DMFS Scores Research Articles

Oral processing behavior and dental caries; an insight into a new relationship.

Previous evidence suggests an individual variation in the preferred oral processing behavior. Individuals can be classified as firm processing(FPL) or soft processing likers(SPL). FPL(crunchers and chewers) prefer using their teeth while SPL(smooshers and suckers) prefer using the tongue and the palate when processing different food items. Variation in the preferred oral processing behavior has been associated with differences in food texture preference and eating time. Time is one of the factors directly related to the development of dental caries(tooth decay). Oral retention and eating times are associated with greater caries experience. This study aims to explore if a relationship exists between the preferred oral processing behavior and the individual's caries experience. This was a cross-sectional, dental center-based study conducted at Jordan University of Science and Technology. Five hundred participants consented to fill out the preferred oral processing behavior(POPB) questionnaire. Anthropometric measurements (including weight, height, and waist circumference) were recorded. A single trained and calibrated dentist registered each participant's caries experience and plaque levels using the DMFS index and plaque index of Silness and Loe. A total of 351(70.2%) and 149(29.8%) participants were typed as FPL and SPL, respectively. SPL demonstrated higher levels of dental caries experience compared to FPL. The mean DMFS score for SPL was 28.8(±25.43) while for FPL was 18.71(± 18.34). This difference remained significant after adjustment for confounders(P<0.001). SPL exhibited a significantly higher mean score for the "M" component(P <0.001) while no significant difference in the mean score of the "D"(P = 0.076) and "F"(P = 0.272) components was observed when compared to FPL. The current findings provide new insight into a possible relationship between the preferred oral processing behavior and an individual's caries experience. A relationship in which the preferred oral processing behavior can potentially affect and/or be affected by the dental caries experience.

Prevalence and Management of Early Childhood Caries in Preschoolers

ABSTRACT Background: “Early childhood caries (ECC)” is a prevalent and serious oral health issue affecting preschool-aged children globally, with adverse effects on their overall health and well-being. Objective: This center-based research designed to investigate the prevalence and management of ECC among preschoolers within a specific setting and evaluate associated factors. Methods: A cross-sectional research design was employed, involving 300 preschoolers aged 3 to 5 years. Clinical examinations were conducted, and data on demographic characteristics, oral hygiene practices, dietary habits, and dental visits were collected through structured interviews. Statistical analysis was performed to assess ECC prevalence and examine associations between demographic/behavioral factors and ECC severity. Results: The prevalence of ECC among preschoolers was 65%, with a mean dmfs score of 4.2. Factors such as age, gender, socioeconomic status, and oral hygiene practices were associated with ECC severity. Management strategies included topical fluoride application, oral health education, and restorative treatments. Conclusion: ECC remains a significant public health concern among preschoolers. Comprehensive oral health programs targeting this population are essential to mitigate ECC burden and improve oral health outcomes. Further research is needed to address systemic barriers and disparities in ECC prevention and management.

Oral health status, related behaviours and perceived stress in xerostomia, Sicca and Sjögren's syndromes patients - a cross-sectional study.

