Clinical Consequences Of Untreated Caries Research Articles

The role of dental pain and psychosocial factors on the relationship between dental caries and oral health-related quality of life in children

BackgroundTo examine the role of dental pain, sense of coherence (SOC) and social support on the relationship between dental caries and oral health-related quality of life (OHRQoL) in children aged 12 years.MethodsA cross-sectional study involving 400 schoolchildren selected from public schools in a socioeconomically disadvantaged region in the city of Manaus, Brazil was carried out. The predictors of OHRQoL were selected according to the Wilson and Cleary theoretical model, including number of decayed teeth and its clinical consequence (component D of the DMFT index and PUFA/pufa index), dental pain (symptom status), and SOC and social support (individual and environmental characteristics). Statistical analysis was conducted through structural equation modelling and multivariable negative binomial regression. The significance level established for all analyses was 5%.ResultsNumber of dental caries was indirectly linked with OHRQoL (β = 0.19, 95% CI 0.11/0.29) through dental pain, SOC and social support. Clinical consequences of untreated caries directly predicted poor OHRQoL (β = 0.12, 95% CI 0.01/0.23). Dental pain, SOC and social support did not moderate the effect of dental caries measures on OHRQoL.ConclusionOur findings suggest the role of dental pain, SOC and social support as mediator factors on the link between dental caries and OHRQoL. Tackling dental caries along with psychosocial factors may attenuated the impact of oral health on OHRQoL in children.

Assessing the Clinical Consequences of Untreated Caries in 8- to 10-Year-Old Children with Pufa Index

Aim: The aim of this study is to assess the oral health conditions of 8- to 10-year-old students in the mixed dentition stage in Erzurum, Turkey, by determining their dental caries’ status and the soft tissue damages by untreated caries. Materials and Methods: The study was carried out in two randomly selected schools in the residential areas populated predominantly by families with mid-and-low socioeconomic levels. A total of 586 children, 275 girls, and 365 boys with a mean age of 8.95 ± 0.8 participated in the study. Number of decayed, missing due to caries, and filled teeth in the permanent dentition/number of decayed and filled teeth in the primary dentition (DMFT/dft) and visible pulpal involvement (P/p), ulceration caused by dislocated tooth fragments (U/u), fistula (F/f) and abscess (A/a) (PUFA)/pufa indices are included in the clinical examination section of the study. Obtained data were analyzed with SPSS (IBM Corp. 2013, IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY). Results: Our research revealed a DMFT score of 2.43 ± 1.7, dft 4.12 ± 2.7, pufa 0.75 ±1.2, PUFA 0.05± 0.24, a caries frequency of 96.1, PUFA/pufa frequency of 40.9, and untreated caries PUFA/pufa ratio was found as 13.3%. A significant difference with positive correlation was found between d and pufa scores ( P < .01). Increasing DMFT, decayed, missing, and filled surfaces (DMFS) in the permanent dentition, and decreasing dft, decayed, and filled surfaces (dfs) in the primary dentition, and pufa scores with the age increment were found to be significant ( P < .05). Conclusion: The frequency of soft tissue damage associated with untreated caries, caries index scores, and frequency of dental caries was found to be quite high in the study population consisting of children belonging to families with similar socioeconomic status.

Socio-Behavioral Risk Indicators Linked to Untreated Early Childhood Caries and its Clinical Consequences in Preschool Children: A Cross-Sectional Study

This study aimed to determine the prevalence of and the socio-behavioral risk indicators associated with untreated dental caries (UDC) and its clinical consequences. A multi-stage cluster sampling approach was used to evaluate 168 preschool children in this cross-sectional study. The risk indicators associated with the presence of one or more decayed teeth (dt ≥ 1) and pulp-involved teeth (pt ≥ 1) were assessed using multiple logistic regression analysis. Overall, the prevalence of dt ≥ 1 and pt ≥ 1 was 82.1% and 27.9%, respectively. Children whose mothers had lower maternal education were 3.7 times more likely to have dt ≥ 1 than those whose mothers were graduates (adjusted odds ratio [AOR] = 3.74, 95% confidence interval [CI] 1.29-10.91). Children whose mothers had a history of maternal caries were 4.2 times more likely to have dt ≥ 1 (AOR = 4.23, 95% CI 1.56-11.44). Children whose mothers had lower maternal education were 5 times more likely to have pt ≥ 1 (AOR = 4.99, 95% CI 2.57-13.39). Underweight children were 7.2 times more likely to have pt ≥ 1 (AOR = 7.17, 95% CI 1.88-5.10). Children whose mothers had a history of maternal caries were 6.6 times more likely to have pt ≥ 1 (AOR = 6.62, 95% CI 7.17-18.88). Maternal education and caries were found to be significant risk indicators for UDC. The clinical consequences of UDC were related to child age, maternal education and caries, socioeconomic status and underweight.

