Dental Patient Record (DPR). Results: The study included 132,529 dental records. The prevalence of patients with SOS teeth was 9.18 % (12,146/132,323). The number of teeth that were found to be SOS teeth was 18,300, i.e., 1.5 SOS teeth per “diseased” patient (18,300/12,146). The mean number of SOS teeth per the whole study population was 0.14 ± 0.52 and the range was 0–20. The mean number of SOS teeth per patient had a statistically significant negative correlation with age (p < 0.001; Odds Ratio (OR) = 0.997; 95% confidence interval: 0.997–0.998) and with male sex compared to females (p < 0.001; OR = 1.029 confidence interval: 1.023–1.036). Conclusion: Assessment of first priority SOS teeth may be part of the dentist’s work-up. It provides dentists and health authorities with useful information regarding urgent dental care needs to plan dental services.