Oral health education interventions may improve the oral health status of older people.

DATA SOURCES: PubMed, Embase, Scopus, Web of Science. STUDY SELECTION: Experimental and quasi-experimental interventional studies. DATA EXTRACTION AND SYNTHESIS: Two authors independently evaluated the included studies using the Effective Public Health Practice Project (EPHPP) quality assessment tool, and any discrepancies in the scoring of the quality assessment tool were resolved through discussion or by involving a third author. The outcome was descriptive in nature. RESULTS: Twenty-three studies were included in the review (17 RCTs and 6 quasi-experimental). The studies showed improvement in all areas related to oral health of the older people after implementation of the interventions. CONCLUSIONS: Well-structured oral health educational programs may help improve the oral health of older people. However, more robust evidence is needed in this area.

Impact of Protracted War Crisis on Dental Students: A Comparative Multicountry Cross-sectional Study.

BACKGROUND: The impact of conflict and war crisis on dental students is poorly understood. Given the prolonged conflicts and political instability in the Arabic-speaking countries, it is crucial to investigate the effect of these conditions on dental students. This study aimed to assess the impact of protracted war on dental students by comparing the personal, university, and wider context challenges they face across war-affected and unaffected countries. METHODS: A cross-sectional study was conducted including a convenience sample of dental students from 13 universities in 12 Arabic-speaking countries. Respondents were those at entry and exit points of their undergraduate dental training. A self-administered paper questionnaire collected anonymized data on sociodemographics, and personal, university, and wider context challenges that students were facing. Multivariable Poisson regression analyses were carried out. RESULTS: The overall response rate was 64.8%. The mean age was 21.2 (standard deviation = 2.1) years, with 68% of participants being female. After adjusting for age and sex, dental students in Arabic-speaking countries affected by protracted war crisis were significantly more likely to report wider context challenges compared to their counterparts in unaffected countries (n = 2448; beta = 1.12; 95% confidence interval: 1.10-1.13; P < 0.001). DISCUSSION: Dental students in Arabic-speaking countries affected by protracted war crisis were more likely to suffer from wider context challenges such as difficulties in attendance due to the deterioration of security and lack of flexibility of teaching time to accommodate the different circumstances induced by the war crisis. Supporting dental students in areas affected by protracted war crises is needed and may include developing online dental education programs.

Breastfeeding beyond 24 months of age could be a risk for higher childhood caries experience.

DESIGN: Cohort study design. COHORT SELECTION: Children from the Birth Cohort Study who attended a 48-month follow-up were included in the study. DATA ANALYSIS: Caries was (caries is not plural. It is the name of the disease) measured using decayed-missing-filled surfaces (dmfs) index score. Relative excess risk due to interaction (PERI) was used to assess the interaction between breastfeeding and processed food consumption. RESULTS: Breastfeeding for prolonged periods was found to be associated with higher experience and prevalence of early childhood caries. Caries prevalence was higher in children who consumed higher amounts of processed food. CONCLUSIONS: Prolonged breastfeeding and high consumption of processed food were associated with early childhood caries. Both seem to affect caries independently, as there was no observed interaction.

Application of Public Health Precautionary Guidelines Before Contracting COVID-19: Lessons Learned from a Qualitative Descriptive Study.

Background: The COVID-19 pandemic has affected the Saudi population despite early efforts taken by officials. This study aimed to describe the precautionary measures taken by patients prior to their diagnosis with COVID-19. Methods: A qualitative descriptive design was employed to collect data from a convenience sample of 26 participants who had COVID-19 and recovered. Data was collected through conducting telephone interviews and was then transcribed and analyzed using inductive content analysis methods adapted from grounded theory. Results: Data analysis yielded six categories of precautionary measures participants reported using to minimize their risk of contracting COVID-19: (1) wearing a mask, (2) staying at home and avoiding crowds, (3) washing hands and wearing gloves, (4) following social distancing, (5) using sanitizers, and (6) not interacting with anyone. Conclusion: The discrepancy found between the participants' reported precautionary measures and their actual behavior, as well as the consistency and specificity with which they implemented some and not all measures raise concerns about existing public health messages. The study findings support the importance of well-structured and detailed communication when designing future public health campaigns and data-driven policies.

