Analysis of sterilizer allocation and related factors in dental health-care settings in Yunnan Province, China: a cross-sectional study.

OBJECTIVE: To investigate the status and related factors of sterilizers in dental health-care settings in Yunnan Province, with the aim of providing a theoretical basis for the health administrative department to formulate regional quality control programs and systems, proposing reasonable suggestions for optimizing the allocation of sterilizer resources in Yunnan's dental health-care settings, thereby improving resource utilization efficiency. METHODS: This cross-sectional survey was conducted in 2600 dental health-care settings in Yunnan Province in March 2020. Uni-variable linear regression, multi-variable linear regression, curve fitting and threshold effect analysis were used to understand the relationship between dental units and sterilizers. RESULTS: A total of 2600 dental health-care settings were included. The disinfection and sterilization work were mainly completed by the dental department in 1510(58.1%) institutions. 44(1.7%) institutions were not allocated sterilization equipment, and 1632 (62.8%) had only one sterilizer. The median allocation of sterilizers was 1.0. Uni-variable linear regression showed significant differences in covariates such as dental unit, dental handpiece, disinfection equipment, dentist, and dental assistant, which were more sensitive (p < 0.001) and statistically significant. The adjusted model was more stable in the multi-variable linear regression, and the differences in covariates between different settings were statistically significant. Curve fitting revealed an S-shaped curvilinear relationship between the number of dental units and sterilizers in oral healthcare settings. CONCLUSION: The disinfection and sterilization work was mainly completed by the dental department in dental health-care settings in Yunnan Province. Sterilizer allocation increases with the number of dental units, but some institutions have insufficient allocation of sterilizer and manpower resources, resulting in certain risks of infection control. Thus, it is necessary to strengthen supervision, inspection and regional quality control work in infection control of dentistry.

Oral health status of 12-year-old children in Lisu minority ethnic group in China: a cross-sectional study.

BACKGROUND: Lisu is an ethnic minority group and most of them are living in Yunnan, China. This study investigated the oral health status among 12-year-old Lisu children in Yunnan. METHOD: This survey employed a multistage sampling method to recruit 12-year-old Lisu children. Two calibrated dentists performed the oral examinations in the primary schools. They examined dental caries, gingival bleeding and dental fluorosis using the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed to the children to collect their sociodemographic background information and oral health-related behaviours. A chi-square test, the Mann-Whitney U test, zero-inflated negative binomial (ZINB) regression and multivariate logistic regression were used for statistical analysis. RESULTS: This survey invited 512 children, and 482 children (48% boys) participated in the study (response rate: 94%). Their caries prevalence was 35% and their caries experience in mean (SD) DMFT scores was 0.63 (0.10). The mean (SD) DT score was 0.60 (1.10), consisting 95% of the mean DMFT scores. No dental fluorosis was observed; whereas 426 children (88%) had gingival bleeding. Results of ZINB model indicated sex and sugary-snacking habits were related to the dental caries experience (p < 0.05). The gingival-bleeding prevalence was associated with the mother's education level, the child's monthly-pocket money and daily toothbrushing frequency (p < 0.05). CONCLUSION: Dental caries and gingival bleeding were prevalent among 12-year-old Lisu children in the Yunnan province in China, and most of the decayed teeth were unrestored. Dental fluorosis was not observed in the children.

Tooth wear among five-year-old children in Jakarta, Indonesia.

BACKGROUND: This study aimed to evaluate the prevalence of tooth wear among preschool children in Jakarta, Indonesia, and examine the risk factors associated with its occurrence. METHODS: An epidemiological survey was conducted with a cross-sectional study design. The participants were recruited via cluster sampling. Tooth wear was clinically assessed by one examiner using the Basic Erosive Wear Examination (BEWE) criteria. The children's caries experience was also recorded. The parents of the participating children completed a self-administered questionnaire to answer demographic questions about the children and gather information about the children's diet and oral health behaviors as well as the parents' dental health-related knowledge. The data were analyzed using the Chi-square test and binary logistic regression. RESULTS: A total of 752 five-year-old children were invited to participate, with 691 (92%) enrolling in the study. Tooth wear occurred in 23% (161/691, BEWE > 0) of the participants, in which 78% (125/161) had at least one moderate tooth wear status (BEWE = 2). The consumption of citrus drinks, fruit juice, and vitamin C supplement drinks, together with the child's caries experience, the father's education level, and the family's socioeconomic status, were significantly associated with tooth wear. CONCLUSIONS: The five-year-old preschool children in Jakarta had a relatively low prevalence of tooth wear. Those consuming more acidic drinks, those with a higher socioeconomic status, and those with an absence of caries experience had a higher risk of tooth wear.

