Rampant early childhood dental decay: an example from Italy

Comparison of Oral Health-Related Quality of Life scores in children treated for early childhood caries under general and local anesthesia: a quasi-experimental study

PURPOSE

The purpose of this study was to compare the changes in oral health-related quality of life (OHRQoL) scores in children treated for Early Childhood Caries (ECC) under general (GA) and local anesthesia (LA).

METHODS

A quasi-experimental study was carried out on 73 children, with 37 in the GA group and 36 in the LA group. The early childhood oral health impact scale (ECOHIS) was used to measure OHRQoL, with the type of anesthesia (LA or GA) serving as the explanatory variable. A Friedman test was used to assess the difference between the LA and GA groups at baseline, one-week, and one-month follow-up points.

RESULTS

The results showed a significant difference in the overall mean ECOHIS scores between the LA and GA groups at 1-week (LAmean ± SD = 6.12 ± 1.11, GAmean ± SD = 5.50 ± 0.88; P = 0.01) and 1-month (LAmean ± SD = 5.87 ± 1.12, GAmean ± SD = 4.96 ± 0.99; P < 0.001) follow-up points. Irrespective of the administered anesthesia, a significant (P < 0.001) reduction in the mean score for dental pain was observed at both 1-week (mean ± SD = 1.30 ± 1.16) and 1-month (mean ± SD = 0.81 ± 0.89) timepoints after the treatment, as compared to the baseline assessment (mean ± SD = 2.02 ± 1.02).

CONCLUSION

Early treatment for ECC reduces pain, restore normal activities, and improves the quality of life of affected children. Specifically, GA was found to be more beneficial for both children and parents. However, further studies using more robust study designs and carefully considering related factors are necessary to confirm these findings.

Prevalence and correlates of dental caries among 2-5 years children with special reference to breastfeeding in Kamrup District, Assam

Background

Dental caries among children is one of the most common health-related issues worldwide.

Aim

To find out the prevalence of dental caries among 2-5 years old children in Kamrup district of Assam with reference to breastfeeding and associated variables.

Materials and Methods

In this community-based cross-sectional study, 1439 children were examined from 15 wards of Kamrup Metro and four randomly chosen blocks of Kamrup Rural. Children were examined to assess the mean decayed/filled primary teeth (dmft) index, and a self-administered validated questionnaire was given to the mothers to collect data on the practice of breastfeeding initiation, its duration, and dental hygiene habits.

Results

Dental caries prevalence was found to be higher in urban areas (54.6%) than rural areas (45.4%). The frequency of using toothpaste was highest among the tooth-cleaning materials. A significant difference in caries prevalence was observed among the children, those who brushed twice a day, and those who did not brush (P = 0.039). The difference was significant in the mean dmft of children from the upper socioeconomic class (P = 0.023) compared with the other classes. A significant difference was also observed between breastfeeding duration (P = 0.010), exclusive and nonexclusive breastfeeding, time of initiation of breastfeeding within 12 h (P < 0.001), and alternative feeding with caries prevalence (P < 0.001).

Conclusions

Dental caries were higher in urban localities and upper socioeconomic classes. Breastfeeding initiation and duration may play an important role in the causation of dental caries. No significant association was found between colostrum, prelacteal feeding, and caries prevalence.

Impact of Dairy Products and Plant-Based Alternatives on Dental Health: Food Matrix Effects

The impact of dairy products on dental health has been researched widely and shows an important role of various constituents, as well as the specific product matrix, in maintaining and improving dental health. These include, for instance, the position of lactose as the least cariogenic fermentable sugar, the high levels of calcium and phosphate, the presence of phosphopeptides as well as the antibacterial peptides lactoferrin and lysozyme and high buffering capacity. With plant-based alternatives for dairy products being developed and marketed these days, the specific benefits of dairy products in relation to dental health are often overlooked and most products contain more cariogenic carbohydrates, lack phosphopeptides, and have fewer minerals and less buffering capacity. Comparative studies performed to date indeed suggest that plant-based products do not match dairy counterparts when it comes to maintaining and improving dental health. Careful consideration of these aspects is required in relation to future developments of products and human diets. In this paper, we review the impact of dairy products and plant-based dairy alternatives on dental health.

