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      Epidemiology of dental caries in permanent dentition: evidence from a population-based survey in Egypt

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          Abstract

          Background

          In recognition of the risk factors common between oral diseases and various chronic conditions and the intersection between oral health and some sustainable development goals, the current cross-sectional study was designed to quantify the burden of dental caries and identify factors associated with its occurrence in permanent teeth.

          Methods

          Using data from Egypt's population-based survey (2013–2014), two individual-level outcomes; past caries experience (DMFT > 0) and presence of untreated carious lesions (DT > 0) were assessed using the WHO basic methods for oral health surveys. Information on potential explanatory variables including sociodemographic characteristics, exposure to fluoridated water, dental attendance, and dental anxiety was gathered using a structured questionnaire. Stratified multistage cluster random sampling was used to recruit survey participants. Multivariable logistic regression was performed to identify significant potential risk factors for caries in the permanent dentition of Egyptians.

          Findings

          A total of 9,457 participants were included of which 70.3% had at least one untreated carious lesion. After adjusting for all covariates, analphabetic Egyptians were found to have significantly higher odds of caries experience in permanent dentition DMFT > 0 (OR 1.54, 95% CI [1.20–1.98]), DT > 0 (OR 1.62, 95% CI [1.32–2.00]). Males, however, had significantly lower caries risk DMFT > 0 (OR 0.75, 95% CI [0.67–0.85]), DT > 0 (OR 0.81, 95% CI [0.73–0.89]) when compared to females. Regarding age, mean DMFT scores were significantly lower in age groups (6–15 years) (OR 0.03, 95% CI [0.014; 0.082]), (16– 20 years) (OR 0.09, 95% CI [0.037; 0.23]), and (21–35 years) (OR 0.22, 95% CI [0.09; 0.53]) than among people ≥ 60 years.

          Conclusion

          Addressing individual-level caries risk factors should be complemented by addressing upstream factors to reduce burden of untreated dental caries among Egyptians.

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          Most cited references30

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          Information bias in health research: definition, pitfalls, and adjustment methods

          As with other fields, medical sciences are subject to different sources of bias. While understanding sources of bias is a key element for drawing valid conclusions, bias in health research continues to be a very sensitive issue that can affect the focus and outcome of investigations. Information bias, otherwise known as misclassification, is one of the most common sources of bias that affects the validity of health research. It originates from the approach that is utilized to obtain or confirm study measurements. This paper seeks to raise awareness of information bias in observational and experimental research study designs as well as to enrich discussions concerning bias problems. Specifying the types of bias can be essential to limit its effects and, the use of adjustment methods might serve to improve clinical evaluation and health care practice.
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            Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression.

            We aimed to consolidate all epidemiologic data about severe periodontitis (SP) and, subsequently, to generate internally consistent prevalence and incidence estimates for all countries, 20 age groups, and both sexes for 1990 and 2010. The systematic search of the literature yielded 6,394 unique citations. After screening titles and abstracts, we excluded 5,881 citations as clearly not relevant to this systematic review, leaving 513 for full-text review. A further 441 publications were excluded following the validity assessment. A total of 72 studies, including 291,170 individuals aged 15 yr or older in 37 countries, were included in the metaregression based on modeling resources of the Global Burden of Disease 2010 Study. SP was the sixth-most prevalent condition in the world. Between 1990 and 2010, the global age-standardized prevalence of SP was static at 11.2% (95% uncertainty interval: 10.4%-11.9% in 1990 and 10.5%-12.0% in 2010). The age-standardized incidence of SP in 2010 was 701 cases per 100,000 person-years (95% uncertainty interval: 599-823), a nonsignificant increase from the 1990 incidence of SP. Prevalence increased gradually with age, showing a steep increase between the third and fourth decades of life that was driven by a peak in incidence at around 38 yr of age. There were considerable variations in prevalence and incidence between regions and countries. Policy makers need to be aware of a predictable increasing burden of SP due to the growing world population associated with an increasing life expectancy and a significant decrease in the prevalence of total tooth loss throughout the world from 1990 to 2010.
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              Global, Regional, and National Levels and Trends in Burden of Oral Conditions from 1990 to 2017: A Systematic Analysis for the Global Burden of Disease 2017 Study

