Root caries experience among Australian adults.

BACKGROUND: Increase in life expectancy and tooth retention in contemporary Australian adults may increase population-level burden of having root caries. This study aimed to describe patterns and evaluate associations of root caries with socio-demographic, socio-economic, clinical and behavioural factors. METHODS: A secondary analysis was undertaken using data from the National Survey of Adult Oral Health 2004-2006, which included 5505 randomly general adults 15+ years old. Participants underwent an oral examination and completed an interview and a questionnaire. Prevalence and mean number of decayed/filled root (root DFS), untreated root (root DS), filled root (root FS), gingival recession, oral hygiene and gingival status were derived from examinations. Socio-demographic, socio-economic and behavioural factors were self-reported. Multivariable models were generated to estimate prevalence ratios (PR), mean ratios (MR) and confidence intervals (95% CI), adjusting for number of surfaces with gingival recession. Additional analysis for older adults 60+ years old was presented. RESULTS: The prevalence of root caries was 25.3% (CI=23.6-27.1) and 62.0% [CI=58.7-65.1] among general and older adults, respectively. Risk factors found were similar in both populations. Smokers had higher prevalence and mean number of root DFS, DS and FS than never-smokers. In contrast with poor oral hygiene, high income and frequent brushing were significantly associated with lower mean root DS. Frequent dental visiting was associated with higher root FS and DFS. CONCLUSIONS: Root caries affected about a quarter of Australian general adults and more than a half of older adults. People who were smokers presented a significantly higher prevalence and severity of root caries.

Dentin-derived alveolar bone graft for alveolar augmentation: A systematic review.

Introduction: Application of alveolar bone graft (ABG) in alveolar augmentation is done to prevent excessive bone resorption due to tooth extraction, missing teeth, or other diseases/conditions affecting the alveolar bone. The use of autogenous dentin-derived ABG has been considered as the composition of dentin appears to be nearly analogous to that of bone. Objective: This systematic review aims to assess the efficacy of dentin-derived ABG for alveolar augmentation of post-extraction sockets or other alveolar bone defects by evaluating volume gain and histomorphometric data. Material and methods: A search of systematic literature was conducted in Pubmed, Scopus, Web of Science, and Embase from database inception to October 2023. The review included both randomized controlled trials (RCT), pilot studies, clinical trials, and retrospective studies reporting on dentin-derived ABG use for alveolar augmentation. Results: Overall, 298 articles were obtained from the initial search. From these articles, 21 articles met the inclusion criteria and were included for descriptive analysis. All of the studies indicated low risk of bias. Studies of dentin-derived ABG, which used bone-derived grafts as the control group, have shown significantly higher percentages of new bone formation, gain in vertical and horizontal dimensions, and less reduction in dimensions. Conclusions: Dentin-derived ABG was effective in volume maintenance, indicating promising results via histomorphometric and radiographic analysis.

The Use of Internet of Things (IoT) Technology to Promote Children's Oral Health: A Scoping Review.

Dental treatments and oral health promotion are now more mobile and versatile thanks to the Internet of Things (IoT)-based healthcare services. This scoping review aims to compile the available data and outline the aims, design, assessment procedures, efficacy, advantages, and disadvantages of the implementation of IoT to improve children's oral health. Articles for this review were gathered from PubMed, Scopus, and Ebscohost databases to identify and construct the keywords and primary research topic. The selected studies were published between 2000 and 2022 and focused on children aged 1 to 18 and/or parents/caregivers of children who received oral health promotion and/or dental disease preventive treatments utilizing the IoT. Each study topic required data extraction. A total of nine papers were included in this review. Two of the nine publications were quasi-experimental, while the remaining six papers were randomized control trials. The nine papers considered in this appraisal have a range of interventions and follow-up periods. Mobile-Health (m-Health), home healthcare, hospital/clinical management, and electronic-Health applications (e-Health) are the most common IoT architecture used as interventions. Three studies assessed oral health knowledge and behavior scores, whereas the bulk of studies (6/7) used m-Health treatments focusing on dental plaque buildup as well as gingival health evaluation to assess oral hygiene. IoT is one of the mediums or instruments that might be used to encourage children's dental health. The studies suggest that the use of IoT could help in improving oral hygiene and oral health, which can further improve children's oral health.

