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BACKGROUND: In this case-control study, the authors examined the relationship between untreated caries in children and parent fluoride treatment refusal. The authors hypothesized that parents of children with a history of untreated caries would be less likely to refuse topical fluoride for their children than parents of children with no history of untreated caries. METHODS: The study included children (≤ 18 years old) who were patients at a university dental clinic from January 2016 through June 2020. Children whose parents refused fluoride treatment were age-matched with children whose parents did not refuse fluoride treatment (n = 356). The outcome variable was parent topical fluoride refusal for their children (no, yes). The predictor variable was a history of untreated caries (no, yes). Confounding variable-adjusted modified Poisson regression models were used to estimate the prevalence ratio of parent fluoride refusal by means of children's untreated caries status. RESULTS: Approximately 46.3% of children had a history of untreated caries. The prevalence of parent fluoride refusal for children with a history of untreated caries was significantly lower than that for children with no history of untreated caries (adjusted prevalence ratio, 0.79; 95% CI, 0.64 to 0.98; P = .03). CONCLUSIONS: Parents of children with a history of caries are less likely to refuse topical fluoride treatment, which suggests that untreated caries may motivate parents to accept preventive dental treatments like fluoride. PRACTICAL IMPLICATIONS: Dental care professionals should assess caries risk and communicate a child's caries risk before making a recommendation regarding topical fluoride treatment.

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OBJECTIVES: This study aims to update the relevant epidemiological information of untreated caries in permanent teeth. METHODS: Data were derived from the Global Burden of Disease (GBD) study 2019. We described temporal trends in age-standardized prevalence rate (ASPR) of untreated caries in permanent teeth by gender and region from 1990 to 2019. Age-period-cohort (APC) model was utilized to analyze age, period and cohort effects on prevalence, and we used the Bayesian age-period-cohort (BAPC) model to make projections of prevalence between 2020 and 2049. RESULTS: The global ASPR of untreated caries in permanent teeth presented a decreasing trend from 1990 to 2019 (26593.58/105 vs. 25625.53/105), with females exceeding males annually. Negative correlation was observed between ASPR and Socio-demographic Index (SDI) levels. APC analyses showed that net drift was -0.16 % globally and generally below 0 across all SDI regions. The overall global peak in prevalence occurred in the 20-24 years group (36319.99/105), and there was a decrease trend in the overall global period rate ratio (RR). Compared to younger birth cohorts, prior birth cohorts had higher prevalence risks globally and across all SDI regions. Significant upward trends was predicted in the global ASPR of untreated caries in permanent teeth for both genders from 2020 to 2049. CONCLUSIONS: Age-period-cohort effects exerted a significant impact on the prevalence of untreated caries in permanent teeth during the study period. CLINICAL SIGNIFICANCE: The ASPR of untreated caries in permanent teeth may increase in the next 30 years by projections. And the disease burden of untreated caries in permanent teeth may be affected by population ageing. It is essential to implement targeted prevention and control policies to disadvantaged groups and attempt to reduce caries inequalities.

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OBJECTIVE: This study aims to examine the Oral Health-Related Quality of Life (OHRQoL) and its determinants among elementary school children in Saudi Arabia, recognizing OHRQoL as a critical aspect of overall health and well-being. BACKGROUND: OHRQoL is an essential element of health, influencing children's ability to engage in daily activities, learning, and social interactions. In Saudi Arabia, despite free dental care, significant occurrences of untreated dental caries among children highlight disparities in oral health outcomes, likely influenced by socioeconomic factors. METHOD: Baseline data from a longitudinal randomized controlled trial conducted in Riyadh, Saudi Arabia was utilized. Participants were elementary school students attending public schools, selected using stratified cluster random sampling. The study focused on both deciduous and permanent dentition, excluding children with medical issues. Data collection involved clinical evaluations and parental questionnaires, adhering to WHO criteria. RESULTS: The results of the study revealed significant associations between age (mean: 98.99 months, 95% confidence interval (CI): 97.8-100.1) and untreated caries (mean: 2.54, 95% CI: 2.34-2.74) with OHRQoL among children in Saudi Arabia. Older children (Rate Ratio (RR) = 1.01; 95% CI: 1.01-1.06) and those with untreated caries (RR = 1.04; 95% CI: 1.01-1.07) had higher rates of experiencing suboptimal oral health outcomes. However, no statistically significant associations were found for other variables such as gender, family income, parental education, oral hygiene frequency, and dental visits with respect to OHRQoL. CONCLUSION: The study underscores that age and untreated caries are significantly and positively associated with OHRQoL in children. These findings point to the need for targeted oral health interventions and policies within the sociocultural context of Saudi Arabia, particularly focusing on early prevention and addressing socioeconomic inequalities.

