Associations between school-based fluoride mouth-rinse program, medical-dental expense subsidy policy, and children's oral health in Japan: an ecological study.

BACKGROUND: Dental caries are a common non-communicable disease among children. As a public health measure at the prefectural level, school-based fluoride mouth-rinse (S-FMR) program, medical/dental expense subsidy policies, and other factors may reduce the incidence of dental caries and tooth loss. Prefectures focusing on promoting oral health policies may promote both, but the interaction effect of implementing both subsidy policies and S-FMR at the prefectural level on caries prevention has not yet been examined. METHODS: We conducted an ecological study using two-wave panel data, prefecture-level aggregated data in Japan for 2016 and 2018. Coefficient and 95% confidence intervals (CI) were calculated for the dependent variables for oral health using mixed-effects linear regression analysis adjusted for possible confounders. Two dependent variables were used; the standardized claim ratio (SCR) of deciduous tooth extraction and 12-year-olds' decayed, missing, or filled permanent teeth (DMFT). Four independent variables were S-FMR, the SCR of dental sealants, prefectural income per person, and subsidy policy in three models: co-payment until children enter elementary school (n = 23), no co-payment until children enter elementary school (n = 7), and co-payment continuing beyond elementary school (n = 17). The effects of six interaction terms, each representing a unique pairing from the four independent variables, were individually calculated. RESULTS: S-FMR was negatively associated with the SCR of deciduous tooth extractions and DMFT (coefficient = -0.11, 95% CI -0.20; -0.01 and coefficient = -0.003, 95% CI -0.005; -0.001, respectively). No co-payment until children enter elementary school was positively associated with the SCR of deciduous tooth extraction compared to co-payment until children enter elementary school(coefficient = 11.42, 95% CI 3.29; 19.55). SCR of dental sealants was positively associated with the SCR of deciduous tooth extractions (coefficient = 0.12, 95% CI 0.06; 0.19) but negatively associated with DMFT (coefficient = -0.001, 95% CI -0.003; -0.0001). Per capita prefectural income was positively associated with the SCR of deciduous tooth extractions(coefficient = 0.01, 95% CI 0.001; 0.02). No interaction was found between S-FMR and the subsidy policy at both outcomes. CONCLUSION: High S-FMR utilization and no co-payment until children enter elementary school were associated with fewer deciduous tooth extractions. Also, S-FMR and dental sealant were associated with decreased DMFT.

Socio-economic status and access to fluoridated water in Queensland: an ecological data linkage study.

OBJECTIVES: To investigate the relationship between access to fluoridated drinking water and area-level socio-economic status in Queensland. STUDY DESIGN: Ecological, geospatial data linkage study. SETTING: Queensland, by statistical area level 2 (SA2), 2021. MAIN OUTCOME MEASURES: Proportion of SA2s and of residents with access to fluoridated drinking water (natural or supplemented); relationship at SA2 level between access to fluoridated water and socio-economic status (Index of Relative Socio-economic Advantage and Disadvantage, IRSAD; Index of Economic Resources, IER). RESULTS: In 2021, an estimated 4 050 168 people (79.4% of the population) and 397 SA2 regions (72.7%) in Queensland had access to fluoridated water. Access was concentrated in the southeastern corner of the state. After adjusting for SA2 population, log area, and population density, the likelihood of access to fluoridated drinking water almost doubled for each 100-rank increase in IRSAD (adjusted odds ratio [aOR], 1.93; 95% confidence interval [CI], 1.59-2.36) or IER (aOR, 1.77; 95% CI, 1.50-2.11). CONCLUSIONS: The 2012 decision to devolve responsibility for water fluoridation decisions and funding from the Queensland government to local councils means that residents in lower socio-economic areas are less likely to have access to fluoridated water than those in more advantaged areas, exacerbating their already greater risk of dental disease. Queensland water fluoridation policy should be revised so that all residents can benefit from this evidence-based public health intervention for reducing the prevalence of dental caries.

Economic inequalities in decayed, missing, and filled first permanent molars among 8-12 years old Iranian schoolchildren.

