Dental Visit Experience Research Articles

Early childhood caries and its associated factors among 5-years-old Myanmar children

IntroductionChildren's oral health plays a crucial role in their overall well-being and there is a significant gap in our understanding of early childhood caries (ECC) in Myanmar. This study aims to bridge this knowledge deficit by investigating the prevalence, causes, and potential interventions for ECC in the Myanmar population, providing crucial insights for future dental health policies and practices.MethodsGenerally healthy 5-year-old kindergarten children from 7 districts in city were recruited. ECC was assessed through clinical examinations using decayed, missed, filled teeth (dmft). Additionally, demographic data of the children and their caregivers, along with information about the children's oral health-related behaviors, were gathered using a structured questionnaire.ResultsOut of the 496 children, the overall prevalence of dental caries was 87.1% (mean dmft score: 5.57, SD: 4.6). Caries experience was categorized as severe (45.8%) and non-severe (41.3%). Decayed teeth constituted the major component of the dmft index (97.8%). Multiple logistic regression analysis revealed two significant factors associated with ECC prevalence: late toothbrushing initiation (OR: 2.54, p = 0.001) and dental visit experience (OR: 2.46, p = 0.010).DiscussionThe study highlights the alarming ECC prevalence in 5-year-old children in Mandalay, Myanmar, with mostly untreated decayed teeth. The findings emphasize early preventive oral health measures for young children to reduce ECC burden in Myanmar.

Global prevalence of early childhood dental fear and anxiety: A systematic review and meta-analysis

ObjectiveThe objective of this review is to determine the global prevalence of dental fear and anxiety (DFA) in early childhood and identify its related factors. MethodsThe systematic review utilized three common English-language databases (PubMed, EMBASE, and Web of Science). Two independent researchers performed a systematic search to include observational studies on young children published from 2000 to 2023. They extracted information on prevalence of DFA, assessment tools used, study sites, respondents, and children's dental visit experiences. ResultsA total of 2,895 studies were identified, and 25 studies met the inclusion criteria for analysis. The pooled prevalence of DFA among 2- to 6- year-old children was estimated to be 30 % (95 % CI=25, 36). Children without dental visit experience (OR=1.37, 95 % CI=1.18, 1.59) and children with caries experiences (OR=1.18, 95 % CI=1.09, 1.27) had higher odds of experiencing DFA compared to those with dental visit experience or caries-free status. The most commonly used assessment tools in the included studies were the Frankl Behaviour Rating Scale (32 %, 8/25), Children's Fear Survey Schedule-Dental Subscale (20 %, 5/25), and Dental Anxiety Question (20 %, 5/25). ConclusionsThis systematic review reveals that approximately one-third of young children globally experience DFA. Children who lack dental visit experience or have caries experiences are at increased risk of DFA. Clinicians can use this information to make informed decisions regarding dental care provision for young children. Clinical SignificanceThis study provides comprehensive information on the global prevalence of dental fear and anxiety and its associated factors in early childhood. The findings can assist clinicians in understanding and addressing DFA in their dental care approach for young children. RegistrationPROSPERO (CRD42023446464)

The disparities of dental anxiety in adult dental patients: a sociodemographic and dental visit experience analysis

ABSTRACTIntroduction: Patient anxiety can impede dental treatment adherence. Several factors influence patient anxiety, including sociodemographic characteristics and prior dental visit experiences. This study aims to analyze the disparities of dental anxiety in adult dental patients from sociodemographic and dental visit experience analysis point of view. Methods: Type of research was cross-sectional study. The population was all dental patients during May 30th and June 16th, 2023 at the Cipondoh Public Health Center in Tangerang City. Sixty-one patients were purposely sampled from the dental clinic. Data were collected via a self-administered questionnaire containing five questions regarding sociodemographic factors and dental visit experiences. Each question offered respondents five response options, represented by scores. Anxiety was measured using the Modified Dental Anxiety Scale (MDAS), and statistical analysis was performed using SPSS version 26 with Mann-Whitney, ANOVA, Kruskal Wallis tests. Results: Among the 61 participants, 33.1% reported experiencing dental anxiety, with an average MDAS score of 8.92. Comparative analysis revealed significant differences in anxiety scores based on age (p<0.05), gender (p<0.05), education level (p<0.05), and dental visit experience (p<0.05). Conclusion: There are significant anxiety differences in adult patients based on sociodemographic factors, including gender, age, educational level, and dental experience factors. Keyword : dental anxiety, socioeconomic factors, dental visit, adult

