Early childhood caries in preschool children of Kosovo - a serious public health problem

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

PURPOSE

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

METHODS

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

RESULTS

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

CONCLUSION

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

Dental Caries Experience in Children in Public Kindergartens of Sarajevo, Bosnia and Herzegovina

OBJECTIVES

Dental caries first occurs within primary dentition in toddlers and preschool children, in a form of early childhood caries (ECC). In every day's busy and employment burdened parenting, caretakers and institutions have become important even more nowadays, not only for forming child general behavior and character, but also for maintenance of their general and oral health as well.

AIMS

To evaluate the presence and severity of ECC in children who attended public kindergartens in Sarajevo, and to offer basic information for the maintenance and improvement of child oral health to their parents and kindergarten teachers.

METHODS

The study included 1722 preschool children aged 3-6 years who attended kindergartens within Sarajevo public kindergarten institution, together with their parents and kindergarten teachers. Dental team members gradually visited all kindergartens situated in four Sarajevo city municipalities and examined kindergarten children according to the WHO Oral Health Survey Manual. Oral health promotion material for parents and kindergarten teachers was also distributed simultaneously during sequential visits.

RESULTS

ECC was present in preschool kindergarten children in Sarajevo, with its high prevalence (67.71%); dmft-value (3.97) and severity (SiC index 8.79). There was also a significant lack of dental healthcare to examined children mostly related to lack of visiting dental offices by children's parents (CI=10.55%, RI=10.80%, TI=12.98%).

CONCLUSION

Parental role in preserving and improving of their children oral health should be systematically and profoundly improved. Kindergarten officials and staff should recognize the importance of anticariogenic diet menus and oral hygiene maintenance within their institutions.

Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010-2021)

Early childhood caries (ECC) is one of the most prevalent chronic childhood diseases affecting the primary teeth of children younger than 6 years of age. The disease etiology is complex and includes social, biological, and dietary factors. This review aims to explore the knowledge of ECC prevalence globally and locally within the Gulf Cooperation Council (GCC) countries during the years 2010-2021. Another aim is to explore oral health promotion programs with more focus on the GCC region. A search was conducted in PubMed, Medline, Scopus, the Cochrane Collaboration database, and Google Scholar to identify relevant studies published between 2010 and 2021 using specific keywords. Studies that utilized both the World Health Organization criteria and International Caries Detection and Assessment System for dental caries assessment were included. The included studies indicated considerable variation in the reported prevalence of ECC. While developed countries show low prevalence, countries in the GCC and other Arab countries show a high prevalence of ECC. Many oral health promotion programs were identified globally including oral health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-professional population-based oral health promotion and prevention programs such as school-based oral health programs, motivational interviewing, and anticipatory guidance. ECC remains a significant problem in many parts of the world including the GCC region. Oral health prevention programs have been established within the GCC region. Nevertheless, the GCC region has some unique characteristics that need to be investigated to contextualize the western model of the dynamics of ECC prevention and promotion programs locally.

Association between developmental defects of enamel and early childhood caries in children under 6 years old: A systematic review and meta-analysis

Early childhood caries (ECC) are an oral health problem worldwide in children under 6 years of age. This disease of rapid development has a multifactorial etiology, and one of the possible risk factors is developmental defects of enamel (DDE), such as hypoplasia and opacities. The aim of this systematic review was to evaluate the association between DDE and ECC in children under 6 years of age. An electronic search was conducted until March 2022 using Medline (PubMed), Scopus, Science-Direct, LILACS, Web of Science, Cochrane Library, EBSCO-Host, EMBASE, and Google Scholar and complemented with a manual search, with no restrictions on language or date of publication. Longitudinal studies of children under 6 years of age with primary dentition were included. A total of 1158 studies were found, of which 651 records were reviewed by title and abstract, and 24 articles were selected for full-text evaluation. Finally, nine studies that met the selection criteria were included in the qualitative synthesis. Study quality and certainty were assessed using the Newcastle-Ottawa scale and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Three cohort studies of good quality were included in the meta-analysis. A risk associated with DDE (RR = 1.94; 95% CI: 1.52–2.49) and a risk associated with enamel hypoplasia (RR = 5.45; 95% CI: 1.84–16.14) were found. The results for diffuse opacity (RR = 1.21; 95% CI: 0.18–8.15) and demarcated opacity (RR = 1.26; 95% CI: 0.43–3.65) were not significant. GRADE analysis presented low and very low certainty of evidence. It was concluded that there is an association between DDE and ECC. However, the results should be interpreted with caution because of the limitations of the study.

The protocol for this study has been registered in PROSPERO under identification number CRD42021238919.

Oral health-related quality of life (OHRQOL) of preschool children's anterior teeth restored with zirconia crowns versus resin-bonded composite strip crowns: a 12-month prospective clinical trial

OBJECTIVES

To compare oral health-related quality of Life (OHRQOL) of preschool children's anterior teeth restored with prefabricated zirconia crowns (ZC) versus resin-bonded composite strip crown (RCSC).

