Parental Attitudes towards Child Oral Health and Their Structural Analysis.

The relationship between parental attitudes towards health and child development has been a topic of interest for many years; however, research results in this field are still inconsistent. This study aimed to develop a structural equation model of the Parental Attitudes toward Child Oral Health (PACOH) scale, using this model to analyse the relationship between parental attitudes with demographic variables and the oral health-related behaviour of parents and children. A total of 302 parents (87% mothers) answered questions regarding their own and their children's, aged 4-7 years, oral health-related actions and completed the 38-item PACOH scale. The structural equation model indicated that parental attitudes captured by the PACOH scale can be fitted to a second-order factorial model, even with the scale shortened to 21 items. The model demonstrated good fit characteristics (CFI = 0.925; IFI = 0.927; GFI = 0.915; RMSEA = 0.049), making it a reliable tool for examining the structure of parental attitudes. This model was employed in the multi-group analysis, revealing the close relationship between positive parents' attitudes towards their child's oral health and oral health-promoting behaviour both in parents and children, such as regular tooth brushing (p < 0.001), visiting the dentist (p = 0.027), and parents helping their child brush his/her teeth (p < 0.001). In light of these findings, it was concluded that Parental Attitudes towards Child Oral Health should be considered an essential factor influencing the development of oral health-promoting behaviour in children.

A Cross-Sectional Study of Oral Health Status and Behavioral Risk Indicators among Non-Smoking and Currently Smoking Lithuanian Adolescents.

The purpose of this study was to evaluate oral health status, behavioral risk indicators, and the impact of smoking on oral health among Lithuanian adolescents. This representative cross-sectional study was conducted among 15-year-old Lithuanian adolescents. The method of multistage cluster sampling was used. A total of 1127 adolescents met the inclusion criteria. Two originally created self-reported questionnaires were used in this study. Dental caries, periodontal status, and oral hygiene status were evaluated by four trained researchers. A p-value ≤ 0.05 was set to indicate statistically significant differences. Statistical analysis included Mann-Whitney, Kruskal-Wallis, and Spearman correlation tests. Out of all the participants, 9.6% self-reported being a current tobacco smoker. The mean PI value was 1.14 ± 0.69 among all the participants. Currently smoking adolescents had more active caries lesions (D-S) than those who did not smoke (13.2 ± 16.4 vs. 9.8 ± 10.7, p = 0.023). Considering periodontal status, non-smoking adolescents had significantly lower mean PSR index scores than current smokers (0.52 ± 0.51 vs. 0.61 ± 0.50, p = 0.0298). Tobacco smoking and the consumption of energy drinks were significantly associated (OR = 3.74, 95% CI 2.66-5.26, p < 0.001) among participants. Currently smoking adolescents tended to have improper dietary habits, especially a higher consumption of energy drinks; thus, they were more likely to have active dental caries lesions, as well as poorer periodontal status, than their non-smoking peers.

Associations of Prenatal Vitamin D status with Oral Health in Offspring: A Systematic Review.

PURPOSE: The aim of this work is to evaluate the impact of prenatal vitamin D levels on oral health in offspring. MATERIALS AND METHODS: The search was carried out in three databases: MEDLINE (PubMed), ResearchGate and Wiley Online Library. The inclusion criteria were randomised controlled trials and cohort studies published between June 16, 2017 and June 16, 2022, laboratory assessment of prenatal vitamin D status and evaluation of primary or mixed dentition for observation of dental caries and developmental defects of enamel. The risk of bias for randomised controlled trials was analysed according to the Cochrane risk-of-bias tool and Newcastle-Ottawa scale was used to assess risk of bias for cohort studies. RESULTS: A total of 177 studies were identified, 11 were included in the data synthesis. Eight out of 11 studies were considered as high quality and the other 3 studies had moderate risk of bias. The synthesis of data revealed that the impact of prenatal vitamin D status on oral health in children is quite controversial and subsequent studies are necessary to examine whether vitamin D levels affect the risk of developing dental caries and enamel defects. CONCLUSION: The effect of prenatal vitamin D on oral health in offspring is not entirely clear. Since disturbances in dental hard tissues have a polyetiological origin, health specialists need to notify mothers about other possible risk factors and emphasise the importance of eating habits and individual oral hygiene in early childhood.

Peculiarities of Dental Treatment among Paediatric Oncological Patients: a Case Report.

