Search

Objective: To describe the association between dental caries and school readiness in 5-year-old children taking part in the Born in Bradford (BiB) birth cohort, UK., Methods: The Early Years Foundation Stage Profile (EYFSP) assesses the school readiness of young children and is strongly predictive of future academic attainment. Children are recorded as 'emerging' (below expected), 'expected', or 'exceeding' in five key learning areas. The Oral Health Survey of 5-year-olds (OHS5) is undertaken biennially in England, assessing caries experience at a dentine threshold (d 3 mft). EYFSP and OHS5 were available for a proportion of children participating in BiB. Odds ratios and confidence intervals for caries experience were established, and odds ratios adjusted for significant sociodemographic variables., Results: EYFSP and OHS5 data were available for 2.5% (n = 346) BiB participants. Nearly half (45.2%) had caries. A measure of socio-economic status, receiving free school meals, was the only demographic variable strongly related to caries experience (OR: 2.8, 95% CI: 1.6-4.9). After adjustment, children 'emerging' in EYFSP learning areas had 1.6- to 2.2-fold (95% CI: 1.0-3.8) higher odds of experiencing caries. Children 'exceeding' EYFSP learning areas had 2.3- to 4-fold (95% CI: 0.1-0.9) lower odds of caries experience., Conclusion: This is the first study to explore the association between caries experience and school readiness using a holistic assessment tool. The association was found across different learning areas and was comparable to and independent of socio-economic status. The findings indicate oral health-related absenteeism is not a causative factor. EYFSP shows potential to enhance the targeting of preventive interventions at a child, class or school level., (© 2024 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Objectives: To examine the association between dental clinical status and school performance and school attendance in the Kingdom of Bahrain (KoB) using a life-course framework., Methods: This time-ordered cross-sectional study included 466 school children in Grade 2 (aged 7-8 years) and their parents in the KoB. Data were collected through parents' self-administered questionnaires, children's face-to-face interviews and dental clinical examinations. Data on children's school performance and school attendance were gathered from parents and school records. Structural equation modelling (SEM) examined the direct and indirect pathways between variables., Results: Children born in families with high socio-economic status (SES) were less likely to have dental caries and more likely to have better school performance at 7-8 years of age. Dentine caries was directly linked with poor school performance. Treated teeth directly predicted high school performance. The presence of dentine caries mediated the relationship of SES with school performance., Conclusions: Birth and current socio-economic factors were significant predictors of dental clinical conditions and school performance. Dental caries and fewer treated teeth directly predicted poor school performance., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: The link between oral diseases and school performance and school attendance remains unclear among Middle Eastern children., Aim: To investigate the relationship of oral conditions with schoolchildren's school performance and attendance using the life-course approach., Design: A cross-sectional study was conducted with 466 schoolchildren aged 7-8 years from Kingdom of Bahrain (KoB) and their parents. Questionnaire data on children's current and at-birth environmental characteristics were completed by their parents. Children's oral health measures, including ICDAS (International Caries Detection and Assessment System), PUFA (pulp, ulcer, fistula, abscess), and DDE (developmental defects of enamel) indices, were the exposure variables. School performance and school attendance data obtained from the school register were the outcome variables. The data were analysed using multivariate ordinal logistic regression., Results: The odds of excellent school performance were significantly lower for children with untreated dentinal caries (OR = 0.98; 95% CI: 0.96-0.99). Children with caries-treated teeth showed greater odds of excellent school performance (OR = 1.41; 95% CI: 1.15-1.74). Disease Control and PreventionNone of the dental conditions were significantly associated with children's school attendance. A permissive parental style was associated with poor school attendance (OR = 2.63; 95% CI: 1.08-6.42)., Conclusion: Dental caries was associated with poor school performance but not with school attendance. Treated caries was associated with good school performance., (© 2021 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

The article examines the common determinants of childhood dental caries and obesity. Longitudinal data from the Born in Bradford cohort study (BiB1000) (n = 1735) and dental data (dental general anaesthetics (GA) and oral health survey 2014/15) (n = 171) were used to test a framework on the social determinants of childhood dental caries (decayed, missing, filled teeth (dmft) index) and obesity (body mass index (BMI)). The BiB1000 data were collected at pregnancy week 26-28 and after birth at 6, 12, 18, 24 and 36 months. The determinants were demographics, wellbeing, socio-economic status (SES), dietary behaviours and physical activity behaviour of the children. Missing data were accounted for through multiple imputation (MI). The framework was tested through structural equation modelling. Overall, the model fit was adequate. No alcohol consumption of the mother after giving birth, higher frequency of child drinking sugar-sweetened beverages, emotional and behavioural difficulties of the child and being male were directly associated with both BMI and dental caries. Caregivers uninvolved or indulgent feeding style were associated with higher BMI and less dental caries. Social deprivation was associated with lower BMI and higher dmft. Five determinants were directly associated with BMI only. Fifteen indirect paths were significant for both child dental caries and BMI. The findings suggest common determinants for both childhood obesity and dental caries. Common risk factor approach seems appropriate for planning future health promotion programmes.

