Dental Health in Primary Teeth after Prevention of Mother-Child Transmission of Mutans Streptococci. A Historical Cohort Study on Restorative Visits and Maternal Prevention Costs

Mutansstreptokokkitartunnan ehkäisemisen pitkäaikaisvaikutukset maitohampaiden terveyteen. Kohorttitutkimus korjaavan hoidon määrästä ja kariesehkäisyn kustannuksista. Tutkimuksen tarkoituksena oli selvittää varhaisen mutansstreptokokki (MS)-kolonisaation ehkäisyn pitkäaikaisvaikutuksia korkean kariesriskin omaavien lasten maitohampaistossa sekä tarkastella MS-tartunnan estämisen kustannuksia. Tiedot lasten hampaiden terveydestä ja hammashoitotoimenpiteistä syntymästä 10-vuotiaaksi sekä äiteihin kohdistuneen kariesehkäisyn kustannuksista kerättiin Ylivieskan terveyskeskuksen asiakirjoista. Tutkimuksessa oli mukana yhteensä 507 lasta, heistä 148 oli osallistunut aikaisempaan Ylivieskan äiti-lapsitutkimukseen, jossa verrattiin äitien käyttämän ksylitolipurukumin ja äidille tehtyjen fluori- tai klooriheksidiinilakkausten vaikutusta pikkulasten hampaiden terveyteen. Maitohammaskariesta esiintyi 10-vuotiaaksi asti merkitsevästi vähemmän lapsilla, jotka eivät olleet saaneet MS-tartuntaa alle 2-vuotiaana, heidän maitohampaansa säilyivät 3,4 vuotta kauemmin täysin ehjinä (p<0.001) ja he tarvitsivat vähemmän maitohampaiden korjaavaa hoitoa (p=0.005) kuin lapset, joiden hampaisto oli kolonisoitunut MS-bakteerilla jo 2-vuotiaana. Koska ksylitoliryhmän lasten MS-kolonisaatio oli vähäisintä, heidän maitohampaissaan oli vähemmän kariesta ja korjaavan hoidon tarvetta kuin kahden muun korkeariskisen ryhmän lapsilla. Äitien käyttämän ksylitolipurukumin kustannukset olivat yhteensä 116 euroa ja lapsen maitohampaiden säilyminen täysin ehjinä vuoden pidempään maksoi 37 euroa. Kun MS-tartunta oli saatu estettyä, korkean kariesriskin omaavien lasten hampaiden terveys oli samalla tasolla kuin keskimäärin koko ikäkohortilla. Lapsen maitohampaat säilyvät terveinä pidempään ja korjaavan hoidon tarve vähenee, kun MS-kolonisaatio alle 2-vuotiaana saadaan estettyä. Lapsen MS-kolonisaatio vähenee merkitsevästi, kun äiti käyttää ksylitolipurukumia lapsen ollessa 0-2 vuoden ikäinen, siten pikkulapsen äidin säännöllinen ksylitolipurukumin käyttö saattaa olla julkisen tereydenhuollon kannalta tarkoituksenmukainenterveyttä edistävä menetelmä.The study aimed to examine the long-term effects of the inhibition of early mutans streptococci (MS) colonization on the health and on the amount of restorative treatment of primary teeth in assumed high-caries-risk children. Furthermore, the costs of maternal use of xylitol in relation to the timing of children’s dental decay were evaluated. The annual data on the dental health, dental treatments and costs of maternal caries prevention were gathered from the files in Ylivieska Public Health Care Centre. Altogether 507 study subjects included 148 participants in the Ylivieska mother-child study, which had compared maternal use of xylitol with maternal chlorhexidine or fluoride varnish treatments in assumed high-caries-risk subjects. The children who had not been colonized by MS at 2 years of age maintained their primary teeth as caries-free 3.4 years longer (p<0.001), had significantly lower caries experience in their primary teeth until 10 years of age, and needed less restorative treatment (p=0.005) in their primary teeth until 10 years of age than MS-colonized children. With the lowest MS colonization figures, the children in the xylitol group had lower figures in caries experience and number of restorative treatment visits than the other two intervention groups. The costs of the maternal prevention programme with xylitol chewing gum were 116 euros; thus the costs for each additional caries-free year in the child were 37 euros. The prevention of MS transmission reduced caries occurrence figures in assumed high-risk children to the same level as the average figures for the whole age cohort. The inhibition of early MS colonization seems to lead to long-term effects on caries experience and need for restorative treatment in primary teeth, and may offer a new strategy for control of caries in public dental care. The maternal use of xylitol chewing gum in children’s caries prevention might be cost-effective when the xylitol chewing gum is purchased in large wholesale amounts by the public dental care.Siirretty Doriast

