Improving accuracy of early dental carious lesions detection using deep learning-based automated method.

OBJECTIVE: To investigate the effectiveness of a convolutional neural network (CNN) in detecting healthy teeth and early carious lesions on occlusal surfaces and to assess the applicability of this deep learning algorithm as an auxiliary aid. MATERIALS AND METHODS: A total of 2,481 posterior teeth (2,459 permanent and 22 deciduous teeth) with varying stages of carious lesions were classified according to the International Caries Detection and Assessment System (ICDAS). After clinical evaluation, ICDAS 0 and 2 occlusal surfaces were photographed with a professional digital camera. VGG-19 was chosen as the CNN and the findings were compared with those of a reference examiner to evaluate its detection efficiency. To verify the effectiveness of the CNN as an auxiliary detection aid, three examiners (an undergraduate student (US), a newly graduated dental surgeon (ND), and a specialist in pediatric dentistry (SP) assessed the acquired images (Phase I). In Phase II, the examiners reassessed the same images using the CNN-generated algorithms. RESULTS: The training dataset consisted of 8,749 images, whereas the test dataset included 140 images. VGG-19 achieved an accuracy of 0.879, positive agreement of 0.827, precision of 0.949, negative agreement 0.800, and an F1-score of 0.887. In Phase I, the accuracy rates for examiners US, ND, and SP were 0.543, 0.771, and 0.807, respectively. In Phase II, the accuracy rates improved to 0.679, 0.886, and 0.857 for the respective examiners. The number of correct answers was significantly higher in Phase II than in Phase I for all examiners (McNemar test;P<0.05). CONCLUSIONS: VGG-19 demonstrated satisfactory performance in the detection of early carious lesions, as well as an auxiliary detection aid. CLINICAL RELEVANCE: Automated detection using deep learning algorithms is an important aid in detecting early caries lesions and improves the accuracy of the disease detection, enabling quicker and more reliable clinical decision-making.

Is oral health literacy associated with conceptions of care and behavior related to the prevention of COVID-19?

The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

The influence of different dimensions of oral health literacy on parental attitudes and comprehension of an information leaflet about permanent tooth avulsion.

BACKGROUND/AIM: Permanent tooth avulsion requires proper management at the time of the accident and parental oral health literacy (OHL) may influence decision-making with regards to dental trauma. The aim of this study was to investigate the influence of OHL on: (1) self-rated comprehension of an information leaflet (IL), (2) self-rated capacity to execute the tasks proposed on the IL, and (3) attitudes regarding the avulsion of a permanent tooth in children. MATERIAL AND METHODS: A longitudinal study was conducted involving the reading of an IL by 466 parents/caregivers. Evaluations were performed prior to the IL (Phase I), immediately after the application of the IL (Phase II) and 60 days after the application of the IL (Phase III). Self-rated comprehension and capacity to execute the proposed tasks were analyzed in Phase II. Attitude was evaluated in all three phases. Functional OHL was measured using the BREALD-30 and interactive OHL was measured using HeLD-14. RESULTS: Correlations were found between self-rated comprehension and both the OHL/BREALD-30 score (rs = 0.179; p = .012) and OHL/HeLD-14 score (r = 0.258; p < .001). Correlations were also found between the self-rated capacity to execute the proposed tasks and both the OHL/BREALD-30 score (rs = 0.133; p = .047) and the OHL/HeLD-14 score (rs = 0.225; p < .001). Higher BREALD-30 and HeLD-14 scores were associated with a better performance regarding parental attitudes toward permanent tooth avulsion comparing Phases I and II and Phases II and III (p < .05). CONCLUSIONS: Higher levels of OHL were associated with better parental self-rated comprehension of the IL and the capacity to execute the tasks proposed therein as well as more adequate attitudes regarding the avulsion of a permanent tooth.

Are Premature Birth and Low Birth Weight Associated with Delay on the Eruption of Deciduous Teeth? A Systematic Review and Meta-analysis

ABSTRACT Objective: To investigate whether children with premature birth (PB) and/or with low birth weight (LBW) have different tooth eruption patterns than those born at term or with normal weight. Material and Methods: Searches were performed in the PubMed, Cochrane Library, Sc1opus, Web of Science, LILACS, and BBO databases as well as the grey literature. Three independent reviewers were involved in study selection, data extraction, and bias assessment. The risk of bias was assessed using the Modified Newcastle-Ottawa Scale. Meta-analysis was conducted to compute the mean difference (MD) in mean chronological or adjusted age at the eruption of the first deciduous tooth between preterm children and those born at full term. The GRADE approach was used. Results: Among a total of 316 articles identified, 21 were eligible for inclusion and three were included in the meta-analysis. PB was associated with the delay in the first tooth deciduous eruption when chronological age was considered (MD: 1.36; 95%CI: 1.02-1.69) but not when considering adjusted age (MD: -0.30; 95%CI: -0.67-0.07). The evidence was graded as having very low quality. Conclusion: Based on a low certainty of evidence the PB is associated with the delayed eruption of the first deciduous tooth when considering chronological age but not when adjusted age is considered.

