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Aim: Our previous three-year randomized control trial showed that the application of MI Varnish™ (5% NaF/CPP-ACP) every 3 months reduced further caries development in 6- and 12-year-olds over a 3-year period. The purpose of this secondary analysis was to investigate whether MI Varnish™ had a differential effect on cumulative caries increment on different tooth surfaces. Methods: Group 1 (n = 48) (6-year-old children) and Group 3 (n = 47) (12-year-old children) received quarterly varnish applications, while Group 2 (n = 48) (6-year-old children) and Group 4 (n = 37) (12-year-old children) did not receive varnish applications. ICDAS caries scoring classified lesions as non-cavitated (n/c) lesions (ICDAS 1 and 2), cavitated (c) lesions (ICDAS II 3–6), non-cavitated lesions around restorations (CARn/c), and cavitated lesions around restorations (CARc). Thus, ‘decayed’ in DFS was calculated as (ICDAS 1–6 + CARn/c + CARc). The Chi-square test, Welch test (paired-t test), risk ratio test, and Pearson correlation coefficient were used for statistical analysis (α = 0.05). Results: After comparing baseline and 36-month data, in group 1, there was a significant (p < 0.01) reduction in caries in occlusal (23.11%) and proximal (21.35%) surfaces and a non-significant reduction in buccal/lingual surfaces (5.28%). In group 2, caries reduction was significant (p < 0.01) in occlusal surfaces (38.52%) but non-significant in proximal (7.78%) and buccal/lingual (7.12%) surfaces. In groups 3 and 4, significant (p < 0.001) increases in caries were observed in proximal (36.03% (group 3)/54.30% (group 4)) and buccal/lingual surfaces (51.02% (group 3)/45.98% (group 4)), and a non-significant increase was observed in occlusal surfaces (11.49% (group 3)/22.01% (group 4)). The relative risk had increased by 4% only on proximal surfaces in 6-year-olds. Conclusions: the application of MI Varnish™ every 3 months demonstrated a caries reduction effect on interproximal and occlusal surfaces among 6- and 12-year-old children. (Trial registration ISRCTN10584414).

Aim: Our previous three-year randomized control trial showed that the application of MI Varnish™ (5% NaF/CPP-ACP) every 3 months reduced further caries development in 6- and 12-year-olds over a 3-year period. The purpose of this secondary analysis was to investigate whether MI Varnish™ had a differential effect on cumulative caries increment on different tooth surfaces. Methods: Group 1 (n = 48) (6-year-old children) and Group 3 (n = 47) (12-year-old children) received quarterly varnish applications, while Group 2 (n = 48) (6-year-old children) and Group 4 (n = 37) (12-year-old children) did not receive varnish applications. ICDAS caries scoring classified lesions as non-cavitated (n/c) lesions (ICDAS 1 and 2), cavitated (c) lesions (ICDAS II 3–6), non-cavitated lesions around restorations (CARn/c), and cavitated lesions around restorations (CARc). Thus, 'decayed' in DFS was calculated as (ICDAS 1–6 + CARn/c + CARc). The Chi-square test, Welch test (paired-t test), risk ratio test, and Pearson correlation coefficient were used for statistical analysis (α = 0.05). Results: After comparing baseline and 36-month data, in group 1, there was a significant (p < 0.01) reduction in caries in occlusal (23.11%) and proximal (21.35%) surfaces and a non-significant reduction in buccal/lingual surfaces (5.28%). In group 2, caries reduction was significant (p < 0.01) in occlusal surfaces (38.52%) but non-significant in proximal (7.78%) and buccal/lingual (7.12%) surfaces. In groups 3 and 4, significant (p < 0.001) increases in caries were observed in proximal (36.03% (group 3)/54.30% (group 4)) and buccal/lingual surfaces (51.02% (group 3)/45.98% (group 4)), and a non-significant increase was observed in occlusal surfaces (11.49% (group 3)/22.01% (group 4)). The relative risk had increased by 4% only on proximal surfaces in 6-year-olds. Conclusions: the application of MI Varnish™ every 3 months demonstrated a caries reduction effect on interproximal and occlusal surfaces among 6- and 12-year-old children. (Trial registration ISRCTN10584414). [ABSTRACT FROM AUTHOR]

IntroductionStunting is a condition of malnutrition in children from the womb to the early life stage that causes growth failure in the body and brain. Stunting influences the development and integrity of the oral cavity and increases the risk of developing diseases in the oral cavity, such as dental caries. The growth barriers in stunting children and parental knowledge can affect maintaining oral hygiene. This study aims to determine the description of oral hygiene practice and caries increment in children with growth stunting.MethodsThis type of research is a quantitative descriptive with a Secondary Data Analysis approach in the form of examination results for the presence or absence of caries through the ICDAS index and the results of the oral hygiene practice questionnaire on 113 children with growth stunting in Sukajadi district, Bandung.ResultsMost stunting children (60.2%) experienced increased caries rates classified as low, and 70.8% had poor oral hygiene practices. There were 50 children (44.3%) with poor oral hygiene practice with low caries increment, while 18 children (15.9%) had good oral hygiene practice with low caries increment.ConclusionOral hygiene practice is classified as poor, but caries increment is still relatively low in most stunting children in Sukajadi district, Bandung.

