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Introduction: This cross-sectional study assessed the association between sense of coherence (SoC) and caries activity (number of active caries lesions) and caries experience (DMFT index) among 18-19-year-old male adolescents who joined the Brazilian Army as draftees for mandatory military service (n = 507)., Methods: Data collection included a questionnaire (level of education, family income, and tooth brushing frequency), the Brazilian short version of the SoC scale (SOC-13), and clinical caries examination (noncavitated/cavitated, inactive/active). The main predictor variable was SoC, categorized as low, moderate, or high. Poisson regression models were used for statistical analysis., Results: A high SoC was significantly associated with a lower number of active lesions (adjusted rate ratio = 0.85; 95% CI = 0.74-0.98). No association between SoC and DMFT was detected., Conclusion: A high SoC was found to be a protective factor to caries activity in this population., (© 2024 S. Karger AG, Basel.)

The aim of this prospective cohort study was to assess the radiographic progression of underlying dentin shadows (UDS) on the occlusal surfaces of permanent posterior teeth of adolescents and young adults over 1-2 years and to identify possible risk factors. A total of 149 UDS lesions (from 101 individuals) were included at baseline. Each participant had to present at least one UDS to be considered eligible for the study. Data collection included the application of a questionnaire, clinical examination, and bilateral bitewing radiographs, performed at baseline and after 1-2 years. The association between possible predictors and UDS progression (defined radiographically as an increase in the radiographic score from baseline to follow-up) was assessed using Weibull regression models. Hazard ratios (HRs) and their 95% confidence intervals (CIs) were estimated. A total of 81 individuals (mean age: 24.0, standard deviation: 8.03) were reexamined after 1-2 years (742 occlusal surfaces, of which 118 were UDS). The overall progression rate was 8.6% after 1-2 years, being 12.6% for UDS without baseline radiolucency and 20% for UDS with baseline radiolucency. The risk analysis showed that UDS without radiolucency at baseline had a similar likelihood of progression (adjusted HR = 1.71, 95% CI = 0.68-4.32, p = 0.26) while UDS with radiolucency at baseline were more likely to progress (adjusted HR = 2.96, 95% CI = 1.06-8.26, p = 0.04) than the reference category (sound occlusal surfaces without radiolucency). These estimates were adjusted for caries prevalence, tooth type, and arch. This study showed low progression rates of UDS after 1-2 years. The presence of radiolucency at baseline was found to predict UDS progression., (© 2023 S. Karger AG, Basel.)

This population-based cross-sectional study investigated the association between toothbrush bristle stiffness and the occurrence of erosive tooth wear (ETW) among 15- to 19-year-old adolescents from southern Brazil. Data collection included the application of questionnaires and clinical examination. One questionnaire on sociodemographic information (sex, age, and socioeconomic status) was sent to the parents/legal guardians, while the other was applied to students and collected data regarding oral hygiene habits (toothbrushing frequency, toothbrushing after meals, and toothbrush bristle stiffness) and dietary habits (frequency of consumption of soft drinks, citric fruits, and fruit juice). After tooth cleaning and drying, all erupted permanent teeth were clinically assessed and classified according to the Basic Erosive Wear Examination (BEWE) by 2 calibrated examiners. The association between explanatory variables and ETW prevalence was assessed using Poisson regression models. Prevalence ratios (PRs) and their 95% confidence intervals (CIs) were estimated. A total of 1,197 adolescents were included (participation rate 72.3%). The overall prevalence of ETW was 57%. The final model showed that individuals who used toothbrushes with soft (PR = 1.28, 95% CI = 1.02-1.60) or medium (PR = 1.30, 95% CI = 1.01-1.69) bristles presented a higher ETW prevalence than those who used toothbrushes with extra-soft bristles, even after the adjustment for important cofactors. In conclusion, this study found a very weak but significant association between toothbrush bristle stiffness and ETW among Brazilian adolescents. Considering the cross-sectional design of this study and considering that some association was found even in such a young population, future studies using different designs and including different age-groups might elucidate the clinical relevance of this finding., (© 2021 S. Karger AG, Basel.)

