Child Dental Research Articles

Correlation of Parental and Child Dental Plaque Levels: A Clinical Study

Objective: This clinical study aimed to explore the correlation between dental plaque levels in parents and their children. Specifically, the study examined differences in plaque correlation between mother–child and father–child pairs and evaluated the role of parental education in influencing children’s oral hygiene practices. Materials and Methods: A total of 196 subjects were recruited, comprising 49 mother–child and 49 father–child pairs, with children aged 6 to 15 years. Dental plaque was assessed using the O’Leary Plaque Control Record, applying a liquid plaque discloser and explorer. The plaque index was calculated as the percentage of dental surfaces with visible plaque relative to the total surfaces examined. Results: The findings revealed a significant positive correlation between the parental plaque index (IP_PARENTS) and the children’s plaque index (IP_CHILD) (p < 0.001), indicating a strong relationship. While the father’s plaque index (ID_PARENTS(FATHER)) showed a marginally positive effect on IP_CHILD (p = 0.0589), the interaction between father identification and IP_PARENTS had a significant negative impact (p = 0.0344), suggesting that paternal influence on children’s plaque levels may vary. The model accounted for 28% of the variability in IP_CHILD (pseudo R2 = 0.2758). Conclusions: The analysis demonstrated a significant association between parental and child plaque levels, with minor differences observed between maternal and paternal influence. No significant effects were found for the age or gender of the children. Overall, increased plaque levels in parents were associated with higher plaque levels in their children, with slight variations depending on the parent’s role.

Postoperative acute psychological complications following dental procedures under general anesthesia in uncooperative children

BackgroundTo ensure comprehensive dental treatment under general anesthesia(GA) is a viable option, postoperative complications must be minimized. This study investigates the incidence and determinants of acute psychological complications following comprehensive dental treatment under general anesthesia in uncooperative children.Materials and methodsThis study included 71 healthy children aged 5 to 10 years who exhibited uncooperative behavior during dental examinations. All participants received parental consent. Data was collected using a checklist encompassing demographic information, treatment details, physical complications, and psychological complications. The Modified Child Dental Anxiety Scale faces version (MCDASf) questionnaire was administered pre-operatively and five days post-operatively.ResultsThe first day exhibited the most pronounced physical and psychological complications. While the most physical complications had diminished by the fifth day, the psychological effects remained permanent. Tooth extraction was associated with a statistically significant impact on fear of being left alone(P < 0.001), unspecified fear (P = 0.001), nyctophobia (P = 0.001), and excessive crying(P < 0.001).ConclusionPsychological complications persisted for a longer period compared to physical complications. The number of extracted teeth under GA had a significant influence on children’s fear.

Electrosurgical Adjunct for Soft Tissue Management of the Paediatric Dental Trauma Patient

The interface between dental restorations and the neighbouring soft tissue is of key significance for restorative success and longevity. Trauma-related enamel–dentine fractures are frequently present with the restorative challenge of subgingival margins and little remaining tooth structure. This report looks at two paediatric dental trauma patients with extensive crown fractures resulting in subgingival margins, which posed a poor long-term tooth survival. Electrosurgery was used before definitive composite restorations to allow for supragingival margins and access. Each patient attended the Child Dental Health Department at the University of Manchester Dental Hospital for assessment and treatment provision. CPD/Clinical Relevance: This article identifies electrosurgery as an increasingly useful adjunct to restorative management of traumatized permanent incisor teeth in paediatric patients.

Implication of Exclusive Breastfeeding in Early Childhood Dental Disorders: Large Cohort Evidence, US National Survey of Children Health.

