Access to oral health in early childhood in the city of Porto Alegre, Brazil. / Acesso à saúde bucal na primeira infância no município de Porto Alegre, Brasil.

The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.

O objetivo foi avaliar o acesso e fatores associados à consulta odontológica em crianças de até 5 anos no município de Porto Alegre, Brasil. Estudo transversal realizado em 10 Unidades Básicas de Saúde, através de questionário e exame clínico em 560 crianças. Foram avaliadas variáveis clínicas (placa visível, sangramento gengival e ceo-s), sociodemográficas, e de acesso à consulta. Regressão de Poisson foi utilizada para cálculo de Razões de Prevalência (RP), com intervalo de confiança de 95%. Os resultados mostraram que 68,2% das crianças nunca haviam ido ao dentista. O principal motivo relatado para a não realização de consulta odontológica foi não ter sentido necessidade (48,7%) e dificuldade de acesso ao posto de saúde (15,8%). A procura pelo dentista teve como propósito a prevenção/revisão (55,8%) e os locais mais procurados para consultas foi o consultório particular (43,9%) e o posto de saúde (39,5%). O modelo multivariado final mostrou que a idade da criança (IC95%, RP = 1,03 (1,02-1,05)), a renda familiar (RP = 1,05; (1,01-1,08)) e a mãe ter concluído o ensino médio (RP = 1,69 (1,15-2,56)) estiveram associados com a procura por consulta odontológica. Assim, torna-se fundamental reconhecer a importância do contexto familiar durante os primeiros anos de vida.

Is there socioeconomic inequality in periodontal disease among adults with optimal behaviours.

OBJECTIVE: To examine if socioeconomic inequalities exist in periodontal disease among adult with optimal oral health behaviours. MATERIALS AND METHODS: Data were from the Adult Dental Health Survey 2009, a national survey of England, Wales and Northern Ireland. Overall, 4738 participants aged 35 years and older were included in the analysis. Periodontal disease indicated by pocket depth or loss of attachment ≥4 mm, and gingival bleeding were used as periodontal outcomes. Education and deprivation indicated socioeconomic position. Behavioural factors were dental visits, toothbrushing and smoking. The subset of adults with and without optimal health related behaviours included 2916 and 1822 participants, respectively. The associations between periodontal disease and socioeconomic position were tested adjusting for demographic and behavioural factors. Additional models stratifying the sample to those with and without optimal behaviour subgroup were constructed. RESULTS: Education and deprivation were significantly associated with periodontal disease in the partially adjusted models. In the analysis of those with optimal behaviours, only deprivation and highest level of education showed significant association with periodontitis (PD), but not with gingival bleeding. Among those without optimal behaviours, all socioeconomic factors were associated with all outcomes except deprivation and PD. CONCLUSIONS: Oral health behaviours marginally contributed to inequalities in gingival bleeding and periodontal disease. Socioeconomic inequalities were attenuated among those with optimal behaviours and persisted among those without optimal behaviours. Behaviours appeared to be an effect modifier for the relationship between periodontal outcomes and socioeconomic factors.

Acesso à saúde bucal na primeira infância no município de Porto Alegre, Brasil / Access to oral health in early childhood in the city of Porto Alegre, Brazil

Resumo O objetivo foi avaliar o acesso e fatores associados à consulta odontológica em crianças de até 5 anos no município de Porto Alegre, Brasil. Estudo transversal realizado em 10 Unidades Básicas de Saúde, através de questionário e exame clínico em 560 crianças. Foram avaliadas variáveis clínicas (placa visível, sangramento gengival e ceo-s), sociodemográficas, e de acesso à consulta. Regressão de Poisson foi utilizada para cálculo de Razões de Prevalência (RP), com intervalo de confiança de 95%. Os resultados mostraram que 68,2% das crianças nunca haviam ido ao dentista. O principal motivo relatado para a não realização de consulta odontológica foi não ter sentido necessidade (48,7%) e dificuldade de acesso ao posto de saúde (15,8%). A procura pelo dentista teve como propósito a prevenção/revisão (55,8%) e os locais mais procurados para consultas foi o consultório particular (43,9%) e o posto de saúde (39,5%). O modelo multivariado final mostrou que a idade da criança (IC95%, RP = 1,03 (1,02-1,05)), a renda familiar (RP = 1,05; (1,01-1,08)) e a mãe ter concluído o ensino médio (RP = 1,69 (1,15-2,56)) estiveram associados com a procura por consulta odontológica. Assim, torna-se fundamental reconhecer a importância do contexto familiar durante os primeiros anos de vida.

