Mean Caries Scores Research Articles

Effect of food marketing on food purchase request, eating behaviour and dental caries amongst 5–8 year old children belonging to different socioeconomic backgrounds

IntroductionAggressive food marketing directed towards children and globalization has caused a nutritional shift in developing nations like India from the minimally processed to ultra-processed food, contributing to the increased risk of dental caries. The current study was undertaken to assess the outcome of food marketing exposure on food purchase requests, eating behaviour and dental health. MethodologyThis cross-sectional study included 260 children aged 5–8 years belonging to different socioeconomic background. Food marketing exposure was assessed using brand logo recognition scale, purchase request behaviour and eating behaviour were measured using questionnaire filled by parents and oral examination was done to record the caries score. ResultsThe mean brand logo recognition score was 15.67, high percentage of parents reported that their children try to influence (40.38% always, 34.61% often) and succeed in influencing (26.92% always, 40.38% often) the food purchase in the family. A large percentage of children consumed packaged snacks (40%), biscuits (75%), candies/chocolates (50%) and sweetened beverages (31%) at least once a day. The mean caries score was 1.41 and the overall caries prevalence was 42.30%. Adjusted for age, gender and socioeconomic group brand logo recognition was significantly associated with purchase request and eating behaviour but not with caries score. ConclusionChildren are found to be able to influence the food purchase practice at home and are clearly are well versed with brand logo recognition. The children from both the socio-economic groups reported similar Brand logo score recognition and food purchase request behaviour scores.

Evaluating a linkage between obesity and the occurrence of dental caries among school going children in Sakaka, Al Jouf, Kingdom of Saudi Arabia.

BackgroundObesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. The aim of this study was to analyze the type of relationship between the dental caries and obesity among school children in Al-Jouf region of Saudi Arabia.MethodsThis cross-sectional study was conducted among 400 participants aged 6 to 14 years. The study involved measuring caries (dmft/DMFT), assessing body mass index (BMI), and administering a self-completion questionnaire. An independent t-test, one-way ANOVA, and multivariate logistic regression analyses were performed.ResultsOut of 400 participants, 380 agreed to participate in the study. Overall caries prevalence among the participants was 76.1% and mean DMFT and dmft values were 2.8 ± 1.0 and 3.7 ± 1.6. Among the factors associated with mean caries scores, relation between DMFT scores and frequency of consumption of sugar was statistically significant (F = 3.82,0.01). Regression models has identified children with increased BMI values has 3.2 times more risk of getting dental caries in permanent teeth (P = 0.001).ConclusionThere was a positive association between obesity and dental caries in school going Saudi Arabian children. Comprehensive multidisciplinary approach by health professionals is recommended for preventive public health issues related to caries and obesity in teenagers.

Oral health assessment in children aging 8–15 years with bronchial asthma using inhalation medication

Objectives:The aim of the present study was to evaluate and compare oral health status of bronchial asthma patients between the age group of 8–15 years with healthy individuals and examines the relationship between the severity of asthma, dose duration, method of taking medication, and use of AeroChamber on the dental health of children diagnosed with asthma.Materials and Methods:The present cross-sectional study assessed the oral status of asthmatic patients and compared with a control group of 200 nonasthmatic patients. Both groups were matched in relation to age and gender. The oral health was assessed by measuring oral hygiene, caries status, periodontal health, and candidiasis of participants. Oral hygiene was measured by plaque index, caries assessment was done with the decayed missing filled teeth index/decayed extracted filled (DMFT/def index) and the periodontal status was measured with community periodontal index (CPI) adapted from the WHO (1997).Results:Plaque index score among asthmatics group was 1.49 ± 0.65 was significantly higher than healthy group 1.08 ± 0.57. The significant difference was noted in the mean caries (DMFT/def) score for asthmatic patients (2.31 ± 1.65/1.02 ± 0.39) and the controls (1.98 ± 1.54/0.74 ± 0.39). The CPI score was also significantly high in asthmatics (3.19 ± 1.68) in comparison to healthy individuals (2.32 ± 2.07). The candidiasis was absent in healthy individuals while it was present among 28 patients in the asthmatic group. The patients who were taking medication from longer period of time (9–12 months) had significantly worse oral health. The study result did not show any significant difference with the type of inhalation. However it showed significantly improved oral health for patients using AeroChamber in comparison to the patients not using it.Conclusion:Oral health was significantly poor in asthmatic patients in comparison with the healthy individuals. Increased frequency of asthma medication use was associated with increased likelihood of poor oral health. Use of AeroChamber improves the oral health of patients.

