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Incarcerated individuals experience poorer health, including dental health, when compared with the general population. Although interventions that target multiple determinants of health are more effective, there are limited investigations of the determinants of dental health, and how these differ, among incarcerated individuals. This article describes a secondary data analysis to investigate caries (dental decay) experience and associated risk indicators from a survey of females, adult males, and young males incarcerated in Scotland. Substance misuse significantly explained caries risk for adults, and tailored interventions are warranted to address smoking and dental attitudes among females, and for adult males housing support alongside oral health education are indicated.

Context: A relationship between obesity and poor oral health has been reported., Objective: To investigate the association between overweight/obesity and oral health in Mexican children and adolescents., Data Sources: A literature search was conducted of 13 databases and 1 search engine for articles published from 1995 onward., Data Analysis: A total of 18 publications were included. Evidence was inconclusive and varied according to sociodemographic factors or outcome measuring tools. The Decayed, Missing, and Filled Teeth and Filled Teeth Surfaces indices and the decayed extracted filled teeth index outcomes were included in a random effects model meta-analysis. Pooled estimates showed no statistically significant oral health differences (measured via the decayed extracted filled teeth or the Decayed, Missing, and Filled Teeth Surfaces indexes) among body mass index (BMI) categories. However, pooled estimates of 6 studies showed that children with higher BMI had worse oral health in permanent teeth (measured via the Decayed Missing Filled Teeth Index) than children with lower BMI (overall mean difference, -0.42; 95%CI, -0.74, -0.11)., Conclusion: Whether there is an association between poor oral health and high BMI is inconclusive; however, both co-exist among Mexican children. Therefore, health promotion and prevention efforts should address common risk factors and broader risk social determinants shared between noncommunicable diseases., (© The Author(s) 2021. Published by Oxford University Press on behalf of the International Life Sciences Institute.)

Objective: To test a theoretical mediation model and investigate whether drug use and/or dental anxiety act as mediating factors between depression and dental decay experience among prisoners., Method: A cross-sectional survey was conducted on a convenience sample of 300 prisoners across three prison establishments in Scotland. Depression and dental anxiety were measured using the Centre for Epidemiological Studies Depression Scale and the Modified Dental Anxiety Scale, respectively. Drug use was assessed using three yes (scoring 1)/ no (scoring 0) questions: 'ever taken (illegal) drugs', 'injecting drugs' and 'ever participated in a rehabilitation programme'. Participants had an oral examination to determine dental caries experience (missing [MT] and untreated decay [D 3cv T]) in all four quadrants. Latent variable path analysis was conducted to test the mediation model., Results: A total of 342 prisoners participated, of which 298 yielded a complete data set. Depression was associated with missing teeth and untreated decay (D 3 T) through an indirect pathway (Total standardized indirect effects = 0.11, P < .01) via drug use and dental anxiety (X 2 [71] = 89.8, P = .07; Root Mean Square Error of Approximation: 0.03; Comparative Fit Index: 0.994 and Tucker-Lewis index: 0.992). Twenty-two percent of the variance in untreated decay and missing teeth was explained by both drug use and dental anxiety; however, the strongest predictor was drug use (total standardized direct effects = 0.45, P < .001)., Conclusion: A relatively simple model to assist understanding dental decay experience of people in prison has been proposed. The data collected were consistent with our specified model. Drug use acted as the primary mediator and dental anxiety as a secondary mediator between depression and dental decay experience. Given the co-morbidity between mental health and drug use and dental decay experience, an integrated or shared approach is proposed. We recommend that future research should concentrate on building a firmer picture by replicating and extending the framework presented., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Data sourcesCochrane Oral Healths Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) Medline, Embase, LILACS BIREME Virtual Health Library CINAHL US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform databases.Study selectionRandomised controlled trials (RCTs) including quasi-randomised and cluster-randomised trials of fluoride supplements (tablets, drops, lozenges or chewing gum) given to women during pregnancy with the aim of preventing caries in the primary teeth of their children were selected.Data extraction and synthesisTwo reviewers independently extracted data and assessed risk of bias using the Cochrane risk of bias tool. No data synthesis was possible.ResultsOnly one RCT met the inclusion criteria. There was no statistical difference in decayed or filled primary tooth surfaces (dfs) or % of children with caries at three years or five years. Risk ratio (RR) at three years = 1.46, (95% CI; 0.75 to 2.85) and RR at five years = 0.84, (95% CI; 0.53 to 1.33). At five years the incidence of fluorosis was similar between the groups.ConclusionsThere is no evidence that fluoride supplements taken by women during pregnancy are effective in preventing dental caries in their offspring.

