Can socioeconomic and psychosocial factors predict the duration of orthodontic treatment?

INTRODUCTION AND OBJECTIVES: Very little is known about the role of socioeconomic and psychosocial factors in predicting orthodontic treatment duration. Thus, this study aimed to test whether socioeconomic position (SEP) and psychosocial factors, namely, family environment and resiliency can predict orthodontic treatment duration. METHODS: Data were analysed from a hospital-based, prospective, longitudinal study that recruited 145 consecutively selected 12- to 16-year-old male and female adolescents. Baseline SEP and psychosocial data were collected by a validated child self-completed questionnaire before the placement of fixed appliances. Linear regression analysis was used. RESULTS: The response rate was 98.6 per cent and the dropout was 8.2 per cent. Maternal emotional support was an important predictor of orthodontic treatment duration. Adolescents with high levels of maternal emotional support were more likely to have a shorter orthodontic treatment duration (by nearly four months) than those with low levels of maternal emotional support (P = 0.02). Parental SEP, paternal emotional support, maternal and paternal control, as well as resiliency were not significantly associated with orthodontic treatment duration (P > 0.05). The multivariable regression analysis (including age, gender, and malocclusion severity) confirmed the significance of maternal emotional support as a predictor of orthodontic treatment duration. CONCLUSIONS: Maternal emotional support is an important predictor of orthodontic treatment duration. This may be explained by a higher maternal involvement in the orthodontic treatment, which may have facilitated achieving the required orthodontic treatment outcome in a shorter treatment duration.

Systematic review and meta-analysis of randomised controlled trials on the effectiveness of school-based dental screening versus no screening on improving oral health in children.

OBJECTIVES: The current study aimed to evaluate the effectiveness of school-based dental screening versus no screening on improving oral health in children aged 3-18 years by a systematic review and meta-analysis of randomised controlled trials. SOURCES AND STUDY SELECTION: Three sets of independent reviewers searched MEDLINE, EMBASE, Web of Science and other sources through April 2016 to identify published and nonpublished studies without language restrictions and extracted data. DATA: Primary outcomes included prevalence and mean number of teeth with caries, incidence of dental attendance and harms of screening. Cochrane's criteria for risk of bias assessment were used. RESULTS: A total of five cluster RCTs (of unclear or high risk of bias), including 28,442 children, were meta-analysed. For an intracluster correlation coefficient of 0.030, there was no statistically significant difference in dental attendance between children who received dental screening and those who did not receive dental screening (RR 1.11, 95% 0.97, 1.27). The Chi-square test for heterogeneity and the Higgin's I2 value indicated a substantial heterogeneity. Only one study reported the prevalence and mean number of deciduous and permanent teeth with dental caries and found no significant differences between the screening and no screening groups. CONCLUSIONS: There is currently no evidence to support or refute the clinical benefits or harms of dental screening. Routine dental screening may not increase the dental attendance of school children, but there is a lot of uncertainty in this finding because of the quality of evidence. CLINICAL SIGNIFICANCE: Evidence from the reviewed trials suggests no clinical benefit from school-based screening in improving children's oral health. However, there is a lot of uncertainty in this finding because of the quality of evidence. There is a need to conduct a well-designed trial with an intensive follow-up arm and cost-effectiveness analysis. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42016038828 (PROSPERO database).