Journal of Clinical Medicine

Research

15 pages, 501 KiB

Open AccessEditor’s ChoiceArticle

Digital Application for Promoting Evidence-Based Children’s Oral Health to Control Early Childhood Caries: Randomized Control Trial on Parental Acceptance and Efficacy

by Jameela Abdul Haq, Christian H. Splieth, Mhd Said Mourad, Annina Vielhauer, Ruba Abdulrahim, Manasi R. Khole and Ruth M. Santamaría

J. Clin. Med. 2023, 12(7), 2680; https://doi.org/10.3390/jcm12072680 - 4 Apr 2023

Cited by 6 | Viewed by 2775

Abstract

Background: Early childhood caries (ECC) remains a major global health problem. Various measures to prevent it have been implemented in the past, including those using digital applications. Aim: To evaluate the acceptance and efficacy of a digital application (FU-APP) based on evidence-based caries [...] Read more.

Background: Early childhood caries (ECC) remains a major global health problem. Various measures to prevent it have been implemented in the past, including those using digital applications. Aim: To evaluate the acceptance and efficacy of a digital application (FU-APP) based on evidence-based caries control recommendations for parents of children aged 6–72 months. Methods: Part 1, prospective questionnaire-based survey to test FU-APP (usage, acceptance, content information, usefulness, and satisfaction) filled out by parents (n = 22); Part 2, two-armed (test n = 20; control n = 23) care-based, randomized controlled trial, where the test arm received instructions verbally and via FU-APP, and the control arm received them only verbally. At baseline and follow-up (4 weeks), intraoral clinical indices (plaque index-API and caries-dmft) were recorded. Results: FU-APP was considered by parents to be a suitable tool for gaining knowledge about oral health practices for their children (all criteria >86%). No differences in the dmft levels were expected. However, API was significantly better at the follow-up in the test-arm (p = 0.01), with no differences in the control-arm (p = 0.72). Conclusion: A digital application can serve as an innovative tool to promote evidence-based oral hygiene recommendations among parents of children to control ECC. Its long-term usability and functionality should be tested. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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8 pages, 514 KiB

Open AccessArticle

Caries Decline in Preschool Children from Low Social Classes and with Migration Background in Hamburg, Germany: Outcome from Repeated Cross-Sectional Caries Epidemiological Studies

by Ulrich Schiffner

J. Clin. Med. 2022, 11(15), 4251; https://doi.org/10.3390/jcm11154251 - 22 Jul 2022

Cited by 4 | Viewed by 1659

Abstract

Over several decades, the dental caries burden in the deciduous dentition has decreased in Germany. However, a dependency of the caries burden on social parameters, such as socio-economic status (SES) or migration background, is generally described. Therefore, the aim of the evaluation was [...] Read more.

Over several decades, the dental caries burden in the deciduous dentition has decreased in Germany. However, a dependency of the caries burden on social parameters, such as socio-economic status (SES) or migration background, is generally described. Therefore, the aim of the evaluation was to analyse to what extent children with a low social class affiliation or a migration background have participated in the caries decline. For the city of Hamburg, Germany, data from a series of five caries epidemiological surveys in day-care centres are available since 1977. Using the same methodology, the dmft values were determined, according to WHO criteria, and in addition including initial caries (IC). For the present evaluation, the data and the changes of caries load (caries prevalence and caries experience; dmft) over time were compared with reference to SES and a migration background. A decrease in the caries prevalence from 58.4% to 22.7% and in the dmft value from 2.6 to 0.8 was determined from 1977 to 2016 (WHO criteria). Including IC, the caries prevalence has decreased from 91.0% to 44.4%, and the caries experience shows a decline from 6.4 to 1.8. The caries reduction can be observed in children of all social classes and regardless of a migration background, although significant differences in caries prevalence and caries experience remain recognisable for each survey through 2016. In conclusion, preschool children from families with low SES or with a migration background have not been left behind in the improvement of dental health, but have also benefited from caries prevention measures in roughly the same order of magnitude as other children. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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10 pages, 859 KiB

Open AccessArticle

Oral Health of Children One to Six Years after Dental Treatment under General Anaesthesia

by Vicky Ehlers, Angelika Callaway, Michael Patyna, Alexandra Pelkner, Birgül Azrak and James Deschner

J. Clin. Med. 2022, 11(13), 3676; https://doi.org/10.3390/jcm11133676 - 25 Jun 2022

Cited by 1 | Viewed by 1606

Abstract

(1) Background: The aim of this study was to assess oral health in children following dental treatment under general anaesthesia and to obtain information about oral health measures in both the children and their parents. (2) Methods: Children were scheduled for regular dental [...] Read more.