Association of Salivary Zinc Levels to Dental Caries and Body Mass Index. A Comparative Study.

Role of salivary zinc to dental caries and body weight has not been studied extensively in children. The aim of the present study was to evaluate the relationship between salivary zinc and caries in overweight/obese Indian children. One hundred and sixty children aged 8-12 years of both genders were divided into two groups of eighty each based on their body mass index into normal weight and overweight/obese. Each child was assessed for their caries experience in primary and permanent dentition. Unstimulated salivary samples were collected from each child to estimate zinc levels by atomic absorption spectrophotometer. Data was subjected to statistical analysis. The mean caries score among the overweight/obese children was 2.2±3.9 and 0.7±1.5 in the primary and permanent dentition respectively compared to the 2.0±2.6 and 0.2±0.5 respectively among normal weight children. Mean salivary zinc levels in overweight/obese children were 0.36±0.27 ppm compared to normal weight children of 0.81±0.46 ppm. Overweight/obese children demonstrated significantly lower salivary zinc levels and higher caries experience in permanent dentition. Salivary zinc levels showed a positive but weak association to caries in permanent dentition in both groups. Salivary zinc levels showed a negative non-significant correlation to caries in primary dentition among the children with higher BMI.

Association between a New Sugar Index and Caries Experience: Results of a Cross-Sectional Field Study

Objectives: The aim of this study was to test the relationship between a newly developed sugar index and caries experience in 4th- and 6th-graders. Materials and Methods: A total of 1,019 fourth-graders and 925 sixth-graders from 2 regions in Northern Germany participated in the study. Caries experience was recorded by applying the ICDAS criteria. Tooth-brushing habits and other independent variables were examined psychometrically. Structured questions were formulated that were related to specific everyday eating situations, especially between main meals, which proved to be relevant for a higher caries risk. To compare mean caries scores, nonparametric tests were applied. The Pearson coefficient was calculated in order to verify the correlation between the sugar index and the caries experience. The influence of various independent variables on caries experience was assessed by stepwise backward logistic regression analysis. Results: With regard to the primary teeth of the 4th-graders, significant correlations with values > 0.1 were found for all ICDAS outcome variables. With regard to the permanent teeth of the 6th-graders, the only significant correlations with the sugar index were for the ICDAS outcome variables D_3–6MFT and D_3–6FS. Conclusion: The results of our study show that not only the correlation between the sugar index and caries experience was stronger for 4th-graders than for 6th-graders, but also more distinctly visible differences were observed when comparing extreme groups. This indicates that protective factors, such as fluoridation and the preventive sealing of fissures, help level out the differences in caries occurrence in older children when compared to younger children.

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.

Zahngesundheit bei 12-Jährigen unter Einbeziehung von Initialläsionen und Dentinkaries

