Cost-effectiveness and cost-benefit analyses of fluoride varnish for caries prevention in Guangxi, China.

OBJECTIVES: The objectives of this study were to evaluate the cost-effectiveness and cost-benefit of fluoride varnish (FV) interventions for preventing caries in the first permanent molars (FPMs) among children in rural areas in Guangxi, China. METHODS: This study constituted a secondary analysis of data from a randomised controlled trial, analysed from a social perspective. A total of 1,335 children aged 6-8 years in remote rural areas of Guangxi were enrolled in this three-year follow-up controlled study. Children in the experimental group (EG) and the control group (CG) received oral health education and were provided with a toothbrush and toothpaste once every six months. Additionally, FV was applied in the EG. A decision tree model was developed, and single-factor and probabilistic sensitivity analyses were conducted. RESULTS: After three years of intervention, the prevalence of caries in the EG was 50.85%, with an average decayed, missing, and filled teeth (DMFT) index score of 1.12, and that in the CG was 59.04%, with a DMFT index score of 1.36. The total cost of caries intervention and postcaries treatment was 42,719.55 USD for the EG and 46,622.13 USD for the CG. The incremental cost-effectiveness ratio (ICER) of the EG was 25.36 USD per caries prevented, and the cost-benefit ratio (CBR) was 1.74 USD benefits per 1 USD cost. The results of the sensitivity analyses showed that the increase in the average DMFT index score was the largest variable affecting the ICER and CBR. CONCLUSIONS: Compared to oral health education alone, a comprehensive intervention combining FV application with oral health education is more cost-effective and beneficial for preventing caries in the FPMs of children living in economically disadvantaged rural areas. These findings could provide a basis for policy-making and clinical choices to improve children's oral health.

Common risk factors for dental caries and impaired glucose regulation in Guangxi, China.

OBJECTIVES: To assess the prevalence of caries and impaired glucose regulation (IGR) and try to investigate their common risk factors among adult residents in Guangxi province. METHODS: A cross-sectional study was conducted on a sample of 2993 adults from five different areas of Guangxi province. The sociodemographic data, history of personal habits such as diet and physical activities, physical measurements, oral examination results and biochemical laboratory test data were collected to establish a database and prepare a sound research model. Chi-square test and multiple logistic regression were used to analyse the risk factors for dental caries and IGR. RESULTS: The prevalence rate for caries was 85.9%, and the mean DMFT score was 7.35. In multiple logistic regression, after adjustment, education level, occupation, daily consumption of vegetables, weekly consumption of carbonated beverages and weekly exercise were associated with caries (odds ratio [OR]: 2.10, OR: 1.80, OR: 1.40, OR: 2.45, OR: 2.38). The prevalence of IGR was 33.5%, and after adjustment, results showed that occupation, body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, high-density lipoprotein-C levels and low-density lipoprotein-C levels were significantly associated with IGR (OR: 0.80, OR: 1.70, OR: 1.56, OR: 1.88, OR: 1.60, OR: 1.43, OR: 1.48). The strength of association between caries/IGR and risk factors was a weak association or moderate association. CONCLUSIONS: We have not found common risk factors between dental caries and IGR. Therefore, further studies are needed to explore these common risk factors to prevent caries and IGR.

Associations of PART1 and DEFB1 polymorphisms with Dental Caries in twelve-year-old children in Southern China: a cross-sectional study.

OBJECTIVE: The aim of this study was to assess associations of PART1 rs27565 and DEFB1 rs11362 polymorphisms with the prevalence of dental caries in twelve-year-old children in Nandan County, Guangxi, China. METHODS: A total of 1,061 children were included in this cross-sectional study and divided into two groups based on the Decayed, Missing and Filled teeth (DMFT) index: caries-free children (DMFT score = 0) and children with caries (DMFT score ≥ 1). Demographic characteristics, oral hygiene behaviour and dietary habits were collected through household records and questionnaires. Genomic DNA was extracted from buccal cells, and PART1 rs27565 and DEFB1 rs11362 polymorphisms were genotyped using a custom-designed 48-Plex single nucleotide polymorphism-scan kit. RESULTS: Carriers of the PART1 rs27565 C allele (odds ratio [OR] = 1.338, 95% confidence interval (CI) = 1.015-1.764, P value = 0.039) and carriers of the DEFB1 rs11362 T allele (OR = 1.364, 95% CI = 1.056-1.762, P value = 0.017) had a higher risk of caries. Carriers of the PART1 rs27565 TC or CC genotype who ate sugary food more than once a week had a 1.6-fold higher risk of caries than TT carriers who ate sugary food at most once a week (OR = 1.579, 95% CI = 1.032-2.414, P value = 0.035). Carriers of the DEFB1 rs11362 CT or TT genotype who ate sugary food more than once a week had a 2.1-fold higher risk of caries than CC carriers who ate sugary food at most once a week (OR = 2.057, 95% CI = 1.438-2.940, P value < 0.001). CONCLUSION: PART1 rs27565 and DEFB1 rs11362 polymorphisms were associated with caries in 12-year-old children in Nandan County, Guangxi, China. Carriers of the PART1 rs27565 TC or CC genotype and the DEFB1 rs11362 CT or TT genotype who ate sugary food more than once a week had a high probability of having caries.