Tooth brushing with fluoridated toothpaste and associated factors among Chinese adolescents: a nationwide cross-sectional study

BackgroundTooth brushing with fluoridated toothpaste has become the most important way to provide the anti-caries effect of fluoride around the world. China has promoted the use of fluoridated toothpaste since 1989. However, there are few studies on the national profile of use of fluoridated toothpaste and related factors in Chinese adolescents. We carried out this study to investigate oral hygiene behaviours, especially the status of tooth brushing with fluoridated toothpaste and its correlates among adolescents, based on data from the latest Nation Oral Health Survey in mainland China.MethodsThis cross-sectional study recruited 118,601 participants aged 12–15 years using multistage stratified sampling. Questionnaires were completed by students at school. Data employed in analyses were extracted from the questionnaire, including information on tooth brushing, fluoridated toothpaste, dental floss, sociodemographic factors, fluoride knowledge and attitude towards regular dental check-ups. A binary logistic regression was performed to compute the odds ratios (OR). Tooth brushing twice daily with fluoridated toothpaste was the dependent variable. Sociodemographic factors, fluoride knowledge, attitude towards regular dental check-ups, dental visit experience and perceived oral health were the independent variables. P < 0.05 was considered statistically significant.ResultsA total of 32.6% of participants brushed their teeth twice daily, 7.4% used fluoridated toothpaste, and 3.9% cleaned their teeth twice daily with fluoridated toothpaste. The logistic regression showed the probability of twice-a-day tooth brushing with fluoridated toothpaste was higher among these groups: females (OR: 1.141; 95%CI: 1.072–1.214), 15-year-olds (OR: 1.786; 95%CI: 1.634–1.952), from urban areas (OR: 1.389; 95%CI: 1.288–1.497), without siblings (OR: 1.351; 95%CI: 1.259–1.450), with an educated father (OR: 1. 605; 95%CI: 1.442–1.788) and mother (OR: 1.706; 95%CI: 1.530–1.903), having dental visit experiences (OR: 1.702; 95%CI: 1.589–1.823), rating one’s oral health as good (OR: 2.341; 95%CI: 2.083–2.631), having fluoride knowledge (OR: 4.345; 95%CI: 4.034–4.678) and having a positive attitude towards regular dental check-ups (OR: 1.589; 95%CI: 1.460–1.729).ConclusionsThe oral hygiene behaviours of Chinese adolescents were undesirable. Twice daily tooth brushing with fluoridated toothpaste was significantly associated with sociodemographic factors, fluoride knowledge, and attitudes towards regular dental check-ups.

Are social stories beneficial for oral health promotion in preschool children with special healthcare needs?

Design A 24-month randomised, two-armed, double-blinded, parallel controlled trial.Methods Participants were recruited from educational centres for children with special healthcare needs (SHCN) aged 2-6 years. Out of the 37 special needs schools in Hong Kong, 19 were randomly selected, of which 16 met the inclusion criteria. Further exclusions occurred if the child was absent, no consent was signed or if they did not meet the inclusion criteria. All participants received standardised tooth brushing instructions. The test group were given validated social stories, while the control group utilised standard leaflets issued by the Department of Health. The resources were used both in education centre sessions in three phases and at home by parents. The oral health-related behaviours were assessed before and after interventions as well as dmft index. Caries was assessed via dmft at baseline and phase 3 (at 24 months). The severity of existing caries was assessed using the International Caries Detection and Assessment System. If existing carious lesions progressed from one stage to a more advanced stage, it was defined as progression. At baseline and each of the three follow-up visits, oral hygiene and gingival health were assessed using the modified gingival index and simplified debris index. Oral health behaviours assessed included tooth brushing performance (assessed by number of tooth brushing steps and duration/frequency), between-meal snacking (assessed by frequency) and dental visit experience (assessed as favourable if the child attended at least annual visits). It was then determined if these behaviours had improved. Data analysis utilised generalised estimating equations, negative binomial regression and binary logistic regression. Kappa statistics were used to test intra-examiner reliability on 10% of randomly selected participants.Results There was no significant difference in caries experience between the two groups after 24 months. The results suggest children in the test group displayed improved tooth brushing performance, better oral hygiene and more frequent dentist visits. Children from higher socioeconomic backgrounds also showed better oral hygiene compared to those from lower socioeconomic backgrounds.Conclusions Social stories may be useful resources to improve oral health-related behaviours in children with SHCN.