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BACKGROUND:  Oral health-related quality of life (OHRQol) is described as the effect of oral conditions on the overall functioning and well-being of individuals. AIM:  This study sought to determine the validity of a modified-child oral health impact profile (M-COHIP) among adolescents living with the human immunodeficiency virus (HIV) infection (ALHIV) and HIV-undiagnosed adolescents and establish the factors influencing OHRQoL among adolescents in central Johannesburg. SETTING:  Schools and HIV wellness centre in central Johannesburg. METHODS:  An interviewer-administered questionnaire was applied, followed by an oral examination. RESULTS:  A total of 504 adolescents were included in the study. The overall mean decayed teeth for permanent dentition was 1.6 (standard deviation [s.d.]: 1.99) and caries prevalence was 62.2% (n = 309). The tool's Cronbach's alpha was 0.88. The item-rest correlations were from 0.6 to 0.85 for all items. The initial exploratory factor analysis explained 76% of the total variance. The overall M-COHIP score was 59.6 (18.2). The overall modified-COHIP scores for those not in care (schools) were higher [62.88] than those of ALHIV. The poor M-COHIP scores were associated with reporting toothache, having active decay, poor oral health-self-rating, and being selected from the school site (p  0.005). CONCLUSION:  The validation study supports the use of the tool as a reliable and valid measure of OHRQoL. Future research can investigate the extent to which the tool is effective in measuring treatment outcomes and patient satisfaction.Contribution: The validated tool will be beneficial in the African context for programme assessments and overall measure of quality-of-life impacts from oral conditions.

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AIM: To investigate the confluence of caries and periodontitis indicators from adolescence to elderhood among Americans. MATERIALS AND METHODS: This cross-sectional study explored the grouping among a set of caries and periodontitis indicators (the proportion of sites with bleeding on probing, moderate probing pocket depth [PPD, 4-5 mm], severe PPD [≥6 mm], moderate clinical attachment level [CAL, 3-4 mm], severe CAL [≥5 mm], number of teeth with furcation involvement, number of decayed teeth, number of teeth with pulp involvement, and the number of missing teeth) in 14,421 Americans from the NHANES III study. Exploratory factorial analysis was used to determine the constructs between those indicators (factorial loading ≥0.3). These analyses were stratified by age and confirmed with a confirmatory factorial analysis. We also performed a sensitivity analysis using the NHANES 2011-2014. RESULTS: Two constructs were extracted. The first, Chronic Oral Diseases Burden, grouped caries indicators with moderate PPD and moderate CAL for the youngest subjects (13-39 years old), while for the subjects over 50 years, the Chronic Oral Disease Burden grouped caries indicators with severe CAL and PPD and furcation involvement. The second construct, Periodontal Destruction, grouped only periodontitis indicators. CONCLUSIONS: Caries and periodontitis indicators grouped consistently across the different age ranges in lapse times of 25 years.

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OBJECTIVES: Little is known about children's oral health disparities and their changes in developing countries. This study aimed to measure rural-urban and maternal education-related disparities in dental visits and untreated caries among Chinese children, and to describe their changes between 2005 and 2015. METHODS: The 12-year-old children's oral health data were from the 3rd (2005) and 4th (2015) oral health surveys in Beijing, China. Rural-urban disparities and maternal education-related disparities in dental visits and untreated caries were measured. The slope index of inequality (SII) and a relative index of inequality (RII) were applied to reflect the absolute and relative disparities respectively. These were estimated using a generalized linear regression model. RESULTS: Data were analysed from 388 children in 2005 and 1926 children in 2015. The proportion of 12-year-old schoolchildren who visited the dentist was 24.0% in 2005 and 36.0% in 2015. Untreated caries prevalence in 2005 and 2015 was 20.9% and 16.2% respectively. Rural-urban disparities in dental visits narrowed between 2005 and 2015 (SII: -10.75 to -3.30, RII: 0.55 to 0.87), and maternal education-related disparities in dental visits also decreased during this decade (SII: -18.52 to -8.49, RII: 0.38 to 0.65). These changes were statistically significant. For disparities in untreated caries, only maternal education-related disparities in untreated caries in 2015 were found. The SII and RII were 6.39% (95% CI: 1.65, 11.13) and 1.57 (95% CI: 1.13, 2.20) respectively. The change in disparities in untreated caries was not statistically significant for rural-urban disparities (P = .319) or maternal education-related disparities (P = .501). CONCLUSIONS: These findings indicate that in Beijing, China, disparities in children's dental visits narrowed between 2005 and 2015. However, maternal education-related disparities in dental visits and in untreated caries were still apparent, suggesting that policies to improve children's oral healthcare utilization equality should target the children with less-educated mothers.

