Research Articles (Community Dentistry)

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Dental anxiety and empathy among undergraduate oral health students in Norway, South Africa and Namibia
(Medical Journals Sweden, 2025-04) Kimmie-Dhansay, Faheema; Hoyvik, Ann Catrin; Bhayat, Ahmed; Hussain, Faezah; Karunakaran, Arannikah; Kaya, Besime; Motloba, Pagollang; Malau, Cathrine; Rutabanzibwa, John; Singh, Shenuka; Wilson, Vivienne; Brusevold, Ingvild Johnsen
PURPOSE/OBJECTIVES : Dental anxiety is a common type of fear that can complicate dental treatment. The dental practitioner is crucial in both treating dental fear and anxiety as well as prevent it from arising. The ability to feel empathy is important in that matter. The dental practitioner’s own level of dental anxiety can possibly affect his or her ability to treat patients in an empathetic manner. The aim of this study was to assess and examine the relationship between level of empathy and dental anxiety in undergraduate oral healthcare students from Namibia, South Africa and Norway. MATERIAL AND METHODS : A cross-sectional study was performed. Questionnaires were distributed, and responses were analyzed anonymously. Dental anxiety was assessed using Modified Dental Anxiety Scale (MDAS), and empathy level was assessed using Toronto Empathy Questionnaire (TEQ). Data were presented as means or medians and analyzed using a linear regression model in STATA with a 5% level of significance. RESULTS : The response rate was 16.0%, and 298 completed questionnaires were received. MDAS was low in all groups (medians 7–10), however, significantly lower in Norway compared to Namibia and South Africa. The mean TEQ score was 46.8 in Namibia, 47.5 in South Africa and 50.4 in Norway, all above average empathy levels but significantly higher in Norway than in Namibia and South Africa. CONCLUSIONS : Oral healthcare students in Africa and Norway showed high empathy and low dental anxiety, which is reassuring for future oral health care professionals.
Letter to the editor : “Oral health research in the WHO African region : a scoping review”
(Sage, 2025) Foláyan, M.O.; Bhayat, Ahmed; El Tantawi, M.
We commend the authors of “Oral Health Research in the WHO African Region: A Scoping Review” for addressing oral health research in Africa (Labarca et al. 2024). However, we express concern about 2 aspects. First, of the 28 authors, only 2 are affiliated with institutions in Africa. The poor representation of African researchers on this study raises concerns about equitable researcher representation in a study about Africa. Including more African scholars could have ensured that findings more accurately reflected African perspectives about the health care systems and challenges faced. The poor representation of African scholars may reflect the external “foreign gaze” in global health narratives (Abimbola 2019).
The oral health status and anthropometric measurements of children at early childhood development centers in an informal settlement in Pretoria, South Africa
(Jaypee Brothers Medical Publishers, 2024) Bhayat, Ahmed; Madiba, Thomas Khomotjo; Beeforth, Marion; Nkambule, Ntombizodwa Rosemary; ahmed.bhayat@up.ac.za
OBJECTIVES : Early childhood caries (ECC) continue to increase, especially among low socioeconomic communities. This study was conducted in an informal settlement comprising mostly foreigners who have settled in the area. Given the limited dental and medical services available to these communities, this study aimed to determine the dental and medical disease profile of these inhabitants. The objective was to determine the oral health status and the body mass index (BMI) of children attending crèches in an informal settlement. MATERIALS AND METHODS : Oral health data, including dental caries (DC), soft tissue lesions, fluorosis, erosion, and trauma, were recorded using the World Health Organization (WHO) recommended methods. The examiners were calibrated, and all examinations took place at the crèches under natural sunlight. The BMI was calculated by a team of dieticians who were blinded to the oral health status. The height and weight were measured by calibrated examiners under standardized conditions. RESULTS : There were a total of 169 participants; the mean age was 4.02 years (±1.13; 1–7) and there was an equal distribution of males and females (49.7% females and 49.3% males). The prevalence of DC was 39.1%, with 19% having 4 or more carious teeth. The mean decayed, missing, and filled teeth (dmft) and plaque scores [Simplified Oral Hygiene Index (OHI-S)] were 1.58 (±2.70) and 0.65 (±0.43), respectively, and the mean dmft score increased with increasing age. The mean d component contributed 99% of the total mean dmft score (1.56). The mean BMI was 15.44, and this decreased significantly (p = 0.009) while the OHI increased significantly (p < 0.001) as the number of carious teeth increased. CONCLUSION : The prevalence of caries was relatively high, and those with caries had multiple decayed teeth. The d component contributed almost 100% to the mean score, indicating a lack of access to dental care. The mean BMI score was inversely proportional to the number of carious teeth, which could imply that those with caries had difficulty eating.