Background: Recent advances in the psychological understanding of health-related behaviour have focused on producing a comprehensive framework to model such behaviour. The Capability-Opportunity-Motivation-Behaviour (COM-B) and its associated Theoretical Domains Framework (TDF) allow researchers to classify psychological and behavioural constructs in a consistent and transferable manner across studies., Aim: To identify oral and dental health-related studies that have used the TDF and/or COM-B as frameworks to guide research and examine the ways in which these concepts have been practically used in such research., Method: Narrative review of published literature. To be included, the paper had to (1) state that the TDF or COM-B had been used and to have targeted at least one construct identified in either framework, (2) include primary empirical data, (3) focus on a behaviour directly related to oral or dental-related health (eg brushing, applying fluoride varnish, flossing) and/or attitudes, intentions and beliefs related to the behaviour. Studies could include any research design, and participants of any age or gender and include patients, parents or dental health professionals., Findings: Nine studies were identified that had drawn on the COM-B and/or TDF as the framework for their research. Seven of the studies were based on the TDF only, with one employing both the COM-B and Health Belief Model, and one using the TDF with COM-B. The nine studies covered a broad range of oral health-related behaviours including child tooth brushing, fluoride varnish application and non- or micro-invasive management of proximal caries lesions. The populations in the studies included dentists, dental teams and parents of children. All studies adopted only a subset of the constructs within the TDF, often without justification., Conclusions: It is encouraging that oral health researchers are adopting standardized psychological frameworks to develop their research and oral health interventions. Future work should build on the small number of studies identified in this review and consider using standardized tools to do so., (© 2021 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Objectives: Paediatric hospital admissions for dental extractions remain a cause for concern, despite decreasing levels of dental diseases in some areas of the country. While local investigations have taken place, little is known about national patterns, and how the relationship between the number of hospital admissions and key independent variables differs across England. The aim of this study was to examine spatial differences in the number of paediatric hospital admissions for extractions in relation to four key independent variables: dental caries, deprivation, units of dental activity and child access to dentists., Methods: Hospital admissions data (for all dental-related reasons) were taken from the Hospital Episode Statistics (HES) for England (2017/18) for children and adolescents aged up to 19 years. All data were collected at local authority level. Geographically weighted regression was used to examine associations between the number of hospital admissions and the independent variables, as well as the strength of these associations and how they differed spatially., Results: Geographically weighted regression revealed considerable differences in the associations between the number of paediatric hospital admissions and the independent variables across England, with distinct regional clusters identified in the data. Some areas exhibited positive associations between independent variables and the number of hospital admissions, such as in Yorkshire and areas of south-west, south-east and north-west England, where greater mean dmft scores were associated with greater numbers of hospital admissions. Negative associations were also found, such as in south-west, north-west and North East England, where higher deprivation scores were associated with lower admission numbers. Despite the patterns found, a much smaller sample of the associations between the independent variables and the number of hospital admissions was statistically significant., Conclusions: This analysis allows for a better understanding of the spatial associations between the number of hospital admissions and key independent variables, as well as how changes to these independent variables may affect the number of admissions in each local authority. These findings should be considered in the context of the limitations of HES dataset., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To explore the impacts of dry mouth in order to develop a comprehensive condition-specific OHRQoL measure., Background: Dry mouth has been shown to have significant, if not more severe impacts on OHRQoL, than dental caries. Yet there remain few studies reporting on how to develop a comprehensive measure of the impact of dry mouth on OHRQoL., Methods: This study was a qualitative study using semi-structured interviews. Data were collected from a purposive sample of 17 people with dry mouth (14 women, three men). The sample was drawn to capture a comprehensive range of impacts of dry mouth. These interviews were analysed using a framework approach informed by existing functionalist approaches to OHRQoL., Results: Participants reported a huge range of symptoms associated with perceived dry mouth resulting in extensive impacts on physical, emotional (psychological) and social functioning. Dry mouth could also result in restrictions in social participation which, under some conditions, could be disabling. These impacts were modified by psychological, social and environmental factors., Conclusions: If we are to measure the impacts of oral conditions, it is important that this is done systematically and with reference to existing conceptual models of health. Current measures of the impact of dry mouth cover symptoms, discomfort and physical impacts along with some aspects of how people cope with the condition. This study proposes a more comprehensive approach that includes the full range of impacts people experience. Such an approach may enable us to focus on "downstream" and "upstream" interventions for dry mouth., (© 2019 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.)

