Salivary microbiota and caries occurrence in Mutans Streptococci-positive school children.

AIM: To compare the composition of the salivary microbiota in caries-affected vs. caries-free mutans streptococci (MS)- positive children with mixed dentition. MATERIALS AND METHODS: Twenty eight healthy, 11-12-year-old schoolchildren with high MS counts (>10⊃5 CFU/mL) were included in this study. The children were screened with the Dentocult SM Strip Mutans test (Orion Diagnostica, Espoo, Finland) and examined using the International Caries Detection and Assessment System (ICDAS). The microbial composition of the saliva was assessed using the Human Oral Microbe Identification Microarray (HOMIM). Microbial differences between caries-affected (n=18) and caries-free children (n=10) were compared by Mann-Whitney analysis. RESULTS: The microbiota of the caries-affected vs. caries-free children was rather similar. Abiotrophia defectiva and Actinomyces meyeri/A. odontolyticus were significantly higher in caries-affected than in caries-free children (p=0.006, 0.046, respectively). Shuttleworthia satelles was significantly higher in caries-free compared to caries-affected children (p=0.031). A. defectiva and A. meyeri/A. odontolyticus correlated positively with caries severity measured by ICDAS Caries Index (p = 0.494, 0.454, 0.400 respectively) while S. satelles was negatively correlated with caries severity (p= -0.489). CONCLUSIONS: Salivary A. defectiva and A. meyeri/A. odontolyticus and are associated with caries occurrence in MS-positive children with mixed dentition.

Parental perceptions of dental visits and access to dental care among disabled schoolchildren in Kuwait.

The objective of this study was to describe dental visiting habits and access to dental care among the disabled schoolchildren in Kuwait. A total of 308 parents of children with a physical disability (n = 211), Down syndrome (n = 97) and teachers, who had normal children (n = 112) participated in the study. Less than one-fourth (21%) of the disabled children and 37% of the normal children had never visited a dentist (p = 0.003). Majority of Down syndrome (72%) and physically disabled children (59%) received curative dental care compared to 47% of normal children (p = 0.016). A bigger proportion of disabled children (42%) visited the dentist due to tooth ache than the normal ones (25%) (p < 0.01). Only 9.6% of Down syndrome children perceived no barriers to seek the dental care compared to 26.2% of physically disabled and 32.2% of normal children (p = 0.008). Difficulty to get an appointment was the most common perceived barrier to dental care by parents of Down syndrome children and the normal children (37.3%). Parents of disabled children considered difficulty in cooperation as a more important barrier to treatment (34.7%) than the parents of normal children (20.3%). Larger proportion of parents of normal children (82%) rated the present dental services as excellent/good compared to 52% of the parents of disabled children (p < 0.001). Toothache and curative treatment need were the main reasons for dental visits among disabled children. Regular dental check-ups and preventive oral health care should be encouraged for comprehensive coverage of the national school oral health program for the disabled in Kuwait.

Validating a measure of the prevalence of dental anxiety as applied to Kuwaiti adolescents.

OBJECTIVES: To assess self-reported dental anxiety (DA) among Kuwaiti adolescents and to test whether different dental anxiety scales are valid for measuring DA in Kuwait. BASIC RESEARCH DESIGN: Cross-sectional, structured, anonymous questionnaire survey in Arabic completed at government schools. PARTICIPANTS: 757 pupils aged 13-15 years from three schools filled the questionnaire. Useable response rate was 93.0%. MAIN MEASURES: DA was assessed by: 1, a single-item dental fear question (DF); 2, the Modified Dental Anxiety Scale (MDAS); and 3, the Modified Child Dental Anxiety Scale: faces (MCDAS(f)). RESULTS: A third of the girls and 6% of boys reported being very much afraid of visiting a dentist. Use of the drill and injection in the gum were the most anxiety arousing MDAS items; tooth extraction and injection of the MCDAS(f) items. Total mean for MDAS was 11.4 (sd 4.6) and for MCDAS(f) 16.6 (sd 6.5). A tenth of the children were highly dentally anxious when measured by MDAS (score ≥ 19). Girls reported statistically significantly higher DA scores with all the measures. There was a high correlation between the total score of the MDAS and the total score of the MCDAS(f) (p = 0.855). Statistically significant relationship (p < 0.001) was found between the single-item DF and the total score of the MDAS and a single item and the total score of the MCDAS(f). CONCLUSIONs: A tenth of children were highly dentally anxious; girls reporting higher scores. A single-item dental fear question, MDAS and MCDAS(f) were valid tools for measuring DA among Kuwaiti adolescents.

