Frequency Of Daily Tooth Brushing Research Articles

Exploring the state and influential factors of dental caries in preschool children aged 3–6 years in Xingtai City

ObjectiveTo explore the main factors affecting early dental caries among preschool children aged 3–6 years in Xingtai City to formulate effective preventive measures.MethodsA cross-sectional study was conducted on 570 preschool children aged 3–6 years in Xingtai City through questionnaire surveys and oral examinations to understand their dental caries situation. Multifactorial logistic regression analysis was used to analyse the main influencing factors for the occurrence of dental caries in preschool children.ResultsUnivariate analysis showed statistically significant differences in age (χ2 = 2.636, p = 0.008), father’s education level (χ2 = 4.207, p < 0.001), mother’s education level (χ2 = 4.217, p < 0.001), daily tooth brushing frequency (χ2 = 3.160, p = 0.002), age of starting tooth brushing (χ2 = 8.756, p < 0.001), mouth rinsing after meals (χ2 = 89.401, p < 0.001), Streptococcus mutans positivity (χ2 = 133.503, p < 0.001), non-sweet snack consumption frequency (χ2 = 5.962, p < 0.001), snack flavour preference (χ2 = 116.119, p < 0.001), use of fluoridated toothpaste (χ2 = 75.639, p < 0.001), regular oral examinations (χ2 = 98.711, p < 0.001), sugary drink consumption frequency (χ2 = 10.370, p < 0.001) and sweet food consumption frequency (χ2 = 9.261, p < 0.001) between the caries and non-caries groups. Multifactorial analysis revealed that older age (odds ratio [OR] = 5.342, 95% confidence interval [CI]: 1.434–6.631), later initiation of tooth brushing (OR = 3.244, 95% CI: 2.413–5.424), S. mutans positivity (OR = 5.357, 95% CI: 4.529–8.563), high snack consumption frequency (OR = 3.452, 95% CI: 2.634–5.442), high sugary drink consumption frequency (OR = 4.414, 95% CI: 2.534–6.451) and high sweet food consumption frequency (OR = 4.531, 95% CI: 3.421–6.354) were risk factors for dental caries. Higher father’s educational level (OR = 0.724, 95% CI: 0.564–0.891), higher mother’s educational level (OR = 0.641, 95% CI: 0.601–0.813), high daily tooth brushing frequency (OR = 0.572, 95% CI: 0.423–0.864), mouth rinsing after meals (OR = 0.743, 95% CI: 0.643–0.813), use of fluoridated toothpaste (OR = 0.657, 95% CI: 0.553–0.931) and regular oral examinations (OR = 0.443, 95% CI: 0.352–0.747) were protective factors against dental caries (all p < 0.05).ConclusionMultiple factors result in early dental caries in preschool children aged 3–6 years; however, the most influential factors are older age and high snack consumption, as well as high sugary and sweet food/drink consumption.

Nomogram prediction for periodontitis in Chinese pregnant women with different sociodemographic and oral health behavior characteristics: a community-based study

