Dental caries and associated factors in 12-year-old schoolchildren in Thiruvananthapuram, Kerala, India

OBJECTIVES: The aims of the present study were to describe the dental health status of 12-year-old schoolchildren in Thiruvananthapuram, Kerala, India, and to identify sociodemographic factors, oral health behaviours, attitudes and knowledge related to dental caries experience. METHODS: The study took the form of a cross-sectional survey of 838 children in upper primary schools. A two-stage cluster sampling technique was used. Dental caries was measured using World Health Organization criteria. Sociodemographic factors, oral health behaviours, attitudes and knowledge were assessed by a self-administered questionnaire. RESULTS: The prevalence of dental caries in the permanent dentition was 27%. The mean number of decayed, missing and filled teeth was 0.5 (SD=0.9). The decayed component (D) constituted 91% of the total number of decayed, missing and filled teeth (DMFT). Multiple logistic regression analysis showed that children had a higher risk of having dental caries if they lived in urban area [OR=1.5, 95% confidence interval (CI)=1.1-2.1], had visited a dentist (OR=1.6, 95% CI=1.2-2.2), did not use a toothbrush (OR=1.9, 95% CI=1.2-2.9), consumed sweets (OR=1.4, 95% CI=1.0-1.9) or performed poorly in school (OR=1.7, 95% CI=1.0-2.3). CONCLUSIONS: The prevalence of caries in this sample of 12-year-old schoolchildren was low compared to that in other developing countries. The present study indicated that urban living conditions were associated with more dental caries. Since urbanization is rapid in India, oral health promotion at the present time would be valuable to prevent increased caries prevalence.     

Dental pain prevalence and association with dental caries and socioeconomic status in schoolchildren, Southern Brazil, 2002

The objective of this study was to assess the relation between dental pain, dental caries and socioeconomic status among 12- and 13-year-old schoolchildren enrolled in a public school in Florianópolis, SC, Brazil in 2002. This study was a cross-sectional study involving 181 schoolchildren. Dental pain experience was the dependend variable analyzed. Socioeconomic data of the children's families were obtained through a questionnaire. Dental caries experience was registered according to the DMFT index (WHO, 1997). The field workteam consisted of an examiner and a recorder. The statistical analysis was performed using the chi-square test and the non-conditional multiple logistic regression. The response rate was 93.4%. The intraexaminer agreement measured on a tooth by tooth basis was high (kappa > 0.73). Dental pain prevalence was 33.7% (CI95% 26.0-42.0). The multiple regression analysis, adjusted by sex and other variables, showed that children with DMFT > 1 presented 2.9 (OR CI95% 1.4-6.1, p < 0.01) more chances of having dental pain when compared with those with DMFT < or = 1. Children whose mother's schooling level was equal or less than 4 years presented 2.5 (OR CI95% 1.2-5.6, p = 0.02) more chances of having dental pain when compared with others whose mothers had more than 5 years of schooling and, finally, children whose family income was up to U$ 67.00 showed 3.2 (OR CI95% 1.2-8.4, p = 0.02) more chances of having dental pain when compared with the ones whose families had higher income. High levels of caries attack, low mother schooling level and low family income were associated to dental pain.     

Social and behavioural determinants of early childhood caries

BACKGROUND: To investigate the association between selected social and behavioural (infant feeding and preventive dental practices) variables and the presence of early childhood caries in preschool children within the north Brisbane region. METHODS: A cross sectional sample of 2515 children aged four to five years were examined in a preschool setting using prevalence (percentage with caries) and severity (dmft) indices. A self-administered questionnaire obtained information regarding selected social and behavioural variables. The data were modelled using multiple logistic regression analysis at the 5 per cent level of significance. RESULTS: The final explanatory model for caries presence in four to five year old children included the variables breast feeding from three to six months of age (OR=0.7, CI=0.5, 1.0), sleeping with the bottle (OR=1.9, CI=1.5, 2.4), sipping from the bottle (OR=1.6, CI=1.2, 2.0), ethnicity other than Caucasian (OR=1.9, CI=1.4, 2.5), annual family income dollars 20,000-dollars 35,000 (OR=1.7, CI=1.3, 2.3) and annual family income less than dollars 20,000 (OR=2.1, CI=1.5, 2.8). CONCLUSIONS: A statistical model for early childhood caries in preschool children within the north Brisbane region has been constructed using selected social and behavioural determinants. Epidemiological data can be used for improved public oral health service planning and resource allocation within the region.     

