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Hussein YA, Refai RH, Hussein MMK, Abdou MH, El Bordini MM, Ewais OM, Hussein MF. Association between environmental stress factors, salivary cortisol level and dental caries in Egyptian preschool children: a case-control study. Sci Rep 2025; 15:11063. [PMID: 40169691 PMCID: PMC11961556 DOI: 10.1038/s41598-025-94327-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 03/13/2025] [Indexed: 04/03/2025] Open
Abstract
Dental caries remains the most common chronic disease in childhood. This study aimed to identify environmental stressors in children and estimate the association between salivary cortisol level as a stress biomarker and childhood caries. We conducted a case-control study involving 80 Egyptian children. The cases were 40 children with early childhood caries (ECC). The controls included 40 caries-free children. Data were collected from the parents or caregivers of the children using a questionnaire. The clinical examination included caries experience and an oral hygiene index. Saliva samples were collected and tested for unbounded cortisol levels. The results from the current study showed that the mean age for participants was 5.09 ± 0.66 years. Twenty-one of the children with ECC were girls. In multivariate regression, there is a significant association between ECC and elevated salivary cortisol levels (> 0.57 µg/dl) with an adjusted odds ratio (AOR) of 9.649 (p = 0.003), father smoking (AOR = 5.791, p = 0.030), sleeping with a bottle or food in the mouth (AOR = 8.481, p = 0.027), and poor oral hygiene evaluated through the Silness-Löe Plaque Index (AOR = 6.681, p = 0.001). As a conclusion, the study indicates that salivary cortisol is an independent stress biomarker in relation to early childhood caries. Salivary cortisol as a stress biomarker can help clinicians provide an additional assessment tool for identifying caries risk in children.
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Affiliation(s)
- Yosra Ahmed Hussein
- Dental Unit, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Rania Hussein Refai
- Department of Medicine Supply and Pharmacy, Alexandria University Hospitals, Alexandria University, Alexandria, Egypt.
| | - Mai M K Hussein
- Clinical Research Administration, Alexandria Directorate of Health Affairs, Alexandria, Egypt
- Ministry of Health and Population, Cairo, Egypt
| | - Mamdouh Hanafy Abdou
- Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | | | - Ola Mohamed Ewais
- Dental Unit, Medical Research Institute, Alexandria University, Alexandria, Egypt
| | - Mohamed Fakhry Hussein
- Department of Occupational Health and Industrial Medicine, High Institute of Public Health, Alexandria University, Alexandria, Egypt
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Xiang L, Kozlitina IA, Mohammadian M, Choopani R, Mohammadian-Hafshejani A. The association between mode of childbirth delivery and early childhood caries: A comprehensive systematic review and meta-analysis. PLoS One 2024; 19:e0310405. [PMID: 39325830 PMCID: PMC11426529 DOI: 10.1371/journal.pone.0310405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/31/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Early childhood caries (ECC), also known as dental caries, poses a significant challenge to the oral health and overall well-being of young children. This study aims to investigate the potential relationship between the mode of delivery and the odds of ECC. METHODS We conducted a meticulous systematic review and meta-analysis, gathering studies from reputable databases, including Web of Science, Scopus, PubMed, Cochrane, Google Scholar, and Embase. The selected studies underwent rigorous evaluation for heterogeneity, utilizing statistical tests such as the Chi-square test, I2, meta-regression analysis, sensitivity analysis, and subgroup analysis. We assessed the presence of publication bias using Begg's and Egger's tests, while the quality of the articles was evaluated using the Newcastle-Ottawa Scale checklist. RESULTS Our analysis included a robust dataset of 24 studies conducted between 1997 and 2024, involving a total of 71,732 participants. The meta-analysis revealed an odds ratio of 1.05 (95% CI: 0.86-1.30; P-value = 0.610) for dental caries in children born via cesarean section. Importantly, we found no evidence of publication bias, as indicated by non-significant results from Begg's test (P-value = 0.568) and Egger's test (P-value = 0.807). Meta-regression analysis did not identify any significant associations between the study variables and the observed heterogeneity (P > 0.10). Sensitivity analysis further confirmed the stability of the study results, with no significant changes detected. CONCLUSION In conclusion, our comprehensive meta-analysis provides compelling evidence that there is no significant association between the mode of delivery and the odds of ECC. These findings enhance our understanding of this important topic and have implications for clinical practice and public health interventions.