MATERIALS AND METHODS

A prospective clinical trial included 136 children with early childhood caries aged 36-71 months who were assigned into prefabricated ZC and RCSC groups. A total of 344 teeth were restored either with 170 ZCs (49.4%) and 174 RCSCs (50.6%). Wilson and Cleary's conceptual model was to associate the study predictors to the OHRQOL. Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess the OHRQOL at 6 and 12 months. Mann-Whitney U test was used in comparing OHRQOL mean scores in the two groups and Wilcoxon signed-rank test with the effect size (r) to measure the intragroup OHRQOL change. A Poisson regression model was used to study potential risk factors associated with the overall OHRQOL.

RESULTS

After 12 months, the USPHS parameters of the ZC were significantly superior compared to the RCSC. Overall ECOHIS mean scores in the ZC group were significantly lower than that of the RCSC group at T₁ and T₂ (p < 0.001). Remarkable enhancement of the OHRQOL at the follow-ups with a large effect size (r < 0.8) was observed. Restoration type, retention, baseline OHRQOL, and color had a significant impact on the overall OHRQOL at 12 months.

CONCLUSIONS

Preschool children OHRQOL treated with ZC were significantly better than those who received RCSC.

CLINICAL RELEVANCE

One of the optimum treatment standards in pediatric dentistry is the esthetic demand which has significance on the child's OHRQOL and subsequently child's general health quality of life. It is beneficial to the dentist to identify the influence of esthetic restorations on the OHRQOL of preschool children which aids in future decision-making. The longitudinal nature of the study enables the dentist to identify the changes of children's OHRQOL.

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

BACKGROUND

Untreated early childhood caries (ECC) can trigger a number of negative consequences, including pain, chewing difficulties, insufficient physical development and low academic performance. Therefore, ECC impacts the oral health-related to quality of life. That is why it is important to assess the ECC prevalence and to determine the associated risk factors.

AIM

The aim of this study was to investigate the relationship between early predictor factors and dental caries among 4-year-old French children, considering the socioeconomic factors, dietary and oral hygiene practices, the access and the follow-up by paediatric dentist.

DESIGN

The study was a cross-sectional observation. A random sample of 4-year-old children was selected among 596 Moselle's public nursery schools in north-eastern France. Data were gathered from clinical dental examinations and a structured questionnaire completed by parents.

RESULTS

In total, 425 subjects with completed questionnaires and clinical examinations were included. The prevalence of ECC and S-ECC (Severe-ECC), including only cavitated lesions, d3mft, were 15.8% and 5.9%, respectively. Multivariable logistic regression modelling identified four main factors associated with a high risk of ECC that were sweet intake (adjusted odds ratio OR_adjusted = 3.43, 95% CI = 1.57-7.53), brushing habits (OR_adjusted = 2.25, 95% CI = 1.23-4.21), childcare arrangement (OR_adjusted = 2.27, 95% CI = 1.23-4.21) and maternal educational level (OR_adjusted = 1.87, 95% CI = 1.06-3.31). These four factors have a cumulative effect. Only 4% of children presented teeth restoration.

CONCLUSIONS

This study highlighted the impact of the family environment on the oral health status of the preschool children. The identification of the risk factors should allow to strengthen preventive measures and initiate oral health education program for children and their family.

Differences in Sweet Taste Perception and Its Association with the Streptococcus mutans Cariogenic Profile in Preschool Children with Caries

The aim of the study was to verify the hypothesis about differences in sweet taste perception in the group of preschool children with and without caries, and to determine its relationship with cariogenic microbiota and the frequency of sweets consumption in children. The study group included of 63 children aged 2–6 years: 32 with caries and 31 without caries. The study consisted of collecting questionnaire data and assessment of dental status using the decayed, missing, filled in primary teeth index (dmft) and the International Caries Detection and Assessment System (ICDAS II). The evaluation of sweet taste perception was carried out using a specific method that simultaneously assessed the level of taste preferences and the sensitivity threshold for a given taste. The microbiological analysis consisted of the assessment of the quantitative and qualitative compositions of the oral microbiota of the examined children. The sweet taste perception of children with caries was characterized by a lower susceptibility to sucrose (the preferred sucrose solution concentration was >4 g/L) compared to children without caries (in the range ≤ 4 g/L, p = 0.0015, chi-square test). A similar relationship was also observed for frequent snacking between meals (p = 0.0038, chi-square test). The analysis of studied variables showed the existence of a strong positive correlation between the perception of sweet taste and the occurrence and intensity of the cariogenic process (p = 0.007 for dmft; and p = 0.012 for ICDAS II), as well as the frequency of consuming sweets (p ≤ 0.001 for frequent and repeated consumption of sweets during the day, Spearman test) in children with caries. Additionally, children with an elevated sucrose taste threshold were more than 10-times more likely to develop S. mutans presence (OR = 10.21; 95% CI 3.11–33.44). The results of this study suggest the future use of taste preferences in children as a diagnostic tool for the early detection of increased susceptibility to caries through microbial dysbiosis towards specific species of microorganisms.

Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study

BACKGROUND

The high prevalence of early childhood caries (ECC) is widespread around the world, and oral health education (OHE) plays a vital role in preventing ECC. Numerous studies on ECC risk factor assessment have assisted us in enriching the content of OHE. The objective of this study was to further assess independent risk factors for ECC at different ages to provide evidence and insights for OHE.