Dental caries experience among 12-year-old children in Northwest Russia.

OBJECTIVE: To estimate the prevalence and experience of dental caries among 12-year-olds in Northwest Russia. METHODS: Altogether 355 schoolchildren at the age of 12 were selected at random from 3 urban and 4 rural areas in the Arkhangelsk region. Girls comprised 53.7% of the sample. Caries experience was assessed at D3 level by a single calibrated examiner. The prevalence of caries was estimated with 95% confidence intervals (CI) using Wilson's method. Caries experience was estimated using DMFT index and presented as means and 95% CIs. Dichotomous and numerical data were analysed by chi-squared tests and Mann-Whitney tests, respectively. RESULTS: The prevalence of caries was 83.4% (95% CI 79.2-86.9) with the mean DMFT of 2.95 (95% CI 2.70-3.20). On average, there were 1.56 (95% CI 1.37-1.76) decayed, 0.03 (95% CI 0.01-0.06) missing and 1.34 (95%CI 1.16-1.52) filled teeth. No gender differences in the prevalence of caries in any of the settings or in the full sample were observed. The overall caries experience was higher in urban than in rural areas (3.38 vs. 2.64, p = 0.001). The mean number of decayed teeth in urban areas was lower (1.29 vs. 1.77, p = 0.009), but the number of filled teeth was greater (2.02 vs. 0.85, p = 0.001) than in rural areas. CONCLUSIONS: The prevalence and experience of caries among 12-year-olds in the Arkhangelsk region is greater than in most European countries. Urgent public health measures at both population and individual levels are needed to improve the situation.

Global oral health inequalities: dental caries task group--research agenda.

The IADR Global Oral Health Inequalities Task Group on Dental Caries has synthesized current evidence and opinion to identify a five-year implementation and research agenda which should lead to improvements in global oral health, with particular reference to the implementation of current best evidence as well as integrated action to reduce caries and health inequalities between and within countries. The Group determined that research should: integrate health and oral health wherever possible, using common risk factors; be able to respond to and influence international developments in health, healthcare, and health payment systems as well as dental prevention and materials; and exploit the potential for novel funding partnerships with industry and foundations. More effective communication between and among the basic science, clinical science, and health promotion/public health research communities is needed. Translation of research into policy and practice should be a priority for all. Both community and individual interventions need tailoring to achieve a more equal and person-centered preventive focus and reduce any social gradient in health. Recommendations are made for both clinical and public health implementation of existing research and for caries-related research agendas in clinical science, health promotion/public health, and basic science.

Dental patient education: a survey from the perspective of dental hygienists.

OBJECTIVES: The aim of this study was to describe the current patient education practices of dental hygienists by exploring their views concerning their skills and knowledge related to patient education and by determining the implementation of patient education in their work, with regard to both method and content. METHODS: The target group consisted of 416 dental hygienists (n = 222, 53%) The research strategy used was a survey. The material was gathered using questionnaire. RESULTS: According to the dental hygienists, their skills and knowledge about patient education were good. However, the implementation of education was not in line with these assessments. The content of the education given focused mostly on the functional dimension. Little use was made of various educational methods, and the dental hygienists felt that they were not in good enough command of the methods. The patient's expectations and learning were not assessed systematically. The education provided and the assessment of the need for education often focused on the professional him/herself and the standpoint of the patient empowerment was disregarded. CONCLUSIONS: These results lay the foundation for additional research aimed at developing the patient education given by these professionals and making it support the empowerment of each patient.