Abstract Background This study aims to investigate the rate of caries increment among 11-12-year-old Pakistani children over 18 months using modified International Caries Detection and Assessment Systems II (ICDAS) and subsequently establish an appropriate dental recall interval for our targeted population according to their caries risk intensity. Methods A prospective longitudinal study was conducted in Bhakkar, Punjab, Pakistan. The 226 children from seven schools of Bhakkar with the highest student enrolment were conveniently selected. Caries risk assessment was performed using a computer-based reduced Cariogram program. Caries increment among cavitated lesions was measured by modified Beck's method or adjusted caries increment. Two ICDAS II cutoffs were created for the analysis of cavitated lesion (ICDAS code 3–6) and cavitated plus non-cavitated lesion (ICDAS code A-6). Results At the risk assessment stage, 39.8% of the children were classified as low risk, 30.5% as medium risk, and 29.7% as high risk. Caries increment at both cutoff points increased with caries risk at all follow-ups. The highest caries increment was recorded at the third follow-up among high-risk children at cutoff 3–6 (1.95 ± 3.18) and A-6 (4.01 ± 4.31). However, the lowest caries increment was recorded at the third follow-up among low-risk children at cutoff 3–6 (0.18 ± 1.42) and A-6 (1.11 ± 3.33). Conclusion Based on the study findings for Pakistani children with cavitated lesions, the recommended risk-based recall interval for caries management is 18 months for those with low and medium caries risk and six months for those with high caries risk. On the other hand, recommendations for risk-based recall intervals for caries management in non-cavitated and cavitated lesions are six months for low-risk, moderate risk and high-risk for Pakistani 11-12-year-old children.

Background: This study aims to investigate the rate of caries increment among 11-12-year-old Pakistani children over 18 months using modified International Caries Detection and Assessment Systems II (ICDAS) and subsequently establish an appropriate dental recall interval for our targeted population according to their caries risk intensity. Methods: A prospective longitudinal study was conducted in Bhakkar, Punjab, Pakistan. The 226 children from seven schools of Bhakkar with the highest student enrolment were conveniently selected. Caries risk assessment was performed using a computer-based reduced Cariogram program. Caries increment among cavitated lesions was measured by modified Beck's method or adjusted caries increment. Two ICDAS II cutoffs were created for the analysis of cavitated lesion (ICDAS code 3–6) and cavitated plus non-cavitated lesion (ICDAS code A-6). Results: At the risk assessment stage, 39.8% of the children were classified as low risk, 30.5% as medium risk, and 29.7% as high risk. Caries increment at both cutoff points increased with caries risk at all follow-ups. The highest caries increment was recorded at the third follow-up among high-risk children at cutoff 3–6 (1.95 ± 3.18) and A-6 (4.01 ± 4.31). However, the lowest caries increment was recorded at the third follow-up among low-risk children at cutoff 3–6 (0.18 ± 1.42) and A-6 (1.11 ± 3.33). Conclusion: Based on the study findings for Pakistani children with cavitated lesions, the recommended risk-based recall interval for caries management is 18 months for those with low and medium caries risk and six months for those with high caries risk. On the other hand, recommendations for risk-based recall intervals for caries management in non-cavitated and cavitated lesions are six months for low-risk, moderate risk and high-risk for Pakistani 11-12-year-old children. [ABSTRACT FROM AUTHOR]

Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-year-old children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia. [ABSTRACT FROM AUTHOR]

Dental caries constitutes a public health challenge. As preventive strategies are desirable, this retrospective cohort study aimed to assess the caries experience and increment in children attending kindergartens with an early childhood caries (ECC) preventive program (intervention group, IG) compared to basic prophylaxis measures (control group, CG) located in areas of different socioeconomic status (SES) within Marburg (Germany). The long-term caries experience (2009–2019) of these 3–5-year-old kindergarten children was evaluated. For the caries increment, dental records of 2019 were screened for the availability of a minimum of two dental examinations at least 8 months apart. Caries was scored according to the WHO criteria (dmf–t). The data were split by observation period (300–550 and >550 days). Overall, 135 children (Ø 3.7 years) attended IG, and 132 children (Ø 3.6 years) attended CG. After 300–550 days, no significant differences were found between both groups regarding mean caries increment and experience (p > 0.05). After >550 days, IG with low SES exhibited a high caries experience. Fluoride varnish applications could not reduce the caries increment compared to CG in the short-term but slightly decreased the long-term caries experience. Comprehensive ECC prevention measures actively involving parents are needed to overcome the caries burden. [ABSTRACT FROM AUTHOR]

Aims: This randomized controlled trial investigated the effect of MI Varnish™ (5% NaF/CPP-ACP) on caries increment in 6- and 12-year-old children in Riga, Latvia within 36 months. Methods: Forty-eight 6-year-old children (Group 1) and forty-seven 12-year-old children (Group 3) received quarterly varnish application, while forty-eight 6-year-old children (Group 2) and thirty-seven 12-year-old children (Group 4) did not have varnish applied. All children/parents received the same preventive advice. All children were visually examined using ICDAS-II criteria. Questionnaires on dietary habits were completed by the children/parents at baseline and after 36 months. DMFS and dfs were calculated from ICDAS data. The statistical analysis was performed (α = 0.05) using a Chi-squared test, paired t-test (Welch test) and the Pearson correlation coefficient. The trial registration number is ISRCTN10584414. Results: In Group 1 versus Group 2, the DMFS(SD) (Baseline/36 months) values were 5.02(5.85)/13.21(6.67) (p < 0.001) versus 2.65(4.54)/10.81(6.14) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 36.75(12.96)/24.04(12.9) (p < 0.001) versus 33.67(12.74)/23.88(11.91) (p < 0.001), respectively. In Group 3 versus Group 4, the DMFS(SD) (Baseline/36 months) values were 48.62(23.18)/70.96(23.28) (p < 0.001) versus 34.73(17.99)/54.95(16.09) (p < 0.001), respectively; the dfs(SD) (Baseline/36 months) values were 1.7(4.4)/0 (p < 0.05) versus 2(6.39)/0 (p = 0.06), respectively. The prevalence of caries (dfs + DMFS) decreased by 4.52 (p < 0.001) and 1.63 (p < 0.001) in Groups 1 and 2, respectively, but increased by 20.64 (p < 0.001) and 18.22 (p < 0.001) in Groups 3 and 4, respectively. An analysis of the questionnaires indicated the habitual, frequent consumption of a sugary diet by all the children. A significant correlation (r = 0.321; p < 0.05) was observed between caries increment and the frequency of daily intake of sugary snacks, soft drinks and tea with sugar at baseline only in Group 1. Conclusions: A quarterly application of MI varnish (CPP-ACP/fluoride) reduced caries increment in 6- and 12-year-old children in Riga, Latvia.

