High Caries Experience Research Articles

Genetic and Environmental Factors in Adults With Low and High Caries Experience

Genetic and Environmental Factors in Adults With Low and High Caries Experience

Prevalence and Treatment Needs for Early Childhood Caries Among 3-5-Year-Old Children From a Rural Community in Uganda.

Introduction: Early Childhood caries (ECC) is the term used to describe dental caries in children aged 71 months and below. ECC causes a lot of pain and discomfort in the affected children and is expensive to treat. There is limited data on the prevalence of ECC in preschool children resident in the rural Uganda.Aim: To determine the prevalence and treatment needs for ECC among 3–5-year-old nursery school children in a rural community in Rukungiri District, Uganda.Study Design: This was a descriptive cross-sectional study in which 432 nursery school children aged 3–5 years from rural Nyakagyeme sub-county in Ugandan, participated. Informed consent for participation in the study by the children was obtained from their parents/guardians prior to the commencement of the study. The examination of the participants was done under field conditions, with the child lying his or her back of the neck on the PI's lap, with both of them seated on a bench and using natural light augmented with a headlamp to examine the oral cavity. The findings of the examination were recorded on individualized modified WHO Oral Health Assessment Forms for children.Data Analysis: The data gathered were analyzed using Windows SPSS Version 23.0 computer programme, and descriptive results for the variables obtained and Mann Whitney and Kruskal–Wallis tests used to compare and relate the variables. The P<0.05 was considered statistically significant with the Confidence interval set at 95%. The findings were presented in Tables and Figures.Results: A total of 230 (53.2%) male and 202 (46.6%) female participants, with 118 (27.3%), 145 (33.6%), 169 (39.1%) aged 3, 4, and 5 years old respectively, participated in the study. The overall prevalence of dental caries among the participants was 48.6%, with 11.6%, 18.5% and 18.5% recorded for the 3-, 4-, and 5-year old children, respectively. The male participants had a higher prevalence (26.1%) than the female counterparts (22.5%). The mean “dmft” for the participants was 2.04 (SD = 3.01) with the decay component (dt) having the highest value (M = 1.97, SD = 2.89), and contributing to 88.6% of the dental caries experience. The mean “dmft” was 1.79, 2.37 and 1.91 for the 3-, 4-, and 5-year old children, respectively, and the difference in the mean “dmft” among the age groups was not statistically significant.Conclusion: The prevalence of ECC of 48.6% was moderate in this study population. The high level of unmet treatment need as exemplified by the high dental caries experience, was a cause for concern as this forms a risk factor for caries in the permanent dentition.

IMPACT OF ORAL HEALTH BEHAVIOURS ON DENTAL CARIES IN CHILDREN WITH CEREBRAL PALSY: A CASE-CONTROL STUDY

INTRODUCTION: Dental caries is consistently reported as one of the primary medical needs of children with Cerebral palsy (CP). It has negative impact on the overall health of these children and increase burden on their parents OBJECTIVES: The aim of the study was to assess the influence of socio-economic profile, previous dental visits, oral hygiene practices, and dietary habits on dental caries experience in children with CP in Alexandria, Egypt. MATERIALS AND METHODS: This case control study included 80 children with CP, who were 3 to 11 years old. Equal number of cases (children with CP who had caries lesions) and controls (caries free children with CP) were included. Data were collected using an interview based questionnaire and clinical examination. Questionnaire assessed socio-economic characteristics, medical history, previous dental visits, oral health behaviours and dietary habits. Clinical examination assessed caries experience and oral hygiene index (OHI-S). Multiple regression analysis was used to examine the factors associated with dental caries. RESULTS: The average age of children in the study was 6.75 years, 68.8% of them were males. Caries experience was expressed through dmft for the primary teeth and dft/DMFT for mixed dentition. The mean values were 6.72± 2.52, 5.64 ±2.98 and 1.32 ±1.73, respectively. Children with CP with caries lesions had statistically significant poorer oral hygiene (p <0.0001), which is highly associated with high caries experience (Regression Coefficient=4.45, 95% CI= 3.75, 5.14). Other factors associated with DMF in children with CP included daily sugary snaking habits and food consistency. CONCLUSIONS: The level of oral hygiene status reflecting the efficiency of oral health behaviours, is considered the main factor associated with caries experience in children with CP. However, eating solid food and less than two sugary snacks per day were considered caries protective factors.

