Caries and dental fluorosis in a western Saharan population of refugee children

The aim of this study was to investigate the relationship between dental fluorosis and dental caries among western Saharan refugee children. The western Saharan child population is characterized by adverse living conditions, an unbalanced diet, poor oral hygiene habits, and a concentration of fluoride in the drinking water of around 2 p.p.m. (2 mg l^?1). A sample consisting of 360 children, 6–7 yr of age, and 212 children, 11–13 yr of age, was obtained from four refugee camps (Smara, Awsard, El‐Aaiun, and 27‐February) situated in the vicinity of Tindouf (southern Algeria). The children were examined using the World Health Organization criteria for caries diagnosis and Dean’s index for fluorosis. The decayed, missing or filled teeth (DMFT) score was 0.48 in the 6–7‐yr‐old children and 1.69 in the 11–13‐yr‐old children, with a caries prevalence (DMFT > 0 or decayed and filled primary teeth (dft) > 0) of 47.2% and 63.2%, respectively. Among the 6–7 yr‐old children examined, 36.9% were free of fluorosis, 15.6% presented moderate fluorosis, and 7.8% presented severe fluorosis. Among 11–13 yr‐old children, only 4.2% were free of fluorosis, 30.2% exhibited moderate fluorosis, and 27.4% presented severe fluorosis. The mean DMFT, decayed permanent teeth (DT), and caries prevalence (DMFT > 0 and DMFT or dft > 0) scores were significantly higher among the children affected by severe fluorosis, suggesting that severe fluorosis might increase the susceptibility to dental caries.     

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.     

Oral health status of 5-year-old Aborigine children compared with similar aged marginalised group in south western India

Objective: To compare and assess oral health status of 5‐year‐old Aborigine children with similar aged, marginalised children in coastal region of south western India. Materials and methods: A total of 418 Aborigine children were invited to participate in the study and a total of 428, 5‐year‐olds were selected randomly for comparison from other government schools to form the other marginalised group. The WHO (1997) proforma was used for clinical examinations. Chi Square test was used to compare between categorical variables. Mann–Whitney U‐test was used for comparison between the two groups for quantitative variables. Logistic and linear regression analysis was performed to determine the importance of the factors associated with caries status. Odds ratio was calculated for all variables with 95% confidence intervals. P ≤ 0.05 was considered as statistically significant. Results: Dental fluorosis was present in 50 (11.9%) Aborigine children, whereas in the other marginalised group 7 (1.6%) children had dental fluorosis (P ≤ 0.001). Untreated dental caries was 76.3% for the Aborigine children and 70.3% in the comparison group. Mean dmft values in the two groups were 4.13 ± 3.90 and 3.58 ± 3.60, respectively (P > 0.01). High frequency of between‐meal sugar consumption was related to dental caries (OR = 1.20; P = 0.001). Utilisation of dental care and dental fluorosis were inversely related to dental caries (OR = 1.16; P = 0.001 and OR = 1.91; P = 0.001). Conclusion: The study revealed poor oral health status among both the marginalised groups. Significant differences were noted between the two groups with respect to oral hygiene practices, dietary habits, and dental utilisation pattern. Schools for tribal children, male gender, low frequency of cleaning teeth and higher in between‐meal sugar consumption were significantly related to dental caries.     

Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa

Objectives. The purpose of this study was to determine the relationship between caries experience, degree of fluorosis and different concentrations of fluoride in the drinking water of children. Sample and methods. The study included 282 children aged 10–15 years, who lived continuously since birth in three different naturally fluoridated areas (Leeu Gamka, 3·0; Kuboes 0·48 and Sanddrif 0·19 p.p.m. F), with virtually no dental care or any fluoride therapy. The teeth of the children were examined for caries using the DMFT index according to the WHO criteria and for fluorosis, using Dean’s criteria according to the WHO guidelines. Results. The prevalence of fluorosis (scores 2, 3, 4 and 5) among the school children was 47% in Sanddrif, 50% in Kuboes and 95% in Leeu Gamka. Almost half the children in the two low fluoride areas had no fluorosis (scores 0 and 1), whereas only 5% in Leeu Gamka had no fluorosis. Of the children in Sanddrif, 42·5% had very mild/mild (scores 2 and 3) fluorosis, 44·3% in Kuboes and 34·1% in Leeu Gamka. Except for one individual in Kuboes, severe fluorosis (score 5) was only observed in the high fluoride area in 30% of the children. According to the Bonferroni adaptation for multiple comparisons, the degree of fluorosis in Leeu Gamka differed significantly from both those of Sanddrif and Kuboes. The mean DMFT for the children in Sanddrif and Kuboes was similar (1·64 ± 0·30 and 1·54 ± 0·24, respectively) but the caries experience of Leeu Gamka (1·98 ± 0·22) was significantly higher (P < 0·05) than that of both the other two areas. A strong positive correlation (P < 0·05) was found between the caries experience and the fluorosis scores of children in the high fluoride area (Leeu Gamka) but no correlation could be found in the other two areas. Significantly (P < 0·01) more children had decayed teeth in the high F area (Leeu Gamka) than in the other two areas. Conclusion. The results suggest a positive association between high F levels in the drinking water and dental caries. Furthermore, a low caries experience and no difference in DMFT and fluorosis between the two low fluoride areas were found.     

