No abstract

Oral health of the young has been reported to be associated with the place of residence, due to differences in socio-economic status. The results of studies on the effect of fluoride in drinking water on caries prevalence have been contradictory. The main aim of our study was to investigate the geographical distribution of dental caries prevalence in Finland and analyse possible regional, associated factors. Oral health of 13,564 men born between 1990 and 1992 was screened using a method based on criteria of the World Health Organization for epidemiological studies by 15 calibrated dentists in 20/24 garrisons of the Finnish Defence Forces in 2011. Mean DMFT and DT values in provinces were calculated. Multilevel analysis was applied to the data using generalized linear mixed models and a logit link function. The binary outcome variable was the cariological treatment need (yes/no) and the garrison was treated as random effect. Mean DMFT and DT values varied significantly between provinces in Finland. Increased levels of fluoride in drinking water, Swedish as the main language in the municipality, and living in urban areas were protective factors against cariological treatment need. Dentist density did not affect caries prevalence. The geographical distribution of dental caries further supported estimates of the protective effects of high fluoride levels in drinking water, Swedish as the main language in the municipality, as well as living in urban areas. Effect of fluoride on caries prevalence still exists, and association with the socio-economic status was confirmed.

Oral health of young males has not improved since the previous study among conscripts 15 years ago. Polarization of dental caries still exists. About half of the young male population still has manifested dental caries. Oral health promotion must not be neglected, even in countries with low caries prevalence.

Objectives:To evaluate the impact of untreated dental caries and its consequences on oral health-related quality of life (OHRQoL), school absenteeism and school performance in Nepal.Methods: This is a population-based, national cross-sectional study. This study was conducted among three WHO index age groups (5-6, 12-and 15-year-olds) of schoolchildren from 18/75 randomly selected districts of Nepal. Clinical findings on untreated dental caries lesions (decay in primary and permanent dentition, dt/DT) and its consequences (pufa/PUFA) were recorded, and the participants were graded into four categories based on the severity of untreated dental caries (GUDC). The Nepali version of Child-Oral Impacts on Daily Performances (C-OIDP) was used to assess the information on OHRQoL. Similarly, school-related information (school absenteeism and school performance) was collected from the school registry. Generalized linear mixed models with random effects were used to evaluate the association between dental caries and OHRQoL, school absenteeism and school performance.Results: Among the study sample, the mean (SD) C-OIDP score was 2.4 (5.0). It was observed that the 15-year-olds, those belonging to the Newari ethnic group, and children with high GUDC grades had poor OHRQoL. After adjusting for confounding factors, high dt + DT or pufa + PUFA was associated with higher impact on OHRQoL.Similarly, lower grades of GUDC (Grade 1 and Grade 2) also had less impact on OHRQoL than the most severe Grade 4. High dt + DT or pufa + PUFA were associated with maximum school absenteeism. Furthermore, high C-OIDP and a grade of GUDC ≥2 score were associated with poor school performance.Conclusion: Untreated dental caries and its consequences have a considerable impact on OHRQoL. These conditions may contribute to high school absenteeism and poor school performance. K E Y W O R D Schildren, dental caries, oral health-related quality of life, school absenteeism, school performance

Among Nepalese children, oral diseases are common, and geographical variation is prevalent. The health policy should address the alarming oral health situation and need for urgent treatment and population-based preventive programmes that is evident in Nepal.