Dental Caries Status among Yi Preschool Children in Yunnan Province, China: A Cross-Sectional Study.

Background: The Yi ethnic group is the sixth largest minority in China. The aim of this study was to investigate dental caries status among Yi preschool children in the Yunnan province, China. Method: This cross-sectional study invited 5-year-old Yi children using multistage cluster sampling. Two trained and calibrated dentists examined the children in kindergartens. The children’s dental caries experience was assessed using the decayed, missing, and filled teeth (dmft) index. Visual plaque on an indexed tooth of each six sextants was recorded and the oral hygiene status was assessed using the Visible Plaque Index. Parents completed questionnaires that surveyed their educational attainment. The questionnaires also collected information about the children’s demographics, snacking habits, oral-health-related behaviors and dental visit experiences. The associations between caries experiences and potential factors were analyzed using zero-inflated negative binomial regression. Results: All 452 invited children (249 boys, 55%) participated in this study with a response rate of 100%. Dental caries prevalence rate was 83%. The mean dmft score and decayed teeth score were 5.2 ± 4.4 and 5.1 ± 4.4, respectively. Almost half of the children (n = 211, 47%) had visible plaque on four or more of the six sextants. Most (n = 366, 81%) of the children had not visited a dentist in the prior 12 months. Regression analysis found the children’s caries experience was associated with their dental visit experience. Conclusion: The great majority of the Yi preschool children experienced dental caries and almost all of the cavities were not restored. Their oral hygiene was poor and visible plaque was commonly found on their teeth.

The Prevalence of Dental Anxiety Associated with Pain among Chinese Adult Patients in Guangzhou.

Background Anxious people appear to exaggerate the severity of aversive experiences such as anxiety and pain. Anxiety towards dental procedures is a common difficulty that may be experienced by dental patients all over the world. The goal of the study is to find out the prevalence of dental anxiety and its associated factors in Chinese adult patients. Methods A cross-sectional study was conducted on 183 dental adult patients whose age ranged from 18 to 70 years. Demographic details, first and most recent dental visits with experience, the MDAS, and the Visual Analogue Scale for Anxiety (VAS-A) were obtained. Data were analyzed by frequency analysis, chi-square test, and Spearman correlation test. Results Most of the respondents were female (68.9%) and 30–45 years age group. The mean total score for dental anxiety on the MDAS was 13.63 (3.1). 80.3% of participants suffered from moderate or high dental anxiety. Age must show a strong association with dental anxiety among the participants (p=0.011). The first dental visit experience, the frequency of the dental visit, most recent dental experience, length of time since the most recent dental visit, and postponement of the dental visit are strongly associated with the MDAS score (p=0.001). Conclusions The MDAS score exhibits that Chinese adult patients have significant dental anxiety and phobia. Identifying patients with dental anxiety as soon as possible is essential to providing better dental care.

Dental visit experience and dental care barriers among Hong Kong preschool children with special education needs.