BackgroundPeriodontitis is associated with poor pregnancy outcomes, indicating periodontal health as an important health concern for pregnant women. Herein, this study identified risk indicators for periodontitis and developed a nomogram for predicting the risk of periodontitis in pregnancy by analyzing periodontitis and associated factors in pregnant women.Materials and methodsA community-based cross-sectional study was conducted by including 438 pregnant women at 10–36 gestational weeks from Langfang, China. Pregnant women were examined for periodontal status, and their demographic, socioeconomic, and oral health behavior data were collected. Potential influencing factors of periodontitis were analyzed with univariate and multivariate logistic regression analyses. A nomogram was developed, followed by the assessment of its validation and discriminatory abilities.ResultsThe prevalence of periodontitis was 59.8% in pregnant women. Periodontitis-associated variables in pregnant women were gestational age, non-first pregnancy, daily tooth brushing frequency of ≤ 1 before pregnancy, and annual frequency of periodontal treatment < 1 (including no periodontal treatment). The risk of periodontitis was positively associated with gestational age (OR = 1.28, 95% CI = 1.17–1.39, p < 0.001). Pregnancy history showed a strong positive association (OR = 6.57, 95% CI = 1.22–35.43, p = 0.03). Daily tooth brushing frequency before pregnancy was also positively associated with periodontitis (OR = 1.54, 95% CI = 1.03–2.79, p = 0.05). Additionally, the annual frequency of periodontal treatment exhibited a positive association, with higher odds observed for those with less frequent treatment (OR = 2.28, 95% CI = 1.25–4.14, p = 0.05; OR = 7.37, 95% CI = 3.04–22.06, p < 0.001). These four factors were used to develop a nomogram for predicting periodontitis in pregnant women. The area under the receiver operating characteristic curve of the nomogram was 0.855 and 0.831 in the training and testing cohorts, respectively, reflecting the superior prediction accuracy of the nomogram. The calibration curve and decision curve analysis demonstrated the good performance and net benefit of the nomogram.ConclusionRisk factors for periodontitis in pregnant Chinese women include gestational age, non-first pregnancy, lower frequency of daily tooth brushing before pregnancy, and lower frequency of periodontal treatment. An easy-to-use nomogram with acceptable accuracy can allow for the prediction of periodontitis risk in pregnant Chinese women.Clinical relevanceWith the assistance of this nomogram, clinicians can evaluate the risk of periodontitis in pregnancy, thereby offering more tailored oral health education to women of reproductive age.

Bridging The Gap Between Dentistry and Chronic Disease Prevention

Over the past few years, oral health has been gaining more attention concerning its connection to overall health and the prevention of chronic diseases. Beijing Health Service Survey research shows that oral health behavior is related to the risk of chronic diseases in middle-aged and older adults living in Beijing, China (Guo et al., 2023). Bad oral hygiene practices are implicated in poor cardiovascular diseases (CVD) as well as endocrine and nutritional metabolic disorders, as stated by the findings. This confirms that oral health behavior is an important modifiable risk factor for chronic illnesses, thereby necessitating integrated intervention programs between oral health and regular disease control. Guo et al. (2023) denote a particular pertinence of the study focusing on middle-aged and older people, considering China’s aging population and the escalating prevalence of chronic diseases. By evaluating the daily frequency of toothbrushing as an oral health behavior index, this research has provided valuable information about how simple oral hygiene practices can impact the risk for chronic conditions. These findings add to a growing evidence base that underscores the significance of oral health in preventive healthcare strategies. This paper aimed to explore paths that would link verbal health behavior with chronic diseases and to develop targeted programs that could enhance middle-aged and older adults’ practices regarding dental management.

Association between multimorbidity and periodontal disease in Korean adults: A nationwide cross-sectional cohort study.

This study aimed to investigate the association between multimorbidity, which refers to the presence of two or more chronic diseases, and periodontal disease in Korean adults using national survey data. A total of 12,440 Korean adults aged ≥19 years were selected from the seventh Korea National Health and Nutrition Examination Survey (KNHANES). We investigated periodontal disease status based on various variables, including the gender, age, educational level, income level, smoking and alcohol drinking status, frequency of daily toothbrushing, and unmet dental treatment needs. Furthermore, periodontal status according to diagnosed chronic diseases, including hypertension, dyslipidaemia, stroke, myocardial infarction, angina pectoris, and diabetes, was investigated, and the association between multimorbidity and periodontal disease was analysed through multiple logistic regression using SAS 9.4. According to the general characteristics of the study participants, the prevalence of periodontal disease was higher in males, smokers, older age, and lower educational and income levels (p < 0.001). Moreover, as the frequency of daily toothbrushing increased, the distribution of periodontal disease decreased (p < 0.001). The prevalence of periodontal disease was higher in those with chronic diseases than in those without chronic diseases and was statistically significantly higher as the number of diagnosed chronic diseases increased (p < 0.001). Additionally, an increase in the number of chronic diseases was observed to increase the prevalence and risk of periodontal disease. These results suggest that multimorbidity significantly affects the prevalence of periodontal disease.

Variables associated with oral health-related self-efficacy - results of a cross-sectional study.