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Affiliation(s)
- Li Xiang
- Department of Pediatric, Preventive Dentistry and Orthodontics, E.V. Borovsky Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Iuliia A. Kozlitina
- Department of Pediatric, Preventive Dentistry and Orthodontics, E.V. Borovsky Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
| | - Mahdi Mohammadian
- MSc in Epidemiology, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Choopani
- Department of Pediatrics, Assistant Professor of Neonatal-Perinatal Medicine, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Abdollah Mohammadian-Hafshejani
- Assistant Professor of Epidemiology, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Manikandan K, Megalaa N, Valliappan S, Nandini K, Rani LV, Dakshinamurthi S, Nagappan N. Risk Factors of Early Childhood Caries among Preschool Children in Madipakkam, Chennai: Cross-Sectional Survey. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1438-S1441. [PMID: 38882890 PMCID: PMC11174276 DOI: 10.4103/jpbs.jpbs_806_23] [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: 08/29/2023] [Revised: 09/11/2023] [Accepted: 09/25/2023] [Indexed: 06/18/2024] Open
Abstract
Background Early childhood caries (ECC) is a major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. Aim A survey to identify the factors influencing the ECC among preschool children in Madipakkam, Chennai. Methodology A descriptive cross-sectional survey was conducted among 3-5-year-old preschool children in Madipakkam, Chennai. Three schoolchildren participated in the study. In total, 313 children aged three to five years took part in the study. A closed-ended questionnaire was used to collect general information to assess their feeding habits and oral hygiene practices. Results Dental caries experience (dmft and deft) was high among children who were bottle-fed compared to children who were breastfed. The children who were breastfed for less than six months had more caries than other children who were breastfed for more than six months. Conclusion Factors such as age and BMI did not show any association with ECC. Other factors such as feeding habits, snacking, oral health behavior, parental assistance in brushing, and regular dental visits are found to be associated with the ECC. Most of the risk factors studied in this study are modifiable. Therefore parents and children should be educated about the risk factors of ECC and mechanisms to control it.
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Affiliation(s)
- K Manikandan
- Department of Public Health Dentistry, Sri Venkateswara Dental College and Hospital, Thalambur, Chennai, Tamil Nadu, India
| | - N Megalaa
- Department of Pediatric and Preventive Dentistry, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Puducherry, India
| | - Subramanian Valliappan
- Department of Pediatrics, ESIC Medical College and Hospital, K. K. Nagar, Chennai, Tamil Nadu, India
| | - K Nandini
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chengalpet, Tamil Nadu, India
| | - Lourdu V Rani
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chengalpet, Tamil Nadu, India
| | - Senthil Dakshinamurthi
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chengalpet, Tamil Nadu, India
| | - Nagappan Nagappan
- Department of Public Health Dentistry, Chettinad Dental College and Research Institute, Chengalpet, Tamil Nadu, India
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Suresh A, Srinivasan D, AR SE, Mahadevan S, Babu HSS. Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam. Int J Clin Pediatr Dent 2023; 16:565-571. [PMID: 37731800 PMCID: PMC10507305 DOI: 10.5005/jp-journals-10005-2606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
Introduction One of the most prevalent oral diseases affecting preschoolers, early childhood caries (ECC), can significantly lower a child's quality of life. The pain and discomfort that ECC causes will alter the child's eating habits, which will have an impact on both their physical and mental health, as shown by the deviation from the body mass index (BMI). Dental caries and deviation from the normal BMI are both significantly influenced by children's eating habits and socioeconomic status (SES). Aim To determine the association of ECC with BMI, dietary habits, and SES among 3-6-year-old preschool children. Materials and methods A cross-sectional study was conducted among 375 preschool children of 3-6 years of age. The decayed, missing, or filled teeth (deft) index was used to determine the caries status. Measurement of height (m) and weight (kg) was done using a stadiometer and electronic weighing machine. For each child, the BMI (kg/m2) was calculated, and the child's body weight status was assessed using Centers for Disease Control and Prevention (CDC)-based classification. Questionnaires were collected with demographic details, 3 days diet diary, and the SES of parents. The dietary habit and SES were obtained from the healthy eating index-2005 (HEI-2005) score and Modified Kuppuswamy's Scale 2018. All the data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) software V 20.0. Result The prevalence of ECC was 44.8%. On comparison of mean height, weight, and BMI scores, there was a significant difference in mean weight (p = 0.006) and BMI (p = 0.001) among the two study groups. Children with ECC had a lower HEI-2005 score and belonged to a lower social class compared to caries-free children (p = 0.001). Conclusion Children with ECC are significantly associated with BMI being overweight, or risk of being overweight; lower grades of SES and lower total score of HEI-2005 with poor diet and diet that needs improvement. How to cite this article Suresh A, Srinivasan D, AR SE, et al. Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam. Int J Clin Pediatr Dent 2023;16(4):565-571.