BACKGROUND: First permanent molars (FPM) play an important role in the masticatory function and oral health. This study aimed to assess the economic inequalities of FPM health indices among schoolchildren in the northeast of Iran. METHODS: A total of 4051 children aged 8-12 years old were included in the analyses of this cross-sectional study in 2015. Economic status was measured using the principal component analysis on home assets. Concentration index (C) was used to measure economic inequality in FPM health indices, and its contributing factors determined by Wagstaff decomposition technique. RESULTS: The prevalence of having decayed, missing, and filled FPMs among children was 40.9% (95% CI: 38.8-43.0), 1.2% (95% CI: 0.8-1.6%), and 7.8% (95% CI: 6.7-8.9%), respectively. Missing FPM was generally more concentrated among low-economic children (C=-0.158), whereas, filled FPM was more concentrated on high-economic children (C = 0.223). Economic status, mother education, having a housekeeper mother, and overweight/obesity, contributed to the measured inequality in missing FPM by 98.7%, 97.5%, 64.4%, and 11.2%, respectively. Furthermore, 88.9%, 24.1%, 14.5%, and 13.2% of filled FPM inequality was attributable to children's economic status, father education, residence in rural areas, and age, respectively. CONCLUSION: There is a significant economic inequality in both missing and filled FPM. This inequality can be attributed to the economic status of individuals. To reduce FPM extraction, it is important to target low-income and rural children and provide them with FPM restoration services. Additionally, it is necessary to provide training to less-educated parents and housekeeper mothers to address the observed inequalities.

Oral health and caries risk profile assessment using the the Cariogram in thalassemia patients with or without splenectomy: A cross-sectional study.

BACKGROUND: Splenectomy is performed in ß-thalassemia cases due to the destruction of red blood cells (RBCs), and the consequent splenomegaly. OBJECTIVES: The aim of the present study was to compare oral health and the caries risk between ß-thalassemia patients with or without splenectomy, using the Cariogram. MATERIAL AND METHODS: In a cross-sectional study carried out in both the Maternity and Children Hospital and the King Fahad Hospital, Al-Madinah al-Munawwarah, Saudi Arabia, interviews, salivary sampling and oral clinical examinations were performed on 60 children and adolescents with ß-thalassemia major (mean age: 13 ±3 years; 65% with splenectomy). The Cariogram program was used to calculate the caries risk. The main outcome measures were the number of decayed, missing due to caries, and filled teeth (DMFT), plaque and gingival indices, and the caries risk. RESULTS: Of individuals with and without splenectomy, tooth brushing was reported in 49% and 57%, respectively (p > 0.05). Individuals with splenectomy had lower plaque and gingival bleeding scores (p ≤ 0.05). Salivary secretion was identical in both groups. Caries experience and the caries risk were higher in individuals without splenectomy (p > 0.05 and p ≤ 0.05, respectively). CONCLUSIONS: Within the study limitations, children and adolescents with ß-thalassemia had high plaque and gingival bleeding scores, as well as caries experience and caries risk. Those with splenectomy demonstrated lower figures than those without. Individuals with ß-thalassemia, particularly those with splenectomy, need to be educated about the oral side effects of the disease and its treatment.

Assessing Adherence to Provider's Recommendations in Caries Risk Assessment and Management: A Retrospective Data Review.

AIM: To evaluate the distribution of caries risk category of patients at a dental institution and determine adherence to providers' recommendations. MATERIALS AND METHODS: A cross-sectional retrospective review of 1,235 patients records that included data collection on demographics, the sum of the number of decayed, missing due to caries, and filled teeth in the permanent teeth (DMFT), presence of frequent snacking, stimulated salivary flow rate, stimulated saliva pH, saliva buffering capacity, biofilm activity, caries risk category, anti-caries prescription accept/decline, and change in the caries risk category. Statistical analysis was carried out through Pearson's Chi-squared test and linear model ANOVA with a significance level of 0.05. RESULTS: Pearson's Chi-squared test showed a statistically significant difference in frequency by risk category (p < 0.001) indicating that patients were skewed toward high and extreme caries risk. Linear model ANOVA showed that higher risk categories were associated with lower salivary flow rates (p = 0.010) and higher biofilm activity (p < 0.001). About, 1 out of 3 patients were reported to have frequent snacking (N = 391, 32%). Frequent snacking patients were more likely to present with higher caries risk assessment (p < 0.001), younger age (p < 0.001), and female (p < 0.001). Despite recommendations from the dental student provider, only 27% accepted the anti-cavity prescriptions while 61% declined the recommendation. CONCLUSION: Distribution of caries risk category is not evenly distributed, but rather skewed toward high and extreme caries risk levels. Despite the identified risks, there is low adherence to the recommendations provided by healthcare providers. The results underscore the necessity for targeted interventions and initiatives aimed at fostering behavioral changes to enhance oral health outcomes. CLINICAL SIGNIFICANCE: There is a high need for targeted interventions and initiatives that promote behavioral changes to enhance oral health outcomes.

