Effect of Preventive Oral Hygiene Measures on the Development of New Carious lesions
Abstract and Figures
Purpose:
To evaluate the effect of preventive oral hygiene measures on the development of new carious lesions.
Materials and methods:
Children regularly and irregularly attending recall appointments in a paediatric dental clinic were interviewed regarding their preventive measures performance. Newly developed carious lesions were also recorded. The files of 651 children were analysed.
Results:
A significant negative correlation was found between newly developed carious lesions and total number (P < 0.001) and frequency (interval in months to the next dental examination) of recall appointments (P = 0.021), regular toothbrushing twice a day (P < 0.0001), regular brushing in the evening (P < 0.001), high fluoride concentration in toothpaste (P < 0.0001) and drinking water between meals (P = 0.015), but not with regular brushing in the morning or eating more than 6 times a day. Multivariate analysis revealed three of the variables independently correlated with the development of new carious lesions: brushing regularly twice a day, concentration of fluoride in the toothpaste greater than 1100 ppm and frequency of follow-ups.
Conclusions:
Regular toothbrushing twice a day is of high importance for caries prevention. Fluoride concentration of > 1100 ppm in toothpaste should be recommended for children (considering the child's age) in order to maximise the fluoride protective effect. The importance of attending periodic recall appointments in order to maintain long term oral health should be emphasised.
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... Por ello, en los últimos años se ha puesto bastante énfasis en la importancia de la prevención en odontología, cuya finalidad es construir barreras que impidan el desarrollo de patologías bucodentales, fomentando conocimiento que permita promover, mantener o restaurar la salud bucal de un individuo o comunidad. (Ramos et al., 2018) Una medida importante para el mantenimiento de la salud bucodental y la reducción del riesgo odontológico individual es práctica meticulosa de medidas preventivas de uso diario en el hogar; lo que incluye, entre otros, correctos hábitos de higiene bucal como cepillado dental por dos minutos al menos dos veces al día, uso de pastas dentales fluoradas, uso de enjuagues bucales, etc. (Ashkenazi et al., 2014). ...
... Esto supone el hecho de estar también asociado a la educación odontológica a la que tiene acceso la persona; lo cual podría estar relacionado su nivel socioeconómico. (Iqbal et al., 2021;Ramos et al., 2018;Ashkenazi et al., 2014;Baker, 2014) Así pues, este estudio es realizado con el objetivo de determinar los factores socioeconómicos relacionados al nivel de conocimiento de higiene oral en padres de familia de la I.E CAP FAP José Abelardo Quiñones, Piura 2022. En la tabla 1, se presenta la relación entre los factores socioeconómicos y el nivel de conocimiento en higiene oral. ...
The aim of this investigation was to determine socioeconomic factors related to knowledge level of oral hygiene in parents from I. E. CAP FAP José Abelardo Quiñones, Piura 2022. The study was basic, observational, correlational, and cross-sectional. The sample consisted of 260 parents from I. E. CAP FAP José Abelardo Quiñones, Piura. There was applied a 9-question survey to identify the socioeconomic factors and an 18-question questionnaire to evaluate the knowledge level of oral hygiene. A Chi-square correspondence test was applied with a significance of 5%. The knowledge level in Oral Hygiene was low in 96.2% of the population and regular in 3.8%. Regarding the Socioeconomic Factors, it prevailed the female sex (96.2%), 30-44 years old (85.4%), secondary education level (92.7%), average monthly income less than a minimum wage (66, 5%), with 0-3 children (85.4%), with water and drainage (93.8%), with cell phone (99.2%), with internet access (100%), without health insurance (92.7%). It is concluded that the socioeconomic factors related to knowledge level of oral hygiene in parents form I. E. CAP FAP José Abelardo Quiñones, Piura 2022 were education level and health insurance.
... These behaviours increased the cariogenic risk by nullifying an important moment of oral hygiene: the evening brushing. Regular tooth-brushing in the evening and the development of new dental caries presented a significant negative correlation [48]. In a recent Italian survey, it emerged that parents still were not fully trained and informed about the management of their child's oral hygiene [49]. ...