Purpose/Objective: Frequent consumption of fermented carbohydrates and bottle feeding contribute to the development of early childhood caries (ECC). There are no substantial findings on the effects of breastfeeding patterns on oral health conditions in children in the United States. We aimed to assess the nexus between exclusive breastfeeding during the first 6 months and oral health disorders, namely toothache, decayed teeth, or unfilled cavities in early childhood. Materials and Methods: Design: Cross-sectional epidemiologic design of nationally representative data collected via telephone surveys in the United States was utilized. Setting: National Survey of Children's Health, 2012 Participants: Population-based random sample of parents/guardians of 24,655 children aged 6 months to 5 years. Main Outcome and Measure: The primary outcome was the presence of oral health disorders (OHD) in children, defined as the parent-reported occurrence of one or more of the following conditions in the past 12 months: toothache, decayed teeth, or an unfilled cavity. This was assessed through a single composite question in the survey, asking parents/guardians if their child had experienced any of these specific oral health issues within the previous year with a binary (yes/no) response option. Results: Among 24,655 children aged 6 months to 5 years, 2392 (9.7%) had experienced an oral health disorder (OHD) in the previous 12 months. In unadjusted analysis, children exclusively breastfed for 6 months were 28% less likely to present with OHD compared to never-breastfed children (OR = 0.72, 95% CI, 0.52-0.98). However, after adjusting for key factors, including maternal health and race/ethnicity, this association was no longer statistically significant (aOR = 1.11, 95% CI 0.79-1.57). Significant predictors of OHD included maternal health (aOR for fair/poor vs. excellent/very good maternal health = 1.79, 95% CI 1.08-2.69) and race/ethnicity, with a higher prevalence among non-Hispanic Black (12.9%) and multi-racial children (12.6%) compared to non-Hispanic White children (7.7%). Conclusions and Relevance: While exclusive breastfeeding for the first six months of life was not found to be a significant predictor of pediatric oral health outcomes after adjustment, maternal health and race/ethnicity were significant determinants of oral health disorders. These findings underscore the importance of comprehensive healthcare approaches that consider maternal well-being and socio-demographic factors. Future research should explore interventions targeting these factors to improve pediatric oral health outcomes.

SmilesUp text message intervention for early childhood dental caries prevention: A protocol for a randomised controlled trial.

Despite improvements in health outcomes for children, early childhood dental caries (ECC) remains a chronic lifestyle-mediated disease that affects an estimated 600 million children worldwide. Parental influence on oral health-promoting behaviours is pivotal in preventing ECC. The latest WHO publications Ending Early Childhood Dental Caries and Mobile Technologies for Oral Health highlights the opportunity for mobile Health programs (including text message programs) to improve oral health behaviours and oral health self-efficacy. In response, our team of parents, oral health professionals (academics and health promotion experts), and IT specialists co-designed a 12-week, behavioural theory-informed text message program (called SmilesUp) to address behavioural risk factors specific to ECC. This randomised trial aims to assess whether the SmilesUp program improves parents' oral health promoting behaviours (like tooth brushing twice a day with toothpaste) and oral health self-efficacy for their children compared to usual care. A randomised controlled trial with a 1:1 parallel design will be conducted among 150 parents with children diagnosed with ECC and accessing public dental care in NSW, Australia. Patients will be stratified by hospital site, and modality of care (Dental General Anaesthetic (DGA) or not) and then randomly assigned to either immediately receive the SMILESup text messaging intervention or receive the program at the end of the study period. The primary outcome at 12 weeks is twice daily brushing with fluoride toothpaste. Secondary outcomes include changes in the intake frequency of sugared drinks and foods, oral health promoting bedtime routines and oral health self-efficacy. The primary analysis will follow an intention-to-treat principle. In addition, a process evaluation will examine barriers, enablers, and opportunities to scale the program. Ethics approval has been obtained from the Western Sydney Local Health District Human Research Ethics Committee 2022/ETH01920. Study results will be disseminated via peer-reviewed publications and presentations at conferences. Trial registration number: This clinical trial has been prospectively registered on the ANZCTR from the 27th of March 2023. Registration number: ACTRN12623000325606.

