RANDOMIZED CONTROLLED TRIALS IN DENTAL JOURNALS ON CHILDREN AND ADOLESCENTS: A BIBLIOMETRIC ANALYSIS.

BACKGROUND: Randomized controlled trials (RCTs) in dentistry provide essential evidence for dentists to practice evidence-based dentistry. This study aimed to analyze the scientific impacts of the RCTs conducted among children and adolescents published in dental journals and summarize the main contents of these studies. METHODS: An electronic literature search was conducted in the database Web of Science (WoS) Core Collection by two independent reviewers in June 2020, without an initial time limit. Articles reporting on RCTs conducted among children and adolescents in dental fields were identified. The most cited articles (the top 100 articles based on total citation counts and citation density) were selected. The bibliometric data were exported from the database WoS for further analysis. The citation counts were cross-checked in Google Scholar. In addition, the main content of the included RCTs was extracted and summarized. RESULTS: A total of 132 papers published in 28 journals reporting on RCTs in dentistry on children and adolescents were included in this study. The mean total citation count (within WoS) of the included RCTs was 60.0, ranging from 17 to 300, and the mean citation density value was 4.6, ranging from 1.3 to 15.0. The majority of the articles were in the thematic field of cariology (n = 79, 59.8%). Other thematic fields, orthodontology (20.5%), endodontology (5.3%), behavior science and quality of life (5.3%), oral and maxillofacial surgery (3.8%), oral hygiene (3.8%) and periodontology (1.5%) were involved as well. Around one-fifth of the articles (n = 23) were produced by the United States, and the included articles were most cited by the publications (n = 1937) from the United States as well. CONCLUSIONS: A wide range of dental topics were covered in the included RCTs conducted among children and adolescents. These top-cited RCTs mainly focus on the thematic field of cariology. The United States is an influential country with a large number of publication outputs and citations.

Knowledge, perceptions, and clinical experiences on molar incisor hypomineralization among dental care providers in Hong Kong.

BACKGROUND: Molar incisor hypomineralization (MIH) is an alarming problem with considerable challenges in management. This study aimed to evaluate and compare the knowledge, perceptions, and clinical experiences of molar incisor hypomineralization (MIH) between general dental practitioners (GDPs) and paediatric dentists (PDs) in Hong Kong. METHODS: A cross-sectional survey of 557 randomly selected GDPs (approximately 25% of all registered dentists) and all registered PDs (n = 31) were invited. They were asked to complete a 4-section questionnaire adapted and modified from a study by Gambetta-Tessini and co-workers on sociodemographic profiles, knowledge, experience, and perceptions regarding MIH. Data were analyzed with chi-square, Fisher's exact, and multiple factor ANCOVA tests. RESULTS: The overall response rate was 43.37% (255/588). Majority (74.1%) of the respondents encountered MIH in their practices. A significantly higher mean knowledge score (46.33 ± 7.1) was observed among PDs than GDPs (43.09 ± 7.0) (P < 0.01) and among PDs who are 40 years old or younger (P < 0.001). Differences in treatment of MIH were also observed between PDs and GDPs (P < 0.05). Paediatric dentists were more confident in diagnosing and treating MIH (P < 0.001). Most respondents (87.8%) expressed a need for continuing education on MIH. CONCLUSION: Continuing education on MIH is needed to assure that the highest quality of evidence-based care is given to patients with MIH. Dissemination of latest best evidence on MIH, especially to GDPs, will assure that the condition is accurately diagnosed and well managed.

Risk Indicators for Noncavitated and Cavitated Carious Lesions in Preschool Children.