Dental caries status of Lisu preschool children in Yunnan Province, China: a cross-sectional study.

BACKGROUND: Dental caries is still considered a major public health concern for human beings, especially minority groups and those living in disadvantaged communities. The Lisu is a minority group in China of more than 702,000 people located primarily in Yunnan Province. The present study was aimed at studying the status of dental caries status, as well as its risk factors, among Lisu children aged 5 years in Yunnan Province, China. METHODS: A multistage cluster sampling method was employed for participants' recruitment. Two calibrated dentists carried out the clinical examination with dental mirrors and CPI probes under an LED headlight. The dental caries experience was assessed by the dmft index. Oral hygiene status was evaluated using the visible plaque index (VPI). Information on the child's socio-demographic characteristics and oral health-related practices were collected using a parental questionnaire. A zero-inflated negative binomial regression (ZINB) was employed to analyse the associations between the dental caries status and the children's social-demographic status and their oral health-related behaviours. RESULTS: In all, 470 Lisu children aged 5 were invited, and 404 were examined. Their mean dmft (±SD) and caries prevalence were 5.6 ± 4.8 and 80%, respectively. Their mean VPI scores were 58% ± 21%. Lisu children who brushed their teeth at least once daily had higher dmft scores, and children from high-income families were more likely to have dental caries. CONCLUSION: The prevalence of dental caries among Lisu children aged 5 years in Yunnan, China was high, and their caries status was severe, with a majority of carious teeth untreated. The dental caries experience of Lisu children aged 5 was related to their brushing frequency and families' economic backgrounds.

Attitude toward and awareness of medical-dental collaboration among medical and dental students in a university in Indonesia.

BACKGROUND: Medical-dental collaboration expands patients' access to health services, improves healthcare outcomes, and reduces the burden and cost of care, especially for those with chronic diseases. The aim of the present study is to investigate the attitude toward and awareness of medical-dental collaboration among medical and dental students attending the Universitas Indonesia. METHODS: All medical and dental students at the Universitas Indonesia were invited to participate in a web-based questionnaire survey that contained eight questions on attitudes toward medical-dental collaboration and two questions regarding awareness of dental-medical collaborative practices. The demographic backgrounds of all participants were obtained. The chi-square test and logistic regression analysis were employed for data analysis. RESULTS: A total of 1,432 questionnaires were distributed, and 1,137 (79%) were appropriately completed. In general, 992 (87%) students had a positive attitude toward medical-dental collaboration. Dental students had a more positive attitude than medical students (odds ratio [OR] = 2.694; p = 0.001), and senior students had a more positive attitude than junior students (OR = 2.271; p = 0.001). Most students (86%) were aware of medical-dental collaboration at the Universitas Indonesia and reported that emergency medicine, surgery, and otolaryngology were the three most common medical disciplines that entailed medical-dental collaboration. CONCLUSIONS: In general, the medical and dental students demonstrated positive attitudes and awareness of medical-dental collaboration at the Universitas Indonesia. Positive attitude and awareness can establish an essential foundation for fostering collaboration between medicine and dentistry, which is vital to improve resource efficiency and healthcare standards.

Clinical studies on core-carrier obturation: a systematic review and meta-analysis.

