Caries increment in the permanent dentition of Mexican children in relation to prior caries experience on permanent and primary dentitions

OBJECTIVE: To evaluate the likelihood of caries increment in schoolchildren, based on their prior caries experience. MATERIAL AND METHODS: We undertook a longitudinal study in 452 six-to-nine year olds between 1999 and 2001 in Mexico, with dental exams conducted by two standardized examiners (kappa>0.85). The dependent variable was the DMFT increment, dichotomized as without increment, and at least one unit of increment. Independent variables estimated caries experience at baseline. Data were analyzed using non-parametric tests and generalized linear models (log-binomial) to calculate relative risk (RR) adjusted for age and sex. RESULTS: The percentage of caries-free children diminished by 20.5% from 1999 to 2001. DMFT index increased two-fold, from 0.25+/-0.70 in 1999 to 0.77+/-1.30 in 2001 (p<0.001). The overall risk for this sample was 24%. The DMFT increment was higher (p<0.001) in children with DMFT>0 and dmft>0 in 1999 (RR=1.89, 95% CI=1.37-2.62; RR=2.71, 95% CI=1.94-3.76, respectively). The likelihood for DMFT increment from the 1999 levels was: (1) 2.78 times higher (95% CI=2.06-3.76) if schoolchildren had caries in any of the first permanent molars and (2) 1.62 times higher (95% CI=1.20-2.19) if schoolchildren were affected by high severity caries at baseline. CONCLUSIONS: Both caries prevalence and mean DMFT had significant increments in 18 months. Dental caries in the primary (dmft) and permanent (DMFT) dentitions at baseline are goods indicators of subsequent caries development in this group of children in a medium income country. This relationship became stronger when the occurrence of caries in the first permanent molars was included.     

Correlation between caries experience in primary and permanent dentition in birth-cohorts 1950–70

Abstract – Caries experience in the primary molars and canines at 8 yr of age and in the permanent dentition at 16 was correlated in every fourth birth-cohort between 1950 and 1970 in a Danish community. Correlations between 0.44 and 0.56 were found. Cross-tabulation of the data also revealed close association, but prediction of individual high caries risk children based solely on screening for caries experience in the primary dentition is hardly cost-effective.     

Caries experience in the primary dentition among French 6-year-olds between 1991 and 2000

BACKGROUND: There are few national caries preventive policies for children in France. Various surveys suggest that in the late 1980s, oral health of the 6-year olds in France was poorer than in those of other European countries. In Val de Marne (a Department just east of Paris) a public dental service was established in 1991. A programme to inform preschool staff about dental diseases was commenced and volunteers brought oral health information to parents and health professionals. Periodical monitoring of primary tooth caries of 6-year olds was planned. AIM: The aim of the study was to evaluate changes in primary tooth caries in 6-year olds over the 10 years of the programme. METHODS: Participating 6-year olds, randomly selected, were examined in schools by dentists. Clinical data were collected (WHO criteria). Sociodemographic data were collected through questionnaire. Statistical analysis involved comparison of mean values, variance analysis and chi-square test for categorical variables. RESULTS: The proportions of children with caries experience were, 38.9%, 30.6% and 22.2% in 1991, 1995 and 2000 respectively (P < 0.01). The dft index decreased from 1.74 to 1.39 and 1.05 respectively. About 75% of children with dental caries remained untreated. Children of non-European native parents or belonging to low socioeconomic families remained those most affected by dental caries in 2000. CONCLUSION: Dental caries in 6-year olds improved between 1991 and 2000 in Val de Marne but caries remained a socially inequitable disease. Most children did not have access to dental care. The situation requires changes to the dental care provision system.     

Caries and fillings in the permanent dentition of cohorts of schoolchildredn in Espoo, Finland

The purpose of the study was to analyze longitudinally the timing of enamel caries and, thereafter, fillings in occlusal, proximal and smooth surfaces of the permanent dentition of cohorts of schoolchildren initially 7, 10, 13, and 15 yr old. Altogether 228 children were examined annually during a 3-year period. Enamel and dentin caries affected on an average less than 15% of the occlusal surfaces in the first molars and at most 4% of the premolars; fillings proved to be the main determinant of the DF-scores for occlusal surfaces. On the other hand, decay was the main determinant of DF-scores on the proximal surfaces of the molars for at least 6 yr after eruption. The results indicate that in the 1970s some overtreatment of occlusal caries may have occurred, whereas indications for fillings on proximal surfaces were more accurate. The reduction in the number of extractions and fillings during the late 1970s resulted in a considerable decrease in the DMF scores. The decrease on DMF scores appears to have been due only to a minor extent to the decrease in caries. Thus, there was a decline in DMF scores rather than a decline in the prevalence of caries during this period.     