The aim of this study was to assess caries prevalence among 12-year-olds, including initial lesions and dentine caries (ICDAS-II criteria, Codes 0-6). The study was conducted in 2 regions of Hesse with different group prevention programmes (in region 1 children receive regular school-based prophylaxis using fluoride varnish twice a year from 1(st)-6(th) grade, in region 2 there is no use of fluoride varnish in schools. The samples were selected by a random sampling procedure using a list of all public schools. Dental caries was recorded on surface base and the presence of sealants was recorded. Additionally, a school-based analysis was performed. Statistical analysis was performed using SPSS 17.0. To compare the mean caries scores of the subgroups, non-parametric tests were performed (α=0.05). 270 12-year-olds were examined in each region. Mean DF-S values were: Region 1: D1-6FS=1.61; D1+2FS=1.5; D3-6FS=0.84; D5+6FS=0.74. Region 2: D1-6FS=2.8; D1+2FS=2.3; D3-6FS=1.1; D5+6FS=0.72. In region 2 significantly more initial lesions were assessed (p=0.01, D1+2FS). The difference between the regions was not statistically significant at the level of dentine caries (p=0.531, D3-6FS and p=0.113, D5+6FS). In region 1 mean DFS values differ significantly between children with and without fissure sealants at all levels (p<0.05). The analysis for region 1 based on the type of school visited showed a significant difference of mean D1+2F-S and D1-6F-S values (p=0.01 and p=0.012, respectively). In total, the caries prevalence in both regions was low. Differences between mean DFS values were clearer when initial lesions were included. The results point out the impact of assessing initial lesions for evaluation of prevention programs.

Caries prevalence (ICDAS) in 12‐year‐olds from low caries prevalence areas and association with independent variables

In areas with low caries prevalence, indices are needed for caries detection, which can also be used to identify initial lesions. The aim of this study was to assess the caries prevalence among 12-year-olds using ICDAS criteria and to investigate the influence of independent variables on the findings. The study was conducted in two regions of Germany. In Region 1, children received regular school-based prophylaxis, including fluoride varnish 2×/yr. In Region 2, there was no use of fluoride varnish in schools. Information on different factors influencing the outcome variable of caries experience was collected using structured questionnaires. DF-S values were calculated at different ICDAS cut-off points. To compare the mean caries scores of the subgroups, nonparametric tests were performed. Variables associated with caries were included in a binary logistic regression analysis. At D(1-6) FS and D(1+2) FS level, the differences between the regions were statistically significant (P = 0.005 and P = 0.01, respectively). Regression analysis identified the variables 'use of fluoridated toothpaste', 'fissure sealants', and 'ethnic origin' as factors significant to the prevention of caries at various stages. In a population with low caries prevalence, significant differences between subgroups could only be found when initial lesions were included.

Evaluation of a preventive program aiming at children with increased caries risk using ICDAS II criteria

A selective intensified prevention (SIP) was introduced at individual schools in deprived areas in Marburg County (Germany) in 1995. The outcome of the program was evaluated in sixth graders (mean age: 12.06 years) in comparison to a control region. Caries experience was recorded by applying International Caries Detection and Assessment System (ICDAS) II criteria. Tooth brushing habits and other independent variables were examined psychometrically. To compare the mean caries scores, non parametric tests were applied. The influence of various independent variables on caries experience was assessed by stepwise backward logistic regression analysis. The matching criteria age, gender, ethnicity and maternal education were used to parallelize the samples. ICDAS scores of 2-6 were detected uniformly more often in the control region than in the test group. Combining ICDAS scores 3-6, children from the control region (mean D(3-6)MFT: 1.73) showed roughly double the caries experience compared to the test group (mean D(3-6)MFT: 0.88, p < 0.005). The D(5,6)MFT score of the test group amounted to 0.50, and the corresponding value of the reference group was 0.77 (p = 0.043). Multivariate analysis disclosed fissure sealants, early start of tooth brushing and topical fluoride application to be associated with the prevention of dental caries. High frequency of sugar intake was associated with the presence of dentine lesions. The results of our study confirm the positive effect of SIP on the dental health of 12-year-old pupils living in deprived areas. On the basis of ICDAS II, targeted preventive measures can be applied in children with increased caries risk. Frequent applications of fluoride varnish inhibit the progression of initial lesions in this group.