Objectives: This study aimed to explore whether population characteristics were associated with the use of dental services, individual's personal oral health practices, dental caries and oral health-related impacts using the revised Andersen's behavioural model as the theoretical framework., Methods: This cross-sectional study included participants from a Norwegian general population (N = 1840; 20-79 years) included in the Tromstannen-Oral Health in Northern Norway (TOHNN) study. The variables included in the model were social structure (income, education, urbanization), sense of coherence (SOC), enabling resources (difficulties accessing the dentist, declined treatment, dental anxiety), treatment need, use of dental services, toothbrushing frequency, sugary soda drink consumption, decayed teeth and oral health-related impacts (OHIP-14). Structural equation modelling was used to test the direct and indirect effects within Andersen's behavioural model of access and health outcomes., Results: Andersen's behavioural model fit the data well and explained a large part of the variance in use of dental services (58%), oral health-related impacts (48%) and, to a lesser extent, decayed teeth (12%). More social structures and a stronger SOC was associated with more enabling resources, which in turn, was associated with more use of dental services. Social structures were not directly associated with use of dental services or decayed teeth but were predictive of oral health-related impacts. A stronger SOC was associated with more frequent toothbrushing, less soda drink consumptions, fewer decayed teeth and less oral health-related impacts. Self-perceived need did not predict dental attendance but was associated with decayed teeth. A less frequent use of dental services, less frequent toothbrushing and more frequent sugary soda drink consumption were associated with more decayed teeth. Decayed teeth were not associated with oral health-related impacts., Conclusion: The findings suggests that, in addition to focusing on reducing socioeconomic inequalities in relation to oral health in the Norwegian population, it is also important to consider how people perceive their own resources (eg financial, psychological, social) as well as their access to dental care in order to support regular dental attendance and potentially, in turn, enhance oral health., (© 2020 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Objectives: The primary aim of this study was to investigate the impact of reduced sugar consumption on caries experience among 12-year-old Libyan schoolchildren during the Libyan conflict, in comparison to preconflict data collected in the same water-fluoridated setting from a similar age group. A further aim was to investigate the socio-demographic and behavioural factors which may impact caries levels during the conflict., Methods: A natural experiment in which dental caries data before and during the Libyan conflict, over a 9-year period, was compared. A cross-sectional survey was conducted between December 2016 and February 2017 to collect during-conflict data comparable to preconflict data collected in 2007. A random sample of 1134, 12-year-olds were recruited from public schools in Benghazi. Epidemiological examinations were undertaken by three trained examiners to measure dental caries. Questionnaires addressing socio-demographic and behaviours related to oral health were completed by participants. Data were analysed using SPSS 24, at P ≤ .05., Results: In the during-conflict period, caries prevalence was 42.8% and mean DMFT was 1.09 (SD ± 1.57). These figures were significantly lower than the caries prevalence and severity reported in the preconflict group (P < .001). Logistic regression analysis indicated that male children, those who frequently consumed sugary drinks, who drank bottled water (low fluoride) and whose fathers had relatively lowly occupations were more likely to have dental caries (all P < .05)., Conclusions: This study indicates that decreased levels of sugar intake during the Libyan conflict are associated with a decline in dental caries prevalence and severity. This provides some support for the notion that reducing sugar intake is still an important factor in caries prevention and control even when fluorides are available in public water and toothpaste., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

A Wicked Problem is a problem that is impossible or difficult to solve partly because of its multi-component nature and its interconnection with other problems (Rittel & Webber, 1973). There are many Wicked Problems in the field of population oral health; tooth decay being one. Tooth decay is a function of biology (destruction of our tooth enamel); a function of our physical environment (availability, advertising and accessibility of sugar sweetened foods and drinks, availability of dental services); a function of our social environment (norms of oral hygiene and sugar consumption vary by socio-economic strata, country, and cultures); a function of us as individuals (dietary habits, visiting the dentist, oral health beliefs, toothbrushing, use of fluoride, dental anxiety, income); and a function of politics (our city, region and national policies on oral health education, tax on sugar sweetened drinks, water fluoridation, dental payment systems)., (Copyright© 2019 Dennis Barber Ltd.)

