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PubMed2006

A reassessment of recall frequency intervals for screening in low caries incidence populations.

OBJECTIVES: To reassess the recall frequency interval for dental examinations for children, based on annual caries increments. METHODS: Cross sectional data collected on school children in eight rural and urban schools through the national Incremental Dental Care Programme (IDCP) for one district in Malaysia were analysed to assess their annual caries increment and trend lines. The Restorative Index was calculated to assess the success of the IDCP in rendering children dentally fit. RESULTS: The annual caries increments were low; the current caries levels were between 0.65 and 1.50 for 12 year-old children in Kota Tinggi District. Most of the caries experience was on pits and fissures. From 7 to 12 years old, the overall annual caries increment for the total study population was 0.19. The mean annual caries increment increased slightly between the ages of 12 to 14 years and 14 to 16 years and was 0.24 and 0.25 respectively. Two distinct caries incremental trend lines were observed for children aged 7 to 16 years. One group reached a mean DMFT of about 0.75 while the other group a mean DMFT of about 1.4 at 12 years. The trend lines continued over the next 4 years until the children were 16 years old. The Restorative Index was higher in urban schools that also had low DMFT levels. CONCLUSIONS: Based on the low annual caries increments of between 0.65 and 1.50, yearly dental examination intervals can safely be extended to 2-yearly intervals or even longer. Such a change of screening recall intervals would help improve resource allocation. Resources saved by extending recall intervals can be redirected to the small proportion of children with higher disease levels. This will help render more school children dentally fit and reduce inequalities in oral health.

Adolescent↗

PubMed2001

Community socioeconomic status and children's dental health.

BACKGROUND: Although a substantial decline in dental caries has occurred among U.S. children, not everyone has benefited equally. The first-ever surgeon general's report on oral health in America indicates that the burden of oral diseases is found in poor Americans. This study investigates the relationship between community socioeconomic status, or SES, and dental health of children. METHODS: An oral health survey of 17,256 children, representing 93 percent of children residing in 62 Tennessee communities, was conducted in public elementary schools during the 1996-1997 school year. Portable dental equipment was used for examinations, and data from each examination were entered directly into a laptop computer. The authors performed analyses of covariance to examine the relationship between community SES (low/medium/high) and dental health, controlling for community fluoridation. RESULTS: Community SES was significantly related to caries experience in the primary teeth, the proportion of untreated caries in the primary and permanent teeth, dental treatment needs, dental sealants and incisor trauma. Overall, dental health was significantly worse for low-SES communities than for medium- and high-SES communities. CONCLUSION: The authors conclude that all specific dental indexes used to measure children's dental health in this study, with the exceptions of caries experience in the permanent teeth and sealant presence, were inversely related to the communities' SES. The percentage of children with dental sealants was directly related to the community's SES. PRACTICE IMPLICATIONS: Further improvements in oral health will necessitate that community-based preventive programs and access to quality dental care be made available to children who are identified as being at highest risk of experiencing oral disease.

Analysis of Variance↗

PubMed2006

[Early childhood caries: prevalence and risk factors in 4-year-old preschoolers in João Pessoa, Paraíba, Brasil].

The purpose of the present study was to evaluate the prevalence of early childhood caries (ECC), in a cohort of children of low socioeconomic status at 48 months of age in João Pessoa, Paraíba, Brazil, in relation to feeding practices, oral health behaviors, fluoride exposure, and enamel defects. 224 children were clinically examined in the Knee-Knee position at the children's home under natural light. Teeth were dried and cleaned with gauze, and caries (WHO index) and defect (DDE Index) were determined. Questionnaires on children's oral hygiene and dietary history were completed by parents or guardians. The SAS statistical program was used with the Mantel-Haenszel tests. The results showed a prevalence of 10.7% and 33.0% for ECC and SECC, respectively. Of all the children examined, 79.9% had at least one tooth with enamel defects, which was the only statistically significant factor (p < 0.001) for ECC. The association between enamel defects and ECC indicates that alterations in the enamel surface may cause progression of dental caries.

Brazil↗

PubMed1994

Dental caries and microbial and salivary conditions in Uruguayan children from two different socioeconomic areas.