Is professionally applied fluoride effective in preventing or arresting caries in older adults?

Design Systematic review of clinical trials.Case selection Clinical trials with adults 60 years of age or older who professionally received fluoride therapy for caries prevention or arrest. Controls were adults of the same age group who received another professionally applied fluoride agent, placebo, or nothing.Data analysis The expected outcomes were the mean difference in the number of new caries, caries prevented fraction and caries arrest rate. Independently, two researchers assessed the risk of bias in the included studies.Results Seven studies met the selection criteria where 5% sodium fluoride varnish, 38% sodium diamine fluoride solution and 1.23% acidulated phosphate fluoride gel were used with root caries and coronal caries. Given the nature of the studies, the three agents were effective in preventing root caries in older adults. None of the agents were particularly superior to the others.Conclusions Professionally applied fluoride is effective in preventing dental caries in older adults.

Could behavioural intervention improve oral hygiene in adolescents?

Design Quasi-randomised controlled trial.Case selection Study participants (312; test: 158, control: 154) were conveniently selected based on age (16-17 years old), marginal gingival bleeding index or plaque index of 50% or more and good command of the Swedish language.Data analysis Measuring study outcomes was dichotomous. Marginal gingival bleeding and plaque were either present (1) or absent (2) at four sites on each tooth. Bleeding index and plaque index were presented as a percentage.Results By the end of the study, only 274 patients showed up for the six-month follow-up (test: 128, control: 146). Both groups showed improvement compared to baseline, although the test group showed significantly higher improvement than the control group.Conclusions A person-centred and theory-based behavioural programme was found to be more effective than conventional programmes in improving oral hygiene habits in adolescents.

Generalized Anxiety Disorder and Its Relationship with Dental Anxiety among Pregnant Women in Dammam, Saudi Arabia.

OBJECTIVE: To assess the relationship between generalized anxiety disorder (GAD), dental anxiety (DA), and other factors among pregnant women. METHODS: The Generalized Anxiety Disorder (GAD-7) scale and the Modified Dental Anxiety Scale (MDAS) were used to evaluate GAD and DA, respectively. Hard copies of self-administered questionnaires were distributed among 780 pregnant women attending hospitals/health centers in Dammam, Saudi Arabia. RESULTS: About 31.7% of the participants demonstrated minimal anxiety, 37.9% mild anxiety, 19.7% moderate anxiety, and 10.6% severe anxiety. The mean GAD score of the sample was 7.53 ± 5.16 which differed significantly among women in the first (7.74 ± 5.47), second (6.82 ± 4.64), and third trimesters (8.13 ± 5.37) (P=0.029). Pregnant women who performed routine dental visits demonstrated lower GAD (6.98 ± 5.23) than those who visited dentists for consultation, pain, or treatment (7.58 ± 5.07). The mean GAD score was significantly higher among participants with dental pain or discomfort during the last 12 months (8.12 ± 5.05) than among those without pain or discomfort (7.02 ± 5.2) (P 0.003). Similarly, the participants with DA showed a significantly higher mean GAD score (7.69 ± 5.17) than those without DA (5.93 ± 4.71) (P 0.006). Multivariate linear regression showed that GAD significantly correlated with DA (B = 0.225, P < 0.001). CONCLUSION: In the present study, GAD was common among pregnant women which significantly correlated with DA. Pregnant women with DA and dental pain demonstrated high GAD. Preventive and therapeutic measures should be taken to reduce GAD and DA during pregnancy.

Is there an association between multiple sclerosis and oral health?