Children with special education needs (SEN) require additional supports in education settings, as well as extra supports in healthcare services. To investigate dental visit experience and dental care barriers among Hong Kong preschoolers with SEN. This was designed as a cross-sectional study. A structured questionnaire was employed to investigate dental attendance and dental care barriers among Hong Kong preschoolers with SEN. Binary logistic regression and multi-factor ANOVA were performed to identify factors associated with children's dental visit experience. A total of 383 children were included in the final analysis. The average age of the recruited children was 3.87±0.95 years. 72.5% parents reported that dental visits were a challenging task for their children. Among children with caries, 70.7% had never visited a dentist. Regression models indicated that (a) children over 3years or children whose parents received tertiary education were more likely to visit a dentist; (b) the existence of dental care barriers was associated with children's primary diagnosis, practical skills, conceptual skills, and parents' education attainment; and (c) children with low conceptual skills (95%CI:0.71 to 2.40, P<.001), or children from low-income families (95%CI:1.21 to -0.06, P=.031) had more dental care barriers than their counterparts. Unmet dental treatment needs and dental care barriers existed among pre-schoolers with SEN. Dental care barriers were associated with children's developmental profile, parents' education attainment, and household income.

Risk indicators of dental caries and gingivitis among 10−11-year-old students in Yangon, Myanmar

To obtain basic data on dental caries and gingival status of students in Myanmar, and to identify related risk indicators, including socioeconomic conditions and oral health behaviours and habits. This cross-sectional study enrolled 537 fifth-grade students in Myanmar. Oral health behaviours and dietary patterns of students were assessed using questionnaires. Oral examinations were conducted to identify dental caries and gingivitis, and the oral samples were obtained to determine the bacteria levels in dental plaque. The dental caries prevalence was 68.5%, with a mean number of decayed teeth of 2.07±2.15. The prevalence of gingivitis was 98.9%, and the mean number of inflamed gingival areas in the anterior region was 16.2±5.4. No significant differences were found between the sexes in terms of dental caries and gingivitis. Oral hygiene was significantly poorer, and levels of bacteria in dental plaque were significantly higher in boys than in girls. Multiple linear regression tests were used to analyse the association between risk indicators and dental caries and gingivitis. Tooth brushing frequency, a daily habit of mouth rinsing, dental visit experience, consumption of sugary snacks and oral hygiene status were significantly associated with dental caries. Mother's occupation, tooth brushing frequency, consumption of sweet drinks, oral hygiene status and bacterial levels in dental plaque were significant predictors of gingivitis. Myanmar students had a high prevalence of dental caries and gingivitis. Socioeconomic condition, oral hygiene status and oral health behaviours were all determined to be significant risk indicators.

Influence of the previous dental visit experience in seeking dental care among young adults.

Introduction:Dental fear is one of the highly prevalent types of fear which deters patients from seeking dental cares.Aim:This study aims to assess the influence of a previous dental visit experience for seeking dental care among adults.Methodology:Young adults (n = 150, 15–26 years) with previous dental visit for care were selected randomly among outpatients’ visit in tertiary dental teaching hospital. To assess the influence of previous experience of dental visit in seeking care, we self-administered a Post-traumatic Check List-Civilian Version [posttraumatic stress disorder (PTSD)], an Autobiographical Memory Questionnaire (AMQ), and a Dental Fear Survey (DFS). The relationship of negative and positive experience of previous dental treatment, dental fear, and symptoms of PTSD was assessed using Pearson's correlations. Spearman's rho was used to find out the correlation between the DFS and PCL-C and history of dental treatment undergone.Results:The mean score of the DFS and PCL-C was found to be 69.57 and 40.17, respectively. The characteristics of the most negative experience including physical reactions (P = 0.936), emotional intensity (P = 0.935), sight (P = 0.941), smell (P = 0.917), and sound (P = 0.911) of dental treatment showed a significant relationship with dental fear, whereas the characteristics of the most positive memory of dental treatment showed only a few statistically significant associations with dental fear. Most of the symptoms of PTSD also show significant associations (P < 0.05) with characteristics of the most negative memory. Spearman's correlation between the DFS and the PCL-C was also statistically significant, r (150) =0.365, indicating that dental fear is indeed associated with symptoms of PTSD.Conclusion:There is a significant association between the characteristics of the most negative experiences of dental treatment and increased dental fear in young adults, while positive experiences did not show the inverse relationship with dental fear.