(1) Background: The aim of this study was to assess oral health in children following dental treatment under general anaesthesia and to obtain information about oral health measures in both the children and their parents. (2) Methods: Children were scheduled for regular dental re-examination one to six years after dental treatment under general anaesthesia. Scores for mixed dmft/DMFT, the plaque control record (PCR), and the gingival bleeding index (GBI) were determined. Information about children’s/parents’ oral hygiene habits and frequency of dental visits was obtained. Scores for mixed dmft/DMFT as assessed before dental treatment under general anaesthesia/at re-examination were compared (Wilcoxon test). (3) Results: From the 134 parents initially contacted, 35 attended regular dental control visits (response rate: 26%) with their children (median age 6 years). Of the 35 children (20 female, 15 male), 18 (51.4%) were healthy and 17 (48.6%) had a pre-existing condition. Mixed dmft/DMFT scores determined at the recall visit differed significantly from the earlier visit (p = 0.006). Children had 1.74 ± 3.64 teeth newly affected by caries. Four children (11.4%) needed dental treatment under general anaesthesia again. Oral hygiene was mediocre (median PCR: 32%). The GBI was high (median: 14%). Children with a high PCR also had a high GBI. (4) Conclusions: Children who had received dental treatment under general anaesthesia still had a high caries risk. Further prophylaxis programs are necessary to prevent caries and further use of general anaesthesia. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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13 pages, 648 KiB

Open AccessArticle

The Influence of Steroid Hormones on Tooth Wear in Children and in Adolescents

by Jeanette Buchhardt, Wieland Kiess, Antje Körner, Ronald Biemann, Christian Hirsch and LIFE Child Study Team

J. Clin. Med. 2022, 11(13), 3603; https://doi.org/10.3390/jcm11133603 - 22 Jun 2022

Cited by 2 | Viewed by 1538

Abstract

(1) Background: From a young age, boys are more often affected by tooth wear than girls. This suggests an influence of the male sex hormone (testosterone) on the aetiology of tooth wear. The aim of the present study was to investigate the incidence [...] Read more.

(1) Background: From a young age, boys are more often affected by tooth wear than girls. This suggests an influence of the male sex hormone (testosterone) on the aetiology of tooth wear. The aim of the present study was to investigate the incidence of tooth wear in relation to steroid hormone levels in children. (2) Methods: 1022 test persons aged between 10 and 18 (491 male, 531 female) from the LIFE Child study underwent medical and dental examination. Tooth wear was measured through clinical inspection. Blood samples were taken to determine hormone levels (testosterone, SHBG). The level of free testosterone was calculated from the ratio of testosterone to SHBG. Using multivariable methods, the incidence of tooth wear was analyzed as a function of hormone levels, while controlling for confounders such as age, sex, social status, and orthodontic treatment. (3) Results: The incidence of tooth wear increased with age in both sexes. Boys showed significantly more often attrition facets than girls (17.5% vs. 13.2%, p < 0.001). Subjects with tooth wear showed significantly higher free testosterone levels than those without (males: p < 0.001, females: p < 0.05). After controlling for confounding variables, the risk of tooth wear increased by approximately 30.0% with each year of life (odds ratio [OR]boys = 1.29, 95% confidence interval [CI] = 1.04–1.56; [OR]girls = 1.32, 95% CI = 1.08–1.61). In addition, the risk of tooth wear increased by 6.0% per free testosterone scale score only in boys (OR = 1.06, 95% CI = 1.01–1.12). (4) Conclusions: Tooth wear is common in children and in adolescents, and it increases steadily with age in both sexes. The stronger increase and the higher prevalence among male adolescents can be explained by the additional effect of free testosterone. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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8 pages, 735 KiB

Open AccessArticle

Impact of Silver Diamine Fluoride Therapy on the Oral Health-Related Quality of Life of Preschool Children with Behavioral Problems after Three Months: A Pilot Study

by Sarra Altner, Daniel Stroj and Katrin Bekes

J. Clin. Med. 2022, 11(11), 3071; https://doi.org/10.3390/jcm11113071 - 29 May 2022

Cited by 2 | Viewed by 2053

Abstract

Background: In Austria, almost every second child has caries. The consequences of untreated carious lesions are infections, pain, and limitations in everyday life. The aim of this study was to evaluate the influence of silver diamine fluoride (SDF) treatment on the oral health-related [...] Read more.

Background: In Austria, almost every second child has caries. The consequences of untreated carious lesions are infections, pain, and limitations in everyday life. The aim of this study was to evaluate the influence of silver diamine fluoride (SDF) treatment on the oral health-related quality of life (OHRQoL) of uncooperative children aged 0–5 years using the German version of the Early Childhood Oral Health Impact Scale (ECOHIS-G). Methods: This prospective study was conducted at the Department of Paediatric Dentistry at the Medical University of Vienna. Preschool children with behavioral problems and carious lesions that required SDF application were included. The ECOHIS-G questionnaire was given to the caregiver before (T0) and three months (T1) after treatment. Using descriptive analysis and the Wilcoxon Signed-Rank test, changes in the ECOHIS scores were evaluated and tested for significance. Results: A total of 30 children aged 0–5 years were enrolled and received SDF treatment. At baseline, the total ECOHIS score was 21.4 (±8.5). Three months after therapy, a significant improvement was achieved (16.3 [±5.6], p < 0.05). Significantly better scores were observed in six subdomains, especially in “child function” (3.9 [±2.0]) and “child symptoms” (2.0 [±1.3]) (p < 0.05). Conclusions: Treatment of carious lesions with SDF in the primary dentition resulted in an improvement in the OHRqoL of children with behavioral problems. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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15 pages, 618 KiB

Open AccessArticle

Caries Experience and Increment in Children Attending Kindergartens with an Early Childhood Caries Preventive Program Compared to Basic Prophylaxis Measures—A Retrospective Cohort Study

by Stefanie Amend, Thea Hartmann, Monika Heinzel-Gutenbrunner, Roland Frankenberger, Norbert Krämer and Julia Winter

J. Clin. Med. 2022, 11(10), 2864; https://doi.org/10.3390/jcm11102864 - 19 May 2022

Cited by 1 | Viewed by 2008

Abstract

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 [...] Read more.

