Early childhood caries and its associated factors among 5-years-old Myanmar children

IntroductionChildren's oral health plays a crucial role in their overall well-being and there is a significant gap in our understanding of early childhood caries (ECC) in Myanmar. This study aims to bridge this knowledge deficit by investigating the prevalence, causes, and potential interventions for ECC in the Myanmar population, providing crucial insights for future dental health policies and practices.MethodsGenerally healthy 5-year-old kindergarten children from 7 districts in city were recruited. ECC was assessed through clinical examinations using decayed, missed, filled teeth (dmft). Additionally, demographic data of the children and their caregivers, along with information about the children's oral health-related behaviors, were gathered using a structured questionnaire.ResultsOut of the 496 children, the overall prevalence of dental caries was 87.1% (mean dmft score: 5.57, SD: 4.6). Caries experience was categorized as severe (45.8%) and non-severe (41.3%). Decayed teeth constituted the major component of the dmft index (97.8%). Multiple logistic regression analysis revealed two significant factors associated with ECC prevalence: late toothbrushing initiation (OR: 2.54, p = 0.001) and dental visit experience (OR: 2.46, p = 0.010).DiscussionThe study highlights the alarming ECC prevalence in 5-year-old children in Mandalay, Myanmar, with mostly untreated decayed teeth. The findings emphasize early preventive oral health measures for young children to reduce ECC burden in Myanmar

A scoping review on the links between sustainable development goal 14 and early childhood caries

DATA AVAILABILITY : All data generated or analysed during this study are included in this published article.CORRECTION: BMC Oral Health 23, 881 (2023). https://doi.org/10.1186/s12903-023-03650-3. In this article [1], the affiliation details for Prof. Ola B. Al-Batayneh were incorrectly given as “1 and 6” only (1. Early Childhood Caries Advocacy Group and 6. Preventive Dentistry Department, Jordan University of Science and Technology, Irbid, Jordan) but should have been “1, 6 and 7” (1. Early Childhood Caries Advocacy Group, and 6. Department of Orthodontics, Pediatric and Community Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, PO Box 27272, United Arab Emirates and 7. Preventive Dentistry Department, Jordan University of Science and Technology, Irbid, Jordan).BACKGROUND : The Sustainable Development Goal (SDG) 14 addresses life below the waters, an important source of protein and contributor to global food security and economic development. Our aim was to explore possible evidence on the links between life below water and early childhood caries (ECC). METHODS : This scoping review identified articles on the link between life below water and caries according to the PRISMA-ScR guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were systematically searched in January 2023, using specific search terms. Studies written in English, with full text available, addressing life under water, focusing on dental caries in humans, with results that can be extrapolated to control ECC in children less than 6 years of age were included in the review. Descriptive statistics were used to summarize the retrieved papers and graphical presentation was used for visualization. RESULTS : There were 224 publications retrieved of which 13 studies, published between 1960 and 2022, were included in the analysis. The papers originated from Asia (7/13), North America (3/13), Europe (1/13), and 2/13 had multi-country authorship. Also, four laboratory studies extracted agents from marine products to determine their efficacy in preventing caries formation and preventing/slowing plaque formation; four letters discussed the caries prevention potential of sea salt as a source of fluoride; and two review articles about the positive effects of extracted marine products for caries prevention. Most (11/13) studies addressed target 14.1 concerned with enriching the marine environment with nutrients and minerals; two addressed target 14.4 focused on ensuring fish stocks are within biologically sustainable levels; two addressed target 14.7 aimed at increasing the economic benefits through sustainable use of marine resources such as fisheries; and one focused on target 14.5 aimed at conserving marine areas by increasing protected areas. In addition, one ecological study assessed the association between the ecosystem and ECC. CONCLUSIONS : Currently, there is little known about the impact of protection of marine and coastal ecosystem from pollution and ocean acidification on the risk of ECC. Further evidence on possible associations between life below water and ECC management is needed.https://bmcoralhealth.biomedcentral.comhj2024Community DentistrySDG-14:Life below wate

Scoping review on the link between economic growth, decent work, and early childhood caries