The relationship between dental caries and dental fluorosis in areas with moderate- and high-fluoride drinking water in Ethiopia

OBJECTIVE: The aim of the study is to assess the relationship between caries and dental fluorosis in Ethiopian children living in Rift Valley areas known for endemic fluorosis. METHOD: A total of 306 children (12-15 years old), selected from areas with moderate (0.3-2.2 mg/l), or high (10-14 mg/l) fluoride concentration in the drinking water were interviewed and examined for caries and dental fluorosis. Scorings were recorded according to the DMF system, and the Thylstrup-Fejerskov (TF) Index. RESULTS: Prevalence of dental fluorosis (TF-score > or = 1) was 91.8% (moderate area) and 100% (high-fluoride area). The corresponding caries prevalence and mean DMFT in the areas were 45.3% versus 61.6%, and 1.2 versus 1.8, respectively. Age and severity of dental fluorosis were found to be independent predictors for DMFT > or = 1. When compared with 12-year olds with TF-scores 0-4, odds ratios were 3.0 (95% CI 1.6-5.7) and 2.0 (95% CI 1.2-3.2) if TF-scores were > or = 5 and age 13-15 years, respectively. A positive relationship between caries and fluorosis was observed across tooth types in both areas. The percentage of children with DMFT > or = 1 was highest in groups with TF-score > or = 5 in the second molar, followed by the first molar. CONCLUSION: The present findings indicate that the second molar is the tooth most severely affected by dental fluorosis and dental caries. Dental caries increased with increasing severity of dental fluorosis, both in moderate- and high-fluoride areas. Thus, a positive relationship between dental caries and dental fluorosis was observed across various tooth types, in both areas.     

Dietary intakes and caries experience in children in Limpopo Province, South Africa.

INTRODUCTION: The identification of a rural village with a very low incidence of dental caries among the children provided the opportunity to study the diets of children apparently not exposed to risk factors for dental caries and compare them with children who were at risk. OBJECTIVE: To compare the diet, nutritional status and dental caries experience of 10- and 15-year-olds in an urban town (Malamulele) and a rural village (Mahonisi) in the Limpopo Province, South Africa. METHODS: Dental examinations and anthropometric measurements were done according to standard procedures. Dietary intakes were assessed by four 24-hour recalls. RESULTS: Mean dft/DMFT (decayed and filled deciduous teeth/Decayed, missing and filled permanent teeth) scores were 1.21 and 0.65 for 10- and 15-year-olds in urban Malamulele compared to 0.33 and 0.02 in rural Mahonisi. The percentage caries free in Malamulele was 36% compared to 88% in Mahonisi. The children in Mahonisi were shorter and lighter than those in Malamulele. Estimated fluoride intakes were significantly lower in Malamulele than in Mahonisi (p = 0.01). Mean total added sugar (all sugar not naturally occurring in foods) intake in Malamulele was significantly higher than in Mahonisi (p < 0.05). CONCLUSION: The most significant dietary differences between the two areas were total added sugar and fluoride intakes. The lower added sugar and higher fluoride intake among the rural Mahonisi children contributed to the lower dental caries experience.     