Impact of the radiographic method on treatment decisions related to dental caries in primary molars: a before-after study.

To evaluate the impact of radiographic examination on changes of treatment decision related to dental caries compared to decisions guided by visual inspection alone in primary molars. A total of 126 children aged 3-6years who had sought dental assistance were randomly selected and examined by two calibrated examiners using visual inspection. A treatment plan regarding dental caries was generated based on this assessment. The same examiners then evaluated two bitewing radiographs, creating an additional treatment plan guided by concurrent assessment of both visual and radiographic methods. Occlusal and proximal surfaces of primary molars received a treatment decision as follows: (i) no treatment, (ii) non-operative treatment, and (iii) operative treatment. The frequency of changes in the treatment decision after radiographic examination was calculated, with subsequent Poisson multilevel regression analysis to evaluate variables influencing such changes. Changes from "no treatment" decided with visual inspection to "non-operative treatment" after radiographic evaluation occurred in 52 surfaces (3.2%), and changes to "operative treatment" were observed in 46 dental surfaces (2.8%). Furthermore, 50 surfaces (6.2%) had their treatment decision changed from non-operative to operative treatment after radiographic assessment. In addition, changes were significantly more frequent in children with higher caries experience, on proximal surfaces and in 1st primary molars. The impact of radiographic examination on changes in the treatment decision of primary molars made with visual inspection is modest. Changes are more frequent in children with higher caries experience and in proximal surfaces. The benefits of the radiographic method for detecting caries in children, as a protocol in the diagnostic process, seem to be overestimated; the impact of this method on changes in treatment decision made by visual examination alone is low. Radiographs could be, however, useful in particular conditions, such as in children with high caries experience.

Caries experience and oral health-related quality of life (OHRQoL) of children and adolescents with cerebral palsy in a low-resource setting

BackgroundChildren with complex neurodevelopmental disabilities such as cerebral palsy (CP), have a higher risk of dental disease related at least in part to greater difficulties in performing and maintaining effective oral hygiene and oral care practices. However, to date, there are very few studies that have considered the impact of dental disease on the Oral Health-Related Quality of Life (OHRQoL) of children and adolescents with cerebral palsy. This study aimed to investigate the association between dental caries experience and oral health related quality of life (OHRQoL) among children and adolescents with cerebral palsy in a low-resource setting (Bangladesh).MethodsA total of 90 children and adolescents with CP, 2–17 years old (median age 10 years; 37.8% female and 62.2% male) were randomly selected from the Bangladesh Cerebral Palsy Register (BCPR) The decayed, missing and filled teeth (dmft/DMFT) index was used to measure caries experience. Child Perceptions Questionnaire (CPQ) and Family Impact Scale (FIS) were used to assess oral health–related quality of life (OHRQoL). Binary logistic regression was used to investigate factors that may contribute to dental caries experience.ResultsDental caries were observed among 55.6% of the participants. After adjusting for age and gender, binary logistic regression analysis showed that dental caries experience was significantly associated with those who had teeth/mouth pain (rate ratio 7.3; P = 0.02), food caught between teeth (rate ratio: 6.4; P = 0.02), difficulty in eating and drinking (rate ratio 5.9; p = 0.02) and those who felt frequently upset (rate ratio: 54.7; P = 0.02).ConclusionIn this study, we found that children and adolescents with CP in a low-resource setting had high dental caries experience and that dental caries had a negative impact on OHRQoL amongst these participants and their parents/caregivers. Health care professionals should be aware of the importance of dental health and oral hygiene in this population. These findings highlight the need for oral health promotion programs for children and adolescents with CP in these settings to reduce pain and to improve quality of life.