... Unfortunately, the COVID-19 lockdown initially limited routine oral care and prevention except for emergency and urgent interventions, but according to Brian and Weintraub, the pandemic offered an opportunity for the dental profession to shift more toward nonaerosolizing and prevention-focused approaches [52]. Attending periodic prevention appointments is essential for oral health and protective factors such as oral professional hygiene, application of high concentrations of fluoride gel, dental sealants, changes in diet, and reinforcement of child compliance [48]. ...
The Severe Acute Respiratory Syndrome Coronavirus 2 disease COVID-19 pandemic caused several lifestyle changes, especially among younger people. The study aimed to describe the impact of eating habits, lifestyle, and home oral hygiene during the COVID-19 pandemic, on the cariogenic risk in the Italian paediatric population, by using an online survey. The survey was conducted through a virtual questionnaire divided into four parts: child personal and anthropometric data; oral health; child dietary habits (KIDMED test); and child lifestyle, before and during COVID-19 lockdown. During the lockdown, only 18.6% of the participants had high adherence to a Mediterranean diet, recording an increase in sweets consumption and the number of meals (p < 0.001). In terms of lifestyle, the percentage of moderately and vigorously active children decreased (41.4% and 5.0%, respectively) (p = 0.014). The percentage of children sleeping more than 9 h increased (p < 0.001). They watched more television programs (p < 0.001). Regarding oral hygiene, children did not change their brushing habits (p = 0.225). The percentage of children using non-fluoridated toothpaste was higher (6.4%), and no changes were observed (p > 0.05). In some cases, dental pain and abscesses were declared (10% and 2.7%, respectively). This study confirms the need for campaigns to promote hygiene and dental care in combination with food education for a correct habit and promotion of a healthy and sustainable dietary style.
... Professional applications, including fluoride gels, solutions, and varnishes, have been developed and research has shown that there are no significant differences in effectiveness between these methods. [59][60][61][62][63] There are numerous studies in the literature supporting the effectiveness of fluoride applications in preventing dental caries. In particular, topical fluoride varnishes have been highlighted as an effective method of caries prevention. ...
Dental caries is a significant oral health issue encountered globally. Unlike bone tissue, dental tissue lacks the capacity for self-renewal, leading to the permanence of pathological changes in teeth. Dental caries is primarily the result of acid production by microorganisms that metabolise sugary foods, which demineralises tooth enamel. If left untreated, caries can progress beyond the enamel and damage the dentin and pulp tissue. The development and spread of dental caries is influenced by an individual’s dietary habits, oral hygiene practices and various socio-economic factors. Throughout history, dental decay has consistently posed a major health issue across both ancient and contemporary communities. The incidence of dental caries has been influenced by factors such as dietary preferences, oral hygiene routines, and shifts in societal lifestyles. In particular, increased consumption of fermentable carbohydrates significantly increases the risk of caries formation. Conversely, preventive measures such as fluoride applications and a balanced diet can substantially reduce the incidence of caries. Other factors impacting the risk of caries include the chemical composition of saliva, the individual’s general health and various medical conditions. Fluoride applications, healthy eating habits and regular dental visits stand out as effective methods for preventing dental caries. Therefore, the success of dental caries prevention strategies depends on raising health awareness at the individual level and strengthening public health policies. This multifaceted approach will help to create healthier oral conditions for future generations.
... Children who were not able to follow home care instructions were counted as dropouts so as to avoid compliance bias. Ashkenazi et al. 28 stated that there was a significant difference seen between brushing and new carious lesions in 651 children. Holmes 29 observed individuals who have brushed their teeth infrequently were at greater risk of new carious lesions occurring than those who brush more regularly. ...
Introduction:
Dental caries is a site-specific, multifactorial chronic disease affected globally. The prevalence of dental caries is strongly associated with social and economic disadvantage, and also the susceptibility of children to dental caries. Dental caries prevention can be achieved with topical fluoride agents. Topical fluoride promotes the remineralization of early carious lesions and reduces the demineralization of healthy enamel.
Aim:
The aim of this randomized clinical trial was to compare the effectiveness of silver diamine fluoride (SDF) and sodium fluoride varnish (FV) in preventing new carious lesions in preschoolers.