Abstract The goal was to assess the access and factors connected to dental visits in children up to age five in the city of Porto Alegre, Brazil. The cross-sectional study was conducted in 10 Basic Health Units through a questionnaire and clinical examination on 560 children. Clinical (visible plaque, gingival bleeding and defs), socio-demographic, and visit access variables were assessed. Poisson Regression was used to calculate the Prevalence Ratios (PR), with a 95% confidence interval. Results showed that 68.2% of children had never gone to a dentist. The main reason reported for not visiting a dentist was not feeling the need (48.7%) and difficult access to a health clinic (15.8%). The purpose of going to the dentist was for prevention/revision (55.8%), and the most sought-after places for visits were the private office (43.9%) and health clinic (39.5%). The final multivariate model showed that age of the child (95%CI, PR = 1.03 (1.02-1.05)), household income (PR = 1.05; (1.01-1.08)), and the mother having completed high school (PR = 1.69 (1.15-2.56)) were associated with seeking dental consultation. Thus, it is crucial to recognize the importance of the family setting during the first years of life.

Pathways of socioeconomic inequalities in gingival bleeding among adolescents.

OBJECTIVES: To explore the pathways through which the socioeconomic inequalities may influence gingival bleeding in adolescents, assessing the direct and indirect effects of material and psychosocial variables. METHODS: This cohort study followed a multistage, random sample of 1134 12-year-old adolescents from 20 public schools of Santa Maria, a city in southern Brazil. The percentage of teeth with gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding) at baseline and at 2-year follow-up. Biological (dental plaque, caries, and dental crowding), material (socioeconomic position [SEP] operationalized as family income and parents' education), psychosocial (parents' religiosity, self-rated health, and happiness) and behavioural (use of dental service by adolescents) factors were collected at baseline. Structural equation modelling (SEM) was guided by the adapted Commission on the Social Determinants of Health model linking material, psychosocial, biological, and behaviour variables to health. The SEM was employed to estimate standardized direct, indirect, and total effects of material and psychosocial factors on gingival bleeding at follow-up. RESULTS: A total of 770 14-year-old adolescents were reassessed (follow-up rate of 68%). The lower SEP at baseline had a higher direct effect (standard coefficient [SC] = -0.17, P < 0.01) than a mediated effect on percentage of teeth with gingival bleeding at 2-year follow-up. The lower indirect effect (SC = -0.06, P < 0.01) from SEP to gingival bleeding at follow-up ran through biological factors-dental plaque (baseline and follow-up) and gingival bleeding at baseline. The lower religiosity of the parents as a psychosocial aspect had only a small direct effect (SC = -0.10, P = 0.03) on gingival bleeding at follow-up. CONCLUSIONS: Material factors such as SEP contributed most to explanations on inequalities in adolescents' periodontal health because of their higher direct effect and additional shared (indirect) effect (through biological factors) on gingival bleeding. Religious practice as a psychosocial factor only explained part of percentage of teeth with gingival bleeding at follow-up.

Utilisation of Oral Health Services and Economic Burden of Oral Diseases in China.

