Analysis of factors associated with tooth loss in older adults from 1995 to 2015: a population-based cross-sectional survey in Guangdong, China.

OBJECTIVES: The aim of this study was to detect trends and related factors in the functional dentition (FD) in 65- to 74-year-olds in Guangdong, China, while also assessing trends in education and income inequality factors. MATERIALS AND METHODS: Three large-scale cross-sectional National Oral Health Surveys (NOHS), specifically NOHS II in 1995, NOHS III in 2005, and NOHS IV in 2015, were included. Post hoc stratification was weighted for 1038 participants aged 65 to 74years. Retaining teeth ≥ 20 teeth and retaining < 20 teeth was defined as functional dentition (FD) and nonfunctional dentition (NFD), respectively. Logistic regression models were established to assess related factors. Slope index of inequality (SII) and relative index of inequality (RII) were used to analyze inequality. RESULTS: From NOHS II to IV, the FD proportion increased from 42.8 to 71.9%. Years of NOH, with caries, with periodontal pocket, high educational level, high income level, female, and those who had dental visits were associated with FD preservation. The education-related SII decreased from 0.44 to 0.20, and the income-related SII increased from 0.13 to 0.16. CONCLUSIONS: The FD proportion among 65- to 74-year-olds improved from 1995 to 2015. Years of NOHS, with caries, with periodontal pocket, high education level, and high income level were associated with higher FD proportion. Female and those who had dental visits were associated lower FD proportion. Social inequalities in FD persisted, especially economic-related inequalities. Public health policy support and respective interventions should be applied to increase FD retention.

The relationship between the source of oral health information and dental caries: Findings from Child Dental Health Survey 2013 in England.

OBJECTIVE: To determine the magnitude and shape of the relationship between dental caries experience and the source of oral health information in England. METHODS: This was a cross-sectional study using the Child Dental Health Survey 2013 in England. Using a negative binomial model, the relationship between the number of decayed, missing, filled teeth (DMFT) of 12- and 15-year-old students and their primary source of oral health information was assessed. The sources of oral health information included parents, television, newspapers, the Internet, and social media. The adjusted model included age, sex, and the Index of Multiple Deprivation (IMD). R was used for data handling, analysis and reporting. RESULTS: Overall, 2,372 children were assessed (48.7% female, 48.6% 12-year-old). For the majority, the primary source of oral health information was their parents (89.5%) followed by the Internet (43.4%). Over nine-tenth of the participants had a DMFT = 0. The adjusted model showed that the prevalence rate of DMFT for the children whose primary source of information is their parents (0.45) or television (0.62) is lower than 1. The prevalence rate for the Internet (1.17) and social media (1.67) was higher than 1, but they were removed from the final model due to being non-statistically significant. Age and deprivation had a direct relationship with the prevalence rate of DMFT, meaning that 15-year-olds and children from more deprived areas had a higher prevalence rate of DMFT. CONCLUSION: Children whose primary source of oral health information was their parents or television had a lower DMFT. On the contrary, using the Internet or social media as the source of oral health information was associated with higher caries experience among schoolchildren.

Findings from the 2019 nationally representative oral health survey for adults in Singapore.

OBJECTIVES: The aim of this study was to present key findings from the 2019 national adult oral health survey in Singapore (NAOHS). METHODS: A multi-stage stratified sampling method was used to recruit participants for a representative national adult oral health survey. A total of 12 212 households were randomly selected from the National Database on Dwellings in Singapore. Within each household eligible persons aged ≥65 years were automatically invited to participate while a Kish selection method was used to invite those between 21 and 64 years old. The survey comprised a face-to-face interview questionnaire and a clinical examination which recorded details of tooth loss, DMFT, DMFS and prevalence of periodontal disease according to the CPITN and the US CDC-AAP classifications. Weighted analysis was performed to adjust for oversampling, non-response and post-stratification. Multivariate regression with backward stepwise selection was carried out to identify predictors of chronic periodontal disease and untreated dental caries. RESULTS: Six hundred and sixty-three participants completed both the questionnaires and the clinical examination. The prevalence of edentulousness was 2.7%. Of participants, 34.8% presented with untreated dental caries with a higher proportion found in those who were aged ≥60 years, of Malay ethnicity, living in 1-2-room public housing and who only visited the dentist when there was a problem. Mean DMFS and DMFT indices were 24.7 and 7.9 respectively. Based on the CDC-AAP classification, the prevalence of moderate-severe chronic periodontitis was 56.9% and increased with age, with a higher proportion in males. Participants with untreated dental caries were more likely to have moderate or severe periodontal disease. CONCLUSIONS: Survey findings showed high prevalence of dental caries and periodontal disease, at 34.8% and 77.6% respectively. A clear socio-economic gradient in the distribution of tooth loss, untreated dental caries and moderate-to-severe periodontitis was observed.

Oral health-related quality of life in the Myanmar population: The first national oral health survey 2016 - 2017.

