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Background: A growing number of Chinese residents are seeking orthodontic treatment. The aim of the study was to investigate rates of orthodontic publicity, orthodontic treatment history and related factors among college freshmen in China, to preliminarily understand the current situation of orthodontic publicity and treatment in China, especially after the 2020s. Methods: Referred to previous studies, a self-designed online questionnaire of Chinese college freshmen was conducted. The questionnaire was divided into two parts, after collecting basic information, we investigated orthodontic publicity rate and orthodontic treatment history with starting age, relapse phenomenon, satisfaction score and willingness to re-treatment. Factors hindering first-time and second-time treatment were also collected. The statistical analysis was performed using the Chi-square test, t-test, Kruskal–Wallis test and logistic regression analysis. Results: The response rate was 100% and 3308 responses were included. The male to female ratio was 1524:1784 with a mean age of 18.43 years (SD 0.91 years). Statistically significant of economic administrative regions, age, major and orthodontics engagement of relatives or friends were found on prevalence and rate of orthodontic treatment (P < 0.05). Average opinion on orthodontic treatment was "satisfied" and most claimed a phenomenon of relapse (slight relapse: 38.22%, obvious relapse: 23.12%), where age, major and orthodontics engagement of relatives or friends showed statistically significant. Retreatment willingness was correlation with start age and relapse phenomenon. For those who refused first-time treatment, except for good tooth arrangement condition, pain, long-time span, and cost weighted, while for those who refused re-treatment, the fair of discomfort and long-time span ranked at the top. Conclusions: In contemporary China, the prevalence and rate of orthodontic treatment had been greatly promoted. Earlier age for receiving orthodontic treatment was also discovered. Subjective factors regarding psychology, self-requirement affected the need of orthodontic treatment. Contemporary Chinese college freshmen had a high ability of judging dental alignment, while improve of overall orthodontic care level is still required. [ABSTRACT FROM AUTHOR]

Introduction: Oral diseases affect a significant proportion of the world's population, yet international comparisons involving oral health outcomes have often been limited due to differences in the way country-level primary data are collected. In response to this, the World Dental Federation (FDI) Oral Health Observatory project was launched with the goal of collecting and producing standardised international data on oral health across countries. The aim of this descriptive cross-sectional study was to examine associations between self-reported general health and a range of factors (sociodemographics, oral health-related behaviours, oral impacts, clinical variables) using these standardised international datasets., Methods: Dentists within FDI member National Dental Associations who chose to take part in the project were selected using a multistage sampling method. The number of dentists in each cluster was set according to the proportion of the national population living in the area, and 50 patients per dentist were systematically approached to take part. Patients and dentists completed 2 separate questionnaires on a mobile app. Ordinal logistic regression (conducted in December 2022) was used to analyse the linked patient and dentist data from 6 countries: China (n = 2242); Colombia (n = 1029); India (n = 999); Italy (n = 711); Japan (n = 1271); and Lebanon (n = 798). Self-reported general health was the dependent variable, with age, sex, education, self-reported oral health-related behaviours, self-reported oral impacts, and clinical variables acting as the independent variables., Results: The results demonstrated a different pattern of associations in the different countries. Better self-reported general health was associated with degree-level education in all 6 countries and with reporting no oral impact and no sensitive teeth in 4 countries. Several country-specific patterns were also found, including the importance of tooth brushing in Colombia, periodontal health in Italy, and differing associations with sugary drinks consumption in India and Japan., Conclusions: These descriptive findings provide a basis for further research and, importantly, for advocacy in identifying patient oral health care needs according to both person-reported and clinical aspects. This can facilitate optimisation of service provision and potentially influence policy and investments., Competing Interests: Conflict of interest None disclosed., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Dental caries is a prevalent infectious disease caused by microbial metabolism, affecting the hard tissues of teeth. According to data from the Fourth National Oral Health Epidemiological Survey, there is a gradual increase in caries prevalence in China, particularly among children and elderly individuals. As an etiological factor for dental lesions, caries not only impact oral health but also exhibit significant associations with various systemic diseases, suggesting that systemic diseases may serve as potential risk factors of caries development. To effectively implement the plan of national oral health action, researchers investigate the pathogenesis of caries actively while concurrently develop innovative preventive and treatment strategies based on advanced concepts and technologies, aiming to comprehensively enhance China's oral health status. Therefore, this article provides insights into the pathogenesis of caries, its correlation with systemic diseases, as well as cutting-edge research advancements pertaining to novel preventive measures for caries.

