The results underline the importance of applying effective treatment methods for dentally anxious patients, not only with the purpose to alleviate their dental anxiety and to improve their oral health, but also because it contributes to an enhancement of their QoL.

SummaryBackgroundAwake bruxism and sleep bruxism are common conditions amongst adult populations, although prevalence data are scarce.ObjectiveThis study aimed to assess the prevalence of awake bruxism and sleep bruxism in the Dutch adult population.MethodsAs part of a large epidemiologic survey on oral health of the general Dutch adult population, a total of 1209 subjects were asked about their bruxism behaviour during the day and during their sleep. The collected data were subjected to stratified analysis by five age groups (25‐34, 35‐44, 45‐54, 55‐64 and 65‐74 years), socioeconomic status, and gender.ResultsA prevalence of 5.0% of the total population was found for awake bruxism and of 16.5% for sleep bruxism. Regarding the five age groups, prevalence of 6.5%, 7.8%, 4.0%, 3.2% and 3.0%, respectively, were found for awake bruxism, and of 20.0%, 21.0%, 16.5%, 14.5% and 8.3%, respectively, for sleep bruxism. Women reported both awake bruxism and sleep bruxism more often than men. These differences were statistically significant. Concerning socioeconomic status (SES), both awake bruxism and sleep bruxism were more often found in high SES groups, being statistically significant for awake bruxism only.ConclusionSleep bruxism is a common condition in the Dutch adult population, while awake bruxism is rarer.

This study aimed to assess the prevalence of tooth wear in different age groups of the Dutch adult population and to determine this tooth wear distribution by gender, socioeconomic class, and type of teeth. Results were compared with the outcomes of a previous study in a comparable population. As part of a comprehensive investigation of the oral health of the general Dutch adult population in 2013, tooth wear was assessed among 1,125 subjects in the city of ‘s-Hertogenbosch. The data collected were subjected to stratified analysis by 5 age groups (25-34, 35-44, 45-54, 55-64, and 65-74 years), gender, socioeconomic class, and type of teeth. Tooth wear was assessed using a 5-point ordinal occlusal/incisal grading scale. The number of teeth affected was higher in older age groups. Men showed more tooth wear than women, and subjects with low socioeconomic status (low SES) showed on average higher scores than those with high SES. Tooth wear prevalence found in this study was higher in all age groups than in the previous study. The present study found prevalences of 13% for mild tooth wear and 80% for moderate tooth wear, leading to the conclusion that these are common conditions in the Dutch adult population. Severe tooth wear (prevalence 6%) may however be characterized as rare. A tendency was found for there to be more tooth wear in older age groups, in men as compared with women, in persons with lower SES, and in the present survey as compared with the previous one.

Background Economic evaluations provide policy makers with information to facilitate efficient resource allocation. To date, the quality and scope of economic evaluations in the field of child oral health has not been evaluated. Furthermore, whilst the involvement of children in research has been actively encouraged in recent years, the success of this movement in dental health economics has not yet been explored. This review aimed to determine the quality and scope of published economic evaluations applied to children’s oral health and to consider the extent of children’s involvement. Methods The following databases were searched: CINAHL, Cochrane Library, Econlit, EThOS, MEDLINE, NHS EED, OpenGrey, Scopus, Web of Science. Full economic evaluations, relating to any aspect of child oral health, published after 1997 were included and appraised against the Drummond checklist and the Consolidated Health Economic Evaluation Reporting Standards by a team of four calibrated reviewers. Data were also extracted regarding children’s involvement and the outcome measures used. Results Two thousand seven hundred fifteen studies were identified, of which 46 met the inclusion criteria. The majority ( n = 38, 82%) were cost-effectiveness studies, with most focusing on the prevention or management of dental caries ( n = 42, 91%). One study quantified outcomes in Quality Adjusted Life Years (QALYs), and one study utilised a child-reported outcome measure. The mean percentage of applicable Drummond checklist criteria met by the studies in this review was 48% (median = 50%, range = 0–100%) with key methodological weaknesses noted in relation to discounting of costs and outcomes. The mean percentage of applicable CHEERS criteria met by each study was 77% (median = 83%, range = 33–100%), with limited reporting of conflicts of interest. Children’s engagement was largely overlooked. Conclusions There is a paucity of high-quality economic evaluations in the field of child oral health. This deficiency could be addressed through the endorsement of standardised economic evaluation guidelines by dental journals. The development of a child-centred utility measure for use in paediatric oral health would enable researchers to quantify outcomes in terms of quality adjusted life years (QALYs) whilst promoting child-centred research.