Mouth dryness increases the risk of some oral health-related conditions. Furthermore, it is unclear if patients with dry mouth engage in appropriate oral health-related behaviours. The study examined oral health, related behaviours, and perceived stress in dry-mouth patients and compared them to matched controls without mouth dryness. Information about 182 dry-mouth patients and 302 age- and sex-matched subjects was retrieved. Three dry mouth groups: xerostomia, Sicca syndrome and Sjögren's syndrome, were formed based on patient self-reported and objectively assessed symptoms. The World Health Organization's Oral Health for Adults and Perceived Stress Scale (PSS-10) questionnaires inquired about sociodemographic characteristics, oral health-related behaviours, and self-perceived stress. Clinical oral health assessments included: caries experience measured as total numbers of decayed (DS), missing (MS), filled surfaces (FS), number of remaining teeth, erosive tooth wear and extent of periodontal pocketing. Data were analyzed using bivariate and multivariable tests. The dry-mouth participants had higher mean (SD) DMFS scores than their matched controls: xerostomia patients vs. controls: 74.6 (34.4) and 66.3 (35.4), Sicca syndrome patients vs. controls: 88.3 (34.0) and 70.1 (33.9), and Sjögren's syndrome patients vs. controls: 95.7 (31.5) and 74 (33.2). In comparison to controls, individuals with Sicca and patients with Sjögren's syndromes had lower mean (SD) number of remaining teeth, 15.9 (10.1) vs. 21.7 (8.4) and 13.8 (10.0) vs. 20.1 (9.2), and a lower mean (SD) extent of periodontal pocketing, 20.7 (28.6) vs. 41.1 (31.0), and 21.2 (24.1) vs. 34.8 (34.2), respectively. Xerostomia, Sicca syndrome and Sjögren's syndrome patients had higher odds of using fluoridated toothpaste; OR 1.8 (95%CI 1.1-2.9), OR 5.6 (95%CI 1.7-18.3) and OR 6.9 (95%CI 2.2-21.3), respectively. Participants with Sjögren's syndrome had lower odds of the last dental visit being within the last year; OR 0.2 (95%CI 0.1-0.8). Dry-mouth patients had higher caries experience and fewer teeth than comparison groups but a lower extent of periodontal pocketing. Even though more participants with dry mouth used fluoridated toothpastes, their oral health-related behaviours were not optimal.

Comparison of Salivary Flow Rate, pH, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children.

Early childhood caries (ECC) is the most common chronic disease of childhood in many developing countries, which is associated with local, systemic, psychological, and social consequences. Multiple variables are shown to be associated with an increased risk of ECC. The knowledge regarding the role of saliva in the pathophysiological process of ECC still remains controversial and unexplored. Scanty studies focused on probing the role of salivary flow rate, pH, buffering capacity, and secretory immunoglobulin A (sIgA) in unstimulated whole saliva of children with ECC and children without ECC. To assess the salivary flow rate, pH, buffering capacity, and sIgA levels in children with ECC and caries-free children and to evaluate their role in caries risk assessment.Materials and Methods: The study was carried out among 64 children aged between 24 and 71 months. Clinical examinations were carried out according to the criteria by the World Health Organization, and carious status was recorded. Subjects were categorized as group I with ECC (dmfs-Decayed, Missing or Filled Surfaces (Deciduous dentition) of ≥5), and group II included children without ECC (dmfs = 0). Unstimulated whole salivary samples were collected in a sterile vial and stored at -70°C by draining. Estimations of salivary flow rate, pH, buffering capacity, and sIgA levels were done. Digital pH meters were used for the estimation of pH and buffering capacity. A human IgA enzyme-linked immunosorbent assay (ELISA) kit was used to estimate sIgA levels. Statistical software IBM Statistical Package for the Social Sciences (SPSS) statistics 20.0 (IBM Corporation, Armonk, New York, United States of America) was used to analyze the data. The mean salivary flow rate decreased in group I children with ECC (0.15 ± 0.05) when compared to group II children without ECC (0.67 ± 0.14), which was statistically significant. In caries active children, no statistically significant correlation was found between salivary flow rate and the dmfs scores [r-value (-0.247)] and p-value (0.147). The mean level of salivary pH is decreased in group I children with ECC (4.65 ± 0.4) when compared to group II children without ECC (7.28 ± 0.18). In the caries active group, the levels of salivary pH decrease as the dmfs scores increase, and this correlation is found to be statistically significant (r-value of 0.547 and p-value of 0.002). The mean level of buffering capacity is decreased for caries-active children (5.45 ± 0.49) when compared to caries-free children (8.94 ± 0.42). In caries active children, as the dmfs scores increase, the salivary buffering capacity decreases, and this correlation is found to be not statistically significant (r-value of -0.334 and p-value of 0.161). The mean levels of sIgA in group I children with ECC were higher (10.61 ± 0.90) than that in group II children without ECC (6.11 ± 1.22). In the caries-active group, the salivary sIgA levels were comparatively higher than in the caries-free children. As the dmfs scores increase, the level of the sIgA increases in caries-active children, and this correlation is noted to be highly statistically significant (r-value of 0.769 and p-value 0.008). Children with ECC showed decreased salivary flow rate, pH, buffering capacity, and increased sIgA levels, while children without ECC showed increased salivary flow rate, pH, buffering capacity, and decreased sIgA levels. The salivary parameters, such as salivary flow rate and buffering capacity, showed no correlation with the dmfs score, while salivary pH and sIgA levels have a positive correlation in caries-active children. Sivakumar A, Narayanan R. Comparison of Salivary Flow Rate, Ph, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children. Int J Clin Pediatr Dent 2024;17(3):334-340.

