Decrease In Caries Prevalence Research Articles

Prevalence and experience of dental caries among Singaporean schoolchildren: A time-trend analysis from 2007 to 2019.

This study aimed to describe caries prevalence and experience trends of permanent teeth among Singapore schoolchildren between 2007 and 2019. Anonymized records of all 6-year-old Primary 1 (P1), 11-year-old Primary 6 (P6) and 14-year-old Secondary 3 (S3) before the start of each school year were extracted from the Integrated Dental Electronic Assessment System (IDEAS) by school level, ethnicity and sex. Prais-Winsten regression was used to assess trends of mean decayed, missing and filled teeth (DMFT) and caries prevalence (% DMFT > 0) among the schoolchildren by school level, with reported Average Annual Percentage Change (AAPC) together with respective 95% confidence interval (CI). In total, 519 471 P1, 566 573 P6 and 548 138 S3 were included during the above period, and the majority were comprised of Chinese children (P1: 67.2%, P6: 68.8% and S3: 71.0%, respectively). Overall, the prevalence of caries dropped from 6.9% in 2007 to 3.5% in 2019 among P1, from 34.5% in 2009 to 20.3% in 2019 among P6 and from 41.5% in 2007 to 33.5% in 2019 among S3 schoolchildren. The mean DMFT reduced from 0.11 to 0.05 among P1, 0.72 to 0.35 among P6 and 1.05 to 0.76 among S3 schoolchildren during the same period. Caries prevalence and mean DMFT were consistently higher among girls. On average, caries prevalence decreased 5% per year in P1 (AAPC -5.0 [95% CI: -6.1, -3.9]) and P6 (AAPC -4.9 [95% CI: -5.7, -4.1]) and 2% among S3 (AAPC -2.0 [95% CI: -3.5, -0.4]) schoolchildren. Caries prevalence decreased approximately 4% ~ 5% annually among P1 and P6 schoolchildren regardless of ethnicity. The average decrease in caries prevalence was lower (about 2%) among all ethnicities at S3 school level. Dental caries in permanent dentition of Singaporean schoolchildren had decreased from 2007 to 2019. However, the decrease observed among primary school students was more than double that among secondary schoolchildren.

FLUORIDES AND ORAL HEALTH

Background. The importance of fluorides in caries prevention is discussed in the article and practical recommendations for the use of fluoride containing products are presented. Objectives. The primary objective of this systematic review is to assess the evidence on the comparative effectiveness of topical fluoride therapy (TFT) in the form of toothpastes, mouth rinses, gels and varnishes in prevention of dental caries in children and adolescents. Methods. A systematic electronic literature search was conducted in the PubMed and Web of Science databases using search terms. Current reports in the literature concerning means and methods of use of fluoride-containing medications are considered. Results. A large number of scientific studies, reviews based on them and meta-analyses conclude that the central element of caries prevention, on which the decrease in caries prevalence and caries experience is based, is the regular topical use of fluoride medications for oral cavity. Conclusions. Topical use of fluorides is a key element in successful caries prevention.

Chapter 5.3: Diet and Coronal Caries.

In this chapter, diet is revisited to shed light on its role in caries development and management in contemporary populations. Measures applied to promote a rational consumption of sugars and changes observed in sugars consumption are also addressed. A cariogenic diet provokes an imbalance in the oral microbiome, resulting in dysbiosis with predominance of acidogenic and aciduric bacteria in the dental biofilm. Both a cariogenic diet and a balanced diet modulate caries development and progression in contemporary populations. A cariogenic diet particularly impacts high-risk groups and should be avoided. A rational consumption of sugars presents a low risk for caries development in populations with regular oral hygiene practices and exposure to fluoride-containing toothpaste or combined exposure to fluoride-containing toothpaste and fluoridated water. Some initiatives have been developed to promote a rational consumption of sugars, but further efforts should be made in this respect. Although the consumption of sugars has remained high and stable, some countries observed a decrease in caries prevalence. A reduction in the daily consumption of sugars provides general and oral health benefits. Therefore, the intake of sugars should be as low as possible in the context of a nutritionally balanced diet.

Effect of Oral Health Promotion on Caries Experience and Oral Cleanliness of School Children in Kerung, Nepal: A Prospective 6-month Follow-Up Study.