Materials and methods:
This randomized clinical trial was conducted on 285 children aged 3-6 years. Children were randomly allocated into three groups namely, group I-deionized distilled water (DIW), group II-sodium FV, and group III-SDF. The biannual application was performed at an interval of 6 months. New carious lesions were recorded using defs and International Caries Detection and Assessment System (ICDAS II) under LED magnifying loupes. Descriptive and inferential statistics were applied and tabulated using Statistical Package for the Social Sciences (SPSS) 23.0 software.
Result:
There was a significant difference seen in the mean values of group III (SDF) when compared with group II (FV) and also between group III (SDF) and group I (DIW) when defs index was used. The mean score of ICDAS II after 12 months in group I (DIW) was -1.171, group II (FV) was -0.690, and group III (SDF) was -0.374.
Conclusion:
silver diamine fluoride (SDF) was found to be most effective in preventing dental caries and also it appears to be the most cost-saving fluoride therapy.
How to cite this article:
Jain A, Deshpande AN, Shah YS, et al. Effectiveness of Silver Diamine Fluoride and Sodium Fluoride Varnish in Preventing New Carious Lesion in Preschoolers: A Randomized Clinical Trial. Int J Clin Pediatr Dent 2023;16(1):1-8.
... Periodic recall appointments have been reported in the literature as an essential factor in maintaining long-term oral health. [20,21] However, some studies have raised concern over the cost-effectiveness of recall appointments for routine dental check-ups. [22] In their Dental Recall Guidelines, the National Institute for Health and Care Excellence recommends dental check intervals of 3 months-24 months between recall appointments for adult patients who have the ability to maintain oral health practices. ...
Objectives
The aim of the present study was to evaluate patients’ oral care habits with fixed dental prostheses and the level of oral hygiene instructions they received from dental professionals.
Material and Methods
A short questionnaire was created containing 12 questions and focusing on four main parts. The first part of the questions included patient demographic information while the remaining part assisted patient’s oral care habits and instructions that patients received from their dentists and dental hygienists.
Results
The study population consisted of 259 patients in which 59% of them were female. Nearly 40% of the patients believed that they did not receive clear information and instructions from their dentists or hygienists on how to clean their fixed dental prosthesis. Although, most of them did visit their dentists and hygienists after they completed the fixed prosthesis treatment. Around 57% of the patients revealed that they did not try to seek information about the correct way of cleaning your fixed dental prosthesis. When they were asked about their cleaning habits of the fixed prosthesis, the majority reported that they use both toothbrush and flossing methods for cleaning.
Conclusion
Most of patients with dental prosthesis believe they are lacking instructions about the proper method for optimal oral hygiene. Meanwhile, patients who believed that they received enough instructions with regard optimal oral hygiene can show better commitment toward daily oral care.
... 5,7 As a consequence, these children may have been at higher risk of developing new carious lesions. [8][9][10][11][12][13] An opposing possibility is that parental presence at home during the lockdown increased supervision of the children, leading to improved oral hygiene habits and consumption of more healthy food. 4,13 Another consequence of the COVID-19 outbreak is related to the warnings regarding the risk of receiving dental treatment during this period. ...
Background
The COVID-19 pandemic was associated with several changes in maintenance of children's dental health. The aim of the present study was to evaluate the extent of these changes.
Methods
Parents were asked to anonymously respond to a questionnaire regarding alterations in their children's oral-habits, such as frequency of eating and drinking, tooth brushing, signs of stress and receiving dental care during the lockdown period. The participants were reached either during their visit to the clinics or by social media groups of the authors.
Results
308 parents to children aged 1-18 years responded to the questionnaires. Associations were shown between increased frequency of eating and drinking, decreased frequency of tooth brushing, and postponing dental care. Of the children, 11% suffered from more frequent oral signs of stress, such as temporomandibular disorder and aphthous-stomatitis, during the lockdown. Although children from all age-groups ate and drank more frequently between meals, younger children were diagnosed with more carious lesions during the lockdown (P=0.015).
Conclusions
During the lockdown many children changed their eating, drinking and tooth-brushing habits, and thus increased their own risk for development of caries.