Does Dental Caries Increase Risk of Undernutrition in Children?

INTRODUCTION

A systematic review of the evidence on the impact of dental caries on malnutrition risk in children was conducted.

OBJECTIVES

To systematically review published evidence pertaining to the effect of dental caries severity and prevalence on risk of wasting or stunting in children.

METHODS

Four questions relating to caries of the permanent dentition, primary dentition, early childhood caries (ECC), and severe ECC as a risk factor for undernutrition were set. The target population was children aged 0 to 18 y from any country. Data sources included MEDLINE and Embase. All human epidemiological studies were included. Quality assessment excluded lowest-quality studies. Evidence synthesis by vote counting was depicted using harvest plots. A best available evidence approach was applied to narrative synthesis. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

RESULTS

Of the 2,690 studies identified, 447 were screened in duplicate; of these, 117 underwent quality assessment, resulting in 46 included studies, of which 38 were included in vote counting (3 quasi-experimental, 1 cohort, 1 case control, and 33 cross-sectional studies). For the permanent dentition, findings were mixed; the balance of data showed no association between caries prevalence (7/11 studies) or severity (8/17 studies) with wasting. For the primary dentition, the balance of data showed a positive association between caries prevalence (10/15 studies) and severity (12/15 studies) with wasting, as well as between-caries prevalence (4/5 studies) and severity (6/6 studies) with stunting. Considering ECC only did not alter this pattern of findings.

CONCLUSION

The balance of evidence suggests that dental caries in the primary dentition is associated with undernutrition. There is a need for well-designed trials on the impact of caries rehabilitation on growth trajectories of children from low- and middle-income countries and for prospective studies of the impact of caries severity on both stunting and wasting to confirm causality.

KNOWLEDGE TRANSFER STATEMENT

The results of this study can be used by policy makers when considering the importance of oral health in addressing the United Nations Sustainable Development Goal to end all forms of malnutrition. The findings suggest that dental caries in the primary dentition may impair children's healthy weight gain. The findings indicate that higher-quality data are required to confirm a causal relationship and thus inform funding bodies of the need for research, especially in low- and middle-income countries, to substantiate the current knowledge and inform clear and accurate policy statements.

Methods for prevention of early childhood caries: Overview of systematic reviews

Early childhood caries (ECC) is a global problem, disproportionately affecting disadvantaged populations. The aim of this study was to evaluate systematically the available scientific evidence on the effectiveness of methods for ECC prevention. Six electronic databases were searched. Two independent reviewers selected the publications and analysed the quality of the included systematic reviews. Thirteen studies were included. Overall, eight reviews were classified with methodological quality critically low using the AMSTAR 2, whereas five reviews achieved a high risk of bias using the ROBIS tool. The methods identified that were positively related to the prevention of ECC were as follows: preventive dental programmes for pregnant women; advice on diet and feeding; prenatal oral health care; integration of maternal and children's oral health promotion into nursing practice; maternal oral health programmes undertaken by non-dental health professionals; dental health education in combination with the use of fluoride for children; early preventive dental visits; and the use of fluoride varnish and toothpastes with more than 1000 ppm of fluoride. The currently available evidence supporting the effectiveness of methods for prevention of ECC, although suggesting some methods of greater potential, is still lacking due to the methodological quality of the systematic reviews and the included primary studies.

Correlation of Feeding Practices and Dental Caries among Preschool Children of Jazan, KSA: A Cross-sectional Study

OBJECTIVE

Breastfeeding is integral for the healthy development of infants during the first year of life. The objective of this study was to investigate the feeding practices and their effect on dental health among Saudi children in rural Jazan, the southern region of Saudi Arabia.

MATERIALS AND METHODS

A cross-sectional study was conducted among 330 participants from two villages namely Baish and Abu-Areesh of Jazan Province, Kingdom of Saudi Arabia. Mothers whose children were above 2 years of age agreed for a face-to-face interview to discuss about feeding practices followed for their children. Later, these children underwent a complete dental examination.

