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Kanmodi KK, Amzat J, Aminu K. Theories, determinants, and intervention models and approaches on inequalities of undernutrition amongst under fives: A literature review. Health Sci Rep 2024; 7:e2078. [PMID: 38690007 PMCID: PMC11058263 DOI: 10.1002/hsr2.2078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/02/2024] Open
Abstract
Background and Aims One of the greatest public health problems of the 21st century is undernutrition in children under the age of 5 years (CAUFY). Globally, over 232 million CUAFY are undernourished and approximately 45% of mortality in this population are undernutrition-induced. This paper reviewed and critically explained the factors perpetuating undernutrition in CUAFY in the global space. It further explained the multi-level determinants that influence health inequalities and consequently exacerbate undernutrition amongst CUAFY globally. It also went further to explain the intervention models and approaches that can be used to tackle undernutrition in CUAFY. Methods/Literature Search Strategy Demiris et al.'s approach to narrative review was utilized for this paper. Relevant articles on child nutrition were retrieved from multiple credible databases and websites of foremost health organizations. Using an iterative process, multiple combinations of search terms were done by stringing relevant key terms and their synonyms with Boolean Operators. This process was constantly refined to align search results with the study aim. Database search produced relevant and resourceful publications which were utilized to develop this review. Results The global burden of undernutrition remains high, especially in Oceania with the highest prevalence of stunting and wasting (41.4% and 12.5%), with Africa and Asia following closely. Malnutrition eradication is a global health issue of high priority as demonstrated by the "Goal 2" of the Sustainable Development Goals (SDGs), and the United Nations (UN) Decade of Action on Nutrition 2016-2025. The review identified no significant positive outcome from previous interventions due to the endemic health inequalities. Determinants of the multi-level health inequalities associated with undernutrition in CUAFY, and probable solutions are explained with theoretical models of health inequalities. A diagonal intervention approach was proposed as a viable solution to ending undernutrition in CUAFY. Conclusion The application of relevant theoretical models and context-specific intervention approaches can be utilized by stakeholders to close the existing inequality gaps, thereby reducing undernutrition amongst CUAFY globally.
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Affiliation(s)
- Kehinde Kazeem Kanmodi
- School of DentistryUniversity of RwandaKigaliRwanda
- Child Health and Wellbeing (CHAW) ProgramCephas Health Research Initiative IncIbadanNigeria
- Faculty of DentistryUniversity of PuthisastraPhnom PenhCambodia
- School of Health and Life SciencesTeesside UniversityMiddlesbroughUK
| | - Jimoh Amzat
- Department of SociologyUsmanu Danfodiyo UniversitySokotoNigeria
| | - Kafayat Aminu
- Center for Child and Adolescent Mental HealthUniversity College HospitalIbadanNigeria
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Moore D, Nyakutsikwa B, Allen T, Lam E, Birch S, Tickle M, Pretty IA, Walsh T. Effect of fluoridated water on invasive NHS dental treatments for adults: the LOTUS retrospective cohort study and economic evaluation. PUBLIC HEALTH RESEARCH 2024; 12:1-147. [PMID: 38785327 DOI: 10.3310/rfqa3841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024] Open
Abstract
Background Most water fluoridation studies were conducted on children before the widespread introduction of fluoride toothpastes. There is a lack of evidence that can be applied to contemporary populations, particularly adolescents and adults. Objective To pragmatically assess the clinical and cost effectiveness of water fluoridation for preventing dental treatment and improving oral health in a contemporary population of adults, using a natural experiment design. Design Retrospective cohort study using routinely collected National Health Service dental claims (FP17) data. Setting National Health Service primary dental care: general dental practices, prisons, community dental services, domiciliary settings, urgent/out-of-hours and specialised referral-only services. Participants Dental patients aged 12 years and over living in England (n = 6,370,280). Intervention and comparison Individuals exposed to drinking water with a fluoride concentration ≥ 0.7 mg F/l between 2010 and 2020 were matched to non-exposed individuals on key characteristics using propensity scores. Outcome measures Primary: number of National Health Service invasive dental treatments (restorations/'fillings' and extractions) received per person between 2010 and 2020. Secondary: decayed, missing and filled teeth, missing teeth, inequalities, cost effectiveness and return on investment. Data sources National Health Service Business Services Authority dental claims data. Water quality monitoring data. Primary outcome Predicted mean number of invasive dental treatments was 3% lower in the optimally fluoridated group than in the sub/non-optimally fluoridated group (incidence rate ratio 0.969, 95% CI 0.967 to 0.971), a difference of -0.173 invasive dental treatments (95% CI -0.185 to -0.161). This magnitude of effect is smaller than what most stakeholders we engaged with (n = 50/54) considered meaningful. Secondary outcomes Mean decayed, missing and filled teeth were 2% lower in the optimally fluoridated group, with a difference of -0.212 decayed, missing and filled teeth (95% CI -0.229 to -0.194). There was no statistically significant difference in the mean number of missing teeth per person (0.006, 95% CI -0.008 to 0.021). There was no compelling evidence that water fluoridation reduced social inequalities in treatments received or missing teeth; however, decayed, missing and filled teeth data did not demonstrate a typical inequalities gradient. Optimal water fluoridation in England in 2010-20 was estimated to cost £10.30 per person (excluding original setup costs). Mean National Health Service treatment costs for fluoridated patients 2010-20 were 5.5% lower per person, by £22.26 (95% CI -£23.09 to -£21.43), and patients paid £7.64 less in National Health Service dental charges per person (2020 prices). Limitations Pragmatic, observational study with potential for non-differential errors of misclassification in fluoridation assignment and outcome measurement and residual and/or unmeasured confounding. Decayed, missing and filled teeth data have not been validated. Water fluoridation cost estimates are based on existing programmes between 2010 and 2020, and therefore do not include the potentially significant capital investment required for new programmes. Conclusions Receipt of optimal water fluoridation between 2010 and 2020 resulted in very small health effects, which may not be meaningful for individuals, and we could find no evidence of a reduction in social inequalities. Existing water fluoridation programmes in England produced a positive return on investment between 2010 and 2020 due to slightly lower National Health Service treatment costs. These relatively small savings should be evaluated against the projected costs and lifespan of any proposed capital investment in water fluoridation, including new programmes. Future work National Health Service dental data are a valuable resource for research. Further validation and measures to improve quality and completeness are warranted. Trial registrations This trial is registered as ISRCTN96479279, CAG: 20/CAG/0072, IRAS: 20/NE/0144. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Public Health Research programme (NIHR award ref: NIHR128533) and is published in full in Public Health Research; Vol. 12, No. 5. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Deborah Moore
- Division of Dentistry, The University of Manchester, Manchester, UK
| | | | - Thomas Allen
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Emily Lam
- Independent Patient and Public Engagement Representative
| | - Stephen Birch
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
| | - Martin Tickle
- Division of Dentistry, The University of Manchester, Manchester, UK
| | - Iain A Pretty
- Division of Dentistry, The University of Manchester, Manchester, UK
| | - Tanya Walsh
- Division of Dentistry, The University of Manchester, Manchester, UK
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Tang Y, Nie H, Zhang Y, Wei Y, Huang Y, Zhuang Y, Yang W, Zhu Y. Effects of Sjogren's syndrome and high sugar diet on oral microbiome in patients with rampant caries: a clinical study. BMC Oral Health 2024; 24:361. [PMID: 38515087 PMCID: PMC10956276 DOI: 10.1186/s12903-024-04150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE The purpose of this study was to assess the composition of the oral microbial flora of adults with rampant caries in China to provide guidance for treatment. PATIENTS AND METHODS Sixty human salivary and supragingival plaque samples were collected. They were characterized into four groups: patients with rampant caries with Sjogren's syndrome (RC-SS) or high-sugar diet (RC-HD), common dental caries (DC), and healthy individuals (HP). The 16S rRNA V3-V4 region of the bacterial DNA was detected by Illumina sequencing. PCoA based on OTU with Bray-Curtis algorithm, the abundance of each level, LEfSe analysis, network analysis, and PICRUSt analysis were carried out between the four groups and two sample types. Clinical and demographic data were compared using analysis of variance (ANOVA) or the nonparametric Kruskal-Wallis rank-sum test, depending on the normality of the data, using GraphPad Prism 8 (P < 0.05). RESULTS OTU principal component analysis revealed a significant difference between healthy individuals and those with RC-SS. In the saliva of patients with rampant caries, the relative abundance of Firmicutes increased significantly at the phylum level. Further, Streptocpccus, Veillonella, Prevotella, and Dialister increased, while Neisseria and Haemophilus decreased at the genus level. Veillonella increased in the plaque samples of patients with rampant caries. CONCLUSION Both salivary and dental plaque composition were significantly different between healthy individuals and patients with rampant caries. This study provides a microbiological basis for exploring the etiology of rampant caries. CLINICAL RELEVANCE This study provides basic information on the flora of the oral cavity in adults with rampant caries in China. These findings could serve as a reference for the treatment of this disease.
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Affiliation(s)
- Yifei Tang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Hua Nie
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yu Zhang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yuan Wei
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yequan Huang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yuan Zhuang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Weidong Yang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
| | - Yanan Zhu
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
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Chrisopoulos S, AlKhtib AO, Al Darwish MS, Mohamed HGS, Mathew T, Al Mannai GA, Abdulmalik M, Al Thani M, de Vries J, Do LG, Spencer AJ. Correlates of childhood caries: A study in Qatar. Int J Paediatr Dent 2024; 34:179-189. [PMID: 37908038 DOI: 10.1111/ipd.13123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 08/09/2023] [Accepted: 09/07/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND The prevalance of dental caries in children in Qatar is high, which necessitates preventive efforts. AIM To identify the sociodemographic and behavioural correlates of dental caries in the primary dentition of children 4- to 8-year-olds in Qatar. DESIGN Weighted data from the Qatar Child Oral Health Survey 2017 were analysed for caries prevalence (dmft>0) and experience (dmft). Sociodemographic and behavioural variables were also drawn from the survey. RESULTS AND CONCLUSION Among the 1154 children, caries prevalence was 69.3% (95%CI [63.4, 74.5]) and experience at 3.8 dmft (95%CI [3.3, 4.2]). The prevalence ratio (PR) 0.82 (0.72, 0.94) was lower among younger than in older children; those for non-Qatari nationality Arabic PR 0.91 (0.82, 1.00) and Other PR 0.75 (0.57, 0.99) than for Qatari nationality; those attending international kindergartens/schools PR 0.89 (0.80, 0.99) than independent schools; and whose parents had university-level education PR 0.85 (0.75,0.95) than did not. Caries prevalence was lower among those toothbrushing by age 3 years PR 0.88 (0.80,0.99) than later; children with low/intermediate sugar exposures PR 0.85 (0.74,0.97) and 0.89 (0.79,1.00) than those with high exposures; children with a dental check-up PR 0.68 (0.53,0.87) than those without; and children who drank bottled water with some fluoride PR 0.89 (0.80,0.99) than those who did not. Findings were similar for dmft. In conclusion caries prevalence varied but was high across sociodemographic correlates indicating vulnerablity. Interventions focusing on behaviours - such as toothbrushing, reducing sugar intake, check-up and encouraging intake of water with fluoride - are needed.
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Affiliation(s)
- Sergio Chrisopoulos
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
| | | | | | - Hasaan Gassim Saad Mohamed
- Primary Health Care Corporation (PHCC), Doha, Qatar
- College of Dental Medicine, Qatar University, Doha, Qatar
| | - Tintu Mathew
- Primary Health Care Corporation (PHCC), Doha, Qatar
| | | | | | | | | | - Loc Giang Do
- School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Andrew John Spencer
- Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, South Australia, Australia
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Frydrych AM, Parsons R, Kujan O. Use of oral nutritional supplements in irradiated patients with head and neck cancer. Oral Dis 2023. [PMID: 38105485 DOI: 10.1111/odi.14837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/17/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Malnutrition is common among patients with head and neck cancer (HNC) and associated with poorer outcomes. Oral nutritional supplements (ONS) are often prescribed, with concerns raised about their cariogenicity. This study examined ONS use and caries experience in patients with HNC 12 months post-diagnosis. METHODS Fifty-four patients with HNC referred for pre-radiotherapy dental assessment were recruited. Data collected included: age, gender, residential postcode, smoking, alcohol use, HNC characteristics, dental history, oral hygiene habits, dietary advice and ONS use. Data was collected at diagnosis, during radiotherapy and 6 weeks, three, six- and 12-months post-treatment completion. RESULTS Fifty-one subjects completed the study. 76.5% of the participants used ONS for an average of 13.8 weeks. Caries developed in 22.9% of ONS users and 11.1% of non-users (p = 0.6585). The mean overall duration of ONS use was 18.7 weeks for the caries group and 8.5 weeks for the caries-free group (p = 0.1507). Lack of collaboration and disconnection was noted between dietary advice given by dieticians and dentists. CONCLUSIONS ONS use is common among patients with HNC. Larger studies are needed to establish the reasons for caries development and impacts of ONS use on oral health. Importance of multidisciplinary management of malnutrition is highlighted.