Data sourcesPubMed, Embase, Scopus, China National Knowledge Infrastructure (CNKI), Ichushi-web, Biblioteca Virtual en Salud Espana (BVSE) and Biblioteca Virtual em Saude (BVS) databases. There were no limits on language or publication dates.Study selectionTwo reviewers selected prospective clinical studies investigating SDF treatment for caries prevention in children.Data extraction and synthesisData was abstracted independently by two reviewers and risk of bias assessed. Meta-analysis was performed on studies in which the caries-arresting rate using 38% SDF solution on primary teeth could be obtained or calculated.ResultsNineteen studies were included; 16 were conducted in the primary dentition and three in permanent dentition. Fourteen studies used 38% SDF, three 30% SDF, and two 10% SDF. Eight studies using 38% SDF contributed to a meta-analysis and the overall proportion of arrested caries was 81% (95% CI; 68-89%). Percentage reductions were also calculated for 6,12,18,24 and >30 months. Arrested carious lesions stained black but no other adverse effects were reported.ConclusionsSDF commonly used at a high concentration (38%, 44,800ppm fluoride) is effective in arresting caries among children. There is no consensus on its number and frequency of application to arrest caries. Further studies are necessary to develop evidence-based guidelines on its use in children.

Data sourcesPubMed, the Cochrane Library, Centre for Reviews and Dissemination (CRD) and Embase.Data abstraction and synthesisTwo independent reviewers selected studies, abstracted data and assessed study quality using the GRADE criteria. Meta-analysis was conducted using a random effects model.Study selectionRandomised controlled trials including in situ studies.ResultsSeven studies were included, five conducted in children and two in adults. The two adult studies and one child study were considered to be at high risk of bias. The remaining four child studies were considered to be at moderate risk of bias. These four studies compared 1450ppm fluoride toothpaste with 1.5% arginine against 1450ppm fluoride toothpaste as a control. Meta-analysis of three studies showed a positive effect on caries measured using quantitative light-induced fluorescence (QLF) in favour of arginine; mean difference -4.67, (95%CI, -6.34 to -3.01). The overall GRADE assessment of this was considered to be very low.ConclusionAt present there is insufficient evidence in support of a caries-preventive effect for the inclusion of arginine in toothpastes. More rigorous studies, and studies which are less dependent on commercial interests, are required.

Background: Obesity and dental caries are global public health problems which can impact in childhood and throughout the life course. In simple terms, childhood dental caries and body weight are linked via the common risk factor of diet. An association between dental caries and obesity has been described in a number of studies and reviews. However, similarly, a relationship has also been noted between low body weight and caries experience in children. This protocol will provide the framework for an umbrella review to address the following question: Does the available evidence support a relationship between dental caries experience and body weight in the child population?, Methods: This review protocol outlines the process to carry out an umbrella systematic review which will synthesise previous reviews of childhood dental caries experience and body weight. An umbrella review methodology will be used to examine the methodological and reporting quality of existing reviews., Discussion: The final umbrella review aims to aggregate the available evidence in order to provide a summary for policymakers and to inform healthcare interventions., Systematic Review Registration: PROSPERO CRD42016047304.

