Pilot study on obesity in caries prediction

The aim of the present study was to explore the possibility of predicting the incidence of dental caries from obesity. The subjects were 516 children living in Luvia, Finland, born between 1972 and 1981. Obesity alone was not a very good predictor of dental decay. When predicting caries in the permanent first molars using both earlier obesity and earlier caries experience as predicting indicators, 65-70% of the true risk group was identified. This combination was even better for the prediction of caries in permanent second molars.     

Dental caries and treatment needs in street children in Toluca, Mexico

OBJECTIVE: To assess dental caries (deft and DMFT) and treatment needs, in street children from the city of Toluca in Mexico. METHODS: After informed consent from their parents, guardian or legal representative, 310 street children, 0 to 17 years of age, from Toluca in the state of Mexico, were evaluated. Caries and treatment needs were recorded according to 1997 WHO criteria. The oral examination was carried out on site in daylight. RESULTS: For the population from which the sample was derived, the caries prevalence was 94.96%, the mean DMFT was 6.0 +/- 4.6 (5.8 decayed), while deft was 3.5 +/- 3.7 (3.4 decayed). Treatment needs in the deciduous dentition revealed that 43.9% of teeth did not require any treatment, 20% needed fissure sealants, 19% required one surface restoration and 13.19% needed restoration in two or more surfaces. In the permanent dentition, the treatment needs were as follows: 51.2% teeth did not need any treatment, 22.9% needed fissure sealants, 18.4% required one surface restoration and 5.3% needed restoration in two or more surfaces. CONCLUSIONS: These findings illustrate the high prevalence of caries in street children in the city of Toluca. There is an enormous need for dental treatment; sealant applications were the treatment most in need. The data can serve as a platform to implement preventive and restorative dental health programmes that meet the needs of Mexican street children,     

根面龋细菌学初步分析

目的 :通过对根面龋菌斑微生物的定量分析 ,进一步了解根面龋的致龋机制。方法 :19例根面龋患者 ,根据临床表现分为活动性和非活动性龋 ,对其根面龋的菌斑微生物进行菌落计数。结果 :无论活动性还是非活动性根面龋 ,厌氧菌都有较高的检出率 ,活动性根面龋检出率更高 ,活动性根面龋中链球菌总菌、变链菌、放线菌和乳杆菌检查率稍高 ,在非活动性根面龋中韦永氏菌和新月单胞菌的检出率稍高。梭杆菌及类杆菌 (包括紫质单胞菌、普氏菌、脆弱类杆菌 )检出率二者相似。活动性根面龋的各菌菌落计数均多于非活动性根面龋 ,差别最明显的是变形链球菌和放线菌。结论 :变形链球菌 ,放线菌是根面龋由非活动性到活动性转变的优势菌     

A review of a community program aimed at preventing early childhood caries among Jerusalem infants--a brief communication

Early childhood caries (ECC) has not been adequately investigated in Israel. A previous Jerusalem study has demonstrated a potential effect on toothbrushing among infants. The present study was initiated in order to examine caries prevalence and the potential effect of a community intervention program. OBJECTIVES: This study aims to review an intervention program and assess ECC distribution and associated variables. METHODS: The study sample included 1,500 infants in matched "intervention" and "control" Mother and Child Health centers. The 2-year program, initially including all children at the age of 6 months, focused on the free distribution of toothbrushes and toothpastes. ECC prevalence was determined in a cross-sectional study. RESULTS: At 2.5 years, 596 children were examined (40 percent compliance). About half of the parents reported that they had participated once or not at all over the 2-year period, which demonstrated low program participation. Among the examined children, ECC prevalence was 15.3 percent. No difference in caries levels was found between the program and control groups. The reported level of brushing twice daily was 13.9 percent, while 26.8 percent reported not brushing at all. Eighty-one percent reported going to bed at night with a bottle. Children who drank sugar-sweetened beverages had ECC levels significantly higher than those who drank milk or natural juice (18.8 percent versus 8.9 percent). CONCLUSIONS: The dental health and behavior and lack of intervention success emphasized the need to seek a more effective strategy. Emphasis on toothbrushing might not be the only nor optimal solution for this serious public health problem.     