The child dental care reform in Israel – service uptake from 2011 to 2022

BackgroundThe 2010 Child Dental Care Reform of the National Health Insurance Law marked a turning point in the Israeli oral healthcare system by establishing Universal Health Coverage of dental care for children. Initially, the reform included children up to age 8 and gradually expanded to age 18 in 2019. The basket of services includes preventive and restorative treatments provided by the four Health Maintenance Organizations (HMO). The aim of this study was to examine the uptake of child dental services during the first decade of the reform.MethodsA retrospective analysis was conducted to determine the treatment uptake, type and amount of the services delivered based on annual service utilization reports submitted by the HMOs to the Ministry of Health in the years 2011–2022.ResultsThe number of insured children increased from 1,546,857 in 2011 to 3,178,238 in 2022. The uptake of dental services gradually increased during the study period with a slight decrease in 2020. The percentage of children who used the services gradually increased from 8 to 33%, with the incremental inclusion of additional age groups. From 2012 onwards the most common treatments provided were preventive, however the single most common treatment was dental restoration. In 2022 35% of the population of Israel was under the age of 18. Out of these, about a third received dental treatment via the HMOs. This is a significant achievement, since before the reform all treatments were paid out-of-pocket. After a short period of increasing uptake, a stable service utilization pattern was evident that can indicate better public awareness and service acceptance.ConclusionAlthough this is a reasonable uptake, additional efforts are required to increase the number of children receiving dental care within the public insurance. Such an effort can be part of a multi-disciplinary approach, in which pediatricians and public health nurses can play a vital role in dental caries prevention, enhancement of awareness and service utilization.

Do Parental and Children’s Dental Anxiety Affect Childhood Dental Caries?

Background: Dental anxiety is an unpleasant reaction to fear or stress related to the dental environment and can be observed in both parents and children as dental patients. Despite several studies challenging the significance of parental anxiety in influencing a child's response to dental treatment, conflicting results have emerged regarding the impact of both parental and children's anxiety on the development of dental caries. Objectives: This study aimed to explore the association between parental and children's dental anxiety and the occurrence of dental caries in children. Methods: A cross-sectional study involving 7 - 12-year-old students and their parents in schools of Rasht, Iran, utilized the Modified Dental Anxiety Scale (MDAS) for parents and the Modified Child Dental Anxiety Scale (MCDAS) questionnaire for children. Participants were chosen through a multistage sampling process. A trained dentist assessed children's dental caries using the DMFT/dmft (decayed, missing, and filled teeth) Index. The data were analyzed using the chi-square test and linear regression. Results: The study included 275 parents and an equal number of children, with a mean child age of 9.32 ± 1.85 years. The findings indicated a significant relationship between maternal dental anxiety and DMFT + dmft scores in boys (P = 0.049). The study revealed that the number of teeth with caries experience (P = 0.023), child's sex (P = 0.007), history of dental clinic visits (P = 0.045), and maternal dental anxiety (P = 0.043) significantly influenced the child's dental anxiety. Conclusions: Children with anxious parents showed lower DMFT/dmft values, suggesting increased attention to their dental health. The study highlights the impact of parental dental anxiety on children's oral well-being and emphasizes the need for comprehensive strategies to address dental anxiety in both parents and children.

The Effect of Probiotic Yogurt and Fermented Skim Milk Beverages on The Reduction of Streptococcus Mutans In Children's Dental Caries

The Effect of Probiotic Yogurt and Fermented Skim Milk Beverages on The Reduction of Streptococcus Mutans In Children's Dental Caries

Evaluation of dental behavior, anxiety, fear, and its correlation with trait emotional intelligence in 8-12-year-old children: Exploring a new frontier in behavior modification.

Children's fear and distress in dental settings often lead to anxiety and behavior issues. This study delves into why some children experience dental anxiety, whereas others do not, attributing differences to child-rearing and personality traits. Emotional intelligence (EQ), the ability to comprehend, generate, and manage emotions, is explored as a factor influencing a child's dental experience. This novel intelligence theory accommodates the intricacies of human-environment interactions. The study aimed to investigate the relationship between EQ and a child's dental anxiety, fear, and behavior in children aged 8-12 years. The Trait Emotional Intelligence Questionnaire-Child Short Form, specifically developed for children aged between 8 and 12 years, was used among 100 participants reporting to the department outpatient department. The Frankl's Behavior Rating Scale, Modified Child Dental Anxiety Scale, and Children's Fear Survey Schedule-Dental Subscale were used to evaluate behavior, anxiety, and fear, respectively. Results show a positive correlation between EQ and dental behavior (P = 0.002) whereas a negative correlation between EQ and dental anxiety and fear (P < 0.001). This study sheds light on the intricate interplay between emotional intelligence, dental behavior, anxiety, and fear among children. By recognizing the impact of EQ, dental practitioners could adopt personalized strategies to alleviate anxiety and enhance cooperation, improving overall dental experiences for young patients.

