Demarcated opacity in primary teeth increases the prevalence of molar incisor hypomineralization

Abstract This cross-sectional study aimed to assess the prevalence of molar incisor hypomineralization (MIH) and its relationship with the number of primary teeth with developmental defects of enamel (DDE). A representative population-based sample of 731 schoolchildren was randomly selected from the public school system in Curitiba, Brazil. Schoolchildren aged 8 years with fully erupted permanent first molars and incisors were eligible for the study. MIH and DDE were classified by four calibrated examiners (kappa > 0.75) according to EAPD criteria and to the FDI-modified DDE index. Clinical data were collected in a school environment. Socioeconomic information was collected through a self-administered semistructured questionnaire applied to the children's caregivers. Statistical analyses were carried out using Poisson multiple regression with robust variance (α = 0.05). MIH prevalence was 12.1% (95%CI: 10-15), and opacities were the most prevalent defect. Socioeconomic factors were not associated with MIH. Children with demarcated opacity in primary teeth presented a higher prevalence of MIH than those without DDE in primary teeth. In the multiple analysis, the increase of one primary tooth affected by demarcated opacity increased the prevalence of MIH by 33% (PR = 1.33, 95%CI: 1.15-1.53, p < 0.001). Asian children had a higher prevalence of MIH (PR = 2.91, 95%CI: 1.08-8.09 p = 0.035) than did Caucasian children.Conclusion: Based on these findings, the prevalence of MIH in Curitiba was 12.1%. Demarcated opacity in primary teeth could be considered a predictor of MIH.

Factors associated with the development of dental defects acquired in the extrauterine environment

Abstract This study aimed to analyze the association of sociodemographic, child health, healthcare service, and access indicators with developmental defects of enamel (DDE) acquired outside the uterus, based on gestational factors. A cohort of births was carried out, and 982 children aged 12 to 30 months were examined. A total of 1,500 women were followed up as of the 5th month of gestation, and the child's gestational age was evaluated at follow-up. The clinical examination was performed as recommended by the World Health Organization, and defects were classified using the modified DDE index. Six models were considered: presence of DDE (Model 1) or opacities (Model 4), number of teeth with DDE (Model 2) or opacities (Model 5), and incidence rate of DDE (Model 3) or opacities (Model 6). Associations were estimated by relative risk (RR) in Poisson regression models. In the adjusted analysis, the mother's lowest education level was associated with the highest occurrence of DDE in Models 1 (RR = 26.43; p = 0.002), 2 (RR = 9.70; p = 0.009), and 3 (RR = 5.63; p = 0.047). Breastfeeding for over 12 months (RR = 0.45; p = 0.030) and recent use of anti-infection drugs (RR = 0.20; p = 0.039) had a protective effect on DDE (Model 1). The factors associated with the highest incidence of opacities were not having health insurance (RR = 2.00; p = 0.043) (Model 5), and belonging to a family of poor social class (RR = 4.67; p = 0.007) (Model 6). Children in a situation of socioeconomic vulnerability have a higher risk of presenting extrauterine DDE. Breastfeeding was a protection factor for DDE development.

Distinguishing predisposing factors for enamel hypoplasia and molar-incisor hypomineralization in children in Ile-Ife, Nigeria

Aim: To determine if the prevalence of enamel hypoplasia, molar-incisor hypomineralisation(MIH) and deciduous molar hypomineralisation (DMH) is associated with the socioeconomicstatus of the child and to determine the prevalence of enamel hypoplasia and MIH/DMH comorbidityin the study population. Methods: Information was collected on the sex andsocioeconomic status of the 1,169 study participants' resident in Ile-Ife, Nigeria, recruited througha household survey. The children were clinically examined to assess for the presence of enamelhypoplasia, MIH and DMH. Associations between sex, socioeconomic status and the prevalenceof enamel hypoplasia, MIH and DMH were determined. The proportion of children with enamelhypoplasia and MIH/DMH co-morbidity was also determined. Results: Among the 1,169 studyparticipants, 47(4.0%) had MIH, 15 (1.3%) had DMH and 161 (13.8%) had enamel hypoplasia. One (0.09%) study participant had MIH/DMH co-morbidity, 12 (1.0%) had DMH/enamel hypoplasiaco-morbidity, and 9 (0.8%) had MIH/hypoplasia co-morbidity. There was no significant associationbetween the socioeconomic status and presence of enamel hypoplasia (p=0.22), MIH (p=0.78) orDMH (p=1.00). Conclusions: The socioeconomic status cannot be used as a distinguishing factorfor enamel hypoplasia, MIH and DMH. The possibility of co-existence of enamel hypoplasia andMIH/DMH makes it imperative to find ways to distinguish between the lesions.

