A school‐based fluoride mouth rinsing programme in Sarawak: a 3‐year field study

Chen CJ‐A, Ling KS, Esa R, Chia JC, Eddy A, Yaw SL. A school‐based fluoride mouth rinsing programme in Sarawak: a 3‐year field study. Community Dent Oral Epidemiol 2010; 38: 310–314. © 2010 John Wiley & Sons A/S Abstract – Background: This study was undertaken to assess the impact of fluoride mouth rinsing on caries experience in a cohort of schoolchildren 3 years after implementation. Methods: 270 children aged 8–9 years from four schools in Sarawak were selected at baseline. Baseline data was collected to ensure that the selected schools did not differ significantly. Children from two schools rinsed with 0.2% sodium fluoride under supervision, while those from the other schools did not. Results: After 3 years, 242 schoolchildren remained in the study. At the end of the study, the mean DMFT for the test group was 2.3 (95% CI, 1.93–2.67) while the mean DMFT for the control group was 4.01 (95% CI, 3.39–4.63). The mean DMFS for the test group was 3.40 (95% CI, 2.68–4.12) while the mean DMFS for the control group was 6.67 (95% CI, 5.47–7.87). After 3 years, 24.2% of those in the test group remained caries free compared to 11.5% in the control group. The risk of developing caries decreased 0.52 times among the children from the ‘test’ group exposed to the fluoride mouth rinsing programme as compared to the unexposed ‘control’ group (RR = 0.48, 95% CI, 0.26–0.85). Discussion and conclusion: The findings show that a school‐based weekly 0.2% sodium fluoride mouth rinsing programme is an effective caries preventive measure and should be implemented in fluoride‐deficient areas as a means of reducing the prevalence of dental caries in these communities.     

Effect of a School-based Fluoride Mouth-rinsing Programme on Dental Caries

AimsThe objective of this study was to evaluate the posttreatment effects of a school-based fluoride mouth-rinsing programme (FMR) on the prevalence of dental caries.MethodsWe included 364 newly enrolled university students aged 20 to 25 years who were not in any FMR and 187 students who had previously participated in such programmes. We calculated the prevalence of dental caries in permanent teeth and the mean decayed, missing, and filled surfaces (DMFS) according to sex, age, participation in FMR, and dental health behaviours. A multivariate logistic regression model was used to analyse the association between dichotomous variables (caries present or absent) and demographic data, participation in FMR, and dental health behaviours.ResultsThe difference in the prevalence of dental caries in permanent teeth between the subjects who participated in the FMR (51.3%) and those who did not (64.5%) was statistically significant. There were 39.6% fewer DMFS in the subjects who participated in the FMR at least during elementary school. The multivariate logistic regression model analysis demonstrated that subjects who participated in the FMR at least during elementary school were protected against dental caries as compared to those who did not. Age and sex were risk predictors of dental caries in adults, whilst other variables were not associated with dental caries.ConclusionsParticipation in an FMR at least during elementary school is a predictor for the reduction in the prevalence of dental caries in permanent teeth.Key words: Fluoride, Mouth rinse, School-based programme, Dental caries, Adults     

Molar incisor hypomineralization in HIV‐infected children and adolescents

The objective was to determine the prevalence of molar incisor hypomineralization (MIH) among individuals between 7 and 15 years old infected or noninfected with human immunodeficiency virus (HIV). The study was conducted with 33 HIV‐infected individuals (study group; SG) and 66 non‐HIV‐infected schoolchildren (control group; CG), paired by gender and age. Data collection was based on medical records (SG), a questionnaire for caregivers and oral examination for diagnosis of MIH (European Academy of Pediatric Dentistry criteria) and caries (DMFT index and ICDAS). Data were analyzed with Mann‐Whitney, chi‐square, and Fisher's exact tests and logistic regression. In SG, MIH (45.5%) and caries (87.9%) had higher prevalence. MIH was associated with use of protease inhibitors in SG (OR: 2.14; 95% CI: 1.21 to 3.77) and incubator need in CG (OR: 2.80; 95% CI: 1.71 to 9.10). HIV‐infected patients had a higher prevalence of MIH and dental caries in the permanent dentition.     

