Caries Research Articles

Evaluation of beverage consumption patterns and oral health in Korean adolescents and young adults

Objectives: This study aimed to investigate the beverage consumption patterns and analyze the relationship between the frequency of beverage consumption and oral health in Korean adolescents and young adults who consumed large amounts of sugar from beverages. Methods: Data from the 8th Korea National Health and Nutrition Examination Survey (2019–2021) were analyzed, and 2,787 individuals aged 12-29 years were selected as the study subjects. A complex sample general linear model was used to assess the associations of subject general characteristics and oral health with the frequency of beverage consumption. Results: Both adolescents and young adults frequently consumed carbonated beverages 2.04 and 2.12 times per week, respectively. The most commonly consumed volume per drink was 200 cc. In both groups, the lower the average number of times teeth were brushed daily, the higher was the frequency of fizzy drink consumption. When teeth were brushed less than once daily, the frequency of carbonated drink consumption was 2.63 in adolescents and 2.22 in young adults. Conclusions: This study highlights the need for oral health education of adolescents and young adults on diet and beverage intake. Additionally, information should be provided on oral diseases associated with beverage consumption, such as dental caries and erosion.

Assessment of parental attitude, knowledge and awareness towards preventive dentistry in south zone of Chhatrapati Sambhajinagar: A questionnaire based cross sectional survey

Introduction: Oral health is a pivotal aspect of overall well-being. In early childhood, primary teeth play a vital role in development of speech, chewing, maintaining proper spacing, and guiding the eruption of permanent teeth. Common oral conditions comprise dental caries, malocclusion, childhood caries, and trauma. Aim: The present study was conducted to assess paternal knowledge towards the forestallment of oral conditions and application of preventive dental procedures in children in South zone of Chhatrapati Sambhajinagar. Materials and Methods: A cross-sectional questionnaire was administered to parents of pediatric patients of age group 3 to12 years in South zone of Chhatrapati Sambhajinagar, Maharashtra, with a sample size of 270 participants. A structured questionnaire, comprising 14 questions in English, was developed, translated and back translated into the local language Marathi by experts to ensure better comprehension by the parents. The questionnaire was divided into two sections: the first focused on demographic information, while the second included 14 multiple-choice, close-ended questions. These questions included topics such as preventive treatments for dental caries, childhood caries, topical fluoride application, fluoridated toothpaste, pit and fissure sealants, habit-breaking dental appliances, malocclusion, mouth guards, and space maintainers. Additionally, the survey addressed harmful habits such as thumb-sucking, tongue-thrusting, and nail-biting. Result: 56.6% of parents sought dental care only after experiencing pain. Additionally, parents of paediatric patients have restricted knowledge about preventive dentistry. Conclusion: Parental knowledge about preventive dental procedures is limited, as is the utilization of these measures.

Potential of avocado seed extract mouthwash in preventing dental caries: A literature review

Potential of avocado seed extract mouthwash in preventing dental caries: A literature review

Effect of Silver Diamine Fluoride and Potassium Iodide on Microleakage of Composite Resin in Anterior Primary Teeth.

One of the preventive interventions for early childhood caries is the use of silver diamine fluoride (SDF), which works uniquely in the prevention of caries. The suggested method to minimize the discoloration of SDF is the use of potassium iodide (KI). However, there are concerns about the bonding properties of dentin after the application of SDF-KI. Therefore, this study aimed to investigate how SDF-KI affects composite resin microleakage in primary teeth. In this in vitro study, class V cavities were created on the buccal surfaces of 60 extracted primary canines. The samples were divided into three groups: Group I: 38% SDF solution was applied to the cavity; Group II: SDF-KI solution was applied to the cavity; and group III: the cavities were irrigated with distilled water. All cavities were filled with composite resin and subjected to a thermocycling regime (500 cycles). The dye penetration of samples was evaluated following a 24-h immersion in 1% methylene blue. Microleakage at the occlusal and gingival margins was evaluated using a stereomicroscope at 40× magnification. Data were analyzed using the Chi-squared test (p < 0.05). There was no statistically significant difference between microleakage scores at the occlusal margin (p = 0.128). At the cervical margin, the SDF-KI group had significantly more microleakage than the SDF and control groups (p = 0.001). Applying the SDF-KI significantly increased microleakage in the cervical margin but had no significant effect on the occlusal margin. Regarding the beneficial effects of SDF in preventing and arresting dental caries, application of it before composite resin is suggested in controlling caries without the negative effects on microleakage. How to cite this article: Meraji A, Asadian F, Hekmatfar S. Effect of Silver Diamine Fluoride and Potassium Iodide on Microleakage of Composite Resin in Anterior Primary Teeth. J Contemp Dent Pract 2024;25(7):691-695.