Introduction: This study was conducted to characterise the oral health conditions of residents in Jiangsu Province, China., Methods: In this descriptive study, 5 groups of participants were selected by a multistage stratified equal capacity random sampling, including 3- to 5-year-olds, 12- to 15-year-olds, 35- to 44-year-olds, 55- to 64-year-olds, and 65- to 74-year-olds. The data were collected by using the fifth edition of Oral Health Surveys-Basic Methods recommended by the World Health Organization (WHO)., Results: In these 5 groups, the mean DMFT/dmft of coronal caries were 3.07, 0.69, 4.03, 7.15, and 11.97, respectively, resulting in prevalence rates of 59.69%, 34.98%, 52.05%, 56.86%, and 72.19%, respectively. However, the filling rates were low in all age groups (1.88%, 17.53%, 29.88%, 16.13%, and 19.36%, respectively). Only 3.58% of the 12-year-old participants had good pit and fissure sealants. The adults include three groups, 35- to 44-year-olds, 55- to 64-year-olds, and 65- to 74-year-olds, and the prevalence rates of clinical attachment loss (CAL ≥4 mm) were 32.19%, 76.47%, and 85.43%, respectively. The proportions of adult groups with implant dentures, fixed dentures, removable partial dentures, complete dentures, and substandard dentures were 0%, 26.44%, 11.11%, 0.67%, and 4.89%, respectively. Additionally, 49.64% of adults had missing teeth that were not replaced., Conclusions: Dental caries and periodontal disease were frequent and common in Jiangsu, China. But only a few of the residents sought treatment. Oral diseases continued to be a major problem for local residents., Competing Interests: Conflict of interest None disclosed., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: This study aimed to examine the association between oral health behaviors and tooth retention among Chinese older adults., Methods: Data were used from the 4th Chinese National Oral Health Survey, a nationally representative sample. The sample included 9054 older adults aged 55 to 74. Control variables and oral health behaviors were measured through a questionnaire interview, and the number of remaining teeth and periodontal health were obtained from an oral health examination. A chi-square test was used for univariate analysis. Multivariate Logistic regression was used to explore the association between health behaviors and the number of remaining teeth., Results: The average number of remaining teeth in the sample was 24.4 ± 7.7. There was a higher proportion of older adults living in urban areas with 20 or more teeth than those living in rural areas (83.2% vs. 79.4%, P < 0.001); and a higher proportion of individuals with high education levels with 20 or more teeth compared to those with low education levels (P < 0.001). Logistic regression models showed that older adults who used toothpicks `(OR = 3.37, 95% CI 2.94-3.85), dental floss (OR = 1.93, 95% CI 1.05-3.53), toothpaste (OR = 3.89, 95% CI 3.14-4.83); and never smoked (OR = 1.43 95% CI 1.20-1.70) were more likely to retain 20 or more natural teeth; whereas older adults who had a dental visit were less likely to retain 20 or more natural teeth (OR = 0.45, 95% CI 0.39-052)., Conclusion: Good oral hygiene practices, never smoking, and regular dental visits focusing on prevention are significantly associated with teeth retention. It is critical to promote a healthy lifestyle and improve prevention-oriented oral health care systems., (© 2022. The Author(s).)

adolescents aged 12 to 15 years based on the 4th National Oral Health Survey and to explore its associated factors., Methods: Students aged 12 to 15 years were recruited using to a multistage stratified random sampling method. All the subjects received oral examination and completed a questionnaire. Information relating to OHRQoL was collected through a Mandarin version of the child oral impacts on daily performances (Child-OIDP) questionnaire. The relationship between the Child-OIDP scores and independent variables was assessed using a Mann-Whitney U-test, Kruskal-Wallis test and a multivariate Poisson regression., Results: A total of 89,582 subjects were included in the analysis, of whom 76.6% reported oral impacts in the last 6 months. Eating was the most affected daily performance. The results of the regression analysis showed that factors associated with adolescents' OHRQoL included sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, self-perception of general/oral health, dental appointments in the past 12 months, oral health knowledge status, age, decayed, missing and filled teeth (DMFT) index and number of teeth with gingival bleeding., Conclusion: Oral impacts were common among Chinese adolescents, although most were not so severe. Eating was the most commonly affected performance. Sex, location of residence, region, only child status, parents' level of education, frequency of sugar consumption, selfperception of general/oral health status, dental appointments in the previous 12 months, oral health knowledge status, age, DMFT index and number of teeth with gingival bleeding were found to be associated with OHRQoL.

Background: We aimed to analyse the oral health status of adolescents in Shandong province, including dental caries and gingivitis, and their associated factors., Methods: Adolescents aged 12-15-years in Shandong province were recruited. Caries and gingival status were assessed following the World Health Organisation diagnostic criteria. Information including the sociodemographic, oral hygiene knowledge, attitudes and practices were collected through the questionnaire. Chi-square test and multivariate logistic regression analysis were used to investigate the oral diseases associated factors., Results: In total, 3868 students (50.2% males) were enrolled. Of these, 39.9% of the participants experienced caries, and 81.7% and 31.3% had calculus and bleeding gingival, respectively. Multivariate logistic regression analysis revealed that there was an association between dental caries and toothaches, dental visits and sleeping troubles caused by oral problems (P < 0.024). A low-frequency of brushing, high sugar consumption and no flossing were more associated with calculus formation and gingival bleeding (P < 0.008)., Conclusion: Compared to caries, worse gingival condition was more prevalent among adolescents in Shandong province. Brushing behaviour is associated with gingivitis, while dental visits and toothaches are associated with caries. Hence, prevention-oriented dental visits and oral hygiene training are strongly recommended to improve oral health status.

Background: The relationship between dental caries and periodontal disease is still controversial. The objective of this study was to explore the relationship between different types of caries and periodontal disease severity in middle-aged and elderly people in China., Methods: The study population consisted of 4407 middle-aged and 4117 elderly subjects. Caries were divided into the following three types: type A, crown caries; type B, lesions involving both the crown and root, representing mixed-type caries; and type C, root caries. These three types together represent the overall caries situation, which we call type ABC. Caries were quantitated by decayed and filled teeth (DFT index). Periodontitis was evaluated by clinical attachment loss., Results: Middle-aged people with periodontitis had a significant association with DFT type B (OR: 1.21, 95% CI 1.17-1.25) and type C (OR: 1.40, 95% CI 1.24-1.56). Elderly people with periodontitis had a significant association with DFT type C (OR: 1.28, 95% CI 1.21-1.35)., Conclusions: In China, caries types B/C were positively correlated with periodontitis in the middle-aged group, and only caries type C was positively correlated with periodontitis in the elderly group.

