Dentistry › Periodontics

Dental Health and Care Utilization

Works Count: 72577

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Description

This cluster of papers focuses on global oral health and dental caries, addressing topics such as the global burden of oral conditions, preventive measures, impact on quality of life, fluoride use, epidemiology, risk factors, and social determinants. It also explores remineralization techniques and the implications of oral health disparities.

Keywords

Oral Health; Dental Caries; Global Burden; Prevention; Quality of Life; Fluoride; Epidemiology; Risk Factors; Social Determinants; Remineralization

The global increase in dental caries. A pending public health crisis.

2009-02-01

Bagramian Er , Franklin García‐Godoy , A R Volpe

A current review of the available epidemiological data from many countries clearly indicates that there is a marked increase in the prevalence of dental caries. This global increase in dental … A current review of the available epidemiological data from many countries clearly indicates that there is a marked increase in the prevalence of dental caries. This global increase in dental caries prevalence affects children as well as adults, primary as well as permanent teeth, and coronal as well as root surfaces. This increase in dental caries signals a pending public health crisis. Although there are differences of opinion regarding the cause of this global dental caries increase, the remedy is well known: a return to the public health strategies that were so successful in the past, a renewed campaign for water fluoridation, topical fluoride application, the use of fluoride rinses, a return to school oral health educational programs, an emphasis on proper tooth brushing with a fluoride dentifrice, as well as flossing, a proper diet and regular dental office visits. If these remedies are not initiated, there could be a serious negative impact upon the future oral health (and systemic health) of the global community, as well as a strain on the dental profession along with a major increase in the cost of dental services.

Trends in oral health status: United States, 1988-1994 and 1999-2004.

2007-04-01

Bruce A. Dye , Sylvia Tan , Vincent C. Smith +7 more

This report presents national estimates and trends for a variety of oral health status measures for persons aged 2 years and older by sociodemographic and smoking status since the late … This report presents national estimates and trends for a variety of oral health status measures for persons aged 2 years and older by sociodemographic and smoking status since the late 1980s in the United States.Data from the third National Health and Nutrition Examination Survey (NHANES III), 1988-1994 and from the NHANES 1999-2004 were used. These data sources were designed to provide information on the health and nutritional status of the civilian noninstitutionalized population in the United States. Information from oral health examination methods common to both survey periods were used to present prevalence estimates and for trend analyses. Statistical significance of differences between common estimates from each survey period was evaluated using two-sided t-tests.This report provides mean, percentile values, and standard errors for dental caries, dental sealants, incisal trauma, periodontal health, dental visits, perception of oral health status, tooth retention, and edentulism. Additional estimates for monitoring progress toward the Healthy People 2010 oral health objectives using NHANES source data are presented as well.For most Americans, oral health status has improved between 1988-1994 and 1999-2004. For seniors, edentulism and periodontitis has declined; for adults, improvements were seen in dental caries prevalence, tooth retention, and periodontal health; for adolescents and youths, dental sealant prevalence has increased and dental caries have decreased; however, for youths aged 2-5 years, dental caries in primary teeth has increased.

Fluoride varnishes for preventing dental caries in children and adolescents

2013-07-11

Valéria CC Marinho , Helen V Worthington , Tanya Walsh +1 more

Parental perceptions of children's oral health: The Early Childhood Oral Health Impact Scale (ECOHIS)

2007-01-30

Bhavna T. Pahel , R. Gary Rozier , Gary D. Slade

Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is … Dental disease and treatment experience can negatively affect the oral health related quality of life (OHRQL) of preschool aged children and their caregivers. Currently no valid and reliable instrument is available to measure these negative influences in very young children. The objective of this research was to develop the Early Childhood Oral Health Impact Scale (ECOHIS) to measure the OHRQL of preschool children and their families.Twenty-two health professionals evaluated a pool of 45 items that assess the impact of oral health problems on 6-14-year-old children and their families. The health professionals identified 36 items as relevant to preschool children. Thirty parents rated the importance of these 36 items to preschool children; 13 (9 child and 4 family) items were considered important. The 13-item ECOHIS was administered to 295 parents of 5-year-old children to assess construct validity and internal consistency reliability (using Cronbach's alpha). Test-retest reliability was evaluated among another sample of parents (N = 46) using the intraclass correlation coefficient (ICC).ECOHIS scores on the child and parent sections indicating worse quality of life were significantly associated with fair or poor parental ratings of their child's general and oral health, and the presence of dental disease in the child. Cronbach's alphas for the child and family sections were 0.91 and 0.95 respectively, and the ICC for test-retest reliability was 0.84.The ECOHIS performed well in assessing OHRQL among children and their families. Studies in other populations are needed to further establish the instrument's technical properties.

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Development of the Geriatric Oral Health Assessment Index

1990-11-01

Kathryn A. Atchison , TA Dolan

The development of measures for assessing oral health status is essential to the evolution and maturation of a scientific knowledge base in geriatric dentistry. The literature suggests a high prevalence … The development of measures for assessing oral health status is essential to the evolution and maturation of a scientific knowledge base in geriatric dentistry. The literature suggests a high prevalence of dental diseases in older adults, yet valid and reliable instruments to assess the impact of oral diseases on older individuals or populations are lacking. This paper describes the rationale for and the development of the Geriatric Oral Health Assessment Index (GOHAI), a self-reported measure designed to assess the oral health problems of older adults. Following a review of the literature and consultation with health care providers and patients, a pilot instrument was developed. The GOHAI was initially tested on a convenience sample of 87 older adults. A revised instrument was then administered to a sample of 1755 Medicare recipients in Los Angeles County. The GOHAI demonstrated a high level of internal consistency and reliability as measured by a Cronbach's alpha of 0.79. Associations of the GOHAI with a single-item rating of dental health and with clinical and sociodemographic supported the construct validity of the index. Having fewer teeth, wearing a removable denture and perceiving the need for dental treatment were significantly related to a worse (lower) GOHAI score. Respondents who were white, well educated, and with a higher annual household income were more likely to have a high GOHAI score, indicating fewer dental problems. Additional applications of the GOHAI are necessary to further evaluate the instrument's validity and reliability, and to establish population norms of oral health in older adult populations as measured by the GOHAI.

The Effect of Different Levels of Carbohydrate Intake on Caries Activity in 436 Individuals Observed for Five Years

1953-01-01

Bengt E. Gustafsson , Carl-Erik Quensel , Lisa Swenander Lanke +4 more

(1953). The Effect of Different Levels of Carbohydrate Intake on Caries Activity in 436 Individuals Observed for Five Years. Acta Odontologica Scandinavica: Vol. 11, No. 3-4, pp. 232-364. (1953). The Effect of Different Levels of Carbohydrate Intake on Caries Activity in 436 Individuals Observed for Five Years. Acta Odontologica Scandinavica: Vol. 11, No. 3-4, pp. 232-364.

Global goals for oral health 2020

2003-10-01

Martin Hobdell , Poul Erik Petersen , P. John Clarkson +1 more

The Common Risk Factor Approach: a rational basis for promoting oral health

2000-12-01

Aubrey Sheiham , Richard G. Watt

Abstract – Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best … Abstract – Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best to a duplication of effort, or worse, conflicting messages being delivered to the public. In addition, oral health programmes tend to concentrate on individual behaviour change and largely ignore the influence of socio‐political factors as the key determinants of health. Based upon the general principles of health promotion this paper presents a rationale for an alternative approach for oral health policy. The common risk factor approach addresses risk factors common to many chronic conditions within the context of the wider socio‐environmental milieu. Oral health is determined by diet, hygiene, smoking, alcohol use, stress and trauma. As these causes are common to a number of other chronic diseases, adopting a collaborative approach is more rational than one that is disease specific. The common risk factor approach can be implemented in a variety of ways. Food policy development and the Health Promoting Schools initiative are used as examples of effective ways of promoting oral health.

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The oral hygiene index: a method for classifying oral hygiene status

1960-08-01

John C. Greene , Jack R. Vermillion

Derivation and validation of a short‐form oral health impact profile

1997-08-01

Gary D. Slade

Growing recognition that quality of life is an important outcome of dental care has created a need for a range of instruments to measure oral health-related quality of life. This … Growing recognition that quality of life is an important outcome of dental care has created a need for a range of instruments to measure oral health-related quality of life. This study aimed to derive a subset of items from the Oral Health Impact Profile (OHIP-49)-a 49-item questionnaire that measures people's perceptions of the impact of oral conditions on their well-being. Secondary analysis was conducted using data from an epidemiologic study of 1217 people aged 60+ years in South Australia. Internal reliability analysis, factor analysis and regression analysis were undertaken to derive a subset (OHIP-14) questionnaire and its validity was evaluated by assessing associations with sociodemographic and clinical oral status variables. Internal reliability of the OHIP-14 was evaluated using Cronbach's coefficient alpha. Regression analysis yielded an optimal set of 14 questions. The OHIP-14 accounted for 94% of variance in the OHIP-49; had high reliability (alpha = 0.88); contained questions from each of the seven conceptual dimensions of the OHIP-49; and had a good distribution of prevalence for individual questions. OHIP-14 scores and OHIP-49 scores displayed the same pattern of variation among sociodemographic groups of older adults. In a multivariate analysis of dentate people, eight oral status and sociodemographic variables were associated (P < 0.05) with both the OHIP-49 and the OHIP-14. While it will be important to replicate these findings in other populations, the findings suggest that the OHIP-14 has good reliability, validity and precision.

Validity and Reliability of a Questionnaire for Measuring Child Oral-health-related Quality of Life

2002-07-01

Aleksandra Jokovic , David Locker , Marlene Stephens +3 more

Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ 11-14 , a self-report measure of the impact of oral … Oral-health-related quality of life measures that exist are designed for adults. This study aimed to develop and evaluate the CPQ 11-14 , a self-report measure of the impact of oral and oro-facial conditions on 11- to 14-year-old children. An item pool was generated with the use of a literature review and interviews with health professionals, parents, and child patients. The 36 items rated the most frequent and bothersome by 83 children were selected for the CPQ 11-14 . Validity testing involved a new sample of 123 children. Test-retest reliability was assessed in a subgroup of these children (n = 65). Mean CPQ 11-14 scores were highest for oro-facial (31.4), lower for orthodontic (24.3), and lowest for pedodontic (23.3) patients. There were significant associations between the CPQ 11-14 score and global ratings of oral health (p < 0.05) and overall well-being (p < 0.01). The Cronbach's alpha and intraclass correlation coefficient for the CPQ 11-14 were 0.91 and 0.90, respectively. These results suggest that the CPQ 11-14 is valid and reliable.

Socioeconomic Inequality and Caries

2014-11-13

Falk Schwendicke , Christof E. Dörfer , Peter Schlattmann +3 more

Dental caries is the most prevalent disease worldwide, with the majority of caries lesions being concentrated in few, often disadvantaged social groups. We aimed to systematically assess current evidence for … Dental caries is the most prevalent disease worldwide, with the majority of caries lesions being concentrated in few, often disadvantaged social groups. We aimed to systematically assess current evidence for the association between socioeconomic position (SEP) and caries. We included studies investigating the association between social position (determined by own or parental educational or occupational background, or income) and caries prevalence, experience, or incidence. Risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies. Reported differences between the lowest and highest SEP were assessed and data not missing at random imputed. Random-effects inverse-generic meta-analyses were performed, and subgroup and meta-regression analyses were used to control for possible confounding. Publication bias was assessed via funnel plot analysis and the Egger test. From 5539 screened records, 155 studies with mostly low or moderate quality evaluating a total of 329,798 individuals were included. Studies used various designs, SEP measures, and outcome parameters. Eighty-three studies found at least one measure of caries to be significantly higher in low-SEP compared with high-SEP individuals, while only 3 studies found the opposite. The odds of having any caries lesions or caries experience (decayed missing filled teeth [DMFT]/dmft > 0) were significantly greater in those with low own or parental educational or occupational background or income (between odds ratio [95% confidence interval] = 1.21 [1.03-1.41] and 1.48 [1.34-1.63]. The association between low educational background and having DMFT/dmft > 0 was significantly increased in highly developed countries (R (2) = 1.32 [0.53-2.13]. Publication bias was present but did not significantly affect our estimates. Due to risk of bias in included studies, the available evidence was graded as low or very low. Low SEP is associated with a higher risk of having caries lesions or experience. This association might be stronger in developed countries. Established diagnostic and treatment concepts might not account for the unequal distribution of caries (registered with PROSPERO [CRD42013005947]).

Reasons for the caries decline: what do the experts believe?

1996-08-01

D Bratthall , Gunnel Hänsel‐Petersson , H Sundberg

The aim of this paper was to describe what experts of today believe are the main reasons explaining the caries decline seen in many westernized countries over the past 3 … The aim of this paper was to describe what experts of today believe are the main reasons explaining the caries decline seen in many westernized countries over the past 3 decades. We have collected the views of a number of international experts, trying to answer the specific question “What are the main reasons why 20‐25‐year‐old persons have less caries nowadays, compared to 30 years ago?”. A questionnaire was mailed to 55 experts with a number of thinkable explanations to be scored according to a predetermined scale. The 25 items were divided into main groups under the heading of diet, fluorides. plaque, saliva, dentist/dental materials and other factors. The experts were asked to think of a specific country or area, and also to specify whether the chosen area had water fluoridation or not. The main finding of our study, based on a 95% response rate, was that there is a very large variation in how the experts graded the impact of various possible factors. For the use of fluoride toothpaste, there was a clear agreement of a definite positive effect.

Influences on Children's Oral Health: A Conceptual Model

2007-08-31

Susan A. Fisher‐Owens , Stuart A. Gansky , Larry J. Platt +4 more

OBJECTIVES. Despite marked improvements over the past century, oral health in America is a significant problem: caries is the most common chronic disease of childhood. Much oral health research examines … OBJECTIVES. Despite marked improvements over the past century, oral health in America is a significant problem: caries is the most common chronic disease of childhood. Much oral health research examines influences primarily in the oral cavity or focuses on a limited number of individual-level factors. The purpose of this article was to present a more encompassing conceptual model of the influences on children's oral health. METHODS. The conceptual model presented here was derived from the population health and social epidemiology fields, which have moved toward multilevel, holistic approaches to analyze the complex and interactive causes of children's health problems. It is based on a comprehensive review of major population and oral health literatures. RESULTS. A multilevel conceptual model is described, with the individual, family, and community levels of influence on oral health outcomes. This model incorporates the 5 key domains of determinants of health as identified in the population health literature: genetic and biological factors, the social environment, the physical environment, health behaviors, and dental and medical care. The model recognizes the presence of a complex interplay of causal factors. Last, the model incorporates the aspect of time, recognizing the evolution of oral health diseases (eg, caries) and influences on the child-host over time. CONCLUSIONS. This conceptual model represents a starting point for thinking about children's oral health. The model incorporates many of the important breakthroughs by social epidemiologists over the past 25 years by including a broad range of genetic, social, and environmental risk factors; multiple pathways by which they operate; a time dimension; the notion of differential susceptibility and resilience; and a multilevel approach. The study of children's oral health from a global perspective remains largely in its infancy and is poised for additional development. This work can help inform how best to approach and improve children's oral health.

