Predicting the experience of dentinal caries or restorative dental treatment in adolescents using D1 and D3 visual caries assessments

Standardised epidemiological caries assessments used in oral health surveys have been shown to be poor at predicting whether a tooth surface will be treated restoratively when a patient visits a dentist. However, it has been argued that oral health surveys may be more relevant in determining needs at the level of an individual or groups of individuals. The objective of this study was to determine the discriminatory power of visual caries assessments at two thresholds (D1 & D3) in adolescents of average age 12.1 years to predict experience of dentinal caries 3 years later or the experience of restorative treatment (not re-treatment) during the 3-year period. The data was derived from a prospective 3-year longitudinal study in which the dental care provided by 41 dentists for 403 adolescents was monitored. Dental caries experience was monitored by annual standardised assessments of caries undertaken by a single trained examiner. ROC analysis showed that caries assessed visually at the D1 threshold in 12-year-olds was a better predictor (P < 0.001) of experiencing some dentinal caries after 3 years (Az = 0.781) than was caries assessed visually at D3 threshold in 12-year-olds (Az = 0.670). Assessing caries visually at either the D1 or the D3 threshold had no discriminatory power for predicting whether an individual would experience some restorative treatment during the ensuing 3-year period (Az for D1 = 0.507; Az for D3 = 0.518).     

Parental smoking behavior and caries experience in preschool children

Abstract – Objectives: The study aimed to explore the association between parental smoking behavior and caries experience in young children, taking into account the socioeconomic status and oral health‐related behavior. Methods: Cross‐sectional data from 1250 3‐year‐old and 1283 5‐year‐old children from four geographical areas in Flanders (Belgium) were analyzed. Children were examined at school by trained dentist‐examiners, using standard criteria and calibrated examination methodology. Data on oral hygiene and dietary habits, oral health behavior, sociodemographic variables, and parental smoking behavior were obtained through structured questionnaires, completed by the parents. Results: Visible caries experience (i.e. d₃mft > 0) was seen in 7% of 3‐year olds and 31% of 5‐year olds. In both age groups, 30% of the parents reported smoking behavior. Univariable logistic regression analysis with caries prevalence as the dependent variable, revealed that parental smoking was a significant independent variable. After controlling for age, gender, sociodemographic characteristics, oral hygiene, and dietary habits, the effect of family smoking status was no longer significant in 3‐year‐old children (OR = 1.98; 95% CI: 0.68–5.76). In 5‐year olds the significant relationship between parental smoking behavior and caries experience persisted after adjusting for the other evaluated variables (OR = 3.36; 95% CI: 1.49–7.58). Conclusion: The results of this study illustrate the existence of a significant association between parental smoking behavior and caries experience in 5‐year‐old children.     

Factors associated with prevalence and severity of caries experience in preschool children

Abstract – Objectives: The aim of the present study was to examine the prevalence and severity of caries experience in the primary dentition of preschool children and to assess the association of disease distribution with oral hygiene levels, reported oral health behaviours and socio‐demographic factors. Methods: Study samples comprised 1250 3‐year‐old and 1283 5‐year‐old pre‐school children from four distinct geographical areas in Flanders. Information on oral hygiene and dietary habits, oral health behaviours and socio‐demographic variables was collected using questionnaires completed by the parents. Clinical examinations were performed using standardized criteria. Caries experience was recorded at the level of cavitation (d₃ level). Simple as well as multivariable logistic regression analyses were performed in order to identify factors associated with prevalence and severity of caries experience. Results: Visible plaque was present in 31% of 3‐year‐olds and 37% of 5‐year‐olds. In 3‐year‐olds, 7% presented with caries experience while this was the case in 31% of 5‐year‐olds. Multivariable logistic regression revealed significant associations, in 3‐year‐olds, of caries experience with presence of dental plaque (OR = 7.93; 95% CI: 2.56–24.55) and reported consumption of sugared drinks at night (OR = 7.96; 95% CI: 1.57–40.51). In 5‐year‐olds, significant associations were seen with age (OR = 7.79; 95% CI: 2.38–25.43), gender (OR = 0.37 with 95% CI: 0.19–0.71 for girls), presence of visible dental plaque (OR = 3.36; 95% CI: 1.64–6.89) and reported habit of having sugar‐containing drinks in between meals (OR = 2.60 with 95% CI: 1.16–5.84 and OR = 3.18 with 95% CI: 1.39–7.28, respectively for 1×/day and > 1×/day versus not every day). In 5‐year‐olds with caries experience (30.8% of total sample), the severity of disease was further analysed (d₃mft between 1 and 4 versus d₃mft 5 or higher). Multivariable analyses showed a significant association with gender [girls more likely to have higher disease levels; OR = 4.67 (95% CI: 1.65–13.21)] and with presence of plaque (OR = 3.91 with 95% CI: 1.23–12.42). Conclusions: Presence of visible plaque accumulation and reported consumption of sugared drinks were associated with prevalence of caries experience in Flemish preschool children. Severity of disease was associated with gender and with presence of plaque. Results underline the importance of plaque control and diet management from very young age on.     