Data sourcesPubMed Central, CINAHL, Embase and reference lists of identified articles.Study selectionObservational and experimental studies published in English where breastfeeding was the exposure and development of caries was the outcome of interest were considered. Two reviewers independently selected studies for inclusionData extraction and synthesisStudy quality was assessed independently by two researchers using the Newcastle Ottawa Scale (NOS). Key data items, exposure and outcome definitions and effect estimates (odds ratios (OR), relative risks, prevalence ratios) with 95% Confidence Interval (95%CI) were abstracted where available for inclusion in a meta-analysis. The aim was to assess breastfeeding in two specific time windows; up to 12 months of age and beyond 12 months of age.ResultsSixty-three papers were included. These consisted of 14 cohort studies of which six were nested within RCTs of breastfeeding promotion interventions, three case-control studies and 46 cross-sectional studies. The studies were predominantly conducted in high and middle income countries with only eight studies from low income countries. Forty-six studies were not included in the meta-analysis because of methodological differences in the measures of exposure and outcomes, or reporting of correlational analyses only.Meta-analysis of one prospective cohort and four cross-sectional studies reported odds ratios for the association between children who were exposed to more versus less breastfeeding up to 12 months OR= 0.50; (95%CI; 0.25-0.99, I 2 86.8%).In the two studies which compared ever breastfeeding in the first 12 months with never breastfeeding, both showed a marked protective effect of breastfeeding on dental caries compared with other feeding. Whereas the three studies which compared a longer duration of breastfeeding in the first 12 months to a comparison group which included children who had had some exposure to breastfeeding did not (34,52,59). A meta-analysis of this three study subgroup found OR= 0.92; (95%CI; 0.69-1.23, I 2 0%)Meta-analysis of two cohort studies, one case-control study and four cross-sectional studies reported odds ratios for the association between more or less breastfeeding after the age of 12 months and dental caries.Comparison groups for these studies included both those who had never been breastfed and those who had been breastfed for shorter durations. The pooled estimate was OR= 1.99; (95% CI: 1.35-2.95, I 2 69.3%).Meta-analysis of one cohort, one case-control and three cross-sectional studies reported odds ratios for the association between more versus less nocturnal breastfeeding and the risk of dental caries amongst the subgroup of children breastfed longer than 12 months. OR= 7.14; (95%CI; 3.14-16.23, I 2 77.1%).ConclusionsBreastfeeding up to 12 months of age is not associated with an increased risk of dental caries and in fact may offer some protection compared with formula. However, children breastfed beyond 12 months, a time during which all deciduous teeth erupt, had an increased risk of dental caries. This may be due to other factors which are linked with prolonged breastfeeding including nocturnal feeding during sleep, cariogenic foods/drinks in the diet or inadequate oral hygiene practices. Further research with careful control of pertinent confounding factors is needed to elucidate this issue and better inform infant feeding guidelines.

Scope and purposeThe guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and disease management.MethodologyThe guidance development is based on three reviews(1,2,3) and an interim seminar and workshop organised by the European Academy of Paediatric Dentistry in Brussels in May 2015.Review and updatingNo indication of a review or update schedule is given.RecommendationsSeven recommendations on caries detection and diagnosis, four recommendations on caries risk assessment and 11 on the management of the early carious lesion were made and they are briefly summarised in the table below.Research RecommendationsCaries detection and diagnosisThere is a need for more research in the primary dentition because most of the available studies consider only the permanent dentitionRadiograph subtraction studies need to be conductedOngoing evaluation of new methods and devicesThere is a need for well-designed prevention studies on early childhood caries which will provide sufficient and strong evidence of the cost-effectivenessThere is a significant need to bring the knowledge and learning to regular dental practice, to all the paediatric health care providers, the children and their parents.Caries risk assessmentClinical trials to assess the validity of models and single risk factors, as well as the role of confounding factors (eg age, lifestyle, socio-economy and socio-demography), for predicting caries.Further quantitative and qualitative health professional and parents would be helpful to identify perceptions and barriers to carrying out a CRA and to deliver a risk-based preventive care that could bridge the social inequalities in dental health.More research on the implementation of risk-based caries prevention and to establish the cost-effectiveness of such strategies.

Methodology: A purposive sample of large NHS dental practices with a minimum of three surgeries employing at least one hygiene-therapist (HT) was taken. Asymptomatic patients attending for routine checkups who consented to the study underwent a screen by H-T for dental caries and periodontal disease (index test) followed by a screen by a general dental practitioner (reference test). Patients were recruited consecutively. H-Ts and dentists attended a compulsory training day, which covered recruitment, consenting, screening process, calibration using stock photographs and patient record form completion. Diagnostic threshold for caries was any tooth in the patient's mouth that showed evidence of frank cavitation or shadowing and opacity that would indicate dental caries into the dentine. The diagnostic threshold for periodontal disease was any pocket in the patient's mouth where the black-band of a basic periodontal examination (BPE) probe (3.5 to 5.5 mm) partially or totally disappeared (ie BPE code 3). The index test was compared with the reference test to determine true-positive, false-positive, false-negative and true-negative values. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic odds ratios are shown in Table 1., Results: Eighteen hundred and ninety-nine patients consented to dental screening with 996 patients being randomly allocated to see the dentist first and 903 H-T first. The time interval between the index and reference test never exceeded 21 minutes. With the exception of two practices failing to collect data on smoking and dentures there were no missing results regarding the outcome of a positive or negative screening decision. No adverse events were reported. Mean screening time was five min 25 s for H-Ts and four min 26 s for dentists. Dentists identified 668 patients with caries (Prevalence of 0.35) while H-Ts classified 548 positive and correctly identified 1,047 of the 1,231 patients with no caries. Dentists identified 1074 patients with at least one pocket exceeding 3.5 mm in depth. Of these 935 were correctly identified by the H-Ts. For the 825 screened as negative by the dentist H-Ts correctly identified 621., Conclusions: The results suggest that hygiene-therapists could be used to screen for dental caries and periodontal disease. This has important ramifications for service design in public-funded health systems.