Oral health-related self-efficacy (OH-SE) is pivotal for oral health and is associated with other oral-health related variables, such as dental fear and anxiety (DF/A) and dental hygiene behaviors (DHB). This study attempts to analyze associations between OH-SE and oral healthrelated variables in a German population to extend previous research by analyzing whether OH-SE can be predicted by these variables, as this might contribute to the development of treatment interventions. OH-SE, DF/A, oral health-related quality of life (OHRQoL), self-perceived dental condition, satisfaction with general health, DHB, and socioeconomic status were assessed as a part of the Saxon Longitudinal Study in an adult sample (n = 309, 56.3% female, all Saxon secondary school 8th graders in 1987). The associations of OH-SE with these variables were examined by means of correlation, multiple linear regression analyses, and group comparisons. Significance (p), standardized regression coefficients (β), and effect size (Cohen's d) were calculated. The correlation analyses revealed increased OH-SE to be accompanied by low levels of DF/A, high levels of OHRQoL, high levels of self-perceived dental condition, increased satisfaction with general health and socioeconomic status (all r ≥ 0.142; all p ≤ 0.013). In the regression analysis, OH-SE was mainly predicted by self-perceived dental condition and satisfaction with general health (R2 = 0.157) as well as by daily frequency of toothbrushing, OHRQoL, and socioeconomic status on a trend-level basis. In the group comparisons OH-SE was lower in participants with moderate for manifest DF/A and higher in individuals with higher OHRQoL, better self-perceived dental condition, increased satisfaction with general health, increased daily frequency of toothbrushing, more dental appointments, and above-average socioeconomic status (trend level; all t ≥ 1.57; p ≤ 0.059). In this cross-sectional study, high levels of OH-SE were mainly predicted by general health as well as self-perceived dental condition. It was also associated with decreased DF/A, increased DHB, higher OHRQoL, and higher socioeconomic status. Future research should analyze these associations in longitudinal designs to address whether interventions focusing on adherence to good DHB improve (dental) health and thus OH-SE. This might be a promising approach, particularly in relation to the treatment of DF/A.

Impact of periodontitis on oral health-related quality of life of patients with psoriatic arthritis.

Since oral health issues can have a negative influence on a person's physical functioning, social status, and wellbeing, oral health-related quality of life (OHRQoL) becomes an indispensable part of overall health. Previous published studies report that periodontitis (PD) and psoriatic arthritis (PsA) have a significant negative impact on OHRQoL. Based on these findings, it would be reasonable to assume that patients with coexisting PsA and PD would see a comparable or maybe synergistic effect on their OHRQoL. Hence, the aim of the present study is to evaluate the OHRQoL and its impact among subjects with concurrent PsA and PD. The present study was a comparative, cross-sectional investigation. A total of 200 participants were categorized into four groups- PD-PsA (n=50), PsA (n=50), PD (n=50), and healthy controls (n=50). Demographic data and periodontal parameters-plaque index, sites with gingival bleeding, probing pocket depth, gingival recession, and clinical attachment level were recorded for all the four groups. Number of mobile teeth due to periodontitis was recorded for the PSA-PD and PD groups. OHIP-14 questionnaire was administered to all the four groups. Collected data was then subjected to statistical analysis. The severity of OHIP-14 summary scores was highest in the PsA-PD group (18.06±11.22) followed by the PD group (17.02±9.99) and lowest in the healthy group (6.32±5.59) (p<.0001). The scores of all the domains- oral pain, oral function, orofacial appearance and psychological impact were highest among the PsA-PD group followed by the PD group (p<.0001). The combined interaction of PsA and PD on the OHRQoL was statistically significant (F=6.33, p=.012). Results of the multiple linear regression analysis indicated that there was a moderate collective significant effect between age, past dental visit, frequency of daily tooth brushing, use of other oral hygiene aids, and OHIP-14 (F(3,196)=13.08, p<.001, R2=0.17, adjusted R2=0.15). The negative impact on OHRQoL was highest in the patients with concurrent presence of PD with PsA followed by those with PD alone. While the summary scores and dimensional scores of OHIP-14 were insignificant when patients with PsA-PD and PD alone were compared, these scores were significantly higher in patients with PsA-PD than patients with PsA alone.