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Affiliation(s)
- Anisha Suresh
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
| | - Daya Srinivasan
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
| | - Senthil Eagappan AR
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
| | - Shruthi Mahadevan
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
| | - Harish Sumathi Suresh Babu
- Department of Pediatric and Preventive Dentistry, Chettinad Dental College and Research Institute, Chennai, Tamil Nadu, India
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Ge X, Lyu X, Zhou Z, Mi Y, He T, Wu B, Liu F. Caesarean-section delivery and caries risk of 3-year-old Chinese children: a retrospective cohort study. BMC Oral Health 2023; 23:373. [PMID: 37291538 PMCID: PMC10251555 DOI: 10.1186/s12903-023-02998-w] [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: 01/17/2023] [Accepted: 04/28/2023] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Caesarean-section (C-section) may influence children's long-term health by affecting bacterial colonization. However, few studies have focused on the association between C-section delivery (CSD) and dental caries, and previous conclusions have been conflicting. This study aimed to explore whether CSD would increase the risk of early childhood caries (ECC) in preschool children in China. METHODS This study was a retrospective cohort study. Three-year-old children with full primary dentition were included through the medical records system. Children in the nonexposure group were vaginally delivered (VD), while children in the exposure group were delivered through C-section. The outcome was the occurrence of ECC. After agreeing to participate in this study, guardians of included children completed a structured questionnaire on maternal sociodemographic factors, children's oral hygiene and feeding habits. The chi-square test was used to determine differences in the prevalence and severity of ECC between the CSD and VD groups and to analyse the prevalence of ECC according to sample characteristics. Subsequently, potential risk factors for ECC were preliminarily identified through univariate analysis, and the adjusted odds ratios (ORs) were further calculated through multiple logistic regression analysis after controlling for confounding factors. RESULTS The VD group included 2115 participants while CSD group included 2996 participants. The prevalence of ECC was higher in CSD children than in VD children (27.6% vs. 20.9%, P < 0.05), and the severity of ECC in CSD children was higher (mean number of decayed, missing, and filled teeth, dmft: 2.1 vs. 1.7, P < 0.05). CSD was a risk factor for ECC in 3-year-old children (OR = 1.43, 95% CI = 1.10-2.83). In addition, irregular tooth brushing and always prechewing children's food were risk factors for ECC (P < 0.05). Low maternal educational attainment (high school or below) or socioeconomic status (SES-5) may also increase the prevalence of ECC in preschool children and CSD children (P < 0.05). CONCLUSIONS CSD would increase the risk of ECC in 3-year-old Chinese children. Paediatric dentists should devote more attention to the development of caries in CSD children. Obstetricians should also prevent excessive and unnecessary CSD.
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Affiliation(s)
- Xin Ge
- Department of Stomatology, Xi'an People's Hospital (Xi'an Fourth Hospital), Northwest University, Xi'an, Shaanxi, China
| | - Xiaolin Lyu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, Guangdong, China
| | - Zhifei Zhou
- Department of Stomatology, General Hospital of Tibetan Military Command, Lhasa, Tibet, China
| | - Yang Mi
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China
| | - Tongqiang He
- Department of Obstetrics, Northwest Women's and Children's Hospital, Xi'an, Shaanxi, China
| | - Buling Wu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, Guangdong, China.
| | - Fen Liu
- Shenzhen Stomatology Hospital (Pingshan), Southern Medical University, Shenzhen, Guangdong, China.
