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Dental caries activity assessment in oral health epidemiological survey with preschool children

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Author(s):
Chaiana Piovesan
Total Authors: 1
Document type: Doctoral Thesis
Press: São Paulo.
Institution: Universidade de São Paulo (USP). Faculdade de Odontologia (FO/SDO)
Defense date:
Examining board members:
Fausto Medeiros Mendes; Jose Leopoldo Ferreira Antunes; Edgard Michel Crosato; Marta Dutra Machado Oliveira; Antonio Carlos Pereira
Advisor: Fausto Medeiros Mendes; Thiago Machado Ardenghi
Abstract

This study aimed to evaluate the magnitude of the reduction in caries parameters after inclusion of dental caries activity assessment and to investigate the strength of association of socioeconomic and biological factors with dental caries lesions activity status in Brazilian preschool children. The survey was carried out in Santa Maria, Brazil, during the National Childrens Vaccination Day, and 639 children aged from 12 months to 59 months were included. Fifteen examiners assessed the children based on the International Caries Detection and Assessment System (ICDAS) and an additional lesion activity assessment criterion. A structured questionnaire was answered by each childs guardian to collect information about demographic, socioeconomic and biological characteristics.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 the second analysis; subsequently, the same caries parameters, at the same thresholds, were recalculated. The reduction in caries parameters and the number of children needed to be assessed in order to change their classification from decayed to sound were also calculated. Furthermore, multivariate Poisson regression analyses using a hierarchical approach was performed to evaluate the association between several independent variables and seven outcomes including number of non-cavitated caries lesions (active, inactive and total), number of cavitated caries lesions (active, inactive and total) and all lesions. 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 non-cavitated thresholds. The number of children requiring assessment in order to change their classification from decayed to sound was less than 20 considering all lesions, but this value increased to approximately 100 when we included only cavitated lesions. The explanatory variables studied were similarly associated with the different outcomes, independently of the caries lesions activity status. Childs age and presence of bacterial plaque were statistically significant associated with non-cavitated caries lesions outcomes. Some socioeconomic variables were statistically significant associated with number of cavitated caries lesions, independently of their activity status. In conclusion, the inclusion of activity assessment in caries epidemiological surveys has little impact on dental caries parameters considering both non-cavitated and cavitated lesions and caries activity assessment is not advantageous to identify risk groups in a public health context. (AU)

FAPESP's process: 11/18286-2 - Predictive and construct validity of a diagnostic criteria for assessing caries activity: a cohort study
Grantee:Chaiana Piovesan
Support Opportunities: Scholarships in Brazil - Doctorate