Prevalence Of Untreated Caries Research Articles

Prevalence of Dental Caries and Predisposing Factors in Obio-Akpor Local Government Area, Port Harcourt, Rivers State, Nigeria

Prevalence of Dental Caries and Predisposing Factors in Obio-Akpor Local Government Area of
 Port Harcourt
 Background: Dental caries is a common oral health disease of global interest. The burden of thedisease and predisposing factors must be determined before a preventive programme could bedesigned, but relevant data from community-based studies are not common in Rivers State.Aims and Objectives: This study was designed to determine the prevalence and predisposing factorsto caries development in the Local Government Area (LGA).Materials and Methods: This was a descriptive cross-sectional study carried out among adultresidents in Obio-Akpor LGA of Rivers State. An interviewer-administered questionnaire was usedto collect personal data and caries predisposing factors while oral examination was carried out todetermine caries severity and oral hygiene status using DMFT and OHI-S indexes respectively. Thesample size (240) was determined using the formula for descriptive studies.Results: The mean (SD) age was 32(±1.113) years. Most of the participants were married, Ikwerres,skilled workers, earn <100dollar and most had secondary education. Most seldom/never use tobaccoproducts. Most ate fresh fruits every day or several times a week and most also ate cariogenic dietevery day or several times a day. Most use fluoride toothpaste once a day and most do not use floss.Most have never seen a dentist. The prevalence of untreated caries was 64.2%. DMFT score=0.91(very low). The OHI-S = 3.3. (>3 indicates poor OHI).Conclusions: The DMFT index was low while OHI-S was high. Poor oral hygiene status, oralhealthcare utilization and cariogenic diets predisposed the participants to caries.Key words: Caries, prevalence, predisposing factors, prevention

Child dental neglect and legal protections: a compendium of briefs from policy reviews in 26 countries and a special administrative region of China.

Child neglect is a public health, human rights, and social problem, with potentially devastating and costly consequences. The aim of this study was to: (1) summarize the oral health profile of children across the globe; (2) provide a brief overview of legal instruments that can offer children protection from dental neglect; and (3) discuss the effectiveness of these legal instruments. We summarized and highlighted the caries profile and status of implementation of legislation on child dental neglect for 26 countries representing the World Health Organization regions: five countries in Africa (Nigeria, South Africa, Sudan, Tanzania, Zimbabwe), eight in the Americas (Argentina, Brazil, Canada, Chile, Mexico, Peru, Unites States of America, Uruguay), six in the Eastern Mediterranean (Egypt, Iran, Libya, Jordan, Qatar, Saudi Arabia), four in Europe (Italy, Latvia, Serbia, United Kingdom), two in South-East Asia (India and Indonesia) and one country (China) with its special administrative region (Hong Kong) in the Western Pacific. Twenty-five of the 26 countries have legal instruments to address child neglect. Only two (8.0%) of these 25 countries had specific legal instruments on child dental neglect. Although child neglect laws can be interpreted to establish a case of child dental neglect, the latter may be difficult to establish in countries where governments have not addressed barriers that limit children's access to oral healthcare. Where there are specific legal instruments to address child dental neglect, a supportive social ecosystem has also been built to facilitate children's access to oral healthcare. A supportive legal environment, however, does not seem to confer extra protection against risks for untreated dental caries. The institution of specific country-level legislation on child dental neglect may not significantly reduce the national prevalence of untreated caries in children. It, however, increases the prospect for building a social ecosystem that may reduce the risk of untreated caries at the individual level. Social ecosystems to mitigate child dental neglect can be built when there is specific legislation against child dental neglect. It may be more effective to combine public health and human rights-based approaches, inclusive of an efficient criminal justice system to deal with child dental neglect.