Laser therapy versus topical desensitising agents in the management of dentine hypersensitivity: A meta-analysis.

OBJECTIVES: To compare the effectiveness of lasers and topical desensitising agent treatments for dentine hypersensitivity. METHODS: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and ISI Web of Knowledge were electronically searched without restrictions. Study search, selection, data extraction and assessment of risk of bias were conducted independently by two reviewer authors. All analyses were performed using Review Manager 5.3 (Cochrane Collaboration). RESULTS: This meta-analysis included 13 eligible studies that compared topical desensitising agents and Nd:YAG or diode laser. Four, six and three studies were considered to have low, moderate and high risks of bias, respectively. The follow-up period varied from immediate to 9 months. All comparisons except the 3-month Nd:YAG laser parallel group and 6-month diode laser group showed that the clinical efficacy of lasers for dentine hypersensitivity was not significantly different with topical desensitising agents. CONCLUSION: We found low-quality evidence that was insufficient to draw any conclusions regarding the superiority of lasers or conventional topical desensitising agents in the treatment of DH. Further well-designed RCTs on this topic are needed to draw definitive conclusions.

Socioeconomic Inequalities in Oral Health among Adults in Guangxi, China.

PURPOSE: To examine the relationship between socioeconomic inequalities and oral health among adults in the Guangxi province of China. MATERIALS AND METHODS: The present work was designed as a cross-sectional study, and comprises a secondary analysis of the Fourth National Oral Health Survey from 2015-2016. A multistage cluster sampling method was adopted for this survey, conducted in three urban and three rural districts Guangxi province. Dental examinations were conducted to determine oral health indicators: decayed teeth (DT), clinical attachment loss (CAL) and missing teeth (MT). The outcome measures were DT, CAL and MT. A structured questionnaire was used to collect data on demographic characteristics and socioeconomic status (SES). Multiple logistic regression models were used to analyse the relationship between SES and oral health by adjusting covariates. RESULTS: The sample consisted of 651 participants aged 35-74 years. Logisitic analysis showed a statistically significant association between SES and oral health indicators. In the fully adjusted model, participants with primary education were more likely to suffer more DT (OR = 2.67, 95% CI: 1.17-6.10), teeth with CAL ≥ 4 mm (OR = 2.15, 95% CI: 1.25-3.67) and MT (OR = 3.04, 95% CI: 1.65-5.60) compared to the higher education group. Participants with secondary education exhibited a higher likelihood of experiencing increased MT compared to those in the higher education group in the fully adjusted model (OR = 3.21, 95% CI: 1.78-5.76). Household income was associated with DT and MT in the unadjusted model only. CONCLUSIONS: There was strong relationship between SES and oral health of adults. The survey suggested a relationship between low educational attainment and oral health.

Association Between the SLC2A2 Gene rs1499821 Polymorphism and Caries Susceptibility.

Objectives: This study was designed to analyze the association between the SLC2A2 rs1499821 polymorphism and caries susceptibility in the Chinese Han, Zhuang, and Baikuyao populations. Materials and Methods: The present case-control study included 1067 12-year-old children: 481 with caries (142 Han, 166 Zhuang and 173 Baikuyao) and 586 who were caries-free (135 Han, 178 Zhuang and 273 Baikuyao). Questionnaires about diet and oral habits were obtained from all subjects. All of the children received dental examinations and DNA collection. The SLC2A2 rs1499821 SNP was genotyped using the SNPscan technique. Results: The rs1499821 T polymorphism was significantly associated with caries susceptibility in both the Han population and the combined populations of the three ethnic subgroups. SLC2A2 rs1499821 was associated with caries susceptibility in the dominant model in the Han (p = 0.045) population and the combined (p = 0.038) group. The CT+TT genotypes at rs1499821 were associated with a higher risk of caries in the Han (OR = 1.69, adjusted 95% CI: 1.01-2.81) and combined (OR = 1.33, adjusted 95% CI: 1.02-1.74) populations. In both Han (p = 0.009) and the combined populations (p = 0.004), there were statistically significant associations between the frequency of sweet food intake and dental caries. However, the rs1499821 polymorphisms did not associate with the frequency of sweet food intake in these ethnic subgroups. Conclusion: In the Han population, the SLC2A2 rs1499821 T allele and the frequency of sweet food intake may be regarded as risk factors for caries susceptibility. The SLC2A2 rs1499821 T allele had no association with the frequency of sweet food intake in any of the three ethnic groups.

