Protective Factors for Early Childhood Caries in 3-Year-Old Children in Poland

Factors Associated With Dental Caries in Primary Teeth of 5- and 6-Year-Old Polish Children

BACKGROUND

Caries in primary teeth remain a common health issue.

AIM

To identify oral health behaviours which significantly affect dental caries in children aged 5-6 years.

DESIGN

A national cross-sectional study of 1892 children integrated dental examinations and a questionnaire regarding socio-economic factors and oral health habits. Caries indices were calculated. The analyses included t- and chi-square tests, Spearman's correlation, bivariate and multivariate logistic regression (p < 0.05).

RESULTS

The majority of children (79.3%) had caries; mean dmft was 4.68 ± 4.05; dmfs-9.12 ± 10.74 and ft/ft. + dt-0.20 ± 0.31. There were correlations between mother's education, her knowledge of oral health, financial burden, the frequency of dental appointments and the treatment (p < 0.001). The dmft indices were correlated with postponing dental appointments and presenting with pain. The association between the treatment index, oral hygiene habits (parental-supervised toothbrushing twice a day, using fluoridated toothpaste) and dietary practices (restrictions of sugar intake, fruit juices and starchy foodstuffs) was found, even after socio-economic confounding factors were introduced.

CONCLUSION

The first years of a child's life are a period when the foundations of adult lifestyle choices are shaped. Parents should be aware of the importance of dental visits, nutritional counselling and proper oral care. The assessment of risk factors related to families is indispensable when prophylactic programmes are implemented.

Dietary and Hygiene-Related Knowledge Versus Reported Behaviors of Eighteen-Year-Olds: A Nationwide Cross-Sectional Study

Background/Objectives: The aim of the present study was to examine eighteen-year-olds' self-assessed knowledge about diet and hygiene, behaviors that they report, and education they receive during dental appointments. Methods: Questionnaires distributed among 1611 subjects included questions concerning sociodemographic factors, dietary and hygiene knowledge and behaviors, and dental visits. Spearman's rank correlation and a bivariate and multivariate logistic regression analysis was conducted; odds ratios (ORs) and adjusted odds ratios (AORs) were calculated (p ≤ 0.05). Results: Respondents self-assessed their oral health knowledge; 63.1% of them considered it to be limited, and 40.7% understood the cariogenic effect of frequent snacking. Dentists and a dental team (DT) were the main source of information (55.7%). Dietary advice was recommended by 10.8% of dentists and the DT, while check-up appointments were advised by 49.2%. Parents' higher education contributed to a lower intake of cariogenic food. This effect was stronger for the mother's education. Dental appointments scheduled twice a year increased the chances of consuming healthy food (A2OR = 1.21 (1.07-2.11); p = 0.0028). Being informed increased the chances of toothbrushing ≥ 2 times (OR: 1.21, CI 1.10-1.46), using fluoridated toothpaste (OR: 1.26 CI1.05-1.55), and the frequency of appointments (A1OR: 1.56 CI 1.21-1.87; A2OR: 1.78 CI 1.54-1.91). Conclusions: Knowledge and oral health related behaviors, as well as the involvement of the dental team in education, are inadequate. Education and instruction in the dental office has a favorable influence on oral-health-related behaviors. It is, therefore, necessary to undertake systemic solutions so that dental practitioners are more involved. Providing oral health knowledge should be the standard of care.