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BACKGROUND: Untreated caries (UC), although highly prevalent, is largely preventable. Information on the contribution of different teeth to UC prevalence and severity could be helpful in evaluating UC surveillance protocols and the relative benefits of caries prevention interventions. METHODS: The authors combined data from 3 cycles (2011-2016) of the National Health and Nutrition Examination Survey for participants aged 6 through 11 years, 12 through 19 years, 20 through 34 years, 35 through 49 years, 50 through 64 years, 65 through 74 years, and 75 years and older. For each age group the authors calculated the contribution of successive permanent tooth types (for example, first molars and second molars) to UC prevalence and severity. RESULTS: UC prevalence and the percentage of prevalence detected by means of screening molars were, respectively, 5% and 95% among participants aged 6 through 11 years; 16% and 92% among participants aged 12 through 19 years; 29% and 86% among participants aged 20 through 34 years; 26% and 70% among participants aged 35 through 49 years; 21% and 48% among participants aged 50 through 64 years; 16% and 36% among participants aged 65 through 74 years; and 17% and 25% among participants 75 years and older. Among adults aged 50 years and older, no teeth appeared to capture a disproportionate share of UC prevalence. Molars accounted for 87%, 79%, and 56% of severity among participants aged 6 through 11 years, 12 through 19 years, and 20 through 34 years, respectively. After age 34 years, molars accounted for less than 50% of severity. CONCLUSIONS: Molars are the tooth type most susceptible to UC well into adulthood. PRACTICAL IMPLICATIONS: Molars could be used as sentinel teeth for surveillance of UC and adults could benefit from caries prevention that targets molars.

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BACKGROUND: National data indicate that working-aged adults (20-64 years) are more likely to report financial barriers to receiving needed oral health care relative to other age groups. The aim of this study was to examine the burden of untreated caries (UC) and its association with reporting an unmet oral health care need among working-aged adults. METHODS: The authors used National Health and Nutrition Examination Survey data from 2011 through 2016 for 10,286 dentate adults to examine the prevalence of mild to moderate (1-3 affected teeth) and severe (≥ 4 affected teeth) UC. The authors used multivariable logistic regression to identify factors that were associated with reporting an unmet oral health care need. RESULTS: Low-income adults had mild to moderate UC (26.2%) 2 times more frequently and severe UC (13.2%) 3 times more frequently than higher-income adults. After controlling for covariates, the variables most strongly associated with reporting an unmet oral health care need were UC, low income, fair or poor general health, smoking, and no private health insurance. The model-adjusted prevalence of reporting an unmet oral health care need among low-income adults with mild to moderate and severe UC were 35.7% and 45.1%, respectively. CONCLUSIONS: The burden of UC among low-income adults is high; prevalence was approximately 40% with approximately 3 affected teeth per person on average. Reporting an unmet oral health care need appears to be capturing primarily differences in UC, health, and financial access to oral health care. PRACTICAL IMPLICATIONS: Data on self-reported unmet oral health care need can have utility as a surveillance tool for monitoring UC and targeting resources to decrease UC among low-income adults.

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Introducción: Las comunidades nativas forman uno de los grupos humanos más olvidados donde se reagudizan las inequidades y desigualdades en salud oral. Objetivo: Determinar el perfil clínico epidemiológico de salud oral en pobladores de las comunidades nativas de Potsoteni, Boca Sanibeni y Unión Puerto Ashaninka del distrito de Mazamari, provincia de Satipo, departamento de Junín, Perú. Material y Métodos: Se realizó un estudio observacional descriptivo de corte transversal. La muestra estuvo integrada por 169 adultos de las comunidades nativas, se tomaron en cuenta criterios de inclusión y exclusión, y se siguieron las normas éticas en investigación científica. Se evaluó la salud oral mediante una ficha epidemiológica con los indicadores: Índice CPOD, índice de significancia de caries dental (SIC), índice de higiene oral simplificado (IHO-S), índice de necesidad de prótesis dentales de la OMS, clasificación de maloclusión de Angle, índice de consecuencias clínicas de caries no tratadas (PUFA), la evaluación fue realizada con luz natural por observadores calibrados. Los datos se analizaron en el programa STATA v 14 mediante tablas de distribución de frecuencias y figura. Resultados: El 100 por ciento de los pacientes estudiados tenía caries dental (CPO-D = 13,23; SIC=19,01), IHO-S: 5,02 (DS=0,51), la mayoría presentó un tipo de maloclusión y consecuencias clínicas de caries no tratadas 116 (68,63 por ciento ) y 115 (68 por ciento ) respectivamente, la prótesis dental unitaria fue la que más se necesitó en ambos maxilares. Conclusiones: El estado de salud bucal fue preocupante, es necesario fomentar políticas que permitan un mejor acceso a los servicios de salud a fin de revertir estos indicadores(AU)