Dental Care-Seeking and Information Acquisition During Pregnancy: A Qualitative Study.

Background: Pregnant women are at risk of oral health problems. This qualitative study aims to understand dental care-seeking behaviours of pregnant women and their oral health-related information acquisition, to identify barriers to and motivators for, dental visits, and further explore their expectations and possible strategies to improve oral health care during pregnancy. Methods: Semi-structured interviews were conducted with 30 pregnant women (after 32 gestational weeks) enrolled in the antenatal care programme in a public hospital in Hong Kong. Two main areas of interest were probed: Dental care-seeking behaviour and oral health information acquisition. Their expectations and suggestions on oral health care service for pregnant women were also explored. An inductive thematic approach was adopted to analyse the data. Results: Pregnant women’s dental care-seeking behaviour was deterred by some internal factors, such as misunderstandings on oral health, and priority on other issues over oral health. External factors such as inconvenient access to dental service during pregnancy also affected their care-seeking behaviours. Oral health information was passively absorbed by pregnant women through mass media and the social environment, which sometimes led to confusion. Oral health information acquisition from antenatal institutions and care providers was rare. Greater attention was paid to dental visit when they obtained proper information from previous dental visit experience or family members. A potential strategy to improve oral health care suggested by the interviewees is to develop a health care system strengthened by inter-professional (antenatal-dental) collaboration. Efficient oral health information delivery, convenient access to dental service, and improved ‘quality’ of dental care targeting the needs of pregnant women were identified as possible approaches to improve dental care for this population. Conclusion: Dental care-seeking behaviour during pregnancy was altered by various internal and external factors. A lack of, or conflict between, information sources result in confusion that can restrict utilisation of dental service. Integrating dental care into antenatal service would be a viable way to improve dental service utilisation.

Early childhood caries among 3- to 5-year-old children in Hong Kong

The aim of this study was to describe the prevalence of dental caries among 3- to 5-year-old children in Hong Kong and to investigate the factors associated with their dental caries status. Seven kindergartens in Hong Kong were selected using stratified random sampling. The 3- to 5-year-old kindergarten children were invited to join the study. The participants' parents were asked to complete a questionnaire regarding their children's demographic and socio-economic backgrounds, their dental habits and their own dental knowledge. Dental caries experience was measured using the decayed, missing and filled primary teeth (dmft) index. The visible plaque index was adopted for recording oral hygiene. The relationships between caries experience and children's demographic backgrounds, dental habits, oral hygiene and parental dental knowledge were studied using a zero-inflated negative binomial (ZINB) regression analysis. Among the 1,204 participating preschool children, the overall prevalence of dental caries (dmft > 0) was 46%. The mean dmft score was 2.1 ± 3.4. The prevalences of dental caries among the 3-, 4- and 5-year-old children were 38%, 43% and 55%, respectively. ZINB regression analysis revealed that the study children who were boys, came from families with lower incomes, had dental visit experiences, had higher plaque scores and had parents with lower levels of dental knowledge, had higher dmft scores (P < 0.05). Dental caries is prevalent among preschool children in Hong Kong. The caries experiences of the study children are associated with gender, family income, parental dental knowledge, dental visit experience and oral hygiene.

Factors influencing anxiety levels in children undergoing dental treatment in an undergraduate clinic.