OBJECTIVES: To describe the oral health-related quality of life (OHRQoL) and its potential influencing factors within the Myanmar population. METHODS: Data were from the first national oral health survey, involving 3,513 participants aged 15-18 years, 35-44 years, and 60-74 years from 21 selected townships in Myanmar. Self-administered questionnaire-based surveys, conducted from December 2016 to January 2017, included socio-demographics, behavioral factors, self-reported oral conditions (number of teeth present, teeth and gingival conditions), and inquiries regarding OHRQoL (a set of 12 questions with 5 response options) using the recommended questions from WHO Oral Health Surveys. RESULTS: The most prevalent oral health issues were difficulties in chewing (32.2%) and biting foods (30.8%). In bivariate analysis, older individuals, rural residents, and participants with higher educational levels were associated with OHRQoL. In multiple regression analysis, self-reported number of teeth, teeth and gingival conditions were strong predictors of OHRQoL in all age groups. CONCLUSION: Self-rated oral health conditions predicted quality of life due to oral problems. The development of national oral health policies and strategies is imperative to facilitate early detection of oral health problems and promote the awareness of oral health importance.

Decomposing Socioeconomic Inequality in Early Childhood Caries Among 3 to 5-Year-Old Children in China.

INTRODUCTION AND AIMS: Early childhood caries (ECC) is a widespread oral disease that harms children's health in China. Although previous studies have linked ECC prevalence to socioeconomic status, few have measured the degree of socioeconomic inequality. This study aimed to evaluate the socioeconomic inequality of ECC in children aged 3 to 5 years in China and identify the contributor to the inequality. METHODS: We extracted data on 3 to 5-year-old children from the fourth National Oral Health Survey. We measured the inequality of ECC by the average household income per capita. We used the average household income per capita to measure the inequality of ECC. To describe inequality both qualitatively and quantitatively, we used the following methods: concentration curve, Erreygers-corrected concentration index, relative index of inequality and slope index of inequality. We also applied a decomposition based on the probit model to identify the factors that contributed to inequality. RESULTS: The prevalence of ECC in Chinese preschool children was 63.11% (95% CIs: 60.54%, 65.61%). The negative value of the Erreygers-corrected concentration index (-0.0459; 95% CIs: -0.0594, -0.0324), slope index of inequality (-0.0674; 95% CIs: -0.0876, -0.0471) and the positive value of relative index of inequality (0.7484; 95% CIs: 0.6856, 0.8169) all indicated that ECC prevalence was higher among children from low-income families. The main factors contributing to inequality were average household income, parents' educational level and living areas. CONCLUSION: There is a pro-poor inequality in ECC among 3 to 5-year-old children in China. CLINICAL RELEVANCE: To improve oral health equality, policymakers should focus more on children from low-income families, with less educated parents and living in rural areas.

Influence of School Type and Class Level on Mean Caries Experience in 12-Year-Olds in Serial Cross-Sectional National Oral Health Survey in Germany-Proposal to Adjust for Selection Bias.

The objective of this study is to analyse the effects of attended school type and class level on the reported caries experience (DMFT) obtained in the serial cross-sectional National Oral Health Study in Children in Germany (NOHSC) for the WHO reference group of 12-year-olds. METHODS: Caries data from the 2016 NOHSC were adjusted for each federal state on the basis of two additional large-scale datasets for school type and class level. RESULTS: Twelve-year-olds in all grades in Saxony-Anhalt (n = 96,842) exhibited significantly higher DMFT values than 12-year-olds in 6th grade (n = 76,456; +0.10 DMFT; ~14.2%, p < 0.001). Adjustments for school type had effects on DMFT on the level of federal states but almost balanced out on the national level (-0.01 DMFT; ~2%). Due to putatively similar structures of the federal states, the national mean DMFT for 12-year-olds in the latest NOHSC (2016; n = 55,002) was adjusted from 0.44 to 0.50 DMFT, correcting for selection bias. CONCLUSION: Selection bias in this NOHSC leads to an underestimation of caries levels by about 15%. Due to very low caries experience in children in Germany, these precise adjustments (+0.06 DMFT) have only a minor effect on interpretations of the national epidemiologic situation. Consequently, other national caries studies worldwide using the robust marker of DMFT should also adjust for systematic selection bias related to socio-economic background rather than increasing efforts in examination strategy.

Knowledge, attitudes and practices related to oral health in participants of the institutional program for the inclusion of people with cognitive disabilities in higher education at the University of Costa Rica / Conocimientos, actitudes y prácticas relacionadas con la salud oral en participantes del Programa Institucional de Inclusión de Personas con Discapacidad Cognitiva a la Educación Superior de la Universidad de Costa Rica