The relationship between the source of oral health information and dental caries: Findings from Child Dental Health Survey 2013 in England.

To determine the magnitude and shape of the relationship between dental caries experience and the source of oral health information in England. This was a cross-sectional study using the Child Dental Health Survey 2013 in England. Using a negative binomial model, the relationship between the number of decayed, missing, filled teeth (DMFT) of 12- and 15-year-old students and their primary source of oral health information was assessed. The sources of oral health information included parents, television, newspapers, the Internet, and social media. The adjusted model included age, sex, and the Index of Multiple Deprivation (IMD). R was used for data handling, analysis and reporting. Overall, 2,372 children were assessed (48.7% female, 48.6% 12-year-old). For the majority, the primary source of oral health information was their parents (89.5%) followed by the Internet (43.4%). Over nine-tenth of the participants had a DMFT = 0. The adjusted model showed that the prevalence rate of DMFT for the children whose primary source of information is their parents (0.45) or television (0.62) is lower than 1. The prevalence rate for the Internet (1.17) and social media (1.67) was higher than 1, but they were removed from the final model due to being non-statistically significant. Age and deprivation had a direct relationship with the prevalence rate of DMFT, meaning that 15-year-olds and children from more deprived areas had a higher prevalence rate of DMFT. Children whose primary source of oral health information was their parents or television had a lower DMFT. On the contrary, using the Internet or social media as the source of oral health information was associated with higher caries experience among schoolchildren.

Influence of maternal attention-deficit hyperactive disorder on child dental neglect - An analytical cross-sectional study.

Attention-deficit hyperactivity disorder (ADHD) is a condition that is characterized by symptoms such as inattentiveness, hyperactivity, and impulsivity. The influence of mothers with ADHD and their attitude towards their wards' oral health has not been explored in the Indian scenario. The aim of this study was to assess the prevalence of ADHD in mother-child dyads in western Tamil Nadu and the mothers' dental neglect toward their children. The prevalence of ADHD in mothers and children was assessed using the Adult ADHD Self-report Scale screener and ADHD Rating Scale, respectively. The Child Dental Neglect Scale (CDNS) was used to assess dental neglect in children. The responses were recorded on a Likert scale and statistical analyses were done. The prevalence of ADHD in mothers and children was 10.65% and 10.57%, respectively. The impulsivity and hyperactivity type of ADHD was commonly seen in both the mothers and their children. Mothers without ADHD felt that their children maintained their oral health well. Mothers with ADHD deferred the needed dental treatment for their children. Mothers with ADHD have four times more risk of having children with ADHD. Maternal ADHD influences their child's oral health. Child dental neglect was more prevalent among mothers with ADHD.

Integration of dental therapists in safety net practice increases access to oral health care in Minnesota.

This study evaluates the impact of introducing dental therapists (DTs) into Children's Dental Services (CDS), a large non-profit organization in Minnesota. The aim is to assess the effect of DTs in improving access and reducing dental care costs in Minnesota by analyzing the trends in dental care delivery and procedures performed by CDS dentists and therapists. Using 2009 to 2021 data from CDS, the study compares trends in patient volume, types of procedures, salary data and payments by dentists, DTs, and registered dental hygienists (RDH). Return on investment (ROI) trends are calculated using salary and revenues for each provider type. After introducing DTs at CDS and implementing mobile clinics, the number of patients served and volume increased steadily, demonstrating increased access. DTs provided an increasing proportion of fluorides, sealants, and extractions through 2020. Interestingly 2021, there was a decrease for DTs, possibly due to Covid related workforce shortages. ROI analysis showed that DTs' ROI dramatically rose, eventually surpassing dentists, while RDHs maintained a constant ROI. Dentists' ROI also initially increased after adopting DTs in the practice. Integrating DTs at CDS improved access by expanding mobile clinics, increasing patient volume, and redistributing procedures, while demonstrating a positive return on investment. Results suggest that adopting the DT model may be a promising practice for other organizations seeking to improve access to dental care, increase operational efficiency, and boost the dental care team's ROI.

