Oral Epidemiological Survey Research Articles

Analysis of epidemiological trends of and associated factors for tooth loss among 35- to 44-year-old adults in Guangdong, Southern China, 1995–2015: a population-based cross-sectional survey

BackgroundTooth loss is a known marker of oral and systemic health, but large-scale population-based and cross-sectional multi-year comparative studies on tooth loss have yet to be much studied in China. This study explores the changing trends in tooth loss status and the associated factors influencing the prevalence of tooth loss over the past two decades in Guangdong, Southern China.MethodsData from three cross-sectional, representative oral epidemiological surveys in Guangdong Province were analyzed, including 400 in 1995, 720 in 2005, and 288 in 2015, for a total of 1408 participants. Sample selection is based on the National Census of China published by the National Bureau of Statistics. In this study, each year, the number of missing teeth (MT) and the prevalence of tooth loss (MT > 0) were calculated. Basic demographic information, socioeconomic status, caries and periodontal status, personal lifestyle factors, and dental health care behaviors were analyzed by multivariate logistic regression to estimate their associations with tooth loss. Statistical significance was evaluated with 2-sided tests with a significance level of P < 0.05.ResultsThis study found that the mean number of missing teeth and the prevalence of tooth loss among adults aged 35–44 years in Guangdong Province did not change significantly in the first decade (1995–2005) but decreased significantly in the second decade (2005–2015) (0.94 and 40.8% in 1995, 0.99 and 42.9% in 2005, and 0.63 and 33.3% in 2015, respectively). The mean number of MT by tooth position was highest for the first and second molars, and both were larger in the mandible than in the maxilla. In 1995, populations with low educational attainment and the presence of caries or periodontal pocket (periodontal probing depth ≥ 4 mm) were associated with a higher chance of MT > 0. In 2005, those with low educational attainment, the presence of caries, and 40–44 years old were associated with a higher chance of MT > 0. Moreover, in 2015, females, rural residents, and those with caries or periodontal pocket were associated with a higher chance of MT > 0.ConclusionsAlthough tooth retention has improved recently (2005–2015) and the preventive effect of education level on tooth loss has increased over time, efforts to prevent tooth loss in adults need to be strengthened. Particular attention should be given to preventive interventions for women, rural residents, and those suffering from caries or periodontal pocket.

Assessment of oral health status and related factors in adolescents aged 12–15 years in the Gansu Province of China: a cross-sectional survey

BackgroundThe national oral epidemiological survey conducted every decade has become an indispensable means of detecting changes in oral disease patterns. This study was undertaken to investigate the oral health status and related factors in 12–15-year-old students in Gansu, China.MethodsAccording to the methodology adopted by the Fourth National Oral Health Survey, a multi-stage, stratified, random sampling method was used to select 3871 adolescents aged 12–15 years from four regions of Gansu Province for oral examination and questionnaire survey. Caries experience was measured using the Decayed, Missing, and Filled Teeth (DMFT) index; and periodontal health examination included gingival bleeding, calculus, periodontal pockets and attachment loss. The questionnaire included questions regarding sociodemographic characteristics, and oral health knowledge and behaviors. SPSS20.0 software was used for statistical analysis of the survey data.ResultsThe mean DMFT index was 0.83 ± 1.42. The prevalence of caries experience was 38.6%, filling rate was 1.6%, and pit and fissure sealing rate was 0.5%. Logistic regression analysis showed that female sex, rural district, older age, non-only child, frequency of dental visits, and toothache experience were the risk factors for caries experience, with OR ranging between 1.280 and 3.831 (p < 0.05). Prevalence of healthy periodontium was 29.8%. Female sex, rural district, and younger age were found to be the protective factors for healthy periodontium, with OR ranging between 1.178 and 1.414 (p < 0.05).ConclusionsAdolescents in Gansu Province had high prevalence of caries experience along with low filling rate, and low prevalence of healthy periodontium. Therefore, it is necessary to vigorously strengthen oral health education, disease prevention and control programs in the province. This would help improve the oral health-related quality of life of these individuals.