Abstract People with cognitive disabilities face multiple challenges concerning oral health and frequently show oral tissue decay because of the barriers society imposes upon them, and due to financial issues, professional and family lack of knowledge, limitations regarding access to services, lack of empowering-driven actions, among others. Positive knowledge, attitudes and practices regarding oral health, developed during the course of a lifetime, help in preserving good health. The aim of the current study is to describe oral health knowledge, attitudes and practices in people with cognitive disabilities participating in the Institutional Program for the Inclusion of People with Cognitive Disabilities in Higher Education at the University of Costa Rica (PROIN, in Spanish), during 2021. A descriptive study with mixed focus was performed; a representative sample comprised of 86 students enrolled in PROIN was used for the quantitative approach, while the qualitative approach used a criteria sample along with an opinion sample, limiting size due to information overload. The survey, along with its corresponding questionnaire and the semi-structured interview, were used as data gathering techniques. It was evidenced that certain issues need to be readdressed, such as bleeding gums, the importance of preserving dental pieces, as well, the practice of flossing, which many students expressed difficulties doing. Good attitudes were found, such as dentist visits; however, access barriers for this population must be overthrown. This article showed the importance of training professionals in disabilities as well as developing oral health promotion programs aimed at people with cognitive disabilities.

Resumen La población con discapacidad cognitiva enfrenta múltiples retos en cuanto a la salud oral, presentado comúnmente un deterioro de los tejidos orales; esto como consecuencia a las barreras impuestas por la sociedad, factores económicos, desconocimiento de los profesionales y familiares, limitaciones en el acceso a la atención, falta de acciones para fomentar su autonomía, entre otras. Los conocimientos, actitudes y prácticas favorables en salud oral ayudan a conservar una buena salud, los cuales se desarrollan a lo largo de la vida. El objetivo del presente estudio es describir los conocimientos, actitudes y prácticas de salud oral en las personas con discapacidad cognitiva que participaron en el Programa Institucional de Inclusión de Personas con Discapacidad Cognitiva a la Educación Superior de la Universidad de Costa Rica (PROIN) durante el año 2021. Se realizó un estudio descriptivo con un enfoque mixto, para el enfoque cuantitativo se utilizó una muestra representativa de 86 estudiantes matriculados en PROIN y para la parte cualitativa se utilizó una muestra por criterio con un muestreo opinático, estableciendo el tamaño por saturación de la información. Se utilizaron como técnicas de recolección de datos la encuesta con su respectivo cuestionario y la entrevista semiestructurada. Se evidenció que existen temas que se deben reforzar, como lo es el sangrado de encías, la importancia de conservar las piezas dentales, así como la práctica de uso de hilo dental, donde la mayoría de los estudiantes expresaron tener dificultades para su utilización. Además, se encontró buenas actitudes con respecto a la visita al odontólogo, sin embargo, se debe derribar barreras de acceso que se presentan para esta población. Este estudio demostró la necesidad de capacitar a los profesionales en el tema de discapacidad y desarrollar programas de promoción de la salud oral específicos para personas con discapacidad cognitiva.

Knowledge, attitudes and practices related to oral health in First-Year university students of the Paraíso campus of the University of Costa Rica / Conocimientos, actitudes y prácticas relacionadas con la salud bucal en estudiantes universitarios de primer año del Recinto de Paraíso de la Universidad de Costa Rica

Abstract People's knowledge, attitudes, and practices related to health are built throughout life, particularly during childhood and adolescence, and they reflect the practices of their family and social circle. The aim of this study was to identify the levels of knowledge, attitudes, and practices related to oral health of first-year university students at the Paraíso Campus of the University of Costa Rica. This was done through a questionnaire of closed questions that would allow oral health educational strategies to be established in the future for this population group. For this purpose, a cross-sectional descriptive study was conducted, where 70 first-year students of the Paraíso Campus participated in the first semester of the year 2019. For data collection, a survey of 22 closed questions on knowledge, attitudes, and practices about oral health was applied, and a score on oral health knowledge was subsequently performed, based on the answers to the questions. According to the results, the level of knowledge shown about oral health is low, since the average knowledge score (7.02 points) was less than half of the maximum score (17 points). The greatest deficiency in knowledge was evidenced in topics, such as, dental biofilm, gingivitis, use of fluorides, and the role of saliva. In addition, several practices that affect the condition of the oral cavity were identified, such as harmful habits, inadequate nutrition, and poor oral hygiene habits. In this study, a general lack of knowledge was identified regarding basic concepts of oral health in young university students, who are not clear about the role of some protective or risk factors related to the main oral diseases.

