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Introduction Impacted mandibular third molars can be asymptomatic or cause some pathologies, such as distal caries and odontogenic cysts and tumours. This study investigates the prevalence of distal caries of the mandibular second molar adjacent to the mesioangular or horizontally partially erupted mandibular third molar and its relationship regarding decayed, missing and filled teeth (DMFT) risk group, age, side (left-right) and sex.Methods The study included patients who had an appointment for mesioangular or horizontally positioned and partially erupted mandibular third molar surgery. Before the surgery, the DMFT score, age, sex and side were recorded. After extraction, the second molar was clinically examined for distal caries. The prevalence of distal caries and the correlation between the DMFT risk group, age, sex and side were determined.Results The study was conducted on 514 patients and involved 639 teeth. Men and patients in the moderate- or high-risk group are significantly prone to developing distal caries of the second molar. No statistically significant relationship exists regarding age group, side and position.Conclusion Sex and DMFT risk groups affect the prevalence of distal caries in second molars adjacent to the mesioangular or horizontally partially erupted third molars. The prophylactic extraction should be considered in men and patients in the moderate- or high-risk group., (© 2024. The Author(s), under exclusive licence to the British Dental Association.)

Design: Interrupted time series analysis., Data Analysis: An interrupted time series (ITS) analysis was conducted to determine if there was an association between the announcement and implementation of the soft drinks industry levy (SDIL) and rates of hospital admission for tooth extractions due to dental caries in children. Hospital Episode Statistics (HES) were used on hospital admissions for tooth extraction of one or more primary or permanent tooth due to a primary diagnosis of dental caries in children aged 0-18 years attending a National Health Service (NHS) hospital in England from January 2012 (pre-SDIL) to February 2020 (post-SDIL implementation). HES data were grouped and summarised by Index of Multiple Deprivation (IMD) and age group., Results: There was an absolute reduction of 3.7% (95% CI 5.3% to 2.2%) per 100,000 population/month and a relative reduction of 12.1% (95% CI 17.0% to 7.2%) in hospital admissions for carious tooth extractions in all children (0-18 years) compared if there had been no announcement of the SDIL (counterfactual scenario). Reductions were observed in children living in most areas regardless of the level of deprivation and most notably in the youngest children (<10 years)., Conclusions: An ITS analysis of administrative data on hospital admissions found the announcement of the UK SDIL was associated with improvements (reduction) in the incidence of hospital admissions for tooth extractions due to dental caries. This study provides evidence of benefits of the UK SDIL to children's oral health., (© 2024. The Author(s).)

Objective: to estimate the prevalence of self-reported tooth extractions and analyze associated factors in quilombola communities in Feira de Santana, Bahia, Brazil., Methods: this was a cross-sectional study, with 864 quilombolas; association between self-reported tooth extractions (no experience of extraction; ≤5 extracted teeth; >5 extracted teeth), and possible associated factors was estimated using multinomial logistic regression, with a 95% confidence interval (95%CI)., Results: tooth extractions were self-reported by 82.0% of quilombolas, 49.8% of whom had ≤5 teeth extracted and 32.2% of whom had >5 teeth extracted; greater likelihood of tooth extraction was associated with being male (adjusted OR = 1.7 - 95%CI1.1;2.7), working as an unregistered worker (adjusted OR = 2.7 - 95%CI1.3;5.7), being ≥60 years old (adjusted OR = 5.2 - 95%CI1.9;14.1) and reporting having dental caries (adjusted OR = 4.1 - 95%CI2.5;6.7)., Conclusion: tooth extractions are associated with social vulnerability conditions experienced by the quilombolas of the semi-arid region of Bahia state.

Introduction: The epidemiological profile of dental caries for Indigenous Peoples is complex and heterogeneous. The oral health of the Kaingang people, third largest Indigenous population from Brazil, has not been investigated so far., Objective: The purpose of this study was to assess the prevalence and severity of dental caries, in addition to the associated factors of the need of dental extraction among Kaingang adult Indigenous., Methods: A cross-sectional oral health survey was conducted among Kaingang adults aged from 35 to 44 years old living in the Guarita Indigenous Land, Rio Grande do Sul. Clinical exams were performed to analyze the conditions of dental crown and treatment needs., Results: A total of 107 Indigenous adults were examined. Mean DMFT score was 14.45 (± 5.80). Two-thirds of the DMFT score accounted for missing teeth. Anterior lower dentition presented the highest rates of sound teeth, whereas the lower first molars had the lowest. Need for dental extraction was observed in 34.58% and was associated with village location, time of last dental visit, and higher number of decayed teeth., Conclusion: The high frequencies of caries and missing teeth observed in this population indicate a lack of adequate assistance. It is essential to discuss health care models in order to combat avoidable social and health injustices.

Objectives: The aim of the study was to examine whether oral health as an infection focus could mediate disease course in patients with Behçet's disease (BD)., Methods: In the study, oral health of 194 BD patients was examined at baseline and follow-up periods. The reasons for last dental visits were recorded as tooth extraction or regular control visits/planned treatments at the end of follow-up period. The Behçet's disease severity score was calculated with higher scores indicating a more severe course. Mediation analysis was carried out to assess the effects of oral health on disease severity score at follow-up period in the study., Results: Dental and periodontal indices were found to be higher at follow-up visit compared to those of baseline (P < 0.05). Disease severity score was found to be higher in males (5.3 ± 2.4) compared to females (4.4 ±2.5) in the whole group (P = 0.005). Moreover, patients having tooth extraction at their last dental visit and patients with dental caries had a more severe disease course (5.4 ± 2.4; 5.5 ± 2.5) compared to others (4.2 ± 2.3; 4.4 ± 2.4; P < 0.0001). In multiple mediation analysis, disease severity score was a dependent variable and was directly mediated by male gender (B = -0.8822, P = 0.0145) and indirectly mediated through the presence of dental caries (B = 0.9509 P = 0.0110) and need of tooth extraction (B = 0.8758, P = 0.0128)., Conclusion: Both presence of dental caries and need of tooth extraction were observed to be effective mediators for a more severe disease course in BD. Therefore, better oral health should be aimed to eliminate microbial factors, which are a part of pathogenic processes., (© 2018 John Wiley & Sons Ltd.)

Purpose: To determine the clinical consequences of untreated dental caries among preschool children by using the pufa index (visible pulp, ulceration of the oral mucosa due to root fragments, a fistula or an abscess) and the incorporation of some risk factors., Materials and Methods: Data were collected via structured, pre-tested questionnaires from 729 parents in Turkey's capital, Ankara. Examinations were performed under field conditions by one examiner. The decayed teeth were scored according to the International Caries Detection and Assessment System (ICDAS) II criteria. The filled and missing teeth and surfaces were also recorded as dmft and dmfs, and the pufa index was used for the consequences of untreated caries. The associations were evaluated by univariate analysis and logistic regression., Results: The means age of the study population was 58.8 ± 8.6 months. 45% of the children were female and 55% were male. Mean dmft and dmfs were 4.8 ± 4.7 and 8.3 ± 10.2, respectively. 73.8% of the children had early childhood caries (ECC), while 51.0% had severe cases. Only 58 children (8.0%) had totally healthy primary teeth according to ICDAS II. Of the children with caries (n = 538), 17.5% had at least one pufa tooth. According to the logistic regression analysis, sex, having at least one sibling, extraction experience, and father's educational level were found to be the factors associated with the existence of pufa., Conclusion: Healthcare providers' attention must be drawn to both untreated carious lesions and the high ECC proportion among preschool children.