Parental Reports of Children's Dental Pain Experience and Associated Factors among Brazilian Children.

Exploring children's dental pain experiences helps to develop healthcare policies for improving oral health and quality of life. A cross-sectional study involved 300 parents/caregivers of four- to seven-year-old children using snowball sampling. Parents/caregivers self-completed an online questionnaire on sociodemographic characteristics, parenting styles, their child's oral hygiene practices, free sugar consumption, and dental history. The questionnaire was created using Google Forms and was disseminated to parents/caregivers via E-mail and/or WhatsApp©. Descriptive and Poisson regression analyses were performed (p < 0.05). Children's dental pain experience was reported by 20.3% of the parents. The authoritative parenting style was predominant. The child's mean age at the first consumption of sugar was 1.38 (±0.64) years, and 40.3% of the children had high-free sugar consumption. The mean age for the first dental appointment was 2.26 (±1.31) years, and 24.3% of the children never went to a dental appointment. The prevalence of dental pain experience was higher in children who attended their first dental appointment later (PR: 1.02; CI 95%: 1.01-1.03) and among those with high-free sugar consumption (PR: 1.90; CI 95%: 1.21-3.00). High sugar consumption and delay in the first dental appointment may increase the likelihood that children will experience dental pain.

Do Parents Dental Neglect and Anxiety Affect Their Children s Dental Neglect and Anxiety

Aim: Dental neglect is an obstacle to obtaining the necessary dental care in protecting and maintaining basic oral health. Dental anxiety can cause difficulties in behavior management, maintenance of dental treatments, and poor oral hygiene. In this study, it was aimed to examine the relationship between dental neglect and anxiety levels of both parents and their children. Material and Methods: 220 people including 110 parents and 110 children were included in the study. The Dental Neglect Scale (DNS), Modified Dental Anxiety Scale (MDAS), and Visual Analogue Scale (VAS) were used for parents. In addition, the Dental Neglect Scale (DNS), the Faces version of the Modified Child Dental Anxiety Scale (MCDASf), and the Wong Baker Faces Pain Rating Scale (WBFS) were applied to children. The statistical analysis was performed using Spearman Correlation test and Mann Whitney-U test. Results: In the study, a positive correlation was found between parent’s and children's neglect scores (r=0.261; p=0.006). Likewise, a positive correlation was observed between the DMFT and anxiety scores of the children (r=0.237; p= 0.013). In addition, it was observed that there was a statistical correlation between the level of pain felt at the last dental treatment and anxiety in children (r=0.316; p=0.001). Conclusion: It was observed that the dental neglect of the children of parents who neglected their own oral health increased. It is thought that informing parents about the importance of oral health and the consequences of dental neglect will have positive effects on their children's oral health.

The Effect of Three-point Acupressure Therapy on Anxiety Levels in Children Undergoing Dental Procedures.

To evaluate the efficacy of three-point acupressure therapy in decreasing the dental anxiety in children undergoing dental procedures and to introduce acupressure as a simple, noninvasive, and cost-effective technique of reducing dental anxiety in children. One hundred and sixty-eight, 8-12 years participants who met the inclusion criteria were randomly allotted to either group I (three-point acupressure) (n = 84) or group II (control) (n = 84). All children were subjected to a self-report measure of anxiety [Modified Child Dental Anxiety Scale (MCDAS)] 30 minutes before starting and after completing the dental treatment. For group I children, acupressure beads were applied on selected three acupoints for approximately 10 minutes and were left adhered in place. After 20 minutes, anxiety scores were recorded for all the children and allotted treatment procedure was initiated. For group II children, the same methodology was followed except for the application of acupressure beads. Frankl behavior (FB) rating scale, pulse rate (PR), and systemic saturation levels of oxygen were also recorded as secondary outcome measures. The data obtained was analyzed statistically using Chi-squared analysis, t-test, repeated measures analysis of variance (ANOVA) along with post hoc Bonferroni test. Significance level was predetermined at p ≤ 0.05. At time frame (TF)-2, significant decrease in anxiety scores was observed in acupressure group irrespective of the treatment procedure, whereas in control group, it increased significantly. PR was also increased in acupressure group and FB scale was improved. In control group, PR increased and behavior was not improved. Between TF-2 and 3, no reduction in anxiety score was observed. The three-point acupressure therapy reduces anxiety in children undergoing dental procedures when compared to nonacupressure group and the difference was statistically significant. Acupressure is a noninvasive stimulation technique applied to acupoints and can be easily administered by a trained pediatric dentist. Sisodia M, Kaur H, Garg N, et al. The Effect of Three-point Acupressure Therapy on Anxiety Levels in Children Undergoing Dental Procedures. Int J Clin Pediatr Dent 2024;17(2):136-142.