The Relationship among Dental Status, Nutrient Intake, and Nutritional Status in Older People

2001-02-01

Aubrey Sheiham , Jimmy Steele , Wagner Marcenes +5 more

Dental health status may influence nutrition. The objective of this part of the National Diet and Nutrition Survey was to assess if there is a relationship between dental status in … Dental health status may influence nutrition. The objective of this part of the National Diet and Nutrition Survey was to assess if there is a relationship between dental status in people 65 years and older and intake of certain nutrients and any link between dental status and blood-derived values of key nutrients. Random national samples of independently living subjects and those living in institutions had dental examinations, interviews, four-day food diaries, and blood and urine analyzed. In the sample living independently, intakes of most nutrients were lower in edentate than dentate subjects. Intake of non-starch polysaccharides, protein, calcium, non-heme iron, niacin, and vitamin C was significantly lower in edentate subjects. People with 21 or more teeth consumed more of most nutrients, particularly of non-starch polysaccharide. This relationship in intake was not apparent in the hematological analysis. Plasma ascorbate and plasma retinol were the only analytes significantly associated with dental status.

Early childhood caries update: A review of causes, diagnoses, and treatments

2013-01-01

Ç. Türksel Dülgergil , Mehmet Dallı , Mehmet Mustafa Hamidi +1 more

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC … Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management.

Effect of controlled oral hygiene procedures on caries and periodontal disease in adults

1978-06-01

Per Axelsson , Jan Lindhe

Abstract The present investigation was carried out to determine if the occurrence of caries and the progression of periodontitis can be prevented in adults, and maintained at a high level … Abstract The present investigation was carried out to determine if the occurrence of caries and the progression of periodontitis can be prevented in adults, and maintained at a high level of oral hygiene by regularly repeated oral hygiene instructions and prophylaxis. An attempt was also made to study the progression of dental diseases in individuals who received no special oral hygiene instruction but regularly received dental care of a traditional type. Two groups of individuals from one geographic site were recruited in 1971‐72 for the trial; 375 were assigned to a test and 180 to a control group. A baseline examination revealed that the socio‐economic status, the oral hygiene status, the incidence of gingivitis and the caries experience were similar among the test and control participants prior to the start of the study. During the subsequent 3‐year period, the control patients were seen regularly once a year and given traditional dental care. The test group participants, on the other hand, were seen once every 2 months during the first 2 years and once every 3 months during the third year. On an individual basis they were instructed in a proper oral hygiene technique and given a careful dental prophylaxis including scaling and root planing. Each prophylactic session was handled by a dental hygienist. A re‐examination was carried out towards the end of the third treatment year. The results of the trial clearly showed that it is possible, by regularly repeated tooth cleaning instruction and prophylaxis, to stimulate adults to adopt proper oral hygiene habits. The findings also demonstrated that persons who utilized proper oral hygiene techniques during a 3‐year period had negligible signs of gingivitis, suffered no loss of periodontal tissue attachment, and developed practically no new carious lesions. The control patients, who during the same period received merely symptomatic treatment, suffered from gingivitis, lost periodontal tisssue support and developed several new as well as recurrent, carious lesions. These results indicate that dental treatment is a highly ineffective means of curing caries and periodontal disease.

Dental caries: a dynamic disease process

2008-08-18

J.D.B. Featherstone

Abstract Dental caries is a transmissible bacterial disease process caused by acids from bacterial metabolism diffusing into enamel and dentine and dissolving the mineral. The bacteria responsible produce organic acids … Abstract Dental caries is a transmissible bacterial disease process caused by acids from bacterial metabolism diffusing into enamel and dentine and dissolving the mineral. The bacteria responsible produce organic acids as a by‐product of their metabolism of fermentable carbohydrates. The caries process is a continuum resulting from many cycles of demineralization and remineralization. Demineralization begins at the atomic level at the crystal surface inside the enamel or dentine and can continue unless halted with the end‐point being cavitation. There are many possibilities to intervene in this continuing process to arrest or reverse the progress of the lesion. Remineralization is the natural repair process for non‐cavitated lesions, and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. These remineralized crystals are acid resistant, being much less soluble than the original mineral.

Oral health, general health and quality of life.

2005-09-01

Aubrey Sheiham

The compartmentalization involved in viewing the mouth separately from the rest of the body must cease because oral health affects general health by causing considerable pain and suffering and by … The compartmentalization involved in viewing the mouth separately from the rest of the body must cease because oral health affects general health by causing considerable pain and suffering and by changing what people eat, their speech and their quality of life and well-being. Oral health also has an effect on other chronic diseases (1). Because of the failure to tackle social and material de-terminants and incorporate oral health into general health promotion, millions suffer intractable toothache and poor quality of life and end up with few teeth.Health policies should be reori-ented to incorporate oral health using sociodental approaches to assessing needs and the common risk factor approach for health promotion (1, 2). Oral diseases are the most common of the chronic diseases and are important public health problems because of their prevalence, their impact on individuals and society, and the expense of their treatment. The determinants of oral diseases are known — they are the risk factors common to a number of chronic diseases: diet and dirt (hygiene), smok-ing, alcohol, risky behaviours causing injuries, and stress — and effective public health methods are available to prevent oral diseases.In some countries, oral diseases are the fourth most expensive diseases to treat. Treating caries, estimated at US$ 3513 per 1000 children, would exceed the total health budget for children of most low-income countries (3). The situation for adults in developing coun-tries is worse, as they suffer from the accumulation of untreated oral diseases. There are few efﬁcient dental care sys-tems to cope with their problems, and where there are, the cost is beyond most people’s means. Millions with untreated caries have cavities and suppuration, yet planners continue to overlook oral dis-eases, despite their signiﬁcant impact on cost and quality of life. This oversight will lead to more decay and expensive, ineffective clinical interventions.

Oral Health-related Quality of Life

2011-03-21

Lacey Sischo , Hillary L. Broder

Despite its relatively recent emergence over the past few decades, oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research. OHRQoL is … Despite its relatively recent emergence over the past few decades, oral health-related quality of life (OHRQoL) has important implications for the clinical practice of dentistry and dental research. OHRQoL is a multidimensional construct that includes a subjective evaluation of the individual’s oral health, functional well-being, emotional well-being, expectations and satisfaction with care, and sense of self. It has wide-reaching applications in survey and clinical research. OHRQoL is an integral part of general health and well-being. In fact, it is recognized by the World Health Organization (WHO) as an important segment of the Global Oral Health Program (2003). This paper identifies the what, why, and how of OHRQoL and presents an oral health theoretical model. The relevance of OHRQoL for dental practitioners and patients in community-based dental practices is presented. Implications for health policy and related oral health disparities are also discussed. A supplemental Appendix contains a Medline and ProQuest literature search regarding OHRQoL research from 1990-2010 by discipline and research design ( e.g., descriptive, longitudinal, clinical trial, etc.). The search identified 300 articles with a notable surge in OHRQoL research in pediatrics and orthodontics in recent years.

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Risk factors for dental caries in young children: a systematic review of the literature.

2004-03-01

Rebecca Harris , Alison D Nicoll , Pauline Adair +1 more

To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for … To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for the international collaborative studies on inequalities in childhood caries.Accepted guidelines were followed. Studies were identified by electronic searching and reviewed on the basis of key words, title and abstract by two reviewers to assess whether inclusion criteria were met. Copies of all articles were obtained and assessed for quality according to the study design.1029 papers were identified from the electronic search, 260 met the prima facie inclusion criteria. 183 were excluded once full copies of these papers were obtained. Of the 77 studies included, 43 were cross sectional, 19 cohort studies, 8 case control studies and 7 interventional studies. Few obtained the highest quality scores. 106 risk factors were significantly related to the prevalence or incidence of caries.There is a shortage of high quality studies using the optimum study design, i.e. a longitudinal study. The evidence suggests that children are most likely to develop caries if Streptococcus Muttans is acquired at an early age, although this may be partly compensated by other factors such as good oral hygiene and a non-cariogenic diet. Diet and oral hygiene may interact so that if there is a balance of 'good' habits by way of maintaining good plaque control and 'bad' habits by way of having a cariogenic diet, the development of caries may be controlled.

Tooth loss and oral health-related quality of life: a systematic review and meta-analysis

2010-01-01

Anneloes E. Gerritsen , Patrick Allen , D.J. Witter +2 more

It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most … It is increasingly recognized that the impact of disease on quality of life should be taken into account when assessing health status. It is likely that tooth loss, in most cases being a consequence of oral diseases, affects Oral Health-Related Quality of Life (OHRQoL). The aim of the present study is to systematically review the literature and to analyse the relationship between the number and location of missing teeth and oral health-related quality of life (OHRQoL). It was hypothesized that tooth loss is associated with an impairment of OHRQoL. Secondly, it was hypothesized that location and distribution of remaining teeth play an important role in this. Relevant databases were searched for papers in English, published from 1990 to July 2009 following a broad search strategy. Relevant papers were selected by two independent readers using predefined exclusion criteria, firstly on the basis of abstracts, secondly by assessing full-text papers. Selected studies were grouped on the basis of OHRQoL instruments used and assessed for feasibility for quantitative synthesis. Comparable outcomes were subjected to meta-analysis; remaining outcomes were subjected to a qualitative synthesis only. From a total of 924 references, 35 were eligible for synthesis (inter-reader agreement abstracts κ = 0.84 ± 0.03; full-texts: κ = 0.68 ± 0.06). Meta-analysis was feasible for 10 studies reporting on 13 different samples, resulting in 6 separate analyses. All studies showed that tooth loss is associated with unfavourable OHRQoL scores, independent of study location and OHRQoL instrument used. Qualitative synthesis showed that all 9 studies investigating a possible relationship between number of occluding pairs of teeth present and OHRQoL reported significant positive correlations. Five studies presented separate data regarding OHRQoL and location of tooth loss (anterior tooth loss vs. posterior tooth loss). Four of these reported highest impact for anterior tooth loss; one study indicated a similar impact for both locations of tooth loss. This study provides fairly strong evidence that tooth loss is associated with impairment of OHRQoL and location and distribution of tooth loss affect the severity of the impairment. This association seems to be independent from the OHRQoL instrument used and context of the included samples.

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Global Burden of Untreated Caries

2015-03-04

N.J. Kassebaum , Eduardo Bernabé , M. Dahiya +3 more

We aimed to consolidate all epidemiologic data about untreated caries and subsequently generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 … We aimed to consolidate all epidemiologic data about untreated caries and subsequently generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 18,311 unique citations. After screening titles and abstracts, we excluded 10,461 citations as clearly irrelevant to this systematic review, leaving 1,682 for full-text review. Furthermore, 1,373 publications were excluded following the validity assessment. Overall, 192 studies of 1,502,260 children aged 1 to 14 y in 74 countries and 186 studies of 3,265,546 individuals aged 5 y or older in 67 countries were included in separate metaregressions for untreated caries in deciduous and permanent teeth, respectively, using modeling resources from the Global Burden of Disease 2010 study. In 2010, untreated caries in permanent teeth was the most prevalent condition worldwide, affecting 2.4 billion people, and untreated caries in deciduous teeth was the 10th-most prevalent condition, affecting 621 million children worldwide. The global age-standardized prevalence and incidence of untreated caries remained static between 1990 and 2010. There is evidence that the burden of untreated caries is shifting from children to adults, with 3 peaks in prevalence at ages 6, 25, and 70 y. Also, there were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of untreated caries due to population growth and longevity and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.

Systematic review of water fluoridation

2000-10-07

Marian McDonagh

<h3>Abstract</h3> Objective: To review the safety and efficacy of fluoridation of drinking water. Design: Search of 25 electronic databases and world wide web. Relevant journals hand searched; further information requested … <h3>Abstract</h3> Objective: To review the safety and efficacy of fluoridation of drinking water. Design: Search of 25 electronic databases and world wide web. Relevant journals hand searched; further information requested from authors. Inclusion criteria were a predefined hierarchy of evidence and objectives. Study validity was assessed with checklists. Two reviewers independently screened sources, extracted data, and assessed validity. Main outcome measures: Decayed, missing, and filled primary/permanent teeth. Proportion of children without caries. Measure of effect was the difference in change in prevalence of caries from baseline to final examination in fluoridated compared with control areas. For potential adverse effects, all outcomes reported were used. Results: 214 studies were included. The quality of studies was low to moderate. Water fluoridation was associated with an increased proportion of children without caries and a reduction in the number of teeth affected by caries. The range (median) of mean differences in the proportion of children without caries was −5.0% to 64% (14.6%). The range (median) of mean change in decayed, missing, and filled primary/permanent teeth was 0.5 to 4.4 (2.25) teeth. A dose-dependent increase in dental fluorosis was found. At a fluoride level of 1 ppm an estimated 12.5% (95% confidence interval 7.0% to 21.5%) of exposed people would have fluorosis that they would find aesthetically concerning. Conclusions: The evidence of a beneficial reduction in caries should be considered together with the increased prevalence of dental fluorosis. There was no clear evidence of other potential adverse effects.

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Global Economic Impact of Dental Diseases

2015-08-28

Stefan Listl , Jennifer Galloway , Peter Mossey +1 more

Reporting the economic burden of oral diseases is important to evaluate the societal relevance of preventing and addressing oral diseases. In addition to treatment costs, there are indirect costs to … Reporting the economic burden of oral diseases is important to evaluate the societal relevance of preventing and addressing oral diseases. In addition to treatment costs, there are indirect costs to consider, mainly in terms of productivity losses due to absenteeism from work. The purpose of the present study was to estimate the direct and indirect costs of dental diseases worldwide to approximate the global economic impact. Estimation of direct treatment costs was based on a systematic approach. For estimation of indirect costs, an approach suggested by the World Health Organization’s Commission on Macroeconomics and Health was employed, which factored in 2010 values of gross domestic product per capita as provided by the International Monetary Fund and oral burden of disease estimates from the 2010 Global Burden of Disease Study. Direct treatment costs due to dental diseases worldwide were estimated at US$298 billion yearly, corresponding to an average of 4.6% of global health expenditure. Indirect costs due to dental diseases worldwide amounted to US$144 billion yearly, corresponding to economic losses within the range of the 10 most frequent global causes of death. Within the limitations of currently available data sources and methodologies, these findings suggest that the global economic impact of dental diseases amounted to US$442 billion in 2010. Improvements in population oral health may imply substantial economic benefits not only in terms of reduced treatment costs but also because of fewer productivity losses in the labor market.