Background: Despite the impact of oral diseases on the quality of life, there is limited updated evidence on oral health status in Limpopo province., Objectives: To determine the epidemiological profile of patients utilising public oral health services in Limpopo province., Method: This was a descriptive retrospective clinical chart review conducted in five purposively selected district hospitals in Limpopo province. The collected data included the patient's sociodemographic information, reasons for dental consultation, information on the dental or oral diseases and the treatment received. Five hundred clinical files were systematically selected (100 from each district hospital) for the period 01 January 1995 to 31 December 2013. Data were collected using the World Health Organization's indicator age groups, namely 6-year-olds, 12-year-olds, 18-year-olds and 35-44-year-old groups. A data capturing sheet was used to record the collected information. Data were analysed using the statistical software package for social sciences SPSS version 23.0., Results: The majority of patients were in the age group of 6 to 20 years (n = 375, 75%). The majority were male patients (n = 309; 62%). Dental caries was the most common complaint (n = 298, 60%). The second most common main complaint in this age group was retained primary or deciduous teeth (n = 60, 12%) affecting children mainly in the age group of 6 to 12 years. The most common clinical procedure across all five districts was dental extractions (n = 324, 64%). Other clinical interventions included scaling and polishing (n = 33, 12%) and dental restorative care (n = 20, 3%)., Conclusion: There is an urgent need to reorient oral health service delivery in Limpopo province to focus more on preventive oral health programmes.

Aim To explore the value of DGA data as an indicator of the impact and inequalities associated with child dental decay (caries) in Southampton.Design Data from the local DGA provider in Southampton was used to investigate trends in child (17 years and under) DGAs between 2006/7 and 2014/15. Retrospective analysis of anonymised child-level 2013/14 and 2014/15 data from the same service was carried out to identify any inequalities with respect to deprivation, impact on school attendance and cost to the health economy.Results Around 400-500 Southampton children needed a DGA annually within this period. There were year-on-year variations, but no upward or downward trend. The DGA rate was 2.5 to three times higher in the most deprived quintile compared to the least. This translates to an equivalent gap in school absences, which could impact on educational achievement. The cost of these procedures in 2014/15 was around £210,000.Conclusions DGA data have value in highlighting the impact and inequalities associated with dental decay on children and the wider economy. Nationally, they could be used for benchmarking. Locally, these data could be used to target and evaluate health improvement programmes as well as to highlight DGA service changes that would disproportionately affect children from more deprived backgrounds.

Purpose: To determine cumulative dental treatment experience in a retrospective clinical cohort, according to baseline caries risk assessment (CRA) information., Methods: Evaluated were electronic records from a university pediatric dental clinic (2009 to 2014) of new, six- to 72- month-old patients who were not treated under sedation or general anesthesia (N equals 750). The mean number of teeth restored or extracted (two-year total and omitting the first 190 days post-baseline to discount initial treatment needs) was compared by baseline CRA category and CRA items (caries risk indicators, protective items, and clinical disease indicators)., Results: The CRA category was associated with mean treated teeth over two years (low equals 0.53, moderate equals 1.02, high/extreme equals 4.47) and post 190 days (low equals 0.51, moderate equals 0.89, high/extreme equals 2.11). Any treatment probability was greatest for high/extreme-risk children but not statistically significantly different between low- and moderate-risk. Age-standardized means were greater for all individual baseline clinical indicators and most risk indicators, but lower for most protective items (not statistically significantly for all items). Clinical indicators were the strongest outcome correlates., Conclusions: In this population, baseline risk information was associated with clinical outcomes. CRA can help identify patients needing more intensive caries prevention.

Purpose: To evaluate the oral health of children who were beneficiaries of a promotion and preventive programme for more than 6 years and to estimate the factors relating to their oral condition., Materials and Methods: In this case-control study, the total population comprised all 7- to 13-year-old children who attended the Paediatric Dentistry Centre of Reference Simón Bolívar (CROSB), a programme for students of the community of Viña del Mar, Chile. The case group was treated from the age of 7 to 13 years and controls were only seen at the age of 13 (had not been previously enrolled in the programme). The compilation of data was carried out through examination of clinical records. Statistical analysis included Fisher's Exact Test, the chi-square and Mantel-Haenszel tests to determine odds ratios, log-linear models to study some types of relationships between the different qualitative variables and Mood's Median Test for quantitative variables. Finally, a logit-type generalised linear model (GLM) was adjusted to estimate the probability of a caries-free child according to the different variables under study., Results: The main finding is that this programme does not successfully control the local risk factors of caries. The factors that jointly explain the presence of caries-free children were: non-participation in the programme, attending public school and the presence of sealed teeth., Conclusion: Even though the evaluated programme creates equity in the indicators of oral health among its beneficiaries, it does not reach the levels of oral health of the non-vulnerable population. It is recommended that this programme seek more effective tools.

Introduction: A non-carious lesion (NCL) is the loss of hard dental tissue on the neck, tuberculum and incisal edges of the teeth. Interest in clinical presence and in unclear etiology of these lesions allows for their future prevention and treatment., Objective: The aim of the study was to determine presence and clinical characteristics of NCLs and dentine hypersensitivity (DH), as well as their possible risk factors in children, in the population of the city of Novi Sad., Methods: A total of 55 subjects were included in the present study, aged between three and 18 years. Each subject completed a structured questionnaire related to the etiological factors, and all teeth of each subject were examined by two independent clinical dentists to determine NCLs and DH. In the case of small children, their parents or guardians filled out the questionnaire. Teeth with NCLs and DH were diagnosed according to the Basic Erosive Wear Examination (BEWE) index and by a blast of air according to Schiff and Hypersensitivity Index. The review was carried out by inspection and probing., Results: The data were analyzed by clinical examination and comparison of the answers to the questionnaires. We observed an increased presence of non-caries lesions on primary teeth, compared to permanent teeth, with a statistically significant difference (X2=3.86, df=1, p=0.04). The changes were observed in 82 teeth, and were most frequent on the canine deciduous teeth (65%) and canine permanent teeth (51%). BEWE index was 10-11% to 92-100% in permanent, and 51-57% in deciduous teeth. Majority of patients with primary teeth (89.36%) did not respond to air stimulus, while most patients with permanent teeth (74.29%) did not react to Schiff Index. In the estimate of sensitivity, the respondents reported hypersensitivity on 6.38% of the deciduous teeth and 22.86% of the permanent teeth. Comparison of etiology factors did not reveal a direct link with the appearance of NCLs., Conclusion: Research has shown that despite the lack of subjective symptoms, these lesions have distinct clinical characteristics. The fact that they occur even in deciduous dentition justifies the need for further investigations.