BACKGROUND: This systematic review aimed to evaluate the clinical performance of core-carrier obturation in endodontic treatment. METHODS: Keywords of "(core carrier OR Thermafil) OR (cold lateral condensation OR lateral condensation) OR (warm vertical condensation OR vertical condensation) AND (obturation OR root canal filling) AND clinical study" were searched for all obtainable publications up to year 2017 in the databases of PubMed, ScienceDirect, EMBASE, Scopus and Web of Science. The success rate, short-term postoperative pain, overfilling and adaptation of core-carrier obturation from clinical studies were selected. Reviews, laboratory studies, animal studies and irrelevant reports were excluded. RESULTS: 1349 relevant articles were identified with 149 duplicated articles removed and 1173 irrelevant articles were excluded after screening. The titles and abstracts of the 19 identified articles were screened in the systematic review. The full texts of remaining articles were retrieved with data extracted for meta-analysis on the success rate, postoperative pain, overfilling and adaptation of obturation. The pooled success rate of core-carrier obturation was 83% (95% CI: 69%-91%). The pooled incidence of 1-day and 7-day short-term postoperative pain were 35% (95% CI: 15%-62%) and 6% (95% CI: 1-35%). The pooled proportion of teeth with overfilling and adequate adaptation of the obturation material were 31% (95% CI: 18%-50%) and 85% (95% CI: 75%-91%), respectively. CONCLUSIONS: The success rate of endodontic treatment using core-carrier obturation was 83%. Short-term postoperative pain was not uncommon (24%). Most teeth (85%) had adequate adaptation using core-carrier obturation material, but a considerable amount of teeth (31%) had overfilling.

Caries remineralisation and arresting effect in children by professionally applied fluoride treatment - a systematic review.

BACKGROUND: As a low-cost and easily operated treatment, the use of professionally applied topical fluoride was approved for preventing dental caries and remineralising early enamel caries or white spot lesions. It is also used to arrest dentine caries. The aim of this study is to investigate the clinical efficacy of professional fluoride therapy in remineralising and arresting caries in children. METHOD: A systematic search of publications from 1948 to 2014 was conducted using four databases: PubMed, Cochrane Library, ISI Web of Science and Embase. The key words used were (fluoride) AND (remineralisation OR remineralization OR arresting) AND (children caries OR early childhood caries). The title and abstract of initially identified publications were screened. Clinical trials about home-use fluorides, laboratory studies, case reports, reviews, non-English articles and irrelevant studies were excluded. The full texts of the remaining papers were retrieved. Manual screening was conducted on the bibliographies of the remaining papers to identify relevant articles. RESULTS: A total of 2177 papers were found, and 17 randomised clinical trials were included in this review. Ten studies investigated the remineralising effect on early enamel caries using silicon tetrafluoride, fluoride gel, silver diamine fluoride or sodium fluoride. Seven studies reported an arresting effect on dentine caries using silver diamine fluoride or nano-silver fluoride. Meta-analysis was performed on four papers using 5 % sodium fluoride varnish to remineralise early enamel caries, and the overall percentage of remineralised enamel caries was 63.6 % (95 % CI: 36.0 % - 91.2 %; p < 0.001). Meta-analysis was also performed on five papers using 38 % silver diamine fluoride to arrest dentine caries and the overall proportion of arrested dentine caries was 65.9 % (95 % CI: 41.2 % - 90.7 %; p < 0.001). CONCLUSION: Professionally applied 5 % sodium fluoride varnish can remineralise early enamel caries and 38 % silver diamine fluoride is effective in arresting dentine caries.

Attitude and awareness of medical and dental students towards collaboration between medical and dental practice in Hong Kong.

BACKGROUND: Medical-dental collaboration is essential for improving resource efficiency and standards of care. However, few studies have been conducted on it. This study aimed to investigate the attitude and awareness of medical and dental students about collaboration between medical and dental practices in Hong Kong. METHODS: All medical and dental students in Hong Kong were invited to complete a questionnaire survey at their universities, hospitals and residential halls. It contained 8 questions designed to elicit their attitudes about the collaboration between medical and dental practice. Students were also asked about their awareness of the collaboration between dentistry and medicine. The questionnaires were directly distributed to medical and dental students. The finished questionnaires were immediately collected by research assistants on site. RESULTS: A total of 1,857 questionnaires were distributed and 809 (44%) were returned. Their mean attitude score (SD) towards medical-dental collaboration was 6.37 (1.44). Most students (77%) were aware of the collaboration between medical and dental practice in Hong Kong. They considered that Ear, Nose & Throat, General Surgery and Family Medicine were the 3 most common medical disciplines which entailed collaboration between medical and dental practice. CONCLUSION: In this study, the medical and dental students in general demonstrated a good attitude and awareness of the collaboration between medical and dental practice in Hong Kong. This established an essential foundation for fostering medical-dental collaboration, which is vital to improving resource efficiency and standards of care.