A bibliometric analysis of African dental research and the sustainable development goals, 2016–2023
(Frontiers Media, 2024-11) El Tantawi, Maha; Bhayat, Ahmed; Folayan, Morenike O
BACKGROUND: The successful implementation of the 2030 sustainable development Agenda in Africa requires active participation from all sectors, including the dental research sector. The aim of this study was to review dental research published by authors affiliated with institutions in African countries from 2016 to 2023, to map papers related to the sustainable development goals (SDGs), and to identify areas of emphasis and gaps in SDGs-related papers on oral health in Africa. METHODS: We conducted a bibliometric analysis of dental literature in Africa (2016–2023) using Scival for performance analysis and VOSviewer for science mapping. The papers addressing and not addressing the SDGs were compared regarding impact, authorship metrics and key phrases. We identified the topic clusters with the greatest number of papers. The key phrase co-occurrence networks and the authors and countries collaboration networks were mapped. RESULTS: There were 4,173 papers and 622 (14.9%) addressed the SDGs, especially SDG3. SDGs papers had greater impact and were more likely to be published in open access journals than non-SDGs papers. Egypt, Nigeria and South Africa had the greatest number of papers and citations. Four of the top ten authors were females. Most of the top ten journals were open access and only three were in quartile 1 (Q1) journals. Springer and Elsevier were the top publishers. The top research clusters addressed rehabilitative care including implants, endodontics, ceramics and zirconia. SDGs papers, however, addressed oral hygiene in caries prevention and to control systemic diseases. Collaboration networks were affected by geographic location and languages. Dental research in Africa is concentrated in three countries and mainly addresses rehabilitative care. SDGs papers had an impact above the global average and addressed prevention and non-communicable diseases. CONCLUSIONS: There is minimal yet increasing contribution of African countries to the evidence on oral health and the SDGs. The focus is on a limited number of SDGs, and publications are from very few countries in Africa. There is a need to focus oral health-related SDGs research on addressing local problems.
An evaluation of knowledge and perception of pharmacology in undergraduate oral hygiene students and recent graduates at a single higher institution in Pretoria
(Wiley, 2024-11) Balmith, Marissa; Cordier, Werner; Bhayat, Ahmed; Basson, Charlize; Morule, Mpho; Schellack, Natalie; marissa.balmith@up.ac.za
INTRODUCTION : Pharmacology is an increasingly important area of study for oral hygienists, as it provides the scientific basis for safe and effective oral healthcare. However, a lack of fundamental understanding of the discipline among clinical graduates can present significant challenges. Oral hygienists require pharmacological training to meet the requirements of their scope of practice. Pharmacology knowledge assists with the diagnosis and treatment of oral conditions and forms the foundation for further clinical competency development. The knowledge and perceptions of pharmacology for pharmacy, nursing and medical students have been well documented; however, little information is present for Bachelor of Oral Hygiene (BOH) students. This paper sets out to evaluate BOH students' and recent graduates' knowledge and perceptions of pharmacology at a single higher institution in Pretoria to identify possible gaps and weaknesses. METHODS : A cross-sectional study design was used to collect data using an online questionnaire. The English-language questionnaire consisted of the self-reported perceptions and knowledge and actual knowledge of pharmacology of undergraduate BOH students and recent graduates. The questionnaire consisted of multiple choice questions, true or false questions and Likert scale questions. Ethics was obtained from the institution's Research Ethics Committee (REC 350/2021). RESULTS : Overall, the participants perceived the pharmacology module positively and understood its importance. Concerns were raised about insufficient time for studying and that assessments were more aligned to gaining factual knowledge than the development of problem-solving skills. Students rated their knowledge between 57.24% and 69.44%, with BOH III students and graduates having a statistically significant greater self-rated knowledge of antivirals, antifungals and common agents used to treat oral conditions in comparison with BOH I and BOH II students. Overall, BOH students and graduates' actual knowledge was between 45.24% and 66.84%. Although not statistically significant, the total self-rated knowledge of BOH III students and recent graduates tended to be higher than their actual knowledge. Knowledge deficits were evident with some pharmacological concepts across the various BOH groups, such as pharmacokinetics, pain, drugs altering dental treatment I: central nervous system drugs, drugs altering dental treatment II: respiratory and endocrine drugs, drugs altering dental treatment III: cardiovascular drugs, drug–drug interactions and common agents used to treat oral conditions. CONCLUSION : Self-rated knowledge deficiencies were noted by students and recent graduates for certain pharmacological concepts and were supported by the measurement of their actual knowledge. Further investigation into knowledge deficiencies is needed to guide curriculum review to further strengthen oral hygienists' pharmacological competencies and ensure alignment to their scope of practice.