Objectives: To document deep carious lesions and other consequences of caries (DCL-CC) in molars of 18-year olds leaving the free-of-charge Public Dental Health Service (PDHS). To explore the association between background factors and DCL-CC., Materials and Methods: The final study sample (n=1876) comprised 95% of individuals born in 1993 and registered in the PDHS in Troms County, Northern Norway. The most recent digital bitewing radiographs of each subject were examined for DCL-CC (deep untreated carious lesions, deep restorations, root canal obturations or extractions due to caries). Inter- and intra-observer kappa scores were 0.62 and 0.87, respectively. Information on background factors (gender, clinic location, history of medical problems, bitewing examination interval, DMFT score and planned recalls) were retrieved from dental records., Results: About one-quarter of subjects (488) had at least one molar with DCL-CC. There were 848 molars in total with DCL-CC; the majority were deep restorations (70%), but 4% were deep untreated carious lesions. More than a quarter of DCL-CC were either root canal obturations (14%) or extractions (12%). Multivariable logistic regression analyses showed that a 1-unit increase in DMFT score was associated with deep untreated carious lesions and extractions due to caries. There was no association between urban/rural clinic location, which indicated socio-economic status, and either DMFT score or DCL-CC., Conclusions: Despite the existence of a free-of-charge dental service, more than one-quarter of the subjects in the present study had at least one molar with DCL-CC.

Objective: Dental caries is one of the most frequent multifactorial diseases. Among the numerous factors influencing the risk of caries, genetics plays a substantial role, with heritability ranging from 40 to 60%. Gene variants affecting taste preference and glucose transport were recently associated with caries risk. The aim of this study was to analyze two common polymorphisms in the sweet taste receptor (TAS1R2) and glucose transporter (GLUT2) genes in children with dental caries and healthy controls in the Czech population., Methods: A total of 637 unrelated Caucasian children, aged 11-13 years, were included in this case-control study. One hundred and fifty-five subjects were caries-free (with decayed/missing/filled teeth, DMFT = 0) and 482 children were caries-affected (DMFT ≥ 1). The TAS1R2 (Ile191Val, rs35874116) and GLUT2 (Thr110Ile, rs5400) genotypes were determined using the 5' nuclease TaqMan® assay for allelic discrimination., Results: Compared with subjects with the common Thr allele, carriers of the Ile allele of GLUT2 had significantly more frequently dental caries (p < 0.05, OR = 1.639, 95% CI: 1.089-2.466). Similarly, children with the Val allele for the TAS1R2 Ile191Val polymorphism were more frequently affected by caries than children who carried the Ile allele (p < 0.05, OR = 1.413, 95% CI: 1.014-1.969). In contrast, no significant associations between GLUT2 and/or TAS1R2 polymorphisms and fillings were found, but allele frequencies of the TAS1R2 variant were marginally significantly different between children with DMFT = 0 and DMFT ≥1 (p = 0.053, OR = 1.339, 95% CI: 0.996-1.799). However, no significant interaction between both genes and risk of dental caries was found., Conclusions: In conclusion, GLUT2 and TASR1 polymorphisms may influence the risk of caries in the Czech population., (© 2015 S. Karger AG, Basel.)

Objective: To provide prevalence data for dental caries in Georgia., Methods: This World Health Organization pathfinder survey was conducted among 1,351 (6, 12 and 15 year-old) Georgian children, representing the main ethnic groups in urban and rural locations. Caries was analysed at univariate and multivariate levels, according to age, gender, urban/rural locality and ethnic group., Results: Caries experience levels among 6-year-olds were dmft = 4.57, sd 3.42 (14.8% caries-free); DMFT = 2.04 (sd 2.02) among 12-year-olds (31.1% caries-free); and DMFT = 3.51 (sd 3.14) for the 15-year-olds (17.7% caries-free). Urban children at ages 6 and 12 years were more likely to be caries-free and have both lower levels of caries-experience and higher levels of filled or restored teeth. In multivariate regression analyses, most age groups showed a significant contribution from residence location. No differences were found by age and no consistent differences were detected by ethnic group., Conclusion: These data should provide the baseline for formulating and conducting public oral health efforts in Georgia, with emphases on rural residence locations.

Background: No reports on a caries pattern covering the full spectrum of the disease could be found in the literature. The aim of this study was to evaluate caries in primary and first permanent molars of 7-8-year-old Polish children by the Caries Assessment Spectrum and Treatment (CAST) index and to find whether there was any correlation between the caries stages in such teeth., Methods: The study covered 284 7-8-year-old children from randomly selected schools in the Bialystok District, Poland. The prevalence of CAST categories was evaluated with regard to the first and second primary, and first permanent, molars. The Spearman's rank correlation coefficient was used to explore the correlation of the distribution of CAST codes among the evaluated teeth. The level of statistical significance was established at p < 0.05. The intra-examiner reliability was determined by the unweighted kappa coefficient., Results: With regard to the permanent molars, caries was observed in 14.8% to 17.3% of the molar and most lesions were scored at the non-cavitation level. Caries in primary molars was most often recorded at the stage of cavitated dentine lesion. Teeth with pulpal involvement, sepsis and extracted due to caries were found to be more prevalent in first, and then in second primary molars. A strong correlation was found between the status of teeth from the right and left sides of the oral cavity. The correlation of the status of first and second primary teeth was stronger for the left than for the right side of the mouth, r was 0.627 and 0.472 in maxilla and 0.513 and 0.483 in mandible (p < 0.001), respectively. For the neighbouring primary and permanent molars the correlation was assessed to be weak. With regard to the teeth situated in opposite jaws the study revealed that the correlations were moderate - r between 0.33 and 0.49. The intra-examiner reliability was established at 0.96 for the primary dentition and at 0.878 for permanent molars., Conclusion: The strongest correlation found in the evaluated population concerned the distribution of caries in primary molars on the left side of the mouth. The study proved the usefulness of the CAST index in epidemiological surveys.

Introduction: Dental caries is a common condition amongst young children that negatively impacts on their quality of life, It is an added burden on children with special healthcare needs (CSHCN) who have an increased risk of developing caries due to the high sugar contents in their medications, regular consumption of cariogenic foods and a poor salivary flow., Aims and Objectives: to analyse the management of dental caries in CSHCN at a tertiary public hospital in South Africa., Methods: A retrospective analysis was conducted of the dental and medical records of 374 medically compromised children presenting with dental caries. Dental treatment and anaesthetic techniques used were reviewed., Results: Results indicated that the majority of CSHCN presenting with caries were managed by extractions (96.5%) under either local anaesthesia (73.3%) or general anaesthesia (26.7%). There was a lack of restorative care provided to these compromised children,, Conclusions: Treatment by extractions may relieve discomfort and pain; however, early loss of teeth leads to functional, psychological, aesthetic and orthodontic problems, which can result in a further decline in the quality of life of these already compromised patients, Restorative treatment and prevention strategies are critical in managing caries in CSHCN in order to improve their quality of life,

Background: Contemporary evidence for the effectiveness of water fluoridation schemes in the U.K. is sparse. The utility of routinely collected data in providing evidence warrants further research., Objectives: To examine inpatient hospital episodes statistics for dental extractions as an alternative population marker for the effectiveness of water fluoridation by comparing hospital admissions between two major strategic health authority (SHA) areas, the West Midlands SHA-largely fluoridated--and the North West SHA--largely unfluoridated., Method: Hospital episodes statistics (HES) were interrogated to provide data on admissions for simple and surgical dental extractions, which had a primary diagnostic code of either dental caries or diseases of pulp and periapical tissues for financial years 2006/7, 2007/8 and 2008/9. Data was aggregated by SHA area and quinary age group. Directly standardised rates (DSR) of admissions purchased for each primary care trust (PCT) were calculated and ranked by index of multiple deprivation (IMD)., Results: A significant difference in DSRs of admission between PCTs in the West Midlands and North West was observed (Mann-Whitney U test [p <0.0001]) irrespective of IMD ranking. The difference in rates between the two most deprived PCTs was 27-fold., Conclusions: After ranking by IMD, DSRs of hospital admissions for the extraction of decayed or pulpally/periapically involved teeth is lower in areas with a fluoridated water supply. The analysis of routinely collected HES data may help identify the impact of water fluoridation schemes.

