Dental caries in Uruguayan adults and elders: findings from the first Uruguayan National Oral Health Survey

This study aimed to assess dental caries status and associated factors in Uruguayan adults and elders using data from the first Uruguayan National Oral Health Survey. Data were representative of the country as a whole. Socio-demographic information was collected with a closed questionnaire. Dental caries was assessed by clinical examination using the DMFT index. The final sample consisted of 769 participants. Mean DMFT was 15.20 and 24.12 for the 35-44 and 65-74-year age groups, respectively. Mean number of decayed teeth was 1.70 in adults and 0.66 in elders. Multivariate analyses showed higher prevalence of dental caries associated with age 65-74 years, low socioeconomic status, use of public dental services, presence of gingivitis; for decayed teeth, age 35-44 years, low socioeconomic status, use of public dental services, infrequent tooth brushing, need for oral health care, and presence of root caries showed higher severity. Uruguayan adults and elders from disadvantaged backgrounds concentrated a heavier burden of dental caries

Tooth wear in the deciduous dentition of 5-7-year-old children: Risk factors

This study was conducted to investigate the distribution and severity of tooth wear in deciduous dentition and its relationship with possible risk factors. A stratified cluster sample of 243 5-7-year-old children was examined using the tooth wear index of Smith and Knight, and their exposure to intrinsic and extrinsic risk factors was retrospectively investigated through a structured questionnaire. The severity of wear was quantitatively estimated by the number of surfaces with affected dentine and by the cumulative score of the sextants, based on the Basic Erosive Wear Examination scoring system. Only 1.6% of the children were tooth wear free, whereas 45.6% had moderate to severe wear involving dentine. Maxillary canines were the most affected teeth (83.2%), and occlusal/incisal the most affected surfaces (52.7%). The likelihood of tooth wear involving dentine was greater in boys than girls (OR = 1.72), in immigrants than in Greeks (OR = 1.93), and in 6- and 7-year olds than in 5-year olds (OR = 2.78 to 2.93). After adjustment for age, gender, and nationality, exposure to several dietary factors and especially to soft drinks was found to significantly affect the prevalence (OR = 1.27) and the severity of tooth wear. Every additional serving/week of consumption of soft drinks increases the number of surfaces with dentine affected by 0.03 per year (p < 0. 05) and the cumulative score of sextants by 0. 04 (p < 0.05). The cluster of children with the higher prevalence and severity of tooth wear had an average exposure to soft drinks of 10 servings/week for a duration of 4 years. The cumulative score of sextants was better predicted by the assessed risk factors, in comparison with the number of surfaces with affected dentine. Tooth wear is a common condition in children, related both to the physiological process of aging of dentition and to the erosive effect of dietary factors. Strategies to reduce the intake of soft drinks in children are expected to have multiple benefits preventing tooth wear in childhood and in later life, as well as many other general and oral health diseases. © 2011 Springer-Verlag

Gender differences in oral health status and behavior of Greek dental students: A meta-analysis of 1981, 2000, and 2010 data

Background: The aim of this study was to investigate the oral health status and behavior of Greek dental students over time, and to meta-analyze these findings to test the widely documented hypothesis that women have better oral health behavior, oral hygiene, and periodontal status but higher dental caries rates than men. Materials and Methods: A total sample of 385 students was examined using identical indices to assess oral health and behavioral data initially in 1981 while the years 2000 and 2010 were selected due to significant changes that took place in the dental curriculum in the 1990s and 2000s. Data by gender concerning the outcome variables recorded in every one of the three surveys were analyzed using Mantel - Haenszel and continuous outcomes methods. Results: A significant improvement in the oral health status and behavior of students was observed over time. The meta-analysis of data by gender showed that females brushed their teeth significantly more often than males [summary odds ratio (OR): 1.95 and 95% confidence interval (CI): 1.08 - 3.54]. Males and females were found to have a similar risk of developing dental caries. Conclusion: The hypothesis that young women have better oral hygiene habits compared to men was confirmed. However, the hypothesis that women have better oral hygiene and periodontal status but exhibit higher dental caries experience than men was not supported by the findings of the study. © 2016 Journal of International Society of Preventive and Community Dentistry | Published by Wolters Kluwer - Medknow

Prevalence of sealants in relation to dental caries on the permanent molars of 12 and 15-year-old Greek adolescents. A national pathfinder survey

