[Influence of Fissure Sealants on Dental Health of Elementary School Children in Weimar - A Longitudinal Observational Study under Real-life Conditions]. / Einfluss der Fissurenversiegelung auf die Zahngesundheit von Weimarer Grundschülern ­ Eine longitudinale Beobachtungsstudie unter Alltagsbedingungen.

The aim of the present observational study was to assess the effect of the number and timing of placing fissure sealants (FS) on caries prevalence in elementary school children under real-life conditions. Methods: Oral health data from 7- to 10-year-old elementary school children (n=505) attending 4 consecutive annual checkups between 2004 and 2009 was extracted from the public health service database. The number of intact FS and the number of teeth affected by caries was scored according to WHO standard (1997). Results: 34.9% pupils had at least one, 10% 4 FS. Children without FS had a higher dental caries rate compared to peers with FS (0.2 DT/0.4 DMFT vs. 0.1 DT/0.2 DMFT). Pupils with 4 FS showed the lowest number of teeth with caries (0 DT/0 DMFT). Children with an early application of FS had a lower D-component than children with a later or missing application (0.1 DT vs. 0.2 DT). Pupils with less than 4 FS had a higher risk of developing caries in their permanent dentition compared to peers with 4 FS (OR 4.36). Conclusion: FS is an effective caries preventive measure under real-life conditions. Early application and sealing of all 4 molars can optimize the prevention of caries in the permanent dentition.

Genetic susceptibility to dental caries on pit and fissure and smooth surfaces.

Carious lesions are distributed nonuniformly across tooth surfaces of the complete dentition, suggesting that the effects of risk factors may be surface-specific. Whether genes differentially affect caries risk across tooth surfaces is unknown. We investigated the role of genetics on two classes of tooth surfaces, pit and fissure surfaces (PFS) and smooth surfaces (SMS), in more than 2,600 subjects from 740 families. Participants were examined for surface-level evidence of dental caries, and caries scores for permanent and/or primary teeth were generated separately for PFS and SMS. Heritability estimates (h(2), i.e. the proportion of trait variation due to genes) of PFS and SMS caries scores were obtained using likelihood methods. The genetic correlations between PFS and SMS caries scores were calculated to assess the degree to which traits covary due to common genetic effects. Overall, the heritability of caries scores was similar for PFS (h(2) = 19-53%; p < 0.001) and SMS (h(2) = 17-42%; p < 0.001). Heritability of caries scores for both PFS and SMS in the primary dentition was greater than in the permanent dentition and total dentition. With one exception, the genetic correlation between PFS and SMS caries scores was not significantly different from 100%, indicating that (mostly) common genes are involved in the risk of caries for both surface types. Genetic correlation for the primary dentition dfs (decay + filled surfaces) was significantly less than 100% (p < 0.001), indicating that genetic factors may exert differential effects on caries risk in PFS versus SMS in the primary dentition.

Caries prevalence of 5, 12 and 15-year-old Greek children: a national pathfinder survey.

AIM: To study the caries prevalence and caries experience of 5, 12 and 15-year-old children in Greece and evaluate how the disease pattern is related to their sociodemographic parameters. METHODS: A stratified cluster sample of 1209, 1224 and 1257 of five, twelve and fifteen-year-old Greek children were randomly selected according to WHO guidelines for national pathfinder surveys and examined for dental caries, according to the BASCD criteria and standards. d3mft, D3MFT and their components, as well as d3mfs, D3MFS, Care Index (CI) and SiC were recorded and related to the demographic data collected concerning age, gender, counties, urban/rural areas and parents' educational status. RESULTS: Dental caries varied considerably between the different districts, with a mean dmft/DMFT value for each age group being 1.77, 2.05 and 3.19 respectively, while 64%, 37% and 29% of them, were with no obvious dentinal caries. Children living in rural areas demonstrated significantly higher dmft/DMFT values and less dental restorative care (CI), whereas children with fathers of a higher educational level showed significantly lower dmft/DMFT values. The significant caries (SIC) index value for the three age groups was 5.01, 4.83 and 7.07 respectively. Posterior occlusal surfaces of the permanent teeth presented most of the caries in the 12 (68%) and 15-year-old group (78%). CONCLUSIONS: Despite the decrease in the prevalence of caries in Greek children disparities remain. Children in rural areas and children with less educated parents had more caries and more untreated caries. All the above call for immediate intervention with comprehensive preventive programs and better geographic targeting of the dental services at a national level including targeted prevention of pit and fissure sealants on posterior permanent molars.