Multilevel assessment of determinants of dental caries experience in Brazil

OBJECTIVE: To examine contextual and individual determinants of dental caries experience, documenting levels of the disease in Brazil. METHODS: The dental status of 34 550 12-year-old schoolchildren was informed by a country-wide survey of oral health comprising 250 towns and performed in 2002-2003. Indices assessing dental caries experience were compared by sociodemographic characteristics of examined children (gender, ethnic group, localization and type of school), and geographic characteristics of participating towns [the human development index (HDI), and access to fluoridated tap water]. A multilevel model fitted the adjustment of untreated caries to individual and contextual covariates. RESULTS: Better-off Brazilian regions presented an improved profile of dental health, besides having a less unequal distribution of restorative dental treatments between blacks and whites, rural and urban areas, and public and private schools. Girls [odds ratio (OR)=1.1; 95% confidence interval (CI): 1.0-1.1], blacks (OR=1.6; 95% CI: 1.5-1.7), and children studying in rural areas (OR=1.9; 95% CI: 1.7-2.0) and public schools (OR=1.7; 95% CI: 1.6-1.9) presented higher odds of having untreated decayed teeth. The multilevel model identified the fluoride status of tap water (beta=-0.3), the proportion of households linked to the water network (beta=-0.3), and the HDI (beta=-0.2), as town-level variables associated with caries levels. CONCLUSION: Dental caries experience is prone to sociodemographic and geographic inequalities. The monitoring of contrasts in dental health outcomes is relevant for programming socially appropriate interventions aimed both at overall improvements and at the targeting of resources for groups of population presenting higher levels of needs.     

Are intrauterine growth restriction and preterm birth associated with dental caries?

OBJECTIVES: To assess the association between two intrauterine growth restriction (IUGR) surrogates - IUGR [small for gestational age birth (SGA) and fetal growth restriction (FGR)] and preterm birth with dental caries. METHODS: Data from the Third National Health and Nutritional Examination Survey (1988-1994) were used, including 2- to 5.9-year-old singletons (n = 3189). Dental caries was defined as presence of any teeth with dental caries (treated or untreated) and also as presence of at least two teeth with dental caries. Exposure variables were preterm birth (<37 gestational weeks), FGR, and SGA. Covariates included were poverty, race/ethnicity, age, sex, sucrose intake, environmental tobacco smoking, dental visits, education of head of household, breastfeeding, and use of baby bottle. Separate statistical analyses were conducted for IUGR and for preterm birth through the estimation of prevalence ratio (PR), taking complex sampling design into consideration and adjusting for confounders. Sensitivity analysis was conducted including and excluding 2-year-old children and also with the two definitions of dental caries. RESULTS: In general, the inclusion of 2-year-old children and the case definition of presence of any teeth with dental caries biased the results toward the null, but with no major changes in the results. In bivariate analysis, SGA and FGR birth were both negatively but not significantly associated with dental caries while a significant positive association was found for preterm birth. Sensitivity analysis showed that the PR for preterm in bivariate analysis varied from 1.65 (95% CI 1.14-2.40) to 1.84 (95% CI 1.19-2.83). After adjusting for confounders, the PR for preterm birth varied from 1.38 (95% CI 1.00-1.89) to 1.64 (95% CI 1.22-2.20). After adjustment, the PR for SGA varied from 0.79 (95% CI 0.56-101) to 0.66 (95% CI 0.33-0.96). For children from 3 to 5.9 years old, the adjusted PR for FGR using the category 'none' as reference were mild (PR 1.10; 95% CI 0.76-1.58), moderate (PR 0.66; 95% CI 0.26-167), and severe (PR 0.59; 95% CI 0.36-0.99). These values for FGR were very similar for the other models using other classifications of case definition or inclusion of 2-year-old children. CONCLUSIONS: Preterm birth was found to be positively associated with dental caries while there is an indication that SGA and FGR are negatively associated with dental caries. Although the negative association is counterintuitive, it is possible that increased antibiotic use and delayed tooth eruption may explain the negative association between IUGR and dental caries.     