铜山县高氟区少年龋病和氟斑牙患病情况的调查

目的调查徐州市铜山县高氟区12~15岁人群氟斑牙和龋病的流行情况,探究龋病患病患病率、龋均与氟斑牙之间的相关关系,为高氟区少年的氟斑牙和龋病的防治提供参考。方法参考第二次全国口腔健康流行病学抽样查的基本方法与诊断标准和Dean氟牙症分类标准,对高氟区12~15岁初中学生氟斑牙和龋病的患病情况进行检查记录。结果社区氟斑牙指数Fci为2.52,为氟斑牙重度流行区域;诊断为氟斑牙的人群中各年龄组氟斑牙患病率无差异;本次调查人群总患龋率为22.7%;氟斑牙人群的患龋率各年龄组间无显著性差异,龋均各年龄组间差异无显著性;诊断为氟斑牙的患龋病人群中患龋率比较不同记分组有显著性差异(P=0.042),重度组与轻度组比较及重度组与非氟斑牙组比较,龋均均有显著性差异。结论高氟区12~15岁少年的氟斑牙人群的患龋率与非氟斑牙人群比有显著性差异(P=0.000),其中记分为重度的组患龋率比轻度的组和非氟斑牙组高。     

Estimation of optimal concentration of fluoride in drinking water under conditions prevailing in Chile

Abstract– The purpose of this comparative study of caries and dental fluorosis experience in Chilean children was to estimate the optimal range of fluoride concentration in tap water under conditions currently prevailing in Chile. The sample included 2431 schoolchildren 7, 12 and 15 years old, life-long residents of five communities with fluoride concentrations in their tap water in the range 0.07–1.1 mg/L. The study population received an oral clinical examination including caries experience and an enamel fluorosis evaluation of the permanent dentition (Dean's scoring system). For 15-year-old children, the DMFT index changed from 5.06 to 2.60, and for 12-year-olds it changed from 3.10 to 1.36 when fluoride water concentration changed from 0.07 to 1.10 mg/L. For 7-year-old children the dmft index correspondingly changed from 3.67 to 1.59. The relationship between DMFT for 12-year-olds and water fluoride concentration was best fitted by a logarithmic function ( r ²=0.98). The Community Fluorosis Index (CFI) was used to assess enamel fluorosis in the study population, and it showed a linear relationship ( r ²=0.983) with increasing fluoride concentration of water for the 12-year-old group. Results obtained suggest that under current Chilean conditions, the optimal range of fluoride concentration in potable water should lie in the 0.5–0.6 mg/L range.     

海南省12岁儿童龋病和氟牙症的流行病学抽样调查

目的：了解海南省城乡12岁年龄组人群恒牙龋病及氟牙症的患病状况,为海南省口腔卫生保健工作提供科学依据。方法：采用多阶段分层等容量随机抽样的方法,抽取海南省12岁城乡常住人口777人,按照《第3次全国口腔健康流行病学调查方案》中临床龋病和氟牙症的检查方法和标准,检查全口恒牙龋病和氟牙症的患病状况。结果：海南省12岁年龄组恒牙患龋率和龋均分别为49.9%和1.1。农村和城市地区的患龋率分别为49.4%和50.3%,城乡之间的差异无统计学意义;男性和女性的患龋率分别为45.3%和55%,具有统计学差异（P〈0.05）。氟牙症患病率为3.6%,氟牙症指数（FCI）为0.09。结论：海南省12岁年龄组人群患龋率和龋均较高,氟牙症患病率和氟牙症指数处于较低水平。海南省应加强口腔预防保健工作。     

Streptococcus mutans and dental caries in urban and rural schoolchildren in Thailand

Two groups of Thai schoolchildren aged 11-13 yr were examined for dental caries, dental fluorosis and Streptococcus mutans. One hundred children lived in an urban district, Bangkok, and 71 children in a rural district, Petchaboon. Saliva samples were analyzed for S. mutans by the spatula method. The fluoride content of the drinking waters was also determined. The prevalence of caries, diagnosed according to WHO, was 89% in Bangkok and 18% in the rural district. Mean DMFT was 3.46 and 0.38 respectively. S. mutans was found in 98% of the urban children and in 82% of the rural. The differences in distribution between S. mutans and DMFT classes were statistically significant for the total sample. Mild fluorosis was present in some of the rural children.     