METHODS

Children aged 3-5 years old (N = 1301) in Shandong Province were enrolled in this cross-sectional study. Data about oral health status and caregivers' oral health knowledge, attitude, and practice (KAP) were extracted from the 4th National Oral Health Survey of China. The associations between ECC prevalence and various KAP variables were tested with chi-square tests, bivariate analysis and multivariable logistic regression analyses.

RESULTS

The ECC prevalence in Shandong Province was 64.6%, and the dmft mean was 3.15. The independent variables with an increased risk for ECC were age, feeding method within 6 months of birth, bedtime sugar frequency, experience of toothache over the past year and dental visits (P < 0.05, chi-square tests). Complete breastfeeding within 6 months of birth primarily contributed to the high ECC risk of the 3-year-old group (OR: 3.39, 95% CI: 1.41-8.17), while high frequency bedtime sweet consumption mainly contributed to that of the 5-year-old group (OR: 3.22, 95% CI: 1.03-10.06; logistic regression analysis). Tooth brushing was not associated with ECC in this study, and some positive knowledge and attitude variables were positively correlated with a high risk of ECC.

CONCLUSION

These data provide evidence to suggest that the ECC-related risk factors at different ages are inconsistent, which provides some insights for OHE. We should highlight the effects of feeding methods in the early stages of deciduous dentition and sugar habits in the late stages of deciduous dentition on ECC, as well as encourage preventive dental visit and supplemental training for oral health practices.

Factors influencing the severity of dental caries among Indonesian children with autism spectrum disorder - a pilot study

Aim

To assess the prevalence of dental caries among autism spectrum disorders (ASD) children in Surabaya, Indonesia, and to explore the association between oral health-related behaviors comprising toothbrushing, snacking and dental visiting and the severity of caries.

Methods

The prevalence and severity of caries were assessed using DMF-T/dmf-t and PUFA/pufa indexes for mixed dentitions. The parents or carers’ responses were collected to identify the oral health-related behaviors that were associated with caries severity.

Results

This study shows that almost 79% of ASD children in Surabaya were experiencing caries and 47.1% had untreated caries with pulp involvement or more severe conditions. Oral health behaviour factors associated with the severity of dental caries experienced by children with autism were brushing frequency (Β [95% CI] =2.46 [0.09–4.83] and 2.03 [0.78–3.28]), brushing time (Β [95% CI] =3.76 [1.32–6.20] and 2.03 [0.74–3.32]) and cleansing after snack (B [95% CI] = 2.04 [0.20–3.89] and 1.21 [0.23–2.18]) in DMF-T/dmf-t and PUFA/pufa indexes, respectively.

Conclusions

The prevalence of caries among children with autism in Surabaya was high. The severity was associated with brushing and snacking behaviors. Caries in children with autism should be paid attention, and research in modifying daily activities are needed to allow them to adopt more healthy oral health-related behaviors.

Risk factors of early childhood caries (ECC) among children in Beijing - a prospective cohort study

BACKGROUND

Early childhood caries (ECC) was a serious oral health concern with high prevalence and a low treatment rate in China, and few researches have focused on preschool children. This study aimed to explore the risk factors of ECC in Beijing, China.

METHODS

Totle of 712 children (mean age: 46.37 ± 5.44 months) participated in this prospective cohort study. Questionnaires and the levels of mutans streptococci in dental plaques and non-stimulated saliva, assessed using Dentocult SM strips, were collected at baseline, respectively. Two calibrated examiners checked for dental caries according to the WHO 1997 criteria at baseline and 1-year follow-up. Negative binomial regression was used for multivariate analysis of factors related to caries development.

RESULTS

For caries-free children at baseline, only plaque mutans streptococci (PMS) levels were associated with caries development (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.08-2.61, P = 0.02). Children with high PMS levels (scored 2 and 3) had higher caries incidence (46.2% vs. 33.8%) and more caries increment (1.87 ± 3.17 vs. 0.90 ± 1.89) than those with low levels (scored 0 and 1). Among all participants, PMS (OR = 1.69, 95% CI: 1.32-2.23, P < 0.001) and previous caries experience (OR = 2.80, 95% CI: 2.20-3.56, P < 0.001) were related to caries increment.

CONCLUSIONS

For caries-free children, the only significant risk factor for ECC was high PMS levels. For all participants, besides high PMS levels, previous caries experience was another significant risk factor for caries development.

TRIAL REGISTRATION

The study design, protocol, and informed consent forms were undertaken with the understanding of Declaration of Helsinki and were approved by the Human Research Ethics Committee of the School of Stomatology, Peking University, China (PKUSSIRB-2012042).

