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Background: To investigate changes in facial morphology during the first six months of orthodontic treatment among adult females receiving orthodontic treatment. Methods: 43 adult females receiving orthodontic treatment were randomly recruited. 3D facial images were taken at baseline (T0), three months (T1), and six months (T2) after treatment initiation. Spatially dense facial landmarks were digitized to allow for sufficient details in characterization of facial features. 3D geometric morphometrics and multivariate statistics were used to investigate changes in mean and variance of facial shape and facial form associated with treatment. Results: We observed statistically significant changes in facial shape across the three treatment stages (p = 0.0022). Pairwise comparisons suggested significant changes from T0 to T1 (p = 0.0045) and from T0 to T2 (p = 0.0072). Heatmap visualization indicated that the buccal and temporal region were invaginated while the labial region became protruded with treatment. The magnitude of shape change was 0.009, 0.004, and 0.010 from T0 to T1, T1 to T2, and T0 to T2, respectively, in unit of Procrustes distance. The average magnitude of change per-landmark was 1.32 mm, 0.21 mm, and 1.34 mm, respectively. Changes in mean facial form were not statistically significant (p = 0.1143). No changes in variance of facial shape were observed across treatment stages (p > 0.05). Conclusion: Rate of facial changes was twice as fast during the first three months as that during fourth to sixth month. Buccal and temporal region became invaginated while labial region became protruded with treatment. [ABSTRACT FROM AUTHOR]

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

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

Objectives: To investigate the impact of adaptive functioning and oral hygiene practices on tooth-brushing performance among preschool children with special health care needs (SHCN). Methods: A cross-sectional study was conducted in Special Child Care Centers. Children's tooth-brushing performance was assessed by a standardized 13-step pro forma. Information regarding children's socio-economic status, adaptive skills, and oral hygiene practices were collected. Bivariate analysis and ANCOVA were used to explore the potential factors which might be associated with children's tooth-brushing performance. Results: The tooth-brushing assessment was provided to 379 children with SHCN. Approximately 3% of the recruited children performed the whole tooth-brushing procedure independently. The number of tooth-brushing steps practiced by those children was 4.47 ± 3.56. Children who had established tooth-brushing habit before age one practiced more tooth-brushing steps than children who brushed their teeth after age one (p = 0.029). When children's age, gender, and socio-economic status were adjusted, children who had established regular tooth-brushing habit or children who had high levels of adaptive skills showed better tooth-brushing performance than their peers. Children who used gauze, cotton swab, or dental floss to clean their teeth practiced fewer key tooth-brushing steps than their peers who had never used additional cleaning approaches (p = 0.038). Conclusions for Practice: Children's tooth-brushing performance was associated with adaptive skills and oral hygiene practices. Tooth-brushing training should be provided to children with SHCN in early childhood. For children who had limitations in adaptive functioning, parental assistance or supervision is recommended to guarantee the efficacy and safety of daily tooth brushing. [ABSTRACT FROM AUTHOR]

Objective: To assess the oral health‐related quality of life among Hong Kong preschool children with severe early childhood caries. Methods: A total of 315 Hong Kong preschool children diagnosed with severe early childhood caries (S‐ECC) were recruited. Their caries and plaque status were evaluated. Their parents were asked to complete the Early Childhood Oral Health Impact Scale (ECHOIS) and a sociodemographic background questionnaire. Results: There was a 98.7% response rate. The mean age was 4.7 ± 0.8 years. The mean decayed, missing and filled teeth (dmft) score was 10.2 ± 4.5. Almost all the children (98.7%) had decayed teeth. More than half of the children (61.4%) had a visible plaque index (VPI) score of above 90%. About one quarter (28.9%) were experiencing symptoms of pain. The dmft score of the child was significantly associated with the ECOHIS child impact, child function, family impact and family distress domains (P < .001). The presence of pain was significantly associated with increased ECOHIS child and family impact scores (P < .001). In the multiple regression analyses, the dmft score and presence of pain showed a significant association with the ECOHIS scores (P < .001). Conclusion: The OHRQoL of children with S‐ECC was worsened with the presence of pain and severity of the disease. More measures need to be placed to decrease the prevalence of children with S‐ECC. [ABSTRACT FROM AUTHOR]