Resumen Los conocimientos, actitudes y prácticas relacionados a la salud en las personas se construyen a través de la vida, particularmente durante la infancia y la adolescencia y reflejan las prácticas de su círculo familiar y social. El objetivo de este estudio fue identificar los niveles de conocimiento, las actitudes y las prácticas relacionadas a la salud bucodental en estudiantes universitarios de primer ingreso en el Recinto de Paraíso de la Universidad de Costa Rica, mediante un cuestionario de preguntas cerradas que permitirá a futuro establecer estrategias educativas en salud bucal para este grupo de población. Se trató de un estudio descriptivo transversal de tipo observacional en 70 estudiantes de primer ingreso del Recinto de Paraíso en el I semestre del año 2019. Para la recolección de datos se aplicó una encuesta de 22 preguntas cerradas sobre los conocimientos, las actitudes y las prácticas sobre la salud oral. A partir de las preguntas sobre conocimiento en salud bucal se creó un puntaje de conocimiento. Se pudo evidenciar que el nivel de conocimiento sobre la salud bucal es bajo, ya que el promedio del puntaje de conocimiento (7,02 puntos) es menos de la mitad del puntaje máximo (17 puntos). La mayor deficiencia en el conocimiento se evidenció en temas como el biofilm dental, gingivitis, uso de fluoruros y el rol de la saliva. Además, se identificaron varias prácticas que afectan la condición de la cavidad bucal, como los hábitos nocivos, una alimentación inadecuada y hábitos de higiene oral deficiente. En este estudio se identificó en general una falta de conocimiento respecto a conceptos básicos de salud bucal en personas jóvenes universitarias, quienes no tienen claro la función de algunos factores protectores o de riesgo relacionados con las principales enfermedades bucales.

Dental caries and school readiness in 5-year-olds: A birth cohort data linkage study.

OBJECTIVE: To describe the association between dental caries and school readiness in 5-year-old children taking part in the Born in Bradford (BiB) birth cohort, UK. METHODS: The Early Years Foundation Stage Profile (EYFSP) assesses the school readiness of young children and is strongly predictive of future academic attainment. Children are recorded as 'emerging' (below expected), 'expected', or 'exceeding' in five key learning areas. The Oral Health Survey of 5-year-olds (OHS5) is undertaken biennially in England, assessing caries experience at a dentine threshold (d3mft). EYFSP and OHS5 were available for a proportion of children participating in BiB. Odds ratios and confidence intervals for caries experience were established, and odds ratios adjusted for significant sociodemographic variables. RESULTS: EYFSP and OHS5 data were available for 2.5% (n = 346) BiB participants. Nearly half (45.2%) had caries. A measure of socio-economic status, receiving free school meals, was the only demographic variable strongly related to caries experience (OR: 2.8, 95% CI: 1.6-4.9). After adjustment, children 'emerging' in EYFSP learning areas had 1.6- to 2.2-fold (95% CI: 1.0-3.8) higher odds of experiencing caries. Children 'exceeding' EYFSP learning areas had 2.3- to 4-fold (95% CI: 0.1-0.9) lower odds of caries experience. CONCLUSION: This is the first study to explore the association between caries experience and school readiness using a holistic assessment tool. The association was found across different learning areas and was comparable to and independent of socio-economic status. The findings indicate oral health-related absenteeism is not a causative factor. EYFSP shows potential to enhance the targeting of preventive interventions at a child, class or school level.

Contextual inequalities in specialized dental public health care in Brazil.

The present study aimed to investigate the contextual inequalities of specialized public dental care (SPDC) in Brazil. The outcome was the trajectory of dental specialized production in municipalities with SPDC (from 2015 to 2017) obtained by group-based trajectory modeling. A Poisson regression model was used to analyze the factors associated with the high trajectory of SPDC production. The inequality indicators for SPDC production were the slope index and the concentration index according to contextual factors. The study included 954 SPDC units distributed across 893 municipalities. Among the municipalities evaluated, 62.9% had a low trajectory of SPDC. Large-sized municipalities had the highest production (IRR = 2.84, 95%CI: 1.94-4.14) and the southern region had the lowest production (IRR = 0.73, 95%CI: 0.58-0.92). Municipalities presenting a very high human development index (HDI) showed the greatest SPDC production (IRR = 3.34, 95%CI: 1.09-10.24), as well as municipalities with the highest tertile of schooling rate (IRR = 1.23, 95%CI: 1.00-1.50). The absolute inequality was 52.1 percentage points for the average monthly wage (p < 0.001), 61.0 percentage points for the HDI (p < 0.001), -22.1 for infant mortality rate (p <0.001), and 14.8 for the schooling rate (p = 0.012). Thus, there are contextual inequalities in the Brazilian SPDC. Higher scores for social indicators were associated with better SPDC performance.

Oral health knowledge, attitudes and behaviours of adults: Findings from a National Oral Health Survey in Singapore.

OBJECTIVES: Prevention complements the curative management of oral diseases. Effective preventive interventions involve the adoption of oral health promoting behaviours. Little is known about the awareness of oral disease and its prevention among Singaporean adults as well as their prevailing oral health attitudes and behaviours. The aim of the study was to describe the oral health knowledge, attitudes and behaviours of adults in Singapore. METHODS: A random sample of adults (≥21 years old) in Singapore was selected to complete an interviewer-administered questionnaire. The questionnaire gathered information about their knowledge of the aetiology, signs and symptoms as well as prevention of dental caries and periodontal disease; attitudes about the value of teeth, locus of control in maintaining oral health and oral health behaviours including toothbrushing, flossing and dental attendance. RESULTS: A total of 1196 adults of weighted mean age 48 years old with almost equal proportions of males and females responded to the questionnaire. Participants were more unaware about the causes of periodontal disease (25.7%) than dental caries (4%). While more than 90% of participants felt that healthy teeth were important and could affect their overall health, many (67.0%) felt it was natural to lose their teeth with old age. Among the participants, 83.5% brushed their teeth twice a day; 41.9% flossed their teeth and 53.9% visited the dentist at least once a year. CONCLUSIONS: The study findings showed good knowledge around dental caries but some gaps around periodontal disease. It also found that participants perceived having limited control over preventing tooth loss. Irregular dental attendance and poor denture wearing habits were also noted. The findings shed light on key areas to focus on through oral health promotion to improve overall oral health.