Updates on Caries Risk Assessment-A Literature Review

This narrative review aims to provide an update on caries risk assessment (CRA) and the available CRA tools. CRA can be used to monitor the status of oral care, as well as for documentation and research purposes. Caries risk is determined by the interplay of risk and protective factors. Common risk factors include suboptimal oral hygiene practices, previous caries experience, low plaque acidity, frequent snacking, cariogenic diet, enamel defects, reduced salivary flow, polypharmacy, and radiotherapy experience. Caries risk can be reduced through some preventive measures, such as the use of fluoride, gum chewing, dental sealants. The CRA process can be categorized as single or multifactor tools. Single-factor CRA tools include diet analysis questionnaires, cariogenic bacteria testing and saliva testing kits, whereas multifactor CRA tools encompass Caries Management by Risk Assessment (CAMBRA), Cariogram, and PreViser. Some CRA tools may quantify risk and protective factors to compute caries risk. Additionally, they can generate visual and educational presentations that foster success in oral care. Clinicians consider CRA beneficial for developing personalized care plans. However, the literature fails to reflect this and reveals limited studies supporting its use as evidence-based practice for caries management.

Impact of Caries Experience on the Oral Health-Related Quality of Life of Pre-school Children and their Families in an Indian City - An Evaluative Study

BACKGROUND

The presence of dental caries may have a negative impact on well-being of children and their parents, causing pain and discomfort, leading to poor oral health-related quality of life (OHRQoL) in them. The objective of this study was to evaluate the impact of different levels of caries experience on the OHRQoL of pre-school children and their families in Odisha, assessed using Odia version of Early Childhood Oral Health Impact Scale (Od-ECOHIS).

METHODOLOGY

A cross-sectional survey was carried out on a sample of 369 pre-school children using Od-ECOHIS. Dental caries was recorded using International Caries Detection and Assessment System (ICDAS) index.

RESULT

The total score of ECOHIS ranged from 0 to 42 with a mean of 2.4 (±5.3) and a median score of 0. The items bearing high mean scores in the child impact section were related to "pain", "difficulty in drinking hot or cold beverages", "difficulty in eating some food", and "irritable or frustrated". Though half of children (50.4%) had cavitated carious lesions, the prevalence of negative impact was 30.6%. Compared to the child being caries-free, the expected count of total Od-ECOHIS score increased by 1.54 times if the child had white spot lesion and 1.94 times if the child had a cavitated lesion.

CONCLUSION

Presence of dental carious lesions has a significant impact on OHRQoL of pre-school children and their families measured by using Od-ECOHIS even after adjusting for SES and caregivers' perception of their children's oral health.

Non-Cariogenic Effect of Milk and Dairy Products on Oral Health in Children and Adolescents: A Scoping Review

Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this scoping review was to analyze the scientific literature on the non-cariogenic effect of milk and DPs, with a focus on their potential to prevent dental caries in children and adolescents. PubMed, EMBASE, and Web of Science were searched for publications relevant to our topic from January 2013 to 30 September 2023. Thirty-eight studies were included in the qualitative analysis. The included studies highlight the properties of milk and DPs that contribute to enamel remineralization, exhibit antibacterial action, inhibit the growth of cariogenic bacteria, and promote a balanced oral microbiome. With regard to the addition of probiotics (PBs) and fluoride (F) to DPs, the mixed results of the studies analyzed did not allow a clear statement to be made about their non-cariogenic effects. However, several studies show that the addition of PBs can reduce cariogenic bacteria, create a protective barrier against pathogens and support the host's natural defense mechanisms. Further long-term and high-quality studies are needed to understand the impact of milk and its constituents on oral health in order to promote effective caries prevention strategies in children and adolescents.

Vitamin D Supplementation, Characteristics of Mastication, and Parent-Supervised Toothbrushing as Crucial Factors in the Prevention of Caries in 12- to 36-Month-Old Children