Caries experience of the primary dentition among groups of Tanzanian urban preschool-children

Five hundred and forty-six urban Tanzanian preschoolchildren aged 5-7 were examined for dental caries in the primary dentition. Caries was diagnosed according to the WHO criteria (1977). The mean dft was 1.06 (1.76) for the whole sample and 62% of the children were caries free. Only three fillings were observed in the primary teeth, indicating a very low rate of conservative treatment in this population group. The results of this study call for both preventive and restorative care for this group. However, for these activities to be cost effective they will have to be focused on the 38% of children who have the experience of dental caries. Planning an appropriate oral care program for this risk group needs careful consideration within the Tanzanian context.     

上海市徐汇区小学生第一恒磨牙龋病调查分析

目的:了解并分析上海市徐汇区小学生第一恒磨牙龋病情况,为防治提供依据。方法:以WHO口腔健康调查基本方法为标准,对采用随机整群抽样方法抽取的上海市徐汇区8所小学7～12岁5698名小学生的第一恒磨牙龋病情况进行调查,采用SPSS 13.0软件包对数据进行统计学分析。结果:第一恒磨牙患龋率为16.18%,患龋者龋均为1.80。女性患龋率和患龋者龋均均显著高于男性(P<0.01)。7～12岁第一恒磨牙患龋率随年龄增长明显升高,第一恒磨牙总体充填率为56.04%,下颌第一恒磨牙比上颌易患龋,每天刷牙1次或以下者,第一恒磨牙患龋率显著高于每天刷牙2次及以上者。结论:上海市徐汇区小学生第一恒磨牙患龋情况不容乐观,需进一步加强对第一恒磨牙龋患的预防和治疗。     

Caries in the primary dentition, after discontinuation of water fluoridation, among children receiving comprehensive dental care

Abstract – The city of Kuopio in central Finland had fluoridated piped water for 33 years, beginning in 1959. Due to strong opposition by various civic groups, water fluoridation was stopped at the end of 1992. There is little information on the consequences of stopping fluoridation in a community with comprehensive dental care for all children and adolescents, who are frequently exposed to different fluoride measures both at home and in the dental office. Objectives: The aim of this repeated cross‐sectional survey was to examine how discontinuation of water fluoridation in Kuopio affected caries in the primary dentition. Changes in the mean dmfs values between 1992 and 1995 in Kuopio were compared to those in Jyväskylä, a low‐fluoride community that has repeatedly been used as the reference area for Kuopio. Methods: In 1992 and 1995, independent random samples of all children aged 3, 6 and 9 years were drawn in Kuopio and Jyväskylä. The total number of subjects examined was 421 in 1992 and 894 in 1995. Calibrated dentists registered caries clinically and radiographically. Results: In all age groups both in 1992 and 1995, the point estimates for mean dmfs values were lower in the non‐fluoridated town. In both towns, the observed mean dmfs values were smaller in 1995 than in 1992. Conclusion: Despite discontinuation of water fluoridation, no increase of caries frequency in primary teeth was observed in Kuopio within a three‐year period.     

Caries prevention with chlorhexidine-thymol varnish in high risk schoolchildren

In a prospective, randomised and blinded cohort study, the acceptance and effectiveness of a 3-monthly chlorhexidine-thymol varnish application was assessed in 8- to 10-yr-old children (n=29) with high caries incidence after brushing with a 1.23% fluoride gel. The children of the control group (n=25) brushed with a fluoride gel only. The standardised interview showed good acceptance of the varnish applications in spite of the bitter taste. Caries incidence in one year was 1.2 DMFS (SD 1.5, median 1; 95% confidence interval 0-1) for the test group and 2.1 DMFS (SD 2.3, median 2; 95% confidence interval 0-3) for the control group. Due to a slightly lower reduction in caries incidence (42.3%) than in other studies and a higher standard deviation than in unselected study groups, the power of the present study was not high enough to prove this difference in caries incidence to be statistically significant in the Mann-Whitney test (P=0.11). This was also found for the difference of 0.4 initial lesions. The distribution patterns of caries incidence for tooth groups (70% in the first permanent molar) and surfaces (58% on occlusal surfaces) did not differ between the test and the control group. The reductions of caries incidence which have been found in highly caries active children of the present study should be evaluated further with a larger study sample.     

Caries in permanent dentition and social class of children participating in public dental care in fluoridated and nonfluoridated areas

Abstract A random sample of 7-16-year-old children (n= 2778) who visited municipal dental clinics in fluoridated and nonfluoridated areas was studied. Structured questionnaires were used to collect data on social class and fluoride exposure; caries diagnoses were made by local dentists in municipal dental clinics. Children from the highest social class had the lowest caries frequency in both fluoridated and nonfluoridated areas. Differences between middle and lower class children were small. Water fluoridation had a similar effect in all social classes.     