RESULTS

In this study, it was found that a majority of mothers, 203 (61.15%) of them breastfed their children for less than a year, 105 (31.8%) of them breastfed for 2 to 4 years, and the remaining 22 (6.6%) of them breastfed for more than 4 years. Two hundred and forty-nine (75.15%) moms reported that they added sugar to milk while feeding and 259 (78.4%) mothers reported using sugar with pacifiers. Increased incidence of caries was seen with a statistically significant difference in children who were fed during sleep (p = 0.038), when the infant's teeth were not brushed after feeding (p = 0.004), and when sugar was added while feeding (p = 0.001).

CONCLUSION

Prevalence of dental caries was high in children who were fed during sleep and also in those kids using pacifiers containing sugar. Oral hygiene practices were also inadequate and positively associated with dental caries. These findings are suggestive of developing general and oral health interventions for children and also educating mothers on appropriate feeding practices.

HOW TO CITE THIS ARTICLE

Dahas ZAH, Khormi HAJ, Vishwanathaiah S, et al. Correlation of Feeding Practices and Dental Caries among Preschool Children of Jazan, KSA: A Cross-sectional Study. Int J Clin Pediatr Dent 2020;13(4):327-331.

Early Childhood Caries

Early childhood caries (ECC) represents a serious problem in pediatric dentistry. Not only because of its rapidity but also because of age of affected children. This has been given different names such as “rampant caries” and “baby bottle syndrome” but now all clinical manifestations have been joined and classified as early childhood caries. The topic of this article is the prevalence, etiology, clinical manifestations and preventive measures of ECC.

Effects of vitamin D status on oral health

Normal humans of all ages have the innate ability to produce vitamin D following sunlight exposure. Inadequate vitamin D status has shown to be associated with a wide variety of diseases, including oral health disorders. Insufficient sunlight exposure may accelerate some of these diseases, possibly due to impaired vitamin D synthesis. The beneficial effects of vitamin D on oral health are not only limited to the direct effects on the tooth mineralization, but are also exerted through the anti-inflammatory functions and the ability to stimulate the production of anti-microbial peptides. In this article, we will briefly discuss the genesis of various oral diseases due to inadequate vitamin D level in the body and elucidate the potential benefits of safe sunlight exposure for the maintenance of oral and general health.

Early Childhood Caries: A Review

AIM

To review and update the current knowledge about early childhood caries (ECC) and its etiology, prevalence, risk factors, management, and preventive strategies.

BACKGROUND

Early childhood caries is a disease affecting significantly both well-developed and industrial nations. The ECC can significantly affect the child's quality of life, as it may lead to infection, swelling, pain, and other symptoms. The ECC affects children after eruption of primary teeth until age of around 5 years.

REVIEW RESULTS

The ECC affects all parts of the tooth including the smooth surface. Upper anterior teeth and primary molars are usually affected. The lower anterior teeth are less likely affected. The risk factors for ECC are diet, bacteria, and host susceptibility. The additional factors, such as presence of enamel defect and the feeding practices also contribute to the initiation and progress of ECC.

CONCLUSION

Dentists must focus on utilizing existing techniques to distinguish indications of right on time and propelled caries and give guidance on the best way to counteract and control caries in children. Approaches should be directed to preventive caries control strategies among children.

CLINICAL SIGNIFICANCE

Preventing and controlling the development of ECC among children is important to maintain effective eating, speech development, and formation of a positive self-image.

The prevalence and distribution of dental caries in four early medieval non-adult populations of different socioeconomic status from Central Europe

OBJECTIVES

The aim of the study was to map the dental health status in non-adult individuals and to verify whether and how the existence of caries in the non-adult age group is associated with the different socio-economic status of early medieval populations.

MATERIAL AND METHODS

We studied the dental remains from the acropolis of the Mikulčice settlement agglomeration, where members of the higher social classes were buried, and from the Mikulčice hinterland. Overall, we evaluated 2544 teeth/3714 alveoli of deciduous dentition and 1938 teeth/2128 alveoli of permanent dentition. We determined the number of individuals with dental caries (i.e., caries frequency index, F-CE) and the proportion of teeth/alveoli with caries/ante-mortem tooth loss (i.e., caries intensity index, I-CE).

