School dental screening does not increase dental attendance rates or reduce disease levels

DESIGN: This was a cluster randomised controlled trial, in which the unit of randomisation was the school. INTERVENTION: Three models of screening were tested against a control. A 'new' model of school dental screening incorporated a consensus view, from clinicians in the northwest of England, on a set of clinical criteria that would prompt a referral following a screening examination. A 'traditional' model involved the delivery of the existing school dental screening programme according to the principle that a child is referred if, in the opinion of the screening dentist, dental care is required. The third intervention tested was a dental information leaflet, distributed via the schools, which encouraged parents to examine their child's mouth and to take their child to a dentist if any problems were noted. Children a ttending the control schools received no intervention during the study period. OUTCOME MEASURE: The main outcome measures were prevalence of teeth with active caries and mean number of teeth with active caries in the permanent or primary dentition. Secondary outcome measures were prevalence of oral sepsis, gross plaque or calculus, and dental trauma to incisor teeth. RESULTS: Seventeen thousand and ninety-eight children in 169 clusters (schools) were eligible for inclusion in the study. One school was withdrawn from the study because of failure to agree to follow the trial protocol. Of the total, 15 004 children were available for baseline examination in 168 schools and 13 570 children received a baseline and outcome examination, representing 80.5% of the eligible population. After adjustment for clustering of children in schools, there was no significant difference in the reduction from baseline in untreated caries between the study groups in either the primary or permanent dentition. Similarly there were no significant differences across the four arms of the study in the secondary outcome measures of prevalence of sepsis, presence of gross plaque or calculus, and trauma to the permanent incisor teeth. In the traditional arms, 42% of children attended a dentist during the study period, with 41% in the new-model arm, 37% in the information-leaflet arm and 38% in the control arm. Although more children in the traditional and new-model arms of the study attended a dental appointment these differences were not statistically significant.CONCLUSIONS: School dental screening delivered according to three different models was not effective at reducing levels of active caries and increasing dental attendance in the population under study.     

The effectiveness of school dental screening: dental attendance and treatment of those screened positive

OBJECTIVE: To determine dental attendance and treatment outcomes following two models of dental screening. DESIGN: An observational prospective cohort study. SETTING: Infant, primary and junior schools in the North West of England. SUBJECTS: Children aged six to nine years at the start of the study. INTERVENTIONS: Subjects received a screening examination according to either a 'Traditional model' or 'New model' of school dental screening. MAIN OUTCOME MEASURES: Attendance at a dentist within four months of the intervention and treatment received by children referred via the 'New model' with caries in their permanent teeth. RESULTS: In the 'New model' of school dental screening 46% of screened positive and 41% of screened negative children attended a dentist during the study period. Some 44% of children referred with caries in permanent teeth attended a dentist and 53% of those attending received treatment for the referred condition. Larger proportions of children from disadvantaged backgrounds were screened positive but higher proportions of children from more affluent backgrounds attended the dentist and subsequently received treatment. CONCLUSION: School dental screening has a minimal impact on dental attendance and only a small proportion of screened positive children receive appropriate treatment. The programme fails to reduce inequalities in utilisation of dental services.     

Effectiveness of the school dental screening programme in stimulating dental attendance for children in need of treatment in Northern Ireland

The school dental screening programme has been in existence from the beginning of the 20th century yet its value in encouraging attendance among children with a dental health need is not fully established. OBJECTIVE: To evaluate the effectiveness of school dental screening in promoting dental attendance among children with a treatment need and to examine the relative importance of screening, social class and other factors in dental attendance. METHODS: Sixty-four participating schools were assigned to study and control groups using a stratified, blocked randomisation technique. The study group children received the standard school dental screening and the dental attendance of those with a positive screening result was assessed after 2 months by means of a questionnaire issued to the children's parents. The control group children were not, at this stage, screened, yet their parents received the same questionnaire assessing dental attendance over the 2-month period. However, only questionnaires from control group children who had a positive result at a subsequent screening were retained for analysis. RESULTS: A total of 2,321 children were screened, with 980 having a positive result. The mean dmft of those screening positive was 4.85. In all, 664 completed questionnaires were returned, giving a response rate of 67.8%. Dental attendance was reported among 45.5% of the study group (n=352) in the 2 months following screening. In the same period, 27.6% of the control group (n=312) claimed attendance. The effect was found to be significant among the high employed group (P<0.01) and the unemployed group (P<0.05). CONCLUSION: School dental screening was capable of stimulating dental attendance. The strong effect among the lowest socio-economic group shows that school dental screening may be used to decrease dental health inequalities.     