On caries prevalence and school-based fluoride programmes in Swedish adolescents

Dental caries on approximal tooth surfaces in adolescents is still a problem in Sweden, as well as in many other industrialised countries. The aims of the present thesis were therefore: 1) to study whether caries prevalence is underestimated, 2) to evaluate the effect of cessation of fluoride mouth rinse (FMR) programme in schoolchildren with low caries prevalence, and 3) to reconsider the school as an arena for population-based fluoride (F) varnish and FMR programmes in order to minimise caries development in 13-16-year-olds. Paper I and II showed that the adolescents' own dentists consistently registered less caries compared to the recordings made by calibrated dentists from outside. Based on 420 16-year-olds at 12 different dental clinics in two neighbouring counties in Sweden, the differences were statistically significant at 10 of the 12 clinics when caries prevalence both was high in 1984 (Paper I) and somewhat lower in 1987 and 1990 (Paper II). About 80% of all approximal caries lesions were enamel lesions and are therefore not reported to the Swedish authorities, as only dentin lesions and fillings are currently included in the official caries data. The basis for Paper III was that many counties in Sweden abandoned school-based FMR programmes in the mid-late 1980s, as the official caries data revealed low caries prevalence among children. The cessation of FMR for 3 years for a group of 13-16-year-old adolescents (n=60) with low caries prevalence did not reveal any statistically significant differences in new caries lesions and fillings or in the progression of existing enamel lesions compared to a group of 13-16-year-olds (n=60) who continued to rinse for 3 years. Nor did a supplementary cross-sectional study reveal any differences in caries prevalence among adolescents who had or had not taken part in FMR programmes for the last 3 years. In Papers IV and V, new models for school-based F treatment were evaluated in two 3-year randomised controlled trials (RCT studies). Fluoride varnish (Duraphat) treatment, carried out at school by specially trained dental nurses using a simple mobile unit, among 854 13-16-year-olds from low, medium and high caries risk areas showed that the control groups developed more caries than the varnish groups (Paper IV). The largest difference was found in the high-risk area. The prevented fraction (PF) with approximal enamel lesions as the diagnostic threshold was 69% in high, 66% in medium and 20% in low risk areas for F varnish applied twice a year at six-month intervals. Supervised school-based FMR among 788 13-16-year-olds with low to moderate caries risk (Paper V) showed that FMR on the first three and the last three school days during the school term, i.e. 12 rinses/year, had a PF of 59%. Enamel lesions constituted > 90% of the new approximal caries lesions in both Papers IV and V. The main conclusions from this thesis are: (1) that enamel caries lesions on approximal surfaces should be included in epidemiological caries data in order to show true caries prevalence, (2) that the cessation of weekly FMR for 3 years did not lead to a statistically significant increase in caries incidence in a relatively small group of adolescents with low caries prevalence, and (3) that the school should be reconsidered as an arena for new models for population-based F school programmes. Fluoride varnish treatment twice a year at six-month intervals in medium and high caries risk areas, as well as supervised FMR on the first and the last three school days during the school term in low and medium caries risk areas, are excellent caries prevention strategies for approximal surfaces in adolescents at the caries risk ages of 13-16 years, as a supplement to dental home care and preventive efforts at dental clinics.     

Caries prevalence of 11.5 year-olds between 1989 and 2001 in a province of North-Eastern Greece

OBJECTIVE & DESIGN: To compare cross-sectional caries prevalence data of 11.5 year old children over a 13 year period (1989-2001) and to evaluate the maximum effect of the applied preventive programme (sealants to 1st molars and 6-year health education) on DMFT values during the last five years. PARTICIPANTS: Using the records of a Public Health Centre (PHC) in NE Greece, a number (153-250) of children aged 11.5-years were selected from each calendar year, constituting 11 study groups (totalling 2,217 children), stratified by area of residency. METHOD: Annual oral health education sessions provided in 1990, a year after the PHC was established. Light-cured fissure sealants were systematically mass introduced in 1996. The same dentist completed all DMFT records in the dental clinic during the children's routine visits. DMFT was analysed using two Poisson and two Binomial models for both data from all years, and for the last five years. The models had as factors: "Time" (year of examination of the study group), "Residency" (semi urban, rural lowland, rural highland), number of "Sealed 1st molars" and "Sealed posterior teeth". RESULTS: All the factors were highly statistically significant (p<0.001). Dental health was found to be good (DMFT=0), improving progressively year by year (range 12-50%). The mean DMFT decreased steadily from 4.5 (in 1989) to 1.81 (in 2001). The Significant Caries index was almost halved (from 8.08 to 4.23). CONCLUSION: An important improvement in the caries status of 11.5 year-olds since 1989 has been demonstrated, irrespective of the residency. The systematic application of fissure sealants to all 1st molars, parallel to the cumulative effect of the 6-year health education programme per child, played a significant role in reducing disparities in disease prevalence, despite the difficulty of improving rates of decline when the caries levels are relatively low.     