Data sources PubMed, Scopus, Web of Science, MEDLINE and CINAHL.Study selection Randomised controlled trials, cross-sectional studies and cohort studies.Data extraction and synthesis Two reviewers independently extracted data using piloted forms and contacted authors if relevant data were missing. Assessment of quality was done using the Newcastle-Ottawa scale (NOS) for both cohort and cross-sectional studies. The score of NOS ranged from 1-9, where 6-7 is considered moderate quality while 8-9 is high quality.Results Seventeen studies were included in the review (13 cross-sectional and four cohort). Seven out of 13 cross-sectional studies scored ≤5 which indicates poor quality. The four case-control studies were of moderate quality. Overall, there is limited evidence that patients with multiple sclerosis (MS) have more dental caries or gingival disease. However, evidence suggests that patients with MS have more risk of periodontal disease and poor oral hygiene. The evidence also suggests a moderate association between MS and temporomandibular disorders (TMD).Conclusions With the exception of TMD, current evidence does not establish an association between MS and most oral health conditions. More high-quality evidence is needed to further explore and establish an association.

Smoking cessation is effective in reducing the risk of tooth loss.

Data sources MEDLINE (PubMed), Web of Science and Cochrane Library in September 2019.Study selection Cross-sectional and cohort studies that explored the relationship between smoking cessation and tooth loss.Data extraction and synthesis The reviewers extracted data and contacted authors if relevant data were missing. Risk of bias was assessed using modified versions of the Newcastle-Ottawa scale (NOS) for both cohort and cross-sectional studies. For cross-sectional studies, random-effects model was used to assess the outcome (tooth loss). Estimates were presented as odds ratios (with 95% confidence interval). For cohort studies, random-effects model was also used to compare former and current smokers to never smokers. The estimates were presented as risk ratio (with 95% confidence interval). Heterogeneity was tested for both types of studies.Results Twenty-one studies were included in the review (14 cross-sectional and seven cohort). Of the cross-sectional studies, five studies were of low risk of bias while seven and two studies were of moderate and high risk of bias respectively. Former vs current smokers showed no significant difference in all levels of tooth loss. Of the cohort studies, the risk of tooth loss was twice as much for current smokers compared to former smokers.Conclusions There was not a significant difference in tooth loss between former smokers and never smokers. Current smokers are at a higher risk for tooth loss than former smokers.

Relationship between Obesity and Dental Caries in Saudi Male Adolescents.

INTRODUCTION: Obesity and dental caries are global public health problems. There are conflicting reports about the relationship between caries and obesity. Therefore, the study aimed to investigate the association between obesity and dental caries among male adolescents. MATERIALS AND METHODS: This cross-sectional study included a sample of 258 male students' aged 12 to 15 years from schools in Dammam/Al-Khobar, Saudi Arabia. The study involved measuring caries prevalence and DMFT estimates, assessing body mass index (BMI), and administering a self-completion questionnaire. Independent samples Student's t-test, one-way ANOVA test, Pearson's correlation test, and bivariate and multivariate logistic regression analyses were performed. RESULTS: Caries prevalence of the sample was 79.8%, and the mean score of DMFT was 3.55 ± 2.94. The mean BMI of participants was 23.42 ± 6.82 and 18% were obese (BMI > 30). The obese participants had a higher mean DMFT score (4.46 ± 3.54) than nonobese participants (3.35 ± 2.77) (P=0.021). Similarly, the mean untreated caries was higher in obese (4.17 ± 3.22) than in nonobese participants (3.01 ± 2.66) (P=0.010). In the logistic regression analysis, after controlling for father's education, family history of obesity, meals per day, fast food per week, and physical activity in the final model, the participants with high caries experience (DMFT = 5-15) were 2.21 times more likely to have obesity than those with low caries experience (DMFT = 0-4) (P=0.04). No/school education of father (odds ratio 3.54, P=0.011), family history of obesity (odds ratio 3.27, P=0.002), and not performing physical activity (odds ratio 4.37, P=0.002) were significantly associated with an increased likelihood of obesity. CONCLUSION: The prevalence of caries and obesity was high in male adolescents in Saudi Arabia. Obesity was significantly associated with untreated caries and caries experience. Children with high caries experience were more likely to have obesity than children with low caries experience. Preventive programs and policies should address public health issues related to caries and obesity in male teenagers.