OBJECTIVE: To evaluate the use of oral health services, the economic burden of oral diseases and related influential factors in China. METHOD: Using the multistage, stratified, equal proportion, random sampling method in the 4th National Oral Health Survey of China conducted in 2015 to 2016, residents aged 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years respectively were recruited, clinically examined and answered a questionnaire. Utilisation of oral health services were assessed in all the age groups and the economic burden of oral diseases in the past 12 months were assessed in the 3 to 5 years and 35 to 74 year-old groups. Chi-squared tests, t tests, correlation analysis and a one-way ANOVA were used to determine the relationships of different factors with utilisation of oral health services and the economic burden of oral diseases. RESULTS: In the subject groups - 3 to 5 years, 12 to 15 years and 35 to 74 years - the prevalence of the utilisation of oral health services in the past 12 months was 14.6% (5,876/40,353), 23.6% (27,936/118,592), and 20.1% (2,708/13,461), respectively. In all three groups, receiving dental treatment was the most common reason for subjects' recent dental visit. The average dental cost in the past 12 months was 403.43 CNY (median = 100) for 3 to 5-year-old children and 850.83 CNY (median = 300) for adults aged 35 to 74 years old. Area, education and annual household income per person were the socio-economic influential factors. Oral health status, oral hygiene and attitudes to and knowledge of oral health affected the utilisation of oral health services and the economic burden of oral diseases. CONCLUSION: The percentage of dental service utilisation was relatively low, and the economic burden was high. The related factors for both utilisation of oral health services and the economic burden of oral diseases included living in area, educational attainment, household income, perceived oral health status, and oral hygiene.

Clinical and Individual Variables in Children's Dental Fear: A School-Based Investigation

Abstract This cross-sectional study evaluated the prevalence of dental fear and associated factors in schoolchildren aged 8 to 12 years old, in Pelotas, southern Brazil. Schoolchildren enrolled in 20 public and private schools were selected using a multi-stage sample design. Sociodemographic characteristics, children's dental visit and oral hygiene habits were assessed by questionnaires. The Dental Anxiety Question was used to measure dental fear prevalence. Children's clinical examination evaluated presence of dental caries (DMFT/dmft index) and gingival bleeding. Data were analyzed using Poisson regression with robust variance (prevalence ratio; 95% confidence interval). One thousand two hundred and two children were included. Dental fear prevalence was 24.6%. After the adjustment, girls [PR=1.71 (CI 95%: 1.31-2.22)], children from poorer families [PR=1.96 (CI 95%: 1.36-2.83)], those who had decayed teeth (D/d index>0)[PR=1.32 (CI 95%: 1.01-1.72), and who had never been at the dentist [PR=1.85 (CI 95%: 1.42-2.41) remained significantly associated with dental fear. The prevalence of dental fear indicates that it is a common problem among schoolchildren. Early dental care and dental caries prevention are important factors to prevent dental fear.

Resumo Este estudo transversal avaliou a prevalência do medo odontológico e fatores associados em escolares de 8 a 12 anos de idade, na cidade de Pelotas, RS, Brasil. Alunos matriculados em 20 escolas públicas e privadas foram selecionados através de um delineamento de conglomerado em duplo estágio. As características sociodemográficas, a experiência odontológica da criança e os hábitos de higiene bucal foram avaliados por meio de questionários. O medo odontológico da criança foi avaliado através da Dental Anxiety Question. Examinadores calibrados avaliaram a presença de cárie dentária (CPOD) e o índice de sangramento gengival. Os dados foram analisados por meio de regressão de Poisson com variância robusta (razão de prevalência; 95% intervalo de confiança). No total, 1202 crianças foram incluídas. A prevalência medo odontológico foi de 24,6%. Após o ajuste, as meninas [RP=1,71 (IC 95%: 1,31-2,22)], as crianças de famílias mais pobres [RP=1,96 (IC 95%: 1,36-2,83)], com lesões de cárie (D/d index>0) [RP=1,32 (IC 95%: 1,01-1,72) e as que nunca tinham ido ao dentista [RP=1,85 (IC 95%: 1,42-2,41) permaneceram significativamente associadas ao medo dental. A prevalência de medo odontológico encontrada indica que este é um problema comum em escolares. O atendimento odontológico precoce e a prevenção de cárie são fatores importantes para evitar o medo.

The associations of socioeconomic status and social capital with gingival bleeding among schoolchildren.