The primary objective of this study was to evaluate the effects of sealants in preventing pit and fissure caries in primary molars. The secondary objective was to assess the sealant retention during a 2‐yr study period. A 2‐yr split‐mouth randomized clinical trial including 90 3–7‐yr‐old children was conducted in the paediatric dental department of Montpellier hospital. The dentition of each included patient was divided into an experimental side and a control side, with annual follow‐up visits. Caries increments, measured as the number of new occlusal cavitated lesions, were not different between the sealed (mean 0.23) and the control primary molars (mean 0.29). A multiple mixed‐effects logistic regression showed that male gender, moderate/high caries risk, and a higher oral hygiene index score, had a statistically significant effect resulting in higher caries increments in the primary molars, than did female gender, low caries risk, and lower oral hygiene index scores. Sealing showed no statistically significant influence on the development of new caries lesions. After 2 yr, the percentages of partially or totally lost sealants were 22.7% and 32.0%, respectively. In this sample of children, the caries increment was not significantly different between the sealed and the unsealed molars. At the end of this 2‐yr study, more than half of the sealants were totally or partially lost, which could explain the low sealant effectiveness. [ABSTRACT FROM AUTHOR]

Objective: To evaluate effects of thresholds on estimates of predictive accuracy of methods for caries risk assessment.Material and Methods: Adolescents, aged 12 visiting two dental clinics, were examined by visual/tactile examination and bitewing radiography at baseline and after one year. Three methods for caries risk assessment were applied: previous caries experience, dentists' risk assessment according to set criteria (presence or absence of caries lesion) and acid tolerance of dental biofilm. The measure for validity (the reference standard) comprised caries lesion progression at 1 year. Predictive accuracy estimates were calculated for several thresholds.Results: Accuracy estimates changed with threshold values of the methods and the reference standard. Patient spectrum differed between the clinics, which resulted in different accuracy estimates for the two samples. Generally, negative predictive values were high while positive ones were low indicating that these methods were more efficient in finding individuals who are at low risk of developing caries lesions than those with increased risk.Conclusions: As thresholds and patient spectrum affected predictive accuracy, it may be difficult to design a universal model with set thresholds for caries risk assessment. Foremost, a model should consider the level of aspiration for prediction and clinical decisions that will be made based on the risk assessment in the actual clinical setting. [ABSTRACT FROM AUTHOR]

Introduction: Stunting is a condition of malnutrition in children from the womb to the early life stage that causes growth failure in the body and brain. Stunting influences the development and integrity of the oral cavity and increases the risk of developing diseases in the oral cavity, such as dental caries. The growth barriers in stunting children and parental knowledge can affect maintaining oral hygiene. This study aims to determine the description of oral hygiene practice and caries increment in children with growth stunting., Methods: This type of research is a quantitative descriptive with a Secondary Data Analysis approach in the form of examination results for the presence or absence of caries through the ICDAS index and the results of the oral hygiene practice questionnaire on 113 children with growth stunting in Sukajadi district, Bandung., Results: Most stunting children (60.2%) experienced increased caries rates classified as low, and 70.8% had poor oral hygiene practices. There were 50 children (44.3%) with poor oral hygiene practice with low caries increment, while 18 children (15.9%) had good oral hygiene practice with low caries increment., Conclusion: Oral hygiene practice is classified as poor, but caries increment is still relatively low in most stunting children in Sukajadi district, Bandung., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Putri, Indriyanti and Setiawan.)