Dental Fluorosis and Caries Prevalence in Children Residing in Communities with Different Levels of Fluoride in the Water

Objectives: This study investigated the prevalence of dental fluorosis and caries in 7–14-year-old children residing in communities with negligible (NF: 0.2 ppm), optimal (OPF: 1.0 ppm), and four-times optimal (4X OPF: 4.0 ppm) naturally occurring fluoride in their water systems. Methods : Examinations were performed on 344 children who were lifetime residents of their communities. Results : Whether using the tooth surface index of fluorosis or Dean's index, children examined in the 4X OPF community had the highest prevalence of dental fluorosis. While the severity of fluorosis seen in the OPF and NF communities was mild in appearance, the results indicate that fluorosis does occur in optimally and negligibly fluoridated communities. Compared to the NF community, DMFT and DMFS scores in the OPF community were 9.2 percent and 21.2 percent lower, respectively. Conclusions : The ingestion of water containing 1 ppm or less fluoride during the time of tooth development may result in dental fluorosis, albeit in its milder forms. However, in these times of numerous products containing fluoride being available, children ingesting water containing 1 ppm fluoride continue to derive caries protection compared to children ingesting water with negligible amounts of fluoride. Thus, the potential for developing a relatively minor unesthetic condition must be weighed against the potential for reducing dental disease.     

Caries prevalence and its relation to water fluoride levels among schoolchildren in Central Province of Saudi Arabia

OBJECTIVE: To determine dental caries prevalence and severity among primary and intermediate schoolchildren in Riyadh and Qaseem Regions, and to determine any correlation between dental caries and fluoride levels in drinking water. DESIGN: Cross-sectional. METHODS: 1,104 children; 431 (6-7-year-old) primary schoolchildren (249 in Riyadh and 182 in Qaseem) and 673 (12-13-year-old) intermediate schoolchildren (392 in Riyadh and 281 in Qaseem) were examined for dental caries utilising the WHO criteria for diagnosis of dental caries. RESULTS: In primary schoolchildren the prevalence of caries was 91.2% both in Riyadh and Qaseem. The mean dmft scores were similar in Riyadh (6.53, SD 4.30) and Qaseem (6.35, SD 3.83). Among the intermediate schoolchildren the prevalence of dental caries was slightly higher in Riyadh (92.3%) than Qaseem (87.9%). The mean DMFT score was higher in Riyadh (5.06, SD 3.65) as compared with Qaseem (4.53, SD 3.57) with marginal statistical significance (p = 0.057). Among the primary schoolchildren there was statistically significant (p < 0.05) difference in mean dmft scores at various fluoride levels with lowest dmft scores at the optimum water fluoride level (0.61-0.80ppm) and highest at two extremes i.e. 0.0 to 0.3ppm and > 2.5ppm, while in intermediate schoolchildren no significant difference in overall mean DMFT scores of children at various water fluoride levels could be found. CONCLUSION: The caries experience among the primary and intermediate schoolchildren in Riyadh and Qaseem was very high, and that there was no linear correlation between water fluoride level and caries experience in these children.     

Relationship between obesity/overweight status, sugar consumption and dental caries among adolescents in South India

To cite this article:
Int J Dent Hygiene 10 , 2012; 240–244
DOI: 10.1111/j.1601‐5037.2011.00534.x Honne T, Pentapati K, Kumar N, Acharya S. Relationship between obesity/overweight status, sugar consumption and dental caries among adolescents in South India. Abstract: Objective: To evaluate the relationship between obesity/overweight status, sugar consumption and dental caries among adolescents in Udupi District, India. Methods: Study population consisted of 463 school children aged between 13 and 15 years. Information on age, sex, type of school attending and frequency of sugar consumption per day was recorded by a structured self‐administered questionnaire. Body mass index (BMI) (height in metres and weight in kilograms) and caries measurements (DMFT) were taken by a trained recorder according to standard criteria. Results: Majority of the children were having low normal weight, with 18.6% in overweight and 3.5% in obese groups. There was a significant difference in the frequency of sugar consumption between the BMI groups. Obese group of children had more caries than the overweight and low‐normal‐weight children. Correlation analysis showed significant positive relation with BMI, decayed teeth and DMFT. Regression analysis showed that caries experience had a significant association with male sex (OR = 2.09, CI = 1.01–4.33), overweight/obese (OR = 3.68, CI = 1.79–7.56) and frequency of sugar consumption more than once per day (OR = 3.13, CI = 1.25–7.85). Conclusion: There was a significant association between overweight/obesity and caries experience among school children of Udupi District. Obesity and dental caries have common risk determinants and require a comprehensive multidisciplinary approach to paediatric patients by both medical and dental healthcare professionals.     