A longitudinal oral health promotion project on caries experience and oral cleanliness was performed in a remote village in Nepal. The aim of this 6-month prospective survey was to investigate the impact of an oral health promotion project on caries experience, oral health-related behaviour, and general knowledge about oral health in Kerung, a remote village in Nepal. A prospective study was conducted in a convenience sample of children from the local school in Kerung. At baseline and after six months, dental plaque scores and caries experience scores were measured by calibrated examiners. Validated questionnaires on oral health habits and knowledge on oral health were taken. In addition, an oral health promotion program was developed. At baseline, 359 children were included, of which 266 could be surveyed after six months. A statistically significant decrease in the mean plaque score was found at after six months with a higher reduction for boys. A significant decrease in caries prevalence, as well as a significant increase in knowledge about oral health, was observed. Furthermore, after six months there were significantly more children reporting that they brushed their teeth for at least two minutes. Dental screenings and a comprehensive educational program resulted in a significant improvement of oral health.

When and How to Intervene in the Caries Process.

The decrease in caries prevalence in many industrialized countries and the improved knowledge about the etiology and pathogenesis of caries have shifted the focus of caries therapy over the past decades toward less invasive approaches. Studies on caries progression indicate that it is generally quite slow in most patients today which should lead to a reconsideration of the practice of early invasive intervention. Today noninvasive (eg, fluorides) and microinvasive (occlusal sealing, proximal infiltration) therapeutic options that address etiological factors are gaining importance. The goal of these therapies is to heal or at least to slow down the progress of the disease. Noninvasive treatments are mainly related to controlling pathogenic factors (ie, sugar consumption) and enhancing protective factors (mainly oral hygiene and fluorides). Microinvasive treatments do not rely on the compliance of the patient as much, since these treatments include a resinous material that is applied to serve as a diffusion barrier for acids formed by cariogenic bacteria in the overlying plaque. To establish a minimum intervention treatment strategy for caries, the disease must be diagnosed at an early stage. In addition to assessing caries lesions in single teeth, individual risk factors need to be identified so that the underlying causes related to patients' behavioral patterns that led to the disease can be addressed as well. The patient should be informed about the scientific evidence related to the treatment choices in a participative atmosphere. Decision trees may help to make the range of findings comprehensible and the therapeutic shared decision-making process understandable to the patients.

Effectiveness of Fluorescence-based Methods in Monitoring Progression of Noncavitated Caries-like Lesions on Smooth Surfaces.

Although there has been a significant decrease in caries prevalence in developed countries, the slower progression of dental caries requires methods capable of detecting and quantifying lesions at an early stage. The aim of this study was to evaluate the effectiveness of fluorescence-based methods (DIAGNOdent 2095 laser fluorescence device [LF], DIAGNOdent 2190 pen [LFpen], and VistaProof fluorescence camera [FC]) in monitoring the progression of noncavitated caries-like lesions on smooth surfaces. Caries-like lesions were developed in 60 blocks of bovine enamel using a bacterial model of Streptococcus mutans and Lactobacillus acidophilus . Enamel blocks were evaluated by two independent examiners at baseline (phase I), after the first cariogenic challenge (eight days) (phase II), and after the second cariogenic challenge (a further eight days) (phase III) by two independent examiners using the LF, LFpen, and FC. Blocks were submitted to surface microhardness (SMH) and cross-sectional microhardness analyses. The intraclass correlation coefficient for intra- and interexaminer reproducibility ranged from 0.49 (FC) to 0.94 (LF/LFpen). SMH values decreased and fluorescence values increased significantly among the three phases. Higher values for sensitivity, specificity, and area under the receiver operating characteristic curve were observed for FC (phase II) and LFpen (phase III). A significant correlation was found between fluorescence values and SMH in all phases and integrated loss of surface hardness (ΔKHN) in phase III. In conclusion, fluorescence-based methods were effective in monitoring noncavitated caries-like lesions on smooth surfaces, with moderate correlation with SMH, allowing differentiation between sound and demineralized enamel.

Changes in the prevalence of dental caries in primary school children in Lagos State, Nigeria

To evaluate the changes in the prevalence of dental caries in Lagos State over a 3 years period and the role of age, sex, and playing in the changes observed. Three primary schools in Lagos State, Nigeria were randomly selected for the study. Six hundred and thirty-three children age 2-12 years, were examined for caries in 2000 while 513 children were examined in 2003. The prevalence of tooth decay and the prevalence of untreated tooth decay were calculated for the two years, that is, 2000 and 2003. Also the degree of unmet treatment need among the population with caries experience was measured. Differences in the prevalence and severity of dental caries in the primary and permanent dentition were assessed. Approximately 18% of children had untreated tooth decay in their primary dentition in 2003: A 26.1% increase from 2000. About 12.0% of the decay, extracted, and filled teeth (deft) index was seen with decayed teeth in 2000 and 16.6% in 2003. Extracted primary teeth decreased from 2.5% in 2000 to 1.5% in 2003. The change in mean deft between 2000 (0.42) and 2003 (0.47) was 11.9%. Over the study period, the overall reduction in the prevalence of dental caries was 34.8% in the permanent dentition. The decline was larger among children aged 5-9 years (62.1%) and among females (75%). The study showed no overall changes in caries severity but a decrease in caries prevalence in the permanent dentition over the study period. The largest decline in caries prevalence in the permanent dentition was observed in children aged 5-9 years and females. On the contrary, there was an increase in the caries prevalence in the primary dentition.