Assessment and treatment of dental caries in semi-urban school children of Tamilnadu (India)

The study was carried out with the purpose of evaluating the prevalence of dental caries, in semi urban school children. The sample comprised of 415 school going children. DMFT/dmft scores were recorded as per WHO 1987 criteria. Mean DMFT was found to be 0.17, 0.06 in male and female children at 3 to 6 age group which increased to 1.21 & 1.10 in males and female in 9 to 12 year age group. Mean dmft at 3 to 6 years was 1.36, 1.17 in male and female children which further increased at 6 to 9 years in both sexes but in the 9 to 12 year age group the value decreased to 1.48, 0.87 in male and female children respectively. The entire sample showed a dental caries prevalence of 58.1. It was noted that the children brushed once a day with toothpaste and toothbrush. Complete oral rehabilitation was undertaken through an incremental school health care programme.     

Psychological distress and social support are determinants of changing oral health status among an immigrant population from Ethiopia

Vered Y, Soskolne V, Zini A, Livny A, Sgan‐Cohen HD. Psychological distress and social support are determinants of changing oral health status among an immigrant population from Ethiopia. Community Dent Oral Epidemiol 2011; 39: 145–153. © 2010 John Wiley & Sons A/S Abstract – Objectives: To examine associations between psychosocial profile (psychological distress and social support) and changing oral health status (dental caries and periodontal disease), among a group of immigrants from Ethiopia to Israel. Methods: Three hundred and forty immigrants, aged 18–75 years, with a mean age of 38.4 ± 13.5 years, comprised the study population and were followed over a 5‐ year period. Dental caries was recorded employing the DMFT index. Periodontal health status was recorded employing the Community Periodontal Index (CPI). Participants were interviewed using a structured written questionnaire which included two validated psychosocial scales, for psychological distress and social support. Bivariate and multivariate analyses were performed. Results: Among subjects with psychological distress, the adjusted mean caries (DMFT) increment in 2004–2005, since baseline (1999–2000), was 3.52 ± 0.19 when compared to 0.35 ± 0.15 among subjects with no psychological distress (P < 0.001). Correspondingly, the percentage of people with increased periodontal pockets was 40%, when compared to 7%, respectively (P < 0.001). In multiple linear regression analysis employing the DMFT as a continuous variable, and in multiple logistic regression analysis employing the DMFT as a dichotomous variable (% caries versus % caries‐free), the four variables that reached statistical significance as predictors of caries status were previous caries experience, psycholog‐ical distress, social support, and age. Gender, income, and education were not significantly related to current caries prevalence. In a multiple logistic regression analysis, the three variables that reached statistical significance as predictors of periodontal disease (shallow and deeppockets) were previous periodontal disease experience, psychological distress, and age. Social support, gender, income, and education were not significantly associated with periodontal disease prevalence. Conclusions: This study presents persuasive evidence that supports the role of psychological distress and social support as determinants of changing oral health levels, among a low socioeconomic, relatively homogenous immigrant minority population.     

Oral health status and treatment needs among school children in Sana’a City,Yemen