Assessment of Oral Health Status of Differently Abled Children in Avadi Taluk, Tiruvallur District: A Cross-sectional Study

Aim: To assess the oral health status of differently abled children in Avadi Taluk, Tiruvallur District. Materials and Methods: The current study was carried out at the Carmel Special School in Avadi Taluk, Tiruvallur District. The study included 131 participants (68 men and 63 women). The age of the participants ranged from 10 to 18 years. The subjects underwent a clinical oral examination after recording participant’s medical and dental histories. Results: The mean Simplified Oral Hygiene Index score for the study population was 3.12 ± 1.12 and the mean DMFS score was 8.9 ± 5.69, and the fluorosis index of the teeth was also measured, showing that 14% of participants had mild fluorosis and &lt;3% of participants had moderate fluorosis. Conclusion: This study provides enough proof to conclude that, differently abled children’s oral health was below average and there was an increased unmet requirement for dental care. Children with disabilities face more significant obstacles in maintaining proper oral hygiene and accessing adequate health care, primarily because their limited motor skills and intellectual abilities often prevent them from engaging in essential practices like tooth brushing.

Association of temperament with oral health behaviour and caries status in Thai preschool children.

Temperament associated with oral health behaviour and early childhood caries (ECC) in preschoolers remains inconclusive. This cross-sectional study investigated the association of temperament with oral health behaviour and ECC status. A total of 421 Thai preschoolers were recruited from elementary schools in Chonburi Province, Thailand. Their caregivers assessed three temperament dimensions (surgency, negative affectivity and effortful control) using the Thai version of the Children's Behaviour Questionnaire Very Short Form and reported oral health behaviours (brushing cooperation and cariogenic snack frequency). Three calibrated dentists assessed ECC status using the modified WHO dmft/dmfs (decayed, missing and filled teeth/surface) index that included noncavitated and cavitated carious lesions. Multiple regression analysis, after adjusting for child's and caregiver's characteristics, revealed that children with high negative affectivity or low effortful control were more likely to have uncooperative brushing behaviour. The temperament scores of children who consumed cariogenic snacks daily and those who did not were comparable. Children with low surgency, high negative affectivity or low effortful control were more likely to have high dmfs scores. Negative affectivity and effortful control were associated with brushing behaviour. Temperament was not associated with the frequency of cariogenic snack consumption. All temperamental dimensions, however, were associated with ECC.

Dental caries in HIV-infected children and adolescents: A systematic review with meta-analysis.

This study aimed to evaluate and compare the risk of dental caries in between human immunodeficiency virus (HIV)-infected and uninfected children and adolescents. An electronic search was performed on PubMed/MEDLINE, Web-of-Science, Scopus, LILACS, ProQuest, and ClinicalTrials.gov up to May 2022. The critical appraisal checklist developed by the Joanna Briggs Institute was used to evaluate the quality of the included studies. Meta-analysis was performed using the RevMan 5.4. Sixteen studies were included. A total of 3231 participants were evaluated, including 1701 and 1530 HIV-infected and uninfected children and adolescents, respectively. The meta-analysis revealed a higher risk of dental caries for primary dentitions in HIV-infected children and adolescents by decayed, missing, filled tooth (dmft) (SMD:0.34; p = 0.006) and decayed, missing, filled surface (dmfs) scores (SMD:0.37; p = 0.001). Similar results were observed for permanent dentition, with increased dental caries in HIV-infected children and adolescents with DMFT (SMD:0.32; p = 0.003) and DMFS (SMD:1.78; p < 0.0001) scores. Regarding the quality assessment, most of the included studies were moderate or good quality. However, the certainty of the evidence of the outcomes was very low. This systematic review and meta-analysis showed higher caries severity in permanent and deciduous teeth among HIV-infected children and adolescents.

