Occlusal Surfaces Of First Molars Research Articles

Fluoride in the drinking water and dental caries experience by tooth surface susceptibility among adults

BackgroundDental caries is the most prevalent non-communicable health condition globally. The surface-based susceptibility hierarchy indicates that surfaces in the same group have similar susceptibility to caries, where the most susceptible group consists of occlusal surfaces of first molars and buccal surfaces of lower first molars, and the least susceptible surfaces are smooth and proximal surfaces of first premolars, canines and incisors. Therefore, fluoride in the drinking water could impact one group more than the other group. The present study examined the association between fluoride levels in the drinking water and dental caries experience in adults in the context of varying tooth surface susceptibility.MethodsData from the cross-sectional National Lithuanian Oral Health Survey conducted in 2017–2019 included a stratified random sample of 1398 35–74-year-olds (52% response rate). Dental caries experience in dentine was measured at a surface level. The surfaces were grouped according to their caries susceptibility (group 1 being the most and group 4 the least susceptible), and dental caries experience was calculated separately for each susceptibility group, creating four outcomes. Information about explanatory variable, fluoride levels in the drinking water, was provided by the water suppliers. The questionnaire inquired about potential determinants: sociodemographic characteristics and oral health-related behaviors. Chi-square, Mann–Whitney U and Kruskal Wallis tests were used for descriptive statistics, and linear regression analyses to examine the association between fluoride levels and four outcomes.ResultsThe proportions of median decayed, missing, filled surfaces decreased following the surface-based susceptibility hierarchy (group 1–33%, group 2–28%, group 3–24%, group 4–15%). When adjusted for potential determinants, higher-level fluoride (≥ 0.7 ppm vs < 0.7 ppm) in the drinking water associated with lower dental caries experience in all surface-based susceptibility hierarchy groups; Group 1: β = − 0.23 (95 %CI − 0.44; − 0.001), Group 2: β = − 0.44 (95 %CI − 0.82; − 0.07), Group 3: β = − 1.14 (95 %CI − 1.88; − 0.41) and Group 4: β = − 6.28 (95 %CI − 9.29; − 3.30).ConclusionsThe higher-level fluoride in the drinking water associated with lower dental caries experience in adults and this was observed in all surface-based susceptibility groups. However, there is a need to validate the surface-based susceptibility hierarchy in longitudinal adult studies.

Caries Epidemiology and Its Challenges.

Despite their limitations, caries epidemiology continues to rely predominantly on visual/tactile indices for detecting and assessing carious lesion-related conditions. Over the last 4 to 5 decades, the prevalence and severity of dental caries in primary and permanent dentitions have been reduced in a number of countries based on the published studies. Despite this achievement, the prevalence and severity of dental caries remains too high at a world level. Pits and fissures in occlusal surfaces of first molars and pits in buccal surfaces of lower first molars are most vulnerable for developing a carious lesion. Dental caries is a preventable, behavioural/life-style disease that is age related and life-long. Preventing dental caries should start at mother-and-child clinics in conjunction with the available educational and health care programmes. Oral health (caries) epidemiological surveys should be held periodically.

A 4 year prospective longitudinal study of progression of dental erosion associated to lifestyle in 13–14 year-old Swedish adolescents