The oral health of adults with learning disabilities: A secondary analysis of the Adult Dental Health Survey 2009.

OBJECTIVES: Adults who have learning disabilities are a vulnerable group, little is known about their oral health and how this affects their quality of life. The aims of this secondary analysis of data from the 2009 Adult Dental Health Survey (ADHS) were to describe the oral health status of adults with learning disabilities, determine if severity of learning disability is associated with oral health and identify some of the methodological complexities of working with this population. The survey yields the most recent representative data on the oral health of adults with learning disabilities in England and importantly, contains information about oral health related quality of life (OHRQoL). BASIC RESEARCH DESIGN: Secondary analysis of data from a supplemental survey of adults with learning disabilities collected alongside the 2009 ADHS. PARTICIPANTS: 607 participants with a diagnosed learning disability aged 18 years and over. RESULTS: Adults with learning disabilities had similar levels of active dental caries, fewer natural teeth, and fewer fillings than comparable participants from the general population. Self-reported oral and general health were worse for adults with learning disabilities than the general population. Possible associations between the severity of learning disability and the numbers of decayed, missing or filled teeth were identified. However, large amounts of missing data limited the analysis. CONCLUSIONS: There are important questions relating to the accessibility of existing self-reported oral health questionnaires and the reliability of proxy-reported questions about OHRQoL that should be addressed to give a fuller picture of the oral health of adults with learning disabilities.

Dental divisions: exploring racial inequities of dental caries amongst children.

DATA SOURCES: The search strategy involved three sequential stages. Initially, MEDLINE/PubMed was explored for relevant articles, identifying pertinent terms for formal searching. Using the terms ethnic, race, minoritised and dental caries, a strategy was formed and nine databases searched. Finally, hand-searching of reference lists of included articles and sourcing grey literature from relevant government reports, national oral health surveys, and registries which had comparative data for dental caries between racial groups, completed the search. STUDY SELECTION: Studies included were original primary research which reported dental caries and compared racially minoritised children, aged 5-11 years, to similarly aged from national, majority, or privileged populations. Dental caries had to be recorded from a clinical examination which assessed decayed, missing, and filled teeth (dmft) in primary dentitions. Studies were excluded if they used immigration status as a basis of racial status, or they were a case report, case series, in vitro study, or literature review. DATA EXTRACTION AND SYNTHESIS: After removing duplicates, two independent researchers screened abstracts, prior to extracting critical data following full-text reviews of included articles. Information collected included study and participant characteristics, definitions of race, and dental caries measurement. The authors of studies which had missing data were contacted, whilst those not written in the English language were translated. Methodological quality of each study was independently assessed by two reviewers using a modified version of the Newcastle-Ottawa scale. All studies were included in the review regardless of quality. A narrative overview of all included studies was conducted. Meta-analyses were completed using studies that reported the mean and standard deviation of the caries outcomes in both groups. Caries outcomes included severity (defined as mean dmft) or prevalence (percentage of teeth with untreated dental caries > 0%). Due to anticipated heterogeneity, statistical analyses approaches such as I2 statistics were used to estimate between-study variability. Additional sub-group analyses were conducted based on country of study and world income index. Contour-enhanced funnel plots and trim-and-fill analysis were completed to explore potential publication bias. Sensitivity analyses were performed to ensure robustness of the findings. RESULTS: Seventy-five studies were included from a variety of countries. A higher mean dmft score of 2.30 (0.45, 4.15) and prevalence of decayed teeth (d > 0) was 23% (95% CI: 16, 31) was noted amongst racially minoritised children compared to privileged children's populations. Notable disparities were reported in high-income countries, with minoritised children burdening the greatest distribution of caries incidence. The study faced challenges in consistent racial classification and encountered high heterogeneity in its findings, leading to varied GRADE assessment scores. CONCLUSIONS: The study calls for global, social, and political changes to tackle the substantial disparities in dental caries among minoritised children to achieve oral health equity.

[Frontiers and advances in dental caries research].

Dental caries is a prevalent infectious disease caused by microbial metabolism, affecting the hard tissues of teeth. According to data from the Fourth National Oral Health Epidemiological Survey, there is a gradual increase in caries prevalence in China, particularly among children and elderly individuals. As an etiological factor for dental lesions, caries not only impact oral health but also exhibit significant associations with various systemic diseases, suggesting that systemic diseases may serve as potential risk factors of caries development. To effectively implement the plan of national oral health action, researchers investigate the pathogenesis of caries actively while concurrently develop innovative preventive and treatment strategies based on advanced concepts and technologies, aiming to comprehensively enhance China's oral health status. Therefore, this article provides insights into the pathogenesis of caries, its correlation with systemic diseases, as well as cutting-edge research advancements pertaining to novel preventive measures for caries.