... For the first 50 years or so it focused on the association between waterborne fluoride, both natural and artificial, and dental caries and fluorosis. In the second half of the twentieth century, this focus shifted to the development and evaluation of different fluoride delivery vehicles including toothpastes, mouth rinses and, to a lesser extent, alternatives to community water fluoridation such as salt and milk fluoridation (Espelid 2009;Ashkenazi et al. 2014). Many trials over the years have shown that there are three major benefits of fluoride. ...
Aim
To evaluate and compare the perceptions and concerns of dental and medical practitioners towards water fluoridation as a caries preventive measure.
Methods
A self-administered questionnaire comprising 21 questions was designed and validated to assess general knowledge and concerns of fluoride and community water fluoridation (CWF) as a dental caries preventive measure. The questions examined participant’s perception regarding effectiveness, advantages, adverse effects, cost-benefit, and concerns pertinent to CWF. Dentists, general physicians and paediatricians were randomly recruited from public medical/dental centres, university clinics, and the private sector to complete the questionnaire.
Results
A total of 474 participants (74% response rate) completed the questionnaire (294 dentists and 180 medical practitioners). About 86% of the dentists and 78% of the medical practitioners agreed that CWF has a role in caries prevention. However, only a few of those would advise their patients to drink fluoridated water. There were some concerns about CWF, and the main concern in both groups was dental fluorosis. The level of awareness regarding CWF status in Kuwait amongst the two groups was low. However, the majority in both groups (77%) believed that the water supply should be optimally fluoridated.
Conclusion
Dental and medical health care professionals agreed that water fluoridation can benefit the oral health of the individuals in the community, however, general knowledge about fluoride benefits, safety, risks and status of public water fluoridation was low.
Objectives:
This study aims to evaluate the effect of prolonged hospitalization on the maintenance of dental health and to assess the nursing staff's approach to addressing these concerns.
Methods:
A survey questionnaire explored changes in the routine dental care of patients hospitalized for over a month. The involvement of nursing staff in addressing dental care was also evaluated.
Results:
Fifty adult patients aged 18-89 years (mean age 62.4 ± 20.54 years), 27 (54%) males, completed the survey. During hospitalization (mean 58.59 ± 38.63 days) 26% and 18%, increased consumption of sweets and sugary beverages, between meals, respectively; 26% and 20% of the patients reduced the frequency of tooth brushing in the morning and in the evening, respectively, and 42.2% of them, reduced the quality of their toothbrushing during hospitalization. Nevertheless, 95.9% and 93.9% of them were never instructed during hospitalization to limit their consumption of sweets and sugary beverages and 83.3% and 62.5% of them had never been reminded or offered assistance during hospitalization in performing toothbrushing, respectively. The lower frequency of morning toothbrushing was significantly correlated with a lack of nurses' assistance (p = 0.004). In contrast, 62.6% reported they were reminded every day to shower. Patients in the rehabilitation and geriatrics departments reported a greater need for a brush/toothpaste (p < 0.0001) and assistance in toothbrushing (p < 0.0001).
Conclusions:
Prolonged hospitalization leads to significant deterioration in inpatients' dental health maintenance. Raising awareness among nurses regarding their inpatient's oral health maintenance is warranted. Providing patients with toothbrushes, toothpaste and educational materials upon hospitalization is recommended.
Patient well-being encompasses the physical, mental, psychological, and social health of an individual. To adequately treat an individual and increase their quality of life, whole-person, patient-centred care needs to be utilised. This review aims to concisely summarise ways to improve patients' well-being through and in dentistry. Oral health is tied to one's quality of life through oral function, overall health, self-perception, social acceptance, and social interaction. These relationships demonstrate the importance of utilising oral health to increase patient quality of life, unify health professions in patient treatment, use preventative medicine, and empower patients about their health. To do so, the dental profession can increase the scope of practice to provide preventative health screening and education on general health, have more open communication, collaborate with other health care professionals, and have broader consultations. This will allow for better continuity of care and shift the focus of treatment to the whole person instead of a symptom. Whilst there are barriers that need to be resolved and cost feasibility requires more exploration, the potential benefit to patients is apparent.
Regular dental recall intervals are widely recommended by dentists in the U.S. to prevent caries and improve periodontal health. However, there is some debate on whether or not compliance with six-month or more frequent recall intervals results in reduced incidence of dental caries. This study examines whether compliance with regular recall and receipt of cleanings, exams and patient education reduces rates of new decay in underserved children and finds a positive impact.