Comparing modified USPHS and FDI criteria for the assessment of glass ionomer restorations in primary molars utilising clinical and photographic evaluation.

To compare the applicability of modified US Public Health Service (USPHS) and FDI criteria for evaluating glass ionomer cement (GIC) restorations in primary posterior teeth through digital image analysis. This comparative analytic study was conducted at the Children's Dental Clinic RSKGM FKG UI, involving 40 GIC restorations on lower first primary molars in children aged 4-9years. After cleaning, the restorations were assessed clinically using modified USPHS and FDI criteria before taking digital images, then the collected images were re-evaluated using both sets of criteria, and the clinical assessment results were compared to the digital image assessment results. Statistical analysis revealed significant differences between the clinical evaluation of GIC restorations in primary teeth and their corresponding digital photographs when using the modified USPHS criteria, and although the use of FDI criteria yielded different results, these differences were not statistically significant. The assessment of GIC restorations through digital images aligns more closely with clinical assessments using the FDI criteria compared to the modified USPHS criteria.

Comparison of Automatically Controlled Injection System with a Traditional. Syringe for Multiple Infiltrations in Children Aged 6-12 Years: A Randomized Controlled Trial.

Children's conduct is significantly impacted by pain during dental procedures. Children's pain and discomfort can be reduced using computer-controlled local anesthetic delivery, which applies a steady, gradual flow of the anesthetic solution into the tissues. Using a self-report anxiety scale, the study aimed to assess and compare children's perceptions of discomfort following a new auto-controlled injection method to a traditional local anesthetic procedure. A total of 25 children, ages 6-12 requiring the use of local anesthesia for treatment on both sides of the arch were selected. It was a split-mouth design, in which each participating child received both types of infiltrations in two separate, consecutive visits, using a metallic syringe in one session, and using the I-Ject device in the other. Before administering anesthesia, all the children's anxiety scales were recorded using the Modified Child Dental Anxiety Faces Scale simplified to assess the anxiety level of a child. In the first appointment, Conventional anesthetic technique was and in the second appointment anesthesia was delivered using a computer-controlled device. Faces pain scaleRevised, a selfreport measure of pain was recorded immediately after completion of both types of local anesthesia (LA) administration. Patients reported greater comfort with the I-Ject computer-controlled device than with conventional anesthesia. Together with the practitioner, the computer system produced a pleasant and cozy environment for the youngster.

Evaluation of the Effectiveness of Children's Dental Care Programs: A Retrospective Study.

This study aimed to evaluate the long-term impact of children's dental care programs on children and adolescents to reduce oral health inequalities. It measured and assessed the improvement effects of children's dental care programs on the oral health of children and adolescents as part of the efforts to decrease oral health disparities in this age group. It included 406 individuals who participated in student and children's dental care program between 2013 and 2019 at screening facilities in Gwangjin-gu, Seoul. A frequency analysis was conducted for demographic characteristics, and a binary logistic regression analysis was performed to identify factors influencing the prevalence of dental caries as the dependent variable. The data were analyzed using PASW Statistics with the statistical significance level set at α = 0.05. Regarding oral health status based on the frequency of participation in children's dental care program for children and adolescents, participants with seven or more sessions had lower prevalence rates of dental caries, malocclusion, and periodontal disease than those with only one session. Second, when comparing oral health status in children's dental care program between primary and adolescent age groups, individuals under continuous oral health care showed a decrease in permanent teeth affected by dental caries, dental caries prevalence, and malocclusion prevalence (excluding primary school age). Third, a binary logistic regression analysis revealed significant influences (p < 0.05) of the developmental stage and frequency of program participation on dental caries prevalence. Children's dental care programs are essential for alleviating oral health inequalities among children and adolescents and preventing oral diseases. Furthermore, the developmental stage of children and the frequency of program participation are crucial factors in preventing oral conditions, such as dental caries.