Dental caries, microbial and salivary conditions, dietary habits, and socioeconomic conditions were studied in 100 12- to 13-year-old children from 2 different socioeconomic areas in Montevideo: Pocitos and Piedras Blancas. The residents of Pocitos had a higher educational level, better housing conditions, and occupations involving higher earnings than those of Piedras Blancas. The caries prevalence in the two areas was about the same, but the children in Piedras Blancas had more decayed surfaces and fewer filled surfaces than the children in Pocitos. The mean values for caries in Piedras Blancas and Pocitos were, DMFT, 4.2 and 4.2; DMFS, 8.1 and 7.8; DS, 4.7 and 2.5; and FS, 1.7 and 4.7, respectively. The differences in DS and FS were statistically significant. The frequency of sugar intake and the salivary secretion rate were similar, but the buffer capacity was significantly higher in Pocitos than in Piedras Blancas. The plaque index was the same, but the distribution of cariogenic microorganisms differed significantly. Fifty-eight per cent of the children in Piedras Blancas had more than 10(6) CFU of mutans streptococci per milliliter saliva, compared with 17% of the children in Pocitos. Similar differences were found with regard to the lactobacilli. The percentage of children with high numbers of mutans streptococci was higher in Piedras Blancas and lower in Pocitos than in previous epidemiologic studies in Scandinavia. It was, however, higher than that recently noted in Finland.

Adolescent↗

PubMed1994

Oral health status among schoolchildren in Romania, 1992.

In Romania, systematic information on the occurrence of oral diseases in children is scarce. The purpose of the present study was to describe the prevalence and the pattern of dental caries in schoolchildren, and to use the data to provide a baseline for planning and evaluation of oral health care. A national sample of children at grade 1 (n = 729) and grade 6 (n = 660) was chosen consistent with the WHO pathfinder principle. Clinical examinations were carried out according to the recording system for the Danish Municipal Dental Service and the following results were obtained. In children of grade 1 (7-yr-olds) the prevalence proportion of caries in primary teeth was 86% and in permanent teeth 39%. The mean caries indices were 11.4 defs and 1.3 DMFS. At grade 6 (12-yr-olds) the prevalence proportion of caries in primary teeth was 17% and in permanent teeth 90%. The mean caries experience was 0.8 defs and 6.5 DMFS, and a mean of 4.1 DMFT was observed. In both groups, the D-component of the caries index was dominant. The children were also classified by caries severity zone. At grade 1, 61% had a very severe pattern of caries in the primary teeth, i.e. caries in pits/fissures, proximal surfaces, smooth surfaces, and incisors. Forty-three percent of the children at grade 6 showed this pattern in permanent teeth. In Romanian schoolchildren the present level and pattern of dental caries are most severe and the implementation of oral health promotion and prevention at the community level is urgently needed.

Adolescent↗

PubMed2002

Detection of potentially cariogenic strains of Streptococcus mutans using the polymerase chain reaction.

Streptococcus mutans is a pathogen related to the occurrence of human dental caries. The determination of total amounts of mutans streptococci, as well as the proportion related to other oral bacteria, is of interest when assessing the risk of developing caries. In this context, it is better to use a sensitive, specific and non-time consuming method such as the polymerase chain reaction (PCR), than to use culture and biochemical identification methods. In this work we identified potentially cariogenic strains of S. mutans and assessed the relationship with the dmft, DMFT or dmft/DMFT index. Using DNA isolated from dental plaque, a 192 bp sequence was identified and amplified from the spaP gene and a 722 bp sequence from the dexA gene. The results suggest that it is important to evaluate the presence of cariogenic S. mutans strains in plaque content rather than the accumulation of plaque itself However, other factors like diet, hygiene, genetic background, the flow rate of saliva and the presence of specific antibodies, also play a key role in the development of caries.

Bacterial Typing Techniques↗

PubMed2004

Leprosy: dental and periodontal status of the anterior maxilla in 76 patients.

OBJECTIVE: To evaluate the presence of oral disease, as assessed by dental and periodontal indices, in the anterior maxilla of a group of 76 patients with leprosy, compared with a group of matched control subjects. MATERIALS AND METHODS: The study included 76 patients with leprosy (age range 40-82 years; 39 males), resident in the sanatorium of San Francisco de Borja de Fontilles (Alicante, Spain). Clinical examination was carried out to evaluate the decayed missing and filled index, and the periodontal status in the anterior maxilla, using the Löe-Silness dental plaque index, mean periodontal probing depth and the average periodontal attachment loss. RESULTS: In the leprosy patients, a large proportion of maxillary incisors and canines were missing. The mean plaque index in leprosy was 2.35 +/- 0.7, with a probing depth of 2.96 +/- 0.8, and an average attachment loss of 4.18 +/- 1.3, indices all statistically greater than in controls. There were no differences detected in the oral indices measured according to the presence or absence of facial destruction or the type of leprosy. CONCLUSIONS: Patients with leprosy show a tendency to poor dental and periodontal health, unrelated to the presence of facial destruction or the type of leprosy.