Cariogenic potential of the Streptococcus mutans Cid/Lrg system: an in vivo animal case study.

In our prior study using a dual-species (Streptococcus mutans/Streptococcus gordonii) competitive mouse caries model to investigate the contribution of S. mutans LrgAB to in vivo fitness, S. mutans wild-type and ΔlrgAB mutants consistently outnumbered S. gordonii and had high caries scores, even though the ΔlrgAB mutant is highly sensitive to oxidative stress. To determine whether the highly cariogenic sucrose diet used in the previous study masked the contribution of LrgAB to competitive fitness of S. mutans against S. gordonii, we recapitulated our previous mouse caries experiment with a modification in which 4% sucrose drinking water was replaced with sterile water, hypothesized to decrease the frequency of exposure of mice to sucrose, a determinant in the cariogenicity of S. mutans. Given that both S. mutans ΔlrgAB and ΔcidB mutants are sensitive to oxidative stress and share similar transcriptional profiles, these strains, as well as wild-type UA159, were tested in this modified dual-species mouse caries model. When comparing between groups the colonization within molar dental biofilms of S. mutans strains, ΔlrgAB mutant was at a level similar to the wild type, whereas S. mutans ΔcidB was modestly lower than both wild-type and S. mutans ΔlrgAB. The severity of total sulcal caries in both the ∆cidB and ∆lrgAB mutant infections was significantly lower than that of wild type. These results demonstrate that the Cid/Lrg system aids in S. mutans fitness against S. gordonii and caries potential in vivo, a phenotype likely masked in our previous study by more frequent exposure to sucrose.IMPORTANCEThe development of a mature biofilm on the tooth surface is the central event in the pathogenesis of dental caries, which primarily requires that cariogenic organisms withstand the limited resources or environmental fluctuations experienced in the oral cavity. The sensitive and heterogeneous response of the cid and lrg operons to complex external signals has been hypothesized to trigger differentiation of the Streptococcus mutans biofilm community into distinct functional subpopulations to promote survival and persistence of the S. mutans community when challenged by an unfavorable environment. The study described herein enlightens our understanding of how Cid/Lrg contributes to S. mutans pathogenic potential in vivo (caries development), warranting further research regarding the adaptive role of Cid/Lrg system in human oral biofilms toward the development of anti-caries strategies directed at the Cid/Lrg system.

Exploring the photosensitizing potential of Nanoliposome Loaded Improved Toluidine Blue O (NLITBO) Against Streptococcus mutans: An in-vitro feasibility study.

Streptococcus mutans is a major contributor to dental caries due to its ability to produce acid and survive in biofilms. Microbial resistance towards common antimicrobial agents like chlorhexidine and triclosan has shifted the research towards antimicrobial Photodynamic therapy (PDT). In this context, Toluidine Blue O (TBO) is being explored for its photosensitizing properties against Streptococcus mutans. There is a huge variation in the effective concentration of TBO among the current studies owing to the differences in source of and delivery system TBO as well as the time, power and energy densities of light. The primary objectives of this study are to encapsulate improved Toluidine Blue O (ITBO) in nanoliposomes (NLITBO), characterize it, and evaluate its antibacterial photosensitizing potential against Streptococcus mutans suspensions in vitro. ITBO was synthesised as per Indian patent (number -543908). NLITBO was prepared using the thin-film hydration method. Dynamic light scattering experiment determined the vesicle size, polydispersity index (PDI), and zeta potential. Surface features were characterized by Scanning and Transmission Electron microscopy. ITBO release from NLITBO was assessed using the extrapolation method. The antibacterial activity of the NLITBO was determined by evaluating the zone of inhibition (ZOI) in the Streptococcus mutans culture and comparing with 2% chlorhexidine gluconate. The minimum inhibitory concentration (MIC) of NLITBO as a photosensitizer with red light (wavelength 650nm, power density 0.1 W/cm2, energy density 9-9.1 J/ cm2, 90seconds time) was evaluated against Streptococcus mutans cells by colorimetric method in 96 well plate. Percentage drug loading, loading efficiency, yield percentage, vesicle size, PDI, Zeta potential of NLTBO was reported as 9.3±0.4%, 84.4±7.6%, 73.5%, 123.52 nm, 0.57, -39.54mV respectively. Clusters of uni-lamellar nanovesicles with smooth non-perforated surfaces were observed in SEM and TEM. The size of the vesicle was within 100 nm. At 24 hours, a cumulative 79.81% of ITBO was released from NLITBO. Mean ZOI and MIC of NLITBO (1 μg /ml) were found to be 0.7±0.2 mm, 0.6μg/ml respectively. We have synthesized and encapsulated improved Toluidine Blue O (ITBO) in nanoliposomes (NLITBO) and thoroughly characterized the formulation. The antibacterial efficacy of NLITBO without light was demonstrated by ZOI which is similar to 2% chlorhexidine gluconate. MIC of NLITBO as a photosensitiser along with the optimal light parameter was also proposed in this study. These findings suggested that NLITBO could serve as an effective alternative to conventional antibacterial treatments in managing Streptococcus mutans rich biofilms. It can have potential pharmaceutical application in oral health care.