Oral Health Status, Treatment Needs and Oral Health Related Quality of Life among Hearing Impaired Adults in Riyadh City, Saudi Arabia

The primary objective was to determine the oral health status and treatment needs among hearing-impaired (HI) adults. Second, to assess the relationship between the oral health variables and oral health-related quality of life (OHRQoL) by using General Oral Health Assessment Index (GOHAI)-Ar questionnaire among HI adults in Riyadh city, Saudi Arabia. A total of 146 HI adults between the age groups of 18-21, 22-25, and >25 years were included in the study. A convenient sampling technique was used to obtain the study sample. Oral health condition was recorded by using oral hygiene index-simplified (OHI-S), plaque index (PI), and gingival index (GI). The WHO methodology was used to record dental caries and treatment needs. The Saudi Arabian version of GOHAI-Ar questionnaire was used to gather information with regard to OHRQoL. A sign language expert communicated information between HI and investigator while answering the questionnaire. More than half of the HI had fair OHI-S (55.2%) and PI score (54.2%), while 60.1% of HI had moderate gingival inflammation. The prevalence of dental caries (82.2%) and treatment needs (85.6%) were found to be high. Mean oral hygiene scores between Saudi and non-Saudi nationals [(1.64) vs (1.12), p = 0.041] showed significant differences. Missing and filled teeth showed significant differences across different age groups (p = 0.000). The mean GOHAI-Ar was found to be low (14.44 ± 9.59). Spearman's test showed a significant positive correlation between the GOHAI-Ar score and the toothbrushing method (r = 0.164, p = 0.047). Toothbrushing time, oral hygiene material, last visit to dentist, OHI-S score, PI score, decayed, missing, and decayed missing filled teeth (DMFT) scores were negatively correlated with GOHAI-Ar. Speech was the main concern for the HI. There was a fair oral hygiene, moderate gingival inflammation, high caries experience, and treatment needs with low GOHAI-Ar scores indicating poor OHRQoL among HI.

Oral hygiene instruction does not seem to have a distinct effect in patients with chronic periodontitis and high caries experience

Oral hygiene instruction does not seem to have a distinct effect in patients with chronic periodontitis and high caries experience

Individuals with special needs and their families' oral health-related quality of life.

To evaluate the impact of dental caries among Brazilian individuals with special health care needs (SHCN) on their families' oral health-related quality of life (OHRQoL). A cross-sectional study was carried out with a population-based sample of 227 subjects who were enrolled from the ACOLHER-PNE project conducted at the Fluminense Federal University. Parents/caregivers answered the Brazilian version of the 14-item Family Impact Scale (B-FIS) to assess the impact on family's quality of life (QoL). The main independent variable was dental caries experience, diagnosed according to the World Health Organization (WHO) criteria. The DMFT/dmft score was categorized into 0 = caries free; 1-2 = low; 3-4 = moderate; and ≥ 5 = high experience. Mother's schooling, age, sex, SHCN conditions, and socioeconomic factors were the other independent variables. QoL was measured through FIS domains and total score. Statistical analyses was performed using the Kruskal Wallis and Mann Whitney U tests and Poisson regression (p<0.05). The impact values observed in moderate and high caries experience were significantly higher than those found in subjects without caries and low level of parental emotions. Parents' years of schooling showed more impact on total score and on parental emotions. Older subjects showed significantly higher impact on total score and in all domains. The multivariate model demonstrated that families of older subjects (> 8 years old) experience a higher impact level compared to younger subjects (PR: 2.43; 95%CI: 1.80-3.29, p = 0.001). High caries experience and other socioeconomic factors were not associated with a greater negative impact on parents' QoL.

