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This study evaluated in vivo, an intraoral device against the gold standard esophageal device for gastroesophageal reflux disease (GERD) monitoring. Subjects scheduled for a catheter-based esophageal pH/impedance testing at a gastroenterology clinic were recruited. They were screened using the GerdQ questionnaire, demographics and dental conditions recorded. A prototype intraoral device, consisting of a Bravo™ capsule embedded in an Essix-style retainer fabricated for each subject, monitored intraoral pH. Concurrently, subjects underwent 24-h esophageal pH-impedance monitoring. A self-administered survey elicited the comfort and acceptance of both devices. The study recruited ten adult subjects (23 to 60-years-old) with a median GerdQ score of 9.5 corresponding to a 79% likelihood of GERD. Subjects with severe dental erosion had significantly (p < 0.05) higher acid exposure time and more non-meal reflux events. No adverse events were associated with the intraoral device while one was recorded for the esophageal device. The intraoral device was significantly more comfortable to place, more comfortable to wear, and interfered less with daily routine compared to the esophageal device. Accuracy of the intraoral device ranged between 86.15% and 37.82%. Being more tolerable than traditional esophageal pH monitoring, intraoral pH monitoring may be a useful adjunct for the diagnosis and management of GERD.
Subject(s)
Esophageal pH Monitoring , Gastroesophageal Reflux , Humans , Gastroesophageal Reflux/diagnosis , Adult , Middle Aged , Male , Female , Esophageal pH Monitoring/instrumentation , Esophageal pH Monitoring/methods , Young Adult , Hydrogen-Ion Concentration , Pilot Projects , Surveys and Questionnaires , Electric ImpedanceABSTRACT
BACKGROUND: There is currently insufficient evidence on potential predictors of a child's behaviour with nitrous oxide (N2O) sedation. AIM: To examine the association between a child's temperament and behavioural outcomes during dental treatment with N2O sedation, and the child's perception to N2O sedation. DESIGN: At the first visit (dental treatment visit), temperament was assessed using the Child Behaviour Questionnaire-Short Form and behaviour was assessed by an independent rater using the Venham Behaviour Rating Scale. At the second visit, the child's experience with N2O sedation was elicited. RESULTS: Seventy-two healthy children aged between 36 and 95 months were recruited. Planned dental treatment was completed in 84.7% of the subjects. Venham behaviour success <3 and Venham behaviour success <1 were achieved in 73.6% and 33.3%, respectively. The temperament domain of effortful control was associated with Venham behaviour score (ρ = -0.266, p = .024) and Venham behaviour success <1 (OR = 3.506, 95% CI = 1.328-9.259, p = .011). Baseline Frankl behaviour score was significantly associated with all behavioural outcomes. Venham behaviour success <3 was significantly associated with a child reporting to have enjoyed the dental treatment visit (p = .026). CONCLUSION: Effortful control and baseline behaviour were associated with behavioural outcomes of N2O sedation and can be used to predict a child's behaviour.
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OBJECTIVES: The aim of this study was to present key findings from the 2019 national adult oral health survey in Singapore (NAOHS). METHODS: A multi-stage stratified sampling method was used to recruit participants for a representative national adult oral health survey. A total of 12 212 households were randomly selected from the National Database on Dwellings in Singapore. Within each household eligible persons aged ≥65 years were automatically invited to participate while a Kish selection method was used to invite those between 21 and 64 years old. The survey comprised a face-to-face interview questionnaire and a clinical examination which recorded details of tooth loss, DMFT, DMFS and prevalence of periodontal disease according to the CPITN and the US CDC-AAP classifications. Weighted analysis was performed to adjust for oversampling, non-response and post-stratification. Multivariate regression with backward stepwise selection was carried out to identify predictors of chronic periodontal disease and untreated dental caries. RESULTS: Six hundred and sixty-three participants completed both the questionnaires and the clinical examination. The prevalence of edentulousness was 2.7%. Of participants, 34.8% presented with untreated dental caries with a higher proportion found in those who were aged ≥60 years, of Malay ethnicity, living in 1-2-room public housing and who only visited the dentist when there was a problem. Mean DMFS and DMFT indices were 24.7 and 7.9 respectively. Based on the CDC-AAP classification, the prevalence of moderate-severe chronic periodontitis was 56.9% and increased with age, with a higher proportion in males. Participants with untreated dental caries were more likely to have moderate or severe periodontal disease. CONCLUSIONS: Survey findings showed high prevalence of dental caries and periodontal disease, at 34.8% and 77.6% respectively. A clear socio-economic gradient in the distribution of tooth loss, untreated dental caries and moderate-to-severe periodontitis was observed.