Background: The use of sealants as an effective measure for the prevention of pit and fissure caries in children has been well documented by several studies; either they are used on an individual or on a public health basis. In order to plan and establish a national preventive program with sealants in a community, it is mandatory to know the epidemiological pattern of caries along with other variables influencing their use and effectiveness. Aims: To assess the utilization and distribution pattern of pit and fissure sealants on the first and second permanent molars of Greek adolescents and to evaluate whether the existing usage of sealants and some socio-demographic factors are correlated to caries prevalence on the population examined. Methods. A stratified cluster sample of 2481 Greek adolescents was selected according to WHO guidelines (1224 twelve and 1,257 fifteen-year-old), living in urban and rural areas in 11 districts within the country. Five calibrated examiners carried out clinical examinations, recording caries experience at the dentine threshold (BASCD criteria) and presence or absence of sealants along with Socio-demographic indicators associated with oral health. Mann Whitney and Pearson's chi-square non parametric tests were utilized for assessing the data. The level of significance was p < 0.05. Results: Sealants utilization varied considerably within the different districts, with 8,3% of the 12 and 8,0% of the 15-year-old adolescents having at least one sealed molar. Sealants reduced DMFS scores by 11% in the 12-year-olds and by 24% in the 15-year-olds, while 15-year-old adolescents from rural areas had a statistically significant (p = 0.002) less chance of having sealants (71%) compared to children from urban areas. Girls had higher chance to receive sealants in both age groups (26% for the 12 and 19% for the 15-year-old) as well as patients that visited the dentist for prevention compared to those visiting the dentist because they thought they needed a restoration or because they were in pain. Conclusions: The finding that sealants reduced DMFS scores despite their very low utilization, along with the high prevalence of dental caries found on the occlusal surfaces of the posterior teeth of Greek adolescents, is calling for a national preventive program with sealants which could eliminate caries to a larger extent. © 2011 Oulis et al; licensee BioMed Central Ltd

Novel methods of balancing covariates for the assessment of dental erosion: A contribution to validation of a synthetic scoring system for erosive wear

Objectives: The purpose of the study was to balance several potential erosive covariates, using traditional and novel epidemiological approaches, in order to assess the relative risks of dental erosion more precisely. Methods: Traditional (univariate and logistic regression analysis) and novel techniques (propensity scores and Inverse Probability Weighting - IPW) were applied for evaluating the effect of twenty covariates on dental erosion among 502 adolescents. Results: Different approaches gave different estimates of the relative risks of dental erosion. The increased consumption of carbonated soft drinks had the major erosive effect, when traditional analyses were used (unadjusted: OR = 3.475 and CI: 1.499-8.052, logistic regression: OR = 3.219 and CI: 1.373-7.547). On the other hand, IPW method indicated that the consumption of erosion drinks immediately after intense physical exercise had the highest odds ratio (OR = 1.363 and CI: 0.963-1.929), followed by the increased consumption of citrus fruit juice (OR = 1.326 and CI: 1.004-1.752). This method also demonstrated a marked improvement in balance, with the 95% CIs for each OR being considerably narrower than those reported in the initial analysis. Conclusions: Standardization of the potential aetiological criteria of erosive wear is a considerably difficult process. Nevertheless, novel methods revealed that the increased consumption of carbonated soft drinks and citrus fruit juices could be included as aetiologic factors in a synthetic scoring system for erosion. Parameters which are related to salivary protective mechanisms (e.g. consumption of erosion drinks immediately after intense physical exercise) could also be a part of such an index. Further research is required in order to achieve the maximum validation of the potential erosive risk factors. © 2011 Elsevier Ltd. All rights reserved

Gender differences in oral health status and behavior of Greek dental students: A meta-analysis of 1981, 2000, and 2010 data

BACKGROUND: The aim of this study was to investigate the oral health status and behavior of Greek dental students over time, and to meta-analyze these findings to test the widely documented hypothesis that women have better oral health behavior, oral hygiene, and periodontal status but higher dental caries rates than men. MATERIALS AND METHODS: A total sample of 385 students was examined using identical indices to assess oral health and behavioral data initially in 1981 while the years 2000 and 2010 were selected due to significant changes that took place in the dental curriculum in the 1990s and 2000s. Data by gender concerning the outcome variables recorded in every one of the three surveys were analyzed using Mantel-Haenszel and continuous outcomes methods. RESULTS: A significant improvement in the oral health status and behavior of students was observed over time. The meta-analysis of data by gender showed that females brushed their teeth significantly more often than males [summary odds ratio (OR): 1.95 and 95% confidence interval (CI): 1.08-3.54]. Males and females were found to have a similar risk of developing dental caries. CONCLUSION: The hypothesis that young women have better oral hygiene habits compared to men was confirmed. However, the hypothesis that women have better oral hygiene and periodontal status but exhibit higher dental caries experience than men was not supported by the findings of the study

