Impact of Sociodemographic Factors on Dental Caries in Children and Availing Fluoride Treatment: A Study Based on National Survey of Children’s Health (NSCH) Data 2016-2019 (original) (raw)
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Fluoride Use in Health Care Settings: Association with Children’s Caries Risk
Advances in Dental Research, 2018
Expanded partnership with the medical community is an important strategy for reducing dental caries disparities. The purpose of this study was to assess the relationship between fluoride (F) "in office" (drops/tablets and/or varnish), as prescribed or applied by a health care professional by age 1 y, and 1) caries development and 2) presence of other caries risk factors or mediators (e.g., socioeconomic status). Child-primary caregiver (PCG) pairs (N = 1,325) were recruited in Indiana, Iowa, and North Carolina as part of a longitudinal cohort study to validate a caries risk tool for primary health care settings. PCGs completed a caries risk questionnaire, while children received caries examinations per the criteria of the International Caries Detection and Assessment System at ages 1, 2.5, and 4 y. Baseline responses regarding children's history of F in office were tested for association with other caries risk variables and caries experience at ages 2.5 and 4 y via generalized estimating equation models applied to logistic regression. The sample was 48% female, and many children (61%) were Medicaid enrolled. The prevalence of cavitated caries lesions increased from 7% at age 2.5 y to 25% by age 4 y. Children who received F in office were likely deemed at higher caries risk and indeed were significantly (P < 0.01) more likely to develop cavitated caries lesions by ages 2.5 and 4 y, even after F application (odds ratios: 3.5 and 2.3, respectively). Factors significantly associated with receiving F included the following: child being Medicaid enrolled, not having an employed adult in the household, child and PCG often consuming sugary drinks and snacks, and PCG having recent caries experience. Increased F in office from a health care provider by age 1 y was associated with known caries risk factors. Most (69%) children had never been to the dentist, suggesting that risk factors could be alerting medical providers and/or parents, thereby affecting in-office F recommendations. Differences among states could also be related to state-specific F-varnish reimbursement policies (ClinicalTrials.gov NCT01707797).
Clinical Oral Investigations, 2001
The aim of this 2-year prospective randomized clinical study was to evaluate the efficacy of a prevention program for schoolchildren with high caries risk. A sample of 419 subjects was divided into a test (T, n=259) and control group (C, n=160). Four times a year, the test group received professional tooth-cleaning and application of a 0.1% fluoride varnish as well as motivation and instruction in oral hygiene. The control group received only oral hygiene instruction and took part in supervised toothbrushing once a year. At baseline and after 2 years, the D 3 , 4 MFS and the incipient lesions (D 1,2 ) were recorded. After 2 years, 318 subjects (T=187, C=131) were included in the data analysis. The baseline D 1,2 was 6.18 (T) and 5.50 (C), the D 3 , 4 MFS 2.13 (T) and 2.08 (C), respectively. No statistically significant difference was found for the baseline values. At the final examination, the D 1,2 increment was 3.96 in the test and 6.53 in the control group, showing a statistically significant difference (P<0.001). No such difference was found for the D 3 , 4 MFS increment (T: 2.22; C: 2.61). The results indicate that it might not be possible to prevent cavities in high caries risk children by means of the described program.
Water Fluoridation and Dental Caries in U.S. Children and Adolescents
Journal of Dental Research, 2018
Fluoridation of America's drinking water was among the great public health achievements of the 20th century. Yet there is a paucity of studies from the past 3 decades investigating its dental health benefits in the U.S. population. This cross-sectional study sought to evaluate associations between availability of community water fluoridation (CWF) and dental caries experience in the U.S. child and adolescent population. County-level estimates of the percentage of population served by CWF (% CWF) from the Centers for Disease Control and Prevention's Water Fluoridation Reporting System were merged with dental examination data from 10 y of National Health and Nutrition Examination Surveys (1999 to 2004 and 2011 to 2014). Dental caries experience in the primary dentition (decayed and filled tooth surfaces [dfs]) was calculated for 7,000 children aged 2 to 8 y and in the permanent dentition (decayed, missing, and filled tooth surfaces [DMFS]) for 12,604 children and adolescents aged 6 to 17 y. Linear regression models estimated associations between % CWF and dental caries experience with adjustment for sociodemographic characteristics: age, sex, race/ethnicity, ruralurban location, head-of-household education, and period since last dental visit. Sensitivity analysis excluded counties fluoridated after 1998. In unadjusted analysis, caries experience in the primary dentition was lower in counties with ≥75% CWF (mean dfs = 3.3; 95% confidence limit [CL] = 2.8, 3.7) than in counties with <75% CWF (mean dfs = 4.6; 95% CL = 3.9, 5.4), a prevented fraction of 30% (95% CL = 11, 48). The difference was also statistically significant, although less pronounced, in the permanent dentition: mean DMFS (95% CL) was 2.2 (2.0, 2.4) and 1.9 (1.8, 2.1), respectively, representing a prevented fraction of 12% (95% CL = 1, 23). Statistically significant associations likewise were seen when % CWF was modeled as a continuum, and differences tended to increase in covariate-adjusted analysis and in sensitivity analysis. These findings confirm a substantial caries-preventive benefit of CWF for U.S. children and that the benefit is most pronounced in primary teeth.