Does school-based dental screening for children increase follow-up treatment at dental school clinics?

The purpose of this study was to evaluate the effectiveness of a screening program and referral system in stimulating dental attendance of children in need of treatment at Bapuji Dental College and Hospital of Davangere, India. A total of fourteen schools in the Davangere area were selected randomly and divided into two groups: seven schools that had a dental screening program (study group, n=2100 children), and seven schools that did not have one (control group, n=2400 children). The attendance rate by members of the study group was determined during the three-month period from the date of initiating the school screening program. During this same period the students who visited the college from the control group underwent a dental examination. Chi-square tests were used to test the difference between different variables. The response rate for seeking treatment was 31 percent for the study group (34.2 percent for males; 26.2 percent for females) and 10 percent for the control group (9.6 percent for males; 10.5 percent for females). In both the groups, the treatment need was highest for dental caries (study group=36.3 percent, control group=11.1 percent) and least for fluorosis (study group=21.2 percent, control group=1.2 percent). The study demonstrated that screening and motivation significantly improved the percentage of school children who sought dental care.     

Dental health of young insulin dependent diabetic subjects in Northern Ireland.

The present study was undertaken to establish the dental disease and treatment levels in 101 young insulin dependent diabetic patients in Northern Ireland. There was a significantly greater proportion of children from the higher social classes in the diabetic group. Their dental caries experience was lower than that reported for the general population and the restorative indices were high. However, those whose diabetes was diagnosed at a late stage had a higher caries experience. There was significantly more gingivitis detected in older diabetic patients, but oral hygiene status did not significantly differ with age. There was a pattern of regular dental attendance in the majority of diabetic subjects.     

免费龋齿充填干预对上海嘉定区学龄前儿童乳牙龋病的影响

目的:为上海市嘉定区儿童口腔预防工作提供基线资料,明确嘉定区儿童中浅度龋齿免费充填活动的效果.方法:使用整体抽样方法,对2所经济条件、生活环境相似的幼儿园中的918名儿童连续观察3 a.一所幼儿园连续3年免费充填中、浅度龋齿,一所幼儿园作为对照.采用SPSS20.0软件包对数据进行r检验.结果:基线时2所幼儿园患龋率、龋均(dft)、龋蚀严重度指数(CSI)均无显著差异.经过3年干预,2组幼儿园儿童患龋率、dft、CSI均有显著差异.经过3年干预,干预组幼儿患龋率(43.90％)、dft(2.86)、CSI(7.34)均显著低于对照组(64.08％、3.51、10.17).结论:免费充填干预提高了儿童龋病充填率,降低了患龋率、龋均、CSI,早期抑制了龋病的发展.     

Dental caries in schoolchildren in some Danish communities with and without school dental service

ABSTRACT The purpose of the investigation was to compare the caries prevalence (DMF-T) among 762 7th grade children, of whom one-hall had received regular school dental care throughout their school attendance and the other half had never received school dental care. The children were grouped according to social status in order to see if there was any difference in the caries prevalence between the social groups. The caries prevalence in children both with and without school dental service was high, 9.5 DMF-T and 10.5 DMF-T. The prevalence of untreated caries and secondary caries was lowest in the group with school dental service.     