Introduction:Dental anxiety is a kind of fear exerted due to threatening stimuli. Assessing a child's dental anxiety level is very important to perform a particular treatment. The aim of this study is to examine the various factors that determine the anxiety levels in children and evaluate their anxiety levels.Materials and Methods:A total of 50 children participated in the survey conducted. Each participant had fulfilled the inclusion and exclusion criteria to answer the questionnaire. It included questions regarding their habits, fears, and dental visit experience. Evaluation of their anxiety levels was done using the facial image scale (FIS) and the modified dental anxiety scale and was correlated with various factors using the Statistical Package for Social Science Software.Results:Female children are more anxious than male children toward dental treatment. About 38% were anxious and 16% refused while undergoing radiographic examination and showed significant anxiety levels (P = 0.012). About 16% of the population were highly uncooperative and were necessary to implement behavioral shaping techniques on them. It influences the FIS anxiety score before initiation of the treatment (P = 0.003). About 48% of children had maintained a good rapport with the dentist and showed strong significance with the child's anxiety (P = 0.025).Conclusion:Gender and behavior of the child while diagnosis and radiographic examination, implementation of behavioral shaping techniques, and rapport developed between child and dentist are all influencing factors of dental anxiety. The number of visits to the dental clinic, socioeconomic status, kind of amount of consumption of sugars, and type of treatment being done do not contribute to a child's anxiety level.

Risk Factors of Early Childhood Caries among Young Children in Hong Kong: A Cross-Sectional Study.

Early childhood caries (ECC) was prevalent in Hong Kong. Children with ECC risk should be identified early for prevention. This study aimed to identify common risk factors of ECC in Hong Kong 3-year-old children. Sample size calculation showed at least 6,321 of 3-year-old children should be invited in this study. A consent form and a questionnaire enquiring the children's oral health behaviours and social-economic background were distributed to their parents. Children with parental consent were examined by a trained dentist. Caries status was recorded in dmft index. Chi-square test and logistic regression analysis were performed to identify the risk factors of ECC. A total of 5,167 children from the 6,331 children invited were examined. Among them, 1,130 children (22%) had ECC (dmft>0). Logistic regression analysis found age of starting tooth brushing, snack-intake frequency, dental visit experience, birthplace, family monthly income, primary caretaker, and mother's education level were factors associated with ECC of the children. Children who started tooth brushing later, had higher snack-intake frequency, were not born in Hong Kong, and whose family monthly income was lower, mother's education level was lower, primary caretaker was not domestic helper, had a statistically significant higher chance of having ECC.

Evaluation of anxiety associated with dental visit and treatment experience: A short study

Objective: The purpose of this hospital based study was to measure dental anxiety level among patients seeking for dental services. Methods: The study was based on interviews with 100 patients, aged 20 years-old and over, reporting to Dr Z A Dental College, AMU, Aligarh. Self-administered questionnaire was asked for information about regular dental visits, and dental treatment experience. Beck Anxiety Inventory Scale was applied to measure the anxiety level in the dental patients. Results: It was reported that 66% of the patients were anxious, according to the Beck Anxiety Inventory Scale. Anxiety was found more in patients who were reporting first time to the dental OPD. Women were more anxious than men at a statistically significant rate and anxiety level was high either at very young or very old age. Conclusions: Within limits of this study it is concluded that anxiety has significant impact on regular dental visits and dental treatment opted.

Barriers to Restorative Care as Perceived by Patients Attending Government Hospitals in Udaipur, Rajasthan

Objective: To determine the barriers to restorative care as perceived by dental patients attending government hospitals in Udaipur, Rajasthan. Material and Methods: A closed ended structured interview was conducted among 242 patients attending government hospitals of Udaipur city Rajasthan, India. The 11-item questionnaire was administered by a trained interviewer. The questionnaire reliability was assessed by using Test-Retest and the values of measured Kappa (k) was 0.86 and Weighted Kappa (kw) was 0.9. Internal consistency of questionnaires was assessed by applying Chronbachs-Alpha (α) and the value of α=0.78 was measured. The effect of socioeconomic status on beliefs and misinformation on restorative care, lack of knowledge on restorative care and past experience with dental treatment was assessed by applying one way ANOVA. P value of P≤0.5 was adopted. Results: Statistical association between past dental visits and beliefs and misinformation about restorative care was observed (P≤0.05). Past dental visit and past experience with dental treatment were significantly associated with each other (P≤0.05). Conclusion: Oral health care services have long been used as indicator of oral healthrelated behavior. It was concluded that associations between past dental visits and beliefs and misinformation about restorative care, past dental visit and past experience with dental treatment, association between misconception on restorative care and past dental visit are significant barriers to restorative care as perceived by dental patients.