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Affiliation(s)
- Agnieszka M Frydrych
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
| | - Richard Parsons
- Medical School, Curtin University, Bentley, Western Australia, Australia
| | - Omar Kujan
- UWA Dental School, The University of Western Australia, Nedlands, Western Australia, Australia
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Melough M, Sathyanarayana S, Zohoori F, Gustafsson H, Sullivan E, Chi D, Levy S, McKinney C. Impact of Fluoride on Associations between Free Sugars Intake and Dental Caries in US Children. JDR Clin Trans Res 2023; 8:215-223. [PMID: 35446163 PMCID: PMC10404899 DOI: 10.1177/23800844221093038] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Dental caries is the most prevalent chronic disease in US children, with the highest burden among Black and Hispanic youth. Sugars are a primary risk factor, but few studies have specifically measured intakes of free sugars and related this to dental caries or explored the extent to which water fluoride mitigates the cariogenicity of free sugars. Furthermore, the cariogenicity of certain free sugars sources, such as extruded fruit and vegetable products, is unclear. METHODS Using cross-sectional data on 4,906 children aged 2 to 19 y in the US National Health and Nutrition Examination Survey 2013-2016, we examined associations of free sugars intake with counts of decayed or filled primary tooth surfaces (dfs) and decayed, missing, or filled permanent surfaces (DMFS) in negative binomial regressions. Stratified models examined these associations in children with home water fluoride above or below the Centers for Disease Control and Prevention (CDC)-recommended level of 0.7 ppm. RESULTS Free sugars accounted for 16.4% of energy, primarily contributed by added sugars. In adjusted models, a doubling in the percentage of energy from free sugars was associated with 22% (95% confidence interval [CI], 1%-47%) greater dfs among children aged 2 to 8. A doubling in energy from added sugars was associated with 20% (95% CI, 1%-42%) greater dfs and 10% (95% CI, 2%-20%) greater DMFS in children aged 6 to 19 y. Beverages were the most important source of added sugars associated with increased caries. Other free sugars were not associated with dfs or DMFS. Associations between free sugars and caries were diminished among children with home water fluoride of 0.7 ppm or greater. CONCLUSIONS Free sugars intake, especially in the form of added sugars and specifically in sweetened beverages, was associated with higher dental caries. Water fluoride exposures modify these associations, reducing caries risk in the primary dentition of children whose home water meets recommended fluoride levels. KNOWLEDGE TRANSFER STATEMENT Intake of free sugars, especially in the form of added sugars and specifically in beverages, was associated with higher dental caries in US children in this study. Water fluoride exposure at CDC-recommended levels protected against caries, especially in the primary dentition. These findings suggest that household water fluoridation at CDC-recommended levels protects against the cariogenic potential of free and added sugars during childhood.
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Affiliation(s)
- M.M. Melough
- Department of Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA
| | - S. Sathyanarayana
- Department of Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA
- Departments of Pediatrics and Environmental & Occupational Health Sciences, University of Washington, Seattle, WA, USA
| | - F.V. Zohoori
- Centre for Public Health Research, School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - H.C. Gustafsson
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - E.L. Sullivan
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - D.L. Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, WA, USA
| | - S.M. Levy
- Department of Preventive & Community Dentistry, College of Dentistry, and Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - C.M. McKinney
- Department of Child Health, Behavior, and Development, Seattle Children’s Research Institute, Seattle, WA, USA
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, WA, USA
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Ha DH, Nguyen HV, Bell LK, Devenish-Coleman G, Golley RK, Thomson WM, Manton DJ, Leary SD, Scott JA, Spencer J, Do LG. Trajectories of child free sugars intake and dental caries - a population-based birth cohort study. J Dent 2023:104559. [PMID: 37230240 DOI: 10.1016/j.jdent.2023.104559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVES To investigate the association between trajectories of free sugars intake during the first five years of life and dental caries experience at five years. METHODS Data from the SMILE population-based prospective birth cohort study, collected at one, two and five years old, were used. A 3-days dietary diary and food frequency questionnaire were used to estimate free sugars intake (FSI) in grams. The primary outcomes were dental caries prevalence and experience (dmfs). The Group-Based Trajectory Modelling method was used to characterize three FSI trajectories ('Low and increasing'; 'Moderate and increasing'; and 'High and increasing'), which were the main exposures. Multivariable regression models were generated to compute adjusted prevalence ratios (APR) and rate ratios (ARR) for the exposure, controlling for socioeconomic factors. RESULTS The prevalence of caries was 23.3%, with a mean dmfs of 1.4, and a median of 3.0 among those who had caries. There were clear gradients of caries prevalence and experience by the FSI trajectories. The 'High and increasing' had an APR of 2.13 (95%CI 1.23-3.70) and ARR of 2.77 (95%CI 1.45-5.32) against the 'Low and increasing'. The 'Moderate and increasing' group had intermediate estimates. A quarter of the caries cases could have been prevented if the whole study sample had been in the 'Low and increasing' FSI trajectory. CONCLUSION A sustained, high trajectory of FSI from a young age was positively associated with child dental caries. Measures to minimise consumption of free sugars must commence early in life. CLINICAL SIGNIFICANCE The study has provided high level evidence to inform clinicians' decisions in promoting a healthy dietary pattern for young children.
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Affiliation(s)
- Diep H Ha
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia.
| | - Huy V Nguyen
- Health Innovation and Transformation Centre, Federation University, Australia
| | - Lucinda K Bell
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | | | - Rebecca K Golley
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | - W Murray Thomson
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Australia
| | | | - Sam D Leary
- Centrum voor Tandheelkunde en Mondzorgkunde, UMCG, University of Groningen, the Netherlands
| | - Jane A Scott
- Nutrition and Dietetics, School of Population Health, Curtin University, Australia
| | - John Spencer
- Bristol Biomedical Research Centre Nutrition Theme, Bristol Dental School, University of Bristol, United Kingdom
| | - Loc G Do
- School of Dentistry, Faculty of Health and Behavioural Sciences, The University of Queensland, Australia; Nutrition and Dietetics, School of Population Health., Curtin University, Australia; Australian Research Centre for Population Oral Health, University of Adelaide, Australia
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Bernstein JT, Christoforou AK, Ng AP, Weippert M, Mulligan C, Flexner N, L'Abbe MR. Canadian Free Sugar Intake and Modelling of a Reformulation Scenario. Foods 2023; 12:foods12091771. [PMID: 37174309 PMCID: PMC10178368 DOI: 10.3390/foods12091771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 04/17/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Recommendations suggest limiting the intake of free sugar to under 10% or 5% of calories in order to reduce the risk of negative health outcomes. This study aimed to examine Canadian free sugar intake and model how intakes change following the implementation of a systematic reformulation of foods and beverages to be 20% lower in free sugar. Additionally, this study aimed to examine how calorie intake might be impacted by this reformulation scenario. Canadians' free sugar and calorie intakes were determined using free sugar and calorie data from the Food Label Information Program (FLIP) 2017, a Canadian branded food composition database, and applied to foods reported as being consumed in Canadian Community Health Survey-Nutrition (CCHS-Nutrition) 2015. A "counterfactual" scenario was modelled to examine changes in intake following the reformulation of foods to be 20% lower in free sugar. The overall mean free sugar intake was 12.1% of calories and was reduced to align with the intake recommendations at 10% of calories in the "counterfactual" scenario (p < 0.05). Calorie intake was reduced by 3.2% (60 calories) in the "counterfactual" scenario (p < 0.05). Although the overall average intake was aligned with the recommendations, many age/sex groups exceeded the recommended intake, even in the "counterfactual" scenario. The results demonstrate a need to reduce the intake of free sugar in Canada to align with dietary recommendations, potentially through reformulation. The results can be used to inform future program and policy decisions related to achieving the recommended intake levels of free sugar in Canada.
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Affiliation(s)
- Jodi T Bernstein
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Anthea K Christoforou
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Alena Praneet Ng
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Madyson Weippert
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Christine Mulligan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Nadia Flexner
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Mary R L'Abbe
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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Flexner N, Bernstein JT, Weippert MV, Labonté MÈ, Christoforou AK, Ng AP, L'Abbe MR. How Many Diet-Related Non-Communicable Disease Deaths Could Be Averted or Delayed If Canadians Reduced Their Consumption of Calories Derived from Free Sugars Intake? A Macrosimulation Modeling Study. Nutrients 2023; 15:nu15081835. [PMID: 37111054 PMCID: PMC10140857 DOI: 10.3390/nu15081835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/07/2023] [Accepted: 04/09/2023] [Indexed: 04/29/2023] Open
Abstract
Free sugars are a major source of calories in diets and contribute to the burden of many non-communicable diseases (NCDs). The World Health Organization (WHO) recommends reducing free sugars intake to less than 10% of total energy. This study aimed to estimate the number of diet-related NCD deaths which could be averted or delayed if Canadian adults were to reduce their calorie intake due to a systematic 20% reduction in the free sugars content in foods and beverages in Canada. We used the Preventable Risk Integrated ModEl (PRIME) to estimate the potential health impact. An estimated 6770 (95% UI 6184-7333) deaths due to diet-related NCDs could be averted or delayed, mostly from cardiovascular diseases (66.3%). This estimation would represent 7.5% of diet-related NCD deaths observed in 2019 in Canada. A 20% reduction in the free sugars content in foods and beverages would lead to a 3.2% reduction in calorie intake, yet an important number of diet-related NCD deaths could be averted or delayed through this strategy. Our findings can inform future policy decisions to support Canadians' free sugars intake reduction, such as proposing target levels for the free sugars content in key food categories.
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Affiliation(s)
- Nadia Flexner
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jodi T Bernstein
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Madyson V Weippert
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Marie-Ève Labonté
- Centre Nutrition, Santé et Société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, QC G1V 0A6, Canada
| | - Anthea K Christoforou
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Alena Praneet Ng
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Mary R L'Abbe
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
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Moran GP, Zgaga L, Daly B, Harding M, Montgomery T. Does fluoride exposure impact on the human microbiome? Toxicol Lett 2023; 379:11-19. [PMID: 36871794 DOI: 10.1016/j.toxlet.2023.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023]
Abstract
Fluoride is added to drinking water in some countries to prevent tooth decay (caries). There is no conclusive evidence that community water fluoridation (CWF) at WHO recommended concentrations for caries prevention has any harmful effects. However, research is ongoing regarding potential effects of ingested fluoride on human neurodevelopment and endocrine dysfunction. Simultaneously, research has emerged highlighting the significance of the human microbiome in gastrointestinal and immune health. In this review we evaluate the literature examining the effect of fluoride exposure on the human microbiome. Unfortunately, none of the studies retrieved examined the effects of ingested fluoridated water on the human microbiome. Animal studies generally examined acute fluoride toxicity following ingestion of fluoridated food and water and conclude that fluoride exposure can detrimentally perturb the normal microbiome. These data are difficult to extrapolate to physiologically relevant human exposure dose ranges and the significance to humans living in areas with CWF requires further investigation. Conversely, evidence suggests that the use of fluoride containing oral hygiene products may have beneficial effects on the oral microbiome regarding caries prevention. Overall, while fluoride exposure does appear to impact the human and animal microbiome, the long-term consequences of this requires further study.
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Affiliation(s)
- Gary P Moran
- School of Dental Science Trinity College Dublin and Dublin Dental University Hospital, Dublin 2, Republic of Ireland.
| | - Lina Zgaga
- Department of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Dublin 24, Republic of Ireland
| | - Blánaid Daly
- School of Dental Science Trinity College Dublin and Dublin Dental University Hospital, Dublin 2, Republic of Ireland
| | - Mairead Harding
- Oral Health Services Research Centre, University College Cork, Cork, Republic of Ireland
| | - Therese Montgomery
- Department of Analytical, Biopharmaceutical and Medical Sciences, Atlantic Technological University (ATU) Galway, Galway, Republic of Ireland
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11
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Loughman A, Adler CJ, Macpherson H. Unlocking Modifiable Risk Factors for Alzheimer's Disease: Does the Oral Microbiome Hold Some of the Keys? J Alzheimers Dis 2023; 92:1111-1129. [PMID: 36872775 DOI: 10.3233/jad-220760] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Advancing age is recognized as the primary risk factor for Alzheimer's disease (AD); however approximately one third of dementia cases are attributable to modifiable risk factors such as hypertension, diabetes, smoking, and obesity. Recent research also implicates oral health and the oral microbiome in AD risk and pathophysiology. The oral microbiome contributes to the cerebrovascular and neurodegenerative pathology of AD via the inflammatory, vascular, neurotoxic, and oxidative stress pathways of known modifiable risk factors. This review proposes a conceptual framework that integrates the emerging evidence regarding the oral microbiome with established modifiable risk factors. There are numerous mechanisms by which the oral microbiome may interact with AD pathophysiology. Microbiota have immunomodulatory functions, including the activation of systemic pro-inflammatory cytokines. This inflammation can affect the integrity of the blood-brain barrier, which in turn modulates translocation of bacteria and their metabolites to brain parenchyma. Amyloid-β is an antimicrobial peptide, a feature which may in part explain its accumulation. There are microbial interactions with cardiovascular health, glucose tolerance, physical activity, and sleep, suggesting that these modifiable lifestyle risk factors of dementia may have microbial contributors. There is mounting evidence to suggest the relevance of oral health practices and the microbiome to AD. The conceptual framework presented here additionally demonstrates the potential for the oral microbiome to comprise a mechanistic intermediary between some lifestyle risk factors and AD pathophysiology. Future clinical studies may identify specific oral microbial targets and the optimum oral health practices to reduce dementia risk.
