Preventive Oral Health Program Research Articles

Impact of the COVID-19 Pandemic on Oral Health Behaviors Among Children in Iran.

Parents are responsible for their children's oral health. This study evaluated parents' knowledge, attitudes, and performance on their children's oral health before and after an educational intervention and the impact of COVID-19 on these variables. This quasi-experimental study included 227 children aged 6-8 years who were referred to 11 Shiraz medical centers from July to December 2021. Data were collected from questionnaires and interviews. After completing the questionnaire, oral health education was provided immediately and then monthly thereafter using dental models and pamphlets. After 3 months, a questionnaire assessed the education's effectiveness. Data were analyzed using independent t-tests, one-way analysis of variance (ANOVA), paired t-tests, and Pearson's correlation. A total of 163 participants (71.80%) completed all phases, including the second questionnaire. Participants showed moderate knowledge (77.30%), attitude (89.00%), and performance (80.40%). Neither knowledge nor attitude before the intervention had a significant association with demographic characteristics. Parents' education, number of children, and maternal employment were significantly associated with performance (p = 0.002, p = 0.040, p < 0.001, respectively). The intervention significantly enhanced these variables (p < 0.001). In terms of COVID-19, 72.40% of participants expressed good knowledge about transmission, 52.80% showed moderate concern, and 54% had poor performance. Parental knowledge, attitude, and performance changed significantly following the intervention (p = 0.030, p < 0.001, p < 0.001, respectively). Educational intervention significantly improved parents' knowledge, attitudes, and performance toward children's oral health. Because of the poor performance of parents during the COVID-19 pandemic, we recommend the implementation of continuing education and preventive oral health programs.

Exploring and enhancing the accessibility of children's oral health resources (called HABIT) for high risk communities

BackgroundWithin the city of Bradford in West Yorkshire, South Asian and Eastern European communities have an increased risk of childhood tooth decay, especially among families with Limited English Proficiency. Tooth decay is preventable, with national guidelines advocating home-based behaviours (toothbrushing with fluoride toothpaste and reducing sugar intake). In England, Health Visitors have opportunities to undertake oral health conversations during universal visits for children aged 0–24 months. The HABIT (Health visitors delivering Advice in Britain on Infant Toothbrushing) intervention provides structured oral health conversations, underpinned by complex intervention methodology. A feasibility study found HABIT acceptable to parents, feasible to deliver and led to improvements in home-based behaviours. However, the reach of this original study was limited to those proficient in English. This new study focused on exploring and enhancing the accessibility of the HABIT intervention to parents with Limited English Proficiency.MethodTwenty-four parents participated in interviews and focus groups, with 21 requesting support from interpreters. Community centres and WhatsApp were used to maximise inclusivity. Interviews and focus groups, followed a topic guide and the “Think Aloud” technique, were professionally transcribed, managed in NVivo, and thematically analysed. Team discussions facilitated analytical rigour. Recruitment continued until data saturation.ResultsThree themes were developed: (1) Navigating linguistic barriers; (2) Engagement through visuals; and (3) Addressing oral health challenges. Parents employed diverse strategies to interpret resources, including Google Translate, as well as family and wider community members. Consequently, the HABIT resources were modified to include simple text, subtitles, and translation tools. Parents highlighted the benefits of shorter oral health messages with clear visuals to help understanding, and this strategy was applied across all resources. Challenges surrounding children's resistance to toothbrushing, high sugar intake within their wider families and communities, and limited dental access were all raised. The HABIT resources were updated to address these challenges.ConclusionCollaborative community engagement has enhanced the HABIT resources, enabling access for high-risk communities to preventive oral-health programmes thereby promoting health equity.

An inverse relationship between dental fluorosis and Molar Incisor Hypomineralization in Mexican schoolchildren in an area with a high concentration of fluoride in drinking water: A cross-sectional study.