This article presents the development of the Dutch value set for the Child Health Utility 9D, a pediatric preference-based measure of quality of life that can be used to generate qualityadjusted life-years. Methods: A large online survey was conducted using a discrete choice experiment including a duration attribute with adult members of the Netherlands general population (N ¼ 1276) who were representative in terms of age, gender, marital status, employment, education, and region. Respondents were asked which of two health states they prefer, where each health state was described using the nine dimensions of the Child Health Utility 9D (worried, sad, pain, tired, annoyed, school work/homework, sleep, daily routine, able to join in activities) and duration. The data were modeled using conditional logit with robust standard errors to produce utility values for every health state described by the Child Health Utility 9D. Results: The majority of the dimension level coefficients were monotonic, leading to a decrease in utility as severity increases. There was, however, evidence of some logical inconsistencies, particularly for the school work/homework dimension. The value set produced was based on the ordered model and ranges from-0.568 for the worst state to 1 for the best state. Conclusion: The valuation of the Child Health Utility 9D using online discrete choice experiment with duration with adult members of the Dutch general population was feasible and produced a valid model for use in cost utility analysis. Normative questions are raised around the valuation of pediatric preference-based measures, including the appropriate perspective for imagining hypothetical pediatric health states.

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A parallel-randomized controlled trial on caries-preventive strategies was conducted in a general dental practice with a mixed socioeconomic background patient population. The aim of this study was to test the hypothesis that, compared to regular care consisting of check-ups twice a year with professional fluoride applications and pit and fissure sealants in all permanent molars, a larger caries-preventive effect can be achieved by following a non-operative caries treatment and prevention (NOCTP) strategy or by following, in addition to regular care, an increased number of professional topical fluoride applications (IPFA). A total of 230 children (6.0 years ± 3 months of age) were randomly assigned to the two experimental groups or the control group. After 3 years, 179 participants remained in the study (54 NOCTP, 62 IPFA and 63 control). The children were examined at baseline and at 3 years by the same experienced examiner, who was blinded for the allocation of the children. Caries was scored clinically at the D₃ level. Per protocol analysis revealed a mean DMFS increment after 3 years of 0.15 (95% CI -0.05 to 0.35) for NOCTP, 0.34 (95% CI 0.11 to 0.54) for IPFA and 0.47 (95% CI 0.26 to 0.68) for the control group. To account for missing data, multiple imputation was used, after which the mean DMFS increment was 0.11 (95% CI -0.05 to 0.27) for NOCTP, 0.29 (95% CI 0.11 to 0.46) for IPFA and 0.40 (95% CI 0.21 to 0.55) for the control group. Testing the differences with independent samples t test revealed a lower caries increment in the NOCTP group compared to the control group. ANCOVA was used to correct for differences in baseline dmfs, socioeconomic status and perceived dental hygiene burden. The ΔDMFS effect size between the NOCTP and the control group dropped, losing statistical significance (p = 0.06). Although the results in this study are promising, it has yet to be established in a larger study whether NOCTP has the ability to be effective in regular dental practice with a mixed socioeconomic status population.

Objectives This study aimed to assess the prevalence of awake bruxism and sleep bruxism in the Dutch adolescent population. Materials and Methods As part of a large epidemiologic survey on oral health of the general Dutch adolescent population in 2017, a total of 920 subjects were asked about their bruxism behaviour during daytime and during sleep. The collected data were subjected to stratified analysis by two age groups (for 17 and 23 years, respectively), gender and socio‐economic status. Results A prevalence of 4.1% and 4.2% was found for awake bruxism and of 7.6% and 13.2% for sleep bruxism. Women reported awake bruxism more often than men in the 17‐year‐old age group (5.0% and 3.2%, respectively), while in the 23‐year‐old age group it was the other way around (4.0% and 4.4%, respectively). Regarding sleep bruxism, women reported higher percentages than men in both age groups (7.8% versus 7.5% and 14.9% versus 11.5%, respectively). Concerning socio‐economic status (SES), awake bruxism was more often found in high SES groups (4.6% versus 3.7% and 4.9% versus 4.0% in both age groups, respectively) as well as for sleep bruxism in the 23‐year‐old group (16.5% versus 8.6%). In the 17‐year‐old group, sleep bruxism was more often reported in the low SES group (9.7% versus 5.3%). Conclusions Sleep bruxism is a common condition in the Dutch adolescent population, while awake bruxism is rarer. Clinical relevance Dental caregivers can use this information when negative healthcare outcomes are present amongst adolescents.