Comparative analysis of antibiotic sensitivity pattern in Streptococcus mutans isolated from dental caries of different age &amp; sex group in Dhaka city, Bangladesh

Comparative analysis of antibiotic sensitivity pattern in Streptococcus mutans isolated from dental caries of different age &amp; sex group in Dhaka city, Bangladesh

Oral and radiological features associated with systemic sclerosis: a literature review

This review aimed to determine the orofacial radiological features associated with systemic sclerosis (SSc) characterises the oral health complications experienced by SSc patients and identifies their potential oral health care needs. SSc has several orofacial manifestations, including fibrosis of the overlying skin, limited mouth opening, a dry mouth, and swallowing difficulties. SSc patients also have an increased risk of periodontal disease and tooth decay. By outlining the orofacial radiological features and related complications, this review hopes to enhance the dental services provided to this population by enabling the prediction of their oral healthcare needs while calling for increased awareness among dental healthcare providers.

Dental impact on daily life and oral health in alcohol use disorder patients

ObjectivesIndividuals with Alcohol Use Disorder (AUD) are at a higher risk of developing dental problems. The present study assessed the dental impact on daily performances among AUD patients seeking treatment in a de-addiction centre and correlated it with their clinical dental status using the WHO oral health assessment form (2013). Materials and methodsThis research took place from January to May 2022. A cross-sectional study was carried out to collect data from 103 subjects among alcohol dependents taking treatment in a de-addiction centre of Dakshina Kannada district, Karnataka state. The Dental Impact on Daily Living Questionnaire (DIDL) assessed patients' satisfaction with their teeth, while the WHO Oral Health Assessment Form for Adults was used for dental caries (DMFT) and periodontal status. Data analysis was performed using the jamovi open-source software (version 2.3), employing t-test, chi-square test, hierarchical regression analysis, and Spearman correlation coefficient. ResultsThe study found low yet significant correlations between clinical oral health and dimensions of the DIDL scale. Social class and the number of decayed teeth emerged as significant predictors of the total DIDL score. ConclusionOral health conditions can adversely affect patient satisfaction, emphasizing the need for healthcare providers to consider these findings when offering comprehensive oral healthcare services. Clinical relevanceThis study underscores the necessity of integrating oral healthcare into the overall treatment regime for individuals with Alcohol Use Disorders (AUDs) to improve their quality of life and satisfaction.

Wearable Multifunctional Hydrogel for Oral Microenvironment Visualized Sensing Coupled with Sonodynamic Bacterial Elimination and Tooth Whitening.

Bacterial-driven dental caries and tooth discoloration are growing concerns as the most common oral health problems. Current diagnostic methods and treatment strategies hardly allow simultaneous early detection and non-invasive treatment of these oral diseases. Herein, a wearable multifunctional double network hydrogel combined with polyaniline and barium titanate (PANI@BTO) nanoparticles is developed for oral microenvironment visualized sensing and sonodynamic therapy. Due to the colorimetric properties of polyaniline, the hydrogel displays a highly sensitive and selective response for visualized sensing of oral acidic microenvironment. Meanwhile, the barium titanate in the hydrogel efficiently generates reactive oxygen species (ROS) under ultrasound irradiation, realizing non-invasive treatment in the oral cavity. Through bacterial elimination experiments and tooth whitening studies, the hydrogel can achieve the dual effect of effectively inhibiting the growth of cariogenic bacteria and degrading tooth surface pigments. Owing to the visualized sensing of the oral acidic microenvironment and efficient sonodynamic therapy function, the proposed hydrogel system offers a solution for the prevention of caries and tooth whitening, which is promising in developing the biomedical system targeting the simultaneous sensing and therapy for oral diseases.