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Affiliation(s)
- Amy Loughman
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, Food & Mood Centre, Barwon Health, Geelong, Victoria, Australia
| | - Christina J Adler
- Charles Perkins Centre, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Helen Macpherson
- Deakin University, IPAN - the Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, Victoria, Australia
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12
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Tay N, Gan H, de Sousa FB, Shen L, Nóbrega DF, Peng C, Kilpatrick-Liverman L, Wang W, Lavender S, Pilch S, Han J. Improved mineralization of dental enamel by electrokinetic delivery of F - and Ca 2+ ions. Sci Rep 2023; 13:516. [PMID: 36627315 PMCID: PMC9832158 DOI: 10.1038/s41598-022-26423-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
This in vitro study evaluated the effects of the infiltration of F- and Ca2+ ions into human enamel by electrokinetic flow (EKF) on the enamel microhardness and F- content. Sound human enamel ground sections of unerupted third molars were infiltrated with de-ionized water by EKF and with F- ion by EKF respectively. All samples were submitted to two successive transverse acid-etch biopsies (etching times of 30 s and 20 min) to quantify F- ion infiltrated deep into enamel. Remarkably, sound enamel showed a large increase in microhardness (MH) after infiltration of NaF (p < 0.00001) and CaCl2 (p = 0.013) by EKF. Additionally, NaF-EKF increased the remineralization in the lesion body of artificial enamel caries lesions compared to controls (p < 0.01). With the enamel biopsy technique, at both etching times, more F- ions were found in the EKF-treated group than the control group (p << 0.05), and more fluoride was extracted from deeper biopsies in the NaF-EKF group. In conclusion, our results show that EKF treatment is superior in transporting Ca2+ and F- ions into sound enamel when compared to molecular diffusion, enhancing both the mineralization of sound enamel and the remineralization of artificial enamel caries.
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Affiliation(s)
- NamBeng Tay
- grid.486188.b0000 0004 1790 4399Engineering Cluster, Singapore Institute of Technology, 10 Dover Drive, Singapore, 138683 Singapore
| | - HiongYap Gan
- Engineering Cluster, Singapore Institute of Technology, 10 Dover Drive, Singapore, 138683, Singapore.
| | - Frederico Barbosa de Sousa
- grid.411216.10000 0004 0397 5145Department of Morphology and Graduate Program in Dentistry, Health Sciences Center, Federal University of Paraiba, Joao Pessoa, Cidade Universitaria, Paraíba, Brazil
| | - Lu Shen
- grid.486188.b0000 0004 1790 4399Engineering Cluster, Singapore Institute of Technology, 10 Dover Drive, Singapore, 138683 Singapore
| | | | - Chenhui Peng
- grid.56061.340000 0000 9560 654XDepartment of Physics and Materials Science, University of Memphis, Memphis, TN USA
| | | | - Wei Wang
- grid.418753.c0000 0004 4685 452XColgate-Palmolive Technology Center, Piscataway, NJ USA
| | - Stacey Lavender
- grid.418753.c0000 0004 4685 452XColgate-Palmolive Technology Center, Piscataway, NJ USA
| | - Shira Pilch
- grid.418753.c0000 0004 4685 452XColgate-Palmolive Technology Center, Piscataway, NJ USA
| | - Jongyoon Han
- Department of Electric Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, MA, USA. .,Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA.
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13
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Karande S, Chong GTF, Megally H, Parmar D, Taylor GW, Obadan‐Udoh EM, Agaku IT. Changes in dental and medical visits before and during the COVID-19 pandemic among U.S. children aged 1-17 years. Community Dent Oral Epidemiol 2022; 51:483-493. [PMID: 36326121 PMCID: PMC9877772 DOI: 10.1111/cdoe.12806] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/14/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The COVID-19 pandemic has tremendously impacted the U.S. healthcare system, but no study has examined the impact of the pandemic on utilization of dental care among U.S. children. Changes in past-year dental versus medical visits and perceived unmet health needs between 2019 and 2020 among U.S. children aged 1-17 years were examined. METHODS National and state representative, cross-sectional data from the National Survey of Children's Health conducted during June 2019-January 2020 (i.e. pre-pandemic, n = 28 500) and July 2020-January 2021 (i.e. intra-pandemic, n = 41 380) were analysed. Any past-year visit and perceived unmet needs (i.e. delay or inability to receive needed care) were reported by the parent proxy. Weighted prevalence estimates were compared using two-tailed chi-squared tests at p < .05. Poisson regression analyses were used to explore the relationship between having dental and/or medical unmet needs during the pandemic and indicators of poor health and social wellbeing. RESULTS Between 2019 and 2020, a significantly reduced prevalence of past-year medical (87.2%-81.3%) and dental visits (82.6%-78.2%) among U.S. children aged 1-17 years (all p < .05) were observed. Correspondingly, perceived unmet needs increased by half for dental care (from 2.9% in 2019 to 4.4% in 2020) and almost one-third for medical care (from 3.2% to 4.2% in 2020). Subgroups with the highest prevalence of unmet dental need included those with low socio-economic status, living with their grandparents, uninsured and living with a smoker. CONCLUSIONS Unmet health needs increased in general but increased more for dental than for medical care among U.S. children aged 1-17 years. Enhanced and sustained efforts will be needed to deliver targeted services towards disadvantaged segments of the population to narrow existing disparities.
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Affiliation(s)
- Sharvari Karande
- Division of Oral Epidemiology and Dental Public HealthUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Gabriel Tse Feng Chong
- Division of Oral Epidemiology and Dental Public HealthUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Hayam Megally
- Division of Oral Epidemiology and Dental Public HealthUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Digvijaysinh Parmar
- Division of Oral Epidemiology and Dental Public HealthUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - George W. Taylor
- Division of Oral Epidemiology and Dental Public HealthUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Enihomo Mary Obadan‐Udoh
- Division of Oral Epidemiology and Dental Public HealthUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Israel Terungwa Agaku
- Division of Oral Epidemiology and Dental Public HealthUniversity of California San FranciscoSan FranciscoCaliforniaUSA,Department of Oral Health Policy and EpidemiologyHarvard School of Dental MedicineBostonMassachusettsUSA
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14
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Cascaes AM, Silva NRJD, Fernandez MDS, Bomfim RA, Vaz JDS. Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis. Br J Nutr 2022; 129:1-10. [PMID: 35894293 DOI: 10.1017/s0007114522002409] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This study summarised the association between ultra-processed food (UPF) consumption and dental caries in children and adolescents through a systematic review and meta-analysis. The search of PubMed, Cochrane, Web of Science and Scopus databases using the 'PECOS' strategy retrieved 1462 eligible articles. Only studies with humans aged ≤ 19 years; that assessed groups of any UPF or specific UPF items; that measured dental caries as the decayed, filled and missing surfaces or teeth indexes, based on the WHO criteria; cross-sectional, case-control, cohort and all types of interventions that examined the adjusted association between UPF consumption and dental caries were included. All studies received qualitative evaluation. Meta-analysis using random-effects models combined multivariable-adjusted OR for case-control and cross-sectional studies and risk ratio (RR) for longitudinal studies of the highest v. lowest category of UPF consumption. Forty-two studies were included in the qualitative synthesis and twenty-seven in the meta-analysis. The pooled RR was 1·71 (95 % CI 1·31, 2·24), and the pooled OR was 1·55 (95 % CI 1·37, 1·75). The highest OR was found among participants who had dental caries prevalence >70 % (OR = 3·67, 95 % CI 2·16, 6·23). Better evidence quality was found among cohort studies that evaluated children <6 years old. The findings suggest that higher UPF consumption is associated with greater dental caries in children and adolescents. Public health efforts to reduce UPF consumption are needed to improve the oral health of children and adolescents.
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Affiliation(s)
- Andreia Morales Cascaes
- Federal University of Santa Catarina, Department of Public Health, Graduate Program in Public Health, Graduate Program in Dentistry, Florianópolis, SC, Brazil
| | | | | | - Rafael Aiello Bomfim
- Federal University of Mato Grosso do Sul, School of Dentistry, Graduate Program in Dentistry, Campo Grande, MS, Brazil
| | - Juliana Dos Santos Vaz
- Federal University of Pelotas, Faculty of Nutrition, Graduate Program in Nutrition and Foods, Pelotas, RS, Brazil
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15
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Martín-Rodríguez A, Bustamante-Sánchez Á, Martínez-Guardado I, Navarro-Jiménez E, Plata-SanJuan E, Tornero-Aguilera JF, Clemente-Suárez VJ. Infancy Dietary Patterns, Development, and Health: An Extensive Narrative Review. CHILDREN 2022; 9:children9071072. [PMID: 35884056 PMCID: PMC9319947 DOI: 10.3390/children9071072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/03/2022] [Accepted: 07/16/2022] [Indexed: 11/27/2022]
Abstract
Correct dietary patterns are important for a child’s health from birth to adulthood. Understanding a child’s health as a state of entire physical, mental, and social well-being is essential. However, reaching adulthood in a complete health proper state is determined by feeding and dietary habits during preconception, pregnancy, or children infancy. Different factors, such as the mother’s lifestyle, culture, or socioeconomic status, are crucial during all these phases. In this review, we aimed to assess the long-term associations between infancy dietary patterns and health and their influence on development and growth. To reach this objective, a consensus critical review was carried out using primary sources such as scientific articles, and secondary bibliographic indexes, databases, and web pages. PubMed, SciELO, and Google Scholar were the tools used to complete this research. We found that high-income countries promote high-calorie foods and, consequently, obesity problems among children are rising. However, undernutrition is a global health issue concerning children in low- and middle-income countries; thus, parental socioeconomic status in early life is essential to children’s health and development, showing that biological, social, and environmental influences are increased risk factors for chronic diseases. This narrative review is aimed to collect evidence for early nutritional intervention and future disease prevention.
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Affiliation(s)
| | - Álvaro Bustamante-Sánchez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | | | | | | | - José Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Correspondence: (Á.B.-S.); (J.F.T.-A.); Fax: +34-911-413-585 (J.F.T.-A.)
| | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain; (A.M.-R.); (V.J.C.-S.)
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia
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16
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Guo A, Wide U, Arvidsson L, Eiben G, Hakeberg M. Dietary intake and meal patterns among young adults with high caries activity: a cross-sectional study. BMC Oral Health 2022; 22:190. [PMID: 35590301 PMCID: PMC9118703 DOI: 10.1186/s12903-022-02227-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/06/2022] [Indexed: 11/16/2022] Open
Abstract
Background Dental caries is a multifactorial disease that is highly dependent on diet, where a lower consumption and intake frequency of sugar would be favorable. The aims were (i) to examine dietary intake and meal patterns, more specifically sugar intake and foods high in sugar, among young adults with high caries activity, and (ii) to investigate the association between dietary and meal patterns consumption, and level of caries activity. Methods This study presents baseline data from an ongoing randomized controlled trial. A total of 50 young adults (aged 23.0 ± 3.0 years) with ≥ 2 decayed tooth surfaces were included. Dietary intake was captured with a 59-item food frequency questionnaire (FFQ) and a three-day food diary. Adherence to dietary guidelines was analyzed by comparing the dietary intake to the Nordic Nutritional Recommendations (NNR) 2012 and by using the Healthy Dietary Adherence score (HDAS). Participants were categorized into two groups: (i) the Caries group with 2–4 decayed surfaces, and (ii) the High caries group with ≥ 5 decayed surfaces. Results The High caries group reported a statistically significantly higher snack and total meal intake compared to the Caries group, as well as a sugar intake exceeding the Nordic nutritional recommendations. The majority of the participants reported a high intake frequency (> 2.5/day) of sweet foods and drinks and less than one intake of fruit and vegetables, respectively, per day. Similar results were found when analyzing adherence by using the HDAS, where the lowest adherence according to dietary guidelines was shown for the food groups of sugar, whole meal products, and fruit and vegetables. Conclusion The results indicated a high intake of sugar and low intake of fruit, vegetables, and fiber in high caries-active individuals.
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Affiliation(s)
- Annie Guo
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg, Sweden
| | - Ulla Wide
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, 40530, Gothenburg, Sweden. .,Public Dental Service, Region Västra Götaland, Sweden.
| | - Louise Arvidsson
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Magnus Hakeberg
- Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, P.O. Box 450, 40530, Gothenburg, Sweden.,Public Dental Service, Region Västra Götaland, Sweden
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17
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Children's and Parents' Marburg Sugar Index (MSI) Values: Are They Comparable? Nutrients 2022; 14:nu14081630. [PMID: 35458192 PMCID: PMC9029305 DOI: 10.3390/nu14081630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/06/2022] [Accepted: 04/08/2022] [Indexed: 11/17/2022] Open
Abstract
Studies on children’s nutritional behaviour (CNB) rarely compare children’s answers regarding the frequency of their sugar intake with the respective statements of their parents. Therefore, data from a prevention study were used to analyse this aspect, as well as a potential correlation between Marburg Sugar Index (MSI) values and caries experience of children. The present study based its questionnaire data on CNB and caries data. Pairs of questionnaires filled in separately by children and parents of the participating families were dichotomised by either having completed the diet section entirely (Group A) or in part (Group B). The MSI scores were calculated separately for children and parents. The statistical confidence level was set at α = 0.05 (two-sided). Furthermore, the Pearson correlation coefficient was calculated and tested for “r = 0”. Additionally, a test for equality of the correlations was applied. The number of available questionnaire pairs was 429 in Group A and 400 in Group B. In both groups, significant correlations between children’s and parents’ MSI scores (A: r = 0.301, p < 0.001; B: r = 0.226, p < 0.001) were found. Using Spearman’s Rho, a significant correlation between MSI scores and children’s caries experiences was observed in Group A. MSI scores based on dietary questionnaires can be used to obtain consistent information on children’s CNB provided by the children themselves or their parents. This is true even when the MSI score has to be calculated on the basis of incomplete questionnaires. Questionnaire-based CNB information can improve the effectiveness of individual or group preventive measures supplemented by individually adapted nutritional counselling.