Gingival recession, oral hygiene and associated factors among Tanzanian women.

BACKGROUND: Females are generally more motivated with regard to oral hygiene practices and thus brush their teeth more frequently than males. OBJECTIVE: To determine the prevalence of gingival recession, oral hygiene status, oral hygiene practices and associated factors in women attending a maternity ward in Tanzania. DESIGN: Cross-sectional descriptive study. SETTING: Maternity ward of Muhimbili National Hospital, Tanzania. SUBJECTS: Four hundred and forty six women were interviewed on oral hygiene practices and maternal factors, and a full-mouth examination was done to determine the presence of plaque, calculus, gingival bleeding and gingival recession at six sites per tooth. RESULTS: The prevalence of gingival recession (GR) > or =1 mm was 33.6%, calculus 99.3%, plaque 100%, and gingival bleeding 100%. Oral hygiene practices included toothbrushing (98.9%), brushing frequency > or =2 times/day (61.2%), horizontal brushing method (98%), and using a plastic toothbrush (97.8%). Factors that were significantly associated with gingival recession were age (OR = 2.0, 95% CI = 1.3-3.2), presence of calculus (OR(a) = 3.8, 95% CI=2.5-7.1), and gingival bleeding on probing (OR = 4.2, 95% CI = 2.5-7.1). Tooth cleaning practices and maternal factors, especially the number of pregnancies or deliveries were not significantly associated with gingival recession. CONCLUSION: In this study population, oral hygiene was poor and gingival recession was associated with age, calculus and gingival inflammation rather than with tooth cleaning practices.

Effect of Lactobacillus rhamnosus and Bifidobacterium lactis on gingival health, dental plaque, and periodontopathogens in adolescents: a randomised placebo-controlled clinical trial.

To determine the effect of a probiotic combination of Lactobacillus rhamnosus GG (LGG) and Bifidobacterium lactis BB-12 on the gingival health, dental plaque accumulation, and the oral carriage of four putative periodontal pathogens in healthy adolescents. 108 schoolboys, aged 13-15 years, participated in this study. They were divided into two groups: probiotics (n=54) and placebo (n=54). Both groups received two probiotic-laced or placebo lozenges twice a day during a four-week period. Plaque Index (PI) and Gingival Index (GI) were recorded at baseline and after four weeks. Salivary and plaque carriage of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum were also monitored likewise. 101 subjects completed the study. A statistically significant reduction in GI was seen in the probiotic group as compared to the placebo group (P=0.012). A reduction in PI was found for both groups, with no difference observed between the groups after intervention (P=0.819). Probiotic lozenges significantly reduced levels of A. actinomycetemcomitans and F. nucleatum in saliva and plaque (P<0.05) and levels of P. gingivalis in plaque (P<0.05), while no significant changes were found in the control group. A significant reduction (P<0.001) was also noted in the total salivary bacterial counts of the test group. The short-term daily consumption of LGG and BB-12 probiotic lozenges improved the gingival health in adolescents and decreased the microbial counts of A. actinomycetemcomitans, and P. gingivalis. Hence probiotic supplements may serve as a simple adjunct to standard oral care for promoting the oral health in adolescents.

Do life- or school-satisfaction and self-esteem indicators explain the oral hygiene habits of schoolchildren?