OBJECTIVE: The aim of this study was to evaluate the risk indicators associated with noncavitated and cavitated lesions in preschool children. METHODS: The cross-sectional study included 3- to 4-year-old healthy children (N = 741) recruited in a randomised controlled clinical trial. After obtaining written informed consent, parents completed a questionnaire about their child's sociodemographic background and oral health-related behaviours and parents' oral health-related knowledge and attitude. Caries and plaque were evaluated using International Caries Detection and Assessment System-II and Visible Plaque Index (VPI), respectively. Children were grouped according to their oral health status as being caries-free (CF), having only noncavitated lesions (NC), or having cavitated lesions (CL). The least absolute shrinkage and selection operator (LASSO) sparse multinomial regression was used to study the variables using 1 standard error above the minimum criterion set at P < .05. RESULTS: The prevalence of children with NC and CL was 29.1% and 49.4%, respectively, with a prevalence of early childhood caries being 78.5%. The proportion of children who brushed twice or more than twice a day was highest in CF (71.7%), followed by NC (58.3%), and was least in CL (57.7%). A higher percentage of CL children (56.2%) had twice or more than twice the frequency of between-meal snacking than CF (41.7%) and NC (41.1%) (P < .001) children. The variables included with non-zero coefficients in the model were mean parental oral health knowledge, attitude score, and children's mean VPI score, and all were significant for CL; however, in NC, only VPI score was found to be significant. CONCLUSIONS: Poor oral hygiene is the risk indicator associated with the presence of NC in preschool children, whilst poor oral hygiene and poor parental oral health knowledge and attitude are associated with the presence of cavitated lesions.

Can mHealth promotion for parents help to improve their children's oral health? A systematic review.

OBJECTIVE: This systematic review evaluated the effectiveness of oral health education using mHealth approach to parents for improving their children's oral health. DATA: Twelve studies were included after the screening and five studies in the data synthesis. The sample size varied from 34 to 1055. There was a very low level of evidence showing that mHealth approach could increase parents' knowledge and improve their brushing behaviors for children when compared to a negative control group. There was a low level of evidence showing mHealth approach could be more effective than printed material in increasing the parents' oral health knowledge. SOURCES: This systematic review was registered on PROSPERO (#CRD42021289324) with no funding support. STUDY SELECTION: Studies targeting parents/caregivers of children age 12 or under were included. Interventions should be oral health promotion delivered via mobile devices. Study outcomes were parents' oral health knowledge, attitude and behaviors, and children's oral health status. Eight electronic databases/registration platforms: PubMed, Cochrane Library, Embase, WoS, Global Health, Engineering Village 2, WHO ICTRP and ClinicalTrials.gov were lastly searched on 6th Oct 2021. The risk of bias tools used were RoB 2.0, ROBINS-I and NIH quality assessment tool for pre-post study. Meta-analysis using a fixed-effect model or vote counting based on the direction of effect was performed. CONCLUSION: All included studies had a high risk of bias. Low/very low certainty of evidence existed that the mHealth approach could improve parents' oral health knowledge. However, there lacks evidence to show the effects of mHealth intervention exerted on other outcomes. CLINICAL SIGNIFICANCE: The mHealth intervention could be a good approach to improve the parent's oral health knowledge. However, the theoretical model must be considered when designing the educational content. More research should be conducted to test the effectiveness of mHealth approaches on children's oral health status.

Health belief model for empowering parental toothbrushing and sugar intake control in reducing early childhood caries among young children-study protocol for a cluster randomized controlled trial.

BACKGROUND: It has been recognized that oral health education for parents is critical for preventing early childhood caries (ECC). Few parents practiced caries prevention procedures for their children in daily life, though. A novel intervention scheme using mobile messages will be developed in this study under the framework of the health belief model (HBM). The objective of the present randomized clinical trial (RCT) is to evaluate the effectiveness of the new scheme in promoting oral health of young children by reducing dental caries. METHODS: This RCT will involve 26-36 child care centers or kindergartens with nursery classes (clusters) located in Hong Kong. A total of 518-628 child-parent dyads (child age 18-30 months) will be recruited and randomly allocated at the cluster level into the test or control group with a 1:1 ratio. For parents in the test group, the intervention will consist of a set of HBM-based text messages sent regularly in 48 weeks. A standard text message will be sent to the parents in the control group in the first week. The primary outcome will be dental caries measured by dmft/dmfs of the children after 2 years (around 4 years of age). The secondary outcomes will be toothbtushing and sugar intake. DISCUSSION: HBM-based intervention via a low-cost text messaging vehicle may serve as a viable way to empower parents to establish proper oral health behaviors for their children and safeguard the oral health of children in Hong Kong. TRIAL REGISTRATION: ClinicalTrials.gov NCT04665219 . Registered on 11 December 2020.

