Caries Assessment Research Articles

Riboflavin (Vitamin B2), Turmeric (Curcumin) Photosensitizers Mediated Photodynamic Therapy, and Er, Cr: YSGG on Microleakage of Class V Cavities Restored by Resin-Modified Glass-Ionomer Cement

Purpose: The present study aimed to assess the effect of RF and CP intervened PDT and Er, Cr: YSGG laser on microleakage in class V RMGIC restorations in permanent teeth. Materials and Methods: In-vitro eighty standardized class V cavities (4×4×2) were prepared in extracted permanent molars based on ICDAS II (International Caries Detection and Assessment System II) caries severity code 0. All samples were arbitrarily alienated into four groups: Group 1, PDT mediated riboflavin photosensitizer (RF) [concentration of 150 μg/mL]; Group 2, PDT with curcumin photosensitizer (CP) [concentration of 100 μg/mL]; Group 3, Er, Cr: YSGG laser application; Group 4, control group: rinsed and dried dentin. Cavities were restored with conventional RMGIC. The specimens were immersed in 0.5% Fuchsine solution for 24 hrs. and sectioned. Microleakage scores were assessed under a microscope. Intergroup and intragroup comparisons were made at enamel and cementum margin respectively. Data were analyzed by non-parametric Kruskal-Wallis test and Wilcoxon tests at the level of significance deemed p < 0.05. Results: Riboflavin and curcuminmediated PDT would produce a superior reduction (95% viz 90%) of microleakage as compared to Er, Cr: YSGG laser (85%), and no control groups. Cu-PDT observed the highest amount of microleakage with the least amount of microleakage in the control group. Conclusion: Riboflavin and curcumin photosensitizers mediated PDT and Er, Cr: YSGG laser has the potential to be utilized in class V cavities before RMGIC restorations at enamel margins without adversely affecting the marginal integrity.

The prevalence of caries in the primary dentition and associated factors in children in the city of Parnaíba-Piauí

Aim: To evaluate the prevalence of caries in primary dentition in preschoolers in Parnaíba, Brazil and identify associated factors. Material and Methods: The sample studies were children in primary dentition aged between two and six years. Both the children and their parents or guardians agreed to the child’s participation in the study. Those preschoolers with syndromes or special needs, those who did not tolerate the dental examination and those with a fixed orthodontic appliance were excluded. The questionnaire was completed by a parent or guardian of each child and the 360 children’s teeth were examined, using the International Caries Detection and Assessment System (ICDAS). The data were dichotomized as presence of cavity related to caries - caries free and non-cavitated lesions (ICDAS 0, 1 and 2) and cavitated lesions (ICDAS ≥3).The presence of early childhood caries was determined and cavitation of the carious process was evaluated. Indications for necessary extraction of any primary teeth due to the carious process were noted. Results: The prevalence of caries in our sample of two to five-year-old children was 43.3% (p<0.05), with no significant difference between ages or genders. The majority of children (84.6%) presented with caries in two or more teeth. Only 15.38% of these children had caries in a single tooth. The most commonly affected tooth was number 75, followed by teeth 55, 54 and 84. The prevalence of caries in preschoolers was found to be correlated with low socioeconomic status and poor quality of life. Conclusion: The prevalence of caries in preschool children was 43.3%. Several factors were associated with dental caries in primary dentition. Children with caries were unlikely to use dental floss or brush their tongues, were only taken for dental treatment when they experienced oral pain and had parents who did not consider brushing teeth after a meal to be important.

Socioeconomic inequalities related to maternal perception of children's oral health at age 4: Results of a birth cohort.

