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PubMed2004

The relationship between Porphyromonas gingivalis infection and local and systemic factors in children.

BACKGROUND: Porphyromonas gingivalis (P. gingivalis) is a major pathogen related to periodontitis. There are few reports on the prevalence and effect of P. gingivalis in children. The purpose of the present study was to describe in children the level of DNA-P gingivalis in subgingival plaque and the IgG serum reactivity to P. gingivalis (IgG-Pg), and examine their relationship to demographic, systemic, and oral variables. METHODS: Thirty-four children, aged 1.83 to 13.42 years, were included in the study; 16 with no systemic disease and 18 with systemic conditions. The demographic data for caries incidence, plaque and gingival indices, probing depth, and alveolar bone height were recorded. The IgG-Pg and DNA-Pg levels were determined by enzyme-linked immunosorbent assay and DNA-DNA hybridization, respectively. The relationships between the IgG-Pg and DNA-Pg values to the demographics, oral parameters, and systemic conditions were examined. RESULTS: IgG-Pg was evident in 53% of the children and DNA-Pg in 47%. IgG-Pg values significantly correlated positively with age, plaque index, and bone height. DNA-Pg values had statistically significant positive correlations with age. IgG-Pg and DNA-Pg values correlated with probing depth among children with systemic diseases. Neither the IgG-Pg nor the DNA-Pg values had a significant correlation to systemic conditions. Multiple regression analyses indicated that only age remained significantly related to IgG-Pg and DNA-Pg values. CONCLUSIONS: P. gingivalis can be found in significant levels in the plaque of young children and elicits an immune reaction that increases with age and may be related to incipient signs of periodontal disease. Plaque DNA-Pg and serum IgG-Pg levels correlate significantly.

Adolescent↗

PubMed2004

Dental treatment needs of children in a rural subcounty of Uganda.

OBJECTIVES: To describe normative dental treatment needs of 5-7 and 12-year-olds in a rural sub county of Uganda and devise a strategy to improve oral health. DESIGN: Clinical survey. SETTING: Primary schools in the subcounty. SAMPLE AND METHODS: School-based random cluster sample of 236 5-7-year-olds and 202 12-year-olds. Dental status and treatment need data were collected according to WHO Oral Health Surveys Basic Methods. Additional data for 12-year-olds included dental fluorosis using the Thylstrup and Fejerskov index (TFI), oral hygiene procedures and experience of oral pain in the previous month. RESULTS: In the 5-7-year-olds, mean dmft was 1.47 (50.8% dmft = 0). A total of 52.5% needed fillings and almost one third needed a tooth extracted. Among the 12-year-olds, mean DMFT was 0.64 (65.8% DMFT = 0), 28.5% had dental fluorosis and 6.7% had TFI > 2. Toothache in the previous four weeks was reported by 36.5%, 30.2% needed a filling and 6.4% needed one or more teeth extracted. CONCLUSIONS: Dental disease is a significant public health problem in this population. An efficient way to meet the needs of the children would be to increase the availability of fluoride toothpaste and to develop a service to provide treatment using Atraumatic Restorative Technique.

Adolescent↗

PubMedDate not supplied

The sensitivity and specificity of a colorimetric microbiological caries activity test (Cariostat) in preschool children.

The purpose of this study was to test the ability of a colorimetric test, Cariostat (Sankin, Tokyo, Japan) to identify preschool children with dental caries. Three- to 5-year-old children (N = 153) from seven preschool programs in Saskatoon, Canada, were examined for dental caries using a mirror and explorer. A caries severity index (csi) was calculated for each subject. In all subjects buccal plaque samples were obtained, incubated, and scored as per the manufacturer's instructions for the Cariostat test. In 98 of 153 children whole stimulated saliva was also collected and population counts of Streptococcus mutans (CFU/ml of saliva) were determined. The test group exhibited mean dft = 1.03, mean dfs = 1.53, and mean csi = 0.46 while 66.67% of subjects were caries free and had no restorations. The S. mutans count was found to be significantly correlated (P < 0.001) with dft, dfs, and csi. Significant differences (P < 0.001) were found between Cariostat groups with respect to dft, dfs, and csi. The sensitivity of the Cariostat test was found to be 98% while the specificity was found to be 14%.

Age Factors↗

PubMed2005

Dental caries and associated factors in Mexican schoolchildren aged 6-13 years.