Caries prevalence of permanent teeth: a national survey of children in Iceland using ICDAS

Agustsdottir H, Gudmundsdottir H, Eggertsson H, Jonsson SH, Gudlaugsson JO, Saemundsson SR, Eliasson ST, Arnadottir IB, Holbrook WP. Caries prevalence of permanent teeth: a national survey of children in Iceland using ICDAS. Community Dent Oral Epidemiol 2010; 38: 299–309. © John Wiley & Sons A/S Abstract – Objectives: The Icelandic Oral Health Survey aimed to obtain new national data on the oral health of Icelandic children and teenagers. Methods: A representative stratified random cluster sample of 2251 Icelandic children in first, seventh and 10th grade, aged approximately 6‐, 12‐ and 15‐years old was examined for caries prevalence using the ICDAS criteria. Bite‐wing digital radiographs were obtained for the children in 7th and 10th grade. Results: D₃MFT scores by visual examination of 6‐, 12‐ and 15‐year olds were 0.12, 1.43 and 2.78 respectively but when including radiographs, the D₃MFT rose to 2.11 at 12 years and 4.25 at 15 years. The Significant Caries Index, SiC, by visual examination for 12 and 15 y was 3.7 and 6.7 respectively but was 4.7 for 12 y and 8.9 for 15 y with radiographs. In all age groups and at most disease levels, caries was active in the majority of the lesions (58–100%). The percentage of children with no visually detectable caries at D₃/D₁ level was 93%/74% for 6 years, 48%/22% for 12 years and 35%/16% for 15 years. When radiographs were included the percentage reduced to 34%/15% for 12 years and 20%/6% for 15 years. Approximately 80% of 12‐ and 15‐year‐olds had at least one of their first molars sealed, with the mean number of sealed first molars being 2.2 among 12 y and 2.0 among 15 y. Conclusions: Caries levels were higher than expected in this national survey and further away from the goals of the National Health Plan for 2010 than anticipated. Caries distribution was skewed with more than half of the children having low caries scores but a wide distribution of caries experience was seen among the remaining population.     

Reproducibility and accuracy of the ICDAS-II for occlusal caries detection

Abstract – Objectives: The aim of this in vitro study was to assess the inter‐ and intra‐examiner reproducibility and the accuracy of the International Caries Detection and Assessment System‐II (ICDAS‐II) in detecting occlusal caries. Methods: One hundred and sixty‐three molars were independently assessed twice by two experienced dentists using the 0‐ to 6‐graded ICDAS‐II. The teeth were histologically prepared and classified using two different histological systems [Ekstrand et al. (1997) Caries Research vol. 31, pp. 224–231; Lussi et al. (1999) Caries Research vol. 33, pp. 261–266] and assessed for caries extension. Sensitivity, specificity, accuracy and area under the ROC curve (A_z) were obtained at D₂ and D₃ thresholds. Unweighted kappa coefficient was used to assess inter‐ and intra‐examiner reproducibility. Results: For the Ekstrand et al. histological classification the sensitivity was 0.99 and 1.00, specificity 1.00 and 0.69 and accuracy 0.99 and 0.76 at D₂ and D₃, respectively. For the Lussi et al. histological classification the sensitivity was 0.91 and 0.75, specificity 0.47 and 0.62 and accuracy 0.86 and 0.68 at D₂ and D₃, respectively. The A_z varied from 0.54 to 0.73. The inter‐ and intra‐examiner kappa values were 0.51 and 0.58, respectively. Conclusions: ICDAS‐II presented good reproducibility and accuracy in detecting occlusal caries, especially caries lesions in the outer half of the enamel.     