Role of Probiotics in Dental Caries Management – A Narrative Review

Probiotics are live microbes that when administered in suitable amounts confer health benefits on the host; they are recognized as potential adjunct therapeutic agents for several diseases. This review highlights various aspects of role probiotics in oral health and management of dental caries

Effect of BMI on Caries Assessed by Structural Equation Modelling in an Adult Brazilian Population.

Compare different behavioural, environmental and socioeconomic factors for caries with transversal data to decompose the direct and indirect effects of body mass index (BMI) in relation to coronal and root caries. This cross-sectional study used a representative sample of 1002 individuals aged ≥ 35 years living in Porto Alegre. Questionnaires recorded age, sex, educational level, tooth brushing frequency and access to dental services. Oral examination assessed gingival bleeding and recession, coronal and root caries. Height and weight were collected to calculate the BMI. The structural equation modelling approach was used, and standardised coefficients (SC) to direct, indirect and total effects were calculated. The prevalence of excessive body weight was 71.17%, of which 40.09% were overweight and 31.07% were obese. The overall prevalence of coronal and root caries was 99.83 and 36.95, respectively. No direct link between BMI and coronal or root caries was observed. For coronal caries, positive SC was found for age (0.56; p < 0.01) and sex (female) (0.14; p < 0.01). For root caries, positive SC was detected for age (0.34; p < 0.01), smoking exposure (0.17; p < 0.01) and gingivitis (0.08; p < 0.01). Overweight and obese adults should not be regarded at higher risk for dental caries.

Prevalence of Tooth Decay and Related Factors Among Primary School Children

Abstract Introduction Tooth decay is considered the fourth most important public health problem in the world. According to the latest studies, the prevalence of this disease is also important in school children. The interest of this work is to study the prevalence of dental caries and its influencing factors in primary school children in the city of Sousse (Tunisia) and to formulate recommendations for the prevention of this phenomenon. Methods It is a cross-sectional study conducted among pupils enrolled from 1st and 3rd grade of 3 primary schools in the city of Sousse in April 2022 through a questionnaire filled out by the pupils. Results A total of 376 participated in the study. Among them, 52,4% were male. The mean age was 7.4 ± 1.2 years. The prevalence of dental caries in our population was 43.9%. Many factors were associated with dental caries including pupils from public schools (p = 0.000), poor oral hygiene: [lack of tooth brushing (p = 0.000), tooth brushing only 1 time per day (p = 0.000), eating in the evening after brushing the teeth (p = 0.000), lack of changing the toothbrush (p = 0.000)] and unhealthy eating habits (p ≤ 0.05). Consequently, dental caries was significantly higher among children with overweight body mass index (BMI) (90.9%; p = 0.016). Conclusions The organization of awareness and information days in schools, the integration of an education program on preventive measures against this phenomenon and the generalization of screening campaigns to detect this disease are necessary measures that should be carried out according to a well determined strategy. Key messages • Dental caries prevalence among primary school children in Sousse is significant, highlighting the urgent need for preventive measures. • Factors such as poor oral hygiene, unhealthy eating habits, and attending public schools contribute to the prevalence of dental caries.

Combined Phase 1/2a Initial Clinical Safety Trials and Proof-of-Concept Assessment of a Novel Antimicrobial Peptide KSL-W Anti-Plaque Chewing Gum.