Comparison of oral health indicators between two places of endemic dental fluorosis in Jordan

IntroductionExcessive fluoride intake during tooth development causes dental fluorosis.AimThis study aimed to (1) determine the prevalence of dental fluorosis in association with fluoride concentrations in drinking water, (2) explore the effects of altitude on the severity of fluorosis in two towns with high fluoride levels in the drinking water, and (3) assess decayed, missing, and filled teeth (DMFT) and oral hygiene practices among participants.Material and methodsThe sample consisted of 100 and 141 schoolchildren, aged 15.3 ± 1.4 and 16.1 ± 1.3 years, living in Ruwaished and Kuraymah, respectively. Oral examinations were carried out, and dental fluorosis was assessed using the Dean’s index. The DMFT index was also used for assessment. Samples of drinking water were analyzed using a fluoride-ion selective electrode. SPSS was used to analyze the data.ResultsTwo-thirds (68.8%) of adults from Kuraymah had moderate to severe fluorosis, with only 7% being unaffected. In Ruwaished, 50% of the sample had severe fluorosis, 22% showed moderate fluorosis, and none were unaffected. The average DMFT scores were 3.18 ± 1.81 and 3.81 ± 1.41 for Kuraymah and Ruwaished, respectively. In both towns, males had significantly higher caries scores than females. Oral hygiene was poor, as 64% and 57% of the participants from Kuraymah and Ruwaished, respectively, did not brush their teeth. A significant correlation was found between poor oral hygiene and increased DMFT scores.ConclusionsThis study concluded that higher fluorosis incidence and severity were present in the higher-altitude location (Ruwaished). Moreover, this study also indicated that fluorosed teeth are not immune to caries, and the preventive management of dental fluorosis should be directed to de-fluoridation of drinking water in endemic areas.     

Prevalence and severity of dental caries in adolescents aged 12 and 15 living in communities with various fluoride concentrations

OBJECTIVES: To determine the experience, prevalence, and severity of dental caries in adolescents naturally exposed to various fluoride concentrations. METHODS: A cross-sectional census was conducted on 1,538 adolescents aged 12 and 15 years living at high altitude above sea level (> 2,000 m or > 6,560 ft) in above-optimal fluoridated communities (levels ranging from 1.38 to 3.07 ppm) of Hidalgo, Mexico. Sociodemographic and socioeconomic data were collected using questionnaires. Two previously trained and standardized examiners performed the dental exams. RESULTS: Caries prevalence was 48.6 percent and mean of decay, missing, and filling teeth (DMFT) for the whole population was 1.15 +/- 1.17. In terms of severity, 9.6 percent of the adolescents had DMFT > or = 4, and 1.7 percent had > or = 7. The significant caries index (SiC) was 2.41 in the group of 12-year-olds, and 3.46 in the 15-year-olds. Higher experience and prevalence were observed in girls, in children with dental visit in the past year, those in the wealthiest socioeconomic status (SES) (quartiles 2, 3, and 4), those whose locale of residence is in San Marcos and Tula Centro, and in fluorosis-free children and those with moderate/severe fluorosis. In an analysis of caries severity (DMFT > or = 4), both adolescents with very mild/mild and moderate/severe dental fluorosis have higher caries severity. CONCLUSIONS: The results indicated that caries experience, prevalence, and severity as well as SiC index among 12- and 15-year-old adolescents were relatively low. Sociodemographic and socioeconomic variables commonly associated with dental caries were also observed in Mexican adolescents. Unlike other studies, we found that caries increased with higher SES. Fluoride exposure (measured through fluorosis presence) does not appear to be reducing the caries prevalence (DMFT > 0) or caries severity (DMFT > or = 4) in these high-altitude communities.     

Dental caries and sugar intake of children from rural areas with different water fluoride levels in Paraíba, Brazil

Few reports have investigated caries prevalence in rural areas of Brazil. OBJECTIVE: The aim of this study was to observe the caries prevalence (DMFT, DMFS) in 12-year-old children living in rural villages of Paraíba, Brazil with low and moderate fluoride levels in the drinking water and to relate it to sugar intake and oral hygiene. METHODS: One hundred and ninety four children from 13 villages were grouped according to the water fluoride levels: low fluoride (LF, <0.2 ppm F, 96 children) and moderate fluoride (MF, 0.7-1.0 ppm F, 98 children). Caries and oral hygiene (OHI-S) were scored according to WHO criteria. Sugar intake was assessed through interviews. A sub-set of subjects (n=23) from the LF group was re-examined 2 years later. RESULTS: For the LF and MF groups the DMFT (mean, SD) observed was 3.9 (3.7) and 2.5 (2.1) respectively, the DMFS was 9.2 (10.6) and 5.4 (5.7). Both indexes (DMFT, DMFS) showed significant differences (P<0.01, Mann-Whitney U-test) according to the fluoride levels in the drinking water. The mean increment of caries in the sub-set group of subjects was approximately 1.5 surfaces per subject/year. The reported sugar intake was low for both water fluoride groups (P>0.05). In a regression analysis the water fluoride levels, the use of fluoridated toothpaste and oral hygiene index were related to DMFS (R2=0.08, P< or =0.05). CONCLUSIONS: Caries prevalence was lower in MF than in LF rural areas of Paraíba. Caries and sugar intake seems to be lower in rural areas than in urban areas of Paraíba with similar fluoride levels in the drinking water.     