The objectives of the present study were to establish dental caries prevalence (percentage with caries) and experience in the primary and permanent dentition (dmft and DMFT) of 6 to 13-year-old schoolchildren in Campeche, Mexico, and to estimate the contributing roles of the likely risk indicators. A cross-sectional study was carried out in 1,644 children aged 6-13 years. Self-administered questionnaires obtained information on social, economic, behavioral, and demographic variables. The primary dentition of 1,309 children and the permanent dentition of 1,640 children were evaluated in the oral examinations. The main outcome measures were DMFT, dmft, and SiC indices. Data were modeled using logistic regression analysis. The overall caries prevalence was 77.4%, 73.6% in the primary dentition (61.6% in 6-year-olds), and 49.4% in the permanent dentition. The dmft and DMFT indices were 2.85+/-2.73 and 1.44+/-2.05, respectively (DMFT = 3.11+/-2.62 in 12-year-olds). The SiC index was 6.05 at 12 years of age. Associated variables to dental caries in both dentitions were presence of enamel defects, presence of dental plaque, low socio-economic status, female sex, and older age. Mother's schooling was negatively associated (OR = 0.95) with caries in primary dentition. Caries experience in the primary dentition (OR = 6.02) was positively associated with caries in the permanent dentition. Dental caries status in these Mexican children was closer to the goals proposed by the WHO/FDI for 2000 than previous studies. This study has identified clinical, socio-economic, and behavioral determinants for dental caries in primary and permanent dentition on Mexican schoolchildren.

Adolescent↗

PubMed1997

Sweet preference, consumption of sweet tea and dental caries; studies in urban and rural Iraqi populations.

The objective of the present study was to explore the association between sweet preference and the levels of dental caries in a large sample of urban and rural children and young adults in Iraq. In addition, the relationship between caries levels and sweet tea consumption was investigated. Sweet preference was assessed using a free choice method while caries was measured by the DMFT index in 4,152 males and females of differing ages living in urban and rural areas. A positive significant correlation between sweet preference and dental caries was found for both urban and rural populations. This relationship was stronger in the rural groups (r = +0.58, P < 0.001) than in the urban groups (r = +0.24, P < 0.001). The number of cups of tea consumed was positively correlated with the DMFT scores as was the number of spoonfuls of sugar taken in each cup of tea. Both these correlations were greater for the rural groups. These findings, together with those showing that sweet preference changes with exposure to sugars; the more sugars people consumed the higher their threshold for sweetness, indicates that exposure to sugar increases the intake sugar and the risk of dental caries.

Adolescent↗

PubMed2003

Dental abnormalities in patients with familial hypophosphatemic vitamin D-resistant rickets: prevention by early treatment with 1-hydroxyvitamin D.

OBJECTIVE: To evaluate the dental effects of 1-hydroxylated vitamin D3 treatment in patients with familial hypophosphatemic vitamin D-resistant rickets. Study design Forty-eight children and adult patients were included in the study; 16 had received no treatment or phosphate supplements with vitamin D/25-(OH) D3 before puberty. The 32 younger ones had received phosphate supplements with 1alpha-(OH)D3 from infancy. All patients were clinically examined, and panoramic and periapical radiographs were made. Evaluations of decayed, missing, or filled teeth and decayed or filled teeth indexes and of pulp ratios allowed comparison with healthy age-matched control patients. RESULTS: Poor dental health and characteristic dental anomalies were found in the 16 older patients. In contrast, the 32 younger patients had a normal dental status as regards reference ranges in healthy age-matched populations, although they still showed prominent pulp horns on deciduous teeth and increased pulp area/tooth area ratios. CONCLUSIONS: This investigation shows the beneficial effects of 1alpha-(OH)D3 treatment on the dental status of vitamin D-resistant rickets patients and emphasizes the necessity of early treatment. Remaining defects may result from early exposure of odontoblasts and surrounding osteoblasts to hypophosphatemia, before the commencement of treatment, and/or from intrinsic cell disturbances linked to the genetic alteration(s).

Adolescent↗

PubMed1981

Effect of fluoridation on the cost of dental treatment among urban Scottish schoolchildren.

Dental treatment needs of 230 children aged 4 and 5 years and 288 aged 9 and 10 years who were lifetime residents of two towns, one fluoridated and the other non-fluoridated, were costed on the Resource Related Index. This index is based on the British National Health Service scale of fees for general dental practitioners. The overall cost of dental treatment required by 4- and 5-year-olds in the fluoridated community was 45% less than in the non-fluoridated community, The corresponding difference for 9- and 10-year-olds was 47%. The differences in the cost of treatment for dental caries only (fillings, extractions and general anaesthetics) were 56% in 4- and 5-year-olds and 76% in 9- and 10-year-olds in favour of the fluoridated community. In the latter community, no child examined required dental extractions under general anaesthesia. Certain assumptions made in the study and the implications of the findings in terms of cost savings brought about by fluoridation are discussed.