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00398.x
Al‐Haddad KA, Al‐Hebshi NN, Al‐Ak’hali MS. Oral health status and treatment needs among school children in Sana’a City, Yemen. Abstract: Data on the oral health status and treatment needs among Yemeni children are lacking. Objectives: To assess caries prevalence, treatment needs and gingival health status among school children in Sana’a City and to examine how these are affected by age, gender and khat chewing. Methods: 1489 children (6‐ to 14‐year old) were randomly selected from 27 schools representing all nine districts of Sana’a City. Dental caries and treatment needs were evaluated using standard WHO oral survey methods. The plaque index (PI), calculus index (CI) and the gingival index (GI), recorded at the six Ramfjord’s teeth, were used to assess gingival health status. Results: 4.1% of the study subjects were caries‐free. Prevalence of these was significantly higher among the males. Overall, mean dmfs, dmft, DMFS and DMFT scores were 8.45, 4.16, 3.59 and 2.25 respectively. The decayed component accounted for >85% of the scores. The highest dmfs/dmft means were found among the 6–8 years age group, while the highest DMFS/DMFT means were scored by the 12–14 years age group. The need for restorative treatment and extractions was high; the former was significantly higher among the females. All subjects had gingivitis; the mean PI, CI and GI were 1.25, 0.3 and 1.36 respectively. Khat chewing did not affect caries experience; however, it was significantly associated with higher PI, CI and GI scores. Conclusions: The prevalence of caries, gingivitis and treatment needs among children in Sana’a city is high. More surveys in other Yemeni cities to generate comprehensive data are required.     

Prevalence and severity of dental caries in Libyan schoolchildren

Objectives: To assess prevalence and severity of dental caries, examine gender differences and assess the relationship of dental caries to socioeconomic status in a group of Libyan schoolchildren. Design and setting: A cross sectional observational study with cluster sampling within schools. Participants: A random sample of 791, 12‐year‐olds in 36 elementary public schools in Benghazi. Methods and main outcome measures: Dental caries was assessed using the DMFT and DMFS indices and WHO (1997) criteria. Information about socioeconomic status was collected through a dental health questionnaire. Results: The prevalence of dental caries was 57.8%. The mean DMFT and DMFS indices were 1.68 (SD ± 1.86) and 2.39 (SD ± 3.05) for all subjects and 2.90 (SD ± 1.56) and 4.14 (SD ± 2.97) for subjects with caries experience. Dental caries was more prevalent amongst girls (P = 0.002). There was a statistically significantly negative association between dental caries and the level of father’s education (P = 0.015). Conclusions: While dental caries prevalence in 12 year‐old Libyan children was high, the mean DMFT was low compared with other developing countries, but higher than the WHO goal for year 2020. The high level of untreated caries is a cause for concern, representing a high unmet treatment need.     

Trends in dental caries among Brazilian schoolchildren: 40 years of monitoring (1971–2011)

The study aimed to estimate the prevalence, severity, and inequality in the distribution of dental caries in schoolchildren from Florianópolis, Santa Catarina, Brazil, in 2011, and to compare the results with data from previous studies carried out since 1971. All 12‐ and 13‐year‐old schoolchildren enrolled in a public school were eligible. Dental caries were assessed according to the World Health Organisation diagnostic criteria. Decayed, missing and filled surfaces and teeth (DMFS/DMFT) indexes, the Significant Caries Index (SiC) and the Gini coefficient (to assess inequalities in the distribution of dental caries) were estimated. The response rate was 82.3% (n = 130). The prevalence of dental caries decreased from 98.0% (95% CI 96.0–100.0) in 1971 to 36.9% (95% CI 28.5–45.3) in 2011. The mean DMFT ranged from 9.2 in 1971 to 0.7 in 2011. The mean DMFS index was 1.2 (95% CI 0.8–1.6) in 2011. The Gini coefficient was 0.624 in 2002 but increased to 0.725 in 2011; the Lorenz curve showed that 70–75% of dental caries attacks was restricted to 20% of the population in 2011. A reduction of 41.2% in the mean SiC index was observed between 2002 (3.4, 95% CI 3.0–3.8) and 2011 (1.9, 95% CI 1.6–2.1). An effective decline in the prevalence and severity of dental caries in schoolchildren was observed throughout 40 years of monitoring. However, a small proportion of the population has experienced most of the caries burden in the recent years studied.     

