World traumatic dental injury prevalence and incidence, a meta-analysis-One billion living people have had traumatic dental injuries

To assess the impact of oral health outcomes on Oral Health-Related Quality of Life (OHRQoL) in a school-based sample of Brazilian preschool children and their families. A cross-sectional study was conducted in 1036 children aged 2-5 years attending all the public nurseries in Canoas, Brazil. Caregivers were asked to complete questionnaire on socioeconomic status and the Early Childhood Oral Health Impact Scale (ECOHIS) on their perception of the children's OHRQoL. Clinical assessment included dental caries, traumatic dental injuries (TDI) and malocclusion. Multivariable Poisson regression models with robust variance were fitted to assess covariates for the prevalence of impacts on OHRQoL following a theoretical hierarchical framework. 17.4% of the caregivers reported that their child had an impact on at least one ECOHIS item. Negative impacts were more prevalent on items related to pain, difficult drinking and eating some foods. The multivariable Poisson regression analysis showed that dental caries, TDI and malocclusion were associated with the outcome. The prevalence of having any impact on OHRQoL was almost three times higher for children with dental caries (PR 2.74 95% CI 2.02-3.72) compared to those who were caries free; and approximately 1.5 times higher for those who presented TDI (PR 1.70 95% CI 1.27-2.27) and malocclusion (PR 1.42 95% CI 1.04-1.94). The findings showed that caregivers of young children with oral disease and disorders perceived that both the children and other family members had poorer quality of life. Oral health policies should be included into general health programs based on common risk approach. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

This study was aimed at estimating the pooled global leukoplakia prevalence using both well-designed studies, which were too few to be representative of the world situation, and less valuable studies. The inverse variance weighting and the random effect methods were used. The latter is based on the principle that if primary studies are heterogeneous, the between-study variance is higher than zero, and its effect must be taken into account in choosing the weighting scheme. The robustness of the estimates was assessed by means of sensitivity analyses. Including 23 primary studies from all over the world published between 1986 and 2002, the point estimates were 1.49% (inverse variance, 95% confidence interval 1.42%-1.56%) and 2.60% (random effect, 95% confidence interval 1.72%-2.74%). The high between-study heterogeneity and the sensitivity analyses suggested that the second estimate was more reliable. Leukoplakia was significantly more prevalent among males (prevalence ratio 3.22), but no difference was found between geographical areas and between younger and older adults. Using these data, the crude annual oral cancer incidence rate attributable to leukoplakia would be between 6.2 and 29.1 per 100000, thus suggesting that the global number of oral cancer cases is probably underreported.

The Decayed, Missing, Filled (DMF) index has been used for over 50 years and is well established as the key measure of caries experience in dental epidemiology. Despite its long history of use, there is debate about the most appropriate number of surfaces to include for a missing tooth. Assigning the maximum possible value for the 'M' component of DMFS (Surfaces) leads to overestimation of an individual's caries experience, and in any associated comparisons of in-caries experience, whereas assigning the minimum possible value for the 'M' component has the opposite effect. Alternative methods of assigning the number of caries-affected surfaces for an extracted tooth are considered. The net caries increment and adjusted caries increment (common methods of correction of the crude increment measure for reversals) are discussed, along with incidence density, a measure of caries extent. Problems exist with the adjusted caries increment, particularly among cohorts with low mean baseline caries experience. Development of an alternative method of estimating the relationship of 'true' and 'examiner' reversals is advocated, as well as greater utilization of incidence density in dental epidemiology.