OBJECTIVE: The aim of this study was to assess the associations of gingival bleeding with individual and community social variables among schoolchildren. METHODS: This cross-sectional study evaluated a representative, multistage, random sample of 1,134 12-year-old schoolchildren from Santa Maria, a city in southern Brazil. The participants were examined clinically, and full-mouth gingival bleeding was recorded according to the Community Periodontal Index criteria (scored as healthy or bleeding). The children's parents or guardians answered questions regarding their socioeconomic status and social capital, and an assessment of the associations was performed using multilevel Poisson regression models. RESULTS: The prevalence of gingival bleeding was 96.21 percent. The multilevel adjusted assessment revealed that socioeconomic, clinical, and social capital variables at the individual level were associated with higher levels of gingival bleeding. Children whose fathers had a low educational level, children who had dental plaque and dental crowding, and children who never/almost never attended religious meetings exhibited significantly higher levels of gingival bleeding than their counterparts. This social gradient remained significant even after adjusting for contextual-level covariates. CONCLUSION: The results indicate that the socioeconomic status and features of social capital are associated with the levels of gingival bleeding among schoolchildren.

Clinical and Individual Variables in Children's Dental Fear: A School-Based Investigation.

This cross-sectional study evaluated the prevalence of dental fear and associated factors in schoolchildren aged 8 to 12 years old, in Pelotas, southern Brazil. Schoolchildren enrolled in 20 public and private schools were selected using a multi-stage sample design. Sociodemographic characteristics, children's dental visit and oral hygiene habits were assessed by questionnaires. The Dental Anxiety Question was used to measure dental fear prevalence. Children's clinical examination evaluated presence of dental caries (DMFT/dmft index) and gingival bleeding. Data were analyzed using Poisson regression with robust variance (prevalence ratio; 95% confidence interval). One thousand two hundred and two children were included. Dental fear prevalence was 24.6%. After the adjustment, girls [PR=1.71 (CI 95%: 1.31-2.22)], children from poorer families [PR=1.96 (CI 95%: 1.36-2.83)], those who had decayed teeth (D/d index>0)[PR=1.32 (CI 95%: 1.01-1.72), and who had never been at the dentist [PR=1.85 (CI 95%: 1.42-2.41) remained significantly associated with dental fear. The prevalence of dental fear indicates that it is a common problem among schoolchildren. Early dental care and dental caries prevention are important factors to prevent dental fear.

[The relationship between gingival condition and socio-demographic factors of adolescents living in a Brazilian region]. / Relação entre condição gengival e fatores sociodemográficos de adolescentes residentes em uma região brasileira.

The scope of this study is to correlate the gingival condition and sociodemographic status of adolescents living in an economically disadvantaged Brazilian region. The survey was conducted with a random sample of 450 adolescents in 13 cities selected in the Jequitinhonha Valley (State of Minas Gerais). The gingival condition was evaluated using a calibrated examiner (Kappa ≥ 0.85). The oral exam was based on the Community Periodontal Index (CPI). The frequencies of individuals were calculated and sextants subsequently assessed using Multiple Correspondence Analysis (ANACOR) to reveal the relationship between CPI and sociodemographic characteristics. The results showed that: 16 (3.6%) were healthy; 235 (52.2%) had gingival bleeding; 36 (8%) had dental calculus and 163 (36.2%) had both bleeding and calculus. ANACOR identified two groups with similarities in relation to periodontal disease. Group one featured 19-year-olds with healthy CPI who work and have higher family income. Group two included 15- and 16-year-olds of both sexes with CPI and gingival bleeding in elementary school with lower family income, who declared themselves to be of mixed or Afro-descendant race. The presence of gingivitis was related to the socioeconomic and demographic characteristics of adolescents in the region.

Relação entre condição gengival e fatores sociodemográficos de adolescentes residentes em uma região brasileira / The relationship between gingival condition and socio-demographic factors of adolescents living in a Brazilian region

O objetivo deste artigo é relacionar as condições gengival e socioeconômica e distribuição demográfica de adolescentes residentes em uma região desfavorecida brasileira. O estudo transversal foi realizado com amostra probabilística de 450 adolescentes (15-19 anos) em 13 municípios sorteados no Vale do Jequitinhonha (MG). A condição gengival foi avaliada por um examinador calibrado (Kappa ≥ 0,85) e baseado Índice Periodontal Comunitário (CPI). Foram calculadas as frequências para indivíduos e sextantes com posterior Análise de Correspondência Múltipla (Anacor) que explorou relações entre o CPI e as características sociodemográficas. Como resultados: 16 (3,6%) apresentaram-se sem alterações gengivais, 235 (52,2%) com sangramento, 36 (8,0%) com cálculo dental e 163 (36,2%) com sangramento e cálculo. A Anacor identificou dois grupos que guardavam semelhanças entre si em relação à doença periodontal. O grupo 1 reuniu os adolescentes com CPI sadio, 19 anos de idade, que trabalham e têm maior renda familiar. No grupo de CPI com sangramento, tem-se os adolescentes com 15 e 16 anos de idade, de ambos os sexos, cursando o ensino fundamental, menor renda familiar e que se autodeclararam pardos ou negros. A gengivite foi relacionada às condições socioeconômicas e demográficas de adolescentes da região.

