The aim of this study was to assess the possibility to arrest occlusal caries lesions in adults by sealant as well as to assess the presence of radiographic progression, arrest, and regression of the ...sealed lesions. Seventy-two occlusal caries lesions in 52 adult patients referred to restorative treatment by senior lecturers at School of Dentistry, Copenhagen, Denmark were included. In case the patient had more than one occlusal caries lesion, randomization between sealing and restoration was made; otherwise, the lesion was sealed. In total, 60 resin sealants and 12 composite restorations were made. Follow-up period was 25–38 months (mean = 33 months). Data were analyzed using non-parametric statistics including kappa statistics. After 2–3 years, the dropout rate was 15%; two patients did not show up for control and nine previously sealed lesions were restored by the patients' general practitioners. All 12 restorations and 39 of the remaining 49 sealants were well functioning, seven (14%) sealants were repaired/replaced due to failure, and three (6%) sealed lesions were restored due to caries progression (
p
> 0.05). The radiographic assessment showed caries progression beneath five (10%) sealants, caries regression beneath one (2%) sealant, and unchanged depth beneath 43 (88%) sealants and all restorations (
p
> 0.05). The majority of the referred lesions were successfully arrested by sealants, indicating the possibility for extending the criteria for sealing occlusal caries lesions in adults. However, a longer observation period is needed for final conclusion. Extending the criteria of therapeutic sealing of occlusal caries lesions in adults will lead to increased dental health.
Objectives
To report the long‐term effect (18 years) of the Nexö‐method, initially implemented in groups of children in Moscow in 1994.
Methods
Three groups of children were included in the initial ...study in 1994. This study is a follow‐up study of two of the three initial groups: a group of 6‐year‐olds (test group6; control group6) and a group of 11‐year‐olds (test group11, control group11), n = 50 individuals in each of the four subgroups. In 2012, >80% of the participants in the two groups (now aged 24 and 28 years old) were re‐examined by the original examiner, who was blinded to which group the patients had belonged in the initial study. After re‐examination, the participants were interviewed by a person not otherwise attached to the study. Finally, caries data were collected from 100 24‐year‐olds and 100 28‐year‐olds who attended the dental school (50%) and private clinic (50%) in Moscow (External control groups24,28). The outcome variables of the study were plaque and gingival status, and DMFT/S.
Results
In 2012, the control groups24,28 displayed significantly higher plaque scores than the test groups24,28 (P‐values < 0.05). No differences were seen regarding gingivitis scores (P‐values > 0.41). Mean DMFT/S in 2012 was test group24 = 6.98/10.51, control group24 = 8.84/13.14 (P = 0.02/0.06). External control group24 = 8.89/15.86 (test24 versus external control group24, P = 0.01/0.007; control24 versus external control group24, P = 0.94/0.16). Test group28 = 6.74/10.83, control group28 = 8.70/14.48 (P = 0.02/0.008). External control group28 = 9.03/18.06 (test28 versus external control28, P = 0.03/0.001; control28 versus external control28, P = 0.68/0.07). The interview indicated that the participants in the test groups were more aware of factors that are considered important for control of caries than participants in the control groups.
Conclusions
The data from this group of Moscow citizens suggest a long‐term positive effect of the Nexö‐method implemented during childhood.
Objective
The International Caries Classification and Management System (ICCMS™), a comprehensive, evidence‐informed, best clinical practice system, comprises a 4D cycle: 1D‐Determine risk; 2D‐Detect ...and assess lesions; 3D‐Decide on a personalized care plan; and 4D‐Do preventive and tooth‐preserving care. The aim of this study was to establish how Colombian dental practitioners, educators and students diagnose and manage caries risk and caries lesions using the COM‐B model and the ICCMS™ system.
Methods
A total of 1094 participants (practitioners: n = 277; educators: n = 212; students: n = 605) completed a previously validated 79‐item questionnaire which explores, based on the COM‐B model, the practitioners' self‐reported caries diagnosis and management behaviours. Descriptive statistics, Welch's ANOVAs and multiple linear regressions were computed.
