Caries risk assessment : state of the art and longitudinal study on risk predictors in schoolchildren / Avaliação de risco de carie dentaria : estado da arte e estudo longitudinal sobre preditores de risco em escolares

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Caries risk assessment is an important tool for dentistry, because it may help planning health actions based on scientific evidences. This thesis, composed of two studies, aimed to a) present an overview of caries risk assessment (Chapter 1); and b) determine which clinical, behavioral, socioeconomic and demographic variables could identify children with higher probability of developing caries increment in a seven-year longitudinal study (Chapter 2). In the first study, a search of the published English language literature from 1997 to 2007 was made for articles that reported on caries risk assessment in the MEDLINE database. The studies were conducted mainly in schoolchildren (n=19), followed by preschool children (n=11), adolescents (n=8), and infants (n=5). Variables such as caries experience, gingival status, microbiological counts, oral hygiene, plaque mineral concentration, fluoride history, socioeconomic and educationallevel, demographic, anthropometrical, oral, dietary and toothbrushing habits were studied. Past caries experience has been the predominant predictor of caries risk in 0-18-years old subjects. Other predictors such as dietary habits, including sugar intake, and toothbrushing habits may also help to identify high-risk individuals. Variables related to caries experience continue to be the main predictor of caries incremento In the second study, two hundred and six children from three schools in Piracicaba, Brazil, were examined at baseline and after 7 years by the same calibrated dentists in an outdoor setting, under natural light, using a dental mirror and probe following the World Health Organization recommendations for oral health surveys. The examiners collected data on the following clinical variables: dental caries, fluorosis, oral hygiene and presence of sealant. Moreover, information on socioeconomic level, fluoride usage, dental service utilization, dietary and oral hygiene habits was also obtained at baseline by means of a semi-structured questionnaire sent to the parents. In order to evaluate the association between the decayed, filling and missed surfaces (DMFS) increment and independent variables, a univariate analysis was performed using the Chi-square or Fisher exact tests. The multivariate logistic regression was used to estimate the adjusted Odds Ratio (OR), their 95% confidence intervals (C I) and significance levels. The prediction model demonstrated that the schoolchildren with caries experience in permanent (OR=2.49; CI=1.02-6.04; p=0.04) or primary teeth (OR=2.29; CI=1.24-4.23; p=0.001), as well as those whose mothers educational level was up to eight years of schooling (OR=1.88; CI=1.03-3.45; p=0.03) were more prone to have DMFS increment. The results of this thesis demonstrated that the educational leveI of mothers could identify the schoolchildren at risk of developing the disease and that variables related to past caries experience continue to be the main risk predictor

ASSUNTO(S)

epidemiology logistic models epidemiologia dental caries prediction (logic) predição (logica) modelos logisticos

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