Dental and periodontal status of 12-year-old Dai school children in Yunnan Province, China: a cross-sectional study.

BACKGROUND: The Dai people are one of the ethnic minorities in China and have a population of 1,260,000. They have the same origin as one of the main ethnic groups in Laos and Thailand. The study aims to describe the dental caries and gingival status of 12-year-old Dai children in China and to study the factors affecting their oral-health status. METHODS: This cross-sectional oral-health survey was conducted from 2011-2012 with ethics approval. A sample of 12-year-old Dai children living in Yunnan, China, was selected using a multistage and cluster sampling method. One trained examiner performed the clinical examination. Caries experience was measured using DMFT index, and gingival status was assessed with CPI index. A self-completed questionnaire was sent to the children, and they were asked about their backgrounds and oral-health-related behaviors and oral-health knowledge. Binary logistic regression analysis was performed to investigate the factors that affected the caries status. RESULTS: A total of 875 children were invited, and 823 (94 %) joined the survey. The prevalence of caries experience among the participants was 40 %. The mean DMFT and DT scores were 0.9 and 0.8, respectively. Most children (93 %) had gingivitis, and many (46 %) had calculus. Girls and those who had visited a dentist during the previous year had a higher prevalence of caries. CONCLUSION: Dental caries were prevalent among 12-year-old Dai children in China. The periodontal condition of most of the children was poor. Caries were associated with gender and dental attendance.

Treatment outcomes of single-visit versus multiple-visit non-surgical endodontic therapy: a randomised clinical trial.

BACKGROUND: Clincians have been providing single-visit and multiple-visit endodontic treatments for their patients. This study aims to compare the success rate, prevalence of postoperative pain and chairside time of single-visit and multiple-visit endodontic treatments. METHOD: Patients who required primary endodontic treatment in a university dental clinic were randomly allocated to two general dentists for single-visit or multiple-visit treatments using the same materials and procedures. Ni-Ti rotary files were used to prepare the root canals, which were subsequently obturated with a core-carrier technique. The chairside time was recorded. The treated teeth were followed up every 6 months on clinically signs and symptoms including pain, tenderness to percussion, sinus tract, mobility and abscess. Periapical radiographs were taken to assess periapical pathology. Successful treatments were neither clinical signs/symptoms noted nor radiographic periapical pathology found postoperatively. RESULTS: A total of 220 teeth from patients aged 46.4 ± 14.1 were followed up for at least 18 months. The mean (±SD) follow-up period was 29.4 ± 9.3 months. The success rates of single-visit and multiple-visit treatments were 88.9 and 87.4 %, respectively (p = 0.729, effect size odds ratio = 1.156). Maxillary teeth had odds ratios of 3.16 (95 % CI: 1.33 to 7.46; p = 0.009) and absence of preoperative apical periodontitis had odds ratios of 4.35 (95 % CI: 1.43 to 13.24; p = 0.010) were identified from logistic regression as having a higher success rate. The average chairside times of single-visit and multiple-visit treatments were 62.0 and 92.9 min, respectively (mean difference = -30.9, 95 % CI: -39.4 to -22.4, p < 0.001, effect size odds ratio = -0.996). Single-visit and multiple-visit treatment had no significant difference in the prevalence of postoperative pain within 7 days (21 and 12 %, p = 0.055, effect size odds ratio = 2.061) and after at least 18 months (0.9 and 1.0 %, p > 0.999, effect size odds ratio = 0.879). CONCLUSIONS: The success rate and prevalence of postoperative pain of single-visit or multiple-visit treatment had no significant difference. The chairside time for single-visit treatment was shorter than multiple-visit treatment. TRIAL REGISTRATION: Clinical Trials (WHO) ChiCTR-IOR-15006117 registered on 20 March 2015.

Incidence of post-obturation pain after single-visit versus multiple-visit non-surgical endodontic treatments.