Diagnosis of the early carious lesion

In recent decades a desire has driven the uptake of the minimum intervention dentistry (MID) philosophy to end the destructive 'drill and fill' mentality prevalent amongst dental training programmes since the establishment of formalized dental training courses more than 100years ago. This change in attitude has been concomitant with the decrease in caries prevalence in large sectors of the community and a better understanding of the caries process. One of the pivotal arms of MID is caries risk assessment, and early and accurate caries detection is a major part of this procedure. There is great variation between the diagnostic decisions between individual clinicians, and the development of valid detection aids may decrease this variation and improve the clinical decision making process as it relates to dental caries.

Assessment, management, and prevention of early childhood caries

To discuss the role of primary care health providers in identifying infants and young children at risk for dental caries during well-child visits, in providing anticipatory guidance to parents and primary care givers of at-risk children, and in providing appropriate referrals for the timely establishment of a dental home. The search included the following: Ovid MEDLINE, PubMed, American Academy of Pediatrics Web site, American Academy of Pediatric Dentistry Web site, and the American Dental Association Web site. The following search terms were used: dental caries prevention, caries process, caries balance, dental home, early childhood caries, oral health disparities, dental caries risk assessment, fluoride varnish, oral health anticipatory guidance. Search was limited to English language sources from 1990 through 2007. Dental caries is a preventable and reversible infectious disease process, yet it continues to be the single most common chronic disease of childhood. Despite a decrease in caries prevalence and a decrease in untreated tooth decay in 6-19-year-olds in the United States, a 15.2% increase in disease was noted among the nation's youngest children aged 2-5 years. Primary care health providers are uniquely positioned to play a significant role in the prevention of dental caries and are encouraged to complete certification courses in caries risk assessment, intervention, education, and referral. Clinicians need to understand the dental caries process, including the process of enamel demineralization and remineralization, and the factors contributing to caries balance. The importance of early identification and intervention for infants and toddlers at high risk for dental caries and primary care health provider-delivered anticipatory guidance during well-child care visits cannot be overestimated.

Patients' satisfaction with dental esthetics

Esthetics has become an important issue in modern society, as it seems to define one's character. In the past, functional demands were the main consideration in dental treatment. Today, with the decrease in caries prevalence, the focus has shifted toward dental esthetics. The authors conducted a study to evaluate the factors influencing patients' satisfaction with their dental appearance and with the results of esthetic treatment. The authors surveyed a population of 407 adults (mean age, 21 years). They distributed a questionnaire regarding satisfaction with current dental esthetics and previous esthetic treatments. Of the 407 subjects, 152 (37.3 percent) were dissatisfied with their dental appearance. Tooth color was the primary reason for dissatisfaction (133 [89.3 percent] of 149 subjects), followed by poor tooth alignment (36 [23.7 percent] of 152 subjects), although 110 (27 percent) of the 407 subjects had received orthodontic treatment. The authors found no correlation between patients' satisfaction with their dental appearance and having undergone any procedure to whiten their teeth. Nevertheless, 134 (88.2 percent) of the dissatisfied subjects reported that they would like to undergo this procedure. Tooth color was a major factor with regard to dental esthetics. Most subjects were interested in improving their appearance and whitening their teeth. When planning treatment, dentists should take into consideration esthetic objectives in addition to function, structure and biology. This requires the clinician to rely on several disciplines in dentistry to deliver the highest level of dental care, which should lead to a higher level of patient satisfaction.

