Early predictors of childhood caries among 4-year-old children: a population-based study in north-eastern France

Impact of Free Sugar Consumption on Dental Caries: A Cross-Sectional Analysis of Children in the United States

Background/Objectives: The excessive consumption of free sugars adversely impacts health, contributing to systemic disorders and significantly increasing the risk of dental caries. Children are particularly vulnerable to dental caries due to their dietary habits and oral hygiene practices. This study aimed to examine the relationship between sugar intake and dental caries experience in a sample of children aged 6-12 years. Methods: Data were analyzed from the National Health and Nutrition Examination Survey (NHANES) covering the years 2011-2016. This cross-sectional study utilized nationally representative data from NHANES, which provides comprehensive health assessments on the U.S. population. This study focused on 3658 children aged 6-12 years. Free sugar intake and its association with dental caries were evaluated using the Decayed, Missing, and Filled Teeth (DMFT) index, a widely accepted measure for assessing cumulative caries experience in permanent teeth. Demographic and socioeconomic factors were also accounted for. The sample primarily consisted of generally healthy children, with mild to moderate health conditions included in the analysis. Results: The average Decayed, Missing, and Filled Teeth (DMFT) score was 1.69 (SD = 2.61). Untreated dental caries affected 19.1% of the sample, with disproportionately higher rates observed among Mexican American children (23.8%), children from lower socioeconomic backgrounds (24.2%), those with less-educated parents (25.1%), and overweight children (22.9%). Mean daily free sugar intake was 72.46 g (SD = 50.45), with significant variations across race/ethnicity, parental education, and gender. A statistically significant association was found between free sugar intake and dental caries in U.S. children (p < 0.001). Conclusions: Free sugar intake is strongly associated with an increased risk of dental caries. Disparities in caries prevalence were evident based on race/ethnicity, socioeconomic status, and parental education levels. Regulating sugar intake and promoting dietary education are effective strategies to reduce the risk of dental caries and improve oral health outcomes among children.

Maternal perceptions of assisting preschool-aged children with toothbrushing

BACKGROUND

Parent-led toothbrushing with fluoride toothpaste is part of an evidence-based strategy to prevent caries in children. There is a gap in the literature regarding perceptions of how and when to assist a child with toothbrushing from the maternal perspective.

METHODS

A qualitative cross-sectional study was conducted with participants in North and North Central Appalachia to examine maternal perceptions of when and how to assist with toothbrushing. From 2018 through 2022, 301 mothers of children aged 3 through 5 years volunteered to participate in semistructured interviews from a more extensive parent study (Center for Oral Health Research in Appalachia cohort). The qualitative data were transcribed, coded, and analyzed using Nvivo software, Version 12 (QSR International). The data were analyzed using grounded theory, constant comparative method, and template analysis.

RESULTS

A total of 301 mothers were interviewed for this study; 156 (52%) lived in West Virginia and 145 (48%) lived in Pittsburgh, Pennsylvania. Four main themes emerged: (1) assisting with child toothbrushing, (2) ceasing to provide assistance with child toothbrushing, (3) lacking recommendations from dental care professionals on child toothbrushing, and (4) adhering to recommendations from dental care professionals on child toothbrushing assistance.

CONCLUSIONS

Understanding the factors that influence how parents brush their children's teeth and the information they receive to guide daily dental hygiene behavior for children is essential in developing effective interventions for preventing caries in children.

PRACTICAL IMPLICATIONS

These insights can improve child toothbrushing quality through improved oral hygiene education, recommendations, terminology, and policies from the dental community.

Comparative study of the dental health of 4-year-old children in north-eastern France between 2001 and 2018

PURPOSE

To analyse the evolution of the oral health of 4-year-old children in nursery school between 2001 and 2018 as well as the early predictor and associated risk factors, in different school areas.

METHODS

We compared (1) the prevalence of ECC (4 ≥ dmft ≥ 1) and S-ECC (dmft ≥ 5) of 4-year-old children and (2) data obtained by a structured questionnaire completed by their parents from two studies performed in 2001 and 2018. Data were analysed using the Chi2 test and odds ratio (OR).