Comprehensive research on ethnic disparities in dental caries in China is limited. The aims of this cross-sectional study were to compare the levels of dental caries in adolescents between the Han ethnic group and ethnic minority groups in China and to explore the risk indicators for dental caries within ethnic subgroups. Data from the Fourth National Oral Health Survey in 2015, which covered all 31 province-level administrative divisions in mainland China, were used. The dental caries status in the permanent dentition of adolescents aged 12, 13, 14, and 15 y was measured using the decayed, missing, and filled teeth (DFMT) score, and sociodemographic characteristics and oral health-related behaviors were also collected. A total of 118,601 adolescents were included, with ethnic minority groups accounting for 13.15%. Of the Han and minority groups, the standardized prevalence of dental caries experience was 40.58% and 47.67%, and the mean DMFT scores were 0.97 and 1.28, respectively. According to the multivariate zero-inflated negative binomial regression analysis, the caries status of minorities was more severe than Han adolescents (adjusted prevalence rate ratio [PRR], 1.14; 95% confidence interval [CI], 1.10-1.18). This disparity was greater among adolescents who lived in rural areas, had mid-level economic status, and frequently consumed sugary beverages. After propensity score matchings, Uygur (PRR, 1.44; 95% CI, 1.25-1.67), Tibetan (PRR, 1.39; 95% CI, 1.3-1.48), and Yi (PRR, 1.24; 95% CI, 1.04-1.48) adolescents were significantly more likely to have caries than Han adolescents. Subgroup analyses revealed that gender, age, location of residence, economic status, region, consumption of sweet snacks and sugary beverages, and dental visit pattern were significantly associated with dental caries within ethnic minorities.

Aim: To evaluate periodontal conditions in adults in mainland China based on data from the 4th National Oral Health Survey., Materials and Methods: Data of adult subjects (35- to 44-year-old group [N = 4409], 55- to 64-year-old group [N = 4622], and 65- to 74-year-old group [N = 4428]) were analysed. Demographic, socio-economic, personal habit, dental history, and health attitude data were obtained using a questionnaire. Periodontal condition was assessed using the standardized case definitions of the 2018 classification scheme. A multivariate analysis was performed to investigate the relationship between periodontitis severity and age, smoking status, gender, and region using generalized additive models after adjusting for confounders., Results: The frequency of subjects with periodontitis was 52.8%, 69.3%, and 64.6% in the three age groups, respectively. The frequency of subjects with severe periodontitis (stage III or IV) was 10.6%, 37.3%, and 43.5% in the three age groups, respectively. The severity of periodontal disease was positively associated with age. Current and former smokers exhibited significantly greater disease severity than non-smokers after adjustment for confounders. No significant difference of severity was found between males and females., Conclusion: Within the limitations of the study, the prevalence of periodontitis is very high among adults in mainland China. Periodontal status is associated with age and smoking status., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: The purpose of this study was to assess periodontal health conditions among 55- to 74-year-old Chinese people and to analyze the factors associated with periodontal diseases., Materials and Methods: In total, 9054 subjects aged 55-74 years were enrolled from all 31 provinces using a stratified multistage probability sampling method, autonomous regions and municipalities of the Chinese mainland, the response rate was 86.9%. All subjects underwent clinical examinations on the severest site for every tooth and completed a questionnaire that collected information on their sociodemographic characteristics and oral habits. T tests, chi-square tests and binary logistic regression analysis were performed to analyze the data., Results: The percentage of people without bleeding on probing, probing depth ≥ 4 mm and attachment loss > 3 mm was 5.0 and 9.3% in the 55- to 64-year-old and the 65- to 74-year-old age group. The prevalence of bleeding on probing was 88.4% among 55 to 64 years old and 82.6% among 65 to 74 years old. Mean number of teeth with bleeding on probing were 13.87 among 55 to 64 years old and 11.25 among 65 to 74 years old. The prevalence of probing depth ≥ 4 mm and attachment loss > 3 mm were 69.3 and 69.9% in people aged 55-64 years and were 64.6 and 74.2% in people aged 65-74 years. Mean number of teeth with probing depth = 4-5 mm and probing depth ≥ 6 mm were 4.48 and 0.36 in 55-64 age group and 3.70 and 0.33 in 65-74 age group. And mean number of teeth with attachment loss > 3 mm were 5.17 among 55 to 64 years old and 5.63 among 65 to 74 years old. Besides, attachment loss > 3 mm was associated with age, gender, smoking, toothbrushing frequency and toothpick use., Conclusions: Periodontitis was not highly prevalent among 55- to 74-year-old Chinese adults. Age, gender, smoking, toothbrushing frequency and toothpick use could be risk factors., Clinical Relevance: Scientific rationale for the study: The periodontal conditions among 55 to 64 and 65 to 74 years old Chinese population were not highly serious, but prevalence of bleeding on probing, periodontal pockets and attachment loss should be drawn enough attention by relevant public health administrations., Principal Findings: The prevalence of periodontal diseases was evaluated in 55- to 64-year-old and 65- to 74-year-old subjects in a nationally representative Chinese sample population. The prevalence of probing depth ≥ 4 mm and AL > 3 mm were high; these values were 69.3% and 69.9%, respectively, in the 55-64 age group and 64.6% and 74.2%, respectively, in the 65-74 age group. In addition, case percentage of AL = 4-5 mm combined with PD < 6 mm were 23.1 and 19.4% among 55- to 64-year-old and 65- to 74-year-old people. And case percentage of AL> 5 mm combined with PD ≥ 6 mm were 11.1% and 12.1% among 55- to 64-year-old and 65- to 74-year-old people, respectively., Practical Implications: The present study provides a reference for the epidemiological analysis of periodontal diseases. To reduce widespread inadequate treatment of periodontal diseases, clinical management should be performed in dental practices. Furthermore, oral health recommendations should be made at multiple levels.