Family behavior theory-based intervention via mobile messaging to improve oral health of adolescents: study protocol for a cluster randomized controlled trial.

BACKGROUND: Due to some unique physical, social and psychological features in the adolescent population, adolescents can be a time of heightened caries activity and periodontal disease. Oral health-related behaviors can be modified to improve oral health status. The family networks and the built environment can promote or inhibit health behaviors. The aim of this study is to implement and evaluate a behavior theory-based, integrated family intervention via mobile messaging to improve oral health of adolescents. METHODS: This is a three-arm parallel-design cluster-randomized controlled trial. This trial will allocate 12 local secondary schools (clusters) in Hong Kong to three test or comparison groups with a ratio 1:1:1. The enrolled Form II to IV students (ages 12 to 15) will be eligible for participation. The intervention to three study groups will be (i) Health Belief Model (HBM)-based mobile messaging to the adolescents and their parents, which will consist of several blocks of HBM-based messages and reinforcement during 24 weeks; (ii) same HBM-based messaging to adolescents only; and (iii) delivering e-version of oral health education pamphlets to adolescents. The primary outcome will be caries increment 2 years post-intervention. Changes in oral health self-efficacy and behaviors, oral hygiene, and gingival status will be the secondary outcomes. DISCUSSION: No school dental care service is available to secondary school students in Hong Kong. This study will be the first to test a theory-driven and family-engaged preventive intervention among adolescents in Hong Kong. Findings will contribute to developing a low-cost, feasible, and efficient oral health preventive program for adolescents. TRIAL REGISTRATION: ClinicalTrials.gov NCT05448664 . Registered on 7 July 2022.

Remineralization Potential of Calcium and Phosphate-based Agents and Their Effects on Bonding of Orthodontic Brackets.

PURPOSE: To compare the remineralization potential of Clinpro Tooth Crème (CTC C, 3M Oral Care) containing functionalized tricalcium phosphate (fTCP), Tooth Mousse (TM, GC) containing casein phosphopeptide amorphous calcium phosphate (CPP-ACP), and Tooth Mousse Plus (TMP, GC) containing casein phosphopeptide amorphous calcium phosphate with fluoride (CPP-ACPF) and their effects on the shear bond strength (SBS) of orthodontic brackets to enamel. MATERIALS AND METHODS: In Part I of the study, 51 premolars were divided into 3 groups: 1: fTCP; 2: CPP-ACP; 3: CPP-ACPF. Artificial carious lesions were created and immersed in remineralizing solution for 30 days. Specimens were evaluated using Knoop microhardness and transverse microradiography. The percentage of surface hardness recovery (%SHR), change in lesion depth (∆LD), and mineral loss (∆∆Z) were analyzed using one-way ANOVA. In Part II of the study, 80 premolars were divided into 5 groups: A: brackets bonded to sound enamel; B: brackets bonded to demineralized enamel (DE); C-E: demineralized enamel immersed in remineralizing solution containing fTCP (group C), CPP-ACP (group D), or CPP-ACPF (group E) before bracket bonding. The SBS of half of the specimens were tested immediately, while the other half were tested after thermocycling. Data were analyzed using two-way ANOVA. RESULTS: TMP showed significantly higher %SHR, ∆LD and ∆∆Z compared to the other groups (p < 0.05). Both control and TMP had the highest SBSs and demineralized enamel the lowest, irrespective of thermocycling. No significant difference in SBS was found between TM and TMP after thermocycling. CONCLUSIONS: Tooth Mousse Plus achieved significant remineralization of artificial enamel carious lesions without adverse effect on shear bond strength of orthodontic brackets to remineralized enamel.