- Department of Pediatric Dentistry, College of Stomatology, Xi'an Jiaotong University, Xi'an, Shaanxi, China.
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6
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Cui Y, Chen D, Lin H, Tao Y. The association between low birth weight and/or preterm birth and dental caries -A systematic review and meta-analysis. Int J Dent Hyg 2022. [PMID: 36524312 DOI: 10.1111/idh.12651] [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: 12/02/2021] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Studies on the association between adverse birth outcomes and dental caries in children have shown conflicting results, so the aim of this systematic review and meta-analysis was to investigate the association between adverse birth outcomes and dental caries in children. METHODS We systematically searched articles in four electronic databases (Web of Science, PubMed, Cochrane Library and Embase) published prior to August 2021. The odds ratio (OR) (or converted OR) and the corresponding 95% confidence intervals (95% CI) were processed. The certainty of evidence was assessed using GRADE's risk bias assessment tool. Random effects model was used for this meta-analysis. RESULTS A total of thirty-one observational studies met the inclusion criteria. The pooled estimates indicated that children exposed to low birth weight (LBW)/preterm birth (PTB) did not experience higher dental caries in primary teeth. Subgroup analyses showed that children with LBW (OR: 1.30, 95% CI: 1.03-1.63) were prone to have dental caries in primary teeth for cross-sectional studies, but no significant differences for prospective studies. PTB children experienced more primary caries in high-income countries (OR: 1.31, 95% CI: 1.00-1.70) than in low- and middle-income countries. CONCLUSIONS The current evidence did not suggest a significant association between LBW and dental caries in children for primary teeth. Children with PTB in high-income countries had a higher prevalence of primary dental caries. Further prospective studies should adjust for confounding factors (age, oral health and family finances) to determine the definitive association between LBW/PTB and dental caries.
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Affiliation(s)
- Yuqi Cui
- Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Dongru Chen
- Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Department of Orthodontics, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Huancai Lin
- Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
| | - Ye Tao
- Department of Preventive Dentistry, Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-Sen University, Guangzhou, China
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Tanner L, Craig D, Holmes R, Catinella L, Moynihan P. Does Dental Caries Increase Risk of Undernutrition in Children? JDR Clin Trans Res 2022; 7:104-117. [PMID: 33797293 DOI: 10.1177/23800844211003529] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
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.
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Affiliation(s)
- L Tanner
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - D Craig
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - R Holmes
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - L Catinella
- Department of Biology, Loyola University, Baltimore, MD, USA
| | - P Moynihan
- School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.,Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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Pandey P, Nandkeoliar T, Tikku AP, Singh D, Singh MK. Prevalence of Dental Caries in the Indian Population: A Systematic Review and Meta-analysis. J Int Soc Prev Community Dent 2021; 11:256-265. [PMID: 34268187 PMCID: PMC8257015 DOI: 10.4103/jispcd.jispcd_42_21] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 02/19/2021] [Accepted: 03/19/2021] [Indexed: 02/03/2023] Open
Abstract
Objectives: To evaluate the pooled prevalence of dental caries among Indian population through systematic review and meta-analysis. Materials and Methods: A keyword search was conducted in PubMed, Science Direct, Google Scholar, Cochrane, and Scopus databases using relevant key words to extract the data pertaining to dental caries in Indian population. The search criteria included manuscripts published in English language from March 2009 to March 2019 and employed standard Boolean operators. The studies which met the inclusion criteria were independently reviewed by two researchers and their quality was assessed by the Newcastle–Ottawa Scale. The overall prevalence was deduced using the random effects model with prime focus given to the site of anatomical origin. R software version 3.5.2. was used for statistical analysis. Results: Post screening, out of the 253 articles identified, 70 met the inclusion criteria and were used to generate the meta-analysis. Among them, only few studies investigated the prevalence of root caries (n = 1). Overall prevalence of dental caries was 54.16% (CI: 0.4966–0.5866), whereas age-specific prevalence was 62% in patients above 18 years and 52% among 3–18 years of age (P < 0.0001). Maximum overall prevalence was noted in mixed dentition (58%). Region wise prevalence was more in western India (72%). Use of decayed, missed, and filled teeth as diagnostic criteria for early childhood caries was only 29%. Conclusions: Besides an overall prevalence of 54.16%, there exists a remarkable variation in dental caries prevalence rates as per age, diagnostic criteria, dentition, and geographical region. Furthermore, research should be focused on the prevalence of anatomical site specific caries as well.