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18
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Moores CJ, Kelly SAM, Moynihan PJ. Systematic Review of the Effect on Caries of Sugars Intake: Ten-Year Update. J Dent Res 2022; 101:1034-1045. [PMID: 35302414 DOI: 10.1177/00220345221082918] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
An update of the systematic review of evidence on the association between amount of sugars intake and dental caries, as well as on the effect of restricting sugars intake to <10% and <5% energy (E) on caries, was conducted, almost 10 y since the review that informed the World Health Organization (WHO) Guideline on Sugars. The aim was to systematically review epidemiological data published from 2011 to 2020 on the amount of sugars consumption and levels of caries and to report the findings for adults and children. Data sources included MEDLINE, EMBASE, Cochrane Database, Cochrane Central Register of Controlled Trials, Latin American and Caribbean Health Sciences, China National Knowledge Infrastructure, Scopus, and Google Scholar. Eligible studies reported the amount of sugars and caries, measured as prevalence, incidence, or severity. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Risk of bias was assessed using the Office of Health Assessment and Translation tool. Vote counting and harvest plots provided the basis for evidence synthesis. From 488 new papers identified, 23 studies were eligible: 4 cohort, 1 case-controlled, 12 cross-sectional, and 6 ecological. Eleven of 15 studies in children and 6 of 8 studies in adults reported at least 1 positive association between sugars and caries. Six of 7 studies in children and 4 of 4 studies in adults, with data enabling comparison of caries levels with sugars intakes >10%E and <10%E, showed lower caries when sugars intake was <10%E. Amalgamating with original studies yielded 64 of 78 studies showing at least 1 positive association, 20 of 78 a null association, and 3 of 78 a negative association between sugars and caries. GRADE profiles of new and original cohort data confirmed "moderate-quality" evidence that caries is lower when sugars intake is <10%E. Furthermore, new cohort data upgraded the quality of evidence (from "very low" to "low") for lower caries when free sugars are <5%E. The findings support and strengthen original evidence underpinning the WHO recommendations for sugars.
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Affiliation(s)
- C J Moores
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - S A M Kelly
- Cambridge Public Health, University of Cambridge, Cambridge, UK.,THIS Institute (The Healthcare Improvement Studies Institute), University of Cambridge, Cambridge, UK
| | - P J Moynihan
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,School of Dental Sciences, Newcastle University, Newcastle, UK
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19
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Al-Jawaldeh A, Abbass MMS. Unhealthy Dietary Habits and Obesity: The Major Risk Factors Beyond Non-Communicable Diseases in the Eastern Mediterranean Region. Front Nutr 2022; 9:817808. [PMID: 35369054 PMCID: PMC8970016 DOI: 10.3389/fnut.2022.817808] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/11/2022] [Indexed: 12/14/2022] Open
Abstract
There are 22 countries in the Eastern Mediterranean Region (EMR) expanding from Morocco in the west to Pakistan and Afghanistan in the east, containing a population of 725,721 million in 2020. In the previous 30 years, the illness burden in the EMR has transmitted from communicable diseases to non-communicable diseases such as diabetes, cardiovascular diseases, and cancer. In 2019, cardiovascular mortality in the EMR was mostly attributed to ischemic heart disease, the first reason for mortality in 19 countries in the region. Stroke was the second reason for death in nine countries followed by diabetes, which was ranked as the second reason for death in two countries. The prominent nutrition-related NCDs risk factors in EMR include obesity, hypertension, high fasting plasma glucose, and upregulated unhealthy diet consumption. Most of the EMR population are unaware of their NCDs risk factor status. These risk factors, even if treated, are often poorly controlled, therefore, inhibiting their existence by changing the lifestyle to proper dietary habits and sufficient physical activity is mandatory. In this review, the epidemiology and nutrition-related risk factors of NCDs in the EMR will be discussed and illustrated, aiming to scale up action and support decision-makers in implementing cost effective strategies to address obesity and NCDs prevention and management in the region.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
| | - Marwa M. S. Abbass
- World Health Organization (WHO), Regional Office for the Eastern Mediterranean (EMRO), Cairo, Egypt
- Oral Biology Department, Faculty of Dentistry, Cairo University, Cairo, Egypt
- *Correspondence: Marwa M. S. Abbass
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20
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Quality of education and adolescents’ oral health-related behaviours: a multilevel analysis. Eur Arch Paediatr Dent 2022; 23:547-556. [DOI: 10.1007/s40368-022-00700-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 02/23/2022] [Indexed: 10/18/2022]
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21
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Ha DH, Nguyen H, Dao A, Golley RK, Thomson WM, Manton DJ, Leary S, Scott J, Spencer AJ, Do LG. Group-based trajectories of maternal intake of sugar-sweetened beverage and offspring oral health from a prospective birth cohort study. J Dent 2022; 122:104113. [DOI: 10.1016/j.jdent.2022.104113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 03/22/2022] [Accepted: 03/25/2022] [Indexed: 11/24/2022] Open
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22
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Ahmed O, Sibuyi NRS, Fadaka AO, Madiehe MA, Maboza E, Meyer M, Geerts G. Plant Extract-Synthesized Silver Nanoparticles for Application in Dental Therapy. Pharmaceutics 2022; 14:pharmaceutics14020380. [PMID: 35214112 PMCID: PMC8875651 DOI: 10.3390/pharmaceutics14020380] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/16/2022] [Accepted: 01/29/2022] [Indexed: 12/22/2022] Open
Abstract
Oral diseases are the most common non-communicable diseases in the world, with dental caries and periodontitis causing major health and social problems. These diseases can progress to systematic diseases and cause disfigurement when left untreated. However, treatment of oral diseases is among the most expensive treatments and often focus on restoration of form and function. Caries prevention has traditionally relied on oral hygiene and diet control, among other preventive measures. In this paper, these measures are not disqualified but are brought into a new context through the use of nanotechnology-based materials to improve these conventional therapeutic and preventive measures. Among inorganic nanomaterials, silver nanoparticles (AgNPs) have shown promising outcomes in dental therapy, due to their unique physicochemical properties and enhanced anti-bacterial activities. As such, AgNPs may provide newer strategies for treatment and prevention of dental infections. However, numerous concerns around the chemical synthesis of nanomaterials, which are not limited to cost and use of toxic reducing agents, have been raised. This has inspired the green synthesis route, which uses natural products as reducing agents. The biogenic AgNPs were reported to be biocompatible and environmentally friendly when compared to the chemically-synthesized AgNPs. As such, plant-synthesized AgNPs can be used as antimicrobial, antifouling, and remineralizing agents for management and treatment of dental infections and diseases.
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Affiliation(s)
- Omnia Ahmed
- Department of Restorative Dentistry, University of the Western Cape, Bellville 7535, South Africa;
| | - Nicole Remaliah Samantha Sibuyi
- Department of Science and Innovation (DSI), Mintek Nanotechnology Innovation Centre (NIC) Biolabels Research Node, Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa; (N.R.S.S.); (A.O.F.); (M.A.M.)
| | - Adewale Oluwaseun Fadaka
- Department of Science and Innovation (DSI), Mintek Nanotechnology Innovation Centre (NIC) Biolabels Research Node, Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa; (N.R.S.S.); (A.O.F.); (M.A.M.)
| | - Madimabe Abram Madiehe
- Department of Science and Innovation (DSI), Mintek Nanotechnology Innovation Centre (NIC) Biolabels Research Node, Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa; (N.R.S.S.); (A.O.F.); (M.A.M.)
| | - Ernest Maboza
- Oral and Dental Research Laboratory, University of the Western Cape, Bellville 7535, South Africa;
| | - Mervin Meyer
- Department of Science and Innovation (DSI), Mintek Nanotechnology Innovation Centre (NIC) Biolabels Research Node, Department of Biotechnology, University of the Western Cape, Bellville 7535, South Africa; (N.R.S.S.); (A.O.F.); (M.A.M.)
- Correspondence: (M.M.); (G.G.); Tel.: +27-219-592-032 (M.M.); +27-846-062-104 (G.G.)
| | - Greta Geerts
- Department of Restorative Dentistry, University of the Western Cape, Bellville 7535, South Africa;
- Correspondence: (M.M.); (G.G.); Tel.: +27-219-592-032 (M.M.); +27-846-062-104 (G.G.)
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Orkusz A. An Assessment of the Nutritional Value of the Preschool Food Rations for Children from the Wroclaw District, Poland—The Case of a Big City. Nutrients 2022; 14:nu14030460. [PMID: 35276818 PMCID: PMC8838055 DOI: 10.3390/nu14030460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 02/04/2023] Open
Abstract
The evaluation of nutrition is an essential element of preventing chronic diseases and can be used to determine nutritional recommendations. A child spends about 7–8 h a day in a kindergarten; therefore, meals served there should be balanced appropriately to ensure the full psychophysical development of the young organism. At preschool age, children develop eating habits that can have life-long effects. Based on 10-day menus, the study aimed to estimate the energy and nutritional value of children’s diets at four randomly selected kindergartens in the Wroclaw district, Poland. In total, 80 menus were analyzed (40 for summer and 40 for autumn). The data from kindergartens were analyzed based on the Diet 6D computer program. Regardless of the kindergarten, the analyzed food rations showed irregularities related to excessive supplies (in reference to the dietary recommendations) of sucrose, fiber, salt, magnesium, and vitamin A. The preschool food rations did not cover demands with respect to PUFA n-3, PUFA-n-6, calcium, and vitamin D. The observed irregularities confirm the need to monitor the content of energy and nutrients in preschool menus to be able to correct any dietary errors.
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Affiliation(s)
- Agnieszka Orkusz
- Department of Biotechnology and Food Analysis, Wroclaw University of Economics and Business, 53-345 Wroclaw, Poland
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24
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Meuffels SA, Kuijpers-Jagtman AM, Tjoa STH, Bonifacio CC, Carvajal Monroy PL. Malocclusion complexity and orthodontic treatment need in children with autism spectrum disorder. Clin Oral Investig 2022; 26:6265-6273. [PMID: 35701552 PMCID: PMC9525343 DOI: 10.1007/s00784-022-04578-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 06/07/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aimed to investigate the malocclusion complexity and orthodontic treatment need among children with and without autism spectrum disorder (ASD) referred for orthodontic treatment by quantifying the Discrepancy Index (DI) and Index of Orthodontic Treatment Need (IOTN). MATERIALS AND METHODS Dental records of 48 ASD and 49 non-ASD consecutive patients aged between 9 and 18 years (median age 13.0 years) referred for orthodontic treatment were reviewed and compared. The Discrepancy Index (DI) was quantified to determine the malocclusion complexity, and the Index of Orthodontic Treatment Need (IOTN), including the Dental Health Component (IOTN-DHC) and Aesthetic Component (IOTN-AC), was quantified to determine the orthodontic treatment need. Statistical analysis included descriptive analysis, Pearson chi-square tests, Fisher's exact test, Mann-Whitney U tests, and several univariate and multivariate regression analyses. The statistical analysis used descriptive analysis, Pearson chi-square test, Fisher's exact test, and multivariate logistic regression. RESULTS The results show that both malocclusion complexity (DI, p = 0.0010) and orthodontic treatment need (IOTN-DHC, p = 0.0025; IOTN-AC p = 0.0009) were significantly higher in children with ASD. Furthermore, children with ASD had a higher prevalence of increased overjet (p = .0016) and overbite (p = .031). CONCLUSIONS Malocclusion complexity and orthodontic treatment need are statistically significantly higher among children with ASD than children without ASD, independent of age and sex. CLINICAL RELEVANCE Children with autism may benefit from visits to a dental specialist (orthodontist) to prevent, to some extent, developing malocclusions from an early age.