An in vivo investigation of salivary properties, enamel hypomineralisation, and carious lesion severity in a group of Iraqi schoolchildren

Hypomineralised enamel is a prevalent, congenital defect vulnerable to deteriorate post-eruptively particularly in the presence of an unfavourable oral environment. To assess the influence of salivary characteristics on the clinical presentation of hypomineralisation lesions diagnosed in first permanent and second primary molars and to evaluate caries severity in relation to the defect's clinical presentation. Recruitment consisted of 445 seven- to nine-year-old participants, of whom 152 were diagnosed as having molar hypomineralisation (MH); the remaining unaffected subjects (N = 293) were considered their controls for saliva analysis. Dental caries status was assessed in 300 subjects of saliva sub-sample, equally divided as MH-affected and non-affected children. The International Caries Detection and Assessment System was used for caries detection. Salivary flow rates, viscosity, pH, and buffering capacity were determined. Molar hypomineralisation-affected children have significantly higher mean caries scores compared to the non-affected group. Dentinal carious lesions were ten times more frequent in teeth with post-eruptive breakdown (PEB) than with teeth with opacities only. Low salivary flow rates (LSFR), moderately viscous saliva, and low pH were significantly more common in the affected group. LSFR and moderate and highly acidic saliva were more likely associated with PEB. Demarcated hypomineralised enamel is a dynamic defect highly influenced by individual characteristics of the oral environment.

The influence of social status on pre-school children’s eating habits, caries experience and caries prevention behavior

To assess the prevalence of Early Childhood Caries (ECC) in a county in Northern Hesse and to correlate this parameter to various independent variables. Additionally to investigate the relationship between preventive measures and the socioeconomic status (SES). In spring 2006, 1,082 preschool children were examined. According to WHO-criteria d(3+4)mft scores were recorded. Information about eating habits and preventive measures were collected by structured questionnaires. To compare the mean caries scores and preventive measures of various subgroups, non-parametric tests were performed. Variables associated with caries were included in a binary stepwise backward logistic regression analysis. The mean d(3+4)mft score amounted to 1.88. Children with high SES had significantly less caries than children with low SES. Significant positive and negative associations of feeding practices and preventive measures to d(3+4)mft scores were observed. Differences between feeding practices and preventive measures were dependent on SES. Long-term use of baby bottles at night is the most important factor of ECC. Differences in feeding practices and preventive measures in the various SES groups are evident but not that significant as supposed.

Radiographic Assessment of Proximal Caries: A Comparison between Film-based and Dexis Digital Imaging Systems

This study compared Kodak Ektaspeed film and Dexis digital imaging systems for their diagnostic accuracy in detection of proximal caries in 210 proximal surfaces from 105 extracted human teeth (20 premolars and 85 molars), 129 of which were carious. Ground teeth were evaluated histologically. The images were assessed by an observer. ANOVA revealed that groups differ in scoring patterns with f-value of 26.72 and p < 0.01. The mean caries score by histologic assessment was significantly (p < 0.01) more when compared with the scores obtained by conventional and Dexis digital radiographic methods. The mean score for conventional radiographic method was slightly more than Dexis digital radiographic method, but the difference was statistically insignificant (p < 0.05). Both the radiographic methods were less accurate in detecting proximal caries confined to enamel, but as the lesion depth was increased to dentin, the rate of caries detection increased dramatically. It was concluded that both conventional and Dexis digital radiographic methods under estimated caries depth when compared with histologic method. Lastly, conventional film radiographs and Dexis digital radiographs did not perform significantly different from each other in the detection of caries.

Association of caries experience in adolescents with different preventive measures

To assess the preventive measures which were associated with the striking caries decline observed in Marburg (Germany) between 1982 and 2002 and to investigate the relationship between caries prevalence and the type of educational level. 1,237 twelve-year-old children were examined in four different types of schools. D3MFT and the number of teeth with fissure sealants were registered. Information about preventive measures carried out in the past was collected by structured questionnaires. To compare the mean caries scores of various subgroups, Mann-Whitney U-tests and ANOVA were performed. Variables associated with caries were included in a binary logistic regression analysis. In 2002 the mean D3MFT score amounted to 0.78. In 80.7% of the pupils fissure sealants were observed, on average 3.5 teeth with sealants were recorded per child. There were significant differences between the mean D3MFT scores and the mean number of teeth with fissure sealants among the various school types. Use of fluoride supplements in the past, use of fluoridated table salt and fissure sealants were the factors in the binary logistic regression analysis which were significant in preventing caries.