Dental caries prevalence and treatment needs of 5- to 12-year-old children in relation to area-based income and immigrant background in Greece

Objectives: To investigate the association between certain socio-demographic characteristics and dental health status of 5- to 12-year-old children attending public kindergarten and primary schools in Piraeus, Greece. Methods: Gender, age, place of residence, immigrant background and area-based income were associated with dental caries prevalence, treatment needs and oral hygiene level in 5,116 children. Results: The mean number of decayed, missing and filled deciduous teeth (dmft) and Unmet Restorative Treatment Needs Index (UTN) at 6-year-olds were 1.54 and 84.6% respectively, and the DMFT and UTN at 12-year-olds were 1.35 and 71.8%. Caries experience/severity significantly increased with age, whereas treatment needs and oral hygiene level decreased (P < 0.001). Immigrant background and low area-based income was associated with poorer oral health outcomes. The above associations retained statistical significance after multivariate analysis. Children who live in areas with lower average income present 1.20 to 2.14 greater risk of having higher caries severity and poorer oral hygiene in comparison to those living in more affluent areas, and children with an immigrant background have 1.68 to 4.34 higher likelihood to present higher dmft and DMFT values, higher unmet treatment needs, and poorer oral hygiene levels compared to their Greek counterparts above and beyond the effect of the other risk factors assessed. Conclusions: The present study revealed a socio-demographic gradient in oral health status and treatment needs of children in Piraeus, Greece. © 2011 FDI World Dental Federation

In vitro evaluation of fluoride and calcium sodium phosphosilicate toothpastes, on root dentine caries lesions

Objectives: The aim of this in vitro study was to assess the effect of toothpastes containing three different sodium fluoride concentrations and a calcium sodium phosphosilicate system, on root dentine demineralization and remineralization. Methods: During a fourteen-day pH-cycling protocol, pre-softened bovine root dentine specimens were immersed twice daily, before and after the demineralization periods, for 2 min, in the following toothpaste slurries: (a) non-fluoridated (control), (b) 7.5% calcium sodium phosphosilicate, (c) 1450 ppm F, (d) 2800 ppm F, and (e) 5000 ppm F. Subsequently, the slabs were subjected to a fifty-hour acid resistance test. Knoop microhardness at different lesion depths was assessed in specimen cross-sections and KHN values were converted to vol.% mineral. Comparisons between the groups were performed at each lesion depth through ANOVA-based tests and furthermore, regression analysis of the derived statistic of "integrated vol.% mineral loss" was carried out. Also, lesions were evaluated qualitatively using transmission and polarized light microscopy. Results: The 5000 ppm F toothpaste group, during pH-cycling, presented significantly less total vol.% mineral loss and subsequently exhibited considerably increased surface acid resistance, compared to all the other tested groups. The calcium sodium phosphosilicate toothpaste, during pH-cycling, inhibited demineralization and/or promoted remineralization of the surface layers significantly more effectively than the control group nevertheless, subsequently, the acid resistance of the calcium sodium phosphosilicate dentifrice group was similar to that of the control group. These observations were confirmed by microscopic examination of the lesions. Conclusions: Under the present experimental conditions, the 5000 ppm F toothpaste, promoted remineralization and inhibited demineralization more effectively, than the other tested toothpastes. © 2011 Elsevier Ltd. All rights reserved

The potential positive impact of supported employment on the oral health status, attitude and behavior of adults with intellectual disabilities

Individuals iyh itellectual disabilities(ID)constitute a unique but heterogeneus population, which include a great variety of mental and developemental disorders, as well as cogential syndromes. Nowadays, many persons with mild or moderate ID,with specific training, can make considerable efforts to improve their lives, by having a job in either open or supported employment. On the other hand, since dental caries and periodontal diseases are among the most common secondary conditions affecting people with ID, oral diseases may detract the quality of life from disabled persons.The hypothesis: Empolyment(sheltered workshop, open or supported empolyment)of persons with ID, may enable these individuals to improve their oral health status, attitudes and behavior, compared to the ID individuals who are not working, due to the developement of specific socio-emotional characteristics and dexterities.Evaluation of the hypothesis: According to previous reports,employed people with ID demonstrated better self-esteem and greater autonomy,more satisfaction with their vocational/non-vocational activities and higher quality of life. copyright © 2012 Mittal and Narang