ObjectivesTo evaluate the progression of dental erosion in 13–14 year-olds after 4 years, and its association with lifestyle and oral health. Methods227 randomly selected 13–14 year-olds from a Public Dental Clinic, Örebro, Sweden, were investigated. A clinical examination was performed which included dental caries/gingival/plaque status, as well as grading of dental erosion at the tooth surface and participant levels in “marker teeth”, including buccal/palatal surfaces of 6 maxillary anterior teeth (13–23), and occlusal surfaces of first molars. An interview and a questionnaire regarding drinking habits and other lifestyle factors were completed. All investigations were repeated at follow-up. The participants were divided into high and low progression erosion groups and logistic regression statistics were applied. Results175 individuals participated at follow-up. Progression occurred in 35% of the 2566 tooth surfaces. 32% of the surfaces had deteriorated by one severity grade (n=51 individuals) and 3% by two grades (n=2 individuals). Boys showed more severe erosion than girls at the follow-up. Among the variables predicting greater progression, a lower severity of erosive wear at baseline had the highest OR (13.3), followed in descending order by a “retaining” drinking technique, more frequent intake of drinks between meals, low GBI and lesser sour milk intake, with reference to the baseline recording. Using these five variables, sensitivity and specificity were 87% and 67% respectively, for predicting progression of erosion. ConclusionsProgression of erosive lesions in Swedish adolescents aged 13–14 years followed up to age 17–18 years was common and related to certain lifestyle factors. Clinical SignificanceIn permanent teeth, dental erosion may develop early in life and its progression is common. Dental health workers should be made aware of this fact and regular screenings for erosion and recording of associated lifestyle factors should be performed.

Students’ perceptions on diagnosis and treatment of occlusal surface of first molars

Accurate diagnosis of dental caries is a fundamental requirement in health care. Objective: The aim of this study was to evaluate the opinions of undergraduates concerning different conditions of the occlusal surface of permanent first molar. Material and methods: Two experienced and trained examiners, using visual and radiographic examinations, classified five occlusal surfaces of permanent first molars. The surfaces were photographed and presented to students with a questionnaire about classification of occlusal surfaces, methods used to aid caries diagnosis and type of treatment to be applied. The answers were classified as correct and incorrect and submitted to Chi-square test (p &lt; 0.05). Results:The results showed a higher percentage of correct answers regarding to dentine caries (87.95%) and no caries (84.34%). For all surface conditions, the methods most commonly used to aid diagnose were professional prophylaxis, good lighting, drying and dental probe. Considering the treatment, a greater number of correct answers were obtained for the surface with dentine caries, with indication of conventional (65.06%) and/or preventive restoration (33.73%) and no caries without treatment need or sealant (53.01%). For students at 6th, 7th and 8th semesters, the percentage of correct answers for classification and treatment was 72.31%, 58.33% and 62.94%, respectively, without statistically significant differences (p &lt; 0.05). Conclusion: It was concluded that the opinion of students differed regarding to the diagnosis and treatment mainly when the occlusal surface showed early stages of dental caries.

One-year changes in early carious lesions on the occlusal surface of first molars measured by the QLF method

One-year changes in early carious lesions on the occlusal surface of first molars measured by the QLF method

Prevalence and Risk Indicators of Erosion in Thirteen- to Fourteen-Year-Olds on the Isle of Man

Aims: The aim was to determine the prevalence of erosion in 13- to 14-year-old children on the Isle of Man and to investigate the strength of association with dietary risk factors. Methods: Exposed dentine was assessed on smooth surfaces of incisors/canines and occlusal surfaces of first molars. A questionnaire assessed the consumption frequency of foodstuffs. Results: Of 629 children examined, 124 (20%) had dentine exposed labially, palatally or occlusally. More males had dentine exposed on these surfaces (OR = 1.7, 95% CI = 1.2–2.6). Palatal dentine exposure was present in 3% of the children and occlusal dentine exposure in 18%. In bivariate analyses, drinking fizzy drinks more than once a day was associated with erosion (OR = 1.6, 95% CI = 1.1–2.3). The mean DMFT scores were not statistically different for the children with smooth surface/occlusally exposed dentine (1.37) compared to those without (1.58). Multiple regression analysis showed age, gender and toothbrushing to be significant predictors of erosion. Conclusion: This study has found a higher proportion of 13- to 14-year-old children with exposed dentine in molars than previous studies. The results corroborate previous reports that males have more erosion than females.

