Occurrence of fluorosis in a population living in a high-fluoride groundwater area: Nakuru area in the Central Kenyan Rift Valley.

Endemic fluorosis caused by the consumption of high-fluoride groundwater is a public health problem in Nakuru, in the Kenyan Rift Valley. The present study was carried out during the period January-February 2017 to determine the prevalence and severity of dental fluorosis among patients of two Nakuru healthcare facilities, namely St. Mary's Hospital-Gilgil and Egerton University-Njoro Dental Clinic. The patients consisted of both young and old members of the Nakuru population served with groundwater containing high levels of fluoride ranging from 0.1 to 72 mg/l. The Thylstrup-Fejerskov (TF) index was used to estimate the severity of dental fluorosis. Among the patients of St. Mary's Hospital-Gilgil, the prevalence of dental fluorosis was 86% (n = 100), whereby 54% of the patients were found to have mild to moderate dental fluorosis and 32% had severe dental fluorosis. Whereas the prevalence of dental fluorosis in patients below the age of 14 years was higher (92%) than in older patients (85.56%), severity was reversed (average TF = 3.77 for older patients; average TF = 2.18 for younger patients). No significant variation in severity and prevalence of dental fluorosis was recorded with respect to both genders of the patients. The dental fluorosis prevalence rate amongst the patients of the Egerton University-Njoro Dental Clinic was found to be 79.49% (n = 73). However, a comparative analysis of the two age groups revealed a much higher prevalence rate of 100% for patients below the age of 14 relative to the older patients (79.49%). While a high number of cases of dental fluorosis from both healthcare facilities were reported in patients residing in Njoro, Nakuru town, Gilgil and Bahati, the fewer cases were from Solai and Rongai. The results seem to suggest a much higher occurrence of dental fluorosis within the younger population group. This implies that rapid population growth and urbanization puts more pressure on public water resources which leads to a strong reliance on fluoride contaminated groundwater and the concomitant increased cases of dental fluorosis. Therefore, there is a need for a change of local government policy to enhance access to safe water and public education on fluorosis in the areas that were under investigation.

Predictors of dental visits among primary school children in the rural Australian community of Lithgow.

BACKGROUND: Regular dental attendance is significant in maintaining and improving children's oral health and well-being. This study aims to determine the factors that predict and influence dental visits in primary school children residing in the rural community of Lithgow, New South Wales (NSW), Australia. METHODS: All six primary schools of Lithgow were approached to participate in a cross-sectional survey prior to implementing water fluoridation in 2014. Children aged 6-13 years (n = 667) were clinically examined for their oral health status and parents were requested to complete a questionnaire on fluoride history, diet, last dental visit, and socio-demographic characteristics. Multiple logistic regression analyses were employed to examine the independent predictors of a 6-monthly and a yearly dental visit. RESULTS: Overall, 53% of children visited a dentist within six months and 77% within twelve months. In multiple logistic regression analyses, age of the child and private health insurance coverage were significantly associated with both 6-monthly and twelve-month dental visits. In addition, each serve of chocolate consumption was significantly associated with a 27% higher odds (OR = 1.27, 95% CI: 1.05-1.54) of a 6-monthly dental visit. CONCLUSION: It is imperative that the socio-demographic and dietary factors that influence child oral health must be effectively addressed when developing the oral health promotion policies to ensure better oral health outcomes.

Is high relative humidity associated with childhood hand, foot, and mouth disease in rural and urban areas?

OBJECTIVE: To examine the relationship between relative humidity and childhood hand, foot and mouth disease (HFMD) in Hefei, China, and to explore whether the effect is different between urban and rural areas. STUDY DESIGN: Retrospective ecological study. METHODS: A Poisson generalized linear model combined with a distributed lag non-linear model was used to examine the relationship between relative humidity and childhood HFMD in a temperate Chinese city during 2010-2012. RESULTS: The effect of relative humidity on childhood HFMD increased above a humidity of 84%, with a 0.34% (95% CI: 0.23%-0.45%) increase of childhood HFMD per 1% increment of relative humidity. Notably, urban children, male children, and children aged 0-4 years appeared to be more vulnerable to the effect of relative humidity on HFMD. CONCLUSIONS: This article study indicates that high relative humidity may trigger childhood HFMD in a temperate area, Hefei, particularly for those who are young and from urban areas.