Can Frequent Toothbrushing Reduce the Risk of Cirrhosis among Patients with Nonalcoholic Fatty Liver Disease? Hints from a Registry-Based Study

Introduction: While poor oral hygiene has been previously associated with an increased risk of nonalcoholic fatty liver disease (NAFLD), its association with hepatic fibrosis remains unclear. Here, we sought to analyze if toothbrushing frequency, an easy-to-assess indicator of oral health habits, would be associated with liver stiffness measurement (LSM) by transient elastography (TE) in patients with an established diagnosis of NAFLD. Methods: In this registry-based study, LSM was measured in 1,156 patients with NAFLD and analyzed in relation to the self-reported daily frequency of toothbrushing. LSM values ≥12 kPa were considered indicative of cirrhosis. Results: A trend toward a stepwise decrease (cross-sectional p = 0.13) in LSM was found in patients who reported having their teeth brushed more frequently: less than once a day (10.6 ± 8.6 kPa; 13% of the study sample), once a day (9.95 ± 8.40 kPa; 40%), twice a day (9.21 ± 7.63 kPa; 43%), and after every meal (8.91 ± 5.30 kPa; 4%). Patients who brushed their teeth less than once a day had a significantly higher prevalence of LSM values ≥12 kPa (p < 0.05). In multivariable logistic regression analysis, the association of LSM values ≥12 kPa with toothbrushing habits remained statistically significant for less than once a day (odds ratio = 1.69, 95% confidence interval = 1.07−2.66, p = 0.02) with reference to twice a day or after every meal. Conclusion: Among patients with NAFLD, there is an independent association between brushing teeth less than once a day and TE-established cirrhosis.

Association between birth-related factors and periodontitis in women: Korea National Health and Nutrition Examination Survey 2013-2018.

Adult women experience several changes in physiological status, such as pregnancy and childbirth, during their life cycle. This study analyses the association between birth-related factors (the number of childbirths, abortions and miscarriages) and periodontitis using data from the Korea National Health and Nutrition Examination Survey, which represents Korean adults. The study used data from Korea National Health and Nutrition Examination Survey VI and VII (2013-2018) and included 10,072 women 19 years or older, with no missing data on the variables assessed. Periodontitis was defined according to the Community Periodontal Index (CPI) criteria. Multiple logistic regression analysis, adjusting for age, household income, education, alcohol consumption, smoking, stress, body mass index, waist circumference, hypertension, diabetes mellitus, an oral examination within 1 year, daily tooth brushing frequency, hygiene products and self-perceived oral health as identified via logistic regression analyses, was performed to determine the association between birth-related variables and periodontitis. In the crude model, the odds ratio (OR) showed a significantly increased risk of periodontitis (CPI ≥ 3) and severe periodontitis (CPI = 4) based on the number of childbirths, abortions and miscarriages (p < .05). After covariate adjustment, periodontitis (CPI ≥ 3) was associated with the number of childbirths (1: OR = 1.92; 95% confidence interval [CI]: 1.47-2.50; 2: OR = 2.03; 95% CI: 1.57-2.61; ≥3: OR = 2.11; 95% CI: 1.60-2.78). Furthermore, severe periodontitis (CPI = 4) was also associated with the number of childbirths (1: OR = 2.33; 95% CI: 1.24-4.38; 2: OR = 2.99; 95% CI: 1.62-5.52; ≥3: OR = 3.34; 95% CI: 1.79-6.21). The findings of this large-scale, nationally representative study suggest that the number of childbirths is associated with the severity of periodontitis. However, the relationship between the number of abortions and miscarriages and periodontitis (CPI ≥ 3) or severe periodontitis (CPI = 4) is not significant.

A Social Media Intervention for Promoting Oral Health Behaviors in Adolescents: A Non-Randomized Pilot Clinical Trial.

Poor oral hygiene and excessive consumption of soda are among the main drivers of systemic health issues in adolescents in the United States. This non-randomized pilot clinical trial focused on the effects of a health text message system and smartphone-based intervention on adolescent tooth-brushing behavior and dietary choices, with a convenience sample of 94 participants aged 12 to 14 years old. A group of 75 participants agreed to use a tooth-brushing app and received a health text message; the other group of 15 agreed to use the tooth-brushing app, but did not receive a health text message. Saliva specimens were collected directly before and at the end of each experiment; changes in the salivary presence of cariogenic bacteria over the duration of the study were evaluated and compared with the demographics and behavioral variables. Within the text message group, 5% of participants increased the frequency of daily tooth brushing. Within the non-intervention group, 29% of participants increased the frequency of their daily tooth brushing. There were reductions in the total salivary bacteria and total streptococci in both groups (p < 0.001), but no change in the presence of cariogenic Mutans streptococci. Raising adolescents' consciousness of oral health behavior resulted in marginal to moderate improvements to oral hygiene and dietary choices, as well as reductions in total salivary bacteria.