Substance use among school-going adolescents and young adults in rural Mpumalanga province, South Africa
(MDPI, 2024-07) Mmethi, Tabeho Godfrey; Modjadji, Perpetua; Mathibe, Mmampedi; Thovhogi, Ntevhe; Sekgala, Machoene Derrick; Madiba, Thomas Khomotjo; Ayo-Yusuf, Olalekan Abdulwahab
The ongoing public health crisis of substance use among school adolescents and young adults (AYAs) in South Africa is not new in research parlance, amidst the national policy of drug abuse management in schools. In view of no tangible progress to reduce substance use in high schools in the country, we conducted a cross-sectional quantitative study aimed at investigating substance use among adolescents and young adults in the four public high schools selected through multistage sampling in rural Mpumalanga province, South Africa. Data on substance use, demographics, household socio-demographics, and related factors were collected via a validated self-administered questionnaire. Hierarchical logistic regression was performed using STATA 18. The study included 402 AYAs aged between 14 and 23 years (18 ± 1 years), and 45% reported substance use in the last twelve months. Alcohol was the most used substance (74%), followed by cigarettes (12%) and cannabis (11%). AYAs used substances out of social influence, curiosity, to find joy, and to eliminate stress, especially in social events, on the streets, and at home, and reported negative physical health outcomes, mainly hallucinations, sleeping disorders, body weakness, and dry mouths. Hierarchical logistic regression showed that the likelihood of substance use was three times in a particular high school (S4) (AOR = 3.93, 95%CI: 1.72–8.99), twice among the grade 12s (AOR = 2.73, 95%CI: 1.46–5.11), over twenty times in the communities with substance availability (AOR = 22.45, 95%CI: 2.75–183.56), almost ten times among AYAs participating in recreational/sports activities (AOR = 9.74, 95%CI: 4.21–22.52), and twice likely to happen in larger households (AOR = 2.96, 95%CI: 1.57–5.58). Prevention and intervention efforts should consider these specific health concerns to develop targeted strategies for mitigating substance use and its adverse consequences in this vulnerable population towards achieving the United Nations’ Sustainable Development Goal Target 3.5, which aims to strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and the harmful use of alcohol.
Early childhood caries, climate change and the sustainable development goal 13 : a scoping review
(BMC, 2024-05) Foláyan, Morẹ́nikẹ́ Oluwátóyìn; Schroth, Robert J.; Abodunrin, Olunike; Al-Batayneh, Ola B.; Arheiam, Arheiam; Mfolo, Tshepiso; Virtanen, Jorma I.; Duangthip, Duangporn; Feldens, Carlos Alberto; El Tantawi, Maha
BACKGROUND: Sustainable development goal 13 centres on calls for urgent action to combat climate change and its impacts. The aim of this scoping review was to map the published literature for existing evidence on the association between the Sustainable Development Goal (SDG) 13 and early childhood caries (ECC). METHODS: The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In August 2023, a search was conducted in PubMed, Web of Science, and Scopus using search terms related to SDG13 and ECC. Only English language publications were extracted. There was no restriction on the type of publications included in the study. A summary of studies that met the inclusion criteria was conducted highlighting the countries where the studies were conducted, the study designs employed, the journals (dental/non-dental) in which the studies were published, and the findings. In addition, the SDG13 indicators to which the study findings were linked was reported. RESULTS: The initial search yielded 113 potential publications. After removing 57 duplicated papers, 56 publications underwent title and abstract screening, and two studies went through full paper review. Four additional papers were identified from websites and searching the references of the included studies. Two of the six retrieved articles were from India, and one was China, Japan, the United States, and the United Kingdom respectively. One paper was based on an intervention simulation study, two reported findings from archeologic populations and three papers that were commentaries/opinions. In addition, four studies were linked to SDG 13.1 and they suggested an increased risk for caries with climate change. Two studies were linked to SDG 13.2 and they suggested that the practice of pediatric dentistry contributes negatively to environmental degradation. One study provided evidence on caries prevention management strategies in children that can reduce environmental degradation. CONCLUSION: The evidence on the links between SDG13 and ECC suggests that climate change may increase the risk for caries, and the management of ECC may increase environmental degradation. However, there are caries prevention strategies that can reduce the negative impact of ECC management on the environment. Context specific and inter-disciplinary research is needed to generate evidence for mitigating the negative bidirectional relationships between SDG13 and ECC.
