Dental fear and adult oral health in Australia

Abstract– Objective: This study aimed to investigate the association between dental fear and both dental caries and periodontal indicators. Methods: A three‐stage stratified clustered sample of the Australian adult population completed a computer‐assisted telephone interview followed by a clinical examination. Oral health measures were the DMFT index and its components, periodontitis and gingivitis. A total of 5364 adults aged 18–91 years were dentally examined. Results: Higher dental fear was significantly associated with more decayed teeth (DT), missing teeth (MT) and DMFT. There was an inverted ‘U’ association between dental fear and the number of filled teeth (FT). Periodontitis and gingivitis were not associated with dental fear. The association between dental fear and DMFT was significant for adults aged 18–29 and 30–44 years, but not in older ages. Dental fear was significantly associated with more DT, MT, and DMFT but with fewer FT after controlling for age, sex, income, employment status, tertiary education, dental insurance status and oral hygiene. Conclusion: This study helps reconcile some of the conflicting results of previous studies and establishes that dental fear is associated with more decayed and missing teeth but fewer FT. That people with higher dental fear have significantly more caries experience underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.     

Caries experience among 45-54 year olds in Adelaide, South Australia

BACKGROUND: Middle-aged adults are an important focus of dental policy with increasing retention of teeth and use of dental services. The aims of the study were to describe the caries experience of 45-54 year olds by dental visit pattern, dental behaviour, socio-demographics and socio-economic status. METHODS: A random sample of 45-54 year olds from Adelaide, South Australia was surveyed by self-complete questionnaire during 2004-2005 with up to four follow-up mailings to non-respondents (n=879, response rate = 43.8 per cent). Oral examinations were performed by calibrated dentists on 709 persons (completion rate = 80.7 per cent). RESULTS: The mean number (95% CI) of decayed teeth was 0.39 (0.31-0.47), with 5.25 (4.92-5.58) missing teeth, 11.0 (10.62-11.32) filled teeth, and DMFT was 16.61 (16.21-17.01). Multivariate regressions of caries experience by dental visit pattern, dental behaviour, socio-demographics and socio-economic status found: time since last visit of less than 12 months was related (P < 0.05) to fewer decayed teeth (beta = -0.40), more filled teeth (beta = 1.55) and a higher DMFT (beta = 1.24); a last visit for relief of pain was related to more decayed teeth (beta = 0.56); tooth brushing 8+ times per week was related to fewer decayed (beta = -0.36), and missing teeth (beta = -1.13), and lower DMFT (beta = -1.58); not cleaning between teeth was related to more missing teeth (beta = 0.94); males had fewer missing teeth (beta = -0.76); having a diploma/degree was related to fewer missing teeth (beta = -1.07) and lower DMFT (p = -1.27); card holder status was related to more missing teeth (beta= 1.26); and household income of $80,000+ was related to fewer missing teeth (beta= -0.96) and a lower DMFT (beta= -1.35). CONCLUSIONS: Dental visit pattern, dental behaviour, socio-demographics and socio-economic status were all related to caries experience. Overall DMFT was lower for those who brushed more frequently, had higher levels of education and higher household income.     

Factors influencing caries experience among adults with physical and intellectual disabilities

Abstract – Background: There is limited and inconsistent evidence on the influence of residential setting on caries experience of adults with physical and intellectual disabilities (PID), described here as care‐recipients. Objective: To examine caries experience and associated factors among adults with PID. Methods: Mailed questionnaire survey (2005–2006) of carers of adults with PID (18–44 years) in South Australia from family homes, community housing, and institutions, and oral examinations of care‐recipients recording decayed (D), missing (M) and filled (F) teeth (DMFT). Results: Carers completed questionnaires for 485 care‐recipients, 267 of whom were examined (completion rate = 55.1%). The prevalence of decay (D > 0) was 16.9% and 76.3% had caries experience (DMFT > 0). In unadjusted analysis, care‐recipients at institutions had a significantly higher mean DMFT than other settings. After adjusting for carer and care‐recipient characteristics, there was no difference in any of the DMFT components among residential settings. However, there were statistically significant associations (OR ± 95% CI excluding unity) between decayed teeth and moderate and high intake of sweet drinks and frequency of dental visits. Higher odds of missing teeth were associated with type of disability, general anaesthetic requirement for dental treatment and low and high carer‐contact. Higher odds of filled teeth were associated with age, no oral hygiene assistance (OHA) and high carer‐contact. Higher odds of caries experience were associated with age and no OHA. Conclusions: Residential setting was not associated with caries experience. Modifiable risk factors were diet, frequency of dental visits, no OHA and carer‐contact hours.     