Prevalence of Dental Trauma and Receipt of Its Treatment among Male School Children in the Eastern Province of Saudi Arabia.

BACKGROUND: Dental trauma is a common dental public health problem, and it affects 20% to 30% of permanent dentition worldwide. OBJECTIVE: To evaluate self-reported dental trauma to permanent anterior teeth and the receipt of dental treatment among male school children. MATERIALS AND METHODS: This cross-sectional study included grade 7 to 9 school children in Dammam/Al-Khobar, the Eastern Province of Saudi Arabia. The participants responded to a pilot-tested self-completion questionnaire which contained questions about experience, types, place, and reasons for dental trauma and the receipt of dental treatment. Bivariate and multiple logistic regression analyses were performed. RESULTS: There were 258 students in the study with a mean age of 14.29 ± 1.11 years. Dental trauma was experienced by 39.5% of the participants. Tooth fracture (22.7%) was the most common type of dental trauma followed by tooth displacement (8.7%) and complete tooth removal (8%). The most common reason of dental trauma included fall (9.3%) and accidental hit by some objects (8.9). Home (19.8%), school (5%), and playground (4.2%) were reported as common places of dental trauma. Dental treatment was received by 20.5% of the samples. Most participants visited a dental clinic (10.8%) and used self-care at home (7.2%) after dental trauma. Nearly 4.7% of the participants received dental treatment immediately, 5% on the next day, and 2.7% after a month. Multiple logistic regression analyses showed a significant association of monthly family income (odds ratio = 0.44) with dental trauma (P = 0.008). CONCLUSION: Dental trauma was highly prevalent among school children; however, few of them received care/dental treatment. Participants frequently experienced dental trauma due to a fall in their homes. Preventive measures should be taken to prevent dental trauma, reduce its burden, and improve quality of life.

First Permanent Molar Caries and Oral Health Practices in Saudi Male Teenagers: Inequalities by Socioeconomic Position.

OBJECTIVES: Caries remains a problem in high-risk groups aggravated by socioeconomic inequalities. The study aimed to investigate (1) oral health practices associated with caries in the 1st permanent molars in Saudi male teenagers and (2) the impact of socioeconomic position (SEP) on caries control using these practices. METHODS: A cross-sectional study targeted 1137 male teenagers in intermediate schools in Khobar and Dammam, Saudi Arabia, in 2016. Caries was examined using the World Health Organization criteria and plaque was assessed using the plaque index of Loe and Silness. A questionnaire assessed SEP (parental education, employment, and home ownership) and oral health practices (using fluoridated toothpaste twice daily, regular dental visits for check-ups, and avoiding daily sugary snacks). Regression models analysed the association of these factors with caries presence and the mean number of decayed 1st permanent molars. Stratification was used to assess differences between SEP levels. RESULTS: The response rate was 81.7%. Caries prevalence and mean (SD) number of decayed 1st permanent molars were 50.4% and 1.08 (1.31). The use of fluoride toothpaste was associated with lower odds of caries and fewer decayed molars (OR = 0.50 and regression coefficient = -0.35). Differences in the relationship between caries and toothpaste were observed by SEP levels with stronger associations in less advantaged groups. CONCLUSIONS: Brushing twice daily using fluoride toothpaste was associated with less caries in Saudi male teenagers with stronger association observed in groups with lower SEP. The use of fluoride toothpaste helps in reducing health inequalities associated with SEP.

Internet Addiction, Oral Health Practices, Clinical Outcomes, and Self-Perceived Oral Health in Young Saudi Adults.