To estimate socioeconomic inequalities in the maternal perception of children's oral health from a birth cohort study in Brazil. The data from this study were collected through perinatal interviews and at the 48-month follow-up from the 2015 Pelotas Birth Cohort Study. The main outcome was the maternal perception of children's oral health, dichotomized into positive (good/very good) and negative (fair/bad/very bad). The secondary outcome was untreated dental caries (absence and presence, according to the ICDAS index - International Caries Detection and Assessment System). For the statistical analysis, the absolute inequality index (Slope Index of Inequality - SII) and the relative concentration index (Concentration Index - CIX) were used. Analyses were stratified by maternal educational level, family income and wealth index. The prevalence of outcomes was 19.4% (95% CI 18.2; 20.7) for the negative maternal perception of children's oral health and 15.6% (95% CI 14.4; 16.8) for untreated dental caries. Socioeconomics inequalities were observed in negative maternal perception of children's oral health in both absolute and relative terms. A SII of -16.6 (95% CI -20.8; -12.5) was observed for family income, with higher prevalence in poor families. A higher prevalence of the negative maternal perception of children's oral health was observed in mothers without any educational level or a few years of study (CIX -21.1 [95% CI -24.5; -17.7]). This study demonstrates socioeconomics disparities in the maternal perception of children's oral health and in the prevalence of untreated caries in children. A higher concentration of negative maternal perception of children's oral health was identified among the most socioeconomically vulnerable individuals. The findings reinforce the presence of socioeconomic inequalities in subjective measures about children's oral health.

Risk prediction models for erosive wear in preschool-aged children: a prospective study

BackgroundDespite increasing prevalence, age-specific risk predictive models for erosive tooth wear in preschool-age children have not been developed. Identification of at-risk groups and the timely introduction of behavioural change or treatment will stop the progression of erosive wear in the permanent dentition. This study aimed to identify age-specific risk factors for erosive wear. Distinct risk prediction models for 3-year-old and 5-year-old children were developed.MethodsA prospective cohort study included school-based clinical examinations and parent administered questionnaires for consented 3 and 5-year-old healthy children. Calibrated examiners measured the following health parameters under standardised conditions: erosion, using the Basic Erosive Wear Examination Index (BEWE), caries using the International Caries Detection and Assessment System (ICDAS), plaque and calculus according to the British Association for the Study of Community Dentistry (BASCD) scores, dental traumatic injuries and soft tissue lesions, salivary testing and BMI. Other health conditions were collected via a parent-administered questionnaire that explored oral- and general-health. Non parametric tests were utilised to explore the temporal relation of erosion with, demographic factors, oral hygiene habits, general health and dietary habits. Variables showing significance with a difference in BEWE cumulative score over time were utilised to develop two risk prediction models. The models were evaluated by Receiver Operating Characteristics analysis.ResultsRisk factors for the 3-year-old cohort (N = 336) included erosive wear (χ2(1, 92) = 12.829, p < 0.001), district (χ2(5, 92) = 17.032, p = 0.004) and family size (χ2(1, 92) = 4.547, p = 0.033). Risk factors for the 5-year-old cohort (N = 441) also included erosive wear (χ2(1, 144) = 4.768, p = 0.029), gender (χ2(1, 144) = 19.399, p < 0.001), consumption of iced tea (χ2(1, 144) = 8.872, p = 0.003) and dry mouth (χ2(1, 144) = 9.598, p = 0.002).ConclusionsPredictive risk factors for 3-year-old children are based on demographic factors and are distinct from those for 5-year-old children based on biological and behavioural factors. Erosive wear is a risk factor for further wear in both age cohorts.

Application of fluoride disturbs plaque microecology and promotes remineralization of enamel initial caries

ABSTRACT Background The caries-preventive effect of topical fluoride application has been corroborated by a number of clinical studies. However, the effect of fluoride on oral microecology remains unclear. Objective To monitor the effect of fluoride on dental plaque microecology and demineralization/remineralization balance of enamel initial caries. Methods Three-year-old children were enrolled and treated with fluoride at baseline and 6 months. International Caries Detection and Assessment System II indices of 52 subjects were measured at baseline, 3, 6, and 12 months. Supragingival plaque samples of 12 subjects were collected at baseline, 3 and 14 days for 16S rRNA sequencing. Results Changes in microbial community structure were observed at 3 days after fluoridation. Significant changes in the relative abundance of microorganisms were observed after fluoride application, especially Capnocytophaga, unidentified Prevotellaceae and Rothia. Functional prediction revealed that cell movement, carbohydrate and energy metabolism were affected significantly after fluoride application. Fluoride significantly inhibited enamel demineralization and promoted remineralization of early demineralized caries enamel at 3 months. Conclusion Fluoride application significantly inhibited the progression of enamel initial caries and reversed the demineralization process, possibly by disturbing dental plaque microecology and modulating the physicochemical action of demineralization/remineralization. This deepened our understanding of caries-preventive effects and mechanisms of fluoride.