BACKGROUND: Post-obturation pain is frustrating to both patients and dentists. Its incidence may change with the use of contemporary endodontic techniques. This randomised clinical trial aims to compare the incidence of post-obturation pain at one and seven days after single-visit and multiple-visit non-surgical endodontic treatments. METHODS: Patients who required primary endodontic treatment in the two clinical trial centres in Hong Kong (HK) and in Beijing (PK) were recruited. Three HK dentists and three PK dentists performed endodontic treatments on 567 teeth using the same procedures and materials, either in a single visit or over multiple visits, using either core carrier or cold lateral condensation for obturation. RESULTS: The attrition rate was 5.1%, and a total of 538 teeth were evaluated. Among these teeth, 232 (43%) were operated in HK, 275 (51%) were treated in a single visit, and 234 (43%) were treated using core carrier obturation. Logistic regression analysis showed that teeth with apical periodontitis (OR = 0.35, 95% CI = 0.21-0.57, p < 0.01) and less pre-operative pain (OR = 1.10, 95% CI = 1.03-1.18, p < 0.01) had lower incidences of post-obturation pain after one day. The incidences of post-obturation pain after one day for single-visit and multiple-visit treatments were 24.7% (68 of 275) and 33.5% (88 of 263), respectively (p = 0.50). The incidences of post-obturation pain after seven days for single-visit and multiple-visit treatments were 4.0% (11 of 275) and 5.3% (14 of 263), respectively (p = 0.47). CONCLUSIONS: There was no significant difference in the incidences of post-obturation pain after one day and seven days with single-visit or multiple-visit endodontic treatments. TRIAL REGISTRATION: ChiCTR-IOR-15005989.

Treatment time for non-surgical endodontic therapy with or without a magnifying loupe.

BACKGROUND: Use of magnifying loupe may increase the efficiency of dental care. This clinical trial compared the time in performing non-surgical endodontic therapy with or without the use of a magnifying loupe. METHODS: Patients who required primary endodontic treatment in clinical trial centres at the University of Hong Kong (HKU) in Hong Kong and Peking University (PKU) in Beijing were invited to participate in this study. Two HKU dentists and 2 PKU dentists, forming 2 pairs of dentists with similar years of clinical experience, performed endodontic treatments according to the same procedures and used the same materials, either in single or multiple visits. They had no prior experience with the use of a magnifying loupe. One dentist from each pair was trained to use a magnifying loupe (x2.5). The treatment time was recorded. RESULTS: Eighty-four PKU patients with a mean age of 42.8 years and 98 HKU patients with a mean age of 46.0 years were recruited in this study. Ninety-six teeth were treated with a magnifying loupe and 86 teeth were treated without a magnifying loupe. The results showed that treatment time was not associated with age, gender, tooth vitality, or the presence of apical radiolucency or sinus tract. The results of ANCOVA revealed the treatment time was associated with the clinic (HKU or PKU), root canal system (single or multiple), presence of preoperative pain, treatment visit (single or multiple), the use of a magnifying loupe, and the experience of the operator. CONCLUSION: In this study, the use of a magnifying loupe could significantly reduce the endodontic treatment time. TRIAL REGISTRATION: Clinical Trials ChiCTR-IOR-15005988 registered 15 February 2015.

Dental caries and erosion status of 12-year-old Hong Kong children.

BACKGROUND: This study aimed to assess the dental caries and erosion status of 12-year-old Hong Kong children and study the determinants of dental caries and dental erosion of these children. METHODS: The survey was performed from 2011 to 2012 with ethics approval. Stratified random sampling was adopted to select 12-year-old children in 7 primary schools in Hong Kong. The participating parents were asked to complete a self-administered questionnaire concerning their children's diet and oral health habits. The children were examined for caries status with WHO criteria by 3 calibrated examiners. Detection of dental erosion followed Basic Erosive Wear Examination (BEWE) criteria. RESULTS: A total of 704 children were recruited and 600 (316 boys, 53%) participated in the survey. There were 124 children (21%) with caries experience (DMFT > 0) and their DMFT was 0.34 ± 0.76. About half of their decay was unfilled (DT = 0.16 ± 0.52) The DMFT of girls and boys were 0.45 ± 0.89 and 0.23 ± 0.61, respectively (p = 0.001). Girls also had a higher DT (0.21 ± 0.62 compared with 0.11 ± 0.41, p = 0.013) and FT than boys (0.23 ± 0.63 compared with 0.12 ± 0.44, p = 0.016). Most children (75%) had at least some sign of erosion (BEWE > 0), but no severe erosion (BEWE = 3). Logistic regression showed girls who consumed soft drinks and took vitamin C supplements had higher caries risk. Dental erosion was more severe among the children who had caries experience and consumed fruit juice. CONCLUSIONS: The 12-year-old Hong Kong children had low caries experience, and almost half of the decay was left untreated. Although severe erosion was not found, many children had early signs of erosion.