Unlabelled: This pilot study has for main objective to measure the applicability and the utility of ICDAS index in a context of prevention in developing countries. Dental caries prevalence was evaluated among schoolchildren using DMF (WHO basic method) vs. ICDAS index in Senegal., Materials and Method: A representative stratified random cluster sample of 677 primary and college schoolchildren aged 12 and 15 years was examined for caries prevalence. The clinical examination was conducted in two steps for each. The investigator proceeded at first to the inventory of the number of teeth decayed (D), missing (M) or filled (F) according to the WHO basic method. Then, after cleaning and drying all teeth, a two-digit ICDAS code was used to record data at each dental surface., Results: Caries prevalence (96%) was higher than expected in Senegal. ICDAS index provides 43% moreover information than DMF. The need for prevention (ICDAS1: 66%/72% and ICDAS2: 54%/58%) and intercept (ICDAS3: 40%/42% and ICDAS4: 31%/33%) are higher than the need of curative treatment (ICDAS5: 18%/23% and ICDAS6: 27%/33%) respectively among primary and college schoolchildren., Conclusion: Preventive programs are urgently needed in Senegal. It's necessary to lead epidemiological studies in other African countries for determining caries prevalence using the ICDAS criteria to harmonize oral health regional planning.

Background: Contemporary evidence for the effectiveness of water fluoridation schemes in the U.K. is sparse. The utility of routinely collected data in providing evidence warrants further research., Objectives: To examine inpatient hospital episodes statistics for dental extractions as an alternative population marker for the effectiveness of water fluoridation by comparing hospital admissions between two major strategic health authority (SHA) areas, the West Midlands SHA--largely fluoridated--and the North West SHA--largely unfluoridated., Method: Hospital episodes statistics (HES) were interrogated to provide data on admissions for simple and surgical dental extractions, which had a primary diagnostic code of either dental caries or diseases of pulp and periapical tissues for financial years 2006/7, 2007/8 and 2008/9. Data were aggregated by SHA area and quinary age group. Directly standardised rates (DSR) of admissions purchased for each primary care trust (PCT) were calculated and ranked by index of multiple deprivation (IMD)., Results: A significant difference in DSRs of admission between PCTs in the West Midlands and North West was observed (Mann-Whitney U test [p <0.0001]) irrespective of IMD ranking. The difference in rates between the two most deprived PCTs was 27-fold., Conclusions: After ranking by IMD, DSRs of hospital admissions for the extraction of decayed or pulpally/periapically involved teeth is lower in areas with a fluoridated water supply. The analysis of routinely collected HES data may help identify the impact of water fluoridation schemes.

Valid estimates of caries experience are needed to monitor oral population health. Obtaining such estimates in practice is often complicated by nonresponse and missing data. The goal of this study was to estimate caries experiences in a population of children aged 5 and 11 years, in the presence of nonresponse and missing data. Four estimation methods are compared. Each method makes implicit assumptions about the processes that caused the nonresponse and the missing data. Three of the four methods are based on unrealistic assumptions about the missing data and underestimate caries experience. Under the missing at random assumption, multiple imputation in combination with direct standardization corrects for the deficiencies of current methodology. In the presence of missing data and nonresponse, we recommend a combination of multiple imputation and direct standardization to obtain correct estimates of caries experience.

Introduction: Caries is the most common chronic disease of childhood, and severe forms may necessitate rehabilitative dental surgery. In this study, administrative data related to pediatric dental surgery performed under general anesthesia to treat severe early childhood caries in Manitoba, Canada, were reviewed to determine trends in pediatric dental surgery, as well as geographic, regional and socio-economic variations in surgical rates., Methods: The total number of dental surgery cases performed under general anesthesia was obtained from provincial administrative databases for fiscal years from 1997-98 to 2006-07. Codes from the International Classification of Diseases and Related Health Problems (9th or 10th revision, as appropriate) were used to identify children who underwent extractions under general anesthesia for a slightly earlier fiscal year period (1996-97 to 2005-06). Each 10-year period was divided into two 5-year periods for comparisons over time. Analyses included descriptive and bivariate statistics, with the data being disaggregated by regional health authority (RHA) or by community area (for Winnipeg). Comparisons for which p ≤ 0.05 were defined as statistically significant., Results: A total of 18,544 children had dental surgery under general anesthesia between 1997-98 and 2006-07 (mean age ± standard deviation 3.28 ± 1.02 years). Many of the children requiring surgery resided in one northern RHA (26.8%) or the Winnipeg RHA (23.8%). More than half of the RHAs (7/11) displayed significant increases in the rate of surgery, with northern RHAs having the highest rates. Within Winnipeg, 3 of the 12 community areas had significant increases in the rate of surgery. Two inner-city neighborhoods accounted for nearly 50% of surgical cases. The rate of extractions under general anesthesia increased significantly in 6 of the 11 RHAs, with northern RHAs having the highest rates. Four Winnipeg communities experienced significant increases in the extraction rate over time., Conclusion: Pediatric dental surgery under general anesthesia for treatment of severe early childhood caries is common in Manitoba, and the demand increased in several communities over the study period. These results are being shared with decision-makers and communities to identify regions where oral health promotion is needed.

Aim: To assess the prevalence of molar incisor hypomineralisation (MIH) in children in Slovenia and explore the relationship between MIH defects and caries in the primary and permanent dentition, and tooth- and surface-specific associations between MIH defects and caries on first permanent molars (FPM)., Materials and Methods: The study population was comprised of 558 children aged 6.011.5 years. The prevalence of developmental defects of enamel (DDE) on FPM and permanent incisors was assessed through clinical examination by a calibrated examiner using the modified DDE Index of the FDI. Also recorded were atypical fillings, post-eruptive enamel breakdowns, and extractions because of MIH. Dental caries was assessed using the WHO criteria., Results: At least one FPM with MIH defects was found in 21.4% of children. Children with MIH had significantly higher (p<0.05) caries experience in their permanent teeth. In primary teeth, higher caries experience was not statistically significant. MIH defects in FPM were associated with higher caries scores at the tooth (p<0.01), and at the surface (p<0.05) level., Conclusion: MIH is common in Slovenia. Children with MIH are more prone to dental caries development on their permanent teeth. On FPM teeth and surfaces affected with MIH defects, even with only mild demarcated opacities with apparently intact enamel, an increased caries experience is present.