Differential Unmet Needs and Experience of Restorative Dental Care in Trajectories of Dental Caries Experience: A Birth Cohort Study

Dental caries is a chronic and cumulative disease but little has been reported on the continuity of the disease and its treatment through life. Group-based multi-trajectory modeling was used to identify developmental trajectories of untreated carious tooth surfaces (DS), restored tooth surfaces (FS), and teeth extracted due to caries (MT) from ages 9 to 45 years in a New Zealand longitudinal birth cohort, the Dunedin Multidisciplinary Health and Development Study (n = 975). Associations between early-life risk factors and trajectory group membership were examined by specifying the probability of group membership according to a multinomial logit model. Six trajectory groups were identified and labeled: “low caries rate”; “moderate caries rate, maintained”; “moderate caries rate, unmaintained”; “high caries rate, restored”; “high caries rate, tooth loss”; and “high caries rate, untreated caries”. The two moderate-caries-rate groups differed in count of FS. The three high-caries-rate groups differed in the relative proportion of accumulated DS, FS, and MT. Early childhood risk factors associated with less favorable trajectories included higher dmfs scores at age 5, lack of exposure to community water fluoridation during the first 5 years of life, lower childhood IQ, and low childhood socioeconomic status. Parent self-ratings of their own or their child’s oral health as “poor” were associated with less favorable caries experience trajectories. Children who had clinical signs of dental caries together with a parent rating of child’s oral health as poor were more likely to follow a less favorable caries trajectory. Higher deciduous dentition caries experience at age 5 years was associated with less favorable caries trajectories, as were children whose parents gave “poor” ratings of their own or their child’s oral health. These findings highlight the considerable intergenerational continuity in dental caries experience from early childhood to midlife. Subjective measures of child oral health are informative and might aid as predictors of adult caries experience in cases where childhood dental clinical data were not available.

Development and validation of a comprehensive food frequency questionnaire that assesses the dietary intake related with dental health in children: A pilot study

This study aimed to develop a validated and reliable food frequency questionnaire (FFQ) that assess dietary intake related with dental health in children. Children, two-to-nine-years old, who consulted to a paediatric dental clinic for any reason, were recruited to complete the FFQ and 24-h recall, inquired oral hygiene habits, performed oral examinations, recorded dmft(s)/DMFT(S) index, and taken anthropometric measurements. The statistical methods used for validation were Wilcoxon signed rank test, Spearman ranked correlations, weighted kappa statistic and Bland-Altman graphs were drawn. Besides, intraclass and spearman correlation coefficients calculated for the reliability. A total of 120 children participated in to the first stage of the study while 70 participants completed the 4-month period. The Spearman correlation coefficient and weighted kappa values confirmed that the FFQ had moderate validation against the food records for lactose, calcium and phosphorus. Dietary fat, fibre, lactose, calcium, potassium, fluoride, magnesium, phosphorus and zinc intakes were negatively and statistically significantly correlated with DMFT and DMFS according to both FFQ and 24-h (p<0.05, for each). Furthermore, a positive correlation between DMFT/S and dietary carbohydrate, starch, polysaccharide and sucrose intakes was obtained. These results provide the preliminary evidence for the moderated reliability and validity of the FFQ; the higher DMFT and DMFS scores might be linked to lower dietary intakes of fat, fibre, lactose, calcium, potassium, fluorine, magnesium, phosphorus and zinc; and probably higher dietary intakes of carbohydrate, starch, polysaccharide and sucrose in children.

Long-term outcome of oral health in uncooperative children with caries treated under general anesthesia.

Although uncooperative children with extensive caries can be treated under general anesthesia (GA), they remain at high-risk for caries recurrence. This study aimed to assess the long-term outcome of the dental health of uncooperative healthy children (HC) and special needs patients (SNP) treated under GA at least 2 years before this study. Data were collected via questionnaire and oral examination. Oral hygiene was assessed using the Hygiene Index, while caries were recorded using ICDAS II. The dmfs/DMFS score was calculated for every participant. A total of 69 patients completed the questionnaire, and 37 were clinically examined (HC = 15, SNP = 22). The mean (±SD-standard diviation) follow-up time was 5.5 (±2.55) years, the mean DMFS score for HC was 6.39 (±4.99), and the mean DMFS score for SNP was 12.95 (±12.29). The SNP group had significantly more filled surfaces on permanent teeth than the HC group (6.18 (±6.17) vs. 1.54 (±3.27), p = 0.004). In regard to primary teeth, HC had a higher dmfs, indicating a clear trend for more decayed surfaces in this group of participants (p = 0.08). The DMFS score was significantly higher in children who underwent GA more than 5 years ago. Oral health-related behavior was not improved as expected. Altogether, HC and SNP have poor oral hygiene and high caries risk in primary and permanent dentition, and their treatment remains challenging.