Results
All groups generally performed the behaviours within the 4‐D categories ‘Most of the time’ to ‘Always’ (students: 4.06 ± 0.95; educators: 3.94 ± 0.98; practitioners: 3.86 ± 1.01). The most frequently performed diagnosis behaviours (1D/2D) were for practitioners assessing initial/moderate lesions (4.09 ± 1.01) and for educators and students cleaning teeth before lesion assessment (4.41 ± 0.80 and 4.38 ± 0.77 respectively). The least frequently performed decision/management (3D/4D) behaviour was non‐operative care for moderate‐caries lesions (when applicable) (practitioners: 2.64 ± 1.23; educators: 2.68 ± 1.17; students: 3.22 ± 1.41). Opportunity (Resources and Relevance) was the best COM‐B predictor for diagnostic behaviours, whereas capability and opportunity (Relevance) were the strongest predictors for management behaviours.
Conclusion
Colombian practitioners, educators and students diagnose and manage caries risk and caries lesions implementing best practice with a high to very high frequency.
Objective
To design and validate a questionnaire to measure caries management based on the Capability, Opportunity, and Motivation Behavior model (COM‐B) and the International Caries Classification ...and Management System (ICCMS™).
Methods
A combination of Cariology and Psychology experts developed a 79‐item pool that measured the COM‐B components according to the ICCMS™ caries management recommended behaviours. After face and content validation and a pilot study, two samples of Colombian dentists participated: clinicians (n = 277) and clinical‐practice educators (n = 212).
Results
Using parallel analysis and exploratory structural equation modelling (ESEM), the questionnaire was reduced to a 47‐item 5‐factor instrument that demonstrated good internal consistency and validity properties, including a robust factor structure, measurement invariance across samples and high predictive validity of ICCMS™ recommended behaviours. Scales’ mean scores showed that dentists were conducting recommended behaviours “most‐of‐the‐time” (Behavior), showed high confidence in their ability to conduct these behaviours (Capability) and considered recommendations as highly relevant (Opportunity‐Relevance), while their appraisals of the available resources (Opportunity‐Resources) and remuneration (Motivation) were notably lower.
Conclusion
Overall, the findings highlight the practical utility of the COM‐B ICCMS™ Questionnaire in understanding the potential antecedent variables that may explain dentists’ behaviours related to caries diagnosis and management and in suggesting avenues for achieving a positive change in their behaviour.
Aims
(1) To describe dental health – and financial goals to be achieved with a national caries strategy in Greenland (CSG) implemented in 2008; (2) to describe the principles of CSG; (3) to report ...caries outcome data for the 3‐and 9‐year‐olds in 1996, in 2008 (baseline), and in 2012; and (4) to assess the effect of CSG on the same age.
Goals and Results
Ad (1) Caries status recorded ≥85% of the children; 3‐year‐olds in 2012:defs = 0 ≥ 80%, defs > 8 ≤ 5%; 9‐year‐olds in 2012: DMFS = 0 ≥ 80%;DMFS > 4 ≤ 5%. CSG should not increase the cost compared to the old programme. Ad (2) CSG focused on predetermined visits/examinations, risk‐related visits, oral health promotion, and predetermined fluoride and sealing policies. Ad (3) 75% and 88% of the total cohorts of 3‐ and 9‐year‐olds in 2012 were recorded, respectively. Seventy‐six percent of the 3‐year‐olds showed defs = 0 in 2012 compared to 64% in 2008 (P < 0.0001). DMFS = 0 data for the 9‐year‐olds were 65% vs 57% (P = 0.003). The cost for running CSG was comparable to the cost before 2008. Ad (4) The annual percentage increase of children with defs/DMFS = 0 after implementation of CSG was twice as high as during 1996–2008.
Conclusion
The caries status improves significantly from 2008 to 2012 exemplified in the 3‐ and 9‐year‐olds without increasing the costs.
Featured Cover Abreu‐Placeres, Ninoska; Newton, Jonathon Tim; Avila, Viviana ...
