Association between gastroesophageal reflux disease and dental caries among adults in the Azar cohort population: A cross-sectional study.

BACKGROUND: Considering the high prevalence of dental caries in adults, it is necessary to study its risk factors to prevent the disease. Gastroesophageal reflux disease (GERD) is a common chronic disease with an increasing incidence that may affect the quality and quantity of saliva. OBJECTIVES: This study aimed to determine the association of gastroesophageal reflux disease (GERD) with dental caries according to the DMFT index in the Azar cohort population. MATERIALS AND METHODS: This cross-sectional study was performed on data obtained from the enrollment phase of the Azar Cohort Study (ACS), conducted on 15,000 adults aged 35 to 70. Data of 905 subjects with gastroesophageal reflux disease in the ACS-without full denture-together with a control group of 1894 subjects, who were matched in terms of gender and age, were included in this study. Dental caries data and data on GERD, demographic and socioeconomic characteristics, individual and nutritional habits, BMI, and toothbrushing frequency were elicited from the databank of the ACS center. A Generalized Linear Models assuming negative binomial distribution with a log-link function was used for analytical statistics to examine the effect of possible confounding variables. RESULTS: The DMFT index in the group with GERD was 15.09±6.18, and for the control group was 15.00±6.07. No statistical association was seen between GERD and dental caries. Among the variables included in the regression analysis, being younger and toothbrushing one or more times per day were associated with a lower DMFT index score. CONCLUSION: According to the results, having GERD did not increase the risk of dental caries. However, due to the cross-sectional design of the study, the results should be interpreted cautiously. The results showed that oral hygiene is one of the most influential factors in reducing dental caries prevalence.

Relationship between DMFT index and reproductive history- a cross-sectional study on enrollment phase of Azar cohort study.

BACKGROUND: Hormonal changes in women throughout life might affect the oral health. The aim of this study is to investigate the relationship between the Decayed, Missing, and Filled Teeth (DMFT) index and reproductive history. METHODS: The present cross-sectional study was performed using data of Azar Cohort Study conducted in 2014, in Shabestar city, East Azerbaijan Province, Iran. In the present study, the data of all 8294 women from the enrollment phase of the Azar cohort were included. All available data related on the variables of reproductive history (including age at the onset of menstruation, age of onset of menopause, age of first pregnancy, and frequency of pregnancy), age at interview, educational level, socioeconomic status, frequency of tooth brushing, chronic diseases, body mass index and DMFT were extracted. Negative binomial regression with loglink was used to analyze the relationship between variables. Three regression models have been applied to adjust the effect of confounding variables. Model 1 adjusted for education, socio-economic status, age, chronic diseases, body mass index and frequency of tooth brushing. Model 2 adjusted for education, socioeconomic status, age, chronic diseases and body mass index. Model 3 adjusted for education, socio-economic status and age. RESULTS: The mean DMFT of 8294 women was 20.99 ± 8.95. In model 1, there was no significant relationship between DMFT and frequency of pregnancy. However, model 2 and 3 showed that in women who had four or more pregnancies, the DMFT rate was significantly higher than those who did not have a history of pregnancy (P = 0.02, P = 0.04). Age at the onset of menopause, age at the onset of menstruation and age of first pregnancy had no significant relationship with DMFT in the models. Brushing less than once a day and increasing age at interview had significant relationship with DMFT in the models (P < 0.001). CONCLUSION: Despite hormonal changes through the life, the history of reproductive showed no significant relationship with women's DMFT. Oral health education for women is an important step in promoting oral health and it is necessary to pay special attention to preventive programs in oral health policy for women specially with increasing the age.

Oral Health Status and Related Factors in Children with Visual Impairment Aged 7-11 Years: A Cross-Sectional Study.

OBJECTIVES: We aimed to investigate oral health, oral hygiene, and associated factors in children with visual impairment aged 7-11 years. MATERIALS AND METHODS: This cross-sectional study was conducted on 47 children with visual impairment aged 7-11 years who were selected from all three schools available for visually impaired children in Tehran in December 2018. Questions regarding age, gender, status of visual impairment, level of education of the parents, self-reported dental and gingival health, oral health, and dietary habits were asked face-to-face using the World Health Organization oral health questionnaire for children. The decayed, missing, and filled teeth index for both primary (dmft) and permanent (DMFT) dentitions was determined by clinical examination. Simplified Oral Hygiene Index (OHI-S), and bleeding on probing (BOP) were also assessed. Linear and logistic regression tests were used for statistical analysis. RESULTS: Over 70% of the children were satisfied with their dental and gingival health. Daily brushing was reported by 70.2%. Over half of the children reported daily consumption of fruits and jam/honey. The mean dmft and DMFT scores were 2.85±3.21 and 0.81±1.15, respectively. The mean OHI-S was 2.09±0.58. Also, 57.4% and 34% of the children had unrestored caries in their primary and permanent teeth, respectively. BOP was seen in 78.7% of the children. A significant correlation was observed between toothache in the past 12 months and dmft score (P<0.003). Daily tooth brushing was inversely correlated with OHI-S index (P=0.02). CONCLUSION: The results highlight an urgent need for implementation of oral health programs for visually impaired children.