Introduction: Native communities are one of the most forgotten human groups where inequities and inequalities in oral health are exacerbated. Objective: To determine the epidemiological and clinical profile of oral health in residents of the native communities of Potsoteni, Boca Sanibeni and Union Puerto Ashaninka of Mazamari district, Satipo province, Junín department, Peru. Material and Methods: A cross-sectional descriptive observational study was conducted. The sample consisted of 169 adults from native communities who fulfilled inclusion and exclusion criteria, following the ethical norms in scientific research. Oral health was evaluated through an epidemiological fact sheet with the following indicators: DMFT index, Significant Caries Index (SCI), simplified oral hygiene index (OHI-S), prosthetic need WHO index, classification of Angle malocclusion, and index of clinical consequences of untreated dental caries (PUFA). The evaluation was made with natural light by calibrated observers. The data was analyzed in the STATA v 14 program by means of frequency and figure distribution tables. Results: It was determined that 100 percent of the patients studied had dental caries (DMFT = 13.23, SCI = 19.01), OHI-S: 5.02 (SD = 0.51), the majority of them presented a type of malocclusion and clinical consequences of untreated caries; 116 (68.63 percent) and 115 (68 percent), respectively. The unitary dental prosthesis was the most needed in both jaws. Conclusions: The state of oral health was worrisome; it is necessary to promote policies that allow better access to health services in order to revert these indicators(AU)

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BACKGROUND: Dental caries is a public health problem globally, especially in children. Thus, it is important to quantify its clinical consequences in terms of its prevalence and severity. AIM: This study aims to assess the prevalence and severity of oral conditions linked with untreated dental caries using pulp involvement, ulceration, fistula, abscess (pufa/PUFA) index in 5-, 12-, and 15-year-old school children in Ambala district. SETTINGS AND DESIGN: This cross-sectional study was conducted among 433 school children of 5-, 12-, and 15-year-old age group in Ambala district. MATERIALS AND METHODS: In the present study, participants were recruited from randomly selected schools and were examined according to pufa/PUFA index and Oral Health Surveys Dentition Status. STATISTICAL ANALYSIS USED: Data were analyzed using SPSS Software Version 20.0 (Chicago, USA). The statistical significance was determined by Chi-square test, and level of significance was set at P < 0.05. Correlation analysis was expressed in terms of Pearson's correlation coefficient (r). RESULTS: Caries prevalence was reported to be 58.4% while the prevalence of odontogenic infections was 45.3%. Untreated caries pufa/PUFA ratio among 5, 12, and 15 years old was 44.58%, 38.33%, and 36.18%, respectively. The care index among 5, 12, and 15 years old was 0, 3.31%, and 36.18% emphasizing the lack of utilization of dental services by school children. CONCLUSIONS: The use of PUFA/pufa index as an adjunct to the classical caries indices can address the neglected problem of untreated caries and its consequences.

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BACKGROUND: The Affordable Care Act of 2010 increased dental coverage for children in the United States, (U.S.) but not for adults. Few studies in current scholarship make use of up-to-date, nationally representative data to examine oral health disparities in the U.S. POPULATION: The purpose of this study is to use nationally representative data to determine the prevalence of untreated caries among children and adults of different socioeconomic and racial/ethnic groups and to examine the factors associated with untreated caries among children and adults. METHODS: This study used the 2011-2014 National Health and Nutrition Examination Survey (NHANES) demographic, oral health questionnaire, and oral health dentition examination data (n = 7008 for children; n = 9673 for adults). Participants that had a standardized oral health examination and at least one natural primary or permanent tooth considering 28 tooth spaces were included in this study. Our main outcome measure was untreated coronal caries defined as decay on the crown or enamel surface of a tooth that had not been treated or filled. Population estimates were calculated to determine the prevalence of untreated caries among children and adults in the United States. Frequencies and Pearson's chi-square tests were used to compare those with and without untreated caries. Multivariate logistic regression models were used to evaluate the factors associated with untreated caries. We conducted analyses among children and adults separately. RESULTS: From 2011 to 2014, 12.4 million children and 57.6 million adults in the United States had untreated caries. Age, family income level, recent dental visit, and financial and non-financial barriers were significantly associated with untreated caries in both children and adults. Race/ethnicity, gender and education level were also significantly associated with untreated caries among adults. The odds of untreated caries associated with financial barriers were 2.06 for children and 2.84 for adults while the odds of untreated caries associated with non-financial barriers were 2.86 for children and 1.67 for adults. CONCLUSIONS: Demographic and socio-economic disparities in untreated caries exist among children and adults.

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