The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries

2007-05-21

Amid I. Ismaïl , Woosung Sohn , Marisol Téllez +4 more

Abstract – This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR‐OHD). … Abstract – This paper describes early findings of evaluations of the International Caries Detection and Assessment System (ICDAS) conducted by the Detroit Center for Research on Oral Health Disparities (DCR‐OHD). The lack of consistency among the contemporary criteria systems limits the comparability of outcomes measured in epidemiological and clinical studies. The ICDAS criteria were developed by an international team of caries researchers to integrate several new criteria systems into one standard system for caries detection and assessment. Using ICDAS in the DCR‐OHD cohort study, dental examiners first determined whether a clean and dry tooth surface is sound, sealed, restored, crowned, or missing. Afterwards, the examiners classified the carious status of each tooth surface using a seven‐point ordinal scale ranging from sound to extensive cavitation. Histological examination of extracted teeth found increased likelihood of carious demineralization in dentin as the ICDAS codes increased in severity. The criteria were also found to have discriminatory validity in analyses of social, behavioral and dietary factors associated with dental caries. The reliability of six examiners to classify tooth surfaces by their ICDAS carious status ranged between good to excellent (kappa coefficients ranged between 0.59 and 0.82). While further work is still needed to define caries activity, validate the criteria and their reliability in assessing dental caries on smooth surfaces, and develop a classification system for assessing preventive and restorative treatment needs, this early evaluation of the ICDAS platform has found that the system is practical; has content validity, correlational validity with histological examination of pits and fissures in extracted teeth; and discriminatory validity.

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Minimal intervention dentistry — a review

2000-02-01

Martin J. Tyas , Kenneth J. Anusavice , Jo E. Frencken +1 more

What do measures of ‘oral health‐related quality of life’ measure?

2007-11-22

David Locker , Patrick Allen

The terms 'health-related quality of life' and 'quality of life' are now in common use to describe the outcomes of oral health conditions and therapy for those conditions. In addition, … The terms 'health-related quality of life' and 'quality of life' are now in common use to describe the outcomes of oral health conditions and therapy for those conditions. In addition, there has been a proliferation of measures designed to quantify those outcomes. These measures, which were initially designated as socio-dental indicators or subjective oral health indicators are now more usually referred to as measures of oral health-related quality of life (OH-QoL). This is based on the assumption that the functional and psychosocial impacts they document must, of necessity, affect the quality of life. While this assumption has been subject to critical scrutiny in medicine, this is not the case with dentistry. Consequently, exactly what is being measured by indexes of OH-QoL is somewhat unclear. Based on the debate between Gill and Feinstein and Guyatt and Cook, we outline a number of criteria by means of which the construct addressed by measures of OH-QoL may be assessed. These are concerned with how the measures were developed and validated. These criteria are then used to appraise five of the many measures that have been developed over the past 20 years--the GOHAI, OHIP, OIDP, COHQoL and OH-QoL. The main conclusion is that while all document the frequency of the functional and psychosocial impacts that emanate from oral disorders they do not unequivocally establish the meaning and significance of those impacts. Consequently, the claim that oral disorders affect the quality of life has yet to be clearly demonstrated. Verifying this claim requires further qualitative studies of the outcomes of oral disorders as perceived by patients and persons, and the concurrent use of measures that more explicitly address the issue of quality of life.

Fluoride toothpastes for preventing dental caries in children and adolescents

2003-01-20

Valéria CC Marinho , Julian P. T. Higgins , Stuart Logan +1 more

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Improving the oral health of older people: the approach of the WHO Global Oral Health Programme

2005-02-21

Poul Erik Petersen , Tatsuo Yamamoto

The proportion of older people continues to grow worldwide, especially in developing countries. Non-communicable diseases are fast becoming the leading causes of disability and mortality, and in coming decades health … The proportion of older people continues to grow worldwide, especially in developing countries. Non-communicable diseases are fast becoming the leading causes of disability and mortality, and in coming decades health and social policy-makers will face tremendous challenges posed by the rapidly changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia and oral precancer/cancer. The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers. The means for strengthening oral health programme implementation are available; the major challenge is therefore to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health. National public health programmes should incorporate oral health promotion and disease prevention based on the common risk factors approach. Control of oral disease and illness in older adults should be strengthened through organization of affordable oral health services, which meet their needs. The needs for care are highest among disadvantaged, vulnerable groups in both developed and developing countries. In developing countries the challenges to provision of primary oral health care are particularly high because of a shortage of dental manpower. In developed countries reorientation of oral health services towards prevention should consider oral care needs of older people. Education and continuous training must ensure that oral health care providers have skills in and a profound understanding of the biomedical and psychosocial aspects of care for older people. Research for better oral health should not just focus on the biomedical and clinical aspects of oral health care; public health research needs to be strengthened particularly in developing countries. Operational research and efforts to translate science into practice are to be encouraged. WHO supports national capacity building in the oral health of older people through intercountry and interregional exchange of experiences.

Global Burden of Oral Conditions in 1990-2010

2013-05-29

Wagner Marcenes , N.J. Kassebaum , Eduardo Bernabé +4 more

The Global Burden of Disease (GBD) 2010 Study produced comparable estimates of the burden of 291 diseases and injuries in 1990, 2005, and 2010. This article reports on the global … The Global Burden of Disease (GBD) 2010 Study produced comparable estimates of the burden of 291 diseases and injuries in 1990, 2005, and 2010. This article reports on the global burden of untreated caries, severe periodontitis, and severe tooth loss in 2010 and compares those figures with new estimates for 1990. We used disability-adjusted life-years (DALYs) and years lived with disability (YLDs) metrics to quantify burden. Oral conditions affected 3.9 billion people, and untreated caries in permanent teeth was the most prevalent condition evaluated for the entire GBD 2010 Study (global prevalence of 35% for all ages combined). Oral conditions combined accounted for 15 million DALYs globally (1.9% of all YLDs; 0.6% of all DALYs), implying an average health loss of 224 years per 100,000 population. DALYs due to oral conditions increased 20.8% between 1990 and 2010, mainly due to population growth and aging. While DALYs due to severe periodontitis and untreated caries increased, those due to severe tooth loss decreased. DALYs differed by age groups and regions, but not by genders. The findings highlight the challenge in responding to the diversity of urgent oral health needs worldwide, particularly in developing communities.

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Global Burden of Severe Periodontitis in 1990-2010

2014-09-26

Nicholas J Kassebaum , Eduardo Bernabé , M. Dahiya +3 more

We aimed to consolidate all epidemiologic data about severe periodontitis (SP) and, subsequently, to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes … We aimed to consolidate all epidemiologic data about severe periodontitis (SP) and, subsequently, to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 6,394 unique citations. After screening titles and abstracts, we excluded 5,881 citations as clearly not relevant to this systematic review, leaving 513 for full-text review. A further 441 publications were excluded following the validity assessment. A total of 72 studies, including 291,170 individuals aged 15 yr or older in 37 countries, were included in the metaregression based on modeling resources of the Global Burden of Disease 2010 Study. SP was the sixth-most prevalent condition in the world. Between 1990 and 2010, the global age-standardized prevalence of SP was static at 11.2% (95% uncertainty interval: 10.4%-11.9% in 1990 and 10.5%-12.0% in 2010). The age-standardized incidence of SP in 2010 was 701 cases per 100,000 person-years (95% uncertainty interval: 599-823), a nonsignificant increase from the 1990 incidence of SP. Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 yr of age. There were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.

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Changes in Dental Caries 1953–2003

2004-01-01

T.M. Marthaler

In the first half of the 20th century, indices and methods of conducting surveys of the level of dental diseases were developed. Modern epidemiological studies began in the fifties and … In the first half of the 20th century, indices and methods of conducting surveys of the level of dental diseases were developed. Modern epidemiological studies began in the fifties and many reliable studies have been conducted after 1960. In the following decades, a substantial decline of caries prevalence was documented in the majority of the highly industrialized countries, with reductions of lifetime caries experience exceeding 75%. The decline comes to an end when low or very low levels of prevalence are reached. Children of low socioeconomic status and immigrants from outside Western Europe, however, generally have higher disease levels and may cause increases in caries prevalence. For this and other reasons, caries epidemiology will remain an indispensable part of dental public health.

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World Health Organization global policy for improvement of oral health - World Health Assembly 2007

2008-06-01

Poul Erik Petersen

The World Oral Health Report 2003: continuous improvement of oral health in the 21st century – the approach of the WHO Global Oral Health Programme

2003-11-21

Poul Erik Petersen

Chronic diseases and injuries are the leading health problems in all but a few parts of the world. The rapidly changing disease patterns throughout the world are closely linked to … Chronic diseases and injuries are the leading health problems in all but a few parts of the world. The rapidly changing disease patterns throughout the world are closely linked to changing lifestyles, which include diets rich in sugars, widespread use of tobacco, and increased consumption of alcohol. In addition to socio-environmental determinants, oral disease is highly related to these lifestyle factors, which are risks to most chronic diseases as well as protective factors such as appropriate exposure to fluoride and good oral hygiene. Oral diseases qualify as major public health problems owing to their high prevalence and incidence in all regions of the world, and as for all diseases, the greatest burden of oral diseases is on disadvantaged and socially marginalized populations. The severe impact in terms of pain and suffering, impairment of function and effect on quality of life must also be considered. Traditional treatment of oral diseases is extremely costly in several industrialized countries, and not feasible in most low-income and middle-income countries. The WHO Global Strategy for Prevention and Control of Noncommunicable Diseases, added to the common risk factor approach is a new strategy for managing prevention and control of oral diseases. The WHO Oral Health Programme has also strengthened its work for improved oral health globally through links with other technical programmes within the Department for Noncommunicable Disease Prevention and Health Promotion. The current oral health situation and development trends at global level are described and WHO strategies and approaches for better oral health in the 21st century are outlined.

Changing Paradigms in Concepts on Dental Caries: Consequences for Oral Health Care

2004-01-01

O. Fejerskov

Kuhn proposed in his Structure of Scientific Revolutions (1962) that the theoretical framework of a science (paradigm) determines how each generation of researchers construes a causal sequence. Paradigm change is … Kuhn proposed in his Structure of Scientific Revolutions (1962) that the theoretical framework of a science (paradigm) determines how each generation of researchers construes a causal sequence. Paradigm change is infrequent and revolutionary; thereafter previous knowledge and ideas become partially redundant. This paper discusses two paradigms central to cariology. The first concerns the most successful caries-preventive agent: fluoride. When it was thought that fluoride had to be present during tooth mineralisation to ‘improve’ the biological apatite and the ‘caries resistance’ of the teeth, systemic fluoride administration was necessary for maximum benefit. Caries reduction therefore had to be balanced against increasing dental fluorosis. The ‘caries resistance’ concept was shown to be erroneous 25 years ago, but the new paradigm is not yet fully adopted in public health dentistry, so we still await real breakthroughs in more effective use of fluorides for caries prevention. The second paradigm is that caries is a transmittable, infectious disease: even one caused by specific microorganisms. This paradigm would require caries prevention by vaccination, but there is evidence that caries is not a classical infectious disease. Rather it results from an ecological shift in the tooth-surface biofilm, leading to a mineral imbalance between plaque fluid and tooth and hence net loss of tooth mineral. Therefore, caries belongs to common ‘complex’ or ‘multifactorial’ diseases, such as cancer, cardiovascular diseases, diabetes, in which many genetic, environmental and behavioural risk factors interact. The paper emphasises how these paradigm changes raise new research questions which need to be addressed to make caries prevention and treatment more cost-effective.

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Global burden of oral diseases: emerging concepts, management and interplay with systemic health

2015-12-24

LJ Jin , IB Lamster , JS Greenspan +3 more

This study presents the global burden of major oral diseases with an exegetical commentary on their current profiles, the critical issues in oral healthcare and future perspectives.A narrative overview of … This study presents the global burden of major oral diseases with an exegetical commentary on their current profiles, the critical issues in oral healthcare and future perspectives.A narrative overview of current literature was undertaken to synthesise the contexts with critical elaboration and commentary.Oral disease is one of the most common public health issues worldwide with significant socio-economic impacts, and yet it is frequently neglected in public health policy. The oral data extracted from the Global Burden of Disease Study in 2010 (Murray et al, 2012) show that caries, periodontal disease, edentulism, oral cancer and cleft lip/palate collectively accounted for 18 814 000 disability-adjusted life-years; and the global burden of periodontal disease, oral cancer and caries increased markedly by an average of 45.6% from 1990 to 2010 in parallel with the major non-communicable diseases like diabetes by 69.0%. Oral diseases and non-communicable diseases are closely interlinked through sharing common risk factors (e.g. excess sugar consumption and tobacco use) and underlying infection/inflammatory pathways.Oral disease remains a major public health burden worldwide. It is of great importance to integrate oral health into global health agenda via the common risk factor approach. The long-term sustainable strategy for global oral health should focus on health promotion and disease prevention through effective multidisciplinary teamwork.

Studies on Dental Caries: I. Dental Status and Dental Needs of Elementary School Children

1938-01-01

Henry Klein , Carroll E. Palmer , John W. Knutson

Development and evaluation of the Oral Health Impact Profile.

1994-03-01

GD Slade , Spencer Aj

The capacity of dental clinicians and researchers to assess oral health and to advocate for dental care has been hampered by limitations in measurements of the levels of dysfunction, discomfort … The capacity of dental clinicians and researchers to assess oral health and to advocate for dental care has been hampered by limitations in measurements of the levels of dysfunction, discomfort and disability associated with oral disorders. The purpose of this research was to develop and test the Oral Health Impact Profile (OHIP), a scaled index of the social impact of oral disorders which draws on a theoretical hierarchy of oral health outcomes. Forty nine unique statements describing the consequences of oral disorders were initially derived from 535 statements obtained in interviews with 64 dental patients. The relative importance of statements within each of seven conceptual subscales was assessed by 328 persons using Thurstone's method of paired comparisons. The consistency of their judgements was confirmed (Kendall's mu, P < 0.05). The reliability of the instrument was evaluated in a cohort of 122 persons aged 60 years and over. Internal reliability of six subscales was high (Cronbach's alpha, 0.70-0.83) and test-retest reliability (intraclass correlation coefficient, 0.42-0.77) demonstrated stability. Validity was examined using longitudinal data from the 60 years and over cohort where the OHIP's capacity to detect previously observed associations with perceived need for a dental visit (ANOVA, p < 0.05 in five subscales) provided evidence of its construct validity. The Oral Health Impact Profile offers a reliable and valid instrument for detailed measurement of the social impact of oral disorders and has potential benefits for clinical decision-making and research.