Knowledge and practices of South African oral
(AOSIS, 2024-08) Chothia, Zara; Nkambule, Ntombizodwa Rosemary; Bhayat, Ahmed; Morule, Mpho; ahmed.bhayat@up.ac.za
BACKGROUND : Severe Acute Respiratory Syndrome Coronavirus 2 is a recently discovered virus responsible for causing coronavirus disease 19 (COVID-19). No study has been carried out on South African oral healthcare workers (OHCWs) regarding their knowledge and practices with regard to COVID-19 and its vaccine. AIM : This study aimed to determine the knowledge, attitudes and practices of South African OHCWs regarding COVID-19 and its vaccine. METHOD : This was a cross-sectional study, which utilised an online questionnaire. The link to the questionnaire was sent via email and social media platforms. There was a total of 8056 OHCWs, and a minimum sample size of 367 was required. All information was confidential and anonymous. RESULTS : A total of 327 OHCWs participated with a mean age of 43 years (±12.23) and the majority (60%) being general dentists. Less than half (42%) had obtained additional postgraduate qualifications while 57% were employed in the private and 24% in the academic sectors. Almost two-thirds (60%) obtained a ‘good’ knowledge score. Overall, OHCWs displayed positive attitudes towards COVID-19 and the majority implemented appropriate infection control protocols at their place of work. The majority (87%) reported to be vaccinated and of those who did not vaccinate, 34% cited concerns about possible side effects as a reason for not vaccinating. CONCLUSION : Respondents displayed gaps in their knowledge. There was a positive attitude towards the prevention of COVID-19, and almost all participants reported to have implemented the necessary infection control methods. CONTRIBUTIONS : This study’s contribution to research was to identify gaps in the knowledge and practices of OHCWs with regards to COVID 19 and its vaccine. Once these gaps have been identified, measures will be put in place to address them.
A scoping review of the links between early childhood caries and clean water and sanitation : the sustainable development goal 6
(BMC, 2024-07) Crystal, Yasmi O.; Luo, Yuanyuan L.; Duangthip, Duangporn; Tantawi, Maha El; Benzian, Habib; Schroth, Robert J.; Feldens, Carlos Alberto; Virtanen, Jorma I.; Al‑Batayneh, Ola Barakat; Diaz, Aida C.M.; Vukovic, Ana; Pavlic, Verica; Mfolo, Tshepiso; Daryanavard, Hamideh; Gafar, Balgis O.; Shamala, Anas; Foláyan, Morẹ́nikẹ́ Oluwátóyìn; Early Childhood Caries Advocacy Group
INTRODUCTION: The United Nation’s Sustainable Development Goal (SDG) 6 calls for universal access to clean water, sanitation and hygiene (WASH), which are crucial elements of health and well-being and fundamental for a life in dignity. Early childhood caries (ECC) is a preventable disease affecting health and quality of life of millions of young children worldwide. This scoping review aims to explore the connection between ECC and access to clean water and sanitation. METHODS: This scoping review, registered on the Open Science Framework and following PRISMA-ScR guidelines, conducted a thorough search in databases (PubMed, Web of Science, Embase, Google Scholar, SciELO) and websites (via Google) in November 2023. The search, without date limitations, targeted studies in English and Spanish linking ECC to SDG6. Exclusions were made for studies solely focusing on ECC without a direct connection to clean water and sanitation. Descriptive statistics summarized the retrieved papers. RESULTS: The initial search yielded 303 articles. After removing duplicates, 264 articles remained for title and abstract screening after which 244 were excluded and one report was added through citation searching. The 21 remaining articles underwent full text review. There were no studies on a direct association between access to clean water and sanitation and the prevalence of ECC. There were nine studies that showed indirect associations between ECC and access to clean water and sanitation through the links of: water and sanitation access as a marker for poverty (n=1), water consumption as a feeding practice (n=4), and the effectiveness of water fluoridation (n=4). These were used to develop a conceptual model. CONCLUSIONS: While it is conceivable that a direct link exists between ECC and access to clean water and sanitation, the available body of research only offers evidence of indirect associations. The exploration of potential pathways con‑ necting water access to ECC warrants further investigation in future research.
A scoping review on the associations between early childhood caries and sustainable cities and communities using the sustainable development goal 11 framework
(BMC, 2024-06) Foláyan, Morẹ́nikẹ́ Oluwátóyìn; De Barros Coelho, Elisa Maria Rosa; Feldens, Carlos Alberto; Gaffar, Balgis; Virtanen, Jorma I.; Kemoli, Arthur; Duangthip, Duangporn; Sun, Ivy Guofang; Masumo, Ray M.; Vukovic, Ana; Al-Batayneh, Ola B.; Mfolo, Tshepiso; Schroth, Robert J.; Tantawi, Maha El
BACKGROUND: Early childhood caries (ECC) is a multifactorial disease in which environmental factors could play a role. The purpose of this scoping review was to map the published literature that assessed the association between the Sustainable Development Goal (SDG) 11, which tried to make cities and human settlements safe, inclusive, resilient and sustainable, and ECC. METHODS: This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to housing, urbanization, waste management practices, and ECC. Studies that solely examined ECC prevalence without reference to SDG11 goals were excluded. Of those that met the inclusion criteria, a summary highlighting the countries and regions where the studies were conducted, the study designs employed, and the findings were done. In addition, the studies were also linked to relevant SDG11 targets. RESULTS: Ten studies met the inclusion criteria with none from the African Region. Six studies assessed the association between housing and ECC, with findings suggesting that children whose parents owned a house had lower ECC prevalence and severity. Other house related parameters explored were size, number of rooms, cost and building materials used. The only study on the relationship between the prevalence of ECC and waste management modalities at the household showed no statistically significant association. Five studies identified a relationship between urbanization and ECC (urbanization, size, and remoteness of the residential) with results suggesting that there was no significant link between ECC and urbanization in high-income countries contrary to observations in low and middle-income countries. No study assessed the relationship between living in slums, natural disasters and ECC. We identified links between ECC and SDG11.1 and SDG 11.3. The analysis of the findings suggests a plausible link between ECC and SDG11C (Supporting least developed countries to build resilient buildings). CONCLUSION: There are few studies identifying links between ECC and SDG11, with the findings suggesting the possible differences in the impact of urbanization on ECC by country income-level and home ownership as a protective factor from ECC. Further research is needed to explore measures of sustainable cities and their links with ECC within the context of the SDG11.