Decomposing socioeconomic inequalities in dental caries among Chinese adults: findings from the 4th national oral health survey.

OBJECTIVE: This cross-sectional study aimed to investigate socioeconomic inequalities in dental caries among adults (35 years and older) in China and explore the contributions of various factors to these inequalities. METHODS: This study included 10,983 adults (3,674 aged 35-44 years, 3,769 aged 55-64 years and 3,540 aged 65-74 years) who participated in the 4th National Oral Health Survey (2015-2016) in China. Dental caries status was evaluated by the decayed, missing and filled teeth (DMFT) index. Concentration indices (CIs) were applied to quantify the different degrees of socioeconomic-related inequality in DMFT, decayed teeth with crown or root caries (DT), missing teeth due to caries or other reasons (MT), and filled teeth without any primary or secondary caries (FT) among adults of different age groups. Decomposition analyses were conducted to identify the determinants and their associations with inequalities in DMFT. RESULTS: The significant negative CI indicated that DMFT for the total sample were concentrated among socioeconomically disadvantaged adults (CI = - 0.06; 95% confidence interval [CI], - 0.073 to - 0.047). The CIs for DMFT for adults aged 55-64 and 65-74 years were - 0.038 (95% CI, - 0.057 to - 0.018) and - 0.039 (95% CI, - 0.056 to - 0.023), respectively, while the CI for DMFT for adults aged 35-44 years was not statistically significant (CI = - 0.002; 95% CI, - 0.022 to 0.018). The concentration indices of DT were negative and concentrated in disadvantaged populations, while FT showed pro-rich inequalities in all age groups. Decomposition analyses showed that age, education level, toothbrushing frequency, income and type of insurance contributed substantially to socioeconomic inequalities, accounting for 47.9%, 29.9%, 24.5%,19.1%, and 15.3%, respectively. CONCLUSION: Dental caries was disproportionately concentrated among socioeconomically disadvantaged adults in China. The results of these decomposition analyses are informative for policy-makers attempting to develop targeted health policy recommendations to reduce dental caries inequalities in China.

Socio-economic status, psychosocial factors, health behaviours and incidence of dental caries in 12-year-old children living in deprived communities in Manaus, Brazil.

OBJECTIVES: This study examines the relationships between socio-economic status, psychosocial factors, health-related behaviours and the incidence of dental caries amongst 12-year-old schoolchildren living in deprived communities in Manaus, Brazil. METHODS: A longitudinal study involving 312 children aged 12 years was conducted in the city of Manaus, Brazil. Baseline data including socio-economic status (number of goods, household overcrowding, parents' schooling, family income), psychosocial factors (sense of coherence [SOC-13], social support [Social Support Appraisals questionnaire]) and health-related behaviours (frequency of toothbrushing, sugar consumption, sedentary behaviour) were collected through structured questionnaires. The number of decayed teeth was clinically assessed at baseline and one-year follow-up. A hypothesised model evaluating the direct and indirect pathways between the variables was tested using confirmatory factor analysis and structural equation modelling. RESULTS: The incidence of dental caries at the one-year follow-up was 25.6%. Sugar consumption (ß = 0.103) and sedentary behaviour (ß = 0.102) directly predicted the incidence of dental caries. A higher socio-economic status was directly linked with lower sugar consumption (ß = -0.243) and higher sedentary behaviour (ß = 0.227). Higher social support directly predicted lower sugar consumption (ß = -0.114). Lower socio-economic status (ß = -0.046) and lower social support (ß = -0.026) indirectly predicted the incidence of dental caries via sugar consumption and sedentary behaviour. CONCLUSIONS: In the population studied, sugar consumption and sedentary behaviour are meaningful predictors of the incidence of dental caries amongst schoolchildren living in deprived communities. Indirect pathways of lower socio-economic status and low social support with dental caries incidence via sugar consumption and sedentary behaviour were detected. These findings should be considered in oral interventions and oral health care policies to prevent dental caries amongst children living in deprivation. CLINICAL SIGNIFICANCE: Social conditions, social support, sedentary behaviour and sugar consumption directly influence dental caries in children.