Occlusal fissures in equine cheek teeth: µCT and histological findings.

Fissures on the occlusal surface of equine cheek teeth are commonly encountered during oral examination. Generally, their presence is considered abnormal but their aetiopathogenesis and clinical impact on pulp disease is still undetermined. The aims of this research were to study the extent of occlusal cheek teeth fissures using high-resolution X-ray computed tomography (µCT) imaging and their histological characteristics. Twenty-seven teeth (of 15 horses) were scanned using µCT imaging to analyse fissure extent. Histological examination of a subset of teeth (n=7) was performed. Forty-three type 1 fissures (35 type 1a, eight type 1b) were identified. The mean length of the fissure of type 1a and type 1b on the occlusal surface was 3.47+/-1.60mm and 13.64+/-7.40mm, respectively. Their mean depth was 13.22+/-10.76mm and 7.42+/-6.42mm, respectively. Potential risk factors associated with fissure depth were identified using a multivariable mixed model The location of the fissure and Triadan number were significantly associated with fissure depth. Fissures could be identified on histological sections with the presence of organic material inside the fissure, microorganisms in the continuation of the fissure extending into the dentinal tubules and the presence of reactionary dentine. This study suggests that fissures can provide a pathway for microorganisms to enter the dentinal tubules, potentially resulting in local pulpal inflammation. It appears that in healthy teeth, vital odontoblasts react by producing reactionary (tertiary) dentin, which lacks patent tubules and thus provides a proper seal.

Risk indicators of dental caries in 5-year-old Brazilian children.

OBJECTIVE: To report the prevalence and severity of dental caries and to identify caries risk indicators among gender, clinical and socioeconomic variables in 5-year-old children attending preschools in Piracicaba, Brazil, in 2005. METHOD: The random sample consisted of 728 subjects attending public and private preschools that were examined by a calibrated dentist. Dental caries was measured using WHO criteria. The socioeconomic variables (type of school, monthly family income, number of people living in the household, parents' educational level and home ownership) were collected by means of a parental semi structured questionnaire. RESULTS: The mean dmft was 1.30 (SD=2.47); 62.2% were caries-free. The multiple logistic regression analyses showed that the risk indicators of caries were father's incomplete college education and presence of initial lesion. CONCLUSIONS: The prevalence of dental caries in 5-year-old preschool attenders in Piracicaba was moderate, and father's educational status below undergraduate level, as well as presence of initial lesions, were risk indicators of the disease.

Equine cheek teeth occlusal fissures: Prevalence, association with dental wear abnormalities and occlusal angles.

BACKGROUND: Fissures of the occlusal surface of equine cheek teeth are commonly encountered during oral examination but their aetiology is unknown. OBJECTIVES: To examine the prevalence and characteristics of occlusal fissures in cadaver teeth. It is hypothesised that their prevalence is influenced by masticatory forces. Consequently, their possible association with wear disorders and occlusal angles were examined. STUDY DESIGN: Cross-sectional survey. METHODS: The dental abnormalities and occlusal fissure findings in the cheek teeth of 143 cadaver heads were recorded. The cheek teeth occlusal angles were measured using the stiff-hinge technique. Multiple regression analyses were performed to establish possible relationships between age, sex, dental wear, occlusal angle and fissure prevalence. RESULTS: Occlusal fissures were found in 103/143 (72%) heads. Sex and age were determining factors in the prevalence of fissures. A similar prevalence was found in mandibular (54.1%) and maxillary teeth (45.9%, OR = 1.10; 95% CI = 0.95-1.29, P = 0.2). Mandibular fissures were more commonly located on the buccal aspect (OR = 1.42; 95% CI = 1.16-1.65, P < 0.001), whereas for maxillary fissures there was no difference in prevalence between palatal and buccal aspects (OR = 1.19; 95% CI = 0.97-1.46, P = 0.1). Two main fissure types were identified. Type 1a fissures were the most prevalent type (39.5%). No significant correlation was found between the presence of wear abnormalities or the occlusal angle of cheek teeth, and the prevalence of fissures. MAIN LIMITATIONS: No dental histories were available. CONCLUSION: Equine cheek teeth show a high prevalence of occlusal fissures. Despite some evidence of predilection sites on the tooth surface that might indicate a mechanical aetiology for these lesions, no associations were found with wear abnormalities or occlusal angles of affected cheek teeth. Further histological and ultrastructural studies are warranted to elucidate their aetiology and possible role in other dental diseases.