Caries in five-year-old children and associations with family-related factors

It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful.     

Life course dental caries determinants and predictors in children aged 12 years: a population-based birth cohort

Abstract – Objective: To investigate the main dental caries life course determinants and predictors of dental caries at age 12. Methods: This study was nested in a population‐based birth cohort started in 1993 in Pelotas, Brazil. A sample of 359 children was followed‐up. Dental examinations and interviews were performed at 6 and at 12 years old. Dental caries (DMFT) at 12 years old was the outcome. Exploratory variables included socioeconomic and demographic variables at birth, children’s nutritional and development characteristics, primary dental caries, oral health related behaviors and dental service use at age 6 and 12. Poisson regression was used in order to provide relative risk ratio estimates. Attributable risk or etiology fraction and population attributable risk for both main early life variables were calculated. Dental caries prediction (DMFT ≥ 1) at 12 years old was tested using logistic regression analyses. Results: Children who presented height‐for‐age deficit at 12 months (RR 1.50 CI: 95% = 1.03–2.18), children who showed a DMFT of 1–3 and 4–19 at 6 years (RR = 2.01; CI: 95% = 1.33–3.03, and RR = 2.66; CI: 95% = 1.81–2.53, respectively) and those children aged 12 in the highest tertile of proportion of teeth experiencing gingival bleeding (RR = 1.58; CI: 95% = 1.11–2.24) presented a higher level of dental caries at age 12. Attributable risk for dental caries at age 12 were 79.1% and 74.2% for deficit in height for age at 12 months and for primary dental caries at age 6 years respectively; population attributable risk for dental caries at age 12 were 3.1% for deficit in height for age at 12 months and 64.9% for primary dental caries at age 6. The level of accuracy in predicting dental caries at age 12 by using life course socioeconomic, behavioral and clinical data was modest. Conclusions: The results of this study support the hypothesis linking social, biological and behavioral exposures and dental caries at 12 years old. In addition, the findings reinforce the lack of accuracy of dental caries predictors therefore limiting the individuals high‐risk approach as a public health strategy.     

Association between developmental defects of enamel and dental caries in schoolchildren

Despite improvement, dental caries is still the main public oral health problem worldwide and the major cause of pain, tooth loss and chewing difficulties in children and adolescents; and it impacts negatively on oral health-related quality of life. A cross-sectional study of a multistage representative sample of 8–12-year-old Brazilian school children was carried out in order to investigate the association between enamel defects and dental caries. Children's mothers completed a questionnaire about socio-demographic and behavioural characteristics at home. Firth's bias reduced logistic regression models were undertaken to assess the association between the main exposure (enamel defects) and caries experience. The prevalence of any enamel defect was 64.0%; the prevalence of diffuse opacities, demarcated opacities and enamel hypoplasia was 35.0%, 29.5% and 3.7%, respectively. The prevalence of dental caries was 32.4%, with mean DMFT of 0.6 (SD, 1.2). Dental caries experience was more common among children who had enamel hypoplasia in their posterior teeth (OR = 2.79; 95% CI: 1.05, 6.51) than among those with none. In anterior teeth, there was no association. Enamel hypoplasia appears to be an important risk factor for dental caries.     