Assessment of Oral Health Knowledge, Attitude, Practice and DMFT Scores among Patients at King Faisal University, Al-Ahsa.

Background and Objectives: Oral health is one of the most significant issues in public health. The Decayed, Missing, and Filled Teeth (DMFT) Index is a useful tool for assessing and measuring the state of oral health in a community. This study aimed to evaluate oral health knowledge, attitudes, and practices among participants who visited a dental clinic at King Faisal University and to evaluate their DMFT scores. Materials and Methods: This cross-sectional, questionnaire-based study was conducted at the King Faisal University dental complex, Kingdom of Saudi Arabia, using a simple random sampling technique. The data were collected using a self-administered structured questionnaire in English and Arabic. All statistical analyses were carried out using the SPSS 20 software. A chi square and ANOVA test were used to assess the association. A p value of <0.05 was considered statistically significant. Results: There were a total of 260 participants, of whom 193 (74.2%) were male and 67 (25.8%) were female. Most participants, 173 (66.5%), were between the ages of 18 and 28. The majority of the participants 191 (73.5%) believed that bad oral hygiene led to gum disease. Additionally, major issues while visiting dental clinics, the importance of routine dental clinic visits, the existence of a connection between oral and general health, brushing time and frequency of change of used brush were significantly influenced by gender (p < 0.05). In terms of the DMFT index, mean numbers of decaying teeth (D) were 4.82 ± 4.15, mean numbers of missing teeth (M) were 1.56 ± 2.94, mean numbers of filled teeth (F) were 5.17 ± 5.28 and mean DMFT score was 11.56 ± 6.32, with a statistically significant difference observed (p < 0.001). Conclusions: This study concluded that, although some of the study participants neglected oral hygiene practices, the majority of participants had good knowledge and attitudes regarding the significance of oral hygiene. Owing to inadequate practices, the decayed, missing, and filled teeth scores increased with increasing age. Additionally, gender had no significant impact on the mean scores for decayed, missing, and filled teeth, although there were significant differences between age groups.

Assessment of dental caries among a group of institutionalized orphan children compared to parented school children: case-control study.

BACKGROUND: It has been well documented that the absence of family support influences the general and oral health of children. Literature regarding the oral health status of institutionalized orphan children, who lost their families' support, especially in Egypt, remains vague. Therefore, the current study was carried out to assess dental caries among two groups of institutionalized orphan children, and compare their results with a group of parented school children in Giza, Egypt. METHODS: A total of 156 children were included in this study, residing in a non-governmental orphanage, a governmental orphanage, and parented children attending private primary school. Written informed consent was obtained before the start of the study from the legal guardians or the child's parent. The dental examination was carried out as recommended by the WHO. DMF and def indices were used to assess dental caries for primary and permanent teeth. Also, the unmet treatment needs index, care index, and significant caries index were calculated. RESULTS: The results revealed that mean values for DMF total score were 1.86 ± 2.96, 1.80 ± 2.54, and 0.7 5 ± 1.29 for, non-governmental, governmental orphanages, and school children respectively. While the mean def total scores were 1.69 ± 2.58, 0.41 ± 0.89, and 0.85 ± 1.79 for non-governmental, governmental orphanages, and school children, respectively. There was a high level of unmet treatment needs, especially among orphans. The significant caries index was 2.5, 4.29, and 2.17 for, non-governmental, governmental orphanages, and school children, respectively. CONCLUSIONS: Within the limitation of this case-control study, the institutionalized orphanage children had a high prevalence of dental caries and worse caries experience compared to parented school children. Effective oral health preventive strategies are required to improve the oral health status and oral health practices of those children. TRIAL REGISTRATION: The trial was registered on ClinicalTrial.gov (ID: NCT05652231).