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. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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12 pages, 1285 KiB

Open AccessArticle

Dental Treatment under General Anesthesia in Pre-School Children and Schoolchildren with Special Healthcare Needs: A Comparative Retrospective Study

by Nelly Schulz-Weidner, Maximiliane Amelie Schlenz, Linda Giuliana Jung, Constanze Friederike Uebereck, Agnes Nehls and Norbert Krämer

J. Clin. Med. 2022, 11(9), 2613; https://doi.org/10.3390/jcm11092613 - 6 May 2022

Cited by 10 | Viewed by 2262

Abstract

The aim of this retrospective study was to evaluate the dental treatments received under general anesthesia (GA) in pre-school children and school children with special healthcare needs (n = 263) compared with healthy controls (n = 62). In order to analyze the impact [...] Read more.

The aim of this retrospective study was to evaluate the dental treatments received under general anesthesia (GA) in pre-school children and school children with special healthcare needs (n = 263) compared with healthy controls (n = 62). In order to analyze the impact of pre-existing cofactors on oral health, children were divided into the following groups: heart disease, cancer, syndromic disease, and other diseases as well as in- and outpatient healthy children. Caries experience (dmf-t/DMF-T) before GA (impulse 1), waiting time, and dental treatment under GA (impulse 2) were determined. Pre-school children showed a higher caries experience (mean ± standard deviation; 8.3 ± 4.8) compared to schoolchildren (6.9 ± 4.3). Predominantly, early childhood caries (ECC) of type 1 were detected. From all groups with special healthcare needs, children with cancer revealed the highest Significant Caries Index (17.0 ± 2.0), followed by other diseases (14.6 ± 2.6), syndromic disease (14.3 ± 1.8), and heart disease (13.8 ± 2.7). Overall, 2607 dental procedures were performed under GA with a mean of 8.0 ± 6.5 dental measures per child. Within the limitations of this study, the data exhibited independent of pre-existing cofactors and age high caries risk in all patient groups showing a high need for treatment. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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10 pages, 559 KiB

Open AccessArticle

Are the Dental Guidelines for Early Dental Visits and Fluoridation Measures Supported by Pediatricians, and What Are Their Caries Prevention Efforts?

by Antje Geiken, Louise Holtmann, Christian H. Splieth, Jonas Conrad, Christof E. Doerfer and Christian Graetz

J. Clin. Med. 2022, 11(5), 1159; https://doi.org/10.3390/jcm11051159 - 22 Feb 2022

Cited by 5 | Viewed by 1830

Abstract

(1) Background: In Germany, new recommendations for dental examinations of children and the use of fluorides have been introduced. The pediatrician (PA) should refer the patient to the dentist for dental examinations and check-ups (DEs) from the sixth month of age. Therefore, our [...] Read more.

(1) Background: In Germany, new recommendations for dental examinations of children and the use of fluorides have been introduced. The pediatrician (PA) should refer the patient to the dentist for dental examinations and check-ups (DEs) from the sixth month of age. Therefore, our aim was to determine with a questionnaire the extent to which PAs find DE useful, make referrals for DE and recommend fluoride. (2) Methods: The nationwide empirical survey was conducted with a self-developed and validated standardized online questionnaire. In addition to personal information, 16 items were collected. Agreement with the items was recorded using Likert scales. The data were primarily analysed descriptively. (3) Results: 696 PAs participated in the survey (age: 51.7 (8.4) years, women/men: 428/286 (61.5/38.5%). A total of 11% of PAs found referral by eruption of first tooth very important (important/neutral/unimportant: 13.8/32/43.2%), compared to 70% for complete deciduous teeth (21.3/7.3/1.4%). A total of 48.8% of PAs always recommended fluoridated toothpaste from the first tooth (often/occasionally/rarely/never: 18.3/7.8/8/17.1%) and 50.6% completely refused to recommend fluoride-free toothpaste (always/often/occasionally/rarely: 9.8/9/14.7/15.9%). A total of 44.8% never recommended the use of fluoridated toothpaste if the child cannot yet spit (always/often/occasionally/rarely: 19.2/13.9/7.8/14.3%). (4) Conclusions: Among PAs, referral to DEs was increasingly implemented as children grew older. Specific fluoride recommendations were accepted. Full article

(This article belongs to the Special Issue Early Childhood Caries: Bio-Psycho-Social Disease Mechanisms, Prevention, and Management)

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