Objectives: Data showed that among 5-year-old Chinese, 96.7% of cavitated primary teeth were left untreated. The study aimed to report on the course of cavitated primary teeth within the Chinese health-care system over a period of 3.5 years., Methods: Selection of high caries risk children for inclusion in a sealant comparison study was based on the presence of cavitated dentine lesions in their primary teeth. At the 6-month sealant evaluation point many of these cavitated dentine lesions had not been treated. This necessitated monitoring these cavitated teeth 6-monthly for those exfoliated, restored, with a cavity left open, having caused toothache (symptom) and having (or having had) an abscess or fistulae (symptom). Care-seeking instruction was given at every evaluation point. anova and t-test were used in analysing the data., Results: A total of 1012 cavitated primary teeth in 305 children (7.6 to 9.3 years old), were followed for 3.5 years. A total of 92.9% of cavitated primary teeth were left open, while 7.1% were restored at some stage during the observation period; 98.5% of restored teeth and 95.5% of cavitated teeth left open exfoliated and 93.9% of restored teeth and 81.5% of cavitated primary teeth left open exfoliated without any symptoms. Having (or having had) toothache was the symptom most frequently related to exfoliated restored teeth and to exfoliated cavitated teeth left open. Restored primary teeth survived statistically significantly longer than cavitated primary teeth left open: 1.99 ± 0.07 years and 1.68 ± 0.03 years, respectively., Conclusion: The large majority of cavitated primary teeth in this child population exfoliated without symptoms., (© 2013 FDI World Dental Federation.)

Use of fluoride has led to dramatic improvements in oral health; however, the impact of these improvements on the volume and mix of treatment provided in dental systems is largely unknown. The use of administrative data to analyze trends in treatment provision gives 'real-life' insight into the impact of changing levels of oral health on oral health services. The first aim of this study was to determine the extent to which useful data on temporal treatment patterns could be extracted from a public insurance database. The second aim, contingent on the first, was to investigate whether increased tooth retention and decreases in caries were reflected in the volume and types of treatment provided to adults within a public social insurance scheme between 1997 and 2008. Data were retrieved from the Dental Treatment Benefit Scheme databases, and new datasets were generated to analyze the distribution of treatments and mean treatments provided to 1,271,937 adults over the 12-year period. Provision of restorations, extractions, and dentures decreased, and the ratio of preventive/diagnostic to invasive treatments per dentist increased, which supports reported improvements in oral health. In conclusion, this paper illustrates the decline in invasive treatments, and increase in preventive treatments that accompanied improvements in oral health.

Objective: To assess the dental health status and treatment needs among children of 'Pardhi' tribal community., Methods: A total of 185 children were examined over a period of 2 months using WHO proforma. The statistical software namely SPSS version 15.0 and data was analyzed using Student's t-test and ANOVA test at p < 0.05., Results: The mean score for dft and DMFT was 1.87 ± 1.073 and 2.04 ± 1.564 respectively with males subjects were having comparatively more scores. It was also found significant differences between age groups. Most of the children needed one surface filling, i.e. 29.40%, followed by pulp care and restoration (19.30%), two or more surface fillings (15.60%) and extraction (11.70%)., Clinical Significance: The study subjects were characterized by a lack of dental care services, high prevalence of dental caries and treatment needs. Therefore, implementation of a basic oral health care program for this tribal population is a high priority.

Background: Studies from Nigeria have documented different reasons for tooth mortality and regular follow-up studies to determine any changes in reasons and pattern among Nigerians appears not to be common. The purpose of this study was to determine the reasons and pattern of tooth mortality among Nigerians and the changes that might have occurred after 38 years of the first report., Materials and Methods: The case records of patients seen at the Oral Surgery clinic of the University of Benin Teaching Hospital between March 2007 and February 2008 were retrieved from the Medical Records Department and analyzed for age, gender, reasons for extraction, tooth extracted, frequency of extraction, and mode of extraction., Results: A total of 990 patients were referred for exodontia and 1050 teeth were extracted from 397 (40.1%) males and 593 (59.9%) females of age 14--89 years. The reasons for extraction include caries and its sequelae (n = 905, 86.2%), periodontal disease (n = 69, 6.6%), trauma (n = 41, 3.9%), orthodontics (n = 24, 2.3%), failed endodontics (n = 5, 0.5%), prosthetics (n = 4, 0.4%), pericoronitis (n = 2, 0.2%). The most frequently extracted teeth were the lower right first molars (n = 109, 10.4%) and the lower left first molars (n = 95, 9.0%), respectively. Molar teeth (n = 830, 79.0%) were more frequently extracted while canines (n = 13, 1.2%) were the least. The lower molars were more commonly extracted (n = 479, 45.6%) followed by upper molars (n = 351, 33.4%). The age range of 21-30 years was more commonly referred for extraction with the most frequently extracted teeth being the lower left first molars (n = 32, 3.0%) in females and (n = 27, 2.7%) in males, respectively., Conclusion: Tooth mortality in Nigerians is significantly associated with dental caries and its sequelae especially in younger patients.

Aim: The aim of this study was to assess and compare the oral health status and the treatment needs of the institutionalised hearing-impaired and blind children and young adults in the city of Udaipur, Rajasthan, India., Methods: A descriptive cross-sectional study was conducted among 498 institutionalised hearing-impaired and blind people, aged 4 to 23 years, in the city of Udaipur, Rajasthan. The World Health Organization oral health assessment basic methods and form (1997) were used for data collection. Clinical examinations were carried out in the institute's medical room or classroom by single examiner with the aid of a mouth mirror, explorer and Community Periodontal Index (CPI) probe under adequate natural light (Type III examination). The resulting data were entered into statistical software and analysed by applying the chi-square test, ANOVA, t-test and stepwise multiple linear regression analysis., Results: The total mean DMFT (decayed-missing-filled teeth) and mean dft scores were 1.77 and 0.27 respectively. The largest component of DMFT was the D, with a mean of 1.49. The F component of 0.08 was very low. Mean DMFT/dft was greater among hearing-impaired than among blind subjects. Overall, 159 (32%) were periodontally healthy (CPI=0), 162 (32%) had shallow pockets (CPI=3) and 36 (7%) had deeper pockets (CPI=4). A higher percentage of the blind (87; 43%) than the hearing-impaired (72; 24%) subjects were periodontally healthy (CPI score=0). One-surface fillings were the most commonly provided form of past treatment., Conclusion: The findings in this study highlight the lack of dental treatment for this group. Overall oral health status was poorer in the hearing-impaired than in the blind subjects.

Background: Dental caries among young children are a global problem. Scant attention is paid towards primary teeth, leading to high prevalence of dental caries. There are only few studies done in Sri Lanka, addressing oral hygiene among preschool children. Scientific evidence is in need to persuade authorities to establish a programme promoting oral hygiene among preschool children., Methods: A descriptive cross sectional study was conducted in Ragama Medical officer of Health area. Consecutive children between 2 - 5 years of age, attending child welfare clinics were recruited for the study. Practices related to dental hygiene and socio-economic characteristics were obtained using an interviewer administered questionnaire. Mouth was examined for evidence of dental caries. Data collection and examination were done by two doctors who were trained for this purpose. The data were analysed using SSPS version 16., Results: Total of 410 children were included. None had a routine visits to a dentist. Practices related to tooth brushing were satisfactory. Prevalence of dental caries gradually increased with age to reach 68.8% by 5 years. Mean total decayed-extracted-filled (deft) score for the whole sample was 1.41 and Significant caries index (SIC) was 4.09. Decayed tooth were the main contributor for the deft score and Care index was only 1.55. Girls had a significantly higher prevalence of caries than boys., Conclusions: Dental care provided for Sri Lankan preschool children appears to be unsatisfactory as prevalence of dental caries among this cohort of preschool children was very high. There is an urgent need to improve dental care facilities for Sri Lankan preschool children.