The effective control of dental plaque is crucial for oral health, given that pathogenic bacteria in plaque are the primary cause of dental caries. Current antimicrobial agents, although effective, disrupt the oral microbiome and lead to oral dysbiosis, hindering efforts to curb dental caries. Novel antimicrobial peptides offer a promising solution due to their selective bactericidal activity against cariogenic bacteria. This study explores the initial safety and efficacy of KSL-W formulated into chewing gum through a Phase 1 and 2a clinical trial. The combined trial, approved by the FDA, follows a double-blind, randomized, placebo-controlled design. Phase 1 assessed safety with single doses (2-100 mg), whereas Phase 2a explored both safety and proof of concept in reducing oral bacteria with multiple doses (4-75 mg). Besides adverse events (Phase 1), outcome measures included whole-mouth plaque and gingival index scores and bleeding on probing (Phase 2a). KSL-W demonstrated safety in both phases, with no severe adverse events. The proof-of-concept analysis revealed a decrease in plaque and gingival inflammation, particularly at doses ≥ 20 mg. The 30 mg dose appeared to yield optimal effects without any adverse reactions in subjects. Results from this study indicate that KSL-W is safe for use in humans and provides initial evidence of its potential efficacy in reducing plaque and gingival inflammation. Further research is essential to determine optimal usage and ultimate safety, and to assess its potential in diverse populations. The trial is registered with the FDA (Trial Registration Number: NCT01877421). The clinical trials were registered in the clinicaltrials.gov database under the title "Safety and Tolerability of Antiplaque Chewing Gum in a Gingivitis Population" and the identifier number is NCT01877421. The URL for accessing the study in clinicaltrials.gov is https://clinicaltrials.gov/study/NCT01877421?intr=Antiplaque%20chewing&rank=1.

Young North African migrants in Europe: exploring their health and the adequacy of health services

Abstract Background Over five million people from North Africa (NA) lived in Europe in 2019, including youth characterized by intense trans-border mobility, precarious living conditions and high-risk behaviours such as prostitution and illegal activities. This population challenges health professionals and institutions ability to deliver medical care and health information remains scarce. This scoping review aims to better understand NA adolescents and young adult (aged 12-25) health status, access to and use of healthcare. Methods Following the Arksey and ÓMalley process and based on the Population-Concept-Context framework, we searched the CINAHL, Cochrane, Embase, PubMed, PsycINFO and Web of Science databases for peer-reviewed articles and non-index reports. We systematically tracked references. Results Initial search returned 5319 articles of which we included 13 (2 Spanish, 2 French, 3 German). All reported about observational studies. Nine of 13 papers included males only and 11 focused exclusively on unaccompanied minors. They reported about physical health conditions related to poverty such as dental caries, iron deficiency and dermatological conditions (n = 5) or infectious diseases, notably tuberculosis (n = 7). Trauma-related mental health conditions were frequently reported (n = 7), including post-traumatic stress disorder and alcohol, cannabis or benzodiazepines harmful use with frequent overlapping presentations. Three studies discussed multi-pronged barriers to healthcare, emphasizing the importance of transcultural approaches and attention to social factors. Conclusions Embedded into multiple factors of vulnerability, poor physical and mental health is commonly associated with young NA migrants. Evidence is limited in scope and quality notably about females and young adults. There is an important gap about optimal strategies to deliver tailored health services, notably to respond to complex mental health needs. Key messages • The complex health needs and barriers to care of young NA migrants in Europe are not adequately documented, understood, and addressed. • Particular attention should be paid to trauma-related mental health conditions.

Public Health Concerns for Dental Caries Vaccine

Public Health Concerns for Dental Caries Vaccine

Changes in heavy metal levels in the oral fluid of young patients with and without plaque-induced gingivitis undergoing treatment with braces

Relevance. Research into the effects of nickel-titanium alloys and heavy metal ions on the development of inflammatory oral diseases is becoming increasingly significant in orthodontics. The relationship between toxic elements and inflammatory responses remains under-researched and controversial. Data on the connection between heavy metals and inflammatory reactions could influence the choice of orthodontic appliance materials and guide the subsequent management and monitoring of patients with braces. The question of the safe use of nickel-titanium alloy braces continues to be a relevant concern.Purpose. To assess the levels of heavy metals in the oral fluid of young patients with braces, both in those who developed plaque-induced gingivitis and those who did not.Materials and Methods. The study involved 50 clinically healthy patients (Groups I and II health categories) with intact teeth, including patients with compensated dental caries (isolated carious lesions – Grade I) and no periodontal diseases (PMA index &lt;20), presenting with dental crowding and malocclusion (K07.2, K07.3). The average age of the patients was 22.1 ± 2.7 years, all of whom were undergoing treatment with metal braces. Oral fluid samples were analyzed for 12 heavy metal elements using inductively coupled plasma mass spectrometry (ICP-MS) in a laboratory setting. Additionally, lysozyme activity and oral fluid pH were measured before appliance placement and six months into orthodontic treatment.Results. Adaptation to braces in young patients is frequently complicated by the development of gingivitis and periodontitis due to impaired oral hygiene and the mechanical pressure exerted on teeth and gums, leading to elemental imbalances. Patients with gingivitis during orthodontic treatment are particularly at risk of developing such imbalances and therefore require timely correction of their mineral metabolism.