Unlabelled: Data, Sources: Cochrane Oral Health Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline , Embase, CINAHL, LILACS, ProQuest Dissertations and Theses, the Web of Science Conference Proceedings, ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform., Study Selection: Randomised or quasi-randomised controlled trials comparing topically applied fluoride gel with placebo or no treatment in children up to 16 years were considered. Studies had to be at least one year in duration with a frequency of application of at least once a year with blind outcome assessment. The main outcome was caries increment measured by the change in decayed, missing and filled tooth surfaces in both permanent and primary teeth (D(M)FS and d(e/m)fs)., Data Extraction and Synthesis: At least two reviewers extracted data and assessed risk of bias. The primary measure of effect was the prevented fraction (PF). Where data could be pooled random-effects meta-analyses were conducted. Potential sources of heterogeneity were examined in random-effects meta-regression analyses., Results: Twenty-eight trials involving 9140 children and adolescents were included. Most of the studies (20) were at high risk of bias, with eight at unclear risk of bias. Twenty-five trials (8479 participants) provided data for meta-analysis on permanent teeth, with a D(M)FS pooled prevented fraction (PF) estimate of 28% (95% CI; 19-36%; P < 0.0001; with substantial heterogeneity (P < 0.0001; I(2) = 82%); moderate quality evidence). Subgroup and metaregression analyses suggested no significant association between estimates of D(M)FS prevented fractions and the prespecified trial characteristics. However, the effect of fluoride gel varied according to the type of control group used, with D(M)FS PF on average being 17% (95% CI 3% to 31%; P = 0.018) higher in non-placebo-controlled trials (the reduction in caries was 38% (95% CI 24% to 52%; P < 0.0001, 2808 participants) for the ten trials with no treatment as control group, and 21% (95% CI 15% to 28%; P < 0.0001, 5671 participants) for the 15 placebo-controlled trials.A funnel plot of the 25 trials in the D(M)FS PF meta-analysis indicated a relationship between prevented fraction and study precision, with an apparent lack of small studies with statistically significant large effects.For primary teeth the d(e/m)fs pooled prevented fraction estimate for the three trials (1254 participants) = 20% (95%CI; 1% - 38%; P = 0.04; with no heterogeneity (P = 0.54; I(2) = 0%); low quality evidence).There was limited reporting of adverse events. Only two trials reported information on acute toxicity signs and symptoms during the application of the gel (risk difference 0.01, 95% CI -0.01 to 0.02; P = 0.36; with no heterogeneity (P = 36; I(2) = 0%); 490 participants; very low quality evidence). None of the trials reported information on tooth staining, mucosal irritation or allergic reaction., Conclusions: The conclusions of this updated review remain the same as those when it was first published. There is moderate quality evidence of a large caries-inhibiting effect of fluoride gel in the permanent dentition. Information concerning the caries-preventive effect of fluoride gel on the primary dentition, which also shows a large effect, is based on low quality evidence from only three placebo-controlled trials. There is little information on adverse effects or on acceptability of treatment. Future trials should include assessment of potential adverse effects.