National Oral Health Policy and Financing and Dental Health Status in 19 Countries.

OBJECTIVE: Dental caries in permanent teeth is one of the most common health issues-despite being preventable in early stages-due to inadequate regulation of preventive dental services in many countries. This study evaluates the association between regulation of preventive dental services and oral health outcomes. METHODS: This mixed-method study analysed data from 19 member countries of the Organisation for Economic Co-operation and Development (OECD). Oral health outcomes were measured using decayed missing and filled teeth (DMFT) indexes for children aged 12 to 18 years. Oral health expenditures were measured as a percentage of each country's gross domestic product (GDP). We conducted web-based research and systematically extracted and coded data on dental policy regarding children's preventive dental services. Preventive care was assessed based on legal policy mandating children receive preventive services, availability of free services for children, and regulation of the services provided. We assessed the relationship amongst oral health policy, outcomes, and expenditure using bivariate regression analysis. RESULTS: The most common preventive policy category is the availability of free dental services for children (78.95%), and the least common is policy mandating dental services for children (26.32%). The oral health expenditure is correlated with DMFT index (-4.42, P < 0.05). The legal policy mandating dental services for children is correlated with DMFT index (-1.32, P < 0.05) and correlated with average oral health expenditure (0.16, P < 0.05). CONCLUSIONS: A percentage increase in oral health expenditure is associated with a 4.42 reduction in DMFT. The existence of legal policy mandating dental care for children is associated with a 1.32 reduction in mean DMFT score and a 0.16% increase in oral health expenditure. These findings highlight the importance of preventive care and may aid policymaking and health system reforms.

Assessment of oral health status and related factors in adolescents aged 12-15 years in the Gansu Province of China: a cross-sectional survey.

BACKGROUND: The national oral epidemiological survey conducted every decade has become an indispensable means of detecting changes in oral disease patterns. This study was undertaken to investigate the oral health status and related factors in 12-15-year-old students in Gansu, China. METHODS: According to the methodology adopted by the Fourth National Oral Health Survey, a multi-stage, stratified, random sampling method was used to select 3871 adolescents aged 12-15 years from four regions of Gansu Province for oral examination and questionnaire survey. Caries experience was measured using the Decayed, Missing, and Filled Teeth (DMFT) index; and periodontal health examination included gingival bleeding, calculus, periodontal pockets and attachment loss. The questionnaire included questions regarding sociodemographic characteristics, and oral health knowledge and behaviors. SPSS20.0 software was used for statistical analysis of the survey data. RESULTS: The mean DMFT index was 0.83 ± 1.42. The prevalence of caries experience was 38.6%, filling rate was 1.6%, and pit and fissure sealing rate was 0.5%. Logistic regression analysis showed that female sex, rural district, older age, non-only child, frequency of dental visits, and toothache experience were the risk factors for caries experience, with OR ranging between 1.280 and 3.831 (p < 0.05). Prevalence of healthy periodontium was 29.8%. Female sex, rural district, and younger age were found to be the protective factors for healthy periodontium, with OR ranging between 1.178 and 1.414 (p < 0.05). CONCLUSIONS: Adolescents in Gansu Province had high prevalence of caries experience along with low filling rate, and low prevalence of healthy periodontium. Therefore, it is necessary to vigorously strengthen oral health education, disease prevention and control programs in the province. This would help improve the oral health-related quality of life of these individuals.

Classification of a patient's caries activity based on lesion activity assessment among adults: findings from a prospective cohort study.