The study assessed the relationship between Internet addiction and oral health practices and clinical outcomes and whether this was affected by oral health perception. In 2017, a cross-sectional study included university students in the Eastern Province of Saudi Arabia. Questionnaires assessed demographic background, oral health practices (consuming sugar, tobacco use, and oral hygiene), perceived oral health, and Internet addiction. Caries experience and gingivitis were assessed using the World Health Organization criteria. The multivariate general linear analysis assessed the relationship between dependent variables (oral health practices, DMFT, and gingivitis) and exposure (Internet addiction). Data were available for 919 participants, 75.4% females, mean age = 19.8 years, and 1.6% with significant Internet use problem. The mean percentage of teeth with gingivitis was 8.5% and mean DMFT was 2.9. Among those with good perception of oral health and compared with participants with significant Internet use problem, average Internet users had lower consumption of sugar and tobacco (B = -6.52, P = 0.03 and B = -2.04, P = 0.03), better oral hygiene practices (B = 2.07, P = 0.33), higher DMFT (B = 2.53, P = 0.10), and lesser gingivitis (B = -15.45, P = 0.06). Internet addiction was associated with negative oral health practices and poor clinical outcomes among young Saudis. Holistic health promotion approaches need to address the negative impact of Internet addiction on health and oral health status for this at-risk age group.

Influence of Dental Pain and Tooth Sensitivity on the Intention to Quit Smoking among Schoolchildren.

OBJECTIVE: To evaluate the association between oral health problems and sociodemographic factors with the intention to quit smoking and join the tobacco cessation program among schoolchildren. MATERIALS AND METHODS: This cross-sectional study included a sample of 10-12 grade male students from public high schools in different cities of the Eastern province of Saudi Arabia. Schoolchildren responded to a pilot-tested questionnaire about self-reported oral health problems and the intention to quit smoking. Bivariate and multivariate logistic regression analyses were performed. RESULTS: Out of 587 schoolchildren, 199 were smokers with a smoking prevalence of 33.9%. Significantly higher proportions of smokers than nonsmokers had tooth sensitivity (P = 0.029) and dryness of the mouth (P = 0.001). Most smokers (75.9%) had a family history of smoking, and 51.8% started smoking within the last two years. Tooth sensitivity (56.3%), dental cavities (52.8%), and dental pain (44.7%) were highly prevalent among smokers. About one-third of smokers expressed their intention to quit smoking (38.2%) and join a smoking cessation program (33.7%). Tooth sensitivity (OR = 3.7, P = 0.004) and dental pain (OR = 2.84, P = 0.014) were significantly associated with quitting smoking. In addition, smokers with tooth sensitivity (OR = 3.22, P = 0.007) had higher odds of joining a smoking cessation program than those without tooth sensitivity. The smokers who started smoking within the last two years (OR = 3.97, P = 0.002) were more likely to quit smoking than those who initiated smoking for more than two years. CONCLUSION: Oral health problems were highly prevalent among smokers. Tooth sensitivity was significantly associated with quitting smoking and joining a cessation program in children. The awareness about the adverse effects of smoking on oral health should be part of regional, national, and global tobacco prevention policies and programs.

Use of Student Evaluation of Teaching (SET) Survey to Evaluate Effectiveness of Teaching in a Leadership Course among Dental Students over Three Years.

Leadership courses are being increasingly integrated into dental curricula. The study aimed to assess the validity and reliability of student evaluation of teaching (SET) instrument among dental students and to evaluate the effectiveness of teaching in a new leadership course over a period of three years. This cross-sectional study was conducted on fourth-year undergraduate dental students (N = 260) who took a practice management course over three consecutive years from 2014 to 2016. A 29-item SET questionnaire was administered among students who were willing to participate in the study. Out of 260 students, 185 returned completed surveys and the response rate was 71.15%. Factor analysis (principal component analysis) showed the validity of four dimensions of the SET instrument. Total variance explained by four dimensions was 62.80%. Cronbach's alpha for the instrument was 0.95 and each dimension had fairly high internal consistency (>0.80). Treating students with respect (94%), accepting different viewpoints of students (94.1%), being flexible/open-minded (92.5%), and preparedness in the course (91.9%) were the most common effective teaching traits. Over the period of three years, 16 items showed improvement in teaching and there was a significant improvement in four items (P < 0.05). In conclusion, it was found that SET is a valid instrument to evaluate the effectiveness of teaching in nonclinical courses in dentistry. This instrument should be used longitudinally to compare the effectiveness of teaching.