Can the sustainable development goal 9 support an untreated early childhood caries elimination agenda?
(BMC, 2024-07) Foláyan, Morẹ́nikẹ́ Oluwátóyìn; Amalia, Rosa; Kemoli, Arthur; Sun, Ivy Guofang; Duangthip, Duangporn; Abodunrin, Olunike; Virtanen, Jorma I.; Masumo, Ray M.; Vukovic, Ana; Al-Batayneh, Ola B.; Mfolo, Tshepiso; Schroth, Robert J.; Tantawi, Maha El
BACKGROUND: Early childhood caries (ECC) is a global public health challenge that requires innovation, infrastructure, and health system influences to bolster initiatives for its management and control. The aim of this scoping review was to investigate the published evidence on the association between ECC and the targets of the Sustainable Development Goal 9 (SDG9) concerned with industry, innovation, and infrastructure development. METHODS: The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. A search was conducted in PubMed, Web of Science, and Scopus between July and August 2023 using a search strategy related to the promotion of resilient infrastructure, sustainable industries, scientific research and innovation, access to the internet and ECC. Only English language publications were included. Studies that solely examined ECC without reference to the SDG9 targets were excluded. RESULTS: The search yielded 933 studies for review. After screening for the eligibility and removing duplicates, 916 unique articles remained for further screening. However, none of the identified studies provided data on the association between resilient infrastructure, sustainable industries, scientific research and innovation, access to the internet and ECC. CONCLUSION :There were no primary studies that assessed the association between ECC and SDG9, even though the plausibility of a potential relationship exists. Future studies are needed to generate evidence on the link between ECC and SDG9 as this link may contribute to the reduction in the proportion of children with untreated ECC.
Scoping review on the association between early childhood caries and responsible resource consumption and production : exploring sustainable development goal 12
(BMC, 2024-01) Foláyan, Morẹ́nikẹ́ Oluwátóyìn; Virtanen, Jorma I.; Gaffar, Balgis; Abodunrin, Olunike; Sun, Ivy Guofang; Duangthip, Duangporn; Kemoli, Arthur; Masumo, Ray M.; Vukovic, Ana; Al-Batayneh, Ola B.; Mfolo, Tshepiso; Schroth, Robert J.; Tantawi, Maha El
BACKGROUND: The Sustainable Development Goal 12 (SDG12) promotes patterns that minimize waste and maximize resource utilization. It is therefore plausible that preventing Early Childhood Caries (ECC) and promoting oral health can contribute to sustainable consumption. In addition, sustainable consumption and production can contribute to the control of ECC. This scoping review aimed to explore the possible evidence on the link between ECC and the SDG12 targets. METHODS: This scoping review identified articles on the link between resource consumption and production and caries according to the PRISMA-ScR guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were systematically searched in August 2023, using specific search terms. Studies written in English, with full text available, addressing dental caries and linked with waste minimization and resource utilization maximisation, with results that could be extrapolated to ECC in children less than 6 years of age) were included. Descriptive statistics were planned to summarize the categories of retrieved papers. RESULTS: The initial search yielded 904 articles, with 863 screened for eligibility after the removal of duplicates. No studies were identified that reported data on an association between responsible consumption and production of resources factors and ECC. CONCLUSION: This scoping review did not identify any articles published in English on evidence of the direct associations between ECC and SDG12 targets. However, there is a plausibility of such a link using minimum intervention dentistry for ECC management as a waste prevention and resource utilisation maximization strategy.