              Government and nongovernmental organizations need national and global estimates on the descriptive epidemiology of common oral conditions for policy planning and evaluation. The aim of this component of the Global Burden of Disease study was to produce estimates on prevalence, incidence, and years lived with disability for oral conditions from 1990 to 2017 by sex, age, and countries. In addition, this study reports the global socioeconomic pattern in burden of oral conditions by the standard World Bank classification of economies as well as the Global Burden of Disease Socio-demographic Index. The findings show that oral conditions remain a substantial population health challenge. Globally, there were 3.5 billion cases (95% uncertainty interval [95% UI], 3.2 to 3.7 billion) of oral conditions, of which 2.3 billion (95% UI, 2.1 to 2.5 billion) had untreated caries in permanent teeth, 796 million (95% UI, 671 to 930 million) had severe periodontitis, 532 million (95% UI, 443 to 622 million) had untreated caries in deciduous teeth, 267 million (95% UI, 235 to 300 million) had total tooth loss, and 139 million (95% UI, 133 to 146 million) had other oral conditions in 2017. Several patterns emerged when the World Bank’s classification of economies and the Socio-demographic Index were used as indicators of economic development. In general, more economically developed countries have the lowest burden of untreated dental caries and severe periodontitis and the highest burden of total tooth loss. The findings offer an opportunity for policy makers to identify successful oral health strategies and strengthen them; introduce and monitor different approaches where oral diseases are increasing; plan integration of oral health in the agenda for prevention of noncommunicable diseases; and estimate the cost of providing universal coverage for dental care.
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                Author and article information

                Contributors
                reham.k.abouelfadl@gmail.com , rehamabouelfadl@dent.asu.edu.eg
                Journal
                BMC Public Health
                BMC Public Health
                BMC Public Health
                BioMed Central (London )
                1471-2458
                27 December 2022
                27 December 2022
                2022
                : 22
                : 2438
                Affiliations
                [1 ]GRID grid.415762.3, Ministry of Health and Population, ; 3 Magles El Shaab Street, Cairo, Egypt
                [2 ]GRID grid.7269.a, ISNI 0000 0004 0621 1570, Faculty of Dentistry, , Ain Shams University, ; Organization of African Unity st. Abbasia, 11566 Cairo, Egypt
                [3 ]Integrative Epidemiology of Cardiovascular Disease, Université de Paris, INSERM U970, 56 Rue Leblanc, 75015 Paris, France
                [4 ]GRID grid.440862.c, ISNI 0000 0004 0377 5514, British University in Egypt, ; Suez Desert Road El Sherouk City, Cairo, 11837 Egypt
                [5 ]GRID grid.412258.8, ISNI 0000 0000 9477 7793, Faculty of Dentistry, , Tanta University, ; Tanta Qism 2, Tanta, Gharbia Governorate, Cairo, 6624033 Egypt
                Author information
                http://orcid.org/0000-0002-4107-1855
                http://orcid.org/0000-0002-5721-9367
                http://orcid.org/0000-0002-2561-2519
                http://orcid.org/0000-0002-7811-1136
                http://orcid.org/0000-0001-8069-8549
                http://orcid.org/0000-0002-5877-424X
                http://orcid.org/0000-0002-7194-9868
                http://orcid.org/0000-0002-8158-0478
                http://orcid.org/0000-0001-6222-3021
                Article
                14844
                10.1186/s12889-022-14844-9
                9794108
                36575430
                58bae252-4aa0-482a-9996-ad85dc295fd6
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                : 26 August 2022
                : 9 December 2022
                Funding
                Funded by: Ain Shams University
                Categories
                Research
                Custom metadata
                © The Author(s) 2022

                Public health
                caries,permanent teeth,epidemiology,dmft,egyptians,upstream health determinants
                Public health
                caries, permanent teeth, epidemiology, dmft, egyptians, upstream health determinants

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