RESULTS

We found no statistical significant difference in the F-CE values between the Mikulčice hinterland and the acropolis. In addition, we found no statistically significant difference in the proportion of teeth with carious lesions (I-CE) either in the case of deciduous dentition or in the case of permanent dentition between the hinterland and the acropolis. In the case of permanent dentition, the statistically significant highest proportion of carious lesions (I-CE) was found in Mikulčice I (p ≤ 0.05). We confirmed an increase in the rate of caries with age.

CONCLUSIONS

The level of caries at all of the studied medieval locations was very low. We presume that lifestyle and the associated dietary habits and hygienic practices of the individuals or population groups had a greater influence on dental caries than did the socio-economic status of these individuals.

Pattern and severity of early childhood caries in Southern Italy: a preschool-based cross-sectional study

BACKGROUND

This survey was intended to investigate prevalence and severity of early childhood caries (ECC) in a sample of children in Southern Italy and to identify factors that may be related to this condition.

METHODS

The study was designed as a cross-sectional survey. The study population (children aged 36-71 months) attending thirteen kindergartens was randomly selected through a two-stage cluster sampling procedure. Parents/guardians of all eligible children were invited to participate filling out a structured self-administered questionnaire, and after having returned the informed consent form an oral examination of the child was performed at school. The questionnaire included information on: socio-demographics about parents/guardians and child, pregnancy and newborn characteristics, oral hygiene habits of child, eating habits particularly on consumption of sweets, access to dental services, and infant feeding practices. The WHO caries diagnostic criteria for deciduous decayed, missing and filled teeth (dmft) and surfaces (dmfs) were used to record ECC and severe-ECC (S-ECC). Univariate and multiple logistic regression analyses were conducted to evaluate statistical associations of social demographics, infant feeding practices, oral hygiene habits, and access to dental services to ECC, S-ECC, dmft and dmfs.

RESULTS

515 children participated in the study. 19% had experienced ECC, and 2.7% severe-ECC (S-ECC), with a mean dmft and dmfs scores of 0.51 and 0.99, respectively. Mean dmft was 2.68 in ECC subjects, and 6.86 in S-ECC subjects. Statistical analysis showed that prevalence of ECC significantly increased with age (OR = 1.95; 95% CI = 1.3-2.91) and duration of breastfeeding (OR = 1.26; 95% CI = 1.01-1.57), whereas it was significantly lower in children of more educated mothers (OR = 0.64; 95% CI = 0.42-0.96), and higher in those who had been visited by a dentist in the previous year (OR = 3.29; 95% CI = 1.72-6.33).

CONCLUSIONS

Results of our study demonstrate that even in Western countries ECC and S-ECC represent a significant burden in preschool children, particularly in those disadvantaged, and that most of the known modifiable associated factors regarding feeding practices and oral hygiene are still very spread in the population.

Early childhood caries update: A review of causes, diagnoses, and treatments

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management.

Consumption of soda and other sugar-sweetened beverages by 2-year-olds: findings from a population-based survey

OBJECTIVE

To determine risk factors for consumption of soda and other sugar-sweetened beverages (SSB) among 2-year-old children.

DESIGN

The analysis was performed using three linked data sets: the 2004-2005 Oregon Pregnancy Risk Assessment Monitoring Survey (PRAMS); its longitudinal follow-up, 2006-2007 Oregon PRAMS-2; and 2004-2005 Oregon birth certificates.

SETTING

PRAMS is a surveillance programme supported by the federal Centers for Disease Control and Prevention and implemented by participating state health departments. Using mixed methods, PRAMS surveys women 2-6 months after a live birth. Oregon PRAMS-2 re-interviews respondents shortly after the index child's second birthday. Oregon PRAMS oversamples minority women.

SUBJECTS

Using monthly cohorts, we randomly selected 5851 women from the 2004-2005 birth certificates. In total 1911 women completed both PRAMS and PRAMS-2. The weighted response rate of PRAMS-2 was 43.5%.

RESULTS

Almost half of mothers (49.9%) reported that their child drank SSB on at least 1 d/week. Mothers whose children drank SSB at least once weekly were more likely to have low income (adjusted OR=2.83, 95% CI 2.09, 3.83) and to eat out on ≥2 d/week (OR=2.11 %, 95% CI 1.66, 2.70). Hispanic and non-Hispanic black women were most likely to report that their child drank SSB at least once weekly.