A multilevel analysis model for dental caries determinants in independently-living elderly

To evaluate the prevalence of untreated caries and its association with biological, individual, and environmental variables in independently-living elderly people. Methods: This cross-sectional study included 72 elderly (≥60 years) patients of a university dental clinic in Belo Horizonte, Brazil. Sociodemographic data, systemic diseases, medications, and free sugar intake were collected. Visible plaque, Decayed, Missing, and Filled Teeth (DMFT), and Decayed and Filled Root (DFR) indexes were assessed through clinical examination. Unstimulated saliva was collected to determine salivary flow, pH, and buffering capacity. Descriptive analysis and multilevel logistic regression analysis were performed following a dental caries theoretical model (p <0.05, 95% CI). Results: The mean DMFT and DFR were 24.44 (SD=4.59) and 3.21 (SD=2.93), respectively. The prevalence of untreated caries was 61.11%. In the adjusted multilevel regression model involving 1639 teeth, untreated dental caries was significantly associated with the presence of biofilm (OR = 1.84; 95% CI: 1.24–2.74), salivary buffering capacity (OR = 0.87; 95% CI: 0.77–0.99) and per capita income (OR = 0.06; 95% CI: 0.004–0.74). Conclusion: The experience of dental caries was widespread among independently-living elderly patients, and its variability was best explained by the presence of biofilm, reduced salivary buffering capacity, and low per capita income. A comprehensive assessment is needed of the biological, individual, and environmental factors related to the presence of dental caries in independently-living elderly people.

A scoping review linking early childhood caries to violence, neglect, internally displaced, migrant and refugee status

BackgroundThe aim of the scoping review was to identify and synthesize the available literature concerning the relationship between the status of refugees, migrants, and internally displaced persons (IDPs) and Early Childhood Caries (ECC) as it relates to the United Nation’s Sustainable Development Goal 16 (SDG 16).MethodsData regarding the links between the status of refugees, migrants, and internally displaced persons (IDPs) and Early Childhood Caries (ECC), and the associations between ECC and maternal and child exposure to physical and sexual abuse, insecurity, crime, exploitation, torture, and displacement were extracted. The search was carried out in January 2023 across three databases (PubMed, Web of Science, and Scopus). Only publications in English with accessible full texts were included. Descriptive statistics were utilized to summarize the categories of the retrieved papers, and graphical representation was employed for visualization purposes. The relationships between the publications and each of the 10 targets of Sustainable Development Goal 16 (SDG 16) were also assessed.ResultsForty-five studies were reviewed. Most studies (42.2%) originated from the Americas Regions, while no studies were identified from the Africa Region. A significant portion (46.7%) of the papers focused on abuse, violence, and neglect as risk factors for ECC. Migrants, refugees, and IDPs were the most investigated populations (44.4%). Only one study specifically focused on IDPs and migrants respectively. The prevalence of untreated caries was higher among migrants, refugees, and IDPs compared to the host community, ECC was more prevalent among children who experienced abuse, neglect, or were in protective care. The was no clear direction on the associations between ECC and intimate partner violence, adverse childhood experiences, and wars. In terms of the SDGs, the reviewed publications addressed four targets (SDG16.1, SDG16.2, SDG16.3, and SDG16.5) out of the ten targets outlined in SDG 16.ConclusionThere is available evidence regarding the connections between ECC and war, refugees, migration, violence, and neglect, as outlined in SDG 16. Future studies are needed to investigate how forced movements directly affects ECC status, how disruptions of peace and stability is a risk factor for ECC, and the associations between ECC and other indicators related to SDG 16 targets.

Structural determinants explain caries differences among preschool children in Chile’s Metropolitan Region

ObjectiveTo estimate the association between Social Determinants of Health (structural and intermediate) and caries indicators in Chile's Metropolitan Region preschool children.MethodsA multilevel cross-sectional study of Social Determinants of Health (SDH) and caries in children aged 1 to 6 years in Chile's Metropolitan Region was conducted in 2014–2015, with three levels: district, school and child. Caries were assessed by the dmft-index and the prevalence of untreated caries. The structural determinants analyzed were Community Human Development Index (CHDI), urban/rural location, school type, caregiver's education and family income. Poisson multilevel regression models were fit.ResultsThe sample size was 2,275 children from 40 schools in 13 districts. While the highest CHDI district had an untreated caries prevalence of 17.1% (12.3–22.7%), in the most disadvantaged district it was 53.9% (95% CI 46.0–61.6%). As family income increased, the probability of untreated caries prevalence decreased (PR = 0.9 95% CI 0.8–1.0). Rural districts had an average dmft-index of 7.3 (95% CI 7.2–7.4), while in urban districts, it was 4.4 (95% CI 4.3–4.5). Higher probabilities of untreated caries prevalence (PR = 3.0 95% CI 2.3–3.9) were observed in rural children. Greater probabilities of untreated caries prevalence (PR = 1.3 95% CI 1.1–1.6) and prevalence of caries experience (PR = 1.3 95% CI 1.1–1.5) were observed in children whose caregivers had a secondary educational level.ConclusionsA strong association was observed between the social determinants of health, specifically the structural ones, and the caries indicators studied in children of the Metropolitan Region of Chile. There were notable differences in caries between districts according to social advantage. Rurality and caregiver's education were the most consistent predictors.