Subject(s)
Dental Caries , Dental Health Surveys , Humans , Singapore/epidemiology , Male , Female , Middle Aged , Aged , Prevalence , Dental Caries/epidemiology , Adult , Periodontal Diseases/epidemiology , Young Adult , DMF Index , Tooth Loss/epidemiology , Oral Health/statistics & numerical dataABSTRACT
OBJECTIVES: Prevention complements the curative management of oral diseases. Effective preventive interventions involve the adoption of oral health promoting behaviours. Little is known about the awareness of oral disease and its prevention among Singaporean adults as well as their prevailing oral health attitudes and behaviours. The aim of the study was to describe the oral health knowledge, attitudes and behaviours of adults in Singapore. METHODS: A random sample of adults (≥21 years old) in Singapore was selected to complete an interviewer-administered questionnaire. The questionnaire gathered information about their knowledge of the aetiology, signs and symptoms as well as prevention of dental caries and periodontal disease; attitudes about the value of teeth, locus of control in maintaining oral health and oral health behaviours including toothbrushing, flossing and dental attendance. RESULTS: A total of 1196 adults of weighted mean age 48 years old with almost equal proportions of males and females responded to the questionnaire. Participants were more unaware about the causes of periodontal disease (25.7%) than dental caries (4%). While more than 90% of participants felt that healthy teeth were important and could affect their overall health, many (67.0%) felt it was natural to lose their teeth with old age. Among the participants, 83.5% brushed their teeth twice a day; 41.9% flossed their teeth and 53.9% visited the dentist at least once a year. CONCLUSIONS: The study findings showed good knowledge around dental caries but some gaps around periodontal disease. It also found that participants perceived having limited control over preventing tooth loss. Irregular dental attendance and poor denture wearing habits were also noted. The findings shed light on key areas to focus on through oral health promotion to improve overall oral health.
Subject(s)
Health Behavior , Health Knowledge, Attitudes, Practice , Oral Health , Humans , Singapore/epidemiology , Male , Female , Middle Aged , Adult , Oral Health/statistics & numerical data , Aged , Periodontal Diseases/epidemiology , Periodontal Diseases/prevention & control , Surveys and Questionnaires , Dental Caries/epidemiology , Dental Caries/prevention & control , Dental Health Surveys , Young Adult , Toothbrushing/statistics & numerical data , Dental Care/statistics & numerical dataABSTRACT
OBJECTIVES: The Oral and Systemic Health Impact Profile for Periodontal Disease (OSHIP-Perio) was developed to measure health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL). This study aimed to determine the responsiveness and minimal importance difference (MID) of the OSHIP-Perio. METHODS: Subjects with periodontal disease completed the OSHIP-Perio at baseline and six to ten weeks after non-surgical periodontal therapy. Comparisons of the clinical variables and the OSHIP-Perio scores before and after treatment were analysed using the Wilcoxon signed-rank test, together with the Oral Health Impact Profile (OHIP-49, OHIP-14 and OHIP-5) scores. The MIDs for all the instruments were calculated using distribution-based methods. RESULTS: Fifty-one case subjects who completed periodontal treatment and the OSHIP-Perio instrument were included for analysis. Significant improvement in all clinical variables after treatment (p < 0.001) was observed. The OSHIP-Perio total score as well as its four-dimensional scores (periodontal, oral function, orofacial pain and psychosocial impact) were significantly reduced after treatment (p < 0.001), indicating better OHRQoL. Findings were consistent with the other OHIP instruments. In determining the MID, the percentage point change of the OSHIP-Perio was found to be lower than the shorter OHIP-5 instrument when using both effect sizes (ES) (10.71% vs. 15.0% at 0.5SD) and standard error of measurement (SEM) (5.36% vs. 10.0% at 1SEM; 8.93% vs. 20.0% at 2SEM) calculations. CONCLUSIONS: The OSHIP-Perio demonstrated good responsiveness which was comparable to the OHIP-49 and its short-form derivatives. Its required percentage point change in determining its MID is smaller than the OHIP-5.