The Influence of Cognitive Bias on Caries Lesion Detection in Preschool Children

We aimed to evaluate whether children’s caries experience exerts an influence on the performance of visual and radiographic methods in detecting nonevident proximal caries lesions in primary molars. Eighty children (3–6 years old) were selected and classified as having a lower (≤3 decayed, missing, or filled surfaces; dmf-s) or higher (> 3 dmf-s) caries experience. Two calibrated examiners then assessed 526 proximal surfaces for caries lesions using visual and radiographic methods. As a reference standard, 2 other examiners checked the surfaces after temporary separation. Noncavitated and cavitated lesion thresholds were considered and Poisson multilevel regression analyses were conducted to evaluate the influence of caries experience on the performance of diagnostic strategies. Accuracy parameters stratified by caries experience were also derived. A statistically significant influence of caries experience was observed only for visual inspection, with more false-positive results in children with a higher caries experience at the noncavitated lesion threshold, and more false results at the cavitated threshold. The detection of noncavitated caries lesions in children with a higher caries experience was overestimated (specificity = 0.696), compared to children with a lower caries experience (specificity = 0.918), probably due to confirmation bias. However, the examiners underestimated the detection of cavitated lesions in children with a higher caries experience (sensitivity = 0.143) compared to lower-caries-experience children (sensitivity = 0.222), possibly because of representativeness bias. The radiographic method was not influenced by children’s caries experience. In conclusion, children’s caries experience influences the performance of visual inspection in detecting proximal caries lesions in primary teeth, evidencing the occurrence of cognitive biases.

Promoting Oral Health and Quality of Life of Older People - The Need for Public Health Action.

This report intends to review the global burden of oral disease among older people and to examine their oral health needs. The evidence on the inter-relationships between poor oral health conditions of older people, general health and quality of life is highlighted. Finally, WHO strategies to improve oral health of older people are reviewed. The information relevant to this review was extracted from the WHO Global Oral Health Data Bank, the PubMed database, and the Cochrane Library. Surveys were carried out according to the criteria recommended by the WHO epidemiological manual Oral Health Surveys - Basic Methods. In addition, global data were sought on coverage of oral health care among older people. Finally, WHO policy documents on health care for aged people were gathered through the WHO website. Across the globe, many older people suffer from oral pain or discomfort. Poor oral health during old age is mostly manifest in high caries experience, high prevalence rates of advanced periodontal disease, severe tooth loss, dry mouth, and oral pre-cancer/cancer. In both developing and developed countries, the burden of disease is particularly high among underprivileged and disadvantaged older people. In numerous countries, high proportions of the aged population are not covered by primary oral health care; this is mainly the case in low and middle income countries due to a critical shortage of dentists. In 2015, the WHO published the World Report on Ageing and Health, which outlines a framework for action to foster healthy ageing. The policies are highly relevant to the improvement of oral health. Transformation of oral health systems away from a disease-based curative model and towards disease prevention, as well as the provision of older-person-centred integrated care are required. Moreover, wide-ranging public health action on ageing is urgently needed.

Orofacial consequences of systemic sclerosis: A systematic review.

Orofacial involvement is common and often understated in the treatment clinical guidelines of systemic sclerosis. It impairs daily life by having repercussions on comfort, nutrition, aesthetics and self-confidence. This review aimed at describing exhaustively the different orofacial consequences of systemic sclerosis. A systematic search was conducted using four databases (PubMed, Cochrane Library, Dentistry & Oral Sciences Source and SCOPUS) up to December 2016 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses. Grey literature and hand search were also included. To be eligible for the inclusion, studies needed to meet the following criteria: randomised controlled trials, cross-sectional studies, case-control studies, pilot studies or cohort studies and full text available in English or French, with abstract. The studies had to concern at least 30 patients suffering from systemic sclerosis and having clinical and radiological oropharyngeal examination. The diagnosis of systemic sclerosis had to be determined according to precise recommendations; the retrieved oropharyngeal manifestations had to affect hard or soft tissues of the mouth and/or pharynx and needed to be evaluated with clinical measures. Study selection, risk bias assessment (Newcastle-Ottawa scale) and data extraction were performed by two independent reviewers. The retrieved features were microstomia and xerostomia associated with real hyposialia, temporomandibular joint symptoms, high caries experience, periodontal diseases as well as an increased risk of oral cavity and pharynx cancer. Early diagnosis enabling early management, prevention and oral hygiene is the key to avoid complicated and invasive procedures. Studies with higher level of evidence remain necessary to create standardised protocols.