To evaluate the association between the frequency and severity of dental fluorosis and Molar Incisor Hypomineralization (MIH) in 8-12-year-old schoolchildren living in an area with a high concentration of fluoride in the drinking water. The present cross‑sectional study was conducted on Mexican children (n = 573) selected from one community presenting a drinking water fluoride concentration of 1.39 ppm/F. The prevalence of dental fluorosis was ascertained using the Thylstrup and Fejerskov Index (TFI). The presence and severity of MIH was evaluated using the European Academy of Pediatric Dentistry (EAPD) criteria. A multinomial regression model was used to estimate the odds ratio (OR) and the 95% confidence intervals (CI), using the severity of MIH as the result. The prevalence of MIH was 37.7% and, by severity, was 16.1% mild, 14.3% moderate, and 7.3% severe. The prevalence of dental fluorosis in permanent dentition was 70.9% (TFI ≥1) and, by severity, was 29.2% (TFI = 0), 45.6% (TFI 1-3) and 25.3% (TFI ≥4), while 54.5% of subjects were found to have poor oral hygiene. Schoolchildren with fluorosis (TFI ≥4) were 49% less likely [OR = 0.51; p = 0.025] to present mild MIH than children with fluorosis (TFI <4). Similarly, children with fluorosis (TFI ≥4) were 53% [OR = 0.47; p = 0.019] and 62% [OR = 0.38; p = 0.036] less likely to present moderate and severe MIH than children with fluorosis (TFI <4). An inverse relationship between the presence of fluorosis and MIH was found. The results obtained by the present study may contribute to both the early identification of disorders affecting the enamel and the creation and implementation of long-term oral health prevention, promotion, and intervention programs in the affected population.

Etiologies of non-surgical root canal treatment and its association with risk factors in a selected Thai population

BackgroundThe aim of this study was to investigate the etiologies of non-surgical root canal treatment (NS-RCT) in a Thai population and examine their association with risk factors.MethodsA cross-sectional observational study was performed to examine the etiologies of NS-RCT and risk factors among Thai-nationality patients treated at a tertiary care dental hospital in Thailand from 2019–2023. Treatment records and radiographs were retrospectively reviewed to identify NS-RCT etiologies, and associated contributing factors were analyzed. Statistical analysis used univariate logistic regression followed by multivariate logistic regression, with a significance level set at P < 0.05.ResultsThe data from 1500 teeth were analyzed, comprising 59.1% females and 40.9% males, with ages ranging from 7–91 years (mean = 48.56 years). The most prevalent age group was 61–70 years-old. Among the treated teeth, the mandibular first molar was the most frequently involved (13.9%), followed by the maxillary first molar (9.9%) and mandibular second premolar (9.7%). The primary etiologies of NS-RCT were dental caries (53.7%), old and large restorations (7.9%), and attrition (5.9%). Analysis of etiology of NS-RCT due to caries revealed that the most commonly affected sites were the occlusal (32.6%), distal (31.6%), and mesial (17.2%) surfaces. In immature teeth requiring NS-RCT, the predominant etiologies were dens evaginatus (32.1%), dental caries (28.6%), and traumatic injury (21.4%). The association between the etiology of NS-RCT and investigated associated factors were identified.ConclusionsThe etiologies of NS-RCT in the selected Thai population were mainly attributed to dental caries, with additional factors being old and large restorations and attrition. Notably, due to the aging society, the elderly population experiences a higher demand for NS-RCT, particularly due to attrition, non-carious cervical lesions, and erosion. In contrast, in immature teeth, the most common etiologies leading to NS-RCT comprise dens evaginatus, dental caries, and traumatic injuries. The distinct etiological patterns observed in different age groups emphasize the importance of specific oral health prevention programs to address individual needs.

Dental caries status and related factors among 12-year-old Somali school children in Hargeisa.

There is little data on the oral health conditions of Somali children. The aim was to assess the dental caries status and related risk factors of 12-aged children in primary schools in Hargeisa, Somaliland. A school-based survey was conducted in Hargeisa in December 2022. Using 2-stage cluster sampling, 405 children (12-aged) were randomly selected from 16 primary schools. Data collection involved WHO structured interviewer-administered questionnaire and clinical examinations. The DMFT index was measured according to WHO criteria, and accordingly, the mean for the significant caries index (SiC) was calculated. The association between the DMFT and the relevant variables was analysed using negative binomial regression in STATA. The overall prevalence of dental caries was found to be 62.7%, with a mean DMFT of 1.7 and a SiC score of 3.7. Non-public school pupils showed significantly higher prevalence of dental caries and mean DMFT compared to public school counterparts (68.5% vs. 58.6%) and (1.91 vs. 1.48), respectively. Merely 14.7% of the participants utilized dental care services in the previous year. The multivariable analysis showed a significant positive association of the DMFT outcome with attending a non-public school (95% CI 1.16-2.12) and having many previous dental visits (95% CI 1.22-2.83). In the adjusted model, fathers of low education had children with better dental caries status (lower mean DMFT) than their well-educated counterparts. The mean DMFT was not significantly influenced by the factors sex, location, educational attainment (school class of the participants) and frequency of teeth cleaning. Although the overall mean DMFT of school children in Hargeisa could be regarded low, the high levels of untreated caries especially in the one-third most affected are a cause for concern. Children enrolled in non-public schools formed the high-risk group. Preventive oral public health programs targeting Somali school children are recommended.