Child↗

PubMed1993

Determinants of variation in dental caries experience in primary teeth of Hong Kong children aged 6-8 years.

A representative sample of Hong Kong children aged 6-8 yr was examined for dental caries, and data on possible explanatory variables for dmft were obtained from questionnaires. Variation in dmft was partially accounted for by the effect of some demographic variables and other variables having a socioeconomic base. Girls had a lower dmft index than boys, and being born in Hong Kong rather than elsewhere (that is, China) was also associated with a lower dmft index. Better dental status was strongly associated with increasing educational level of the mother, monthly household income, and with an increasingly positive perception of the questionnaire respondent's own dental status. Preschool dental visits and enrollment in the School Dental Care Service were associated with higher dmft indices. Altogether, 22.5% of the variance in dmft was explained. It was concluded that: 1) demographic and socioeconomic factors significantly affect dmft variation in Hong Kong. 2) the mother's role in determining the dental status of her child is probably important, and 3) further elucidation of the variation in dmft will depend on the analysis of data pertaining to dietary and oral hygiene practices during the preschool years and to an analysis of tooth morphology, fluoride exposure, and microbiologic, salivary, and genetic factors.

Analysis of Variance↗

PubMed2000

Hepatitis C infection and associated oral health problems.

Hepatitis C infection is widespread throughout the community. This study aimed to assess the status of oral health of persons infected with hepatitis C. DMFT and CPITN indices were recorded at a clinic providing priority dental care for people with hepatitis C infection. The data were compared with information from an existing survey of general dental patients. Social impact was assessed using a modified Oral Health Impact Profile questionnaire. The DMFT index differed significantly between hepatitis C and general patients. The number of decayed and missing teeth was greater in those infected with hepatitis C for all patients aged between 25 and 50 years. Although there was no significant difference in CPITN categories for subjects evaluated, a marked trend for poor periodontal health was noted for those individuals with hepatitis C. Salivary flow was reduced in 50 per cent of hepatitis C infected subjects. Social impact was significantly affected with 71 per cent of hepatitis C subjects reporting painful aching in the mouth and 56 per cent having difficulty in relaxing. In conclusion, the results from the project strongly indicate an urgent need for priority delivery of dental care for people with hepatitis C infection.

Adolescent↗

PubMed2005

Caries experience and status in school-age children residing in four North Italian communities.

PURPOSE: The aim of this paper was to describe the caries experience in four North Italian areas. The areas selected were four North Italian medium-sized cities: San Remo located in western Liguria, Ferrara in Emilia, and Varese and Melegnano (Milan suburbs). MATERIALS AND METHODS: 1104 subjects (560 males and 544 females) were examined. Several dental outcomes were used: DMFT Index and SiC index following WHO recommendations; and the caries experience ratio; the percentage of children with high caries disease and with rampant caries was calculated as the percentage of subjects with DMFT > 0, DMFT > or = 4 and DMFT > or = 7. RESULTS: Mean DMFT ranged from 1.21 +/- 1.65 in the Ferrara group to 1.83 +/- 2.49 in San Remo. Among the groups, statistically significant differences were observed for DT and DMFT (p = 0.04 and p = 0.01 respectively). The SiC index was 3.75 +/- 1.87, 3 (2-5) in all samples, with significant differences among the four areas (p = 0.04). No statistical differences were observed among the four areas regarding caries experience and the proportion of children with high and rampant caries. An elevated proportion of subjects with high caries (DMFT > or = 4) was noted in the San Remo group (22.9%). The distribution of children by gender according to DMFT levels was not statistically significant either. The F/DMFT ratio was similar in the survey areas, from 0.30 in San Remo, 0.38 in Varese and Ferrara, to 0.40 in the Milan suburbs. CONCLUSION: Information drawn from this study can be helpful to describe and plan future dental prevention programmes aimed at reducing caries experience and promoting better oral health level.

Analysis of Variance↗

PubMed2004

Assessment of different methods for diagnosing dental caries in epidemiological surveys.