Evaluation of a brief tailored motivational intervention to prevent early childhood caries

Ismail AI, Ondersma S, Willem Jedele JM, Little RJ, Lepkowski JM. Evaluation of a brief tailored motivational intervention to prevent early childhood caries. Community Dent Oral Epidemiol 2011; 39: 433–448. © 2011 John Wiley & Sons A/S Abstract – Objectives: This pragmatic randomized trial evaluated the effectiveness of a tailored educational intervention on oral health behaviors and new untreated carious lesions in low‐income African‐American children in Detroit, Michigan. Methods: Participating families were recruited in a longitudinal study of the determinants of dental caries in 1021 randomly selected children (0–5 years) and their caregivers. The families were examined at baseline in 2002–2004 (Wave I), 2004–2005 (Wave II) and 2007 (Wave III). Prior to Wave II, the families were randomized into two educational groups. An interviewer trained in applying motivational interviewing principles (MI) reviewed the dental examination findings with caregivers assigned to the intervention group (MI + DVD) and engaged the caregiver in a dialogue on the importance of and potential actions for improving the child’s oral health. The interviewer and caregiver watched a special 15‐minute DVD developed specifically for this project based on data collected at Wave I and focused on how the caregivers can ‘keep their children free from tooth decay’. After the MI session, the caregivers developed their own preventive goals. Some families in this group chose not to develop goals and were offered the project‐developed goals. The goals, if defined, were printed on glossy paper that included the child’s photograph. Families in the second group (DVD‐only) were met by an interviewer, shown the DVD, and provided with the project’s recommended goals. Both groups of families received a copy of the DVD. Families in the MI + DVD group received booster calls within 6 months of the intervention. Both caregivers and the children were interviewed and examined after approximately 2 years (Wave III: 2007). Results: After 6‐month of follow‐up, caregivers receiving MI + DVD were more likely to report checking the child for ‘precavities’ and making sure the child brushes at bedtime. Evaluation of the final outcomes approximately 2 years later found that caregivers receiving the MI + DVD were still more likely to report making sure the child brushed at bedtime, yet were no more likely to make sure the child brushed twice per day. Despite differences in one of the reported behaviors, children whose caregivers received the motivational intervention did not have fewer new untreated lesions at the final evaluation. Conclusions: This study found that a single motivational interviewing intervention may change some reported oral health behaviors, it failed to reduce the number of new untreated carious lesions.     

Indigenous Australian dental health: a brief review of caries experience

The indigenous community in Australia is an at risk population for oral diseases such as dental caries. The majority of communities are isolated and dental services in these areas are limited. Oral hygiene standards are poor and this combined with a diet rich in refined carbohydrates has led to high incidences of dental caries. In addition, diabetes, which is related to obesity (and a diet high in sugar and fat) has been linked to increases in oral disease. Caries prevalence was found to be low in areas where fluoridation levels in the water were high. The fact that the fluoride supplementation appears to improve oral health to a significant degree suggests that implementation of fluoride treatment programmes for school children and, where viable, fluoridation of water sources would be appropriate. In addition, dental education programmes should receive high priority. As with the rest of the community, these preventive measures will result in less need for emergency dental treatment in the future, better oral health for the community and reduced financial burden on the State. It is under these circumstances that oral health planners and providers must, in consultation with the relevant community representatives, develop appropriate mechanisms to address the needs of this group. The development of strategies that integrate with the plethora of general health strategies currently being implemented is just one means of achieving improved oral health outcomes for indigenous Australians.     

伢典去龋法在龋病治疗中的应用

伢典去龋法是一种无痛的微创去龋技术,其克服了常规机械去龋法的缺点和潜在的不良反应,消除了病人对治牙的恐惧感,增加了就诊的舒适度和安全感,有良好的临床应用前景。该文就伢典的作用原理以及对牙体、牙髓组织的影响作一综述。     

Dental caries status and treatment needs of the permanent dentition of 6–12-year-olds in Hong Kong

An oral health survey was conducted in 1986 on a representative sample of primary school children in Hong Kong. 1483 Chinese children of both sexes, aged 6-12 yr, attending 56 primary schools were surveyed. The DMFT index for the 6-yr-olds was 0.1, and for the 12-yr-olds it was 1.5. Forty percent of the 12-yr-olds were clinically caries-free. The permanent molars constituted 90% of the total caries experience of the 12-yr-olds. Over 90% of the caries lesions were found in pits and fissures. The dental caries treatment need in the permanent dentition was low and of the simple type. A great reduction in the dental caries experience of the permanent dentition of children has occurred since the introduction of water fluoridation 25 yr ago. In addition to treatment care, preventive measures should be provided by the School Dental Care Service for children with a high caries risk.     