This cohort study evaluated the fate of sound surfaces and inactive non-cavitated (INC) and active non-cavitated (ANC) caries lesions in a population-based sample of South Brazilian adolescents, in answer to the question: "Is lesion activity assessment a reliable criterion to diagnose a patient's caries activity?" A total of 801 schoolchildren were examined at baseline (aged 12 years) and after a mean time interval of 2.5 years. Data collection included a questionnaire and clinical examination. Patients were classified as caries-free (patients without any lesion), caries-inactive (patients with only inactive lesions), and caries-active (patients with at least one active lesion). The primary outcome was caries progression (presence of cavity, underlying dentin shadow, filling, or extraction at the follow-up exam). Negative binomial regression models were used to estimate the risk for caries progression. The main predictor variable was status of the surface at baseline: sound, INC, or ANC. Progression rates of 1.0, 9.0, and 12.6% were found for sound surfaces, INC, and ANC, respectively. INC (incidence risk ratio [IRR] 5.37, 95% CI 4.22-6.83) and ANC (IRR 4.96, 95% CI 3.43-7.17) had greater risk for caries progression than sound surfaces. Similar risks for progression were found for ANC and INC (IRR 0.92, 95% CI 0.64-1.32). Progression rates were 0.6, 1.1, and 2.2% for caries-free, caries-inactive, and caries-active individuals, respectively (p < 0.05). The risk for caries progression of sound surfaces was higher among caries-active adolescents (caries-free: IRR 2.78, 95% CI 1.63-4.72; caries-inactive: IRR 2.19, 95% CI 1.65-2.90). Caries-inactive patients behaved similarly to caries-free individuals (IRR 1.27, 95% CI 0.73-2.20). This study demonstrated the possibility of defining a patient's caries activity profile based on lesion features., (© 2020 S. Karger AG, Basel.)

This systematic review and meta-analysis were undertaken to assess the responsiveness of validated oral health-related quality of life (OHRQoL) questionnaires to dental caries interventions in children, adolescents, and young adults. Studies eligible were randomized clinical trials (RCTs), controlled clinical trials (CCTs), and prospective case series (PCS), which had OHRQoL questionnaires answered before and after caries intervention(s). The main outcome was improvement in OHRQoL mean scores following caries intervention. Twenty-six studies were selected for the quality assessment and 14 were selected for the meta-analysis. Most of the studies were PCS with a single group pretest and posttest study design (n = 19). Five studies were CCT and only 2 were RCT. The numbers of participants were 3,522 in the control group (baseline = 2,002; final = 1,520) and 5,917 in the test group (baseline = 3,102; final = 2,815). The age of the subjects ranged from 3 to 19 years. All studies showed significant improvement in OHRQoL following caries intervention. Most of nonrandomized studies (n = 15) had low or moderate risk of bias. The meta-analysis showed the effect of caries interventions (standardized weighted mean differences = -1.24; 95% CI: -1.68 to -0.81; p < 0.001). However, high heterogeneity between the studies was found. The Grading of Recommendations Assessment, Development and Evaluation approach classified the quality of evidence as very low and its strength weak. In conclusion, there is evidence that the OHRQoL of children and adolescents improved following caries intervention procedures, but the quality of the evidence was very low. In spite of that, caries interventions are highly recommended as abstaining from treatment is likely to result in a deterioration of OHRQoL., (© 2019 S. Karger AG, Basel.)

This cross-sectional study assessed the relationship between fixed orthodontic treatment duration and caries activity. Two hundred and sixty 10- to 30-year-olds were divided into 4 groups (n = 65): no fixed orthodontic appliances (G0), orthodontic treatment for 1 year (G1), 2 years (G2), or 3 years (G3). Orthodontic treatment duration was significantly associated with active caries: prevalence was 1.5% for G0, 27.7% for G1, and 72.3% for G2 and G3; the median number of lesions was 0 for G0 and G1 and 2 for G2 and G3. No differences were observed between G2 and G3. The longer the duration of orthodontic treatment, the higher the prevalence/extent of active caries lesions., (© 2018 S. Karger AG, Basel.)