Background: Tibet, a region where average elevation is above 3500 m and socio-economic development is relatively lower, was not included in National Oral Health Survey over decades. The cross-sectional study aimed to investigate the status of dental caries and associated factors in Tibetan adults., Methods: Participants aged 35-44, 55-64 and 65-74 years were selected. Decayed, missing, and filled tooth (DMFT), decayed and filled root (DF-Root) and root canal index (RCI) were used to evaluate dental caries. Questionnaire survey on demographic information, socioeconomic status, dietary habits, and oral health knowledge and behavior was conducted. Mann-Whitney U test, logistic regression were used for the statistical analyses., Results: A total of 446 participants were enrolled in the survey. Of these: 222 (49.8%) were females, 224 (50.2%) were males; 149 (33.4%), 151 (33.9%), 146 (32.7%) were aged 35-44, 55-64 and 65-74 years respectively. The mean DMFT (SD) was 7.62 (4.84), 12.46 (8.16), and 21.38 (8.93). The filling rate was very low in all age groups (1.77%, 0.98%, 0.45%). The mean DF-Root (SD) was 0.50 (1.04), 1.04 (2.02), 1.32 (2.14), respectively. Root caries index was 42.27, 44.78 and 57.60%. Older age (65-74 age group) was positively associated with crown caries (odds ratio = 31.20, 95% confidence interval: 10.70-90.96). College degree and above and brushing teeth at least once a day were negatively associated with crown caries (odds ratio = 0.28, 95% confidence interval: 0.09-0.89; odds ratio = 0.39, 95% confidence interval: 0.21-0.72, respectively). Rural area, high income level and brushing teeth at least once a day were negatively and tooth with attachment loss was positively associated with root caries., Conclusions: The status of dental caries in the adults in Tibet is severe and the treatment rate is very low. The study suggests a correlation between crown caries and the variables age, level of education and frequency of tooth brushing; correlation between root caries and residence, income level, frequency of tooth brushing and exposed root surfaces. These findings could be as reference to develop community based interventions to reduce the prevalence of caries in Tibet.

Objectives: To explore the factors associated with utilization of oral health services among Chinese adults and older adults according to the Andersen Behavior Model., Methods: Data from the 4th National Oral Health Survey (2015-2016) in China were used. A total of 7206 people (3669 adults aged 35-44 years and 3537 older adults aged 65-74 years) were included in our analysis. Oral health service utilization in the past 12 months was the outcome variable. Explanatory variables were selected according to the Andersen Behavior Model. Descriptive statistics and bivariate associations (chi-square tests) were analysed, followed by hierarchical Poisson regression models, which were conducted to determine the factors associated with oral health service utilization., Results: In total, 21.4% (95% CI: 19.4%-23.7%) of adults (35-44 years old) and 20.7% (95% CI: 18.6%-22.9%) of older adults (65-74 years old) utilized oral health services in the past 12 months. Nearly 80% of adults (78.7%, 95% CI: 74.0%-82.7%) and more than 90% of older adults (93.7%, 95% CI: 91.0%-95.6%) visited a dentist for treatment. Adults aged 35-44 years old who were female (IRR: 1.15, 95% CI: 1.00-1.33, P = .047), had good oral health knowledge and attitudes (IRR: 1.30, 95% CI: 1.06-1.59, P = .011), perceived their oral health status as fair (IRR:1.51, 95% CI:1.24-1.85, P < .001) or poor/very poor (IRR:2.52, 95% CI:2.01-3.18, P < .001) and had a decayed, missing and filled teeth (DMFT) index >0 (IRR: 1.52, 95% CI: 1.11-2.09, P = .009) were more likely to report dental visits in the past 12 months. Older adults who utilized oral health services tended to be female (IRR: 1.32, 95% CI: 1.09-1.59, P = .004); to be covered by Urban Resident Basic Medical Insurance (URBMI) (IRR: 1.56, 95% CI: 1.18-2.05, P = .002), Urban Employee Basic Medical Insurance (UEBMI) (IRR: 1.69, 95% CI: 1.32-2.16, P < .001) or government medical insurance (GMI) (IRR: 1.03, 95% CI:1.01-2.16, P = .044); to have a high education level (IRR: 1.37, 95% CI: 1.08-1.74, P = .010); to have an income level in the 2nd tertile (IRR: 1.44, 95% CI: 1.13-1.84, P = .003) or 3rd tertile (IRR:1.52, 95% CI:1.18-1.95, P = .001); and to perceive their oral health status as poor or very poor (IRR: 1.53, 95% CI: 1.21-1.95, P = .001)., Conclusions: Sex and self-perceived oral health status were associated with oral health utilization among Chinese population. Additionally, for older adults, education level, household income and insurance coverage were determinants of dental service use. These findings can aid in creating more targeted policies to increase the use of dental services by Chinese adults., (© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: This study sought to evaluate dental utilization among 3-,4-, and 5-year-old children in China and to use Andersen's behavioural model to explore influencing factors, thereby providing a reference for future policy making., Methods: This study is a cross-sectional study. Data of 40,305 children aged 3-5 years were extracted from the Fourth National Oral Health Survey, which was performed from August 2015 to December 2016. Patient data were collected using a questionnaire, which was answered by the child's parents, and clinical data were collected during a clinical examination. Stratification and survey weighting were incorporated into the complex survey design. Descriptive statistics, bivariate correlations and hierarchical logistic regression results were then analysed to find the factors associated with oral health service utilization., Results: The oral health service utilization prevalence during the prior 12 months were 9.5% (95%CI: 8.1-11.1%) among 3-year-old children, 12.1% (95%CI: 10.8-13.5%) among 4-year-old children, and 17.5% (95%CI: 15.6-19.4%) among 5-year-old children. "No dental diseases" (71.3%) and "dental disease was not severe" (12.4%) were the principal reasons why children had not attended a dental visit in the past 12 months. The children whose parents had a bachelor's degree or higher (OR: 2.29, 95%CI: 1.97-2.67, p < 0.001), a better oral health attitude ranging from 5 to 8(OR: 1.64, 95%CI: 1.43-1.89, p < 0.001), annual per capital income more than 25,000 CNY (OR: 1.40, 95%CI: 1.18-1.65, p < 0.001),think their child have worse or bad oral health (OR: 3.54, 95%CI: 2.84-4.40, p < 0.001), and children who often have toothaches (OR: 9.72, 95%CI: 7.81-12.09, p < 0.001) were more likely to go to the dentist in the past year., Conclusion: The prevalence of dental service utilization was relatively low among preschool children. It is necessary to strengthen oral health education for parents and children, thereby improving oral health knowledge as well as attitude, and promoting dental utilization.