Adult↗

PubMed1998

Relationship between mothers' gingival condition and caries experience of their 3-year-old children.

OBJECTIVES: The main aim of this study was to investigate the relationship between mothers' gingival condition (an assumed indicator of their self-care level) and the prevalence and severity of dental caries of their children. SAMPLE AND METHODS: Subjects comprised 1471 pairs of mothers and their children who attended for the 3-year-old dental check-up at a community health centre in Hiroshima. The mothers' gingival condition was scored as 'excellent (+2)', 'good (+1)', 'questionable (0)', 'poor (-1)' or 'very poor (-2)' according to the criteria of the Oral Rating Index (ORI). Caries experience of the children was recorded using the WHO caries diagnostic criteria for dmft. RESULTS: The percentage of caries-free children was 51.3%, and the mean dmft score was 2.61. The percentages of caries-free were higher and the mean dmft level were lower in the children of mothers with better gingival condition compared to the children of mothers with worse gingival condition. CONCLUSIONS: Mothers' gingival condition was associated with the prevalence and severity of dental caries of their children.

Adult↗

PubMed1995

Caries experience in rural Victorian adolescents.

An oral health status survey was conducted on 818 adolescents aged 12 to 16 years in a non-fluoridated area in rural Victoria. The prevalence and severity of dental caries experience was found to increase with age. The occlusal surface was the predominant surface affected by dental caries for all age groups. Filled surfaces represented the largest component of the DMFS index and were responsible for the increasing dental caries experience with age. Fewer fissure sealants were present with increasing age and second molars were sealed less often than the first molars. Although no difference was evident in the total caries experience between those with and without access to public dental services, a statistical difference was found to exist in unmet need between these two groups. Untreated caries levels were significantly higher in health card holders. The provision of preventive and dental treatment services to this group should be a priority in the future.

Adolescent↗

PubMed1998

Dental caries and oral health behaviour situation of children, mothers and schoolteachers in Wuhan, People's Republic of China.

This study was undertaken in order to describe the occurrence of dental caries in Chinese schoolchildren and to highlight the oral health behaviour situation. Clinical examinations of grade 1 children (age 6, n = 381) and grade 6 children (age 12, n = 413) were performed. At age 6, 86 per cent of the children were affected by dental caries and at age 12 the mean DMFT index was 1.0. Personal interviews with the mothers (n = 691) showed that dental care habits of children were poor; 22 per cent of all children brushed their teeth twice a day and 20 per cent had seen the dentist within the past 12 months. Very few children (4 per cent) had practical support from their parents in daily toothcleaning. Self-administered questionnaires for schoolteachers (n = 138) revealed that most (85 per cent) are positive towards oral health education of children. Systematic school-based programmes should be implemented to promote oral health.

Attitude to Health↗

PubMed1976

Turku sugar studies. V. Final report on the effect of sucrose, fructose and xylitol diets on the caries incidence in man.

The purpose was to study differences in the caries increment rate as influenced by various sugars. The trial involved almost complete substitution of sucrose (S) by fructose (F) or xylitol (X) during a period of 2 years. There were no significant initial differences as to caries status between the prospective sugar groups; 35 subjects in the S-group, 38 in the F-group, and 52 in the X-group. During the entire study 10 subjects discontinued or were excluded. The clinical and radiographical observer error was reported and discussed. After 2 years the mean increment of decayed, missed and filled tooth surfaces was 7.2 in the S-group, 3.8 in the F-group, and 0.0 in the X-group. The weakness of the DMFS-index in not showing the development of new secondary caries and the increase in size of the lesions was overcome by expressing the caries activity in terms of indices showing the total quantitative and qualitative development. The results showed a massive reduction of the caries increment in relation to xylitol consumption. Fructose was found to be less cariogenic than sucrose. It was suggested that the non- and anticariogenic properties of xylitol principally depend on its lack of suitability for microbial metabolism and physico-chemical effects in plaque and saliva.

Adolescent↗

PubMed2001

The dental caries experience of 5-year-old children in Great Britain. Surveys coordinated by the British Association for the Study of Community Dentistry in 1999/2000.