Milk fluoridation: a comparison of dental health in two school communities in England

OBJECTIVE: To compare levels of caries experience in children attending schools in Wirral that have a fluoridated milk programme with children in a similar community which does not have a fluoridated milk programme. STUDY DESIGN: A cross sectional study measuring caries experience in first permanent molars. Children were examined on an 'intention to treat' basis and the effect of clustering of children within schools was taken into account. PARTICIPANTS: 690 children in Wirral (test group) and 1,835 children in Sefton (comparison group) were examined for caries experience (DMFT/DT/DFS) in 2003. The mean ages of the children examined in the test and comparison groups were 10.79 and 10.83 years respectively. RESULTS: Mean DMFT/DT/DFS values were 1.01/0.59/1.20 respectively in the test group and 1.46/1.02/1.89 respectively in the comparison group. Multiple linear regression analysis taking clustering of children within schools into account and with the Index of Multiple Deprivation 2000 as an explanatory variable gave the coefficients and p-values for DMFT/DT/DFS of 0.49 (p < 0.001)/0.43 (p < 0.001)/0.74 (p < 0.001) respectively. CONCLUSION: A difference in children with caries experience of 13% and a difference in children with active decay of 16% was found when a district with a community fluoridated milk programme was compared with a district without a fluoridated milk programme.     

The comparison of root caries experience between HIV-positive patients and HIV-negative individuals in a selected Iranian population

To cite this article:
Int J Dent Hygiene 9 , 2011; 261–265 DOI: 10.1111/j.1601‐5037.2010.00491.x
Rezaei‐Soufi L, Davoodi P, Jazaeri M, Niknami H. The comparison of root caries experience between HIV‐positive patients and HIV‐negative individuals, in a selected Iranian population. Abstract: Objectives: Human immunodeficiency virus (HIV) infection is a concerning problem in dentistry and HIV‐infected patients may experience root caries due to different risk factors. The aim of this study was to find the prevalence of root caries in a selected Iranian HIV‐positive population. Methods: One hundred and seven IV drug users, based on ELISA and Western Blot test, were divided into two groups: group 1: HIV‐positive patients and group 2: HIV‐negative individuals. According to the T‐CD4⁺ cell count, subjects in group 1 were placed in two subgroups: Moderate immunodeficiency (200 mm^?3 < T‐CD4⁺ cells <500 mm^?3) and Severe immunodeficiency patients (T‐CD4⁺ cells <200 mm^?3). Teeth were examined by an examiner under suitable light to detect any changes in colour, texture or contour. The values of DMFT, DMFS, decayed root surfaces and total decayed surfaces were calculated. Data were analysed by independent t‐test and chi‐squared test. Results: The mean DMFT, DMFS and decayed root caries in group 1 and 2 had no significant difference. The mean value of total decayed surfaces of HIV+ patients was significantly higher compared with HIV? individuals (P = 0.03). The comparison of all parameters between two subdivisions of group 1 showed no significant difference. Conclusions: The results indicate that HIV+ patients experienced more dental caries, but not more root caries than healthy ones. Along with decreasing T‐CD4⁺ cell count, tooth caries’ prevalence did not increase. Clinical relevance: Based on our findings, root caries prevalence is almost the same in HIV‐positive and negative individuals; however, it is necessary to decrease tooth caries by continual monitoring and periodic dental examination.     

The effectiveness of a 6-year oral health education programme for primary schoolchildren

OBJECTIVES: The aim of this study was to evaluate the effect of a 6-year oral health education programme in primary schoolchildren. METHODS: This programme was part of the Signal-Tandmobiel project, a longitudinal collaborative project combining the registration of oral health data and oral health promotion. The intervention group comprised 3291 children with a mean age of 7.1 years (SD 0.43) at the start of the programme. Every year these children were examined clinically and a questionnaire, to be filled in by the parents, was administered to assess oral health behaviour. These children received an oral health education programme which consisted of a yearly 1-h instruction. Data collected using the same questionnaire and clinical examination in 676 12-year-old children were included as control group. The samples were obtained using stratified cluster sampling. The effect of the interventional programme was assessed by measuring differences in caries prevalence and incidence, levels of dental care and reported oral health behaviour. RESULTS: Mean DMFT/S values, although higher in the control group, were not significantly different. The reported frequency of brushing was the same in both groups. Significant differences in favour of the intervention group were found in the number of between-meal snacks (P < 0.001) and the proper use of topical fluorides (P < 0.05). Children in the control group showed a significantly lower proportion of filled teeth than those in the intervention group (P < 0.01), with a care index of 73% versus 80%.CONCLUSION: In conclusion, the implemented minimal school-based oral health education programme did not result in a significant reduction of the caries prevalence measured. The programme has been effective in improving reported dietary habits and the proper use of topical fluorides and resulted in a higher care index.     