Discriminatory ability of caries diagnosis from bitewing radiographs in caries prophylactic trials

The discriminatory ability of radiological criteria in common use in clinical trials was tested on 99 female teenagers selected from a larger sample taking part in a 3–year caries prophylactic clinical trial. Four radiological caries diagnostic criteria were selected as generally representative of those in current use following a comprehensive review of the literature. A significant preventive effect was evident from the radiographic examinations after 3 years. At this time a significant difference between mean DFS increments was recorded when enamel lesions were omitted (P < 0.05). Although preventive treatment effects were evident at all diagnostic levels, the discriminatory abilities differed. The criterion “involvement of amelodentinal junction but not beyond” was most discriminatory.     

Effect of diagnostic threshold on the validity and reliability of epidemiological caries diagnosis using the Dundee Selectable Threshold Method for caries diagnosis (DSTM)

OBJECTIVES: To develop a method for recording dental caries at the D1 (enamel and dentine) diagnostic threshold (without loss of D3 information) and assess its reliability, 'benchmark' validity and potential effects on reported caries prevalence and needs assessment. METHODS: Multi-examiner training, calibration and validation trial. Two groups of 10 dental examiners were trained to diagnose dental caries at the D1 (enamel and dentine) diagnostic threshold under the conditions of a caries prevalence survey, prior to a calibration trial being undertaken. RESULTS: Where 'experienced examiners' were trained to examine at the D1 (enamel and dentine) diagnostic threshold, under the conditions of a cross-sectional epidemiological survey, there was no significant deterioration in inter-examiner agreement on the assessment of teeth and a significant difference in one of two comparisons on the assessment of surfaces using the kappa statistic. Assessed against a benchmark examiner, there was no significant loss of sensitivity at the D1 diagnostic threshold compared with the D3 threshold and, although there was a significant loss of specificity at the D1 threshold, all specificity values could be considered to be high. CONCLUSIONS: Modifying the diagnostic criteria typically used in surveys of caries prevalence (to allow assessment of the levels of enamel caries which could benefit from preventive care as well as dentinal caries requiring restorative care) in adolescents does not adversely affect the reliability or benchmark validity of experienced examiners to a significant degree.     

Exploring the contributions of components of caries risk assessment guidelines

Abstract – Objective: To examine the relative contribution of current caries activity, past caries experience, and dentists’ subjective assessment of caries risk classifications. Methods: Administrative data from two dental plans were analyzed to determine dentists’ risk classification, as well as current caries activity and previous caries experience at the time of the classification. The performance of these predictors in identifying patients who would experience subsequent caries was then modeled using logistic regression. Results: In both plans, current caries activity alone had relatively low sensitivity and high specificity in identifying patients who would experience subsequent caries. Sensitivity improved, but at the cost of specificity when previous caries experience was included in the models. Further improvement in sensitivity accrued when dentists’ subjective assessment was included, but performance was different in the two plans in terms of false‐positives. Conclusions: Consideration of previous caries experience tends to strengthen the predictive power of caries risk assessments. Dentists’ subjective assessments also tend to improve sensitivity, but overall accuracy may suffer.     

Clinical performance of a new laser fluorescence device for detection of occlusal caries lesions in permanent molars

Objectives

To determine the clinical performance of a laser fluorescence device (DIAGNOdent pen, KaVo) to discriminate between different occlusal caries depths (D₀–D_1–4; D_0–2–D_3,4) in permanent molars.