Dental caries experience and factors among preschoolers in southeastern México: a brief communication

OBJECTIVE: To examine the association between dental caries prevalence and selected variables in preschool children. METHODS: A cross-sectional study was carried out with 1,303 preschoolers (ages 3-6 years old), and the mothers completed questionnaires. The children were examined by one of three standardized dental examiners. Logistic regression was performed to identify associations between dental caries and other factors. RESULTS: Mean dmft was 1.54+2.47, with 44.1% of children having dmft>0. Caries prevalence was associated with older children (OR=1.39); medium (OR=1.66) and low (OR=2.41) socioeconomic levels; mediocre (OR=1.71) and inadequate (OR=2.25) hygiene; negative attitude toward oral health (OR=1.51); and the presence of enamel defects (OR=1.74). CONCLUSION: Both overall caries prevalence and dmft index were relatively low. The results of this study substantiate previous reports in the international literature for clinical, behavior, socio-demographic, and socio-economic variables that contribute to dental caries in Mexican children.     

Tooth wear: prevalence and associated factors in general practice patients

Cunha‐Cruz J, Pashova H, Packard JD, Zhou L, Hilton TJ for Northwest PRECEDENT. Tooth wear: prevalence and associated factors in general practice patients. Community Dent Oral Epidemiol 2010; 38: 228–234. © 2010 John Wiley & Sons A/S Abstract – Objectives: To estimate the prevalence of tooth wear and to investigate factors associated with tooth wear in patients from general practices in the Northwest United States. Methods: Data on the diagnosis and treatment of oral diseases during the previous year were collected in a survey with a systematic random sample of patients (n = 1530) visiting general dentists from the Northwest Practice‐based REsearch Collaborative in Evidence‐based DENTistry (PRECEDENT) (n = 80). Prevalence ratios (PRs) of moderate to severe occlusal and incisal tooth wear by patient characteristics were estimated using cluster‐adjusted multiple binomial regression for adults (18+ years) and children/adolescents (3–17 years). Results: For adults, the mean number of teeth with wear facets was 5.4 [95% confidence interval (CI) = 4.6–6.2] and 51% of the adults had four or more teeth with wear. Participants 45–64 and 65+ years old were 1.3 (95% CI = 1.1–1.6) and 1.4 (95% CI = 1.1–1.8) times as likely to have 4+ teeth with moderate to severe wear facets as participants 18–44 years old. Adult males had a 20% (PR = 1.2; 95% CI = 1.1–1.4) higher prevalence of wear than adult females. Adults who were using, or had ever used occlusal splints had higher prevalence of tooth wear compared to those who never used such appliances (PR = 1.3; 95% CI = 1.0–1.5). Adults with any periodontal bone loss also had a 20% higher prevalence of wear than adults without periodontal disease (PR = 1.2; 95% CI = 1.0–1.4). For children/adolescents, the mean number of teeth with moderate to severe wear facets was 1.6 (95% CI = 0.9–2.6) and 31% of the children had one or more teeth with wear facets. The adjusted prevalence ratio of tooth wear (1+ teeth with wear facets) for boys was 1.6 times as high (95% CI = 1.1–2.4) as compared with girls. The prevalence of wear for children 12+ years old was 50% (PR = 0.5; 95% CI = 0.3–0.8) lower than that of children <12 years old. Angle’s class II was associated with higher tooth wear prevalence (PR = 1.8; 95% CI = 1.3–2.6) than class I. Children with posterior or anterior open bite had lower prevalence of wear than their counterparts (PR = 0.6; 95% CI = 0.3–1.0). No associations were observed between tooth wear and orthodontic treatment, missing teeth, and race/ethnicity. Conclusion: Tooth wear is a prevalent condition in this population. Among adults, higher prevalences of tooth wear were observed among those who were older, males, had used occlusal splints and had periodontal disease. Among children, higher prevalences were associated with younger age, male gender, class II malocclusion and the absence of open bite. Submitted on behalf of the Northwest PRECEDENT network, with support from NIDCR grants DE016750 and DE016752.     