Association of dental caries with socio-demographic and nutritional factors among school children in Guntur district of Andhra Pradesh,India

ObjectiveThe main objective of the study was to determine the association of dental caries with socio-demographic factors like age, gender and socioeconomic status (SES); second is to explore the relationship between dental caries and nutritional status in school going children of Guntur district, Andhra Pradesh.MethodsIn this cross-sectional study, SES of 1022 children aged between 5 and 11 years were assessed according to modified kuppuswamy SES scale. The body mass index (BMI) values were calculated and then the children were grouped into 3 categories (underweight, normal, overweight + obese) based on revised World Health Organization (WHO) growth charts. Caries index (deft+/DMFT) of each child was recorded using American Dental Association (ADA) Type 3 examination. Data was analysed and the tests employed were Chi-Square (X2); Analysis of Variance (ANOVA) and Logistic regression analysis.ResultsThe prevalence of dental caries was 57.14% and underweight was 40.3% among Guntur district school children. A significant association between dental caries and SES was noticed (OR = 1.74). However, no significant association of dental caries experience with other factors like age, gender and BMI was observed.ConclusionNutritional status of children may not show association with dental caries, but SES influences the caries prevalence in children.     

The caries-preventive effect of xylitol/maltitol and erythritol/maltitol lozenges: results of a double-blinded, cluster-randomized clinical trial in an area of natural fluoridation

International Journal of Paediatric Dentistry 2012; 22: 180–190 Objective. Xylitol studies suggest caries reductions in the order of 50%. Based on animal/microbial studies, erythritol potentially has caries‐preventive properties. However, clinical studies are required to confirm this.The aim of the study was to investigate the additional caries‐preventive effect of xylitol/maltitol and erythritol/maltitol lozenges delivered at school, relative to controls receiving comprehensive prevention, in a low‐caries prevalence population. Methods. A 4‐year, cluster‐randomized, double‐blinded clinical trial. Five hundred and seventy‐nine 10‐year‐old consenting subjects from 21 schools were randomly assigned to one of five groups. Four groups used the lozenges on school days, in three teacher‐supervised sessions daily, over 1 or 2 years. The daily amount was 4.7 g/4.6 g for xylitol/maltitol and 4.5 g/4.2 g for erythritol/maltitol. The groups received free examinations and care in the public health centre. Four hundred and ninety‐six children were analysed. The main outcome measure was dentin caries increment based on a clinical examination at 4 years since the start. The groups were compared in relation to the increment using hierarchical logistic regression to adjust for potential clustering. Results. Use of xylitol/maltitol or erythritol/maltitol lozenges did not result in caries reduction. A strong relationship between baseline caries prevalence and the 4‐year increment was observed (OR = 7.38; 95% CI: 3.78–14.41). Conclusions. The results suggest that in relatively low‐caries conditions the school‐based use of xylitol/maltitol or erythritol/maltitol lozenges would not have additional caries‐preventive effect when compared with comprehensive prevention.     

Socioeconomic factors in adolescents’ oral health: are they mediated by oral hygiene behaviors or preventive interventions?

Polk DE, Weyant RJ, Manz MC. Socioeconomic factors in adolescents’ oral health: are they mediated by oral hygiene behaviors or preventive interventions? Community Dent Oral Epidemiol 2010; 38: 1–9. © 2009 John Wiley & Sons A/S Abstract – Objectives: To determine whether there is a socioeconomic status (SES) disparity in caries experience (i.e., DMFT) in an adolescent sample from Pennsylvania and to determine whether differences in oral hygiene behaviors and preventive interventions account for this disparity. Methods: A cross‐sectional clinical assessment was conducted on a representative sample of 9th grade and 11th grade students across Pennsylvania. These students also completed a brief questionnaire regarding their oral hygiene behaviors. From this group of students, a random subsample of 530 parents completed a questionnaire assessing SES, fluoride exposure, and recency of receipt of dental services. DMFT was examined at two thresholds of severity: simple prevalence (DMFT > 0) and severe caries (DMFT > 3). Results: Using structural equation modeling, we found that lower SES was associated with higher prevalence of DMFT and higher prevalence of severe caries. Although lower SES was associated with lower rates of brushing, less use of sealants, and less recent receipt of dental services, these oral health behaviors and preventive interventions did not account for the disparities in DMFT defined by SES. Conclusions: There is an SES gradient in caries experience in adolescents in Pennsylvania. Disparities in caries experience, however, cannot be accounted for by SES‐associated differences in brushing, flossing, sealant use, fluoride exposure, or recency of use of dental services. To facilitate the design of preventive interventions, future research should determine the pathways through which SES‐associated disparities occur.     