Situational awareness in the context of clinical practice
(MDPI, 2023-12-04) Feller, Shani; Feller, Liviu; Bhayat, Ahmed; Feller, Gal; Khammissa, Razia Abdool Gafaar; Vally, Zunaid Ismail
In the context of clinical practice, situational awareness refers to conscious awareness (knowledge), which is a mental model of a given clinical situation in terms of its elements and the significance of their interrelation. Situational awareness (SA) facilitates clinical reasoning, diagnostic accuracy, and appropriate goal-directed performance, and it enables clinicians to immediately adapt treatment strategies in response to changes in clinical situational actualities and to modify the course of goal-directed activities accordingly. It also helps clinicians prepare future operational plans and procedures based on the projection of situational developments. SA, therefore, is an important prerequisite for safe clinical procedures. The purpose of this narrative review is to highlight certain cognitive and external (environmental) situational factors that influence the development of situational awareness. Understanding the dynamic, adaptive, and complex interactions between these factors may assist clinicians and managers of healthcare systems in developing methods aimed at facilitating the acquisition of accurate clinical situational awareness and, in turn, may bring about a reduction in the incidence of SA, diagnostic, and operational errors.
A scoping review on the association of early childhood caries and maternal gender inequality
(BMC, 2023-07-26) Sun, Ivy Guofang; Duangthip, Duangporn; Kwok, Charis Hiu‑Kei; Chu, Chun Hung; Crystal, Yasmi O.; Schroth, Robert J.; Feldens, Carlos Alberto; Virtanen, Jorma I.; Al‑Batayneh, Ola Barakat; Gaffar, Balgis; Mfolo, Tshepiso; El Tantawi, Maha; Mohebbi, Simin Z.; Daryanavard, Hamideh; Foláyan, Morẹ́nikẹ́ Oluwátóyìn; Early Childhood Caries Advocacy Group (ECCAG)
AIM : The objective of this scoping review is to present current evidence regarding the association between early childhood caries (ECC) and maternal-related gender inequality. METHODS : Two independent reviewers performed a comprehensive literature search using three databases: EMBASE, PubMed, and Web of Science. Literature published in English from 2012 to 2022 was included in the search and was restricted to only primary research by using the following key terms: "dental caries", "tooth decay", "gender", "sex", "preschool", "toddler," and "infant". The included studies were limited to those reporting an association between ECC and maternal aspects related to gender inequality. Titles and abstracts were screened, and irrelevant publications were excluded. The full text of the remaining papers was retrieved and used to perform the review. The critical appraisal of selected studies was guided by the Joanna Briggs Institute (JBI) Critical Appraisal Tools. RESULTS : Among 1,103 studies from the three databases, 425 articles were identified based on publication years between 2012 and 2022. After full-text screening, five articles were included in the qualitative analysis for this review. No published study was found regarding a direct association between ECC and maternal gender inequality at the level of individuals. Five included studies reported on the association between ECC and potential maternalgender- related inequality factors, including the mother’s education level (n = 4), employment status (n = 1), and age (n = 1). Regarding the quality of the included studies, out of five, two studies met all JBI criteria, while three partially met the criteria. CONCLUSIONS : Based on the findings of this scoping review, evidence demonstrating an association between gender inequality and ECC is currently limited.
A scoping review on the links between sustainable development goal 14 and early childhood caries
(BMC, 2023-11) Foláyan, Morẹ́nikẹ́ Oluwátóyìn; Ayouni, Imen; Nguweneza, Arthemon; Al-Batayneh, Ola Barakat; Virtanen, Jorma I.; Gaffar, Balgis; Duangthip, Duangporn; Sun, Ivy Guo Fang; Onyejaka, Nneka Kate; Daryanavard, Hamideh; Mfolo, Tshepiso; Feldens, Carlos A.; Schroth, Robert J.; El Tantawi, Maha
BACKGROUND : The Sustainable Development Goal (SDG) 14 addresses life below the waters, an important source of protein and contributor to global food security and economic development. Our aim was to explore possible evidence on the links between life below water and early childhood caries (ECC). METHODS : This scoping review identified articles on the link between life below water and caries according to the PRISMA-ScR guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were systematically searched in January 2023, using specific search terms. Studies written in English, with full text available, addressing life under water, focusing on dental caries in humans, with results that can be extrapolated to control ECC in children less than 6 years of age were included in the review. Descriptive statistics were used to summarize the retrieved papers and graphical presentation was used for visualization. RESULTS : There were 224 publications retrieved of which 13 studies, published between 1960 and 2022, were included in the analysis. The papers originated from Asia (7/13), North America (3/13), Europe (1/13), and 2/13 had multi-country authorship. Also, four laboratory studies extracted agents from marine products to determine their efficacy in preventing caries formation and preventing/slowing plaque formation; four letters discussed the caries prevention potential of sea salt as a source of fluoride; and two review articles about the positive effects of extracted marine products for caries prevention. Most (11/13) studies addressed target 14.1 concerned with enriching the marine environment with nutrients and minerals; two addressed target 14.4 focused on ensuring fish stocks are within biologically sustainable levels; two addressed target 14.7 aimed at increasing the economic benefits through sustainable use of marine resources such as fisheries; and one focused on target 14.5 aimed at conserving marine areas by increasing protected areas. In addition, one ecological study assessed the association between the ecosystem and ECC. CONCLUSIONS : Currently, there is little known about the impact of protection of marine and coastal ecosystem from pollution and ocean acidification on the risk of ECC. Further evidence on possible associations between life below water and ECC management is needed.