Incidencia de fracturas dentales verticales reportadas en la Ciudad de Chihuahua y su relación con la evolución de la pandemia por COVID-19 / Incidence of vertical dental fractures reported in Chihuahua City and its relationship with the evolution of the COVID-19 pandemic

Durante la pandemia por COVID-19, la presencia de un incremento de fracturas y/o fisuras verticales ha sido reportada por Cirujanos Dentistas en diferentes países y foros, Objetivo: Determinar por medio de un análisis si existe una relación con este aumento de casos y la evolu- ción de la pandemia. Material y método: Se recopilaron los casos de fracturas verticales no restaurables durante el periodo de mayor índice de casos de contagio y defunciones por COVID-19 en la Ciudad de Chihuahua, México. Resultados: Durante el primer pico de casos y defunciones causadas por la pandemia, se incrementó el número de casos de fracturas verticales no tratables. Conclusiones: Existió una relación entre la evolución de la pandemia con la aparición de casos de fracturas dentales verticales no restaurables (AU)

During the COVID-19 pandemic, the presence of an increase in fractures and/or vertical fissures has been reported by Dental Surgeons in different countries and forums. Objective: To determine through an analysis, if there is a relationship with this increase in cases and the evolution of the pandemic. Material and methods: The cases of non-restorable vertical fractures were collected during the period of highest rate of cases of contagion and deaths due to COVID-19 in the City of Chihuahua, Mexico. Results: during the 1st peak of cases and deaths caused by the pandemic, the number of cases of untreatable vertical fractures increased. Conclusions: There was a relationship between the evolution of the pandemic and the appearance of cases of non-restorable vertical dental fractures (AU)

Risk indicators for early childhood caries in Taiwan.

OBJECTIVES: The purpose of this study was to investigate the prevalence, patterns, and etiological factors for caries in children. METHODS: A total of 981 children less than 6 years of age were examined using a dental mirror and explorer. A parent or a caregiver was asked to complete a questionnaire regarding information about the child, the household, and oral hygiene. The prevalence and patterns of dental caries including pit and fissure caries, facial/lingual caries, molar proximal caries, and facial/lingual molar proximal lesions, were analyzed. Each child was classified as caries free or as having one of these four caries patterns. RESULTS: Weighted mean deft was 0.14 at age 2, 2.58 at age 3, 4.41 at age 4, 6.94 at age 5, and 7.31 at age 6. Weighted mean defs was 4.71, 8.44, 16.45 and 18.64 at ages 3, 4, 5, and 6, respectively. By age 2, 5.09% of children had caries. By age 6, 89.38% of children had caries. By age 3, 30.02% of children fitted the facial and lingual pattern of caries and by age 6, 52.90% of children fit the 'facial-lingual and molar-proximal' pattern, indicating extensive smooth surface decay. The total prevalence of early childhood caries was 56%. Multivariate-adjusted odds ratios identified factors associated with the high caries experience of the young children and found caries was strongly associated with the lack of proper tooth brushing and high consumption of sweets. Higher caries scores were also associated with areas of low urbanization. CONCLUSIONS: The findings of this survey indicated a high level of untreated caries among children in Taiwan.

Caries experience variables as indicators in caries risk assessment in 6-7-year-old Chinese children.