The objective of this study was to verify, using periapical radiographs, whether a partially erupted mandibular third molar is a factor in the presence of dental caries on the distal surface of the adjacent second molar. Two-forty six high quality periapical radiographs were selected, each showing a partially erupted mandibular third molar. The variables analyzed were: tooth number; gender; age; radiographic presence of caries on the distal surface of the adjacent molar; Pell and Gregory classification; Winter classification; angulation and distance between the second and mandibular third molar. The examiners were previously calibrated to collect data (kappa statistics from 0.87 to 1.0). The prevalence rate of caries on the distal surface of the second molar was 13.4%. In the logistical multivariate regression analysis, the angulation (OR=8.5; IC95%: 1.7-43.8; p=0.011) and the gender (OR=3.3; IC95%: 1.4-7.7; p=0.005) remained statistically significant after an age adjustment was made. The results indicate that the presence of a partially erupted mandibular third molar with an angulation of 31 degrees or more, is a risk factor for caries on the distal surface of the mandibular second molars., (Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Unlabelled: The aim of this exhaustive descriptive epidemiological study was to determine the clinical approach to be adopted by practitioners specializing exclusively in pediatric odontology and by orthodontists when confronted with decayed molars in children and adolescents., Material and Method: A questionnaire was sent out to all corresponding practitioners (n=2076). Six questions related to treatment decisions taken when faced with decayed permanent first molars (unfavorable short or middle-term prognosis) in patients needing, or not, orthodontic care. The Chi(2) test was used to compare responses., Results: Thirty-eight per cent of pedodontists (n=38) and 12.5% (n=246) of orthodontists answered the questionnaire. Faced with a permanent first molar with an unfavorable middle-term prognosis, 75.7% needed criteria to help them reach their treatment decision. In decreasing order of importance, these criteria were: presence of the third molar, patient motivation, inter-arch relationship, patient's oral hygiene, facial type, anterior jaw-teeth discrepancy and the number of molars to be extracted. Faced with a permanent first molar requiring extraction and when orthodontic treatment was not required, 31.7% of practitioners decided to close the maxillary space immediately as opposed to 13.4% who closed the space at the mandible. In the presence of a single decayed first molar, 68.7% of practitioners did not extract the antagonist or contralateral first molars., Conclusion: These treatment decisions were not always unanimous and call for a combined approach between dental surgeon and orthodontist., (Copyright © 2012. Published by Elsevier Masson SAS.)

Objective: To evaluate the frequency of common causes of permanent tooth extraction and severity of dental condition at the time of tooth extraction., Methods: The cross-sectional study was conducted at the Department of Oral and Maxillofacial Surgery, Punjab Dental Hospital, Lahore, Pakistan, from February to June 2010, and involved 1026 patients who were referred for the extraction of permanent teeth. The inclusion criteria comprised caries, periodontitis, restoration failure, trauma, and local pathologies, while 3rd Molar impactions, supernumerary tooth extraction and extractions done as part of orthodontic or prosthodontic treatment were excluded. Oral hygiene was recorded using the Simplified Oral Hygiene Index. SPSS version 17 was used for statistical analysis., Results: The mean age of the study population was 46.60 +/- 11.321 years, and there were 611 (59.6%) males. A total of 1178 teeth were extracted. Advanced dental caries was the leading cause of tooth extraction (n = 743; 63.1%), followed by periodontitis (n = 309; 26.2%) restoration failure (n = 54; 4.6%), trauma (n = 38; 3.2%) and miscellaneous local pathologies (n = 34; 2.9%). More than half of the patients (n = 540; 52.6%) had poor oral hygiene., Conclusion: Advanced dental caries is the most common cause behind tooth extraction.

The aim of the present study was to assess the caries experience of children aged 6 to 7 years old in a socially deprived suburban area of Brazil's Federal District, using the ICDAS II system and to investigate determinants of dental caries. The survey was carried out in six public schools by three calibrated examiners, on a sample of 835 children. ICDAS II codes had to be converted into dmf/DMF components at surface and tooth levels, resulting in unfamiliar caries variables, to enable some meaningful reporting of the findings. The prevalence of dental caries, including enamel and dentinal carious lesions, in primary teeth was 95.6% and in permanent teeth it was 63.7%. Mean values of d(2)mf(2)-t (enamel and dentinal lesions), d(3)mf(3)-t (dentine lesions), D(2)MF(2)-T and D(3)MF(3)-T indices were 6.9 ± 3.8, 3.2 ± 3.4, 1.7 ± 1.6 and 0.2 ± 0.5, respectively. Enamel carious lesions predominated in the dmf-t/s and DMF-T/S indices. Seven-year-old children had statistically significantly more enamel and dentine carious lesions in permanent teeth than 6-year-old children had. Using ICDAS II, the prevalence of dental caries in both dentitions was very high. In both dentitions, the decay component predominated, with hardly any restorations or extractions observed. The new ICDAS II system leads to overvaluation of the seriousness of dental caries experience and made reporting of outcomes cumbersome. Guidelines on analysing data and reporting results should be agreed upon before this system can be used in epidemiological surveys globally.

Objective: This paper brings together summarised findings on surveys of 106,828 mainstream school pupils aged 11-12 years old undertaken in Scotland, Wales and England in 2008/09. These surveys are the latest in a series using common criteria for measurement and a range of consent arrangements which, for this age group, allow comparison between the three "countries" and over time., Method: Representative samples were drawn within the geographies of primary care organisations in the three countries and within English Local Authorities according to BASCD criteria for sampling. Consent was sought from pupils in Wales and England and passive consent was used in Scotland. Children aged twelve were examined in England and children in school year 7 (rising 12) were examined in Wales and Scotland. Examinations were conducted in schools by trained and calibrated examiners using BASCD standard criteria and caries was diagnosed at the dentinal threshold using visual criteria., Results: The trend for reducing caries prevalence and severity continues in this age group in all three countries. Unlike data for 5 year old children, the impact of seeking positive consent from pupils does not appear to have introduced bias into the results. Variation in caries levels between and within geographical areas continues., Conclusion: Caries prevalence surveys of children aged 11-12 years have been conducted across Great Britain. Those carried out with positive consent appear to produce unbiased results, comparable with previous surveys. Health inequalities in this age group persist, as does the burden of disease for those with end-stage caries.

Introduction: Multiple extractions under Dental General Anaesthesia (DGA) are frequently performed on pre-school children treated in the public sector in the Western Cape. There s a need to examine current public health strategies in relation to Early Childhood Caries (ECC) in order to provide a framework for both the improvement of treatment and the prevention of ECC in general., Methods: This retrospective descriptive study reviewed the records on the Department of Health (DoH) database of 16 732 pre-school patients treated under Dental General Anaesthesia over a three year period., Results: Of the 58 255 procedures recorded for these preschool patients in the district health clinics in the Western Cape, 99.94% were for extractions and 0.0001 for restorations. The average rate of DGA per 1000 of the population was 1.06. Only 9% (i.e.: 2/22) of dentists at district clinics reported that pre-DGA prevention was provided., Conclusion: The demand for DGA was found in this study to be relatively high and the associated treatment was almost exclusively by means of extractions. The lack of preventive measures could possibly result in a need for retreatment under DGA. Therefore, preventive guidelines are recommended for use in the Public Service.