Sealant Penetration into Occlusal Fissures: An In-Vitro Optical Coherence Tomography Study

Objective: This study was designed to use Optical Coherence Tomography (OCT) to quantify depth of occlusal fissures on premolar teeth and to quantitatively evaluate the penetration of pit and fissures sealants relative to fissure depth. The study aimed to evaluate the penetrability of Pit and Fissure Sealant (PFS) in covering the full-depth of different occlusal fissure depths using Swept-Source Optical Coherence Tomography (SS-OCT). Methods: Ninety-seven investigation sites on f occlusal fissures of fifteen premolar teeth with International Caries Detection and Assessment System (ICDAS) scores of 01 or 02 were categorized using SS-OCT into four groups (smooth, shallow, intermediate, and deep fissures). After PFS placement, cross-sectional images of these fissures were observed again with SS-OCT. Results: The result of this study shows that PFS can fully penetrate the smooth fissures (100%) followed by shallow fissures (94.2%) and intermediate fissures (47.6%). Incomplete full depth PFS penetration can be seen in all deep fissures (100%). Conclusion: The depth of the fissure will largely affect the penetrability of PFS into the fissure.

Management Thresholds for Molars With Occlusal Noncavitated Caries Lesions

AimThere is sparse research on the effect of factors related to the dentist and patient in the caries management decision-making process. This in vitro study explored the influence of factors related to dentists and patients on the management decision of occlusal noncavitated caries lesions in children. Materials and methodsFive investigators in the specialties of dental public health (DPH), paediatric, prosthetic, and operative dentistry and a general dentist (GDP) participated in this study. Initially, the investigators were asked to independently assess the occlusal surfaces of 175 noncavitated permanent molars and choose a management recommendation using 2 caries risk patients’ scenarios. After 1 month, investigators were trained and calibrated to use the International Caries Detection and Assessment System (ICDAS) scoring system. Then, they examined the same teeth, recorded the highest/worst ICDAS score, and chose a management recommendation. Two weeks later, the investigators repeated the teeth examination using magnification loupes and again chose a management recommendation. The teeth were sectioned to study the relationship between the presence of caries and the management recommendations. ResultsFor the low– and the high–caries risk scenarios, ICDAS training increased the operative intervention by 20% to 27% and 14% to 22%, respectively, for both the GDP and the paediatric dentist (P < .0001). For the low–caries risk scenario, using the magnifying loupes increased the operative recommendations for the DPH, GDP, and the operative dentist by 5% to 23% (P < .05). Compared to the low–caries risk scenario, teeth for patients with high caries risk received more surgical interventions (9%-30%) at all examination conditions for the GDP and the paediatric and operative dentists (P < .0001). ConclusionsFor occlusal noncavitated caries lesions, enhancing dentists’ caries detection skills had a significant impact on decisions of surgical intervention. This also influenced the appropriateness of the treatment recommended for the different caries risk groups.

Inequalities in caries among pre-school Italian children with different background

BackgroundThe 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.MethodsThe ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.8% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) was 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, children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic and logistic regression) were used to elucidate the associations between all explanatory variables and caries prevalence.ResultsOverall, 54.4% (95%CI 46.7–58.3%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.6% vs 41.6% p < 0.01) and to the area of living (p = 0.03). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z = 5.24, p < 0.01). Children in the highest household income group had lower levels of caries. In multivariate analysis, Immigrant status, the highest parents’ occupational and educational level, only one kid in the family, living in the North-Western Italian area and a high household income, were statistically significant associated (p = 0.01) to caries prevalence. The social gradient was statistically significant associated (p < 0.01) to the different caries levels and experience in children with European background.ConclusionsData show how caries in preschool children is an unsolved public health problem especially in those with a non-European background.

Differentiation of Occlusal Discolorations and Carious Lesions with Hyperspectral Imaging In Vitro