Dentists thoughts about COVID-19.

Data sources Self-developed survey.Data extraction and synthesis This was a cross-sectional study using a self-administered online survey.Results Out of 700 randomly selected dentists in Jordan, 368 completed an online survey. Of those, 36% reported that the incubation period for COVID-19 is 1-14 days. The majority were aware of the symptoms of the disease and can identify affected patients. Nonetheless, 36.7% of dentists did not believe it to be a serious public health issue.Conclusions This group of Jordanian dentists was generally aware of COVID-19 symptoms and mode of transmission. Clinical practice guidelines should be made available to dentists by their associations during such crises.

Global Prevalence of Periodontal Disease and Lack of Its Surveillance.

BACKGROUND: Periodontal disease is a public health problem and is strongly associated with systemic diseases; however, its worldwide distribution is not fully understood. OBJECTIVE: To evaluate global data of periodontal disease: (1) among adolescents, adults, and older population and (2) in low-, middle-, and high-income countries. METHODS: This ecological study included data of periodontal disease from the World Health Organization's data bank which are based on the Community Periodontal Index of Treatment Needs (CPITN code: 0 = no disease; 1 = bleeding on probing; 2 = calculus; 3 = periodontal pocket (PD) 4-5 mm; 4 = PD (6+ mm). Age- and income-related periodontal disease inequalities were evaluated across the globe. RESULTS: Compared with 9.3% of adults and 9.7% of older persons, 21.2% of adolescents had no periodontal disease (P = 0.005). Nearly 18.8% of adolescents compared with 8.9% of adults and 5% of older persons had bleeding on probing (P ≤ 0.001). Similarly, 50.3% of adolescents, 44.6% of adults, and 31.9% older persons demonstrated the occurrence of calculus (P = 0.01). On the other hand, older persons had the highest prevalence of PD 4-5 mm and PD 6+ mm than adults and adolescents (P ≤ 0.001). The distribution of periodontitis (CPITN code 3 + 4) in adults differed significantly in low- (28.7%), lower-middle- (10%), upper-middle- (42.5%), and high-income countries (43.7%) (P = 0.04). However, no significant differences in periodontitis (CPITN code 3 + 4) were observed in adolescents and older persons in low- to high-income countries. CONCLUSIONS: Within the limitations of data, this study found that the distribution of periodontal disease increases with age. Periodontitis was the most common in older persons and in population from high-income countries.

Intention to seek esthetic dental treatment and the theory of planned behavior in Saudi dental students and the general population.