Molecular Genetic Study of Dental Caries Susceptibility in Mice

The purpose of this study was to identify the major candidate chromosome influencing susceptibility to dental caries in mice and to detect the region that contains it. Genetic factors affecting dental caries in mice were examined using two inbred strains of mice, C57BL/6J and C3H/HeJ, and these genetic crosses were inoculated with Streptococcus mutans serotype c (1.0 x 109 CFU/mouse). The caries scores for C3H/HeJ and C57BL/6J were 3.1±2.6 and 39.8±12.6 (Mean±S.D.), respectively. The mean caries score of the F1 hybrids was 17.6 ±13.2 (Mean±S.D.) which was in the range 1 to 46. The caries scores of F2 [(C57BL x C3H) x (C57BL x C3H)] mice had an extensive range from 0 to 68. These findings suggested that some genes play roles in caries development.Based on our results with the genetic crosses, we used F2 intercross mice to investigate candidate chromosomal linkages using DNA pooling methods and obtained a valuable linkage on chromosomes 2 and 17. Thus, we concluded that one of the candidate genes controlling the genetic difference for the dental caries promoting ability between C3H/HeJ and C57BL/6J might be located on chromosomes 2 and 17.

High caries levels: problems still to be tackled

According to the World Health Organization more than 60% of European countries have achieved the goal of no more than 3 DMFT at the age of 12 years. The others, including the newly independent Baltic states, still have high caries levels. Data from recent studies show that mean caries prevalence among 12-year-olds in Latvia, Lithuania, and Estonia was 5.8, 4.9, and 4.6, respectively. Absence of caries was recorded in 5% of Latvian and Estonian and 12% of Lithuanian 12-year-olds. Fifteen-year-old Latvians and Lithuanians averaged 8.1 and 7.0 DMFT, which, owing to the absence of radiographic examination, may be a substantial underestimation of real caries levels. The possible adverse effects of the privatization of dental care and the benefits of increased access to fluoride dentifrice in these countries have not yet been evaluated. The extremely poor oral hygiene seen in epidemiologic surveys indicates that fluoride dentifrices may not be widely used. The caries levels in the Baltic states resemble those commonly encountered a couple of decades ago in the Nordic countries. Data from two follow-up studies in Iceland show 66% and 52% decline in caries prevalence for 12- and 15-year-old children, respectively, over a period of 7 years. However, the caries experience of the 15-year-olds in the latter study was similar to that of 12-year-olds 10 years earlier, both in mean caries score (DMFS 11.3 and 12.1) and frequency distribution. Nor has the proportion of occlusal and approximal DF values changed in spite of frequent use of fissure sealants. While caries has become mainly a pit and fissure phenomenon in 12-year-olds, 44.3% of Swedish 19-year-olds reportedly have approximal lesions, and, when enamel lesions are recorded, approximal caries dominates the DFS scores. Analyses of trends in Nordic countries show that, despite a substantial decline in caries prevalence, vigilance is required to prevent a delayed caries development in the future adult population.

Longitudinal study of caries, cariogenic bacteria and diet in children just before and after starting school

Fifty 5-yr-old preschool children living in Akranes, a small community in West Iceland known to have a high caries prevalence, were investigated with respect to caries, salivary counts of mutans streptococci and lactobacilli, and consumption of cariogenic foods. Fifteen months later, after being in school for half a year, 43 of the 50 children were reexamined and investigated as before. Mean dmfs scores rose from 7.1 to 9.0, but the scores including initial caries rose from 9.7 to 15.3. Mutans streptococci were carried by 84% of children on both occasions with a mean count 2.1 and 3.6 x 10(5) cfu/ml. Lactobacillus carriage increased from 29 to 38% and the mean count from 5.1 to 13 x 10(3) cfu/ml at 6 yr. The frequency of consumption of sugar-containing foods increased from 4.2 to 5.2 intakes per day and between-meal snacks rose from 3.0 to 3.7 per day. Children classified as "misusing" sugar were 59% at 5 yr and 83% at 6 yr. The mean caries score at 6 yr for children "misusing" sugar was 10.7 but only 2.0 for those not misusing sugar. Thus the deterioration in dental health appears, in these children, to be associated with the increased consumption of sweets and other cariogenic between-meal snacks after starting school.