Burden, Trends, and Inequality of Dental Caries in the U.S., 1990–2019

Over the past 2 decades in the U.S., the reduced burden and narrowed inequality in oral health among children are in stark contrast with the high burden and widening inequality in adult oral health. This study aimed to explore the burden, trends, and inequalities of untreated caries in permanent teeth in the U.S. during 1990-2019. Data on burden of untreated caries in permanent teeth were extracted from the Global Burden of Disease Study 2019. A set of advanced analytical methods were applied to provide an in-depth characterization of the epidemiologic profile of dental caries in the U.S. Analyses were conducted during April 2022-October 2022. In 2019, age-standardized incidence and prevalence of untreated caries in permanent teeth were respectively 39,111.7 (95% uncertainty interval=35,073.0-42,964.9) and 21,722.5 (95% uncertainty interval=18,748.7-25,090.3) per 100,000 person-years. Population growth was the primary driver of the increased caries cases, which contributed 31.3% and 31.0% of the increase in the number of incident and prevalent caries cases, respectively, during 1990-2019. The highest caries burden was noted in Arizona, West Virginia, Michigan, and Pennsylvania. The slope index of inequality remained stable (p=0.076), whereas the relative index of inequality increased significantly (average annual percent change=0.04, p<0.001) in the U.S. The burden of untreated caries in permanent teeth remained significant with a widening cross-state inequality during 1990-2019. The oral healthcare system in the U.S. needs to prioritize health promotion and prevention with a focus on expanding access, affordability, and equity.

Condições bucais adversas associadas a pior bem-estar emocional e social de adolescentes brasileiros: um estudo de base populacional em uma periferia rural-urbana negligenciada

Abstract Background The relationship between dental appearance and emotional/social well-being in underprivileged areas undergoing rapid urbanization is unknown. Objective To assess if the emotional and social well-being of teenagers living in urban areas might be more affected by unfavorable dental appearance determined by oral conditions. Method A population-based cross-sectional exploratory study with 12-year-old Brazilian schoolchildren was carried out in two poor, underserviced districts of Sao Paulo City, Brazil. Outcome was severity of oral health-related quality of life (QHRQoL) due to the emotional and social well-being and exposures were oral conditions and residence district (rural or urban). Results The impact on severity of QHRQoL due to emotional well-being and due to social well-being, respectively, were 14% and 16% higher for those presenting at least one untreated decayed tooth; 36% and 54% higher for those with unfavorable dental appearance and 25% and 39% higher for those from the urban district. No association between malocclusion and district was observed. Conclusion Despite higher prevalence of untreated dental caries in the rural district, teenagers from the urban district felt that their OHRQoL, adjusted by oral conditions investigated, was more negatively affected. This suggests that urban environmental influences can lead to stressful social pressures stemming from dental appearance, leading to diminished emotional and social well-being.

Prevalence of Untreated Caries in US Adults

Prevalence of Untreated Caries in US Adults

Socio-economic and health determinants of untreated Dental Caries Burden of a group of children in rural Sri Lanka

Introduction/Background: Dental caries is a result of complex interactions between an array of biological, social and environmental factors. Since dental diseases are the 4th most expensive disease to be treated, poor people may not have financial security to access for treatments of dental caries of their children unless free oral health care services are provided. The low socio-economic status is categorized as a risk factor for dental caries along with equally important life-style-related factors such as high refined sugar consumption and poor oral hygiene. Methodology: A descriptive cross-sectional study was conducted to explore the relationship between prevalence and the severity of untreated dental caries with selected socio-economic and health service factors. A multi stage cluster sampling technique was employed to select 479 Grade I school children attending to Government schools of Wellawaya MOH area. A self- administered questionnaire was used to collect socio- demographic information. Dental caries was recorded using dmft index and severity of untreated dental caries was recorded using pufa index. Data analysis was done using SPSS version 20.The relationship of prevalence and severity of untreated dental caries with soc-economic and health service factors was assessed using Chi -square test. Results: There was a significant differences of untreated dental caries prevalence among children by different levels of father’s education (p =0 .027) and levels of family income (p= 0.018) There was a significant difference of severity of untreated dental caries among children by different levels of father’s occupation (p=0.001) and family income (p= 0.013). Conclusion: Prevalence of untreated dental caries was significantly associated with father’s educational attainment. Severity of untreated dental caries of children was significantly associated with father’s occupational status. Moreover, prevalence and severity of untreated dental caries of children were significantly associated with family income there by demonstrating oral health inequality patterned by their socio-economic status.