Dentists' knowledge and attitudes regarding PFPT: A single study in East Java, Indonesia.

Objective: Pigmented fungiform papillae of the tongue (PFPT) are infrequently encountered and inadequately documented pigmented lesions that pose challenges in diagnosis and subsequent treatment planning. The study was aimed at analyzing dentists' knowledge and attitudes regarding PFPT morphologies, to determine diagnosis and subsequent treatment planning. Methods: A cross-sectional study was conducted among dentists in East Java through an online questionnaire. Four clinical photographs of PFPT were presented, accompanied by seven questions assessing dentists' knowledge of PFPT, including lesion types, tongue structure involvement, Holzwanger classification, lesion patterns, suspected diagnoses and the nature of the lesion (benign or malignant). Additional questions to evaluate attitudes included prior experience with PFPT in practice, potential malignant transformation, diagnostic investigation and required treatment. Knowledge-associated attitude differences were statistically analyzed with the Mann-Whitney test with a threshold of p < 0.05. Result: A total of 117 dentists participated, most of whom were women (69.23%) and were 26-30 years of age (44.44%). Dentists 41-50 years of age had superior knowledge to those 20-30 years of age (p = 0.005). Practitioners with 1-5 years of experience showed significant differences in knowledge regarding PFPT (p < 0.05). No significant differences in knowledge level and attitudes were observed, particularly regarding PFPT treatment and supporting investigation (p > 0.05). However, prior encounters with PFPT cases were significantly associated with treatment decisions and supporting investigations for diagnosis (p < 0.05). Conclusion: Most participating dentists had substantial knowledge of PFPT cases. Dentists' understanding, as reflected in their attitudes toward investigating and treating PFPT, was notably influenced by prior encounters with PFPT cases.

The Association between Dental Pain and Psychological Symptoms: Evidence from a Population-Based Study in Indonesia.

OBJECTIVES: This study aimed to determine the prevalence and distribution of dental pain and its association with psychological symptoms: stress and depression. MATERIALS AND METHODS: The 2014 Indonesia Family Life Survey data were used for the abovementioned purposes. Records of self-reported dental pain and stress as well as the occurrence of depression based on the 10-item Center for Epidemiologic Studies-Depression scale were analyzed. Multivariable ordinal regression models were fitted to test the hypothesized associations between dental pain and each of the psychological symptoms, controlling for age, sex, education, wealth, and religiosity. RESULTS: Dental pain prevalence among Indonesian population was approximately 15%. The adjusted odds ratios (ORs) from the ordinal regression models indicated that dental pain was related to the increase of the stress and depression level (OR: 1.31, 95% confidence interval [CI]: 1.14-1.49 and OR: 1.59, 95% CI: 1.41-1.79, respectively). Higher education, higher wealth, and being male are risk factors for stress. However, higher wealth and being male are protective factors for depression. Furthermore, higher religious level was a protective factor for both stress and depression. CONCLUSION: Dental pain was associated with a higher level of stress and a higher score of depression, even after being adjusted with age, sex, education, wealth, and religiosity.

Effect of Socioeconomic Status on Teeth and Dental Care - Evidence from a Population-based Study in Indonesia.

PURPOSE: Education is well-known as a determinant of oral health and dental behaviours in high-income countries, but much less is known for countries with lower incomes. This study aimed to identify the extent to which education affects oral health and dental behaviours in Indonesia. MATERIALS AND METHODS: This study used data from the Indonesian Basic Health Survey 2013. From this nationally representative sample of 945,057 people 5-100 years old, a series of mixed-effects Poisson regression models that accounted for sampling weights estimated the effect of educational attainment on edentulism, dental care utilisation, and toothbrushing behaviour. RESULTS: Consistent educational gradients were found for all outcomes and across all model specifications. People without a formal educational degree had a 1.03 (95% CI: 1.03-1.04) times higher risk of not utilising any dental care, a 3.15 (95% CI: 2.47-4.02) times higher risk of being edentulous, and a 15.6 (95% CI: 12.76-19.02) times higher risk of having low toothbrushing frequency than people having a university degree or higher. CONCLUSIONS: Stark and consistent educational gradients were observed in the dentate status, dental services utilisation, and toothbrushing in Indonesia. Educational inequalities were much larger for toothbrushing behaviours than for dental care utilisation. Intervention points for health policy should urgently prioritise public health interventions to promote overall educational attainment, preventive services, and dental care targeted at those with lower educational attainment.

