Shun-Te Huang

The impact of dietary and tooth-brushing habits to dental caries of special school children with disability

The daily oral activities may severely influence oral health of children with disabilities. In this survey, we analyzed the impact of dietary and tooth-brushing habits to dental caries in special school children with disabilities. This cross-sectional survey investigated 535 special school children with disabilities aged 6-12 years, 60.93% males, 39.07% females from 10 special schools in Taiwan. Oral examinations were carried out by dentists with a Kappa score of their inter-examiner agreement exceeding 0.8. Data on demographics, diet, and tooth-brushing habits of children with disabilities were collected using a standardized questionnaire completed by parents/caregivers. More than three quarters of the participants were combined with severe or profound disability. Children with profound severity in disability had a higher percentage (67.37%) in teeth-brushing by parents/caregivers compared to those children with mild/moderate severity in disability which had a higher percentage (81.60%) in teeth-brushing by themselves. Children whose teeth were brushed by parents/caregivers had a better dental health, and lower caries prevalence. The main risk factors related to decayed teeth of children with disabilities are frequency of sweets intake, ability to brush teeth and with plaque or not. The dental health education, prevention program and periodical oral check-up to children with disabilities and their parents/caregivers should be reinforced. Brushing skill should be taught to children according to their type, severity and individual characteristics of disability.

The oral health status and treatment needs of institutionalized children with cerebral palsy in Taiwan

Background/purpose In this study, we investigated the dental health status of children with cerebral palsy (CP) by determining their dental treatment needs in terms of different grades of disability, sex, and age. Materials and methods In total, the dental health of 345 children with CP aged £ 18 years residing in institutions was examined, and their treatment needs were evaluated. Stratified cluster sampling by probability proportional to size was used for sampling. A dental examination was conducted according to the protocol criteria of the World Health Organization. A databank was designed using Microsoft Office Access, and SAS and JMP were used for the statistical analysis. Results The deft (decayed, extracted and filled primary teeth) index in 5-year-old children with CP was 7.00 ± 6.73; the DMFT (decayed, missing and filled permanent teeth) index of 12- and 18-year-old children with CP were 2.50 ± 3.17 and 7.42 ± 5.48, respectively. The dental treatment needs increased with increasing age and the grade of disability. Children with a moderate grade of CP had the highest dental treatment needs. Conclusion More decayed and missing teeth and fewer dental restorations are common problems in children with CP, and the conditions worsen with age. The grade of CP and having mental retardation or not also worsens their dental health. Promoting the oral health education of parents, caregivers and nurses, strengthening prevention programs from childhood, and motivating dental practitioners to create a dental care system for this population with disabilities are urgently required.

Dental caries associated with dietary and toothbrushing habits of 6- to 12-year-old mentally retarded children in Taiwan

Background/Purpose In this study, we analyzed the influence of dietary factors and toothbrushing habits on dental caries in children with mental retardation (MR). Materials and methods In total, 168 children with MR, aged 6–12 years, were selected from a large cross-sectional survey entitled “Oral health survey and oral hygiene education for the disabled in Taiwan”, which used a stratified cluster sampling design and probability proportional to size for sampling. Oral examinations were carried out by dentists, who were trained such that the kappa score of their interexaminer agreement exceeded 0.8. Data on demographics, diet and toothbrushing habits were collected using a standardized questionnaire completed by a parent or caregiver. A database was designed using Microsoft Access, and the data were analyzed with SAS and JMP software. Results The number of permanent decayed teeth, DMFT index, and caries prevalence of 6-year-old children (0.25, 0.25, and 18.75%, respectively) significantly increased with age to 12 years old (2.37, 3.54, and 72.88%, respectively) (P Conclusion Children with MR tend to have poor oral health. A higher number of decayed teeth and a higher prevalence of caries were statistically significantly related to eating sweets and not having good oral hygiene habits of toothbrushing after eating.

Toothbrushing Habits and Risk Indicators of Severe Early Childhood Caries Among Aboriginal Taiwanese

The purpose of this study was to investigate the toothbrushing habits and risk indicators among aboriginal children with severe early childhood caries (S-ECC). This was a cross-sectional purposive sampling study that included 281 aboriginal children aged 2 to 5 years living in remote regions in southern Taiwan. Participant received dental examinations and questionnaires that were completed by caretakers. From among the 281 participants, 238 children (84%) presented with S-ECC. A low-frequency toothbrushing habit among the children with S-ECC was associated with caretakers with low-frequency toothbrushing (P = .001). The odds ratio of a child using improper toothbrushing methods having a caretaker with a low brushing frequency was 3.45 (P = .0157). Low-frequency toothbrushing and improper toothbrushing methods were associated with S-ECC. The caretakers’ brushing frequency was a risk indicator associated with the children’s poor oral hygiene.