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Affiliation(s)
- Stephanie A. Meuffels
- Department of Pediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands ,Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Bern, Switzerland ,Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia
| | - Stephen T. H. Tjoa
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Clarissa C. Bonifacio
- Department of Pediatric Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, the Netherlands
| | - Paola L. Carvajal Monroy
- Department of Oral and Maxillofacial Surgery, Special Dental Care and Orthodontics, Erasmus Medical Center, Rotterdam, the Netherlands
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25
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Subramanyam D, Selvaraju G, Shankari SV, Parthasarathi S, Thomas P, Settu S. Incidence of dental caries in relation to sweet taste perception and dietary habits among students – A cross sectional study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2022; 14:S662-S665. [PMID: 36110626 PMCID: PMC9469261 DOI: 10.4103/jpbs.jpbs_862_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 11/04/2022] Open
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26
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Effenberger S, Greenwall L, Cebula M, Myburgh N, Simpson K, Smit D, Wicht MJ, Schwendicke F. Cost-effectiveness and efficacy of fluoride varnish for caries prevention in South African children: A cluster-randomized controlled community trial. Community Dent Oral Epidemiol 2021; 50:453-460. [PMID: 34676577 DOI: 10.1111/cdoe.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/28/2021] [Accepted: 10/04/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This cluster-randomized controlled community trial aimed to assess the efficacy and costs of fluoride varnish (FV) application for caries prevention in a high-risk population in South Africa. METHODS 513 children aged 4-8 years from two schools in a township in South Africa were randomly allocated by class to the FV or Control (CO) groups. In addition to supervised toothbrushing with fluoridated toothpaste in both groups, FV was applied in 3-month intervals by trained local non-professional assistants. Intraoral examinations were conducted at baseline, 12, 21 and 24 months. Primary outcome was the increment of teeth with cavitated lesions (i.e. newly developed or progressed, formerly non-cavitated lesions), requiring restoration or extraction over the study period. Additionally, treatment and re-treatment costs were analyzed. RESULTS 513 children (d1-4 mft 5.9 ± 4.3 (mean ± SD)) were randomly allocated to FV (n = 287) or CO (n = 226). 10.2% FV and CO teeth received or required a restoration; 3.9% FV and 4.1% CO teeth were extracted, without significant differences between groups. While FV generated high initial costs, follow-up costs were comparable in both groups, resulting in FV being significantly more expensive than CO (1667 ± 1055 ZAR vs. 950 ± 943 ZAR, p < .001). CONCLUSIONS Regular FV application, in addition to daily supervised toothbrushing, had no significant caries-preventive effect and was not cost-effective in a primary school setting within a peri-urban, high-risk community in South Africa. Alternative interventions on community or public health level should be considered to reduce the caries burden in high-risk communities.
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Affiliation(s)
| | | | - Marcus Cebula
- DMG Dental-Material Gesellschaft mbH, Hamburg, Germany
| | - Neil Myburgh
- Department of Community Oral Health, University of the Western Cape, Bellville, South Africa
| | - Karen Simpson
- Department of Community Oral Health, University of the Western Cape, Bellville, South Africa
| | - Dirk Smit
- Department of Community Oral Health, University of the Western Cape, Bellville, South Africa
| | - Michael J Wicht
- Department of Operative Dentistry and Periodontology, University Hospital of Cologne, Cologne, Germany
| | - Falk Schwendicke
- Department of Oral Diagnostics, Digital Health and Health Services Research, Charité - Universitätsmedizin Berlin, Berlin, Germany
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27
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Nunes LM, Führ J, Belin CHS, Moreira PR, Neves RO, de Brito ML, Morando LA, Mariath AAS, Gomes E, Bernardi JR. Complementary feeding methods in the first year of life: a study protocol for a randomized clinical trial. Trials 2021; 22:687. [PMID: 34627344 PMCID: PMC8501700 DOI: 10.1186/s13063-021-05647-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 09/20/2021] [Indexed: 12/01/2022] Open
Abstract
Background The traditional spoon-feeding approach to introduction of solid foods during the complementary feeding period is supported by consensus in the scientific literature. However, a method called Baby-Led Introduction to SolidS (BLISS) has been proposed as an alternative, allowing infants to self-feed with no adult interference. To date, there have been no trials in the Brazilian population to evaluate the effectiveness of BLISS in comparison to the traditional approach. Methods/design To evaluate and compare three different complementary feeding methods. Data on 144 mother-child pairs will be randomized into intervention groups by methods: (A) strict Parent-Led Weaning; (B) strict Baby-Led Introduction to SolidS; and (C) a mixed method. Prospective participants from Porto Alegre, Brazil, and nearby cities will be recruited through the Internet. The interventions will be performed by nutritionists and speech therapists, at 5.5 months of age of the child, at a private nutrition office equipped with a test kitchen where meals will be prepared according to the randomized method. The pairs will be followed up at 7, 9, and 12 months of age. Data will be collected through questionnaires designed especially for this study, which will include a 24h child food recall, questionnaires on the child’s and parents’ eating behavior, oral habits, eating difficulties, and choking prevalence. At 12 months of age, children will undergo blood collection to measure hemoglobin, ferritin, and C-reactive protein, saliva collection for analysis of genetic polymorphisms, and oral examination. Anthropometric parameters (child and maternal) will be measured at the baseline intervention, at a 9 month home visit, and at the end-of-study visit at the hospital. The primary outcome will be child growth and nutritional status z-scores at 12 months; secondary outcomes will include iron status, feeding behavior, acceptability of the methods, dietary variety, choking, eating behaviors, food preferences, acceptance of bitter and sweet flavors, suction, oral habits, oral hygiene behavior, dental caries, gingival health status, and functional constipation. Discussion The trial intends to ascertain whether there are potential advantages to the BLISS complementary feeding method in this specific population, generating data to support families and healthcare providers. Trial registration Brazilian Clinical Trials Registry (ReBEC): RBR- 229scm number U1111-1226-9516. Registered on September 24, 2019.
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Affiliation(s)
- Leandro Meirelles Nunes
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil.,Neonatology Section, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
| | - Jordana Führ
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil
| | - Christy Hannah Sanini Belin
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil
| | - Paula Ruffoni Moreira
- Graduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul (UFRGS) Nutrition Department, Medical School, Porto Alegre, Brazil
| | - Renata Oliveira Neves
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil.
| | - Mariana Lopes de Brito
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil
| | - Lorenzo Andreazza Morando
- Department of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul (UFRGS) Dentistry School, Porto Alegre, Brazil
| | - Adriela Azevedo Souza Mariath
- Department of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul (UFRGS) Dentistry School, Porto Alegre, Brazil
| | - Erissandra Gomes
- Department of Surgery and Orthopedics, Universidade Federal do Rio Grande do Sul (UFRGS) Dentistry School, Porto Alegre, Brazil
| | - Juliana Rombaldi Bernardi
- Graduate Program in Child and Adolescent Health, Universidade Federal do Rio Grande do Sul (UFRGS) Medical School, Porto Alegre, Brazil.,Graduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul (UFRGS) Nutrition Department, Medical School, Porto Alegre, Brazil.,Nutrition Department, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil
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28
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Drapkina OM, Karamnova NS, Kontsevaya AV, Gorny BE, Dadaeva VA, Drozdova LY, Yeganyan RA, Eliashevich SO, Izmailova OV, Lavrenova EA, Lischenko OV, Skripnikova IA, Shvabskaya OB, Shishkova VN. Russian Society for the Prevention of Noncommunicable Diseases (ROPNIZ). Alimentary-dependent risk factors for chronic non-communicable diseases and eating habits: dietary correction within the framework of preventive counseling. Methodological Guidelines. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2021. [DOI: 10.15829/1728-8800-2021-2952] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
The methodological guidelines are developed as a practical document for medical specialists working in the field of preventive medicine, in order to expand and improve the provision of this type of medical service to the adult population. The methodological guidelines include an informational and informative part for medical specialists and a practical part for patients, presented in the format of memos, contain the main sections-healthy nutrition, correction of eating habits, issues of modifying the diet for the main alimentary-dependent risk factors for chronic non-communicable diseases, such as arterial hypertension, obesity, disorders of lipid, carbohydrate and purine metabolism, a decrease in bone mineral density. They are intended for medical specialists working in the field of prevention, for doctors and secondary medical personnel of offices and departments of medical prevention, public health and medical prevention centers, healthy lifestyle specialists, teachers of medical educational institutions, for specialists who develop and implement educational programs for patients, as well as for medical specialists of a therapeutic profile.
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Affiliation(s)
- O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| | - N. S. Karamnova
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. V. Kontsevaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - B. E. Gorny
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. A. Dadaeva
- National Medical Research Center for Therapy and Preventive Medicine
| | - L. Yu. Drozdova
- National Medical Research Center for Therapy and Preventive Medicine
| | - R. A. Yeganyan
- National Medical Research Center for Therapy and Preventive Medicine
| | - S. O. Eliashevich
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Izmailova
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. A. Lavrenova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. V. Lischenko
- National Medical Research Center for Therapy and Preventive Medicine
| | - I. A. Skripnikova
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. B. Shvabskaya
- National Medical Research Center for Therapy and Preventive Medicine
| | - V. N. Shishkova
- National Medical Research Center for Therapy and Preventive Medicine
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29
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Assessment of Food Quality in School Canteens: A Comparative Quantitative Study between Primary and Secondary Schools in Malaysia. Nutrients 2021; 13:nu13093009. [PMID: 34578887 PMCID: PMC8471405 DOI: 10.3390/nu13093009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/11/2021] [Accepted: 07/19/2021] [Indexed: 12/14/2022] Open
Abstract
Schools are an important food environment to cultivate and promote healthy food choices and practices among children and adolescents. The aim of the present study was to assess the type and quality of food and beverages sold in school canteens in public primary and secondary schools in Kelantan, Malaysia. Eligible schools were randomly selected from the list of all schools and detailed information of all food and beverage items sold in the school canteens were collected during school days. Food and beverages were classified based on food groups derived from the Malaysian Food Dietary Guideline and the Recommended Foods for Healthy Cafeteria Guideline. An assessment of the traffic-light nutrition food-labelling system of the total sugar content in all pre-packaged foods was also undertaken. A total of 568 food items were identified, with secondary school canteens selling a greater proportion of food items than the primary schools (55.5% vs. 44.5%). In terms of the main food groups, grains and cereal products represented the largest food group served (33–36%), followed by beverages (21–25%) and confectionary and sweet foods (12–13%). In contrast, the vegetable and fruit group represented the smallest proportion of food items sold (1–3%). Comparisons between primary and secondary schools showed a similar trend and pattern of food types and quality of foods sold, except for animal-based foods. A greater percentage of food items in this category was found among secondary schools (12.1%) versus primary schools (6.7%). When total sugar content of all pre-packaged foods was quantified based on the traffic-light nutrition-labelling system, almost one-third of foods and beverages were classified as high (29.1%). Confectionary (19.1%) and flavoured milk and fruit drinks (10.0%) both exceeded the recommended sugar levels of >22.5 g per 100 g and >11.25 mL per 100 m L, respectively. Only one of these packaged foods and beverages (0.9%) was classified as a healthy food choice. About a quarter of the food items available in school canteens were classified as prohibited based on a new revised list of prohibited food and beverage items. These findings indicate that, despite the Guidelines, a large number of unhealthy food items are being sold in school canteens. Hence, interventions such as sustainable healthy school canteen menus should be implemented to promote healthy food choices amongst school-aged children.
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30
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Evaluation of the 'H2NOE Water Schools' programme to promote water consumption in elementary school children - a non-randomised controlled cluster trial. Public Health Nutr 2021; 25:159-169. [PMID: 34384513 PMCID: PMC8825982 DOI: 10.1017/s1368980021003438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: This study evaluated a simple environmental intervention called ‘Water Schools’ in Lower Austria providing free refillable water bottles and educational material. Design: Non-randomised controlled cluster trial with three measurements: at baseline (T0), after the intervention at 9 months (T1) and after 1-year follow-up (T2). Setting: Half-day elementary schools in Lower Austria (Austria). Participants: Third-grade pupils from twenty-two schools in the intervention group (IG) and thirty-two schools in the control group (CG) participated in the study. Data were analysed for 569 to 598 pupils in the IG and for 545 to 613 in the CG, depending on the time of measurement. Results: The consumption of tap water increased in the IG from baseline to T1 and then decreased again at T2, but this was similar in the CG (no statistically significant difference in the time trend between the IG and CG). Similar results were seen for tap water consumption in the mornings. The proportion of children who only drank tap water on school mornings increased significantly from baseline to T1 in the IG compared to the CG (P = 0·020). No difference in the changes over time occurred between the groups for the proportion of pupils drinking approximately one bottle of tap water during school mornings. Conclusions: Not only the children in the IG but also those in the CG drank more tap water after 1 school year than at the beginning. The measurement of drinking habits in the CG may have been intervention enough to bring about changes or to initiate projects.
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Hagenaars LL, Jeurissen PPT, Klazinga NS, Listl S, Jevdjevic M. Effectiveness and Policy Determinants of Sugar-Sweetened Beverage Taxes. J Dent Res 2021; 100:1444-1451. [PMID: 34034538 DOI: 10.1177/00220345211014463] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Sugar consumption is on the rise globally with detrimental (oral) health effects. There is ample evidence that sugar-sweetened beverage (SSB) taxes can efficiently reduce sugar consumption. However, evidence alone is seldom enough to implement a policy. In this article, we present a narrative synthesis of evidence, based on real-world SSB tax evaluations, and we combine this with lessons from policy development case studies. This article is structured according to the Health Policy Analysis Triangle, which identifies a policy's content and process and important contextual factors. SSB tax policy content needs to be coupled to existing problems and public sentiment, which depend on more aspects than aspects related to (oral) health alone. Whether or not to include artificially sweetened beverages, therefore, is not solely a matter of showing the evidence of their oral health impact but also dependent on the stated aim of a tax and public sentiment toward tax policies in general. SSB taxes also need to be in line with existing tax and decision-making rules. Earmarking revenue for specific (health promotion) purposes may therefore be less straightforward as it might appear. The policy process of creating context-sensitive SSB tax policy content is not easy either. Advocacy coalitions need to be formed early in the process, and stamina, expertise, and flexibility are required to get a SSB tax adopted in a specific community. This requires a meticulously considered SSB tax structure implementation process. Oral health professionals who want to lead the way in advocating for SSB taxes should realize that evidence-based arguments on potential effectiveness alone will not be enough to realize change. The oral health community can learn important lessons from other "doctor-activists" such as pulmonologists, who have successfully advocated for higher tobacco taxes by being visible in the public debate with clear messaging and robust policy proposals.