Subject(s)
Periodontal Diseases , Quality of Life , Humans , Oral Health , Periodontal Diseases/therapy , Surveys and Questionnaires , Dental CareABSTRACT
OBJECTIVES: This study aimed to develop and validate the Oral and Systemic Health Impact Profile for Periodontal Disease (OSHIP-Perio), a disease-specific instrument for assessing the impact of periodontal disease on both general and oral health-related quality of life. METHODS: A pool of 58 items, developed from the Oral Health Impact Profile (OHIP-49) and data generated through semi-structured patient interviews, was tested on 80 case subjects with periodontal disease and 80 control subjects. The dimensionality of the preliminary measure was evaluated using exploratory factor analysis (EFA). Rasch analysis was then performed on the primary dimension using the Winsteps software (Version 5.1.4.0) to render the final items for the OSHIP-Perio. The reliability and validity of the final OSHIP-Perio were subsequently determined. RESULTS: Using an EFA factor loading >0.50, the primary dimension comprised 18 items. Using Rasch analysis, four items were subsequently excluded. The final OSHIP-Perio with 14 items showed excellent test-retest reliability (overall intraclass correlation coefficient index = 0.99) and internal consistency (overall Cronbach's alpha coefficient = 0.96). It also exhibited good discriminant validity when case and control groups were compared (p < 0.001). It showed very strong correlations (rho coefficients >0.90) with the OHIP-5, OHIP-14 and OHIP-49, exhibiting good concurrent validity. It demonstrated a moderate correlation (rho coefficient = 0.60) with the global health rating, exhibiting a moderate convergent validity. CONCLUSIONS: The 14-item OSHIP-Perio exhibited good psychometric properties comparable to the OHIP-5, OHIP-14 and OHIP-49 for evaluating the impact of periodontal disease on quality of life.
Subject(s)
Periodontal Diseases , Quality of Life , Humans , Oral Health , Reproducibility of Results , Surveys and QuestionnairesABSTRACT
PURPOSE: Oral mucositis is a common complication for patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) and causes pain and difficulties in functions like eating and swallowing, resulting in lower quality of life and greater need of treatment with opioids and parenteral nutrition. This prospective multicenter study focused on pediatric recipients of HSCT in the neutropenic phase concerning oral complications, timing, severity, and patient experience. METHODS: The cohort comprised 68 patients, median age 11.1 years (IQR 6.3) receiving allogeneic HSCT at three clinical sites. Medical records were retrieved for therapy regimens, concomitant medications, oral and dental history, and subjective oral complaints. Calibrated dentists conducted an oral and dental investigation before HSCT. After HSCT graft infusion, study personnel made bedside assessments and patients filled out a questionnaire once or twice a week until neutrophil engraftment. RESULTS: We followed 63 patients through the neutropenic phase until engraftment. 50% developed oral mucositis of grades 2-4. Peak severity occurred at 8-11 days after stem cell infusion. Altogether, 87% had subjective oral complaints. The temporal distribution of adverse events is similar to the development of oral mucositis. The most bothersome symptoms were blisters and oral ulcerations, including mucositis; 40% reported severe pain and major impact on activities of daily living despite continuous use of opioids. CONCLUSION: This study highlights the burden of oral complications and their negative effect on the health and quality of life of HSCT recipients.
Subject(s)
Hematopoietic Stem Cell Transplantation , Stomatitis , Humans , Child , Prospective Studies , Incidence , Quality of Life , Activities of Daily Living , Stomatitis/epidemiology , Stomatitis/etiology , Hematopoietic Stem Cell Transplantation/adverse effects , Hematopoietic Stem Cell Transplantation/methods , Pain/etiology , Multicenter Studies as TopicABSTRACT
OBJECTIVES: There is a lack of studies evaluating the accuracy of the 2009 American Association of Endodontists (AAE) diagnostic criteria for diagnosing pulpal health in primary teeth. This study aimed to estimate and correlate the diagnostic accuracy of clinical diagnosis of reversible and irreversible pulpitis using the 2009 AAE criteria with histological findings in primary teeth. METHODS: Eighty primary teeth that were clinically diagnosed with normal pulp (n = 10), reversible pulpitis (n = 30), irreversible pulpitis (n = 30) and pulp necrosis (n = 10) were collected. The teeth were histo-processed, and pulp tissues were diagnosed histologically as uninflamed pulp, reversible or irreversibly inflamed and necrosis based on previously proposed criteria. RESULTS: The clinical diagnosis of pulp necrosis (sensitivity 70%, specificity 96%) and normal pulp (sensitivity 91%, specificity 100%) matched the histological diagnosis of necrosis and uninflamed pulp in 70% and 100%, respectively. The clinical diagnosis of irreversible pulpitis (sensitivity 64%, specificity 72%) matched the histological diagnosis of irreversible pulp inflammation for 47% of teeth evaluated. For the clinical diagnosis of reversible pulpitis (sensitivity: 65%, specificity: 86%), 80% matched the histological diagnosis of reversible pulp inflammation. Teeth with histologically diagnosed irreversible pulp inflammation were more likely to have lingering (OR 5.08; 95% CI 1.48-17.46, P = 0.010) and nocturnal tooth pain (OR 15.86; 95% CI 1.57-160.47, P = 0.019) when compared to teeth with reversible pulp inflammation. Using the classification and regression tree model, the presence of widened periodontal ligament space and nocturnal tooth pain were useful predictors of irreversible pulp inflammation with an accuracy of 78%. CONCLUSION: The 2009 AAE criteria was acceptable for primary teeth with pulp necrosis and normal pulp but poor for reversible pulpitis and irreversible pulpitis.