OBJECTIVES: According to the National Cancer Institute of Lithuania, cancer is diagnosed for almost 100 children each year. Oncological patients suffer from complications during and after treatment. Radiation therapy also affects dental hard tissues. Many oncological patients lose motivation to take care of their oral hygiene because they are focused on cancer diagnosis. This case report discusses prevention and dental treatment severity after radiation therapy treatment. MATERIAL AND METHODS: A 9-year-old boy with cancer diagnosis visited a dentist in 2017. The patient was complaining about poor aesthetic quality of the teeth, but there were no complaints about teeth sensitivity or pain. Different stages of active caries, poor oral hygiene, visible abundant plaque, swollen, red and bleeding gums were observed during appointment. A motivational interview explaining the importance of oral hygiene was conducted. Non-surgical caries treatment was prescribed during the first visit. Restorative treatment was performed after 1 month. RESULTS: The motivational interview explaining the importance of oral hygiene was conducted during every appointment per 3-year period. Unfortunately, oral hygiene is still poor due to the lack of motivation. Active-cavitated caries lesions were restored with glass ionomer cement and composite resin. The aesthetics of teeth was improved. CONCLUSIONS: Oncological and recovered patients after radiation therapy should be assigned to a high risk of caries. These patients should be treated individually by the algorithm. Psychological or psychotherapeutic assistance is necessary for patients due to motivation for treatment and oral care.

Estimation of Caries Treatment Needs in First Permanent Molars of Lithuanian 5-6-Year-Old Children, Based on Caries Lesion Activity Assessment.

Background and Objectives: Early detection of dental caries lesions at active stages of development can facilitate their monitoring and reduce needs for restorative dental care. This study aimed to describe the prevalence and caries treatment needs in first permanent molars of pre-school children, based on a caries lesion activity assessment, and in relation to participants' ages, dental plaque levels and toothbrushing habits. Materials and Methods: Large cross-sectional dental caries survey using multistage cluster sampling was conducted among Lithuanian 4-6-year-old children attending kindergartens. For the present study purpose, all individuals presenting erupted permanent molars were selected. Thus, only 5-6-year-olds (n = 453) took part in this study. They were examined for caries by one calibrated examiner using Nyvad clinical diagnostic criteria that differentiate between active and inactive caries lesions. Dental plaque was assessed by the Silness-Löe index, and parents' reports about toothbrushing frequency were collected. Results: Overall, 41% of permanent molars were affected by caries; 6-year-olds had more caries lesions than 5-year-olds (p <0.05). Mean number of decayed and filled surfaces (DF-S) of all participants was 1.79 (SD 2.93), half of lesions were noncavitated, more than one-third were cavitated and fillings comprised less than one surface per child. Majority of lesions were active; prevalence of inactive lesions (all noncavitated) was 1% and 6% in 5- and 6-year-olds, respectively. Prevalence of active lesions increased with age; it correlated with plaque levels and with toothbrushing frequency (<0.001). Likelihood to detect active lesions was up to nine times higher in teeth with abundant plaque (odds ratio (OR) 8.73; confidence interval (CI) 5.35-14.25), and up to seven times higher in individuals brushing teeth irregularly (OR 6.88; CI 2.21-21.41). Conclusions: The obtained data indicate high treatment needs in the erupted permanent molars of the Lithuanian pre-school population and imply that caries management should primarily focus on improved biofilm removal, accompanied with regular use of fluoridated toothpaste.

Periodontal status in 18-year-old Lithuanian adolescents: An epidemiological study.

OBJECTIVE: The aim of this study was to investigate the periodontal and oral hygiene status of 18-year-old Lithuanian adolescents. MATERIALS AND METHODS: Cross-sectional data were collected by a multistage sampling approach that was used to draw a representative sample of 1063 adolescents attending schools. In total, 20 schools from the alphabetical list of educational institutions in Lithuania agreed to participate. Periodontal status was evaluated using the Periodontal Screening and Recording (PSR) index. The oral hygiene status was assessed using the Silness-Löe plaque index. RESULTS: The analysis of the PSR index showed that 77.1% of the study population exhibited gum bleeding on probing, had supragingival and/or subgingival calculus, and shallow pockets. Analysis of the composition of the PSR index revealed that in children whose parents had low education levels (18.6%), gum bleeding was more common than in those whose parents had medium education levels (9.5%) (P<0.05). Our data showed that in 40.0% of the study participants, oral hygiene status was satisfactory, with a statistically significant difference between boys (46.9%) and girls (35.3%) (P<0.001). CONCLUSIONS: The results of our study showed that the periodontal and oral hygiene status of 18-year-old Lithuanian population could be characterized as poor. In total, 77.1% of the study participants were found to have periodontal conditions such as gum bleeding, dental calculus, and shallow pockets. The anterior teeth of the mandible were most frequently affected.

