Caries Incidence Among Obese Adolescents: A 3-year Prospective Study.

PURPOSE: To determine the incidence of caries in a 3-year follow-up of obese adolescents. MATERIALS AND METHODS: Seven-hundred eighty five 13-year-old school children were selected randomly. Caries was recorded according to WHO criteria and body mass index was assessed in a medical evaluation. With appropriate sample weighting, relationships between caries and other variables were assessed using the chi-squared test, Kruskal-Wallis H-test, and multivariable logistic regression. RESULTS: At baseline, 185 (24.2%) adolescents presented with caries, having mean DMFT and DMFS scores of 0.9 ± 2.0 and 2.4 ± 3.6, respectively. The accumulated incidence of caries during the 3-year period of study was 16.5%, with mean DMFT and DMFS increments of 0.8 ± 0.2 and 1.1 ± 3.3, respectively. Obese and overweight adolescents had a 3.7 times (95% CI = 1.3-6.8) greater chance of developing caries after adjusting for socioeconomic status, gender, use of fluoridated dentifrice, and past caries experience. CONCLUSION: Obese and overweight adolescents were at a higher risk of developing new caries in a 3-year-follow-up.

Untreated Gross Dental Malocclusion in Adolescents: Psychological Impact and Effect on Academic Performance in School.

PURPOSE: To evaluate the psychological impact and effect on academic performance of untreated gross dental malocclusion in adolescents. MATERIALS AND METHODS: A total of 366 (181 girls and 185 boys) adolescents with gross dental malocclusion were selected for the study group. A modified oral aesthetic subjective impact scale questionnaire was applied in face-to-face interviews. Similar data were collected from parents, schoolteachers and one friend of each adolescent selected for the study. Academic performance was evaluated from school records and compared with a control group of 400 adolescents (200 girls and 200 boys) having normal occlusion and an aesthetically pleasing facial appearance. The Kruskal-Wallis H and chi-square tests were used to analyse the data. The correlation between the academic performance of adolescents and the psychological impact of malocclusion was assessed using the Spearman rank correlation. RESULTS: Significant numbers of adolescents (81.1%) were concerned about the appearance of their teeth, with significant gender variation (0.02). 88.5% of the adolescents received comments from others about their appearance. The results differed significantly by gender for 'avoiding smiling' (p = 0.02) and 'participation in social activities' (p = 0.02). The evaluation of academic performance showed that 42.1% of the adolescents with gross dental malocclusion performed below average; this also differed statistically significantly by gender (p = 0.04). CONCLUSION: Untreated gross dental malocclusion significantly affects the psychosocial well-being of adolescents, who may avoid participating in social activities and tend to underperform in school.

Association between Traumatic Dental Injury, Obesity, and Socioeconomic Status in 6- and 13-Year-Old Schoolchildren.

Obesity and poverty are independent risk factors in trauma-related morbidity in children as well as adolescents. The main objective of this study was to investigate the association between traumatic dental injury, obesity, and socioeconomic status in 6- and 13-year-old schoolchildren in Davangere city, Karnataka, India. Data were obtained from 1,550 schoolchildren. Dental trauma was classified according to Andreasen's criteria. The medical evaluation assessed the Body Mass Index. Overjet was considered a risk factor when it presented values higher than 3 mm, whereas lip coverage was classified as adequate or inadequate. With appropriate sample weighting, relationships between traumatic dental injury and other variables were assessed using the chi-squared test and multivariable logistic regression. Overall prevalence of dental injuries was 10.52% (3.6% in 6-year-olds and 17.2% in 13-year-olds). Boys experienced more injuries than girls, 11.03% and 9.97%, respectively (p>.05). There was a statistically significant difference between traumatic dental injury and overjet (95% confidence interval [CI] [2.06, 4.78], p < 001) and between traumatic dental injury and inadequate lip coverage (95% CI [1.23, 4.65], p < .001). When adjusted for covariates, the logistic regression model showed that there was a significant association between obese children (p < .05) and dental trauma prevalence. Children from low socioeconomic status had an odds ratio 2.33 (95% CI [1.05, 3.97]) times higher likelihood of having dental trauma than children from medium and upper socioeconomic status. To conclude the results of this study support an association between traumatic dental injuries, obesity, and poverty.

Incidence of dental trauma among obese adolescents--a 3-year-prospective study.