Early Childhood Caries in 3 to 5 Year Old Children in Trinidad and Tobago

Background: This study was done to evaluate the prevalence and contributory factors of early childhood caries (ECC) and severe ECC (S-ECC) among preschool children of Kindergartens and Early Childhood Centres in Trinidad and Tobago. Methods: A cross-sectional study was carried out involving 342 preschool children aged 3 to 5 years. The school staff distributed a structured questionnaire to the children to be completed by the mother. Clinical examinations were conducted by calibrated examiners. Statistical significance was set at p < 0.05 in all analyses. Results: The prevalence of ECC and S-ECC was 50.3% and 52.3%, respectively. Dietary and oral hygiene factors particularly with bottle feeding and high plaque levels were major contributors to dental caries in this population. Conclusion: ECC and S-ECC are significant issues that occur in preschool children in Trinidad and Tobago. The development of ECC and S-ECC can be attributed to certain environmental factors like dietary habits and oral hygiene practices. Early dental assessment, broad-based oral health education programmes, increased parental/guardian engagement during oral hygiene practices and greater access to facilities for early childhood caries prevention and management can help alleviate the problems of ECC and S-ECC in this population.

Foreign Body causing Displacement of Immature Fractured Apical Root Fragment: An Unusual Case Report

Trauma is a common cause of fractured teeth with exposed canals in growing children. These children use foreign bodies like stapler pin, lead pencil, nail, etc., to explore the canal of fractured tooth. Sometimes, these foreign objects may get stuck in the canal, which the children do not reveal to their parents because of fear. These foreign objects may act as a potential source of infection. We herewith present a case of a 12-year-old boy who presented with a stick lodged in the root canal of maxillary right lateral incisor along with the displaced fractured tooth segment at the apex and the associated management. How to cite this article: Moda A, Singla R, Agrawal PM. Foreign Body causing Displacement of Immature Fractured Apical Root Fragment: An Unusual Case Report. Int J Clin Pediatr Dent 2018;11(3):247-249.

Early childhood caries and dental treatment need in low socio-economic communities in Cape Town, South Africa

Background

Early childhood caries (ECC) is a particularly severe problem in low socio-economic communities which impacts the overall health and well-being of children. The extensive waiting lists for general anaesthesia and sedation services at the only tertiary dental care centre in the study area for the treatment of children with ECC were an indication of the extent of the problem. The true extent of the problem in this area was, however, not known. This information is crucial in order to plan and execute remedial measures.

Aim

To assess the prevalence of oral and dental problems, especially ECC, in children under six years of age in the study population, and ascertain their need for dental treatment.

Methods

A cross-sectional survey of 659 children from selected schools and clinics in the study area was carried out between 2010 and 2013.

Results

A caries prevalence of 71.6% (472/659) was recorded. Of these, 67.5% (445/659) of children were in need of dental treatment.

Conclusion

Over the last decade, there has been no improvement in the caries status of children in the study population, and no organised measures have been put in place to address this problem. Awareness needs to be raised so that governments, especially in developing countries, can take appropriate measures to alleviate this public health problem. Time and resources have to be invested in the education of all health professionals dealing with children, by raising their awareness of the early stages of the disease so that timeous referrals can be made.

Nonsyndromic Gingival Fibromatosis: A Rare Case Report

Hereditary gingival fibromatosis (HGF) is an uncommon gingival disease of attached gingiva, which is manifested as localized or generalized form. The HGF inheritance is transmitted through both autosomal dominant and recessive modes. Here, we are discussing a rare case report of an 8-year-old child with gingival fibromatosis in mixed dentition, which caused damage to his speech, mastication, and esthetics and led to significant change in his facial profile.

The patient noticed that the gingival enlargement was simultaneous with deciduous dentition eruption and gradually covered entire dentition. Gingival enlargement covered all teeth anteriorly and posteriorly and only occlusal surfaces were visible. The enlarged tissue was resected by the external bevel gingivectomy under general anesthesia arch wise.

The postoperative healing was satisfactory, uneventful, and there was significant change in patient’s esthetics. Patient has been kept on regular recall visits.

How to cite this article: Gandhi M, Tandon S, Sharma M, Vijay A. Nonsyndromic Gingival Fibromatosis: A Rare Case Report. Int J Clin Pediatr Dent 2018;11(3):250-253.

Prevalence and Risk Factors for Dental Caries among Preschool Children: A Cross-sectional Study in Eastern India

INTRODUCTION

Dental caries is one of the major widespread health issues that continue to negatively affect the oral health of children globally.

AIM

To estimate the prevalence of dental caries and its risk factors among preschool children of Bhubaneswar, Odisha, India.

MATERIALS AND METHODS

The study was a community-based cross-sectional one among preschool children with (N = 425) participants recruited from the Anganwadi centers (AWCs) of Bhubaneswar, Odisha, India. By using a cross-sectional study design, dental caries was assessed using the World Health Organization (WHO) guidelines, and other socioeconomic and risk factors data were collected through parental interview using questionnaires. Caries was identified at both tooth and surface levels through visual dental examinations by trained and calibrated dentists. Logistic regression analyses were used to identify associations among variables and caries.