The aim of this study was to assess the prevalence, extent, severity, intraoral distribution and risk indicators for erosive tooth wear (ETW) among 12-year-old schoolchildren from Montevideo, Uruguay. A population-based, cross-sectional survey was conducted using a representative sample of 1,136 12-year-old schoolchildren attending public and private schools. Parents answered questions on socioeconomic status and general health. Schoolchildren answered questions on dietary and oral hygiene habits. Two calibrated examiners recorded ETW on permanent teeth according to the Basic Erosive Wear Examination (BEWE) score system. Logistic regression models were performed to assess the association between the predictor variables and the prevalence of ETW (overall and severe ETW). Odds ratios (OR) and the respective 95% confidence intervals (CI) were estimated. The prevalence of ETW was 52.9%, being mild erosion (BEWE = 1) in the vast majority of cases (48.5%). Severe erosion (BEWE ≥2) was detected in 4.4% of schoolchildren. The overall prevalence of ETW differed significantly between categories of gender and socioeconomic status, but only between gender in the severe ETW analysis. The overall extent of ETW was significantly different between categories of gender, socioeconomic status, and swish before swallow. The extent of severe ETW differed between categories of swish before swallow and brushing frequency. In the logistic regression analysis, no association was found between the studied variables and the overall prevalence of ETW. Males were more likely to have severe ETW than females (OR = 3.22, 95% CI = 1.50-6.89). ETW may be considered a public health problem among 12-year-old-Uruguayan schoolchildren.

This population-based cross-sectional study aimed to assess the prevalence and risk indicators for tooth loss due to dental caries among 12-year-old schoolchildren from South Brazil. 1,528 out of 1,837 (participation rate = 83.17%) schoolchildren were included. Tooth loss prevalence was 5.81% (95% CI = 3.71-8.98) and 0.08 (95% CI = 0.04-0.12) teeth were missing. Schoolchildren with low socioeconomic status (OR = 2.28, 95% CI = 1.23-4.21), who repeated years in school (OR = 1.56, 95% CI = 1.01-2.42), and with gingivitis (OR = 1.81, 95% CI = 1.33-2.45) were more likely to have missing teeth. Schoolchildren brushing 2 times/day (OR = 0.78, 95% CI = 0.64-0.96) or more (OR = 0.49, 95% CI = 0.33-0.74), and those with dental insurance or private dentists (OR = 0.60, 95% CI = 0.39-0.93) were less likely to present missing teeth. © 2014 S. Karger AG, Basel., (© 2014 S. Karger AG, Basel.)

This study investigated the radiographic pattern of underlying dark shadow from dentin (ICDAS 4) in permanent molars and assessed the association between enamel breakdown and radiographic features. Ninety-five teeth (54 patients) were clinically and radiographically assessed. The majority of ICDAS 4 caries lesions presented enamel breakdown (n = 78, 82.1%) and no radiographic image (n = 64, 67.4%) or a radiolucent zone restricted to the enamel-dentin junction (n = 17, 17.9%). No association was found between enamel breakdown and radiographic features. This study suggests that a radiographic examination is needed prior to the decision making process for underlying dark shadows from dentin., (Copyright © 2013 S. Karger AG, Basel.)

The aim of this study was to estimate the independent effects of biofilm accumulation and eruption stage on the occurrence of active caries lesions on occlusal surfaces of permanent molars. The sample consisted of 298 schoolchildren (6-15 years) who were examined by a calibrated examiner at a dental unit, using artificial light, a dental mirror and a WHO probe. The occurrence of visible biofilm on occlusal surfaces and the eruption stage of each permanent molar were recorded. After professional prophylaxis and air drying, the occlusal surfaces were classified as sound, caries-inactive or caries-active. To evaluate the association of eruption stage and biofilm accumulation with active caries lesions, a logistic regression model was used. Since data were clustered, odds ratios were obtained using generalized estimating equations with a logistic link function. 1,779 permanent molars were examined. All eruption stages were associated with active caries lesions. After adjustment for biofilm accumulation and type of molar, molars with occlusal surfaces partially exposed to the oral cavity were 63.6 times more susceptible to caries activity than molars with full occlusion (95% CI = 22.0-183.7). After adjustment for eruption stage and type of molar, teeth with a high degree of biofilm accumulation were 14.5 times more susceptible to caries activity than those without visible biofilm accumulation (95% CI = 6.5-32.4). No association between active caries and hardly detectable biofilm was found in this population. The present study found that the eruption stage of permanent molars is strongly associated with active caries lesions, adjusted for biofilm accumulation and type of molar., (Copyright © 2012 S. Karger AG, Basel.)