Childhood caries management in the European Union: A cross-sectional study.

OBJECTIVES: Dental caries is one of the most widespread childhood diseases worldwide, although it is largely preventable. In Europe, there is an observable difference between caries prevalence in Eastern and Western European states. This study aimed to gather data on the characteristics of publicly financed dental preventive services for children in European Union (EU) member states. METHODS: Data on important indicators were collected through an online survey. National and international professional bodies specializing in pediatric dentistry and dental services were invited to participate in the study. Descriptive statistics and information gain were applied in the analysis to identify the strongest indicators of the availability and content of childhood caries services. Additionally, the reimbursement characteristics were examined. RESULTS: We received responses from 27 EU member states. The accessibility and assessment of dental preventive services among the member states vary notably. The frequency of screenings and the screened age groups differ by country and free screenings for preschool children are not common. Monitoring systems were present in only 37% of the responding countries, but brief dental interventions are available to promote caries prevention in 25 of the 27 countries. However, these interventions are mainly focused on basic oral health education. Regarding the reimbursement characteristics, we found that the amount of reimbursement is larger for higher-cost treatments targeting already developed caries than for cost-effective preventive treatments, which are less likely publicly financed. CONCLUSIONS: The prevention of dental caries is part of oral health promotion and education efforts in the EU; unlike the treatment of already developed dental caries, the accessibility of clinical prevention services is limited and usually not free for children. Further comprehensive studies are necessary to identify key indicators for international assessment and facilitate the standardization of the screening process, thus promoting the collection of comparable data.

The Burden of Early Childhood Caries in Children under 5 Years Old in the European Union and Associated Risk Factors: An Ecological Study.

The associations among early childhood caries (ECC), socioeconomic status, and sugar consumption are of the utmost importance, due to their potential policy implications. The purpose of this study was to identify trends in ECC burden in children under 5 years old among European Union (EU) member states over time and to evaluate the relationship with its risk factors. Global Burden of Disease 2019 data were analyzed to estimate the burden of ECC over time, specifically incidence, prevalence, and years lived with disability (YLDs) for children under 5 years old. Four ecological variables with a potential effect on YLDs for ECC were used to investigate the association between 2014 and 2017. The YLDs rate was consistently higher among Eastern EU countries over time. Univariate models showed a positive significant association between at-risk-of-poverty rate and YLDs rate, while GDP per capita and urbanization were inversely associated with YLDs rate. In the multivariate analysis, sugar consumption, GDP per capita and urbanization showed significant association with YLDs rate. After stratification by region, association remained significant only in the Eastern EU countries between GDP, urbanization, and YLDs rate, while sugar consumption and at-risk-of-poverty rate had no significant impact on YLDs rates. This study found increasing ECC burden in the EU. The complexity of the problem indicates the need for innovative and personalized policy approaches to tackle the disease.

Clinical Effectiveness and Cost-Effectiveness of Oral-Health Promotion in Dental Caries Prevention among Children: Systematic Review and Meta-Analysis.

The objective of this study was to evaluate the clinical effectiveness and cost-effectiveness of oral-health promotion programs (OHPPs) aiming to improve children's knowledge of favorable oral health behavior to lower decayed/-missing/-filled teeth (DMFT) while reducing the financial cost on health institutions. An electronic search was performed in seven databases. Studies were restricted to human interventions published in English. The search study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and the risk of bias was assessed based on the Drummonds Checklist. A total of 1072 references were found. Among these, 19 full texts were included. Most studies had a strong quality. The overall pooled impact of OHPPs estimates children suffering from DMFT/S to have 81% lower odds of participating in OHPP (95% CI 61-90%, I2: 98.3%, p = 0). Furthermore, the program was shown to be effective at lowering the cost in 97 out of 100 OHPPs (95% CI 89-99%, I2: 99%, p = 0). Three subgroups analyses (age groups, study countries, studies of the last five years) were performed to evaluate the influence modification on the pooled effect. A comprehensive analysis of the OHPPs confirmed a reduction effect on child DMFT, hence, lowering the financial burden of dental-care treatment on health institutions.

Patent Landscape Analysis of Dental Caries in Primary Teeth.

Inventions from the field of health research are mostly protected by patents. The main objective of this study is to identify the research and development trends of dental innovations for children, with a special focus on the inventions for dental caries in primary teeth and early childhood caries (ECC) by performing a patent landscape analysis on a global scale with special attention to the role of European countries in patenting activities. A patent landscape analysis is a tool used to identify trends in different areas of innovations. Patents and patent applications were extracted from Orbit Intelligence. The keyword based search process was refined by manual selection and grouped into prevention, treatment and diagnosis categories. The absolute number and legal status of patent families, priority years, priority countries, and assignees were examined. The total number of patents of dental caries in primary teeth was 61. According to the legal status of the patents, 27% are granted, 19% pending and 54% are dead. The earliest patent is from 1931 and the most recent is from 2018. Regarding the field of inventions, 37 patents were identified as prevention, 16 patents were treatment and 8 were diagnostics related. China holds the most patents. The huge burden of dental caries in primary teeth is poorly represented in global research and development. Additionally, inventions in dental caries of the primary dentition from the European Union lagged far behind China and the US, highlighting our insufficient research initiatives and programs.