Caries prevalence and salt fluoridation among 9-year-old schoolchildren in Strasbourg, France

Abstract The 9-year-old group (236 children) of an epidemiological study carried out in 1991 in Strasbourg on children aged 6 to 15 years was selected with the aim of determining if the caries prevalence reduction observed could be related to the use of salt fluoridation (FS) introduced in France in 1987. From these 236 children, 143 answered a questionnaire which showed that 36 of them were fluoridated salt users and 107 were not. The dft index was significantly lower in the FS consumers which showed 35.5% dft reduction compared to the non-FS-consuming children. When using the Generalized Linear Model, this reduction was significant (P=0.03). Although lower in the FS group, the DMFT and DMFS indices showed no statistical significant difference. It appeared that 72.2% of the users took simultaneously fluoride tablets but no dental fluorosis was observed. The use of fluoride tablets had a significant effect on the DMFS (P= 10^-2). The children who consumed FS used more frequently fluoridated mouthrinses (P=10^-3) and had more frequent professional application of fluoridated gel and varnishes than non-consumers (P=0.02). The DMFS index increased with the number of meals (P= 10^-6), which was the most significant variable entered into the Generalized Linear Model. The children who brushed their teeth once a day had a DMFS value 2.6 times higher than those who brushed regularly three times a day (P= 10^-3). The DMFS value was 4.4 times higher among the children who brushed their teeth irregularly when compared with those who brushed three times a day (P= 10^-2).     

Pattern of traumatic dental injuries in the permanent dentition among children,adolescents, and adults

Abstract – Background: Traumatic dental injuries (TDI) comprise six types of luxation and seven types of tooth fractures. The risk of pulp necrosis is increased in teeth with combination injuries where fractures and luxations occur concomitantly. Aim: To report and compare the distributions of luxations and fracture types among children, adolescents, and adults, and to analyze the distribution and prevalence of combination injuries. Material and method: The study group included 4754 patients (3186 men and 1568 women) with 10 166 traumatized permanent incisors treated at Copenhagen University Hospital, Rigshospitalet. Differences in the distributions of trauma types among age groups (children <12 years, adolescents 12–20 years, and adults >20 years) and distributions of concomitant crown fractures for each luxation type were analyzed with the Chi‐square test. Results: A total of 7464 teeth (73.4%) had suffered a luxation injury and 5914 teeth (58.2%) a fracture. The overall most frequent injuries were crown fractures without pulp exposure (34.9%), concussions (24.2%), and subluxations (22.2%). The relative frequency of crown fractures without pulp exposure decreased across age groups (children 45.2%, adolescents 36.5%, adults 26.3%, P < 0.001), whereas the relative frequencies of other injury types increased across age groups : crown–root fractures (children 1.8%, adolescents 6.3%, adults 9.2%, P < 0.001), root fractures (children 2.5%, adolescents 4.6%, adults 8.7%, P < 0.001), and lateral luxations (children 5.7%, adolescents 10.9%, adults 13.0%, P < 0.001). One‐third of the traumatized teeth (n = 3212) had sustained a combination of a fracture and a luxation injury. The luxation types most frequently presenting with a concomitant crown fracture were concussion (57.9%), intrusion (47.2%), and subluxation (33.4%) (P < 0.001). Conclusion: The majority of TDI were minor injuries. The relative frequencies of injury types varied among age groups. Combination injuries were observed in one‐third of the traumatized teeth and occurred most frequently in teeth with concussion, intrusion, and subluxation.     

四川省6岁儿童乳恒牙患龋状况及相关性研究

目的了解四川省6岁儿童患龋情况,探讨乳磨牙患龋与第一恒磨牙患龋之间的相关性。方法参照第三次全国口腔健康流行病学抽样调查方案,在四川省3个城市、3个农村随机抽样选取调查点,共调查714名6岁儿童的患龋情况,并分析乳磨牙患龋情况与第一恒磨牙患龋情况之间的相关性。结果四川省6岁儿童乳牙患龋率为74.37%,龋均为3.94±3.93,龋齿充填率为4.96%。乳牙患龋率和龋均在男性和女性、城市和农村儿童间无统计学差异（P>0.05）,城市乳牙龋齿充填率高于农村（P<0.05）。已萌的第一恒磨牙中有2.98%患龋,充填率为7.69%。乳磨牙患龋是第一恒磨牙患龋的危险因素[P=0.001,r=0.175,OR=5.756,95%CI（1.733,19.121）],乳磨牙与第一恒磨牙的龋均呈弱相关（P<0.001,r=0.194）。结论四川省6岁儿童乳牙患龋情况较重,乳磨牙龋坏可作为临床及预防工作中预测第一恒磨牙龋坏的因素之一。