OBJECTIVE: To investigate whether the classification of a patient's caries activity based on lesion activity assessment can predict the increment and progression of coronal and root caries lesions among adults. METHODS: This population-based prospective cohort study followed 413 individuals (mean age 54.1) from southern Brazil for 4 years. Data collection included a questionnaire and clinical examination to record coronal/root caries and gingival recession. The main outcomes were caries increment measured as decayed, missing and filled tooth surfaces (DMFS) and caries progression (surface-level analysis). The main predictor variable was patients' caries activity at baseline ("caries-inactive" or "caries-active"). Negative binomial regression models (unadjusted and adjusted) were used. RESULTS: Caries-active individuals were more likely to present DMFS increment than caries-inactive ones when migrations among DMFS components were considered (IRR [incidence risk ratio] = 1.26, 95%CI [confidence interval] = 1.01-1.58). On the other hand, no such association was found when these migrations were disregarded. The risk for coronal caries progression on filled surfaces was 90% higher among caries-active patients (IRR=1.9; 95%CI=1.4-2.6). In addition, patient's caries activity was able to predict higher risk for root caries progression in newly exposed root surfaces (IRR=1.9; 95%CI=1.0-3.6). CONCLUSION: The classification of a patient's caries activity based on lesion activity was able to foresee lesion progression on the coronal and root surfaces more susceptible to caries among adults. Clinical relevance Classifying a patient's caries activity is a useful tool for the clinical management of dental caries in adults.

Risk indicators for dental caries, and gingivitis among 6-11-year-old children in Nigeria: a household-based survey.

BACKGROUND: There is little is known about the factors associated with caries experience and gingivitis among 6-11-year-old children in Nigeria. The aim of the study was to determine the prevalence and preventive oral health behaviors associated with caries and gingivitis among 6-11-year-old children in Nigeria. METHODS: A cross-sectional questionnaire-based survey was conducted in Ile-Ife, Nigeria. The dependent variables were caries and gingivitis. The dmft/DMFT index was used to assess dental caries experience (present or absent) and caries severity. The gingival index was used to assess the prevalence (present or absent) and severity of gingivitis (healthy gingiva/mild gingivitis versus moderate/severe gingivitis). The independent variables were preventive oral health behaviors (frequency of daily tooth brushing, frequency of consumption of refined carbohydrates in-between-meals, use of fluoridated toothpaste, and use of dental floss, history of dental service utilization). A series of logistic regression analysis models were constructed to determine the associations between the dependent and independent variables after adjusting for confounders (age, sex, and socioeconomic status). RESULTS: There were 69 (5.2%) children with caries. The mean (standard deviation) dmft was 0.08 (0.457) and the mean DMFT was 0.02 (0.159). There were 839 (63.3%) children with gingivitis with a mean (SD) gingival index score of 0.503 (0.453). Children who seldom or never used fluoride toothpaste had significantly higher odds of developing moderate to severe gingivitis (AOR; 1.671; 95% CI: 1.003-2.786; p = 0.049). Children with middle socio-economic status had significantly lower odds of developing moderate to severe gingivitis (AOR: 0.573; 95%CI: 0.330-0.994; p = 0.048). There were no risk indicators identified for caries. CONCLUSION: The prevalence of dental caries was low while the prevalence of gingivitis was high in the study population. The daily used of fluoridated toothpaste seem to reduce the risk for moderate/severe gingivitis. Further studies are needed to understand these findings.

Caries experience scores revisited for caries risk assessment using cariogram model - A cross-sectional study.

Context: The widely accepted caries risk assessment tools such as the Cariogram model needs modifications in the scoring of different factors for reliable results. Aims: The study was aimed to report the caries experience in 3-60 years of the Rajasthan population and to apply the newly derived average decayed exfoliated filled teeth/Decayed Missing Filled Teeth (deft/DMFT) scores in the Cariogram model to assess the caries risk. Settings and Design: The cross-sectional study was planned in the Department of Dentistry and a total of 500 participants were equally divided into five groups (3-6, 7-12, 13-30, 31-44, and 45-60 years) were included. Methods and Material: All participants were examined for caries detection using deft/DMFT, ICDAS, and CAST indices according to the predefined protocol. A single examiner evaluated the participants in a dental operatory and data was recorded. Statistical Analysis Used: One-Way ANOVA and Tukey's Post-Hoc tests were used to evaluate the significant difference between the groups of each caries index. Results: A statistically significant difference was observed between the mean deft/DMFT and CAST scores of 3-6, 7-12, and 13-30 age groups with the 45-60 years age group. Caries prevalence was highest (83%) in 31-44 and 45-60 year age groups and lowest (51%) in the 3-6 year age group. Conclusions: Caries experience scores increase as the age increases and the highest scores were observed in 31-44 and 45-60 year age groups and the lowest were observed in the 3-6 year age group. The average ICDAS and CAST scores were higher when compared to the deft/DMFT index.