OBJECTIVE: This paper reports the results of standardised clinical caries examinations of 199,440 5-year-old children from across Great Britain. These 1999/2000 coordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: The results again demonstrated a wide variation in prevalence across Britain, with mean values for d3mft for the current English regions (of the National Health Service) and for Wales and Scotland ranging from 0.94 in the West Midlands to 2.55 in Scotland. Mean d3mft across Great Britain was 1.57 (d3t=1.14. mt=0.22, ft=0.21). Overall, 40% of children had evidence of dentinal caries experience (d3mft>0), although the means ranged between 30% (West Midlands) and 55% (Scotland). The distribution of caries was highly skewed. Thus the British mean caries experience for those with the disease was 3.88, as opposed to the overall mean of 1.57. Trends over time demonstrate a modest improvement of 4% in overall d3mft for Britain since 1997/98, compared with the 8.6% improvement seen for the two previous years. All three components with dmft have also fallen. The care index has remained virtually unchanged in Britain as a whole (13.6% in 1999/2000, compared to 13.9% in 1997/8). Regional/country means for 1999/2000 ranged from 8-20%. This indicator has not, however, regained the levels seen in the past. CONCLUSION: There has been some improvement in the dental health of 5-year-old children. Overall, the provision of operative care for those with dental decay has not changed; significant groups remain within the population of 5-year-old children who have dental disease and who are in need of dental care.

Child, Preschool↗

PubMed1990

Final results of a dental caries clinical trial using heat killed lactic bacteria (Streptococci and Lactobacilli) orally.

The results of a dental caries clinical trial in 245 seven-year-old children are reported. Chewable tablets of two different types were prepared: A) Containing pyridoxine (Vit. B6) and heat-killed lactic bacteria. B) Placebo tablets with pyridoxine only. They were randomly given once a week for 16 weeks to experimental and control groups respectively. Four evaluation surveys were conducted during 24 months of follow up, using the "Decay, Missing, Filled, Surfaces" index (DMFS) for the clinical evaluation of the permanent teeth. A consistent reduction in the incidence of dental caries in the experimental group was observed in all 4 surveys. After 2 years of follow up a 42% reduction in the incidence rate of dental caries was observed in the experimental group compared to the control group. Summary tables and discussion of the clinical evaluation surveys are given. The potential use of these clinical findings as support for a future dental caries vaccine evaluation project is proposed.

Chi-Square Distribution↗

PubMed1997

On longitudinal caries index data. A comparison study between cohort and cross-sectional attempts.

The aim of the present study was to compare registered data of caries prevalence and incidence from cross-sectional studies of specified age groups with the corresponding caries data from cohorts of individuals receiving dental health service from the same dental clinic during the years studied. The study covered two 15-19-year groups, who had been offered complete dental care from three years of age in the City of Göteborg for the time periods 1986/7-1990/1. When compared, the longitudinal cohort attempts often gave statistically significant different values to those of the cross-sectional year classes, which should be considered when presenting caries index mean values in dental health reviews. It is not indifferent to choose between longitudinal cohort and cross-sectional year class attempts when searching for dental health treatment effects. Due to the advantages of using longitudinal cohort study methods, and with regard to the differences of the study design used, as pointed out in the study, the use of longitudinal cohort patient material, extracted from cross-sectional epidemiological data bases, could favour analysis of the effects of different preventive dental care programs.

Adolescent↗

PubMed1996

Caries prevalence and salivary and microbial conditions in 88-year-old Swedish dentate people.

As part of a comprehensive investigation of 88-year-old people, caries prevalence, stimulated salivary secretion rate, buffer capacity, and the prevalence of lactobacilli and mutans streptococci were studied in a subsample of 92 dentate subjects. The mean number of remaining teeth was 14.1 +/- 7.3. The DMFT was 25.2 +/- 3.0, and DF surfaces 38.3 +/- 22.7. Root caries experience was found in 85% of the subjects, with a mean root caries index of 36.6 +/- 28.5%. The men had significantly higher mean values of salivary secretion rate (2.0 +/- 1.3 ml/min) than the women (1.1 +/- 0.6 ml/min) (p < 0.001). The mean final pH of buffer capacity was 6.3 +/- 1.3. High counts of lactobacilli (> 10(5)) and mutans streptococci (> 10(6)) were found in 49% and 55% of the subjects, respectively, of whom most were denture wearers. The mean number of total mutans streptococci was higher in persons harboring both Streptococcus mutans and S. sobrinus than in subjects with only S. mutans.

Aged↗

PubMed1999

The dental caries experience of 5-year-old children in the United Kingdom. Surveys co-ordinated by the British Association for the Study of Community Dentistry in 1997/98.