Profile of nonsurgical root canal treatment under the National Health Insurance in Taiwan in 2006

Background/purpose Nonsurgical root canal treatment (NSRCT) is a valuable dental procedure, because it is reported to have a high 5-year tooth retention rates of > 90% in Taiwan. The purpose of this study was to investigate the pattern of NSRCT by analyzing different age groups of patients and tooth types according to different age groups of patients in Taiwan in 2006. Materials and methods Data on the population were obtained from a database of the Ministry of Interior, Taiwan, and the data of the NSRCT were obtained from a database of the Taiwan Dental Association. The population older than 5 years was divided into seven age groups, and the treatment rate and number of permanent tooth which received NSRCT per 1000 patients in each age group were analyzed. Results The results found that 8,865,201 patients received dental treatment, and 1,907,325 permanent teeth received NSRCT in a total population of 21,783,585. This gave an overall dental treatment rate of 40.7%, and overall number of NSRCTs of 215.1 teeth per 1000 patients. The number of NSRCTs per 1000 patients gradually increased from 34.6 in the 5- to 14-year age group to a peak of 342.5 in the 55- to 64-year age group and then slightly declined to 322.5 in the oldest age group of ≤ 65 years. The most frequent tooth type which received NSRCT was first molars (21.0%), followed by second premolars (18.4%), second molars (16.7%), first premolars (13.0%), central incisors (10.6%), lateral incisors (9.7%), canines (9.0%), and third molars (1.9%). Conclusion The overall NSRCT rate per 1000 patients was 215.1 teeth, the incidence of NSRCT increased with the age of the patients, and the frequency of canine treatment increased with the age of patients.

Urinary fluoride concentration in children with disabilities following long-term fluoride tablet ingestion

Urine is the most commonly utilized biomarker for fluoride excretion in public health and epidemiological studies. Approximately 30-50% of fluoride is excreted from urine in children. Urinary fluoride excretion reflects the total fluoride intake from multiple sources. After administering fluoride tablets to children with disabilities, urinary fluctuation patterns should be investigated. The purpose of this study was to monitor the short and long term fluctuating patterns of urinary fluoride concentration after fluoride tablets were ingested by children with disabilities. Children with disabilities aged 6-12 years old were selected randomly and were divided into three groups: Group A, 1.0mg fluoride tablet, Group B, 0.5mg fluoride tablet, and Group C, control group. The urine samples were collected in the morning (MU) and 2h after fluoride tablets were ingested (AU). Urine was collected on the day prior to fluoride intake (baseline), the first, the third, the fifth and the eighth day of fluoride ingestion for a short term, and once every 6 months for a total of 18 months for long-term observation. The AU sample showed statistically significantly higher concentrations of urine fluoride than those of the MU samples, and no statistically significant difference was noticed in the MU samples among the three groups. Group A showed the highest urinary fluoride concentration (UFC) among the three groups. UFC increased as ingested fluoride tablet dosage increased, and it returned to the baseline level on the following day and persisted throughout the study period.

Impact of 24-month fluoride tablet program on children with disabilities in a non-fluoridated country.

The aim of this study was to evaluate the caries preventive effects of a school-based fluoride tablet program in children with disabilities. Two hundred and seventeen children with disabilities were divided into two groups: the intervention group (IG) ingested 1.0mg fluoride tablet daily while the control group (CG) ingested a placebo. The initial oral examinations were conducted prior to fluoride intake and 24-month follow-up examinations were conducted to evaluate the effectiveness of fluoride tablet ingestion. The results from this study demonstrated significant reductions in the DMFT index (the sum of decayed, missing, and filled permanent teeth), 0.63, as well as the DMFS index (the sum of decayed, missing, and filled surfaces of the permanent dentition), 1.25, when compared with the CG. A statistically significant reduction in the DMFT index and DMFS index (30.42% and 36.84%, respectively) suggested an anti-cariogenic benefit to fluoride tablet administration. Greater caries reduction occurred on mesio-distal and bucco-lingual surfaces (53.27% and 52.57%, respectively). Fluoride tablets should be considered as a caries preventive strategy in school-based caries prevention programs for children with disabilities in fluoride deficient areas.