Health-risk behaviours co-occur among children with untreated caries.

The aim of this study was to examine whether an aggregate of health risk behaviours is associated with the number of untreated dental caries among 12- and 15-year-old children in England, Wales and Northern Ireland. Data were from the Children's Dental Health Survey (CDHS) 2013, a nationally representative sample of England, Wales and Northern Ireland. The survey included assessment of oral health and data on socioeconomic, demographic and behavioural factors pertaining to children aged 12-15 years. Tooth condition (decayed, missing and filled) was assessed by NHS dentists. The survey included questions on age, sex, country, index of multiple deprivation, smoking, alcohol consumption, frequent sugar consumption and sweetened sodas, infrequent dental visit, infrequent toothbrushing and infrequent consumption of fresh fruits. Health risk behaviours were summed up to create an aggregate variable of health risk behaviour. The association between number of untreated caries and the aggregate of health risk behaviours was assessed using negative binomial regression and adjusting for age, sex, country and deprivation. The total number of children included in the analysis was 4414. The mean number of untreated caries was generally higher among children with health risk behaviours. The aggregate of risk behaviour was associated with greater prevalence of untreated dental caries with rate ratio (RR) 1.26 (95% confidence interval: 1.18, 1.36). This study demonstrated an association between an aggregate of health risk behaviours and untreated caries. The findings highlight the importance of addressing multiple risk factors not only those directly related to dental caries.

Prevalence of dental caries and associated factors of detention center inmates in South Korea compared with Korea National Health and Nutrition Examination Survey (KNHANES) respondents: a retrospective study

BackgroundCorrectional institution inmates have reduced access to dental care; however, a quantitative assessment of their oral health condition has not yet been performed in South Korea. Therefore, this study aimed to assess dental caries and compare the prevalence of dental caries and associated factors between inmates and the general South Korean population.MethodsThe dental records of two detention centers in South Korea were retrospectively analyzed to assess the clinical oral health condition of inmates using the Decayed, Missing, and Filled Teeth (DMFT) index and self-reported questionnaire. These data were compared with similar data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES) for the general South Korean population.ResultsIn total, 642 inmates were analyzed and compared with 13,345 KNHANES participants in the KNHANES. The inmate and KNHANES groups demonstrated significant intergroup differences, with a higher prevalence of untreated caries, DMFT, decayed teeth (DT), and missing teeth (MT) values among the inmates. The prevalence of untreated caries decreased according to the history of dental pain in the inmate group but increased in the KNHANES group. The decrease in DMFT with a history of dental pain was significant only in the inmate group. Furthermore, self-rated oral health was significantly associated with prevalence of untreated caries, DMFT, DT, MT, and filled teeth (FT) in the inmate group but with prevalence of untreated caries, DMFT, DT, and MT in the KNHANES group. It was found that this is because there is an interaction effect by the group.ConclusionsThe oral health of the inmate group was significantly poorer than that of the general group. Since DMFT, DT, MT, and FT values and prevalence of untreated caries in the inmate group were significantly related to their self-rated oral health, suggesting that self-rated oral health should be incorporated into the dental health screenings of correctional institution inmates.

Oral health status and absence from school among 12 year olds.