Two years outcome of an individualized oral health preventive program for preschool children with neurodevelopmental disorders.

Limited data exist on the effectiveness of oral health preventive programs in children with Neurodevelopmental Disorders (NDD). The aim of this study was to evaluate the effectiveness of an individualized preventive oral health program for preschool children with NDD at a rehabilitation center, over a two years period. In this study, 102 preschool children with NDD were assessed for caries (dmft), oral hygiene status (Green & Vermillion Index) and presence of developmental dental defects. An individualized preventive program was applied based on caries risk and children were followed for two years. Effectiveness of the program was assessed for caries and dental plaque change and explanatory individual factors were used in multivariate models. After two years prospective, dmft increased significantly from 1.1 (SD=2.7) to 2.04 (SD=3.6), while GVPI was reduced significantly from 1.8 (SD=0.9) to 1.4 (SD=0.9). Children in the moderate and high-risk groups missed significantly more follow-ups compared to the low caries risk group (p<.001) while older maternal age (OR=1.38, 95%CI=1.057-1.808) and consumption of more than three sugary snacks/day (OR=0.005, 95%CI=0-0.0794) were significantly correlated with dental caries. The individualized preventive program for preschool children with NDD was effective in improving oral hygiene but not dental caries status.

Impact of oral health preventive program using specialized audio and tactile aids in visually impaired school children. A cross-sectional study.

The maintenance of oral hygiene and subsequent health related issues in visually handicapped children is a challenging task. Hence, tools must be used to ensure good oral health in these children. The study aimed to analyze the effectiveness of preventive programs on oral health using specialized audio and tactile aids in visually impaired school children. 100 visually handicapped children were selected for the study. They were divided into two groups: Group A (Training using Braille) and Group B (training by means of audio aids). Children were trained using appropriate tools and oral health was assessed using Plaque and Gingival bleeding indices. Independent 'T-test' was used for comparing mean ± SD values. Statistically significant improvements in both plaque and gingival bleeding indices were obtained on follow-up observations at 3rd and 6th months. The use of specialized tactile and audio tools significantly improved the oral health status of visually impaired school children.

Dental caries status among elementary students at Medowo III Elementary School, Kandangan, Kediri, East Java

Background: Dental caries is frequently observed in children. Increasing the awareness of oral health among school-age children is anticipated to decrease the occurrence of dental caries. Purpose: The aim of this study was to determine the prevalence of dental caries among students in Medowo III elementary school using dmft/DMFT index. Methods: A cross-sectional descriptive study was carried out among the entire student at Medowo III elementary school. The dental caries of each student were assessed using the dmft and DMFT indices. The assessment of variable distribution was conducted using the Shapiro-Wilk test. The dmft/DMFT values were compared between different age groups and genders using either the Student's t-test or the Mann-Whitney test. The data was processed using a significance level of p &lt; 0.05. Results: The study included a total of 43 students. The average caries index in primary dentitions was markedly greater than in permanent dentitions. According to WHO, the prevalence of dental caries was very high in the primary dentition of students aged 7-9 years. No notable disparities were detected between female and male students in relation to the caries index of both primary and permanent teeth. However, the average caries index of primary teeth was considerably higher in middle-childhood students compared to preadolescence students. Conclusion: The dental caries prevalence among students in Medowo III elementary school were still high. Therefore, oral health prevention program was needed in order to enhance the community's awareness toward dental caries.

Dental caries and associated factors among Turkish children and adults: Findings from the 3rd National Oral Health Survey.