Presence of Helicobacter pylori and Campylobacter ureolyticus in the oral cavity of a Northern Thailand population that experiences stomach pain

ABSTRACT Objective: To investigate oral diseases and microbiological conditions, such as the presence of ureolytic bacteria in dental plaque, in relation to experience of stomach pain in a remote adult Asian population. Methods: Ninety-three adults, 40–60-years old, from the Karen Hill tribe in Northern Thailand with no regular access to dental care were examined. Clinical registrations were performed and interproximal gingival plaque samples were collected and analyzed with the checkerboard (CKB) method for the presence of 14 oral bacterial species. Results: A number of 61 subjects reported daily stomach pain while 32 subjects had no symptoms from the stomach. The subjects with stomach pain had fewer remaining teeth (p < 0.05), higher caries experience (p < 0.05) and less BoP (p < 0.01). Most of the bacterial species were clustered statistically in three factors in a factor analysis, which together explained 65% of the microbiological variance. Factor 1, explaining 43.0% of the variance, was statistically associated with stomach pain (p < 0.001). Conclusions: The interproximal plaque/biofilm in adults of the study population showed a common presence of two gastrointestinal pathogens H. pylori and C. ureolyticus. The study also indicates for the first time a potential association between C. ureolyticus and stomach pain.

Lack of Association between BMP2/DLX3 Gene Polymorphisms and Dental Caries in Primary and Permanent Dentitions

The aim of this study was to analyze the association between BMP2 (rs1884302) and DLX3 (rs2278163) gene polymorphisms and dental caries in primary and permanent dentitions. A total of 914 subjects were genotyped by the TaqMan methods: 176 caries-free children (with Decayed/Missing/Filled Teeth, DMFT = 0), 542 patients with dental caries in permanent dentition (DMFT ≥1), 83 caries-free children with primary teeth (with decayed/missing/filled teeth, dmft = 0), and 113 children with early childhood caries (ECC, dmft ≥1). There were no significant differences in allele/genotype frequencies between patients with caries in permanent dentition/ECC and caries-free children or between patients with very low (DMFT = 0-2), low (DMFT = 3-5), moderate (DMFT = 6-8), or high (DMFT ≥9) caries experience. Variability in BMP2 and DLX3 was not associated with caries in the Czech population.

Dental caries remains as the main oral condition with the greatest impact on children's quality of life.

PurposeThe objective of this study was to assess the negative impact of dental caries on the OHRQoL of 8- to 10-year-old Brazilian children.MethodsThis population-based case-control study involved 546 children (8–10 years old), 182 cases with a high negative impact on OHRQoL and 364 controls with a low negative impact on OHRQoL. Children’s OHRQOL was measured using the Child Perceptions Questionnaire (CPQ8-10). Cases and controls (1x2 ratio) were individually matched by school and gender. Dental caries experience, malocclusion, and traumatic dental injuries were used as independent variables. Dental examinations were carried out at school during daytime hours by two calibrated examiners (Kappa = 0.93-interexaminer and 0.95- intraexaminer). The data were analyzed by descriptive statistics, conditional bivariate and multiple logistic regression, with the significance level set at 5%.ResultsThere was no significant difference in traumatic dental injuries and malocclusion between the case and control groups (p>0.05). Children with DMFT/dmft ≥3 had a 2.06-fold (95%CI = 1.28–3.31, p = 0.003) greater chance of experiencing a high negative impact on OHRQoL than those with DMFT/dmft = 0ConclusionChildren with high dental caries experience are more likely to present a high negative impact on OHRQoL than those with no dental caries experience.

Dental caries and related risk factors in Saudi cerebral palsy children.