Factors Associated with Tooth Loss in Older Adults in Rural Colorado.

The purpose of this paper is to examine factors that are associated with tooth loss in older adults living in the San Luis Valley (SLV), Colorado, which is a rural and large geographical area (roughly the size of Connecticut) that has a large population age 60 years or older. Data used in this manuscript were collected as a part of the SLV Community Health Survey. The analyzed sample included 308 adults over the age of 65 years who completed the survey. Basic descriptive statistics and a series of step-wise binary logistic regression analyses were conducted; the dependent variable was the number of permanent teeth removed because of tooth decay or gum disease. Fifty-two percent of the participants were male, Hispanic participants made up 40 % of the sample and 76 % of the participants had at least a high school education. Tooth loss was significantly associated with older age (OR = 1.09; p = 0.02), lower income (OR = 0.01; p = 0.00), less than high school education (OR = 0.32; p = 0.01), being Hispanic (OR = 2.15; p = 0.05), self-reported fair-poor health status (OR 2.94; p = 0.02), consumption of one or more than one sweet beverage per day (OR = 4.52; p = 0.00), no dental insurance (OR = 4.70; p = 0.01) and length of time since last dental visit (OR = 0.21; p = 0.01). The findings of the present study suggest possible causes for tooth loss in rural adults and underscore the need for in-depth research to study the overall oral health of rural older adults living in SLV.

Demographic factors and dental health of Swedish children and adolescents.

OBJECTIVE: To investigate the dental health of Swedish children and adolescents with reference to age, gender and residence. MATERIAL AND METHODS: Electronic dental records from 300,988 3-19-year-olds in one Swedish region were derived in a cross-sectional study in years 2007-2009. The DMFT system was used. Age was categorized into 3-6/7-9/10-12/13-15/16-17/18-19-year-olds and residence into 'metropolitan', 'urban' and 'rural' areas. ANOVA, generalized linear regression models and Fisher's exact test were used. RESULTS: Among 7-9-year-old children, nine out of 10 were free from fillings and manifest caries, while for 18-19-year-olds; this proportion was one third. Girls (18-19-year-olds) had a significantly lower risk of caries compared to boys of the same age, RR for the DT index = 0.83 (95% CI = 0.81-0.85). This pattern was reversed in 7-12-year-old children. Children and adolescents in metropolitan and urban areas had significantly more caries than subjects in rural areas, for instance the RR for the DT index in metropolitan 7-9-year-olds was 2.26 (95% CI = 2.11-2.42) compared to their rural counterparts. CONCLUSIONS: In the permanent dentition, the overall pattern revealed that girls ≤ 12 years had a higher risk of caries, while adolescent girls had a lower risk of caries, both compared with boys of corresponding ages. Living in an urban or metropolitan area entailed a higher risk of caries than living in a rural area. A greater occurrence of dental caries in adolescents than in children was confirmed. The findings should have implications for planning and evaluation of oral health promotion and disease prevention activities.

Epidemiology of Caries in 12-Year-Olds in Slovenia 1987-2013.

PURPOSE: The first large-scale epidemiological survey on dental caries in the Republic of Slovenia was conducted in 1987 and repeated in 1993, 1998, 2003, 2008 and 2013, using the same methodology. The aim of the study was to describe the trend of caries in 12-year-olds in Slovenia from 1987 to 2013. MATERIALS AND METHODS: The method applied in all six surveys was the National Oral Pathfinder Survey using WHO combined oral health and treatment need assessment forms. The surveys were performed in ten towns in all nine geographical regions of Slovenia. One randomly selected primary school in each town participated in the surveys. In each subject selected from the respective class of 12-year-old children, the caries experience and sealant data were recorded, using artificial light, a plane mirror and a sharp explorer. For statistical analysis of the results, the Statistical Package for Social Sciences (SPSS) was used. RESULTS: The mean DMFT decreased significantly from 5.1 in 1987 to less than 1.7 in 2008 (p < 0.0001), but afterwards began to increase and reached a mean value of almost 1.9 in 2013 (p > 0.05). The percentage of sealed teeth increased from 6% in 1987 to 92% in 2013. CONCLUSION: The substantial caries decline in 12-year-olds was evaluated as being due to the preventive measures implemented. However, in the last survey, the caries decline had stopped.