To assess dental caries, periodontal status, malocclusion and absenteeism from school among 12-year-olds in Bhopal district, Central India. Two-stage random sample of 1238 school children. Decayed missing filled teeth (DMFT), Significant caries index (SiC), community periodontal index (CPI) and dental aesthetic index (DAI) were used to record dental caries, periodontal status and malocclusion. Information on absence from school in the previous year due to pain/discomfort in the teeth or mouth was collected via interviews. Generalized structural equation modelling (GSEM) examined the direct and indirect predictors of absence from school. A total of 39.1%, 17.3% and 23.9% of children had dental caries, calculus and gingival bleeding respectively. Mean DMFT and SiC scores were 1.82± 1.36 and 3.15 ± 1.47. 5,127 school hours were missed due to oral health problems per 1,000 children. None of the studied variables predicted absence from school. Utilization of dental care was associated directly with gender and malocclusion (p⟨ 0.001). Periodontal status was associated with male gender, nuclear families, tobacco consumption, and malocclusion (p⟨ 0.001). Higher DMFT was associated with male gender, malocclusion and experience of pain/discomfort (p⟨ 0.001). Poor oral health and a high prevalence of untreated dental caries were noted. Despite a considerable number of missed school hours reported due to dental conditions, none of the studied variables predicted absence from school.

Socioeconomic inequalities related to maternal perception of children's oral health at age 4: Results of a birth cohort.

To estimate socioeconomic inequalities in the maternal perception of children's oral health from a birth cohort study in Brazil. The data from this study were collected through perinatal interviews and at the 48-month follow-up from the 2015 Pelotas Birth Cohort Study. The main outcome was the maternal perception of children's oral health, dichotomized into positive (good/very good) and negative (fair/bad/very bad). The secondary outcome was untreated dental caries (absence and presence, according to the ICDAS index - International Caries Detection and Assessment System). For the statistical analysis, the absolute inequality index (Slope Index of Inequality - SII) and the relative concentration index (Concentration Index - CIX) were used. Analyses were stratified by maternal educational level, family income and wealth index. The prevalence of outcomes was 19.4% (95% CI 18.2; 20.7) for the negative maternal perception of children's oral health and 15.6% (95% CI 14.4; 16.8) for untreated dental caries. Socioeconomics inequalities were observed in negative maternal perception of children's oral health in both absolute and relative terms. A SII of -16.6 (95% CI -20.8; -12.5) was observed for family income, with higher prevalence in poor families. A higher prevalence of the negative maternal perception of children's oral health was observed in mothers without any educational level or a few years of study (CIX -21.1 [95% CI -24.5; -17.7]). This study demonstrates socioeconomics disparities in the maternal perception of children's oral health and in the prevalence of untreated caries in children. A higher concentration of negative maternal perception of children's oral health was identified among the most socioeconomically vulnerable individuals. The findings reinforce the presence of socioeconomic inequalities in subjective measures about children's oral health.

Oral Health Status among Refugees and Internally Displaced Children (3-11 Years Old) from Western Kordofan State, Sudan

Background: Refugees and internally displaced children are often fed food with a low nutritional value or high in carbohydrates, predisposing them to a relatively higher risk of dental caries, and periodontal diseases. Objectives: The aim of this study was to assess the oral health status among a group of refugees and displaced children. Materials and Methods: A descriptive cross-sectional study among (172), 3–13-year-old children (59 boys (34.3%) and 113 girls (65.7%) from in Almoshama camp for displaced and refugees coming from different areas of Sudan and outside Sudan. The participants were selected by non-probability sampling technique based on convenient accessibility and availability of children from friendly child spaces in the camp. Dental caries was assessed by dmft for primary teeth and DMFT for permanent teeth, while periodontal status was assessed by community periodontal index (CPI). Comparison between different non-parametric data was done by Chi-Squire test and parametric data by student T-test, with the level of statistical significance difference set at P-value ≤ 0.05. Results: The prevalence of dental caries among the participants was 33.3%. The mean ±SD dmft score was 2.28±1.77 and the DMFT score was 1.63±1.51. A statistically significant difference in mean DMFT between different age groups (P=0.004) and between boys and girls (P-0.03). While the mean CPI was 0.73. Almost half of the participants had periodontal diseases (54.1%) of whom 37.2% had gingival problems, 14.5% calculus, and only 2.32% have pocket problems. Conclusions: High prevalence of untreated dental caries and periodontal diseases among Refugees and internally displaced children living in Almoshama camp in West Kordofan, Sudan. Emphasis on motivation in oral health promotion campaigns and provision of primary health care services among those vulnerable groups is paramount.