Dental findings in diabetic adults

The dental status of dentate diabetic adults (n = 299) and its associations with diabetes-related factors was explored in Tehran, Iran. Presence of diabetes-related complications made no difference in mean values of DMFT, but was associated with a higher number of decayed and missing teeth, and fewer filled teeth. Higher level of HbA1c was associated with higher DMFT for men, but not for women. In conclusion, the results suggest a possible association between the level of metabolic control of diabetes mellitus and cumulative caries experience.     

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.     

Impact of dental visiting trajectory patterns on clinical oral health and oral health-related quality of life

Background: Previous studies have shown variation in long‐term dental visiting but little is known about the oral health outcomes of such variation. Objective: The objective of this study is to determine the association of different dental visiting trajectories with dental clinical and oral health‐related quality of life (OHRQoL) indicators. Methods: This study utilized data from the Dunedin Multidisciplinary Health and Development Study, a continuing longitudinal study of 1,037 babies born in Dunedin (New Zealand) between April 1, 1972 and March 31, 1973. Data presented here were collected at ages 15, 18, 26, and 32 years. Three categories of dental attendance were identified in earlier research, namely: regulars (n = 285, 30.9 percent of the cohort), decliners (441, 55.9 percent), and opportunistic users (107, 13.1 percent). Results: There was a statistically significant association between opportunistic dental visiting behavior and decayed missing and filled surfaces score (Beta = 3.9) as well as missing teeth because of caries (Beta = 0.7). Nonregular dental visiting trajectories were associated with higher Oral Health Impact Profile (OHIP‐14) scores (Beta = 2.1) and lower self‐rated oral health scores (prevalence ratio = 0.8). Conclusion: Long‐term, postchildhood dental attendance patterns are associated with oral health in adulthood, whether defined by clinical dental indicators or OHRQoL. Improving dental visiting behavior among low socioeconomic status groups would have the greatest effect on improving oral health and reducing oral health impacts.     

Monitoring time-related trends in dental caries in permanent teeth in Japanese national surveys

Objectives: According to dental examinations of 3‐ and 12‐year‐old children conducted throughout Japan, the prevalence of dental caries in children is decreasing. However, little is known about changes in the prevalence of dental caries in adults. This study analysed past and present prevalences of dental caries in permanent teeth and predicted future trends in dental caries in adults. Methods: Data were sourced from nine national dental surveys conducted in Japan at 6‐year intervals from 1957 to 2005. Data from oral examinations were recorded as indices of decayed, missing and filled teeth. Results: The mean number of filled teeth increased markedly, whereas mean numbers of decayed teeth and missing teeth decreased substantially in people aged ≥ 40 years. By contrast, the mean number of filled teeth first increased and then decreased in groups aged 5–39 years. Conclusions: Among Japanese respondents sampled in a series of cross‐sectional studies between 1957 and 2005, the incidence of dental caries in young adults decreased, suggesting a decrease in prevalences of dental caries in future generations. However, this tendency was not observed in respondents aged ≥ 40 years. The results suggest adults will experience less dental caries in the near future.     

Changing Inequalities in the Distribution of Caries Associated with Improving Child Oral Health in Australia

Objectives: This study aimed to document the changing distribution of and inequalities in dental caries in Australian children across the 25-year period from 1977 to 2002. Methods: Oral health data were obtained from Australia's national Child Dental Health Survey. Measures of caries distribution included the Significant Caries Index and the proportions of children with high caries experience [decayed, missing and filled teeth (DMFT) ≥ 4], while inequality was assessed by using Gini coefficients calculated from Lorenz curves. Changes in caries distribution were compared with changes in child dmft/DMFT. Results: While appreciable reductions occurred in child caries experience, in terms of both mean dmft/DMFT and for those children with the poorest oral health, inequalities in the distribution of caries experience increased across the 25-year period. Inequalities in the distribution of decayed and filled teeth differed for the deciduous and permanent dentition and, in the permanent dentition, became increasingly similar in the 1990s. Conclusions: Increasing inequalities in child dental caries in Australia must be interpreted in the context of declines in both mean caries experience and in the caries experience of those children with the poorest oral health. The Gini coefficient documents that the majority of the caries experience is increasingly being confined to a smaller percentage of the child population; however, this is a consequence of population-wide child oral health improvements.     