CONCLUSIONS

Half of mothers reported that their 2-year-old children drank SSB at least once weekly. Public health interventions and policies should address childhood SSB consumption including educating health-care providers and parents.

Prevalence of dental caries in 3- and 5-year-old children living in a small Brazilian City

Despite the reduction in the prevalence of dental caries, very little is known about the prevalence of the disease, especially in deciduous teeth, in small Brazilian cities (<20,000 inhabitants). The aim of this study was to evaluate the prevalence of dental caries in children aged 3 and 5 years of age in the city of Cambira - State of Parana. All children that participated in the national vaccination campaign against poliomyelitis in 2002 at the two basic health units of the city were examined. The campaign covered 99.5% of the population aged 1 to 5 years. Two previously trained and calibrated dentists performed the clinical examinations after the children brushed their teeth and recorded their caries experience by means of the dmf index. The results showed that there was no statistically significant difference in the prevalence of the disease between the male and female genders and between the rural and urban zones. At the age of 3, 68.50% of the children were caries-free, compared to 31.10% at the age of 5. In the total population, 11.19% of the children accounted for 50.86% of the teeth affected by dental caries. The dmf index at 3 and 5 years in the study population was 2.10 and 3.51, respectively. These data showed that the city has not yet reached the goals proposed by the WHO for the year 2000, what indicates the need for greater investment in programs aimed to prevention and control of the disease.

Recommendations for healthier hydration: addressing the public health issues of obesity and type 2 diabetes

Given the rapid increase in the prevalence of overweight, obesity, type 2 diabetes and other obesity-related conditions across the world, despite a plethora of evidence-based guidance for clinicians, innovative campaigns aimed at the general public and widespread government public health initiatives, it is clear that a novel approach is required. The importance of fluid intake has been overlooked in campaigns and guidelines and also in the clinical setting, where the question 'what do you drink?' is often omitted. It is a significant oversight that food pyramids and healthy-eating plates across the world omit fluids from their graphics and advice. While guidelines include recommendations on changes in physical activity and diet, often little or no advice is offered on the importance of healthier hydration practices, neglecting to highlight the contribution of beverages high in sugar, alcohol or additives. An interdisciplinary group of experts in medicine, nutrition, physiology and public health discussed issues surrounding healthy-hydration practices in March 2010 in Paris to create a consensus statement on hydration and gain of body weight and provide recommendations.

Prevalence and socio-behavioral influence of early childhood caries, ECC, and feeding habits among 6-36 months old children in Uganda and Tanzania

Background

Early childhood caries (ECC) is a serious problem that has remained unexplored in sub-Saharan Africa. This study aimed to identify possible socio-behavioral correlates of ECC focusing 6–36 months old children and their caretakers.

Methods

Cross sectional studies were conducted in a high fluoride rural area, Manyara, Tanzania and a low fluoride urban area, Kampala, Uganda. Totals of 1221 and 816 child - caretaker pairs attending health care facilities for growth monitoring were recruited in Manyara and Kampala, respectively. All caretakers completed face to face interviews at the health care facility. Children underwent oral clinical examination whereby ECC and Enamel hypoplasia were recorded using the dmft (WHO 1997) and the DDE index (FDI 1992).

Results

The prevalence of ECC was 3.7% in Manyara and 17.6% in Kampala. According to multiple logistic regression analyses, received oral health information from health worker was the strongest determinant of ECC in Manyara, adjusted OR 0.3, 95% CI 0.09 – 0.93. In Kampala, visible plaque, high sugar intake and presence of enamel hypoplasia associated with ECC, adjusted ORs 2.8 (95% CI 1.61- 4.95), 3.0 (95% CI 1.39 – 6.34) and 2.3 (95% CI 1.36 - 3.95).

Conclusion

Oral health education aimed at caretakers of 6–36 months, including health care workers’ information regarding the detrimental consequences for oral health of frequent sugar consumption and poor oral hygiene is important for prevention of ECC in Tanzania and Uganda.

Longitudinal associations between children's dental caries and risk factors

Dental caries is a common disease in children of all ages. It is desirable to know whether children with primary, mixed, and permanent dentitions share risk factors for cavitated and non-cavitated caries.

OBJECTIVE

To assess the longitudinal associations between caries outcomes and modifiable risk factors.

