Association between sociodemographic factors and noncavitated and cavitated caries lesions in 8- to 12-year-old Mexican schoolchildren.

ABSTRACT: The aim of this study was to evaluate the association between sociodemographic factors and noncavitated and cavitated caries lesions in Mexican schoolchildren.This cross-sectional study was conducted in 2020 on 8-to-12-year-old schoolchildren of different socioeconomic status (SES). The caries was evaluated using ICDAS II, SES was evaluated using three categories---a high, middle, or low-income level---of the CONAPO. Multinomial logistic regression analyses were performed in order to ascertain the associations between socioeconomic factors and noncavitated and cavitated caries lesions.The prevalence of noncavitated lesions was 38.0% and cavitated lesions was 43.4% in permanent dentition. In all the samples, 50.6% of schoolchildren had poor oral hygiene. About 52.5% of the mothers and 64.7% of the fathers had less than 9 years of education. Schoolchildren with a low-income level have more cavitated lesions (ICDAS II 4-6) than schoolchildren with high-income level (56.3% vs 15.8%, P = .009). The multinomial logistic regression models showed that mother's level of education <9 years and low-income level were significantly associated with cavitated caries lesions (ICDAS II 4-6), [odds ratio = 1.79 (1.17 - 2.75); P = .007], [OR = 2.21 (1.23 - 3.97); P = .008], respectively. The socioeconomic level was not associated with noncavitated caries lesions (ICDAS II 1-3).An association was found between the presence of cavitated caries lesions and the subject's mother's level of education and a low-income level. Socioeconomic factors were found to be associated with inequalities in caries distribution in the age group studied.

Traumatic dental injuries in preschool-age children: Prevalence and risk factors.

This study examined the prevalence, socio-demographic correlates, and clinical predictors of traumatic dental injuries (TDIs) in the primary dentition among a community-based sample of preschool-age children. The sample comprised 1,546 preschool-age children (mean age 49 [range: 24-71] months) in North Carolina public preschools, enrolled in a population-based investigation among young children and their parents in North Carolina. Information on socio-demographic, extraoral, and intraoral characteristics was collected and analyzed with bivariate and multivariate methods, including logistic regression modeling and marginal effects estimation. The prevalence of dental trauma was 47% and 8% of TDI cases were "severe" (pulp exposure, tooth displacement, discolored or necrotic tooth, or tooth loss). In bivariate analyses, overjet and lip incompetence were significantly associated with TDI. Overjet remained positively associated with severe trauma in multivariate analysis, OR = 1.4, 95% confidence interval (CI) [1.2, 1.6], corresponding to an absolute 1.3%, 95% CI [0.7, 1.8], increase in the likelihood of severe trauma, per millimeter of overjet. Children with increased overjet (>3 mm) were 3.8, 95% CI [2.0, 7.4], times as likely to have experienced severe TDI compared with those with ≤3 mm. Overjet is a strong risk factor for TDIs in the primary dentition. Incorporating and operationalizing this information may help TDI prevention and related anticipatory guidance for families of preschool-age children.

The Role of Feeding Practices as a Determinant of the pufa Index in Children with Early Childhood Caries.

OBJECTIVE: To evaluate the prevalence and severity of untreated dental caries among young children (aged <6 years) with early childhood caries (ECC) using the pufa index and to examine the relationship between caries and feeding practices. STUDY DESIGN: A cross-sectional study of children with ECC was undertaken in two stages: a questionnaire survey based on interviews and an intraoral examination using the defs and pufa indices. RESULTS: The overall prevalence of untreated dental caries in our sample of 238 ECC-affected children was 72.3%. The abscess component (code a) was the most common condition. There was an increase in the ECC patterns and the severity of untreated dental caries with increasing age for all teeth groups. ECC and untreated caries lesions for the various teeth groups and study sites varied inversely with current feeding status. The majority of the children had posterior ECC, and the fewest were affected by ulceration (code u) as a consequence of untreated dental caries. Except for the posterior caries pattern, all other caries patterns and pufa components (code u alone, p<0.05) had a significantly higher prevalence among children with nocturnal feeding practices (p<0.001). Binary logistic regression analyses revealed that older age (p<0.05) and nocturnal feeding practices (p<0.001) were significantly associated with pufa scores>0. CONCLUSION: These data provide valuable evidence of the effect of nocturnal feeding as an important determinant of the increased prevalence of untreated caries lesions among children with ECC.