RESULTS

The proportion of preschool children suffering from dental caries was found to be 47.29%. The multivariable-adjusted model depicted that longer duration of breastfeeding was a significant predictor as follows: Those who had breastfed for more than 36 months [adjusted odds ratio (AOR): 5.41; 95% confidence interval (CI): 2.97-9.85; p = 0.001], 12 to 24 months (AOR: 2.1; 95% CI: 1.04-4.36; p = 0.037), followed by increase in age 61 to 72 months (AOR: 5.39; 95% CI: 2.72-10.67; p = 0.001), 49 to 60 months (AOR: 2.53; 95% CI: 1.41-4.52; p = 0.002), more than two children in the family (AOR: 2.70; 95% CI: 1.55-4.69; p = 0.001), and children who did not brush the teeth under the parent's supervision (AOR: 2.70; 95% CI: 1.55-4.69; p = 0.001).

CONCLUSION

The study highlights the need to increase awareness about the oral health and hygiene among parents of preschool children in India.How to cite this article: Chugh VK, Sahu KK, Chugh A. Prevalence and Risk Factors for Dental Caries among Preschool Children: A Cross-sectional Study in Eastern India. Int J Clin Pediatr Dent 2018;11(3):238-243.

Squamous Papilloma on Hard Palate: Case Report and Literature Review

Most of the lesions in the oral cavity have papillary appearance. Oral squamous papilloma (SP) is one such type, which is a benign proliferation of the stratified squamous epithelium and presents as papillary or verrucous exophytic mass induced by human papillomavirus (HPV). Most of the oral mucosal lesions are often asymptomatic and have small progression. The common sites of occurrence include tongue, soft palate, and uvula. Squamous papilloma arising on hard palate is described in this article. Surgical excision of the lesion was done and sent for histopathological analyses that confirmed the clinical diagnosis. In larynx and trachea, malignant transformation of papillomas has been reported. The potentially malignant nature of SP if present needs to be explored. How to cite this article: Chaitanya P, Martha S, Punithvathy R, Reddy M. Squamous Papilloma on Hard Palate: Case Report and Literature Review. Int J Clin Pediatr Dent 2018;11(3):244-246.

Factors Affecting Oral Hygiene and Tooth Brushing in Preschool Children, Shiraz/Iran

STATEMENT OF PROBLEM

Inadequate tooth brushing and inappropriate oral hygiene can lead to dental caries, the most common chronic diseases of childhood with several side effects.

OBJECTIVES

To evaluate factors affecting on preschool children's oral hygiene and tooth brushing in Shiraz, Iran.

MATERIALS AND METHODS

In this cross-sectional study, we selected 453 children registered in Shiraz kindergartens in 2013 by randomized cluster sampling. The children's tooth brushing and oral hygiene were assessed using a reliable and valid questionnaire and Simplified Debris Index (DI-S), respectively. A dental student examined all the children in each kindergarten to determine their DI-S. The relationship between the children's demographic variables and their oral hygiene and tooth brushing status were evaluated.

RESULTS

Tooth brushing for 272 children (71.2%) had been started after the age of 2 years. The teeth in 96 children (24.2%) had been brushed lower than once daily. The mean of the children's DI-S was 1.19 ± (0.77). The DI-S of only 126 children (31.8%) was found to be good and very good. After controlling the effect of confounding factors, we found that the children's tooth brushing frequency was significantly associated with the number of children in the family and mothers' employment status. The age at which tooth brushing had been started was significantly associated with the fathers' education. Furthermore, the DI-S was associated with children's age, number of the children in the family, and their mothers' education.

CONCLUSIONS

Oral hygiene and tooth brushing of the preschool children were not in a desirable status. Interventional procedures, especially educational programs, are recommended for children and their parents. These programs seem to be more necessary for older children, low socioeconomic families, and families with more than one child.

Association of Feeding Methods and Streptococcus mutans Count with Early Childhood Caries: A Cross-sectional Study

Introduction

Early childhood caries (ECC) is a virulent form of dental caries that can destroy the primary dentition of toddlers and preschool children. The aim was to determine the relationship of feeding methods and oral Streptococcus mutans count in 3- to 5-year-old children with ECC.

Materials and methods

A cross-sectional study was conducted in children aged 3 to 5 years. Participating mothers were interviewed regarding child’s demographic profile, educational level and socioeconomic status of parents, past medical and dental history of the mother and child, child’s feeding habits, and dietary habits and oral hygiene practices of mother and child. Clinical examination for dental caries was done using the World Health Organization criteria (1997). Salivary samples of mother-child pair were collected to determine the pH, flow rate, and S. mutans count. Statistical tests, such as Student’s t-test, analysis of variance, and Pearson’s correlation were applied.

Results

Out of 150 mother-child pair, statistically significant difference in the caries experience was found between mothers and children with high and low S. mutans count. Moderate but statistically significant negative correlation was found between mean decayed, missing, and filled teeth of mothers and mean decayed, extracted and filled teeth (deft) of children with high S. mutans count. Regarding deft, there was no statistically significant difference between children who were exclusively breast fed (7.85 ± 2.94), exclusively bottle-fed (8.67 ± 3.98), and both breast and bottle-fed (7.77 ± 2.91).

Conclusion

The mean caries experience of mothers and children was 2.66 ± 2.01 and 7.82 ± 2.94 respectively, with decayed component being maximum. Moderate and significant correlation (r = 0.5) was found between S. mutans of mothers and children in saliva. Significant negative correlation was found between mothers and children with high S. mutans count (r = -0.0284; p = 0.046).