METHODS

One hundred and fifty-six children in the Iowa Fluoride Study met inclusion criteria of three dental examinations and caries-related risk factor assessments preceding each examination. Surface-specific counts of new non-cavitated caries and cavitated caries at the primary (Exam 1: age 5), mixed (Exam 2: age 9) and permanent (Exam 3: age 13) dentition examinations were outcome variables. Explanatory variables were caries-related factors, including averaged beverage exposure frequencies, tooth brushing frequencies, and composite water fluoride levels collected from 3-5, 6-8, and 11-13 years, dentition category, socioeconomic status, and gender. Generalized linear mixed models (GLMMs) were used to explore the relationships between new non-cavitated or cavitated caries and caries-related variables.

RESULTS

Greater frequency of 100 percent juice exposure was significantly associated with fewer non-cavitated and cavitated caries surfaces. Greater tooth brushing frequency and high socioeconomic status (SES) were significantly associated with fewer new non-cavitated caries. Children had significantly more new cavitated caries surfaces at the mixed dentition examination than at the primary and permanent dentition examinations.

CONCLUSIONS

There were common caries-related factors for more new non-cavitated caries across the three exams, including less frequent 100 percent juice exposure, lower tooth brushing frequency and lower SES. Less frequent 100 percent juice exposures might be associated with higher exposures to several other cariogenic beverages.

Intake of dairy products and the prevalence of dental caries in young children

OBJECTIVES

In vitro studies show that milk or milk components may have cariostatic properties. However, the results of epidemiological studies on the association between intake of dairy products and dental caries have been inconsistent. The purpose of this cross-sectional study was to examine the association between intake of dairy products and the prevalence of dental caries in young children.

METHODS

Study subjects were 2058 Japanese children aged 3 years. Information on diet was assessed with a self-administered brief diet history questionnaire for children. The consumption of dairy products was categorized into 3 levels in order to represent the tertiles as closely as possible. Dental caries was assessed by a visual examination. Adjustment was made for sex, toothbrushing frequency, use of fluoride, between-meal snack frequency, maternal smoking during pregnancy, environmental tobacco smoke exposure at home, and paternal and maternal educational levels.

RESULTS

Compared with yogurt consumption at the lowest tertile (<1 time/week), its intake at the highest level (> or =4 times/week) was significantly associated with a lower prevalence of dental caries, showing a clear dose-response relationship (adjusted prevalence ratio=0.78, 95% confidence interval: 0.62-0.98, P for trend=0.04). There were no material associations between intake of cheese, bread and butter, or milk and the prevalence of dental caries.

CONCLUSIONS

These data suggest that a high consumption of yogurt may be associated with a lower prevalence of dental caries in young children.

Risks for Early Childhood Caries Analyzed by Negative Binomial Models

Because of the high incidence of early childhood caries (ECC), a longitudinal study to identify risk factors from the prenatal period to the child’s first birthday among 9- to 18-month-old children was conducted with negative binomial modeling. Overall, 495 children had dental examinations at ages 9, 12, and 18 months. Mothers were interviewed during the 2nd trimester of pregnancy and when the children had dental examinations. The highest incidence of caries was found among children who were born to mothers with ≥ 10 decayed teeth and who never received calcium supplements during pregnancy, and children who were not fed supplementary foods at age 3 months, had sweet-tasting foods at 5 months, started snacking at 5 months, had sugary snacks, had soft drinks, and did not have their teeth brushed daily at 9 months. Thus, prenatal care and child-rearing-practices during and after birth are important risk factors for the incidence and incremental rate of ECC.

The independent impact of household- and neighborhood-based social determinants on early childhood caries: a cross-sectional study of inner-city children

This study examined the relationship between early childhood caries (ECC) and measures of socioeconomic status as environmental determinants of oral health inequalities. Dental caries and quality of oral hygiene were reported on 384 young inner-city children (24-35 months) by clinical examination. Early childhood caries was diagnosed in 18.5% of children. Ethnicity (P < 0.001) and neighborhood (P < 0.001) were the social variables significantly predictive of ECC in a logistic regression model. Living in a deprived neighborhood and the mother being of East European descent were the social variables with strongest association with ECC. These variables can be considered adequate criteria to identify groups at risk within the overall population.