Dental disorders in brown howler monkeys (Alouatta guariba clamitans) maintained in captivity.

BACKGROUND: The aim of this study was to investigate dental disorders of brown howler monkeys maintained in captivity. The hypothesis is that the identification and diagnosis of the lesions may contribute to control and prevention. METHODS: Sixteen intact brown howler monkeys (Alouatta guariba clamitans), eight females and eight males, weighing from 3.9 to 6.8 kg, were studied. Under general anesthesia, the teeth were evaluated by visual inspection, probing, palpation, and intra-oral radiographic exam. The findings were registered on a dental chart specific for primates. RESULT: Of the 16 monkeys evaluated in the present study, 94% (n = 15) had some type of dental disorder. The lesions observed were dental calculus (88%), dental wear (81%), missing teeth (38%), gingivitis (19%), gingival recession (6%), dental fracture (19%), pulp exposure (19%), and dental staining (25%). CONCLUSIONS: Alouatta guariba clamitans maintained in captivity have a high rate of dental problems.

Tooth wear in aging people: an investigation of the prevalence and the influential factors of incisal/occlusal tooth wear in northwest China.

BACKGROUND: The aim of this study was to estimate the prevalence of tooth wear in the aging population of northwest China and to investigate the factors associated with such tooth wear. METHODS: Cross-sectional analytic clinical and questionnaire study was performed in 704 participants who had a mean age of 46.5 ± 0.2 SD and of which 367(52.13%) were males and 337(47.87%) female. These participants were invited when they attended the hospital which located in northwest China for routine oral examination. RESULTS: In the maxilla of the examined patients, the rate of tooth wear varied from 85.51% for molar group, 89.77% for premolar group, 100.0% for canine group to 87.22% for incisor group. In the mandible, the rates were 86.36%, 88.92%, 100.0% and 91.19% for the four groups respectively. Moreover, both the incisor and canine groups of these patients showed median scores of 3, the premolar group showed a median score of 1, and the molar group had a median score of 2. Additionally, multiple factors were considered to contribute to these patterns of tooth wear, especially the habitual consumption of a hard or sour diet (P < 0.05,odds ratio 1.21, 95% confidence intervals 1.04-1.49). CONCLUSIONS: Tooth wear is a common disease in which the anterior teeth exhibit greater wear than posterior teeth. The data support an association between tooth wear and dietary patterns.

Association of dental caries and weight status in 6- to 7-year-old Filipino children.

OBJECTIVES: The aims of the study were (1) to assess in 6- to 7-year-old Filipino children caries prevalence and experience and the weight status and (2) to investigate the association between dental caries and weight status. MATERIALS AND METHODS: Dental and anthropometric examinations were conducted on 1,962 6- to 7-year-old children during the National Oral Health Survey in 2005-2006. Dental caries assessments were carried out using World Health Organisation (WHO) criteria (1997). Weight status was assessed with body mass index according to WHO growth reference. A multivariable logistic regression model was applied to investigate the effect of dental caries and sociodemographic variables on the children's weight status. RESULTS: Caries prevalence was 96.8 % in primary and 39.7 % in permanent teeth, and caries experience was 8.4 dmft and 0.6 DMFT. Of the children, 17.8 % were underweight, 73.0 % had normalweight, 6.0 % were overweight and 3.2 % were obese. Girls had a lower risk of being underweight than boys odds ratios (OR) 0.70, confidence interval (CI) 0.55-0.88. Children living in rural areas and with no television at home were more likely to be underweight (OR 1.36, CI 1.07-1.72; OR 1.37, CI 1.07-1.76, respectively). Fewer primary and permanent teeth were risk factors for being underweight (OR 0.93, CI 0.92-0.95; OR 0.90, CI 0.89-0.94, respectively). CONCLUSIONS: Underweight was associated stronger with demographic and socioeconomic conditions than with dental variables. However, underweight and dental caries are public health issues of high priority affecting children at an important phase of their development. CLINICAL RELEVANCE: Definite conclusions upon an association between dental caries and weight status in high caries risk schoolchildren cannot be drawn.