Frequent consumption of sugar-sweetened beverages and sweets starts at early age

Objectives: We aimed to investigate the habitual consumption of sugar-sweetened beverages (SSBs) and sweets in relation to mothers' behaviours and practices with their infants. Methods: We targeted mothers with children 1-24 months (N=200) visiting Public Child Health clinics in Finland. During routine visits mothers (N=179) volunteered to complete a self-administered anonymous questionnaire about their child's health-related behaviours (consumption of sweets and SSBs, tooth brushing frequency). The questionnaires also included questions about the mothers' background (age, education) and health-related behaviours (consumption of sweets, tooth brushing frequency and smoking habits). The children were categorised by age, and Chi-squared tests, Fischer's exact test, ANOVA and correlation coefficient served for the statistical analyses. Results: Of those under 6 months, almost half (44%) received SSBs, and 45% of them more than once a week. Their use gradually increased by age such that by 19-24 months, all received SSBs at least sometimes, and 56%, frequently. Fewer than half of the mothers (33-43%) gave sweets to their children between the ages of 10-15 months, but 92% by the age of 2 years. Children's twice-a-day tooth brushing increased from 14% to 33%. The child's age and tooth brushing frequency correlated with the consumption of sugar-sweetened products (r=0.458). Conclusions: Infants frequent consumption of sugar-sweetened products begins early in childhood. Thus, tackling these common risk factors in the first years of life is essential and calls for health-promoting actions in multiple areas that target primarily the parents of infants.Peer reviewe

Information Retrieval and Awareness about Evidence-Based Dentistry among Dental Undergraduate Students—A Comparative Study between Students from Malaysia and Finland

Background: A fundamental skill in education includes the ability to search for, evaluate, and synthesize information, and this cannot be underestimated in dental education. The aim of this study was to assess how dental students from Malaysia and Finland acquire scientific information and to compare their information retrieval skills. Methods: Fourth and fifth-year dental students from Malaysia and Finland were invited to participate. A self-administered structured questionnaire including items about the use of information sources, subjective assessment of literature retrieval skills and knowledge was used. Results: A total of 226 dental students participated in the survey: 131 from Malaysia and 95 from Finland. In both countries, the highest interest for data retrieval among students was found in the oral surgery specialty. The three most used sources of information among Malaysian students were personal lecture notes, dental textbooks, and colleagues; while Finnish students used colleagues, lecture notes, and current clinical guidelines. Students’ knowledge of evidence-based practice was inadequate in both student groups. Though the majority of participants reported that they had good or passable skills in literature retrieval, more students from Finland judged themselves to have at least good skills compared to those from Malaysia. Conclusion: Dental education in both countries includes information retrieval studies and mandatory research projects. However, students did not often use those sources that are considered essential in evidence-based dentistry. Universities should further develop educational and training interventions that guide students to use knowledge resources more effectively for critically appraising scientific evidence

Information Retrieval and Awareness about Evidence-Based Dentistry among Dental Undergraduate Students—A Comparative Study between Students from Malaysia and Finland