Data Sources: Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase and CINAHL., Study Selection: Randomised controlled trials (RCTs) comparing the effects of chlorhexidine-containing oral products with no treatment or placebo on dental caries, and comparing the effects of one chlorhexidine-containing oral product with another were considered., Data Extraction and Synthesis: Two reviewers independently extracted trial data and assessed risk of bias. Owing to the clinical diversity of the included studies with respect to age, composition of intervention, and variation in outcome measures and follow-up, meta-analysis was not carried out. A narrative synthesis was presented., Results: Eight trials were included. Six were at high risk of bias and two at unclear risk. Six trials compared chlorhexidine varnish with placebo or no treatment. Data from two trials (690 patients) one using 10% chlorhexidine varnish and the other, 40%, showed that this led to an increase in the DMFS increment in the varnish group of 0.53 (95% CI; -0.47 to 1.53). Only one trial involving 496 patients and using 10% chlorhexidine varnish provided usable data for elevated mutans streptococci levels > 4 with RR 0.93 (95% CI; 0.80 to 1.07). Two trials (487 patients) compared 0.12% chlorhexidine gel with no treatment in the primary dentition. The presence of new caries gave rise to a 95% confidence interval that was compatible with either an increase or a decrease in caries incidence (RR 1.00, 95% CI 0.36 to 2.77)., Conclusions: The authors found little evidence from the eight trials on varnishes and gels included in this review to either support or refute the assertion that chlorhexidine is more effective than placebo or no treatment in the prevention of caries or the reduction of mutans streptococci levels in children and adolescents. There were no trials on other products containing chlorhexidine such as sprays, toothpastes, chewing gums or mouthrinses. Further high quality research is required, in particular evaluating the effects on both the primary and permanent dentition and using other chlorhexidine-containing oral products.

Data Sources: Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, US National Institutes of Health Trials Register and World Health Organisation (WHO) International Clinical Trials Registry Platform., Study Selection: Parallel randomised controlled trials (RCTs) of any type of slow-release fluoride device irrespective of publication status, language or blinding were considered. Split mouth studies were excluded., Data Extraction and Synthesis: Standard Cochrane methods were followed with at least two reviewers independently undertaking all the key steps., Results: Only one trial which was considered to be at high risk of bias was included. The trial included 174 children with 132 available for two year examination. However statistical analysis was performed on only the 63 children (31 in intervention group, 32 in control group) who had retained the beads (retention rate was 47.7% at two years). Among these 63 children, caries increment was reported to be statistically significantly lower in the intervention group than in the control group (DMFT: mean difference -0.72, 95% confidence interval (CI) -1.23 to -0.21; DMFS: mean difference -1.52, 95% CI -2.68 to -0.36 (very low quality evidence)). Although this difference was clinically significant, it only holds true for those children who retained the fluoride beads; over 50% of the children did not retain the beads. Adverse effects were not reported., Conclusions: There is insufficient evidence to determine the caries-inhibiting effect of slow-release fluoride glass beads. The body of evidence available is of very low quality and there is a potential overestimation of benefit to the average child. The applicability of the findings to the wider population is unclear; the study had included children from a deprived area that had low levels of fluoride in drinking water, and were considered at high risk of carries. In addition, the evidence was only obtained from children who still had the bead attached at two years (48% of all available children); children who had lost their slow-release fluoride devices earlier might not have benefited as much from the devices.

Data Sources: Cochrane Effective Practice and Organisation of Care (EPOC) Group's Specialised Register; Cochrane Oral Health Group's Specialised Register; the Cochrane Central Register of Controlled Trials Medline; Embase; CINAHL; Cochrane Database of Systematic Reviews; Database of Abstracts of Reviews of Effectiveness; five other databases and two trial registries. A number of dental journals were hand-searched and a grey literature search preformed., Study Selection: Randomised controlled trials (RCTs), non-randomised controlled trials (NRCTs), controlled before and after studies (CBAs) and interrupted time series (ITSs) were considered. Selection was conducted independently by two reviewers., Data Extraction and Synthesis: Three reviewers extracted data and assessed risk of bias. Meta-analysis was not possible so a narrative summary was presented., Results: Five studies (one cluster RCT, three RCTs and one NRCT) were included. All the studies were at high risk of bias and the overall quality of evidence was very low. The majority of the studies were more than 20 years old.Four studies evaluated sealant placement; three found no evidence of a difference in retention rates of those placed by dental auxiliaries and dentists over a range of follow-up periods (six to 24 months). One study found that sealants placed by a dental auxiliary had lower retention rates than ones placed by a dentist after 48 months (9.0% with auxiliary versus 29.1% with dentist); but the net reduction in the number of teeth exhibiting caries was lower for teeth treated by the dental auxiliary than the dentist (three with auxiliary versus 60 with dentist, P value < 0.001). One study showed no evidence of a difference in dental decay after treatment with fissure sealants between groups. One study comparing the effectiveness of dental auxiliaries and dentists performing ART reported no difference in survival rates of the restorations (fillings) after 12 months., Conclusions: We only identified five studies for inclusion in this review, all of which were at high risk of bias, and four were published more than 20 years ago, highlighting the paucity of high-quality evaluations of the relative effectiveness, cost-effectiveness and safety of dental auxiliaries compared with dentists in performing clinical tasks. No firm conclusions could be drawn from the present review about the relative effectiveness of dental auxiliaries and dentists.