STATEMENT OF PROBLEM: Tooth shade is of major concern for patients when receiving esthetic dental treatment. Understanding the motivating factors that drive patients' intentions to seek esthetic dental treatment helps in planning services. PURPOSE: The purpose of this cross-sectional study was to assess the relationship between the intention to seek esthetic dental treatment and the theory of planned behavior (TPB), including attitude regarding tooth shade, perceived ability to seek treatment, and subjective norms of how others perceive tooth shade. MATERIAL AND METHODS: The study included first-year dental students and clinic patients in a Saudi dental school (N=283). The shade of the maxillary central incisors was clinically assessed by using the Crystaleye spectrophotometer, and the L*, a*, and b* values were recorded. Participants were asked to select a shade that represented how others perceived their shades by using the VITA classical shade guide and to respond to a self-administered questionnaire based on a TPB assessing attitude regarding shade (9 items), perceived ability to seek esthetic treatment (7 items) on a 5-point Likert scale, and intention to seek esthetic treatment. The internal consistency of the TPB items was assessed, and scores were calculated. Logistic regression analysis was used to assess factors associated with the intention to seek esthetic treatment, including the TPB components controlled for L*, a*, and b* values in addition to age (α=.05). RESULTS: Of all participants, 49.5% indicated that they intended to seek esthetic treatment. The most commonly perceived shades were B1, B2, A2, A1, and A3 (76%). In adjusted regression, the intention to seek esthetic treatment was significantly associated with a more positive attitude regarding shade (OR=2.31, 95% CI=1.54, 3.47) and a lower b* value (OR=0.74, 95% CI=0.59, 0.93), but not with shade coordinates (P values of L*=.94, a*=.64, and b*=.13). CONCLUSIONS: Intention to seek esthetic dental treatment was associated with a positive attitude regarding the importance of shade and a greater perception of having a less yellow shade, regardless of the shade.

Association of body mass index and gross national income with caries experience in children in 117 countries.

Objective: To evaluate the association of body mass index (BMI) and gross national income (GNI) per capita with dental caries experience in children at population levels.Methods: This ecological study used global data of decay, missing, and filled teeth (DMFT), BMI, and GNI. DMFT data of 12 years old children from 117 countries were obtained from the World Health Organization. BMI data of children and adolescents from the same 117 countries were retrieved from the NCD Risk Factor Collaboration and GNI per capita from the World Bank. ANOVA test, Pearson's correlation coefficient (r), and multivariable linear regression were performed.Results: Globally mean BMI ranged from 16.1 to 22.2 in children. Low-income countries had the lowest BMI (17.41 ± 0.57) and high-income countries had the highest BMI (20.14 ± 0.87) (p < .001). The highest mean DMFT was observed in upper-middle-income countries (2.48 ± 1.16) and the lowest in low-income countries (1.22 ± 0.83) (p = .001). There was no significant correlation between BMI and dental caries (DMFT) (r = .063; p = .498). However, there were significant correlations between GNI per capita and BMI (r = 0.366; p < .001) and GNI per capita and DMFT (r= -0.252; p = .007). In multivariable linear regression, GNI per capita was negatively associated with caries experience in children (B= -1.83; p < .001).Conclusion: The study found that BMI was associated with income levels of the countries. GNI per capita significantly and negatively correlated with DMFT in children. Further investigation into the association between BMI and dental caries is warranted.

Which final impression technique and material is best for complete and removable partial dentures?

Data sources Cochrane Oral Health's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, the US National Institutes of Health Trials Registry (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform databasesStudy selection Randomised controlled trials (RCTs) comparing different final-impression techniques and materials for treating people with complete dentures (CD) and removable partial dentures (RPD) were included.Data extraction and synthesis Two reviewers independently extracted data and assessed risk of bias. Results were expressed as risk ratios (RR) for dichotomous outcomes, and as mean differences (MD) or standardised mean differences (SMD) for continuous outcomes, with 95% confidence intervals (CI). Meta-analysis used a random-effects model.Results Nine studies were included, eight involving CD. Six of the CD studies were at high risk of bias, two at low risk. For complete dentures there was low-quality evidence that silicone was a better final-impression material for oral health-related quality of life than alginate. There was also very low-quality evidence of no clear differences between the single-stage impression alginate and the two stage- two step elastomer groups in participant-reported quality of life using OHIP-EDENT. The RCT involving RPD altered-cast technique versus one-piece cast technique found low quality evidence of no difference between groups, for general satisfaction at one-year follow-up.Conclusions There is no clear evidence that one technique or material has a substantial advantage over another for making complete dentures and removable partial dentures. Available evidence for the relative benefits of different denture fabrication techniques and final-impression materials is limited and is of low or very low quality. More high-quality RCTs are required.