Diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders for children aged 8-12 years.

BACKGROUND AND OBJECTIVE: Objective of this study was to determine whether the diagnostic accuracy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) is sufficient for use among schoolchildren aged 8-12 years. METHODS: This prospective cohort study on diagnostic accuracy with calibrated examiners was conducted among 533 children of both sexes aged 8-12 years, with and without TMD symptoms, selected randomly from the Rhein-Neckar district. Self-reporting of non-dental facial pain was used as the reference standard, against which we calculated the following for the pain-related items of the DC/TMD (index test): sensitivity, specificity, positive and negative likelihood ratios, diagnostic odds ratio, accuracy and 95% Wilson Score confidence intervals. We also calculated the area under the receiver-operating characteristic (AUROC) curve displaying sensitivity and specificity. RESULTS: Our final sample consisted of 282 children, half of whom reported having facial pain and 3.2% reported sounds from the temporomandibular joints (TMJs). Despite high specificity (90.78%; 95% confidence interval (CI): [84.86%; 94.53%]), sensitivity of the adapted DC/TMD for pain on maximum jaw opening was poor (37.59%; 95% CI: [30.02%; 45.81%]). For pain on palpation, more similar values were recorded for sensitivity (74.47%; 95% CI: [66.69%; 80.95%]) and specificity (70.21%; 95% CI: [62.21%; 77.14%]). The diagnostic odds ratio was >1 for both examinations. The AUROC for pain on opening was 68.39% (95% CI: [62.62%; 74.16%]), and for pain on palpation, it was 74.63% (95% CI: [69.45%; 79.81%]), whereas the combination of both resulted to an AUROC of 74.09% (95% CI: [68.96%; 79.21%]). It was not possible to measure the diagnostic accuracy of the DC/TMD regarding TMJ sounds or jaw-opening limitations, as they occurred too rarely in our sample. CONCLUSION: In this study, the diagnostic accuracy of the DC/TMD for TMD-related pain in children was lower than that recorded for adults in previous studies.

Prevalence of Molar-Incisor-Hypomineralisation among school children in four German cities.

BACKGROUND: A wide range for the prevalence of Molar-Incisor-Hypomineralisation (MIH) has been found in regional studies. AIM: The aim of this study was to determine the prevalence of MIH in Germany and to compare the findings with other studies. DESIGN: In the compulsory dental school examination, the first permanent molars, permanent incisors, and second primary molars were examined according to EAPD criteria in 2395 children (8.1 ± 0.8 years) in four regions in Germany for the presence of MIH. Examinations were performed by five calibrated examiners (κ = 0.9) on clean teeth after toothbrushing. RESULTS: The prevalence of MIH at the four regions differed considerably (4.3-14.6%) with a mean prevalence of 10.1%. The DMFT/dmft was generally low, but children with MIH exhibited statistically significant higher caries values. A total of 12.0% of the children with MIH also had at least one affected primary molar, which resulted in a statistically significant correlation between primary and permanent teeth. Most of the affected teeth had demarcated opacities, but more than half of the affected children showed at least one tooth with severe MIH. CONCLUSIONS: Molar-Incisor-Hypomineralisation is a prevalent finding in German school children. The prevalence varies highly in different regions, and the high rate of severe forms has clinically relevant implications.

Oral health in 12- to 17-year-old athletes participating in the German Special Olympics.

BACKGROUND: There is a lack of actual data regarding oral health in children and adolescents with intellectual disabilities. AIM: To evaluate the oral health in adolescents with intellectual disabilities participating in the German Special Olympics games 2008. METHODS: A free voluntary dental examination was offered to the participating athletes. Dental examinations were performed according to WHO criteria by dental clinicians. In addition, information about the athletes' oral hygiene habits was collected. RESULTS: The number of adolescent athletes aged between 12 and 17 years who had their teeth examined was 160. On average they were 15.3 years old. Caries prevalence was 58.1% and the mean DMFT was 2.3. The mean number of fissure sealed teeth was 2.5. About half of the participants showed signs of gum inflammation. The proportion of the adolescents living at home with their parents was 88%. More than 90% of them brushed their teeth by themselves without assistance. CONCLUSIONS: Adolescents with intellectual disabilities seem to have benefited from various caries preventive measures which had been introduced during the last two decades in Germany but still have a poorer oral health than the general population. More specific prevention programmes seeking close cooperation with parents, custodians, and caretakers should be developed.

Dental health, received care, and treatment needs in 11- to 13-year-old children with immigrant background in Heidelberg, Germany.

OBJECTIVES: The purpose of the survey was to evaluate the caries experience, the provided care, and the unmet treatment need in 11- to 13-year-old schoolchildren with immigration background compared to children without migration experience. METHODS: A cross-sectional study of 502 schoolchildren, 48% of which have immigration background, was conducted. Schools in areas of disadvantaged socio-economic status were chosen for this study. DMFT scores, fissure sealants, and the occurrence of orthodontic treatments were recorded. RESULTS: The mean DMFT score of the immigrant children was significantly higher than that of the nonmigrants: 1.5 vs. 0.8. The SiC Index was also significantly different in both groups: 3.7 vs. 2.4, respectively. The Unmet Restorative Treatment Need Index was twofold higher in the immigrants compared to the nonmigrants. Only 45.6% of the immigrants had sound permanent teeth compared to 65.5% of the nonmigrants. The average number of sealants per child was 1.9 vs. 2.8, respectively. In addition, only 31.5% of the immigrants were provided with an orthodontic treatment compared to 48.3% of the nonmigrants. CONCLUSION: Children with immigration background demonstrated more caries and received less dental care when compared to children without migration experience. The community prevention programmes, addressed similarly to all children, could not close the gap in oral health between immigrant and non-immigrant children.

Caries prevalence in 11- to 14-year old migrant children in Germany.

OBJECTIVES: To assess whether immigration stage is associated with higher prevalence of dental caries among schoolchildren in Heidelberg, Germany. METHODS: A cross-sectional dental examination on 570 schoolchildren, aged 11 to 14 years, in schools with high proportions of immigrant pupils (49.5%) was performed. Carious, missing and filled permanent teeth were recorded for each child, so that mean DMFT values could be calculated. The pupils were classified into three groups: M0 (children and their parents were born in Germany), M1 (children who were born in Germany but whose parents were born outside of Germany), and M2 (children and their parents were born outside of Germany). RESULTS: The mean DMFT values in M1 and M2 were close, and both were significantly higher than the corresponding values in M0. The proportions of caries-free children in M0, M1 and M2 were 63.7%, 40.3% and 42.3%, respectively. CONCLUSION: In Germany, migrant children have a poorer dental health status than native children coming from the same low socio-economic classes. Risk-oriented public health policies with appropriate prevention programs must be developed for these children.