How to cite this article

Bullappa D, Puranik MP, Sowmya KR, Nagarathnamma T. Association of Feeding Methods and Streptococcus mutans Count with Early Childhood Caries: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(2):119-125.

Measuring Potential of Preschool Facility Staff to Prevent Early Childhood Caries

The aim of this study was to investigate the possible potential of preschool staff through a newly designed questionnaire and evaluate their role in the prevention of early childhood caries (EEC) in Serbia where extremely high prevalence of this preventable disease was recorded.

We preformed a cross-sectional study of 268 preschool staff using specially prepared semi-structured questionnaire for measuring potential of secondary children’s caregivers to prevent EEC. The questionnaire was tested on a pilot sample and after that all collected data were analyzed trough construction of correlation matrix with the evaluation of the value of each question, reliability testing, factorial analysis and estimating of its validity using SPSS software.

The tested questionnaire had good internal consistency based on the Cronbach’s alpha coefficient value of 0.873 calculated directly and similar value (0.899) after applied Spearman-Brown “prediction” formula. Using exploratory factorial analysis and orthogonal rotation, we identified two domains that emerged with similar loadings (4.043 and 3.183). The first factor (domain) reflected attitudes of the study participants towards prevention of EEC, and the second factor (domain) showed behaviour of the study participants, which includes preventive actions against EEC.

The total score of the questionnaire was correlated positively with oral health knowledge (Spearman’s correlation coefficient 0.331, p=000) and inversely with the length of employment, where each additional year of employment decreased the total score of the questionnaire by 1.20.

These findings could partially explain an extremely high prevalence of EEC in young children and indicate that preschool teachers should be more engaged in health education activities and motivation programs.

Prevalence of early childhood caries and enamel defects in four and five-year old Qatari preschool children

Background

Dental caries is the most prevalent chronic disease in early childhood in most communities worldwide. Several studies conducted in the Gulf Cooperation Council countries have documented a high prevalence of early childhood caries (ECC). To date, no studies have been conducted in Qatar to examine the prevalence of ECC and enamel developmental defects in preschool children. The present study aimed to determine the prevalence of ECC and enamel defects in preschool children aged four and five years attending kindergartens in Qatar.

Methods

A descriptive cross-sectional study was performed among 250 children randomly selected from 16 public kindergartens. Caries experience was measured using the World Health Organization caries criteria (dmft) for tooth rather than surface; enamel defects were scored by the modified developmental defects of enamel index. Descriptive statistics and Chi-Square test of relatedness were used.

Results

A response rate of 63 % was reported. The overall caries prevalence of the study sample was 89.2 %; 15.6 % of the examined children had ECC and 73.6 % had severe ECC. Developmental enamel defects were present in 39 % of children and 27 % had demarcated enamel opacities.

Conclusion

The high rate of dental caries and enamel defects recorded in this study for this young age group has strongly emphasized the necessity of community-based preventive programs and professional care that should begin during pregnancy and in early childhood.

Prevalence of dental caries and toothbrushing habits among preschool children in Khartoum State, Sudan

BACKGROUND

Dental caries in preschool children remains a major dental public health problem and affects significant numbers of children in developed and developing countries. The incidence is increasing in developing countries, such as Sudan, because of lifestyle changes, absence of oral health-preventive services and inadequate access to oral health care.

OBJECTIVES

This study assessed the prevalence of dental caries and toothbrushing habits among 3- to 5-year-old preschool children in Khartoum State, Sudan, and described the correlation between the mean decayed, missing and filled tooth (dmft) score for primary teeth with toothbrushing and sugar consumption.

MATERIALS AND METHODS

The subjects were 553 preschool children with their mothers/guardians, selected by random sampling from the kindergartens of the seven localities of Khartoum State, Sudan. Data were obtained through clinical examination using a modified World Health Organization (WHO) examination data-capture sheet and through structured administered interviews with mothers/guardians.

RESULTS

The prevalence of dental caries was 52.4%, with a mean dmft score of 2.3. There was an increase in the dmft scores with increasing age. The frequency of children who brushed their teeth regularly at least once a day was high (83.4%), lower dmft scores were associated with starting toothbrushing earlier in life and with increased frequency of brushing per day. Eating sugar-containing food was significantly associated with dmft score.

CONCLUSIONS

The prevalence of dental caries was found to be high among 3- to 5-year-old preschool children, and caries experience increased with age. This was mostly associated with sugar consumption and therefore calls for educational interventions to control sugar intake. The toothbrushing habit is well established in Khartoum State, Sudan, as a large number of children were found to be brushing their teeth regularly. No significant association was found between feeding habits and dmft score.

Impact of oral hygiene on oral health-related quality of life of preschool children

OBJECTIVES

To assess the impact of oral hygiene of preschool children and parental attitude on children's oral health-related quality of life (OHRQoL).

METHODS

In this cross-sectional study, 396 children of Shiraz kindergartens were selected by a randomized cluster sampling. Children's oral hygiene was assessed using the Simplified Debris Index (DI-S) and a self-made questionnaire about oral hygiene habits. Children's OHRQoL was evaluated by the Farsi version of Early Childhood Oral Health Impact Scale (F-ECOHIS). The effect of oral hygiene determinants on OHRQoL was measured using Pearson and Spearman correlation, independent-sample t-test and anova.