Objective:To determine caries experience and related risk factors in cerebral palsy (CP) children.Methods:Random sample of CP children was examined for dental caries and oral hygiene. Questionnaire was utilized for information about caries risk factors. This cross-sectional study was conducted in Riyadh from December 2014 to May 2015.Results:Fifty-two CP children were examined with mean age of 6.3±2.7 years. Only one (1.9%) child out of the 52 had no clinical caries. Combined (dmft plus DMFT) mean caries score among study sample was 9.98±3.99. Older children had significantly higher mean caries scores (11.5±3.34) than younger children (8.86±4.1, p=0.017). The CP children with good oral hygiene had lowest mean caries score (5.8±7.32) as compared to those with fair (9.72±3.3) and poor (11.55±3.05) oral hygiene (p=0.012). Those children whose first dental visit was for routine check-up had significantly (p=0.02) lower mean caries scores (7.33±4.65) than those who made their first visit due to dental problem (11.57±4.15). Similarly, those who had topical fluoride applications by dentist had significantly (p=0.003) lower mean caries scores (8.67±4.14) than those with no topical fluoride application (11.9±2.89).Conclusion:The studied CP children had very high caries experience and poor oral hygiene. There was strong association between the high caries experience and poor oral hygiene.

Dental caries experience and treatment needs of an adult female population in Nigeria.

Experience and awareness of adult females concerning dental caries is important in its prevention particularly in children because of their natural role as care givers. To determine the prevalence of dental caries and treatment needs in an adult female Nigerian population. In this cross-sectional study, adult females attending outreach programmes were examined for dental caries using the Decayed Missing and Filled Teeth caries index (DMFT). Socio-demographic variables were also recorded and statistical analysis done with SPSS software. A total of 430 females aged 16 to 59 years participated in the outreach programme out of which 109 (25.3%) had a DMFT score > 0. Mean DMFT was 0.7 ± 1.6. Fifty-five (12.8%) participants had decayed teeth, 78 (18.1 %) had missing teeth and 10(2.3%) had filled teeth. The treatment need was 34.3%, restorative index was 13.3% and significant caries index was 2.0. There were significant differences in caries experience based on age, marital status and educational qualifications of participants p < 0.05. The prevalence of dental caries among the study group was low but the treatment need was high. Younger females, singles and those with lower educational qualifications had a higher dental caries experience.

Survival and Associated Risk Factors of Selective Caries Removal Treatments in Primary Teeth: A Retrospective Study in a High Caries Risk Population

Objective: The aim of this retrospective study was to analyze the survival probability of selective caries removal (SCR) treatments in the primary teeth of children with high caries experience and factors potentially associated with treatment failure. Methods: The sample included SCR treatments conducted in anterior and posterior teeth without sedation or general anesthesia among children attending a university dental service. Kaplan-Meier survival analysis was used to estimate the longevity of restorations and multivariate Cox regression with shared frailty was used to assess risk factors. Results: A total of 284 SCR treatments in 88 children (aged 5.2 ± 1.91 years) with high caries experience (mean dmft/DMFT = 11.1 ± 5.04) were analyzed. The 3-year survival reached 48.8%, with an annual failure rate of 21.2%. Restorative failures (n = 60) were found more frequently compared to pulp complications (n = 12). SCR performed in anterior primary teeth were more prone to failure (hazard ratio = 3.6, 95% CI: 1.94; 6.71). Patients with a higher amount of visible plaque experienced more failures in SCR treatments (hazard ratio 3.0, 95% CI:1.27; 7.07). Conclusions: In this retrospective study, SCR showed restricted survival when compared to other prospective clinical trials. Patient-related factors, especially the young age and high caries experience of the children, may represent a challenge for restoration survival. Regardless of the caries removal technique or restorative material, cariogenic biofilm has a negative effect on the survival of restorations, probably by acting directly on material deterioration and, particularly, on the development of new caries lesions of rapid progression.

Trends in socioeconomic inequalities in oral health among 15-year-old Danish adolescents during 1995-2013: A nationwide, register-based, repeated cross-sectional study.

