Caretaker’s caries experience and its association with early childhood caries and children’s oral health-related quality of life: A prospective two-generation study

Objectives: The first objective of this study is to examine the association between caretakers’ caries experience and caries experience of their children. Second, to investigate whether children’s and caretaker’s caries experience is associated with oral health-related quality of life (OHRQoL) of children and their families.

Methods: This study is based on the prenatal recruitment interviews and the 5-year follow-up of 417 caretaker–children pairs from the Ugandan site of the PROMISE-EBF trial conducted in Mbale, Eastern Uganda. Face-to-face interviews were conducted with caretakers at the household level. Caries experience of caretakers (DMFT >0) and children (dmft >0) were assessed in accordance with the criteria of the World Health Organization. OHRQoL was assessed using an abbreviated version of the Early Childhood Oral Health Impact Scale (ECOHIS).

Results: Adjusted negative binomial regression analysis revealed that caretaker’s caries experience was positively associated with early childhood caries of their offspring (IRR 2.0, 95% confidence interval (CI) 1.3–3.0). Children’s caries experience (IRR 1.8, 95% CI 1.2–3.0), but not caries experience of caretakers, was associated with worse OHRQoL of children and their families. Caretakers who perceived good child oral health were less likely to report OHRQoL impacts (IRR 0.20, 95% CI 0.12–0.35).

Conclusion: Improving caretaker’s caries experience and her perception of child’s oral health status could improve children’s caries experience and the OHRQoL of children and family. Such knowledge is important and should inform public oral health programs for young children.     

Relationship of children’s salivary microbiota with their caries status: a pyrosequencing study

Purpose

Different dental caries status could be related with alterations in oral microbiota. Previous studies have collected saliva as a representative medium of the oral ecosystem. The purpose of this study was to assess the composition of oral microbiota and its relation to the presence of dental caries at different degrees of severity.

Materials and methods

One hundred ten saliva samples from 12-year-old children were taken and divided into six groups defined in strict accordance with their dental caries prevalence according to the International Caries Detection and Assessment System II criteria. These samples were studied by pyrosequencing PCR products of the 16S ribosomal RNA gene.

Results

The results showed statistically significant intergroup differences at the class and genus taxonomic levels. Streptococcus is the most frequent genus in all groups; although it did not show intergroup statistical differences. In patients with cavities, Porphyromonas and Prevotella showed an increasing percentage compared to healthy individuals. Bacterial diversity diminished as the severity of the disease increased, so those patients with more advanced stages of caries presented less bacterial diversity than healthy subjects.

Conclusion

Although microbial composition tended to be different, the intragroup variation is large, as evidenced by the lack of clear intragroup clustering in principal component analyses. Thus, no clear differences were found, indicating that using bacterial composition as the sole source of biomarkers for dental caries may not be reliable in the unstimulated saliva samples used in the current study.     

Influence of examiner’s clinical experience on the reproducibility and accuracy of radiographic examination in detecting occlusal caries

The aim of this in vitro study was to assess the influence of varying examiner’s clinical experience on the reproducibility and accuracy of radiographic examination for occlusal caries detection. Standardized bitewing radiographs were obtained from 166 permanent molars. Radiographic examination was performed by final-year dental students from two universities (A, n = 5; B, n = 5) and by dentists with 5 to 7 years of experience who work in two different countries (C, n = 5; D, n = 5). All examinations were repeated after 1-week interval. The teeth were histologically prepared and assessed for caries extension. For intraexaminer reproducibility, the unweighted kappa values were: A (0.11–0.40), B (0.12–0.33), C (0.47–0.58), and D (0.42–0.71). Interexaminer reproducibility statistics were computed based on means ± SD of unweighted kappa values: A (0.07 ± 0.05), B (0.12 ± 0.09), C (0.24 ± 0.08), and D (0.33 ± 0.10). Sensitivity, specificity, and accuracy were calculated at D₁ and D₃ thresholds and compared by performing McNemar test (p = 0.05). D₁ sensitivity ranged between 0.29 and 0.75 and specificity between 0.24 and 0.85. D₃ specificity was moderate to high (between 0.62 and 0.95) for all groups, with statistically significant difference between the dentists groups (C and D). Sensitivity was low to moderate (between 0.21 and 0.57) with statistically significant difference for groups B and D. Accuracy was similar for all groups (0.55). Spearman’s correlations were: A (0.12), B (0.24), C (0.30), and D (0.38). In conclusion, the reproducibility of radiographic examination was influenced by the examiner’s clinical experience, training, and dental education as well as the accuracy in detecting occlusal caries.     