Comparison of Contributing Risk Factors for Primary Tooth Caries in Down Syndrome and Non-Special Health Needs Children.

Purpose: To evaluate decayed, missing, and filled surfaces in primary teeth (dmfs) in Down syndrome subjects (DS) compared to typically developed (TD) controls using analysis. Methods: A retrospective study of 440 matched subjects (220 DS and 220 TD) was conducted. Categorical variables were evaluated for association with dental caries, with mean dmfs as the main outcome measure. Pearson's chi-square and independent sample t-tests for unequal variances for means were employed. Results: Overall, the TD control group was found to have significantly higher mean dmfs scores than the DS group: TD Equals 17.65 (mean dmfs), 95% confidence interval (CI) equals 15.48 to 19.90; DS equals 10.30 (mean dmfs), at 95% CI equals 7.96 to 12.78, (P<0.001). However, when controlled for the variable factors African American status (P=0.11), Hispanic status (P=0.07) and income level at or below 200 percent of poverty level (P=0.24) there was no significant difference in mean dmfs. Conclusions: In the study population DS and TD exhibited dissimilar dmfs scores, while when taking into consideration social and economic factors dmfs was equivalent. Caries risk factors modulate disease experience and should be considered in all population-specific studies. Patients with multiple high-risk factors should be treated as such, regardless of DS status.

Assessment of oral health status and treatment needs of HIV positive transgenders in Odisha - a cross-sectional study.

Introduction: Human Immunodeficiency virus (HIV) causes the human immunodeficiency infection which is a major global health problem. Oral health status of people infected by HIV is also compromised. There is limited literature on oral health status of HIV/AIDS transgenders in Odisha. Aim: This study was conducted to assess the oral health status of HIV-positive transgenders. Methodology: A cross-sectional study was conducted among the HIV positive transgenders in Odisha. Snowball sampling technique was employed to reach the population. Oral health was recorded using modified WHO 2013 proforma. Clinical examination using disposable mouth mirror and explorer. Chi square statistics was used for finding the association between the socio-demographic variables and DMFT, CPI, and LOA scores. Results: The study included 153 participants out of which seventy participants belonged to the age group 18-30 years. Majority of the participants were unemployed and most of them had spent around 6-10 years in school. Majority of the participants used toothbrush for cleaning their teeth and the average duration of cleaning tooth was less than two minutes. Toothpick was the most common method used for cleaning interdental areas and none of the participants used dental floss or interdental brushes. The mean DMFT score which was recorded to be 1.424. Around 28.10% (43) inmates had pockets of depth 4 mm to 5 mm. Loss of attachment of 6 mm to 8 mm was found in majority (57, 37.25%) of the participants. Most of the participants did not require any prosthesis both in the upper and lower arches. Around 32 participants (20.91%) had very mild fluorosis, 29 participants (18.95%) exhibited signs of moderate fluorosis. Age was found to be significantly associated with loss of attachment score (p = 0.023). Occupation had an association with the DMFT score (p = 0.002) while years in school was found to be significantly associated with CPI score (p = 0.045). Conclusion: The oral health status of transgenders is poor and needs immediate attention.

The Assessment of Early Server Childhood Caries Status in Abandoned Institutionalized Children.

Oral health is a critical indicator of children's quality of life, which at this early age, depends exclusively on the attention, involvement, and guidance of parents or caregivers. Assessing carious damage and measuring the prevalence of early severe tooth decay in temporary teeth in children is obtained by calculating the dmft index, giving the sum of an individual's decayed, missing, and filled teeth. The aim of our study was to conduct a clinical examination of the oral status of institutionalized children from Romania. We selected and included in the study 144 children, both boys and girls in equal number, with ages of five or six years old, from which 110 were eligible for the study and met the inclusion criteria. Of all children, 20.90% were five years old girls, 27.27% five years old boys, 26.36% six years old girls, and 25.46% six years old boys. Of all, 10,45% had more than three incisors presenting decays, equally affected by gender. Of the boys' group, 20% of age six had more de two canines affected, and 26.7% of five years old girls had more than three affected canines. Of the five years boys' group, 24.3% had more than three affected temporary molars, 44.9% of six years boys had more than five. Of the five years old girls, 33.3% had more than four temporary molars affected and, 56.6% of the six years old girls' group had more than five molars presenting carious lesions. The dental status and dmft values were similar for five years old and six years old children and similar boys and girls. Due to the vulnerability of young children that consists not only in their inability to identify, express, and address their own needs but also the lack of parental support, lack of an optimal diet for age, and proper hygiene, they reach adolescence with an impaired dental status, inappropriate for their age.