Assessment of Indonesian-Language Orthodontics-Related YouTube Video as a Source of Information.

OBJECTIVES: Health-seeking behavior through social media including orthodontics treatment has become popular among community in Indonesia. However, the characteristics of uploaded video in term of quality, reliability, and usefulness are unknown. This study aims to analyze the characteristics of Indonesian-language orthodontic-related YouTube videos uploaded. MATERIALS AND METHODS: This study adopted cross-sectional design and analyzed 300 videos as the sample. A final 100 related videos were included for analysis of the quality, usefulness, and reliability of the video uploaded as well as viewers' interaction in term of popularity and visibility. Mann-Whitney's test was used for the statistical analysis. RESULTS: The majority of the videos were uploaded by individual users (60%) with moderate quality, usefulness, and reliability. Statistical analysis showed that orthodontics-related YouTube videos uploaded by individuals have lower popularity and reliability compared with health professional (p < 0.05). CONCLUSION: Most of the Indonesian-language orthodontic-related YouTube videos have moderate quality, usefulness, and reliability. There is a need from health professional to contribute more related video as main source of health information for the general to make healthy health-seeking behavior.

Analysis of Quality, Usefulness, Reliability, Visibility, and Popularity of Videos about Dental Caries on YouTube: A Cross-sectional Analysis.

Objectives: YouTube is the most popular social media and is widely used to access dental and oral diseases information. Nonetheless, the quality of online health information remains a problem. This study aimed to analyze the quality, usefulness, reliability, visibility, and popularity of YouTube videos about dental caries as a source of information. Materials and Methods: The study design was a cross-sectional analytical study. Here, 300 videos that were uploaded in September 2019-2020 were screened, and total duration, number of views, number of likes, number dislikes, uploader category (individual users or health professionals), and upload date of the videos were recorded. One hundred videos were analyzed in terms of their quality, usefulness, reliability, visibility, and popularity using the Global Quality Scale, usefulness score, DISCERN, viewing rate, and interaction index, respectively. Results: Videos were 78% uploaded by individual users. Videos uploaded by health professionals showed high scores in quality, usefulness, and reliability. Videos that were greater than 6 min long exhibited both better quality and higher popularity. Video with good-quality showed high visibility and popularity. In addition, videos with better usefulness and reliability showed high visibility; however, their popularity was low. Conclusions: Information about dental caries on YouTube is limited in quality. YouTube videos have a potentially important role in oral health education.

Teledentistry and Online Referral System in Indonesian Primary Health Care Center During the COVID-19 Pandemic: A Narrative Review.

Aims: This review aims to map the needs and challenges in the application of teledentistry and online referral system encountered by dental health care professionals in Indonesian primary health care centers (puskesmas) to provide safe dental health service to the population during the COVID-19 pandemic. Materials and Methods: Literature search was undertaken of both in Indonesian and overseas context related to teledentistry. Narrative review of the literature was written to present the challenges, solutions, and application of teledentistry at Puskesmas to optimize oral health services during the COVID-19 pandemic. Results: Online referral system and teledentistry are options to help dental health service delivery in the pandemic era. While it has been adopted in many private clinics, there are many challenges to adopt it at the puskesmas level due to a lack of infrastructure, human resources, and budget allocation. While the Indonesian government has plans to support the digitization in the education and health sector, this pandemic shall pose an opportunity for Indonesian health department to develop and facilitate the use of teledentistry and online referral system. During this situation, health cadres can bridge the relationship between Puskesmas and the poor community through the help of teledentistry. Conclusions: The government commitment in applying online referral system and teledentistry in Puskesmas is needed. Dental education institutions can help to supply human resources, who are capable of developing and carrying out the most suitable teledentistry application for all stakeholders.

Mouse periodontitis models using whole Porphyromonas gingivalis bacteria induction.