Information on the current status of oral health and related risk factors is lacking in Turkiye. This study aimed to evaluate dental caries and associated factors among the Turkish population using the findings of the third national oral health survey. This cross-sectional epidemiological survey was carried out between March and September in 2018 including five index ages and age groups (5-, 12-, 15-year-olds, 35-44 and 65-74 age groups). A multistage cluster sampling design was used to obtain a national representative sample of these age groups. Participants were interviewed face-to-face using a structured questionnaire, and oral examinations were performed based on the methods and criteria suggested by the World Health Organization. The adjusted prevalence ratio for dental caries was estimated considering sociodemographic and behavioural characteristics by using log-binomial and robust Poisson regression analysis in R and SAS software. After data cleaning, a total of 11 091 participants remained. The prevalence of dental caries was 76.5% (95% confidence interval: 75.4%-77.7%) and determined to be associated with age, dental visit, and pain or discomfort history during the previous year among the Turkish population. Prevalence was also associated with the mother's education level among 5-, 12- and 15-year-olds. For the 35-44 age group, individuals living in urban areas had lower dental caries than those living in rural areas. For 65-74 age group, none of the factors were significantly associated with dental caries. A high prevalence of dental caries was observed in Turkish children and adults. Therefore, it is necessary to strengthen current preventive oral health programs. Regular disease surveillance should be maintained. National oral health targets should be formulated in accordance with Turkiye's needs, resources and structure.

Prevalence and severity of dental caries using ICDAS in predicting treatment needs in Mexican school-age children.

Evaluate the prevalence and severity of caries in permanent teeth and their association with the treatment needs of 8-12-year-old Mexican schoolchildren. The cross-sectional study was conducted on 1139 8-12-year-old schoolchildren attending two public primary schools in State of Mexico. The study used the International Caries Detection and Assessment System (ICDAS) to examine the prevalence of caries and identify treatment needs in schoolchildren. Other variables considered were age, gender, oral hygiene, dental visits ≤6 months, toothbrushing frequency, and the mother's years of education. A logistic regression model was used to identify the association between independent variables and treatment needs. In all analyses, two-tailed p values ≤ 0.05 were considered statistically significant. The prevalence of caries lesions was 82.1% (82.2% boys vs. 81.9% girls) considering all lesion categories (ICDAS 1-6), while the distribution of the severity of caries was 17.9% (ICDAS 0), 13.9% (ICDAS 1-2), 28.3% (ICDAS 3-4) and 39.9% (ICDAS 5-6). The treatment needs index was 77.3%. The logistic regression model showed that the schoolchildren with moderate (ICDAS 3-4) and extensive carious (ICDAS 5-6) lesions were, respectively, 61% Odds Ratio ((OR) = 1.61; p = 0.036) and 77% (OR = 1.77; p = 0.013) more likely to present treatment needs. Other variables, such as poor oral hygiene (OR = 1.52; p = 0.009), the mother's low level of education (OR = 1.53; p = 0.007), and a lack of dental visits (OR = 1.42; p = 0.030) were associated with dental treatment needs. The results obtained show that the 8-12-year-old Mexican schoolchildren presented a high level of treatment needs for moderate and extensive carious lesions (ICDAS 3-6). These findings reiterate the importance of implementing oral health prevention, promotion, and intervention programs to help protect the oral health of school-age children.

Barriers and enablers for oral health promotion programs amongst primary healthcare stakeholders in Qatar – a qualitative investigation

BackgroundOral health of preschool children remains a concern globally. Primary healthcare providers are in a vital position to support preventive oral care programmes. This study explored current practices, perception and barriers of primary health care professionals towards oral health promotion program of children in Qatar.MethodsThe qualitative research used focus group discussions and interviewed a total of 108 participants that were audio recorded and transcribed verbatim. Four major themes emerged and were analysed to explore contextual patterns within the data.ResultsParticipants acknowledged the high prevalence of caries in children and identified the causes in the local context which included parental practices, poor dietary habits, impact of culture lack of oral health knowledge, limitations in the healthcare system, and negative role of the media. However, complex barriers were exposed, including lack of time and ownership, system coordination between organizations, and lack of policy.ConclusionHealth professionals and bureaucrats involved in decision-making held a positive attitude towards oral health prevention programs and were enthusiastic to initiate and support these programs.