OBJECTIVES: The aim of this study was to ascertain how frequently toothbrushing and flossing are practiced among schoolchildren in Kuwait and whether life- and school-satisfaction and self-esteem indicators are associated with oral hygiene habits. METHODS: A sample of 2312 schoolchildren between 11 and 13 years old filled out a structured questionnaire anonymously in school classrooms during 2002 and 2003. For this study, nationally representative samples of children were drawn from all six governorates of Kuwait. Only government schools were included. The questionnaire of the Health Behaviour in School-Aged Children Study was used in this study after it was modified to suit Kuwait. A chi-squared test and logistic regression model were used for analyzing the data. RESULTS: Over half of the pupils reported brushing their teeth more than once a day; girls reported brushing more frequently than boys did. One-fifth of the pupils did not brush their teeth even on a daily basis. The life- and school-satisfaction and self-esteem indicators were associated with more-than-once-a-day toothbrushing frequency. The strongest predictors for recommended brushing were: feeling very happy (OR 2.0, 95% CI 1.38-2.77), feeling that other pupils always accept him/her (1.5; 1.16-2.02), never/sometimes feeling lonely and feeling that it is very easy to make friends (1.4; 1.06-1.94). The summary variables of life-satisfaction, school-satisfaction and self-esteem seemed to be strongly associated with brushing. Dental floss was never used by 45% of the children, weekly by 18% and daily by 17%; 20% did not even know what dental floss was. CONCLUSIONS: Among intermediate schoolchildren in Kuwait, oral hygiene practices were far behind the international recommendations. Special emphasis should be placed on children who have personal problems with their life, school and self-esteem.

Don't be rejected, how can we help authors, reviewers and editors?: Report of a Symposium for Editors Publishers and Others with an Interest in Scientific Publication, Held in Boston on Wednesday, 11 March 2015, during the Annual Meeting of the International Association for Dental Research.

This satellite symposium was the fifth in a series for editors, publishers, reviewers and all those with an interest in scientific publishing. It was held on Wednesday, 11 March 2015 at the IADR meeting in Boston, Massachusetts. The symposium attracted more than 210 attendees. The symposium placed an emphasis on strategies to ensure that papers are accepted by peer reviewed journals. The speaker, representing the Journal of Dental Research gave a history of peer review and explained how to access material to advise new authors. The speaker from India outlined the problems that occur when there is no culture for dental research and it is given a low priority in dental education. He outlined remedies. The speaker from SAGE publications described the help that publishers and editors can provide authors. The final speaker suggested that in developing countries it was essential to create alliances with dental researchers in developed countries and that local conferences to which external speakers were invited, stimulated research both in terms of quantity and quality. A wide ranging discussion then took place.

An exploratory study on cultural variations in oral health attitudes, behaviour and values of freshman (first-year) dental students.

OBJECTIVE: To identify similarities and differences in oral health attitudes, behaviour and values among freshman dental students. DESIGN: Cross-cultural survey of dental students. SETTING: 18 cultural areas. PARTICIPANTS AND METHODS: 904 first-year dental students completed the Hiroshima University-Dental Behavioural Inventory (HU-DBI) translated into their own languages. Individual areas were clustered by similarity in responses to the questions. RESULTS: The first group displayed an 'occidental-culture orientation' with the exception of Brazil (Cluster 1 comprised: Australia, United Kingdom, Ireland, Belgium and Brazil, Cluster 2: Germany, Italy, Finland and France). The second group displayed an 'oriental-cultural orientation' with the exception of Greece and Israel (Cluster 3 comprised: China and Indonesia, and Cluster 4: Japan, Korea, Israel, Hong Kong, Malaysia, Thailand and Greece). Australia and United Kingdom were the countries that were most alike. Ireland was the 'neighbour' to these countries. Greece and Malaysia had similar patterns of oral health behaviour although geographic conditions are very different. Although it was considered that in Hong Kong, occidental nations have affected the development of education, it remained in the oriental-culture group. Comparison with the data from the occidentals indicates that a higher percentage of the orientals put off going to the dentist until they have toothache (p < 0.001). Only a small proportion of the occidentals (8%) reported a perception of inevitability in having false teeth, whereas 33% of the orientals held this fatalistic belief (p = 0.001). CONCLUSIONS: Grouping the countries into key cultural orientations and international clusters yielded plausible results, using the HU-DBI.