Scoping review on the link between economic growth, decent work, and early childhood caries
(BMC, 2024-01) Foláyan, Morẹ́nikẹ́ Oluwátóyìn; Amalia, Rosa; Kemoli, Arthur; Ayouni, Imen; Nguweneza, Arthemon; Duangthip, Duangporn; Sun, Ivy Guofang; Virtanen, Jorma I.; Masumo, Ray M.; Vukovic, Ana; Al-Batayneh, Ola B.; Gaffar, Balgis; Mfolo, Tshepiso; Schroth, Robert J.; El Tantawi, Maha
BACKGROUND : Early Childhood Caries (ECC) is a prevalent chronic non-communicable disease that affects millions of young children globally, with profound implications for their well-being and oral health. This paper explores the associations between ECC and the targets of the Sustainable Development Goal 8 (SDG 8). METHODS : The scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. In July 2023, a search was conducted in PubMed, Web of Science, and Scopus using tailored search terms related to economic growth, decent work sustained economic growth, higher levels of productivity and technological innovation, entrepreneurship, job creation, and efforts to eradicate forced labor, slavery, and human trafficking and ECC all of which are the targets of the SDG8. Only English language publications, and publications that were analytical in design were included. Studies that solely examined ECC prevalence without reference to SDG8 goals were excluded. RESULTS : The initial search yielded 761 articles. After removing duplicates and ineligible manuscripts, 84 were screened. However, none of the identified studies provided data on the association between decent work, economic growth-related factors, and ECC. CONCLUSIONS : This scoping review found no English publication on the associations between SDG8 and ECC despite the plausibility for this link. This data gap can hinder policymaking and resource allocation for oral health programs. Further research should explore the complex relationship between economic growth, decent work and ECC to provide additional evidence for better policy formulation and ECC control globally.
Frozen sections in head and neck surgery and the impact of intraoperative analysis on final resection margins : an institutional study
(South African Dental Association, 2022-02) Kungoane, Tsholofelo; Robinson, Liam; Madiba, Thomas Khomotjo
BACKGROUND : Frozen section (FS) analysis is an indispensable tool for intraoperative patient management. AIMS : To assess the utilisation of head and neck FS analysis, with a particular focus on the concordance rate between the intraoperative FS margin analysis and the final FFPE results. Additionally, to determine whether FS analysis had any impact on intraoperative patient management. Lastly, to determine the impact of the FS analysis on the final margin status of resection specimens. MATERIALS AND METHODS : Histopathology reports from January 2015 to December 2018 were reviewed at Pretoria Oral and Dental Hospital to analyse all FS requests involving the head and neck region. Captured data was analysed to determine the concordance rate, discordance rate, and FS deferral rates, with correlations performed using the Chi-square test. RESULTS : Eighty-two frozen section cases were reviewed with a total of 312 FS tissue sections performed. The majority (73%) of the FS requests were from the Maxillofacial and Oral Surgery (MFOS) department for the assessment of surgical margins. The FS-FFPE concordance and discordance rates were at 97.5% and 2.4% respectively, with a deferral rate of 1.2%. Additional surgical margins were only received in 16 of the 26 cases with positive margins on intraoperative FS analysis. There was no statistically significant correlation between intraoperative FS positive margin status and advanced pathological T staging. CONCLUSIONS : The concordance rate between intraoperative FS margin analysis and final FFPE results were within an acceptable range. In a significant number of cases, the intraoperative FS margin analysis did not influence further surgical management.
Buccal corridor changes in orthodontically treated extraction and non-extraction Class 1 patients
(South African Dental Association, 2022-06) Choma, Ntwampe M.; Madiba, Thomas Khomotjo; Sethusa, Peter M.S.
BACKGROUND : Patients seek orthodontic treatment mainly to improve their facial aesthetics and obtain an acceptable smile. It is purported that orthodontic extraction treatment may result in narrow buccal corridors which in turn may lead to unaesthetic smile AIM : To determine if the dimensions of the buccal corridors are influenced by extraction or non-extraction treatment in Class 1 patients DESIGN : Retrospective record-based study conducted between 2012 and 2017 at University of Pretoria Orthodontic department MATERIALS AND METHOD : Smile pictures of pre- and post-treatment Class 1 patients treated with or without premolar extractions were matched. Buccal corridors between the two groups were measured by measurement of visible maxillary dentition and oral aperture dimensions. Data analysis included frequencies and correlations using chi-square test, with a significance level set at p<0.05. RESULTS : Seventy-one patient records met the selection criteria with the majority being females (70%). The age range was between 10 and 37 with a mean of 17.5 years. Thirty-five patients were treated with extractions and thirty-six patients with non-extraction treatment. There was a significant difference in the visible maxillary dentition pre and post treatment with extraction patients showing a 6 to 6 and non-extraction showing 5 to 5 dentition post treatment (p<0.05). There were no differences in the ratios of the visible maxillary dentition and oral aperture in both groups pre and post treatment (p> 0.05 CONCLUSION : Orthodontic treatment of Class 1 cases with premolar extraction did not lead to deleterious changes in the buccal corridors.
