Jamil David

Factors associated with traumatic dental injuries among 12-year-old schoolchildren in South India

AIMS To assess the prevalence of, and correlates of traumatic dental injuries among 12-year-old schoolchildren in Kerala. MATERIAL AND METHODS A cross-sectional, two-stage cluster sampling technique was used. The sample size included 838 12-year-old school children. Traumatic dental injuries to the anterior teeth were evaluated clinically by one examiner. Teeth examined were maxillary and mandibular incisors and canines. The children answered a structured questionnaire on sociodemographics, subjective oral health assessments and behavioural aspects. RESULTS Six per cent of the 12-year-old school children had traumatic dental injuries to the anterior teeth. The right central incisors were most frequently affected. Multiple logistic regression analysis showed that boys (Adjusted Odds Ratio (Adj OR) = 2.2, 95% Confidence Interval (CI) = 1.1-4.1) and children who disagreed that good marks in school were important to them (Adj OR = 2.3, 95% CI = 1.2-4.3) had a higher probability of having traumatized teeth than other children. CONCLUSIONS The prevalence of traumatized anterior teeth among 12-year-olds in Kerala was low compared with other studies. Being male and negative about future career were associated with a higher probability of having a traumatized tooth.

Dental pain, oral impacts and perceived need for dental treatment in Tanzanian school students: a cross-sectional study

BackgroundDental caries, dental pain and reported oral problems influence peoples oral quality of life and thus their perceived need for dental care. So far there is scant information as to the psychosocial impacts of dental diseases and the perceived treatment need in child populations of sub-Saharan Africa.ObjectivesFocusing on primary school students in Kilwa, Tanzania, a district deprived of dental services and with low fluoride concentration in drinking water, this study aimed to assess the prevalence of dental pain and oral impacts on daily performances (OIDP), and to describe the distribution of OIDP by socio-demographics, dental caries, dental pain and reported oral problems. The relationship of perceived need estimates with OIDP was also investigated.MethodsA cross-sectional study was conducted in 2008. A total of 1745 students (mean age 13.8 yr, sd = 1.67) completed an extensive personal interview and under-went clinical examination. The impacts on daily performances were assessed using a Kiswahili version of the Child-OIDP instrument and caries experience was recorded using WHO (1997) criteria.ResultsA total of 36.2% (41.3% urban and 31.4% rural, p < 0.001) reported at least one OIDP. The prevalence of dental caries was 17.4%, dental pain 36.4%, oral problems 54.1% and perceived need for dental treatment 46.8% in urban students. Corresponding estimates in rural students were 20.8%, 24.4%, 43.3% and 43.8%. Adjusted OR for reporting oral impacts if having dental pain ranged from 2.5 (95% CI 1.8–3.6) (problem smiling) to 4.7 (95% CI 3.4–6.5) (problem sleeping),- if having oral problems, from 1.9 (95% CI 1.3–2.6) (problem sleeping) to 3.8 (95% CI 2.7–5.2) (problem eating) and if having dental caries from 1.5 (95% CI 1.1–2.0) (problem eating) to 2.2 (95% CI 1.5–2.9) (problem sleeping). Students who perceived need for dental care were less likely to be females (OR = 0.8, 95% CI 0.6–0.9) and more likely to have impacts on eating (OR = 1.9, 95% CI 1.4–2.7) and tooth cleaning (OR = 1.6, 95% CI 1.6–2.5).ConclusionSubstantial proportions of students suffered from untreated dental caries, oral impacts on daily performances and perceived need for dental care. Dental pain and reported oral problems varied systematically with OIDP across the eight impacts considered. Eating and tooth cleaning problems discriminated between subjects who perceived need for dental treatment and those who did not.

Caries increment and prediction from 12 to 18 years of age: A follow-up study

Aim: This was to determine the increment of caries from 12 to 18 years of age and to explore the possibility of predicting caries increment in this period based on the caries experience at age12 years. Study design: Prospective longitudinal survey. Methods: A sample of 12-year-old children (n =159) were examined in 1993 and 70% of them re-examined at 18 years of age. Bitewing radiographs were taken and a diagnostic system using five caries grades (D1−D5) was used at both ages. Children at risk were defined as those who developed manifest caries lesions (D3−5FS) on approximal surfaces during the follow-up period. Possible predictors were analysed by calculation of sensitivity, specificity, and actual proportion of the population at risk. Results: The mean caries increment (D1−5MFS) from 12 to 18 years of age was 4.2 (SD±9.1). The percentage of caries-free adolescents at 12 and 18 years of age was 10% and 1% respectively; 25% had either a reversal or no increment in caries experience while the D1−5MFS increased in 65% of the adolescents. Of the increment of manifest lesions (D3−5FS), 18% were located in incisors/canines, 40% in premolars, 26% in first molars and 16% in second molars. Premolars had the largest proportion of the approximal surfaces with manifest caries increment. The best predictors of children at risk of approximal caries increment (D3−5FS) were caries experience (D1−5FS) on the approximal surfaces of premolars and second molars at the age of 12 years. The individuals that developed four or more manifest lesions on approximal surfaces between 12 and 18 years were the easiest to predict (sensitivity + specificity = 175%). Conclusions: There was a considerable increment of manifest caries lesions from 12 to 18 years of age in all tooth groups. The best predictors for increment of manifest caries on approximal surfaces during the age period were approximal caries in premolars and second molars at the age of 12 years.