A field trial on semi-annual fluoride varnish applications among the special needs schoolchildren.

This study assessed cariostatic effect of one fluoride varnish Duraphat among children with a low caries risk and compared this effect to group of a moderate caries risk, belonging to same ethnic group with same socioeconomic background. Results of this study showed that fluoride varnish had cariostatic effect in a group of children with a moderate caries risk but not among those with a low caries risk.

Toothbrushing as part of the adolescent lifestyle predicts education level.

Socio-economic differences in health and health behavior are well-known. Our hypothesis was that toothbrushing frequency in adolescents predicts their education level in adulthood. The aim was also to study the role of toothbrushing in adolescents' health-related lifestyle. Data from nationally representative samples of 12- to 16-year-olds (N = 11,149) were linked with register data on the highest level of education attained at age 27-33 years. Adolescents with a low toothbrushing frequency reached only the lowest education levels. School achievement or sociodemographic background only partly accounted for the association. Exploratory factor analysis found four dimensions of health behaviors. At age 12, a low toothbrushing frequency was loaded highly with "street-oriented" behaviors, concentrated around smoking and alcohol use. At ages 14 and 16, it was associated with a "traditional" lifestyle of the less-well-educated. Altogether, a low toothbrushing frequency indicated selection into the less-well-educated stratum of society. This is likely to be reflected in socio-economic health differences in adulthood.

The trend and risk factors of perceived toothache among Finnish adolescents from 1977 to 1997.

Toothache is a subjective oral health indicator that should become uncommon when oral health is improving. The aim of this study was to assess changes in perceived toothache between 1977 and 1997 among Finnish adolescents. In the Adolescent Health and Lifestyle Survey, a self-administered questionnaire was mailed to a representative sample of 12-, 14-, 16-, and 18-year-old Finns every second year. The sample sizes in the surveys varied from 2422 to 11,105, making a total of 35,349 subjects in the entire study. The incidence of toothache during the previous 2 years was requested in 1977, 1985, 1991, 1995, and 1997, and the prevalences were 31%, 25%, 28%, 29%, and 37%, respectively. The increase between 1995 and 1997 was highest among 16- and 18-year-olds. There was no tendency for perceived toothache to decline over the study period, despite the decrease in caries experience. Toothache varied by age, socioeconomic status (SES), place of residence, and toothbrushing frequency. The increase in the incidence of toothache reported after 1995 could be a warning signal that economic recession in Finland has caused changes in the dental care system.

Oral hygiene habits of 11-year-old schoolchildren in 22 European countries and Canada in 1993/1994.

This study is part of the Cross-National Survey on Health Behaviour in School-aged Children--a WHO Collaborative Study, which started in 1982. The aim of the study was to describe the oral hygiene habits (toothbrushing and flossing) of 11-year-old schoolchildren in 22 European countries (Austria, Belgium, the Czech Republic, Denmark, Estonia, FInland, France, Germany, Greenland, Hungary, Israel, Latvia, Lithuania, Northern Ireland, Norway, Poland, Russia, Scotland, the Slovak Republic, Spain, Sweden, and Wales) and Canada. The data were collected from standardized anonymous questionnaires in school classrooms during the 1993-1994 school year. At least 1300 school children, representing the whole country, participated in the study in each country. Oral hygiene habits were analyzed according to gender, age, country, school performance, and family economy. The children brushed most favorably in Sweden, Denmark, German, Austria, and Norway (83-73% brushed twice a day). More-than-once-a-day toothbrushing was especially uncommon (from 26 to 33%) among boys in Finland, Lithuania, Russia, Estonia, and Latvia. Toothbrushing frequency differed significantly according to school performance in Canada, the Czech Republic, Scotland, Poland, Northern Ireland, and Wales and between different socio-economic groups in Northern Ireland, Wales, the Czech Republic, Scotland, Poland, and Russia. Use of dental floss was rare. In general, flossing was less frequent among boys than among girls. Daily flossing was most common among Canadian adolescents (25%). In conclusion, there are considerable differences in toothbrushing frequency among children in European countries.