Identifying children with dental care needs: evaluation of a targeted school-based dental screening program

OBJECTIVES: It has been suggested that changes in the distribution of dental caries mean that targeting high-risk groups can maximize the cost effectiveness of dental health programs. This study aimed to assess the effectiveness of a targeted school-based dental screening program in terms of the proportion of children with dental care needs it identified. METHODS: The target population was all children in junior and senior kindergarten and grades 2, 4, 6, and 8 who attended schools in four Ontario communities. The study was conducted in a random sample of 38 schools stratified according to caries risk. Universal screening was implemented in these schools. The parents of all children identified as having dental care needs were sent a short questionnaire to document the sociodemographic and family characteristics of these children. Children with needs were divided into two groups: those who would and who would not have been identified had the targeted program been implemented. The characteristics of the two groups were compared. RESULTS: Overall, 21.0 percent of the target population were identified as needing dental care, with 7.4 percent needing urgent care. The targeted program would have identified 43.5 percent of those with dental care needs and 58.0 percent of those with urgent needs. There were substantial differences across the four communities in the proportions identified by the targeted program. Identification rates were lowest when the difference in prevalence of need between the high- and low-risk groups was small and where the low-risk group was large in relation to the high-risk group. The targeted program was more effective at identifying children from disadvantaged backgrounds. Of those with needs who lived in households receiving government income support, 59.0 percent of those with needs and 80.1 percent of those with urgent needs would be identified. CONCLUSIONS: The targeted program was most effective at identifying children with dental care needs from disadvantaged backgrounds. However, any improvements in cost effectiveness achieved by targeting must be balanced against inequities in access to public health care resources.     

Assessing the effectiveness of a school-based oral health promotion programme in Yichang City, China

Abstract – Objectives: To assess the outcome of oral health promotion in schoolchildren over a 3‐year period in Yichang City, Hubei, China. Methods: In a cluster randomized controlled trial, the concept of the World Health Organization Health Promoting Schools Project was applied to primary schoolchildren. Seven intervention schools and eight control schools were randomly selected from one district by stratified cluster sampling. The study was conducted as a 3‐year follow‐up study. After 3 years, 661 children remained in the intervention group and 697 children in the control group. Data on dental caries, plaque accumulation, and sulcus bleeding were collected by clinical examination, while behavioural data were gathered by self‐administered questionnaires. Results: The 3‐year net mean DMFS increment score was 0.22 in the intervention schools and 0.35 in the control schools (P < 0.013). A statistically significant difference in mean plaque (P < 0.013) and sulcus bleeding (P < 0.005) increment scores after 3 years was found between the two groups. Statistically significant higher scores were observed in restorations received and sealants placed, and a lower score in untreated dental caries, in children from the intervention group than the control group after 3 years (P < 0.01). In addition, more children in the intervention schools adopted regular oral health behavioural practices such as brushing their teeth at least twice a day, visiting the dentist within the past calendar year, and using fluoride toothpaste. Conclusion: The study suggests that the school‐based oral health promotion was an effective way to reduce new caries incidence, improve oral hygiene and establish positive oral health behavioural practices in the targeted schoolchildren.     

Dental caries and dental attendance patterns in Vietnamese children aged 11-12 years resident in three inner London boroughs, UK

Ninety-one Vietnamese children aged 11-12 years were examined in schools in Lambeth, Lewisham and Southwark. Their dental caries prevalence and attendance for dental care were compared with 464 Caucasians, Negroes and Asians. Vietnamese children had a greater caries experience than all except Asians. Although most caries was treated, over a third of Vietnamese children were symptomatic attenders.     

A staged intervention dental health promotion programme to reduce early childhood caries