AIMS: The aims of the study were: (i) to assess different clinical diagnostic methods of dental caries during epidemiological surveys; (ii) to determine which combinations of methods and diagnostic adjuncts show the best performances in epidemiological surveys when compared with examinations performed in a traditional dental setting (standard); (iii) to evaluate the influence of including noncavitated (NC) lesions in dental caries estimation. METHODS: Forty 12-year-old children were divided into low and moderate caries prevalence groups. The individuals were submitted to 12 epidemiological examinations (in an outdoor setting), which combined three methods (blade, mirror and mirror + CPI (Community Periodontal Index) dental probe) with or without diagnostic adjuncts (previous dental brushing and dental drying). The last examination was performed in a traditional dental setting (standard examination). The unit of measure was the DMFS (decayed, missing and filled surfaces) index according to WHO criteria. The variance analysis, Dunnet's and Tukey's tests were applied. RESULTS: For the DMFS analysis, the visual/tactile method, with or without diagnostic adjuncts, was the best method for both groups, presenting a performance higher than 90% when compared with the standard examination, except for the examinations without previous dental brushing for the low caries prevalence group. Previous dental brushing was more relevant than dental drying (P = 0.0054). All of the epidemiological examinations underestimated the NC diagnosis even with the association of diagnostic adjuncts when compared with the standard examination. CONCLUSION: The visual-tactile (for both groups) and the visual (mirror) methods plus dental brushing (for the moderate group) are appropriate for diagnosing cavitated lesions, but not NC lesions.

Analysis of Variance↗

PubMed2004

Association between functional dental state and dietary intake of Chinese vegetarian old age home residents.

OBJECTIVE: To examine the association between dental functional status and dietary intakes of Chinese vegetarian old age home residents. SUBJECTS AND METHODS: A cross-sectional survey was performed in a group of 76 older vegetarian Chinese women living in an old age home. Oral examination was performed by a dental surgeon. Sixty-eight of them had a 24-hour food record by direct observation, analysed by a Chinese food composition table. Nutritional status was measured by Body Mass Index (BMI), and the functional status by modified Barthel Index (BI). RESULTS: Forty-two subjects (55.3%) were edentulous; 59 subjects (77.6%) had chewing difficulties; 35 subjects (46%) had poor dental functional status defined by having five or less functional teeth unit (FTU). When compared with those older people with better dental functional status, the poor dental functional status group was more likely to have chewing difficulties, tolerate soft diet only, and be functionally dependent (BI < 15/20). Poor dental functional status was associated with lower mean daily fibre intake, but not with intakes of macronutrients and micronutrients, after adjustment by BI categories. CONCLUSION: Poor dental functional status is associated with impaired chewing and lower fibre intake in Chinese vegetarian old age home residents, but it is not associated with reduced intakes of macronutrients or micronutrients.

Activities of Daily Living↗

PubMed1997

Caries prevalence and periodontal treatment needs in public and private school pupils in Jordan.

A total of 886 pupils aged 15-16 years selected from 20 public and 10 private schools in northern Jordan were investigated for frequency of toothbrushing and sweet consumption, dental caries and periodontal treatment needs. A questionnaire and clinical examination were used utilising decayed-missing-filled teeth (DMFT) code and the Community Periodontal Index of Treatment Needs (CPITN), respectively. Results revealed that 35.5 per cent of public and 57.1 per cent of private school pupils reported to brush their teeth regularly while the majority of them frequently consumed sweets. There were slight differences in caries experience amongst public and private school pupils, as measured by DMFT (4.74: 4.95). While bleeding and calculus scores were prevalent in pupils of both types of schools, they were slightly higher in pupils of public schools than those in private schools. Both shallow and deep pathological pockets were found in fewer numbers (6.09 per cent) in pupils in public schools only. Oral hygiene instruction and scaling were the predominant periodontal treatment needs in both types of schools. However, the treatment needed by pupils in public schools was higher than those in private schools. Complex treatment was rarely needed by public school pupils only.

Adolescent↗

PubMed2006

A comparative study of oral health status in a migrant/Japanese sample.

OBJECTIVES: The aim of this study was to compare the oral health status of migrants to Japan with that of Japanese using the questionnaire and the Oral Health Status Index (OHSI). METHODS: The questionnaire for collecting demographic and behavioral variables and the OHSI were applied in a mixed migrant/Japanese sample of patients from a dental clinic in Yokohama. A sample of 224 subjects, 52% of whom were migrants, was selected from new patients. RESULTS: The mean OHSI scores were 78.56 for migrants and 83.16 for Japanese (p<0.01). Multiple regression analysis of OHSI showed that the statistically significant contributors were: age, status (migrants / Japanese), reason for initial visit, perceived oral health, and flossing behavior. CONCLUSION: The oral health status of migrants was worse than that of Japanese even though they were younger than Japanese. The present public support system for foreign patients and their self-care behavior were considered to be the factors for the inequity in oral health status.

Adolescent↗

PubMed1995

The dental health of 3-year-old children in east Cumbria 1993.