Objectives: Children in a German region took part in regular toothbrushing with fluoride gel during their time in primary school after having received a preventive program in kindergarten. The study aimed at determining the dental health of the students as a function of prevention in kindergarten and at school while taking into account their socioeconomic status and other confounders.Materials and methods: The subjects were in six groups: groups 1 and 2, intensive prevention in kindergarten with and without fluoride gel at school; groups 3 and 4, basic prevention in kindergarten with and without fluoride gel at school; groups 5 and 6, no organized prevention in kindergarten with and without fluoride gel at school. Two dental examinations were performed for assessing caries experience and calculating caries increment from second grade (7-year-olds) to fourth grade (9-year-olds). A standardized questionnaire was used to record independent variables. To compare caries scores and preventive measures of various subgroups, non-parametric tests and a binary logistic regression analysis were performed.Results: A significant difference was found in the mean decayed, missing, and filled tooth/teeth (DMFT) depending on socioeconomic status (no prevention in kindergarten, fluoride gel at school in children with low SES: DMFT = 0.47 vs. DMFT = 0.18 in children with high SES; p = 0.023). Class-specific differences were no longer visible among children who had taken part in an intensive preventive program combining daily supervised toothbrushing in kindergarten and application of fluoride gel in school.Conclusions: Early prevention, focusing on professionally supported training of toothbrushing in kindergarten and at school, has a positive effect on dental health and is able to reduce class-specific differences in caries distribution.Clinical relevance: Early training of toothbrushing and fissure sealing of first permanent molars are the most important factors for the dental health of primary school children. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The first aim was to describe presence of plaque, caries and oral health behaviours in 2‐year‐old children. The second aim was to measure increments in caries experience from 2 to 5 years of age and to study whether national background, visible plaque, caries and oral health behaviour at 2 years of age were associated with increments in caries experience. Methods: The study population consisted of 392 children, of whom 211 were monitored from 2 to 5 years of age. At age 2 years, parents completed a questionnaire about family background and oral health behaviour. The presence of plaque and caries at tooth level was obtained from dental records. Data were tested with chi‐square statistics and Mann‐Whitney U test. Negative binomial regression analysis was conducted to explore the association between caries increment between 2 and 5 years of age and national background, visible plaque, caries and oral health behaviour at 2 years of age. Results: Caries was found in 4.6% of 2‐year‐olds, and 4.6% had visible plaque. More than half of these children (57.9%) brushed twice daily, toothbrushing was introduced when the child was 7 months or older in 61.0% of the children, and 15.6% consumed sugary snacks daily. Non‐Western children more often had caries, visible plaque and unfavourable oral health behaviour than Western children (P < .05). At age 5 years, 28.9% of the children had caries experience. Non‐Western background, toothbrushing less than twice daily, not using fluoridated toothpaste, not using fluoride lozenges, consuming sugary drinks at night, consuming sugary snacks daily, presence of plaque and caries at 2 years of age were associated with caries increment between 2 and 5 years of age in bivariable analyses. The results from multivariable analysis showed that children who started toothbrushing late, children who brushed less than twice daily at 2 years of age and children of non‐Western background had a higher probability of having caries increment from 2 to 5 years of age than other children. Conclusions: A small proportion of 2‐year‐olds had caries, but these children had several decayed teeth. Substantial differences in oral health and oral health behaviour were found between Western and non‐Western children. The preventive care delivered to the studied children failed to prevent caries increment from 2 to 5 years of age. [ABSTRACT FROM AUTHOR]

Objectives: In one region of Germany, a group of children took part in regular fluoride gel applications during primary school following intensified prevention in kindergarten. This observational study aimed to ascertain whether the dental health of primary school children can be improved by introducing a group prevention program based on applications of fluoride gel. Materials and methods: The subjects were distributed among six groups with varying preventive measures in kindergarten and at school. The basis for determining caries experience and calculating the caries increment consisted of dental findings gathered in the second and fourth grade. Results: While second graders without professionally supported daily toothbrushing in kindergarten exhibited an average d mft of 2.17, in those who had enjoyed intensive dental prevention, the corresponding value was 19% lower (dmft = 1.74). The caries increment was significantly lower mainly among children who had received the maximum of group prevention (intensive prevention in kindergarten and gel program at school). Conclusions: The results show that intensified preventive programs in kindergartens and schools, based mainly on supervised toothbrushing, have a positive effect on the dental health of primary school children. Clinical relevance: Such programs are efficient in reducing caries experience especially in socially deprived areas. [ABSTRACT FROM AUTHOR]

Aim of Study: The study was designed as a prospective model of caries increment, plaque presence and levels of cariogenic microorganisms with repeated examinations over three years to determine the caries increment dynamics and its relationship to risk factors of carious attack. Material and Methods: At the baseline, 273 children (150 boys and 123 girls) with the mean age of 3.86 years were included in the study. Dentition of the children was clinically examined in the field, in nurseries, using a mirror, rounded probe and headlight with a caries detection limit of a D3 lesion according to the WHO recommendations. The presence of plaque on the upper frontal teeth was recorded and Dentocult SM test was performed. At an interval of approximately one year from the baseline the test was repeated in the second and third year of the study. To determine differences in age, caries indicators (dt, dmft), presence of plaque and Dentocult SM results Mann-Whitney and Wilcoxon tests were used. Correlations of caries increment, plaque and Dentocult SM scores were evaluated by Wilcoxon's test and Pearson's correlation coefficient. Pearson's test was also used to assess the predictivity of plaque and Dentocult SM over time (the significance level at p < 0.05). Results: At baseline, the mean number of teeth with untreated caries per child was 1.28 and the mean dmft was 1.75. At baseline, 30.8% of the children were free of dental caries, 56.8% had restored teeth and 12.4% of the children had some untreated decay. Plaque on the anterior teeth at baseline was present in 30.98% of the children. The difference between the boys and girls was not significant. The mean value of Dentocult SM test at baseline was 1.40. At the second examination, the boys had a significantly higher mean Dentocult SM score than girls (p = 0.042), in the first and third test, the differences between the boys and girls were non-significant.The mean caries increment between the first and second examination was dmft = 0.68 per child. In the first and second year of the study the boys had a significantly higher caries increment than the girls (0.80 vs. 0.55 and 0.33. vs. 0.18). The caries increment after the first year of the study was significantly higher for boys and girls than in the second year (0.68 vs. 0.26). A highly significant association of the presence of plaque and the number of teeth with untreated caries (the teeth) and the dmft score (0.0001) was found during all three consecutive examinations. Significant correlations were found between Dentocult=0 and caries increment in the subsequent investigation, both between the first and second (p = 0.002), the second and third (p = 0.032) and the first and third examinations (p = 0.003). Conclusion: The three-year longitudinal study of caries increment in the deciduous dentition and its relationship to the microbial agents (plaque and cariogenic microorganisms) showed the dynamics of the dental caries development and the importance of assessing these factors in preschool children by caries risk analysis. The study documented the need for enhanced preventive measures at the older preschool age in compliance with primary preventive strategies against dental caries.