Dental caries and associated factors among Turkish children and adults: Findings from the 3rd National Oral Health Survey.

BACKGROUND: Information on the current status of oral health and related risk factors is lacking in Turkiye. This study aimed to evaluate dental caries and associated factors among the Turkish population using the findings of the third national oral health survey. METHODS: This cross-sectional epidemiological survey was carried out between March and September in 2018 including five index ages and age groups (5-, 12-, 15-year-olds, 35-44 and 65-74 age groups). A multistage cluster sampling design was used to obtain a national representative sample of these age groups. Participants were interviewed face-to-face using a structured questionnaire, and oral examinations were performed based on the methods and criteria suggested by the World Health Organization. The adjusted prevalence ratio for dental caries was estimated considering sociodemographic and behavioural characteristics by using log-binomial and robust Poisson regression analysis in R and SAS software. RESULTS: After data cleaning, a total of 11 091 participants remained. The prevalence of dental caries was 76.5% (95% confidence interval: 75.4%-77.7%) and determined to be associated with age, dental visit, and pain or discomfort history during the previous year among the Turkish population. Prevalence was also associated with the mother's education level among 5-, 12- and 15-year-olds. For the 35-44 age group, individuals living in urban areas had lower dental caries than those living in rural areas. For 65-74 age group, none of the factors were significantly associated with dental caries. CONCLUSION: A high prevalence of dental caries was observed in Turkish children and adults. Therefore, it is necessary to strengthen current preventive oral health programs. Regular disease surveillance should be maintained. National oral health targets should be formulated in accordance with Turkiye's needs, resources and structure.

Caries clusters at lesion-severity thresholds: A Sierra Leone case study.

OBJECTIVES: Despite being almost entirely preventable, globally, dental caries is extremely prevalent. Moreover, dental caries will continue to present an even larger challenge for lower income countries, particularly those in the African context, as they transition to a more Western diet. Hence, epidemiological data providing insight into disease patterns and trends is critical to inform public health action. The purpose of this study was to examine dental caries clusters by caries detection threshold among 15-year-old adolescents in Sierra Leone, using data from the latest national survey, and to explore associated sociodemographic factors. METHODS: This paper presents a secondary analysis of oral health data on 490 15-year-olds from the Sierra Leone national oral health survey of schoolchildren. Hierarchical cluster analysis of dental caries experience was conducted across all surfaces at four decay detection thresholds using the International Caries Detection and Assessment System (ICDAS) (clinical: ICDAS 2-6, cavitated: ICDAS 3-6, obvious: ICDAS 4-6 and extensive obvious: ICDAS 5-6 decay) across the four regions of Sierra Leone. Ordered logistic regression was used to estimate the association of sociodemographic factors with generated clusters relating to clinical and obvious decay experience. These are of both clinical and epidemiological relevance. RESULTS: A 3-cluster decay pattern representing a 'low' to 'high' decay experience distribution was observed under each decay detection threshold across surfaces. For clinical decay (including visual enamel caries), 28.8% had low, 55.1% medium and 15.9% high caries status. In the adjusted model, the only significant risk factor across obvious and clinical decay thresholds was region, with adolescents outside the Western region more likely to experience decay. CONCLUSION: This study suggests that adolescents in Sierra Leone fall into three distinct caries clusters: low, medium to high decay experience distribution, regardless of decay threshold. It reinforces the importance of recognizing dental caries detection thresholds and the use of contemporary epidemiological methodology. This suggests that adolescents outside the Western region are likely to have higher caries experience. The data also provides insight to the nature of adolescents in each cluster and should help to inform policy and planning of the integration of oral health into primary care and school systems.

Modalidades de administración de un cuestionario referido a hábitos de salud bucal: análisis de concordancia / Modalities for the administration of a questionnaire on oral health habits: a concordance analysis

Objetivo: Analizar las diferencias entre dos modali-dades de administración de un instrumento, autoad-ministrado o guiado por un investigador, aplicados a tutores legales de infantes de una institución educa-tiva. Materiales y Métodos: muestra de 130 tutores legales de niños/as (3 y 5 años) pertenecientes a un jardín de infantes municipal de Avellaneda. Se aplicó un instrumento de recolección de datos sobre hábi-tos de salud bucal constituido por 14 preguntas sim-ples, múltiples y cerradas. La entrega y devolución del instrumento fue a través de la institución. A los 2 meses se convocó a la misma población para comple-tar el mismo instrumento guiado por un investigador. Se evaluó: porcentajede concurrentes e instrumen-tos respondidos totalmente (modalidad autoadminis-trada), porcentaje de concurrentes que completaron el instrumento guiado y concordancia total y por res-puesta de las 2 modalidades. Se analizaron frecuen-cias y porcentajes. Para comparar la concordancia se utilizó Kappa global y Kappa de Cohen para cada pregunta. Resultados: 76,9% de tutores legales res-pondieron en la modalidad autoadministrada y 48,5% la guiada por el investigador. El 80,0% respondió la totalidad de las preguntas del instrumento autoad-ministrado. Al comparar las respuestas para ambas modalidades, no se observaron diferencias signifi-cativas en la totalidad de las mismas. Al analizar las respuestas solo 3 de las 14 preguntas tuvieron una concordancia menor (0,70). Conclusión: Para la po-blación estudiada, la forma autoadministrada tuvo mayor tasa de respuesta que la guiada por un inves-tigador, sin que se registren diferencias en las res-puestas de ambas formas de administración (AU)