Dental caries experience and its relationship to social and behavioural factors among 3-5-year-old children in Uganda

OBJECTIVE

The aim of this study was to assess the socio-demographic and behavioural correlates of caries experience and sugar intake patterns among pre-school children in Uganda.

METHODS

Five hundred and eighty-nine, 3-5-year-old children (51% boys, response rate = 85%), attending nursery schools in urban and peri-urban settings in central Kampala and Nakawa, respectively, were clinically examined for dental caries using the dmft index. Visible plaque on the labial surfaces of their maxillary incisors was recorded as a proxy for oral hygiene habits. A questionnaire designed to assess socio-demographic factors and sugar habits was completed by their caregivers in face-to-face interviews.

RESULTS

The mean dmft scores were 1.7, 2.4 and 3.1, and 42%, 44% and 42% had visible plaque among 3-, 4- and 5-year-olds, respectively. In Nakawa, a total of 64%, 62% and 22% of the subjects had dmft > 0, decayed teeth (dt) > 0 and missing teeth > 0, respectively. The corresponding rates in central Kampala were 56%, 55% and 17%. Multivariate analyses revealed that attending school in Nakawa, having a mother with a lower level of education, reporting the intake of cough syrup, visiting a dentist and scoring positively for plaque were associated with higher odds (1.6, 1.5, 3.7 and 2.7) for having dmft > 0. The adjusted mean frequency sugar scores varied systematically between mothers with low and high levels of education (mean scores = 11.0 vs. 10.4), and for children with negative and positive plaque scores (mean scores = 10.6 vs. 10.9).

CONCLUSION

The caries experience was highest among children attending nursery schools in Nakawa and those who had had longer periods of cough syrup consumption, whereas children from the two locations were equally exposed to sugar consumption generally. Both caries experience and frequency of sugar consumption was highest among children of less-well-educated mothers.

Prevalence of early childhood caries among First Nations children, District of Manitoulin, Ontario

BACKGROUND

Epidemiological studies of Aboriginal communities in Canada and Native American populations in the United States have reported that early childhood caries (ECC) is highly prevalent. The purpose of this study was to determine the prevalence of ECC and dental caries in the First Nations population of 3- and 5-year-old children in the District of Manitoulin, Ontario to assist in developing effective dental health promotion strategies.

METHODS

All 3- and 5-year-old children in elementary schools and day-care centres in seven First Nation communities were eligible for the survey examination. Three-year-old children at home and 5-year-old children attending school off-reserve in six of the communities were also eligible for epidemiological survey examination of oral health status including caries, gingival and soft tissue conditions. Cases of ECC were defined as children with caries or restorations on two or more primary maxillary incisors or canines or those having a total decayed, missing, filled primary teeth (dmft) score of 4 or greater.

RESULTS

A total of 87 children (59% 5 years old, 54% females) were examined. Seventy-four per cent of children had one or more carious lesions. Forty-five cases of ECC were found, a prevalence of 52%. The mean dmft score for cases was 7.5 (95% CI 6.5-8.4) and 0.8 (95% CI 0.5-1.1) for non-cases (P < 0.001). Boys in both age groups were more likely to be affected by ECC than girls.

CONCLUSION

Our results indicate that dental caries and ECC are highly prevalent in this population, with ECC cases having 6.7 more dmft than non-cases.

Salivary antibodies, amylase and protein from children with early childhood caries

The aim of this study was to analyze the organic composition of saliva from children without dental caries and children with early childhood caries (ECC). Two groups of 20 children varying in age from 12 to 47 months were selected: Group I, caries-free children; Group II, children with early childhood caries (ECC). Samples of saliva were collected from each subject and submitted to immunological and biochemical assays. Measurements of total salivary IgA, IgG and IgM were performed by using nephelometric techniques, while total protein concentrations and amylase activity were determined by colorimetric techniques. Comparisons of values between groups were made by using U Mann-Whitney test ( p<0.05). Children with ECC presented significantly higher levels of total salivary IgA and IgG, while the mean values of amylase activity, total protein concentrations and total IgM were similar between the groups. In this study, the presence of ECC was associated with an increase in total salivary IgA.