Objective

The objectives were to assess early childhood caries (ECC) in rural areas of El Salvador and to investigate the changes in caries and mouth pain in the presence of community-based interventions.

Methods

This study was a retrospective analysis of de-identified and anonymous data obtained from baseline and four annual follow-up visits that focused on the preventive oral health intervention and nutrition in a convenience sample of children 0-6 years of age. The decayed, missing and filled teeth (dmft) index for primary teeth was used as the survey tool. Caries was defined as a cavitated lesion. Descriptive statistics were used to describe the prevalence of ECC in the sample in relation to age and dmft score. Linear mixed model analysis of variance (ANOVA) and generalised linear mixed effects models were used to compare the pre-intervention and post-intervention outcomes.

Results

The prevalence of caries was 58%. Incorporation of a community oral health education and fluoride supplementation programme contributed to significant reductions in caries experience (from 74% to 61%) and mouth pain (from 58% to 39%), in children 3-6 years of age.

Conclusions

ECC is a common public health problem in rural El Salvador. In an established community-based maternal-child health programme in El Salvador, there appears to be an association between the incorporation of preventive oral health intervention and improvement in children's oral health and quality of life over time.

Background and objectives

Dental caries is an important healthcare challenge in adults over 65 years of age. Integration of oral health screening into non-dental primary care practice may improve access to preventive dental care for vulnerable populations such as the elderly. Such integration would require easy, fast, and accurate early caries detection tools. Primary goal of this study was to evaluate the diagnostic performance of optical coherence tomography (OCT) imaging for detecting very early caries in the elderly living in community-based settings. The International Caries Detection and Assessment System (ICDAS) served as gold standard. Secondary goal of this study was to provide baseline prevalence data of very early caries lesions in independent living adults aged 65+ years.

Materials and methods

Seventy-two subjects were recruited from three sites in Southern California: a retirement community, a senior health fair, and a convalescent hospital. Clinical examination was performed using the ICDAS visual criteria and this was followed by OCT imaging. The two-dimensional OCT images (B-scan) were analyzed with simple software. Locations with a log of back-scattered light intensity (BSLI) below 2.9 were scored as sound, and areas equaling or exceeding 2.9 BSLI were considered carious. Diagnostic performance of OCT imaging was compared with ICDAS score.

Results

OCT-based diagnosis demonstrated very good sensitivity (95.1%) and good specificity (85.8%). 54.7% of dentate subjects had at least one tooth with very early coronal caries.

Conclusions

Early coronal decay is prevalent in the unrestored pits and fissures of coronal surfaces of teeth in independent living adults aged 65+ years. Though OCT imaging coupled with a simple diagnostic algorithm can accurately detect areas of very early caries in community-based settings, existing devices are expensive and not well-suited for use by non-dental health care providers. Simple, inexpensive, fast, and accurate tools for early caries detection by field health care providers working in non-traditional settings are urgently needed to support inter-professional dental health management.