Objective: Analyze the differences between two methods of administration of an instrument, self-administered or guided by a researcher, applied to legal guardians of infants in an educational institution. Materials and Methods: Population 130 legal guardians of children (3 and 5 years old) belonging to a municipal kindergarten in Avellaneda. A data collection instrument on oral health habits was applied, consisting of 14 simple, multiple, and closed questions. The delivery and return of the instrument was through the institution. After 2 months, the same population was called to complete the same instrument guided by a researcher. The following were evaluated: percentage of participants and instruments fully answered (self-administered mode), percentage of participants who completed the guided instrument. The total and response agreement of the 2 modalities was evaluated. Frequencies and percentages were analyzed. To compare agreement, global Kappa was used, and Cohen's Kappa was used for each question. Results: 76.9% of legal guardians responded to the self-administered modality and 48.5% to the one guided by the researcher. 80.0% answered all the questions of the self-administered instrument. When comparing the responses for both modalities, no significant differences were observed in all of them. When analyzing the answers, only 3 of the 14 questions had a lower agreement (0.70). Conclusion: For the population studied, the self-administered form had a higher response rate than the one guided by a researcher, with no differences recorded in the responses of both forms of administration (AU)

Perfil dos pacientes atendidos na clínica de traumatismo dentário na dentição decídua em Belo Horizonte/MG / Profile of patients assisted at the dental traumatic clinic in the primary dentition in Belo Horizonte/MG

Objetivo: O presente estudo teve como objetivo avaliar o perfil dos pacientes atendidos em um centro de referência de traumatismos dentários na dentição decídua, identificando as características sociodemográficas, frequência, tipos de lesões traumáticas e tratamentos realizados. Métodos:Trata-se de um estudo retrospectivo com prontuários odontológicos de crianças de 6 a 60 meses de idade atendidas na Clínica de Traumatismo na Dentição Decídua da FAO/UFMG no período de 2007 a 2019. Foram analisadas características das lesões traumáticas, da criança, atendimento imediato (2h após o trauma) e condições socioeconômicas. A análise dos dados foi realizada de maneira descritiva e consistiu na distribuição de frequência das variáveis. Resultados:Entre os 610 prontuários odontológicos, 365 crianças (59,8%) eram do sexo masculino; 335 (54,9%) tinham 3 anos de idade ou menos, 446 (73,1%) eram de baixa renda e 335 (54,9%) das mães estudaram até o ensino médio. Lesões aos tecidos duros dentários apresentaram a maior frequência em crianças com 3 anos de idade ou menos (60,4%), entretanto, após os 3 anos de idade, as lesões mais frequentes foram lesões aos tecidos de sustentação (48,0%). Dentre a classificação de lesões aos tecidos duros dentários, a trinca e/ou fratura de esmalte foi a lesão mais frequente (15,0%). A luxação intrusiva foi o trauma mais frequente nos tecidos de sustentação (11,2%) e lesão em gengiva foi mais frequente dentre lesões nos tecidos moles (9,5%). Em geral, 212 crianças (34,8%) buscaram atendimento em um intervalo menor ou igual a duas horas após o trauma. A exodontia foi o tratamento mais realizado: em casos de lesões aos tecidos de sustentação (47,1%), seguido do mantenedor de espaço (24,3%). Em tecidos duros dentários a exodontia também foi o tratamento mais frequente (50,7%), seguido de restauração e mantenedor de espaço (18,0%). Conclusão: Conclui-se que a maioria dos traumatismos dentários na dentição decídua foram em meninos com menos de 3 anos e as lesões mais comuns foram trincas/fratura de esmalte, seguidas das luxações intrusivas.