Is oral health literacy associated with conceptions of care and behavior related to the prevention of COVID-19?

Abstract The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

Dental anxiety in schoolchildren with molar incisor hypomineralization-A population-based cross-sectional study.

BACKGROUND: Identifying patients with high levels of DA helps to define the most adequate oral healthcare strategy, especially for pediatric patients. AIM: To investigate the association between parental reports of dental anxiety (DA) and molar incisor hypomineralization (MIH) in schoolchildren. DESIGN: A cross-sectional study was conducted in a representative sample of 731 8-year-old schoolchildren from the city of Curitiba, Brazil, who were clinically examined (k ≥ 0.75) for the diagnosis of MIH and dental caries using the EAPD criteria and dmft/DMFT index, respectively. Parents/guardians reported children's DA using the Dental Anxiety Question (DAQ) and answered a self-administered structured questionnaire addressing socioeconomic and demographic characteristics. Associations were evaluated using Poisson regression analysis with robust variance (P < 0.05). RESULTS: A significant association was found between DA and MIH (PR = 1.20; 95%CI: 1.01-1.42; P = 0.038), but this association lost its significance when adjusted for the other characteristics (PR = 1.13; 95%CI: 0.93-1.38; P = 0.215). Caries experience in primary teeth was associated with lower levels of DA (PR = 0.83; 95%CI: 0.71-0.96; P = 0.0013). The most recent visit to the dentist due to pain increased the levels of DA (PR = 1.18; 95%CI: 1.07-1.30; P = 0.001). CONCLUSIONS: The presence of MIH in schoolchildren was not associated with parental reports of DA.

Impact of molar incisor hypomineralization on quality of life in children with early mixed dentition: A hierarchical approach.

BACKGROUND: Molar incisor hypomineralization (MIH) is associated with unfavourable dental conditions such as dental caries and may consequently impact oral health-related quality of life (OHRQoL). OBJECTIVE: To assess the impact of MIH on OHRQoL in children with early mixed dentition. METHOD: A population-based cross-sectional study of 728 8-year-old children from the public school system in Curitiba, Brazil, was conducted. The Child Perception Questionnaire for 8- to 10-year-olds (CPQ8-10 ) was used to evaluate OHRQoL. MIH was diagnosed according to the European Academy of Paediatric Dentistry (EAPD) criteria. The assessments of MIH, dental caries, and malocclusion were performed by four calibrated examiners (κ ≥ 0.80). Demographic and socioeconomic data (DSE) were obtained from the children's parents/caregivers using a structured questionnaire. The analysis of OHRQoL determinants was performed through a three-level hierarchical approach: mesial (DSE), intermediate (clinical conditions), and distal (child's oral self-perception), using Poisson regression with robust variance (α = 0.05). RESULTS: The prevalence of MIH was 12.1% (95% CI: 10-15). An association was found between MIH and OHRQoL in the "oral symptoms" domain of the CPQ8-10 (PR: 1.07, 95% CI: 1.03-1.11, P < 0.001) after adjusting for other clinical variables and DSE. CONCLUSION: Molar incisor hypomineralization was associated with a greater impact on OHRQoL in children's oral symptoms.

Molar-Incisor Hypomineralization and Associated Factors: A Case- Control Study

Objective: To evaluate systemic factors those are related to molar incisor hypomineralization (MIH), its association with dental caries, and the impact on oral health-related quality of life (OHRQoL) in Brazilian children. Material and Methods: This case-control study was conducted at the Pediatric Dentistry Clinic, Federal University of Parana, Brazil. Patients with MIH who were assisted from 2014 to 2015 were included in the study, for a total of 31 children, 6-13 years of age. The control group consisted of 62 children who were matched by sex and age. European Academy of Pediatric Dentistry criteria were used for MIH diagnosis. The children's mothers answered a questionnaire regarding the children's history of health intercurrences in the pre-, peri-, and postnatal periods. The Decayed, Missing, or Filled Teeth indices for permanent and primary teeth (dmft index and DMFT index, respectively) were used for dental caries examination by two calibrated examiners. Child Perceptions Questionnaires for 8- to 10-year-old children and 11- to 14-year-old children (CPQ8-10 and CPQ11-14) were used to assess OHRQoL. Results: Prematurity and prolonged delivery were significantly associated with the occurrence of MIH. In the postnatal period, recurrent fevers in the first 3 years of life were associated with MIH. Of the 339 incisors and first permanent molars that were examined, 178 presented MIH, of which 116 (65%) were demarcated opacities. A significant difference was found in the mean DMFT index between groups. No impact of MIH on OHRQoL was observed. Conclusion: The present results suggest higher intercurrences during the perinatal period and a higher incidence of caries among children with MIH.