Related factors of periodontal health among Chinese middle school students, findings from a national cross-sectional survey

BackgroundTo investigate the related risk factors of periodontal health status among Chinese middle school students.MethodsThis study is a part of the Fourth National Oral Health Epidemiological Survey, which is by far the largest oral epidemiological survey in China, including all provinces, municipalities and autonomous regions in mainland China. A multi-stage stratified sampling method was used to select middle school students aged 12–15 from the sampled middle school for investigation. The survey consisted of two parts: oral examination and questionnaire survey. The oral examination included gingival bleeding and calculus. The questionnaire included sociodemographic information, oral health knowledge, attitudes and behaviors. Logistic regression and generalized linear mixed model were used to investigate the risk factors of gingival bleeding and calculus.ResultsA total of 118,514 middle-school students has been examined. Less gingival bleeding (OR = 0.746, CI 0.718–0.774) and calculus (OR = 0.550, CI 0.529–0.527) were found in 12-year-old group compared to 15-year-old group. The periodontal health status of males was worse than that of females (gingival bleeding OR = 1.102, CI 1.074–1.132, calculus OR = 1.258, CI 1.223–1.295). Besides age and gender, region, living place, ethnic groups, family structure, parent’s education level, oral health knowledge and behavior were also related to gingival bleeding and calculus.ConclusionsGingival bleeding and calculus occurred most of 12–15 years old adolescents in China. Several related factors, such as gender, age, ethnicity, father’s education level, oral health knowledge and behavior, were found in multi-factorial models. The impact of province should arouse people’s attention.

Comparative analysis of physiologic rest position of the mandible with twins

Identical twins are multidisciplinary phenomenon, a miracle of fetal biology, medical reproductive challenge, the closest and most enduring biological connection. The aim of the research is a comparative analysis of physiologic rest of the mandible identical twins. This longitudinal oral epidemiological survey was conducted in a randomized sample of 30 pairs of identical twins, of equal gender representation and chronological age from 20 to 40 years. Based on the statistical parameters evaluated the position of physiologic rest and made a comparative analysis, that a certain degree of intra pairs similarities and differences among members of the same pair and a degree inter pairs similarities and differences among the members of different pairs of monozygotic twins. An evaluation comparing the position of physiologic rest, identical twins, t-test no significant difference in physiological rest, in the area of the front teeth. Concordance or conformity final ioshoda is proven among members of the same and different pairs. The difference was not observed, even compared to a gender. Comparing valuables of physiologic rest position, no significant intra pairs not inter pairs difference between members of the same and different MZ twin pairs.

Oral health survey and oral health questionnaire for high school students in Tibet, China.

ObjectivesThe aim of this study is to identify the oral health status as well as oral health practices and access for care of graduating senior high school Tibetan students in Shannan prefecture of Tibet.MethodsBased on standards of the 3rd Chinese National Oral Epidemiological Survey and WHO Oral Health Surveys, 1907 graduating students from three senior high schools were examined for caries, periodontitis, dental fluorosis, and oral hygiene status. The questionnaire to the students addressed oral health practices and present access to oral medical services.ResultsDental caries prevalence (39.96%) and mean DMFT (0.97) were high in Tibetan students. In community periodontal indexes, the detection rate of gingivitis and dental calculus were 59.50% and 62.64%, respectively. Oral hygiene index-simplified was 0.69, with 0.36 and 0.33 in debris index-simplified and calculus index-simplified, respectively. Community dental fluorosis index was 0.29, with 8.13% in prevalence rate. The questionnaire showed students had poor oral health practices and unawareness for their needs for oral health services. It was also noted that the local area provides inadequate oral medical services.ConclusionsTibetan students had higher prevalence of dental diseases and lower awareness of oral health needs. The main reasons were geographical environment, dietary habit, students’ attitude to oral health, and lack of oral health promotion and education. Oral health education and local dentists training should be strengthened to get effective prevention of dental diseases.