Background: Provision of oral health care in India, especially for the underprivileged is limited due to inadequate finances and manpower. Resources of dental colleges in such a scenario can be utilized to provide prevention oriented oral health care. Aim: To improve the oral health status of children at an institute in Nellore district of Andhra Pradesh, India, through prevention based comprehensive dental health care program (CDHP). Design and Setting: A longitudinal institution based interventional study conducted among the primary grade children (n=162). Materials and Methods: Baseline data collection included (i) basic demographic data (ii) body mass index (BMI) (iii) assessment of the dentition status and treatment needs according to WHO 1997 criteria. The CDHP included group based dental health education, professional oral prophylaxis, weekly (0.2%) sodium fluoride mouth rinse program, biannual application of topical fluoride (1.23% APF), pit and fissure sealants for all first permanent molars and provision of all necessary curative services. Results: Mean treatment requirements per child decreased at 18 months. New caries lesions developed among four children. BMI of children with decay was seen to improve significantly after instituting the CDHP. Conclusion: CDHP is effective in overall improvement of general and oral health. In resource limited countries like India, such programs organized by dental schools can improve oral health.

Caries experience dental status, oral hygiene and salivary levels of cariogenic streptococci were examined in the three years prospective study among older preschool children in relation to the dynamics of caries increment and with regard to the educational level of their mothers. Mean caries increment between the second and third year of study did not differ significantly amounting to 0.3 new decayed teeth per year however it was highest among children caries free in the onset of study. Higher caries experience significantly positively correlated with the presence of dental plaque and in the final of study also with the salivary levels of cariogenic streptococci. Mothers of caries free children assigned significantly higher educational level than those of children with tooth decay and on the contrary the proportion of children at need of restorative care was highest among mothers with elementary educational level. The educational level of mothers can be taken as the significant predictor of caries risk in children and as such it can be taken as one of important causes of the inequalities in oral health of children.

Although 1000 ppm fluoride (F) toothpaste is recommended for all age groups, many parents still choose 500 ppm F or non-F toothpaste for their toddlers to avoid the possibility of an excessive intake of F. As the comparison of the efficacy of F toothpastes has rarely been studied in infants and toddlers, the present study aimed to compare the caries increment with the use of 1000 ppm F, 500 ppm F, and non-F (xylitol with triple calcium phosphate) toothpastes in infants and toddlers. One hundred and seventy-three children aged 9–18 mo were randomly assigned into 3 groups according to the toothpaste used over a 12 mo period: group A: 1000 ppm F toothpaste; group B: 500 ppm F toothpaste; and group C: non-F toothpaste with xylitol and triple calcium phosphate. The children’s caregivers received oral health education with hands-on tooth brushing practice several times during the study. Oral examinations were conducted at baseline and after 12 mo. The differences in the caries increment among the groups were analyzed with the Kruskal-Wallis test. There were no significant difference in the dmfs, both including and excluding white lesions, among three groups at baseline. After 12 mo, no significant difference was seen in the incremental dmfs, both including and excluding white lesions, among the three groups. Thus, the low dose F and the xylitol with triple calcium phosphate toothpastes might be suitable alternatives to high dose F toothpaste for use in the infants and toddlers age group in order to minimize the risk of an excessive intake of F and the development of dental fluorosis. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the study was to evaluate the effect of an intensified preventive programme in kindergartens. Materials and methods: Two thousand two hundred twenty-eight 2- to 4-year-old children attending kindergartens in two counties in northern Hesse were randomly allocated to two groups. Children in the test group participated in daily tooth brushing with 500 ppm fluoride toothpaste, which was supervised by specially trained dental nurses. Children in the control group received tooth brushing instructions three to four times a year. Caries experience was recorded using WHO criteria. The basic survey was performed from October 2006 to April 2007, with the final examinations between March and July 2009. The statistical evaluation was performed by means of the software package SPSS 17.0. To compare the mean Δdmf values of the test and control groups, Mann-Whitney U tests were performed. Results: Two thousand one hundred twelve children (test group, 1096; control group, 1048) participated in the final examinations. The caries increment of the test group (Δdmf-s = 1.55) was 24 % lower than the increment of the control group (Δdmf-s = 2.02, p = 0.043). Based on Δdmf-t values, the corresponding figures were 0.79 for the test group and 1 for the control group ( p = 0.44). High increment values (Δdmf-s >7) were observed in the control group twice as often as in the test group. Conclusion: The results show that an intensified preventive programme in kindergartens, based on supervised daily tooth brushing, has a positive effect on the dental health of preschool children. Clinical relevance: It is sufficient to offer such programmes in socially deprived areas. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the present study was to evaluate the influence of various risk factors on dental caries increment in deciduous teeth of preschool children over 2.5 years. Materials and methods: A longitudinal study was carried out in kindergartens in two German counties in Northern Hesse. At baseline examination in 2006-2007, the mean age of the children was 3.5 years. Caries experience was recorded according to WHO standards. Information about feeding practices during early childhood and preventive measures were collected by a structured questionnaire for each child. Results: Three hundred ninety-five (69.8 %) of the 566 children showed no caries increment. A caries increase of 1 to 10 dmf-teeth was exhibited by 171 children (30.2 %). The mean dmf-t increment amounted to 0.75. The bivariate analysis revealed that the consumption of sugary food and beverages had a negative impact on oral health. Early start of toothbrushing, use of fluoridated children's toothpaste, and frequent toothbrushing exerted a positive influence on dental health. Stepwise backward logistic regression analysis confirmed that a high social status has a significant positive impact on dental health ( p = 0.028), whereas the consumption of sugary food and beverages was significantly associated with a higher dental caries increment ( p = 0.004). Conclusion: Obviously, it is not possible to limit the caries increment in children of low socioeconomic status as successfully as in children of high socioeconomic status. Clinical relevance: There must be a stronger focus on families of low socioeconomic status when preventive measures are performed on groups or individuals. [ABSTRACT FROM AUTHOR]