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Affiliation(s)
- Pragya Pandey
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Tanya Nandkeoliar
- Department of Periodontology, Regional Institute of Medical sciences, Imphal, Manipur, India
| | - A P Tikku
- Conservative Dentistry and Endodontics, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Diksha Singh
- Oral Pathology, King George Medical University, Lucknow, Uttar Pradesh, India
| | - Manish Kumar Singh
- Department of Community Medicine, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Is the mode of childbirth delivery linked to the prevalence of early childhood caries? A systematic review and meta-analysis. Eur Arch Paediatr Dent 2021; 22:765-772. [PMID: 33973156 PMCID: PMC8526466 DOI: 10.1007/s40368-021-00621-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Abstract
Aim The mode of childbirth delivery can influence the child’s future health and the aim of this study was to explore the association between the delivery mode and the prevalence of early childhood caries.
Methods We searched the PubMed, Google Scholar and Cochrane databases up to September 15, 2020. Two independent reviewers screened the papers for relevance, extracted data and assessed the risk of bias with the Newcastle–Ottawa Scale. We performed a random effects meta-analysis to pool the prevalence of early childhood caries according to the mode of delivery. Results The authors included 11 studies in the review, comprising 47,688 children with vaginal delivery and 10,994 with caesarean section (C-section). The publication years ranged from 1997 to 2020 and included birth cohorts, cross-sectional, register-based and case–control studies. We assessed three publications with low or moderate risk of bias. The median caries prevalence in the C-section group was 56.4% compared to 45.9% in the vaginal group and this difference was statistically significant (p < 0.05). The pooled overall odds ratio was 1.48 (95% CI 1.07–2.05) indicating a weak but statistically significant trend towards a higher caries occurrence among children delivered with C-section. The certainty of this finding was low due to heterogeneity and inconsistencies across the studies. Conclusion We found a weak but inconsistent association between the mode of delivery and the prevalence of early childhood caries. Further studies based on representative, prospective cohorts reporting a standardized core outcome set are required to answer the research question with higher certainty. Supplementary Information The online version contains supplementary material available at 10.1007/s40368-021-00621-6.
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Ladeira LLC, Martins SP, Costa CM, Costa EL, da Silva RA, Fraiz FC, Ribeiro CCC. Caesarean delivery and early childhood caries: Estimation with marginal structural models in Brazilian pre-schoolers. Community Dent Oral Epidemiol 2021; 49:602-608. [PMID: 33834500 DOI: 10.1111/cdoe.12634] [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: 12/05/2019] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This study analysed the association between caesarean section and early childhood caries (ECC), estimating the effects using regression and causal inference models. METHODS This was a historical cohort study of 697 mother-child dyads, conducted in São Luís, Brazil. The caesarean section was the exposure, and the severity of ECC (dmft) was the outcome. Covariates household income, maternal schooling, maternal hypertension, maternal obesity and birth weight were adjusted for in the models. The effects were estimated by Poisson regression (Means Ratio-MR) and causal inference using a marginal structural model (MSM) (MR and Average Treatment Effect-ATE coefficients), weighted by the inverse probability (IPW) of exposure. RESULTS Caesarean section was protective against caries in the bivariate (MR 0.81; CI 0.70-0.94; P = 0.005) and multivariate (MR 0.78; CI 0.67-0.91; P = 0.002) models. In MSM analyses, the caesarean section had no effect on ECC (ATE = -0.35; P = 0.107), controlling for IPW of exposure. CONCLUSION The apparent association between caesarean section and ECC severity seems spurious, as it did not persist after employing a superior approach to estimating causality.