Dental caries at enamel and dentine level among European adolescents – a systematic review and meta-analysis

BackgroundIn contrast with the last century, caries epidemiology has begun integrating enamel caries into determinations of caries prevalence and experience. The objective of the present systematic review and meta-analysis was to assess the caries status including estimations of enamel caries, of European adolescents.MethodFour databases (Medline Ovid, Embase, CINAHL, and SweMed+) were systematically searched from 1 January 2000 through 20 September 2021 for peer-reviewed publications on caries prevalence and caries experience in 12–19-year-olds; that also included evaluations of enamel lesions. Summary estimates were calculated using random effect model.ResultsOverall, 30 publications were selected for the systematic review covering 25 observational studies. Not all studies could be used in the meta-analyses. Caries prevalence was 77% (n = 22 studies). Highest prevalence was reported in the age groups 16–19 years, and in studies where caries examinations were done before 2010. The overall mean DMFS score was 5.93 (n = 14 studies) and it was significantly lower among Scandinavian adolescents than among other European adolescents (4.43 vs. 8.89). The proportion of enamel caries (n = 7 studies) was 50%, and highest in the lowest age group (12–15 years). Results from the present systematic review reflected the caries distribution to be skewed at individual-, tooth- and surface levels; at tooth and surface level, also changed according to age.ConclusionsAlthough studies in which the caries examinations had been done in 2010 or later documented a reduction in caries prevalence, caries during adolescence still constitutes a burden. Thus, the potential for preventing development of more severe caries lesions, as seen in the substantial volume of enamel caries during early adolescence, should be fully exploited. For this to happen, enamel caries should be a part of epidemiological reporting in national registers.

Quantitative analysis of salivary and biofilm bacteria associated with cavitated and non-cavitated carious lesions in pre-school children

ObjectiveTo quantify and compare Streptococcus mutans (S. mutans) and Lactobacillus fermentum (L. fermentum) in saliva and biofilm of caries-free children to those with cavitated and non-cavitated lesions. DesignOne hundred and thirty-five 3–4 years old children were grouped (n = 45 in each group) according to their caries status:•Caries-free (absence of any clinically detectable non-cavitated and cavitated lesion)•With only non-cavitated lesions (presence of at-least one non-cavitated lesion on any tooth surface but no evidence of cavitated lesion anywhere); and•With cavitated lesions (presence of at least one cavitated carious lesion with or without any other non-cavitated carious lesion anywhere).Clinical examination was done by a calibrated examiner. Biofilm and saliva were collected to quantify the microorganisms using qRT-PCR. The decayed-missing-filled surfaces (dmfs) was calculated by adding the number of decayed (ICDAS-II score 3–6), filled (ICDAS-II score 7 and 8) and missing (ICDAS-II score 9) surfaces due to caries. The correlation between the bacterial amounts and the number of carious surfaces was evaluated using Spearman’s correlation coefficient. The levels and proportions of the microorganisms were compared using the Kruskal-Wallis test at an α-level of 0.05. ResultsThe quantity of S. mutans and L. fermentum was significantly higher in saliva and biofilm of children with cavitated lesions, followed by those with non-cavitated lesions and the lowest in caries-free children. Also, salivary and biofilm S. mutans, along with biofilm L. fermentum levels, significantly correlated with the number of non-cavitated surfaces; while salivary and biofilm S. mutans and L. fermentum levels significantly correlated with the number of cavitated surfaces. Additionally, dmfs scores significantly correlated with the salivary and biofilm S. mutans and L. fermentum levels. ConclusionsS. mutans and L. fermentum in saliva and biofilm samples are associated with caries lesion severity.