Practice of Self-Medication for Dental Problems in Uttar Pradesh, India.

PURPOSE: To assess the practice of self-medication for oral health problems in Uttar Pradesh, India. MATERIALS AND METHODS: This multiregional cross-sectional questionnaire-based study was conducted in four towns; Moradabad, Meerut, Ghaziabad and Bareilly over a 2-month period on 352 subjects. The questionnaire consisted of a demographic profile, questions related to problems of oral health for self-medication, substances used, source of the substance, duration, reason and source of advice for self-medication. The data were analysed using the chi-square test with significance set at p < 0.05. RESULTS: The prevalence of self-medication was 72%. The source of substances in most of the cases was a pharmacy shop (62.5%). The most frequent self-medicated oral health problem was toothache (55.6%), followed by other problems, and the most frequently used substance was analgesics (59%). 49.8% self-medicated due to lack of money for consulting a doctor and 45% of the population received advice from the pharmacist for self-medication. CONCLUSION: The majority of those surveyed practiced self-medication using an array of drugs, e.g. analgesics, native herbs, antibiotics, etc, either alone or in combination. The main reason identified for self-medication was motivation from relatives and friends.

Dental Caries and its Socio-Behavioral Predictors- An Exploratory Cross-Sectional Study.

OBJECTIVES: To assess dental caries status and oral health related behavior of 12 year old school children in relation to urbanization and gender; to analyze the effect of socio-demographic and behavioral variables on dental caries experience. STUDY DESIGN: Study sample comprised 831, 12 year old school children in, India. Caries status was assessed by Decayed, missing, filled teeth (DMFT) index and a 16 item closed ended questionnaire was administered to children for assessing their oral health related knowledge, beliefs and behavior. RESULTS: Mean caries experience and prevalence was 1.94 and 64.9% respectively. Decay was the dominant component of DMFT. Greater proportion of female and urban children presented better oral health knowledge, beliefs and practices. Boys were more liable (OR=1.2, 95% CI=1.10-1.96) for having caries than girls. Children living in rural areas and whose parents were not professionals or semiprofessionals were more likely to experience caries. Children whose mothers were unskilled or house wives were more than twice likely to present caries (OR=2.14, 95% CI-2.03-2.45) than those children whose mothers were skilled or semi-skilled. Children of illiterate fathers and mothers were 1.09 (95% CI, 1.02-1.49) and 1.98 (95% CI, 1.13-1.99) times more likely to have dental caries than those children whose parents had greater than 10 years of education. Children, those who cleaned their teeth less than once a day presented an odds ratio of 1.36 (CI-1.17-1.86) also higher odds of dental caries was observed in children consuming sweets or soft drinks more than once a day. CONCLUSIONS: The prevalence and severity of dental caries was low among urban children and girls than their rural and boy counterparts. In general, oral health knowledge, beliefs and practices were low, predominantly in rural and male children. Caries experience was significantly associated with gender, location of residence, brushing frequency, frequency of consumption of soft drinks and sweets, parents' occupation and education.

Dental pain and self-care: a cross-sectional study of people with low socio-economic status residing in rural India.