Caries prevalence,severity, and 3‐year increment,and their impact upon New Zealand adolescents' oral‐health‐related quality of life

Objective: To examine dental caries experience among New Zealand adolescents and determine the nature of caries‐associated differences in oral‐health‐related quality of life (OHRQoL) among adolescents. Method: Follow‐up was conducted of a random sample of 430 children first examined in 2003 at age 13, when they completed the Child Perceptions Questionnaire (CPQ_11‐14). At age 16, 255 (59.3% of the baseline sample) were re‐examined and again completed the CPQ_11‐14. Results: Caries prevalence (1 + DMFS) rose from 68% to 79.2%; mean DMFS rose from 2.9 (SD 4.7) to 3.6 (SD 4.8), and the prevalence of high caries experience (5 + DMFS) rose from 20.0% to 40.8%. The 3‐year mean net caries increment of 0.5 surfaces (SD 2.6) was dominated by occlusal surfaces. At both ages, overall CPQ_11‐14 scores, as well as emotional well‐being subscale scores, were significantly higher for those with DMFS values of 5 or more. Conclusion: Caries experience increased over the three years; this age group is caries‐active. Dental caries affects adolescents' OHRQoL, although not as strongly as maybe expected.     

Dental caries prevalence and risk factors among 12-year old schoolchildren from Baghdad, Iraq: a post-war survey

AIM: To examine the prevalence of dental caries in 12-year-old schoolchildren from Baghdad after the end of the United Nations' economic sanctions and to investigate related dental caries risk factors including gender, socio-demographic factors, oral hygiene and sugar intake. DESIGN: A cross-sectional dental caries examination and questionnaire survey was conducted in 10 schools from west Baghdad. METHODS: Dental examinations based on WHO criteria and questionnaire surveys were performed on 392 children. Water samples were collected and fluoride concentration assessed. RESULTS: The mean DMFT and DF were 1.7 and 1.3. The rate of caries experience (DMFT > 0) was 62%. DMFT increased significantly with higher education of the mother, not being embarrassed to smile, missing school due to dental pain and between-meals mode of drinking. Increased sugar consumption was associated with being a boy, having mothers with low education, living in a low socio-economic area and brushing at least once-a-day. Positive oral hygiene practices were higher for girls. Western sweet snacks were preferred and sweet tea was frequently consumed. The fluoride content in drinking water was too low for caries prevention. CONCLUSION: It is important to maintain the low prevalence of caries among children by increasing awareness and promoting oral health care strategies.     

Oral health in Hlabisa, KwaZulu/Natal--a rural school and community based survey

AIMS: To investigate rates of dental caries and periodontal disease, available dental services and resources and perceived needs in a rural South African community. DESIGN: A cross-sectional field study including situational analysis and focus group discussions. SETTING: KwaZulu/Natal, South Africa. PARTICIPANTS: A total of 520 children, adolescents and adults. METHODS: WHO caries scores and periodontal CPI score were determined through clinical examinations in five age groups, 5-6 years, 12 y, 15 y, 35-54 y, 55 y+. Focus groups included ten 15-year-old children and ten adults. RESULTS: Caries prevalences and (mean scores) were 5-6 y 64% (dmft 3.0), 12 y 24% (DMFT 0.4), 15 y 27% (DMFT 0.8), 35-54 69% (DFT 2.6) and 55 y+ 80% (DFT 2.7). Most caries was untreated and where present, treatment had been extraction. Dental caries rates were low and except for 5-6 y were within WHO targets for the year 2000. Periodontal disease prevalence was high but would respond to improved oral hygiene. Knowledge of oral health was rudimentary. CONCLUSIONS: A district-wide oral health promotion programme is required preceded by research to define effective health education messages. Access to simple but effective preventive and curative services would seem reasonable. In view of the lack of resources ART is suggested as caries treatment.