Stains and stained incipient lesions can be challenging to differentiate with established clinical tools. New diagnostic techniques are required for improved distinction to enable early noninvasive treatment. This in vitro study evaluates the performance of artificial intelligence (AI)-based classification of hyperspectral imaging data for early occlusal lesion detection and differentiation from stains. Sixty-five extracted permanent human maxillary and mandibular bicuspids and molars (International Caries Detection and Assessment System [ICDAS] II 0–4) were imaged with a hyperspectral camera (Diaspective Vision TIVITA® Tissue, Diaspective Vision, Pepelow, Germany) at a distance of 350 mm, acquiring spatial and spectral information in the wavelength range 505–1000 nm; 650 fissural spectra were used to train classification algorithms (models) for automated distinction between stained but sound enamel and stained lesions. Stratified 10-fold cross-validation was used. The model with the highest classification performance, a fine k-nearest neighbor classification algorithm, was used to classify five additional tooth fissural areas. Polarization microscopy of ground sections served as reference. Compared to stained lesions, stained intact enamel showed higher reflectance in the wavelength range 525–710 nm but lower reflectance in the wavelength range 710–1000 nm. A fine k-nearest neighbor classification algorithm achieved the highest performance with a Matthews correlation coefficient (MCC) of 0.75, a sensitivity of 0.95 and a specificity of 0.80 when distinguishing between intact stained and stained lesion spectra. The superposition of color-coded classification results on further tooth occlusal projections enabled qualitative assessment of the entire fissure’s enamel health. AI-based evaluation of hyperspectral images is highly promising as a complementary method to visual and radiographic examination for early occlusal lesion detection.

Lesion activity assessment of early caries using dye-enhanced quantitative light-induced fluorescence

We aimed to determine whether dye-enhanced quantitative light-induced fluorescence (DEQLF), wherein porous structure of caries lesions is stained with a fluorescent dye, could quantitatively distinguish between active and inactive caries. A total of 126 bovine specimens were prepared to artificially simulate caries activity. Active caries were demineralized with 1% carbopol solution for 3 (A3), 5 (A5), and 10 days (A10). For inactive caries, half specimens in each group were remineralized with 2% NaF and reallocated into three groups (I3, I5, and I10, respectively). Wet specimens were dried with compressed air for 10 s and then dyed with 100-µM sodium fluorescein for 10 s. Fluorescence images of speicmens were captured with a QLF-digital 2 + Biluminator. Fluorescence intensity (ΔG) was measured in fluorescence images of dyed specimens. ΔG between active and inactive groups was compared using independent t-test, and ΔG among active groups (or inactive groups) were compared using ANOVA (α = 0.05). ΔG in the active groups was 33.7–59.0 higher than that in the inactive groups (P < 0.001). Except between I3 and I5, there was significant differences in ΔG according to the demineralization period (P < 0.001). DEQLF might be used to evaluate early caries activity, and longitudinally monitor changes in lesion activity.

Дослідження активності каріозного процесу у осіб різного віку, за допомогою індексної оцінки КПВ та ICDAS

The purpose of the work was to study the activity of the carious process in people of different ages using the assessment of the Decayed, Missing, and Filled Teeth and the International Caries Detection and Assessment System index. Materials and methods. The study involved 53 people who were divided into groups: group 1 – 16 people aged 18 to 25 years, group 2 – 20 people aged 26 to 35 years and group 3 – 17 people aged 36 to 45 years. The intensity of caries was determined using the Decayed, Missing, and Filled Teeth index. The International Caries Detection and Assessment System index was used to assess the activity of carious lesions. Results. The indicators of the Decayed, Missing, and Filled Teeth index in the group of people aged 18-25 years significantly differed (p &lt;0.05) from the indicators in the group of people aged 26-45 years. In the group of people aged 36-45 years the indicators were higher than in the group of people aged 26-45 years, but no significant difference (p˃0.05) was found. In the group of people aged 18-25 years the share of filled teeth was 61.5%, teeth affected by caries were found in 29.4%, and removed teeth – in 9.1%. In the group of people aged 26-45 years, the rate of filled teeth was lower compared to people of the 1st group, the share of carious teeth increased up to 35.0%, and the number of removed teeth increased up to 16.4%. In the group of people aged 36-45 years the share of teeth affected by caries was lower than in the 1st and 2nd groups and was equal to 27.3%, the share of filled teeth was 46.2%, which is lower than in other groups, but the share of removed teeth was the highest of the groups which were examined and was 26.5%. The results indicate a rapid increase in the intensity of caries in patients of main working age, namely persons of the 2nd and 3rd groups compared with persons of young working age of the 1st group. The study of the depth of caries in enamel and dentin according to the International Caries Detection and Assessment System showed that in patients aged 18-25 years, from all teeth which are affected by caries in 71.4% enamel caries was found, which averaged 1.81 ± 0.2 teeth and in 28.6% – dentin lesions, which was an average of 0.68 ± 0.2. In patients aged 26-35 years, codes 1-3 accounted for 41.0% of affected teeth (mean 2.05 ± 0.1 teeth) and code 4-6 accounted for 59.0% of affected teeth (average 2.95 ± 0.2 teeth). In patients of the oldest age group, the number of teeth affected by caries with a code of 1-3 was 27.9% (average of 1.12 ± 0.1 teeth) and with a code of 4-6 was 72.1% (average of 2.88 ± 0.2 teeth). Conclusion. As the age of patients increases, the proportion of filled teeth decreases, but the proportion of removed teeth increases. The highest percentage of teeth affected by caries was found in the 3rd group. As the age of patients increases, both the average number of carious teeth and the number of teeth with damage dentin increase

