Severity of MIH findings at tooth surface level among German school children.

AIM: This study was to investigate the distribution and clinical characteristics of teeth diagnosed with MIH at surface and defect type level in a cohort of German children. METHODS: The study cohort included 242 children diagnosed with MIH which had been recorded during the compulsory dental school examinations of 20 German primary schools. The subjects had been enrolled by cluster sampling. All children attended the second to fourth grade (age 7-10 years, mean 8.1 ± 0.8). The children were examined by five calibrated examiners (kappa = 0.9) after tooth brushing. The recording comprised teeth, surfaces, type and severity of MIH defects and was conducted using a portable light, mirrors and cotton rolls. MIH was registered according to the EAPD criteria. Defects <1 mm were not recorded. Statistical analysis included descriptive statistics and Spearman's correlation. RESULTS: Most affected teeth were first permanent molars (71.4 %) followed by the maxillary central incisors (15.6 %). The most common defects were demarcated opacities (82.2 %), while the remaining 17.8 % of the affected teeth exhibited severe enamel defects. The most frequently affected surface in molars was the occlusal surface (72.4 %); in incisors, it was the buccal surface (73.5 %). There were no atypical restorations in the affected incisors. Different types of MIH defects at various surfaces of the same tooth were common. The number of affected tooth surfaces was positively correlated with the severity of MIH at child (p < 0.001). CONCLUSIONS: The study demonstrates severe enamel defects involving in almost one-fifth of all MIH teeth. The knowledge of the intra-oral distribution and severity of MIH findings at the enamel surface level is important for assessing the treatment needs.

Factors contributing to severe early childhood caries in south-west Germany.

OBJECTIVES: The purpose of this study is to investigate the contribution of selected variables to the occurrence of severe early childhood caries (S-ECC) in 3- to 5-year-old kindergarten children. METHODS: A cross-sectional study was conducted in 2010 in 30 randomly selected kindergartens in the German Rhein-Neckar district. After informed consent, parents were asked to complete a questionnaire. The oral examinations took place in the selected kindergartens and the WHO methods as well as the criteria proposed by the American Academy of Pediatric Dentistry were followed. Logistic regression was applied to explore the main factors contributing to S-ECC in a multivariate model. RESULTS: In all, 1,007 children aged 3 to 5 years with an average age of 4.1 (SD = 0.8) years were examined. Five variables were associated significantly with the occurrence of S-ECC: breastfeeding for more than 12 months (OR = 3.27), use of the nursing bottle in bed (OR = 3.08), start of tooth brushing after the first anniversary (OR = 2.42), regular visits at the dentists (OR = 0.14) and mother with immigration background (OR = 4.05). Prevalence rate of S-ECC was 9.5 %. The mean d(3+4)mft values were 5.69 (S-ECC group) and 0.23 (non-S-ECC group). CONCLUSION: These results show that occurrence of S-ECC is a complex interaction between socioeconomic, psychological and behavioural factors of parents. New and specific ways to provide preventive dental care for toddlers and infants of caries risk groups have to be developed. CLINICAL RELEVANCE: Parents of newborn children have to receive information about timely start of tooth brushing and adequate use of nursing bottles.

Caries experience and treatment need in adults with intellectual disabilities in two German regions.

OBJECTIVE: The aim of the study was to determine the caries experience, caries prevalence, dental treatment need and care index of adults with intellectual disabilities living in the German federal states of Baden-Württemberg and Sachsen which differ distinctly with respect to the socio-economic conditions. RESEARCH DESIGN: In 2007, legal custodians of all persons working in special day-care institutions (n=2037) were asked to give consent for dental examinations of their custodees. Some 21.9% consented. Thus, 428 persons received a dental examination in the day-care institutions. RESULTS: The mean age of the participants was 35.5 years (range 18-64). Caries prevalence was 93.7% (95% CI 91.3-95.9) in Baden-Württemberg and 97.6% (95% CI 96.2-99.0) in Sachsen. All caries-free persons (n=19) were younger than 35 years. The mean DMFT of the whole sample was 12.3 (95% CI 11.6-12.9). Although DMFT values were the same in both German regions, persons from Baden-Württemberg had more missing teeth than those from Sachsen but untreated carious defects were more common in Sachsen. CONCLUSIONS: Dental care for those with intellectual disabilities could be better harmonised within Germany. Furthermore, specific dental care and dental treatment strategies could be introduced in Germany in order to reduce caries prevalence and number of extracted teeth in persons with intellectual disabilities.

[Oral health in adult athletes with intellectual disabilities in Germany]. / Mundgesundheit erwachsener Athleten mit geistiger Behinderung.

In 2008 the summer games of Special Olympics Germany took place in Karlsruhe, Germany. The athletes were offered on site the opportunity to have a voluntary and free dental examination. The examinations were performed by dental clinicians in rooms which were equipped with dental chairs. Data were collected following the criteria of WHO. 420 adult athletes took part in the dental examination. Their age ranged between 18 and 70 years and their mean age was 30.8 years. Nearly two thirds of the participants were males. The caries prevalence of the athletes was 90.8% (95% confidence interval 86.9-92.8%). The mean DMFT value was 9.4. Athletes who were living with their families had a significantly lower mean DMFT value than those living in an institution. In 22.1% of the examined athletes at least one fissure sealed tooth was observed. 58.8% presented with gingivitis and 21% had received prosthodontic care. 95% of the athletes brushed their teeth alone. Only 28% used an electric toothbrush. Less than 7% used regularly a gel with high fluoride concentration. This study shows that persons with intellectual disability still have a poorer oral health than the general population. In order to improve dental health and quality of life in persons with intellectual disability, efficient preventive programmes should be developed and applied in cooperation with parents, relatives and caregivers.