Longitudinal evaluation of the impact of dental caries treatment on oral health‐related quality of life among schoolchildren

This study aimed to evaluate the impact of dental caries treatment on oral health‐related quality of life (OHRQoL) among schoolchildren and the responsiveness of the Child Perceptions Questionnaire (CPQ_8‐10) instrument. Brazilian schoolchildren, 8–10 yr of age, were randomly selected and assigned to two groups – dental caries treatment (DCT) and caries‐free (CF) – according to their caries experience [decayed, missing, or filled primary teeth (dmft) and decayed, missing or filled secondary teeth (DMFT) values of ≥0]. The CPQ_8‐10 instrument was administered at baseline and at 4 wk of follow‐up (i.e. 4 wk after completion of dental treatment). In the DCT group, increases in CPQ_8‐10 scores were observed between the baseline and follow‐up results. However, longitudinal evaluation of the CF group demonstrated no statistically significant difference in CPQ_8‐10 scores. Responsiveness of the CPQ_8‐10 instrument (magnitude of change in CPQ_8‐10 scores) in the DCT group was greater (effect size >0.7) than in the CF group. The findings of this study show that dental caries treatment has an important impact on OHRQoL of children. The CPQ_8‐10 was considered an acceptable instrument for longitudinal measurement of changes in OHRQoL.     

Prevalence of dental caries and caries-related risk factors in premature and term children

This study evaluated the prevalence of enamel defects and dental caries and their risk factors on primary and permanent dentitions of prematurely-born children and term children. Eighty children were examined, 40 born prematurely (G1) and 40 born term (G2), in the age group between 5 and 10 years. The demographic variables, medical history and oral health behaviors were recorded on a questionnaire. The teeth were examined for presence of deficiencies of the enamel and caries that were registered. The caries were registered, focusing on the indices dmft (decayed, missing, and filled primary teeth) and DMFT (decayed, missing, and filled permanent teeth). The results showed that 75% of the total sample had enamel defects. The logistic regression model showed that other risk factors such as per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases had no correlation with enamel defects and caries. A smaller value of total DMFT (0.95) was found in the group of premature children in comparison to the term children (2.07) p = 0.0164. There was no difference concerning the permanent dentition between the two groups (p = 0.9926). One concludes that prematurity can't be a predisposing factor for the presence of dental caries.     

Dental caries and dental health behavior of patients with primary Sjögren syndrome

This comprehensive study was carried out to describe and analyze the oral health status, perceived oral health problems, patients' costs, and oral health behavior in a group of patients with primary Sj?gren syndrome (PSS). In particular, the objective of this report was to assess whether Sj?gren syndrome patients had more dental caries experience than a control group. Data were collected by means of interviews and clinical oral examinations. The study comprised 53 patients with PSS and a control group of 53 persons matched by age. Among the younger patients the number of decayed, missing, or filled teeth (DMFT) was 22.3, compared with 18.8 among controls (P< 0.05). In parallel, the DMFT in the old-age PSS patients was 26.2, against a DMFT of 22.1 for controls (P< 0.001). On average, the young patients had seven teeth missing, whereas two missing teeth were found among controls (P < 0.01). PSS patients had more frequent dental visits--every 3-4 months (40%)--than controls (19%). In parallel, 78% of the PSS patients brushed their teeth more than twice daily, compared with 28% of the control group. The PSS patient group reported having had more teeth extracted, more trouble with their teeth during lifetime, and higher expenses for dental treatment than controls. In spite of the more regular oral health care practices than the general population, PSS patients had experienced more dental caries and more radical dental treatment. It is suggested that the National Health Insurance should give emphasis to preventive care to patients with PSS.     