Pattern of traumatic dental injuries in the permanent dentition among children, adolescents, and adults.

BACKGROUND: Traumatic dental injuries (TDI) comprise six types of luxation and seven types of tooth fractures. The risk of pulp necrosis is increased in teeth with combination injuries where fractures and luxations occur concomitantly. AIM: To report and compare the distributions of luxations and fracture types among children, adolescents, and adults, and to analyze the distribution and prevalence of combination injuries. MATERIAL AND METHOD: The study group included 4754 patients (3186 men and 1568 women) with 10 166 traumatized permanent incisors treated at Copenhagen University Hospital, Rigshospitalet. Differences in the distributions of trauma types among age groups (children <12 years, adolescents 12-20 years, and adults >20 years) and distributions of concomitant crown fractures for each luxation type were analyzed with the Chi-square test. RESULTS: A total of 7464 teeth (73.4%) had suffered a luxation injury and 5914 teeth (58.2%) a fracture. The overall most frequent injuries were crown fractures without pulp exposure (34.9%), concussions (24.2%), and subluxations (22.2%). The relative frequency of crown fractures without pulp exposure decreased across age groups (children 45.2%, adolescents 36.5%, adults 26.3%, P < 0.001), whereas the relative frequencies of other injury types increased across age groups : crown-root fractures (children 1.8%, adolescents 6.3%, adults 9.2%, P < 0.001), root fractures (children 2.5%, adolescents 4.6%, adults 8.7%, P < 0.001), and lateral luxations (children 5.7%, adolescents 10.9%, adults 13.0%, P < 0.001). One-third of the traumatized teeth (n = 3212) had sustained a combination of a fracture and a luxation injury. The luxation types most frequently presenting with a concomitant crown fracture were concussion (57.9%), intrusion (47.2%), and subluxation (33.4%) (P < 0.001). CONCLUSION: The majority of TDI were minor injuries. The relative frequencies of injury types varied among age groups. Combination injuries were observed in one-third of the traumatized teeth and occurred most frequently in teeth with concussion, intrusion, and subluxation.

Retrospective study on the occurrence of primary incisor trauma in preschool children of a low-income area in Brazil.

AIM: The objective of this study was to investigate the occurrence of trauma in primary incisors in a sample of preschool Brazilian children living in a low-income area of Rio de Janeiro, Brazil. METHODS: For the study 527 dental records of a Municipal Children's Hospital were evaluated, and the following related factors were recorded: gender age, tooth affected, type and cause of trauma. Data were tabulated and subjected to statistical analysis (chi-square test). RESULTS: There were no significant differences in the prevalence of injuries among boys and girls. Children 10 to 24 months-old were the most affected (p < 0.05). The maxillary central incisor was the most affected tooth (p < 0.05), with predominance of lateral luxation and concussions (p > 0.05). The most common cause of trauma was associated with child's own-height fall (p < 0.05). CONCLUSION: Based on the results, it was concluded that the high incidence of incisor trauma in deciduous teeth should be viewed with concern, requiring the implementation of health policies aimed primarily at the prevention of such accidents.

Prevalence and severity of clinical consequences of untreated dentine carious lesions in children from a deprived area of Brazil.