Objectives: Differences in oral health perceptions complicate comparisons of self-reported oral health in countries with considerably different cultures, traditions, and dental care. We compared it in China and New Zealand (NZ), to determine whether adults in those countries differ in how self-report oral health item responses distinguish those with different clinical oral disease states., Materials and Methods: Analysis of representative data on dentate 35-44-year-olds and 65-74-year-olds from the 3rd National Oral Health Survey of China in 2005 (for Sichuan province) and the NZ Oral Health Survey in 2009. Self-rated oral health in the Chinese survey was assessed by asking "Overall, how would you rate your oral health?"(responses: "Very poor," "Poor," "Fair," "Good," and "Very good"). The NZ survey asked "How would you describe the health of your teeth or mouth?" (responses: "Excellent," "Very good," "Good," "Fair," or "Poor"). To enable comparability, these were combined to create a four-category ordinal measure of self-reported oral health. The slope index of inequality (SII) and the relative index of inequality (RII) determined the extent to which the four-category self-report item distinguished those with better or poorer oral status., Results: A higher proportion of Chinese than NZ 35-44-year-olds rated their oral health as poor or fair, and the NZ proportion rating their oral health as very good was four times that observed among Chinese. The 65-74-year-olds differed even more in their overall responses. For most aspects of clinical disease experience, the two populations were responding similarly to the self-reported oral health item, although the SII and RII values were more pronounced among 35-44-year-olds in NZ than in China; among 65-74-year-olds, both countries were more similar., Conclusions: Chinese and NZ adults' self-ratings reflect their oral disease experience in largely similar ways, despite considerable absolute differences., Clinical Relevance: These findings support the cross-cultural applicability of self-report oral health measures.

Objectives: To use recent national survey data to compare dentition status and oral diseases in China and New Zealand (NZ), with a particular focus on differences by sex and education level., Methods: We undertook secondary analysis of representative data from oral health surveys conducted in 2009 in Sichuan (China) and NZ. Both surveys had an oral examination component and collected detailed demographic data. Socioeconomic position in this analysis was represented by the highest level of education completed. Participants were allocated to 1 of 3 comparable ordinal categories of years of education (primary, middle or tertiary). Analyses used survey weights., Results: The proportion of Chinese who had been educated to only primary level was 3 times higher than that among their NZ counterparts, and the proportion with a tertiary education was correspondingly lower. In the 35-44 age group, the dentate proportions were similar, although the mean number of teeth was higher in China than in NZ. There were substantial differences in dental caries experience, with the mean DMFT in NZ being almost 3 times that observed in China. New Zealanders had more filled teeth, but the prevalence of 1+ missing teeth was lower. Periodontitis was more common in the NZ sample than in the Chinese one, although the extent of bleeding on probing was almost 3 times higher among the latter. For the 65-74 age group, there were significant differences in dentition status, with greater tooth retention among Chinese people. There were also significant differences in dental caries experience, with Chinese 65- to 74-year-olds having more decayed teeth but fewer filled or missing teeth, and lower DMFT scores, on average. Periodontal health was better among the New Zealanders. There were notable differences by sex and education level., Conclusions: The differences observed in this study provide strong support for using broader sociocultural models of oral health., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To investigate the dental caries status and related factors in Chinese elderly people, using data from the 4th National Oral Health Survey of China., Methods: In this cross-sectional study, a multistage, cluster strategy was used to recruit 4,431participants (2,222 male and 2,209 female) aged 65 to 74 years from all 31 provinces, autonomous regions and municipalities of the mainland of China. The survey was performed according to the diagnostic standard proposed by the World Health Organization (WHO). Socio-demographic information was collected with a closed questionnaire., Results: The caries prevalence in 65 to 74-year-olds was rather high; the report shows it was 98.0% (DMFT ≥ 1) among elderly people in China. The mean DMFT, DT, MT and FT was 13.33 ± 9.32, 3.33 ± 4.17, 9.50 ± 8.66 and 0.49 ± 1.41, respectively. The filling rate was very low, assessed as 12.8%. The number of DMFT related to gender, residential district type, educational level, level of annual household income, toothbrushing frequency, consumption frequency of desserts, attitudes to oral health and oral health-related knowledge., Conclusion: The prevalence of dental caries in Chinese elderly people is rather high and a lot of decayed teeth still need to be filled and suitable prevention and treatment for this group is urgently needed.