Dental health behaviour in relation to caries status among medical and dental undergraduate students of Udaipur district,India

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2008.00346.x
Kumar S, Motwani K, Dak N, Balasubramanyam G, Duraiswamy P, Kulkarni S. Dental health behaviour in relation to caries status among medical and dental undergraduate students of Udaipur district, India. Abstract: Objective: To compare the caries status and oral hygiene behaviour of dental and medical students and to assess the influence of oral hygiene behaviour on the caries status. Methods: A questionnaire survey was conducted to assess the knowledge, attitudes and behaviour along with clinical examination to asses the caries status. A total of 403 dental and medical students enrolled with Rajasthan University of Health Sciences of Udaipur district, India were recruited in the study. Results: 56.4% of dental students brushed their teeth twice daily compared to 38.5% of medical students. There was no significant difference between the mean decayed components of males and females of dental stream, whereas among medical subjects, males had a higher decayed score than females (P = 0.012). The mean behaviour score obtained by dental students (19.38) was greater than that of medical students (18.34). Moreover, medical students presented a higher decayed, missing and filled teeth (DMFT) score (1.96) than dental students (1.16). Subjects who had a habit of brushing after every meal showed lower DMFT score (1.4) than those who brushed only once a day (1.64). Step‐wise linear regression analysis revealed that course of education and final behaviour score were the best predictors for the DMFT status. Conclusion: This study revealed significant differences between the oral hygiene behaviour and caries status of dental and medical students; furthermore, caries status was significantly influenced by the oral hygiene behaviour.     

Dental caries, sugar consumption and restorative dental care in12–13-year-old children in Riyadh, Saudi Arabia

A 3-day dietary history was obtained from 363 Riyadh schoolchildren aged 12-13 yr, after which their dentitions were examined for dental caries. About 16-31% of the children were caries-free and the mean DMFT varied between 1.67 and 2.43. However, in those with at least one tooth decayed, missing or filled, the mean DMFT remained constant at about 3, irrespective of age or gender; and most of the carious teeth were unrestored. There was a statistically significant relationship between DFS and the frequency of sugar consumption on the first 2 days of the dietary diary. It is suggested that the management of dental caries in the children must include the control of dietary sugar.     

Caries experience in a Norwegian urban population

DMF teeth were recorded in a random sample of 117 35-year-old citizens of Oslo. The mean number of DMF teeth was 25.7, reflecting a high caries experience in the population surveyed. The mean number of decayed teeth was 5.1, the majority being due to recurrent carious lesions. Only 61.2% of the total number of posterior carious teeth were observed clinically. The remaining lesions (38.8%) were diagnosed on bitewing radiographs. The mean number of missing teeth in the sample was 6.3, while the mean number of filled teeth was 18.9. This indicates that the subjects have had acces to regular dental treatment. Females in the lower educational group had significantly more missing teeth and fewer filled teeth than females in the higher educational group. Similar differences could not be detected in males.     

Lifetime fluoridation exposure and dental caries experience in a military population

Abstract – While there is good evidence of caries‐preventive benefits of fluoride in drinking water among children and adolescents, there is little information about effectiveness of water fluoridation among adults. Objectives: To determine whether exposure to fluoride in drinking water is associated with caries experience in Australian Defence Force (ADF) personnel. Methods: Cross‐sectional study of 876 deployable ADF personnel aged 17–56 years. At each person’s mandatory annual dental examination, military dentists recorded the number of decayed, missing and filled teeth (DMFT) using visual, tactile and radiographic criteria. Participants also completed a questionnaire, listing residential locations in each year from 1964 to 2003. People were classified into four categories according to the percentage of their lifetime living in places with fluoridated water: <10%, 10% to <50%, 50% to <90% and ≥90%. Mean DMFT was compared among those categories of fluoridation exposure and the association was evaluated statistically using analysis of variance to adjust for age, sex, years of service and rank. Results: Without adjustment for confounders, the mean DMFT (±95% confidence interval) was 6.3 ± 0.8 for <10% fluoridation exposure, 7.8 ± 0.8 for 10% to <50% exposure, 7.5 ± 0.7 for 50% to <90% exposure and 4.6 ± 0.6 for ≥90% exposure (P < 0.01). However, age was inversely associated with mean DMFT and in the <10% exposure group, 91% of people were aged <35 years. Service rank was also significantly associated with both fluoridation exposure and DMFT. After adjustment for all covariates, mean DMFT was 24% lower among people in the two groups with ≥50% exposure compared with the <10% exposure group. Conclusions: Degree of lifetime exposure to fluoridated drinking water was inversely associated with DMFT in a dose–response manner among this adult military population.     