Orofacial dysfunction, nonnutritive sucking habits, and dental caries influence malocclusion in children aged 8-10 years

Malocclusion is one of the most prevalent oral health problems and can affect self-esteem, social relations, and oral health-related quality of life. The present study aimed to evaluate associations between malocclusion and orofacial dysfunction, nonnutritive sucking habits, cavitated carious lesions, and anxiety in Brazilian children. An analytical cross-sectional study was conducted with a representative sample of 739 children aged 8-10 years. Parents or guardians provided sociodemographic data and information on the nonnutritive sucking habits of the children. The children answered the Revised Children's Manifest Anxiety Scale. Four trained examiners examined the children for the diagnosis of malocclusion (dental aesthetic index), dental caries (International Caries Detection and Assessment System), and orofacial dysfunction (Nordic Orofacial Test-Screening). The control variables were selected using a directed acyclic graph. Descriptive statistics were performed, followed by unadjusted and adjusted robust logistic regression analysis (P<0.05). The following variables remained associated with the occurrence of malocclusion in the final model: nonnutritive sucking habits (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.25-4.08), orofacial dysfunction (OR, 1.56; 95% CI, 1.13-2.17), and cavitated carious lesion (OR, 1.39; 95% CI, 1.03-1.89). Nonnutritive sucking habits, orofacial dysfunction, and cavitated carious lesions were associated with the presence of malocclusion in children aged 8-10 years.

Caries assessment in Egyptian adolescents concerning some epidemiological factors

Caries assessment in Egyptian adolescents concerning some epidemiological factors

Interfacial Bond Strength and Morphology of Sound and Caries-affected Dentin Surfaces Bonded to Two Resin-modified Glass Ionomer Cements.

To evaluate the shear bond strength and interfacial morphology of sound and caries-affected dentin (CAD) bonded to two resin-modified glass ionomer cements (RMGICs) after 24 hours and two months of storage in simulated body fluid at 37°C. Sixty-four permanent human mandibular first molars (32 sound and 32 with occlusal caries, following the International Caries Detection and Assessment System) were selected. Each prepared substrate (sound and CAD) was conditioned (10% polyacrylic acid) and bonded to Activa BioACTIVE Restorative (Activa) and Fuji II LC (F2LC) as per the manufacturers' instructions. Shear bond strength (SBS) was performed after 24 hours and two months of storage. The interfacial surfaces were examined using a digital microscope and scanning electron microscope (SEM). Three-way ANOVA, Bonferroni post-hoc tests (α=0.05), and independent T-tests were used for multifactorial analysis. Activa exhibited reduced bond strength values to sound and CAD in comparison to F2LC after two time periods (p=0.01). There is a pronounced enhancement in SBS of F2LC when bonded to CAD (p=0.01) after storage, with no statistically significant effect on sound dentin (p=0.309). Activa showed stable SBS to sound and CAD immediately and post-aging (p>0.05). However, the evidence of mineral-like deposits under an SEM attached to the aged, debonded dentin surfaces, thereby obliterating the exposed dentinal tubules, might support the tissue repair potential of Activa. The SBS of Activa was lower than F2LC when bonded to sound and CAD, but the bonding stability and sealing ability is advantageous in minimally invasive therapy, suggesting use with a resin composite coverage when used in stress-bearing areas.

Early Prediction of Dental Caries using Hormonal Fingerprint in 6-12 Years Old Children: A Cross-sectional Study.

