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Objective: To assess the association between dental anxiety and caries experience from late childhood through adolescence and into early adulthood (12, 15 and 18 years old, respectively). Methods: A prospective cohort study was conducted among a population‐representative sample of Chinese in Hong Kong. A baseline survey was conducted at age 12 and follow‐up assessments were completed at ages 15 and 18. Caries experience was assessed as the number of decayed, missing and filled teeth (DMFT). Dental anxiety was assessed using the Modified Dental Anxiety Scale (MDAS). Participants' socio‐economic status and oral health‐related behaviours were ascertained using a self‐complete questionnaire. Negative binomial regression was used to explore the association between dental anxiety and subsequent caries status, controlling for other factors. Results: At baseline, 668 children participated; 279 (41.8%, comprising 57.0% females) completed all three phases of data collection. MDAS scores at age 18 were lower than at age 12. Caries experience increased as participants aged. At age 15 and 18, females had higher MDAS and DMFT scores than males. Reported frequency of snacking between meals was associated with MDAS scores at age 18. In regression analyses, dental anxiety at age 12 was not significantly associated with dental caries experience at age 15, controlling for socio‐demographic and oral‐health behaviour factors at age 12. Likewise, dental anxiety at age 15 was not significantly associated with dental caries experience at age 18, controlling for the same factors at age 15. Conclusion: Dental anxiety assessed by MDAS in late childhood and adolescence appears not to predict dental caries experience later in life in this population. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the efficacy of the social story‐based intervention in promoting the oral health status among preschool children with special healthcare needs. Methods: The 24‐month randomized controlled trial recruited 306 children from centres that provided educational training for 2‐ to 6‐year‐old children who had special healthcare needs. The participants received standardized toothbrushing training and oral health education materials. The education materials for children in the test group were validated social stories, while materials for children in the control group were standard leaflets. Those materials were introduced in each training session and used at home by parents. Children's oral health status and oral health‐related behaviours were assessed before and after interventions. Data were analysed via generalized estimating equations, negative binomial regression and binary logistic regression. Results: There was no significant difference in caries experience among children in both groups after 24 months. However, children in the test group showed better oral hygiene status and better toothbrushing performance, and they were more likely to visit a dentist (OR = 2.00, 95% CI:1.15,3.49) than their peers in the control group. Caries progression was more likely to be observed among children who had low social skills or whose parents were not working full‐time. Children from high‐income families showed better oral hygiene status than their peers (Estimate = −0.11, 95%CI: −0.20,−0.01). Conclusion: Social stories could be used to improve oral health‐related behaviours among young children with SHCN. The efficacy of the intervention might be associated with children's adaptive skills and family socio‐demographic status. [ABSTRACT FROM AUTHOR]

Objectives Studies investigating influencing factors of permanent tooth eruption/emergence have primarily focused on anthropometric measurements while less attention has been paid to the effect of perinatal factors. We aimed to explore early factors associated with eruption status of permanent teeth among 12-year-olds through a population-representative prospective cohort. Methods A community sample of Hong Kong children born in 1997 was obtained by random sampling from local secondary schools. Participants' background information including birth characteristics, prenatal and early childhood exposures, family socioeconomic status and medical records was prospectively collected. Clinical examination of tooth emergence was conducted in 2010. Children were divided into complete emergence (of 28 permanent teeth) and partial emergence groups based on clinical examinations. Bivariate analyses were used to assess the association of tooth emergence status with each putative predictor. Unadjusted and adjusted logistic regression models were applied to select the best predictors for tooth emergence status at age 12. Results Complete background information and clinical data were available from 514 children (76.9% of the invited participants). Bivariate analyses showed that the average birthweight in the partial emergence group was significantly lower than the complete emergence group (mean difference 0.2 kg, P = 0.006). The finding was confirmed by logistic regression analyses. In the adjusted regression model, it was found that for every 1 kilogram increase in birthweight, the odds of having partial emergence would be lowered by 0.49 (odds ratio 0.49, P = 0.006). Conclusions Birthweight is associated with status of permanent tooth emergence at 12 years of age, as observed from a population-representative sample of Hong Kong children. [ABSTRACT FROM AUTHOR]