Community dentistry and oral epidemiology, 2017
Early childhood caries (ECC) constitutes a serious public health issue, especially in communities without water fluoridation. We assessed the effectiveness of biannual fluoride varnish applications to prevent ECC in children from nonfluoridated rural areas. A triple-blind randomized control trial with two parallel arms was conducted with 275 two- to three-year-old children without cavitated carious lesions from 28 rural public preschools in Chile. The preschools were located in areas of low socioeconomic status without access to fluoridated water. An oral health education component was administered to children, parents and educators. A new toothbrush and toothpaste for each child was delivered to the parents at baseline and at four follow-up visits. The participants were randomly allocated to receive fluoride varnish or placebo applications every six months. Trained, calibrated dentists blind to the treatment arm performed visual dental assessments at 6, 12, 18 and 24 months. The pr...
Fluoride varnish in the prevention of dental caries in children and adolescents: a systematic review
2008
OBJECTIVE To develop a scientifically current and evidence-based protocol for the use of fluoride varnish for the prevention of dental caries among high-risk children and adolescents. METHODS Previous systematic reviews on this topic were used as the basis for the current review. Ovid, MEDLINE, CINAHL and several other relevant bibliographic databases were searched for English-language articles, with human subjects, published from 2000 to 2007. RESULTS A total of 105 articles were identified by the literature search; relevance was determined by examining the title, abstract and body of the article. Seven original research studies met the inclusion criteria. These articles were read and scored independently by 2 reviewers, and evidence was extracted for systematic review. RECOMMENDATIONS The following recommendations were developed on the basis of the evidence: 1. For high-risk populations (e.g., people with low socioeconomic status, new immigrants and refugees, First Nations and Inu...
The open dentistry journal, 2013
Dental caries is a multifactorial disease that includes behavioral and cultural components. The study's purpose was to determine the caries experienced (as measured by dmft) in a group of 2-5 y/o children, assess their family and home environment including consumption of fluoridated drinking water, use of a fluoride containing dentifrice, and level of caregiver formal education. Parents of children referred for dental treatment under general anesthesia and who either spoke and read English or Spanish were recruited and consent obtained. Selected information on the family home, parental education and selected fluoride contact data was obtained. An oral clinical examination of the child assisted by intraoral radiographs was completed and the number of decayed, missing, filled primary teeth (dmft) recorded for each child. Bitewings were obtained if posterior or anterior teeth contacts were closed but only periapical radiographs were obtained if contacts were open. Children of Engli...
Iranian journal of pharmaceutical research, 2011
Previous studies have indicated that there may be a relationship between the salivary fluoride concentrations and dental caries while the emphasis was on dental caries in permanent teeth. The aim of this study was to assess the prevalence of dental caries and its predictors in 3-6 year-old children in Tehran, Iran. The other objective of this investigation was to clarify a relationship between salivary fluoride levels of the studied children and their socioeconomic situations. The study population consisted of 205 children aged 3-6 years living in Tehran. Each child was examined for dental caries (decayed missing filled teeth (DMFT)) and unstimulated whole mixed saliva was collected 2 h post-prandial. All of the saliva samples were analyzed for fluoride concentration using an ion-specific electrode. The children were then grouped according to their DMFT, salivary fluoride levels (ppm) and socioeconomic factors (parent's education and occupation) that resulted in a statistically ...