OBJECTIVE: This paper reports the results of a community trial to assess the effects of a multi-stage dental health promotion programme in reducing Early Childhood Caries (ECC). RESEARCH DESIGN: Two health districts (Primary Care Groups) were matched for dental disease levels and socio-demographic factors. One was randomly allocated to be the test Primary Care Group (PCG), the other the control PCG. Children in the test PCG received a series of interventions to support positive dental health behaviour from the age of 8 to 32 months. Interviews were conducted with parents of children aged 21 months and clinical examinations were undertaken on a larger cohort of children aged 3-4 years in test and control PCGs. SETTING: The interventions were gift bags containing a trainer cup, toothpaste containing 1,450 ppm F and toothbrush, and advice given to the children's parents on attendance at designated clinics and medical practices and further paste and brushes posted to the children's homes. Parents were interviewed on the telephone. Examinations took place at Children's Centres and nursery departments attached to primary schools. OUTCOME MEASURES: Severity and prevalence of ECC and general caries and proportion of parents reporting adopting dentally healthy behaviours. RESULTS: In the test PCG the prevalence of ECC in children who had received the interventions was 16.6% compared with 23.5% of children in the control area, a reduction of 29% (p=0.003). The mean dmft (1.17) and prevalence of general caries experience (28.7%) in the test children were also significantly lower than for children in the control PCG (1.72: 39.2%) (p=0.001). Analysis from a community perspective, which included data from all children examined in both areas, showed the prevalence of ECC in the test and control PCGs was 21.3% and 22.8% respectively and the mean dmft 1.47 and 1.72. The proportion with general caries experience remained statistically significant in favour of the test area 33.8% vs 39.9% (p=0.01). Parents in the test PCG were more likely to report cessation of bottle use (33% vs 18%), use of sugar-free drinks (49% vs 24%), commencement of brushing before first birthday (45% vs 27%) and twice daily brushing (52% vs 34%). CONCLUSION: The parents who received this multi-stage intervention were more likely to report adoption of three positive oral health behaviours; using a trainer cup from one year of age, using safe drinks and brushing twice daily with a fluoride toothpaste. The programme failed to reduce the prevalence of ECC in the community but the prevalence of ECC and general caries experience among the children who participated was less than among children in the control PCG.     

A randomised controlled trial to determine the effectiveness of glass ionomer sealants in pre-school children

BACKGROUND: Caries levels in pre-school children remain high in some areas of the UK. Studies of glass ionomer fissure sealants show their potential for caries prevention in permanent teeth, but their use in primary teeth has not been reported. AIM: To determine whether a glass ionomer fissure sealant placed on primary molars in pre-school children at high risk of developing dental caries can decrease the incidence of dental caries. MATERIAL: 508 children aged 18-30 months from high caries areas of South Wales with caries-free first primary molars were recruited to the trial after informed consent. METHODS: This was a placebo-controlled individual randomised controlled trial (RCT). All children (n = 508) received a standard package of dental health education. Children in the test group (n = 241) had their first primary molars sealed with glass ionomer. All the children were re-examined once at varying intervals between 12 and 30 months. RESULTS: Analysis of the caries data revealed no significant difference between test and control groups for any of the parameters examined. Examination of the confidence intervals showed no indication that there might be a difference even if the sample size had been increased. CONCLUSION: There is no evidence that the intervention as used in this population had any effect on caries incidence and it cannot be recommended as a clinical procedure.     

Recent dental attendance and levels of untreated caries in a sample of 11-12 year old children in Northern Ireland

The object of the present study was to determine the relationship between dental attendance and the levels of untreated caries in a sample of 11-12 year old pupils attending first form of second level schools in the South Belfast area of Northern Ireland. A sample of 199 first form pupils attending second level schools in the area was obtained. The diagnosis of caries depended mainly on visual evidence following removal of debris and moisture. Blunted probes were used to confirm or reject doubtful lesions and no radiographs were taken. Details of parental employment status were obtained by a questionnaire to the parents. The data were entered on to an N.C.S.S. data analysis system for stepwise regression and analysis of variance. Overall there was a significant difference in the untreated caries status of those with different attendance patterns, the major difference being that a much higher proportion of those who had not attended within the previous 12 months had active caries. Almost half of the children had attended in the previous six months and only 16 (8 per cent) had not attended in the previous 12 months. Independent analysis indicated that parental employment status was significantly related to the level of untreated caries (p > or = 0.05). Independent variables entered in the stepwise regression were attendance, employment status and DMFT. The strongest predictors of untreated caries were previous caries experience and period since dental attendance, while employment status was a significant but weaker factor in the analysis. These findings may be relevant when planning the frequency of school dental screenings and managing the frequency of dental recalls and examinations.     