RESULTS

Children's mean DI-S and F-ECOHIS scores were 1.19 (± 0.77) and 19.36 (±8.42), respectively. Only 75% of the children had their teeth brushed once a day or more, and in 28%, toothbrushing had started before 2 years of age. DI-S values (P < 0.001) and frequency of toothbrushing (P < 0.001) had a statistically significant impact on OHRQoL of the children. Children's OHRQoL was also significantly associated with parents' attitude towards the importance of brushing deciduous teeth (P = 0.002).

CONCLUSIONS

Oral health status of preschool children in Shiraz was less than optimal and had a significant impact on their OHRQoL. Therefore, improvement of children's OHRQoL could be achieved by improving their home dental care. Strategies promoting parental attitude about the importance of children's toothbrushing may significantly influence children's oral hygiene and are highly recommended.

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.

Do the more caries in early primary dentition indicate the more caries in permanent dentition? Results of a 5-years follow-up study in rural-district

Aim:

In the deprived communities with high caries incidence, determination of high-risk children in early age is a valuable tool to apply the individual and/or community-level preventive measures. The purpose of this 5-years follow-up study was to examine the relationship between early caries occurrence on primary incisors and the future caries occurrence on both first permanent molars and all permanent dentition in the children living in rural Turkey.

Materials and Methods:

Total 34 children living in rural-districts of southeastern Anatolia were included, and divided in both test (caries positive for maxillary primary incisors) and control groups (caries free on the same teeth). During the 5-years they were examined annually regarding new caries occurrence in either first permanent molars for the Decayed, Missing, Filled Tooth Index [(DMF(T)_[6])] or all permanent dentition (DMF(T)).

Results:

At the beginning of the study, the age range of the children was 3 to 5 (mean ± St dv; 4.03 1.24), and d(t)_{[max 1,2]} and df(t) indices for the deciduous dentition of test and control groups were 2.65 ± 0.78; 4.29 ± 2.08 and 0; 0.24 ± 0.43, respectively. After 5-years mean DMF(T)_[6] and total DMF(T) for test and control groups were 1.88 ± 0.66; 3.12 ± 0.69 and 0.47 ± 0.62; 0.65 ± 0.93, respectively (for each parameters the difference was statistically significant P < 0.01). For test group the number of caries on primary-incisors (d(t)_{[max 1,2]}) was correlated with the DMF(T)_[6] (r = 0.80) and DMF(T) (r = 0.59).

Conclusion:

The caries-information including the early primary incisors could be helpful in identifying children with increased risk so that preventive measures could be directed at those who fit the high-risk-caries profile.

Can child temperament be related to early childhood caries?

Beyond the biological risk factors of early childhood caries (ECC) is child temperament. This study aimed to investigate the relationship of ECC to different traits of child temperament, directly and indirectly through the nutritional and oral hygiene habits. Through a multi-stage sampling, 373 kindergarten children aged 18-36 months participated in this study. The primary caregivers filled in the Early Childhood Behaviour Questionnaire (ECBQ) and a checklist containing demographic data and the dietary and oral hygiene habits of the children. Children were examined for dental caries. The frequency of ECC was 41.14%. With 18 aspects of a child's temperament under consideration, attentional shifting, fear, frustration, low-intensity pleasure, sadness and shyness were significantly higher in the ECC group. Cuddliness, perceptual sensitivity, positive anticipation and soothability were significantly higher in caries-free children. Attentional shifting (p = 0.02), frustration (p = 0.02) and shyness (p = 0.03) were risk factors and cuddliness (p < 0.001) was a protecting factor for ECC. In the multiple regression model regarding nutritional and oral hygiene habits, easily soothable children were 0.69 times less likely to use sweetened liquids frequently [odds ratio (OR) 0.69, 95% confidence interval (CI) 0.49-0.97, p = 0.03], while sad children were 0.58 times less likely to brush (OR 0.58, 95% CI 0.36-0.94, p = 0.02). Considering temperament traits along with socioeconomic status, positive anticipation was the most significant determinant of ECC (OR 1.57, 95% CI 1.13-2.19, p = 0.007). However, considering temperament, socioeconomic measures and child habits among ECC risk factors, the most significant was the initiation of brushing habits (OR 5.41, 95% CI 2.81-12.98, p = 0.002).

Prepregnancy Body Mass Index and Feeding Practices in Relation to Infants' Growth

Obesity has now emerged as 1 of the most serious public health problems facing American Indian (AI) children and adolescents. However, little is known about what factors contribute to the early development of obesity in AI children. This study explored the relationships between maternal prepregnancy BMI, feeding practices, and growth in AI infants. The findings of this study highlight the need for nurse midwives and pediatric nurse practitioners to increase AI mothers' awareness about their feeding practices, exclusive breastfeeding, and timing for solid food introduction.