Dental Caries in 3-Year-Old Children is Associated More with Child-Rearing Behaviors than Mother-Related Health Behaviors

Objective: We assessed whether child- or mother-related health behaviors were associated more strongly with dental caries in 3-year-old children. Methods: Multiple logistic regression analyses were performed on dental caries' presence as the dependent variable with independent variables from the results of examination and a self-administered questionnaire of 396 mother–child pairs. Result: Dental caries of 3-year-old children was more strongly associated with child-related health behavior than mother-related health behavior. Of the child-related variables, "a habit of feeding in bed"[OR (odds ratio) 10.14; 95 percent class interval (CI) 1.80-56.97], "eating between meals three times a day or more" (OR 3.33; 95 percent CI 1.56-7.10), "consuming a sports drink three times a week or more" (OR 4.47; 95 percent CI 1.60-12.49), "having both home and professional preventive dental care" (OR 3.02; 95 percent CI 1.44-6.32), and "having professional preventive dental care" (OR 3.79; 95 percent CI 1.75-8.21) were significantly associated with dental caries in children. Of the mother-related variables, "brushing teeth once a day or less" (OR 2.72; 95 percent CI 1.19-6.20) and "drinking alcohol three times a week or more" (OR 0.38; 95 percent CI 0.16-0.93) had significant effects. Conclusion: Dental caries of 3-year-old children was more strongly associated with child-related health behavior than mother-related health behavior. The results of this study suggest that encouraging good child-rearing behavior among mothers could result in better dental health among their children regardless of the mother's dental health status.     

Children's use of dental services: influence of maternal dental anxiety, attendance pattern, and perception of children's quality of life

OBJECTIVES?: The purpose of the study was to investigate the influence of a child's clinical condition; maternal characteristics such as dental anxiety and dental visit pattern; socioeconomic conditions; and maternal perception of the child's oral health-related quality of life (OHRQoL) on a child's use of dental care services. METHODS?: A cross-sectional study of 608 mother-child dyads was conducted during the Children's Immunization Campaign in Pelotas, Brazil. Mothers answered a questionnaire regarding their use of dental services, dental anxiety (Dental Anxiety Scale), socioeconomic status, and perception of their children's OHRQoL (the Early Childhood Oral Health Impact Scale). Clinical examination of the children was performed to assess dental caries (dmf-t). Associations between the above-mentioned factors and child use of dental services were assessed using Poisson regression models (prevalence ratio [PR]; 95% CI; P?≤?0.05). RESULTS?: The majority of children (79.3%) had never had a dental appointment and of the children who had visited a dentist, 55 (43.65%) presented with untreated dental caries at the time of examination. More than half the mothers (60.2%) did not visit a dentist regularly. In the final model, low schooling level of mothers (PR, 0.64) and irregular visits to a dentist by the mother (PR, 0.48) were factors because of which a child did not have a dental appointment. Children who had experienced pain (PR, 1.56), those who had poor OHRQoL (PR, 1.49), and older children (PR, 2.14) visited a dentist with higher frequency. CONCLUSIONS?: Use of dental care services by preschool children was low, and treatment was neglected even among children who had visited a dentist. Children of mothers with low schooling level who do not visit a dentist regularly were at greater risk of not receiving dental care. Maternal perception of their child's oral health motivated visits to the dentist.     

Dental caries experience and use of dental services among preschool children in Ajman, UAE

OBJECTIVE: The aim of this study was to estimate the prevalence and severity of dental caries in the primary dentition of young children in Ajman, UAE, and investigate its association with sociodemographic characteristics and use of dental services. METHODS: A cluster-sampling approach was used to randomly select children aged 5 or 6 years who were enrolled in public or private schools. Clinical examinations for caries were conducted by a single examiner using World Health Organization criteria. Parents completed questionnaires seeking information on socioeconomic background and dental service utilization. Zero-inflated negative binomial (ZINB) regression modelling was used to identify risk markers and risk indicators for caries experience. RESULTS: The prevalence of dental caries in the sample was high 76.1%. The average dmfs score 10.2. Caries severity was greater among older children and among male children of less educated mothers. Emirati (local) children had higher caries severity than others. Children who had higher level of caries visited the dentist more frequently than other children whose visits were for check-up only. CONCLUSIONS: Dental caries prevalence and severity in young children in Ajman are high, and socioeconomic characteristics and dental utilization are important determinants of their dental caries experience. There is an urgent need for oral health programmes targeted at the treatment and underlying causes of dental caries in these children.     