Comprehensive review of caries assessment systems developed over the last decade

World Health Organization (WHO) in the year 2007 recognized the growing burden of oral diseases worldwide and emphasized the need to scale up action based on comprehensive data collection systems. In view of the global epidemic of untreated caries in children there is an urgent need to establish a scoring system that both assesses and quantifies various advanced stages of caries. Furthermore, the available data are not readily comparable due to the different scoring systems used. The DMF index despite having limitations has been widely utilized in oral epidemiological surveys. It is recommended by the WHO for measuring and comparing the experience of dental caries in populations. The path of future research in caries epidemiology will depend on finding an ideal caries index. Objective: This review is prepared to present and critically evaluate various new caries assessment systems that have been developed in the last decade. Literature review: A literature search was done to find out major caries assessment systems developed over last decade, it revealed there were five new indices developed to assess caries. These indices were critically evaluated to list their strengths and limitations. Conclusion: There are many promising new caries indices purposed, but still there is a need for further studies to evaluate their validity and reliability before they can replace DMFT index.

Avaliação da doença periodontal em adultos na população quilombola

O objetivo deste estudo epidemiológico foi analisar a condição periodontal de população adulta quilombola sergipana. Foram avaliados 29 sujeitos pertencentes à comunidade na faixa etária de 35 a 44 anos. Foi realizado levantamento epidemiológico bucal com utilização de uma ficha clínica padronizada para investigar a ocorrência de doença periodontal utilizando o Índice Periodontal Comunitário (CPI) que permite avaliar a condição periodontal quanto à higidez, sangramento e presença de cálculo ou bolsa. A análise estatística foi conduzida com cálculo da prevalência da doença periodontal na faixa etária estudada, e teste qui-quadrado para verificar as diferenças significativas das relações pesquisadas. Os resultados apontaram que entre os adultos da população quilombola do povoado Patioba, em Japaratuba-SE, Brasil, houve prevalência da doença periodontal, considerada alta (75,86%), sendo maior no 1º e 6º sextantes bucais. Ressalta-se a necessidade de políticas de saúde com enfoque maior na promoção de saúde bucal para os quilombolas sergipanos.

What Difference Does Using Bitewing Radiographs Make to Epidemiological Estimates of Dental Caries Prevalence and Severity in a Young Adolescent Population with High Caries Experience?

The study aimed to determine the relative contributions of bitewing radiography and clinical examination to caries estimates for a New Zealand child population with high caries experience. An epidemiological survey was conducted of 171 12- and 13-year-old children attending schools in five communities. Examinations were conducted in dental clinics. Bitewing radiographs were taken at the time of the clinical examination. These were developed and read later, and the data from those were used at the analysis stage to adjust the caries diagnosis for the mesial, occlusal and distal surfaces of the posterior teeth. For almost all parameters, the use of radiographs resulted in higher estimates, although at the whole-mouth prevalence level the difference was not great. The percent difference between the estimates ranged from –0.1 to 166.7%. There were moderate differences between the clinical-only and radiographically adjusted whole-mouth estimates for mean DMFT, DT, DMFS and DS, but only a minor difference in caries prevalence. With the mesial and distal surfaces only, the prevalence and severity estimates were significantly greater, with a one-surface difference (on average) in mean DS being the largest difference observed, at 166.7%. The diagnostic discrepancy was much greater for approximal than occlusal surfaces. These findings support but also build upon earlier findings and again underline the need for bitewing radiographs to be a routine part of oral epidemiological surveys wherever logistics and funding permit.

Are people with dental fear under-represented in oral epidemiological surveys?

Dental phobia is associated with poorer dental attendance so epidemiological surveys requiring participants to undertake a dental examination may result in an under-representation of participants with high dental fear. We compared the dental fear distribution of participants and non-participants in an oral examination component of a national epidemiological survey of oral health. Of 12,606 in-scope dentate people aged 15+ who completed a structured computer-assisted telephone interview (CATI) survey, 5,505 (43.7%) participated in the oral examination. Dental fear was assessed with a single-item measure in the CATI. There was a significant difference between the percentages of participants and non-participants who rated themselves as "extremely" afraid, although the absolute difference (1.9%) was small. The association between extreme dental fear and participation was significant (OR = 0.66, 95% CI = 0.56-0.77) in multivariate analyses after controlling for possible confounders. Females with extreme dental fear were also significantly less likely to undertake an oral examination. Even though people with dental fear and phobia may delay or avoid dental visits, they do not appear to be appreciably under-represented in oral epidemiological surveys.