Dental caries, gingival health and malocclusion in 12-year-old urban Black schoolchildren from Soweto, Johannesburg

Abstract The oral health of 402 12-year-old Black schoolchildren was studied. Dental caries was seen in 65.6%, but 58.2% had a DMFT of less than 6, while the mean DMFT was 2.3. Few teeth were missing or filled, the majority being decayed. No significant association was found between DMFT and sex, ethnic group or father's occupation. Periodontal disease was seen in 40.3% and malocclusions were rare, being present in only 11.1%.     

Dental plaque, caries prevalence and gingival conditions of 14-15-year-old schoolchildren in Jerash District, Jordan

Abstract:  The aim of this cross-sectional study was to evaluate oral hygiene, gingival condition and dental caries prevalence in 14–15-year-old school children in Jerash District, Northern Jordan. Twenty schools (10 male and 10 female schools) with 1362 children of eighth and ninth grades were randomly selected and incorporated in this study. All participants had dental examinations for oral hygiene, gingival condition and dental caries experience using the Silness and Löe Plaque Index (PI), Löe and Silness Gingival Index (GI), and decayed (D), missing (M) and filled (F) teeth (DMFT) and surface (DMFS) codes respectively. The results showed that males had significant lower plaque but significantly higher gingival scores than females ( P  < 0.001). About 24% of children were caries-free. The proportions of children with one, two or three decayed teeth were between 10% and 18%. Slight non-significant variations between males and females were observed in regard to DMFT/S and their components ( P  < 0.05). It is concluded that significant gender variations were noted in PI and GI scores but not in DMFT/S or their components. However, the values of these clinical scores were lower than those results previously reported in northern Jordan.     

Relationship between orthodontic treatment and dental caries: results from a national survey

Objectives: Orthodontic treatment has been suggested to increase the risk of dental caries. The aim of this study was to evaluate the association between orthodontic treatment and the likelihood of dental caries. Methods: The study included data for adults aged ≥ 19 years who participated in the Korea National Health and Nutrition Examination Survey in 2013–2015. The participants’ demographic, socio-economic, and general and oral health-care data were collected by trained interviewers using a structured questionnaire. The number of decayed teeth (DT) and the decayed, missing and filled teeth (DMFT) index score on oral examinations performed by dentists were compared between subjects who underwent orthodontic treatment and those who did not, using the chi-squared test and logistic regression analysis. Results: All logistic regression analysis models showed a significant association between orthodontic treatment and untreated dental caries. The likelihood of having untreated dental caries was lower in subjects who had received orthodontic treatment than in those who had not, regardless of confounding factors (P < 0.001). After adjustment for confounding factors, the mean number of DT was lower in subjects who had received orthodontic treatment than in those who had not (0.66 vs. 0.94; P < 0.001). There was no statistically significant difference in the DMFT index score between the two groups. Conclusions: Orthodontic treatment was associated with a decreased likelihood of untreated dental caries. Moreover, there was no evidence indicating a link between the DMFT index score and orthodontic treatment.Key words: Dental caries, DMFT index, DT index, epidemiology, orthodontic treatment     

Comparative assessment of dentition status among poliomyelitis children in Udaipur,India

To determine and compare the dental caries experience and treatment needs of children with Poliomyelitis at Udaipur, India. Total sample comprised of 344 children with Poliomyelitis (upper limb disability: 33.4%; lower limb disability: 33.7%; both upper and lower limb disability: 32.8%) in the age group of 12–15 years. Clinical examination included recording Dentition Status and Treatment Needs. Chi‐square test, Analysis of variance (ANOVA), multiple logistic and stepwise linear regressions were used for statistical analysis. The mean decayed, missing, filled teeth (DMFT) score (4.47 ± 3.09) was found to be highest among children with Poliomyelitis having both upper and lower limb impairment (p < .05). Stepwise and logistic regression analysis showed that the best predictors for dental caries were disability, socioeconomic status and snacks in between meals. A significant relationship of dental caries with limb involved in impairment draws immediate attention for a planned approach in improving the oral health.