INTRODUCTION: Due to the increasing prevalence of periodontitis within the general population, it is important to study the progress and stages of periodontal disease and the efficacy of periodontal treatment through in vitro and in vivo experiments. Mouse periodontitis models are important in many in vivo studies. This study presents the findings from a scoping review of the current literature regarding the available method to produce mouse periodontitis models using whole Porphyromonas gingivalis (P. gingivalis) bacteria. METHODS: The scoping review was carried out based on the methodology described by Arskey and O'Malley. An electronic literature search was conducted in the PubMed database. Inclusion and exclusion criteria were established. The data were collected on a purpose-made data extraction table for descriptive analysis. RESULT: The researchers identified 11 articles that met the inclusion criteria for the review. Factors most considered in the literature relating to this topic are the vehicle to induce periodontitis, the type of strain for mice and P. gingivalis, the region of application, sacrifice day and the detection method used to measure the parameters. CONCLUSION: The most frequently used vehicle to induce a mouse periodontitis model is the combination of P. gingivalis with ligature. Future research on different types of vehicles and bacteria for inducing more effective and more time-efficient periodontitis models is needed to guide future researchers on this topic.

Clinical utility of dermoscopy on diagnosing pigmented papillary fungiform papillae of the tongue: A systematic review.

INTRODUCTION: The practice of dermoscopy in dental and oral examination is low due to less popularity and not well established of the diagnostic tool in dental practice. The dermoscopy examination provides a specific dermoscopes details for pigmented papillary fungiform of tongue (PPFT) as cobblestone appearance and rose-petal appearance. With this dermoscopes details serves as a non-invasive diagnostic tool and prevents biopsy procedure. OBJECTIVE: We performed a systematic review to evaluate the published papers related to pigmented papillary fungiform on the tongue, aiming to understand the diagnostic role of dermoscopy examination in pigmented papillary fungiform. DATA SYNTHESIS: Initial result was 136 studies. Final exclusion of 27 articles was made based on the following factors: reports with no clinical images, studies that did not confirm the diagnosis of PPFT and studies that did not use the dermoscopes details. Finally, seventeen studies with nineteen cases, reported of pigmented papillary fungiform of the tongue. Six studies (consist six cases) reported the dermoscopy and histopathology diagnosis of pigmented papillary fungiform, eleven studies (consist thirteen cases) reported only the dermoscopy. The dermoscopy examination presented cobblestone appearance is 47.37% and rose petal appearance is 52.63%. The comparation study by histopathology diagnosis was done, revealed no specific appearances. CONCLUSIONS: The clinical appearance and dermoscopy is the key for diagnosis of the papillary fungiform on the tongue. Further research is needed for determining the etiology and predisposing factor in papillary fungiform so that the possibility of developing this condition can be predicted and proper treatment could be performed.

Calcium Hydroxide Increases Human Umbilical Cord Mesenchymal Stem Cells Expressions of Apoptotic Protease-Activating Factor-1, Caspase-3 and Caspase-9.

PURPOSE: Calcium hydroxide is a gold standard dental material generally used for pulpal and periapical therapy including regenerative endodontic procedures because of its positive properties. However, evaluation about this material on stem cells is limited. Human umbilical cord mesenchymal stem cells (HUCMSCs) are potential to be used in regenerative therapy. Regenerative therapy needs a sustainable cell supply to maintain its regenerative capacity. The aim of this study was to ascertain the apoptosis result of calcium hydroxide on HUCMSCs through the expression of apoptotic protease-activating factor-1 (APAF-1), caspase-3, and caspase-9. MATERIALS AND METHODS: This study used a thawed frozen stock of passage 5 HUCMSCs, grown in minimum essential medium (MEM) alpha containing calcium hydroxide at concentration of 0.1 microgram/mL for 1, 3 and 7 days. Polyclonal antibody with fluorescence isothiocyanate (FITC) label was used to evaluate the expressions. APAF-1, caspase-3, and caspase-9 expressions were recorded and compared on every observation day using fluorescence microscope. Analysis of variance was performed to analyze the significance among the results of treatment groups. The results were concluded significant if p<0.05. RESULTS: The addition of calcium hydroxide in MEM alpha medium increases HUCMSCs expression of APAF-1, caspase-3 and caspase-9 significantly, compared to the control group without calcium hydroxide (p<0.05) in all the times. Day 1 showed the lowest increase followed by higher expressions on day 3 and day 7. CONCLUSION: HUCMSCs express increased APAF-1, caspase-3 and caspase-9 after in-vitro calcium hydroxide exposure. This should be considered when using calcium hydroxide on HUCMSCs for regenerative procedures with regard to other positive properties.