Global, Regional, and National Prevalence, Incidence, and Disability-Adjusted Life Years for Oral Conditions for 195 Countries, 1990–2015: A Systematic Analysis for the Global Burden of Diseases, Injuries, and Risk Factors

2017-02-01

Nicholas J Kassebaum , Alison Smith , Eduardo Bernabé +7 more

The Global Burden of Disease 2015 study aims to use all available data of sufficient quality to generate reliable and valid prevalence, incidence, and disability-adjusted life year (DALY) estimates of … The Global Burden of Disease 2015 study aims to use all available data of sufficient quality to generate reliable and valid prevalence, incidence, and disability-adjusted life year (DALY) estimates of oral conditions for the period of 1990 to 2015. Since death as a direct result of oral diseases is rare, DALY estimates were based on years lived with disability, which are estimated only on those persons with unmet need for dental care. We used our data to assess progress toward the Federation Dental International, World Health Organization, and International Association for Dental Research's oral health goals of reducing the level of oral diseases and minimizing their impact by 2020. Oral health has not improved in the last 25 y, and oral conditions remained a major public health challenge all over the world in 2015. Due to demographic changes, including population growth and aging, the cumulative burden of oral conditions dramatically increased between 1990 and 2015. The number of people with untreated oral conditions rose from 2.5 billion in 1990 to 3.5 billion in 2015, with a 64% increase in DALYs due to oral conditions throughout the world. Clearly, oral diseases are highly prevalent in the globe, posing a very serious public health challenge to policy makers. Greater efforts and potentially different approaches are needed if the oral health goal of reducing the level of oral diseases and minimizing their impact is to be achieved by 2020. Despite some challenges with current measurement methodologies for oral diseases, measurable specific oral health goals should be developed to advance global public health.

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Single Nucleotide Polymorphism in the Aetiology of Caries: Systematic Literature Review

2017-01-01

Paula Piekoszewska‐Ziętek , Anna Turska‐Szybka , Dorota Olczak‐Kowalczyk

Recent progress in the field of molecular biology and techniques of DNA sequence analysis allowed determining the meaning of hereditary factors of many common human diseases. Studies of genetic mechanisms … Recent progress in the field of molecular biology and techniques of DNA sequence analysis allowed determining the meaning of hereditary factors of many common human diseases. Studies of genetic mechanisms in the aetiology of caries encompass, primarily, 4 main groups of genes responsible for (1) the development of enamel, (2) formation and composition of saliva, (3) immunological responses, and (4) carbohydrate metabolism. The aim of this study was to present current knowledge about the influence of single nucleotide polymorphism (SNP) genetic variants on the occurrence of dental caries. PubMed/Medline, Embase, and Cochrane Library databases were searched for papers on the influence of genetic factors connected with SNP on the occurrence of dental caries in children, teenagers, and adults. Thirty original papers written in English were included in this review. Study groups ranged from 30 to 13,000 subjects. SNPs were observed in 30 genes. Results of the majority of studies confirm the participation of hereditary factors in the aetiology of caries. Three genes, AMELX, AQP5, and ESRRB, have the most promising evidence based on multiple replications and data, supporting a role of these genes in caries. The review of the literature proves that SNP is linked with the aetiology of dental caries.

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Ending the neglect of global oral health: time for radical action

2019-07-01

Richard G. Watt , Blánaid Daly , Paul Allison +7 more

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Oral diseases: a global public health challenge

2019-07-01

Marco Aurélio Peres , L.M.D. Macpherson , Robert J. Weyant +7 more

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Oral Health Surveys: Basic Methods

1971-12-01

World Health Organization

Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study

2020-03-02

Eduardo Bernabé , Wagner Marcenes , Cristhiam Rojas Hernandez +7 more

Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global … Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global Burden of Disease study was to produce estimates on prevalence, incidence, and years lived with disability for oral conditions from 1990 to 2017 by sex, age, and countries. In addition, this study reports the global socioeconomic pattern in burden of oral conditions by the standard World Bank classification of economies as well as the Global Burden of Disease Socio-demographic Index. The findings show that oral conditions remain a substantial population health challenge. Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions, of which 2.3 billion (95% UI, 2.1 to 2.5 billion) had untreated caries in permanent teeth, 796 million (95% UI, 671 to 930 million) had severe periodontitis, 532 million (95% UI, 443 to 622 million) had untreated caries in deciduous teeth, 267 million (95% UI, 235 to 300 million) had total tooth loss, and 139 million (95% UI, 133 to 146 million) had other oral conditions in 2017. Several patterns emerged when the World Bank’s classification of economies and the Socio-demographic Index were used as indicators of economic development. In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss. The findings offer an opportunity for policy makers to identify successful oral health strategies and strengthen them; introduce and monitor different approaches where oral diseases are increasing; plan integration of oral health in the agenda for prevention of noncommunicable diseases; and estimate the cost of providing universal coverage for dental care.

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Dental caries

2017-05-24

Nigel Pitts , Domenick T. Zero , Phil Marsh +7 more

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Dental caries

2007-01-01

Robert H. Selwitz , Amid I. Ismaïl , Nigel Pitts

Measuring oral health: a conceptual framework.

1988-03-01

David Locker

The burden of oral disease: challenges to improving oral health in the 21st century.

2005-01-01

Poul Erik Petersen

Dental caries and periodontal diseases have historically been considered the most important part of the global burden of oral diseases. At present, the distribution and severity of oral diseases vary … Dental caries and periodontal diseases have historically been considered the most important part of the global burden of oral diseases. At present, the distribution and severity of oral diseases vary in different parts of the world and within the same country or region. Dental caries is still a major public health problem in most industrialized countries, affecting 60-90% of schoolchildren and the vast majority of adults. It is also a prevalent oral disease in several Asian and Latin American countries, while it appears to be less common and less severe in most African countries. It is expected, however, that the incidence of dental caries will increase in the near future in many developing countries of Africa, as a result of growing consumption of sugars and inadequate exposure to fluorides. The significant role of socio-behavioural and environmental factors in oral disease and health is demonstrated in a large number of epidemiological surveys. The current pattern of dental caries reflects primarily distinct risk profiles across countries (related to living conditions, lifestyles and environmental factors) and the implementation of preventive oral health systems. In some industrialized countries there has been a positive trend in the reduction of tooth loss among adults in recent years, though the proportion of edentulous persons in the elderly population is still high in some countries. In most developing countries, access to oral health services is limited and teeth are often left untreated or are extracted because of pain or discomfort. Tooth loss and impaired oral function are therefore expected to increase as a public health problem in many developing countries. Tooth loss in adult life may also be attributable to poor periodontal health. Severe periodontitis, which may result in tooth loss, is found in 5-15% of most populations. In industrialized countries, studies show that tobacco use is a major risk factor for adult periodontal disease. With the growing consumption of tobacco in many developing countries, the risk of periodontal disease and tooth loss may therefore increase. Oral cancer is closely related to the use of tobacco and excessive consumption of alcohol. The prevalence of oral cancer is particularly high among men, and is the eighth most common cancer worldwide. In south and central Asia, consumption of tobacco in various forms is particularly high, and cancer of the oral cavity ranks among the three most common types of cancer. Periodontal disease and tooth loss are also related to chronic diseases such as diabetes mellitus: the growing incidence of diabetes may further impact negatively on oral health of people in several developing countries. …

Assessment of the Oral Health Impact Profile-14 Based on Health-Related Characteristics in Patients with Diabetes

2025-06-26

Se-Yun Oh , Min-Kyung Lee , Kyung-Min Kim +1 more | Journal of dental hygiene science

Halitosis among users of electronic nicotine delivery systems in a multi-center cross-sectional study

2025-06-25

Saadi M. Saleh , Abdelrahman Shata , Ali Malik Tiryag +7 more | Scientific Reports

The role of socioeconomic and geographic contexts in shaping oral health inequalities: a cross-national analysis

2025-06-24

Joanna Domagalska , Ewelina Mażysz , Monika Rusin +1 more | MEDICAL SCIENCE PULSE

<ns3:p>Background: This study examines the impact of socioeconomic, healthcare access, and environmental factors on oral health inequalities, with a particular focus on the roles of income level, access to dental … <ns3:p>Background: This study examines the impact of socioeconomic, healthcare access, and environmental factors on oral health inequalities, with a particular focus on the roles of income level, access to dental care, and lifestyle habits such as tobacco and sugar consumption. Aim of the study: The objective of this review paper is to conduct a comprehensive analysis of global health inequalities, with oral health conditions as a case study.Material and methods: A multilevel analytical approach is employed to assess the influence of these determinants on disparities in oral health outcomes and to compare key indicators across populations, including the prevalence of oral diseases and lip and oral cavity cancer. Moreover, an investigation was undertaken into the financial commitments made towards dental care, including the total expenditure on dental care in millions of US dollars and the per capita expenditure on dental care in US dollars.Results: The findings illustrate a strong correlation between socioeconomic factors and healthcare accessibility and oral health inequalities. Populations with lower incomes and limited access to dental care are at significantly higher risk of developing oral diseases and oral cancers. Furthermore, environmental factors, particularly the consumption of tobacco and sugar, contribute to the exacerbation of these disparities. Conclusions: Our analysis highlights a significant imbalance in health expenditures. This research provides crucial insights for policymakers seeking to reduce oral health disparities by addressing both economic and environmental determinants, thereby fostering a more inclusive approach to public health.</ns3:p>

Experience of Foreign Domestic Caregivers in Oral Hygiene Care for Older Adults With Dementia in Taiwan: A Qualitative Study

2025-06-24

Sumandar , Kuei-Yun Lu , Min‐Tao Hsu +4 more | Gerodontology

ABSTRACT Objective This study aimed to explore the experiences of Indonesian domestic paid caregivers in providing oral hygiene care for older adults with dementia. Background As dementia progresses, individuals increasingly … ABSTRACT Objective This study aimed to explore the experiences of Indonesian domestic paid caregivers in providing oral hygiene care for older adults with dementia. Background As dementia progresses, individuals increasingly rely on their caregivers for help with daily oral care. Methods A qualitative descriptive study was conducted. Indonesian domestic caregivers were recruited through purposive sampling at four community‐based dementia service sites in Kaohsiung, Taiwan. A total of 12 Indonesian female domestic caregivers participated in face‐to‐face interviews, which lasted between 30 and 70 min. The interview transcripts were analysed using Braun and Clarke's thematic analysis approach. Results Three main themes and six sub‐themes were identified from the interviews: (1) caring for the oral health of older adults with dementia as one would for a family member, (2) providing person‐centred interactions during oral hygiene routines and (3) addressing the systemic and practical challenges related to oral hygiene. Conclusion Indonesian female domestic caregivers recognise the importance of consistently providing oral hygiene care to older adults with dementia. There is a need for training programmes to improve caregiving skills, create supportive environments and foster a positive approach to care.

Assessment of Management Strategies and Oral Health Challenges in Elderly Patients With Cognitive Impairment in Long-Term Care Facilities: An Original Research

2025-06-23

Kumudhati Tiwari , Digvijaysinh Parmar , Tejaswi Kala +5 more | Journal of Pharmacy And Bioallied Sciences

A BSTRACT Introduction: Oral health is a critical concern for elderly patients, especially those with cognitive impairment residing in long-term care facilities. Cognitive decline often leads to difficulties in maintaining … A BSTRACT Introduction: Oral health is a critical concern for elderly patients, especially those with cognitive impairment residing in long-term care facilities. Cognitive decline often leads to difficulties in maintaining oral hygiene, resulting in poor oral health outcomes. This study aims to evaluate the oral health challenges faced by these individuals and propose management strategies to address these issues. Methods: The study employed a systematic literature review method, focusing on articles from PubMed and related databases. Three key parameters were assessed: (1) oral health status of elderly patients with cognitive impairment, (2) the role of caregivers in oral hygiene maintenance, and (3) strategies for improving oral health outcomes. Results: The findings revealed a significant correlation between cognitive impairment and deteriorating oral health. The use of caregiver-assisted interventions and regular dental check-ups improved oral health outcomes. Two statistical tables are included to highlight the impact of interventions. Conclusion: Effective management of oral health in cognitively impaired elderly patients requires collaborative efforts between healthcare providers, caregivers, and dental professionals. Timely interventions can significantly enhance oral health outcomes.

Epidemiology of oral health in older adults aged 65 or over: prevalence, risk factors and prevention

2025-06-23

Jimmy Xiangji Huang , Lin Kang , Jingru Bi | Aging Clinical and Experimental Research

Oral diseases have emerged as one of the most prevalent non-communicable diseases (NCDs) worldwide, with a high global average prevalence of 45%, affecting an estimated 3.5 billion people globally. With … Oral diseases have emerged as one of the most prevalent non-communicable diseases (NCDs) worldwide, with a high global average prevalence of 45%, affecting an estimated 3.5 billion people globally. With the acceleration of global aging, oral health issues among the older adults have become increasingly prominent. According to the global multi-country epidemiological survey and the WHO report, the prevalence of oral diseases in the elderly aged 65 and above showed a significant increase, and the burden of disease was concentrated on dental caries, periodontal disease and tooth loss. This article synthesizes recent epidemiological data on the rising prevalence of oral health problems in older adults(aged ≥ 65), including inflammatory or non-inflammatory oral diseases, such as dental caries, periodontal disease, tooth loss, oral cancer, dry mouth and dysphagia, illustrates their multidirectional connections with systemic health, their risk factors and prevention, finally advocates for integrating oral health into holistic geriatric care frameworks.