Oral health status of 6- to 12-year-old children in Madrid, Spain: A cross-sectional study

Based on the results of the 2015 oral health survey in Spain, the prevalence of untreated dental caries in temporary dentition, in the six-year cohort was 27,8%, and in the twelve-year cohort 14,6%. Due to the magnitude of the problem, the high health cost and the possibilities of prevention, monitoring the oral health status of the child population is extremely important, as it will allow the implementation of prevention and early care strategies. Objectives: To study the caries prevalence and malocclusion in the mixed dentition in children aged 6–12 years in Madrid, Spain. . Materials and methods: This is a descriptive, cross-sectional study carried out in the city of Madrid during the 2018–2019 school year. Fifth year students of the European University of Madrid through health surveys, calibrated and supervised by the two main researchers, collected the data. The schoolchildren assessed were students from different schools in the city of Madrid, between 6 and 12 years old. According to WHO standards, data were collected in 2 months. Results: The total number of students examined was 303 students from 4 different schools in the community of Madrid. The prevalence of caries in our sample in the primary dentition was 45.21% with dmf> 0 and in the permanent dentition it was 23.7 % with a DMF> of 0. Conclusions: The oral health survey carried out in the sample shows a high prevalence of caries, as well as in the dmf and DMF indicators. Most of the children needed fluoride applications, so it would be interesting to evaluate which of them can be prevented with different public health projects.

Situación de salud oral en preescolares chilenos entre los años 2007-2015: Revisión sistemática y análisis a nivel individual

Introduction: Oral diseases are a worldwide public health problem in need of constant evaluation and follow-up. Aim: To analyze Chilean preschoolers’ oral health indicators by age, sex, socioeconomic status and urban/rural location of their school. Material and Methods: Systematic review conducted in PubMed, EMBASE, Scielo and gray literature to identify oral health epidemiological studies in Chile. We included studies with regional representativeness, published until May 2021. We requested the studies’ datasets (individual data) and conducted a reanalysis for six oral health indicators: prevalence of untreated caries, caries experience, gingivitis, malocclusions and dmft/DMFT. Sex, age, urban/rural location of their school and socioeconomic status (SES) were considered as exposure variables. We assessed the risk of bias in each study and synthesized the oral health results for each of them. Differences between each indicator and explanatory variables were analyzed through Fisher’s exact test. Adjusted prevalence ratios were estimated through Poisson regression. Results: We selected nine studies and had access to five individual-level study datasets. Differences were observed in caries and gingivitis according to age, SES and rurality in most of the studies, observing highest differences for low SES in 2009 (PR caries experience = 2.68; PR untreated caries = 2.90). No differences were observed for SES nor rurality for malocclusions. Conclusion: A reduction of indicators was not observed over the years. SES has remained as a social determinant of oral health in preschoolers in Chile.

COVID-19 Pandemic Impact on US Childhood Caries and Potential Mitigation

Non-Hispanic Black (NHB) and Hispanic and low-income US children have a higher prevalence of untreated caries than their higher-income and non-Hispanic White (NHW) counterparts. Due to the COVID-19 pandemic, many dental offices and school sealant programs closed beginning March 2020. We examine the effect of reduced access to restorative care and sealants on the oral health of children from low-income households overall and by race/ethnicity and how increased sealant delivery in September 2022 could mitigate these effects. We used Markov chain Monte Carlo simulation to model COVID-19’s impact on first permanent molar (1M) caries incidence and loss in quality of life (disability-adjusted life years [DALYs]) due to time lived with 1M untreated caries. Our model followed a cohort of children aged 7 y in March 2020 until February 2024. Model inputs were primarily obtained from published studies and nationally representative data. Excess DALYs per 1,000 children attributable to reduced access to care during the pandemic were 1.48 overall and greater for Hispanic (2.07) and NHB (1.75) children than for NHW children (0.94). Excess incidence of 1M caries over 4 y was 2.28 percentage points overall and greater for Hispanic (2.63) and NHB (2.40) children than for NHW (1.96) children. Delivering sealants to 50% of eligible 1Ms in September 2022 would not completely mitigate COVID-19’s health access impact: overall excess DALYs would decrease to 1.05, and absolute disparities in excess DALYs between NHW children and Hispanic and NHB children would remain but decrease by 0.38 and 0.33, respectively. Sealing 40% of eligible 1Ms, however, would bring overall 4-y caries incidence down to pre–COVID-19 levels and eliminate the differential effect of the pandemic on children from minority groups. The pandemic’s negative impact on the oral health of children from low-income households and increased disparities could be partially mitigated with increased sealant delivery.