Perception of oral health and medical conditions as possible predictors of oral health status in visually impaired adolescents: a cross-sectional study.

BACKGROUND: We aimed to assess oral health and oral hygiene status among visually impaired adolescents and also to evaluate the factors related to their oral health. METHODS: This was a cross-sectional study among 130 visually impaired adolescents in Tehran, Iran, in December 2018. Of three schools for visually impaired children in Tehran, children in the sixth to the tenth grade (aged 12-17 years) were included after obtaining their parents' consent. WHO oral health questionnaire for children was filled out through face to face interviews. General characteristics were age, gender, status of visual impairment, place of residence, and parental education level. Oral health-related questions were perceived dental and gingival health, dental self-care, dental visits, medical conditions, and dietary habits. Oral examinations included Decayed, Missing, and Filled Teeth (DMFT) index, the Simplified Oral Hygiene Index (OHI­S), and Bleeding on Probing (BOP). Univariate and multiple logistic regression tests were applied using STATA. RESULTS: The mean age (SD) of the adolescents was 14.45 (1.61) years. The fully blind children were 33.8%, and those with low vision were 66.2%. Regarding the perception of dental and gingival health, nearly half of the adolescents were satisfied. The mean DMFT and decayed component (DT) were 2.43 ± 2.24 and 1.92 ± 2.12, respectively. The frequency of DMFT ≥ 3 was 45.4%. The mean OHI-S was 2.01 ± 0.70, and OHI-S > 1.8 was reported in 60% of children. The prevalence of BOP was 79.2%. DMFT was significantly associated with toothache (P = 0.003, OR = 3.70, 95% CI: 1.54-9.09), perceived dental health (P = 0.005, OR = 3.06, 95% CI: 1.40-6.67), and medical conditions (P = 0.03, OR = 3.13, 95% CI: 1.13-8.68). In addition, OHI-S was related to gender (P = 0.02, OR = 0.36, 95% CI: 0.15-0.83), perceived dental health (P = 0.006, OR = 2.87, 95% CI: 1.35-6.12) and medical conditions (P = 0.04, OR = 3.05, 95% CI: 1.04-8.97). BOP was associated with perceived gingival health (P = 0.02, OR = 2.94, 95% CI: 1.18-7.33). CONCLUSIONS: Medical conditions and perceived dental and gingival health are possible predictors for oral health status in these adolescents. Although these children could not visualize caries or gingival bleeding during the brushing time, they could perceive the status of their oral health correctly. Also, being involved in medical problems can make more ignorance of oral health.

A music- and game-based oral health education for visually impaired school children; multilevel analysis of a cluster randomized controlled trial.

BACKGROUND: Visually impaired children encounter some challenges for their oral health. We aimed to compare the effectiveness of oral health education using Audio Tactile Performance (ATP) technique alone, ATP combined with oral health education for mothers, and ATP along with art package on the oral health status of visually impaired children. MATERIALS AND METHODS: This cluster, randomized trial, included visually impaired children from preschool to 10th grade (32 classes, n = 200), in Tehran, Iran, in 2018-2019. A questionnaire was filled out through face to face interviews at baseline regarding age, gender, status of visual impairment, and place of residence. The Simplified Oral Hygiene Index (OHI-S) and Bleeding on Probing (BOP) were examined afterward. Classes were randomly assigned to three groups through simple randomization: 1. Art group (ATP, game-based, and music-based education (11 classes, n = 66); 2. Mothers group (children received ATP and their mothers received education by telephone (10 classes, n = 73); and 3. Control group (children received ATP (11 classes, n = 61). Children received reinforcement after 1 and 2 weeks. Follow-up oral examinations were performed after 1 and 2 months by a blind calibrated examiner. Descriptive statistics were performed using Chi-Square, and ANOVA tests by SPSS (version 22). In analytic statistics, two-level mixed-effects models for BOP and OHI-S were fitted using the Statistical Analysis Software (SAS) version 9.4. Both models fitted with the grouping variable and time (baseline, 1, and 2 months after interventions) as the fixed effects. RESULTS: The mean age (SD) of the children was 12.29 (3.45) years (range: 6-17). Male children (67%) more than female children (33%) participated in the study. Also, 35.5% were blind, and 12% resided at the dormitory. The art and mothers groups had no statistically significant difference compared with the control group, in terms of OHI-S (P = 0.92, and 0.39, respectively) and BOP (OR = 0.64, and 0.66, respectively). The time effect was statistically significant in both BOP and OHI-S models (P < 0.0001). CONCLUSIONS: ATP technique is an effective method to improve the oral health status of visually impaired school children. Oral health promotion programs can be done using this method to tackle oral hygiene problems in visually impaired children. TRIAL REGISTRATION: (https://www.irct.ir/trial/34676: Nov 29th, 2018).