CONTEXT: Self-care is one of the ways in which people without access to professional care can actively engage in managing their oral health problems. AIM: To find out the prevalence of dental pain and the type of self-care remedies utilised for pain relief by people with low socio-economic status residing in Kollipara mandal, Guntur district, Andhra Pradesh. SETTINGS AND DESIGN: This was a cross-sectional population-based study. METHODS AND MATERIAL: A multistage simple random-sampling technique was adopted to obtain an appropriate sample. A questionnaire, which consisted of sections on socio-economic and demographic variables, dental pain, pain characteristics and self-care remedies utilised to combat dental pain, was used to collect data. Statistical analysis used the chi-square test and descriptive statistics. RESULTS: The survey covered a total population of 630 individuals. The mean age of the population was 32.8±16.7 years. Among the total study subjects, 44.1% were male and 55.9% were female. The prevalence of dental pain reported during the preceding 6 months was 28.3%. Subjects who experienced dental pain reported the home remedies and self-care methods that they utilised to get relief from the pain. They more frequently reported using over-the-counter medication (49.6%) for pain relief. CONCLUSIONS: This study provides an insight into the type and usage of self-care in relief of dental pain. Pain sufferers used a variety of self-care methods to deal with their problems.

Deep carious lesions and other consequences of caries among 18-year-olds at Public Dental Health Service in Northern Norway: A cross-sectional age cohort study.

OBJECTIVES: To document deep carious lesions and other consequences of caries (DCL-CC) in molars of 18-year olds leaving the free-of-charge Public Dental Health Service (PDHS). To explore the association between background factors and DCL-CC. MATERIALS AND METHODS: The final study sample (n=1876) comprised 95% of individuals born in 1993 and registered in the PDHS in Troms County, Northern Norway. The most recent digital bitewing radiographs of each subject were examined for DCL-CC (deep untreated carious lesions, deep restorations, root canal obturations or extractions due to caries). Inter- and intra-observer kappa scores were 0.62 and 0.87, respectively. Information on background factors (gender, clinic location, history of medical problems, bitewing examination interval, DMFT score and planned recalls) were retrieved from dental records. RESULTS: About one-quarter of subjects (488) had at least one molar with DCL-CC. There were 848 molars in total with DCL-CC; the majority were deep restorations (70%), but 4% were deep untreated carious lesions. More than a quarter of DCL-CC were either root canal obturations (14%) or extractions (12%). Multivariable logistic regression analyses showed that a 1-unit increase in DMFT score was associated with deep untreated carious lesions and extractions due to caries. There was no association between urban/rural clinic location, which indicated socio-economic status, and either DMFT score or DCL-CC. CONCLUSIONS: Despite the existence of a free-of-charge dental service, more than one-quarter of the subjects in the present study had at least one molar with DCL-CC.

The Dental Health of primary school children living in fluoridated, pre-fluoridated and non-fluoridated communities in New South Wales, Australia.

BACKGROUND: The Local Government Area of Gosford implemented a water fluoridation scheme in 2008. Therefore the opportunity was taken to record the dental health of primary school children aged 5-7 years prior to the fluoridation and compare the results with other communities in NSW with different access to fluoridated water. The aim was to compare the oral health of New South Wales (Australia)s 5-7 year olds living in fluoridated, and non- fluoridated communities. One of the areas was due to implement water fluoridation and is termed the pre-fluoridation site. METHODS: Pupils in the first year of Public and Catholic Schools in three areas of NSW were recruited. Class lists were used to draw a sample of approximately 900 per area. This number allowed for a non-response rate of up to 30 per cent and would give a sample sufficient numbers to allow statistical inferences to be drawn. Children whose parents consented received a dental examination and the clinical data was collected on mark sense cards. RESULTS: In the 3 areas the proportion of children who received a dental examination varied; 77.5% (n = 825) for the fluoridated area, 80.1% (n = 781) for the pre-fluoridated area and 55.3% (n = 523) for the non-fluoridated area. The mean dmft was 1.40 for the fluoridated area, 2.02 for the pre-fluoridated area and 2.09 for the non-fluoridated area. These differences were statistically significant (p < 0.01). Differences were also noted in the proportion of children who were caries free, 62.6% fluoridated area, 50.8% for the pre-fluoride area and 48.6% for the non-fluoride location. CONCLUSION: The children living in the well-established fluoridated area had less dental caries and a higher proportion free from disease when compared with the other two areas which were not fluoridated. Fluoridation demonstrated a clear benefit in terms of better oral health for young children.

Characteristics of dental care-seeking behavior and related sociodemographic factors in a middle-aged and elderly population in northeast China.