This was to assess factors associated with children's non-compliance with regular dental appointments. The study used demographics, oral health behaviour, oral health and use of dental services for children with a recent history of broken appointments and compared them with children who kept recall appointments.
Children (n=576) recalled for routine examination in the public dental services were studied. Information regarding failed dental appointments during the previous 2 years was collected from each child's record. At examination, past history, clinical and radiographic information was recorded.
The data were analysed using multiple logistic regression analysis.
During the previous 2 years 15% of the children had broken at least one appointment. No significant differences were found between children with and without failed appointments regarding demographic variables (age, gender, immigrant status and medical condition) or dental health behaviours. Compared with other children, those with a history of broken appointments had more enamel disturbances, higher caries experience and higher caries activity (more new caries at the examination), and more time was needed to complete their dental treatment. They were given shorter recall intervals to the next dental examination.
The results suggest that children who break appointments are caries risk patients and need special attention.
A 3-yr clinical trial has been conducted on 3000 12-yr-old children in Lanarkshire, Scotland, with the aim of investigating the effects on oral health of toothpastes containing both sodium monofluorophosphate and zinc citrate, the former being present at fluoride levels of 1000. 1500, and 2500 ppm F. No significant difference in caries increments was found between the group of children using toothpastes incorporating zinc citrate and their counterparts using zinc-free pastes. However, a significant anti-caries dose-response was demonstrated over the SMFP range used. This dose-response was evident for boys and girls and also for the various types of teeth and tooth surfaces.
Abstract – The aim of the present study was to assess indicators shown to be associated with the prevalence of caries in the primary dentition of 7-year-old Flemish schoolchildren. Cross-sectional first year data of the longitudinal Signal-Tandmobiel® survey were analysed (n=4468). Gender, age, oral hygiene habits, use of fluorides, dietary habits, geographical factors and parental modelling were the considered predictors. From the multiple logistic regression analysis, including schools as a random effect, and after adjusting for the confounding variables–educational system and province (stratification variables), gender and age–it became clear that the following risk indicators remained significant (at 5% level) for the presence of caries: frequency of toothbrushing (P=0.05) with an OR 1.24 for brushing less than once a day, age at start of brushing (P<0.001) with an OR=1.22 for a delay of 1 year, regular use of fluoride supplements (P<0.001) with an OR=1.54 for no use, daily use of sugar-containing drinks between meals (P<0.001) with an OR=1.38, and number of between-meals snacks (P=0.012) with an OR=1.22 for using more than 2 between-meal snacks. There was a significant difference (P<0.05) in caries experience determined by the geographical spread, with an explicit trend of caries declining from the east to the west. In a model with an ordinal response outcome, the daily use of sugar-containing drinks between meals had a more pronounced effect when caries levels were high. From this study it became obvious that, in Flemish children, an early start of brushing and a brushing frequency of at least once a day need to be encouraged, while the use of sugar-containing drinks and snacks between meals needs to be restricted to a maximum of 2 per day. Geographical differences need to be investigated in more detail.
To examine the effect of reported toothbrushing frequency and method of rinsing after brushing on caries experience and increment.
Data are presented from 2621 adolescents (mean age 12.5 years at outset) participating in a 3-year double-blind caries clinical trial. At baseline, examiners questioned each participant about their toothbrushing habits, and at subsequent examinations, this information was obtained using a self-administered computer-based questionnaire. Participants used a fluoride-containing dentifrice throughout and clinical examinations were conducted using a mirror, CPITN probe and fibre-optic transillumination.
The reported brushing frequency increased throughout the trial. Caries experience at baseline was inversely related to toothbrushing frequency with mean DMFS=9.66, 8.12 and 7.63 respectively for <1/day, 1/day and >1/day brushers (P<0.001). Mean 3-year DMFS increments of 8.90, 6.63 and 5.48 (P<0.01) were observed in those reporting to brush <1/day, 1/day or >1/day, on not less than two of the three clinical examinations during the trial. Caries increment was also significantly related to the claimed method used to rinse post-brushing. Overall frequency of brushing and rinsing method accounted for over 50% of the explained variance in the ANOVA model used to analyse the DMFS increments.