Caries Patterns in the Primary Dentition: Cluster Analysis of a Sample of 5,169 Arizona Children 5–59 Months of Age

AimCluster analysis was conducted on data from 5,169 United States (U.S.) Arizona children, age's 5-59-months with the goal of delineating patterns of caries in the primary dentition of pre-school children without a priori pattern definitions.MethodologyCluster analyses were conducted using all data for children ages 0–4 years in aggregate: 1) for all subjects, and 2) for subjects without crowned restored teeth. Each of these two sets of analyses consisted of 8 differently specified cluster analyses as a validation procedure.ResultsThe caries patterns identified from the clustering analysis are: 1) smooth surfaces (other than the maxillary incisor), 2) maxillary incisor, 3) occlusal surfaces of first molars, and 4) pit and fissure surfaces of second molars.ConclusionThe cluster analysis findings were consistent with results produced by multidimensional scaling. These cross-validated patterns may represent resulting disease conditions from different risks or the timing of various risk factor exposures. As such, the patterns may be useful case definitions for caries risk factor investigations in children under 60 months of age.

Unrestored Dentin Caries and Deep Dentin Restorations in Swedish Adolescents

The objectives of this longitudinal study were to assess: (a) the prevalence of unrestored dentin caries among 15-year-olds, (b) the proportion of these lesions that had progressed to deep dentin lesions (inner half of dentin) since the immediately preceding examination at the age of 14 and (c) the frequency of deep restorations (extending into the inner half of the dentin). The sample consisted of all 15-year-olds (n = 2,487) born in 1990 and included in the Public Dental Service in Malmö, Sweden. Bitewing radiographs taken during 2005–2007 and the immediately preceding radiographs were analysed and scored by two examiners. The main radiographic scores were: sound; radiolucency in the outer or inner half of dentin; restored surface. The results showed that 22% of the individuals had 1 or more dentin lesions left unrestored from the time of the examination at the age of 14 until the next recall examination at the age of 15. During the observation period (median time 1.2 years), 9% of the unrestored outer dentin lesions progressed to deep dentin lesions. The majority of these (93%) were in molars. One or more deep restorations were found in 22% of the 15-year-olds; the majority involved occlusal surfaces of first molars. In conclusion, unrestored dentin lesions were common in 15-year-olds. Progression to deep dentin lesions occurred in 9% of these lesions and was most common in first molars. Occlusal surfaces of first molars had the highest frequency of deep restorations.

Caries-Preventive Effect of a One-Time Application of Composite Resin and Glass Ionomer Sealants after 5 Years

The aim of the present trial was to (1) compare the caries-preventive effect of glass ionomer sealants, placed according to the atraumatic restorative treatment (ART) procedure, with composite resin sealants over time and (2) investigate the caries-preventive effect after complete disappearance of sealant material. Forty-six boys and 57 girls, mean age 7.8 years, were randomly divided into two treatment groups in a parallel-group study design. A light-polymerized composite resin sealant material and a high-viscosity glass ionomer were each placed in 180 fully erupted first molars in their respective treatment groups. Evaluation took place annually for 5 years by calibrated examiners. After 5 years, 86% composite resin and 88% glass ionomer sealants did not survive. Three categories of re-exposure periods for caries development in pits and fissures after complete loss of sealants were distinguished: 0–1, 1–2 and 2–3 years. In the 2- to 3-year group, 13 and 3% of pits and fissures previously sealed with composite resin and glass ionomer, respectively, were diagnosed as having developed a dentine lesion. The relative risks (95% CI) of dentine lesion development in surfaces sealed with glass ionomer compared to those sealed with composite resin after 3, 4 and 5 years were 0.22 (0.06–0.82), 0.32 (0.14–0.73) and 0.28 (0.13–0.61), respectively. The relative risks of dentine lesion development in pits and fissures previously sealed with glass ionomer compared with composite resin over re-exposure periods of 1–2 and 2–3 years were 0.26 (0.14–0.48) and 0.25 (0.09–0.68), respectively. We conclude that the caries-preventive effect of high-viscosity glass ionomer sealants, placed using the ART procedure, was between 3.1 and 4.5 times higher than that of composite resin sealants after 3–5 years. Furthermore, high-viscosity (ART) glass ionomer sealants appear to have a four times higher chance of preventing caries development in re-exposed pits and fissures of occlusal surfaces in first molars than light-cured composite resin sealant material over a 1- to 3-year period. A well-designed clinical trial using different types of oral health personnel should be implemented to confirm these initial results.

