Is wearing orthodontic appliances associated with eating difficulties and sugar intake among British adolescents? A cross-sectional study

Summary Aim To determine whether wearing orthodontic appliances was associated with eating difficulty and lower sugars intake among British adolescents. Methods This study analysed data from 4116 12- and 15-year-olds who participated in the 2013 Children’s Dental Health Survey in the UK. Information on eating difficulties in the past 3 months and usual intake of six sugary items was collected through self-administered questionnaires. The presence and type of orthodontic appliances (fixed or removable) were assessed during clinical examinations. Logistic regression was used to evaluate the association between wearing orthodontic appliances and eating difficulty whereas linear regression was used to evaluate the association between wearing orthodontic appliances and sugars intake. Regression models were adjusted for socio-demographic, behavioural, and clinical characteristics of adolescents. Results 12.9 per cent of the 4116 adolescents wore orthodontic appliances (10.1 per cent fixed and 2.8 per cent removable), 21.0 per cent reported eating difficulties and the mean daily intake of sugars was 5.3 times/day (SD: 3.7, range: 0–20). Adolescents with fixed appliances had 4.02 (95% CI: 3.03, 5.33) greater odds of reporting eating difficulty than those with no appliances, but no differences were found between adolescents wearing removable and no appliances. No association was found between wearing orthodontic appliances and daily sugars intake either [coefficients of 0.20 (95% CI: –0.27, 0.66) and –0.30 (95% CI: –0.96 to 0.36) for adolescents wearing fixed and removable appliances, respectively]. Conclusion Wearing fixed orthodontic appliances were associated with greater odds of reporting eating difficulty, but not with lower sugars intake among British adolescents.

Operative treatment of dental caries in the young permanent dentition

Caries is a chronic disease. If it starts to affect the permanent teeth the child patient is drawn into a cycle requiring ongoing care for the rest of his/her life. Therefore when treating the young permanent dentition we have to adopt an approach that considers and addresses the whole disease process and not just treat the outcome of the disease. Caries is still a considerable problem in children and adolescents. The 2013 Child Dental Health Survey for England, Wales, and Northern Ireland found that, on average, nearly half (46%) of 15-year-olds and a third (34%) of 12-year-olds had obvious decay experience. Although the proportion of children with untreated dentinal caries has improved from 2003, it remained high at 21% and 19% for 15-year-olds and 12-year-olds, respectively. These children are at high risk of pain and discomfort relating to their teeth. The 2013 survey also looked at the impact on daily life. On average, a fifth of 12- and 15-year-old children reported experiencing difficulty eating, and about half reported that their life had been affected by problems with their teeth or mouth within the previous 3 months (Steele et al. 2015). Caries prevalence declined in the later decades of the twentieth century. As it dropped, a concentration of the disease occurred, with a small percentage of the population experiencing most of the disease. Caries prevalence is greatest in the occlusal surfaces of the first permanent molars and buccal grooves of the lower first molars, and the prevalence in these sites has dropped by the smallest proportion. The least susceptible sites are the approximal surfaces of the incisors, so caries seen in these permanent teeth indicates more extensive disease (Sheiham and Sabbah 2010). The first permanent teeth erupt in the mouth at approximately 6 years of age, but may appear as early as 4 years of age. The eruption of the anterior teeth usually causes great excitement, as it is associated with ‘the fluttering of tooth fairy wings’. However, the eruption of the first permanent molars goes largely unnoticed until there is a problem.

The Emergency Dental Appointment: Restorative Emergencies Part 1 – Tooth Related Problems

Dental emergencies affect a large proportion of the population. While there is ample information in the literature on how to manage medical emergencies in dental practice, there is little information on common dental emergencies and how to manage them. In the UK, the 2009 Adult Dental Health Survey reported 9% of dentate adults reporting pain at their clinical examination.1 The prevalence of non-pain related restorative dental emergencies is estimated to be higher, and will be a common presenting situation in the dental clinic. Often these unplanned events cause difficulties for dental practitioners, who are already constrained by time, to fit in these patients and manage them. Over and above this, the increasing life spans, retention of teeth into later life and finite life of dental restorations all add to the challenges encountered by the dental practitioner. Prompt and effective management of these conditions often leads to optimising patient experience, but also offers better outcomes. This two-part series provides an overview of the more common dental emergencies encountered by the dental practitioner and their management. Paper 1 focuses on the management of common tooth-related emergencies and includes non-odontogenic and odontogenic pain. Paper 2 focuses on the management of osseointegrated dental implant related emergencies.