Objective: To investigate the periodontal health status and associated factors of adolescents aged 12 to 15 years old in China., Methods: A cross-sectional national oral health survey was conducted in 2015-2016. The multi-stage stratified cluster sampling was used to select participants in all 31 provinces, autonomous regions and municipalities in the mainland of China. Each participant received a clinical assessment including periodontal bleeding and calculus, and 15-year-old adolescents received additional examinations including for periodontal pocket depth and attachment loss, using the latest criteria from the Oral Health Survey Basic Methods, as recommended by the World Health Organization (WHO). A self-answered structured questionnaire was designed to collect the data of background information and associated risk factors., Results: A total of 118,514 adolescents (14.0 ± 1.09 years old) completed all the oral examinations and the questionnaire. The prevalence of periodontal bleeding and calculus was 61.0% and 67.3% respectively. In the group of 15 year olds, 6.5% adolescents had periodontal pocket and 0.5% had attachment loss. Molars were often involved and, furthermore, calculus also occurred on lower incisors. The periodontal status of adolescents became worse as they grew up. The condition of girls was significantly better than boys., Conclusion: This survey illustrated a brief picture of periodontal status of adolescents in China showing that gingival bleeding and calculus were very common and frequent. Further actions on oral health education were necessary, especially for those in lower socio-economic classes.

Objective: To investigate the oral health status and related factors of 12-year-olds from regions with and without coverage of the National Oral Health Comprehensive Intervention Program in China by means of analysing national data from the 4th National Oral Health Survey., Methods: Data of 12-year-olds participating in the 4th National Oral Health Survey of China were used for statistical analysis. Children who were recruited in the survey completed a dental examination and filled in a questionnaire. Oral health status, pit-and-fissure sealant history, oral hygiene behaviours, sugar consumption habits, status of dental service utilisation, and oral health knowledge were compared between children from regions with and without coverage of the national programme. For the number of decayed, missing and filled permanent teeth (DMFT) and its components, as well as the number of teeth with pit-and-fissure sealants, mean values were statistically tested to see if significance existed between regions covered by the national programme and uncovered regions, whereas caries prevalence and percentage of pit-and-fissure sealants presented were also compared., Results: Data from 27,821 12-year-old children were analysed, among whom 7,726 were from regions covered by the national programme and 20,095 were from uncovered regions. Statistical significance was found in caries experience and activity, pit-and-fissure sealant history, sugar consumption habits, utilisation of dental services and oral health knowledge when compared between the covered and uncovered regions. Prevalence of dental caries and indices for caries experience and activity was lower in regions covered by the national programme than those not covered, while the percentage of pit-and-fissure sealants presented and the number of teeth with pit-and-fissure sealants exhibited higher in the covered regions. This remained the same even if we focused only on the first molars instead of the full dentition., Conclusion: The National Oral Health Comprehensive Intervention Program for Children in China potentially contributed to better oral health status, behaviour and knowledge in 12-year-old children. The expansion and extension of coverage of the national programme was expected to be beneficial for improving oral health status in children, as well as constructing teams of oral and dental workforce and working mechanisms in some underdeveloped regions.

Oral disease patterns change over time and it is important to conduct epidemiological surveillance population surveys regularly to monitor the situation. The overall objectives of the present survey were: (1) to describe the oral health status of Chinese children and adults in the 2015-2016 4th National Oral Health Survey; (2) to investigate the oral health knowledge, attitudes, and behaviours among children and adults; (3) to explore the association among sociodemographic characteristics, oral health behaviours, and the oral health status of Chinese children and adults. A national oral health survey was conducted among a representative sample of Chinese children and adults. Local residents from the five age groups - 3 to 5 years, 12 to 15 years, 35 to 44 years, 55 to 64 years, and 65 to 74 years - were selected. A multi-stage cluster sampling method was adopted for the identification of participants. All 31 provinces, autonomous regions and municipalities of the mainland of China were included. All participants were clinically examined and information on their oral health status, including oral mucosal lesions, dental caries experience, periodontal health status, dental fluorosis, and dental prosthesis status, was collected according to the procedures and criteria recommended by the World Health Organization (WHO). A calibration training programme and quality control procedures were conducted to ensure the reliability of the findings. Information on sociodemographic background, oral health behaviours, knowledge and attitude was also collected from all five age groups through a questionnaire survey.