The effects of at-home whitening on patients’ oral health,psychology, and aesthetic perception

Background

The aesthetic self-perception and psychosocial impact of whitening is poorly explored in the literature; it is even less clear whether the effect of whitening may influence the psychology or social relations of patients. Therefore, the aim of this trial is to evaluate the impact of an at-home whitening procedure on patients’ quality of life. Also, this study’s secondary objective is the adaptation and validation of the Spanish version of the OES questionnaire (OES-SP).

Methods

Fifty eight patients underwent whitening with 10% carbamide peroxide (CP) gel for 1?h daily for 3?weeks. For these participants, the OHIP-Esthetics, PIDAQ, and OES surveys were applied before, one week after, and one month after the whitening procedure. Oral health-related quality of life was measured using the OHIP-Esthetics survey and the psychosocial impact using the PIDAQ survey. The orofacial aesthetics was measured by OES and validated for the Spanish Chilean context. The treatment efficacy (ΔE and ΔSGU) and data from the OHIP-Esthetics PIDAQ and OES surveys were compared using the Wilcoxon Signed-Rank test.

Results

The whitening procedure was effective (ΔE?=?5.9?±?1.8). The OHIP-Esthetics results were significant when comparing the initial baseline survey prior to the treatment and one week after whitening (p?<?0.001) and when comparing the baseline and one-month results (p?<?0.001). The overall score on the PIDAQ, after one week post-whitening, was separated into factors and all factors were statistically significant (p?<?0.03); the factors for the one-month results were also all statistically significant (p?<?0.001), except the social impact factor. The OES questionnaire had statistically significantly increased scores both one week and one month post-treatment (p?<?0.0001). The reliability, validity, and responsiveness of the OES-SP were satisfactory.

Conclusion

The at-home whitening procedure with carbamide peroxide 10% had a positive effect on patients’ oral health-related quality of life, psychology, and aesthetic perception after one month post-whitening. The Chilean Spanish version of the OES showed satisfactory psychometric characteristics to evaluate dental whitening.

Trial registration

NCT02605239. Date that the study was retrospectively registered: 11-11-2015.

     

Patients’ and health professionals’ experience of the Danish fast track treatment pathway for head and neck cancer patients receiving oral rehabilitation

Abstract

Objective: This study aims to investigate the responsiveness of the Danish treatment pathway for head-and-neck-cancer (HNC) patients receiving oral rehabilitation.

Material and Methods: Eighteen HNC-patients who had received oral rehabilitation as well as five medical and four oral health care professionals involved in the treatment of HNC-patients filled in a questionnaire on responsiveness. The responsiveness was further described in individual interviews in the HNC-patients and focus group interviews in the health care professionals. All interviews were semi-structured and analysed using the grounded theory.

Results: Patients and health care professionals overall reported good responsiveness of the pathway. Prompt attention was in both groups considered the most important aspect, although the patients found it difficult to cope mentally with the fast-track and the health care professionals reported insufficiencies giving prompt attention. The patients in general described a good relationship with their health care professionals, but along with the health care professionals also reported some problems regarding communication. Further, the health care professionals reported a gap between medical treatment and oral rehabilitation.

Conclusions: The Danish treatment pathway for HNC-patients was, in general, evaluated positively. Communication and relationship between patient and health care professional can affect the responsiveness of the pathway.     

Examiner’s experience and the outcome interpretation of ICDAS and Nyvad’s system – a prospective in vitro study

Objective: To evaluate, prospectively, the influence of examiner’s experience in interpreting and applying the caries detection systems ICDAS (IC) and Nyvad (NY).