RESULTS

A total of 322 children and of 425 children randomly selected among Moselle's public nursery schools in north-eastern France were, respectively, included in the study in 2001 and 2018. The prevalence of ECC was respectively 40.70% and 21.65% in 2001 and 2018 (p < 0.001; OR = 2.48; 95% CI = 1.78-3.47). We also observed a decrease of S-ECC prevalence (10.56% in 2001 vs 5.90% in 2018, p < 0.05, OR = 1.89; 95% CI = 1.07-3.38). The intake of cariogenic food (sweet drink, biscuits, candies, milk, baby bottle) decreased but the knowledge of parents concerning cariogenic food did not improve. The proportion of parents helping their child has not changed in 17 years (82.33% vs 86.52%, p > 0.1) but tooth brushing was initiated earlier in 2018 than in 2001 (p < 0.01). Prescription of systemic fluoride decreased (39.14% vs 3.62%; p < 0.001).

CONCLUSION

The identification of the food consumption habits and the knowledge of parents concerning oral health should enable strengthening of preventive measures and the initiation of an oral health education programme for children and their family.

Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review

BACKGROUND

The goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC.

METHODS

The two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework.

RESULTS

In total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4-12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services.

CONCLUSION

The study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.

The Impact of Socioeconomic Factors on Pediatric Oral Health: A Review

This narrative review examines the impact of socioeconomic status (SES) on pediatric oral health, emphasizing disparities in dental caries prevalence and oral health-related quality of life (OHRQoL) among children from different socioeconomic backgrounds. Utilizing an extensive literature search through PubMed, Google Scholar, and the chat.consensus.app plugin, we synthesized findings from studies published up to December 2023. The review highlights a consistent association between lower SES and adverse pediatric oral health outcomes, influenced by parental education, household income, food security, and neighborhood conditions. It also underscores the importance of the life-course perspective, showing how early-life socioeconomic disadvantages can have long-lasting effects on oral health. Furthermore, the review points to the critical role of school-based oral health education programs and the complex interplay between mental health, SES, and pediatric oral health. By examining the impact of socioeconomic factors across different childhood stages and the effectiveness of educational interventions, this review calls for targeted interventions and policy initiatives aimed at reducing socioeconomic inequalities in pediatric oral health. The findings advocate for a multifaceted approach to improve oral health outcomes for children across socioeconomic backgrounds, ensuring equitable access to oral health care and promoting overall well-being.

Maternal factors and risk of early childhood caries: A prospective cohort study

OBJECTIVE

To evaluate the associations between time-varying factors (mother's oral health, oral hygiene, smoking habits, diet, food insecurity and stress) socioeconomic factors (mother's employment, marital status, household income, insurance status, household size) and medical history on children's risk of developing a carious lesion in the first 3 years of life.

METHODS

Longitudinal data from the Center for Oral Health Research in Appalachia Cohort Two (COHRA2) were analysed. Pregnant women ≥18 years in the USA were recruited during pregnancy; all consenting women delivering at term and their babies had regular dental assessments and complete in-person surveys and telephone interviews regarding sociodemographic factors, medical and dental history, and oral health behaviours.

RESULTS

In a logistic regression model adjusting for covariates, children whose mother had two or more prior pregnancies, smoked cigarettes post-partum, or had a recent unfilled carious lesion were at least twice as likely to experience a dental lesion by the three-year visit. The magnitude of these associations varied by maternal education and state of residence.

CONCLUSIONS

Untreated maternal decay but not maternal oral hygiene or diet were associated with cumulative risk of childhood caries by age three but were modified by maternal education and state of residence. Addressing structural and behavioural issues that reduce use of restorative dental care are needed to prevent the adverse impacts associated with early childhood caries.

Assessment of knowledge, attitude, and behavior related to children's oral health in pediatricians and students in the pediatric field in Iran: a cross-sectional study

Background

Pediatricians have an important role to play in motivating and instructing parents on oral health in children. The aim of this study was to assess knowledge of, attitude to, and behavior regarding oral health care in children among pediatricians and students in the pediatric field in Iran.

