Applying Bayesian Model to Predict Socio-demographic and Occlusal Determinants of Early Childhood Caries (ECC)

Objective: To use the Bayesian statistical Model approach to predict the most important socio-demographic and occlusal factors pertinent to high prevalence of ECC. Material and Methods: A questionnaire and an oral examination was conducted on children who attended a pediatric dental clinic in Nairobi during the period of study. The parents provided information on socio-demographic and oral habits of the children. The oral examination for presence of dental caries was recorded for each child. Descriptive statistics were obtained for dental caries, oral hygiene, using plaque score, and malocclusion. The results of the questionnaire and presence of dental caries were analyzed and the results subjected to Bayesian statistical analysis to determine any predictive factors for ECC. Results: 55% of the children had plaque accumulating on more than one third but less than two thirds of tooth surfaces. The highest plaque scores were reported among children whose fathers (48.2%) and mothers (42.0%) had completed secondary, and whose fathers were in non-formal employment 73.2%. The overall prevalence of dental caries in the study group was 95.5% with a mean dmft of 8.53 (+ 5.52 SD), with the male children having higher dmft 8.65 (SD+5.54) than the female children 8.37 (SD+ 5.50). The prevalence of malocclusion among children in the study was 55%. The majority had mesial step, 51.5% (n=140) and flush terminal plane 28.3% (n=77). Conclusion: The Bayesian Model, with a correct assumption, can be used to determine the important factors involved in high prevalence of ECC.

Renaissance or dimming hope - The dilemma of managing multi-surface dental carious lesions in primary dentition using an Atraumatic Restorative Treatment (ART)

Introduction: Atraumatic restorative treatment (ART) has been in use for the last couple of years. The survival rate of multi-surface restorations using this method has generally been very low for any given follow-up period. Most commonly quoted as the causes for the low survival rate included early restoration loss, poor choice of the cavity to be restored, operator factors, material factors and patient related factors, among other factors. Speculation has been that the premature loss may not actually denote failure to preserve the carious dental element, and that probably, the fluoride leach from the glass ionomer cement used with the technique, might be helping elongate the survival of the restored tooth. The question is whether, therefore, it is important to only look at the survival of the ART restoration or to also consider the survival of the tooth with premature restoration loss. Objective: To determine the current general survival rates of multi-surface ART restorations in the primary dentition, while simultaneously considering any consequences of the premature loss of these restorations in the primary dentition. The data for the study was obtained through Pubmed/Medline search for publications on multi-surface ART restorations from 2000 to 2011. Only publications on ART in the primary dentition were included and analyzed for survival rate, premature loss of restoration and effect of such loss. Conclusion: While the survival rates of multi-surface ART restorations in the review studies were low, the restorations appeared to provide some beneficial effects to the retention-longevity of the restored tooth even after the premature loss of restorations...