BACKGROUND: The etiologies of oral disease are generally progressive and cumulative, such that compared with younger individuals, middle-aged and elderly people are at greater risk of active dental caries and periodontal disease risk. They usually suffer from multiple oral diseases, and obstacles to their use of dental care services are numerous. OBJECTIVES: The objectives of this study were to investigate the characteristics of dental care-seeking behaviors and related sociodemographic factors in a middle-aged and elderly population in northeast China. METHODS: This was a cross-sectional study of 1188 subjects, including 792 middle-aged (35-44 years-old) and 396 elderly (65-74 years-old) residents of northeast China. Information on dental care-seeking behaviors and sociodemographic characteristics was collected during face-to-face structured interviews conducted between May and June 2010. Chi square tests, Ridit scoring, and multivariate logistic regression analysis were employed to characterize dental care-seeking behaviors and their associations with sociodemographic factors. RESULTS: A greater proportion of middle-aged participants reported a need for dental visits compared with the elderly participants (75.8 % vs. 60.9 %; P < 0.01), as did more urban that rural residents (P < 0.05). The majority of individuals in both the middle-aged and elderly groups obtained for dental care at their own expense, and they predominantly chose private dental clinics. Ridit analyses showed that education level and income were significantly associated with oral care in both middle-aged and elderly people (Ps < 0.05). In addition, logistic regression analysis indicated that rural residence was negatively associated with dental visits in both middle-aged (odds ratio = 0.649, 95 % confidence interval: 0.447-0.884) and elderly (odds ratio = 0.604, 95 % confidence interval: 0.394-0.924) individuals. CONCLUSION: The rate of dental care visits is low in the middle-aged and elderly populations of northeast China. Among sociodemographic factors, education level and income are positively associated with dental care visits, and rural residence is negatively associated with the frequency of such visits.

Prevalence and unmet treatment need of traumatized incisor among Cameroonian schoolchildren in North West Province.

OBJECTIVE: To determine the prevalence and unmet treatment need of traumatized incisor in 12-13 years old among Cameroonian Schoolchildren in the North West Province. MATERIALS AND METHODS: This cross-sectional survey among 12-13 years old children of selected rural and urban secondary schools in North West province of Cameroon was conducted between March and November, 2010. RESULTS: The majority of the 2287 studied children were females (50.2%) and urban dwellers (51.8%). Of the 2287 studied children, 45 of them exhibited evidence of incisor trauma giving a prevalence of 2.0%. This prevalence was higher in males than females (2.3% versus 1.7%) and also higher in urban than rural schools (2.2% versus 1.7%). Upper central incisor was the predominantly traumatized tooth and enamel fracture constituted 62.2% of incisor trauma. Fall and sports were the leading cause of incisor trauma in this study. Some minor variations in the causes of incisor trauma were found among gender and location. The prevalence of unmet treatment need was 91.1% which were mainly acid etch restoration. Males and rural dwellers had more unmet treatment need. CONCLUSION: Data revealed a low prevalence of traumatized incisor with high prevalence of unmet treatment needs among Cameroonian Schoolchildren in North West Province. Findings of this survey provide baseline information on prevalence and unmet treatment need for traumatized incisor among Cameroonian Schoolchildren in the North West Province.

Caries experience and treatment needs among Albanian 12-year-olds.

OBJECTIVE: To determine the dental caries experience and treatment needs among 12-year-olds in Albania. RESEARCH DESIGN: This 2011 cross sectional survey used cluster sampling with DMFT and SiC indexes used to assess dental caries experience; DT/DMFT to assess untreated caries; FT/DMFT the care index and MT/DMFT as missing index. PARTICIPANTS: 1928 12-year-olds selected from state schools across 16 local districts with a mix of urban and rural areas and contrasting socio-economic groups. METHOD: WHO protocols were used. RESULTS: The caries prevalence (DMFT > 0) was 87% (95%CI 85.6,88.4) and 29.6% were without cavitated carious lesions (DT = 0). The mean caries experience (DMFT) was 3.73 (sd 2.71) for boys, 3.71 (sd 2.61, p = 0.88) for girls and 3.72 (sd 2.66) overall. The caries treatment needs DT/DMFT was 56% (sd 0.36), the mean FT/DMFT (Care Index) was 31% (sd 0.34) and the mean SiC index was 6.72 (sd 1.92). CONCLUSIONS: Dental caries experience and untreated dental caries were high compared with 12-year-olds in most European Union Member States. This suggests an urgent need for a national preventive program and improved access to oral care for this age group.