Data Sources: The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, LILACS and BBO, ProQuest Dissertations and Theses, Web of Science Conference Proceedings and ClinicalTrials.gov databases were searched. Reference lists of identified articles were also scanned for relevant papers. Study authors were contacted for additional information., Study Selection: Randomised or quasi-randomised controlled trials using or indicating blind outcome assessment that compared fluoride varnish to placebo or no treatment for at least one year were included. Risk of bias assessment was undertaken., Data Extraction and Synthesis: Study assessment and data extraction was carried out independently by at least two reviewers. The primary measure of effect was the prevented fraction, that is the difference in mean caries increments between the treatment and control groups expressed as a percentage of the mean increment in the control group. The caries increments nearest to three years were used from each included study. Random-effects meta-analyses were performed where data could be pooled. Potential sources of heterogeneity were examined in random-effects meta-regression analyses. Adverse effects information was collected from the included trials., Results: Twenty-two trials (12,455 participants) were included. Thirteen trials were included in the permanent tooth surfaces meta-analysis, the pooled D(M)FS prevented fraction estimate comparing fluoride varnish with placebo or no treatment was 43% (95% confidence interval (CI) 30% to 57%; P < 0.0001). There was substantial heterogeneity, confirmed statistically (P < 0.0001; I(2) = 75%), however this body of evidence was assessed as of moderate quality. Ten trials contributed to the meta-analysis of primary teeth, the pooled d(e/m)fs prevented fraction estimate was 37% (95% CI 24% to 51%; P < 0.0001), there was some heterogeneity (P = 0.009; I(2) = 59%) this evidence was assessed as of moderate quality. No significant associations in either dentitions were found with baseline caries severity, background exposure to fluorides, application features such as prior prophylaxis, concentration of fluoride or frequency of application. There was little information concerning possible adverse effects or acceptability of treatment., Conclusions: The conclusions of this updated review remain the same as when it was first published. The review suggests a substantial caries inhibiting effect of fluoride varnish in both permanent and primary teeth; however the quality of the evidence was assessed as moderate, as it included mainly high risk of bias studies, with considerable heterogeneity.

Objectives: Obesity and dental caries have become increasingly prevalent challenges to public health. Research results into the relationship between obesity and dental caries in children have been mixed and inconclusive. The aim of this review and meta-analysis was to provide evidence to quantify the relationship between obesity and dental caries in children using a systematic approach., Methods: A systematic search for papers between 1980 and 2010 addressing childhood obesity and dental caries was conducted and a random effects model meta-analysis applied., Results: Fourteen papers met the selection criteria. Overall, a significant relationship between childhood obesity and dental caries (effect size = 0.104, P = 0.049) was found. When analysed by dentition type (primary versus permanent), there was a nonsignificant association of obesity and dental caries in permanent and primary dentitions, yet on accounting only for standardized definitions for assessment of child obesity using body mass index, a strong significant relationship was evident in children with permanent dentitions. Moderating for study country of origin (newly 'industrialized' versus industrialized) showed a significant relationship between obesity and dental caries in children from industrialized but not newly industrialized countries. Cofactors such as age and socioeconomic class were significant moderators., Conclusions: Future analysis should investigate these confounding variables, helping shape the future of obesity management programmes and oral health interventions, through determining common risk factors., (© 2012 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Data Sources: The Cochrane Oral Health Group's Trials Register, and Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, CINAHL, PsycINFO, Current Controlled Trials, ClinicalTrials.gov, Web of Science and Dissertations and Theses via Proquest databases were searched. A number of relevant journals, (Acta Odontologica Scandinavica, ASDC Journal of Dentistry for Children, British Dental Journal, Caries Research, Community Dental Health, Community Dentistry and Oral Epidemiology, Journal of the American Dental Association, Journal of Dental Research, Journal of Public Health Dentistry, Swedish Dental Journal, International Journal of Paediatric Dentistry) not already searched as part of the Cochrane Journal Handsearching Programme were handsearched. There were no restrictions regarding language or date of publication., Study Selection: Randomised controlled trials (RCTs) where randomisation occured at the level of the group (cluster by school and/or class) or individual children were included. Included studies had to include behavioural interventions addressing both toothbrushing and consumption of cariogenic foods or drinks and have a primary school as a focus for delivery of the intervention., Data Extraction and Synthesis: Two pairs of review authors independently extracted data related to methods, participants, intervention design including behaviour change techniques (BCTs) utilised, outcome measures and risk of bias. A qualitative synthesis was conducted., Results: Four studies involving a total of 2302 children were included. One study was at unclear risk of bias and three were at high risk of bias. The studies were heterogeneous in both intervention and outcome measures and also suffered from poor reporting. Only one included study reported caries development as an outcome. This small study at unclear risk of bias showed a prevented fraction of 0.65 (95% confidence interval (CI) 0.12 to 1.18) in the intervention group. However, as this is based on a single study, this finding should be interpreted with caution. All three studies that reported plaque outcomes found statistically significant reduction in plaque in the intervention groups, but due to differences in plaque reporting between studies these could not be combined. Two of these studies included an active home component where parents were given tasks relating to the school oral health programme (games and homework), to complete with their children. Secondary outcome measures from one study reported that the intervention had a positive impact upon children's oral health knowledge., Conclusions: Currently, there is insufficient evidence for the efficacy of primary school-based behavioural interventions for reducing caries. There is limited evidence for the effectiveness of these interventions on plaque outcomes and on children's oral health knowledge acquisition. None of the included interventions were reported as being based on or derived from behavioural theory. There is a need for further high quality research to utilise theory in the design and evaluation of interventions for changing oral health related behaviours in children and their parents.