Methods

In this prospective, randomized two-centre-study 120 sound/uncavitated carious sites in 120 patients were measured after visual and radiographic caries assessment. In cases of operative intervention (n = 86), the lesion depths after caries removal were recorded (reference). In cases of preventive intervention (n = 34), the sites were reassessed visually/radiographically after 12 months to verify the status assessed before (reference). The discrimination performance was determined statistically (Mann–Whitney test, Spearman’s rho coefficient, and areas under the receiver operating characteristic curves (AUCs)). Sensitivities (SE) and specificities (SP) were plotted as a function of the measured values and cut-off values for the mentioned thresholds suggested.

Results

Sound sites (n = 13) had significantly minor fluorescence values than carious sites (n = 107) (P < 0.0001) as had sites with no/enamel caries (n = 63) compared to dentinal caries (n = 57). The AUCs for the same discriminations were 0.92 and 0.78 (P < 0.001). For the D₀–D_1–4 threshold, a cut-off at a value of 12 (SE: 0.88, SP: 0.85) and for the D_0–2–D_3,4 threshold at 25 (SE: 0.67, SP: 0.79) can be suggested. A moderate positive correlation between the measurements and the caries depths was calculated (rho = +0.57, P = 0.01).

Conclusion

Within this study, the device’s discrimination performance for different caries depths was moderate to very good and it may be recommended as adjunct tool in the diagnosis of occlusal caries.     

Ecological time-trend analysis of caries experience at 12 years of age and caries incidence from age 12 to 18 years: Norway 1985–2004

Objectives. The purpose of the present investigation was to report on caries experience among Norwegian 12-year-olds from 1985 to 2004 and to assess caries incidence from 12 to 18 years of age for birth cohorts 1973 to 1986. Material and methods. Aggregated data from the Norwegian Public Dental Services and from official statistics were employed. Information was available about the number of subjects, the proportion receiving treatment, sales of fluoride tablets, socio-demographics, caries prevalence, and the number of decayed, missing, and filled teeth (DMFT). Results. An almost linear decline in caries prevalence and mean D₃MFT (dentine level) occurred among 12-year-old children from 1985 until the year 2000, but from 2000 to 2004 an increasing trend was observed. The highest mean 6-year D₃MFT increment (age 12–18 years) was 4.1 (cohort 1976), while the lowest was 3.2 (cohorts 1982 and 1983). In multiple linear regression analyses of trend, baseline D₃MFT accounted for more than 91% of total explained variance in D₃MFT increment (Models I and III). Without baseline D₃MFT as predictor (Models II and IV), there was a significant association between education, social assistance, mobility, infant mortality, percentage examined, and the additive interaction terms year?+?income and year?+?education and D₃MFT increment after controlling for confounding and multicollinearity. Conclusions. Four consecutive years of increase in caries experience among 12-year-old children after 15 years of decline and evidence of stability or increase of the caries increment from 12 to 18 years of age among Norwegian teenagers give cause for concern.     

Family characteristics and caries experience in preschool children. A longitudinal study from pregnancy to 5 years of age

Wigen TI, Espelid I, Skaare AB, Wang NJ. Family characteristics and caries experience in preschool children. A longitudinal study from pregnancy to 5 years of age. Community Dent Oral Epidemiol 2011; 39: 311–317. © 2010 John Wiley & Sons A/S Abstract – Objective: The purpose of the study was to explore associations between family status, family income, family size, mother’s age at child birth, mother’s education and parents’ national background and caries experience in 5‐year‐old children. Method: This study is based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and the Public Dental Services. A total of 1348 children were followed from pregnancy to the age of 5 years. Questionnaires were completed by mothers twice during pregnancy and when the children were 3 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. Results: Caries experience in the 5‐year‐old children was low; 89% had no caries experience (d_3–5 mft = 0). In multiple logistic regression having one or both parents of non‐western origin (OR 3.4, CI 1.6–7.3), having had a change in family status from pregnancy to 5 years of age (OR 2.0, CI 1.1–3.4) and having mother with low education (OR 1.9, CI 1.3–2.8) were statistically significant risk indicators for having caries experience at the age of five. Conclusion: Family characteristics in pregnancy and early life were associated with caries experience in 5‐year‐old children. Primary care personnel meeting young children with one or several of these characteristics should consider referring the child to dental personnel to enable early initiation of health‐promoting activities.     

