Quarter of a century of change: caries experience in Australian children, 1977-2002.

BACKGROUND: The establishment of the evaluation programme of the Australian School Dental Scheme has led to continuous surveillance of child oral health extending from 1977 to the present day. The aims of this study were to examine the state of child oral health in Australia in 2002 and to explore longer term trends across the quarter of a century of recorded surveillance activity. METHODS: Caries data were obtained for children who were enrolled in the School Dental Services of each state and territory for the years 1977-2002. Data collection derived from routine examinations within the School Dental Service with oral examinations carried out by dentists and dental therapists. RESULTS: There were considerable declines in caries experience between 1977 and the mid to late 1990s, with mean decayed, missing and filled deciduous teeth (dmft) for 6-year-old children decreasing from over 3 in 1977 to approximately 1.6 in 1996, and permanent 12-year-old decayed, missing and filled teeth (DMFT) decreasing from 4.8 in 1977 to 0.89 in 1998. However, since the mid to late 1990s, deciduous 6-year-old dmft has increased by 24 per cent and 12-year-old DMFT has increased by almost 15 per cent. Reductions in caries experience of those children with the most disease have also ceased, and between 1999 and 2002 an increase in the Significant Caries Index occurred. CONCLUSIONS: Improvements in the oral health of Australian children halted during the mid 1990s, after which caries experience has increased. It is important that we understand the changes taking place and their causes, so that action can be taken to halt any further possible declines in child oral health.     

Quarter of a century of change: caries experience in Australian children, 1977–2002

Background:  The establishment of the evaluation programme of the Australian School Dental Scheme has led to continuous surveillance of child oral health extending from 1977 to the present day. The aims of this study were to examine the state of child oral health in Australia in 2002 and to explore longer term trends across the quarter of a century of recorded surveillance activity.
Methods:  Caries data were obtained for children who were enrolled in the School Dental Services of each state and territory for the years 1977–2002. Data collection derived from routine examinations within the School Dental Service with oral examinations carried out by dentists and dental therapists.
Results:  There were considerable declines in caries experience between 1977 and the mid to late 1990s, with mean decayed, missing and filled deciduous teeth (dmft) for 6-year-old children decreasing from over 3 in 1977 to approximately 1.6 in 1996, and permanent 12-year-old decayed, missing and filled teeth (DMFT) decreasing from 4.8 in 1977 to 0.89 in 1998. However, since the mid to late 1990s, deciduous 6-year-old dmft has increased by 24 per cent and 12-year-old DMFT has increased by almost 15 per cent. Reductions in caries experience of those children with the most disease have also ceased, and between 1999 and 2002 an increase in the Significant Caries Index occurred.
Conclusions:  Improvements in the oral health of Australian children halted during the mid 1990s, after which caries experience has increased. It is important that we understand the changes taking place and their causes, so that action can be taken to halt any further possible declines in child oral health.     

Prevalence of caries in urban Australian aborigines aged 1-3.5 years

PURPOSE: This study investigated the prevalence and etiological factors associated with caries in a group of young Australian aboriginal children from 1 to 3.5 years of age. METHODS: One hundred and forty-seven healthy infants, aged from 1 to 3.5 years, attending a community health center in Brisbane, a nonfluoridated state capital city, were randomly selected for the study. RESULTS: The caries prevalence was 39% by subjects and 32% by the total number of teeth present. The mean number of decayed, filled teeth (dtf) was 2.5 +/- 0.4, which is more than twice the figure for 3-year-old children in Australia. Furthermore, the filled (f) component represented only 1% of the total dft, suggesting very low treatment levels. Increased caries experience of the infants was strongly associated with high dental plaque scores, high levels of Streptococcus mutans infection, and sleep-time consumption of milk containing added sugar. CONCLUSION: The results suggest that urban Australian aboriginal infants are at high risk for caries, and that preventive strategies are urgently required.     

Prevalence of dental caries, severity, and pattern in age 6 to 7-year-old children in a selected community in Saudi Arabia

AIMS: The aim of this study was to determine the prevalence, severity, and pattern of dental caries in 6 to 7-year-old children in military primary schools in Jeddah city, Saudi Arabia. METHODS AND MATERIALS: A random sample of 300 children (6 to 7-year-olds) was drawn from six schools of military dependents. Clinical examinations were carried out under standardized conditions by two trained and calibrated examiners (MAM) and (YR). Caries were diagnosed using the British Association for the Study of Community Dentistry (BASCD) criteria. RESULTS: Caries were diagnosed in 288 (96%) of the children, and only 4% were clinically caries free. Mean decayed, missing, and filled teeth (dmft) for the 300 children was 8.06 (+ 4.04) per child and mean decayed, missing, and filled surfaces (dmfs) was 23.18 (+ 15.64). The teeth most affected by caries were mandibular primary second molars (83.35%), and the least affected were mandibular primary central incisors (1.15%). CONCLUSIONS: The level of caries was higher than seen in children of equivalent age in other studies. The level of caries is expected to increase in permanent dentition. The above findings stress the need for an effective program of oral prevention in these children, such as a school dental health education program for children and their parents in order to improve their oral health status.     