Disadvantaged children suffer because tooth cavities are not being treated and their clinical consequences not being surveyed. The present study aimed to assess the prevalence and severity of clinical consequences of untreated dentine carious lesions in schoolchildren from a deprived area of Brazil and to investigate the determinants of the pufa index. A sample of 835 children aged 6-7 years, from six public schools, was examined by 3 calibrated examiners. Clinical consequences of untreated dentine carious lesions in primary teeth were diagnosed using the four codes of the pufa index: 'p' (pulpal involvement), 'u' (ulceration), 'f' (fistulae), 'a' (abscess). Effects of gender, age, school, history of extraction, and toothache on the prevalence of pufa codes were tested. The prevalence of pufa codes was 23.7%. The mean pufa score was 0.4 ± 0.9. Code 'p' was the most prevalent (19.5%), whereas code 'u' was least prevalent (0.1%). Children with a history of extracted primary teeth due to caries had a 2.7 times higher chance to have a pufa code than children with no previous extraction. Children with toothache had a 5.6 times higher chance to have a pufa code than children without toothache. The prevalence of clinical consequences of untreated dentine carious lesions was moderate and the severity was low. The pufa index is an epidemiological tool complementary to existing caries indices aimed to assess dental caries. However, there appears to be no need to include code 'u' nor to score codes 'f' and 'a' separately.

Non-accidental collision followed by dental trauma: associated factors.

The aim of the present cross-sectional survey was to assess factors associated with non-accidental collision followed by dental trauma among adolescents in the city of Diamantina, Brazil. A total of 387 students from 12 to 15 years of age (mean = 14 SD = 0.9) were randomly selected. The study was carried out in two stages. Firstly, data were collected through dental examinations of permanent incisors. Secondly, a thorough interview was held with 85 adolescents who exhibited dental trauma in the dental examinations. The interview consisted of a detailed description of the incident and physical environment in which it occurred. Descriptive analysis and the chi-square test (P < 0.05) were performed. The prevalence of dental injury was 22% (n = 85). Dental trauma was more prevalent in boys (P = 0.001) and individuals with overjet >3 mm (P = 0.007) and inadequate lip coverage (P = 0.013). Analysis of the event revealed that 22.3% of the cases of dental trauma occurred because of non-accidental collision. Non-accidental collision followed by injury occurred mainly at school (P < 0.001) and in an environment with a concrete, tiled or ceramic floor (P = 0.001). No statistically significant associations were found between non-accidental collision and gender, age or mother's schooling. It was concluded that the non-accidental collisions happened especially at school and in indoor environments with a concrete, tiled or ceramic floor.

[An index for untreated severe caries]. / Een index voor onbehandelde ernstige cariës.

Hardly any data are available on the clinical consequences of untreated severe caries, because there is no method to quantify the prevalence of oral conditions resulting from untreated caries. In the Philippines, an index was developed which records for (the location of) each tooth whether caries has reached the dental pulp, whether ulceration is present in the surrounding soft tissues due to sharp edges of fragments of a tooth lost due to caries, or whether a fistula or abscess is present. By adding the index to the existing Decayed Missing Filled Tooth index, insight is provided on the extent and the consequences of untreated caries and research may be carried out on its possible impact on the general health and wellbeing of national populations.

PUFA--an index of clinical consequences of untreated dental caries.