AVAILABILITY OF DATA AND MATERIALS : The datasets used and/or analysed for the study are publicly accessible.BACKGROUND : Early Childhood Caries (ECC) is a prevalent chronic non-communicable disease that affects millions of young children globally, with profound implications for their well-being and oral health. This paper explores the associations between ECC and the targets of the Sustainable Development Goal 8 (SDG 8). METHODS : The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to economic growth, decent work sustained economic growth, higher levels of productivity and technological innovation, entrepreneurship, job creation, and efforts to eradicate forced labor, slavery, and human trafficking and ECC all of which are the targets of the SDG8. Only English language publications, and publications that were analytical in design were included. Studies that solely examined ECC prevalence without reference to SDG8 goals were excluded. RESULTS : The initial search yielded 761 articles. After removing duplicates and ineligible manuscripts, 84 were screened. However, none of the identified studies provided data on the association between decent work, economic growth-related factors, and ECC. CONCLUSIONS : This scoping review found no English publication on the associations between SDG8 and ECC despite the plausibility for this link. This data gap can hinder policymaking and resource allocation for oral health programs. Further research should explore the complex relationship between economic growth, decent work and ECC to provide additional evidence for better policy formulation and ECC control globally.https://bmcoralhealth.biomedcentral.comhj2024Community DentistrySDG-08:Decent work and economic growt

A scoping review on the association of early childhood caries and maternal gender inequality

AVAILABILITY OF DATA AND MATERIALS : All data generated or analysed during this study are included in this published article.AIM : The objective of this scoping review is to present current evidence regarding the association between early childhood caries (ECC) and maternal-related gender inequality. METHODS : Two independent reviewers performed a comprehensive literature search using three databases: EMBASE, PubMed, and Web of Science. Literature published in English from 2012 to 2022 was included in the search and was restricted to only primary research by using the following key terms: "dental caries", "tooth decay", "gender", "sex", "preschool", "toddler," and "infant". The included studies were limited to those reporting an association between ECC and maternal aspects related to gender inequality. Titles and abstracts were screened, and irrelevant publications were excluded. The full text of the remaining papers was retrieved and used to perform the review. The critical appraisal of selected studies was guided by the Joanna Briggs Institute (JBI) Critical Appraisal Tools. RESULTS : Among 1,103 studies from the three databases, 425 articles were identified based on publication years between 2012 and 2022. After full-text screening, five articles were included in the qualitative analysis for this review. No published study was found regarding a direct association between ECC and maternal gender inequality at the level of individuals. Five included studies reported on the association between ECC and potential maternalgender- related inequality factors, including the mother’s education level (n = 4), employment status (n = 1), and age (n = 1). Regarding the quality of the included studies, out of five, two studies met all JBI criteria, while three partially met the criteria. CONCLUSIONS : Based on the findings of this scoping review, evidence demonstrating an association between gender inequality and ECC is currently limited.Health and Medical Research Fund, Hong Kong.https://bmcoralhealth.biomedcentral.comam2024Community DentistrySDG-05:Gender equalit

Oral Health Policies to Tackle the Burden of Early Childhood Caries: A Review of 14 Countries/Regions

Aim: Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions.Method: Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country.Results: The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to population ratio was reported by Nigeria at 1:48,400, whereas the highest ratio was in Brazil (1:600). Out of 14, three (21%) countries namely India, Venezuela and Cambodia had no national oral health policies addressing ECC and four (29%) countries (Cambodia, China, India, Venezuela) had no publicly funded dental care program for 0–5-year-old children. Water fluoridation is available in four countries/regions (Australia, Brazil, Hong Kong, USA).Conclusion: ECC remains a global health challenge and dental workforce is limited. National/regional programs to tackle ECC are not yet prioritized in many countries/regions. Evidence to support demonstration projects is limited. Further research on the cost-effectiveness of interventions strategies is required for policymakers

Global Oral Health Policies and Guidelines: Using Silver Diamine Fluoride for Caries Control