Material and methods: Twelve second-year undergraduate dental students (UG) and 12 postgraduates (PG) MSc level analysed and codified 77 clinical dental caries photographs at three different moments: initially, without any training; after one week of receiving training through a theoretical class; and after two years. Reproducibility and correlation was evaluated; sensitivity, specificity and area under ROC curve (AUC) were dichotomized according to the presence of cavitation (IC) and in relation to disease activity (NY).

Results: IC presented good kappa values for the first two evaluations. Both criteria resulted in good Spearman’s correlation after two years (IC?=?UG: 0.89; PG: 0.93/NY?=?UG: 0.81; PG: 0.82). Sensitivity, specificity and AUC were statistically higher in the third evaluation by UG for Nyvad.

Conclusions: ICDAS criteria seem to be instinctively understood by students without clinical experience. Nyvad’s concepts performed better after two years where the students deepened their theoretical knowledge and experienced clinical practice, collaborating with the identification of activity signs.     

Influence of children’s oral health promotion on parents’ behaviours,attitudes and knowledge

Objective The aim was to compare the changes in parents’ oral health-related behaviour, knowledge and attitudes in 2001–2003 and 2003–2005, during a 3.4-year-intervention in Pori and in the reference area Rauma, Finland. Materials and methods The study population consisted of parents of children who participated in the oral health promotion programme in Pori (all 5th and 6th graders who started the 2001–2002 school year in the town of Pori, n?=?1691) and the parents of same-aged children in a reference town (n?=?807). In 2001–2003, the promotion was targeted only to the children in Pori. In 2003–2005, the promotion was targeted also to parents, for example via local mass media. The statistical significances of the differences in parents’ self-reported behaviour, knowledge and attitudes, and changes in these, were evaluated using Mann-Whitney U-tests and confidence intervals. Results In 2001–2003, the trend in changing behaviours was in favour of parents in Pori. Mothers in Pori also improved their knowledge and the attitude ‘importance of brushing for health and appearance’. In 2003–2005, the trend in changing behaviours was rather similar in both towns, which may be due to diffusion of the oral health intervention to Rauma via the media. Conclusions The results suggest that health promotion targeted to children, which in previous studies has been shown to be successful in improving children’s behaviours, also helped their parents in mending their habits.     

The relationship between sweetness preference and dental caries in mother/child pairs from Maringá-Pr, Brazil

AIM: Children's patterns of sugar consumption and dental health status have been associated to their mothers' patterns. As a liking for sweetness has been related to caries levels, this study was carried out to analyse the relationship between sweetness preference and caries experience in mother/child pairs. PARTICIPANTS AND METHODS: A cross-sectional survey was conducted on a sample of low socio-economic mothers and their 4-5-year-olds from Maringá-Pr, Brazil. Mothers' and children's preference for sugar was measured using the Sweet Preference Inventory. Their caries experience was assessed according to World Health Organization (WHO) guidelines. RESULTS: High levels of sweetness preference and caries experience were found in the sample studied. Although not strong, a significant correlation in patterns of sweetness preference (r=0.12, P<0.05) and caries experience (r=0.14, P<0.05) between mother/child pairs was identified. Among the social-demographic variables, only family income was statistically associated with the children's preference for sweetness (P<0.05). No significant association between sweetness preference and caries experience could be established. CONCLUSION: The findings of this study suggest that mothers may play an important role on the establishment of their children dietary preferences and patterns of dental health. Also, that the socio-economic status may influence children's preference for sugar.     

Impact of cleft lip closure on the perception of the child by the mother and the social environment – A retrospective,self-reported,standardized pretest