The scope of this study is to correlate the gingival condition and sociodemographic status of adolescents living in an economically disadvantaged Brazilian region. The survey was conducted with a random sample of 450 adolescents in 13 cities selected in the Jequitinhonha Valley (State of Minas Gerais). The gingival condition was evaluated using a calibrated examiner (Kappa ≥ 0.85). The oral exam was based on the Community Periodontal Index (CPI). The frequencies of individuals were calculated and sextants subsequently assessed using Multiple Correspondence Analysis (ANACOR) to reveal the relationship between CPI and sociodemographic characteristics. The results showed that: 16 (3.6%) were healthy; 235 (52.2%) had gingival bleeding; 36 (8%) had dental calculus and 163 (36.2%) had both bleeding and calculus. ANACOR identified two groups with similarities in relation to periodontal disease. Group one featured 19-year-olds with healthy CPI who work and have higher family income. Group two included 15- and 16-year-olds of both sexes with CPI and gingival bleeding in elementary school with lower family income, who declared themselves to be of mixed or Afro-descendant race. The presence of gingivitis was related to the socioeconomic and demographic characteristics of adolescents in the region.

Income gradients in oral health according to child age.

This study aimed to confirm whether the well-known income disparities in oral health seen over the life course are indeed absent in 9- to 11-yr-old children, and to explore the role of access to dental care in explaining the age-profile of the income gradient in child oral health. We used data from the 2007 United States National Survey of Children's Health. Income gradients in parental reports of children's decayed teeth or cavities, toothache, broken teeth, bleeding gums, and fair/poor condition of teeth were assessed in stratified analyses according to age of child (1-5, 6-8, 9-11, 12-14, and 15-17 yr), using survey logistic regression to control for family-, parental-, and child-level covariates. Health insurance status and use of preventive dental care were the indicators for children's access to dental care. The adjusted ORs for the effect of family income on having decayed teeth or cavities, toothache, and fair/poor condition of teeth were not significant in 9- to 11-yr-old children. Different age-patterns were found for broken teeth and bleeding gums. The attenuation of the income gradients in having decayed teeth or cavities, toothache, and fair/poor condition of teeth, previously seen in 9- to 11-yr-old children, was also seen in 15- to 17-, 12- to 14-, and 6- to 8-yr-old children, respectively, after controlling for children's access to dental care. This study supports the attenuation of income inequalities in oral health in 9- to 11-yr-old children. Access to dental care could attenuate income gradients in oral health in other age groups.

Dietary intake of calcium, vitamins A and E and bleeding on probing in Sri Lankan preschoolers.

OBJECTIVE: To determine the prevalence of gingival bleeding on probing and the associations between dietary intake of calcium, vitamins A and E and gingival bleeding on probing in Sri Lankan preschool children. BASIC RESEARCH DESIGN: A cross-sectional study. PARTICIPANTS: 784 children aged 48-72 months attending preschools in the Kegalle district and their mothers/carers. RESULTS: The prevalence of gingival bleeding on probing was 52.9%. A Poisson logistic regression model revealed that children with a high daily dietary intake of calcium were less likely to have gingival bleeding on probing than those with low intake (PR=0.80; 95%CI 0.64,0.98). Also prevalence of gingival bleeding was higher in children: with plaque on their teeth; whose mothers were not employed; or, were from families with three or more children. CONCLUSIONS: The prevalence of gingivitis was high in the children and the findings suggest that high levels of dietary calcium intake are associated with reduced gingival bleeding in preschool children.

Risk factors for oral diseases among workers with and without dental insurance in a national social security scheme in India.