Socially constructed beliefs and the uptake of the Child Dental Benefits Schedule.

The Child Dental Benefits Schedule (CDBS) provides automatic access to subsidized dental care for eligible Australian children, but uptake is low. As cost is not a factor, socially constructed perceptions, which may be subscribed to without personal experience, were explored as potential barriers. Two studies with parents (child <18 years) were conducted. In Study one (N=317) participants completed a free-response task eliciting socially constructed perceptions about the dentist. These were factor-analysed in Study two (N=231), and the salience of these perceptions in relation to uptake was measured for the 113 eligible to access the CDBS participants. In Study one, similar positive, negative, procedural and time words were elicited across conditions. Study two revealed Negative, Positive and Hassle perception factors associated with the dentist and that 61% of eligible participants had accessed the CDBS. Generalized Structural Equation Modelling with eligible participants revealed Positive and Negative perceptions were negatively correlated, Negative perceptions were positively correlated with Hassle, and, as Hassle increased, the probability of parents accessing the CDBS significantly decreased. Confusion around eligibility to access CDBS is still an issue. Low CDBS uptake may be associated with perceived hassle associated with the dentist, which may reflect parental negative perceptions. © 2024 Australian Dental Association.

Socioenvironmental sugar promotion and geographical inequalities in dental health of 5-year-old children in England.

To investigate the relationship between socioenvironmental sugar promotion and geographical inequalities in the prevalence of dental caries amongst 5-year-olds living across small areas within England. Ecological data from the National Dental Epidemiology Programme (NDEP) 2018-2019, comprising information on the percentage of 5-year-olds with tooth decay (≥1 teeth that are decayed into dentine, missing due to decay, or filled), and untreated tooth decay (≥1 decayed but untreated teeth), in lower-tier local authorities (LAs) of England. These were analysed for association with a newly developed Index of Sugar-Promoting Environments Affecting Child Dental Health (ISPE-ACDH). The index quantifies sugar-promoting determinants within a child's environment and provides standardized scores for the index, and its component domains that is, neighbourhood-, school- and family-environment, with the highest scores representing the highest levels of sugar promotion in lower-tier LAs (N = 317) of England. Linear regressions, including unadjusted models separately using index and each domain, and models adjusted for domains were built for each dental outcome. Participants lived across 272 of 317 lower-tier LAs measured within the index. The average percentage of children with tooth decay and untreated tooth decay was 22.5 (SD: 8.5) and 19.6 (SD: 8.3), respectively. The mean index score was (0.1 [SD: 1.01]). Mean domain scores were: neighbourhood (0.02 [SD: 1.03]), school (0.1 [SD: 1.0]), and family (0.1 [SD: 0.9]). Unadjusted linear regressions indicated that the LA-level percentage of children with tooth decay increased by 5.04, 3.71, 4.78 and 5.24 with increased scores of the index, and neighbourhood, school and family domains, respectively. An additional model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.37, and by family domain it increased to 6.33. Furthermore, unadjusted models indicated that the LA-level percentage of children with untreated tooth decay increased by 4.72, 3.42, 4.45 and 4.97 with increased scores of the index, and neighbourhood, school, and family domains, respectively. The model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.24 and by family domain rose to 6.47. School-domain was not significantly associated with either outcome in adjusted models. This study reveals that socioenvironmental sugar promotion, particularly within neighbourhood- and family-environments, may contribute to geographical inequalities in dental caries in children. Further research involving data on individual-level dental outcomes and confounders is required.