Changes in Dental Health and Dental Health Habits from 3 to 5 Years of Age

Objectives : This study sought to determine how dental health and dental health habits change from 3 to 5 years of age and to consider whether preventive dental health care helped in preventing or halting caries in children. Methods : The study included 67 maternity health care clinics, 72 well-baby clinics, and 69 dental health care clinics. Of the 1,292 newborn children, 1,003 (90.8%) were included in this study. Results : Preventive dental health care contributed to dental caries being halted in only 13.2 percent of those children who had enamel caries at 3 years of age. The dmft index did not increase in 22.6 percent of those children who had dentinal caries at 3 years of age. For all others, the disease became more severe. Toothbrushing habits of 3-year-old children were very consistent over the two years studied. Children were at a risk for caries when their mothers had nine years of basic education, when they already had plaque and caries at 3 years of age, and when the frequency of eating sweets increased the most during the two-year study period. Conclusion : Among 3-year-old children, plaque is an indicator of caries risk and therefore should be a key element in health education. Those children who already have evidence of caries at 3 years of age should be the target of preventive dental services because of their increased risk.     

Effects of School Dental Care Service in Hong Kong-primary teeth

The aim of this study was to describe the effects of the School Dental Care Service on the dental status of primary teeth, against the background of the water fluoridation program. A representative sample of Chinese children aged 6-12 yr was selected for a dental examination for caries and treatment needs. Thirty-two percent of the children aged 6-8 yr were caries free. The dmft indices for 6, 7, and 8-yr-olds were 2.8, 3.1, and 2.9 respectively, and the ratio of decayed to filled teeth declined from 3.2 at age 6 to 1.0 at age 9. The average child aged 6-8 yr needed treatment for caries on just fewer than two teeth. More teeth were in need of 1-surface fillings and such complex treatment as pulpotomy than other treatment types. It was concluded that 1) dental caries prevalence and severity in primary teeth of Hong Kong children continues to decline, 2) there has been an obvious improvement in dental fitness as a result of establishing the School Dental Care Service, 3) the risk to dental caries appears to be associated with the preschool time-frame and therefore 4) the dental service should redirect its attention to preschool children and 5) replace its restorative policy with a preventive policy.     

Dental caries, age and anxiety: factors influencing sedation choice for children attending for emergency dental care

OBJECTIVES: The aim of the study was to examine how physical (dental caries) and psychosocial (age, dental anxiety and dental health behaviour) factors, associated with child and parent, influenced dentists' sedation choice when a child presents in pain. METHODS: 600 parents whose children were aged between 5 and 11 years took part: 200 attended for routine dental care (RDC); the remaining 400 attended as emergency patients and were offered either dental general anaesthesia (DGA) or relative analgesia (RA). The subjects were approached and invited to take part. The researcher was blind as to the child's pattern of dental attendance and the type of sedation offered. All parents and children completed self-reported ratings of dental anxiety. The children's teeth were examined to determine past and present dental caries experience. RESULTS: The results showed that children who were offered DGA had greater experience of dentinal caries, were younger and dentally anxious. The children offered RA were older, had a higher frequency of brushing their teeth with fluoride toothpaste and were also dentally anxious. Discriminant analysis showed that 2 canonical functions provided clear categorisation of the three treatment groups. Function 1 was a physical (dental caries) factor, which was related to the child's experience of dentinal caries. Function 2 was a psychosocial factor, which was related to the child's age, dental anxiety and frequency of tooth brushing. A greater proportion of the variance in the treatment offered was explained by Function 1, suggesting that the most important factor in the decision to offer DGA was dentinal caries. Function 2 was of lesser importance. CONCLUSIONS: The findings have implications for the type of sedation offered to children presenting for emergency care. These children may not otherwise receive treatment and the need to provide less anxiety provoking forms of sedation must be promoted. By doing so, parents who have only brought their children when in pain may take advantage of RDC and the treatments offered to prevent and control dental caries and anxiety in their children.     

Incidence of Coronal and Root Caries in an Older Adult Population

Incidence rates for new root caries and new coronal caries in noninstitutionalized older adults are unknown. In this study, a representative sample of 451 elderly Iowans received dental examinations at the start of the study and again after 18 months. This dentate cohort had a mean of 0.87 new surfaces of coronal decay per person per year and a mean of 0.57 new surfaces of root decay per person per year. Coronal caries occurred at an annual rate of 1.4 surfaces per 100 susceptible coronal surfaces. Root caries occurred at an annual rate of 2.6 surfaces per 100 susceptible root surfaces. This study shows that both coronal and root caries were active in this older population, indicating a need for emphasis on the prevention and treatment of dental caries in older adults.     