The search for healthy sugar substitute in aid to lower the incidence of early childhood caries : a comparison of sucrose, xylitol, erythritol and stevia
(South African Dental Association, 2022-09) Moelich, Nadine; Potgieter, Nicoline; Botha, Francien Susanna; Wesley-Smith, James; Van Wyk, Candice; candice.vanwyk@up.ac.za
AIM : A pursuit to And a healthy alternative to sucrose with less cariogenic potential, which can potentially lower the incidence of Early Childhood Caries (ECC), by means of comparison. METHODS : Primary tooth enamel blocks (n=32) were randomly divided into four groups and exposed to 5% concentrations of the respective test groups (sucrose, xylitol, erythritol and stevia). All samples were inoculated with S. mutans standard strain (ATCC 25175) at room temperature. Analysis of Colony Forming Units (CFUs), acidity measurements (pH) and Scanning Electron Microscopy (SEM) observations were done after 6, 12, 18 and 24 h and compared. RESULTS : After 6 h, the marginal mean CFU count indicated equal S. mutans growth in all groups. Stevia showed lower CFU counts compared to other groups at 12, 18 and 24 h. The pH levels for all non-fermentable sugar substitutes (NSS) initially decreased but never below the critical pH=5.5 and stabilized from 12 to 18 h. The pH levels of sucrose dropped and remained below pH=5.5 at all time intervals. The SEM analysis of S. mutans supported the CFU results indicating growth in the presence of sucrose and reduction in the presence of the NSS. CONCLUSIONS : Compared to sucrose, xylitol, erythritol and stevia have less cariogenic potential with reduced growth of S. mutans and subsequent acidity levels. Stevia had the least cariogenic potential of all the NSS tested, followed by erythritol and then xylitol.
Prevalence of dental caries in the permanent dentition amongst 12-year-olds in Africa : a systematic review and meta-analysis
(BMC, 2022-10) Kimmie-Dhansay, F.; Bhayat, Ahmed
BACKGROUND : Dental caries (DC) is highly prevalent condition affecting mostly young children. There has been no systematic review done on the prevalence of DC amongst 12-year-olds in Africa. Although some African countries have reported a decrease in DC prevalence, others have shown an increase and it is essential to measure current trends in order to identify strategies and programmes that could assist in reducing DC in Africa. The aim of this systematic review was to determine the prevalence of DC (condition) amongst the permanent dentition of 12-year-old children (population) in Africa (context). METHODS : A systematic review and meta-analysis was performed. Peer reviewed cross-sectional articles from January 2000 until December 2021 was searched and this included the following databases: Pubmed (Medline); SCOPUS; CINAHL (via EBSCOhost); Academic Search Complete (via EBSCOhost); Dentistry and Oral Sciences Sources (via EBSCOhost); and Science Direct. The search was last updated on the 10th January 2022. Joanna Briggs Institute critical appraisal tools were used to assess risk of bias. Prevalence figures were stratified by Urban/Rural status, country and time using a random-effects model. All studies performed on children 12-year-olds on the African continent were included. The prevalence of DC and the DMFT scores were the primary and secondary outcome measures, respectively. Only articles consisting of 12-year-old children who reside in Africa were included in this study. The systematic review was registered with Prospero CRD42021293666. RESULTS : 18,080 participants were included in this review. A total of thirty studies were included in the review. The pooled effect size of dental caries severity was 1.09 (CI 0.91–1.27) and the overall prevalence was 36% (CI 29.4–41.7%). Eritrea (78%) had the highest prevalence of DC while Zambia had the lowest (11%); Eritrea also had the highest DMFT score (2.5) with Sudan having the lowest score (0.49). Urban cities had the highest DMFT score (1.32, CI 0.97–1.68), compared to rural cities (1.13, CI 0.86–1.4) and there was an increasing trend in DC prevalence over time from 28% (CI 23–34%) in 2000 to 2005 to 57% (CI 43–72%) in studies conducted after 2015. The risk of bias was very low where majority of the studies scored more than 50% in the JBI critical appraisal tool. CONCLUSIONS : There was a wide discrepancy in the DC prevalence and scores across the different countries, settings (rural versus urban) and there was an increase in the prevalence over time. This review was self-funded.

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