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.

Dental and periodontal status of 12-year-old Bulang children in China.

BACKGROUND: Bulang is an ethnic minority group living in Yunnan in the southwestern part of China. There is little information pertaining to the oral health of Bulang children. This study aims to examine the dental caries and periodontal status of 12-year-old Bulang children in China and the factors affecting their oral-health status. METHODS: 12-year-old Bulang school children in Yunnan, China, were recruited through a multi-stage cluster sampling method. Following the recommendation of the World Health Organization, caries experiences were recorded using the DMFT index and periodontal status with the CPI index. A self-completed questionnaire was used to collect information on the background and oral health-related behaviours of the children. RESULTS: A total of 900 children in primary schools were invited, and 873 (97%) joined the survey. Their caries prevalence was 35%. Their caries experience in mean DMFT (±SD) score was 0.6 ± 1.1, and 94% of the carious teeth had no treatment. Most children (71%) had bleeding gums, and 58% of them had calculus. Girls and those who had visited a dentist in the previous year had higher caries risk. CONCLUSIONS: Dental caries was common among the 12-year-old Bulang children in China. Most of the carious teeth were left untreated. Caries prevalence was associated with gender and dental attendance. Their periodontal condition was poor, and more than half of them had calculus.

Dental caries status of Dai preschool children in Yunnan Province, China.

BACKGROUND: The Dai people, one of the ethnic minorities in China, have a population of 1,260,000. They have the same origin as one of the main ethnic groups of Laos and Thailand. Most of the Dai live in Yunnan province, which is located in the less-developed southwestern part of China. This study aimed to describe the oral health status of Dai preschool children in China and the factors that influence their oral health status. METHODS: An oral health survey was performed between 2011 and 2012 to select Dai five-year-old children using multi-stage stratified sampling in Yunnan. Their dental caries experience was measured using the "dmft" index, and severe caries was assessed using the "pa" index, which is modified from the "pufa" index. Oral hygiene status was assessed using the visual plaque index (VPI). A questionnaire to study the children's socio-demographic background and oral health-related behaviours was completed by the children's parents. RESULTS: A total of 833 children were examined. Their caries prevalence was 89% and 49% of the children had carious tooth with pulp involvement. The mean (SD) dmft score was 7.0 (5.3). Higher dmft scores were found among children who were girls, were currently bottle-fed, took daily sweet snacks, had higher VPI scores, and had visited a dentist within the last year. CONCLUSIONS: The caries prevalence and experience of the five-year-old Dai children in Yunnan, China was high, and almost half had severe caries. The caries experience was associated with gender, snack habits, dental visit habits, and oral hygiene status.

Pathway of Effects of Socioeconomic Status on Rural Left-behind Children to Receive Oral Health Services: A Structural Equation Modeling.

In a rural area with a high proportion of left-behind children (LBC), we aimed to identify the pathway of influence of socioeconomic status (SES) on LBCs to receive oral health services after individualized advice. Between September and October 2020, in a rural area of Yunnan, a survey of 238 LBC and 210 non-left-behind children (NLBC) showed that 91.9% and 94.2% had primary teeth caries, respectively. Their caregivers were advised on (1) dental care: bringing the children to seek professional dental care; and (2) self-care: supervising the children's oral health behaviors. Two to three months later, the children and their caregivers were visited to assess the compliance with these items of advice. Structural equation modeling (SEM) was used to handle the association between SES and compliance with the advice. A heatmap was used to visualize the data of reasons for seeking dental care or not. A total of 183 (87.1%) NLBCs and 206 (86.6%) LBCs were given the above advice; 32.9% of caregivers complied with dental care advice without a statistical difference between the LBC and NLBC group; 69.9% of caregivers of NLBCs complied with self-care advice, statistically more than those LBCs (59.2%). The education of caregivers was significantly associated with compliance with both advice items in univariate analysis. SES had a direct effect on the children being left behind and the level of oral health knowledge and awareness of the caregivers. Being left behind did not have an independent effect on receiving oral health services for children. "Dental disease was not severe" and "having no pain" were the main reasons for not seeking dental care. There was no clear grouping of participants with different background information based on the reasons given for seeking or not seeking dental care. Our study pointed to the importance of SES level. Being left behind alone may not be a risk factor for missing oral health services among rural children.