To assess the progression of dental caries among Malaysian infantry soldiers after 5 years in military service. A retrospective cohort study with a self-administered questionnaire and a clinical oral examination. Data were available for 173 (67.3%) soldiers. Mean decayed, missing, or filled teeth had increased significantly by 20.6% (P = .001) over 5 years. The highest increase was in the missing teeth component (+120%), followed by filled teeth (+23%). This was accompanied by a decrease in decayed teeth (−23.5%; P < .05). In terms of surfaces, mean decayed, missing, or filled surfaces, missing surfaces, and filled surfaces had increased significantly (P < .05). Caries experience was significantly associated with smoking status and rank (P < .05). Dental caries experience was worse after 5 years in military service compared with during recruitment, and there were more tooth extractions than restorations. Health promotion interventions are needed to prevent further tooth loss among soldiers. [ABSTRACT FROM PUBLISHER]

The aim of this 5-year longitudinal cohort study was to assess the prevalence, severity, and trends in caries increment and impact of the School Dental Incremental Care Programme (SDICP). Data were gathered from school dental records as part of the SDICP. A sample of 1830 children were included and checked for caries experience annually using World Health Organization criteria. In total, 95.4% of the children were caries free in 2004, and caries experience declined to 70.5% in 2009 with an average of 4.9% annually. At baseline, the mean DMFT (confidence interval [CI]) was 0.06 (0.05-0.08) and increased to 0.58 (0.53-0.63) in 2009. Children with active caries were 4.4% in 2004, and figures rose to 9.6% in 2009. The FT component increased most rapidly during these 5 years from 0.2% to 25.1%. Overall caries prevalence and increment was low in this study. Proportions of FT component were higher as compared with DT component with low rate of extractions during the latter years of the study. [ABSTRACT FROM PUBLISHER]

Objective. To achieve greater motivation for behavioural changes; educating, motivating and supporting the patient's ability to change lifestyle factors related to the caries disease are important tasks in the prevention of the disease. The aim of this study was to evaluate whether a visual aid (Visual Caries Dialogue, VCD) in combination with a comprehensive open discussion has a beneficial effect on approximal caries development among a population of young adolescents. Materials and methods. The study subjects were randomized to either an intervention group ( n = 118), where VCD was conducted, or a control group ( n = 112) receiving traditional oral healthcare information, at the annual dental health examination. The number of caries lesions reaching through the entire enamel (D2) and dentin caries reaching through the enamel into the dentin (D3) were recorded from bitewing radiographs each year, from 2001-2004. Differences between the study groups regarding at least two new approximal surfaces with caries (D2-D3) were tested using logistic regression. Results. The caries increment was lower in the intervention group compared to the control group. During the 3-year follow-up, 18 (15.3%) patients in the intervention group and 40 (35.7%) patients in the control group demonstrated a DS-approximal increment of at least two surfaces with a risk ratio of 2.34 (95% CI = 1.43-3.83). Conclusion. Visual Caries Dialogue in combination with a comprehensive open discussion reduced approximal caries increment among young individuals. The method provides an innovative simple and low-cost way of delivering information to patients and guides busy dental healthcare personnel in the approach. [ABSTRACT FROM AUTHOR]

Aim of Study: The study was designed as a prospective model of caries increment, plaque presence and levels of cariogenic microorganisms with repeated examinations over three years to determine the caries increment dynamics and its relationship to risk factors of carious attack. Material and Methods: At the baseline, 273 children (150 boys and 123 girls) with the mean age of 3.86 years were included in the study. Dentition of the children was clinically examined in the field, in nurseries, using a mirror, rounded probe and headlight with a caries detection limit of a D3 lesion according to the WHO recommendations. The presence of plaque on the upper frontal teeth was recorded and Dentocult SM test was performed. At an interval of approximately one year from the baseline the test was repeated in the second and third year of the study. To determine differences in age, caries indicators (dt, dmft), presence of plaque and Dentocult SM results Mann-Whitney and Wilcoxon tests were used. Correlations of caries increment, plaque and Dentocult SM scores were evaluated by Wilcoxon's test and Pearson's correlation coefficient. Pearson's test was also used to assess the predictivity of plaque and Dentocult SM over time (the significance level at p < 0.05). Results: At baseline, the mean number of teeth with untreated caries per child was 1.28 and the mean dmft was 1.75. At baseline, 30.8% of the children were free of dental caries, 56.8% had restored teeth and 12.4% of the children had some untreated decay. Plaque on the anterior teeth at baseline was present in 30.98% of the children. The difference between the boys and girls was not significant. The mean value of Dentocult SM test at baseline was 1.40. At the second examination, the boys had a significantly higher mean Dentocult SM score than girls (p = 0.042), in the first and third test, the differences between the boys and girls were non-significant. The mean caries increment between the first and second examination was dmft = 0.68 per child. In the first and second year of the study the boys had a significantly higher caries increment than the girls (0.80 vs. 0.55 and 0.33. vs. 0.18). The caries increment after the first year of the study was significantly higher for boys and girls than in the second year (0.68 vs. 0.26). A highly significant association of the presence of plaque and the number of teeth with untreated caries (the teeth) and the dmft score (0.0001) was found during all three consecutive examinations. Significant correlations were found between Dentocult=0 and caries increment in the subsequent investigation, both between the first and second (p = 0.002), the second and third (p = 0.032) and the first and third examinations (p = 0.003). Conclusion: The three-year longitudinal study of caries increment in the deciduous dentition and its relationship to the microbial agents (plaque and cariogenic microorganisms) showed the dynamics of the dental caries development and the importance of assessing these factors in preschool children by caries risk analysis. The study documented the need for enhanced preventive measures at the older preschool age in compliance with primary preventive strategies against dental caries. [ABSTRACT FROM AUTHOR]