Objective: To investigate the prevalence and severity of dental caries among pre-school children in China as part of the 4th National Oral Health Survey., Methods: The sampling process was conducted with a multistage stratified cluster method. A total of 40,360 children aged between 3 and 5 years were recruited for this study. Each participant was clinically assessed according to the 5th edition of the oral health survey's basic methods recommended by the World Health Organization (WHO) and their parents or grandparents completed a questionnaire at a face-to-face interview. The status of dental caries was shown in the form of the mean dmft and the prevalence of dental caries. The logistic regression analysis was performed to study the relationships between the prevalence of dental caries and the selected variables., Results: The prevalence of dental caries was 50.8%, 63.6% and 71.9% for 3-, 4- and 5-year-olds, respectively. The mean dmft was 2.28, 3.40 and 4.24, respectively. Logistic regression analysis showed that children who were mixed-fed had a higher chance of staying free of dental caries; children who had dessert before going to bed were associated with a higher probability of caries., Conclusion: The status of dental caries among preschool children in China is on the increase. The preschoolers' dental caries status related to their breastfeeding conditions within the first 6 months of life and their snacking habits.

Objective: To investigate the status of tooth loss and denture restoration in Chinese adults, analyse the changing trend and provide fundamental data for oral health policy., Methods: According to the protocol of the 4th National Oral Health Survey, a multistage stratified random cluster-sampling method was used to enrol adult subjects aged 35 to 44, 55 to 64 and 65 to 74 years in all 31 provinces, municipalities and autonomous regions of the mainland of China. The status of tooth loss and denture restoration was investigated. SPSS20.0 software was used for statistics analysis., Results: Among the 13,464 subjects investigated, 13.8% had complete dentition, 84.4% had dentition defects, and 1.8% was edentulous. Urban subjects showed a significantly higher proportion of complete dentition than those in rural (P = 0.02), and males showed the statistically higher proportion of complete dentition than females (P = 0.01). The mean of remaining teeth was 26.1 ± 6.90, which in urban areas was significantly higher than in rural areas (P < 0.01). The means of remaining teeth were 29.6 ± 2.3, 26.3 ± 6.1, and 22.5 ± 8.7 in the 35 to 44, 55 to 64 and 65 to 74 age groups, respectively. The detection rate of fixed partial dentures (FPD) was statistically higher in urban than in rural areas and in males than that in females (P < 0.01). The detection rate of removable partial dentures (RPD) was statistically higher in urban areas than in rural locations (P < 0.01). However, the detection rates of irregular denture and unrepair of tooth loss were both significantly lower in urban than in rural areas (P < 0.01). The rate of restoration of tooth loss was 41.6% in Chinese adults., Conclusion: Although the tooth loss and denture restoration status recorded in the survey was improved compared with the results of 10 years ago, more efforts need to be made on strengthening oral health promotion, particularly for elderly people and those living in rural areas.

Objective: To explore the clinical and socio-demographic factors influencing oral health-related quality of life (OHRQoL) of Chinese adults in the 4th National Oral Health Survey., Methods: Multistage stratified cluster sampling and PPS method were used in sampling and 4720 adults aged 35 to 44 years were recruited. The study subjects completed a structured questionnaire in an interview and underwent a clinical examination. The questionnaire was a Putonghua version of the General Oral Health Assessment Index (GOHAI) and was completed by the interviewer on the site of the 4th National Oral Health Survey. Clinical examination was performed using the criteria recommended by the World Health Organization (WHO)., Results: The mean GOHAI score of the subjects was 54.42 (SD 6.01). Result of Poisson regression showed that subjects with a higher household income per capita, had lower DMFT, fewer missing teeth, had no unrepaired missing teeth, or not wearing a partial denture had higher GOHAI scores indicating better OHRQoL., Conclusion: The OHRQoL of the adults in China was fair and was mainly influenced by dental caries, integrity of dentition and restoration of lost teeth. With limited resources and dental manpower in China, higher priority should be given to the prevention and treatment of the main cause leading to losing teeth.

Objective: To assess the current periodontal status of 35 to 44-year-olds from the Chinese population and to analyse potential influence factors on periodontal disease., Methods: The data of subjects were collected from both urban and rural areas of all 31 provinces, autonomous regions and municipalities of the mainland of China, as part of the 4th National Oral Health Survey. All subjects were aged 35 to 44 years old. In total, 4,410 subjects were enrolled in the present study. Each subject was asked to undergo a professional oral examination and to fill in a questionnaire. Periodontal health status was evaluated by probe bleeding, calculus, periodontal pocket depth and clinical attachment loss. The data were analysed using the chi-square test and binary logistic regression analysis., Results: The prevalence of probe bleeding and calculus was 87.4% and 96.7% respectively among the 35 to 44-year-old population. Prevalence of shallow pockets (4 mm ≤ PD < 6 mm) and deep pockets (PD ≥ 6 mm) was 45.8% and 6.9% respectively among 35 to 44-year-old people. In addition, prevalence of clinical attachment loss (CAL > 3 mm) was 33.2%. Gender, educational level, smoking, teeth brushing frequency, dental floss and toothpick use were found relevant to periodontal condition., Conclusion: Periodontal disease was highly prevalent among 35 to 44-year-old Chinese adults. Gender, educational level, smoking, teeth brushing frequency, toothpick and dental floss use could be potential influence factors of periodontal health status.