The impact of oral health on physical fitness: A systematic review.

BACKGROUND: Oral health problems may have numerous effects on general health, including physical fitness and performance. In this review, we aimed to systematically review the available evidence to assess the effect of oral health on general physical fitness. METHODS: We systematically performed a literature search in two different databases (PUBMED and EMBASE) without restriction to the year of publication. Articles were included if the subjects were humans and the primary aim was to assess the effects of dental and/or oral health problems on physical activity using either objective physical measurements or physical performance tests. The quality of the studies was then assessed using a Joanna Briggs Institute (JBI) Critical Appraisal tool. RESULTS: A total of 2651 articles were initially retrieved from the systematic search of the literature. Of these, a final total of 11 articles following the inclusion criteria were included in the review. All of the 11 articles included in the review had good methodological quality. Of the 11 articles, ten articles suggested a correlation between dental and oral condition toward physical fitness, body balance, cardiorespiratory function, and also cognitive function. Only one article found contradictory results, which showed that periodontal conditions did not correlate with the cardiorespiratory function. Malocclusion, including the number of remaining teeth, was reported in five studies (45.4%), periodontal disease was evaluated in six studies (54.5%), along with slight evaluation of periapical inflammation. CONCLUSION: This review suggests that there is a negative effect of poor dental and/or oral health on physical fitness and performance.

Cytokines and Chemokines in Periodontitis.

Periodontitis is a common inflammatory periodontal disease affecting a wide range of population all over the world. The causing bacteria releases chemicals which activate the innate immune system to release proinflammatory cytokines contributing to more progression. This activates the acquired immune system leading to more progression of periodontitis. As the immune response goes on, released cytokines and chemokines can damage the periodontal ligaments, gingiva, and alveolar bone. There are many types of cytokines and chemokines in periodontitis. Cytokines are peptide mediators who are responsible for cell signaling and communication. Chemokines are a large subfamily of cytokines having the ability to coordinate leukocyte recruitment and activation. This paper is a narrative review of the literature.This review ensures that inflammatory mediators in the case of periodontitis can cause a noticeable damage in the whole apparatus of the periodontium. It causes soft tissue inflammation and bone damage affected by the mediators of both innate and acquired immune system.The inflammatory process is accompanied by large network of cytokines and chemokines. There is high expression of proinflammatory cytokines such as interleukin (IL)-1α, IL-1ß, IL-6, IL-12, tumor necrosis factor (TNF)-α, and regulatory cytokines such as IL-4, IL-1(RA) receptor antagonist, IL-10, and induced protein (IP)-10. There is also increased production of cytokines IL-10, IL-12, interferon-γ, IP-10, IL-1RA, and IL-4. Cytokines IL-17, IL-6, IL-1ß, TNF-α, macrophage colony-stimulating factor, and prostaglandin E2 trigger the osteoclast activity causing bone resorption.

Factors influencing the utilization of dental services in East Java, Indonesia.

Background: Despite high levels dental issues and insurance coverage in the East Java province Indonesia, the utilization of dental services is still low. This research aims to test whether certain individual-level sociodemographic, behavioural, and clinical characteristics influenced the current level of dental services utilization by East Java residents. Methods: A secondary analysis was undertaken using data on the East Java province from the Indonesian Basic Health Research 2013, which included 90,551 randomly selected respondents aged 5-100 years old. Socio-demographic characteristics (age, sex, education and residential location), dental behavior (tooth brushing habit), and clinical (dental) condition were self-reported through a questionnaire. Multivariable models were generated to estimate prevalence ratios (PR), and 95% confidence intervals (95% CI). Results: Prevalence of dental service utilization during the last 12 months in East Java province is only 9 %. Respondents 25-<50 years old showed the highest utilization of dental services. Being male, having lower education and living in a district (as opposed to municipalities) were indicators for having lower utilization of dental treatment (PR [95% CI] = 0.81 [0.79-0.84], PR [95% CI] = 0.89 [0.86-0.93] and PR [95% CI] = 0.91 [0.88-0.95], respectively). Respondents with poor tooth brushing habit showed lower utilization of dental services. Having teeth was associated with higher utilization of dental treatment (PR [95% CI] = 1.39 [1.16-1.66). Conclusions: Age, sex, education and residential location influence the utilization of dental services among Indonesia's East Java residents. Poor tooth brushing habits and being edentulous are also indicators of lesser utilization. These results call for urgent public health interventions to increase equitable dental care services utilization.