Objective: To examine dental caries experience among New Zealand adolescents and determine the nature of caries-associated differences in oral-health-related quality of life (OHRQoL) among adolescents. Method: Follow-up was conducted of a random sample of 430 children first examined in 2003 at age 13, when they completed the Child Perceptions Questionnaire (CPQ11-14). At age 16, 255 (59.3% of the baseline sample) were re-examined and again completed the CPQ11-14. Results: Caries prevalence (1 + DMFS) rose from 68% to 79.2%; mean DMFS rose from 2.9 (SD 4.7) to 3.6 (SD 4.8), and the prevalence of high caries experience (5 + DMFS) rose from 20.0% to 40.8%. The 3-year mean net caries increment of 0.5 surfaces (SD 2.6) was dominated by occlusal surfaces. At both ages, overall CPQ11-14 scores, as well as emotional well-being subscale scores, were significantly higher for those with DMFS values of 5 or more. Conclusion: Caries experience increased over the three years; this age group is caries-active. Dental caries affects adolescents' OHRQoL, although not as strongly as maybe expected. [ABSTRACT FROM AUTHOR]

Background: Provision of oral health care in India, especially for the underprivileged is limited due to inadequate finances and manpower. Resources of dental colleges in such a scenario can be utilized to provide prevention oriented oral health care. Aim: To improve the oral health status of children at an institute in Nellore district of Andhra Pradesh, India, through prevention based comprehensive dental health care program (CDHP). Design and Setting: A longitudinal institution based interventional study conducted among the primary grade children (n=162). Materials and Methods: Baseline data collection included (i) basic demographic data (ii) body mass index (BMI) (iii) assessment of the dentition status and treatment needs according to WHO 1997 criteria. The CDHP included group based dental health education, professional oral prophylaxis, weekly (0.2%) sodium fluoride mouth rinse program, biannual application of topical fluoride (1.23% APF), pit and fissure sealants for all first permanent molars and provision of all necessary curative services. Results: Mean treatment requirements per child decreased at 18 months. New caries lesions developed among four children. BMI of children with decay was seen to improve significantly after instituting the CDHP. Conclusion: CDHP is effective in overall improvement of general and oral health. In resource limited countries like India, such programs organized by dental schools can improve oral health. [ABSTRACT FROM AUTHOR]

Evidence on the contribution of social support to oral health is scarce. We first explored the association of social support with caries experience and the relative roles of support from family, friends and a special person on caries experience in 15-16-year-old adolescents. We then explored whether social support at 11-12 years of age predicts caries increment in second permanent molars over 4 years and the relative roles of different sources of support on 4-year caries increment. Data from phases 1 and 3 of the Research with East London Adolescents Community Health Survey (RELACHS), a school-based prospective study of a representative sample of adolescents in East London, were used for cross-sectional (phase 3) and longitudinal analyses (phases 1 and 3). Data were collected by questionnaires including the same questions on demographic characteristics, socioeconomic measures and the Multidimensional Scale of Perceived Social Support at phases 1 and 3. A questionnaire section on dental behaviours and an oral clinical examination were also included in phase 3. Social support was negatively related to both caries experience and increment independently of demographic characteristics, socioeconomic measures and dental behaviours. Furthermore, only support from a special person was significantly related to caries experience and increment in unadjusted and adjusted regression models. In conclusion, adolescents who perceived higher levels of social support had lower caries experience and increment. However, support from a special person was more relevant for these adolescents than support from family and peers. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

We explored the association between caries development, colonization with caries-associated microflora, and immunity as children begin the transition to mixed dentition. Forty children received dental examinations at 3-4 years of age, repeated a year later. Children were grouped into caries-free (n = 23; CF) and caries-active (n = 17; CA ≥3 new lesions on follow-up). Salivary IgA and IgA antibody to Streptococcus mutans virulence epitopes were measured by Luminex assay. Mutans streptococci (MS), lactobacilli and total microorganisms were enumerated on selective media from plaque samples. There was no significant difference in baseline levels of MS or lactobacilli between CF and CA groups. However, both MS and lactobacilli levels were higher at follow-up in the CA group. Furthermore, children with detectable lactobacilli at baseline had significantly higher caries risk. Salivary IgA concentrations increased significantly in both groups during the study. Both CF and CA groups also displayed significant increases in salivary IgA antibody levels to glucosyltransferase, glucan-binding protein (Gbp) and antigen I/II salivary binding region. CF antibody levels to seven peptides associated with domains of biological importance increased at follow-up, in contrast to increases to only three peptides in CA saliva samples. Multivariate modeling showed that a lower baseline level of salivary IgA anti-GbpB was associated with higher caries risk. These data indicate that MS and lactobacilli are associated with caries in this population, that the secretory immune system is undergoing significant maturation during this period, and that the breadth of mucosal IgA response to epitopes of S. mutans virulence components may influence the degree to which these cariogenic microorganisms can cause disease. Copyright © 2011 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

A study is presented which evaluated a transition scoring system (TSS) that can be utilized for longitudinal studies using the International Caries Detection and Assessment System (ICDA) in low-income African-American children and their caregivers who are enrolled in the Detroit Dental Health Project. The TSS is compared with the method used by Beck and his colleagues, that used an increment formula for prevalence-based caries.