Association of oral hygiene practices with the outcome of untreated dental caries and its clinical consequences in pre- and primary school children: A cross-sectional study in a northern province of Saudi Arabia.

ObjectivesTo assess the association amongst oral hygiene practices, untreated dental caries (UDC) and clinical consequences of UDC in pre‐ and primary school children aged 3–5 and 6–7 years.Materials and methodsA total of 250 subjects were recruited. The demographic and oral hygiene data were collected using a closed‐ended questionnaire. The UDC was measured using the ‘d/D' component of the decayed, missing, filled teeth (dmft/DMFT) index, and its clinical consequences were recorded using the ‘p/P' component of the pulpal involvement, ulceration, fistula and abscess (pufa/PUFA) index. The data were analyzed by multiple logistic regression.ResultsOverall, 94.2% and 56.5% of the participants had one or more UDC and pulp involvement (p ≥ 1), respectively in 3–5‐year‐old age group. In the 6‐7‐year‐ age group the prevalence of UDC was 26.7% and the pulp involvement was 11.6%. Children who brushed with their fingers were 4.7 times more likely to have UDC (crude odds ratio [COR] = 4.71; 95% CI: 1.21–18.40). Twice‐daily brushing resulted in a 39% (p = 0.732) lower likelihood of having UDC compared with once‐daily brushing (COR = 0.61; 95% CI: 0.04, 10.09). Children with irregular brushing frequency were 3.2 times more likely to have pulpal involvement (COR = 3.21; 95% CI: 1.74–5.93).ConclusionFinger brushing, irregular frequency of brushing and lack of parental supervision whilst brushing were associated with UDC and its consequences.

Oral disorders associated with the experience of verbal bullying among Brazilian school-aged children: A case-control study

BackgroundDental features have been considered a potential target of verbal bullying (VB) among school-aged children. The authors conducted a study to investigate the association between the presence of oral disorders and the occurrence of VB among 8- through 10-year-old school-aged children. MethodsThe study included 445 school-aged children 8 through 10 years old. VB was verified by a specific validated question from the Child Perceptions Questionnaire 8-10 index. Oral disorders such as untreated caries, fluorosis, clinical consequences of untreated caries, and malocclusion were evaluated. The Pearson χ2 test and bivariate and multivariate conditional logistic regression analyses were used for statistical analysis. ResultsA total of 390 school-aged children completed the study. The results of the multivariate logistic regression model showed that a severe malocclusion (odds ratio [OR], 2.29; 95% confidence interval [CI], 1.03 to 5.10), a greater maxillary misalignment (OR, 2.23; 95% CI, 1.05 to 4.73), and the presence of a tooth with pulp exposure (OR, 2.93; 95% CI, 1.58 to 5.45) were significantly associated with the occurrence of VB. ConclusionChildren aged 8 through 10 years with a severe malocclusion, larger maxillary misalignment, or the presence of pulp exposure had increased odds of experiencing VB compared with children without those oral health conditions. Practical ImplicationsOnce oral disorders involved in VB are identified, appropriate approaches should be used to address this issue. With this course of action, oral health care professionals may use the treatment and preventive care to eliminate potential factors for peer aggression.

Clinical Consequences of Untreated Dental Caries, Individual Characteristics, and Environmental Factors on Self-Reported Oral Health Measures in Adolescents: A Follow-Up Prevalence Study