Association between early childhood caries and diet quality among Chinese children aged 2-5 years.

Early childhood caries (ECC) is a major oral problem affecting the health and wellbeing of children worldwide. Diet quality is a better predictor of ECC risk than single foods or specific nutrients. The purposes of this study were to assess the associations between ECC and diet quality among 2- to 5-year-old Chinese children. A total of 150 eligible children were included in this study. The decayed, missing, or filled surface (dmfs) score was recorded for each child by dental examination. All participants were divided into three groups based on their age and dmfs score [the caries-free group, the ECC group, and the severe early childhood caries (S-ECC) group]. Parents were invited to complete a questionnaire on the general characteristics and oral health behaviors of the participants. The information of 24-h dietary intake from each child was captured via a mobile APP. The Chinese diet balance index for preschool children (DBI_C) indicators score, high bound score (HBS), low bound score (LBS), and diet quality distance (DQD) score were calculated to assess the diet quality of study subjects. The associations of ECC with HBS, LBS, DQD score, and DBI_C indicators score were analyzed by Mann-Whitney U test and multivariable logistic regression analysis. In this study, 21, 31, and 98 children were diagnosed with caries-free, ECC, and S-ECC, respectively. Statistical analysis revealed that the risk of ECC and S-ECC were significantly increased with the DQD score (OR = 1.283 and 1.287, respectively), but both were not associated with HBS and LBS (P > 0.05). In the meantime, the risk of ECC and S-ECC were significantly increased with the Grains score (OR = 1.623 and 1.777, respectively), and significantly decreased with the Food diversity score (OR = 0.271 and 0.315, respectively). Moreover, the risk of S-ECC also significantly decreased with the Vegetables score (OR = 0.137). Both ECC and S-ECC were associated with a high degree of dietary imbalance and grains intake as well as a low degree of food diversity among Chinese children aged 2-5 years. In addition, S-ECC was also associated with a low degree of vegetable intake.

Is Oral Candida associated with Dental Caries in Children - A Cross Sectional Analysis.

BACKGROUND: Dental caries is a world-wide public health issue and is considered the most common of all non-communicable disease. There has been a growing interest in association between oral fungal flora especially candida and dental caries. Hence the aim of the study was to assess the correlation between active caries status and oral candida carriage in children aged twelve years.MATERIALS AND METHODS: This is a cross-sectional study where a multiphase sampling was done and a total of thirty children were selected randomly among children screened previously. Data was collected through clinical oral examinations and structured interviews. The oral rinse technique described by Samaranayake et al. was used for extracting candida spp. The correlation between candida spplevel and caries experience was performed by the Pearsons correlation coefficient.RESULTS: The mean DMFS and defs scores of the children were 3.70±4.61 and 5.83±5.51 respectively. Significant association with decay scores for deciduous teeth (P&lt;0.05) and defs (p= &lt;0.001) was demonstrated. Candida species was associated highly with caries prevalence and significant positive correlation was found between Candida (CFU/plate) and defs scores (r=0.790) (p= &lt;0.001)CONCLUSION: The study results suggested that there is a significant positive correlation between candida carriage and caries, especially in children in the age group of 12 years.

Prevalence of Dental Caries Among Smoking and Smokeless Tobacco Users Attending A Dental Hospital

Objective: To determine the prevalence of dental caries among smoking and smokeless tobacco users attending a dental hospital. Study design: Randomized Controlled Trial. Study Setting: The study was conducted at Oral &amp; Maxillofacial Surgery Department, Akhtar Saeed Medical &amp; Dental College, Lahore from November 2021 to April 2022. Methods: Patients were instructed to brush their teeth and gargle with water before their examinations, after which a cotton swab was used to dry the teeth and note any instances of dental caries. We utilised an index called DMFT, where D stands for decaying teeth, M for missing teeth, F for filled teeth, and T for tooth health Results: There were 42 chewers and 42 non-chewers in the age between 20 – 60 yrs. Subjects of same age groups were selected in both the groups. 73.8% of the study subjects in both the groups were males and the remaining 26.2% were females. Results shows the distribution of the study subjects according to DMFS scores. Among the chewers, 38.1% of study subjects were caries free (DMFS = 0) and 61.9% were caries affected (DMFS = 1 or more). In the non-chewers group, 9.5% were caries free and 90.5% were caries affected. Conclusion: A greater incidence of dental caries has been linked to tobacco use. Those who smoked cigarettes had a higher DMFT score. They also had a higher caries index, which is an indicator of poor oral hygiene. Keywords: Prevalence, Dental Caries, Smokeless Tobacco Users

Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income countries: a systematic review and meta-analysis

BackgroundRisk factors for oral disease can potentially be ameliorated by school-based interventions. This review evaluates the effectiveness of primary school-based interventions in improving oral health among children in low-and middle-income countries (LMICs).MethodsOur systematic review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness. Medline, Embase, Global Health, CINAHL, Emcare, Scopus, Web of Science, WHO website, Google Advanced and Google Scholar were searched for experimental and observational studies published between 1995 and 2021 in English. Quality assessment and data extraction of the articles were performed by two independent reviewers. The primary outcome was decayed, missing, and filled teeth/surfaces [dmft(s)/DMFT(S)] scores. Seven meta-analyses were conducted.ResultsThe search yielded 1178 publications and after removing duplicates, 753 remained. A further 648 publications were excluded after screening titles and abstracts. 105 publications were reviewed in full and 34 were included. Narrative synthesis showed school-based interventions had a positive effect on oral health outcomes. Meta-analysis showed a significant positive effect on dental caries measured by DMFT scores (standardised mean difference (SMD) = − 0.33; 95% CI − 0.56 to − 0.10; P = 0.005), net increment in DMFS scores (SMD = − 1.09; 95% CI − 1.91 to − 0.27; P = 0.009), dmft and DMFT/S score > 1 (Risk Ratio = 0.70; 95% CI 0.53 to 0.94; P = 0.02) and plaque scores (SMD = − 0.32; 95% CI − 0.46 to − 0.18; P < 0.00001). Non-significant positive effect was observed for dental caries measured by net increment in DMFT scores (SMD = − 0.34; 95% CI − 0.69 to 0.02; P = 0.06) and DMFS scores (SMD = − 0.26; 95% CI − 0.70 to 0.18; P = 0.24), and gingival health (SMD = 0.12; 95% CI − 0.32 to 0.55; P = 0.60). Certainty of evidence was assessed as very low for all oral health outcomes.ConclusionSchool-based interventions can be effective in reducing the burden of oral disease among primary school children in LMICs, with skills-based education, teacher training, provision of access to oral health services and parental engagement emerging as particularly promising. Further research is required to provide evidence of effectiveness of primary school-based interventions to improve oral health.Systematic review registration The title of this review was registered with PROSPERO (registration number: CRD42020202599).

Do glycemic index and glycemic load of diet contribute to early childhood caries in preschool children?

PurposeThe purpose of this study was to examine the potential association between the glycemic index (GI) and the glycemic load (GL) with early childhood caries in preschool children.Design/methodology/approachThis cross-sectional study collected data from 225 children aged 37–71 months in governmental nursery schools within the Altindag district of Ankara, Turkey. GI and GL values of foods and beverages were calculated using 2008 international tables of GI and GL. Dental examinations were done under daylight and by using a headlight. The prevalence of caries was obtained by calculating the number of the decayed, missing and filled teeth (dmft) index score or decayed, missing and filled surface (dmfs) index score.FindingsThere were significant differences in the dmft and dmfs scores according to GI groups (p = 0.022 for both). The multivariate models showed that children who consumed a high-GI diet had higher dmft scores compared to children who consumed a medium-GI diet (ß 1.48, 95% CI −1.48, 4.44), whereas children who consumed a high-GL diet had lower dmft score compared to children who consumed low-GL diet (ß 0.55, 95% CI −0.97, 2.07), however, they were not statistically significant.Originality/valueDietary total GI and GL did not significantly influence the caries experience of preschool children. Future studies should focus on the different age groups with a broader perspective.

Anti-caries and Anti-microbial Effects of School-based Fluoride Programs in Myanmar Schoolchildren.