Main problem. Caries as a multifactorial process is influenced by salivary defense. Cluster analyses should give additional information on the role of salivary variables in relation to caries increment. Methods. Samples of unstimulated and stimulated whole saliva from 28 young adults (mean age 23.5±2.1 years) were analyzed for flow rate, pH and buffer variables, lysozyme, lactoferrin, peroxidase, thiocyanate, secretory immunoglobulin A, and total protein. The decayed, missing, and filled surfaces (DMFS) were recorded at baseline and after 4 years. Cluster analyses were executed on the basis of salivary data. Results. The mean caries increment (ΔDMFS) over 4 years was 6.7±4.0 (range 1–16). In two-cluster processing, three out of four volunteers with low caries increments were grouped into one cluster. Only a few variables proved to be important for cluster characteristics. Conclusions. The results suggest that over 4 years (1) the volunteers with very low caries increment (ΔDMFS=1) are classified always together, (2) these volunteers do not form a separate cluster by themselves, (3) low caries increment was related to higher salivary flow rate and lower levels of lysozyme and lactoferrin for unstimulated saliva and (4) the partial pressure of CO2 was of importance in stimulated saliva. [ABSTRACT FROM AUTHOR]

The aim of the study was to examine the caries experience of 10-year-olds as measured with dmft/DMFT, to explain how caries increases by the age of 10 years, and which factors would explain caries increments. The setting was a representative population sample of first-born children in southwestern Finland. Dental health at 10 years of age was found to be good in 45%, fairly good in 40% and poor in 15% of the children. The caries index remained stable in 23% of carious children from 7 to 10 years of age. Daily consumption of sweets at the age of 3 years (OR 2.7; 95% CI 1.5-4.8; p < 0.001) was associated with a caries increment between 7 and 10 years of age (both deciduous and permanent teeth). This daily consumption of sweets and a child's late bedtime (OR 1.9; 95% CI 1.1--3.1; p = 0.023) were explanatory factors in the permanent teeth alone. In the deciduous teeth, mother's previous caries and child's earlier tooth brushing habits were explanatory factors of caries. As hypothesized, all five significant factors remaining in the final logistic regression analysis were family-related. Parental ability to care for and educate a child could be seen in dental health still at the age of 10 years. The family-related factors which were associated with caries should be emphasized much more comprehensively in everyday dental health care practice. [ABSTRACT FROM AUTHOR]

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365 2nd through 4th graders completed a 3-yr clinical trial on the caries-preventive effect of rinsings every second week during the school year with 10 ml of an 0.2% neutral solution of sodium fluoride. All children received regular dental examinations and treatment in clinics established by the municipality in which the study took place. The trial was performed under double-blind conditions. The caries increment on teeth erupted at baseline was 1.75 DMFS in the fluoride group and 1.83 DMFS in the placebo group (P>0.05; 95% confidence limits for percentage caries reduction: - 20.7% and 29.5%). The caries increment on [erupting during the trial was 0.73 DMFS in the fluoride group and 0.99 DMFS in the placebo group (P>0.05; 95% confidence limits for percentage caries reduction: 1.0% and 51.6%). [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the capability of caries-related salivary tests and a test based on past caries experience (baseline DFS) to select persons at high risk for caries. The subjects (n = 122) were 12-17 years old at the beginning of the study. Caries was registered and salivary samples were taken annually during the 3-study period. The 3-year caries increment was positively correlated to the baseline DFS (r = 0.46, p < 0.001), salivary level of mutans streptococci (r = 0.30, p < 0.001) and lactobacilli (r = 0.30, p < 0.001), and combined level of mutans streptococci and lactobacilli (r=0.39, p < 0.001) and negatively correlated to the buffering capacity of saliva (r = -0.22, p < 0.05). Tests based on either past caries experience or mutans streptococci or lactobacilli levels alone were not efficient in selecting persons at high risk for caries. Among the tests, DFS was the most sensitive and specific. A combination of either microbial test and DFS was more efficient to select persons at risk than various alternatives alone. The sensitivity was 84% and the specificity 62% for the combination of lactobacilli test and DFS and 71% and 79% respectively for the combination of mutans streptococci and DFS. In the former combination the positive prediction value was 43% and in the latter 56%. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the association between the fissure depth (tooth morphology) of permanent molars and dental caries incidence with a five-year follow-up period. In total, 110 Mexican schoolchildren aged seven years were recruited at baseline, of which 88 children completed the follow-up assessments. The fissure depths of the first permanent lower molars were recorded, and dental caries [decayed, missing, and filled deciduous surfaces (dmfs) and decayed, missing, and filled permanent surfaces (DMFS)] was evaluated annually. A generalized estimating equation model was constructed for evaluating the association between dental caries and fissure depth. The initial and final DMFS scores were 0.02 (±0.2) and 1.55 (±2.49), respectively. The generalized estimating equation model showed that children with deep molar fissures were more likely to develop caries lesions, (Odds Ratio OR = 3.15, p = 0.028) compared to children with shallow fissures. Moreover, dental caries in primary teeth (OR = 1.07, p = 0.005) was associated with the development of carious lesions in the permanent dentition. Fissure depth was a useful predictor of dental caries, according to this five-year follow-up study. The detection of deep occlusal fissures in the lower first permanent molars could contribute to the identification of children at high risk of dental caries. Tooth morphology may be used to identify children at a higher caries risk, particularly in settings with limited resources.