Dental caries risk indicators in early childhood and their association with caries polarization in adolescence: a cross-sectional study.

BACKGROUND: Based on the hypothesis that biological and social risks accumulate during life, it is important to identify possible dental caries risk indicators from the life course of early childhood and assess their association with caries polarization in adolescence. METHODS: A cross-sectional design was applied to the study, and a multistage cluster sampling method used to draw a representative sample of 1063 18-year-old Lithuanian adolescents. The dental examinations were performed according to the methodology for oral status evaluation recommended by the World Health Organization. Parents of the participating adolescents completed a self-administered questionnaire about their children's life course during early childhood. The interdependence of characteristics was evaluated by chi-square (χ (2)) and Student's (t) criteria. A multivariate logistic regression model with the Significant Caries (SiC) index as an outcome was performed. RESULTS: The mean scores for the number of decayed, missing, and filled teeth (DMFT) and decayed teeth (DT) in the SiC positive group were higher than the corresponding values in the SiC negative group (6.14 [SD, 2.30] and 1.67 [SD, 2.02] vs 1.28 [SD, 1.11] and 0.34 [SD, 0.69], p < 0.001, respectively). Three dental caries risk indicators were identified that were independently associated with a SiC positive outcome: gender(OR = 1.32 [95 % CI: 1.01-1.73]), earlier eruption of the first primary tooth(OR = 1.43 [95 % CI: 1.03-1.97]), and past caries experience in the primary dentition (OR = 1.62 [95 % CI:1.22-2.14]). CONCLUSIONS: These study findings provide reliable evidence that gender, earlier eruption of the first primary tooth, and past caries experience in the primary dentition should be considered to be dental caries risk indicators and may have an adverse effect on caries polarization in adolescence.

The role of parental education and socioeconomic status in dental caries prevention among Lithuanian children.

BACKGROUND AND OBJECTIVE: The aim of this study was to disclose parental attitudes toward their children's dental care and preventive measures used as well as to evaluate their associations with parental education and socioeconomic status. MATERIALS AND METHODS: A total of 1248 parents of 7-, 9-, and 12-year-old children from 5 largest Lithuanian cities were enrolled in the study. The questionnaire comprised 34 items, which were grouped into 4 clusters. RESULTS: The parents with a high educational level scored better than those who had a low educational level (2.13 [SD, 0.39] vs. 2.2 [0.43], P=0.002). The parents who reported sufficient-family income scored their child's and their own health significantly better than those reporting insufficient-family income (2.02 [SD, 0.37] vs. 2.27 [SD, 0.41], P<0.001). The parents cared about their child's health more than about their own (1.53 [SD, 0.51] vs. 2.15 [0.61], P<0.001). The parents with a high educational level and those receiving sufficient income cared about education on oral hygiene and regular preventive dental check-ups more than those with a low educational level and insufficient income (36.7% and 40.8% vs. 30.2% and 28.7%, P<0.01 and P<0.001, respectively). The children whose parents had a high educational level brushed their teeth 2 times a day more frequently than those of the parents with a low educational level (48.5% and 42.4%, respectively, P<0.001). CONCLUSIONS: Greater attention to children's dental care as well as keeping their teeth healthy was paid by the parents with a high educational level and sufficient income.

Severe early childhood caries and behavioral risk factors among 3-year-old children in Lithuania.

UNLABELLED: The objective of the present study was to investigate the prevalence and severity of early childhood caries (ECC) and severe early childhood caries (S-ECC) in 3-year-old Lithuanian children. The impact of selected behavioral risk factors on the development of S-ECC was investigated. MATERIAL AND METHODS: A total of 950 children were examined in kindergartens. Diagnosis of dental caries followed the WHO criteria. Questionnaires were delivered to mothers of the children with S-ECC and caries-free children. The questions were related to the children's dietary habits, temperament, oral hygiene, and the use of fluoride toothpaste. RESULTS: The prevalence of ECC was 50.6% with a mean dmft of 2.1 (SD, 0.1) and a mean dmfs of 3.4 (SD, 0.2). The prevalence of S-ECC was 6.5% with a mean dmft of 7.8 (SD, 0.1) and dmfs of 18.1 (SD, 0.6). A significantly higher percentage of children developed S-ECC when they were breast-fed for a period longer than one year, were sleeping with a bottle containing carbohydrates during the night, or were allowed to sip from a bottle either going to sleep or during the day. A significantly higher percentage of mothers having caries-free children knew about risk factors of S-ECC and started tooth brushing after the eruption of the first tooth. There was no significant difference between the groups regarding the use of fluoride toothpaste. CONCLUSIONS: Improper infant bottle-feeding habits and no tooth brushing were found to be significant for the development of S-ECC among 3-year-old Lithuanian children.