Severe early childhood caries (S-ECC), defined as any sign of smooth-surface caries in a child younger than three years of age, remains a serious health issue. The aim of this study was to indicate oral health behaviours related to S-ECC. The study surveyed parents (socio-economic and medical factors, oral health behaviours) and clinically examined children including non-cavitated d1,2/cavitated d ≥ 3 lesions. %S-ECC, and caries indices (d1,2 d ≥ 3 mft and d1,2 d ≥ 3 mfs) were calculated. Spearman’s correlation and simple and multiple logistic regression were used to assess the relationships between various factors and S-ECC. A total of 496 children were examined. S-ECC occurred in 44.8%: d1,2 d ≥ 3 mft = 2.62 ± 3.88, d1,2 d ≥ 3 mfs = 4.46 ± 8.42. S-ECC was correlated with socio-economic factors, vitamin D supplementation, breastfeeding and using formula after the 18th month, and toothbrushing. Supplementation of vitamin D and toothbrushing tended to decrease the odds of S-ECC (OR = 0.49 (0.27−0.87); p = 0.016, OR = 0.46 (0.24−0.86) p = 0.015, respectively). Feeding exclusively with formula was observed to increase the odds of S-ECC (OR = 2.20 (1.29−3.76); p = 0.004). Consuming > three snacks daily (OR = 1.39 (0.97−1.98); p = 0.072) and the reluctance to eat resilient foods (OR = 1.63 (1.05−2.51); p = 0.028) were nullified by the confounding factors. Vitamin D supplementation, mastication of resilient food, breastfeeding in the first six months of a baby’s life, and parent-supervised toothbrushing are factors in the prevention of caries in toddlers. Breast- and bottle-feeding after the 18th month of life, the reluctance to eat solids, lack of vitamin D supplementation, hygienic neglect, and delay in introducing oral health behaviours may contribute to the development of caries in toddlers.

Exploring the Relationships between Children's Oral Health and Parents' Oral Health Knowledge, Literacy, Behaviours and Adherence to Recommendations: A Cross-Sectional Survey

Although preventable, early childhood caries (ECC) is a burdening condition in all WHO regions, with Poland being one of the most affected countries in Europe. Effective home-based prevention of ECC is available and recommended by several expert bodies. Therefore, we wanted to determine how well parents were following selected oral health recommendations in preschool children. Additionally, we wanted to determine which socioeconomic factors influenced such practices the most, and how parents' oral health literacy and behaviours affected the oral hygiene and oral health status of their children. A cross-sectional survey involving 2338 parents and caregivers of children from 167 kindergartens was performed. Children's oral hygiene and oral health status were found to be associated with parents' education and economic status. They were also strongly influenced by parental health literacy and behaviours. With respect to recommendations for preschoolers, the lowest adherence was found in the use of fluoride toothpaste and its age-appropriate amount, supervision of toothbrushing, and refraining from eating after last toothbrushing. The improvement in these areas could be achieved thanks to the involvement of health professionals such as gynaecologists, midwives, and primary care personnel in efforts aimed at increasing parents' oral health knowledge and literacy.

Association between Vitamin D and Dental Caries in a Sample of Canadian and American Preschool-Aged Children

Background: Inadequate vitamin D levels may increase the risk of caries during childhood. The purpose of this study was to investigate the association between 25-hydroxyvitamin D (25(OH)D) status and severe early childhood caries (S-ECC) in preschool children. Methods: Data were obtained from children <72 months of age in two case–control studies in Winnipeg, Manitoba and Richmond, Virginia. Serum analysis assessed 25(OH)D, calcium and parathyroid concentrations. Data on demographics, dental history and oral hygiene were obtained via questionnaires. Bivariate and multiple logistic regression analyses were performed to assess the relationships between demographic and biological variables and S-ECC. A p-value of ≤0.05 was significant. Results: Data were available for 200 children with S-ECC and 144 caries-free controls. Children with S-ECC had significantly lower 25(OH)D levels than those who were caries-free (p < 0.001), and children with deficient 25(OH)D levels were 10 times more likely to have S-ECC (p < 0.001). Multiple logistic regression revealed that having higher 25(OH)D and calcium concentrations (p = 0.019 and p < 0.0001, respectively), as well as being breastfed in infancy (p < 0.001), were significantly and independently associated with lower odds of S-ECC, while dental insurance (p = 0.006) was associated with higher odds of S-ECC. Conclusions: This study provides additional evidence of an association between nutritional status, specifically vitamin D and calcium levels, and S-ECC.