Objective: The objective of the study was to determine the effect of dental health status, dental anxiety and oral-health-related quality of life (OHRQoL) upon homeless people's experience of depression., Methods: A cross-sectional survey was conducted on a sample of homeless people in seven National Health Service Boards in Scotland. All participants completed a questionnaire to assess their depression, dental anxiety and OHRQoL using reliable and valid measures. Participants had an oral examination to assess their experience of tooth decay (decayed and missing teeth). Latent variable path analysis was conducted to determine the effects of dental health status on depression via dental anxiety and OHRQoL using intensive resampling methods., Results: A total of 853 homeless people participated, of which 70% yielded complete data sets. Three latent variables, decayed and missing teeth, dental anxiety (Modified Dental Anxiety Scale: five items) and depression (Center for Epidemiological Studies Depression Scale: two factors), and a single variable for OHRQoL (Oral Health Impact Profile total scale) were used in a hybrid structural equation model. The variable decayed and missing teeth was associated with depression through indirect pathways (total standardised indirect effects=0.44, P<.001), via OHRQoL and dental anxiety (χ²=75.90, df=40, comparative fit index=0.985, Tucker-Lewis index=0.977, root mean square error of approximation=0.051 [90% confidence interval: 0.037-0.065])., Conclusion: Depression in Scottish homeless people is related to dental health status and oral-health-related factors. Decayed and missing teeth may influence depression primarily through the psychological constructs of OHRQoL and, to a lesser extent, dental anxiety., (Copyright © 2010 Elsevier Inc. All rights reserved.)

The article presents questions and answers related to Evidence-based Dentistry (EBD) of oral health care on topics including dental caries, dental trauma, and oral surgery.

Objectives: To review the evidence of a relationship between sugar-containing methadone and dental caries.Data sources: A systematic search of Cochrane Library, PubMed, PsychINFO, EMBASE, MEDLINE,Current Controlled Trials, WHO, OHRN, SIGLE and ERIC databases was conducted from January 1978 upto June 2010.Study selection: Articles were assessed and data abstracted independently by two reviewers. Papersthat provided information about methadone and dental caries and were written in English were included,regardless of type of publication, authors, source of financial support and outcomes. Nineteen articles wereidentified; of these only three contained quantitative evidence, one of which was a survey.Conclusions: Many people on oral methadone maintenance programmes have been reported to havehigh levels of dental caries. However, there is no strong evidence to support a direct link between sugarcontainingmethadone and an increase in dental caries. High quality studies are required to assess thepotential adverse effects of methadone on oral health. [ABSTRACT FROM AUTHOR]

The article presents questions and answers related to dentistry including effectiveness of fluoride supplements, relationship between asthma and dental caries, and yet another on increased risk of meningioma from dental x-rays.