Subject(s)
Endodontists , Pulpitis , Humans , Pulpitis/diagnosis , Dental Pulp Necrosis/diagnosis , Dental Pulp , Inflammation/pathology , Necrosis/pathology , Tooth, Deciduous , PainABSTRACT
PURPOSE: Le Fort I maxillary impaction is an orthognathic surgical procedure to reposition the maxillary complex superiorly. The objective of this study is to investigate if maxillary impaction negatively affects the nasal airway. METHODS: A systematic review with meta-analysis was performed to investigate the effects of maxillary impaction on the nasal cavity. PubMed, Embase, and Cochrane Library databases were accessed. Observational studies, nonrandomized, and randomized controlled trials were included if Le Fort 1 maxillary impaction and nasal airway outcomes assessments were performed. Studies were excluded if maxillary impaction or nasal airway outcome assessment was not performed or if the study included patients with cleft or craniofacial syndromes, previous nasal surgeries, or active respiratory tract. The demographic data, study methodology, magnitude of maxillary impaction, and outcomes related to the nasal airway were collected. These outcomes includes anatomical changes (evaluated by rhinoscopy, acoustic rhinometry, and computed tomography), changes to nasal airflow and resistance (evaluated by rhinomanometry) and changes to quality of life. RESULTS: The search yielded 7517 studies. Ten studies were included after the application of the selection criteria. A total of 126 patients underwent pure maxillary impaction, 97 underwent maxillary impaction and advancement, and 12 had impaction with setback. Despite that maxillary impactions decreased the nasal cavity volume by +21.7%, the cross-sectional area of the narrowest parts of the cavity was only reduced by -8.4%. Maxillary impactions generally increases the nasal airflow (+12.6%) while reducing nasal resistance (-20.2%). Rhinoscopies also showed a reduction in nasal obstruction. CONCLUSION: Maxillary impaction did not negatively affect the nasal airway. The surgeries did not lead to the reduction of the cross-sectional area at the strictures of the nasal cavities. The nasal airflow and resistance was not decreased and increased, respectively. The quality of life of the patients was also not shown to have worsened.
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OBJECTIVE: To explore the decision-making patterns among expert and novice orthodontists and oral maxillofacial surgeons in the management of adults with Class III malocclusions and moderate skeletal discrepancies. DESIGN: Self-administered questionnaire survey. SETTING: Faculty of Dentistry, National University of Singapore and the University Dental Cluster, National University Hospital, Singapore. PARTICIPANTS: A total of 55 clinicians, comprising 13 expert orthodontists, 20 novice orthodontists, 10 expert oral maxillofacial surgeons and 12 novice oral maxillofacial surgeons. METHODS: Clinicians assessed six adults with a Class III malocclusion and moderate skeletal discrepancy. They were asked to decide who could be managed exclusively by orthodontic camouflage, who would require combined orthodontic-orthognathic surgery as the only viable treatment, or who could be offered both treatment options. RESULTS: The study found variable decision-making patterns among the clinicians in each case. Only 18.2%-40.0% of clinicians agreed that the cases selected were of moderate skeletal discrepancies and could be offered both treatment options whereas the rest were either more inclined to recommend orthodontic camouflage or orthognathic surgery. Intra-clinician agreement (n = 20) was only fair (Kappa value = 0.31). There was only slight inter-clinician agreement (n = 55) on their clinical decisions (Kappa value = 0.10). Clinical experience and dental specialty did not significantly influence clinicians' decisions. Oral and maxillofacial surgeons were 1.98 times more likely to indicate orthognathic surgery as the only viable treatment compared to the orthodontists (95% confidence interval = 1.15-3.42). CONCLUSION: Variability in the patterns of decision-making for adults with a Class III malocclusion and moderate skeletal discrepancy was observed among the clinicians with low repeatability and agreement.