Background/Aims: This study evaluated the relationships of clinical consequences of untreated dental caries, individual characteristics, and environmental factors on self-reported oral health measures in adolescents. Methods: A follow-up prevalence study was conducted involving 406 twelve-year-old adolescents selected from public schools in the eastern area of the city of Manaus, Brazil. Baseline data included clinical consequences of untreated caries (PUFA/pufa index), DMFT, sociodemographic characteristics (sex, parental schooling, and family income), psychosocial factors (sense of coherence [SOC-13 scale], oral health beliefs and self-esteem [Rosenberg Self-Esteem Scale]), and social support (SSA questionnaire). Oral health-related quality of life (OHRQoL [CPQ_11–14]) and self-rated oral health were assessed at the 6-month follow-up. Structural equation modelling was used to explore the relationships between variables according to the Wilson and Cleary model. Results: The prevalence of PUFA/pufa was 17.8% and mean DMFT was 1.5. The number of teeth with clinical consequences of untreated caries predicted poor self-rated oral health at the 6-month follow-up. Low parental schooling predicted low family income and clinical consequences of untreated dental caries. Psychosocial factors predicted OHRQoL directly and self-rated oral health indirectly. OHRQoL was linked to self-rated oral health. Clinical consequences of untreated dental caries mediated the relationship of parental schooling with OHRQoL and self-rated oral health. OHRQoL mediated the relationship of psychosocial factors and sex with self-rated oral health. Clinical consequences of untreated dental caries was associated with adolescents’ self-rated oral health. Furthermore, the former was an important mediator on the link between low parental education and adolescents’ self-reported oral health measures. Conclusions: Socioeconomic status, psychosocial factors, and social support were related to OHRQoL and self-rated oral health via direct and indirect pathways.

Clinical Consequences of Untreated Dental Caries among Primary School Children: A Cross-Sectional Study

Objective: To evaluate the dental caries experience and clinical consequences of untreated dental caries (UDC) among primary school children of Al Jouf region, Saudi Arabia and to determine the correlation between dental caries experience and clinical consequences of UDC. Material and Methods: A 250 primary school children 6-7 years were recruited using systematic random sampling. The prevalence of dental caries in deciduous dentition was assessed by following WHO criteria using the dmft index and the clinical consequence of UDC was assessed with the pufa index. The pufa score was calculated cumulatively following the pufa diagnostic criteria. The Student’s t-test was used to equate the mean dmft and pufa scores between boys and girls. The correlation between the dmft and the pufa scores was evaluated using Pearson's correlation coefficient (r), and the p-value was set at 0.05 for statistical significance. Results: Out of which 154 (61.60%) boys and 94 (37.60%) were girls. The mean (SD) values of dmft for boys reported to be 5.37 (± 3.31) and for girls 6.35 (± 3.27), which was statistically significant with gender (p<0.001). Statistically, significant mean values of pufa were 1.20 (± 1.37) in boys and 1.71 (± 1.58) in girls, respectively was observed (p<0.001). The Pearson correlation between dmft and pufa values showed a highly significant positive correlation among dmft and pufa values (r= 0.635, p<0.001). Conclusion: The present study revealed that high caries prevalence and experience of the clinical consequences of UDC in the primary dentition, and there was a strong positive correlation between dmft and pufa score values.

Added Sugar Consumption and Chronic Oral Disease Burden among Adolescents in Brazil

Chronic oral diseases are rarely studied together, especially with an emphasis on their common risk factors. This study examined the association of added sugar consumption on “chronic oral disease burden” among adolescents, with consideration of obesity and systemic inflammation pathways through structural equation modeling. A cross-sectional study was conducted of a complex random sample of adolescent students enrolled at public schools in São Luís, Brazil (n = 405). The outcome was chronic oral disease burden, a latent variable based on the presence of probing depth ≥4 mm, bleeding on probing, caries, and clinical consequences of untreated caries. The following hypotheses were tested: 1) caries and periodontal diseases among adolescents are correlated with each other; 2) added sugar consumption and obesity are associated with chronic oral disease burden; and 3) chronic oral disease burden is linked to systemic inflammation. Models were adjusted for socioeconomic status, added sugar consumption, oral hygiene behaviors, obesity, and serum levels of interleukin 6 (IL-6). All estimators of the latent variable chronic oral disease burden involved factor loadings ≥0.5 and P values <0.001, indicating good fit. Added sugar consumption (standardized coefficient [SC] = 0.212, P = 0.005), high IL-6 levels (SC = 0.130, P = 0.036), and low socioeconomic status (SC = −0.279, P = 0.001) were associated with increased chronic oral disease burden values. Obesity was associated with high IL-6 levels (SC = 0.232, P = 0.001). Visible plaque index was correlated with chronic oral disease burden (SC = 0.381, P < 0.001). Our finding that caries and periodontal diseases are associated with each other and with added sugar consumption, obesity, and systemic inflammation reinforces the guidance of the World Health Organization that any approach intended to prevent noncommunicable diseases should be directed toward common risk factors.