Multiomics analysis reveals the genetic and metabolic characteristics associated with the low prevalence of dental caries.

Background: Despite poor oral hygiene, the Baiku Yao (BKY) ethnic group in China presents a low prevalence of dental caries, which may be related to genetic susceptibility. Due to strict intra-ethnic marriage rule, this ethnic has an advantage in studying the interaction between genetic factors and other regulatory factors related to dental caries. Methods: Peripheral blood from a caries-free adult male was used for whole genome sequencing, and the BKY assembled genome was compared to the Han Chinese genome. Oral saliva samples were collected from 51 subjects for metabolomic and metagenomic analysis. Multiomics data were integrated for combined analysis using bioinformatics approaches. Results: Comparative genomic analysis revealed the presence of structural variations in several genes associated with dental caries. Metabolomic and metagenomic sequencing demonstrated the caries-free group had significantly higher concentration of antimicrobials and higher abundance of core oral health-related microbiota. The functional analysis indicated that cationic antimicrobial peptide resistance and the lipopolysaccharide biosynthesis pathway were enriched in the caries-free group. Conclusions: Our study provided new insights into the specific regulatory mechanisms that contribute to the low prevalence of dental caries in the specific population and may provide new evidence for the genetic diagnosis and control of dental caries.

Association between socioeconomic status and dental caries among Chinese preschool children: a cross-sectional national study.

OBJECTIVES: Socioeconomic inequalities in oral health are often neglected in oral health promotion. This cross-sectional study assessed the association between dental caries and socioeconomic status (SES) among preschool children in China. DESIGN: Cross-sectional study. SETTING: Data from the Fourth National Oral Health Survey of China (2015), comprising of 40 360 children aged 3-5 years was used. METHODS: Dental caries indicators including prevalence of dental caries, dental pain experience and number of decayed, missing and filling teeth (dmft). SES indicators included parental education and household income. The associations between SES and dental caries were analysed by using negative binomial regression or Poisson regression models according to data distribution. Relative and absolute inequalities in dental caries were quantified by using the Relative Index of Inequality (RII) and Slope Index of Inequality (SII), respectively. RESULTS: There were significant associations between SES and prevalence of dental caries and dmft (p<0.001). Children from lower educated (RII 1.36, 95% CI 1.3 to 1.43; SII 0.97, 95% CI 0.81 to 1.13) and lower household income (RII 1.17, 95% CI 1.11 to 1.24; SII 0.55, 95% CI 0.35 to 0.75) families had higher dmft than those from well-educated and most affluent families. Relative and absolute inequalities in dental caries were larger in urban areas by household income, and in rural areas by parental education. CONCLUSIONS: Association between dental caries and SES was demonstrated and socioeconomic inequalities in dental caries existed among Chinese preschool children.

Effectiveness of fluoride varnish on caries in the first molars of primary schoolchildren: a 3-year longitudinal study in Guangxi Province, China.

AIMS: To evaluate the effectiveness of 5% sodium fluoride varnish on caries in first permanent molars and to assess the suitability of using this method to control caries among children in rural areas of Guangxi province, China. METHODS: A total of nine schools with 32 classes were selected by simple random sampling. There were 999 students in the experimental group and 1,004 in the control group. The experimental group received oral health education and topical application of 5% sodium fluoride varnish, while the control group received oral health education only. Dental examinations were performed in November 2014 and November 2017, and the modified International Caries Detection and Assessment System (ICDAS-II) was used to record the caries status of the first permanent molars. The data were entered into SPSS 22 for statistical analysis. RESULTS: A total of 1,748 students (853 in the experimental group and 895 in the control group) completed the study. After 3 years of intervention, the experimental group had a lower prevalence of caries, a lower caries increment, a lower decayed, missing and filled teeth (DMFT) index and a lower decayed, missing and filled surfaces (DMFS) index compared with the control group (respectively: 58.9% vs 65.5%, 34.8% vs 42.1%, 1.38 vs 1.59 and 2.06 vs 2.38). All the differences were statistically significant (P < 0.05). CONCLUSION: In this study population, twice-yearly application of 5% sodium fluoride varnish and oral health education were more effective for preventing caries in first permanent molars than oral health education alone. The implementation of fluoride varnish application as a public health measure in schools in rural areas is recommended.