Comparative Plaque Removal Efficacy of a Power and a Manual Toothbrush Among Children With Cerebral Palsy - A Crossover Randomised Control Trial

2025-06-23

Muhammad Mohsin Haider , Sohail Saadat , Lubna Khan +5 more | Research Square (Research Square)

<title>Abstract</title> <bold>Objective: </bold>To assess the plaque removal efficacy of Power toothbrush versus manual toothbrush evaluated by improvement in oral hygiene status of 12-15 year age children with Cerebral Palsy.<bold> </bold> … <title>Abstract</title> <bold>Objective: </bold>To assess the plaque removal efficacy of Power toothbrush versus manual toothbrush evaluated by improvement in oral hygiene status of 12-15 year age children with Cerebral Palsy.<bold> </bold> <bold>Methods: </bold>A crossover randomized controlled trial with three month study duration on eighty Cerebral Palsy children were divided into two groups. Plaque index, gingival index & Oral Hygiene Index Simplified (OHI-S) used at baseline. The group I received a manual toothbrush and group II received Power toothbrush. After 4 weeks, parameters were reassessed. After 1 month washout, interventions were crossed-over. After 4 weeks markers were again recorded. The scores were compared and analyzed from baseline, after phase-I and phase-II.<bold> </bold> <bold>Results: </bold>Between group comparison showed no significant change at the end of phase-I (p>0.05). The median decreased from baseline pre intervention PI=2.0, GI=2.0 & OHI-S=3.5 to post intervention PI=1.45, GI=1.00 & OHI-S=1.90 for power brush and for manual brush pre intervention PI=2.00, GI=2.00, OHI-S=2.9 to post intervention PI=1.00, GI=0.90, OHI-S=1.25). After exchange of brushes there was a significant change at the end of phase-II (p<0.05).Highly significant for Post PI (p=0.000) and Post GI (p=0.000) and Post OHIS (p=0.002). The medians decreased from pre intervention PI=1.25, GI=1.00, OHIS=1.50 to PI=0.80, GI=0.35, OHIS=0.95 for power brush and PI=1.65, GI=1.30, OHIS=2.05 to PI=1.50, GI=1.15, OHIS=1.80 for manual brush. Within group comparison showed highly statistically significant values for both the groups. (p=<0.000). Median difference was greater for the power brush irrespective of the order of intervention given. <bold>Conclusion: </bold>The study shows that both the Power Brush and Manual Brush brought statistically significant reduction in oral parameters. However the median difference values were greater by the use of power brush. <bold>Trial registration:</bold> <underline>www.clinicaltrials.gov</underline> - Registration no. NCT05768568 (17-9-2021)

Comparative Evaluation of the Cariostatic and Antibacterial Efficacy of Nano Silver Fluoride With Silver Diamine Fluoride in Children With Special Health Care Needs: A Randomized Controlled Clinical Trial

2025-06-23

Asuk A A Dasofunjo K , Nupur Ninawe , Shivani Sawant +3 more | Cureus

The Use of AI PROMs in CYP and Clinicians

2025-06-23

Jenan Altaher , Susan Parekh , Fiona Ryan | Research Square (Research Square)

<title>Abstract</title> <bold>Background:</bold> Amelogenesis Imperfecta (AI) is a genetic enamel defect affecting both primary and permanent dentitions, often leading to functional, aesthetic, and psychosocial challenges. Patient Reported Outcome Measures (PROMs) are … <title>Abstract</title> <bold>Background:</bold> Amelogenesis Imperfecta (AI) is a genetic enamel defect affecting both primary and permanent dentitions, often leading to functional, aesthetic, and psychosocial challenges. Patient Reported Outcome Measures (PROMs) are increasingly used in paediatric dentistry, including ones developed for AI. <bold>Aim: </bold>To explore the impact of AI on oral health-related quality of life in children and young persons’ using an AI-specific PROM, and to assess clinician use of the PROM in the UK. <bold>Methods: </bold>This single-centre retrospective service evaluation involved children with AI who completed a 9-question PROM pre- and mid-treatment. Responses were analysed by treatment stage, age group, and AI subtype. Clinician feedback of the AI PROM was obtained via an online survey administered via the electronic platform Qualtrics™. <bold>Results:</bold> A total of 68 completed AI PROMs, with ages ranging between 7-19 were analysed at pre-treatment and mid-treatment stages. Younger children (under 13 years) were more likely to report functional difficulties, such as pain and eating challenges, while adolescents (over 13 years) more frequently expressed psychosocial concerns including bullying and low self-confidence. Notably, satisfaction with dental appearance increased from 26% to 42% by the mid-treatment stage. In the clinician feedback survey regarding use and effectiveness of the AI PROM, 23 paediatric dentists responded from a mailing list of 78, representing a 29.5% response rate. Of the clinicians familiar with the AI PROM, <bold>67% reported actively using it</bold> in their clinical practice. Most found the tool valuable for enhancing communication and supporting care planning, though some highlighted workflow constraints and difficulty interpreting subjective responses. <bold>Conclusion: </bold>The AI PROM, while non-validated, provided meaningful insights into patient experiences and supported more empathetic, patient-centred care. Incorporating clinician perspectives highlighted both its promise and areas for refinement. Further validation is needed to support broader clinical implementation.

Impact of Parental Knowledge on Prevention Risk of Caries in Seville Children Between 6 and 14 Years Old, Applying the CAMBRA Protocol

2025-06-23

Esther Pérez de Mora , José María Barrera-Mora , Marcela Arenas +2 more | Children

Background/Objectives: To explore the association between parental knowledge on dental caries prevention and the risk of caries in pediatric patients aged 6 to 14 years who reside in the province … Background/Objectives: To explore the association between parental knowledge on dental caries prevention and the risk of caries in pediatric patients aged 6 to 14 years who reside in the province of Seville, using the CAMBRA preventive protocol as an assessment tool. Methods: After the approval granted by the Ethics Committee, a descriptive and analytical observational study was conducted. Caries risk was established using the CAMBRA Questionnaire, pH measurement, and salivary flow rate. To assess the socioeconomic background of the patients and their hygiene and dietary habits, parents completed two surveys: the first about the quality of the patient’s diet, and the second directly related to the CAMBRA questionnaire used and validated by the University of Seville. Results: The final study sample consisted of 300 pediatric patients, aged 6 to 14 years, of whom 54% were boys and 46% were girls. The caries risk distribution was as follows: 33% low, 7% moderate, 48.6% high, and 11.3%. A total of 61.7% of the participants live in urban areas, while 38.3% are from peri-urban regions. There is a statistically significant association between socioeconomic status and family circumstances in children with a risk of caries. Furthermore, an association was established between caries risk, dietary habits, and oral hygiene. Conclusions: Parental knowledge about dental caries prevention and caries risk in children was found to have a strong association with reduced caries risk in children.

Comments on ‘Root Caries in Older Adults: A Co‐Citation Network Analysis (1980–2023)’ by Su and Chang

2025-06-21

Yuh‐Shan Ho , Nikolaos Christidis | Gerodontology

Trends in education-economy-related inequalities in the prevalence of early childhood untreated caries in Guangdong, China from 2005 to 2021

2025-06-21

Linxin Jiang , Shaohong Huang , Linmei Wu +6 more | BMC Oral Health

Early childhood untreated caries (ECC) has numerous adverse effects on children and remains more prevalent in Asia than the global average. Despite recent improvements in ECC prediction and treatment, inequalities … Early childhood untreated caries (ECC) has numerous adverse effects on children and remains more prevalent in Asia than the global average. Despite recent improvements in ECC prediction and treatment, inequalities related to parental education and economic status may persist and have potentially worsened in the context of the COVID-19 pandemic. This study analyzed the trends and associated factors of education- and economy- related inequalities in ECC among 5-year-old children in Guangdong, China, from 2005 to 2021. Data from three cross-sectional surveys from Guangdong, China, were utilized, including dental examinations of 2,584 five-year-old children and parental questionnaires. Logistic regression models and education-economy-related interactions were used to identify factors associated with ECC. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII), derived from linear regression models, were applied to access trends in inequalities over the survey years. Children living in rural areas (OR = 1.97, 95%CI = 1.47 to 2.64) and those who have dental visits because of treatment (OR = 5.73, 95%CI = 2.73 to 12.05) were associated with a higher chance of having ECC, compared to their urban and non-visiting counterparts. Children whose parents had high (OR = 0.53, 95%CI = 0.31 to 0.88) or medium (OR = 0.64, 95%CI = 0.41 to 0.99) educational levels and those had high (OR = 0.60, 95%CI = 0.43 to 0.85) and medium (OR = 0.59, 95%CI = 0.42 to 0.84) economic levels were associated with a lower chance of having ECC compared those with levels. The highest education- and economy- related SII were observed in 2005. These declined by 14.0 and 4.3% points, respectively, in 2015, but increased again by 9.8 and 0.4% points in 2021. Besides, inequality as measured by SII increased continuously in rural areas. The RII values reflected similar trends in inequality distribution. Children from rural areas, lower parental education and family economic level exhibited significantly higher ECC prevalence. The education- and economy- related inequalities persisted across different groups and demonstrated a downward trend overall, but inequalities have continued to rise in rural regions from 2005 to 2021.

Knowledge, practice, and challenges in the use of stainless steel crowns and the Hall technique among Yemeni general dental practitioners: a cross-sectional study

2025-06-20

Sarah Al-Rai , Mohanad A. Alyousefy , Zainab Al-Twaili +5 more | Frontiers in Oral Health

Objectives Stainless steel crowns (SSCs) and Hall technique (HT) are used to restore decayed primary molars. This study aimed to critically evaluate the practice, knowledge, and challenges faced by general … Objectives Stainless steel crowns (SSCs) and Hall technique (HT) are used to restore decayed primary molars. This study aimed to critically evaluate the practice, knowledge, and challenges faced by general dental practitioners (GDPs) in Yemen when restoring caries-affected primary molars using stainless steel crowns (SSCs) and the Hall technique (HT) in their routine clinical practice. Methods A web-based cross-sectional survey was randomly distributed among GDPs registered with the Yemeni Dental Association using a Google Form (Google LLC, California, USA). The questionnaire comprised 21 questions organized into four sections: demographic information, SSC and HT practice, knowledge of SSC and HT, and challenges in SSC placement and HT use. Results A total of 501 participants were included in the final analysis, with (54.7%) were females and (45.3%) were males. The majority graduated from public universities (68.5%). SSCs were used in daily practice by 51.3%, primarily for multisurface caries (67.3%). A low percentage used HT (30.1%), with the main concern being insertion difficulty due to lack of preparation (43.5%). Age and residency place significantly influenced SSC usage ( p = 0.01 and p &lt; 0.001, respectively). Frequent SSCs use was higher among dentists &gt;30 years and those with &gt;10 years of experience ( p &lt; 0.001). No demographic factors were associated with HT use. However, females and younger practitioners &lt;30 were more likely to report needing additional practical training ( p = 0.023 and p = 0.04, respectively). Conclusion Enhancing GDPs' knowledge and skills in SSCs and HT through updated curricula and training could improve and enhance pediatric dental care.

Exploring the Link between Sociodemographics, Oral Hygiene, Body Mass Index, and Dental Caries in Children Aged 6–13 Years: A Cross-sectional Study

2025-06-20

Yuanita Lely Rachmawati , Aufa Y Rahmah , Nahira F Azzahra +3 more | World Journal of Dentistry

CDS dental therapists win national award to improve dental care for autistic children

2025-06-20

| BDJ Team

Patient- and Clinician-Reported Oral Health Data in Primary Dental Care Practices in Lebanon

2025-06-20

Dany Daou , Antoine Choufani , Mohamad Mashmouchi +1 more | Cureus

Strategies for attracting and retaining dentists in deprived areas: A scoping review

2025-06-20

Ali Mohammad Mosadeghrad , Maryam Saadati , Mahnaz Afshari +3 more | Research Square (Research Square)

<title>Abstract</title> <bold>Objective (s)</bold> The shortage and improper distribution of dentists can prevent people from accessing oral and dental services, slow down the achievement of the Millennium Development Goals, and limit … <title>Abstract</title> <bold>Objective (s)</bold> The shortage and improper distribution of dentists can prevent people from accessing oral and dental services, slow down the achievement of the Millennium Development Goals, and limit the achievement of desirable health outcomes. Therefore, this study aimed to identify strategies for attracting and retaining dentists in deprived areas. <bold>Methods</bold> This study was carried out using a scoping review method. All published articles on strategies for attracting and retaining dentists in underprivileged areas until the end of January 2024 were searched and collected in 9 databases and search engine. 25 articles were analyzed using MAXQDA software. <bold>Results</bold> About 62 strategies were identified for attracting and retaining dentists in deprived areas and classified. The most frequent strategies include providing platforms for professional development and increasing continuous independence for dentists in remote areas, financial support policies for dentists by creating incentives such as mortgages or loan forgiveness, strengthening the infrastructure of villages in order to develop and increase the motivation of employees. Dentistry was the equitable distribution of manpower to reduce the workload in rural areas, the development of rural access to dental services by strengthening remote dental infrastructure and the development of transportation facilities to the workplace. <bold>Conclusion</bold> Implementation of effective interventions in financing, manpower, technology, equipment and medicine, information systems, service delivery and management and leadership lead to the attraction and retention of dentists in deprived areas. Therefore, health policy makers and managers should take appropriate measures for the attraction and retention of dentists in these areas.

Response to the Letter to the Editor Regarding ‘Root Caries in Older Adults: A Co‐Citation Network Analysis (1980–2023)’

2025-06-20

Wen‐Song Su , Ching‐Yi Chang | Gerodontology

Evaluation of Effectiveness of Silver Diamine Fluoride in Arresting Early Childhood Caries: A Prospective Study

2025-06-20

Anjumoni Daimary , Rajnish Kumar Verma , Linda F. Mirza +5 more | Journal of Pharmacy And Bioallied Sciences

A BSTRACT Introduction: Silver diamine fluoride (SDF) is a minimally invasive option for the arrest of early childhood caries (ECC). Its usage has been associated with significant reductions in caries … A BSTRACT Introduction: Silver diamine fluoride (SDF) is a minimally invasive option for the arrest of early childhood caries (ECC). Its usage has been associated with significant reductions in caries progression, providing a cost-effective solution in pediatric dental care. This research aims to evaluate the efficacy of SDF compared to sodium fluoride varnish in arresting ECC in preschool children. Methods: This randomized controlled trial included 120 preschool children aged 2–5 years with diagnosed ECC. Participants were randomly assigned to receive either 38% SDF application or sodium fluoride varnish. The primary outcome was caries arrest rate, measured at 6 months. Secondary outcomes included parental satisfaction and child “oral health-related quality of life (OHRQoL)”. Data analysis was performed using Chi-square and t-tests for comparison between groups. Results: At the 6-month follow-up, children who received SDF treatment demonstrated a significantly higher caries arrest rate (85%) compared to those who received sodium fluoride varnish (50%) ( P < 0.05). Parents reported higher satisfaction with the SDF treatment group, and improvements in OHRQoL were observed across both groups. Conclusion: SDF is a highly effectual treatment for arresting ECC in preschool children, offering a more efficacious option compared to traditional fluoride varnish treatments. Its application is well accepted by parents and positively impacts children’s OHRQoL.