Oral health status of students with visual or hearing impairments in Northeast China

BackgroundVisual or hearing impairments in students seriously affect their quality of life. The aim of this study was to identify oral hygiene status and its influencing factors on visual or hearing impairments in students in Northeast China.MethodsThis study was conducted in May 2022. A total of 118 visually impaired students and 56 hearing impaired students from Northeast China were included in this study via census. Oral examinations and questionnaire-based surveys of students and their teachers were conducted. The oral examinations included caries experience, prevalence of gingival bleeding and dental calculus. The questionnaires included three parts: Social demographics (residence, sex and race) and parents’ educational level; Oral hygiene habits and medical treatment behaviors; Knowledge and attitudes towards oral health care. This questionnaire was selected from the Fourth China National Oral Health Survey and the reliability and validity of the questionnaire were previously tested. T tests, one-way ANOVA, χ2 tests and multivariate logistic analyses were conducted to evaluate the differences and dependent variables of dental caries.ResultsThe prevalence of dental caries in visually impaired and hearing impaired students were 66.10% and 66.07%. The mean number of DMFT, prevalence of gingival bleeding and dental calculus in visually impaired students were 2.71 ± 3.06, 52.08% and 59.38%, respectively. The mean number of DMFT, prevalence of gingival bleeding and dental calculus in hearing impaired students were 2.57 ± 2.83, 17.86% and 42.86%, respectively. The results of the multivariate logistic analysis showed that fluoride use and parents’ educational background had an impact on the caries experience of visually impaired students. The daily toothbrushing frequency and parents’ educational background had an impact on the caries experience of hearing impaired students.ConclusionsThe oral health situation of students with visual or hearing impairments remains severe. It is still necessary to promote oral and general health in this population.

Association of Oral Health with Risk of Rheumatoid Arthritis: A Nationwide Cohort Study.

Periodontitis and rheumatoid arthritis (RA) are inflammatory diseases that share many similarities. We aimed to investigate the associations of periodontitis and oral hygiene status and behaviors with RA in a nationwide general population cohort. Participants from the National Health Screening cohort database of Korea who underwent oral health screening by dentists between 2003 and 2004 were included. The occurrence of RA was analyzed according to the presence of periodontitis, oral health examination findings, and behaviors. Overall, 2,239,586 participants were included. During a median of 16.7 years, RA occurred in 27,029 (1.2%) participants. The risk for incident RA was higher when participants had periodontitis (hazard ratio (HR) 1.2, 95% confidence interval (CI), 1.08-1.24) and an increased number of missing teeth (HR 1.5, 95% CI, 1.38-1.69). In contrast, better oral hygiene behaviors, such as a higher frequency of daily tooth brushing (HR 0.76, 95% CI 0.73-0.79, p for trend <0.001) and a recent history of dental scaling (HR 0.96, 95% CI 0.94-0.99), were associated with a lower occurrence of RA. Periodontitis and increased missing teeth were associated with an increased risk of RA. Maintaining good oral hygiene through frequent tooth brushing and regular dental scaling may reduce the risk of RA occurrence.

Early Childhood Caries in a Preschool-based Sample in Northeast Italy: Socioeconomic Status and Behavioral Risk Factors.