OBJECTIVE: This paper reports the results of standardised clinical caries examinations of 176,781 5-year-old children from across the United Kingdom. These 1997/98 co-ordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: The results again demonstrated a wide variation in prevalence across the UK, with mean values for d3mft for the current English regions (of the National Health Service) and the other UK 'territories' ranging from 1.02 in the West Midlands to 2.92 in Northern Ireland. Mean d3mft across the UK was 1.68 (d3t = 1.18, mt = 0.26, ft = 0.23). Overall, 43% of children had evidence of caries experience (d3mft > 0), although the means ranged between 33% (West Midlands) and 63% (Northern Ireland). The distribution of caries was highly skewed. Thus the UK mean caries experience for those with disease was 3.94, as opposed to the overall mean of 1.68. Trends over time demonstrate a modest improvement of 8.7% in overall d3mft for Great Britain since 1995/96, compared to the small improvement seen two years ago and the deterioration seen four years previously. Both dt and mt have fallen while ft remained unchanged. The care index has increased in all but one region/territory (14% in 1997/8, compared to 12% in 1995/6). Regional/country means for 1997/8 ranged from 9-23%. This indicator has not, however, regained the levels seen in the past. CONCLUSION: There has been some improvement in the dental health of 5-year-old children. Overall, the provision of operative care for those with dentinal decay has also improved; however, significant groups remain within the population of 5-year-old children who have dental disease and who are in need of dental care.

Child, Preschool↗

PubMed2003

The dental caries experience of 5-year-old children in England and Wales. Surveys co-ordinated by the British Association for the Study of Community Dentistry in 2001/2002.

OBJECTIVE: This paper reports the results of standardised clinical caries examinations of 170,731 5-year-old children from across England and Wales. These 2001/2002 co-ordinated surveys are the latest in a series which seek to monitor the dental health of children and to assess the delivery of dental services. METHOD: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine threshold using a visual method without radiography or fibre-optic transillumination. RESULTS: The results again demonstrated a wide variation in prevalence across Britain, with mean values for d3mft for the current English Strategic Health Authorities (SHA) (of the National Health Service), Wales and British 'territories' ranging from 0.75 in Jersey and 0.84 in Kent & Medway to 2.73 in Gwent and 2.47 in Greater Manchester. Mean d3mft across England and Wales was 1.52 (d.t = 1.11, mt = 0.20, ft = 0.20). Overall, 40% of children had evidence of caries experience (d3mft > 0); the percentages ranged between 23% (Jersey) or 29% (Essex) and 61% (Gwent) or 54% (Greater Manchester). The distribution of caries was highly skewed. Thus the mean caries experience for those with disease in England and Wales was 3.83, as opposed to the overall mean of 1.52. Trends over time demonstrate slight increase of 3% in overall d3mft for England and Wales since 1999/2000, compared to the 4% improvement seen for the two previous years. Of the three components of dmft, d3t and mt have increased while ft has fallen. The care index has also fallen (13.2% in 2001/2002, compared to 14.3% in 1999/2000); SHA/country percentages for 2001/2002 ranged from 8-29%. This indicator has not, however, regained the levels seen in the past. CONCLUSION: There has been no improvement in the dental health of 5-year-old children. Overall, the provision of operative care for those with dentinal decay has decreased slightly; significant groups remain within the population of 5-year-old children who have dental disease and who are in need of dental care.

Catchment Area, Health↗

PubMed2006

Caries prevalence in 12-year-old children from Germany. Results of the 2004 national survey.

OBJECTIVE: To determine the prevalence of dental caries in 12-year-old children in all 16 German Federal States in 2004 as part of a longitudinal observation project. DESIGN: A cross-sectional oral health survey of children 12 years of age was performed in 2004. SUBJECTS: After random selection 43,950 children were examined in schools. METHOD: DMFT and fissure sealants were recorded following WHO criteria. Caries was diagnosed at the caries into dentine threshold (D3) using the visual method without radiography or fibre-optic transillumination. RESULTS: The proportion of children with caries experience was 39.3% throughout Germany. The mean DMFT score was 0.98 and the average Significant Caries Index (SiC) was 2.72. Compared to the results obtained in 2000, caries prevalence and caries experience decreased in this age group. As in 2000, all these specific results showed a wide variation among the different federal states, i.e., mean regional DMFT values between 0.71 and 1.42 were found and the mean number of fissure sealed teeth ranged between 1.9 and 3.4. CONCLUSION: The decrease in caries prevalence observed between 1994 and 2000 continued between 2000 and 2004, although once again considerable inequalities in oral health between the various federal states were observed.

Child↗