OBJECTIVES: The aim of the present study is to investigate variables of the past caries experience as indicators of future caries in a Chinese child population. METHODS: Caries was recorded at baseline and 2 years later in 433, 6-7-year-old Chinese children. Correlation coefficients between variables of the past caries experience and caries increment were calculated. Stepwise logistic regression analyses provided predictor variables. ROC curves presenting sensitivity as function of (100-specificity) were employed to summarize the obtained information. The area under the ROC curves was used as a measure of predictive accuracy. RESULTS: Twelve variables of baseline caries experience had a significant (p

Incidencia de fracturas dentales reportadas en la Ciudad de Chihuahua durante la pandemia por COVID-19 / Incidence of dental fractures reported in Chihuahua city during COVID-19 pandemic

Se presentan los casos de fracturas verticales sintomáticos que ameritaron la extracción de las órganos dentales afectados en un periodo de cinco meses durante la pandemia por COVID-19 en la ciudad de Chihuahua, México. Material y métodos: Se recolectaron 26 muestras para el estudio, proporcionadas por los cirujanos dentistas integrantes del Grupo de Egresados de la Facultad de Odontología de la Universidad Autónoma de Chihuahua. Resultados: Los resultados muestran diferencias a lo reportado previamente respecto al tipo de diente involucrado, sexo de los pacientes, restauraciones coronales y tratamientos endodóncicos previos. Conclusiones: Se puede suponer que las modificaciones en el estilo de vida de la población, sumadas a la angustia permanente, pueden ser factores que contribuyen a las fracturas dentales (AU)

There are cases of symptomatic vertical fractures that warranted the extraction of affected teeth are presented, over a period of five months during the COVID-19 pandemic in Chihuahua City, Mexico. Material and methods: 26 samples were collected for the study, provided by the dentist who were members of the Graduate Group of the Faculty of Dentistry of the Autonomous University of Chihuahua. Results: The results show differences from what was previously reported regarding the type of tooth involved, sex of patients, coronal restorations and previous endodontic treatments. Conclusions: It can be assumed that changes in the lifestyle of the population, added to permanent distress, may be factors to preserve dental fractures (AU)

Caries prevalence in 6- to 15-year-old French children based on the 1987 and 1991 national surveys.

The caries prevalence in a multi-stage probability sample of 18,786 children representative of all French children 6-15 years of age was studied in 1991 and compared with the results of a similar survey made in 1987. A significant decline in dental caries in France became evident. This decline, observed in primary as well as in permanent teeth, was of variable magnitude among the different age groups. At the age of 6, 48.6% of the children were totally caries-free in 1991. At the age of 12, the DMFT and DMFS indices were 2.59 and 4.72, respectively, representing a corresponding decrease of 38% and 37%. In 1991, more caries-affected teeth or surfaces were filled, whereas fewer caries-affected teeth or surfaces were untreated. Females and children living in rural areas had a higher caries prevalence in both surveys. Pit-and-fissure lesions were the predominant caries types. Dental fluorosis was very uncommon; 96.1% of the 18,786 children examined in 1991 were totally free of any such lesions. Average plaque and calculus indices were similar in 1987 and in 1991, but a decrease of 25% was observed in the average gingival indices. Although the relative contributions of various preventive factors leading to this caries reduction are not clear, it should be noted that use of fluoridated salt (250 mg/kg KF) started in January, 1987. The sale of fluoridated dentifrices and the use of fluoride tablets and sugar substitutes increased during the period from 1987 to 1991.

Dental predictors of high caries increment in children.

A comprehensive set of dental variables was investigated to find the "best" combination of predictors for high caries increment in 7/8-year-old and 10/11-year-old children. Four populations with widely different caries prevalence were studied. Logistic regression analysis supplied multiple-input models by stepwise selection of predictors. A "low number of sound primary molars" was the best and most consistent predictor of high caries increment. The second best predictors were "high numbers of pre-cavity lesions on permanent first molars" (discolored pits and fissures in the younger age group and white spots on the smooth parts of buccolingual surfaces in the older age group). Inclusion of radiological variables did not substantially increase the quality of prediction. For practical application, models with various multiple inputs selected by stepwise procedures were compared with "fixed" three-input models. These three-input models resulted in predictive quality nearly equal to those of the multiple models. Traditional one-input models, containing DMFT or dmft, were inferior to the three-input models, particularly in the older age class. The lower the caries prevalence of the source data, the better was the prediction. As a summary measure characterizing the predictive performance of a model, we used the index "area under the receiver operating characteristic curve" A. For the 1984 data and the three-input models, the area was approximately 80%, and for the 1972 data, the area was 65-70%.