OBJECTIVES: The target population for this cross sectional study comprises subjects with and without social security in a national social security scheme. The study aimed to compare and assess the risk factors for oral diseases among insured (organised sector) and non-insured workers (unorganised sector) in New Delhi, India. METHODS: The sample comprised a total of 2,752 subjects. Of these, 960 workers belonged to the formal or organised sector with a social security and dental health insurance and 1,792 had no social security or dental insurance from the informal or unorganised sector. RESULTS: Significant differences were noted between the two groups for literacy levels, between-meal sugar consumption, tobacco-related habits and utilisation of dental care. Bleeding/calculus and periodontal pockets were present among 25% and 65.4% of insured workers, respectively. Similarly, 13.6% and 84.5% of non-insured workers had bleeding/calculus and periodontal pockets, respectively. The mean DMFT (decayed, missing, filled teeth) value among the insured workers and non-insured workers was 3.27 ± 1.98 and 3.75 ± 1.80, respectively. The association between absence of health insurance and dental caries was evident with an odds ratio (OR) of 1.94. Subjects with below graduate education were more prone to dental caries (OR = 1.62). Subjects who cleaned their teeth two or more times a day were less likely to have dental caries (OR = 1.47). Utilisation of dental care was inversely related to dental caries (OR = 1.25). CONCLUSION: The major risk factors for oral diseases in both the groups with similar socio-economic status were the lack of social security and health insurance, low literacy levels, high tobacco consumption and low levels of dental care utilisation.

Socio-behavioral variables effecting oral hygiene and periodontal status of 12 year-old schoolchildren of Udaipur district.

AIM: To assess the effect of various socio-demographic in addition to oral hygiene variables on the oral hygiene and periodontal status. METHODS: A combination of multi stage and cluster sampling procedure was followed to collect a representative population of 831, 12 year-old schoolchildren of Udiapur district. Oral Hygiene Index Simplified (OHI-S) and Community Periodontal Index (CPI) were used to evaluate oral hygiene and periodontal status respectively. Along with the clinical examination, each subject was interviewed to collect the socio-demographic information and oral hygiene practices. RESULTS: The overall mean OHI-S was 1.42 and debris component of the oral hygiene index was dominant. Unpaired 't' test showed significantly higher DI-S (p = 0.0001) and OHI-S (p = 0.007) among boys than girls. The overall prevalence of periodontal disease was 89.9% and gingival bleeding was widespread. Chi square test demonstrated significant differences (p = 0.0001) with 14.6% urban children having healthy periodontium in comparison to 5.6% rural residents. Oral hygiene scores were dependent on the father's occupation (p = 0.046), father's (p = 0.002) and mother's level of education (p = 0.0001). CONCLUSIONS: Oral hygiene status was poor, more among boys with debris contributing a major part for oral hygiene index. Periodontal status was poor with bleeding being most prevalent indicator. The multivariate analysis of oral hygiene status confirmed the existence of socio-behavioural determinants for oral hygiene.

Global burden of oral conditions in 1990-2010: a systematic analysis.

The Global Burden of Disease (GBD) 2010 Study produced comparable estimates of the burden of 291 diseases and injuries in 1990, 2005, and 2010. This article reports on the global burden of untreated caries, severe periodontitis, and severe tooth loss in 2010 and compares those figures with new estimates for 1990. We used disability-adjusted life-years (DALYs) and years lived with disability (YLDs) metrics to quantify burden. Oral conditions affected 3.9 billion people, and untreated caries in permanent teeth was the most prevalent condition evaluated for the entire GBD 2010 Study (global prevalence of 35% for all ages combined). Oral conditions combined accounted for 15 million DALYs globally (1.9% of all YLDs; 0.6% of all DALYs), implying an average health loss of 224 years per 100,000 population. DALYs due to oral conditions increased 20.8% between 1990 and 2010, mainly due to population growth and aging. While DALYs due to severe periodontitis and untreated caries increased, those due to severe tooth loss decreased. DALYs differed by age groups and regions, but not by genders. The findings highlight the challenge in responding to the diversity of urgent oral health needs worldwide, particularly in developing communities.

Assessment of periodontal status and treatment needs among 12 and 15 years old school children in Udaipur, India.