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Affiliation(s)
| | | | - Cayara Mattos Costa
- Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Elizabeth Lima Costa
- Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Brazil
| | | | | | - Cecilia Claudia Costa Ribeiro
- Postgraduate Program in Dentistry, Federal University of Maranhão, São Luís, Brazil.,Postgraduate Program in Public Health, Federal University of Maranhão, São Luís, Brazil
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11
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Relationship between preterm, low birth weight and early childhood caries: a meta-analysis of the case-control and cross-sectional study. Biosci Rep 2021; 40:225943. [PMID: 32729621 PMCID: PMC7419784 DOI: 10.1042/bsr20200870] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 05/04/2020] [Accepted: 07/27/2020] [Indexed: 11/17/2022] Open
Abstract
Early childhood caries (ECC) is one of the most prevalent chronic infectious diseases in children. The effective prevention and treatment are heavy burdens and study hotspots for pediatric dentists. Many studies had investigated the relationship between preterm, low birth weight (LBW) and ECC; however, the results were inconsistent. The present study was conducted with an evidence-based study to figure out the relationship between preterm, LBW and ECC for the first time. After searching the database, case–control and cross-sectional studies relevant to the relationship between preterm, LBW and ECC up to December 2019 were included. The data about odds ratio (OR) and 95% confidence interval (95% CI) were extracted and calculated with STATA 14.0 Software. A total of 22 studies were included in this meta-analysis, 9 studies of which did not only explore the relationship between ECC with preterm, but also study the relationship between ECC and LBW, 7 studies of which explored the relationship between preterm and ECC, and 6 studies of which studied the relationship between LBW and ECC. The meta-analysis results showed that the preterm increased the risk of ECC (OR = 1.59, 95% CI: 1.36–1.87) significantly. There was no difference between LBW and normal birth weight in the incidence of ECC (OR = 1.12, 95% CI: 0.94–1.33). The meta-analysis results of adjustment OR about LBW were similar to the crude OR (OR = 1.05, 95% CI: 0.71–1.57). This meta-analysis indicated that preterm increased the risk of ECC significantly; however, LBW was not a risk factor for ECC.
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Twetman S, Boustedt K, Roswall J, Dahlgren J. Systematic review suggests a relationship between moderate to late preterm birth and early childhood caries. Acta Paediatr 2020; 109:2472-2478. [PMID: 32559323 DOI: 10.1111/apa.15424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/11/2020] [Accepted: 06/12/2020] [Indexed: 01/28/2023]
Abstract
AIM The aim was to examine the association between moderate to late preterm birth and the prevalence of early childhood caries. METHODS We searched the PubMed, Scopus, Cochrane Trials Register databases up to February 28, 2020. Two independent reviewers screened the papers for relevance, extracted data and assessed the risk of bias. A random-effects meta-analysis was performed to pool the prevalence of early childhood caries by gestational age. RESULTS The authors identified 14 studies covering 210,691 children. They were published from 2007-2020 and included birth cohorts, cross-sectional, register-based and case-control studies. We assessed eight of them as having low or moderate risk of bias. The median caries prevalence was 48.8% among children born moderate to late preterm compared to 20.5% for those born full term. The pooled overall odds ratio was 1.48 (95% confidence interval 1.16-1.89; P < .001). The certainty of this finding was low due to heterogeneity and inconsistencies across the studies. CONCLUSION This systematic review and meta-analysis displayed a significantly higher prevalence of early childhood caries in children born moderate to late preterm compared to full term children. The finding suggests that the gestational age should be collected as a risk factor in the paediatric dental records.
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Affiliation(s)
- Svante Twetman
- Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Josefine Roswall
- Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Sweden
- Department of Pediatrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Boustedt K, Roswall J, Kjellberg E, Twetman S, Dahlgren J. A prospective study of perinatal and metabolic risk factors for early childhood caries. Acta Paediatr 2020; 109:2356-2361. [PMID: 32064658 DOI: 10.1111/apa.15231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 02/10/2020] [Accepted: 02/13/2020] [Indexed: 12/13/2022]
Abstract
AIM To study the relationship between early childhood caries and perinatal and metabolic risk factors in a cohort of preschool children. METHODS The study population consisted of 208 children followed from birth to 6.5 years. We extracted the perinatal factors from medical records and questionnaires and assessed the occurrence of caries at the age of 5 years. Indicators of the metabolic syndrome (waist circumference, blood pressure, fasting insulin, glucose and dyslipidaemia) were recorded at 6.5 years of age. RESULTS Infants born moderately to late preterm and infants born small for gestational age were more likely to have early childhood caries at 5 years of age (relative risk 4.2 and 2.3, respectively; P < .05). The presence of metabolic risk factors according to the IDEFICS monitoring levels did not differ between children with or without caries but a statistically significant correlation was found between the fasting glucose values and the number of decayed or filled teeth (r = 0.18; P < .05). CONCLUSION Being born preterm or small for gestational age increased the risk of early childhood caries. Preschool children with caries had higher fasting glucose levels but no other signs of the metabolic syndrome.