Dental caries among children in Georgia by age, gender, residence location and ethnic group.

OBJECTIVE: To provide prevalence data for dental caries in Georgia. METHODS: This World Health Organization pathfinder survey was conducted among 1,351 (6, 12 and 15 year-old) Georgian children, representing the main ethnic groups in urban and rural locations. Caries was analysed at univariate and multivariate levels, according to age, gender, urban/rural locality and ethnic group. RESULTS: Caries experience levels among 6-year-olds were dmft = 4.57, sd 3.42 (14.8% caries-free); DMFT = 2.04 (sd 2.02) among 12-year-olds (31.1% caries-free); and DMFT = 3.51 (sd 3.14) for the 15-year-olds (17.7% caries-free). Urban children at ages 6 and 12 years were more likely to be caries-free and have both lower levels of caries-experience and higher levels of filled or restored teeth. In multivariate regression analyses, most age groups showed a significant contribution from residence location. No differences were found by age and no consistent differences were detected by ethnic group. CONCLUSION: These data should provide the baseline for formulating and conducting public oral health efforts in Georgia, with emphases on rural residence locations.

Turning Australia into a 'flat-land': what are the implications for workforce supply of addressing the disparity in rural-city dentist distribution?

Dentistry in Australia has faced, and continues to face, significant workforce issues, in particular, a grossly distorted workforce distribution. In this study, an analysis of the consequences for the workforce that would occur under a series of reduced maldistribution scenarios is examined and reported. Three different scenarios were tested based on existing dental practice to population data at a national level. This study clearly highlights the very significant maldistribution of practices in Australia. However, more importantly, it highlights that to address this maldistribution requires something in the order of a tenfold increase in dental practice numbers (and the commensurate increase in workforce), which is not possible (or reasonable). As a nation, Australia has to look to other methods of achieving equity in access to good oral health. The application of modes of care delivery including, but not limited to visiting services needs to be examined and extended. Clearly, these new methodologies are going to rely on non-dental health professionals taking a far more significant role in leading oral health-care models as well as the expanded application of technology to bring unique skill bases to areas where these skilled individuals do not (and will not) reside.

Background factors of molar-incisor hypomineralization in a group of Finnish children.

OBJECTIVE: Molar-Incisor Hypomineralization (MIH) is a common developmental enamel defect characterized by demarcated opacities in permanent molars and incisors. Its etiology still remains unclear. The aim of this retrospective cohort study was to assess if the socioeconomic environment of the child is associated with MIH. MATERIALS AND METHODS: The study was located in two rural towns and three urban cities in Finland. A total of 818 children, between 7-13 years old, were examined for MIH using the evaluation criteria in line with those of the European Academy of Paediatric Dentistry, but excluding opacities smaller than 2 mm in diameter. The mothers filled in a questionnaire which included questions related to the family's way of living (e.g. area of residency, farming, day care attendance) and socioeconomic status (family income, number of mother's school years, level of maternal education). RESULTS: The prevalence of MIH in the study population was 17.1%. Family income, urban residency and day care attendance were associated with MIH in the univariate analysis. In the multivariate analysis using binary logistic regression, only urban residency during a child's first 2 years of life remained associated with MIH. The prevalence of MIH in urban areas was 21.3% and in rural areas 11.5% (OR = 2.18, CI = 1.35-3.53, p = 0.001). CONCLUSIONS: The prevalence of MIH was related to urban residency and could not be explained by any other factor included in the study.

The oral health of ageing baby boomers: a comparison of adults aged 45-64 and those 65 years and older.