Severity and clinical consequences of untreated dental caries using PUFA index among schoolchildren in Udupi Taluk, India

Background: Data on dental decay using the Decayed, Missing, Filled teeth (DMFT/dmft) index provides information on caries and treatment experiences only, but fails to give information on clinical consequences of untreated dental caries. Aim: The aim of the study was to determine the prevalence and clinical consequences of untreated dental caries using Pulp, Ulceration, Fistula, Abscess (PUFA) index among schoolchildren. Materials and Methods: A cross-sectional survey of 957 schoolchildren, aged 6–15 years in Udupi taluk was conducted. Caries experience was evaluated according to World Health Organization (WHO) criteria, 1997 (DMFT/dmft index) and clinical consequences of untreated dental caries by PUFA/pufa index. Results: The results showed that 77.3% of 6–10 years old children had caries (mean dmft score: 3.30 ± 2.9, mean DMFT score: 0.26 ± 0.7), 47.3% showed clinical consequences of untreated caries (mean pufa score: 1.30 ± 1.9, mean PUFA score: 0.03 ± 0.2) and 26.8% reported pain. In 11–15 years old children, 55.6% had caries (mean dmft score: 0.36 ± 0.9, mean DMFT score: 1.04 ± 1.4), 18% showed prevalence of pulpal involvement (mean pufa score: 0.15 ± 0.5, mean PUFA score: 0.14 ± 0.4) and 11.6% reported pain. Statistical analysis revealed a strong relation between DMFT/dmft and PUFA/pufa in both age groups. Conclusion: The present study revealed negligence in the dental treatment of children resulting in pulpal involvement. This index is a valuable measurement tool to record clinical consequences of untreated dental caries.

Clinical consequences of untreated early childhood caries in urban population of children with high risk of caries in Poland

Background. The anatomy and low mineral content of primary teeth, especially soon after their eruption, predispose to acute progression of caries. Untreated early childhood caries (ECC) can rapidly lead to destruction of the crown and to pulpal involvement. It is, therefore, important to depict its clinical consequences in relation to caries intensity and age. Aim of the study. To assess the correlation of clinical consequences of ECC with its intensity and age in urban population of children with high risk of caries in Poland. Material and methods. In a group of high caries risk children from Warsaw aged below 6 years the following were evaluated: dental health (decayed, filled, missing teeth due to caries (dmft/dmfs), carious pulp exposure) and mucosal health (ulcerations caused by decayed teeth, fistulae, abscesses (pufa). Four age groups were distinguished: less than 3 years, 3-4 years, 4-5 years and 5-6 years. Statistical analysis: Kruskal-Wallis test (significance level p=0.05). Results. Among 223 children (mean age 4.30±1.154 years) dmft&gt;0 was found in 80% (mean dmft=6.14±5.49, dmfs=11.60±12.92), restorative index was 0.23±0.33. Pufa &gt;0 was observed in 26% (mean 0.853±1.839) with the highest value in the youngest age group (mean 1.20±2.222). Correlations between dmft, dmfs and pufa were observed. Statistically significant correlations were found between teeth missing due to caries and the clinical consequences of untreated caries. Conclusions. The younger the child affected by caries, the more severe the consequences of untreated caries. It has been observed that the rate of consequences increases with caries intensity.

Pulpal Involvement-Roots-Sepsis Index: A New Method for Describing the Clinical Consequences of Untreated Dental Caries

Objectives: To describe a modification of the index of clinical consequences of untreated dental caries [pulpal involvement, ulceration, fistula and abscess (PUFA/pufa) index] to pulpal involvement-roots-sepsis (PRS/prs) and to compare the two indices using the example of caries in primary molar teeth in children aged 6-8 years. Subjects andMethods: The study sample included 542 children aged 6-8 years, from five randomly selected schools in the Bialystok District, Poland. The occurrence of clinical consequences of untreated caries in deciduous molars using the pufa and prs indices was evaluated. Data were analysed to express the prevalence, the experience and the distribution of particular pufa and prs codes in the sample population. The differences in layout of the pufa and prs components were expressed. Results: The response rate was 77.6%. The prevalence of the clinical consequences of untreated caries was 40.77%, mean pufa and prs were the same (0.85 ± 1.33). According to the pufa index, the following mean values were obtained: p = 0.79, u = 0.01, f = 0.04 and a = 0.01. For the prs index, the mean values were as follows: p = 0.45, r = 0.35 and s = 0.05. Conclusion: The proposed prs index was a useful epidemiological instrument for the evaluation of the clinical consequences of untreated caries in the surveyed population. The PRS instrument could be a good alternative to the PUFA index.