AIM: To assess and compare the periodontal status and treatment needs among school children aged 12 and 15 years in public and private schools of Udaipur, India and to provide baseline data for planning and evaluation of oral health care promotion programmes. STUDY DESIGN: A cross-sectional descriptive survey. METHODS: A survey was conducted on 900 school children aged 12 and 15 years in Udaipur. The data were collected by means of clinical examination using the CPITN index. STATISTICS: Data was analysed using Pearson's Chi-square and student's t-test. RESULTS: Children aged 15 years had higher scores of healthy gingiva compared with 12 years old. Gender difference of females having better gingival health than males was seen in both age groups. Amongst the schools, children in private schools had good periodontal status in comparison to public schools. A statistically significant association between frequency of tooth brushing and CPITN scores was found among children of the 15 year old group. CONCLUSION: There is a need for a long term school oral health promotion program to sustain the healthy tissues of this growing Indian population.

Caries experience in 14-year-olds from Northeast Italy. Is socioeconomic-status (SES) still a risk factor?

AIM: Prevalence and severity of dental caries in 14-year-olds of Northeast Italy were estimated, evaluating the dependence to SES. MATERIALS AND METHODS: An epidemiological survey was performed among a randomised cluster sample of 560 (290 M and 270 F) 14-year-olds attending secondary schools, to evaluate DMFS following WHO indications. Association between caries occurrence and SES was evaluated in a logistic regression model. To account for high proportion of zero scores (DMFS and DS distribution highly positively skewed) data was moreover modelled with negative binomial regression and zero-inflated models. RESULTS: Caries prevalence was 63.4% with a mean DMFS of 3.0 ± 3.8. A significant trend between means was observed regarding DS in the different SES levels: z = 2.22 p = 0.03 (occupational level) and z = 3.45 p<0.01 when SES was based on educational level. The Negative Binomial Regression model resulted more appropriate than the Poisson model because the dispersion parameter was significantly different from zero (alpha=1.5, 95% CI=1.3-1.8). Working class status showed significant association with DMFS (p=0.04) while using DS as dependent variable, working class subjects and subjects with medium-low and low educational level, showed a statistically significant association. CONCLUSION: Socioeconomic status is still a predictor for dental decay in the Italian 14-year-olds.

Validity of partial protocols to assess the prevalence of periodontal outcomes and associated sociodemographic and behavior factors in adolescents and young adults.

BACKGROUND: Most studies comparing prevalence of periodontal disease and risk factors by using partial protocols were performed in adult populations, with several studies being conducted in clinical settings. The aim of this study is to assess the accuracy of partial protocols in estimating the prevalence of periodontal outcomes in adolescents and young adults from two population-based birth cohorts from Pelotas, Brazil, and to assess differences in the estimation and strength of the effect measures when partial protocols are adopted compared to full-mouth examination. METHODS: Gingival bleeding at probing among adolescents (n = 339) and young adults (n = 720) and dental calculus and periodontal probing depth among young adults were assessed using full-mouth examinations and four partial protocols: Ramfjord teeth (RT), community periodontal index (CPI), and two random diagonal quadrants (1 and 3, 2 and 4). Socioeconomic, demographic, and periodontal health-related variables were also collected. Sensitivity, absolute and relative bias, and inflation factors were calculated. Prevalence ratio for each periodontal outcome for the risk factors was estimated. RESULTS: Two diagonal quadrants showed better accuracy; RT had the worst, whereas CPI presented an intermediate pattern when compared to full-mouth examination. For bleeding assessment in adolescence, RT and CPI underestimated by 18.4% and 16.2%, respectively, the true outcome prevalence, whereas among young adults, all partial protocols underestimated the prevalence. All partial protocols presented similar magnitude of association measures for all investigated periodontal potential risk factors. CONCLUSION: Two diagonal quadrants protocol may be effective in identifying the risk factors for the most relevant periodontal outcomes in adolescence and in young adulthood.

Dental health of children with autism spectrum disorders: a population-based study.

Data from the 2007 National Survey of Children's Health were used to investigate how autism spectrum disorder (ASD) symptom severity and comorbidity are associated with the dental health needs of children. The results of this study help provide insights into the greater oral needs of the increasing population of children with ASD that reside in our communities and their dependency upon local practitioners for treatment.