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Affiliation(s)
- Katarina Boustedt
- Maxillofacial Unit Halland Hospital Halmstad Halmstad Sweden
- Department of Pediatrics The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Josefine Roswall
- Department of Pediatrics The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Pediatrics Halland Hospital Halmstad Halmstad Sweden
| | - Emma Kjellberg
- Department of Pediatrics The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
| | - Svante Twetman
- Department of Odontology Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Jovanna Dahlgren
- Department of Pediatrics The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
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Korolenkova MV, Khachatryan AG, Arutyunyan LK, Gadzhikulieva KA. [Perinatal risk factors of the early childhood caries]. STOMATOLOGII︠A︡ 2020; 99:47-51. [PMID: 32692519 DOI: 10.17116/stomat20209904147] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
THE AIM Of the study was to find possible correlations between early childhood caries (ECC) prevalence and intensity and perinatal factors, such as pregnancy and birth adverse events, terms and mode of delivery, child's weight at birth. MATERIALS AND METHODS The study comprised 165 3-6 years old healthy children (80 boys and 85 girls) examined in Khimki nurseries. Perinatal background data were collected through validated questionnaires. RESULTS ECC prevalence and dmft median were 41.2% and 1.2 teeth, correspondingly, in 3-years-olds and values growth up to 64.8% and 3.5 teeth was seen in 6-years-olds. Exact Fisher test showed significant positive correlation between adverse pregnancy events and caries risk, as ECC had 8.6 and 51.7% of children born from complicated and non-complicated pregnancies, correspondingly (p<0.05). In children born by cesarean section ECC was detected more often, than in born via vaginal delivery (62.8 vs 49.6%, correspondingly). The correlation became statistically significant by the age of 6 (p=0.02). In 6-years-olds we also noted significant correlation between mode of delivery and dmft numbers (p<0.05). CONCLUSION Adverse pregnancy events and cesarean section are ECC risk factor affecting the intensity of the disease.
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Affiliation(s)
- M V Korolenkova
- National Medical Research Center of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | | | | | - K A Gadzhikulieva
- National Medical Research Center of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Occhi-Alexandre IGP, Cruz PV, Bendo CB, Paiva SM, Pordeus IA, Martins CC. Prevalence of dental caries in preschool children born preterm and/or with low birth weight: A systematic review with meta-analysis of prevalence data. Int J Paediatr Dent 2020; 30:265-275. [PMID: 31854043 DOI: 10.1111/ipd.12610] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/22/2019] [Accepted: 12/12/2019] [Indexed: 12/19/2022]
Abstract
The aim of the present systematic review and meta-analysis was to evaluate the prevalence of dental caries among preschool children who had been born preterm and/or with low birth weight (LBW) compared with those who had been born full term and/or with normal birth weight (NBW). Eight electronic databases were searched from interception up to November 2018 with no restrictions imposed regarding the date of publication or language. Two independent reviewers screened studies, extracted data, and assessed the risk of bias. A random-effects meta-analysis was run to pool the crude prevalence of dental caries according to gestational age and birth weight. We performed a narrative synthesis and assessed the certainty of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE). Fifty-nine observational studies were included (55 in the meta-analysis). The prevalence of dental caries was 39% among preterm children, 30% among full-term children, 40% among LBW children, and 33% among NBW children (I2 :97%-99%). The majority of studies reported that dental caries was not associated with gestational age or birth weight, with very low certainty of evidence. Preschool children born preterm or with LBW have similar dental caries experience as those born full term or with NBW, with very low certainty of evidence (PROSPERO #CDR42018118086).
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Affiliation(s)
| | - Poliana Valdelice Cruz
- Department of Paediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Cristiane Baccin Bendo
- Department of Paediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Saul Martins Paiva
- Department of Paediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Isabela Almeida Pordeus
- Department of Paediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Carolina Castro Martins
- Department of Paediatric Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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