A longitudinal study of caries experience and extraction of permanent first molars in English children

One hundred and twenty eight children in Leeds, England, initially aged 11 years, were examined annually for 6 years. The site of dental caries on 441 permanent first molars was recorded at the first examination. Twelve per cent of the teeth were caries free, 83 % had between one and three DF sites each, and 6 % had four or more DF sites. After 6 years 8 % of the originally caries free teeth had been extracted, compared with 19 % of those that initially had had up to three DF sites and 58 % of those with four or more DF sites at the first examination. With the exception of the distal surface site a consistent pattern of the prevalence of caries was seen in each of the sites in the permanent first molar teeth that were not extracted during the study. In the distal site dental caries became relatively more prevalent as the children grew older. The accumulation of similar information from other populations should provide a useful guide for the prognosis of dental caries in the permanent first molar teeth.     

Epidemiology of dental caries in 5-year-old children in Israel

The objective of this study was to assess the prevalence of dental caries in the earliest age at which children were organized as a group in the national education system and to find possible associations with variables that may help to identify "groups at risk" in this population. A total of 965 children, 5 years old, were examined. They were selected by a method to form a representative sample of all West Jerusalem compulsory kindergarten classes in 1971. Caries, gingivitis and oral hygiene were assessed and demogrphic data were collected. It was found that 84% of the children were affected with mean dif value of 4.7 (+/- 3.6). Association was found between caries and social class. The high morbidity suggests that organized services should be planned for this age group. Since the resources are limited, efforts should be directed mainly towards "groups at risk".     

龋病微生物因素研究进展

龋病是发病率最高的口腔慢性感染性疾病,以变异链球菌为代表的一系列细菌曾被认为是龋病的单一致病菌。然而,近几十年来,基于传统致病菌的防治手段未能有效降低龋病的发病率,人们逐渐认识到单一致病菌理论并不能全面反映疾病与微生物的关系。龋病病因学的微生物研究逐步从传统致病菌理论过渡至微生态失衡理论。目前,随着检测手段的不断发展,大量龋病微生物群落研究陆续开展,龋病“核心微生物组”的概念得以提出,即在龋病发生发展中起到关键作用的一组微生物,这将是未来龋病微生物因素研究的方向。     

Longitudinal study of dental health behaviors and other caries predictors in early childhood

This longitudinal study of 231 preschoolchildren from a medium sized Norwegian town had three aims: firstly, to examine the children's early dental behavior, secondly to study the variation of dental health behavior according to mother's education, mother's dental health, and her dental attendance pattern, and thirdly to identify any behavioral or social predictors of dental caries in 36-month-old children. Data were collected at health centers, using precoded questionnaires and examinations, when the children were 6, 18, and 36 months old. Data about the mothers were collected at the maternity ward. At 36 months of age, 80% of the children were caries free. Favorable dental behaviors were related to toothbrushing and use of fluorides. These behaviors were so well established and consistent at all ages that they can be regarded as norms for this community. The most unfavorable and inconsistent behavior was related to sugar consumption. Dental health education could be most usefully applied to this area, where the greatest potential for improvement in behavior exists. A relationship was found between the children's caries experience and the number of missing teeth of the mother, her dental attendance pattern and her level of education. None of the social or behavioral variables tested had a strong enough association with caries experience to justify their use as caries predictors in this age group.     

How successful are surveys on the relationship between caries and sociocultural variables?

Abstract A combined dental and sociologic investigation was carried out in Leeuwarden, a non-fluoridated town in the north of the Netherlands. A large group of 14–15-year-old schoolchildren was clinically examined. To collect data on attitude, knowledge and behavior regarding dental health, the children were asked to fill out a preceded questionnaire. The mothers of the children were interviewed on these subjects. The sociocultural variables correlated slightly with the caries experience of the children. Only 13% of the variance in caries experience within the group of children could be explained by the independent variables. The single best predictor of the caries experience appeared to be the dental status of the mothers. Though human behavior is supposed to be a strong causal factor in the etiology of caries, this relation was not found in our investigation, just as it is absent in many other studies. The main conclusion is that surveys to estimate the relation between caries and sociocultural variables are of little value.     