Background: A fundamental skill in education includes the ability to search for, evaluate, and synthesize information, and this cannot be underestimated in dental education. The aim of this study was to assess how dental students from Malaysia and Finland acquire scientific information and to compare their information retrieval skills. Methods: Fourth and fifth-year dental students from Malaysia and Finland were invited to participate. A self-administered structured questionnaire including items about the use of information sources, subjective assessment of literature retrieval skills and knowledge was used. Results: A total of 226 dental students participated in the survey: 131 from Malaysia and 95 from Finland. In both countries, the highest interest for data retrieval among students was found in the oral surgery specialty. The three most used sources of information among Malaysian students were personal lecture notes, dental textbooks, and colleagues; while Finnish students used colleagues, lecture notes, and current clinical guidelines. Students’ knowledge of evidence-based practice was inadequate in both student groups. Though the majority of participants reported that they had good or passable skills in literature retrieval, more students from Finland judged themselves to have at least good skills compared to those from Malaysia. Conclusion: Dental education in both countries includes information retrieval studies and mandatory research projects. However, students did not often use those sources that are considered essential in evidence-based dentistry. Universities should further develop educational and training interventions that guide students to use knowledge resources more effectively for critically appraising scientific evidence

E-Professionalism among Dental Students from Malaysia and Finland

The increased use of social media in dentistry is associated with both advantages and disadvantages. A new form of professionalism, “e-professionalism,” has emerged. It includes an online persona and online information in any format that displays cues to professional identity, attitudes, and behaviors. The objective was to explore the perceptions of Malaysian and Finnish dental students on e-professionalism. A survey of 613 Malaysian and Finnish students was performed. The main variables assessed were posting of objectionable or inappropriate content among students, attitudes towards unprofessional online content, perceived online presence, contacts with patients and faculty members on social media, and concerns about social media use. The prevalence of posting clearly unprofessional content was not high among dental students. Revealing information of patients was most common content of clear unprofessionalism. Students from Malaysia contacted patients and faculty members more actively in social media than students in Finland (73.6% of students in Malaysia and 11.8% in Finland had invited faculty members to be “friends”). Malaysian students were more concerned and more likely to react to inappropriate content on social media. Attitude of dental students towards social media use in dentistry were very positive in both countries. Students agreed that guiding patients online is a new responsibility for dentists in the digital age (86.4% of students in Malaysia and 73.4% in Finland). The findings indicate the existence of both benefits and dangers of social media on e-professionalism among students. There is a need to include robust digital professionalism awareness training for students

E-Professionalism among Dental Students from Malaysia and Finland

The increased use of social media in dentistry is associated with both advantages and disadvantages. A new form of professionalism, “e-professionalism,” has emerged. It includes an online persona and online information in any format that displays cues to professional identity, attitudes, and behaviors. The objective was to explore the perceptions of Malaysian and Finnish dental students on e-professionalism. A survey of 613 Malaysian and Finnish students was performed. The main variables assessed were posting of objectionable or inappropriate content among students, attitudes towards unprofessional online content, perceived online presence, contacts with patients and faculty members on social media, and concerns about social media use. The prevalence of posting clearly unprofessional content was not high among dental students. Revealing information of patients was most common content of clear unprofessionalism. Students from Malaysia contacted patients and faculty members more actively in social media than students in Finland (73.6% of students in Malaysia and 11.8% in Finland had invited faculty members to be “friends”). Malaysian students were more concerned and more likely to react to inappropriate content on social media. Attitude of dental students towards social media use in dentistry were very positive in both countries. Students agreed that guiding patients online is a new responsibility for dentists in the digital age (86.4% of students in Malaysia and 73.4% in Finland). The findings indicate the existence of both benefits and dangers of social media on e-professionalism among students. There is a need to include robust digital professionalism awareness training for students