Effects of Parental Migration on Dental Caries of Six- to Eight-Year-Old Children Using Structural Equation Modeling.

This cross-sectional study aimed to document the relationship between dental caries, oral health behaviors, and the duration of parental migration in rural Yunnan, China, from September to December 2020. Seven rural primary schools with high parental migration were studied. The oral health status of 500 six- to eight-year-old students was assessed using clinical examination and caregivers' interviews. A total of 51.8% of the children had at least one parent absent for at least 6 months (left-behind children). Among those children with parental migration <6 months, 40.0% consumed sugar twice or more daily and 82.8% of those with parental migration from 6 to 12 months brushed once a day or less. The percentage of daily sugar consumption twice or more and brushing once or less among those without parental migration were 36.0% and 68.6%. Prevalence of caries in permanent teeth (DMFT) in children without parental migration and those whose parental migration <6 months, 6 to <12 months, and ≤12 months were 30.9%, 20.0%, 28.7% and 19.8%, respectively. Out of several other causal pathways between parental migration and dental caries, our structural equation model delineated that sugar consumption is the important mediator variable. Special education programs may be needed to educate caregivers on sugar consumption for the left-behind children in rural areas.

Oral Health Status of 12-Year-Old Hani Children in the Yunnan Province of China: A Cross-Sectional Study.

BACKGROUND: The aim of this cross-sectional study was to investigate the oral health status of Hani 12-year-old children in Yunnan, a province in Southwest China. METHOD: This study employed a multistage sampling method to recruit children from local primary schools. Two calibrated dentists examined the status of dental caries, gingival bleeding and dental fluorosis by adopting the diagnosis criteria recommended by the World Health Organization. A self-administrated questionnaire was distributed. The chi-square test and multivariate logistic regression were conducted. RESULTS: This study invited 480 Hani children, and recruited 413 children (52% boys) (response rate: 86%). The dental caries prevalence was 52%, and the caries experience associated with the mean (standard deviation) decayed, missing and filled teeth (DMFT) score was 1.10 (1.46). Gingival bleeding was diagnosed in 252 children (61%), and dental fluorosis was found in two children (0.5%). The results of the regression model indicated the prevalence of dental caries were associated with sugary snacking habits (p = 0.002). The prevalence of gingival bleeding was related to the mother's education level as well as the child's monthly pocket money (p < 0.05). CONCLUSION: Dental caries and gingival bleeding were prevalent among 12-year-old Hani children in the Yunnan province in China. Dental fluorosis was uncommon.

Dental Caries Status among Yi Preschool Children in Yunnan Province, China: A Cross-Sectional Study.

BACKGROUND: The Yi ethnic group is the sixth largest minority in China. The aim of this study was to investigate dental caries status among Yi preschool children in the Yunnan province, China. METHOD: This cross-sectional study invited 5-year-old Yi children using multistage cluster sampling. Two trained and calibrated dentists examined the children in kindergartens. The children's dental caries experience was assessed using the decayed, missing, and filled teeth (dmft) index. Visual plaque on an indexed tooth of each six sextants was recorded and the oral hygiene status was assessed using the Visible Plaque Index. Parents completed questionnaires that surveyed their educational attainment. The questionnaires also collected information about the children's demographics, snacking habits, oral-health-related behaviors and dental visit experiences. The associations between caries experiences and potential factors were analyzed using zero-inflated negative binomial regression. RESULTS: All 452 invited children (249 boys, 55%) participated in this study with a response rate of 100%. Dental caries prevalence rate was 83%. The mean dmft score and decayed teeth score were 5.2 ± 4.4 and 5.1 ± 4.4, respectively. Almost half of the children (n = 211, 47%) had visible plaque on four or more of the six sextants. Most (n = 366, 81%) of the children had not visited a dentist in the prior 12 months. Regression analysis found the children's caries experience was associated with their dental visit experience. CONCLUSION: The great majority of the Yi preschool children experienced dental caries and almost all of the cavities were not restored. Their oral hygiene was poor and visible plaque was commonly found on their teeth.