Subject(s)
Malocclusion, Angle Class III , Orthodontists , Humans , Adult , Oral and Maxillofacial Surgeons , Malocclusion, Angle Class III/surgery , Surveys and QuestionnairesABSTRACT
Interpreting radiographic lesions on dental radiographs is a challenging process especially for novice learners, and there is a lack of tools available to support this diagnostic process. This study introduced dental students to two diagnostic aids with contrasting reasoning approaches-ORAD DDx, which uses an analytic, forward reasoning approach, and a Radiographic Atlas, which emphasizes a non-analytic, backward reasoning approach. We compared the effectiveness of ORAD DDx and the Atlas in improving students' diagnostic accuracy and their ability to recall features of radiographic lesions. Participants (99 third-year dental students) were assigned to ORAD DDx, Atlas and Control groups. In the pre-test and post-test, participants provided their diagnosis for eight types of radiographic lesions. All groups also completed a Cued Recall Test. Feedback about ORAD DDx and the Atlas was collected. Results indicated that the Atlas was more effective than ORAD DDx in improving diagnostic accuracy (Estimated marginal mean difference = 1.88 (95% CI 0.30-3.46), p = 0.014, Cohen's d = 0.714). Participants in the Atlas group also outperformed the Control group in the recall of the lesions' radiographic features (Estimated marginal mean difference = 3.42 (95% CI 0.85-5.99), p = 0.005, Cohen's d = 0.793). Students reported that both ORAD DDx and Atlas increased their confidence and decreased the mental effort required to develop differential diagnosis (p ≤ 0.001). This study demonstrates the effectiveness of a non-analytic approach in interpreting dental radiographs among novice learners through the novel use of diagnostic aids.
Subject(s)
Dichlorodiphenyl Dichloroethylene , Students, Dental , Humans , Cues , Diagnosis, Differential , Mental RecallABSTRACT
PURPOSE: Rodent models have emerged as an alternative to established larger animal models for peri-implantitis research. However, the construct validity of rodent models is controversial due to a lack of consensus regarding their histological, morphological, and biochemical characteristics. This systematic review sought to validate rodent models by characterizing their morphological changes, particularly marginal bone loss (MBL), a hallmark of peri-implantitis. METHODS: This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A literature search was performed electronically using MEDLINE (PubMed), and Embase, identifying pre-clinical studies reporting MBL after experimental peri-implantitis induction in rodents. Each study's risk of bias was assessed using the Systematic Review Center for Laboratory animal Experimentation (SYRCLE) risk of bias tool. A meta-analysis was performed for the difference in MBL, comparing healthy implants to those with experimental peri-implantitis. RESULTS: Of the 1,014 unique records retrieved, 23 studies that met the eligibility criteria were included. Peri-implantitis was induced using 4 methods: ligatures, lipopolysaccharide, microbial infection, and titanium particles. Studies presented high to unclear risks of bias. During the osseointegration phase, 11.6% and 6.4%-11.3% of implants inserted in mice and rats, respectively, had failed to osseointegrate. Twelve studies were included in the meta-analysis of the linear MBL measured using micro-computed tomography. Following experimental peri-implantitis, the MBL was estimated to be 0.25 mm (95% confidence interval [CI], 0.14-0.36 mm) in mice and 0.26 mm (95% CI, 0.19-0.34 mm) in rats. The resulting peri-implant MBL was circumferential, consisting of supra- and infrabony components. CONCLUSIONS: Experimental peri-implantitis in rodent models results in circumferential MBL, with morphology consistent with the clinical presentation of peri-implantitis. While rodent models are promising, there is still a need to further characterize their healing potentials, standardize experiment protocols, and improve the reporting of results and methodology. TRIAL REGISTRATION: PROSPERO Identifier: CRD42020209776.