Dental caries status and need for dental treatment of Pennsylvania public school children in grades 1, 3, 9, and 11

OBJECTIVES: This cross-sectional study was designed to determine the caries status and provide a general evaluation of the level of dental treatment need of Pennsylvania public school children in grades 1, 3, 9, and 11 on a statewide and regional basis. METHODS: Between September 1998 and May 2000, caries status and treatment need were assessed using a school-based dental examination, performed on a representative sample (n=6,040) of public school children in grades 1, 3, 9, and 11 (age range=6 to 21 years). Children's caries status in the primary and permanent dentition was assessed. Need for treatment was scored on a three-level categorical scale--no treatment need identified, routine treatment need, and urgent treatment need--and was based on the presence and severity of caries and other oral conditions. Population estimates of the prevalence of untreated dental caries, DMFT and dft scores, and treatment need were calculated by grade and geographically, using the six Pennsylvania health districts and the cities of Pittsburgh and Philadelphia. The inequality of caries distribution in the population was assessed for both permanent and primary caries using Lorenz curves and Gini coefficients. RESULTS: Dental caries has remained highly prevalent among Pennsylvania's public school children. Caries levels varied considerably by health districts and city. Urgent treatment needs were significant and also varied by health district and city. CONCLUSIONS: Dental caries remains the most prevalent disease affecting Pennsylvania's schoolchildren. Caries status varies significantly by region of the state, suggesting that environmental, social, and demographic contextual factors may be important determinants of disease prevalence.     

Behavioural and socioeconomic factors associated with the simultaneous occurrence of periodontal disease and dental caries

Abstract

Objective: The aim was to evaluate the association of behavioural and socioeconomic factors with the occurrence of periodontal disease and dental caries, paying special attention to the simultaneous occurrence of these diseases.

Materials and methods: The study population consisted of 5255 dentate persons aged ≥30 years from a nationally representative survey. Caries and probing pocket depth were recorded by tooth and calculated in relation to the number of existing teeth. The groups were: non-affected (A), the two most affected quintiles for periodontal disease with little or no dental caries (B), the two most affected quintiles for dental caries with little or no periodontal disease (C) and the two most affected quintiles for both periodontal disease and dental caries (D). Presence of dental plaque was determined, and behavioural and socioeconomic factors were established.

Results: Dental plaque, smoking, lack of regular dental check-ups, older age and a basic level of education were strongly associated with the simultaneous occurrence of periodontal disease and dental caries.

Conclusions: There are many behavioural and socioeconomic factors that associate with the occurrence of both periodontal disease and dental caries. These factors also increase the risk of individuals having these diseases simultaneously.     

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龋病是人类最常见的感染性疾病之一,严重威胁人群口腔健康。变形链球菌组细菌,主要是Streptococcus mutans和Streptococcus sobrinus被认为是最重要的致龋微生物。动物实验和临床研究已证实,通过免疫学干预致龋菌在口腔的定植能够影响龋病的发生,防龋疫苗有望成为一种新的龋病预防措施。     

Dental caries in a group of 20-year-olds after previous participation in public child dental health services in Copenhagen, Denmark

The present study was undertaken to investigate the prevalence of dental caries in a group of 20-year-olds who had previously participated in Public Child Dental Health Services. Dental caries was related to social status and preventive vists to the private dentist after termination of school. The study population comprised 389 persons aged 20, out of which 313 (80.5%) were examined clinically and radiographically by one dentist according to standardized criteria. Mean DMFT was 10.4 and mean DMFS 16.7. Differences in relation to sex were not significant. The distribution of subjects according to DMFS was uneven. The 20% with the highest DMFS accounted for about 45% of the total amounts of DS. A consistent pattern with higher mean DMFS in the low social groups was found. Attendance to Regular Youth Dental Service was higher the longer the subjects had been students and higher mean DMFS was found in nonregular attenders. The presence of a high caries risk group is discussed in relation to the dental care system received by the study population.     

The decline in dental caries among Belgian children between 1983 and 1998

OBJECTIVES: to investigate cross-sectionally a probable dental caries decline in Belgian 12-yr-olds and to analyse some factors that may be associated with dental caries during the study period. METHODS: In the region of Brussels, children in the 7th grade at the same schools were sampled in 1983 (n=533) and 1998 (n= 496). DMFT, DMFS and dental fluorosis were clinically recorded. Data on children's home-based and professional dental health care habits were registered. RESULTS: Caries-free children increased from 4% to 50%. A reduction of the mean number of teeth attacked by dental caries from 7.5 to 1.6 and of tooth surfaces from 11.5 to 2.5 (P<0.001) was observed. Early signs of dental fluorosis were identified in 5% in 1983 and 30% of the subjects in 1998. Multiple linear regression analyses revealed that tooth brushing with fluoridated toothpaste, dental appointments and dental fluorosis were significantly related to dental caries reduction. CONCLUSIONS: A remarkable decline in dental caries was observed during the 15-yr period. The factors related to the children's home-based and professional dental health care were associated with the observed decline.     