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Affiliation(s)
- L L Hagenaars
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - P P T Jeurissen
- Radboud University Medical Center, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, the Netherlands
| | - N S Klazinga
- Department of Social Medicine, Amsterdam UMC-University of Amsterdam, Amsterdam, the Netherlands
| | - S Listl
- Department of Dentistry-Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands.,Department of Conservative Dentistry, Translational Health Economics Group, Heidelberg University, Heidelberg, Germany
| | - M Jevdjevic
- Department of Dentistry-Quality and Safety of Oral Healthcare, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, the Netherlands
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32
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Thornley S, Bach K, Bird A, Farrar R, Bronte S, Turton B, Atatoa Carr P, Fa'alili-Fidow J, Morton S, Grant C. What factors are associated with early childhood dental caries? A longitudinal study of the Growing Up in New Zealand cohort. Int J Paediatr Dent 2021; 31:351-360. [PMID: 32602981 DOI: 10.1111/ipd.12686] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 05/06/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The relative importance of different strategies to prevent dental caries is not known. AIM We explored the relationship between oral health behaviours, diet, and the incidence of dental caries. DESIGN We conducted a study of children participating in the 'Growing Up in New Zealand' cohort. Exposures were oral health behaviours, a food frequency questionnaire, and sociodemographic characteristics that were recorded when the child was nine months and two years old. Outcomes were records of dental caries at ages four to seven years. RESULTS 4111 children had dental examination records from between the ages of four and seven years. High levels of dental caries were reported in children of Pacific, Asian, and Māori ethnicity. Food frequency questionnaire information was summarised into two principal components. The major axis of variation was in the intake of food and drinks with high concentrations of sugar and refined starch, with this component strongly associated with caries (multivariable incidence rate ratio of caries 0.48; 95% confidence interval: 0.38-0.61, comparing the extreme quintiles of the first principal component). CONCLUSIONS A diet high in sugar or refined starch was strongly linked to caries. Policies to reduce sugar and refined starch intake should be considered.
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Affiliation(s)
- Simon Thornley
- Section of Epidemiology and Biostatistics, University of Auckland, Auckland, New Zealand.,Auckland Regional Public Health Service, Cornwall Complex, Greenlane Clinical Centre, Auckland District Health Board, Auckland, New Zealand
| | - Katie Bach
- Paediatric Oral Health, Auckland District Health Board, Greenlane Clinical Centre, Auckland, New Zealand
| | - Amy Bird
- School of Psychology, University of Wollongong, Wollongong, NSW, Australia
| | - Rachel Farrar
- Faculty of Dentistry, Discipline of Orthodontics, University of Otago, Dunedin, New Zealand
| | - Sarah Bronte
- Paediatric Oral Health, Auckland District Health Board, Greenlane Clinical Centre, Auckland, New Zealand
| | - Bathsheba Turton
- Dental Department, University of Puthisastra, Phnom Penh, Cambodia
| | - Polly Atatoa Carr
- National Institute of Demographic and Economic Analysis, Faculty of Arts and Social Sciences, The University of Waikato, Hamilton, New Zealand.,Child and Youth Health, Waikato District Health Board, Hamilton, New Zealand.,School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand
| | | | - Susan Morton
- School of Population Health, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.,Growing Up in New Zealand, The University of Auckland, Auckland, New Zealand.,Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Cameron Grant
- Centre for Longitudinal Research - He Ara ki Mua, The University of Auckland, Auckland, New Zealand.,Department of Paediatrics: Child & Youth Health, University of Auckland, Grafton, Auckland, New Zealand.,General Paediatrics, Starship Children's Hospital, Auckland District Health Board, Auckland, New Zealand
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33
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Ha DH, Spencer AJ, Moynihan P, Thomson WM, Do LG. Excess Risk of Dental Caries from Higher Free Sugars Intake Combined with Low Exposure to Water Fluoridation. J Dent Res 2021; 100:1243-1250. [PMID: 33899569 DOI: 10.1177/00220345211007747] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The study aimed to quantify the excess risk of interaction between high free sugars (sugars) intake and lack of exposure to water fluoridation on child dental caries. Data from the Australian National Child Oral Health Study, a population-based survey of 24,664 children aged 5 to 14 y, were collected using parental questionnaires and oral epidemiological examinations by trained examiners. Information on socioeconomic status, dental health behaviors, and dental service use was used as covariates. The number of servings of sugars-containing foods and drinks consumed in a usual day was assessed as the main exposure, categorized into 5 groups. Residential history was used to calculate lifetime exposure to fluoridated water (LEFW), categorized as low (<25%), medium (25% to <75%), or high (75%-100%). Caries prevalence (dmfs/DMFS >0) and experience (dmfs/DMFS) in the primary (ages 5-10 y) and permanent (ages 8-14 y) dentitions were the main dependent variables. The association of sugars intake and LEFW with each outcome was estimated in multivariable log-Poisson regression models with robust standard error estimation, adjusted for covariates. The relative excess risk due to interaction (RERI) between sugars intake and LEFW was estimated. Strong positive gradients in all outcomes were observed across sugars intake groups. Relative to the lowest intake group, the 3 highest intake groups had significantly higher adjusted prevalence ratios for having caries and higher adjusted mean ratios of caries experience in both dentitions, after controlling for all covariates. LEFW strongly and consistently attenuated the effects of all levels of sugars intake on the outcomes. RERI estimates indicated that a combination of lack of exposure to fluoridated water and high sugars intake resulted in greater excess risk of primary and permanent caries than if there was no interaction. Evidently, children with high sugars intakes and low exposure to water fluoridation are at disproportionately higher risk of dental caries.
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Affiliation(s)
- D H Ha
- School of Dentistry, Faculty of Health Sciences, University of Queensland, Herston, Queensland, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
| | - A J Spencer
- School of Dentistry, Faculty of Health Sciences, University of Queensland, Herston, Queensland, Australia
| | - P Moynihan
- Adelaide Dental School, Faculty of Health Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | | | - L G Do
- School of Dentistry, Faculty of Health Sciences, University of Queensland, Herston, Queensland, Australia.,Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, South Australia, Australia
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Lee HJ, Han DH, Kim JH, Wu HG. The effect of comprehensive oral care program on oral health and quality of life in patients undergoing radiotherapy for head and neck cancer: A quasi-experimental case-control study. Medicine (Baltimore) 2021; 100:e25540. [PMID: 33879699 PMCID: PMC8078395 DOI: 10.1097/md.0000000000025540] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/25/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES The purpose of this study is to investigate the effect of the comprehensive oral care program on oral health status and symptoms in head and neck cancer (HNC) patients undergoing radiotherapy. METHODS This was a quasi-experimental study using a non-equivalent control group in non-synchronized design. All participants including control and experimental group were asked for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire H&N35 (EORTC QLQ-H&N35) and given an oral health education 4 times at baseline, immediate postradiotherapy, 3 months after radiotherapy, and 6 months after radiotherapy. In each visit except for final, the experimental group was given fluoride varnish application and fluoride mouth rinsing solution for daily use. Oral health examination for dental caries, plaque score (PS), bleeding on probing (BOP), and salivary flow rate was performed in baseline and 6 months after radiotherapy. Statistical analyses were done by paired t-tests and mixed ANCOVA repeated-measures analysis. RESULTS From November 1, 2013 to October 31, 2015, a total 61 patients undergoing radiotherapy for HNC cancer were enrolled (30 in control and 31 in experimental groups). Decrease in salivary flow rate was comparable between 2 groups. Dental caries increased in control group (P = .006); PS and BOP were decreased in experimental group (P < .001 and .004, respectively). Experimental group showed lower swallowing, speech problems, and less sexuality scores in EORTC QLQ-H&N35 than control group. CONCLUSION We found improvement in oral health and the quality of life in HNC patients with comprehensive oral care intervention by dental professionals. Communicating and cooperating between the healthcare and dental professionals is needed to raise the quality of health care services for HNC patients receiving radiotherapy.
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Affiliation(s)
- Hye-Ju Lee
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry
- Dental Research Institute, Seoul National University
| | - Dong-Hun Han
- Department of Preventive and Social Dentistry, Seoul National University School of Dentistry
- Dental Research Institute, Seoul National University
| | - Jin-Ho Kim
- Department of Radiation Oncology and Cancer Research Institute, Seoul National University College of Medicine
| | - Hong-Gyun Wu
- Department of Radiation Oncology and Cancer Research Institute, Seoul National University College of Medicine
- Institute of Radiation Medicine, Medical Research Center
- Cancer Research Institute, Seoul National University, Seoul, Korea
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Free Sugars Intake among Chinese Adolescents and Its Association with Dental Caries: A Cross-Sectional Study. Nutrients 2021; 13:nu13030765. [PMID: 33652968 PMCID: PMC7996778 DOI: 10.3390/nu13030765] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 02/22/2021] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
This study aims to estimate the free sugars intake, identify the primary food sources of free sugars, and explore the relationship between free sugars intake and dental caries among Chinese adolescents. This cross-sectional study included 1517 middle-school students aged 12–14 years in Changsha city, China. Adolescents completed a 12-item Food Frequency Questionnaire (FFQ) and oral health assessment. The students’ dental caries experience was available as DMFT score (number of decayed, missing, and filled permanent teeth). Statistical analyses included the Mann–Whitney test, Kruskal–Wallis test, Chi-square test, and binary logistic regression model. The average intake of free sugars was 53.1 g/d in adolescents, and 43.2% of the students consumed more than 50 g of free sugars daily. The primary contributor to free sugars was sugar-sweetened beverages (SSBs). Age, boarders, and high family income were risk factors for excessive free sugars intake (p < 0.05), and increased free sugars intake was a risk factor for dental caries (odds ratio, OR = 1.446, 95% confidence interval: 1.138–1.839). Both the free sugars intake and dental caries prevalence in Chinese adolescents were high. Targeted interventions are urgently needed to address the excessive consumption of free sugars and improve Chinese adolescents’ oral health.
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Moore D, Allen T, Birch S, Tickle M, Walsh T, Pretty IA. How effective and cost-effective is water fluoridation for adults? Protocol for a 10-year retrospective cohort study. BDJ Open 2021; 7:3. [PMID: 33479223 PMCID: PMC7820470 DOI: 10.1038/s41405-021-00062-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Tooth decay can cause pain, sleepless nights and loss of productive workdays. Fluoridation of drinking water was identified in the 1940s as a cost-effective method of prevention. In the mid-1970s, fluoride toothpastes became widely available. Since then, in high-income countries the prevalence of tooth decay in children has reduced whilst natural tooth retention in older age groups has increased. Most water fluoridation research was carried out before these dramatic changes in fluoride availability and oral health. Furthermore, there is a paucity of evidence in adults. The aim of this study is to assess the clinical and cost-effectiveness of water fluoridation in preventing invasive dental treatment in adults and adolescents aged over 12. METHODS/DESIGN Retrospective cohort study using 10 years of routinely available dental treatment data. Individuals exposed to water fluoridation will be identified by sampled water fluoride concentration linked to place of residence. Outcomes will be based on the number of invasive dental treatments received per participant (fillings, extractions, root canal treatments). A generalised linear model with clustering by local authority area will be used for analysis. The model will include area level propensity scores and individual-level covariates. The economic evaluation will focus on (1) cost-effectiveness as assessed by the water fluoridation mean cost per invasive treatment avoided and (2) a return on investment from the public sector perspective, capturing the change in cost of dental service utilisation resulting from investment in water fluoridation. DISCUSSIONS There is a well-recognised need for contemporary evidence regarding the effectiveness and cost-effectiveness of water fluoridation, particularly for adults. The absence of such evidence for all age groups may lead to an underestimation of the potential benefits of a population-wide, rather than targeted, fluoride delivery programme. This study will utilise a pragmatic design to address the information needs of policy makers in a timely manner.