Dental caries prevalence among 12-15-year-olds in Lithuania between 1983 and 2005.

OBJECTIVE: To analyze the dynamics of prevalence and severity of dental caries among 12- and 15-year-old schoolchildren in six regions of Lithuania. MATERIAL AND METHODS: A total of 5910 schoolchildren aged 12 and 15 years were examined. Dental caries was diagnosed according to the criteria of World Health Organization. The prevalence of dental caries was calculated by dividing the number of children with caries by the number of all children examined and expressed as percentage. Severity of dental caries was described by DMF-T index. DMF-T indices of individual persons as well as each age group were determined. Oral hygiene was evaluated by a simplified oral hygiene index. Fluoride concentration in Kretinga was 1.6-2.2 ppm; in the other regions, it varied between 0.2 to 0.4 ppm. RESULTS: The prevalence of dental caries among 12-year-olds was 88.4% in 1983 and 85.5% in 2005; among 15-year-olds, it was 95.5% and 92.9%, respectively. Mean DMF-T score decreased from 4.5 (in 1983) to 3.7 (in 2005) among 12-year-olds and from 6.4 (in 1983) to 5.6 (in 2005) among 15-year-olds. Oral hygiene index decreased from 1.69 in 1983 to 1.34 in 2005 among 12-year-olds and from 1.46 to 1.22 among 15-year-olds, respectively. CONCLUSIONS: A tendency towards decrease in the prevalence and severity of dental caries was observed, when caries prevention program was running. Correlation between oral hygiene and DMF-T was observed in both age groups. Decreased prevalence and intensity of dental caries among 12- and 15-year-olds were associated with improved oral hygiene, usage of fluoride toothpaste, and fluoride content in drinking water.

Oral health status and effectiveness of caries prevention programme in kindergartens in Kaunas city (Lithuania).

PURPOSE: To describe oral health status and to evaluate the effectiveness of a caries prevention programme in preschool children. MATERIALS AND METHODS: A sample of 1656 3- to 7-year-old children were examined in kindergartens in 2002, and 411 3-year-old children were then selected to participate in the prevention programme. The test group A (n = 156), group B (n = 118), and the control group (n = 137) were defined for the study. For test group A, supervised toothbrushing was prescribed and for test group B, fluoride gel applications were used. For the control group, children did not undergo any of the aforementioned procedures. Dental caries was assessed according to the World Health Organization (WHO) criteria, and oral hygiene according to the Greene-Vermillion simplified oral hygiene index. Preventive programmes were based on oral hygiene instructions, supervised daily toothbrushing, and fluoride gel applications. The relationship between oral hygiene and severity of dental caries was determined by using Fisher's test. RESULTS: The prevalence of dental caries varied between 39.7% and 90.8%, and the decayed, missing, and filled teeth (dmf-t) varied between 1.3 +/- 0.16 and 5.0 +/- 0.24. Oral hygiene was satisfactory in 43.2% of children. During the 3 years of the programme, a significant difference was found between the test and the control groups. The reduction in test group A was 45.4% and in test group B was 60.1%. CONCLUSIONS: The prevalence and severity of dental caries among the examined children increased with age, and was lower in both the test groups compared with the control group. The professional fluoride applications and proper oral hygiene showed the most effective results in caries prevention.

Dynamics of pregnant women's oral health status during preventive programme.

UNLABELLED: The aim of the study was to determine the efficiency of the applied preventive measures during pregnancy and to improve oral health status to pregnant women. MATERIAL AND METHODS: Oral health status of 180 pregnant women was determined according to WHO criteria (WHO: Basic methods, 1997). Dental caries prevalence, DMF-T and DMF-S were evaluated. Gingival status was estimated according to Silness-Loe (GI) index. Women were asked about tooth brushing frequency; oral hygiene was evaluated according to Green-Vermilion (OHI-S) index. Participants were divided into test (89) and control (91) groups. During pregnancy, the following preventive measures were applied to the test group: fluoride varnish applications, mouthrinsing with 0.12% chlorhexine digluconate, professional oral hygiene. RESULTS: Oral health status was evaluated three times during pregnancy. Reduction in dental caries increment of the test group was 56.25% in comparison with the control group. The periodontal status has improved, oral hygiene index (OHI-S) has decreased from 1.48+/-0.05 to 0.94+/-0.06 in the test group, and from 1.49+/-0.06 to 1.9+/-0.06 in the control group. CONCLUSION: Results of the study showed that selected dental caries preventive measures were effective and significantly improved women's oral health during pregnancy.