Effects of subjective oral and mental health on health-related quality of life (EQ-5D) in cancer survivors: The 8th Korea National Health and Nutrition Examination Survey (8th KNHANES, 2019-2020)

Objectives: This study aimed to prepare basic data to improve the health-related quality of life of cancer survivors by confirming their oral and mental health statuses and identifying factors affecting their health-related quality of life. Methods: Of all participants in the 8th KNHANES (2019–2020), adults aged 19 years or older who responded ‘yes’ to the diagnosis of cancer and 404 cancer survivors who responded ‘none’ to the current cancer prevalence item were selected as the final research participants. Multiple regression analysis was conducted to confirm the effect of cancer survivors’ oral and mental health on health-related quality of life. Results: Subjective oral health (p&lt;0.01), chewing problems (p&lt;0.05), subjective health (p&lt;0.001), and depression (p&lt;0.01) had an effect on health-related quality of life from multiple regression analyses. Conclusions: Therefore, oral and mental health promotion may improve health-related quality of life. Thus, it is necessary to recognize the importance of oral and mental health and implement preventive education and programs.

Caries experience and risk indicators of having decayed teeth among 65-year-olds in Oslo, Norway: a cross-sectional study

BackgroundMeeting the oral health needs of the increasing population of older adults presents a major challenge in dental care. Knowledge about the oral health status in the young-elderly age group is essential for the planning of future oral health education and prevention programs. The aims of the present study were therefore to investigate the caries experience among 65-year-olds in Oslo, Norway, and to explore associations between having decayed teeth and sociodemographic, behavioural, and biological factors.MethodsA random sample of 65‑year‑olds in Oslo answered a questionnaire and underwent clinical and radiographic examinations (n = 457, 52% men and 48% women) at the Research Clinic, Faculty of Dentistry, University of Oslo, between February and December 2019. Primary- and secondary coronal and root caries lesions, root remnants, and missing and restored teeth were recorded. Decayed teeth (DT) were defined as teeth with coronal- and root caries lesions that had progressed into dentine and root remnants, and the DMFT/S scores were calculated.ResultsThe mean number of teeth was 25 (SD: 4) and the mean DMFT was 19.4 (SD: 4.7). Thirty seven percent of the individuals had at least one decayed tooth (DT > 0), and the mean number of filled teeth (FT) was 16.1 (SD: 5.4). Multivariable logistic regression analysis showed that male gender (OR: 1.8, 95% CI: 1.2–2.8), basic level of education (OR: 1.9, 95% CI: 1.2–2.9), irregular dental attendance (OR: 2.2, 95% CI: 1.0-4.8), and hyposalivation (OR: 2.1, 95% CI: 1.0-4.4) were significant risk indicators for having decayed teeth (DT > 0) (p < 0.05).ConclusionsIn conclusion, 65-year-olds in Oslo had a low average number of decayed and missing teeth, and a high number of restored teeth. Irregular dental attendance and hyposalivation were the strongest risk indicators for having decayed teeth. Based on the present results, it will be important to ensure access to regular dental care and to increase the emphasis on caries preventive measures for individuals with hyposalivation in this age group.

Social determinants of health for moderate and severe periodontal disease in rural and urban populations.

We assessed the prevalence of moderate and severe periodontitis and its association with social determinants of health in rural and urban population from the State of Chiapas, in Southern Mexico. A cross-sectional population-based study was conducted in 2013 comprising people 20 years and older. The determinants were categorized as proximal (age, sex, indigenous origin, diabetes, smoking, diet), intermediate (level of schooling, occupation, medical and dental care), and structural (type of institution of health care provision, residence area). Periodontal status was assessed using the Periodontal Screening and Recording (PSR) Index. In total, 467 persons (72.4% women; mean age 43.0 years [s.d 14.7]) participated. Of them, 76.5% lived in rural areas and 56.7% were of indigenous origin. Participants with moderate and severe periodontitis had a significantly lower toothbrushing frequency (44.1% and 44.8%, respectively), and poorer oral hygiene (90% and 90.3%, respectively) compared with people without periodontitis (29.4% for toothbrushing frequency and 74.5% for oral hygiene). Moderate periodontitis was associated with poor oral hygiene (OR=2.63) and no schooling (OR=1.86). Severe periodontitis was associated with age (OR=1.05), poor oral hygiene (OR=3.99), no schooling (OR=2.08), and the interaction term of rural area and indigenous origin (RM=5.23). Social determinants of health play an important role in the development of periodontitis. Preventive oral health programs should thus focus on the specific social, economic, and geographical context of the population.

Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic.