Purpose: Osteoradionecrosis (ORN) is a known complication of radiation therapy to the head and neck. However, the incidence of this complication with intensity-modulated radiation therapy (IMRT) and dental sequelae with this technique have not been fully elucidated., Methods and Materials: From December 2000 to July 2007, 168 patients from our institution have been previously reported for IMRT of the oral cavity, nasopharynx, larynx/hypopharynx, sinus, and oropharynx. All patients underwent pretreatment dental evaluation, including panoramic radiographs, an aggressive fluoride regimen, and a mouthguard when indicated. The median maximum mandibular dose was 6,798 cGy, and the median mean mandibular dose was 3,845 cGy. Patient visits were retrospectively reviewed for the incidence of ORN, and dental records were reviewed for the development of dental events. Univariate analysis was then used to assess the effect of mandibular and parotid gland dosimetric parameters on dental endpoints., Results: With a median clinic follow-up of 37.4 months (range, 0.8-89.6 months), 2 patients, both with oral cavity primaries, experienced ORN. Neither patient had preradiation dental extractions. The maximum mandibular dose and mean mandibular dose of the 2 patients were 7,183 and 6,828 cGy and 5812 and 5335 cGy, respectively. In all, 17% of the patients (n = 29) experienced a dental event. A mean parotid dose of >26 Gy was predictive of a subsequent dental caries, whereas a maximum mandibular dose >70 Gy and a mean mandibular dose >40 Gy were correlated with dental extractions after IMRT., Conclusions: ORN is rare after head-and-neck IMRT, but is more common with oral cavity primaries. Our results suggest different mechanisms for radiation-induced caries versus extractions., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Context: Dental caries is the most common oral disease that affects significant number of Indian population. The prevalence of caries in India is reported 31.5% to 89%., Aims: This study was aimed to estimate the prevalence of dental caries and treatment needs in school going children of Delhi., Materials and Methods: A school based cross-sectional study was conducted in various educational zones of Delhi. A total of 520 school children in age range of 9-12 years were examined using WHO (1997) criteria., Statistical Analysis Used: Chi-square test., Results: The prevalence of dental caries was found to be 52.3% with mean deft and DMFT of 0.5038 ± 1.0859 and 0.8250 ± 1.3437, respectively. Besides various treatment needs 49.7% required restorative treatment., Conclusion: The prevalence of dental caries in Delhi school children is high with D+d components comprising of more than 95%. This indicates lack of awareness and affordability to the dental facilities available. Therefore, there is a need to develop preventive and promotional oral health strategies to combat this infectious disease.

Objective: To determine the frequency, causes and pattern of tooth extraction in a Nigerian rural health facility., Materials and Method: This descriptive cross sectional study was conducted in Eden dental clinic of Mount Gilead hospital; Uselu from January 2006 to December 2008. The information collected with questionnaire included demography of patients, indications for extraction, type of tooth extracted and other treatments performed. Results were presented as simple frequency tables and graph. Data analysis was done with SPSS statistical software version 13.0., Results: Tooth extractions represented one third (33.4%) of the total treatment procedure. Periodontal disease (45%) and caries (32.6%) were the main reasons for extraction. Other reasons in descending order are failed root canal treatment (1.5%), orthodontic reason (1.2%), tooth in fracture line (1.0%), trauma (0.6%), supernumeraries (0.4%) and prosthetic reasons (0.2%). There was higher extraction among females than males p > 0.05. Tooth extraction in 27-36 years age group was the highest and the main reason for extraction in this age group was impaction (47.8%). Higher number of extracted teeth was from lower right quadrant, lower arch and right side of mouth in this survey. Molars made up 95.3% of all extracted teeth with first molar predominating (40.1%). The proportion of extractions attributed to periodontal disease increased from 17-56 years, but declined thereafter., Conclusion: Tooth extraction was a highly frequent treatment procedure in this survey. Molars were mostly extracted as a result of caries although periodontal disease was the dominant reason for extractions. This result is different from results from previous studies., Recommendation: Findings in this study showed that tooth extraction constitute about one third of the total procedures done in this rural health facility during the study period. This is mainly due to late presentation and brings to the fore, the degree of ignorance on oral health issues among the Nigerian rural dwellers. It is the opinion of the authors that the attention of the dental professionals be drawn to the need to reach out, educate and encourage best oral healthcare practices.

Aim: To investigate the reasons for tooth extraction and their correlations with age and gender in Greece., Materials and Methods: The study population consisted of 1,018 patients, 560 males and 458 females, aged 18-74 years from a private practice in Greece. Each patient's age, gender, number of extracted teeth and the reasons for the extraction were recorded for a period of 5 years., Results: Two thousand four hundred and eighteen permanent teeth were extracted for various reasons during the study period. The results showed that the main reasons for extraction were caries (45.6%), periodontal disease (32.1%), failed root canal treatment (7.3%) and root fracture (4.4%). Caries was the main reason for extraction in patients up to 44 years old (64.7%), while periodontal disease was the main reason for extraction in patients over years of age (77.6%). Maxillary and mandibular 1st and 2nd molars, were the most frequently extracted teeth due to dental caries. Premolars of the mandible and maxillary and mandibular anterior teeth were the most frequently extracted teeth due to periodontal disease., Conclusions: Although the targets of the WHO regarding the reduction of dental caries were accomplished, dental caries and periodontal disease are still the main reasons for tooth extraction regardless of the age of the patients., (© 2011 FDI World Dental Federation.)

Objective: To examine maternal and socio-demographic factors associated with oral health practices and experiences in six-year-old Pacific children., Methods: The longitudinal Pacific Islands Families (PIF) study is following a cohort of Pacific children born in Auckland, New Zealand in 2000. At approximately six years postpartum maternal reports (n = 1001) on child oral health practices and experiences of fillings and extractions were gathered., Results: Forty-five per cent of mothers reported that their child had experienced fillings or extractions. After adjusting for confounding factors, we found that Tongan children were almost twice as likely to have their teeth filled or extracted than Samoan children (OR, 1.93; 95%, 1.34-2.77). Differences between Samoan children and children of other ethnic groups were not significant. Children of mothers who had secondary qualifications were significantly less likely to have their teeth filled or extracted compared to children of mothers who had postsecondary qualifications (OR, 0.634; 95%, 0.44-0.90). Prolonged duration of breastfeeding was associated with an increased likelihood of filling or extraction experience. In terms of maternal oral hygiene, maternal tooth brushing frequency of less that once a day was significantly associated with increased odds of fillings and/or extractions in their children (OR, 1.35; 95% CI, 1.02-1.79). Children who were sometimes supervised for tooth brushing were significantly more likely to have fillings or extractions than children who were not provided supervision., Conclusions: These findings highlight the role of cultural factors and maternal hygiene in child oral health outcomes and suggest that health promotion efforts should encompass the whole family and embrace a culturally appropriate approach., (© 2010 John Wiley & Sons A/S.)

Disadvantaged children suffer because tooth cavities are not being treated and their clinical consequences not being surveyed. The present study aimed to assess the prevalence and severity of clinical consequences of untreated dentine carious lesions in schoolchildren from a deprived area of Brazil and to investigate the determinants of the pufa index. A sample of 835 children aged 6-7 years, from six public schools, was examined by 3 calibrated examiners. Clinical consequences of untreated dentine carious lesions in primary teeth were diagnosed using the four codes of the pufa index: 'p' (pulpal involvement), 'u' (ulceration), 'f' (fistulae), 'a' (abscess). Effects of gender, age, school, history of extraction, and toothache on the prevalence of pufa codes were tested. The prevalence of pufa codes was 23.7%. The mean pufa score was 0.4 ± 0.9. Code 'p' was the most prevalent (19.5%), whereas code 'u' was least prevalent (0.1%). Children with a history of extracted primary teeth due to caries had a 2.7 times higher chance to have a pufa code than children with no previous extraction. Children with toothache had a 5.6 times higher chance to have a pufa code than children without toothache. The prevalence of clinical consequences of untreated dentine carious lesions was moderate and the severity was low. The pufa index is an epidemiological tool complementary to existing caries indices aimed to assess dental caries. However, there appears to be no need to include code 'u' nor to score codes 'f' and 'a' separately., (Copyright © 2011 S. Karger AG, Basel.)