Sleep Problems, Early Childhood Caries, and Oral Health‐Related Quality of Life: An Approach Using Structural Equation Modeling

2025-06-20

Caroline de Oliveira Rodrigues , Jéssica Madeira Bittencourt , Laura Jordana Santos Lima +3 more | International Journal of Paediatric Dentistry

ABSTRACT Background Early childhood caries (ECC) has a multifactorial nature. Objective This study aimed to develop a structural model to identify the association between possible sleep problems, ECC, and oral … ABSTRACT Background Early childhood caries (ECC) has a multifactorial nature. Objective This study aimed to develop a structural model to identify the association between possible sleep problems, ECC, and oral health‐related quality of life (OHRQoL). Design A cross‐sectional study was conducted with 575 children aged 3–5 years. ECC was assessed using the ICDAS‐II by calibrated dentists. Possible sleep problems were determined using the Children's Sleep Habits Questionnaire. OHRQoL was measured using the ECOHIS. Data were analyzed using structural equation modeling through Mplus, version 8.6. Results Children with more severe stages of ECC experienced dental pain (β = 0.712; p < 0.001), and the presence of dental pain was associated with more disturbed sleep (β = 0.723; p < 0.001). ECC and dental pain negatively impacted the child's (β = 0.208; p < 0.001; β = 0.750; p < 0.001) and the family's (β = 0.347; p < 0.001; β = 0.612; p < 0.001) OHRQoL, respectively. Conclusion An indirect association was found between ECC and children's sleep, mediated by the variable dental pain. ECC and dental pain were associated with higher OHRQoL scores.

Smiles Unseen: Assessment of Oral Health Status, Knowledge, Attitude, and Practice among Visually Impaired Adolescents in Tamil Nadu

2025-06-20

Saravanan Natarajan , Subban Ravi , Bharath Champakesan +2 more | World Journal of Dentistry

Integrating oral health into primary healthcare: lessons from project OHE-NCHeW (oral health education for nurses and community health workers) in Nigeria

2025-06-20

Abimbola M. Oladayo , Folake Barakat Lawal , Oyinkansola Sofola +7 more | Frontiers in Oral Health

Introduction Oral health disparities in Nigeria highlight the need to integrate basic oral health into Primary Health Care (PHC). Project OHE-NCHeW (Oral Health Education for Nurses and Community Health Workers) … Introduction Oral health disparities in Nigeria highlight the need to integrate basic oral health into Primary Health Care (PHC). Project OHE-NCHeW (Oral Health Education for Nurses and Community Health Workers) was developed to train PHC workers in providing basic oral health care, education, and referrals in underserved communities. This study explored the impact of the training program on participants' knowledge, referral practices, and patient outcomes, and gathered feedback to optimize the program for future implementation. Methods Using a qualitative phenomenological approach, five focus group discussions (FGDs) were conducted with participants to gather insights on knowledge acquisition, changes in referral practices, and barriers or facilitators to implementation. Audio recordings were transcribed verbatim and analyzed thematically using the CREATIVE framework. Additional feedback from trainers and observed patient impact were also considered. Results The trained PHC workers reported enhanced knowledge and confidence, resulting in improved patient education and referrals. Patients also noted better oral health literacy and increased trust in dental referrals. Facilitators viewed the program as valuable and feasible, emphasizing the importance of ongoing training, resource allocation, and policy integration to maintain the program's impact. Key barriers included insufficient resources, lack of supervision, and cultural beliefs. Discussion The pilot training enhanced PHC worker capacity and was positively perceived by trainers. Patients reportedly responded favorably, indicating potential impact. However, addressing identified systemic and resource barriers is crucial for sustainable integration. This study offers multi-perspective insights for optimizing oral health integration within PHC in similar settings.

The effect of periodontal status in the associations between socioeconomic status and cognitive performance: a mediation analysis in older adults

2025-06-19

Heming Zhang , Hongxia Xiang , Lin Zhang +2 more | Frontiers in Aging Neuroscience

Introduction The aim of this study is to analyse the association of socioeconomic status (SES) with cognitive performance, and the mediation effect of periodontal status in this relationship in the … Introduction The aim of this study is to analyse the association of socioeconomic status (SES) with cognitive performance, and the mediation effect of periodontal status in this relationship in the National Health and Nutrition Examination Survey (NHANES) database from 2011–2014. Methods The SES was evaluated based on poverty-income ratio (PIR), occupation, educational level, and health insurance using latent class analysis. Multivariable logistic regressions were used to determine the association of cognitive performance, examined by Consortium to Establish a Registry for Alzheimer’s Disease (CERAD) test, animal fluency test (AFT), and digit symbol substitution test (DSST), with SES, attachment loss (AL) and probing depth (PD). Multivariable linear regressions were used to explore the association of mean AL and mean PD with SES. A mediation analysis was conducted to examine the impact of mean AL and mean PD on the relationship between SES and cognitive performance. Results The study included 1,812 participants aged 60 years or older. In the fully adjusted model, SES showed a positive correlation with all three cognitive tests. Meanwhile, mean AL [odds ratio (OR) = 1.61; 95% confidence interval (CI): 1.33 to 1.95] and mean PD (OR = 2.14; 95% CI: 1.54 to 2.96) were inversely related to the DSST scores, accounting for 12.17 and 6.91% of the relationship between SES and DSST, respectively. The mediation effect of periodontal status in this association was significant only in non-HSB participants or in younger participants. Conclusion SES was negatively associated with periodontal status in older adults in the United States. Furthermore, the link between SES and cognitive performance can be partially explained by periodontal status.

The Impact of Peri‐Implant Diseases and Complications on Oral Health‐Related Quality of Life Following Dental Implant Therapy in Norway: A Cross‐Sectional Study

2025-06-19

Erik Klepsland Mauland , Mehrnaz Beheshti Maal , Elisabeth Lind Melbye +6 more | Clinical Oral Implants Research

ABSTRACT Objectives To report oral health‐related quality of life (OHRQoL) in a sample rehabilitated with dental implants and assess the influence of self‐reported implant complications and clinical peri‐implant status. A … ABSTRACT Objectives To report oral health‐related quality of life (OHRQoL) in a sample rehabilitated with dental implants and assess the influence of self‐reported implant complications and clinical peri‐implant status. A secondary aim was to investigate associations between OHIP‐14 scores and patient‐related variables. Materials and Methods The Norwegian National Insurance Scheme registry for implant rehabilitation in 2014 was searched, and patients ( n = 3083) were mailed a survey including OHIP‐14, questions about peri‐implant status, and patient‐related variables. A subsample was examined clinically ( n = 242). Associations of self‐reported implant complications and clinical peri‐implant status with OHIP‐14 scores were evaluated by the Kruskal–Wallis test and logistic regression models. Results The OHIP‐14 mean sum score reported by the 1299 survey respondents was 4.1 (± 6.4). Self‐report of complications was associated with higher OHIP‐14 scores in a dose‐dependent manner. Lower education (OR 1.54, 95% CI 1.05–2.22), female sex (OR 1.75, 95% CI 1.23–2.56), technical complication(s) (OR 1.58, 95% CI: 1.07–2.34), biological complication(s) (OR 2.41, 95% CI 1.67–3.49) and poor cleansability (OR 2.94, 95% CI 1.64–5.37) were associated ( p < 0.05) with higher OHIP‐14 mean sum scores in the adjusted regression model. For the 242 patients examined clinically, the OHIP‐14 mean sum score was 3.8 (± 6.5). Peri‐implant soft tissue dehiscence (OR 2.53, 95% CI 1.17–5.49) was associated with higher OHIP‐14 mean sum scores in the adjusted regression model. Conclusions OHIP‐14 scores were low in this study, indicating good OHRQoL following implant rehabilitation in Norway. Complications lowered OHRQoL in a dose–response manner, confirmed by self‐reports of complications and by the presence of peri‐implant soft tissue dehiscence.

STUDYING THE CAUSES AND CONSEQUENCES OF RESTORATION FAILURE AND POTENTIAL STRATEGIES FOR PREVENTION

2025-06-19

Dr.Quratulain , Dr.Unzila Memon , Dr.Suman Shujaat +3 more | Journal of medical & health sciences review.

Dental restoration failure is one of the major problems faced in dentistry and results in further treatment requirements, dissatisfaction by the patients, and increased costs. Therefore, a thorough knowledge of … Dental restoration failure is one of the major problems faced in dentistry and results in further treatment requirements, dissatisfaction by the patients, and increased costs. Therefore, a thorough knowledge of causes and consequences of restoration failure is necessary for designing effective preventive measures. Objective: The present study aimed to determine the causes and consequences leading to restoration failure and eventually develop prevention strategies. Methodology: This cross-sectional study was conducted in a dental clinic setting. Dental records of 100 middle-aged patients (25-50 years) from restoration failure were used for the record review study. Standardized Dental Record Extraction Form (SDREF) was used to extract the relevant clinical and demographic data. Patient Satisfaction Questionnaire (PSQ) was used to assess the satisfaction levels of patients with their dental restorations. Descriptive statistics and logistic regression were used for data analysis to determine factors associated with restoration failure. Results: The study reveals that 62% of those restoration failures are due to poor oral hygiene, 22% to inadequate restoration design, and 16% due to material failure. The logistic regression analysis demonstrated that a significant association was found between restoration failure and poor oral hygiene (OR=2.3, p<0.001). Results revealed that patient satisfaction was significantly lower among subjects experiencing restoration failures (mean: 2.9 vs. 4.1, p < 0.001). Conclusion: This study emphasized the importance of accurate restoration design, material, and the maintenance of acceptable oral hygiene standards in hindering restoration failure. The results will aid in developing evidence-based strategies to enhance restoration success rates and improve the patients' conditions.

Tooth brushing learning methods: time to change practice?

2025-06-19

Patrick Quinn , Máiréad Harding | Evidence-Based Dentistry

Abstract A Commentary on Leghrouz L, Khole M R, Splieth C H, Schmoekel J . Tooth Brushing Learning Methods: Differential or Conventional? – A Randomized Controlled Clinical Trial. Caries Res … Abstract A Commentary on Leghrouz L, Khole M R, Splieth C H, Schmoekel J . Tooth Brushing Learning Methods: Differential or Conventional? – A Randomized Controlled Clinical Trial. Caries Res 2024; 58: 399–406. Design A two-arm single-blinded randomised controlled clinical trial to investigate the effects of the differential learning method versus conventional tooth brushing instruction by assessing changes in plaque levels and gingivitis in children aged three to eight years. Case Selection Children aged three to eight years with poor oral hygiene at baseline, needing parental assistance with tooth brushing, and available to attend follow-up appointments were included in the study. Exclusion criteria included children with acute dental pain, those with serious systemic diseases requiring special attention during dental care, and those who refused to participate in the study. Participants were randomly assigned to the test and control groups by self-drawing an unlabelled envelope from a box. The sealed envelopes contained oral hygiene instructions with exercises to use the differential learning method for the test group and children in the control group received the usual tooth brushing instructions. Participants were asked to follow the instructions at home for 28 days. Data Analysis The sample size was calculated according to previous similar oral hygiene studies, with a final sample size of 29 participants in each group to allow for dropouts of approximately 30%. Data was analysed using Microsoft Excel, with the significance threshold set at p < 0.05. Descriptive analysis included the calculation of means, standard deviation, absolute numbers, and percentages. Comparisons between the two groups were made using the independent samples t -test for quantitative variables and the chi-squared test for categorical variables. Results Two calibrated and blinded examiners recorded the papillary bleeding index (PBI) and the Quigley-Hein Index for dental plaque (QHI) at baseline and at the first and second recall visits at four and twelve weeks respectively. Of the 58 children recruited for the study, 46 were included in the final analysis with 22 in the control group and 24 in the test group. At baseline, there were no significant differences between the groups with respect to plaque and gingival indices. At the first recall, a statistically significant difference in the PBI index was found in favour of the test group (test: 0.1 ± 0.2 v. control: 0.3 ± 0.2; p < 0.001) but the difference in relation to the QHI index was not statistically significant (test: 2.1 ± 0.9 v. control 2.6 ± 0.9; p = 0.07). At the second recall, statistically significant differences in both indices were found in favour of the test group (PBI test: 0.1 ± 0.2 v. PBI control: 0.5 ± 0.2; p < 0.001; QHI test: 2.1 ± 0.9 v. QHI control: 3.2 ± 1; p < 0.001). Conclusions The authors of the study concluded that simple instructions with the differential learning method for home tooth brushing can lead to significantly greater improvements in oral hygiene in children with poor oral hygiene when compared to traditional instructions, particularly in the medium term retention phase.

Regional Disparities in User Perception of Oral Health in Brazil’s Primary Care: An Integrative Review

2025-06-19

Patrícia Silva Chaves , Yago Cesar Do Nascimento Souza , Yann Nobre Viana +5 more | Archives of Current Research International

Aim: One of the alternatives used to evaluate the quality of dental services is the use of instruments, which provide an analysis of the user's perception of health care in … Aim: One of the alternatives used to evaluate the quality of dental services is the use of instruments, which provide an analysis of the user's perception of health care in the service. The study aims to identify regional differences in the quality of oral health in Primary Health Care (PHC) from the perspective of service users. Study Design: This is an Integrative Literature Review. Methodology: This is a qualitative study using the Scielo, Bireme and PubMed databases. By crossing the descriptors “Health Assessment”, “Primary Health Care”, “Oral Health”, and “Brazil”, 661 studies were obtained, of which 14 were selected for meeting the inclusion criteria. No specific and relevant studies were found for other regions of Brazil, such as the North, Central West regions. Results: The results of the studies in the different regions of Brazil showed similarities. It was found that women, elderly people, those with low levels of education and socioeconomic status were more expressive in the use and evaluation of services, exposing the need for Public Policies that recognize the user's vision as a means of improving the service provided by PHC.

Drug Court Smiles: Addressing Dental Care Equity for Justice-Involved People

2025-06-19

Linda Kahn-DAngelo , Maximilian J. Brimmer , Matthew C. Thomas +4 more | Health Promotion Practice

People in the criminal justice system, especially those enrolled in drug treatment courts, have complex health profiles, limited access to medical and dental care, and a high prevalence of substance … People in the criminal justice system, especially those enrolled in drug treatment courts, have complex health profiles, limited access to medical and dental care, and a high prevalence of substance use disorders (SUD). SUD is associated with poor oral health, including severe dental caries and periodontal disease. Both poor oral health and SUD can contribute to low self-esteem and stigma that pose barriers to seeking care. The aim of this study is to examine dental care and oral health disparities among community-dwelling justice-involved people with SUD enrolled in the drug treatment courts. We surveyed clients (N = 59) and leadership team members (n = 23) in four drug treatment courts. Clients responded to questions about dental care needs and self-reported oral health; leadership team members provided their perspectives on clients’ oral health needs and barriers to care. Most clients (61%) rated their oral health as fair to very poor, and 27% had not seen a dentist in at least 3 years. Most (70%) leadership team members indicated that clients had occasionally or frequently discussed an oral health problem and 26% noted that clients occasionally or frequently missed court due to dental pain. Both clients and team members identified cost, transportation, fear, and stigma as key barriers to addressing clients’ dental health needs. Improving oral health for justice-involved people with SUD may entail a multifaceted approach to address these barriers, and might consider novel approaches, such as co-locating dental and SUD providers.