BackgroundThe ratio between second and fourth digit lengths (2D:4D ratio) is termed as hormonal fingerprint. Second and fourth digit lengths ratio is used as a biological marker for predicting and diagnosis of many metabolic disorders mainly coronary heart disease and autism, whereas, in dentistry, this method is still in blooming stage. The aim of the study was to assess the relationship between the new biological marker–hormonal fingerprints in the early detection of caries in children.MethodologyA total of 250 children were randomly selected from both sexes of the age group 6–16 years. Caries assessment was done using standard mouth mirrors and community periodontal index probes. Caries status (deft and DMFT) was recorded and subjects with a total DMFT/deft score of >5 were considered to have a high caries rate. The hormonal fingerprint was made by measuring the length ratio of the index and ring finger with the help of vernier caliper. The entire study population was divided into children with 2D:4D ratio less than 1 and ≥1 based on the calculations of 2D:4D.ResultsThe results showed that 79.67% males and 29.92% females have 2D:4D ratio <1 and 70.07% females and 20.32% males have 2D:4D ≥1. There is negative correlation between caries incidence and 2D:4D ratio. Children with low 2D:4D ratio have high caries index (54.4%) and high 2D:4D ratio have low caries index (45.6%), which is statistically significant.ConclusionThe study confirms a positive correlation between low 2D:4D ratio and high caries, which could be used as an early biological predictor of dental caries.How to cite this articleBeegum F, Khan N, George S, et al. Early Prediction of Dental Caries using Hormonal Fingerprint in 6–12 Years Old Children: A Cross-sectional Study. Int J Clin Pediatr Dent 2022;15(3):247-250.

Oral health profile status and treatment needs in the Salvadoran elderly population: a cross-sectional study

IntroductionOlder adults are a highly vulnerable group in their general health condition, including oral health that can be influenced by different factors, among them, changes in oral tissues inherent to the physiological processes of aging and by systemic condition. In El Salvador, it is a group that has received little attention at the public health level.ObjectiveTo determine the profile of the oral health status and treatment needs of the elderly population in El Salvador.Materials and methodsSecondary cross-sectional analysis of data from the last oral health survey in 471 Salvadorans aged 60 years and older. The variables under study were: sociodemographics, brushing frequency, oral hygiene according to simplified oral hygiene index (OHI-S), caries experience according to decayed, missing, and filled teeth index (DMFT) modified with international caries detection and assessment system (ICDAS) criteria, periodontal status through the community periodontal index of treatment needs (CPITN), edentulism and treatment needs. Statistical analysis was conducted using chi-square test, ANOVA, z-test and linear regression (p < 0.05).ResultsThe older adults presented poor oral hygiene, low brushing frequency, high tooth loss with an average of 16 missing teeth while one third presented total edentulism. Most of the older adults were categorized as having "poor or very Poor" oral hygiene. Almost all respondents presented some degree of periodontal disease and required restorative intervention.ConclusionThe oral health status of elderly Salvadoran is poor. Furthermore, the development of public policies and specific oral health strategies aimed at this population is urgent.

Dental Caries, Oral Health Behavior, and Living Conditions in 6-8-Year-Old Romanian School Children.

Dental caries still have a high prevalence in Romania. The aim of this paper is to determine the prevalence of caries in children (aged 6 to 8 years) correlated with individual-level predictors and socio-economic variables. A stratified, randomized nationally representative sample was established, taking into consideration the total number of preschool children and based on administrative units and residence. Self-assessment was performed by means of the Oral Health Questionnaire for Children (WHO). Examinations were conducted by 10 standardized examiners, with International Caries Detection and Assessment System (ICDAS) caries codes higher than 3 considered as dentinal caries, missing teeth as MT, and restorations as FT. DMFT and SiC indexes were calculated accordingly. The dataset for each outcome variable was analyzed by the Hurdle approach analyzed. The gender distribution was similar (47.22% male and 52.78% female), with 42.65% residing in rural areas. The mean DMFT value for the sample was 4.89 and SiC index 9.83. A negative association could be seen between DMFT and the father’s level of education (β = −0.33, SE = 0.07, p < 0.01) as well as the mother’s education (β = −0.25, SE = 0.07, p < 0.01). In conclusion, caries prevalence is very high in Romania as compared to the World Health Organization (WHO) recommendation for this age group in correlation with socio-economic factors and oral health behavior.

Prevalence of Caries According to the ICDAS II in Children from 6 and 12 Years of Age from Southern Ecuadorian Regions.