Oral health related cardiovascular disease risk factors: a cross-sectional study

Abstract Background Hypertension, cardiovascular disorders, and hypercholesterolemia represent significant public health concerns. This research presentation examines the impact of various oral health indicators, such as bleeding gums, untreated dental decay, loose teeth, and missing teeth, on these conditions within Hungary. Materials and methods This study utilized data from 5,603 individuals participating in the 2019 Hungarian European Health Interview Survey. Predictor variables were chosen using elastic net regularization and k-fold cross-validation to enhance the performance of weighted logistic regression models. Sensitivity analysis underpinned the robustness of the results. Results Significant associations emerged between deteriorating oral health and the prevalence of various cardiovascular conditions. An increased likelihood of hypertension was observed in individuals with multiple tooth removals, showing an odds ratio (OR) of 1.67 with a 95% confidence interval (CI) of [1.01-2.77]. The use of dental prosthetics presented an OR of 1.45 [1.20-1.75]. Additionally, presence of gum bleeding corresponded to elevated odds for both cardiovascular disease (OR = 1.69 [1.30-2.21]) and hypercholesterolemia (OR = 1.40 [1.09-1.81]). Conclusions enhancing oral health could potentially mitigate chronic cardiac conditions, highlighting the importance of integrating dental care in comprehensive disease management strategies. Key messages • Poor oral health is linked to higher hypertension and heart disease odds. • Dental care is crucial in cardiac disease prevention and management.

The Correlation Between Dental Caries And Nutritional Status In Children Between The Ages Of Three And Five

Data from the Indonesian Ministry of Health in 2018 indicate that only 7% of children in Indonesia are cavity-free, while a staggering 93% of children under the age of three experience dental caries. The pathological process known as tooth decay is characterized by damage restricted to the hard tissues of the tooth, starting with the enamel and progressing to the dentin. Nutritional status, which can be classified as adequate, inadequate, poor, or stunted, plays a crucial role in the overall health of children, including their oral health. This study aims to investigate the relationship between dental caries levels and nutritional status among preschool children at Aisyiyah Kindergarten/RA Kemantren Tulangan, Sidoarjo. The study employs a cross-sectional methodology and adopts an analytical survey approach. The sample used in this research consists of a total sampling of sixty individuals. The def-t index is utilized as the measuring tool to evaluate the presence of cavities, while the PB/U or TB/U index is used to determine the short nutritional status based on the WHO Anthro 2005 reference standards. Data analysis is conducted using SPSS, where a Chi-square test is performed to ascertain the association between the degree of dental caries in preschool-aged children and their nutritional status. The results of the study are presented in both tabular and narrative forms to provide a comprehensive overview of the relationships identified. This research is expected to contribute to a deeper understanding of the importance of proper dental care and nutrition in promoting the health of young children

Effect of malocclusion severity on oral health and its correlation with socioeconomical status in Iranian adolescents

BackgroundThis study aimed to assess the effect of malocclusion severity according to the Index of Treatment Need (IOTN) on oral health (dental caries and gingivitis), and its correlation with socioeconomic status (SES) in Iranian adolescents.MethodsThis descriptive cross-sectional study was conducted on adolescents between 10 and 16 years in Tehran city, who underwent clinical dental examination. The Dental Health Component (DHC) of the IOTN was used to assess the severity of malocclusion. The DMFT index was calculated to assess dental caries, and the gingival index (GI) was calculated for gingival health assessment. For oral hygiene assessment, the Oral Hygiene Index-Simplified (OHI-S) was calculated, and a questionnaire was used.ResultsTotally, 306 adolescents participated in this study. The frequency of IOTN grades was 88 (28.8%), 89 (26.1%) ,49 (16%), 60 (19.6%), and 29 (9.5%) for grades 1 to 5, respectively. The multinomial logistic regression showed that by an increase in OHI-S score, the odds of having IOTN grade 4 compared to grade 1 increased. Postgraduate parental level of education decreased the odds of having IOTN grade 4 compared to grade 1. Furthermore, there was an inverse correlation between oral hygiene practice and the odds of having IOTN grade 5 compared to grade 1.ConclusionsMalocclusion may hinder oral hygiene practice, and resultantly increase plaque accumulation. This risk may be amplified in children with lower SES, highlighting the need for preventive and educational oral health programs.