Caries experience in the primary dentition of Tanzanian and Finnish 3-7-year-old children.

Caries experience of primary teeth in relation to age, sex, ethnic group, socioeconomic status and frequency of consuming sweet snacks and drinks was studied among groups of Tanzanian and Finnish 3-7-yr-olds, a total of 1118 children. In all age groups the Tanzanian children had higher mean dmft scores than Finnish children did. In the Finnish group the mean dmft score was higher at age 7 than at age 3, while in the Tanzanian group no statistically significant difference in dmft scores was found between age groups. In both groups maxillary incisors and molars were the main teeth affected by caries. Frequent consumption of sweet snacks and drinks increased the risk for caries in Tanzanian but not in Finnish children. High socioeconomic status decreased the risk for caries in Finnish children but among Tanzanian children high SES was not associated significantly with the risk of developing caries. According to these results, caries experience in Tanzanian urban nursery school children was significantly higher than in Finnish children of the same age, the differences being especially high among the youngest age groups.

Oral hygiene behavior and periodontal status in European adolescents: an overview.

The object of this review is to examine toothbrushing as a health behavior in European adolescents. The aims are to investigate the role of environmental and social factors on toothbrushing as a health behavior, to illustrate the importance of such factors in the prevention of periodontal diseases and to demonstrate how a knowledge of these factors can aid the development of specific health education programs. In order to do this the results of many studies concerned with oral hygiene behavior from different European countries have been examined. It is from the detailed study of these various European investigations that the results section is composed. The findings from this review demonstrate that toothbrushing as a health behavior is influenced by both environmental and social factors, that both of these factors affect the incidence of gingivitis and periodontal disease in the countries examined, and that when they are incorporated into health education programs based on the community development approach they can aid behavior change.

How is oral health education conducted in Finnish health centers?

The oral health education (OHE) given in Finnish health centers is mostly implemented by dental assistants and hygienists. However, there is no exact information concerning the distribution of OHE work and the working methods among individual health educators. The aims of this study were to assess 1) the time used for OHE by the dental professionals who bear most of the responsibility for OHE in health centers, and to evaluate 2) the collaboration between OH-educators and the parents of schoolchildren, school personnel and the other health care personnel and 3) the sources of the OHE knowledge and skills of these OH-educators and their methods according to their work load. The data for this study were collected from 323 OH-educators. About one fourth (28%) of the OH-educators used 40% or more of their working time for group OHE and one third (33%) used 40% or more of their time for individual OHE. These workers were considered to be full-time OH-educators. The mean age of the OH-educators was 36 yr. The mean length of the OHE career was 8 yr. The most common OHE methods were a usual type of school lesson or a lesson in which the audience was questioned. Slides, models, transparencies and leaflets were the most general visual aids used.

Fluorosis in relation to fluoride levels in water in central Nigeria.

OBJECTIVES: This study was conducted to examine the prevalence of dental fluorosis in relation to fluoride levels in water among children aged 12-15 years in the states of Plateau and Bauchi, Nigeria. METHODS: Children (N = 203) were examined using WHO criteria. The children were from two schools and permanent residents of the communities in which the schools are located (Tilden Fulani and Kanadap). Intra-examiner reliability for determining fluorosis scores was 80%. RESULTS: Fluoride levels in the water ranged from 0.0-0.4 mg/L. Prevalence of dental fluorosis in the sample was 51%. Forty-one percent had very mild fluorosis, 7% had mild fluorosis and 3% had moderate to severe fluorosis. The lowest DMFT was observed in the school where the fluoride level of the water ranged between 0.0 and 0.4 mg/L, and in the group with very mild fluorosis. CONCLUSION: Fluoride levels in water for central Nigeria were appropriate for oral health. In the areas where the children were permanent residents, factors other than the fluoride levels of the water contributed to the severity of dental fluorosis.