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Affiliation(s)
- Deborah Moore
- grid.5379.80000000121662407Dental Public Health, Division of Dentistry, Dental Health Unit, The University of Manchester, Lloyd Street North Manchester Science Park, Manchester, M15 6SE UK
| | - Thomas Allen
- Director, Centre for the Business and Economics of Health, University of Queensland, St Lucia, Queensland, 4072 UK
| | - Stephen Birch
- Director, Centre for the Business and Economics of Health, University of Queensland, St Lucia, Queensland, 4072 UK ,grid.5379.80000000121662407Health Economics, Manchester Centre for Health Economics, The University of Manchester, Jean McFarlane Building Oxford Road, Manchester, M13 9PL UK
| | - Martin Tickle
- grid.5379.80000000121662407Dental Public Health & Primary Care, Division of Dentistry, The University of Manchester, Coupland 3, Manchester, M13 9PL UK
| | - Tanya Walsh
- grid.5379.80000000121662407Healthcare Evaluation, Division of Dentistry, The University of Manchester, Coupland 3, Manchester, M139PL UK
| | - Iain A. Pretty
- grid.5379.80000000121662407Public Health Dentistry, Division of Dentistry, Dental Health Unit, The University of Manchester, Lloyd Street North Manchester Science Park, Manchester, M15 6SE UK
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Wang ML, Minyé HM, Egan KA, Heaton B. Community-based sugar-sweetened beverage intervention associated with short-term improvements in self-rated oral health. Community Dent Oral Epidemiol 2021; 49:362-368. [PMID: 33389770 DOI: 10.1111/cdoe.12610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 10/07/2020] [Accepted: 11/24/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the efficacy of a community-based childhood obesity prevention intervention targeting Sugar-sweetened beverage (SSB) consumption on self-rated oral health among children and their parents/caregivers. METHODS This study is a secondary analysis of data from a pilot site-randomized intervention (H2 GO!) targeting SSB consumption and obesity risk among children. The 6-week SSB behavioural intervention was implemented in two Massachusetts Boys and Girls Club sites that were matched for size and racial/ethnic composition. Children ages 9-12 years and their parents/caregivers were eligible to participate. Data on self-rated oral health and sociodemographics were obtained via self-report surveys at baseline, 2 and 6 months. Generalized linear mixed regression models were used to estimate 2- and 6-month change in oral health associated with the intervention. RESULTS Data are from 100 child participants (46% female; 38% Black, 20% Hispanic, 13% White, 12% Multiracial, 11% Asian) and 87 parent participants (78.2% female; 37.9% Hispanic, 29.9% Black, 14.9% Asian, 10.3% White). At baseline, 47% of child participants rated their oral health as good, followed by very good (32%), fair (11%) and excellent (10%). Among parents, 46.3% rated their oral health as good, followed by very good (29.3%), excellent (9.8%), fair (9.7%) and poor (4.9%). The intervention was associated with 2- and 6-month improvements in child participants' mean self-rated oral health scores (β = 0.78; 95% CI: 0.48, 1.087; P < .001; β = 0.98; 95% CI: 0.61, 1.34; P < .001, respectively) and with 2-month improvements in parent participants' mean self-rated oral health (β = 0.42; 95% CI: 0.016, 0.82; P = .042). CONCLUSION Short-term improvements in oral health among children and their parents/caregivers were observed among those participating in a SSB behavioural intervention. Community-based behavioural programmes targeting SSB consumption may be a promising approach to promote oral health as well as prevent childhood obesity.
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Affiliation(s)
- Monica L Wang
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA.,Boston University Center for Antiracist Research, Boston, MA, USA.,Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, OH, USA
| | - Helena M Minyé
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, OH, USA.,Center for Reconstructive Dentistry & Oral Surgery, P.C., Dallas, TX, USA
| | - Kelsey A Egan
- Division of General Pediatrics, Department of Pediatrics, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Brenda Heaton
- Department of Health Policy and Health Services Research, Boston University School of Dental Medicine, Boston, MA, USA
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Dreher IL, Herrmann R, Ferreira FM, Casagrande L, Lenzi TL. Can Schoolchildren Substitute Mothers' Reports of Cariogenic Foods Consumption? PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2021. [DOI: 10.1590/pboci.2021.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Cantoral A, Muñoz-Rocha TV, Luna-Villa L, Mantilla-Rodriguez A, Ureña-Cirett JL, Castiblanco GA, Solano M, Howard HH, Peterson KE, Téllez-Rojo MM, Martínez-Mier EA. Association of Dietary Fluoride Intake and Diet Variables with Dental Caries in Adolescents from the ELEMENT Cohort Study. Caries Res 2021; 55:88-98. [PMID: 33535210 PMCID: PMC9944613 DOI: 10.1159/000511699] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 09/14/2020] [Indexed: 02/04/2023] Open
Abstract
To examine the association of dietary fluoride intake, total carbohydrate consumption and other key dietary variables with dental caries experience among adolescents, a cross-sectional analysis was conducted in a sample of 402 participants from the Early Life Exposures in Mexico to Environmental Toxicants cohort. The presence and severity of dental caries were assessed using the International Caries Detection and Assessment System (ICDAS) to calculate the number of decayed, missing, and filled teeth or surfaces (D1MFT/D4MFT). The dietary intake of fluoride, energy, carbohydrates, and food groups was estimated using a validated food frequency questionnaire (FFQ). Multivariate zero-inflated negative binomial regression models and negative binomial regression models were run to estimate the association of fluoride intake (mg/day) and total carbohydrate intake (g/day) with the D1MFT/D4MFT index. We found that 80% of the adolescents experienced dental caries (D1MFT >0), with 30% presenting cavitated lesions (D4MFT >0). The mean scores for D1MFT and D4MFT were 6.2 (SD 5.3) and 0.67 (SD 1.3), respectively. The median intake of fluoride estimated by the FFQ was 0.015 mg/kg/day. This intake was statistically higher in participants with a D4MFT = 0 compared to those with a D4MFT >0 (0.90 vs. 0.82 mg/day; 0.016 vs. 0.014 mg/kg/day; p < 0.05). For D1MFT, D1MFS, D4MFT, and D4MFS scores, a higher fluoride consumption (mg/day) from foods and beverages was associated with a statistically significant reduction in the number of lesions. The reported frequency of consumption of sugary foods in a whole day was statistically higher in those with D1MFT >0 than in those with D1MFT = 0 (p < 0.05). The total carbohydrate intake (g/day) was positively associated with dental caries experience. We conclude that a higher fluoride intake through foods and beverages is associated with a lower dental caries experience among adolescents; this effect was seen even when the dietary intake of fluoride was 0.015 mg/kg/day, which is lower than the average intake recommendation. In contrast, a higher total carbohydrate intake and the frequency of intake of sugary foods were associated with a higher dental caries experience, with no apparent threshold for the effects.
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Affiliation(s)
- Alejandra Cantoral
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Teresa V. Muñoz-Rocha
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Lynda Luna-Villa
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Andres Mantilla-Rodriguez
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | | | - Gina A. Castiblanco
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
| | - Maritsa Solano
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Hu H Howard
- School of Public Health, University of Washington, Seattle, USA,School of Public Health, University of Michigan, Ann Arbor, USA
| | | | - Martha M. Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Esperanza A. Martínez-Mier
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, Indianapolis, Indiana, USA
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Abstract
This paper concerns the assessment of the current state of dentistry in the world and the prospects of its sustainable development. A traditional Chinese censer was adopted as the pattern, with a strong and stable support on three legs. The dominant diseases of the oral cavity are caries and periodontal diseases, with the inevitable consequence of toothlessness. From the caries 3.5–5 billion people suffer. Moreover, each of these diseases has a wide influence on the development of systemic complications. The territorial range of these diseases and their significant differentiation in severity in different countries and their impact on disability-adjusted life years index are presented (DALY). Edentulousness has a significant impact on the oral health-related quality of life (OHRQoL). The etiology of these diseases is presented, as well as the preventive and therapeutic strategies undertaken as a result of modifying the Deming circle through the fives’ rules idea. The state of development of Dentistry 4.0 is an element of the current stage of the industrial revolution Industry 4.0 and the great achievements of modern dental engineering. Dental treatment examples from the authors’ own clinical practice are given. The systemic safety of a huge number of dentists in the world is discussed, in place of the passive strategy of using more and more advanced personal protective equipment (PPE), introducing our own strategy for the active prevention of the spread of pathogenic microorganisms, including SARS-CoV-2. The ethical aspects of dentists’ activity towards their own patients and the ethical obligations of the dentist community towards society are discussed in detail. This paper is a polemic arguing against the view presented by a group of eminent specialists in the middle of last year in The Lancet. It is impossible to disagree with these views when it comes to waiting for egalitarianism in dental care, increasing the scope of prevention and eliminating discrimination in this area on the basis of scarcity and poverty. The views on the discrimination of dentistry in relation to other branches of medicine are far more debatable. Therefore, relevant world statistics for other branches of medicine are presented. The authors of this paper do not agree with the thesis that interventional dental treatment can be replaced with properly implemented prophylaxis. The final remarks, therefore, present a discussion of the prospects for the development of dentistry based on three pillars, analogous to the traditional Chinese censer obtaining a stable balance thanks to its three legs. The Dentistry Sustainable Development (DSD) > 2020 model, consisting of Global Dental Prevention (GDP), Advanced Interventionist Dentistry 4.0 (AID 4.0), and Dentistry Safety System (DSS), is presented.
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Hancock S, Zinn C, Schofield G. The consumption of processed sugar- and starch-containing foods, and dental caries: a systematic review. Eur J Oral Sci 2020; 128:467-475. [PMID: 33156952 DOI: 10.1111/eos.12743] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 12/11/2022]
Abstract
The relationship between high dietary intakes of sugar (sucrose) and dental caries is well established. Processed sugars and starches have been associated with greater dental caries experience in retrospective studies. The aim of this systematic review was to determine the relationship between the consumption of processed sugar- and starch-containing foods, the frequency of consumption of these foods, and dental caries. Prospective studies were identified in databases searched from 1970 to July 2020, and relevant retrieved papers that examined associations between the consumption of sugar- and starch-containing foods by human participants and dental caries were eligible for inclusion. Five cohort studies were identified for inclusion, all of which evaluated caries risk in young children or pre-adolescents. The between-meal consumption of processed sugar- and starch-containing foods was consistently found to be associated with greater caries experience. There were mixed findings on total consumption of processed sugar- and starch-containing foods, owing to a range of confounding factors, including the simultaneous consumption of caries-protective foods at mealtimes. Although there is a paucity of research of the dietary effects of frequent consumption of processed sugar- and starch-containing foods on dental caries, there is some evidence of plausible associations between this dietary behaviour and dental caries. Future research should investigate the effectiveness of interventions to change the dietary behaviour of high-frequency consumption of processed sugar- and starch-containing foods to decrease the risk of dental caries.
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Affiliation(s)
- Sarah Hancock
- The Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
| | - Caryn Zinn
- The Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
| | - Grant Schofield
- The Human Potential Centre, Auckland University of Technology, Auckland, New Zealand
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Angst PDM, Maier J, Dos Santos Nogueira R, Manso IS, Tedesco TK. Oral health status of patients with leukemia: a systematic review with meta-analysis. Arch Oral Biol 2020; 120:104948. [PMID: 33130400 DOI: 10.1016/j.archoralbio.2020.104948] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/27/2020] [Accepted: 10/06/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this study was to systematically review the literature regarding the prevalence of periodontal diseases and dental caries in patients with leukemia. METHODS An electronic search for observational studies on oral health outcomes in patients with leukemia was performed on Medline/PUBMED, Embase, Web of Science, and Science Direct databases up to April 2020. Dental caries and periodontal diseases were assessed using the following standardized parameters, respectively: mean number of decayed, missing and filled teeth (DMFT), and presence of marginal inflammation (gingivitis) or clinical attachment loss (periodontitis). Two independent reviewers conducted all phases of review. Included studies reporting similar outcomes were subjected to random-effects meta-analysis. RESULTS From 1,246 retrieved references, 39 were included. Most studies were cross-sectional investigations involving young patients with acute lymphoblastic leukemia. Nine studies presented high risk of bias and were not included on quantitative analyses. All studies in the meta-analysis (n = 14) were conducted with children/teenagers with acute leukemia. Pooled gingivitis prevalence in patients before and during leukemia treatment was 85% (95%CI 75, 97%; 4 studies) and 82% (95%CI 71, 94%; 6 studies), respectively. Pooled DMFT means were 2.28 (95%CI 1.31, 3.25; 7 studies) and 3.65 (95%CI 1.45, 5.86; 5 studies) respectively for patients during and after leukemia treatment. Studies regarding periodontitis prevalence were too few to run a meta-analysis. CONCLUSIONS Based on cross-sectional data, young people with acute leukemia have high prevalence of gingivitis and caries experience. These findings indicate that the effect of leukemia on oral health still needs to be better investigated.