E-Professionalism among Dental Students from Malaysia and Finland

The increased use of social media in dentistry is associated with both advantages and disadvantages. A new form of professionalism, "e-professionalism," has emerged. It includes an online persona and online information in any format that displays cues to professional identity, attitudes, and behaviors. The objective was to explore the perceptions of Malaysian and Finnish dental students on e-professionalism. A survey of 613 Malaysian and Finnish students was performed. The main variables assessed were posting of objectionable or inappropriate content among students, attitudes towards unprofessional online content, perceived online presence, contacts with patients and faculty members on social media, and concerns about social media use. The prevalence of posting clearly unprofessional content was not high among dental students. Revealing information of patients was most common content of clear unprofessionalism. Students from Malaysia contacted patients and faculty members more actively in social media than students in Finland (73.6% of students in Malaysia and 11.8% in Finland had invited faculty members to be "friends"). Malaysian students were more concerned and more likely to react to inappropriate content on social media. Attitude of dental students towards social media use in dentistry were very positive in both countries. Students agreed that guiding patients online is a new responsibility for dentists in the digital age (86.4% of students in Malaysia and 73.4% in Finland). The findings indicate the existence of both benefits and dangers of social media on e-professionalism among students. There is a need to include robust digital professionalism awareness training for students.Peer reviewe

The association between dental caries and physical activity, physical fitness, and background factors among Finnish male conscripts

Studies on measured physical fitness and oral health are sparse. The aim of this study was to investigate the associations between self-reported physical activity and measured physical fitness and oral health of young men. The study population consisted of 13,564 Finnish male conscripts who had mandatory clinical oral examinations and physical fitness tests at the beginning of military service in 2011. Finally, around 10,800 conscripts had physical fitness test outcomes available and a total of 8552 conscripts answered a computer-based questionnaire on background factors. Decayed Tooth (DT) and Decayed, Missing, or Filled Tooth (DMFT) indices, outcomes of surveys and fitness tests were used in analyses by cross-tabulation and multivariable logistic regression model (odds ratios [OR] with 95% confidence interval [CI]) were calculated. Regularly exercising conscripts had a reduced need for dental restorative treatment than those reporting no physical activity (p < 0.0001). The proportion of participants with sound dentition (DT = 0) increased steadily with increasing physical activity (39.0-59.4%). Good measured physical fitness was a protective factor against increased dental restorative treatment need. A low prevalence of smoking and low use of alcohol and energy drinks were associated with frequent exercise, whereas consumption of sport drinks and snuff use were common among those who exercised frequently. Good measured physical fitness and self-reported physical activity are associated with reduced caries burden. There is a need for information about the harms of tobacco products and the benefits of a healthy diet, even for the increased energy needs of the physically active.Peer reviewe

Association of erosive tooth wear and dental caries in Northern Finland Birth Cohort 1966-an epidemiological cross-sectional study

Background: The main aim of this cross-sectional study was to investigate the prevalence and severity of erosive tooth wear and its association with dental caries and socio-demographic factors among middle-aged Finnish adults. Methods: Of the total Northern Finland Birth Cohort 1966 (n = 12,058), a convenience sample (n = 3181 adults) was invited for an oral health examination of which 1962 (61.7 %) participated, comprising the final study group. Clinical examinations were carried out by trained and calibrated dentists. Erosive tooth wear was assessed by sextants using the Basic Erosive Wear Examination Index (BEWE, 0-18) and dental caries at surface level using the ICDAS criteria (0-6). Socio-demographic data were obtained from a postal questionnaire. A logistic regression model was generated to test the association of the variables. Results: The prevalence of erosive tooth wear was 75 % and the mean of the BEWE sum score was 3.4 (SD 3.30). Almost half of the members needed non-invasive or invasive measures to prevent further progression of the condition. Of those with erosive lesions, 14.6 % suffered from severe erosive tooth wear. There was a strong positive relationship between the presence of severe erosive tooth wear (BEWE sum score >= 9) and male gender and restorative treatment need. Conclusions: Erosive tooth wear is a common finding in Finnish adult population; almost one in ten suffer from severe erosive tooth wear. Restorative treatment need seems to be associated with severe erosive tooth wear.Peer reviewe