RATIONALE: Dental caries is a global public health problem, especially in children. Most caries in developing countries remains untreated. Only limited data are available on the clinical consequences of untreated dental caries because there is no measure to quantify the prevalence and severity of oral conditions resulting from untreated dental caries. OBJECTIVES: To present a new index to evaluate the prevalence and severity of oral conditions resulting from untreated dental caries. To validate the index within the Philippines National Oral Health Survey, 2006. METHODS: The PUFA index records the presence of severely decayed teeth with visible pulpal involvement (P/p), ulceration caused by dislocated tooth fragments (U/u), fistula (F/f) and abscess (A/a). RESULTS: Good kappa values show the reliability of the index. The prevalence of PUFA/pufa >0 was 85% and 56% for 6- and 12-year-olds, respectively. The mean number of teeth affected (PUFA/pufa) was 3.5 and 1.2 for 6- and 12-year-olds, respectively. In 6- and 12-year-olds, 40% and 41% of decayed teeth had progressed to odontogenic infections. CONCLUSION: The PUFA index complements classical caries indices with relevant information for epidemiologists and health care planners.

[Frequency and etiology of noncarious cervical lesions with pulp exposure]. / Badanie czestosci wystepowania i przyczyn powstawania niepróchnicowych ubytków przyszyjkowych powiklanych obnazeniem miazgi.

PURPOSE: Noncarious cervical lesions have a multifactorial etiology encompassing occlusal trauma, toothbrush abrasion, and exposure of enamel to erosive factors. The purpose of this study was to determine the frequency of cervical lesions with exposure of pulp and to analyze their etiology. MATERIAL AND METHODS: The study was done in 124 patients (59 women and 65 men) with a mean age of 44 years (15-72 years). Clinical assessment of cervical lesions was based on criteria of the universal tooth wear index for the cervical surface. Additionally, the following findings were recorded: frequency of cervical lesions depending on tooth type, pulp exposure, oral hygiene status, and type of occlusal guidance. The questionnaire consisted of detailed questions concerning toothbrushing, frequency of consumption of some foods, and parafunctional habits. The risk of cervical lesion was estimated with the logistic regression model. RESULTS: The frequency, localization, and depth of noncarious cervical lesions were related to age of the patient. Very deep defects with pulp exposure were found in 44 teeth. The effect of consumption of acid foods and drinks and of oral hygiene habits on the depth of wedge-shaped defects was corroborated. Correlations between lateral excursive tooth contact, bruxism, and formation of cervical lesions were disclosed, confirming the relationship between occlusal pathology and cervical lesions. CONCLUSIONS: Elucidation of the multifactorial etiology of cervical lesions is important for proper treatment and prevention of pulp exposure.

Dental erosion among 12-14 year old school children in Khartoum: a pilot study.

OBJECTIVES: To investigate dental erosion among 12-14 year old Sudanese school children and evaluate the associated risk factors. BASIC RESEARCH DESIGN: Cross sectional survey in secondary schools in Khartoum city, Sudan. METHOD AND PARTICIPANTS: A sample of 157 school children was obtained from both private and public schools. Erosion on the labial and palatal surfaces of maxillary incisors was measured by criterion based on the Smith and Knight Tooth Wear Index. Dietary intake and other related factors were assessed using a questionnaire. RESULTS: The overall erosion prevalence in this group was 66.9%, of which 45.2% was mild and 21.7% was moderate erosion. A strong association was found between erosion and private schooling (higher socioeconomic groups), carbonated drinks, herbal hibiscus drink and traditional acidic food consumption. CONCLUSION: There was a high prevalence of dental erosion among Sudanese school children which was mild to moderate in severity and was strongly associated with acidic dietary intake

Prevalence of crown trauma in free-ranging maned wolves (Chrysocyon brachyurus) in central Brazil.

Nineteen free-ranging maned wolves (Chrysocyon brachyurus) were captured in central Brazil from April through November 2003. Oral cavity examination revealed 34 teeth with crown trauma in twelve animals. Canine teeth were most commonly affected (44.2%), followed by premolar (29.4%) and incisor teeth (26.5%). Trauma to maxillary teeth (67.7%) was more frequent compared with mandibular teeth (32.3 %). The majority of dental fractures were located at the cuspid portion of the crown (56.0%). Slab fractures were the most frequent type (37.0%), followed by horizontal (24.0%), oblique (24.0%) and longitudinal fractures (15.0%). Complicated crown fracture (pulp exposure) was diagnosed in 13 (38.2%) of these teeth while pulpitis noted by tooth discoloration was diagnosed in 8 (23.5%) teeth.