Impact of socioeconomic inequalities on dental caries in deprived children: a multilevel analysis.

OBJECTIVES: Inequalities have been reported between high, middle and low socioeconomic position (SEP) children. However, the effect of contextual and individual SEP on existing inequalities among socioeconomically deprived children varies between local contexts. The aim of this study was to assess the impact of contextual and individual SEP on individual caries experience among socioeconomically deprived children in Chile. METHODS: Cross-sectional multilevel analysis of data from the 2015 electronic register of the National Board of School Aid and Scholarships (JUNAEB) of Chile. The contextual variables were the municipality Human Development Index (HDI) and rurality index. Individual variables included gender, living in extreme poverty and school grade. Multilevel negative binomial models assessed their impact on DMFT/dmft. RESULTS: 112,429 children in 255 municipalities were included. Overall, contextual SEP (HDI) was not associated with caries experience in the primary or permanent dentition. Individual SEP (living in extreme poverty) was associated with caries experience in both dentitions. The proportion of children living in extreme poverty with caries experience in the primary teeth was 17% higher than children not living in extreme poverty (PR 1.17; 95% CI 1.15-1.19), while for children with permanent teeth it was 9% higher (PR 1.09; 95% CI 1.08-1.11). CONCLUSION: These findings could support the development of health strategies focused on individual SEP to efficiently reduce oral health inequalities among socioeconomically deprived children.

Inequalities in caries among pre-school Italian children with different background.

BACKGROUND: The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient. METHODS: The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.8% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) was estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated, children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic and logistic regression) were used to elucidate the associations between all explanatory variables and caries prevalence. RESULTS: Overall, 54.4% (95%CI 46.7-58.3%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.6% vs 41.6% p < 0.01) and to the area of living (p = 0.03). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z = 5.24, p < 0.01). Children in the highest household income group had lower levels of caries. In multivariate analysis, Immigrant status, the highest parents' occupational and educational level, only one kid in the family, living in the North-Western Italian area and a high household income, were statistically significant associated (p = 0.01) to caries prevalence. The social gradient was statistically significant associated (p < 0.01) to the different caries levels and experience in children with European background. CONCLUSIONS: Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background.

Oral health profile status and treatment needs in the Salvadoran elderly population: a cross-sectional study.

INTRODUCTION: Older adults are a highly vulnerable group in their general health condition, including oral health that can be influenced by different factors, among them, changes in oral tissues inherent to the physiological processes of aging and by systemic condition. In El Salvador, it is a group that has received little attention at the public health level. OBJECTIVE: To determine the profile of the oral health status and treatment needs of the elderly population in El Salvador. MATERIALS AND METHODS: Secondary cross-sectional analysis of data from the last oral health survey in 471 Salvadorans aged 60 years and older. The variables under study were: sociodemographics, brushing frequency, oral hygiene according to simplified oral hygiene index (OHI-S), caries experience according to decayed, missing, and filled teeth index (DMFT) modified with international caries detection and assessment system (ICDAS) criteria, periodontal status through the community periodontal index of treatment needs (CPITN), edentulism and treatment needs. Statistical analysis was conducted using chi-square test, ANOVA, z-test and linear regression (p < 0.05). RESULTS: The older adults presented poor oral hygiene, low brushing frequency, high tooth loss with an average of 16 missing teeth while one third presented total edentulism. Most of the older adults were categorized as having "poor or very Poor" oral hygiene. Almost all respondents presented some degree of periodontal disease and required restorative intervention. CONCLUSION: The oral health status of elderly Salvadoran is poor. Furthermore, the development of public policies and specific oral health strategies aimed at this population is urgent.