To assess the relationship among caries and age, gender, immigrant condition, socioeconomic status (SES), and a behavioral risk factor (toothbrushing) in a sample of 3-5-year-old children. We performed a random cross-sectional survey from January to December 2017, carrying out clinical examinations to estimate the decayed, missing, and filled teeth (dmft) score. Parents filled in a questionnaire reporting their education level (SES) and the daily frequency of children's toothbrushing. The multivariate analysis assessed the association between caries occurrence and the independent variables. The dmft score was assessed by zero-inflated negative binomial regression (ZINBR). Out of 1,441 children in the sample, 357 (26.0%) presented at least one caries-affected tooth. Caries risk significantly increased with age and irregular toothbrushing, and it was significantly higher in children with lower SES levels. We modeled caries risk by means of ZINBR. The degree of caries experience increased in children from lower SES positions, immigrant status, and of older age; regular toothbrushing (twice a day) is a predicting factor to belong to the "zero caries" group. Dental caries represent a significant burden in preschool children and can be regarded as an early marker of social disadvantage. The confirmation of the earliest preventive approach as the only chance to grant a "caries free" dentition in all ages and the first target for a pediatric dentist. Ferro R, Besostri A, Olivieri A, et al. Early Childhood Caries in a Preschool-based Sample in Northeast Italy: Socioeconomic Status and Behavioral Risk Factors. Int J Clin Pediatr Dent 2022;15(6):717-723.

Oral Health and Risk of Retinal Vascular Occlusions: A Nationwide Cohort Study.

Retinal vascular occlusions are a common cause of visual loss. The association between oral health and the risk of retinal vascular occlusions remains unknown. We investigated whether oral health was associated with the risk of retinal vascular occlusions. We conducted a retrospective cohort study including 138,484 participants who completed a national health screening program with an oral health examination from the National Health Insurance Service-National Health Screening Cohort (NHIS-HEALS) 2002-2015. Oral health markers, such as the presence of periodontitis, tooth loss, and dental caries, and the frequency of daily tooth brushing, were evaluated. The primary outcome was the occurrence of retinal vascular occlusions up to December 2015. In total, 2533 participants developed retinal vascular occlusions (215 with retinal artery occlusion, 1686 with retinal vein occlusion, 632 with unspecified retinal vascular occlusion). In the multivariable Cox regression analysis, periodontitis was an independent risk factor for retinal vascular occlusions (adjusted hazard ratio: 1.18; 95% confidence interval: 1.02-1.36; p = 0.024). Frequent tooth brushing was negatively associated with the risk of retinal vascular occlusions (adjusted hazard ratio: 0.89; 95% confidence interval: 0.80-0.98; p = 0.022). Improving oral hygiene may contribute to the attenuation of the risk of retinal vascular occlusions.

Knowledge and Attitudes on Preventing and Treating Dentin Hypersensitivity and Its Predicting Factors: A Cross-sectional Study with Brazilian Citizens.

Most dental schools have included dentin hypersensitivity (DH) as part of their taught curriculum to educate undergraduates; however, it is possible that the public still does not recognize its symptoms and the factors that predispose to the onset of this condition. Thus, the aim of this study was to assess the knowledge of a Brazilian population regarding the prevention and treatment of DH and to identify what self-reported factors can serve as predictors of the frequency of DH. An online questionnaire investigated the demographic characteristics, oral health self-perception and attitudes, and DH prevention and treatment measures of 226 participants. Data were analyzed descriptively and by a multiple linear regression with DH frequency score as the dependent variable (α < 0.05). Total 61.1% of females (n = 138) and 38.9% of males (n = 88) (mean age: 35.1 ± 12.2 years) completed the questionnaire. The sample's mean DH frequency score (minimum 0; maximum 20) was 4.2 and classified as low, with 19.1% using desensitizing products and 22.1% reporting having noncarious cervical lesions (NCCLs). When experiencing DH episodes, 21.2% never and 30.1% rarely scheduled dental appointments. Regression analysis retrieved a significant final model (F [5,220] = 12.047; p < 0.001; R 2 = 0.215). This study identified that 36.7% and 18.6% of the sample were unaware that DH can be both prevented and treated, respectively. Moreover, the presence of NCCLs, frequency of daily toothbrushing, use of desensitizing products, presence of DH modulating factors, and the presence of parafunctional habits symptoms served as predictors of DH frequency.