Maternal caries experience influences offspring's early childhood caries-a birth cohort study.

OBJECTIVE: To describe early childhood caries (ECC) patterns and evaluate the associations with maternal caries experience and other factors. METHODS: A secondary analysis was undertaken using data from the Study of Mothers' and Infants' Life Events Affecting Oral Health (SMILE), a population-based birth cohort study. It used data from 1040 mother/child dyads. Standardized oral examinations of the mothers and the children were conducted when children were 2-3 years old to determine the prevalence of ECC (main outcome) and maternal caries experience (main exposure variable). Maternal sociodemographic characteristics, time-restricting conditions (relationship status, work status and number of children in the household) and dental health behaviours (brushing frequency and sugary beverage consumption) served as covariates. Data on child dental health behaviours were collected at two years of age. Multivariable models were generated for ECC to estimate prevalence ratios (PR) for the association between ECC and maternal caries experience, controlling for the covariates. RESULTS: The prevalence of ECC among 2- to 3-year-old children was 10.6% (95%CI: 8.7%-12.5%). It was higher in children whose mothers had greater caries experience. Children whose mothers had higher caries experience had 86% (PR = 1.86 [1.27-2.72]) greater risk of having ECC than those whose mothers had low caries experience. Children whose teeth had not been brushed the night before had a higher risk of ECC (PR = 1.4 [1.01-1.9]) than their counterparts. Women born in Australia, New Zealand or the UK had offspring with lower risk of ECC. CONCLUSIONS: Maternal caries experience was an independent risk factor for offspring ECC. However, good oral health behaviours practised by mothers for their children may alleviate such risk. Mothers need to be supported to adopt good oral health behaviours and a healthy diet for their child.

Husband's Support and Wife's Decision to Children's Dental Visit: Is There Any Relationship?

BACKGROUND: Early childhood caries (ECC) is the most common dental caries in children. The 2013 Indonesian basic health survey showed that there were still many children in developmental age affected by dental caries. Parents' participation is very necessary in guiding, giving understanding, reminding, and providing facilities so that children can maintain their overall oral hygiene. Hence, parents can prevent plaque accumulation and the occurrence of caries in children. OBJECTIVE: This study aimed to determine the effect of husbands' support on the decision of mothers to take their children to the dentist. SUBJECTS AND METHODS: This study used a cross-sectional method. The samples from this study were 95 mothers from 3 kindergartens in Surabaya. Ninety-five mothers were randomly chosen as research respondents and filled out the research questionnaires. The data obtained were processed using statistical analysis to determine the correlation. RESULTS: Research respondents with low husband support (subjective norms) who did not take their children to the dentist had a significant value (p = 0.004) compared to the study respondents with high husband support who did not bring their children to the dentist (p = 0.093). CONCLUSION: Mothers with low support from husbands tend to have the attitude not to take their children to do routine dental and oral examinations.

Factors influencing the severity of dental caries among Indonesian children with autism spectrum disorder - a pilot study.

AIM: To assess the prevalence of dental caries among autism spectrum disorders (ASD) children in Surabaya, Indonesia, and to explore the association between oral health-related behaviors comprising toothbrushing, snacking and dental visiting and the severity of caries. METHODS: The prevalence and severity of caries were assessed using DMF-T/dmf-t and PUFA/pufa indexes for mixed dentitions. The parents or carers' responses were collected to identify the oral health-related behaviors that were associated with caries severity. RESULTS: This study shows that almost 79% of ASD children in Surabaya were experiencing caries and 47.1% had untreated caries with pulp involvement or more severe conditions. Oral health behaviour factors associated with the severity of dental caries experienced by children with autism were brushing frequency (Β [95% CI] =2.46 [0.09-4.83] and 2.03 [0.78-3.28]), brushing time (Β [95% CI] =3.76 [1.32-6.20] and 2.03 [0.74-3.32]) and cleansing after snack (B [95% CI] = 2.04 [0.20-3.89] and 1.21 [0.23-2.18]) in DMF-T/dmf-t and PUFA/pufa indexes, respectively. CONCLUSIONS: The prevalence of caries among children with autism in Surabaya was high. The severity was associated with brushing and snacking behaviors. Caries in children with autism should be paid attention, and research in modifying daily activities are needed to allow them to adopt more healthy oral health-related behaviors.