In Ecuador, national data on dental caries are scarce and the detection of incipient enamel lesions has been omitted. The objective of this study was to determine the prevalence of caries in school children aged 6 and 12 years of both sexes, belonging to urban and rural areas of three provinces of the country, using the International Caries Detection and Assessment System (ICDAS II). The sample consisted of 665 children from public schools, examined according to ICDASII. Caries prevalence and caries index were established using ICDAS II 2-6/C-G and ICDAS II 4-6/E-G criteria for comparison with WHO indicators. The Mann–Whitney U statistical test was used for comparison of two groups, the effect size was measured with the correlation coefficient. and the Kruskal–Wallis H test (p < 0.05) for multiple comparisons. Caries prevalence exceeded 87% for primary and permanent dentition. There were no significant differences according to province (p ≤ 0.05). The caries index at 6 years was 6.57 and at 12 years 9.21. The SIC was high at 12 years in rural areas. The prevalence of caries in the population studied was high despite the preventive measures established by health agencies.

Unmet need in Sierra Leone: a national oral health survey of schoolchildren

ObjectiveSierra Leone (SL), in West Africa, with a population of over 7.5 million people has suffered the effects of a civil war previously, and more recently Ebola & Covid-19. Dental care is very limited, mostly in the capital Freetown and the private sector. No dental education is available in the country. The objective of this research was to investigate the oral health needs of schoolchildren at key ages, to inform future action.Materials and methodsThis first national oral health survey of schoolchildren at 6-, 12- and 15-years was conducted in urban and rural settings across all four regions using a multi-stage cluster sampling in line with the WHO guidelines, adapted according to contemporary survey methods to include ‘International Caries Detection and Assessment System (ICDAS)’. Whilst parents were invited to complete a questionnaire for 6-year-old children, 12- and 15-year-olds self-completed a questionnaire. Data were weighted according to age and regional population and analysed using STATA v.15 and SPSS v.22.ResultsA total of 1174 children participated across 22 schools from all four regions. Dental caries was prevalent (over 80% of all age-groups having clinical decay; ICDAS score ≥ 2) and largely untreated. No children had fillings and only 4% had missing teeth. Amongst 6, 12 and 15-year-olds, average decay levels at ICDAS > 3 threshold was 3.47 (primary teeth), 2.94 and 4.30 respectively. Almost, 10% (n = 119) of all children reported experiencing pain in their teeth with 7% (n = 86) children having PUFA lesions present. At least one in five children required one or more dental extractions. ‘Age’ was a significant predictor of dental caries experience and the odds of having dental caries experience was higher in rural areas at D3–6MFT (p < 0.05).ConclusionThe findings demonstrate a vast unmet oral health need in the children of SL. Using ICDAS as an epidemiological tool in a low-income country provides valuable insight to the pattern of oral disease to inform health service planning. Urgent action is required to address this silent epidemic.

Dietary Factors Influencing the Caries Status of Adults in Karachi, Pakistan: Initial Findings.

Objective: The objective was to identify the relationship between the dietary factors related to increases in the number of dental caries among an adult population group. Methods: A cross-sectional study was conducted involving adult patients and their accompanying person, aged 18 years and above (n = 1730) visiting the dental outpatient department (OPD) of a public sector tertiary healthcare institute in Karachi, Pakistan. A 39-item Food Frequency Questionnaire (FFQ) was administered to the patients, followed by a dental caries assessment using Radke’s WHO criteria. Caries assessment data were transformed into the DMFT Index (D = decayed, M = missing, F = filled teeth). Factor analysis (FA) was performed using Stata v. 11.0, followed by assessing the internal consistency of the FFQ. Multilogistic analysis was performed to explore the association between dental caries (cut-off = 5) and other independent variables, considering a p-value < 0.05 as significant. Results: The mean age of participants in the group was 32.65 ± 10.49 years. The number of female participants (934; 54%) was higher than male participants (796; 46%). Of the total, 951 (52%) participants were married. The internal consistency value for the FFQ, as measured by Cronbach’s alpha, was 0.80. In addition to age and gender, out of four dietary patterns, only “cereals” were found to be significantly (p < 0.05) associated with increased DMFT. Conclusion: This study established that the high intake of cereals is a contributory factor to the high prevalence of dental caries among adults.