OBJECTIVES: The main objective of the present investigation was to estimate the incidence of traumatic dental injuries (TDI), in particular crown fractures in a 3-year follow-up of obese adolescents. MATERIALS AND METHODS: Seven hundred and eighty-five 13-year-old school children were selected randomly. The crown fracture was classified according to Andreasen's criteria by visual examination without radiographs. Body mass index of the study subjects was determined. Increased overjet was considered as a risk factor when it presented values higher than 3 mm, while lip coverage was classified as adequate or inadequate. With appropriate sample weighting, relationships between TDI and other variables were assessed using the chi-squared test, Kruskal-Wallis H-test and multivariable logistic regression. RESULTS: At baseline, 131 (17.15%) adolescents presented with TDI. The accumulated incidence of TDI during the 3-year period of study was 9.03%. Children with obesity and overweight were 2.78 times greater chance suffering TDI after adjusting for socioeconomic status, lip coverage, incisal overjet and previous history of trauma. Both at baseline and follow-up examination, most frequently affected tooth is right maxillary central incisor and most frequent type of TDI was enamel fracture (44.68%). CONCLUSION: Adolescents with obesity and overweight were a greater chance of TDI in a 3-year follow-up.

Prevalence and associated factors to developmental defects of enamel in primary and permanent dentition.

BACKGROUND: The disturbances during enamel formation manifesting as Developmental Defects of Enamel (DDE) present important clinical significance since they are responsible for aesthetic problems, dental sensitivity and may act as predisposing factor for dental caries. The aim of the present study was to examine the prevalence of DDE and associated etiological factors. MATERIALS AND METHODS: A total of 1550 children was examined, using a mouth mirror and a CPI probe. Diagnosis of DDE was established according to the modified DDE index. Relationships between DDE and body mass index (BMI), socioeconomic status (SES), childhood illness and birth weight were assessed using the multivariable logistic regression. Difference in proportion was tested using Kruskal-Wallis H, followed by Mann-Whitney U test for inter group comparison, and Chi-Square tests. RESULTS: The prevalence of DDE was 42.19%. The logistic regression model showed that there was a significant association of DDE with age (p<0.05), gender (p<0.05), low SES (p<0.05) and obesity (p<0.001). Demarcated opacity was the most frequent type of DDE both in primary and permanent dentition. Prevalence was more frequent in permanent dentition compared to primary dentition, with the permanent maxillary central incisor and primary maxillary second molars being the teeth affected most commonly. CONCLUSIONS: Prevalence of DDE was more in permanent teeth compared to primary teeth. A significant association of DDE with gender, low SES and BMI was demonstrated in the present study.

Relationship between severe-early childhood caries, salivary mutans streptococci, and lactobacilli in preschool children of low socioeconomic status in Bengaluru city.

AIM: To find out the relationship between severe-early childhood caries (s-ECC) and salivary counts of mutans streptococci (MS) and lactobacillus (LB) in preschool children of low socioeconomic status. MATERIALS AND METHODS: A cross-sectional study was designed among 50 children aged 2-5 years selected from five Anganwadi centers in Bengaluru city. Clinical examination was carried out and caries status was recorded using the World Health Organization (WHO) criteria. Twenty-five children diagnosed with s-ECC based on American Association of Pediatric Dentistry (AAPD) criteria and 25 caries-free counterparts were selected. Whole non-stimulated saliva was collected from all children and cultured for MS and LB. Data were analyzed using SPSS version 14. Fisher's exact test, Mann-Whitney test, and Spearman's correlation were used to find out significant relationships. P values <0.05 were considered as statistically significant. RESULTS: Twenty-one out of 25 children with s-ECC were positive for MS and 22 children were positive for LB. A significant difference in the mean number of MS colonies (12.2 vs. 4.16) and LB colonies (8.4 vs. 3.8) among children with s-ECC and caries-free counterparts (P < 0.01) was also found. A significant positive correlation was also found between caries experience and salivary MS and LB counts. CONCLUSION: s-ECC is positively correlated with salivary levels of both MS and LB in preschool children of low socioeconomic status. Suitable preventive strategies need to be planned when children are still young.

Association between obesity, dental caries and socioeconomic status in 6- and 13-year-old school children.

PURPOSE: To investigate the association between dental caries, obesity and socioeconomic status (SES) in 6-and 13-yearold school children in Davangere city, Karnataka, India. MATERIALS AND METHODS: Data were obtained from a cohort of 1,550 children. Dental caries detection was performed according to the World Health Organization criteria and the medical evaluation assessed the body mass index (BMI). With appropriate sample weighting, relationships between dmft/DMFT, obesity and socioeconomic status were assessed using the Kruskal-Wallis H test and multivariate logistic regression. RESULTS: The prevalence of dental caries was 28.9%. The mean dmft and DMFT scores for 6-year-olds were 2.1 ± 3.75 and 0.16 ± 0.59, respectively, and corresponding values for 13-year-olds were 0.03 ± 0.19 and 0.91 ± 2.04. Of the total sample, the mean BMI was 16.56 ± 2.8. Approximately 63.4% of the children were classified as normal weight, 18.1% as overweight and 7.5% as obese. When adjusted for covariates, the logistic regression model showed that there was a significant association between overweight children (P < 0.001), obese children (P < 0.05) and caries prevalence. CONCLUSION: This study demonstrated a significant association between caries frequency and obesity in school children. In future preventive programmes, the importance of obesity should not only be emphasised with respect to general diseases but also with regard to carious lesions.