Silver diamine fluoride (SDF) was developed in Japan in the 1960s. It is a clear solution containing silver and fluoride ions. Because of its anti-bacterial and remineralizing effect, silver diamine fluoride has been used in managing dental caries for decades worldwide. This paper aims to summarize and discuss the global policies, guidelines, and relevant information on utilizing SDF for caries management. SDF can be used for treating dental caries in most countries. However, it is not permitted to be used in mainland China. Several manufacturers, mainly in Australia, Brazil, India, Japan, and the United States, produce SDF at different concentrations that are commercially available around the world. The prices differ between contents and brands. Different government organizations and dental associations have developed guidelines for clinical use of SDF. Dental professionals can refer to the specific guidelines in their own countries or territories. Training for using SDF is part of undergraduate and/or postgraduate curriculums in almost all countries. However, real utilization of SDF of dentists, especially in the private sector, remains unclear in most places because little research has been conducted. There are at least two ongoing regional-wide large-scale oral health programs, using SDF as one of the components to manage dental caries in young children (one in Hong Kong and one in Mongolia). Because SDF treatment does not require caries removal, and it is simple, non-invasive, and inexpensive, SDF is a valuable strategy for caries management in young children, elderly people, and patients with special needs. In addition, to reduce the risk of bacteria or virus transmission in dental settings, using SDF as a non-aerosol producing procedure should be emphasized under the COVID-19 outbreak.</p

A randomized clinical trial on arresting dentin caries in preschool children by topical fluorides

Introduction: Silver diammine fluoride (SDF) has been found to be effective in preventing and arresting dental caries in children. The annual or semi-annual application of SDF may not be practical in migratory populations or effective high caries risk patients. So far, no data are available about the effectiveness of intensive fluoride treatment in arresting dental caries in primary teeth. Objectives: This study aimed to compare the effectiveness of three topical fluoride application protocols in arresting dentin caries in primary teeth of preschool children. Methods: Children aged 3-4 years who had at least one active dental caries lesion were clinically examined by a trained examiner. The visible plaque index (VPI), the dmfs index, extent of carious lesion (ICDAS codes 3-6), color of lesion and presence of plaque on lesion were recorded. After examination, the study children were randomly allocated into three intervention groups: Group 1 – annual application of 30% SDF solution; Group 2 - three applications of 30% SDF solution at weekly intervals; and Group 3 - three applications of 5% sodium fluoride (NaF) varnish at weekly intervals. Information about the children’s background, and oral health related behaviors was collected by a parental questionnaire. The masked examiner carried out follow-up examinations every 6 months. For cavitated dentin lesions (ICDAS code 5 or 6 at baseline), lesions with smooth and hard surfaces were classified as arrested caries. For established carious lesions (ICDAS 3 or 4 at baseline), caries arrest was recorded if they did not progress to cavitated dentin carious lesion. Results: A total of 371 children with 2526 tooth surfaces with active caries lesions received treatment at baseline. After 24 months, 316 children (85%) remained in the study. Of the children remaining, 61% had received only the assigned fluoride treatments provided in the study, while 39% of them had received dental treatments from other dentists. For cavitated dentin lesions, the caries arrest rates among the children receiving only the assigned fluoride treatment were 37%, 35% and 27% for Groups 1, 2 and 3, respectively (p=0.04), while for the children receiving other dental treatments, no significant differences in caries arrest rates between the three groups were observed. The results of multi-level survival analysis showed that the arrest times of dentin caries in both SDF groups were significantly shorter than those of the NaF varnish group. For established carious lesions, the caries arrest rates were 50%, 48% and 54% in Groups 1, 2 and 3, respectively. No statistically significant differences were found among three groups. Presence of plaque on lesion, tooth type, tooth surface and extent of the caries lesion had significant effects on caries arrest rates. Conclusions: For cavitated dentin carious lesions, application of SDF solution, either 3 weekly applications at baseline or annual application, can arrest active dentin caries in primary teeth faster than 3 weekly applications of NaF varnish at baseline. However, for established carious lesions, the three fluoride application protocols are equally efficient in controlling established carious lesions.published_or_final_versionDentistryDoctoralDoctor of Philosoph

Risk Factors of Dental Caries in Preschool Children in Thailand: A Cross-Sectional Study