Precise Control of the Frequency and Amount of Food Provided for Small Laboratory Animals by a New Electronic Metering Technique, Used to Evaluate the Cariogenic Potential of Chocolate

A new electronic system was set up for accurately regulating the amount and frequency of food dispensed to laboratory rats so that investigations of the cariogenic potential of foods can be carried out under strictly controlled conditions according to the stipulations of the San Antonio Consensus Conference, 1985. The system was used to evaluate the cariogenicity of sucrose incorporated into plain and milk chocolate. The results suggested that 18.75% of sucrose in the diet had the same cariogenic potential no matter whether it was in the form of fine crystals or incorporated into plain chocolate, but mean caries scores were nearly 30% higher on a plain chocolate than on a milk chocolate regime.

Experimental Dental Caries on Gnotobiotic Inbred Mice

The purpose of this study in mono-infected gnotobiotic BALB/cA and C3H/HeN mice was to evaluate the cariogenicity of Enterococcus faecalis. The caries incidence and mean caries score in the BALB/cA mice were significantly higher than those in the C3H/HeN. In both of the mouse strains, the mean number of E. faecalis isolated from the cecum content was almost the same, however, the mean number of E. faecalis from the maxilla of BALB/cA was significantly higher than that of C3H/HeN. These results indicate that C3H/HeN has some factors that prevent E. faecalis from attaching to the tooth surfaces.

Caries Susceptibility in Inbred Mouse Strains and Inheritance Patterns in F1and Backcross (N2) Progeny from Strains with High and Low Caries Susceptibility

We studied dental caries susceptibility in various inbred mice strains infected with Streptococcus mutans and the inheritance pattern in the F1 and the N2 backcross animals. A high caries score was observed in four laboratory strains, BALB/cAJcl, C57BL/6NJcl, C57BL/10Slc and DBA/2NJcl. Three strains, C3H/HeNJcl, AKR/JSlc and CBA/JNCrj, showed less caries. Males of strain C57BL/10Slc (mean caries score = 112.2) and females of strain C3H/HeNJcl (mean caries score = 24.0) were chosen for examinations of the inheritance of the caries susceptibility. The mean caries score in (C57BL/10Slc x C3H/HeNJcl) F1 hybrids was 98.4, demonstrating that F1 progenies were susceptible. A number of N2 mice were obtained by mating the F1 male and the C3H/HeNJcl female. The caries scores of these N2 male mice had an extensive range, from 14 to 194. Assuming that a caries score over 74 (median of the scores between C57BL/10Slc and C3H/HeNJcl) belonged to the highly caries-susceptible group, N2 mice could be divided into groups with low or high caries susceptibility. Furthermore, the effect of nu/nu mutation on caries susceptibility in mice was also examined.

Effect of Two Recently Developed Antiseptics on Dental Plaque and Caries in Rats

This investigation measured the effect of two agents: CK 0569 A (a piperazine derivative) and octenidine on dental caries and plaque when used as oral rinses in rats. Twice daily flushings with aqueous solutions of either agent (0.5%) provided significant protection against dental caries and plaque, similar to that provided by chlorhexidine, when compared to the effects of the placebo rinses. However, when flushings (1.0%) were provided only once daily, only the octenidine-treated group exhibited a mean caries score that was significantly lower than that in the placebo-treated group. Animals receiving oral flushings once daily with octenidine (1.0%) in an oral flushing vehicle exhibited a 37% numerical decrease (0.1 > p > 0.05) in plaque scores compared with the animals treated with the carrier solution without additive.