{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:50:52Z","timestamp":1747183852278,"version":"3.40.5"},"reference-count":29,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T00:00:00Z","timestamp":1692921600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Despite being almost entirely preventable, globally, dental caries is extremely prevalent. Moreover, dental caries will continue to present an even larger challenge for lower income countries, particularly those in the African context, as they transition to a more Western diet. Hence, epidemiological data providing insight into disease patterns and trends is critical to inform public health action. The purpose of this study was to examine dental caries clusters by caries detection threshold among 15\u2010year\u2010old adolescents in Sierra Leone, using data from the latest national survey, and to explore associated sociodemographic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This paper presents a secondary analysis of oral health data on 490 15\u2010year\u2010olds from the Sierra Leone national oral health survey of schoolchildren. Hierarchical cluster analysis of dental caries experience was conducted across all surfaces at four decay detection thresholds using the International Caries Detection and Assessment System (ICDAS) (<jats:italic>clinical<\/jats:italic>: ICDAS 2\u20136, <jats:italic>cavitated<\/jats:italic>: ICDAS 3\u20136, <jats:italic>obvious<\/jats:italic>: ICDAS 4\u20136 and <jats:italic>extensive obvious<\/jats:italic>: ICDAS 5\u20136 decay) across the four regions of Sierra Leone. Ordered logistic regression was used to estimate the association of sociodemographic factors with generated clusters relating to <jats:italic>clinical<\/jats:italic> and <jats:italic>obvious<\/jats:italic> decay experience. These are of both clinical and epidemiological relevance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A 3\u2010cluster decay pattern representing a \u2018low\u2019 to \u2018high\u2019 decay experience distribution was observed under each decay detection threshold across surfaces. For <jats:italic>clinical<\/jats:italic> decay (including visual enamel caries), 28.8% had low, 55.1% medium and 15.9% high caries status. In the adjusted model, the only significant risk factor across <jats:italic>obvious<\/jats:italic> and <jats:italic>clinical<\/jats:italic> decay thresholds was region, with adolescents outside the Western region more likely to experience decay.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study suggests that adolescents in Sierra Leone fall into three distinct caries clusters: low, medium to high decay experience distribution, regardless of decay threshold. It reinforces the importance of recognizing dental caries detection thresholds and the use of contemporary epidemiological methodology. This suggests that adolescents outside the Western region are likely to have higher caries experience. The data also provides insight to the nature of adolescents in each cluster and should help to inform policy and planning of the integration of oral health into primary care and school systems.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cdoe.12903","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T11:58:54Z","timestamp":1692964734000},"page":"76-83","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Caries clusters at lesion\u2010severity thresholds: A Sierra Leone case study"],"prefix":"10.1111","volume":"52","author":[{"given":"L.","family":"Sibanda","sequence":"first","affiliation":[{"name":"Faculty of Dentistry, Oral &amp; Craniofacial Sciences Centre for Host Microbiome Interactions, King's College London, Denmark Hill Campus  London UK"},{"name":"NHS England London Region, Wellington House  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. G.","family":"Ghotane","sequence":"additional","affiliation":[{"name":"Department of Women &amp; Children's Health, Faculty of Life Sciences &amp; Medicine King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1858-3713","authenticated-orcid":false,"given":"E.","family":"Bernabe","sequence":"additional","affiliation":[{"name":"Centre of Dental Public Health and Primary Care, Institute of Dentistry Queen Mary University of London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. J.","family":"Challacombe","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Oral &amp; Craniofacial Sciences Centre for Host Microbiome Interactions, King's College London, Tower Wing, Guys Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N. B.","family":"Pitts","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Oral &amp; Craniofacial Sciences, Centre for Oral Clinical and Translational Sciences, King's College London, Tower Wing, Guys Hospital  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. E.","family":"Gallagher","sequence":"additional","affiliation":[{"name":"Faculty of Dentistry, Oral &amp; Craniofacial Sciences Centre for Host Microbiome Interactions, King's College London, Denmark Hill Campus  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,8,25]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Sierra Leone Immigration Department.Affairs DatMoI National Migration Policy for Sierra Leone Sierra Leone Immigration Department Department and the Ministry of Internal Affairs.2022."},{"key":"e_1_2_7_3_1","unstructured":"World Health Organization.Health Topics (Sierra Leone): World Health Organization Regional Office for Africa.2022https:\/\/www.afro.who.int\/health\u2010topics\/health\u2010topics\u2010sierra\u2010leone."},{"key":"e_1_2_7_4_1","unstructured":"Global nutrition report. Country nutrition profiles. Sierra Leone.2022https:\/\/globalnutritionreport.org\/resources\/nutrition\u2010profiles\/africa\/western\u2010africa\/sierra\u2010leone\/"},{"volume-title":"Poverty & Equity Brief\u2014Sierra Leone","year":"2022","author":"Sattar S","key":"e_1_2_7_5_1"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41405-022-00107-7"},{"volume-title":"Oral Health\u2014a Silent Emergency. Initial Report from Sierra Leone","year":"2013","author":"Gallagher JE","key":"e_1_2_7_7_1"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.30"},{"volume-title":"Oral Health Surveys Basic Methods","year":"2013","author":"World Health Organization","key":"e_1_2_7_9_1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520908533"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034514559408"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034511434355"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ypmed.2014.07.007"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ins.2013.05.040"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/9780470977811"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034512463241"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1159\/000518964"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-021-01507-1"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1127489"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/cdoe.12317"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bdj.2013.991"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1159\/000308091"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1963.10500845"},{"volume-title":"UK Child Dental Health Survey 2013: Protocol and Tools","year":"2013","author":"Office for National Statistics","key":"e_1_2_7_24_1"},{"volume-title":"Sierra Leone Demographic and Health Survey 2019","year":"2020","author":"Statistics Sierra Leone (Stats SL)","key":"e_1_2_7_25_1"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12903-019-0997-9"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034514557546"},{"key":"e_1_2_7_28_1","unstructured":"UNESCO.Sierra Leone.2022https:\/\/uis.unesco.org\/en\/country\/sl."},{"key":"e_1_2_7_29_1","unstructured":"World Health Organization.Political declaration of the third high\u2010level meeting of the General Assembly on the prevention and control of noncommunicable diseases.2022Contract No: EB150\/7."},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12960-021-00623-x"}],"container-title":["Community Dentistry and Oral Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.12903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,21]],"date-time":"2024-01-21T15:31:06Z","timestamp":1705851066000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cdoe.12903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,25]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1111\/cdoe.12903"],"URL":"https:\/\/doi.org\/10.1111\/cdoe.12903","archive":["Portico"],"relation":{},"ISSN":["0301-5661","1600-0528"],"issn-type":[{"type":"print","value":"0301-5661"},{"type":"electronic","value":"1600-0528"}],"subject":[],"published":{"date-parts":[[2023,8,25]]},"assertion":[{"value":"2022-11-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-08-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}