Dental caries remains prevalent in young children. This study determined dental caries prevalence and risk factors associated with caries experience in Thai preschool children. Five kindergartens in Samut Sakhon Province were evaluated. Preschool children (4- to 5-year-old children) were recruited. The participants’ parents completed a questionnaire regarding their children’s demographic and socio-economic backgrounds and their oral health-related behaviors. Dental caries status and oral hygiene were recorded using the decayed, missing, and filled teeth index (dmft) and visible plaque index (VPI), respectively. In total, 308 children completed the oral examination (93.9% response rate). The mean age of the children was 5.1 ± 0.5 years old. Among them, 249 children (80.8%) had dental caries (dmft > 0) and their mean dmft score (SD) was 8.2 (4.7). The children’s age, VPI, primary caregiver, age of starting tooth brushing, assisted tooth brushing, and mother’s education level were significantly associated with dental caries (X2test, p p < 0.05). Caries prevalence was high among the evaluated Thai preschool children. The child’s age, visible dental plaque, and mother’s educational level are significant risk factors for dental caries

Is Silver Diamine Fluoride Effective in Arresting Enamel Caries? A Randomized Clinical Trial

Background: There is limited information on the effectiveness of 38% silver diamine fluoride (SDF) in managing enamel caries. Objective: This study aimed to compare effectiveness of 38% SDF and 5% Sodium fluoride (NaF) varnish in arresting enamel caries in young children when applied semiannually over 18 months. Methods: A randomized controlled trial was conducted on children aged 1&ndash;3 years who had at least one active carious surface. They were allocated into two groups: Group 1 (38% SDF) and Group 2 (5% NaF varnish). Visual-tactile examination was used to assess extent of carious lesions. Enamel caries that did not progress to dentin were classified as having caries arrest. Intention-to-treat analysis was performed. Results: At baseline, 290 children with 1974 tooth surfaces with enamel caries were recruited. Caries arrest rates at the tooth surface level in Group 1 and Group 2 were 59.1% and 58.8%, respectively (p = 0.873), at 18 months. The multilevel logistic regression analysis revealed that tooth position, tooth surface, extent of enamel caries at baseline, caries experience, and brushing with fluoride toothpaste influenced caries arrest (p &lt; 0.05). Conclusion: The semiannual application of 38% SDF and 5% NaF varnish had comparable effectiveness in arresting enamel caries in primary teeth

Cross-cultural adaptation and psychometric properties of the Myanmar version of the scale of oral health outcomes for 5-year-old children.

ObjectiveThe aim of this study was to cross-culturally adapt the child's self-report and parental report of the scale of oral health outcomes for 5-year-old children (SOHO-5) for use in Myanmar (Burmese-speaking) population and to assess the reliability and validity of the Myanmar version.Materials and methodsThe forward-backward translation method was used to develop the Myanmar SOHO-5 version and the final questionnaires were tested on 173 five years old children and their parents for reliability and validity. A single dentist examined the caries experience of the children (Kappa:0.90). The structural validity was assessed through confirmatory factor analysis. The internal consistency and test-retest reliability (1-2 weeks) were evaluated using Cronbach's alpha and intraclass correlation coefficient (ICC), respectively. The association between SOHO-5 scores and additional global rating questions for child oral health status (convergent validity) and the differences between the total SOHO-5 score of children with caries and children without caries (discriminant validity) were investigated.ResultsA confirmatory factor analysis indicated a good fit for the one-factor structure of the SOHO-5. Cronbach's alpha coefficient values for internal consistency were 0.82 for the children's report and 0.79 for the parental report. The ICCs were 0.90 and 0.89 for the total scores of the children and parental versions in the test-retest reliability analysis. The total SOHO-5 scores for both reports were significantly associated with the global rating questions except for the 'impact on children's general health' question in the parental report. Furthermore, the Myanmar version discriminated between the children with and without caries experiences (p ConclusionThis study provided evidence that both children and parental reports of the Myanmar SOHO-5 version have good reliability and validity to assess the OHRQoL of 5-year-old children in a Burmese-speaking population