Topical fluoride and regulation of salivary pH in Peruvian Altiplano schoolchildren: a comparative longitudinal study

2025-06-19

Vilma Mamani-Cori , Talia Paola Calcina-Asillo , Marleny Chino-Mamani +6 more | Frontiers in Oral Health

Introduction Saliva acts as a natural buffer, neutralizing the acids produced by bacterial metabolism. Maintaining salivary pH in a range close to neutrality is essential for enamel remineralization processes. This … Introduction Saliva acts as a natural buffer, neutralizing the acids produced by bacterial metabolism. Maintaining salivary pH in a range close to neutrality is essential for enamel remineralization processes. This study aimed to evaluate and compare the effect of different concentrations and formulations of topical fluoride on the regulation of salivary pH in schoolchildren from the Altiplano region of Peru. Method A quantitative, longitudinal, double-blind, randomized experimental design was employed. A total of 200 children aged 6–12 years who voluntarily agreed to participate were randomly and equally distributed into four study groups. To ensure homogeneous assignment, sociodemographic variables (sex, family type, age, number of siblings, and frequency of daily brushing) and clinical variables (caries severity and oral hygiene level) were controlled. Data were analyzed using SPSS version 25.0. The Shapiro–Wilk test assessed normality ( p &lt; 0.05), while Kruskal–Wallis test was used for between-group comparisons and the Friedman test for intragroup comparisons. Results Intragroup analysis revealed statistically differences in salivary pH at initial, post-brushing, 10, 30, 60 min and 24-hours measurements across all groups (Friedman's Test; p &lt; 0.001). Between-group comparisons also showed significant differences in salivary pH at 10, 30, 60 min, and at 24 and 48 h (Kruskal–Wallis test; p &lt; 0.05). Conclusion In conclusion, the 5% fluoride varnish and fluoride gels (1.23% and 2%) demonstrated greater efficacy in regulating salivary pH, especially during the initial hours following application.

Editorial: Improving children's oral health

2025-06-18

Phoebe Pui Ying Lam , Duangporn Duangthip | Frontiers in Oral Health

Assessment of Oral Health-related Quality of Life and Self-esteem among Cigarette Smokers of Different Nicotine Dependence Levels in Chennai: A Cross-sectional Study

2025-06-18

Pallavi Ammu Thomas , B Saravana Kumar | Advances in Human Biology

Abstract Introduction: Cigarette smoking has a profound impact on oral health-related quality of life (OHRQoL) and self-esteem. Nicotine dependence exacerbates oral health deterioration, leading to dental issues such as periodontal … Abstract Introduction: Cigarette smoking has a profound impact on oral health-related quality of life (OHRQoL) and self-esteem. Nicotine dependence exacerbates oral health deterioration, leading to dental issues such as periodontal disease and halitosis, which in turn affect psychological well-being. The study aims to assess the impact of nicotine dependence levels on OHRQoL and self-esteem among cigarette smokers in Chennai. Materials and Methods: A cross-sectional study was carried out among 160 cigarette smokers at a tertiary hospital-based tobacco cessation centre. Participants were categorised into nicotine dependence levels using the Fagerström Test and carbon monoxide levels. Oral Health Impact Profile-14 was taken to analyse the OHRQoL while self-esteem was measured with the Rosenberg Self-Esteem Scale. Analysis was performed with one-way analysis of variance and Spearman’s correlation coefficient was performed to determine associations. Results: Higher nicotine dependence levels were significantly associated with poorer OHRQoL scores and lower self-esteem ( P < 0.001). Functional limitation, psychological discomfort and physical pain were most affected. Participants with high nicotine dependence reported the lowest self-esteem due to oral health concerns and social stigma. Conclusions: The results indicate the impact of oral health in association with self-esteem due to nicotine dependence where higher dependence to nicotine worsens OHRQoL and lowers confidence, emphasising focus on targeting smoking cessation programs and interventions on oral health to improve overall well-being.

Oral Health Meets Commercial Determinants: An Opportunity to Bridge Individual and Structural Approaches

2025-06-18

MS Hopcraft , Adyya Gupta , Ankur Singh +1 more | Australian Dental Journal

ABSTRACT Oral diseases are among the most prevalent conditions affecting Australians, yet oral health agendas often focus on individual treatment rather than prevention at the population level. Viewing oral health … ABSTRACT Oral diseases are among the most prevalent conditions affecting Australians, yet oral health agendas often focus on individual treatment rather than prevention at the population level. Viewing oral health through a commercial determinants of health lens provides an opportunity to bridge this treatment‐centred approach with a prevention‐focused agenda that targets structural determinants of oral health—the causes of the causes. We highlight the role of structural and commercial factors, operating outside an individual's control, that drive the high prevalence of oral disease and inequities at a population level. Good oral health is a human right, and the role of commercial actors must be acknowledged and addressed to improve health and reduce inequities.

Carer perspectives on overweight, obesity and dental caries in early childhood: findings from a systematic qualitative review

2025-06-18

Heilok Cheng , Rebecca Chen , Bradley Christian +3 more | Frontiers in Oral Health

Introduction Formula and bottle feeding behaviours can increase obesity and tooth decay (early childhood caries, ECC) in early childhood, through non-responsive feeding and prolonged exposure to sugar. Parents’ beliefs can … Introduction Formula and bottle feeding behaviours can increase obesity and tooth decay (early childhood caries, ECC) in early childhood, through non-responsive feeding and prolonged exposure to sugar. Parents’ beliefs can be barriers to behaviour change for obesity and ECC prevention. Understanding these beliefs towards children's teeth and weight can address parents’ priorities and develop prevention messages. This qualitative systematic review (PROSPERO registration #CRD42022348783) aimed to identify parent or carer perspectives on obesity and ECC in children aged ≤6 years. Methods Database searching of CINAHL, Medline and EMBASE, with hand searching, was undertaken. Included papers were qualitative research publications, focused on parent or carer beliefs and attitudes towards overweight, obesity or ECC in infants and children. Inductive thematic analysis was undertaken to generate themes, with a strengths-based approach focused on parents’ lived experience. Quality appraisal was undertaken with the CASP Qualitative Checklist. Descriptive characteristics of the study and participants, and qualitative findings, were extracted qualitatively in NVivo. Results 7,365 references were identified from database and hand searching, with 98 references included for analysis. Three research themes were generated: (1) parenting to support child wellness, including healthy teeth and weight; (2) parents’ response to unwellness, including identifying symptoms, causes and protective factors for unhealthy weight and teeth; (3) information and resources needed to support healthy weight and teeth. There was high or potential risk of bias in qualitative methodology when studies did not address researcher-participant relationships or rigorous data analysis processes. Discussion Findings highlight the need for strength-based messages for children's teeth and weight, increased understanding of formula and bottle feeding as obesity and ECC risk factors, and holistic approaches to care by dental and primary care professionals. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/view/CRD42022348783 , PROSPERO CRD42022348783.

Preventing the Risk of Dental Problems in Children With Special Health Care Needs: A Case Series

2025-06-18

Varsha Sharma , Sushmita Pattnaik , Brahmananda Dutta +3 more | Cureus

The Importance of Interprofessional Dental Care in the Community in the United States

2025-06-17

Sangeeta Gajendra , Walter J. Psoter | JDR Clinical & Translational Research

There is a growing sense of urgency to address the oral health needs in the United States. The increased burden of oral diseases is compounded by the lack of access … There is a growing sense of urgency to address the oral health needs in the United States. The increased burden of oral diseases is compounded by the lack of access to dental care, including the lack of adequate providers to treat the underserved and disadvantaged population, leading to an exponential use of the emergency department for nontraumatic dental conditions. Strategies need to focus on the inadequacies of the current U.S. oral health care system not only to prevent and treat oral diseases but also to reduce oral health disparities. Several studies have underscored the need for collaborative efforts and community partnerships to improve oral health care access for the disadvantaged population. Public health as well as institutions in charge of professional training should implement innovative strategies that address barriers to increasing access to dental care through organized community efforts. Community-based learning and interprofessional collaboration are key strategies proposed by international and national organizations to address these concerns. Opportunities for extramural rotations are now provided by dental schools to all dental students and trainees to fulfill the Commission on Dental Accreditation’s requirement of community-based learning. Community partnerships with academia can help improve access to dental care and increase the efficacy and efficiency between dental and primary care professionals for better integration and care coordination. In this article, the authors reviewed policy statements and position papers of health care agencies as well as the scientific literature on interprofessional dental education and collaborative practice in the community. Working with multidisciplinary teams, dental providers can provide distinctive insights and can add value to the team. With appropriate interprofessional education and practice in communities, robust community–academic partnerships can be built. The future health care workforce can address the needs of the diverse and ever-evolving patient population to prevent, diagnose, and treat oral and systemic diseases. Knowledge Transfer Statement: This article will help dental students, trainees, and academicians understand the issues related to access to dental care and how collaborative partnerships in the community, including interprofessional dental education and care, can help alleviate this problem.

All in for Integration: Oral Health in Interprofessional Education and Training

2025-06-17

Christine A. Riedy , Md. Ahshanul Haque , Shenam Ticku | JDR Clinical & Translational Research

Stark inequities exist in oral health care access with minoritized and marginalized populations facing more barriers to attaining care than the general population does. Considerably more individuals have access to … Stark inequities exist in oral health care access with minoritized and marginalized populations facing more barriers to attaining care than the general population does. Considerably more individuals have access to primary health care than to dental services. The high prevalence of access to primary care services relative to dental services suggests a key role for primary care providers to address the oral health needs of patients. A limiting factor is a lack of uniformity of standards and curricula that exist for integrating oral health into primary care training disciplines. Based on the Center for Integration of Primary Care and Oral Health’s (CIPCOH) research over the past 5 y, we have developed broad recommendations for training programs across the primary care spectrum: (1) support champion training programs that incorporate promising and/or best practices, (2) incorporate oral health into interprofessional standards, and (3) establish a curricular and evaluation framework for oral health integration into primary care training. Knowledge Transfer Statement: The recommendations from this article can be used by primary care educators and policy makers to better integrate oral health into primary care training programs and ensure a competent primary care workforce.

Role of Dentistry in Interprofessional Primary Care

2025-06-17

K. West , J. Stewart , Marsha A. Pyle | JDR Clinical & Translational Research

Each day there is growing evidence surrounding the relationship of oral disease and general health. With increasing recognition of the science describing the nature of associations between oral health and … Each day there is growing evidence surrounding the relationship of oral disease and general health. With increasing recognition of the science describing the nature of associations between oral health and general health, as well as the global acknowledgment of oral disease as one of the most common noncommunicable diseases, global attention of dentistry’s role in primary care and universal health coverage is increasing. As the evidence continues to mount, opportunities to modify existing health care systems and related barriers will elevate policy, programs, training, and the need for public health approaches to transcend existing inflexible health care operations, training, and research. Oral health has a critical role in collaborative actions to improve the health of individuals and communities. Knowledge Transfer Statement: Oral health is an essential component of general health. Including oral health within health systems, processes, and training is critical to the health of individuals and communities.

Primary Care Integration into Postdoctoral Dental Curricula: A Cross-Sectional National Survey

2025-06-17

Shenam Ticku , Tao Jiang , Betty Ben Dor +1 more | JDR Clinical & Translational Research

Background: Dental providers frequently deliver care for individuals with chronic medical conditions (CMCs) such as hypertension, diabetes mellitus, and obesity and should be prepared to address their oral and systemic … Background: Dental providers frequently deliver care for individuals with chronic medical conditions (CMCs) such as hypertension, diabetes mellitus, and obesity and should be prepared to address their oral and systemic health needs. The goal of this study was to assess the current integration of CMC education into advanced education in general dentistry (AEGD) and general practice residency (GPR) curricula. Methods: A 46-question cross-sectional survey was sent electronically to all 265 U.S. AEGD and GPR program directors (PDs) in February 2019. The survey consisted of multiple-choice questions about CMC curricular content, mode of delivery, barriers to teaching the content, evaluation technique, and competence of residents upon graduation. The survey was adapted from relevant literature and prior validated surveys. The data were analyzed using univariate statistics such as frequencies and percentages to describe all survey items. Results: Of the 265 programs surveyed, 42% of PDs responded ( N = 111). Most agreed that it was important for residents to receive training to identify diabetes (88%), hypertension (90%), and obesity (78%). However, only 62% of PDs taught their residents to identify obesity compared with hypertension (90%) and diabetes (85%). Regarding health assessments, nearly half the PDs reported that their residents do not collect body mass index for obesity, while only 12% and 4% were not collecting HbA1c values and blood pressure, respectively. In addition, among residents being evaluated, 65% of PDs agreed that their residents were competent in knowing health system resources for obesity compared with hypertension (78%) and diabetes (76%). Conclusion: While most programs are teaching their residents to identify diabetes and hypertension, greater focus on obesity is needed. Increased efforts should be devoted to closing this gap in dental training so that residents are comfortable not only discussing medical conditions with their patients but also with performing regular chairside examinations, providing counseling, and making appropriate referrals. Knowledge Transfer Statement: The results of this study can be used by educators charged with creating and revising curricula for postgraduate dental residency programs. Knowing the current status of the integration of primary care topics into such programs can assist in the identification of existing curricular gaps and solutions to barriers. This could lead to the development of better integrated curricula, which will result in more comprehensive care for patients.