Caries experience in the permanent dentition among first- and second-grade schoolchildren in southeastern Estonia

Abstract

Objective. This study aims to assess the caries experience among first- and second-grade children in the elementary schools of southeastern Estonia. Materials and methods. A representative sample of 485 children was studied. The mean age of children in the first grade was 7.8 years (SD = 0.35) and in the second grade 8.8 years (0.38). The clinical examinations using ICDAS criteria were completed by four calibrated examiners. The inter- and intra-examiner consistency of the examiners was high (surface and tooth-based kappa >0.9). Results. The mean caries experience of dentinal caries lesions was 0.8 (D_4–6MFT) and 1.6 (D_4–6MFS) among the first graders and 1.1 (D_4–6MFT) and 1.6 (D_4–6MFS) among the second graders. The mean caries enamel lesions among the first graders was 1.6 (D_1–3T) and 2.2 (D_1–3S) and among the second graders 2.1 and 3.0, respectively. The most affected surfaces were the occlusal surfaces of the lower first molars. The prevalence of sealants was very low—only 2.4% of the first molars were sealed among the first graders and 3.9% among the second graders. There were no statistically significant differences in caries experience or in the provision of restorative treatment between the schools. Conclusions. Caries experience is high in southeastern Estonia. Preventive programs are urgently needed.     

Caries and background factors in Norwegian and immigrant 5-year-old children

Wigen TI, Wang NJ. Caries and background factors in Norwegian and immigrant 5‐year‐old children. Community Dent Oral Epidemiol 2010; 38: 19–28. © 2009 John Wiley & Sons A/S Abstract – Objectives: The purpose of this study was to assess the caries status of 5‐year‐olds in a low caries area, and study associations between dental caries and parent‐related factors: parents’ education, national origin, oral health behaviours and attitudes. Methods: The material consisted of 523 children and was a stratified random sample. Clinical and radiographic examination was performed in 2007. Enamel and dentine caries were recorded at surface level. Parents filled in questionnaires regarding socioeconomic status, their own oral health behaviours and attitudes. Results: Most participants (66%) had no caries experience and 16% had enamel caries only. Dentine caries experience was present in 18% of the children, and 5% had dentine caries experience in five or more teeth. Surfaces with enamel caries constituted half of all surfaces with caries experience. In multiple logistic regression, statistically significant risk indicators for the child having dentine caries experience at the age of five were: having one or both parents of non‐western origin (OR = 4.8), both parents (OR = 3.0) or one parent (OR = 2.1) with low education, parental laxness about the child’s tooth brushing (OR = 2.8), parents’ brushing their own teeth less than twice a day (OR = 2.2) and having parents with frequent sugar intakes (OR = 1.8). Conclusion: Caries prevalence in 5‐year‐olds was strongly associated with parent‐related factors signifying that information on parents’ socioeconomic status, dental behaviours and attitudes should be considered when planning dental services for young children. Our results suggest that the real high risk group is non‐western children whose parents have low education.     

MBL2, MASP2, AMELX, and ENAM gene polymorphisms and dental caries in Polish children

