BackgroundAssessing caries risk is an essential element in the planning of preventive and therapeutic strategies. Different caries risk assessment (CRA) models have been proposed for the identification of individuals running a risk of future caries. This systematic review was designed to evaluate whether standardized caries risk assessment (CRA) models are able to evaluate the risk according to the actual caries status and/or the future caries increment.MethodsRandomized clinical trials, cross-sectional studies, cohort studies, comparative studies, validation studies and evaluation studies, reporting caries risk assessment using standardized models (Cariogram, CAMBRA, PreViser, NUS-CRA and CAT) in patients of any age related to caries data recorded by DMFT/S or ICDAS indices, were included. PubMed, Scopus and Embase were searched from 2000 to 2016. A search string was developed. All the papers meeting the inclusion criteria were subjected to a quality assessment.Results One thousand three-undred ninety-two papers were identified and 32 were included. In all but one, the Cariogram was used both as sole model or in conjunction with other models. All the papers on children (n = 16) and adults (n = 12) found a statistically significant association between the risk levels and the actual caries status and/or the future caries increment. Nineteen papers, all using the Cariogram except one, were classified as being of good quality. Three of four papers comprising children and adults found a positive association. For seven of the included papers, Cariogram sensibility and specificity were calculated; sensibility ranged from low (41.0) to fairly low (75.0), while specificity was higher, ranging from 65.8 to 88.0. Wide 95% confidence intervals for both parameters were found, indicating that the reliability of the model differed in different caries risk levels.ConclusionsThe scientific evidence relating to standardized CRA models is still limited; even if Cariogram was tested in children and adults in few studies of good quality, no sufficient evidence is available to affirm the method is effective in caries assessment and prediction. New options of diagnosis, prognosis and therapy are now available to dentists but the validity of standardized CRA models still remains limited.Electronic supplementary materialThe online version of this article (10.1186/s12903-018-0585-4) contains supplementary material, which is available to authorized users.
Objectives A multicentre survey was designed to evaluate the impact of COVID-19 outbreak on dental practice worldwide, estimate the COVID-19 related symptoms/signs, work attitudes and behaviour and the routine use of protective measures and personal protective equipment (PPE). Methods A global survey using a standardized questionnaire with research groups from 36 countries was designed. The questionnaire was developed and pretested during April 2020 and contained three domains: 1) personal data; 2) COVID-19 positive rate and symptoms/signs presumably related to the coronavirus; 3) working conditions and PPE adopted after the outbreak. Countries’ data were grouped by the country positive rate (CPR) during the survey period and by Gross-National-Income per capita. An ordinal multinomial logistic regression model was carried out with COVID-19 self-reported rate referred by dental professionals as dependent variable to assess the association with questionnaire items. Results A total of 52,491 questionnaires were returned with a male/female ratio of 0.63. Out of the total respondents, 7,859 dental professionals (15%) reported symptoms/signs compatible with COVID-19. More than half of the sample (n=27,818; 53%) stated to use FFP2/N95 masks, while 21,558 (41.07%) used eye protection. In the bivariate analysis, CPR and N95/FFP2 were significantly associated (OR=1.80 95% CI=1.60/2.82 and OR=5.20 95% CI=1.44/18.80, respectively), while Gross-National-Income was not statistically associated with CPR (OR=1.09 95% CI=0.97/1.60). The same significant associations were observed in the multivariate analysis . Conclusions Oral health service provision has not been significantly affected by COVID-19, although access to routine dental care was reduced due to country-specific temporary lockdown periods. While the dental profession has been identified at high-risk, the reported rates of COVID-19 for dental professionals were not significantly different to those reported for the general population in each country. These findings may help to better plan oral health care for future pandemic events.
Objective This online cross-sectional survey assesses the signs/symptoms, the protective measures taken and the awareness and risk perception regarding COVID-19 among Italian dental hygienists. All Italian dental hygienists were invited to participate. The ad hoc online questionnaire was divided into four domains: personal data, protective measures (−before patient arrival; −in the waiting room; −in the operating room) and PPE, awareness and risk perception. Results Two-thousand-seven-hundred-ninety-eight subjects participated. Only 0.25% of the sample was positive to the virus. Sense of fatigue (8.19%), headache (7.81%) and sore throat (7.32%) were the most common symptoms. A statistically significant trend across the areas with a different prevalence of COVID-19 was observed related to the number of signs/symptoms (areas z = 6.38 p < 0.01). Overall, 90.55% of the sample used protective glasses or visor, 90.10% disposable gloves and 82.80% surgical mask. Regarding the confidence to avoid the infection, a statistically significant difference was found among dental hygienists belonging to the 3 years-professional-experiences groups who worked in the high COVID-19 prevalence area. The findings of this survey show that Italian dental hygienists have modified their working habits according to the professional risk related to the current pandemic and they seem correctly prepared to face the risk of a SARS-CoV-2 infection.
Background: This online cross-sectional survey assesses the signs/symptoms, the protective measures taken and the awareness and risk perception regarding COVID-19 among Italian dental hygienists. All Italian dental hygienists were invited to participate. The ad hoc online questionnaire was divided into four domains: personal data, protective measures (-before patient arrival; -in the waiting room; -in the operating room) and PPE, awareness and risk perception. Results: Two-thousand-seven-hundred-ninety-eight subjects participated. Only 0.25% of the sample was positive to the virus. Sense of fatigue (8.19%), headache (7.81%) and sore throat (7.32%) were the most common symptoms. A statistically significant trend across the areas with a different prevalence of COVID-19 was observed related to the number of signs/symptoms (areas z=6.38 p<0.01). Overall, 90.55% of the sample used protective glasses or visor, 90.10% disposable gloves and 82.80% surgical mask. Regarding the confidence to avoid the infection, a statistically significant difference was found among dental hygienists belonging to the three years-professional-experiences groups who worked in the high COVID-19 prevalence area. The findings of this survey show that Italian dental hygienists have modified their working habits according to the professional risk related to the current pandemic and they seem correctly prepared to face the risk of a SARS-CoV-2 infection.
The aim was to compare two strategies for caries prevention in children with Autism Spectrum Disorders (ASDs). Participants were retrospectively retrieved and divided in two groups. Group one had first permanent molars treated with fluoride varnishes, FA group (n = 92, 9.43 ± 2.44 years) whilst the second, with dental sealant plus fluoride varnishes, FA + S group (n = 140, 7.77 ± 2.57 years). Logistic and multivariate analysis were run to evaluate the caries incidence, the retention rate of sealants, and background factors associated with caries risk over a period of at least 11 years. Survival rates from dental caries were statistically significantly higher in the FA + S group compared to the FA group (LogRank test p < 0.01). Dental sealant plus fluoride varnish played as a protective factor towards the development of caries (HR = 0.25 95%CI = 0.00/0.55 and HR = 0.34 95%CI = 0.00/0.66 in the upper right and left first molars; HR = 0.32 95%CI = 0.00/0.66 and HR = 0.26 95%CI = 0.00/0.58 in the lower right and left first molars). Dental sealants retention rate was high, ranging between 58.02% and 64.29%. No baseline variable was statistically significantly associated to the risk of caries development. Combined dental sealant and fluoride varnish application was more effective in reducing caries risk in first permanent molars of ASDs children than fluoride varnish alone. This preventive strategy should be therefore routinely applied in high caries risk patients as ASDs children.
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