To assess oral hygiene and dietary patterns in school children participating in a school-based preventive oral health program during the COVID-19 pandemic. In this cross-sectional study, an anonymous questionnaire exploring oral hygiene and dietary patterns during the COVID-19 pandemic was completed by parents of school children. Data were compared among different schools, school years, and between genders using nonparametric tests. Associations among further nominal and categorical variables related to oral hygiene and dietary habits were also assessed using the chi-square test. Only 26% (n = 32) of parents reported that their children brushed their teeth the recommended amount of twice or more per day during the pandemic. In addition, 17.2% of the parents reported less brushing than before the pandemic. A total of 40 parents (32.8%) reported that their child consumed unhealthy beverages once a day or more. Comparison between genders revealed that male participants were drinking significantly unhealthier than female (p = 0.038). Sugary foods were consumed once a day or more by 63.1% of children. No significant differences were found between public and church schools. Significant direct associations were found between changes in dietary habits and brushing frequency (p = 0.017), between parental concern regarding the interruption of the school program and decreased brushing frequency (p = 0.005), and negative changes in dietary habits (p = 0.013). Within the limitations of this study, the present significant findings observed during the pandemic support the importance of school programs in promoting oral hygiene and healthy dietary habits of children. Agius A-M, Gatt G, Cortes ARG, et al. Patterns in Oral Hygiene and Dietary Habits in School Children during the COVID-19 Pandemic. Int J Clin Pediatr Dent 2023;16(2):205-210.

Management of Oral Hygiene in Head-Neck Cancer Patients Undergoing Oncological Surgery and Radiotherapy: A Systematic Review.

In the literature, among oral health prevention programs dedicated to cancer patients, a wide heterogeneity is evident. The purpose of this work is to analyze the available scientific evidence for the treatment of head and neck cancer (HNC) patients undergoing resective surgery and radiotherapy and to draw up a diversified oral hygiene protocol during oncological therapy. PubMed was used as database. Studies published from 2017 to September 2022 were analyzed. Studies investigating the effectiveness of the preventive procedures carried out by the dental professionals in HNC patients undergoing postoperative adjuvant therapy have been taken into account. The application of the search string on PubMed allowed the selection of 7184 articles. The systematic selection of articles led to the inclusion of 26 articles in this review, including 22 RCTs, 3 observational studies, and 1 controlled clinical study. Articles were divided according to the debated topic: the management of radiation-induced mucositis, xerostomia, the efficacy of an oral infection prevention protocol, and the prevention of radiation-induced caries. Dental hygienists are fundamental figures in the management of patients undergoing oncological surgery of the maxillofacial district. They help the patient prevent and manage the sequelae of oncological therapy, obtaining a clear improvement in the quality of life.

Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010-2021).

Early childhood caries (ECC) is one of the most prevalent chronic childhood diseases affecting the primary teeth of children younger than 6 years of age. The disease etiology is complex and includes social, biological, and dietary factors. This review aims to explore the knowledge of ECC prevalence globally and locally within the Gulf Cooperation Council (GCC) countries during the years 2010-2021. Another aim is to explore oral health promotion programs with more focus on the GCC region. A search was conducted in PubMed, Medline, Scopus, the Cochrane Collaboration database, and Google Scholar to identify relevant studies published between 2010 and 2021 using specific keywords. Studies that utilized both the World Health Organization criteria and International Caries Detection and Assessment System for dental caries assessment were included. The included studies indicated considerable variation in the reported prevalence of ECC. While developed countries show low prevalence, countries in the GCC and other Arab countries show a high prevalence of ECC. Many oral health promotion programs were identified globally including oral health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-professional population-based oral health promotion and prevention programs such as school-based oral health programs, motivational interviewing, and anticipatory guidance. ECC remains a significant problem in many parts of the world including the GCC region. Oral health prevention programs have been established within the GCC region. Nevertheless, the GCC region has some unique characteristics that need to be investigated to contextualize the western model of the dynamics of ECC prevention and promotion programs locally.

The 20-Year Trends in Caries and Associated Determinants among Adults in Post-Soviet Lithuania: Repeated Cross-Sectional Studies