Dental caries among urban schoolchildren in Madagascar.

An epidemiological survey of prevalence and severity of dental caries was carried out in an urban population of children in Madagascar. The study population comprised 1257 children in the age groups 4-5 yr to 14-15 yr equally distributed by sex. The children were examined according to the recording system for the Danish Child Dental Services. The caries experience in the primary dentition as well as in the permanent dentition was high. For example, among 6-yr-olds a mean number of 11.8 defs and 5.2 deft was observed and 82% of the children were affected by caries in primary teeth. In particular, primary molars in the mandibular and incisors in the maxilla were affected and approximal caries was frequent. Among 12-yr-olds mean DMFS was 4.0 and DMFT 2.4 and 75% of the children had caries in permanent teeth. In permanent teeth caries was located predominantly to mandibular molars and occlusal surfaces. In both dentitions almost all decay was untreated, indicating lack of dental treatment available due to the shortage of dental manpower. The establishment of a child dental service system is a matter of urgency. Dental health education and primary health care should be organized.

Comparative study of oral conditions in schoolchildren of Strasbourg, France, 1974-85.

A representative sample of 1650 children randomly selected in the 6-15-yr-old schoolchild population of Strasbourg was examined by well-calibrated examiners. The prevalence of caries was determined with the DMFT, DMFS and dft indices using bitewing radiographs. Plaque, calculus and gingival indices were also determined. The results obtained were compared with the initial study of 1974 performed in Strasbourg using the same epidemiologic methods. Whereas no important variations were observed in caries prevalence of primary teeth, a significant reduction of caries activity was observed in DMFT and DMFS indices in all age groups. There was a reduction of these two indices of respectively 32% and 33% in the 12-yr-old children. The reduction was the most significant on approximal surface lesions. A statistically significant decrease of the calculus and gingival indices was also observed between 1974 and 1984. A less significant decrease was observed for the plaque index.

Caries in fissures of permanent first molars as a predictor for caries increment.

A group of 268 children were checked for caries experience at the age of 7.2 yr later at the age of 9 and 4 yr later at the age of 11 yr. Caries experience of fissures in permanent first molars at the age of 7 yr served as a screening criterion for caries increment between the ages of 7 and 11 yr. This screening resulted in a sensitivity of 0.62, a specificity of 0.82, and a diagnostic power of 0.83 for total caries increment in the permanent dentition and in a sensitivity of 0.68, a specificity of 0.80, and a diagnostic power of 0.78 for caries increment in fissures of permanent first molars. It was concluded that this screening offered the best method available for identifying children at risk from fissure caries in their permanent first molars. Cost effectiveness of preventive treatment directed towards individuals, for instance the application of fissure sealants, can be improved by using this screening method.

Sugar consumption and caries risk in schoolchildren with low caries experience.

This paper assesses the risk from sugar consumption in a population of school children with low caries experience. It relates eight different measures of sugar consumption to the occurrence of any DMFS increment, and, separately, to approximal and pit-and-fissure DMFS. The data are from a 3-yr longitudinal study of 429 children, initially aged 11-15, residing in non-fluoridated rural communities in Michigan, USA. All children completed at least three dietary interviews, were present for baseline and final dental examinations, and had a parent or guardian provide questionnaire information on residence history, use of fluoride and dental services, and family history. Results indicated that a higher proportion of total energy intake from sugars increased the probability of caries on all surfaces, and a higher total intake of sugars was also associated with total caries increment. No relationship, however, was found between DMFS increment and the frequency of eating high sugar foods. Each additional 5 g of daily sugars intake was associated with a 1% increase in the probability of developing caries, and those whose energy intake from sugars was 1 SD above the mean had 2.0 times the risk of developing approximal caries than did children whose energy intake from sugars was 1 SD below the mean.

Prevalence of non-cavitated and cavitated carious lesions in a random sample of 7-9-year-old schoolchildren in Montreal, Quebec.