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BACKGROUND/AIM: The knowledge of standardized care guidelines is critical to the confidence of practitioners in managing dental trauma. Therefore, the aim of this study was to assess the awareness, use and impact of the International Association of Dental Traumatology guidelines, and the online Dental Trauma Guide on general dental practitioners' self-reported confidence and knowledge in managing traumatic dental injuries in the primary and permanent dentitions. MATERIALS AND METHODS: A cross-sectional, pre-piloted, 27-item self-administered questionnaire survey was distributed electronically to general dental practitioners' working within five member states of the Gulf Cooperation Council countries (Kingdom of Bahrain, Kingdom of Saudi Arabia, Kuwait, Oman, and Qatar) between September and December 2020. Data were collected and analysed using descriptive statistics and Wilcoxon Signed Rank test analysis for relevant comparisons. RESULTS: A total of 294 respondents completed the survey, with the majority being from the Kingdom of Saudi Arabia (47.4%) and Qatar (27.3%). A lack of evidence-based knowledge in managing traumatic dental injuries was evident among more than half of the respondents. Respondents who were cognizant of the recent International Association of Dental Traumatology guidelines (2020) and those who use the Dental Trauma Guide routinely demonstrated a higher self-reported confidence level in managing both simple and complex primary dentition trauma, as well as simple traumatic dental injuries in the permanent dentition (p < .05). CONCLUSION: This survey highlights critical deficiencies in the knowledge of a large number of the respondents in the management of dental trauma which is likely to cause irreversible long-term patient effects.
Subject(s)
Dentists , Tooth Injuries , Cross-Sectional Studies , Humans , Professional Role , Saudi Arabia , Surveys and Questionnaires , Tooth Injuries/therapyABSTRACT
OBJECTIVES: The primary aim of this study was to assess the linear and geometric accuracy of 3-dimensional (3D) printed tooth replicas when compared to the actual tooth. The secondary aims were to compare the accuracy of three different 3D printers and to evaluate dimensional changes of tooth replicas after sterilization. METHODS: A sample of 16 teeth were selected from recruited patients. Segmentation was carried out to generate files from the patient's cone beam computed tomography (CBCT) data, Tooth replicas were then printed using three printers making use of Polyjet, laser stereolithography (SLA) and digital light processing (DLP) technology respectively. These replicas, along with the actual tooth, were scanned by an optical scanner. Replicas were sent for sterilization and scanned again. Paired superimposition of the scans was performed. RESULTS: A mean length difference of 0.36 mm and mean geometric (root mean square [RMS]) difference of 0.56 mm was found. Qualitative analysis showed that the replicas were generally larger in size. Repeated ANOVA tests showed that the Polyjet printer had the highest accuracy (p<0.0001). After sterilization, there was an overall mean length difference of 0.10 mm and RMS deviation of 0.02 mm. CONCLUSION: This study found that there was a significant difference in linear and geometric measurements of the tooth replicas when compared to the actual tooth. This study also provides evidence that the printer which made use of Polyjet technology was able to produce more accurate models than SLA or DLP printers. Printed tooth models demonstrated clinically insignificant changes after heat sterilization. CLINICAL SIGNIFICANCE: 3D printed tooth replicas derived from the patient's CBCT data may be used in autotransplantation to increase predictability of the procedure. In order for this novel digital approach to realize its potential, it is critical to address questions as to how accurate the various printing technologies are in fabricating replicas.
Subject(s)
Spiral Cone-Beam Computed Tomography , Tooth , Computer-Aided Design , Cone-Beam Computed Tomography , Humans , Printing, Three-Dimensional , Tooth/diagnostic imaging , Transplantation, AutologousABSTRACT
BACKGROUND: There is no consensus regarding when children are ready to brush independently. AIM: To examine the effects of chronological age and motor development on toothbrushing effectiveness in 5- to 7-year-old children. DESIGN: In this cross-sectional study, the change in Oral Hygiene Index (OHI) score and the improvement in OHI category (eg, poor to fair) were used to measure toothbrushing effectiveness. Motor development was assessed using the Beery-Buktenica Developmental Test of Visual Motor Integration, and a parental questionnaire was used to determine the child's ability to perform certain daily tasks. RESULTS: Children aged ≥6 years were significantly more likely to show improvement in OHI category (OR = 2.4, p = .032) than 5-year-old children. Parental report of their child's ability to write/print addresses (OR = 3.7, p = .009), tie shoelaces (OR = 2.9, p = .008), and cut/file nails (OR = 3.2, p = .036) was significantly more likely to show improvement in OHI category. A model using chronological age, visual motor age, ability to write/print addresses, tie shoelaces, cut/file nails, and toothbrushing duration achieved 61.8% sensitivity and 80.4% specificity in predicting a child's ability to achieve improvement in OHI category. CONCLUSIONS: Children entering elementary school (≥6 years old) brushed their teeth more effectively than preschool children. A multifactorial model provided an acceptable predictor of the child's ability to brush effectively.