Methods

This cross-sectional study included all students in the pediatric field (those who had started a residency or fellowship) and practicing pediatricians in provincial centers and universities (61 setting centers) throughout Iran in the course of 2021. Participants completed an online questionnaire assessing details of the parameters of knowledge of, attitude to, and behavior toward oral health for each individual. A convenience sampling technique was used to gather the study sample. All data were coded for each of the parameters. The data were analyzed by one-way ANOVA (Analysis of Variance)/Tukey and Pearson's correlation tests and path analysis.

Results

Out of 582 participants who visited the website, a total of 217 completed the entire questionnaire (participation rate of 37.2%). On the attitude parameter, 84.8% of participants scored above 75% of the possible attainable score, while only 37.9% and 48.1% of them had adequate knowledge and behavior for the possible score, respectively. Specialists had a higher mean score on behavior and knowledge than residents (P=0.001). There was a significant correlation between the scores on attitude and behavior (r=0.42, P<0.001), attitude and knowledge (r=0.19, P=0.005), and behavior and knowledge (r=0.25, P<0.001). Nearly all of the participants, 216 (99.5%), felt the need for the principles of dentistry to be included in the curriculum.

Conclusions

Pediatricians showed a favorable attitude to oral health, but their knowledge of and behavior in the field was inadequate. Improvement of pediatricians' interest and performance in oral health in children should be encouraged through the inclusion of these parameters in the curriculum for students of the pediatric field. Implementing training programs for practical pediatricians or incorporating independent theoretical and clinical courses offered by pediatric dentists in dental school departments into the field curriculum of the students in the pediatric field is recommended.

Oral hygiene practices in nurseries (0-3 years) in the cities of Pavia and Vigevano

Aim

This study was conducted to evaluate attention to and knowledge of oral care in children aged 0-3 years, on the basis of data collected from early years educators working with this age group. Information was also collected about the oral hygiene practices adopted in nurseries and the types of food provided, with the aim of increasing knowledge and raising awareness of this topic.

Materials and methods

A questionnaire was created using the "Google Forms" program and sent to all the 47 nurseries in the city of Pavia and Vigevano.

Results

Twenty establishments agreed to take part in the research. Assessment of knowledge and of awareness of oral care among early years educators caring for children in the age range 0-3 years revealed variability and some confusion. The results showed a general lack of attention to oral care in the period before the milk teeth appear, as well as limited use of gauze swabs. There was generally some use of educational play focusing on this issue, albeit not daily across all the nurseries participating in the survey. Nurseries rarely had the support of a professional dental hygienist to raise awareness among early years educators and parents.

Conclusions

The findings obtained through this study indicate that, in the area surveyed, there is a lack of widespread knowledge and awareness of oral prevention in young children, and of the oral hygiene maintenance techniques to use in this age group. This suggests a need to develop preventive protocols to improve knowledge and awareness of children's oral health among the adults who care for them.

[Prevalence, intensity, and efficacy of dental caries treatment in pre-school children living in the town of Khimki]

THE AIM OF THE STUDY

Was to assess the prevalence, intensity, and treatment efficacy of dental caries in children aged 3 to 6 years residents of the town of Khimki, Moscow region. The number of decayed, filled, and missed due to caries teeth was registered. The parents were interviewed in order to reveal dental caries treatment experience as well as reasons for negative experience, age of the first dental office visit and the reasons for it.

RESULTS

The incidence of dental caries in 3-6 years old living in Khimki is 52%. The prevalence and incidence unsurprisingly grow with age as well as the number of children having the experience of toothache and early extractions. The vast majority of children including these with positive dental treatment experience have untreated carious lesions. The difference of decayed teeth between children having negative and positive treatment experience in statistically insignificant (p=0.57), and the number of filling is equally small in both subgroups (p=0.99). This means even cooperative children who underwent dental treatment have untreated (or previously treated but having no fillings - in 22.6% of treatment cases) cavities.

CONCLUSION

The dental caries intensity growth outpaces the possibilities of the Khimky dental service resulting in the low number of caries-free previously treated children (17.9% of all treated). All this dictates the necessity for dental caries prevention programs and implementation of new models for dental care organization in preschool children.