Objectives Epidemiological studies on developmental defects of enamel ( DDE) have focused on its potential contributory factors and prevalence while there is limited evidence on the longitudinal changes in the epidemiological profile of DDE. Thus, the objective of this longitudinal study was to investigate whether any type of DDE changes with time. Methods A total of 668 participants were initially recruited in 2010, and 432 participants were successfully followed up and examined for DDE both at the age of 12 in 2010 and 15 in 2013. The central incisor, lateral incisor and first molar in each quadrant were chosen as index teeth and were examined 'wet' by two trained and calibrated examiners using the modified FDI ( DDE) Index. Results The mouth prevalence and tooth prevalence of 'any defect' showed a significant decrease from 2010 to 2013 ( P < 0.001). This was predominantly due to the decrease in diffuse opacities ( P < 0.001). Significant difference in the distribution of the extent of DDE was also found for diffuse opacities at both the participant and tooth levels irrespective of the types of tooth ( P < 0.0001). Median extent score for diffuse opacities in 2013 was lower than those in 2010 at both participant and tooth level irrespective of the types of tooth ( P < 0.001). Conclusions Diffuse opacities, in terms of prevalence and severity, did fade out over time. The observed overall change in DDE was due to the dominating effect of diffuse opacities over demarcated opacities and hypoplasia. [ABSTRACT FROM AUTHOR]

Objectives To compare the prevalence and severity of diffuse opacities among subjects whose maxillary incisors developed during periods with different concentrations of fluoride in the Hong Kong public water supply. Methods Standardized intra-oral photographs of random samples of 12-year-old children were collected in 1983, 1991, 2001 and 2010 ( n = 2658) in Hong Kong and were assessed for diffuse opacities by a calibrated and blinded examiner. The fluoride concentrations in the public water supply at the times when the enamel on their maxillary incisors developed were 1.0, 0.7, 0.5 and 0.5 ppm, respectively. Results The mouth prevalence figures for diffuse opacities of these children (based on the maxillary incisors) were 89.3%, 48.5%, 32.4% and 42.1 in the years 1983, 1991, 2001 and 2010, respectively. Variation in the mouth and tooth prevalences of diffuse opacities was apparent among the four different year groups ( P < 0.0001). Marked differences in severity of diffuse opacities, in terms of different subtypes and maximum extent of tooth affected, were also observed in association with the year of study ( P < 0.001). Conclusions The prevalence and severity of diffuse opacities among maxillary incisor teeth of Hong Kong children decreased from 1983 and then increased in 2010; however, this change did not fully correspond to the concentration of fluoride in the drinking water during the time of enamel development. [ABSTRACT FROM AUTHOR]

Wong HM, McGrath CPJ, King NM. Rasch validation of the early childhood oral health impact scale. Community Dent Oral Epidemiol 2011; 39: 449-457. © 2011 John Wiley & Sons A/S Abstract - Objectives: The early childhood oral health impact scale (ECOHIS), a proxy measure to assess the impact of oral health problems and on the quality of life of preschool children and their families, has been translated into Chinese and validated employing the classical test theory. However, some invariable problems are related to this theory. The objective of this study was to assess the metric properties of the ECOHIS by applying the item response theory. Methods: A random sample of 1296 Chinese preschool children in Hong Kong participated in the study and were subjected to an oral examination for their caries status. Their parents were asked to respond to the ECOHIS and an extra set of questions concerning their socio-demographic backgrounds. The collected data were analysed using Rasch model. Results: The obtained results support the interpretation of adequate total fit of persons and items, because the mean infit MNSQ (1.08) and outfit MNSQ (0.94) for persons, and the mean infit MNSQ (0.99) and outfit MNSQ (0.94) for items, are within the acceptable ranges (0.6-1.4). The difficulty spread of the items was between −0.81 and 1.96 logits, and the levels of respondents spanned from −5.56 to 6.72 logits on the person-item map. The spread of respondents was skewed and mistargeting, between the items and respondents, was confirmed. Combination of responses of 'often' and 'very often' was suggested because of their flat probability showing on the characteristic curves. Conclusions: Rasch model has been shown to be a feasible and practicable way of assessing the metric properties of the ECOHIS. The results allow the use of ECOHIS to be recommended for clinical research in oral health-related quality of life in young children with minor modifications. [ABSTRACT FROM AUTHOR]