Objectives: We aimed to understand why German dentists remain reluctant about selective carious tissue removal (SE), and to develop and test two interventions for changing dentists' behavior., Methods: Ten one-to-one interviews with German dentists were conducted, and identified themes linked to the Behavioral Change Wheel to develop two interventions. The intervention "Guideline" summarized a scientific statement on SE, while the intervention "Tool" simulated dentists having a removal tool (self-limiting handpiece) allowing them to reliably perform SE. For testing these interventions, a postal behavioral-change simulation-experiment was performed on German dentists (n = 1226/intervention), delivered via sealed envelopes. Dentists were first, without knowledge of the intervention, asked to fill out a questionnaire, including a question on their simulated removal behavior in deep lesions in vital teeth, measured via the dentin hardness dentists would leave close to the pulp. After opening the sealed envelope and receiving the simulated intervention, dentists filled out a second identical questionnaire., Results: Based on identified barriers (lack of guidelines, discrepancy between established and "new" knowledge, lack of routine) and facilitators (understanding the biological foundations for SE, knowing it was evidence-based, having reliable criteria for determining the endpoint of SE), the two interventions were developed. 504 dentists participated in the experiment (response rate:24.9%). For both interventions, the outcome behavior improved significantly after the intervention (p < 0.001), with 29.6% (guideline) and 17.9% (tool) changing their behavior towards SE, respectively. There were no significant differences in the outcome behavior between the two interventions (p = 0.933)., Conclusion: Systematically developed behavior-change interventions may be efficacious to improve the uptake of SE., Clinical Significance: Understanding the barriers and facilitators for applying SE facilitates the development of interventions which may be efficacious for changing carious tissue removal., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objectives: To examine any change over time in the association between deprivation and caries experience between 2003 and 2013 in a nationally representative sample of UK children., Methods: Data from UK Children's Dental Health Surveys, 2003 and 2013, were used. The target population was 5-, 8-, 12- and 15-year-olds. A total of 9604 children in 2003 and 9866 in 2013 were included in the surveys. Outcome variables were any active caries, caries experience and total number of carious teeth. Family socio-economic position (SEP) or deprivation level was measured at school level using eligibility for free school meals (FSM) to identify children from low-income families. Incidence rate ratios (IRR) and pooled standardized incidence rates ratios were calculated to measure dichotomous outcome variables by year, age group and status of deprivation. The study continuous outcome was modelled using a zero-inflated Poisson regression while the dichotomous outcomes were modelled using logistic regressions. The multivariable analyses were run by age groups accounting for year, sex and deprivation status., Results: The percentage of those identified as deprived was significantly higher in 2013 (35.8% in 2013 vs 26.0% in 2003, P < 0.001). Among both deprived and non-deprived children, the prevalence of any active caries significantly dropped over the years, observed in all age groups. Comparing 2013 with 2003 and accounting for sex, deprivation level, "any active caries," "any caries experience" and "total number of carious teeth" significantly dropped were observed in all age groups. Comparing the years, the association of deprivation with caries outcomes mostly remained the same or decreased. This decrease was predominantly seen in "any caries experience." Only among the 5-year-olds, did the association between deprivation and total number of carious teeth over the years significantly increase. For all age groups, the likelihood of "any active caries" and "total number of carious teeth" by deprivation remained the same comparing the two points in time: 2003 and 2013. However, irrespective of year, deprivation was significantly associated with caries observed in all age groups., Conclusion: In the UK, the prevalence of active dental caries and caries experience has decreased in the period between 2003 and 2013. Similarly, the likelihood of having dental caries by deprivation in 2013 was predominantly lower than that observed in 2003., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: This study aimed to identify barriers and enablers for dentists managing non-cavitated proximal caries lesions using non- or micro-invasive (NI/MI) approaches rather than invasive and restorative methods in New Zealand, Germany and the USA., Methods: Semi-structured interviews were conducted, focusing on non-cavitated proximal caries lesions (radiographically confined to enamel or the outer dentine). Twelve dentists from New Zealand, 