Two decades of socioeconomic inequalities in the prevalence of untreated dental caries in early childhood: Results from three birth cohorts in southern Brazil.

To estimate the socioeconomic disparities in untreated dental caries in early childhood according to socioeconomic characteristics in three birth cohorts in Southern Brazil. The socioeconomic data to this study were collected at the 48-month follow-up and oral health studies of 1993, 2004 and 2015 Pelotas birth cohort studies. The outcome was untreated dental caries in children aged 6 (1993 cohort), 5 (2004 cohort) and 4years (2015 cohort), dichotomized into absence/presence. Analyses were stratified by maternal skin colour/race, maternal education and family income. For statistical purposes, the prevalence difference, relative risk and absolute and relative indices of health inequality (Slope Index of Inequality-SII and Concentration Index-CIX) were used. The prevalence of untreated dental caries in primary dentition was 63.4%, 45.5% and 15.6%, in 1993, 2004 and 2015 cohorts, respectively. The prevalence of untreated dental caries was concentrated in the poorest quintile and lower maternal education group in both absolute (SII) and relative (CIX) measures of inequality, being characterized as a pro-poor event. A higher risk of untreated caries was found in the poorest quintile of family income compared with the richest quintile in the 1993 cohort (RR 1.44 [95% CI 1.05; 1.98]). That risk was higher considering the 2004 Cohort (RR 1.78 [95% CI 1.42; 2.23]) and 2015 cohort (RR 4.20 [95% CI 2.97; 5.94]) data. Over the course of two decades, a higher prevalence of untreated dental caries is concentrated among the most socioeconomically deprived children.

Is neighborhood income associated with untreated dental caries irrespective of family income?

To assess the status of untreated dental caries in adolescents exposed to different conditions of family and neighborhood income. This cross-sectional study included a representative sample of 1197 15-19-year-old adolescents attending high schools from Santa Maria, southern Brazil. Data collection included a questionnaire and clinical examination (DMFT index). Neighborhood mean income was collected from official sources. The main predictor variable was a combination of household income and neighborhood mean income resulting in four categories: low household income/low neighborhood income, low household income/high neighborhood income, high household income/low neighborhood income, or high household income/high neighborhood income. The outcome was untreated caries (number of teeth with dentin cavities or residual roots). Multilevel Poisson regression analysis was used to assess the association between predictors and untreated caries. Rate ratio (RR) and 95% confidence intervals (CI) were estimated. The prevalence of untreated dental caries was 26% (n = 312), with a mean (± standard deviation) of 0.47 (± 1.05) teeth. Adolescents with low household income living in areas with low neighborhood income had the worse caries scenario. Compared with them, those classified as low-income households residing in high-income neighborhoods had 37% lower rate of untreated dental caries (adjusted RR = 0.63; 95%CI = 0.44-0.89). No neighborhood effect was detected among adolescents of more affluent families. Neighborhood income contributed to the rate of untreated dental caries over and above household income among adolescents with low household income only. Improving living conditions in disadvantaged neighborhoods may positively impact the oral health of residents, thus reducing oral health inequalities.

Changes in the prevalence of decayed permanent teeth in Brazil and upper-middle income countries in the years 1990 and 2017

The distribution of caries is uneven and strongly associated with the different socioeconomic profiles of countries. The scope of this study was to describe the changes in the prevalence of decayed permanent teeth in Brazil and in upper-middle income countries for the years 1990 and 2017. It is a descriptive study based on secondary data extracted from the Global Burden of Disease. The 53 countries included in the upper-middle income group were included. Caries prevalence estimates were collected for the years 1990 and 2017. The percentage change in prevalence was calculated between the two years. The values of the Human Development Index (HDI) for each country were also collected. The results show the trend of a reduction in the prevalence of decayed permanent teeth in Brazil and in most upper-middle income countries. The prevalence of untreated caries in Brazil was 38.17% in 1990 and 37.46% in 2017. Brazil occupies the 41st position in the ranking of the reduction in the prevalence of caries among the 53 countries evaluated. The countries that achieved the greatest reductions in the prevalence of caries were those with an improvement in their HDI. In this respect, the need to review public oral health policies is revealed, as well as a reflection on addressing the inequities present in the countries surveyed.