Is dental caries experience increased in HIV-infected children and adolescents? A meta-analysis

Abstract

Objective. To undertake a systematic review to assess if HIV-infected children and adolescents have an increased dental caries experience. Methods. A search of MEDLINE, BIREME, EMBASE, GOOGLE SCHOLAR, SIGLE (Grey Literature) and reference lists of included studies was carried out. To be eligible the studies had to present HIV-infected and non-infected children/adolescents between 0–18 years old. To assess the methodological quality, the studies were categorized in scores from ‘A’ to ‘C’. To perform a meta-analysis a random effect model was used with 95% confidence intervals and two distinct sub-group analyses were carried out in terms of caries progression: data for cavitated and non-cavitated lesions (sub-group 1) and data only for cavitated lesions (sub-group 2). Results. Five studies fulfilled the selection criteria. Four studies (two ranked A and two B in the quality assessment) revealed higher caries scores in primary teeth in the HIV-infected patients with mean dmft/dmfs scores of 3.8–4.1/7.8–11.0 compared to the control group 1.5–2.4/3.4–5.1. No differences in caries index were found for permanent dentition. The meta-analysis excluded caries data of permanent teeth and showed a significant association between caries experience in primary dentition and HIV infection considering cavitated and non-cavitated lesions (OR = 2.33, 95% CI = 1.48–3.68) or only cavitated lesions (OR = 2.98, 95% CI = 1.59–5.59). Conclusion. Evidence exists that suggests HIV-infected children/adolescents have an increased caries experience in primary dentition.     

Is the utilisation of dental care based on need or socioeconomic status? A study of dental care in Indonesia from 1999 to 2009

Objective: One of the goals of Indonesian health policy is ‘Health for All’; this includes dental health care. Therefore, it is important to continually evaluate and dynamically assess the effects of government policies, particularly whether these policies promote or obstruct social justice. This study is intended to describe the need for and utilisation of dental care and how disparities in dental care provision to people of varying socioeconomic status (SES) have changed over time. Methods: We used secondary cross‐sectional data from the Indonesian Socioeconomic Surveys for 1999, 2001, 2003, 2005, 2007 and 2009. The concentration index was used to describe disparities in need for and utilisation of dental care. Results: The concentration index showed a significant concentration of dental care utilisation among groups of higher SES. Conclusions: The use of dental care services is more dependent on ability to pay than on need for care. In addition, inequality in dental care in Indonesia persisted from 1999 to 2009.     

Does dental agenesis have an impact on OHRQoL of children,adolescents and young adults? A systematic review

Dental agenesis (DA) is defined as the congenital absence of teeth and is considered as the most common dental anomaly. It may cause speech and masticatory dysfunctions as well as esthetic problems. Its impact on oral health-related quality of life (OHRQoL) is not fully understood. The aim of the study was to assess whether DA affects OHRQoL of children, adolescents and young adults. A broad search was done on databases (Pubmed, Scopus, Web of Science and Virtual Health Library) using Medical Subject Headings (MeSH) and free terms. Eligibility criteria for article selection were predetermined and were classified according to quality assessment and risk of bias. The electronic search produced 178 titles and abstracts. After excluding duplicate abstracts and applying the eligibility criteria, three articles were assessed for the final qualitative synthesis. The three articles were classified as moderate quality and present risk of bias. No articles were found that had evaluated children and young adults. From the three articles that were selected, only one was found to have a greater impact in the adolescent agenesis group with statistical differences in all domains. There is insufficient evidence available to conclude if DA affects OHRQoL of children, adolescents and young adults.     

What do polish parents know about dental trauma and its management in children’s treatment? A questionnaire study

Objectives: To evaluate the knowledge of Polish parents concerning traumatic dental injuries (TDIs) and their management in children and to assess the influence of TDI experience on parents’ knowledge.

Methods: A questionnaire study conducted from May 2014 to February 2015 involved 741 randomly selected individual parents of children aged 1–17 receiving treatment at the Department of Pediatric Dentistry at the Medical University of Warsaw. The questionnaire consisted of 28 questions concerning TDI management.

Results: The study included 600 questionnaires subjected to statistical analysis using a χ² independence test and Spearman’s rank correlation (p?Conclusions: It appears necessary to introduce programmes for parents to raise their level of awareness concerning this topic.     

Exploring the association of dental care utilization with oral impacts on daily performances (OIDP) – a prospective study of ageing people in Norway and Sweden

Objectives: To explore the association of dental health care utilization with oral impacts on daily performances (OIDP) across time focusing ageing Norwegian and Swedish adults adjusting for predisposing, enabling, and need related-factors as defined by Andersen’s model.

Methods: Data were based on Norwegian and Swedish 1942 birth-cohorts conducted in 2007 (age 65) and 2012 (age 70). In Norway, the response rates ranged from 54% to 58%. Corresponding figures in Sweden were from 72% to 73%. Self-administered questionnaires assessed OIDP, dental care utilization and predisposing, enabling and need related factors. Logistic regression with robust variance estimation was used to adjust for clustering in repeated data.

Results: Significant covariates of OIDP were satisfaction with dental services, dental care avoidance due to financial constraints, frightening experience with dental care during childhood and patient initiated dental visiting. Frequency and regularity of dental attendance were associated with OIDP in the Swedish cohort, only.

Conclusions: In spite of country differences in the public co-financing of dental care, dental care utilization indicators were associated with OIDP across time in both cohorts. Encouraging regular and dentist initiated visiting patterns and strengthening beliefs in keeping own teeth could be useful in attempts to reduce poor oral health related quality of life in ageing people.     

Metronidazole dental gel as an alternative to scaling and root planing in the treatment of localized adult periodontitis. Is its efficacy proved?

Eight randomized clinical trials, comparing the application of 25% metronidazole dental gel (Elzylol dental gel) once a week for two weeks with scaling and root planing in the "split-mouth" design for treating adult periodontitis, were evaluated and scored according to ANTCZAK et al. (1986) and BEGG et al. (1996). The aim of this investigation was to determine whether both treatment methods are of equal value. With a maximum of 1.0 in each case, the scores determined were (M +/- SD) 0.107 +/- 0.033 (range 0.072-0.168) for reporting the study protocol and 0.285 +/- 0.084 (range 0.120-0.400) for the data analysis, presentation and discussion. Though the study results show that both treatment modalities are of equal value, the quality of the trials does not allow a comparative therapy assessment at present. The state of the data is inadequate for applying local metronidazole dental gel as an alternative to mechanical instrumentation in adult periodontitis.