Comparación de la prevalencia de hipomineralización molar incisiva en niños con diferente cobertura asistencial en las ciudades de Buenos Aires (Argentina) y Montevideo (Uruguay) / Comparison of the prevalence of molar incisor hypomineralization among children with different health care coverage in the cities of Buenos Aires (Argentina) and Montevideo (Uruguay)

El objetivo fue comparar la frecuencia de la hipomineralización molar incisiva (HMI) entre niños con diferente cobertura de salud en Buenos Aires y Montevideo. Se diseñó un estudio transversal, observacional y descriptivo con los nacidos entre 1993-2003, asististidos en las Cátedras de Odontología Integral Niños (Universidad de Buenos Aires) y de Odontopediatría (Universidad de la República) y en cinco clínicas privadas, entre abril y diciembre 2010. Se conformaron dos grupos: A (Buenos Aires; n=1.090) y B (Montevideo; n=626). El diagnóstico clínico fue realizado por examinadores calibrados (Kappa: 0,94) con los criterios de Mathu-Muju y Wright. Los resultados mostraron una prevalencia de HMI en A del 16,1% y en B del 12,3% (p=0,03), con diferencias significativas entre los sectores público y privado en ambos grupos (A p=0,0008; B p=0,0004) y una correlación positiva entre la HMI y el año de nacimiento (A p=0,001; B p=0,005) Los resultados permiten concluir que la HMI es una patología emergente y su prevalencia se relaciona al año de nacimiento y al acceso al cuidado de salud.

The aim of this study was to compare the prevalence of molar incisor hypomineralization (MIH) among children with different health care coverage in Buenos Aires and Montevideo. An observational, cross-sectional and descriptive study was designed, considering children born from 1993-2003 who were seen in the Chairs of Comprehensive Children's Dentistry (Universidad de Buenos Aires) and of Pediatric Dentistry (Universidad de la República) and at five private dental offices between April and December 2010. Two groups were defined: A (Buenos Aires; n=1,090) and B (Montevideo; n=626). The clinical diagnosis was carried out with calibrated examiners (Kappa: 0.94) using the Mathu-Muju and Wright criteria. The prevalence of MIH was found to be 16.1% in A and 12.3% in B (p=0.03), with statistically significant differences between the public and private care sectors in both groups (A p=0.0008; B p=0.0004) and a positive correlation between MIH and year of birth (A p=0.001; B p=0.005). The results show that MIH is an emerging pathology and that MIH prevalence is related to year of birth and access to health care.

Relationship between dental fluorosis and quality of life: a population based study

O objetivo do estudo foi verificar a prevalência de fluorose dentária em escolares de 6 a 15 anos de idade e sua possível associacão com o impacto nas atividades diárias. Trata-se de um censo observacional, transversal, analítico. Participaram do estudo 513 escolares do município de Pinheiro Preto-SC. Os escolares foram examinados por 3 cirurgiões-dentistas devidamente calibrados, após obtencão de kappa > 0,80. Para avaliar a prevalência de fluorose foi realizado exame clínico segundo metodologia da 4ª edicão da OMS. Para verificar os impactos nas atividades diárias foi utilizado o OIDP (Oral Impacts on Daily Performance) modificado. O teste estatístico utilizado foi o do Qui-quadrado, com nível de significância de 5%. Foram examinados 262 (51,1%) escolares do sexo feminino e 251 (48,9%) do sexo masculino. Em relacão à prevalência de fluorose, 94 (18,3%) escolares a apresentaram, e 419 (81,7%) apresentaram condicões normais. Em relacão à gravidade, poucos escolares apresentaram alteracões severas. Não foram verificadas associacão entre a fluorose dentária e o gênero (p = 0,646), fluorose e condicão socioeconômica (p = 0,848) e tal condicão e acesso a abastecimento de água fornecido pela rede geral (p = 0,198). As atividades mais citadas que afetaram o desempenho diário foram: limpar os dentes (40,9%) e se alimentar ou gostar de comida (40,4%). Nenhuma atividade diária pôde ser associada com presenca de fluorose dental. Verificou-se prevalência de fluorose em consonância com padrões para localidades com teor ideal de flúor na água de abastecimento. As fluoroses questionável e muito leve foram as mais freqüentes, não influenciando a qualidade de vida dos escolares que participaram do estudo.