Dental Faculty Knowledge, Attitudes, and Willingness to Treat Pregnant Persons at 2 Institutions

2025-06-17

Linda Rasubala , Stefanie L. Russell , Yan‐Fang Ren +4 more | JDR Clinical & Translational Research

Objectives: Physiologic and behavioral changes during pregnancy adversely affect oral health. Despite practice guidelines stating that dental care is a safe and necessary part of prenatal care, some dental providers … Objectives: Physiologic and behavioral changes during pregnancy adversely affect oral health. Despite practice guidelines stating that dental care is a safe and necessary part of prenatal care, some dental providers remain reluctant to treat pregnant persons. Only a single investigation (at New York University [NYU]) has evaluated the knowledge, attitudes, and willingness of dental faculty to treat pregnant persons. Faculty affect the treatment preferences of their students and therefore have an outsized influence on prenatal dental care. Methods: We cross-sectionally administered an anonymous 14-item REDCap survey to faculty from the Eastman Institute for Oral Health, School of Medicine and Dentistry, University of Rochester (UR), to evaluate their knowledge, attitudes, and willingness to provide dental treatment for pregnant persons. We compared these results against NYU data. Results: Sixty-five (72.2%) UR faculty completed the survey. Most agreed that women should see a dentist during pregnancy (90.8%) and that dental treatment should be part of prenatal care (98.5%). However, only 47.7% were aware of professional practice guidelines for oral health during pregnancy, and 21.5% reported liability concerns when treating pregnant persons. UR faculty knew more about the relationship between maternal and child oral health than NYU faculty. Using the combined data set (UR + NYU), we found that concern about liability was a significant predictor of unwillingness to treat pregnant persons, and this relationship remained when controlling for knowledge and covariates. Conclusion: While dental faculty’s knowledge and attitudes were generally in line with current guidelines for oral care during pregnancy, 1 in 5 UR faculty reported liability concerns. In the combined data set, we found that those with liability concerns were 5 times more unwilling to provide dental care to pregnant persons. Continuing education based on evidence and current guidelines on oral health in pregnant women should be considered necessary but may be insufficient to improve dental care for pregnant women. Knowledge Transfer Statement: In the United States, only about 50% of pregnant persons report a dental visit during this vulnerable time. Dental faculty members transfer their beliefs, knowledge, attitudes, and willingness to treat pregnant persons to their students. These study results demonstrate that many faculty are unaware of the professional practice guidelines and that knowledge and attitudes affect willingness to treat pregnant persons. Continuing education based on current guidelines for the oral health of pregnant persons is necessary but may be insufficient to affect willingness.

Barriers and Facilitators to Topical Fluoride Varnish Application in Well-Child Visits

2025-06-17

Stephanie A. Gill , Debbie Ho , Susan Veldheer +4 more | JDR Clinical & Translational Research

Introduction: Dental caries is the most common chronic childhood disease in the United States. Topical fluoride varnish (TFV) is a simple evidence-based preventive procedure shown to reduce early childhood caries … Introduction: Dental caries is the most common chronic childhood disease in the United States. Topical fluoride varnish (TFV) is a simple evidence-based preventive procedure shown to reduce early childhood caries and is approved for the primary care setting; however, rates of TFV application nationally are low. Less than 10% of eligible children received TFV at 1 academic family medicine group during well-child visits. This study assessed the clinician-reported barriers and facilitators to TFV application in that group to inform quality improvement efforts. Methods: Using an exploratory sequential design, we developed a 29-item survey assessing knowledge, attitudes, and perceived barriers and facilitators to TFV application. The survey was distributed to outpatient family medicine practice clinicians in a mid-Atlantic academic health center in July 2020. Data were analyzed by univariate descriptive statistics. Results: Of 163 eligible clinicians, 93 (57%) completed the survey, including 60 MD/DO attending physicians, 12 advanced practice clinicians (5 physician assistants, 7 nurse practitioners), and 21 resident physicians. The most frequently reported facilitator was having TFV supplies preplaced in the examination room (92%), followed by nursing staff providing patient education (84%). The most frequently reported barrier was time constraints (61%), followed by the belief that dentists already provide TFV (47%). Advanced practice clinicians expressed a greater need for hands-on training, while residents prioritized refreshers on eligibility and billing. Attending physicians were more likely to report insufficient time for parent education as a barrier. Conclusions: The study highlights key workflow and education-related barriers affecting TFV application in family medicine. Strategies such as interprofessional workflow optimization, previsit planning, and enhanced EHR documentation may address these barriers. Findings support the need for quality improvement initiatives to integrate TFV more effectively into routine pediatric preventive care, ultimately improving early childhood caries prevention. Knowledge Transfer Statement: Despite recommendations for topical fluoride varnish in primary medical care, application rates remain low due to time constraints, workflow inefficiencies, and unclear clinician roles. This study identifies key barriers and facilitators, highlighting the need for team-based workflows, previsit planning, electronic health record enhancements, and targeted training. Findings can inform quality improvement initiatives to streamline topical fluoride varnish application, optimize interprofessional collaboration, and enhance early childhood caries prevention in primary medical care settings.

Economic evaluation of dental prevention programmes in primary schools: a scoping review

2025-06-17

Rosanna Orlando , Samia Turkistani , Chris Louca +1 more | Research Square (Research Square)

<title>Abstract</title> Introduction: Evidence for Economic Evaluations (EEs) is essential for informed decision-making in healthcare. This scoping review of economic studies based on school dental screening and prevention programmes summaries the … <title>Abstract</title> Introduction: Evidence for Economic Evaluations (EEs) is essential for informed decision-making in healthcare. This scoping review of economic studies based on school dental screening and prevention programmes summaries the key facts in a narrative format and analyses knowledge gaps. Aim: This scoping review mapped the existing literature on EEs in school dental screening and prevention, and assessed the completeness of reporting using the CHEERS 2022 checklist. Methods: A comprehensive literature search was conducted across four databases for EEs with no date restriction. EEs of school-based dental prevention programmes were included and grouped into three categories based on the intervention focus: prevention only, combined prevention and treatment interventions, and screening interventions. Quality assessment was conducted using CHEERS checklist. Results: A total of 11 EEs met inclusion criteria. While most studies reported short-term outcomes, fewer than half adequately estimated future cost saving. Discussion: The evidence base for economic evaluations in school-based caries prevention is fragmented, with many studies focusing on isolated components rather than broader, integrated models of care. Conclusion: Caries prevention is a long-term investment, and evaluations should account for future reduced treatment needs. More comprehensive and context-sensitive evaluations are needed to guide resource allocation and improve long-term oral health outcomes for children.

Parental Knowledge, Attitudes, and Practices and Their Association with Dental Caries in Children Aged 5–9 Years: A Cross-Sectional Study in Rural Ecuador

2025-06-17

María Gabriela Saquicela-Pulla , Mónica Beatriz Dávila Arcentales , Eleonor Vélez-León +2 more | International Journal of Environmental Research and Public Health

Childhood dental caries remains a critical public health issue in rural areas, where caregivers' knowledge, attitudes, and practices (KAP) significantly influence oral health outcomes. This study assessed the association between … Childhood dental caries remains a critical public health issue in rural areas, where caregivers' knowledge, attitudes, and practices (KAP) significantly influence oral health outcomes. This study assessed the association between parental KAP and the prevalence and severity of caries in children aged 5-9 years in Cayambe, Ecuador. A cross-sectional study was conducted with 229 schoolchildren and their caregivers, using a validated questionnaire and clinical examinations (ICDAS criteria). Caries severity was categorized as "obvious decay" (ICDAS 4-6) or "no obvious decay" (ICDAS 0-3). Advanced dental caries affected 73.4% of children (ICDAS 4-6). While parental knowledge and attitudes showed no significant association, brushing teeth ≥2 times/day significantly reduced caries severity (p < 0.05). Sociodemographic factors, such as parental education, were not significant predictors. Oral hygiene practices-particularly frequent toothbrushing-were the key protective factor against severe caries, highlighting the need for behavior-focused interventions promoting daily habits. Future research should evaluate long-term preventive strategies.

Challenges in Accessing Dental Care for Special Care Populations in Jazan, Saudi Arabia: A Study among Health Professionals and Caregivers

2025-06-17

Mohammed Najmuddin , Yaser Ali Alhazmi , Safeena Abdul Khader Saheb +7 more | European Journal of General Dentistry

Abstract Those with disabilities lack access to adequate dental health care services that are fundamental for maintaining their oral health. The study was primarily conducted to identify the actual barriers … Abstract Those with disabilities lack access to adequate dental health care services that are fundamental for maintaining their oral health. The study was primarily conducted to identify the actual barriers to dental care services for disabled patients. The study aimed to find the perfect solution capable of addressing the problems encountered by both dental practitioners and disabled patients. The present cross-sectional study was performed on 160 study subjects, 100 including parents and patients and 60 dental professionals including consultants, dental practitioners, interns, and dental undergraduate students, by using two self-administered structured questionnaires for both groups. The demographic variables and any information by parents and dental professionals that might be helpful in managing the treatment of disabled children were recorded. The data obtained was subjected to statistical analysis using IBM SPSS version 20.0 software. Note that 56.7% of the dental professionals who participated in the study were dental interns in the age group of 20 to 25 years belonging to the Saudi region. Majority of these dental professionals treated disabled children during their dental practice and even acquired specialized training for their management. While a majority of the hospitals comprise of renowned facilities for managing disabled children, right from parking facilities to wheelchairs, most of them lack special facilities like signboards, special toilets, adequate equipment, trained associates, pharmacy, etc. Most of the parents of these disabled children come from rural areas having only secondary education levels. A majority of the patients were physically disabled and suffered from dental problems, the most prevalent one being dental caries. Most parents discovered that the brushing methodology contributed to such dental problems. Few parents blamed the unavailability of equipment as a barrier to getting treated. Most parents were worried constantly over treatment costs and were fearful to get treated. Despite dental care provided to parents and caregivers of disabled individuals, it is our observation that the numbers are still inadequate in the Jazan region, Saudi Arabia. The most common barriers for this include treatment cost and the constant fear of getting the dental treatment done by a dental care provider.

Barriers and Facilitators to Providing Preventive Dental Care for Young Children in Dental Settings

2025-06-17

Sarah L. Goff , Charlotte F. Gilson , Marisa C. DaCosta +2 more | Journal of Public Health Dentistry

ABSTRACT Objectives This qualitative study aimed to understand dental professionals' perspectives and practices regarding preventive dental care for very young children and preventive oral health services (POHS) provided outside of … ABSTRACT Objectives This qualitative study aimed to understand dental professionals' perspectives and practices regarding preventive dental care for very young children and preventive oral health services (POHS) provided outside of dental practices. Methods Semi‐structured interviews were conducted on Zoom with a purposive sample of dental professionals in Massachusetts between December 12, 2022, and June 15, 2023, until theoretical saturation was reached. The Consolidated Framework for Implementation Research was the study's conceptual framework. Applying Charmaz's approach to grounded theory, transcripts were coded line‐by‐line in an iterative process, using memos and axial coding to identify themes. Results Twenty‐eight interviews were conducted with general dentists ( n = 18), pediatric dentists ( n = 5), registered dental hygienists ( n = 3), a dental assistant ( n = 1), and a dental administrator ( n = 1). Major themes included: (1) facilitators and barriers to providing preventive dental care for children under 3 years old; (2) perceptions of POHS delivery outside of dental practices and care coordination; (3) public policies potentially impacting the provision of preventive dental care for young children; and (4) potential levers for change to improve receipt of recommended preventive dental services. Sub‐themes included training, concerns about the quality of care in non‐dental sites, public insurance barriers, and increasing joint dental‐medical curriculum programs. Conclusions Potentially modifiable barriers were identified at provider, practice, and policy levels. Further research is needed regarding the financial impacts of public insurance reimbursement rates, the potential role of bias in access to preventive dental services, and the effects of systematic accountability for performance on quality and equity measures related to preventive dental care.

Application and effectiveness of experiential education combined with health coaching techniques in extended care for elderly patients with dental implants

2025-06-17

Juan Huang , Fanghua Gong , Chen Zhou +2 more | Frontiers in Oral Health

Objective Experiential education (EE) and health coaching techniques (HCT) were proved to be effective in health management. This study investigated the effectiveness of EE combined with HCT in extended care … Objective Experiential education (EE) and health coaching techniques (HCT) were proved to be effective in health management. This study investigated the effectiveness of EE combined with HCT in extended care for elderly patients with dental implants. Methods A total of 90 elderly patients who received implant restoration were randomly divided into intervention group (IG) and control group (CG). CG received standard health education. IG received EE, HCT and standard health education. Periodontal conditions of peri-implants (plaque Index, PLI; sulcus bleeding index, SBI; gingival Index, GI) were assessed at 1-, 3-, and 6-months. Oral health self-efficacy and implant survival rates after 6 months were compared between two groups. Results No significant differences in periodontal indices were observed between groups at 1 and 3 months post-intervention. After 6 months of intervention, the experimental group showed significantly superior PLI, mSBI, and GI scores relative to the control group ( P &lt; 0.05). IG also showed an improvement in oral health self-efficacy compared to the CG ( P &lt; 0.05). The implant survival rate in the IG was higher than in the CG after 6 months, but the difference was not significant. Conclusion EE combined with HCT improves oral health self-efficacy and periodontal health in elderly patients with dental implants.

Disparities in Oral Health Among Middle and Old Ages in the United States: The Association of Minority and Immigrant Status

2025-06-17

Chengming Han | Research Square (Research Square)

<title>Abstract</title> Objectives This paper explores the joint effects of minority and immigrant status on dentist visits and missing teeth among adults aged 45 years and older in the United States. … <title>Abstract</title> Objectives This paper explores the joint effects of minority and immigrant status on dentist visits and missing teeth among adults aged 45 years and older in the United States. Methods This is a cross-sectional study with data from National Health and Nutrition Examination Surveys (NHANES) 2011–2018. Five racial/ethnic groups were included: whites, blacks, Mexican Americans, other Hispanic Americans, and Asian Americans. Interaction effects were included to estimate the heterogeneity of minority and immigrant status. A series of ordinal logistic regression was employed to analyze the association on missing teeth. Coefficient tests were used to examine the effect size of slope difference between whites and minorities. Results Irregular dentist visits were associated with markedly higher odds of tooth loss for whites than for minorities. Being foreign-born indicates more missing teeth for Non-Mexican Hispanic Americans (OR = 1.538, 95%CI = 1.202–1.968) and Asian Americans (OR = 1.653, 95%CI = 1.237–2.209), but is associated with lower odds of irregular dentist visits for whites (OR = 0.539, 95%CI = 0.387–0.751) and Mexican Americans (OR = 0.655, 95%CI = 0.457–0.940). Non-U.S. citizen was associated with lower odds of irregular dentist visits for blacks (OR = 0.569, 95%CI = 0.379–0.816) and less missing teeth for blacks (OR = 0.361, 95%CI = 0.219–0.597). Discussion Racial disparities persist in middle and old age in dentist visits and missing teeth. Whether being foreign-born or using a non-English language in daily life is a risk or protective factor depends on the racial/ethnic group

Determinantes del acceso a la salud dental en España

2025-06-17

Sofía Ruíz Campo , Sergio Zúñiga-Jara , Karla Soria-Barreto | Atención Primaria