Dental caries risk indicators in early childhood and their association with caries polarization in adolescence: a cross-sectional study.

BACKGROUND: Based on the hypothesis that biological and social risks accumulate during life, it is important to identify possible dental caries risk indicators from the life course of early childhood and assess their association with caries polarization in adolescence. METHODS: A cross-sectional design was applied to the study, and a multistage cluster sampling method used to draw a representative sample of 1063 18-year-old Lithuanian adolescents. The dental examinations were performed according to the methodology for oral status evaluation recommended by the World Health Organization. Parents of the participating adolescents completed a self-administered questionnaire about their children's life course during early childhood. The interdependence of characteristics was evaluated by chi-square (χ (2)) and Student's (t) criteria. A multivariate logistic regression model with the Significant Caries (SiC) index as an outcome was performed. RESULTS: The mean scores for the number of decayed, missing, and filled teeth (DMFT) and decayed teeth (DT) in the SiC positive group were higher than the corresponding values in the SiC negative group (6.14 [SD, 2.30] and 1.67 [SD, 2.02] vs 1.28 [SD, 1.11] and 0.34 [SD, 0.69], p < 0.001, respectively). Three dental caries risk indicators were identified that were independently associated with a SiC positive outcome: gender(OR = 1.32 [95 % CI: 1.01-1.73]), earlier eruption of the first primary tooth(OR = 1.43 [95 % CI: 1.03-1.97]), and past caries experience in the primary dentition (OR = 1.62 [95 % CI:1.22-2.14]). CONCLUSIONS: These study findings provide reliable evidence that gender, earlier eruption of the first primary tooth, and past caries experience in the primary dentition should be considered to be dental caries risk indicators and may have an adverse effect on caries polarization in adolescence.

Prevalence and severity of dental caries among 18-year-old Lithuanian adolescents.

OBJECTIVE: The aim of the study was to evaluate the prevalence and severity of dental caries among 18-year-old Lithuanian adolescents and to disclose possible differences in the prevalence and severity of dental caries related to gender, urbanization, and different county. MATERIAL AND METHODS: A total of 1063 18-year-old adolescents attending school, 427 boys and 636 girls from 10 Lithuanian counties including urban and rural areas, were included in the cross-sectional study on dental caries. The method of multistage cluster sampling was used. The dental examination was performed according to the methodology of oral status evaluation recommendations by the World Health Organization (WHO). The prevalence of dental caries, DMFT score, Significant Caries Index, and dental care index were determined. RESULTS: The overall prevalence of dental caries among 18-year-old Lithuanian adolescents was 78.3%. The study population had a mean DMFT score of 2.93 [SD, 2.81]. Considering the gender, a higher DMFT score was observed among girls than boys (3.03 [SD, 2.88] versus 2.73 [SD, 2.71]) and in rural than urban areas (3.02 [SD, 2.98] versus 2.89 [SD, 2.73]). The Significant Caries Index and the dental care index among 18-year-old adolescents were 6.14 and 62.3%, respectively. CONCLUSION: This study showed a relatively high prevalence of dental caries. The existing differences of caries experience between the urban and the rural areas as well as between the counties could be influenced by the socioeconomic differences in the country.

Stress experience and effect on self-perceived oral health status among high school students.

OBJECTIVES: Stress is a common phenomenon in our society. Several studies indicate that stress has an adverse effect on oral condition. The aim of this study was to evaluate the relationship between stress and self-perceived oral health status among high school students population. MATERIAL AND METHODS: A cross-sectional design was applied to the study, and a simple random sampling method was used to draw a representative sample of 200 15 to 19-year-old students from Siauliai Didzdvaris gymnasium. This study was based on annonymous self-reported questionaries about self-perceived oral and systemic conditions. The interdependence of characteristics was evaluated by chi-square (χ2) and ANOVA criteria. RESULTS: 171 participants (85.5%) expierenced stress. 22.5% of the interviewees answered that they have symptoms of the gastroesophageal reflux disease (GERD), 22.5% - bruxism signs, 71.5% - dental decay, 59.5% - gum problems. Increased stress level was related with more frequent bruxism signs. The difference between groups was statistically significant (χ2=13.444; p=0.009). CONCLUSIONS: The prevalence of stress among high school students is high. This study demonstrates that increased stress level might be a risk indicator and have negative outcome to oral health.

Biological approach of dental caries management.

Dental caries is a disease induced by dental plaque, which can be described as a community of microorganisms (biofilm). Because of genetic and environmental factors a number of changes in the oral microbiome takes place; in case of commensalism and mutualism between biofilm microorganisms and the host, homeostasis in oral microbiome is maintained. However, when a risk factor occurs parasitic relationship starts prevailing and activity of the pathogenic cariogenic microorganisms increases leading to a dental caries. According to the newest technologies of molecular microbiology new cariogenic microorganisms species have been determined. Each individual's oral microbiome is as unique as his/her immune system; therefore, commonly taken caries prevention measures cannot be of the same effectiveness for all individuals. Each person has his own caries risk which is determined by the oral microbiome and immune system influenced by the environmental and genetic factors. Early caries diagnostic, risk assessment and individualized caries prevention plan will allow us to control the disease and achieve a desirable effect. For the dentist the most important thing is not to treat the consequences of the disease - cavities - but be aware of the dental caries as a biological phenomenon.