Dental caries status and treatment needs of the permanent dentition of 6–12-year-olds in Hong Kong

An oral health survey was conducted in 1986 on a representative sample of primary school children in Hong Kong. 1483 Chinese children of both sexes, aged 6-12 yr, attending 56 primary schools were surveyed. The DMFT index for the 6-yr-olds was 0.1, and for the 12-yr-olds it was 1.5. Forty percent of the 12-yr-olds were clinically caries-free. The permanent molars constituted 90% of the total caries experience of the 12-yr-olds. Over 90% of the caries lesions were found in pits and fissures. The dental caries treatment need in the permanent dentition was low and of the simple type. A great reduction in the dental caries experience of the permanent dentition of children has occurred since the introduction of water fluoridation 25 yr ago. In addition to treatment care, preventive measures should be provided by the School Dental Care Service for children with a high caries risk.     

Long‐term patterns of dental attendance and caries experience among British adults: a retrospective analysis

There is inconclusive evidence on the value of regular dental attendance. This study explored the relationship between long‐term patterns of dental attendance and caries experience. We used retrospective data from 3,235 adults, ≥16 yrs of age, who participated in the Adult Dental Health Survey in the UK. Participants were classified into four groups (always, current, former, and never regular‐attenders) based on their responses to three questions on lifetime dental‐attendance patterns. The association between dental‐attendance patterns and caries experience, as measured using the decayed, missing, or filled teeth (DMFT) index, was tested in negative binomial regression models, adjusting for demographic (sex, age, and country of residence) and socio‐economic (educational attainment, household income, and social class) factors. A consistent pattern of association between long‐term dental attendance and caries experience was found in adjusted models. Former and never regular‐attenders had a significantly higher DMFT score and numbers of decayed and missing teeth, but fewer filled teeth, than always regular‐attenders. No differences in DMFT or its components were found between current and always regular‐attenders. The findings of this study show that adults with different lifetime trajectories of dental attendance had different dental statuses.     

Relative contribution of dental services to the changes in caries levels of 12-year-old children in 18 industrialized countries in the 1970s and early 1980s

Abstract The contribution of health services to improvements in health is contentious. The main aim of the present study was to assess the relative contribution that dental services may have made to the changes in dental caires (decayed, missing or filled permanent teeth) level of 12-year-old children in some industrialized countries in the 1970s and early 1980s. A secondary aim was an analysis of the association of the changes in caries levels with broad socioeconomic factors. In this study aggregate (ecological) data from 18 industrialized countries were analyzed at a national level. Data were obtained from published papers and official publications and included 3 kinds of variables: caries, presence of dental service and broad socioeconomic factors (including fluoridated toothpastes). Dental services explained 3% of the variation in changes in 12-year-old caries levels in the 1970s and early 1980s period whereas broad socioeconomic factors (including or excluding fluoridated toothpastes) explained 65%. The findings suggest that dental services were relatively unimportant in explaining the differences in changes in 12 year-old caries levels in the 1970s and early 1980s in the 18 countries. The view that fluoride in toothpaste was the only important cause of the declines in decayed, missing or filled permanent teeth in industrialized countries was questioned. A possible important contribution of the dental services to the declines was a change in the diagnostic and treatment criteria of caries.     

An evaluation of a hierarchical method of describing the pattern of dental caries attack

abstract A number of procedures have been developed to reduce the time needed to examine and record dental caries in epidemiologic studies. One such method is described in a 1967 draft of a WHO Manual. The present report is an evaluation of that method, and is based on analysis of data from 2,123 individuals 6 to 17 years old examined in three previous studies. The method is based on assigning individuals to one of five zones of increasing severity, assuming that once an individual is classified into a given zone, he automatically belongs to all zones of lesser severity (except zero). The analysis carried out in this study shows that Zones 2 and 3 as well as Zones 4 and 5 have to be combined in order for the above mentioned assumption to be fullfilled. Furthermore, it is shown that there is good agreement between information on severity of dental caries attack obtained by this method and measurements of dental caries prevalence obtained by conventional methods (DMF). Finally, it is demonstrated that the modified method is sensitive enough to be able to detect the caries preventive effect of fluoridation of school water supplies.     

Epidemiologic study of dental emergencies among utilizers in an insured population in Washington, USA

Abstract This is a study of the epidemiology of dental emergencies based on information abstracted from the microfilmed dental claim forms of a large American insurance program in 1981–82. Overall, about 4% of all dental visits were classifiable as emergencies. There were significant seasonal and age variations in dental emergencies. There was no variation with respect to geographic regions in the State of Washington (USA) or sex. Paradoxically, residents in regions having fluoridated water supplies were at equal risk of developing dental emergencies due to dental caries, relative to those residing in non-fluoridated regions. There was also no difference in risk associated with insurance deductibles, although generally deductibles are thought to deter first-contact visits.