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.     

Caries and dental fluorosis in a 0·25 and a 2·5 ppm fluoride area in the Sudan

The purpose of this study was to assess the caries prevalence of children living in areas with either 0·25 or 2·5 ppm fluoride in the drinking water, and to relate caries experience to the severity of dental fluorosis. The children, aged 6–16 years (mean 11·3 years), were lifelong residents of their rural villages. The severity of dental fluorosis in the maxillary central incisors, assessed by Deans index, was 1·4 ± 0·9 ( n  = 59) and 2·3 ± 0·9 ( n  = 65) in the 0·25 and 2·5 ppm areas, respectively. There was no significant difference in DMFT between children from the two areas (2·6 ± 2·3 n  = 59 versus 2·1 ± 2·3, n  = 65). In the low-fluoride area 75% of the children had decayed permanent teeth compared to 66% in the high-fluoride area. In the primary teeth, however, both the caries prevalence and the dmft were significantly lower in the 2·5 ppm area than in the low-fluoride area. Stepwise, multiple, linear regression analyses, including all children, showed a significant effect of age on DMFT (30% of the variance explained), but no explanatory effect of fluoride in drinking water, severity of dental fluorosis, or gender. Regression analyses based on children in the 2·5 ppm area alone, showed significantly higher DMFT by increased severity of dental fluorosis. In children with a mixed dentition ( n  = 66), there was no association between caries in the primary and permanent teeth.     

The role of school-based dental programme on dental caries experience in Yogyakarta Province, Indonesia

International Journal of Paediatric Dentistry 2012; 22: 203–210 Objectives. To assess the effectiveness of a school‐based dental programme (SBDP) in controlling caries by measuring the relationship between the SBDP performance and caries experience in children aged 12 in Yogyakarta Province, Indonesia, by taking into account influencing factors. Methods. A cross‐sectional survey was undertaken of 1906 children participating in SBDPs. Four SBDPs were chosen by good and poor performances in urban and rural areas. Caries was assessed using WHO criteria whereas behaviour and socio‐demographic factors were collected using a questionnaire administered to the children. Results. The decayed, missed, and filled teeth (DMFT) of children in good SBDPs (2.8 ± 2.4) was lower than that of the counterparts (3.8 ± 3.4). From path analysis using a structural equation model (SEM), place of residence (OR = 4.0) was shown to have a strongest direct relationship to caries experience, whereas SBDP performance showed no direct relationship. At the same time, SBDP performance was significantly related to frequencies of dental visits (OR = 0.3), sugar consumption (OR = 0.8), and tooth brushing (OR = 3.2), which in turn are interrelated with place of residence, gender, and mother’s education. Conclusions. The study suggests that the differences in DMFT of children in good and poor performance SBDPs were caused by relation to social factors rather than by relation to oral health service activities.     

Fluorosis in relation to fluoride levels in water in central Nigeria

Abstract– Objectives : This study was conducted to examine the prevalence of dental fluorosis in relation to fluoride levels in water among children aged 12–15 years in the states of Plateau and Bauchi, Nigeria. Methods : Children ( N =203) were examined using WHO criteria. The children were from two schools and permanent residents of the communities in which the schools are located (Tilden Fulani and Kanadap). Intra-examiner reliability for determining fluorosis scores was 80%. Results : Fluoride levels in the water ranged from 0.0–0.4 mg/L. Prevalence of dental fluorosis in the sample was 51%. Forty-one percent had very mild fluorosis, 7% had mild fluorosis and 3% had moderate to severe fluorosis. The lowest DMFT was observed in the school where the fluoride level of the water ranged between 0.0 and 0.4 mg/L, and in the group with very mild fluorosis. Conclusion : Fluoride levels in water for central Nigeria were appropriate for oral health. In the areas where the children were permanent residents, factors other than the fluoride levels of the water contributed to the severity of dental fluorosis.