The article presents a question-and-answer advisory related to evidence-based dentistry. A query on the effect of behavioral intervention to anxiety reduction and result in significantly improved dental attendance in adults. An inquiry on the efficacy of fluoride toothpaste in preventing dental caries. The difference in implant survival and complications between implants placed in augmented maxillary sinus and non-augmented posterior maxilla.

Presents a lists of questions, answers and evidence levels of areas addressed in volumes 3 and 4 of the journal "Evidence-Based Dentistry". Cariology; Cosmetic dentistry; Dental education; Dental implants; Endodontics; Infection control; Oral cancer; Oral medicine.

In most, if not all, studies we collect data to obtain information about an area of research in which we have an interest. For example, we might want to know the level of dental caries in our area. In order to discover this we might need to observe a number of different variables, which could include, age, sex, number of teeth, cavities, fillings, extraction, pain, sepsis and quality of life. This information or data is normally obtained from a sample of the population which can then be summarised, analysed and conclusions drawn. This collection, summarising and analysis of data are what statistics and statistical technique are all about.Evidence-Based Dentistry (2007) 8, 22–23. doi:10.1038/sj.ebd.6400501 [ABSTRACT FROM AUTHOR]

The article talks about the latest dental guideline released by the Scottish Intercollegiate Guidelines Network (SIGN). It mentions a recent systematic review that compared the dissemination and implementations methods of different clinicians. SIGN, one of the oldest evidence-based guideline organizations, has developed a program of 113 evidence-based clinical guidelines, the latest of which is "SIGN 83: Prevention and Management of Dental Decay in the Pre-school Child". The applicability of the guideline depends on the extent to which it harmonizes with four local or patient-specific factors referred to as the "killer Bs": Burden, Beliefs, Bargain and Barriers.

Discusses recommendations made by the Medical Research Council concerning further research that might be required to improve the evidence base in the area of water fluoridation and health. Total exposure and uptake; Dental caries; Dental fluorosis; Social inequalities in relation to water fluoridation; Bone health; Cancer.

Data sourcesMedline, Embase, Lilacs.Study selectionPublished and unpublished observational population-based studies presenting information on the prevalence, incidence, case fatality and cause-specific mortality related to untreated caries, severe periodontitis and severe tooth loss between January 1980 and December 2010. There were no language restrictions. Study quality was assessed using the STROBE checklist (http://www.strobe-statement.org/).Data extraction and synthesisPrevalence estimates were calculated on the database for all age-gender-country-year groups using a specifically developed Bayesian meta-regression tool. Disability-adjusted life-years (DALYs) and years lived with disability (YLDs) metrics were used to quantify the disease burden. Disability weights were calculated based on population-based surveys in five countries (USA, Peru, Tanzania, Bangladesh and Indonesia) and an open Internet survey. Uncertainties in estimates were examined using Monte Carlo simulation techniques with uncertainty levels presented as the 2.5th and 97.5th centiles, which can be interpreted as a 95% UI.ResultsOral diseases remain highly prevalent in 2010 affecting 3.9 billion people. Untreated caries in permanent teeth was the most prevalent condition evaluated for the entire GBD (Global Burden of Disease) 2010 Study with a global prevalence of 35% for all ages combined. Severe periodontitis and untreated caries in deciduous teeth were the 6th and 10th most prevalent conditions, affecting, respectively, 11% and 9% of the global population. Oral conditions combined accounted for 15 million DALYs globally (1.9% of all YLDs and 0.6% of all DALYs), implying an average health loss of 224 years per 100,000 people. 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.ConclusionsThe findings highlight the challenge in responding to the diversity of urgent oral health needs world-wide, particularly in developing communities. [ABSTRACT FROM AUTHOR]

The article presents the author's comments on the issues related to the use of fluoride toothpaste. He refers to two recent papers which highlight the benefits and risks, associated with the use of fluoride toothpaste. He says that toothpaste-swallowing or eating/ licking habits may increase the risk of fluorosis, therefore toothbrushing in children under seven should be supervised. According to him, the use of fluoride toothpaste should depend on the child’s risk of caries.

This article systematically reviews the effectiveness of routine dental checks of different recall frequencies in adults and children. This review demonstrates a lack of consistency in the direction of effect of oral health outcome measures with different frequencies of routine dental check. Six-monthly routine dental checks or any other specific frequency of routine dental check for adults or children cannot be advocated on the basis of existing evidence. There is a need for further primary research to investigate the relative effectiveness of routine dental checks of different frequency in terms of the separate impact on caries, periodontal disease, oral cancer and patient-centred oral health outcomes.