Prevalence and correlates of self-reported state of teeth among schoolchildren in Kerala, India

BackgroundOral health status in India is traditionally evaluated using clinical indices. There is growing interest to know how subjective measures relate to outcomes of oral health. The aims of the study were to assess the prevalence and correlates of self-reported state of teeth in 12-year-old schoolchildren in Kerala, India.MethodsCross-sectional survey data were used. The sample consisted of 838 12-year-old schoolchildren. Data was collected using clinical examination and questionnaire. The clinical oral health status was recorded using Decayed, Missing and Filled Teeth (DMFT) and Oral Hygiene Index – Simplified (OHI-S). The questionnaire included questions on sociodemographics, self reports of behaviour, knowledge and oral problems and a single-item measuring self-reported state and satisfaction with appearance of teeth. The Kappa values for test-retest of the questionnaire ranged from 0.55 to 0.97.ResultsTwenty-three per cent of the schoolchildren reported the state of teeth as bad. Multivariate logistic regression showed significant associations between schoolchildren who reported to have bad teeth and poor school performance (Odds Ratio (OR) = 2.5), having bad breath (OR = 2.4), food impaction (OR = 1.7) dental visits (OR = 1.6), being dissatisfied with appearance of teeth (OR = 4.2) and caries experience (OR = 1.7). The explained variance was highest when the variables dental visits, bleeding gums, bad breath, food impaction and satisfaction with appearance were introduced into the model (19%).ConclusionA quarter of 12-year-olds reported having bad teeth. The self-reported bad state of teeth was associated with poor school performance, having bad breath and food impaction, having visited a dentist, being dissatisfied with teeth appearance and having caries experience. Information from self-reports of children might help in planning effective strategies to promote oral health.

Utilization of dental health care services in context of the HIV epidemic- a cross-sectional study of dental patients in the Sudan

BackgroundHIV infected patients should be expected in the Sudanese dental health care services with an increasing frequency. Dental care utilization in the context of the HIV epidemic is generally poorly understood. Focusing on Sudanese dental patients with reported unknown HIV status, this study assessed the extent to which Andersens model in terms of predisposing (socio-demographics), enabling (knowledge, attitudes and perceived risk related to HIV) and need related factors (oral health status) predict dental care utilization. It was hypothesized that enabling factors would add to the explanation of dental care utilization beyond that of predisposing and need related factors.MethodsDental patients were recruited from Khartoum Dental Teaching Hospital (KDTH) and University of Science and Technology (UST) during March-July 2008. A total of 1262 patients (mean age 30.7, 56.5% females and 61% from KDTH) were examined clinically (DMFT) and participated in an interview.ResultsA total of 53.9% confirmed having attended a dental clinic for treatment at least once in the past 2 years. Logistic regression analysis revealed that predisposing factors; travelling inside Sudan (OR = 0.5) were associated with lower odds and females were associated with higher odds (OR = 2.0) for dental service utilization. Enabling factors; higher knowledge of HIV transmission (OR = 0.6) and higher HIV related experience (OR = 0.7) were associated with lower odds, whereas positive attitudes towards infected people and high perceived risk of contagion (OR = 1.3) were associated with higher odds for dental care utilization. Among need related factors dental caries experience was strongly associated with dental care utilization (OR = 4.8).ConclusionDisparity in the history of dental care utilization goes beyond socio-demographic position and need for dental care. Public awareness of HIV infection control and confidence on the competence of dentists should be improved to minimize avoidance behaviour and help establish dental health care patterns in Sudan.

Work, Stress, and Diurnal Bruxism: A Pilot Study among Information Technology Professionals in Bangalore City, India.

The study assessed the prevalence of diurnal bruxism among information technology (IT) professionals and explored plausible predictors associated with the parafunctional habit. A cross-sectional study was designed and IT professionals were invited to participate. The inclusion criteria composed of participants in service for at least one year, having natural dentition, no history of cervical or facial injury and not undergoing orthodontic therapy. The participants (N = 147) were interviewed by a trained interviewer to record information. A pre-tested questionnaire that included questions related to work, stress symptoms and diurnal bruxism was completed by each participant. The prevalence of self-reported diurnal bruxism was 59%. Bivariate analyses revealed that work (P < 0.05) and work experience (P < 0.05) were significantly associated with self-reported diurnal bruxism. In the binary logistic regression analysis stress (Odds Ratio [OR]  = 5.9, 95% Confidence Interval [CI] 2.6–13.3) was identified to be a strong predictor of diurnal bruxism. Professionals with 11 or more years of experience were less likely to report diurnal bruxism (OR = 0.04, 95% CI 0.00–0.43) than those with 1 to 5 years of work experience. The study revealed that stress and less work experience were associated with diurnal bruxism among IT professionals in Bangalore city.

Classification and Epidemiology of Orofacial Pain

Classification of orofacial pain-producing diseases can be done according to various methods including, but not limited to, site of origin, like somatic pain, neuropathic pain, and pain-related psychologic disorders. A robust or a complete classification system has not been developed for orofacial pain to date, because of the overlapping pathophysiology as well as symptomatology. A simple and broad classification is proposed in this chapter to aid a clinician in the diagnosis and management of orofacial pain. Orofacial pain is a common presentation in general population with prevalence of up to 26 %. Dental source of pain resulting from dental caries and sequel of pulpal disease is the most common cause of pain in the orofacial region; other causes include disease of the periodontium, teeth with wasting diseases, and cracked teeth. Non-dental causes of orofacial pain include diseases like temporomandibular diseases, trigeminal neuralgia with incidence up to 4 to 5/100,000/year, and postherpetic neuralgia, seen in up to 30 % of patients with herpes zoster. Pain secondary to oral mucosal lesions, sinonasal diseases, psychosomatic causes, and cardiac causes form the spectrum for orofacial pain. The prevalence of facial pain is a public health concern.