Stated toothbrushing frequency and rinsing method after brushing were found to be strongly correlated with caries experience and caries increment. These factors should be reflected in the design of oral health education material and taken into account in the design and analysis of caries clinical trials.
It is assumed that removing plaque (a layer of bacteria in an organic matrix which forms on the teeth) will help prevent gum disease (gingivitis) and tooth decay (dental caries). Gum disease, which appears as red, bleeding gums, may eventually contribute to tooth loss. Untreated tooth decay may also result in tooth loss. Toothbrushing removes some plaque, but cannot reach in-between the teeth, where gum disease and tooth decay are common. This review looks at the added benefit of dental flossing, in people who brush their teeth regularly, for preventing gum disease and tooth decay. Twelve trials were included in this review which reported data on two outcomes (dental plaque and gum disease). Trials were of poor quality and conclusions must be viewed as unreliable. The review showed that people who brush and floss regularly have less gum bleeding compared to toothbrushing alone. There was weak, very unreliable evidence of a possible small reduction in plaque. There was no information on other measurements such as tooth decay because the trials were not long enough and detecting early stage decay between teeth is difficult.
The purpose of this study was to evaluate a risk-based dental caries prevention program at an urban pediatric primary care clinic serving low-income residents.
A demonstration caries prevention trial lasting 26 months was conducted with 219 6- to 27-month-old children. A "prevention" group of 6- to 15-month-old children (initial visit) were compared at the end of the trial with a "comparison" group at their initial visit. The latter children were patients of the same clinic who were 12 months older (18-27 months). Preventive services included: caries-risk assessments; mutans streptococci (MS) monitoring; fluoride varnish applications; dental health counseling; referral for dental treatment, if indicated; and periodic recalls.
Prevention group children at the last recall experienced fewer mean carious dental surfaces (0.1 vs 1.29, P=.01) and over 8-fold less MS (P=.01) than comparison group subjects at their initial visit. The number of precavitated lesions was not significantly different
Administration of prevention measures was shown to reduce dental caries experience in low socioeconomic status infants and toddlers, and oral MS levels were a reliable indicator of future caries status. Outcomes support establishment of caries prevention programs at urban primary care pediatric clinics.
To investigate long-term clinical effects of fissure sealing in permanent teeth with regard to sealant retention, reduction of occlusal caries, and effect on the increment of smooth surface caries.
The study included 360 children aged 7 to 8 years with caries-free permanent teeth. Children were divided into 4 groups, and fissure sealing was performed as follows: group 1 -- 1 maxillary first molar and 1 mandibular first molar sealed; group 2 -- all first molars sealed; group 3 -- all molars and premolars sealed on eruption; group 4 -- controls, no teeth sealed. Materials used for sealing were Nuva-Seal (Caulk), Concise Brand White Sealant System (3M ESPE), and Concise Enamel Bond System (3M ESPE). Control examinations were performed over 15 years, every 6 months for 2 years and then every 12 months.
Complete sealant retention after 15 years was observed in 22.0% of cases, and partial retention in 35.0%. The degree of sealant retention affected the occurrence of occlusal caries in sealed teeth. Reduction in caries after 15 years was 36.0% when all first molars were sealed and 54.0% when all posterior teeth were sealed. Caries developed in 7.4% of teeth with complete sealant retention, in 15.0% of teeth with partial sealant retention, and in 31.0% of teeth with complete loss of sealant.
The degree of sealant retention depends on the duration of observation and tooth type. The degree of caries reduction depends on the number of teeth sealed. Mean caries increment was lower in children with sealed teeth than in controls.
The objective of this study was to compare the dental caries status of the occlusal surfaces of permanent first molars of Grade 2 (7-8 years of age) children who kept, and those who missed their Grade 1 (6-7 years of age) dental public health clinic appointment.
The data were obtained from the records of schoolchildren attending the clinic for a comprehensive dental public health programme, with emphasis on fissure sealing permanent first molars. The records were grouped into those who had attended the clinic the previous year and those who did not attend.
The permanent first molars were significantly more likely to be carious in children who missed the Grade 1 appointment compared to those who kept the appointment.
A one year delay in fissure sealing the occlusal surfaces of permanent first molars substantially increased the likelihood of dental caries on these teeth.