Background: A visual‐verbal integration model (VVIM) was used to train parents and their children with intellectual and developmental disabilities (IDD) to dispense a pea‐sized amount of fluoridated toothpaste, aiming to balance the occurrence of dental caries and fluorosis. Method: Participants were 370 pairs of IDD preschool children and their parents. A two‐phase pre‐post‐intervention study was performed. The weight of toothpaste was calculated by a portable electronic compact balance. Results: A quarter of parents and <20% children dispensed the appropriate amount at baseline. Almost 85% parents and 50% children achieved the pea‐sized amount after intervention. Half of the children continued to use the recommended toothpaste amount after 6 months. Children with higher intellectual functioning and conceptual skills were more likely to dispense the pea‐sized amount of toothpaste. Conclusions: Visual‐verbal integration model training had a desired impact on parents' toothpaste‐dispensing performance. Children with higher adaptive skills may benefit from VVIM training. [ABSTRACT FROM AUTHOR]

Objective: To investigate the oral health status and associated factors among preschool children with special healthcare needs. Subjects and methods: This was designed as a cross‐sectional study. Dental examination was provided to 383 children at Special Child Care Centres. Covariates of interest included children's age, developmental profile, oral health‐related behaviours and family social‐economic status. The association between children's dental caries experiences, dental plaque deposition and gingival health status were analysed by negative binomial regression, multiple factor ANOVA and binary logistic regression when appropriate. Results: The proportion of children with caries, gingival inflammation and plaque were 30.3%, 89.6% and 95.0%, respectively. Final regression models indicated that (a) tooth decay was associated with dental visit experiences, night bottle‐feeding habit, fluoridated toothpaste and monthly income; (b) plaque deposition was associated with intellectual functioning, practical skills, night bottle‐feeding habit, use of toothpaste, initiation of toothbrushing habit, toothbrushing duration and additional cleaning habit; (c) gingival status was associated with children's intellectual functioning and toothbrushing frequency. Conclusions: Poor oral hygiene status existed among preschool children with special healthcare needs. Children's oral health status was associated with their developmental profile, oral health‐related behaviours and social‐economic status. [ABSTRACT FROM AUTHOR]

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

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

Background To date, research on the relationship between dental caries experience and adiposity status is debated. Aim To determine associations between dental caries experience and adiposity status among a community sample of preschool children in Hong Kong. Design Among a random sample of 5-year-old children, clinical assessment for dental caries was conducted using WHO criteria. Anthropometric measurements for body weight, body height, waist circumference ( WC), hip circumference, and triceps skinfold thickness ( TRSKF) were performed to assess general adiposity, central adiposity, and peripheral adiposity. Associations between adiposity status and caries were examined in regression analyses. Results The response rate was 83.1% (324/390). Regression analyses (adjusted for tooth brushing habits, snacking habits, and socio-demographic factors) identified that weight/height ratio z-score was associated with caries experience: prevalence of dental caries experience (dmft > 0), OR 1.41 (95% CI 1.04, 1.91), and 'very high' caries experience (dmft ≥ Si C10 Index value), OR 1.62, (95% CI 1.05, 2.50). In addition, WC z-score was associated with 'very high' caries experience (dmft ≥ Si C10 Index value), OR 1.72, 95% CI 1.06, 2.81. Conclusion In a Hong Kong community sample of preschool children, dental caries experience was associated with general adiposity (as assessed by weight/height ratio) and central adiposity (as assessed by WC). [ABSTRACT FROM AUTHOR]

Background Oral health literacy is a newly emerging field with considerable research potential. Aim To validate an original instrument, the Hong Kong Oral Health Literacy Assessment Task ( HKOHLAT-P) for paediatric dentistry. Design A convenient sample of 200 child/parent dyads attending a dental hospital in Hong Kong was selected. Convergent validity was tested by examining the association of HKOHLAT-P scores with those derived from the Test of Functional Health Literacy in Dentistry ( TOFHLi D) and Hong Kong Rapid Estimate of Adult Literacy in Dentistry ( HKREALD-30). The predictive validity of HKOHLAT-P was determined by testing the association between HKOHLAT-P and children's caries experience (dmft) and the Chinese Early Childhood Oral Health Impact Scale ( ECOHIS). The test-retest reliability and internal consistency of HKOHLAT-P were also evaluated. Results HKOHLAT-P was positively correlated with TOFHLi D and HKREALD-30 ( P < 0.01), and was negatively correlated with children's dmft and ECOHIS. In the regression model, HKOHLAT-P was associated with TOFHLi D, HKEALD-30, children's dmft, and ECOHIS ( P < 0.05) after controlling for participants' demographic characteristics. The intra-class correlation coefficient of HKOHLAT-P was 0.63 and the Cronbach's α was 0.71. Conclusion Initial testing of HKOHLAT-P suggested that it is a valid and reliable instrument. [ABSTRACT FROM AUTHOR]