Aim: The aim of the study was to examine the 20-year trend in dental caries and associated determinants among adults in Lithuania after the country restored its independence. Material and Methods: Data from two cross-sectional national surveys included samples of 35–44-year-olds (adults) and 65–74-year-olds (early elderly). The 1997/1998 survey (first survey) recruited a stratified random sample of 569 individuals from 10 selected areas in Lithuania (response rate 52%), and the 2017/2019 survey (second survey) recruited a stratified random sample of 723 individuals from 5 biggest Lithuanian cities and one randomly selected peri-urban/rural area from each of 10 Lithuanian counties (response rate 53%). The information about the social (sex, residence, education) and behavioral (toothbrushing frequency, use of fluoridated toothpaste, and last dental visit) determinants was collected via self-reports using the World Health Organization (WHO) Oral Health Questionnaire for Adults questions. Information about the fluoride level in the drinking water was retrieved from the water suppliers. Dental caries was recorded at the surface level following the WHO criteria by two calibrated examiners, one at each of the national surveys. Bivariate and multivariate analyses were used. Results: According to multivariable negative binomial regression analysis, in adults, 67% lower DS scores (IRR 0.33, 95% CI 0.26–0.42) and in early elderly 47% lower DS scores (IRR 0.53, 95% CI 0.38–0.74) were observed in the second survey. Adults in the second survey (vs. first survey) had 62% lower MT scores (IRR 0.38, 95% CI 0.32–0.46), and the early elderly had 19% lower MT scores (IRR 0.81, 95% CI 0.72–0.92). Adults in the second survey had 21% lower DMFT scores (IRR 0.79, 95% CI 0.73–0.85). The changes in behavioral determinants were observed over the 20-year period. Conclusion: An improvement in dental health during the 20-year period, mainly related to reduction in untreated caries and missing teeth, was observed in adults and early elderly. However, early elderly still had high numbers of missing teeth. The decrease in total caries experience during the 20 years was significant only in adults. Our findings support an urgent need to design and implement national oral health promotion and prevention programs with increased focus on oral self-care and fluoridated toothpaste use.

Age, Reason, and Experiences Regarding the First Dental Visit among Children Belonging to Lucknow

Background: According to the American Academy of Pediatric Dentistry guidelines, the first dental visit of a child is within 6 months of age. The need of such early visits is to help dentists to detect and treat incipient lesions, to educate parents about proper oral hygiene maintenance and the importance of diet and fluorides. Moreover, the visit helps the child to understand and adapt to the dental setup, thereby showing a positive dental attitude in future visits. Aim: The aim of this study was to find out the age at which children receive dental care for the first time and the reasons for such dental visits. Subjects and Methods: A cross-sectional study was conducted at the Department of Pedodontics and Preventive Dentistry, wherein a questionnaire was provided to the parents of pediatric patients attending the outpatient department for their first dental visit, which included the sociodemographic details along with the questions related to their first dental visit, reason, and experiences regarding their visit. Results: On average, children reported for their first dental visit only after 5 years of age for the complaints such as pain and dental caries. Thus, indicating oral health education and preventive treatment program are yet to reach the general population. Conclusion: From the present study, it was evident that necessary awareness regarding the first dental visit is very low, with the subjects approaching the dentist after the establishment of ill oral health, thus demanding interception rather than prevention of diseases.

Family behavior theory-based intervention via mobile messaging to improve oral health of adolescents: study protocol for a cluster randomized controlled trial

BackgroundDue to some unique physical, social and psychological features in the adolescent population, adolescents can be a time of heightened caries activity and periodontal disease. Oral health-related behaviors can be modified to improve oral health status. The family networks and the built environment can promote or inhibit health behaviors. The aim of this study is to implement and evaluate a behavior theory-based, integrated family intervention via mobile messaging to improve oral health of adolescents.MethodsThis is a three-arm parallel-design cluster-randomized controlled trial. This trial will allocate 12 local secondary schools (clusters) in Hong Kong to three test or comparison groups with a ratio 1:1:1. The enrolled Form II to IV students (ages 12 to 15) will be eligible for participation. The intervention to three study groups will be (i) Health Belief Model (HBM)-based mobile messaging to the adolescents and their parents, which will consist of several blocks of HBM-based messages and reinforcement during 24 weeks; (ii) same HBM-based messaging to adolescents only; and (iii) delivering e-version of oral health education pamphlets to adolescents. The primary outcome will be caries increment 2 years post-intervention. Changes in oral health self-efficacy and behaviors, oral hygiene, and gingival status will be the secondary outcomes.DiscussionNo school dental care service is available to secondary school students in Hong Kong. This study will be the first to test a theory-driven and family-engaged preventive intervention among adolescents in Hong Kong. Findings will contribute to developing a low-cost, feasible, and efficient oral health preventive program for adolescents.Trial registrationClinicalTrials.govNCT05448664. Registered on 7 July 2022.