Oral Diseases (2012) 18 , 389–395 Objective: The aim of the study was to examine whether the MBL2 C(‐290)G and G161A, MASP2 A359G, AMELX C287T and C522T, and ENAM C2452T polymorphisms are associated with dental caries. Subjects and methods: Genomic DNA of 95 Polish children with ‘higher caries experience’ (HC) and 84 subjects with ‘lower caries experience’ (LC) belonging to two age‐groups (5 and 13 years old) was extracted from the buccal mucosa. SNPs were genotyped with PCR‐RFLP methods. Results: Among 5‐year‐old children, we found significantly higher percentage of subjects carrying MBL2 (‐290)G allele in HC group compared with LC group (43.2%vs 17.6%, P = 0.023). MBL2 C(‐290)G–G161A C–G haplotype was overrepresented in LC group in 5‐year‐olds (P = 0.01), while the opposite association was observed in 13‐year‐olds, where C–G was overrepresented in HC group (P = 0.028). In 5‐year‐old children, the frequency of MBL2 G–G haplotype was higher in HC group compared with LC subjects (P = 0.045), while the opposite association (with borderline significance) was observed in 13‐year‐old children (P = 0.057). SNPs in MASP2, AMELX, and ENAM were not associated with dental caries. Conclusion: MBL2 gene polymorphism is associated with caries experience in Polish children, but the direction of this association seems to be opposite in primary and permanent dentition.     

Effect of high-concentration ammonium and sodium fluoride rinses on dental caries in schoolchildren

abstract A double-blind clinical trial was conducted in a non-fluoridated community to determine the effect on enamel fluoride and caries experience of daily rinsing in school with 1,000 parts/10⁶ solutions of ammonium fluoride or sodium fluoride at pH 4.4. Subjects were 10- to 12-year-old children (n ? 200/group at baseline), about one-half of whom reported the usage of fluoride supplements. Dental caries (DFS index) and enamel fluoride (in vivo biopsy) were evaluated at baseline, 12 months, and 24 months. Supplement users had higher enamel fluoride levels and less caries experience initially, as well as generally lower caries increments over the study. In year 1, the overall caries reductions (supplement users and non-users combined) were 23% (ammonium fluoride) and 33% (sodium fluoride), P < 0.01. For year 2, treatment effects were significantly greater: 54 % (ammonium fluoride) and 47 % (sodium fluoride). In newly erupted teeth, the effects of the ammonium fluoride (70 % DFS reduction) was significantly greater (P = 0.013) than that of the sodium fluoride (48 % DFS reduction). Enamel fluoride levels at the end of 2 years were 3,124 parts/10⁶ (ammonium fluoride), 2,771 parts/10⁶ (sodium fluoride), and 2,603 parts/10⁶ (placebo), P= 0.025.     

Factors predicting caries risk in children

Abstract – Selection of caries-risk groups is difficult and unreliable. In this study we analyzed the known correlates of caries and their interrelations. The subjects (n= 153) were seventh graders (13 yr old) from a school in Kuopio. Data were collected by mail survey (n= 150), from the clinical registers of the local health center (n= 135), and from a saliva test. In the first stage we computed the bivariate correlates between the D-index and its traditionally defined determinants. In the second stage the predictors of caries risk were ranked using discriminant and multiple regression analyses. The bivariate correlates of caries were: DMF-index of the previous year (r = 0.69), D-index of the previous year (r = 0.59), lactobacillus count (r = 0.26), buffer capacity (r = 0.20), and toothbrushing frequency (r = 0.07). In discriminant analyses the DMF-index among girls and the frequency of consumption of sweets among boys were the only significant discriminators. In the multiple regression analyses, however, the final model (P <0.001) for girls included: DMF-index of the previous year (β= 0.64) and lactobacillus count (β= 0.31). The corresponding model for boys (P <0.001) included: DMF-index of the previous year (β= 0.55) and frequency of consumption of sweets (β= 0.24). Using these variables, it is difficult to develop a reliable method for determining the caries susceptible groups, but of them, the DMF-index seems the most reliable for predicting caries risk among children.     