Traumatized primary teeth in children assisted at the Federal University of Santa Catarina, Brazil.

The goal of the present study was to identify the factors related to the occurrence of dental trauma in deciduous teeth. Over a period of 25 months, 85 children between 10 months and 6 years of age were assisted by the staff of the Pediatric Dentistry Clinic of the Federal University of Santa Catarina (UFSC) Florianópolis, Brazil. The children, all assisted by only one professional, a dentist working as a trainee in the Pediatric Dentistry Clinic, had 157 traumatized teeth treated. The occurrence of trauma was higher in male patients (51.8%) and in children between 1 and 3 years old. The average age was about =2.7 years. The 54.1% of the assisted children had more than one traumatized tooth and the repeat trauma occurred 16.7% of the time. Anterior teeth represented 98.7% of the cases and 76.4% of the trauma were on the maxillary central incisor teeth. Both sides of the mouth had approximately the same number of traumatic injuries. Luxations were more frequent (85.4%) than fractures (14.6%). Subluxations represented 38.8% of the luxated teeth. Falls were the main cause of trauma (78%). A percentage of 41.9 children were assisted by a dental professional during the first 24h after the incident. The study concluded that the deciduous dentition is mostly affected by luxations (subluxations) that occur specially on the maxillary central incisor teeth, in patients between 1 and 3 years of age. Falls are the most common etiological factor and more than one traumatized tooth is common. Some of the cases were repeat traumatic injuries.

Social deprivation and traumatic dental injuries among 14-year-old schoolchildren in Newham, London.

AIMS: To assess the epidemiology of dental injuries among schoolchildren in Newham, London. MATERIAL AND METHODS: This study was carried out as part of the annual Community Dental Service's School Dental Inspection (SDI) programme in Newham. All schoolchildren aged 14 years were invited to participate in the study. Dental examinations were carried out by one trained examiner (SM) and included presence of clinical evidence of dental injuries, treatment provided and needed in the upper and lower permanent incisors, size of incisal overjet and type of lip coverage. The postcode was recorded to assess the levels of social deprivation. FINDINGS: 2242 out of 2684 children were examined. The prevalence of dental injuries was 23.7%. Treatment of dental injuries was neglected. Being male, having an incisal overjet greater than 5 mm and living in an overcrowded household increased the risk of having dental injuries. CONCLUSIONS: The prevalence of dental injuries in Newham (23.7%), which is a deprived area of London, was much higher than the overall prevalence in the UK (17%). Traumatic dental injuries seem to be a serious dental public health problem among children in deprived areas. Thus, there is an urgent need to collect local data on dental injuries in order to obtain a more comprehensive picture of the dental health.

Incidence of traumatic tooth injuries in children and adolescents in the county of Västmanland, Sweden.

The study reports the total incidence as well as the incidence of different types of traumatic tooth injuries in a Swedish county in the age interval 0-19 years during 1989/90. The incidence of individuals experiencing tooth injuries was 13 per 1000 per year. Boys were more frequently injured in the age-groups 3-4 years and 7-9 years and girls, in the age-group 5-6 years. A method is presented defining uncomplicated and complicated tooth injuries as a basis for estimating the economic consequences of these injuries in the community. Boys more often suffered uncomplicated injuries to permanent teeth and girls, to primary teeth (p < 0.05). The same distribution was found for uncomplicated multiple tooth injuries. Boys sustained more uncomplicated hard tissue injuries and girls, more uncomplicated luxation injuries (p < 0.01). Using a classification according to the most serious tooth injury in each episode, 33% of the episodes had resulted in complicated injuries in which the pulpal tissue and/or periodontal membrane was severely damaged.