乳牙化学去龋法的细菌学研究

目的：比较化学去龋法和机械去龋法清除细菌的效果。方法：选取40个龋坏深至牙本质的乳磨牙,中龋或深龋,随机分为化学法去龋组和机械法去龋组,每组20个牙,去龋前后使用无菌挖匙对龋坏牙本质进行取样,分别在4种不同的培养基上进行厌氧培养和计数。结果：两种方法去龋后,除机械法去龋组放线菌外,两种方法其他细菌数显著减少,有统计学意义（P〈0．05）,化学法去龋组比机械法去龋组的总菌数量减少更显著（p〈0．05）。结论：化学去龋法比机械去龋法清除乳牙龋坏细菌效果好。     

Estimation of actual caries prevalence and treatment needs from field survey caries information on a child population in U.S.A.

Caries scores (DT + Dt) were recorded under simulated field survey conditions on 270 children ranging in age from 3 to 12 years. The children were subsequently diagnosed under optimum clinical conditions. The findings from the field and clinical examinations were statistically analyzed to determine the relationships between "survey" and "true" caries scores. It is proposed that the true mean caries score can be estimated from the survey mean score by adding 1.5 teeth in the primary dentition and 2 teeth in the mixed dentition. Tables were devised to estimate treatment needs for children at various survey caries scores in each dentition category.     

釉质龋的非破坏性治疗方法

釉质龋是一种非细胞反应性病变,可导致牙齿硬组织的破坏.传统治疗釉质龋的方法往往会损害到正常的牙体组织,因此目前非破坏性修复釉质龋的新方法成为了研究的热点和难点,本文就非破坏性治疗釉质龋的2种方法——再矿化和仿生矿化法的最新进展作一综述.     

釉质龋的非破坏性治疗方法

釉质龋是一种非细胞反应性病变,可导致牙齿硬组织的破坏。传统治疗釉质龋的方法往往会损害到正常的牙体组织,因此目前非破坏性修复釉质龋的新方法成为了研究的热点和难点,本文就非破坏性治疗釉质龋的2种方法——再矿化和仿生矿化法的最新进展作一综述。     

正畸治疗中早期龋的防治

错畸形是仅次于龋病和牙周疾病的第三高发口腔疾病,随着文化和社会经济水平的不断提高,人们对正畸治疗的需求逐年增加。正畸固定矫治最常见的并发症——早期龋,已经严重挑战龋病预防和正畸治疗的美学效果,值得医患双方高度重视并采取有效的防治措施。     

伢典(Carisolv)治疗老年人根面龋的临床研究

目的：观察伢典（Carisolv）去腐法治疗老年人根面龋的疗效及对老年人血压、心率、治疗心理反应的影响。方法：选择老年根面龋患者64例，随机分为伢典（Carisolv）治疗组和对照组。伢典（Carisolv）治疗组30例，采用伢典（Carisolv）去腐法治疗患牙；对照组34例，采用传统牙钻去腐法治疗患牙，比较2种方法的治疗效果，并且去腐前后测量患者血压、心率及了解患者对治疗的心理反应，采用统计学方法进行比较。结果：2组患者治疗1年后复查，成功率无统计学差异（P〉0．05）；2组患者去腐治疗前后血压、心率的变化及对治疗的心理反应有统计学差异（P〈0．05）。结论：伢典（Carisolv）对老年人根面龋的治疗安全、有效，可大大降低患者对口腔治疗的紧张和恐惧，有利于维护老年人的牙齿健康。     

Dental caries experience, oral health status and treatment needs of dental patients with autism

Objectives

Autism is a lifelong neurodevelopmental disorder. The aims of this study were to investigate whether children with autism have higher caries prevalence, higher periodontal problems, or more treatment needs than children of a control group of non-autistic patients, and to provide baseline data to enable comparison and future planning of dental services to autistic children.

Material and Methods

61 patients with autism aged 6-16 years (45 males and 16 females) attending Dubai and Sharjah Autism Centers were selected for the study. The control group consisted of 61 non-autistic patients chosen from relatives or friends of autistic patients in an attempt to have matched age, sex and socioeconomic status. Each patient received a complete oral and periodontal examination, assessment of caries prevalence, and caries severity. Other conditions assessed were dental plaque, gingivitis, restorations and treatment needs. Chi-square and Fisher''s exact test of significance were used to compare groups.

Results

The autism group had a male-tofemale ratio of 2.8:1. Compared to controls, children with autism had significantly higher decayed, missing or filled teeth than unaffected patients and significantly needed more restorative dental treatment. The restorative index (RI) and Met Need Index (MNI) for the autistic children were 0.02 and 0.3, respectively. The majority of the autistic children either having poor 59.0% (36/61) or fair 37.8% (23/61) oral hygiene compared with healthy control subjects. Likewise, 97.0% (59/61) of the autistic children had gingivitis.