A longitudinal study of occlusal caries among schoolchildren in Dar es Salaam, Tanzania

To describe the clinical caries status and the radiographic progression of occlusal caries lesions in permanent first and second molars among primary schoolchildren in Dar es Salaam over a 3-year period. Clinical and radiographic diagnosis of caries in first and second permanent molars in 223 children aged 8-16 years were carried out annually from 1994 to 1997. The drop-out rates from the baseline in 1994 to the follow-up examinations in 1995, 1996 and 1997 were 16.6%, 22.0% and 35.4%, respectively. Twenty-one percent of the dropouts were picked up during the study. Less that 5% of all occlusal surfaces that were sound at the beginning of the study developed new clinical caries lesions over the 3-year study period. The highest rate of new lesions was found in second molars. The mandibular second molars were most frequently affected by new caries lesions followed by the mandibular first molars. Progression of lesions was generally slow. After 1, 2 and 3 years, 30.0%, 47.9% and 52.8% of lesions in occlusal surfaces of first molars had progressed, compared to 47.9%, 71.3% and 100.0% of lesions in second molars. Dental caries prevalence was low. New occlusal lesions were more likely to appear in mandibular second molars. Carious lesions were progressing slowly, especially in the first molars. Fissure abrasion may play a role in minimizing the risk of developing new occlusal lesions as well as progression of existing lesions.

Timing of first fillings on different permanent tooth surfaces in Finnish schoolchildren.

The timing of the placement of first fillings because of caries on different permanent tooth surfaces was determined at three health centers in Finland. The 927 subjects analyzed were born either in 1970-71 o4 in 1980-81. Basically, two different types of filling placement site were identified: 1) fissures and pits and 2) proximal and smooth surfaces. In some fissures and pits a 'post-eruptive'--that is, fillings placed in the year of emergence--was observed. This step had decreased markedly in the cohort born in 1980-81. The curves plateaued (retardation phase) at 50-60% for the occlusal surfaces in first molars for the children born in 1970-71 and at 20-30% for the younger cohort. The time without any filling varied from 1 to 7 years on smooth surfaces, and some surfaces remained totally filling-free. The filling placement curves followed the pattern of caries attack and can thus be used as an indicator of dental health.

The prevalence of caries in groups of children aged 4-5 and 7-8 years in Khartoum, Sudan.

A total of 544 children, 275 pre-school children (aged 4-5 years) and 269 school children (aged 7-8 years), were examined for dental caries using WHO criteria with some modifications. The children were resident in Khartoum, Sudan. The mean dmft was 1.68 in the 4-5-year group, and 58% of them were caries-free. In the 7-8-year group the mean dmft (molars and canines) was 2.77, and 33% of the children were caries-free. Most of the caries in both groups was untreated. In decayed teeth which were not beyond repair, occlusal caries was most prevalent in the pre-school group and approximal caries most prevalent in the school group. The mean DMFT in the 7-8-year group was 0.15, and only occlusal surfaces in first molars were affected. Ninety-four percent in the 7-year group and 88% in the 8-year group were caries-free in the permanent dentition. When the children were grouped according to their socio-economic level, there were no statistically significant differences in caries prevalence between the groups. Since this is the first comprehensive caries prevalence study of these age groups in Sudan, it is impossible to conclude whether caries is increasing or not. The prevalence of caries-free preschool children is above the global goal of FDI/WHO for the year 2000, but below the goal for developing countries.

Three-dimensional measurements of the occlusal surface of upper first molars in a modern Japanese population.

Moiré photographs of the occlusal surface of first molars of Japanese children were taken by means of a specially designed moiré contourograph apparatus. They were then used for three-dimensional measurements. The heights of 4 cusps and some other points were measured by counting contour lines. Distances and angles between them were also measured. Sex differences of these measurements are found mainly around the metacone and hypocone. There is no clear correlation of the four cuspidal heights to the distances between them.