OBJECTIVES: To compare the oral health status of adults aged 45-64 (baby boomers) and those aged 65 and older. METHODS: An observational, cross-sectional survey of adults living independently in rural and urban settings in Nova Scotia, Canada was conducted. Using random digit dialing, calibrated interviewers completed a telephone survey, and clinicians calibrated to WHO standards conducted clinical examinations. Weighting was used to correct for sampling bias. RESULTS: 747 community dwelling adults completed both the clinical exam and the questionnaire (n=411, age 45-64; n=336, age 65 or older). Rates of edentulism were low (2.6% aged 45-64; 15.7% aged 65+; p<0.001). Untreated root caries was greater in the older dentate group (19.7 vs. 10.1%; p<0.001). Being 65 years of age or older was identified as a predictor of increased decayed, missing, filled teeth, presence of decayed and/or filled roots and presence of attachment loss≥4 mm, but was not a significant predictor of presence of untreated coronal caries. CONCLUSIONS: A falling rate of edentulism and a higher risk for root caries with increasing age may predict the need for more complex dental care as our population ages.

The relationship of dental caries and dental fear in Malaysian adolescents: a latent variable approach.

BACKGROUND: To investigate the role of geography (place of residence) as a moderator in the relationship between dental caries disease and treatment experience and dental fear in 16-year-olds living in Malaysia. METHODS: A multi-stage-stratified sampling method was employed. Five hundred and three, 16-year-olds from 6 government secondary schools participated in this study. The questionnaire examined participants' demographic profile and assessed their dental fear using the Dental Fear Survey (DFS). The clinical examination consisted of the DMFT as the outcome measure of dental caries disease and treatment experience by a single examiner (ICC = 0.98). Structural equation modelling inspected the relationship between dental fear and dental caries disease and treatment experience. RESULTS: The mean DMFT was 2.76 (SD 3.25). The DT, MT and FT components were 0.64 (SD 1.25), 0.14 (SD 0.56) and 1.98 (SD 2.43) respectively. Rural compared with urban adolescents had significantly greater mean numbers of decayed and missing teeth. The mean DFS score was 40.8 (SD 12.4). Rural compared with urban adolescents had significantly higher mean scores for physical symptoms of dental fear. The correlation between dental fear (DFS) and dental caries disease and treatment experience (DMFT) was 0.29, p < 0.0001. The structural equation model fitted the raw data well (χ2 = 9.20, df = 8, p = 0.34). All components of DMFT were closely associated in equal strength to the unidimensional hypothetical latent variable of dental caries disease and treatment experience. The strength of the relationship between dental fear and dental caries disease and treatment experience varied in accordance with place of residence. CONCLUSION: In conclusion a relationship between dental fear and dental caries disease and treatment experience was shown to exist in 16-year-old adolescents living in Malaysia. This study showed that the rural-urban dichotomy acted as a moderator upon this relationship.

Dental caries status of Bulang preschool children in Southwest China.

BACKGROUND: Bulang is one of the 55 ethnic minorities in China with a population of around 120,000. They live mainly in Yunnan, which is a less-developed province in southwestern China. Many Bulang people live in remote villages and have little access to dental care. They like hot and sour food and chew betel nut. This study examines the caries status of 5-year-old Bulang children and factors that influence their caries status. METHODS: A sample of 5-year-old Bulang children in Yunnan was selected using a multi-stage cluster sampling method. One trained dentist examined the children using dental mirrors with intra-oral LED light and CPI probes. Caries experience was measured according to the dmft index. Oral hygiene status was recorded according to the visible plaque index (VPI). A parental questionnaire was used to study the children's oral health-related behaviours. RESULTS: A total of 775 children were invited and 723 joined the survey. The caries prevalence was 85%, and 38% of them had caries involved in pulp. The mean dmft and dt score were 5.8 ± 4.9 and 5.6 ± 4.8, respectively. Visible plaque was found on 636 children (88%). Multi-factor ANCOVA analysis found that higher dmft scores were found among the children who snacked on sweets daily, had visited a dentist within the last year and had higher VPI scores. CONCLUSIONS: The caries prevalence and experience among 5-year-old Bulang children in Yunnan was high, and most of the caries were left untreated. The caries experience was associated with snacking habits, dental visit habits and oral hygiene.