Subject(s)
Parents , Toothbrushing , Child , Child, Preschool , Cross-Sectional Studies , Humans , Schools , Surveys and QuestionnairesABSTRACT
BACKGROUND: Parents are frequently concerned that their child's mastication may be compromised after comprehensive dental treatment. AIM: To evaluate changes in masticatory function and food preferences after dental treatment in children with early childhood caries. DESIGN: This prospective study assessed masticatory function with the (1) mixing ability test using duo-coloured chewing gum and (2) the number of chews/g and time taken to eat six food items before and 3 months after dental treatment. A dental examination and a food preference questionnaire were also completed. RESULTS: Twenty-five children (age: 4.9 ± 0.5 years, baseline dmft/child: 11.4 ± 4.9) completed the study. The mean number of restorations/child, total extractions/child, and posterior extractions/child was 5.1 ± 2.9, 6.4 ± 5.2, and 3.6 ± 2.3, respectively. The number of chews/g of cereal (p = .014) and popcorn (p = .003) significantly increased after dental treatment. The number of chews/g and duration taken for cereal (chews/g: r = 0.795, p = .000, duration: r = 0.794, p = .000) and peanuts (chews/g: r = 0.459, p = .032) were significantly associated with more extractions. There was no change in mastication function for the other foods, mixing ability score, and child's food preferences after dental treatment. CONCLUSIONS: An increased number of chews/g is needed for certain hard foods after dental treatment, which was associated with an increased number of total and posterior extractions.
Subject(s)
Dental Caries Susceptibility , Dental Caries , Child , Child, Preschool , Dental Care , Dental Caries/therapy , Food , Humans , Prospective StudiesABSTRACT
Oral health status ideally warrants for a holistic biopsychosocial approach to health and wellness. Little is known about the impact of behavioral problems on oral health-related quality of life (OHRQoL) in children due to the paucity of studies in early childhood, particularly in Asian multi-ethnic populations. This study evaluated the relationship between early child's socioemotional factors and OHRQoL, as well as its association with orofacial pain (OFP) and early childhood caries (ECC) in the Asian GUSTO birth cohort. Mother-child dyads were postnatally assessed at 3 time points. The Child Behavior Checklist (CBCL) was used to assess the child's socioemotional and behavioral problems at age 4-4.5 years together with other validated questionnaires to evaluate maternal anxiety and depression. ECC detection was performed at age 5, and OHRQoL (primary) and OFP (secondary) outcomes were assessed at age 6 from a total of 555 mother-child dyads. After a univariate regression analysis was performed to identify potential predictors and confounders, a multivariate regression model was run with predisposing factors (CBCL internalization and externalization problems, OFP, ECC) and adjusted for confounders (maternal psychosocial states, maternal education) to determine associations with OHRQoL. Results showed an association between CBCL internalization scores and poorer OHRQoL (RR = 1.03, p = 0.033, 95% CI 1.01 to 1.05), although the limited risk ratio may not have a practical applicability in psychosocially healthy children, alike the majority of those evaluated in this cohort. The average OHRQoL overall score among children with OFP was 2.39 times more than those without OFP (OR = 2.39, p < 0.001, 95% CI 2.00 to 2.86). Thus, in early childhood, OFP, and to lesser extent internalizing behaviors, may negatively impact OHRQoL. This study therefore highlights the complex relationship between OHRQoL and its predisposing socioemotional and somatic pain factors, and demands further investigations in clinically relevant populations.