A study of the dental health of 135 3-year-old children, with reference to social class group, was undertaken in East Cumbria District between September and December 1993. Caries free subjects numbered 110 (81.5 per cent), the mean number of decayed, missing, and filled teeth was 0.59; the value of the decayed component of the dmft index was 0.49. Caries experience was confined to 25 (18.5 per cent) individuals whose mean dmft was 3.20, seven of these subjects experienced rampant decay to the maxillary incisor teeth and three had received a dental general anaesthetic. An inverse relationship was demonstrated between dental caries and social class. Trauma to the maxillary incisors had occurred in 17 (12.6 per cent) children, with discolouration and fracture of the enamel and dentine the most prevalent types of injuries sustained. A relatively high proportion of the subjects, 39 (28.9 per cent), had experienced erosion to palatal surfaces of the maxillary incisors. The most prevalent type of erosion was that involving both enamel and dentine. Only 14 (10.4 per cent) children examined used fluoride supplements in this low-fluoride area; 98 (72.6 per cent) subjects reported registration with a dentist.

Cariostatic Agents↗

PubMed1996

Effects of a chlorhexidine varnish on the gingival status of adolescents.

The purpose of this blind study was to determine the effect of a two-stage chlorhexidine varnish, after three months, on the gingival status of 11- to 15-year-old children attending a school in Rio de Janeiro, Brazil. Subjects participating in the study were randomly allocated to control (C) and treatment (T) groups, n = 53 and n = 57, respectively. All subjects were matched at baseline on age, salivary levels of mutans streptococci, and caries scores. After elimination of carious lesions, a prophylaxis was given to both groups. The chlorhexidine varnish was then painted on the entire dentition of Group T subjects only. Prior to caries elimination, and again after three months, the gingival index was used to assess the gingival status of study subjects. An average of 106.6 +/- 8.9 and 107.7 +/- 6.2 gingival sites per subject (four sites per tooth) in Groups C and T, respectively, were examined by the same calibrated examiner on two occasions. For statistical purposes, data were dichotomized [(0,1) (2,3)] for the gingival index. Independent t-tests and paired t-tests were used to analyze the data. The percentage of sites per subject with scores of two or three at the baseline were balanced between study groups (3.7 +/- 7.1 for T; 1.8 +/- 3.2 for C; p = 0.08). After three months, a statistically significant decrease in the average percentage of sites with scores of two or three was demonstrated in the T group (0.7 +/- 2.4, T, p < 0.0001; 1.3 +/- 3.0, C, p < 0.25). The authors concluded that the application of a chlorhexidine varnish significantly improved the gingival health of T subjects for up to three months. A significant improvement in the gingival health could not be demonstrated in the C group.

Adolescent↗

PubMed1990

Occurrence of periodontitis in an urban adolescent population.

The presence of periodontitis in 307 black, Hispanic, and Asian students age 12 to 15 years was evaluated by calibrated examiners in a Los Angeles inner city junior high school. The periodontal status of maxillary and mandibular incisors and permanent first molars was evaluated using the Plaque Index, probing depth, attachment loss, bleeding on probing, tooth mobility, presence of calculus, and caries. Thirty-nine (12.7%) of 307 students had 5 mm or deeper probing depths and associated attachment loss of at least 2 mm and were considered to have periodontitis (PD). The PD group had significantly more bleeding, calculus, and missing teeth than the non-PD group, but both groups had moderate to severe plaque accumulation. The distribution and severity of disease increased with age. Deeper probing depths were associated with the molar teeth and six (15.4%) of the 39 subjects in the PD group had furcation involvement. Clinical screening alone was not sufficient to determine if the periodontitis seen was localized juvenile periodontitis; however, the program detected a high occurrence of periodontitis in this population group.

Adolescent↗

PubMed2001

Analysis of caries status development in relation to socio-economic variables using a case-based system.

The aim of this study was to detect, using case-based reasoning (CBR) induction methods in time series analysis, how measurable socio-economical adjustments were related to the caries status development. The study concerned the year classes leaving the organised dental care for the time period 1987-95, and had received dental care at the Public Dental Service of Göteborg. The results, as presented by a caries incidence index, indicated that at least one socioeconomical factor, individuals seeking employment, was of importance for the caries status development, a factor with an increase of considerable proportions since 1990. The findings indicated that the other socio-economic variables used did not have the same importance for the caries status development. One feasible explanation is that these factors reflect more upon the social family situation than the economical. If the caries status reflects the social situation of the individual more than the economical, this argument will elucidate the reasoning. Using CBR for the analysis of relationships between oral disease and parameters possibly influencing health development has proven to be a valuable tool and complement to more traditional statistical methods. The analysis can make relationships explicit through the hierarchic knowledge trees and also show redundant information, attributes not appearing in the trees.

Adult↗