Risk indicators for dental caries, and gingivitis among 6–11-year-old children in Nigeria: a household-based survey

BackgroundThere is little is known about the factors associated with caries experience and gingivitis among 6–11-year-old children in Nigeria. The aim of the study was to determine the prevalence and preventive oral health behaviors associated with caries and gingivitis among 6–11-year-old children in Nigeria.MethodsA cross-sectional questionnaire-based survey was conducted in Ile-Ife, Nigeria. The dependent variables were caries and gingivitis. The dmft/DMFT index was used to assess dental caries experience (present or absent) and caries severity. The gingival index was used to assess the prevalence (present or absent) and severity of gingivitis (healthy gingiva/mild gingivitis versus moderate/severe gingivitis). The independent variables were preventive oral health behaviors (frequency of daily tooth brushing, frequency of consumption of refined carbohydrates in-between-meals, use of fluoridated toothpaste, and use of dental floss, history of dental service utilization). A series of logistic regression analysis models were constructed to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, and socioeconomic status).ResultsThere were 69 (5.2%) children with caries. The mean (standard deviation) dmft was 0.08 (0.457) and the mean DMFT was 0.02 (0.159). There were 839 (63.3%) children with gingivitis with a mean (SD) gingival index score of 0.503 (0.453). Children who seldom or never used fluoride toothpaste had significantly higher odds of developing moderate to severe gingivitis (AOR; 1.671; 95% CI: 1.003–2.786; p = 0.049). Children with middle socio-economic status had significantly lower odds of developing moderate to severe gingivitis (AOR: 0.573; 95%CI: 0.330–0.994; p = 0.048). There were no risk indicators identified for caries.ConclusionThe prevalence of dental caries was low while the prevalence of gingivitis was high in the study population. The daily used of fluoridated toothpaste seem to reduce the risk for moderate/severe gingivitis. Further studies are needed to understand these findings.

Trends in Self-Rated Oral Health and Its Associations with Oral Health Status and Oral Health Behaviors in Japanese University Students: A Cross-Sectional Study from 2011 to 2019.

Self-rated oral health (SROH) is a valid, comprehensive indicator of oral health status. The purpose of this cross-sectional study was to analyze how oral health behaviors and clinical oral status were associated with SROH and how they had changed over the course of nine years in Japanese university students. Data were obtained from 17,996 students who underwent oral examinations and completed self-questionnaires from 2011 to 2019. Oral status was assessed using the decayed and filled teeth scores, bleeding on probing (BOP), probing pocket depth, the Oral Hygiene Index-Simplified (OHI-S), oral health behaviors, and related factors. SROH improved from 2011 to 2019. The logistic regression model showed that university students who were female and had a high daily frequency of tooth brushing, no BOP, no decayed teeth, no filled teeth, and a low OHI-S score and were significantly more likely to report very good, good, or fair SROH. An interaction effect was observed between survey year and regular dental check-ups (year × regular dental check-ups). The improvement trend in SROH might be associated with changes in oral health behaviors and oral health status.

Oral symptoms and oral hygiene behaviours among patients with type 2 diabetes at a hospital in Japan: A cross-sectional study.

Effective daily oral hygiene behaviour will prevent periodontal disease. This study aimed to examine the oral symptoms, oral hygiene behaviours and factors contributing to oral hygiene behaviours among patients with type 2 diabetes in a hospital in Japan. A cross-sectional survey was conducted with 198 patients with type 2 diabetes. Oral symptoms were assessed using a dichotomous scale based on clinical guidelines. Oral hygiene behaviours were assessed based on the frequency of daily tooth brushing and the use of interdental cleaning aids. Chi-square tests and logistic regression analyses were also performed. Overall, 71.2% of the participants had oral symptoms. Of the participants, 80.3% performed twice daily tooth brushing and 61.1% did not perform interdental cleaning on a daily basis. Logistic regression analysis revealed that tooth brushing behaviour was negatively associated with male patients (odds ratio [OR]=0.45, 95% confidence interval [CI]: 0.25-0.80), difficulty with mastication (OR=0.63, CI: 0.43-0.92) and tooth loss (OR=0.68, CI: 0.46-1.00) and positively associated with periodontal disease (OR=1.73, CI: 1.10-2.72). There were no significant variables related to the use of interdental cleaning aids. Patients need to learn about the necessity for regular oral hygiene behaviours and the appropriate way. In particular, support for male patients, those who have difficulty with mastication, those who have experienced natural tooth loss, and those who have not been diagnosed with periodontal disease are needed.