Objective: To explore the prevalence and associated risk indicators of dental fluorosis in the mainland of China., Methods: Data for this study was obtained from the 4th National Oral Health Survey in China, conducted from 2015 to 2016. The sample population was 12-year-old school students. Study participants were selected using a multi-stage, stratified random sample selection procedure using a sampling frame compiled from geographical distribution of China. The level of dental fluorosis was determined using the Dean index recommended by the World Health Organization (WHO). A structured questionnaire was distributed to all the subjects in schools. Participants completed a questionnaire with assistance from staff. A bivariate analysis was performed using the chi-square test. Logistic regression was performed to evaluate the association between dental fluorosis and the independent variables., Results: A total of 27,495 students were evaluated, of which 13,650 (49.6%) were male. Overall, dental fluorosis was found in 13.4% of participants; 6.3% had very mild fluorosis, 4.3% had mild fluorosis, 2.3% had moderate fluorosis, and 0.5% had severe fluorosis. The community fluorosis index was 0.28. In the final logistic regression model students from rural areas (RR:1.582, 95%CI 1.473-1.700), students whose fathers had low education (RR:1.429, 95%CI 1.230-1.661 & 1.184, 95%CI 1.026-1.365), and those students with sibling (RR:1.537, 95%CI 1.414-1.671) were more significantly associated with dental fluorosis., Conclusion: As a whole, China has a low dental fluorosis prevalence. Rural areas were the key places for the prevention of dental fluorosis. More prevention measures should be conducted on the children whose fathers were of lower education and who were not an only child.

Objective: To investigate the differences in distribution of root caries and related factors between middle-aged and elderly people in China., Methods: In this cross-sectional study, a multistage, cluster strategy was used to recruit 4,410 participants (2,197 males and 2,213 females) aged 35 to 44 years and 4,431 participants (2,222 males and 2,209 females) aged 65 to 74 years from all 31 provinces, autonomous regions and municipalities of the mainland of China. The survey was conducted according to the basic methods proposed by the World Health Organization (WHO). Sociodemographic information, oral health behaviour, attitude and knowledge, history of dental prophylaxis and general health condition were collected with a closed questionnaire., Results: A great increase in the occurrence of root caries in Chinese adults from 35 to 44-year-old to 65 to 74-year-olds, with the prevalence (DFR ≥ 1) from 25.4% to 61.9% and with the mean DFR score from 0.54 ± 1.34 to 2.63 ± 3.75. Filling rates were also very low, only 1.8% and 3.0%, respectively. Females and residents of rural areas were more likely to suffer from root caries. In both the middle-aged group and the elderly group, root caries related to gender, education level, sweet food/drinks consumption, oral health knowledge and status of root surface explosion. In 35 to 44 year olds, toothbrushing is a significant protection factor (OR = 0.88, 95%CI 0.81 ~ 0.96), while using toothpicks is a risk factor (OR = 1.06, 95%CI 1.02 ~ 1.10). In 65 to 74 year olds, not having dental had scaling in the past 12 months is a risk factor (OR = 1.66, 95%CI 1.09 ~ 2.53)., Conclusion: Root caries among middle-aged people and elderly people in China have different risk factors and need more attention in future research to develop proper prevention.

Objective: To investigate the dental caries status of teenagers in China by means of analysing national data from the 4th National Oral Health Survey of China., Methods: Data for 12- to 15-year-olds participated in the 4th National Oral Health Survey of China were used for statistical analysis. Children who were recruited in the survey completed a dental examination and filled in a questionnaire. Social demographic factors, oral hygiene behaviours, sugar consumption habits, status of dental service utilisation, and pit-and-fissure sealant history were compared between adolescents with caries experiences and those without. For decayed, missing and filled permanent teeth (DMFT) and each of its components, mean values were statistically tested to see if significance existed between or among different categories of all involved variables., Results: In total, data from 27,821, 30,961, 30,691 and 29,128 Chinese 12-, 13-, 14-, and 15-year-olds respectively, were analysed. Social demographic factors, sugar consumption and dental service utilisation showed statistical significance when compared between those with and without dental caries experience in the 12- and 15-year-old groups. Certain categories of these factors above also had important influence on the mean value of the number of decayed teeth (DT), filled teeth (FT) and DMFT, and they might be potential determinants of dental caries experience of permanent teeth for teenagers., Conclusion: Dental caries in 12- and 15-year-old Chinese adolescents was impacted by certain social demographic and dental behavioural factors, which could provide some implications for policy makers and dental public health professionals when attempting to enhance oral health status for those teenagers in the early stages of permanent dentition.

Background: The Dai people are one of the ethnic minorities in China and have a population of 1,260,000. They have the same origin as one of the main ethnic groups in Laos and Thailand. The study aims to describe the dental caries and gingival status of 12-year-old Dai children in China and to study the factors affecting their oral-health status., Methods: This cross-sectional oral-health survey was conducted from 2011-2012 with ethics approval. A sample of 12-year-old Dai children living in Yunnan, China, was selected using a multistage and cluster sampling method. One trained examiner performed the clinical examination. Caries experience was measured using DMFT index, and gingival status was assessed with CPI index. A self-completed questionnaire was sent to the children, and they were asked about their backgrounds and oral-health-related behaviors and oral-health knowledge. Binary logistic regression analysis was performed to investigate the factors that affected the caries status., Results: A total of 875 children were invited, and 823 (94 %) joined the survey. The prevalence of caries experience among the participants was 40 %. The mean DMFT and DT scores were 0.9 and 0.8, respectively. Most children (93 %) had gingivitis, and many (46 %) had calculus. Girls and those who had visited a dentist during the previous year had a higher prevalence of caries., Conclusion: Dental caries were prevalent among 12-year-old Dai children in China. The periodontal condition of most of the children was poor. Caries were associated with gender and dental attendance.