To investigate the anti-caries effects of the school-based fluoride varnish (FV) application at 3-month intervals and ?weekly fluoride mouthrins?ing? (FMR) ?on primary teeth and to evaluate the anti-microbial effects of FV or FMR on cariogenic bacteria among Myanmar children. A 6-month interventional study was conducted on 234 schoolchildren who were divided into three groups: group A received FV application at 3-month intervals, group B received weekly FMR,? and group C received no fluoride application. A clinical oral examination and caries risk tests were performed at baseline and the 6-month follow-up. Caries prevalence and ?the debris score did not change statistically significantly from baseline to the 6-month follow-up in all groups, whereas the dmfs score statistically significantly increased in group C (p = 0.001). The plaque and saliva scores of Dentocult SM statistically significantly decreased in group A (p = 0.049 and p = 0.006), but those scores statistically significantly increased in group C (p = 0.001 and p = 0.014) after six months. On the other hand, no statistically significant changes were observed in group B. Although the Cariostat scores decreased from baseline to the 6-month follow-up in group A and group B, but increased in group C, no statistically significant differences were observed in any of the groups. Better anti-microbial effects were obtained for children who received FV application than for those who received FMR, but no statistically significant difference existed between the anti-caries effects of these two approaches.

Amount and Frequency of Added Sugars Intake and Their Associations with Dental Caries in United States Adults.

The relative importance of amount and frequency of sugars intake for caries development has been a matter of debate in recent years, yet only one study has formally evaluated this question among adults. The aims of this study were to explore the shape of the relationship between amount and frequency of added sugars intake and their associations with dental caries among adults. Cross-sectional data from 10,514 adults, aged 20+ years, from the National Health and Nutrition Examination Survey (NHANES) 2011–2016 were analyzed. The amount (g/day) and frequency (items/day and episodes/day) of added sugars intake were derived from dietary recalls. Dental caries was indicated by the DMFS and DS scores. Fractional polynomials were used to characterize the relationship between amount and frequency of added sugars intake. Their associations with DMFS and DS were evaluated in negative binomial regression models adjusting for confounders. There was a logarithmic relationship between amount and frequency of added sugars intake. The amount of added sugars intake was positively associated with the DMFS (rate ratio: 1.11, 95% CI: 1.07–1.15) and DS scores (1.43, 95% CI: 1.33–1.54). However, the estimates for frequency of added sugars intake varied depending on how it was expressed. When expressed in items/day, it was not associated with the DMFS (1.02, 95% CI: 0.99–1.04) or DS score (0.91, 95% CI: 0.81–1.02). When expressed in episodes/day, it was positively associated with the DMFS (1.43, 95% CI: 1.33–1.54) but not with the DS score (0.95, 95% CI: 0.86–1.04). This study found a curvilinear relationship between the amount and frequency of added sugars intake. Furthermore, the amount of added sugars intake was more consistently and strongly associated with dental caries than the frequency of intake.

Prevalence of dental caries among government primary school children: a cross-sectional study

Background: Oral health is fraction of the whole health portion. The causal link connecting oral and complete disease has been revealed in recent years. Oral wellbeing has also affected the quality of life deeply. The extremely prevalent diseases in many communities include dental cavities and parodontal diseases. Once they happen, and even with complex etiology, they are rather irreversible. While there are primary preventive strategies, they do not offer maximum security. Methods: A total of 200 school children were selected randomly and dental caries assessment was recorded according to DMFT/DMFS indices.Results: Dental Caries was found to be 76 (38.0%) with mean DMFT scores 2.22±2.404 and mean DMFS scores 5.46±7.242, gender wise DMFT scores of school children is 2.22±2.404 and DMFS scores of school children is 5.46±7.242. The highest prevalence of dental caries 48.8% (mean dmft 2.27) was seen in 10-year children, followed 45.7% (mean dmft 1.69) was seen in 6-year children, 37.0% (mean dmft 2.3) was seen in 8-year children, 31.4% (mean dmft 2.26) was seen in 9-year children and lowest prevalence of dental caries 27.9% (mean dmft 2.49) was seen in 7-year children and females with 42.7% (mean dmft 2.15) and males with 32.2% (mean dmft 2.15).Conclusions: There is an urgent need to change from restorative dental services to preventive oriented dental services for government primary school children to improve the oral health status.