Betydelsen av bitewingundersökning i kombination med klinisk undersökning bland 15 åriga barn i Da Nang, Vietnam

Syfte: Att enbart jämföra klinisk undersökning med klinisk undersökning i kombination med bitewingundersökning avseende initial och manifest approximalkaries på premolarer och molarer hos 15-åriga barn i Da Nang, Vietnam. Metod och material: En tvärsnittsstudie. Röntgenbilder har använts som material i denna studie. Studien bygger delvis på kliniskt insamlat material från en randomiserad epidemiologisk studie. Studien bestod av sammanlagt 200 slumpmässigt utvalda 15-åriga deltagare. Undersökningen bestod av fyra röntgenbilder med bitewingteknik. Studien fokuserar på mesiala och distala ytor på premolarer och molarer. Resultat: Vid jämförelse av klinisk undersökning med bitewingundersökning hittades ytterligare 152 approximala initiala kariesangrepp respektive 71 approximala manifesta kariesangrepp vid bitewingundersökningen. Total kariesprevalens på molarer och premolarers alla ytor visar ett medelvärde för initialkaries på 2,1 ytor per barn och vid manifest karies ett medelvärde på 4,6 ytor per barn vid klinisk undersökning i kombination med bitewing. Karies förekom oftast på bettets första molarer vid klinisk undersökning och bitewingundersökning. En statistisk signifikant skillnad, p-värde <0,001 fanns mellan klinisk undersökning och klinisk undersökning i kombination med bitewingundersökning av approximal initial och manifest karies. Slutsatser: En kombinerad undersökningsstrategi (klinisk undersökning och bitewingundersökning) är säkrare som metod vid undersökning av initial och manifest approximal karies. Title: The importance of radiographic examination (bitewing) combined with clinical examination of 15-year old children in Da Nang, Vietnam. Aim: Comparing only clinical examination with clinical examination combined with radiographic examination (bitewing) in initial and manifest proximal caries on premolars and molars of 15-year-old children in Da Nang, Vietnam. Methods: A cross-sectional study. X-ray images were used as material in this study. This study includes partly data from a randomized epidemiological study. The subjects were 200 children, 15 years old. A set of standard posterior bitewing radiographs was taken. Two surfaces (mesial and distal approximal surfaces) of premolars and molars were noted and recorded. Results: On comparing clinical examination findings with radiographic examination, radiographic examination found an additional 154 approximal initial surfaces and 71 approximal manifest surfaces that were not evident clinically. Caries prevalence of molars and premolars on all surfaces with clinical examination combined with radiographic examination showed a mean value of 6,8 decayed surfaces per child. The proximal surfaces most often affected by caries at the radiographic and clinical examination were the first molars. A statistically significant difference, p-value < 0,001 was when comparing the clinical examination alone and clinical examination combined with radiographic examination of proximal initial and manifest caries lesions. Conclusions: The use of bitewing radiographs combined with careful clinical examination is of great advantage in detection of proximal initial and manifest caries of premolars and molars in children.

Dental care professionals' awareness of oral dryness and its clinical management : a questionnaire-based study

Background: Despite the high prevalence of oral dryness and awareness of its complications, there is limited research on the clinical management of patients with oral dryness in general dental care. Purpose: To (1) describe and compare awareness among dental care professionals regarding saliva functions, potential causes and complications of oral dryness, and patient management (2) Investigate if the length of professional experience influences these aspects. Methods: A digital self-administrated survey was sent to 2668 dental care professionals working in the general dental care, Public Dental Service, in Sweden. Twelve dental care professionals reviewed the questionnaire prior to its distribution. The questionnaire comprised 32 questions about patient management, awareness of saliva functions, causes and complications of oral dryness, and self-assessment queries. Results: The response rate was 18.6% (241 dentists and 257 dental hygienists). Older adults (65+) were asked more often about dry mouth (93.0%) compared to those aged 18-23 years (50.0%) and those under 18 years (24.9%). Dental hygienists encountered individuals with oral dryness more frequently (61.1%) than dentists (48.5%) (p < 0.01), and more often asked individuals in the age groups 18-23 years (p = 0.003), 24-40 years (p = 0.045), and 41-65 years (p = 0.031) about dry mouth. A higher proportion of dental hygienists (88.3%) than dentists (51.0%) had measured salivary secretion rate, (p < 0.001) and more often suggested preventive dental care 3-4 times a year, (42.5% vs. 30.5%) (p < 0.007). Dentists had a higher awareness of saliva functions, while dental hygienists had a higher awareness about causes and complications of oral dryness. Higher proportions of dentists and dental hygienists with over 10 years of professional experience had measured salivary secretion rate (69.1% vs. 95.7%) compared to their counterparts with less than 10 years of professional experience (35.9% vs. 79.5%) (p < 0.001 for both). Conclusion: Compared to dentists, dental hygienists were more attentive to patients with oral dryness as they encountered these individuals more often, asked more age-groups, suggested frequent preventive measures, and had higher awareness of the causes and complications of oral dryness. Length of professional experience could improve both the management of patients with oral dryness and awareness of its causes, particularly for dental hygienists