Aim: The aim of the present study was to evaluate the profile and characteristics of patients treated at a dental trauma reference center, and identifying frequency, types of traumatic injuries and treatments performed. Methods: This retrospective study was carried out with dental records of children aged 6 to 60 months attended at the Primary Dental Trauma Clinic of FAO/UFMG between 2007 and 2019. Characteristics of the child and traumatic dental injuries, immediate care (2 hours after the trauma) and socioeconomic status were analyzed. Data analysis was performed descriptively using frequency distribution. Results:Of the total of 610 dental records, 365 children (59.8%) were male; 335 (54.9%) were up to 3 years old, 446 (73.1%) were low-income and 335 (54.9%) had mothers who studied up to high school. Dental hard tissue injuries were more frequent in children aged 3 years or less (60.4%), but after 3 years of age, the most frequent injuries were supporting tissue injuries (48.0%). Among dental hard tissue injuries, enamel crack and/or fracture was the most frequent injury (15.0%). Intrusive luxation was the most frequent lesion in supporting tissues injuries (11.2%) and gingival lesions was the most frequent soft tissue injuries (9.5%). Overall, 212 children (34.8%) sought care within two hours of the injury. Extraction was the most common treatment for supporting tissue injuries (44.3%), followed by space maintainers (22.8%). In dental hard tissues injuries, extraction was also the most frequent treatment (35.8%), followed by restoration (30.2%). Conclusion: In conclusion, most traumatic dental injuries in the primary dentition occurred in boys under 3 years of age, and the most common injuries were enamel cracks/fractures, followed by intrusive luxation.

Determinants of oral health status: an ecological study in Iran.

OBJECTIVES: The aim of this ecological study was to assess the association between behavioral, social position, circumstance factors, and caries experience in 35- to 44-year-old adults in Iran at a provincial level. MATERIALS AND METHODS: The data from the 2011 Iranian Oral Health Survey were obtained from all 31 provinces across Iran on the population level. Oral health status was measured as the number of decayed, missing (MT), and filled (FT) teeth and the percentage of the population who were edentulous. Data were also gathered from each province on the percentage of smokers (Non-Communicable Diseases Risk Factors Surveillance Provincial Report 2009), per capita consumption of free sugars, concentration of fluoride in the drinking water (National and Sub-national Burden of Disease (NASBOD) Survey), number of dentists per 10,000 people, mean years of schooling of adults, expected years of schooling of children, life expectancy at birth and Gross National Income (Integrated Public Use Microdata Series, Global Data Lab). The data were analyzed using simple and multiple linear regression (α = 0.05). RESULTS: Mean DMFT was positively associated with the percentage of smokers (B = 0.01 95%CI 0.01-0.14), and negatively with fluoride concentration (B =-2.6 95%CI -4.3- -0.96). The edentulousness percentage was positively associated with smoking (B = 0.2 (with 95%CI: 0.07-0.37) and negatively with mean years of education (B =-1.08 (with 95%CI: -2.04- -0.12). DT was associated with expected years of schooling (B =-0.6 (with 95%CI: -1.07- -0.17), negatively. Mt was negatively associated with life expectancy (B =-0.5 (with 95%CI: -1.1- -0.007), fluoride concentration (B =-3.4 (with 95%CI: -4.5- -1.5) and number of dentists per 10,000 people (B =-0.4 (with 95%CI: -0.8- -0.01). Mean Years of Schooling (B = 0.5 (with 95%CI: 0.2-0.8) and number of dentists per 10,000 people (B =-0.62 (with 95%CI: 0.51 - 0.48) were positively in associated with FT. CONCLUSIONS: The present findings indicate that there were differences in the oral health measures and their social determinants among the provinces of Iran. Regarding the limitations of the study especially the limitation of the number of independent variables, it seems, this discrepancy could be better explained by social variables of the provinces such as income than by environmental factors.

Dental caries in the Myanmar population: Findings from the first national oral health survey in 2016-2017.

OBJECTIVES: This study aimed to investigate the dental caries status of indicator age groups as mentioned in the WHO pathfinder methodology, compare caries experiences among those age groups according to gender and geographical location, and assess the association between dental caries and related risk factors in primary and permanent dentition. METHODS: A sample of 5928 participants aged 6, 12, 15-18, 35-44 and 60-74 years were recruited from 21 selected townships in the first Myanmar national oral health survey. Clinical oral examinations and questionnaire-based surveys were conducted from December 2016 to January 2017. RESULTS: The prevalence of dental caries in primary teeth was 85.3% with a mean dmft of 5.7 at age 6 years. The prevalence of dental caries in permanent teeth and mean DMFT were 36.5% and 0.8 at 12 years, 43.8% and 1.1 at 15-18 years, 64.7% and 3.0 at 35-44 years, and 93.6% and 11.5 at 60-74 years. Missing teeth were higher in 60-74-year-olds, with 27 participants being fully edentulous. There were significant differences in caries experiences between males and females aged 15-18, 35-44 and 60-74 years. In the adjusted logistic regression, consumption of sweets or candies three times or more a day showed significantly higher risks of dental caries in primary teeth. Age, gender, consumption of sweets or candies and consumption of sweet drinks were associated factors for dental caries in permanent teeth. CONCLUSION: The findings from the first national oral health survey indicate that caries in primary teeth is an important oral health problem for Myanmar children. Tooth loss was also found to be a concern in the aging population. National oral health policies and strategies need to be developed to promote awareness and understanding of oral health, in particular the role of risk factors such as sugary foods and drinks in tooth decay in children and adults.