Background: The authors examined the association of patterns of soft drink consumption and primary tooth extractions in Queensland children aged 12 years or less., Methods: Data were gathered through the Child Health Surveys conducted by Queensland Health in 2003 and 2008. The analysis allowed for various demographic characteristics using logistic regression analysis., Results: The data in both surveys showed an increased risk of tooth extraction in children who had a greater frequency and amount of soft drink consumption, and those that consumed soft drink between meals. In 2008, the percentage of children that had soft drink daily or several times a week had decreased, with an increase in those that never had soft drink., Conclusions: To reduce the risk of primary tooth extraction due to decay, this paper recommends the continuing moderation of soft drink consumption frequency and the consumption of soft drinks with, rather than between, meals., (© 2010 Australian Dental Association.)

Aim: The aim of this study was to identify the causes and patterns of tooth loss among Nigerian adults., Background: Tooth loss continues to be a major problem in clinical dentistry and has received significant attention in everyday dental practice. In Nigeria there is a discernible lack of current data that would explain the reasons and patterns of tooth loss from its different geopolitical zones., Methods and Materials: The reasons for tooth extractions during a period of 12 months were obtained from the hospital records of teaching and specialist hospitals in Nigeria's six geopolitical zones and the Federal Capital Territory (FCT). Data were analyzed using Statistical Package for the Social Sciences for Windows (SPSS) version 9.0., Results: A total of 4,204 teeth were extracted from 3,431 patients. Of these teeth 52.4 percent were lost due to dental caries while 30.2 percent were removed because of periodontal disease, 5.0 percent were missing as a result of trauma, and 3.9 percent were impacted and required extraction. The remaining 8.5 percent were extracted for a variety of reasons such as orthodontic treatment, overeruption, neoplasms, supernumerary teeth, attrition, a cystic lesion, and hypoplasia. Dental caries was the most common diagnosis given for tooth loss in the South-South (79 percent), South-East (68 percent), North-East (47 percent), North-West (69 percent), and North-Central (35 percent) zones followed by periodontal disease. In contrast, periodontal disease was the most common cause of tooth loss in the South-West zone (65 percent) and in the FCT (55 percent), followed by dental caries at 22 percent and 33 percent, respectively., Conclusion: Although teeth were extracted based on a variety of diagnoses, dental caries was identified as the common reason cited for tooth loss in Nigeria and to a lesser extent periodontal disease. Also different reasons were given for tooth loss among the various geographical zones., Clinical Significance: Tooth loss among Nigerians was attributed largely to dental caries and secondarily to periodontal disease. Both conditions can be prevented if diagnosed early enough and treatment is instituted in a timely manner.

To date, studies on the contributions of genetic factors to oral health have been inconclusive. We hypothesized that major dental diseases show a significant genetic component. The study was based on self-reported oral health among young adult twins. The data were derived from the fourth wave of the longitudinal FinnTwin16 study, in which participants completed a questionnaire in 2000-2002 enquiring about the number of filled teeth and the prevalence of gingival bleeding. We used quantitative genetic modeling, based on the genetic similarity of identical and non-identical twins, to calculate the most probable model for both filled teeth and gingival bleeding. The models revealed a strong genetic component behind the number of filled teeth, differing between males (49%) and females (68%), and a weaker genetic component affecting gingival bleeding, being similar for males and females (32%). Genetic factors contribute to inter-individual differences in oral health among young adults.

Aim: This was to analyse the tooth types extracted and the reasons for extractions in 3-8 year-old Swedish children. Another aim was to determine what treatments and attendance patterns preceded the caries-related extractions., Study Design and Methods: A retrospective study of all 5,045 dental records of the 3-8 year-olds at six public dental clinics in a Swedish county was performed to find all extractions performed during one year and the reason for each extraction. The dental records, that included a caries related extraction of a primary molar, were further analysed to find possible non-attended dental visits and treatments preceding the extraction., Statistics: The data were analysed using Pearson correlation test, Mann-Whitney U test, and Chi-2 test., Results: 309 (4 permanent and 305 primary) extractions were performed in 206 (119M, 87F) (4.1%) of the patients. The primary molar was the tooth type most frequently extracted, while the central primary incisor was the tooth most frequently extracted. Reasons for extractions were; caries: 60.5%, orthodontics: 11.3%, trauma: 10.4%, other reasons: 17.8 %. Dental records from 100 children with caries-related extractions of primary molars were analysed. A previous treatment had been performed in 51.0% of the caries-related extractions of primary molars, but only 24.0% had any long term restoration material with glass ionomer cement, composite resin or compomer. Non-attendance frequency prior to caries-related extraction of primary molar was higher (P=0.004) among the non-treated children, but 40.1% of the non-treated children had no missed appointments. Caries-related extractions were more common among boys (p=0.0315)., Conclusions: Every 25th child in the age group 3-8 years had extractions performed during a one-year period. Only every second primary molar had received any treatment before caries-related extraction, and only (1/4) had received long-term restorations. A considerable number (40%) of the non-treated children had no missed appointments before the caries related extractions. The routines for dental care and caries treatment in the primary dentition need a revision.

Background: Before strategies or protocols for oral health care can be advised at population level, epidemiological information on tooth decay patterns and its effects on oral function are indispensable. The aim of this study was to investigate influences of socio-demographic variables on the prevalence of decayed, missing, filled (DMF) and sound teeth (St) and to determine the relative risk of teeth in different dental regions for D, M, and F, of adults living in urban and rural areas in Southern Vietnam., Methods: Cross-sectional DMF and St data of 2965 dentate subjects aged 20 to 95 living in urban and rural areas in three provinces were collected by means of a self-administered questionnaire and an oral examination. The sample was stratified by age, gender, residence and province., Results: The percentage of subjects having missing teeth was high for all ages while it was low for subjects with decayed and filled teeth. The mean number of missing teeth increased gradually by age from approximately 1 in each jaw at the age of 20 to 8 at the age of 80. The number of decayed teeth was relative low at all ages, being highest in molars at young ages. The mean number of filled teeth was extremely low at all ages in all dental regions. Every additional year of age gives a significantly lower chance for decay, a higher chance for missing, and a lower chance for filled teeth. Molars had a significantly higher risk for decay, missing and filled than premolars and anterior teeth. Females had significantly higher risk for decayed and filled teeth, and less chance for missing teeth than males. Urban subjects presented lower risk for decay, but approximately 4 times greater chance for having fillings than rural subjects. Low socio-economic status (SES) significantly increased the chance for missing anterior and molar teeth; subjects with high SES had more often fillings., Conclusions: The majority of adults of Southern Vietnam presented a reduced dentition. The combination of low numbers of filled teeth and relative high numbers of decayed and missing teeth indicates that the main treatment for decay is extraction. Molars are more at risk for being decayed or missing than premolars and anterior teeth.