Evidence for reversal of the caries decline among Norwegian children

Summary. Objective. The purpose of the present study was to report on caries status and to explore possible reasons for changes in caries experience among 5‐ and 12‐year‐old Norwegian children. Design. National cross‐sectional and time trend study. Methods. Aggregated data from the Public Dental Services and from official statistics were used. Information was available on the total number of children, the proportion receiving treatment, sale of fluoride tablets, socio‐economic background, caries prevalence and dmft/DMFT scores. Results. The prevalence of caries among 5‐year‐olds reached a low of 30·4% in 1997 and increased to 38·9% in 2000. The mean dmft scores increased from 1·1 to 1·5. Conversely, the prevalence of caries among 12‐year‐olds decreased from 55·4% in 1997 to 52·2% in 2000 and the mean DMFT score from 1·7 to 1·5. Bivariate analyses at county level revealed significant associations, which for the most part disappeared in multivariate analyses. The sale of fluoride tablets had a significant effect on caries prevalence among 5‐year‐olds in 1998, in 1999 and in 2000. Infant mortality was associated with the dmft score in 1999. The only consistently significant predictor of caries experience at 12 years of age was caries prevalence at age 5. Conclusions. There has been a highly significant increase in caries experience among 5‐year‐olds (P < 0·001) and a levelling off among 12‐year‐olds over the past 3 years. Considering the association between caries prevalence at age 5 and caries experience at 12 years of age, there is a need for reassessment of the caries preventive programmes for children in Norway.     

Restorative dental care of children participating in a school based plaque control programme in London

Abstract The effect of a school based plaque control programme on restorative dental treatment was investigated over a 4-yr period. The programme consisted of fortnightly visits to a hygienist during term time for oral hygiene reinforcement and prophylaxis during the first 3 yr. The subjects were girls aged 11–12 yr at baseline and all attended the same school; the present study was concerned with the subjects in both the experimental and control groups who attended the dentist based in the school for restorative care (n= 147 for the first year falling to 108 for the 4-yr period). During the first year, the subjects treated from the experimental group received significantly fewer restorations than the subjects treated from the control group. This significant difference was not seen in the subsequent 3 yr and the mean number of restorations provided over the 4-yr period in the experimental and control groups respectively was 5.45 and 6.67. The corresponding 4 yr DFS increments for these groups were 5.56 and 5.52. The anomalous first finding appeared to have been due more of decayed surfaces being present in the control group at baseline. The results for restorative care generally confirmed the ineffectiveness of the programme in preventing caries and the relatively low caries increments reflect the reductions in caries experience occurring in similar communities during the period of the study.     

Longitudinal evaluation of the impact of dental caries treatment on oral health‐related quality of life among schoolchildren

This study aimed to evaluate the impact of dental caries treatment on oral health‐related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ_8‐10) instrument. Brazilian schoolchildren, 8–10 yr of age, were randomly selected and assigned to two groups – dental caries treatment (DCT) and caries‐free (CF) – according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥0]. The CPQ_8‐10 instrument was administered at baseline and at 4 wk of follow‐up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ_8‐10 scores were observed between the baseline and follow‐up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ_8‐10 scores. Responsiveness of the CPQ_8‐10 instrument (magnitude of change in CPQ_8‐10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ_8‐10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.     

Do enamel and dentine caries at 5 years of age predict caries development in newly erupted teeth? A prospective longitudinal study

Abstract

Objective: To explore caries development in children from 5 to 12?years of age, and to study whether enamel caries and dentine caries at 5?years of age could predict caries prevalence at 12?years of age, controlled for child characteristics.

Methods: The study included 3282 children examined at 5 and 12?years of age. Data were collected by clinical examination and questionnaire. Enamel and dentine caries were registered at surface level. Data were tested by t-test and analysed by bi- and multivariate logistic regression. The study was ethically approved.

Results: In 5-year-olds, 15% of the children had dentine caries experience and 21% had enamel caries. In 12-year-olds, 32% had dentine caries experience and 47% had enamel caries. Children with dentine caries experience at 5?years of age had at 12?years of age developed more surfaces with enamel caries (mean 2.8, SD 4.2) and dentine caries experience (mean 1.8, SD 2.5) than other children (p?<?.05). Dentine caries experience at 12?years of age was associated with having only enamel caries (OR 1.6, CI 1.2–2.0) and dentine caries experience (OR 3.2, CI 2.6–3.9) at 5?years of age. Family status and parental education were related to caries development.

Conclusion: Children with caries in primary teeth continued to be caries risk children during the mixed dentition period. In addition to dentine caries experience, enamel caries in primary teeth was a predictor for caries development in young permanent teeth and may be used to improve the caries risk assessment.