Trends in dental caries among Brazilian schoolchildren: 40 years of monitoring (1971–2011)

The study aimed to estimate the prevalence, severity, and inequality in the distribution of dental caries in schoolchildren from Florianópolis, Santa Catarina, Brazil, in 2011, and to compare the results with data from previous studies carried out since 1971. All 12‐ and 13‐year‐old schoolchildren enrolled in a public school were eligible. Dental caries were assessed according to the World Health Organisation diagnostic criteria. Decayed, missing and filled surfaces and teeth (DMFS/DMFT) indexes, the Significant Caries Index (SiC) and the Gini coefficient (to assess inequalities in the distribution of dental caries) were estimated. The response rate was 82.3% (n = 130). The prevalence of dental caries decreased from 98.0% (95% CI 96.0–100.0) in 1971 to 36.9% (95% CI 28.5–45.3) in 2011. The mean DMFT ranged from 9.2 in 1971 to 0.7 in 2011. The mean DMFS index was 1.2 (95% CI 0.8–1.6) in 2011. The Gini coefficient was 0.624 in 2002 but increased to 0.725 in 2011; the Lorenz curve showed that 70–75% of dental caries attacks was restricted to 20% of the population in 2011. A reduction of 41.2% in the mean SiC index was observed between 2002 (3.4, 95% CI 3.0–3.8) and 2011 (1.9, 95% CI 1.6–2.1). An effective decline in the prevalence and severity of dental caries in schoolchildren was observed throughout 40 years of monitoring. However, a small proportion of the population has experienced most of the caries burden in the recent years studied.     

Caries prevalence in 2-year-old children in the city of Zurich

OBJECTIVES: To establish caries prevalence in 2-year-olds in the city of Zurich; and to investigate the relationship between caries prevalence and dietary habits, and oral hygiene practices in native children and children with immigrant background. METHOD: 1,000 randomly selected 2-year-olds were invited to participate in a clinical examination, at which parents were interviewed about the child's oral hygiene and dietary habits. Caries diagnosis was based on visual inspection of all tooth surfaces and included both initial (d1) and cavitated (d2) lesions. Univariate and multivariate logistic regressions for two subgroups of children (children of Swiss and foreign-born mothers) were performed in order to assess the association between predictor variables and caries. RESULTS: 771 children were examined (participation rate 78%; mean age 2.4 years (age range 2.06-2.90 years)). Although the majority (94%) was born in Switzerland, 61% of children had immigrant backgrounds (mother not born in Switzerland). Cavitated teeth (d2mft) were observed in 12.6% of children (95% CI: 10.4-15.1%). Caries including initial lesions (dl2mft) affected 25.3% of children (95% CI: 22.4-28.5%). There were 34 (4.4%) children with severe caries (all maxillary incisors cavitated). For children with caries, the mean d2mft was 4.3 (+/- 2.8). Children with foreign-born mothers (mothers not born in Switzerland) exhibited a significantly higher caries prevalence than those with Swiss-born mothers (17.4% versus 5.0% with d2mft > 0). CONCLUSIONS: Children with foreign-born mothers exhibited significantly higher caries prevalence rates than those with Swiss-born mothers. Poor oral hygiene and night-time bottle use were identified as risk indicators for caries in all children. Further risk indicators identified in children of foreign-born mothers were a preference for sugar-containing non-milk drinks, no pacifier use, child's age and male gender.     