Conclusions

Children with autism exhibited a higher caries prevalence, poor oral hygiene and extensive unmet needs for dental treatment than non-autistic healthy control group. Thus oral health program that emphasizes prevention should be considered of particular importance for children and young people with autism.     

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随着应用于儿童龋病治疗材料的进步和知识的更新,儿童龋病的临床治疗技术也在不断发展。由于粘接修复材料和先进仪器设备的临床应用,牙体预备和修复逐渐向无痛、微创治疗发展。儿童龋病治疗的美观和功能恢复的效果日臻完善[1]。     

Threshold values affect predictive accuracy of caries risk assessment

Objective: To evaluate effects of thresholds on estimates of predictive accuracy of methods for caries risk assessment.

Material and methods: Adolescents, aged 12 visiting two dental clinics, were examined by visual/tactile examination and bitewing radiography at baseline and after one year. Three methods for caries risk assessment were applied: previous caries experience, dentists’ risk assessment according to set criteria (presence or absence of caries lesion) and acid tolerance of dental biofilm. The measure for validity (the reference standard) comprised caries lesion progression at 1 year. Predictive accuracy estimates were calculated for several thresholds.

Results: Accuracy estimates changed with threshold values of the methods and the reference standard. Patient spectrum differed between the clinics, which resulted in different accuracy estimates for the two samples. Generally, negative predictive values were high while positive ones were low indicating that these methods were more efficient in finding individuals who are at low risk of developing caries lesions than those with increased risk.

Conclusions: As thresholds and patient spectrum affected predictive accuracy, it may be difficult to design a universal model with set thresholds for caries risk assessment. Foremost, a model should consider the level of aspiration for prediction and clinical decisions that will be made based on the risk assessment in the actual clinical setting.     

Do enamel and dentine caries at 5 years of age predict caries development in newly erupted teeth? A prospective longitudinal study

Abstract

Objective: To explore caries development in children from 5 to 12?years of age, and to study whether enamel caries and dentine caries at 5?years of age could predict caries prevalence at 12?years of age, controlled for child characteristics.

Methods: The study included 3282 children examined at 5 and 12?years of age. Data were collected by clinical examination and questionnaire. Enamel and dentine caries were registered at surface level. Data were tested by t-test and analysed by bi- and multivariate logistic regression. The study was ethically approved.

Results: In 5-year-olds, 15% of the children had dentine caries experience and 21% had enamel caries. In 12-year-olds, 32% had dentine caries experience and 47% had enamel caries. Children with dentine caries experience at 5?years of age had at 12?years of age developed more surfaces with enamel caries (mean 2.8, SD 4.2) and dentine caries experience (mean 1.8, SD 2.5) than other children (p?<?.05). Dentine caries experience at 12?years of age was associated with having only enamel caries (OR 1.6, CI 1.2–2.0) and dentine caries experience (OR 3.2, CI 2.6–3.9) at 5?years of age. Family status and parental education were related to caries development.

Conclusion: Children with caries in primary teeth continued to be caries risk children during the mixed dentition period. In addition to dentine caries experience, enamel caries in primary teeth was a predictor for caries development in young permanent teeth and may be used to improve the caries risk assessment.     

Community risk indicators for dental caries in schoolchildren: an ecologic study

Abstract A statewide survey of NC schoolchildren found wide variation in dental caries prevalence among sampled classrooms. This study examined factors associated with this variation using classrooms as a surrogate for the larger community, in order to identify community risk indicators (CRI). In all, 172 classrooms (3400 students) in Grades K-6 were available for analysis. Initially, 56 sociodemographic, environmental, health system, and clinical factors were evaluated for their association with caries prevalence (K-3: average dfs-f DMF'S; 4–6: average DMFS) using univariate and bivariate analyses. Of these, 21 factors met our criteria for evaluation using WLS multivariate regression. For Grades K-3 (w=108), population density, parental education, and coastal residence were negatively associated with caries scores, while age, and medical and dental Medicaid expenditures were positive. For Grades 4–6 (n=64), age and fs:dfs ratio were positively associated with caries scores, while population density, population: dentist ratio, and years of natural fluoride exposure were negative. CRIs for both models, when compared to individual models, explained a substantial portion of the variation in caries prevalence, 31% for Grades K-3 and 51% for Grades 4–6. Results suggest that a risk assessment model based on community rather than individual variables is feasible and further refinement may reveal factors useful in identifying high risk communities.