Dental caries experience in Ghana among 12-year-old urban and rural schoolchildren

Children aged 12 years from two geographical regions in Ghana were examined for dental caries according to criteria of the World Health Organization. Urban and rural areas were included, the urban sample comprising 502 children attending both private (fee-paying) schools and government (non-fee-paying) schools and the rural sample 483 children attending government schools. A high proportion (78%) of the children examined were found to be caries free. The mean DMFT (decayed, missing, filled teeth) value for the urban children was 0.7 with 68% caries free, whilst that of rural children was 0.2 with 88% caries free, a statistically significant difference. Most of the caries recorded involved the occlusal surfaces of the first permanent molars, mandibular teeth being the most frequently affected. There were no missing of filled teeth among rural children. The results indicate that, compared with earlier studies in Ghana, dental caries is not increasing in this age group. The DMFT values reported here are the lowest recorded since 1968.     

An evaluation of the PALS after treatment modelling intervention to reduce dental anxiety in child dental patients

Aim.  The aim of this study was to assess the effectiveness of the passivity to activity through live symbolic (PALS) after treatment modelling intervention to reduce child dental anxiety.
Methods.  A convenience sample of consecutive 5- to 10-year-old dental patients were randomly assigned to intervention or control groups. Self-reported child dental anxiety was assessed at the start of each visit. At the end of each visit, children in the intervention group were introduced to a glove puppet, which acted as the PALS model. The intervention group children re-enacted the treatment they had just received on the puppet's teeth. At the end of each visit, the control children received motivational rewards only. The change in dental anxiety scores was examined by t -tests and analysis of covariance.
Results.  The final analysis included 27 intervention children and 26 control children. For the intervention group, there were no statistically significant changes in dental anxiety over a course of treatment, between first and second preventive visits, between first and second invasive treatment visits, or between first attendance and subsequent recall attendance. For the control group, a statistically significant decrease in dental anxiety was observed between the first and second invasive dental treatment visits.
Conclusion.  The PALS after treatment modelling intervention was ineffective in reducing child dental anxiety.     

Decayed, missing, and filled teeth among Jewish and Arab schoolchildren in Israel

The purpose of this investigation was to gather information on caries prevalence in schoolchildren of Arab and Jewish populations, and compare caries prevalence according to sex, age and population examined. Altogther, 3672 children were included in the survey (1975 Jews, 1001 of whom were females; and 1697 Arabs, 840 of whom were females). During the examination only dental caries were checked. Caries were marked according to the DMF index. Compared to former years there is an increase in the prevalence of caries throughout the population. A slightly lower caries prevalence was found among Jewish children than among Arab children of the same age. However, when DMF is broken down into its component parts, Arab children were seen to have a greater number of teeth affected by caries and in need of treatment (D). Furthermore, treatment need has been met to a much greater degree among Jewish children than among Arab children. Arab children received almost no dental care.     

Study on availability of dental health services for children in health center--correlation between attendance of 3-year-old children at dental health services and caries prevalence]

The purpose of this study was to evaluate the dental health services for children in a health center. The samples were 316 children who had 3-year-old dental examination at a health center in Tokyo. The analysis was carried out by a computer using the results of the children's oral status and of their mothers', questionnaires and past records showing when and how many times they had attended such activities. The results were as follows: 1. Attendance of children at dental services showed the effectiveness in preventing dental caries, and it was suggested that attendance at least 3 times before the age of 18 months should be the most effective way to decrease the dental caries in the 3-year-olds. 2. According to the questionnaires, time of going to bed, snacks time, and the habit of thumb-sucking at the age of 3 years, and stopping the habit of bottle-feeding and of night breast-feeding at 18 months of age showed a great correlation concerning the number of dental caries in the 3-year-olds. 3. The more often the children had attended the dental services, the more often their behavior for eating snacks and toothbrushing changed for the better. 4. The more the mothers had dental caries, the more was the number of dental caries in their children and moreover their attendance at the dental services was less.     