The aim of the study was to describe the attractiveness of a newborn with CL/P and the maternal reaction in relation to the child. Another purpose was to explore and describe the experience and subjectively perceived reaction of the mother and the social environment to the child before and after cleft lip surgery.Material and methodsA study to describe and evaluate mothers' experiences, feelings and emotions (n = 84) regarding having a child with CL/P was performed. Therefore mothers were asked to complete a self-reported, standardized Likert-scale questionnaire. The questions were focused on the mother's own experiences, and the reaction of close family members and the social environment (friends, unknown people) to the child. Therefore two essential situations during the first year of life were analyzed: the first contact with the child, and a second one after lip surgery. The influence of lip reconstruction on the attractiveness of the child and the following reactions were analyzed. The timeline includes surveys from 01/2014 to 12/2016.Results84 mothers of affected children (CL/P) replied to the questionnaire (84/103). Most mothers (n = 64) described the attractiveness of their child at birth as “very good” (n = 37) and “good” (n = 27). After lip reconstruction the subjective attractiveness in the mothers’ opinions increased to 90.5% (n = 76): 24 “good” (p = 0.23) and 52 “very good” (p = 0.73). 50 mothers defined the postoperative surgical result as “very good”, 21 did not see any improvement (p = 0.001). Poor postoperative evaluations like “very poor” (n = 0), “insufficient” (n = 1) or “sufficient” (n = 1) were found two times.The majority of mothers (n = 78) reported negative reactions of the social environment to the child before lip surgery. Friends reacted in general more positively to the child with the visible deformity than did the social environment. 41 mothers described that their life partner or husband reacted “always” more positively to the child (p = 0.018). After surgical lip closure, strangers (n = 22) and even friends (n = 27) did not change their reactions obviously.ConclusionFor the mother, the attractiveness of a child with CL/P is not significantly affected by the visible facial malformation. Even if the lip reconstruction increases the child's attractiveness from the mother's perspective, the often negative reactions of the family and social environment did not change.     

Self perceived oral health, oral treatment need and the use of oral health care of the adult population in Skåne, Sweden

The aim was to describe how the adult population in Sk?ne, Sweden, perceived their oral health, dental status, oral treatment need and use of oral health care. A questionnaire was sent to a randomly selected sample of 10 000 persons in Sk?ne, Sweden. The individuals were between 20 and 89 years old and registered as residents of the region during 2006. After excluding those no longer living in the region, 9 690 individuals remained. The response rate to the questionnaire was 63%, of which 57% were women and 43% men.A majority was satisfied with their teeth and with their teeth's appearance, 65% and 62% respectively. Of the respondents, 35% considered their dental health to be better than others in their age group. Symptoms associated with periodontitis were experienced by 40%. 7% were missing more than ten teeth while 7% had no dental fillings. 30% rated their need of dental treatment as high and most expected their treatment need to increase in the future. Most of the respondents, 60%, received their oral care at a private practice, whereas 13% did not see a dentist regularly for check-ups. More women than men perceived a high dental treatment need, 32% compared to 28%. CONCLUSIONS: A majority of the adult population in Sk?ne have a positive attitude towards their oral health. Most individuals had lost few teeth and removable dentures were uncommon.A third rated their dental treatment need as high and most expected their treatment need to increase in the future..     

Is there a positive relationship between molar incisor hypomineralisations and the presence of dental caries?

International Journal of Paediatric Dentistry 2013; 23: 116–124 Objective This epidemiological study aimed to compare the caries experience in 10‐year‐olds with and without molar incisor hypomineralisation (MIH). Methods About 693 children from an ongoing birth cohort study (GINIplus10) were examined for caries lesions to determine the DMF index. Furthermore, enamel hypomineralisation (EH) was scored on all permanent teeth/surfaces, according to the criteria of the European Academy of Paediatric Dentistry. Children with EH were categorised into those with a minimum of one EH in the permanent dentition (MIH/1), with EH on at least one‐first permanent molar (MIH/1A), on at least one‐first permanent molar and permanent incisor (MIH/1B), and on other permanent teeth (MIH/1C). Results The mean caries experience was 0.4 (SD 0.9) DMFT. Existence of MIH/1, MIH/1A, MIH/1B, and MIH/1C was determined in 36.5%, 14.7%, 9.4%, and 21.8% of all children. The corresponding DMFT values were the following: no MIH: 0.3 (SD 0.8); MIH/1: 0.5 (SD 0.9); MIH/1A: 0.5 (SD 0.9); MIH/1B: 0.4 (SD 0.9); and MIH/1C: 0.4 (SD 0.9) DMFT. No significant differences were found between all groups. Conclusions There was no relationship between the presence of EH/MIH and caries in 10‐year‐olds. A ratio of one EH‐associated defect to two caries lesions indicates that both conditions are prevalent and influence the oral health status of 10‐year‐old children from Munich, Germany.