The prevalence and severity of root surface caries across Australian generations.

BACKGROUND: The "failure of success" theory predicts that as subsequent generations of older adults retain more teeth, those additional teeth will experience more oral disease like root surface caries. The theory in relation to root surface caries has never been tested in a cross-generational study. This study aims to compare root surface caries across generations of South Australian older adults to test the theory and explore risk indicators for root surface caries. METHODS: Data were from the baseline of two South Australian studies separated by 22 years. In both studies, stratified random samples of people aged 60+ years from Adelaide and Mount Gambier were recruited. Dental examinations were performed by trained and calibrated dentists. One of the dental examiners from the earlier study was the gold standard examiner in the second study. Risk indicators included behavioural factors, clinical oral conditions, sociodemographic and socioeconomic status. Root surface caries was assessed as untreated root surface caries (root decayed surfaces [RDS]), treated root surface caries (root filled surfaces [RFS]) and treated or untreated root surface caries (root decayed and filled surfaces [RDFS]) and was presented as the prevalence and summed count. Multivariable models for Poisson and negative binomial distributions were used to estimate prevalence ratios (PR) and mean ratios (MR), respectively, and their 95% confidence intervals (95% CI). RESULTS: The current generation of South Australian older adults has significantly lower RDS (PR [95% CI] = 0.65 [0.47-0.89]; MR [95% CI] = 0.51 [0.35-0.73]) and RDFS (PR [95% CI] = 0.84 [0.71-0.99]; MR [95% CI] = 0.76 [0.65-0.90]) than the previous generation. The RFS in the previous and current generation was similar. Gingival recession, irregular brushing, dental visiting for a problem and smoking were the indicators for RDS, while age, gingival recession, tooth brushing frequency, time since last dental visit and reason of visiting were the indicators for RFS or RDFS. CONCLUSIONS: These results do not support the "failure of success" theory in relation to root surface caries among South Australian older adults. Despite the higher number of teeth retained, the current generation of older adults has less root surface caries than the previous generation. Behavioural factors remain the indicators of root surface caries across the generations.

Root surface caries among older Australians.

OBJECTIVES: Root caries has increased as a clinical problem in recent decades. However, the use of multiple waves of longitudinal follow-up data in estimating root caries increment has not been previously attempted. The aims of this study were to quantify root caries increment from a longitudinal study of older adults with 4 oral examinations over 11 years and to examine behavioural factors associated with root caries. METHODS: A secondary analysis was undertaken using data collected in 4 waves (baseline, 2-year, 5-year and 11-year) of the South Australian Dental Longitudinal Study which began in 1991/92. The study group consisted of a stratified random sample of people aged 60+ years at baseline. A total of 358 participants with complete oral examinations in all 4 waves were included. The examinations were performed by trained and calibrated dentists. Baseline behavioural risk factors (toothbrushing frequency, flossing frequency, dental visiting pattern, reason for dental visiting and tobacco smoking status) and time in years across the 4 waves were the main exposures. Baseline clinical oral conditions (gingival condition and gingival recession), demographic and socio-economic risk factors served as covariates. Root caries was measured as mean number of untreated root surfaces (root DS) and decayed/filled root surfaces (root DFS) at each wave of examinations. Multivariable multilevel growth model using linear regression analysis was used to get an estimate for root caries increment and associated oral health-related behaviours adjusting for all the covariates. RESULTS: Findings from the multivariable models indicated that the annual increment of root DS and root DFS were 0.07 (SE = 0.01) and 0.11 (SE = 0.02) surfaces, respectively. Irregular brushing (E [SE] = 0.25 [0.12]), visiting the dentist only for problems (E [SE] = 0.30 [0.13]) and smoking (E [SE] = 0.33 [0.12]) were risk factors for the increase in root DS. Irregular flossing and more frequent dental visit were associated with the increase in root DFS. CONCLUSIONS: Root caries increased slowly across time among relatively healthier Australian older adults. Irregular brushing, unfavourable dental visiting and tobacco smoking were risk factors for the increase in untreated root caries, while irregular flossing and more frequent dental visiting were associated with the increase in root DFS.