12 from Germany and 20 from the state of Michigan (USA) were interviewed. Convenience and snowball sampling were used for participant recruitment. A diverse sample of dentists was recruited. Interviews were conducted by telephone, using an interview schedule based on the Theoretical Domains Framework (TDF)., Results: The following barriers to managing lesions non- or micro-invasively were identified: patients' lacking adherence to oral hygiene instructions or high-caries risk, financial pressures and a lack of reimbursement for NI/MI, unsupportive colleagues and practice leaders, not undertaking professional development and basing treatment on what had been learned during training, and a sense of anticipated regret (anxiety about not restoring a proximal lesion in its early stages before it progressed). The following enablers were identified: the professional belief that remineralisation can occur in early non-cavitated proximal lesions and that these lesions can be arrested, the understanding that placing restorations weakens the tooth and inflicts a cycle of re-restoration, having up-to-date information and supportive colleagues and work environments, working as part of a team of competent and skilled dental practitioners who perform NI/MI (such as cleaning or scaling), having the necessary resources, undertaking ongoing professional development and continued education, maintaining membership of professional groups and a sense of professional and personal satisfaction from working in the patient's best interest. Financial aspects were more commonly mentioned by the German and American participants, while continuing education was more of a focus for the New Zealand participants., Conclusions: Decisions on managing non-cavitated proximal lesions were influenced by numerous factors, some of which could be targeted by interventions for implementing evidence-based management strategies in practice.

Background: This study aims to cross-culturally adapt the original English-language COHIP-SF 19 to Arabic culture and to test its psychometric properties in a community sample., Methods: The Arabic COHIP-SF 19 was developed and its psychometric properties were examined in a population-based sample of 876 schoolchildren who were aged 12 years of age, in Benghazi, Libya. The Arabic COHIP-SF 19 was tested for its internal consistency, reproducibility, construct validity, factorial validity and floor as well as ceiling effects. A Mann-Whitney U test was used to compare the mean scores of COHIP-SF 19 by participants' caries status and self-reported oral health rating, satisfaction and treatment need., Results: The Arabic COHIP-SF 19 was successfully and smoothly developed. It showed an acceptable level of equivalence to the original version. Overall, the internal consistency and reproducibility were acceptable to excellent, with a Cronbach's alpha of 0.84 and an intra-class correlation coefficient (ICC) of 0.76. All hypotheses predefined to test construct validity were confirmed. That is, children who had active dental caries, and who rated their oral health as poor, were not satisfied with their oral health or indicated the need of treatment had lower COHIP-SF 19 scores (P < 0.05). Floor or ceiling effects were not observed. The exploratory Factorial analysis suggested a 4-component solution and deletion of one item., Conclusion: The Arabic COHIP-SF 19 was successfully developed. The measure demonstrated satisfactory reliability and validity to estimate OHRQoL in a representative sample of 12-year-old schoolchildren.

Objective: To find the most accurate indicators of the distribution of dental caries in 5-year-olds in the city of Sheffield, UK, using a conceptual framework based on the social determinants of health., Method: A list of structural and intermediary indicators was compiled based on the Commission on the Social Determinants of Health's (CSDH) conceptual framework. To quantify these indicators, existing data on dental caries were obtained from the NHS Dental Epidemiology Programme, while data on social position, education, employment, income, material circumstances, social cohesion, psychosocial factors and individual behaviours were obtained from the Public Health Intelligence Team at Sheffield City Council. These data were mapped onto a simplified framework of the social determinants of dental caries. Regression analysis was conducted on this simplified framework to determine the amount of variance each indicator contributed to the distribution of dental caries at neighbourhood level., Results: The total score for the 2010 Index of Multiple Deprivation contributed a significant amount of variance (60.4%) compared to the combined variance of the other 13 indicators (70.5%)., Conclusion: The total IMD score has the potential to be used as an indicator for the targeting of oral health improvement programmes where survey data are not available. A large prospective study is required in the UK to investigate the full range of factors in the CSDH model to develop a new index which might better predict dental caries experience than IMD.