The severity of dental caries in adults aged 35 to 44 years residing in the metropolitan area of a large city in Brazil: a cross-sectional study

ABSTRACT: BACKGROUND: In recent decades, studies in the field of public health have increasingly focused on social determinants that affect the health-illness process. The epidemiological perspective considers oral health to be a reflection of socioeconomic and environmental aspects, and it is particularly influenced by the social context. The aim of the present study was to assess the association between the severity of dental caries among adults aged 35 to 44 years and characteristics on the different levels at which the determinants of caries operate (individual, social structure and social context). METHODS: A home-based, cross-sectional field study was carried out involving a sample of 1,150 adults (35 to 44 years of age) residing in metropolitan Belo Horizonte, Brazil. The DMFT (decayed, missing, filled tooth) index ([greater than or equal to]14) was used to determine the severity of dental caries. Bivariate and multivariate analyses were carried out using the Poisson regression model with the level of significance set at 5 % (p < 0.05) and 95 % confidence intervals. RESULTS: The majority of the participants (68.5 %) had high caries severity. The rate of high-severity caries in the group between 40 and 44 years of age was 1.15-fold (CI: 1.04-1.26) greater than that among those aged 35 to 39 years. A greater prevalence of high caries severity was found among those who frequently visited the dentist (PR = 1.18; CI: 1.07-1.30), those with a lower income (PR = 1.11; CI: 1.01-1.23), those who reported that their neighborhood did not come together in the previous year to petition political leaders for benefits (PR = 1.16; CI: 1.05-1.28) and those who are unable to make decisions (without empowerment) (PR = 1.12; CI: 1.01-1.24). CONCLUSIONS: The present study revealed high dental caries severity in adults, which was associated with individual characteristics, health-related behavior and social structure and contextual variables. These findings underscore the importance of considering social determinants involved in the health-illness process when carrying out epidemiological studies on dental caries.     

Epidemiology of caries in Alicante preschoolers. 2. Risk factors

An epidemiological study of dental caries amongst preschoolers (aged between 4 and 6 years) from the city of Alicante has been carried out. The influence of the socioeconomic class as well as higienic and diet habits on the appearance dental caries of deciduous teeth has been evaluated. From a total population 7,289 preschoolers, a representative sample of 1,292 children was obtained by the sampling process of a stratified randomization. A statistical significant association was found between socioeconomic class and dental caries (p less than or equal to 0.05), being the lower classes the more prone to dental caries. Higienic habits of the examined children were clearly inadequate; 75.62% of preschoolers showing dental plaque. There was a statistical significant relationship between dental plaque and caries (p less than or equal to 0.05). The ingestion of candies has been shown to be also related with dental caries. Those children who never eat candies showed a prevalence of dental caries of 30.84%, whereas the prevalence increased up to 44% in cases of frequent ingestion of sugared food.     

Age of first dental visit and predictors for oral healthcare utilisation in preschool children

Purpose: To assess the age the of the first dental visit and the association of self-perceived oral health, socioeconomic and clinical indicators with healthcare utilisation in Brazilian preschool children. Materials and Methods: An epidemiological survey with 455 5- to 59-month-old children was conducted on National Children's Vaccination Day in Santa Maria, RS, Brazil. Data about age and reasons for the first dental visit, healthcare utilisation, socioeconomic status and self-perceived oral health were collected by means of a parental semi-structured questionnaire. Calibrated examiners evaluated the prevalence of dental caries (WHO) and dental trauma. The assessment of the association used Poisson regression models (prevalence ratio; 95% confidence interval [CI]). Results: A total of 24.2% (95% CI: 20.3% to 28.4%) of the study sample had already had a first dental visit. Older children, those with dental caries and dental trauma and whose mothers had a higher level of education were more likely to have gone to the dentist. Children of low socioeconomic status were more likely to have visited public than private healthcare services. The reasons for the first dental visit were associated with clinical indicators of the sample. The distribution of utilisation of the types of oral healthcare services (public or private) varied across the socioeconomic groups. Non-white children with dental caries and dental trauma tended to visit a dentist only for treatment reasons. Conclusion: Socioeconomic and clinical indicators are associated with the use of dental services, indicating the need for strategies to promote public health and reorientation of services that facilitate dental access for preschool children.