Scandinavian welfare states, despite having better population oral health than less egalitarian societies, are characterized by ubiquitous social gradients and large relative socioeconomic inequalities in oral health. However, trends in these inequalities among Scandinavian children and adolescents have not been studied in detail. To describe the associations between socioeconomic position (SEP) and oral health in adolescents and to investigate the trends in these associations between 1995 and 2013. Nationwide repeated cross-sectional studies (using individual-level data) were conducted on 15-year-olds in Denmark from 1995, 2003, and 2013 (N=154,750). Dental data were obtained from the national dental register of the Danish Health Authority (Sundhedsstyrelsens Centrale Odontologiske Register [SCOR]) and data on social variables from administrative registers at Statistics Denmark. SEP measures included previous year's parental education (highest attained educational level by either of the parents), income (equivalized household disposable income), and occupational social class (highest recorded occupational class between the parents). Covariates were immigration status, country of origin, number of children and persons in the family, and household type. The outcome was dental caries experience, represented by the decayed, missing, and filled surfaces (DMFS) index. Negative binomial regression models were used to examine the association between DMFS count and each of the explanatory variables separately while accounting for cluster-correlated family data. Furthermore, hierarchical multiple regressions of DMFS on SEP indicators-using the zero-inflated negative binomial (ZINB) distribution as the outcome distribution-were estimated while successively adjusting for the potential effects of the included covariates. Caries prevalence declined from 71% in 1995 to 63% in 2003 and 45% in 2013. Separate assessment of each covariate showed statistically significant graded associations between each covariate and DMFS count at all time points. Similarly, in the ZINB models, in all 3 years, clear gradients were observed in terms of caries differentials in all three SEP categories, with statistically significant associations (Type 3 P values, <.0001) even after adjustment for all other covariates. For instance, in 2013, even among adolescents with positive caries experience, being of lower occupational social class was associated with up to 2.4-fold (95% confidence interval [CI]: 2.2-2.6) higher caries experience. Between 1995 and 2013, relative inequalities increased in all SEP categories, while absolute inequalities decreased in the education and occupation categories. Considerable progress has been made in reducing dental caries rates among Danish adolescents; however, this progress has benefited the disadvantaged social groups less than the better-off groups.

Dental caries experience among Albanian pre-school children: a national survey.

To determine the dental caries experience and treatment needs among 5-year-olds in Albania. This cross sectional study was conducted in 2015 by using a cluster sampling technique. The dmft was used to assess dental caries experience and caries prevalence as percentages of children with dmf⟩0. Caries treatment needs were assessed with dt/dmft x 100, missing teeth with mt/dmft x 100 and ft /dmft x 100 as the Care Index. 2,039 five-year-olds, from 17 districts of Albania were selected . Children's residency was divided into 3 main regions (South, West, Central and North). WHO 2013 diagnostic criteria were used and dental caries was recorded at cavity level d3. The mean age was 5.4 (SD 0.5) years. The caries prevalence (dmf⟩0) was 84.1%. The prevalence of children without cavitated lesions (d=0) was 20.1%. The mean dmft index was 4.41 (SD 3.83). The caries treatment needs were 84% (SD 26%). The Albanian 5-year-olds assessed in this survey had a high dental caries experience and untreated cavities in the primary dentition. The national health authorities should introduce preventive programs and improved dental care access for this age group.

Can clusters based on caries experience and medical status explain the distribution of overhanging dental restorations and recurrent caries? A cross-sectional study in Madinah - Saudi Arabia.

Overhanging dental restorations (ODRs) and secondary caries lesions (SCLs) are of high prevalence and jeopardize the fate of the restoration. To assess the relationship between ODRs, SCLs and certain caries contributory factors. A total of 502 radiographic records of dental patients with proximal fillings (mean age 38±13 years, 50% females) were screened for ODRs and SCLs. Descriptive and inferential statistics were used. In addition, two-step cluster analysis was performed in an attempt to explain trends in ODR and SCL distribution. A p value of ≤0.05 was considered statistically significant. More than 30% of the individuals had ODRs and SCLs. No differences between genders were observed (p>0.05). Individuals with medical conditions had more ODRs than those without (49% vs. 34%, p≤0.05), while those with high caries experience had more SCLs (49%, p≤0.05). The cluster analysis grouped the participants in five clusters, with the cluster involving individuals with no medical conditions and low caries experience demonstrating the lowest prevalence of ODRs and SCLs. Within the study limits, more than one third of the sample of dental patients had ODRs and SCLs. The medical condition was associated with ODRs, while the past caries experience was associated with SCLs.