Dental neglect as a marker of broader neglect: a qualitative investigation of public health nurses' assessments of oral health in preschool children

BACKGROUND

Child neglect is a pernicious child protection issue with adverse consequences that extend to adulthood. Simultaneously, though it remains prevalent, childhood dental caries is a preventable disease. Public health nurses play a pivotal role in assessing oral health in children as part of general health surveillance. However, little is known about how they assess dental neglect or what their thresholds are for initiating targeted support or instigating child protection measures. Understanding these factors is important to allow improvements to be made in care pathways.

METHODS

We investigated public health nurses' assessment of oral health in preschool children in relation to dental neglect and any associations they make with child neglect more broadly. A qualitative study was conducted in Scotland during 2011/12. Sixteen public health nurses were recruited purposively from one health region. Individual, semi-structured interviews were undertaken and data were analyzed inductively using a framework approach. Categories were subsequently mapped to the research questions.

RESULTS

Public health nurses assess oral health through proxy measures, opportunistic observation and through discussion with parents. Dental neglect is rarely an isolated issue that leads on its own to child protection referral. It tends to be other presenting issues that initiate a response. Threshold levels for targeted support were based on two broad indicators: social issues and concerns about child (and parental) dental health. Thresholds for child protection intervention were untreated dental caries or significant dental pain. Barriers to intervention are that dental neglect may be 'unseen' and 'unspoken'. The study revealed a communication gap in the care pathway for children where a significant dental problem is identified.

CONCLUSIONS

Public health nurses take their child protection role seriously, but rarely make a link between dental caries and child neglect. Clear guidance on oral health assessment is required for public health nurses. Establishing formal communication pathways between child dental care providers and public health nurses may help close gaps in care pathways. However, further research is required into how these communication mechanisms can be improved.

Prevalence and factors related to dental caries among pre-school children of Saddar town, Karachi, Pakistan: a cross-sectional study

BACKGROUND

Dental caries is highly prevalent and a significant public health problem among children throughout the world. Epidemiological data regarding prevalence of dental caries amongst Pakistani pre-school children is very limited. The objective of this study is to determine the frequency of dental caries among pre-school children of Saddar Town, Karachi, Pakistan and the factors related to caries.

METHODS

A cross-sectional study of 1000 preschool children was conducted in Saddar town, Karachi. Two-stage cluster sampling was used to select the sample. At first stage, eight clusters were selected randomly from total 11 clusters. In second stage, from the eight selected clusters, preschools were identified and children between 3- to 6-years age group were assessed for dental caries.

RESULTS

Caries prevalence was 51% with a mean dmft score being 2.08 (±2.97) of which decayed teeth constituted 1.95. The mean dmft of males was 2.3 (±3.08) and of females was 1.90 (±2.90). The mean dmft of 3, 4, 5 and 6-year olds was 1.65, 2.11, 2.16 and 3.11 respectively. A significant association was found between dental caries and following variables: age group of 4-years (p-value < 0.029, RR = 1.248, 95% Bias corrected CI 0.029-0.437) and 5-years (p-value < 0.009, RR = 1.545, 95% Bias corrected CI 0.047-0.739), presence of dental plaque (p-value < 0.003, RR = 0.744, 95% Bias corrected CI (-0.433)-(-0.169)), poor oral hygiene (p-value < 0.000, RR = 0.661, 95% Bias corrected CI (-0.532)-(-0.284)), as well as consumption of non-sweetened milk (p-value < 0.049, RR = 1.232, 95% Bias corrected CI 0.061-0.367).

CONCLUSION

Half of the preschoolers had dental caries coupled with a high prevalence of unmet dental treatment needs. Association between caries experience and age of child, consumption of non-sweetened milk, dental plaque and poor oral hygiene had been established.

Parental influence and the development of dental caries in children aged 0-6 years: a systematic review of the literature

OBJECTIVE

A well established body of research documents the role of individual factors, such as biology and diet, in the aetiology of early childhood caries (ECC). Recently empirical attention has shifted to the relationships between broader ecological influences (e.g., education, ethnicity and income) and ECC; however, how such determinants interplay in the aetiology of ECC remains unclear. An intermediary mechanism that warrants greater empirical attention is parental influences. This oversight is interesting given the primacy of the parent in governing the child's proximate environment and the likelihood of the child endorsing adaptive or maladaptive health attitudes, beliefs and behaviours. The objective of this paper was to conduct a systematic review of the evidence for parental influences on the development of caries in children aged 0-6 years.

DATA

All studies testing associations between dental caries and socio-demographic factors, feeding practices, parent attributes, behaviours, oral health, attitudes, knowledge and beliefs in children aged 0-6 years, published between 2006 and 2011.

SOURCE

Medline, ISI, Cochrane, Scopus, Global Health and CINAHL databases.

STUDY SELECTION

Fifty-five studies were included from an initial identification of 1805 studies.

CONCLUSIONS

To date, most research has focused on the association between caries and socio-demographic and feeding factors with few studies exploring parents' attributes, attitudes, knowledge and beliefs, and none exploring possible pathways between the multiple layers of influences potentially accounting for how determinants of ECC operate and traverse individual, familial, community, and socio-cultural contexts. Collaboration between Psychologists and Dentists may accelerate the identification and understanding of mechanisms that underlie risk associated with ECC.