This report describes the prevalence of non-cavitated and cavitated carious lesions in 911 randomly selected children in grades one through three on the Island of Montreal, Quebec, Canada. The criteria for diagnosis were developed for a longitudinal epidemiological study of restorative treatment decisions by dentists practising under a provincial dental insurance program for children. The intra- and inter-examiner reliability correlation coefficients of the two examiners were excellent (Kappa > or = 0.80). The most frequent carious lesion found in the examined children were non-cavitated carious lesions (incipient) within 1.5 of the gingival line on smooth tooth surfaces, and stained or non-cavitated carious lesions on pits and fissures. Out of 911 children in the study, 19.6% had sealants. Children whose parents completed a university education had a significantly lower prevalence of non-cavitated and cavitated carious lesions and fillings, and a significantly higher mean number of sealants than children whose parents had only primary school education. Education status of the parents was a significant risk marker of children with high caries experience and these children had a significantly higher mean number of non-cavitated carious lesions. This study has found that non-cavitated carious lesions are significantly more prevalent than cavitated carious lesions in children.

Caries prevalence and patterns in 3-6-year-old Beijing children.

A total of 400 Beijing children, 3-6-yr-old, equally distributed by age and sex, were examined for dental cares. Results were analyzed with the traditional dmfs/t index and with the Caries Analysis System. The system differentiated between caries patterns and examined the percentage of affected children (Prevalence), the degree to which these children were affected (Severity), and the proportion of total caries each disease pattern represented (Distribution). Over 67% of the children experienced caries, a level comparable to other reports from China and other developing countries, but 50% greater than those seen in United States preschool children. Nearly all children with caries experienced fissure caries. In 3-yr-olds maxillary anterior caries was the next most prevalent pattern with 43% affected, whilst in the 6-yr-olds, posterior proximal caries was the second most prevalent pattern with 68% affected. Since maxillary anterior caries was so prevalent, and because the presence of this pattern has been shown to be a risk factor for future caries, preventing the maxillary anterior pattern may markedly reduce caries in this population.

Caries prevalence in primary teeth as a predictor of early fissure caries in permanent first molars.

The study aimed to examine the validity of employing the caries experience of the primary dentition for predicting early caries in the permanent first molar fissures. Subjects consisted of 192 children who were followed for 2 yr, 91 of whom were pursued for a further year, all receiving semiannual check-ups. The caries prevalence in the primary dentition (dmft), excluding incisors, was recorded at baseline, which was the year the children became 6. Fissure caries in the permanent first molars was recorded as being confined to enamel or dentin, based on findings during cavity preparation. The correlation between dmft and the number of intact permanent first molars was -0.368 and -0.337 after 2 and 3 yr observation respectively. When the children were grouped according to their dmft, a statistically significant relationship was found between the dmft and the number of intact molars in each individual. The positive and negative predictive values as well as the sensitivity and specificity of different dmft values were calculated, and the relationship between them illustrated by the use of ROC curves. Even if there are no specific dmft values which seem obviously favorable for the purpose, these data give information relevant in planning for large scale use of fissure sealing in preventing early fissure caries in permanent first molars.

Comparative effectiveness of visual/tactile and simplified screening examinations in caries risk assessment.

Central to the development of a model for identifying children at high risk to caries is a clinical evaluation to assess dental status and other conditions potentially useful in caries prediction. Traditionally, this evaluation has been based on a relatively lengthy visual/tactile examination conducted by a dentist. Replacing the dentist examination with a dental auxiliary conducted screening evaluation could lead to reduced time and costs. The 4-yr University of North Carolina Caries Risk Assessment Study involved approximately 5000 schoolchildren initially in Grades 1 and 5 living near Aiken, South Carolina, and Portland, Maine. The effectiveness of caries prediction models using visual/tactile examination data were compared with the same models using simplified screening evaluation data. Results showed sensitivity ranged from 0.57 to 0.61 for the visual/tactile and screening models by site and grade cohort. Specificity for the models ranged from 0.80 to 0.83. None of these differences in sensitivity and specificity between visual/tactile (dentist) and screening (hygienist) models was statistically significant. Findings show that for the prediction of children at high risk to dental caries the clinical evaluation may be conducted with no reduction of precision by using dental hygienist performed screening evaluations rather than dentist conducted visual/tactile examinations. While no cost data were collected, these results imply that costs to future prediction programs could be reduced by using screening evaluations.