Prevalence and severity of dental caries in Costa Rican schoolchildren: results of the 1999 National Survey

In 1987, Costa Rica implemented a comprehensive national salt fluoridation programme using sodium fluoride (225-275mg F/kg salt). To describe dental caries prevalence and severity in Costa Rican children in 1999. Eight calibrated examiners (inter-examiner Kappa = 0.70 or higher) recorded information on dental caries, treatment needs, enamel fluorosis, and dentofacial anomalies for schoolchildren aged 6-8,12, and 15-years (N=3758). The survey utilised a multistrata probability sample with fixed allocation to represent seven regions of the country. The overall mean dmft for age 6-8 years was 3.32. The DMFT for age 12 was 2.46 and for age 15 was 4.37. Regional differences were observed; for example, the DMFT at age 12 years ranged from 1.93 to 3.86. Compared with pre-fluoridation data collected in 1984, schoolchildren aged 12 years, experienced a 28 per cent decrease in caries prevalence (100 per cent to 72 per cent) and a 73 per cent decrease in severity (DMFT from 9.13 to 2.46, representing an 8.3 per cent compound annual per cent reduction). Between 1984 and 1999, Costa Rican schoolchildren experienced substantial reductions in caries prevalence and severity. Many factors may be involved in this decline, but the most important appears to be exposure to fluoridated salt.

Trends in dental caries in Latin American and Caribbean 5-6- and 11-13-year-old children: a systematic review.

To determine trends in dental caries prevalence and severity in Latin America and Caribbean. A systematic review was done of studies published between 1970 and 2000 among 5-6- and 11-13-year-old children that used WHO caries diagnostic criteria. Over the last 30 years, there has been a significant decrease in caries severity for children 5-6 years old and also a significant decrease in caries prevalence and severity for children 11-13 years old. The same broad trends were observed when caries prevalence and severity was analyzed for the last 20 and 10 years but these were not statistically significant. Evidence of a decrease in dental caries in Latin American and Caribbean children has been shown, although the decrease was less prominent in the past few years.

Is there a long-term caries-preventive effect of sugar restrictions during World War II?

Wartime decrease in caries prevalence among children explained by restrictions in sugar availability and consumption is widely documented. The aim of the present investigation was to study possible long-term effects of this regimen on dental caries. Norwegian age cohorts who were 7 years old during World War II were reexamined in 1983. On the basis of DMF recordings of their first permanent molars, a long-lasting beneficial effect of the wartime caries decrease could not be demonstrated.

Prevalence and distribution of caries in a Jerusalem adolescent population by age, sex, and family income.

Four hundred and fourteen high school students aged 12-17 were examined clinically using the DMFS index and bitewing radiographs. Analyses by age, sex, economic status, and types of teeth and tooth surfaces were performed and results were compared with other international studies. Only 7.5 percent of the study population had a zero DMFS score. Females had a significantly higher DMFS score than males (13.21 vs 9.59). Caries experience increased with age and a general trend of increasing DMFS was observed with increasing levels of income. Socioeconomic status (SES) was related directly to DMFS in Israel, in contrast to an inverse relationship observed in most other western countries. First molars were most susceptible to caries attack and accounted for 41.2 percent of the total DMFS. Almost 50 percent of all affected surfaces were occlusal and 29.4 percent were proximal. Caries prevalence in general and proximal caries in particular were found to be much higher in the study population than corresponding figures in other industrialized countries. A significant decrease in caries prevalence could be expected in Israel in the next decade if primary preventive measures are implemented immediately.

某高等専門学校の１９７５年〜１９８７年度学生におけるう蝕有病状況

In order to examine the reduction of dental caries in Japanese adolescents, 1368 male students aged 15 to 19 years were examined from 1975 to 1987. Because an irregular yearly variation in caries prevalence among the same age groups was observed, the method of 3-year moving average was used and statistically analyzed on a linear regression. From the yearly trend in the same age groups, peaks were shown in the mean DMFT of students 15 to 17 years of age in 1979 to 1981 and in the mean DMFS of students 15 to 19 years of age in 1979 to 1983. After the peaks, a statistically significant decrease in caries prevalence was found in the mean DMFT of students 15 years of age and in the mean DMFS of students 15 and 17 years of age. It is therefore concluded that a decline in dental caries in Japanese adolescents is clear and will be more evident in the near future.

Continual highly significant decrease in caries prevalence among 14-year-old Norwegians.

The MFS of 14-year-old children in Lillehammer, Norway, were recorded in 1959, 1969, 1979, and 1984. The data were extracted from dental records of random samples of 76 children. The mean MFS was 34.1 in 1959 and 28.0, 13.8, and 7.5 the following years. The caries prevalence was reduced by 78% from 1959 to 1984. In 1959, 16.6 approximal surfaces were filled, but in 1984 only 1.3. Significantly fewer radiographically initial lesions were observed in 1984 than in 1979. The continual decrease in caries prevalence is related to various fluoride programs, fluoride dentifrices, decreased caries prevalence among preschool children, and an assumed decreased challenge.