Dermatoglyphics in patients with dental caries: a study on 1250 individuals

Aim: This study was undertaken to investigate and analyze the significance of dermatoglyphics in predicting the susceptibility of individuals to develop dental caries. Materials and methods: This case-control study was conducted on 1250 children in the age group of 5 to 12 years from Chennai Corporation School, Vadapalani, Chennai. Out of 1250 subjects, 625 subjects were in the study group and the remaining 625 subjects were the control group. The study group included children with dental caries in 5 or more teeth based on the DMFT index performed and control group consisted of normal, healthy children without any dental caries. The finger and palmar prints of both hands were taken using a stamp pad. The fingertip patterns were analyzed according to the classical method and configurational types were classified according to the topological method. Statistical analysis was performed using nonparametric tests and t-test to compare the dermatoglyphic pattern changes between the study group and the control group and was applied for each variable, to compare the proportions, and p-value. Results: (1) Dental caries susceptibility of an individual increases with an increase in the incidence of whorl pattern (83% correlation). (2) All the variables show statistically significant value, with a degree of divergence of specific dermatoglyphic patterns among study and control group. (3) The dermatoglyphic patterns are efficient and can predict in assessing the risk of susceptibility to dental caries in study group. Conclusion: The dental caries susceptibility of an individual increased with incidence of whorl pattern and it decreased with incidence of loop pattern. Clinical significance: The dermatoglyphic patterns may be utilized effectively to study the genetic basis of dental caries. In a developing country like India, it might prove to be a noninvasive, inexpensive and effective tool for screening. Keywords: Dermatoglyphics, Fingerprint pattern, Dental Caries, Case-control study. How to cite this article: Abhilash PR, Divyashree R, Patil SG, Gupta M, Chandrasekar T, Karthikeyan R. Dermatoglyphics in Patients with Dental Caries: A Study on 1250 Individuals. J Contemp Dent Pract 2012;13(3):266-274. Source of support: Nil Conflict of interest: None declared.     

A study of the dental health of children and young adults attending special schools in South Glamorgan.

An epidemiological study was carried out involving 677 children and young adults aged between 3 and 19 years who were attending special schools in South Glamorgan. The children and young adults were examined for caries and periodontal disease. Their dental attendance pattern and the dental service they used were recorded, and their mobility and posture, and comprehension and cooperation, were assessed. The results showed that the majority were receiving regular dental care and that the caries experience of 12- and 14-year-old children was lower than that of children of the same ages in other state schools. Five-year-old children were found to have a dmft of 4.18, which was significantly higher than that of similar-aged children attending state schools. Forty-seven per cent of the children and young adults were found to have periodontal disease; the greatest percentage (60%) was found in the young adults in the 15-19-year-old age group. Caries experience and gingival health were not related to the subjects' mobility and posture but caries experience was greater and gingival health was poorer in subjects who had reduced comprehension and cooperation. The study highlighted deficiencies in the service provided for this group, especially for pre-school children.     

Effect of caries preventive measures directed to expectant mothers on caries experience in their children

The aim of this prospective study was to determine the effectiveness of caries preventive measures started during pregnancy on the caries experience of first-time mothers and their infants. Eighty-one pregnant women with low social background were selected on the basis of the presence of active carious lesions and were randomly divided into control (38) and experimental (43) groups. The initial dental status (DMFS and white spot lesions) was established through clinical examination. The prophylactic measures were repeated during pregnancy and 6 and 12 months after delivery. Both groups received primary care intervention. They were instructed in relation to the etiologic factors of dental caries and received oral hygiene kits. Oral hygiene instructions were reinforced through interactive brushing. The experimental group also received antimicrobial treatment (topical application of NaF and iodine solution immediately after prophylaxis and 3 and 5 days later) and restorative care using glass ionomer cement. By the time the children were 2 years of age, 33.3% of the infants in the control group and 14.7% in the experimental group had caries activity. A significant difference in caries prevalence was observed between children with and without visible dental plaque. The mean number of tooth surfaces with carious lesions (including areas of demineralization) was higher among the children in the control group compared to the experimental group (6.3 x 3.2), however, with no statistical significance. Maternal caries increase was a significant factor influencing the caries experience of the children. These data support the evidence of an association between caries prevalence in young children and clinical (dental plaque) and maternal factors.