Subject(s)
Asian People/psychology , Child Behavior/psychology , Ethnicity/statistics & numerical data , Facial Pain/physiopathology , Oral Health/standards , Quality of Life , Child , Child, Preschool , Educational Status , Ethnicity/psychology , Facial Pain/psychology , Female , Humans , Longitudinal Studies , Male , Prospective Studies , Surveys and QuestionnairesABSTRACT
Objective: This study aimed to compare the clinical outcomes in dental prophylaxis between rubber cup polishing and an air polishing system using erythritol powder, with or without prior dental plaque disclosure. Method and materials: In this single-blind, randomized, controlled, split-mouth clinical trial, healthy participants with full-mouth plaque score ≥ 60% were recruited. Quadrants in each participant were randomly assigned to four treatment groups: air polishing with prior plaque disclosure; air polishing without plaque disclosure; rubber cup polishing with prior plaque disclosure; or rubber cup polishing without plaque disclosure. Plaque scores and treatment time for each quadrant were recorded. Posttreatment satisfaction questionnaires for both the participants and operators were also completed. Results: In total, 88 participants consisting of 42 men and 46 women (mean age 23.1 ± 2.0 years) were recruited. Air polishing with prior plaque disclosure had significantly lower posttreatment marginal mean plaque score (21.7 ± 17.5%) compared to air polishing (33.5 ± 23.4%) or rubber cup polishing (34.5 ± 19.7%) without prior plaque disclosure (P < .001). Marginal mean treatment time for air polishing (325 seconds; SE = 10 seconds) was significantly shorter compared to rubber cup polishing (407 seconds; SE = 15 seconds) (P < .001). Both the participants and operators preferred air polishing over rubber cup polishing (P < .001). Conclusion: Prior plaque disclosure enhanced the effectiveness of plaque removal. Air polishing exhibited better treatment efficiency than rubber cup polishing and was the patients' and clinicians' preferred treatment modality.
Subject(s)
Dental Plaque , Rubber , Adult , Dental Plaque/prevention & control , Dental Polishing , Dental Prophylaxis , Disclosure , Female , Humans , Male , Single-Blind Method , Young AdultABSTRACT
OBJECTIVE: To detail a scoping review on the global and regional relative frequencies of oral mucosal disorders in the children based on both clinical studies and those reported from biopsy records. MATERIALS AND METHODS: A literature search was completed from 1 January 1990 to 31 December 2018 using PubMed and EMBASE. RESULTS: Twenty clinical studies (sample size: 85,976) and 34 studies from biopsy services (40,522 biopsies) were included. Clinically, the most frequent conditions were aphthous ulcerations (1.82%), trauma-associated lesions (1.33%) and herpes simplex virus (HSV)-associated lesions (1.33%). Overall, the most commonly biopsied lesions were mucoceles (17.12%), fibrous lesions (9.06%) and pyogenic granuloma (4.87%). By WHO geographic region, the pooled relative frequencies of the most common oral lesions were similar between regions in both clinical and biopsy studies. Across regions, geographic tongue (migratory glossitis), HSV lesions, fissured tongue and trauma-associated ulcers were the most commonly reported paediatric oral mucosal lesions in clinical studies, while mucoceles, fibrous lesions and pyogenic granuloma were the most commonly biopsied lesions. CONCLUSIONS: The scoping review suggests data from the clinical studies and biopsy records shared similarities in the most commonly observed mucosal lesions in children across regions. In addition, the majority of lesions were benign in nature.
Subject(s)
Mouth Diseases/epidemiology , Oral Ulcer/epidemiology , Stomatitis, Aphthous/epidemiology , Biopsy , Child , Congresses as Topic , Humans , Mouth Diseases/diagnosis , Mouth Mucosa/pathology , Oral Medicine , Oral Ulcer/diagnosis , Stomatitis, Aphthous/pathologyABSTRACT
Dental caries, although preventable, remains one of the most prevalent chronic disease worldwide. Most studies focused on the relationship between sugar intake and caries. However, examining multidimensional dietary patterns is becoming increasingly important. Here, we examined the relationship between dietary patterns from ages 6 to 12 months and early childhood caries (ECC) at age 2 to 3-years. Infant dietary data was collected from caregivers and dietary pattern trajectories from 6 to 12 months derived. Oral examinations were carried out by trained calibrated dentists at ages 2 and 3 years. Associations between dietary pattern and ECC were estimated using generalized estimating equation. We found a 3.9 fold lower prevalence of decayed surfaces among children with high Guidelines dietary pattern scores at 6-months (IRR 0.26; CI [0.12-0.53]; p-value < 0.001) and 100% reduction of decayed surfaces with increased intakes of Guidelines dietary pattern foods from 6 to 12-month (IRR 2.4 × 10-4; CI [4.2 × 10-7-0.13]; p-value = 0.01). Suggesting that following the Guideline dietary pattern, which corresponds most closely to current World Health Organization weaning guidelines, at 6 months and an increase in pattern score between 6 and 12 months were protective against ECC development compared to Predominantly breastmilk, Easy-to-prepare foods and Noodles (in soup) and seafood dietary patterns.