Quality of education and adolescents' oral health-related behaviours: a multilevel analysis.

The school environment may positively influence student health behaviours and learning. This study aimed to investigate the association between cities' quality of education and adolescent students' oral health-related behaviours. Cross-sectional study using data of the 2015 Brazilian National Adolescent School-Based Health Survey and other public databases. The sample was composed of adolescents (N = 23,674) from public schools of the 27 Brazilian state capitals. Outcomes were four oral health-related behaviours: toothbrushing, sweets and soft-drink consumption, and dental visits. The explanatory variable was the cities' quality of education, measured by the Brazilian Basic Education Development Index. Covariates were individual (sociodemographic) and contextual (socioeconomic, oral health coverage and oral health-promoting schools). Multilevel logistic regression was performed considering two levels: individual (adolescents) and contextual (city). The prevalence of the outcomes were: low daily toothbrushing frequency 6.7% (95% CI 6.0-7.4); high weekly sweets consumption 41.5% (95% CI 40.3-42.7); high weekly soft-drink consumption 28.5% (95% CI 27.2-29.9); and low frequency of annual dental visits 31.2% (95% CI 30.1-32.3). In the adjusted models, cities whose schools had higher scores of education quality were more likely to have students with low toothbrushing frequency and high frequency of sweets consumption. The cities' quality of education was associated with unhealthy oral health-related behaviours, particularly the frequency of toothbrushing and sweets consumption. Therefore, appropriate health promotion strategies as well as high-quality education are needed in schools.

Kariesprävalenz und Karieserfahrung bei 3- bis 6-jährigen Kindern in Hamburg

Background and objectives: A caries epidemiological survey in daycare centers in the city of Hamburg, Germany, was conducted to determine the caries prevalence and the mean caries experience in 3- to 6-year-old children in 2016. The findings were compared with a survey conducted 10 years earlier. Special focus was placed on the caries burden of 3 year olds. Methods: A visual caries examination was conducted according to World Health Organization (WHO) criteria and with additional registration of initial lesions. A questionnaire was used to obtain information from the parents about tooth brushing in their children. Results: A total of 933 children were examined. The caries prevalence was 22.7%, the decayed/missing/filled teeth (DMFT) value was 0.8. Each child with caries had a mean of 3.5 affected teeth. Including initial lesions, the caries prevalence was 44.4% with a mean DMFT value of 1.8. Compared to the previous study, a further decrease in caries was observed. However, this was only minimal in the 3-year-old children. Of note is the already high incidence of initial caries in the 3 year olds. Univariate statistical analyses showed significant relationships between the start of tooth brushing (fewer caries when starting in the first year of life), daily tooth brushing frequency (more caries when brushing less than twice a day), and quality of oral hygiene (high caries burden with large amounts of plaque). Conclusions: The unfavorable results for the 3-year-old children and the correlations between tooth brushing and caries prove once again that structured caries prevention measures must begin well before the age of 3. This highlights the potential of the recently implemented dental screening examinations in very young children and the current recommendations for an early start of tooth brushing with fluoride-containing toothpaste for children.

White Spots Prevalence and Tooth Brush Habits during Orthodontic Treatment.

White spots (WS) are one of the most undesirable side effects in patients undergoing orthodontic therapy and are usually located around bracket bases and even detected under the molar bands. The aim of the present cross-sectional study was to evaluate the WS lesion during orthodontic therapy and the correlation between WS and oral hygiene habits. Patients requiring orthodontic treatment with a fixed appliance were screened for the inclusion/exclusion criteria, and 74 subjects were finally enrolled. Each patient received three examinations: at T0, the day of the application of the fixed appliance; at T1, three months later; and at T2, six months after treatment start. After calculating descriptive statistics, differences between groups were evaluated with an independent sample t-test. The first type error was set as p ≤ 0.01. The observed prevalence of WS lesions was 59.5% on T1 and 60.8% on T2. The most affected teeth result to be upper molars, lower left first molar, upper right central incisor and upper left lateral incisor, upper right canine, upper left first premolar, and lower right first molar. A higher frequency of daily tooth brushing was accompanied by a lower prevalence of WS. No significant effect of sex was observed.