Oral cleanliness of 12-13-year-old and 15-year-old school children of Sunsari District, Nepal

The aim of the study was to evaluate the oral cleanliness of school children in the District of Sunsari, Nepal. A multi-stage random sampling oral epidemiological survey was conducted in private and government, urban, rural town and rural village schools in 15 illakas of Sunsari District, Eastern Nepal. A total of 600, 12-13-year-old and 600 15-year-old school children were examined by trained examiners using the simplified oral hygiene index (OHI-S). The average age-group, debris and calculus index scores were combined to obtain the simplified oral hygiene index (OHI-S). The mean OHI-S scores were compared and evaluated using the parametric t-test for two independent samples. The mean OHI-S for urban 12-13-year-old school children was 0.98 compared to 1.34 for school children of rural towns and 1.44 for school children of rural villages and these differences in mean OHI-S were statistically significant (P < 0.005). In the 15-year-old age group, urban school children had a mean OHI-S score of 1.00 compared to 1.37 for rural towns and 1.43 for rural villages. The variance in the mean OHI-S scores were statistically significant (P < 0.005). The overall level of cleanliness in the school children surveyed was good. Children of urban schools had the lowest scores followed by school children from rural towns and then rural villages. When the mean OHI-S scores were compared with the DMFT scores, there was an inverse relationship between oral cleanliness and dental caries. Frequency of sugar consumption and the availability and affordability of fluoridated toothpaste may be important factors in the development of dental caries than oral cleanliness.

The second national survey of oral health status of children and adults in China

To describe the oral health status of Chinese children and adults at national level in relation to location and province and to highlight changes in dental caries experience. Cross-sectional study, oral epidemiological survey based on WHO methodology, clinical examinations. National survey by National Committee for Oral Health. Representative samples of provinces, districts, townships; cluster sampling including subjects aged 5,12,15,18, 35-44 and 65-74. Each age group consisted of 23,452 participants, i.e. total of 140,712 individuals. At age 5, 76.6% were affected by dental caries and mean dmft was 4.5. Mean DMFT varied from 1.0 in 12-year-olds, 1.4 in 15-year-olds, 1.6 in 18-year-olds, 2.1 in 35-44-year-olds to 12.4 in 65-74-year-olds. In adults, caries experience was higher in females than in males. The effect of urbanisation on caries prevalence in children varied by province and age. Among adolescents and young adults caries levels were high in urban areas while caries experience was high for old-age people of rural areas. At national level, changes in dental caries prevalence of 12- and 15-year-olds were small. However, some provinces with extensive oral health programmes (e.g. Love Teeth Day) showed declining caries experience whereas provinces with limited preventive activities had increasing levels of caries. For all age groups, gingival bleeding and calculus were most frequent. Severe periodontal conditions were relatively rare. The systematic implementation of preventive oral care and community-oriented health programmes are needed for the continuous promotion of oral health in China.

Tooth loss and chewing capacity among older adults in Adelaide

This study aimed to identify sociodemographic factors associated with edentulism (loss of all teeth) and the average number of teeth lost, and to investigate relationships between tooth loss and chewing capacity. Data were obtained in 1991-92 from a cross-sectional oral epidemiological survey of Adelaide residents aged 60+ years. Interviews with 1160 participants provided information on edentulism while oral examinations among 560 dentate participants and 313 edentulous participants provided information on the number of missing teeth. People were asked if they could chew or bite six common foods. Some 41.1 per cent of persons were edentulous, and nearly half the natural teeth (mean 15.2) were missing among dentate people. Multivariate analyses revealed higher rates of edentulism (P < or = 0.05) for people who were older, female, Australian-born, or holders of pensioner health benefit cards, and for people who left school at an early age, or who did not own their residence. Among dentate people there were more (P < or = 0.05) missing teeth among those who were older, Australian-born, health benefit card holders, and who left school at an early age. Some 37.9 per cent of people reported difficulty chewing at least one food, although 57 per cent of dentate people and virtually all edentulous people wore dentures. Difficulty chewing was associated with tooth loss: 6.1 per cent of people with fewer than nine missing teeth reported difficulty compared with S8.6 per cent of edentulous people (P < 0.01). The findings show substantially compromised oral health among older adults, particularly the oldest-old and disadvantaged groups.