Community dentistry and oral epidemiology,
April 2023, 2023-04-00, 20230401, Letnik:
51, Številka:
2
Journal Article
Recenzirano
Odprti dostop
The cover image is based on the Original Article How do dental practitioners, educators and students diagnose and manage caries risk and caries lesions? A COM‐B analysis by Ninoska Abreu‐Placeres et ...al., https://doi.org/10.1111/cdoe.12735.
Although visual inspection is the most commonly used method for caries detection, and consequently the most investigated, studies have not been concerned about the clinical relevance of this ...procedure. Therefore, we conducted a systematic review in order to perform a critical evaluation considering the clinical relevance and methodological quality of studies on the accuracy of visual inspection for assessing caries lesions. Two independent reviewers searched several databases through July 2013 to identify papers/articles published in English. Other sources were checked to identify unpublished literature. The eligible studies were those which (1) assessed the accuracy of the visual method for detecting caries lesions on occlusal, approximal or smooth surfaces, in primary or permanent teeth, (2) used a reference standard, and (3) reported data about sample size and accuracy of the methods. Aspects related to clinical relevance and the methodological quality of the studies were evaluated. 96 of the 5,578 articles initially identified met the inclusion criteria. In general, most studies failed in considering some clinically relevant aspects: only 1 included study validated activity status of lesions, no study considered its prognosis, 79 studies did not consider a clinically relevant outcome, and only 1 evaluated a patient-centred outcome. Concerning methodological quality, the majority of the studies presented a high risk of bias in sample selection. In conclusion, studies on the accuracy of the visual method for caries detection should consider clinically relevant outcomes besides accuracy; moreover, they should be conducted with higher methodological quality, mainly regarding sample selection.
Objectives
This study aimed to evaluate the magnitude of the reduction in caries parameters after inclusion of dental caries activity assessment, in an epidemiological survey of preschool children, ...involving cavitated and noncavitated caries lesions.
Methods
The survey was carried out in Santa Maria, Brazil, during the National Children's Vaccination Day, and 639 children aged between 12 months and 59 months were included. Fifteen examiners assessed the children based on the International Caries Detection and Assessment System (ICDAS) and additional lesion activity assessment criteria. The mean of decayed surfaces (d‐s), the mean of decayed teeth (d‐t), caries prevalence, and 95% confidence intervals were calculated, initially by classifying all lesions using the various thresholds defined by the ICDAS. Caries activity status was then evaluated, and inactive lesions were classified as sound in a secondary analysis; subsequently, the same caries parameters, at the same thresholds, were recalculated. The reduction in caries parameters and the number of children requiring assessment to change their classification from decayed to sound (number needed to be assessed) were also calculated.
Results
The majority of lesions were classified as active, mainly at cavitated thresholds. When activity was considered, values of all caries parameters decreased. This decrease was more evident at noncavitated thresholds. The number of children requiring assessment to change their classification from decayed to sound was <20 considering all lesions, but this value increased to approximately 100 when we included only cavitated lesions.
Conclusions
The inclusion of activity assessment in caries epidemiological surveys has little impact on the d‐s, d‐t and prevalence of dental caries considering both noncavitated and cavitated lesions.
Aim
To investigate the risk of sound surfaces, and initial and moderate caries lesions to progress to dentine cavitation in preschool children.
Design
A cohort study was designed with 639 children ...(12–59 months old) who had been examined by visual inspection during a survey in 2010. After 2 years, 469 children were re‐examined regarding the presence of dentine cavitations. The probability of progression was calculated for sound and carious (initial and moderate lesions) surfaces. Relative risk of progression and 95% confidence intervals for each condition compared with sound surfaces were calculated using multilevel Poisson regression analysis. Association with explanatory variables, including caries experience of the children, was also investigated.
Results
The higher the initial score attributed to the dental surface, the more likely was the progression. Moreover, children with severe lesions at baseline had higher risk of having a sound surface or a non‐cavitated caries lesion progressing to cavitation when compared with caries‐free children; however, this increased risk was not observed in children with only initial caries lesions.
Conclusions
Initial caries lesions present a low frequency of progression. Moreover, sound surfaces and initial caries lesions in children already presenting cavitations are more likely to progress to more severe conditions.
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