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Affiliation(s)
- Patrícia Daniela Melchiors Angst
- Department of Conservative Dentistry, Periodontics Unit, Dental School, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Juliana Maier
- Dental School, Universidade Franciscana, Santa Maria, RS, Brazil
| | | | - Isabella Schönhofen Manso
- Graduate Program in Dentistry, Emphasis in Periodontics, Dental School, Federal University of Pelotas, Pelotas, RS, Brazil
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Tenelanda-López D, Valdivia-Moral P, Castro-Sánchez M. Eating Habits and Their Relationship to Oral Health. Nutrients 2020; 12:nu12092619. [PMID: 32867393 PMCID: PMC7551577 DOI: 10.3390/nu12092619] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/13/2020] [Accepted: 08/25/2020] [Indexed: 11/10/2022] Open
Abstract
The objective of this research was to compare the healthy behaviors and caries index of young people in school to obtain an overview of their lifestyles, which would enable the development of educational programs for the promotion of oral health. The study design was carried out using a descriptive, cross-sectional, and observational methodology with a mixed approach. 380 twelve-year-old students participated in this research conducted in the city of Riobamba-Ecuador. The techniques used were observational and surveys with their respective instruments, the Dental Clinical History, and the Health Behavior in School-aged Children 2014-Spain questionnaire. The community index of the Decayed, Missing due to caries, and Filled Teeth (DMFT) reflected a high level (6.47) in the study subjects. A variety of foods such as fruits, chips, vegetables, candy, sugar-containing drinks, meat, fish, dairy, and cereals were consumed at least once a week by most students. Two statistically significant associations were demonstrated in this investigation. The first one was between fruit consumption and the DMFT index, the second one was between vegetable consumption and the DMFT index. Both associations showed significant values (p) of 0.049 and 0.028, respectively; these were not determining indicators since caries is a multifactorial pathology, which can develop not only as a product of poor eating habits.
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Affiliation(s)
- Dennys Tenelanda-López
- Faculty of Natural Resources, Escuela Superior Politécnica de Chimborazo, Riobamba EC060155, Ecuador
- School of Dentistry, Universidad Nacional de Chimborazo, Riobamba 060150, Ecuador
- Correspondence: ; Tel.: +593-9-9258-3944
| | - Pedro Valdivia-Moral
- Faculty of Education, Universidad de Granada, 18011 Granada, Spain; (P.V.-M.); (M.C.-S.)
| | - Manuel Castro-Sánchez
- Faculty of Education, Universidad de Granada, 18011 Granada, Spain; (P.V.-M.); (M.C.-S.)
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Lau KTR, John J, Eaton KA, Keightley AJ. Service evaluation of the paediatric dental general anaesthesia service in NHS Lothian. Br Dent J 2020:10.1038/s41415-020-1982-z. [PMID: 32855519 PMCID: PMC7451226 DOI: 10.1038/s41415-020-1982-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objective To gain insight into the reasons for children undergoing dental treatment under general anaesthesia in NHS Lothian.Methods This service evaluation was based on a representative sample size of 294 patients, randomly selected from the 1,236 children seen for dental general anaesthesia (DGA) during 2017 in NHS Lothian. Data on patient and treatment descriptors were collected retrospectively from clinical records and analysed to identify significant correlations.Results The data indicated paediatric DGAs were mostly provided due to dental caries (88%, 260/294) and for children from the most deprived areas of Lothian. Most children were referred because they were of a very young age or had needs which precluded treatment under local anaesthesia (LA). Almost every child had teeth extracted under DGA (99%, 290/294) and a third of children received restorations (33%, 96/294).Discussion and conclusion This study highlighted the disproportionate increased risk of dental caries and DGA in children from more deprived backgrounds, despite a nationwide reduction of children with caries experience. There is a need for more holistic, whole-system approaches to reduce child dental caries, with opportunities for collaborative work with local stakeholders to follow-up children who have had DGA. More research is needed locally and nationally to inform the translation of evidence into effective interventions.
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Affiliation(s)
- Kirstie T-R Lau
- Senior House Officer, Oral and Maxillofacial Surgery, Torbay Hospital, Newton Road, Torquay, Devon, TQ2 7AA, UK.
| | - Jeyanthi John
- Consultant, Dental Public Health, Wessex & Thames Valley, Public Health England South East, Wellington House, 133-155 Waterloo Road, Lambeth, London, SE1 8UG, UK
| | - Kenneth A Eaton
- Honorary Professor, University of Kent, Centre for Professional Practice, Compass Centre South, Chatham Maritime, Kent, ME4 4YG, UK
| | - Alexander J Keightley
- Consultant, Paediatric Dentistry, Edinburgh Dental Institute, Lauriston Building, Lauriston Place, Edinburgh, EH2 9HA, UK
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Cesur Aydin K, Tekin A. Impact of Body Mass Index on dental health status. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020. [DOI: 10.23736/s0393-3660.19.04092-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Petrauskienė S, Narbutaitė J, Petrauskienė A, Virtanen JI. Oral health behaviour, attitude towards, and knowledge of dental caries among mothers of 0- to 3-year-old children living in Kaunas, Lithuania. Clin Exp Dent Res 2020; 6:215-224. [PMID: 32250563 PMCID: PMC7133724 DOI: 10.1002/cre2.272] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 11/21/2019] [Accepted: 11/28/2019] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the oral health behaviours of mothers with young children and their attitudes towards dental caries. METHODS The survey targeted all mothers with children under 3 years attending a primary healthcare centre (Department of Family Medicine at the Lithuanian University of Health Sciences [LSMU] Hospital) in Kaunas, Lithuania. The Bioethics Centre of the LSMU approved the study (No. BEC-OF-14). Of 176 mothers, 123 (69.9%) took part in the 2016-2017 study. The self-administered questionnaire enquired about mothers' attitudes towards oral health and behaviours related to the potential transmission of oral bacteria to their children, dietary habits, tooth brushing, smoking, and background factors. The chi-squared test and univariate/multivariate logistic regression analyses served for the statistical analysis. (p values ≤ .05 indicated statistically significant differences). RESULTS Most (76; 68.5%) of the mothers brushed their teeth twice daily, and 97 (87.4%) reported themselves as nonsmokers. We found a statistically significant association between mothers who brushed their own teeth twice daily and those who cleaned their children's teeth likewise (OR = 5.42, 95% CI [1.28-6.63]; p = .005). We observed significant associations among mothers who gave their children sugar-sweetened beverages (SSBs) daily and the mothers' college or lower education (OR = 6.51, 95% CI [1.59-27.19]; p = .01) and maternal tooth brushing less than twice daily (OR = 3.88, 95% CI [0.99-15.18]; p = .05). CONCLUSIONS A majority of mothers who took part in this survey did not brush their children's teeth as recommended. Mothers with a lower education and who brushed their teeth less than twice daily offered their children SSBs more frequently.
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Affiliation(s)
- Sandra Petrauskienė
- Clinic for Preventive and Paediatric DentistryLithuanian University of Health SciencesKaunasLithuania
| | - Julija Narbutaitė
- Clinic for Preventive and Paediatric DentistryLithuanian University of Health SciencesKaunasLithuania
| | - Aušra Petrauskienė
- Department of Preventive MedicineLithuanian University of Health SciencesKaunasLithuania
| | - Jorma I. Virtanen
- Department of Clinical DentistryUniversity of BergenBergenNorway
- Medical Research CenterOulu University HospitalOuluFinland
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Devenish G, Mukhtar A, Begley A, Spencer AJ, Thomson WM, Ha D, Do L, Scott JA. Early childhood feeding practices and dental caries among Australian preschoolers. Am J Clin Nutr 2020; 111:821-828. [PMID: 32047898 DOI: 10.1093/ajcn/nqaa012] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/21/2020] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Recent reviews have proposed a causal relationship between prolonged breastfeeding and early childhood caries (ECC), but the evidence to date is inconsistent, with few cohort studies and limited investigation of key confounders. OBJECTIVE This study aimed to investigate the relationship between dietary practices and early childhood caries in a birth cohort of Australian preschoolers. METHODS Participants underwent a standardized dental examination at 2-3 y of age to determine the prevalence of ECC (based on the presence of decayed, missing, or filled tooth surfaces). Breastfeeding practices were reported at 3, 6, 12, and 24 mo of age. Intakes of free sugars were assessed at 1 and 2 y of age. Multivariable regression models generated prevalence ratios (PR) for the association between ECC and breastfeeding duration, and between ECC and sleep feeding practices at 1 y, controlling for sociodemographic factors and free sugars intake. RESULTS There was no independent association between breastfeeding beyond 1 y of age and ECC (PR 1.42, 95% CI: 0.85, 2.38), or between breastfeeding to sleep and ECC (PR 1.12, 95% CI: 0.67, 1.88), although the direction of effect was suggestive of an association. The only factors independently associated with ECC were high free sugars intakes (PR 1.97, 95% CI: 1.13, 3.44), and greater socioeconomic disadvantage (PR 2.15, 95% CI: 1.08, 4.28). Most participants who were breastfed at 1 y of age had ceased by 18 mo or 2 y. CONCLUSIONS Breastfeeding practices were not associated with ECC. Given the wide-ranging benefits of breastfeeding, and the low prevalence of sustained breastfeeding in this study and Australia in general, recommendations to limit breastfeeding are unwarranted, and breastfeeding should be promoted in line with global and national recommendations. To reduce the prevalence of early childhood caries, improved efforts are needed to limit foods high in free sugars.
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Affiliation(s)
- Gemma Devenish
- School of Public Health, Curtin University, Perth, Australia
| | - Aqif Mukhtar
- School of Public Health, Curtin University, Perth, Australia
| | - Andrea Begley
- School of Public Health, Curtin University, Perth, Australia
| | - A John Spencer
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - W Murray Thomson
- Department of Oral Sciences, University of Otago, Dunedin, New Zealand
| | - Diep Ha
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - Loc Do
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, Australia
| | - Jane A Scott
- School of Public Health, Curtin University, Perth, Australia
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Eyles H, Trieu K, Jiang Y, Mhurchu CN. Reducing children's sugar intake through food reformulation: methods for estimating sugar reduction program targets, using New Zealand as a case study. Am J Clin Nutr 2020; 111:622-634. [PMID: 31880774 DOI: 10.1093/ajcn/nqz313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/25/2019] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Reducing sugar in packaged foods and beverages could help protect children's future health. Clear methods for the development of feasible yet impactful sugar reduction program targets are needed. OBJECTIVES To outline methods for the development of program targets that would reduce, by 20%, the total sugar content of packaged foods and beverages commonly consumed by children. New Zealand (NZ) is used as a case study. METHODS Sugar content and pack size targets were developed using a 6-step process informed by the UK sugar and salt reduction programs. Food groups contributing ≥2% to children's total sugar intake were identified using national dietary survey data. Consumption volume, sugar content, and pack size were obtained from household panel data linked with a packaged food composition database. Category-specific targets were set as 20% reductions in sales-weighted means adjusted for feasibility, i.e., ∼1/3 of products already meeting the target, and alignment with existing, relevant targets. RESULTS Twenty-two food groups were identified as major contributors to NZ children's total sugar intake. Mean reductions required in sugar content and pack size to meet the targets were 5.2 g per 100 g/mL (26%) and 61.2 g/mL/pack (23%), respectively. The percentage of products already meeting the sugar targets ranged from 14% for electrolyte drinks and flavored dairy milk to 50% for cereal bars, and for pack size targets compliance ranged from 32% for chocolate confectionary to 62% for fruit juices and drinks. Estimated reductions in annual household sugar purchases if the sugar and pack size targets were met were 1459 g (23%) and 286 g (6%), respectively. CONCLUSIONS Methods for the development of sugar and pack size reduction targets are presented, providing a robust, step-by-step process for countries to follow. The results of the case study provide a suggested benchmark for a potential national sugar reduction program in NZ.
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Affiliation(s)
- Helen Eyles
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland 1023, New Zealand.,Department of Epidemiology and Biostatistics, School of Population Health, The University of Auckland, Auckland 1023, New Zealand
| | - Kathy Trieu
- The George Institute for Global Health, University of New South Wales, NSW 2052, Sydney, Australia.,Sydney School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, NSW 2006, Australia
| | - Yannan Jiang
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland 1023, New Zealand
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland 1023, New Zealand.,The George Institute for Global Health, University of New South Wales, NSW 2052, Sydney, Australia
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Babaeekhou L, Mehrizi A, Ghane M. Streptococcus mutans, sugar consumption, and oral hygiene: Which one has more effect on decayed, missing, and filled teeth (DMFT) score in Iranian adults? Dent Res J (Isfahan) 2020. [DOI: 10.4103/1735-3327.280884] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lewis CW. Teeth: Small but Mighty and Mighty Important. A Comprehensive Review of Children's Dental Health for Primary Care Clinicians. Curr Pediatr Rev 2020; 16:215-231. [PMID: 32108010 DOI: 10.2174/1573396316666200228093248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/12/2019] [Accepted: 01/27/2020] [Indexed: 11/22/2022]
Abstract
Healthy teeth allow us to eat and stay well-nourished. Although primary care clinicians receive limited training about teeth, given the common nature of dental problems, it is important that they understand and recognize normal and abnormal dental conditions and can implement primary and secondary prevention of dental conditions in their practice. PubMed has been used to search the scientific literature for evidence on the following topics: normal dental development, dental abnormalities, malocclusion, teething, dental caries and related epidemiology and prevention, fluoride, dental injury and its management and prevention; and identification, prevention and treatment of gingivitis and periodontal disease. Literature review relied on randomized controlled trials, meta-analyses, systematic reviews, and Cochrane reviews when relevant and available. Other sources of evidence included cohort and case-control studies. Consensus statements and expert opinion were used when there was a paucity of high-quality research studies. The literature has been synthesized on these topics to make them relevant to pediatric primary care clinicians, and as available, the strength of evidence has been characterized when making clinical recommendations.
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Affiliation(s)
- Charlotte W Lewis
- Division of General Pediatrics, Department of Pediatrics, University of Washington School of Medicine,Seattle Children’s Hospital, Seattle, WA, USA
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