Diet and caries experience among preschool children in Ajman,United Arab Emirates

The study investigated the association between food and drink consumption and the caries experience among young children in Ajman, United Arab Emirates. A one‐stage cluster sample was used to select children who were 5 or 6 yr of age. Clinical examinations for caries were conducted. Parents completed questionnaires seeking information on dietary habits. Principal components analysis was used to derive a summary score for the dietary variables (designated ‘snack consumption level’) and thus overcome the multicollinearity problems associated with using multiple dietary variables. Dental examination and questionnaire data were obtained for 1,036 children (79.9% participation rate). The overall mean number of decayed, missing or filled teeth (dmft) was 4.5. Snacking three or more times per day was associated with a dmft score that was almost one‐third higher than the dmft score for children who snacked only once daily. One‐third of children had a low overall snack consumption level (41% moderate and 25% high). There was a consistent dmft gradient across those categories. The severity of Early Childhood Caries (ECC) in young Ajman children is high, with dietary habits being important determinants. Cariogenic snack consumption can be represented using a summary exposure variable that appears to be valid. Young children in Ajman would benefit from health‐promotion strategies directed towards appropriate dietary practices.     

儿童龋病与吃糖行为的关系

目的 评价儿童进食各种含糖食品行为和龋病的关系。方法 检查河北省宜昌市1356名6岁儿童患龋情况，并通过母亲问卷调查儿童进食含糖食品行为，运用Logistic回归模型评价其关系。结果 甜早点、蛋糕、饼干与儿童患龋情况关系密切，餐间吃糖＋正餐吃糖的危险度明显高于餐间吃糖或正餐吃糖。结论 饮食结构、吃糖频率与儿童制龋病有明显关系。     

Risk behaviors and its association with caries activity and dental caries in Japanese children

The aim of this study was to assess risk behaviors and its association with caries activity and dental caries in Japanese children. The subjects were 392 young Japanese children who underwent dental health check-up at 18, 30 and 42 months of age. Oral examinations, Cariostat tests and dental health questionnaires were carried out at each time. The caries prevalence of children was 1.5% at 18 months, 9.9% at 30 months and 28.1% at 42 months. Caries activity based on the Cariostat scores of children was correlated with caries status (caries-free/carious) at 42 months. In children with caries during each examination period at 42 months, eating snacks while playing was ranked as the most important behavioral risk (P < 0.001), followed by breast-feeding (P < 0.01), non setting of time for snacks (P < 0.05) and frequency of snacks (P < 0.05) at 18 months old; non brushing by mother (P < 0.05) and eating snacks while playing (P < 0.05) were ranked highest at 30 months old. In addition, eating snacks while playing (P < 0.001) at 42 months old was the only a significant factor for children with caries. Caries activity and risk behaviors were associated with caries experience at different age periods of childhood.     

Dental caries and associated factors in 12-year-old schoolchildren in Thiruvananthapuram, Kerala, India

OBJECTIVES: The aims of the present study were to describe the dental health status of 12-year-old schoolchildren in Thiruvananthapuram, Kerala, India, and to identify sociodemographic factors, oral health behaviours, attitudes and knowledge related to dental caries experience. METHODS: The study took the form of a cross-sectional survey of 838 children in upper primary schools. A two-stage cluster sampling technique was used. Dental caries was measured using World Health Organization criteria. Sociodemographic factors, oral health behaviours, attitudes and knowledge were assessed by a self-administered questionnaire. RESULTS: The prevalence of dental caries in the permanent dentition was 27%. The mean number of decayed, missing and filled teeth was 0.5 (SD=0.9). The decayed component (D) constituted 91% of the total number of decayed, missing and filled teeth (DMFT). Multiple logistic regression analysis showed that children had a higher risk of having dental caries if they lived in urban area [OR=1.5, 95% confidence interval (CI)=1.1-2.1], had visited a dentist (OR=1.6, 95% CI=1.2-2.2), did not use a toothbrush (OR=1.9, 95% CI=1.2-2.9), consumed sweets (OR=1.4, 95% CI=1.0-1.9) or performed poorly in school (OR=1.7, 95% CI=1.0-2.3). CONCLUSIONS: The prevalence of caries in this sample of 12-year-old schoolchildren was low compared to that in other developing countries. The present study indicated that urban living conditions were associated with more dental caries. Since urbanization is rapid in India, oral health promotion at the present time would be valuable to prevent increased caries prevalence.     

Dental caries experience and association to risk indicators of remote rural populations

Background.  Dental caries continues to be the most common infectious disease of childhood; however, it is no longer pandemic, but endemic in specific sectors of populations. Therefore, it is important to identify and target patients at risk of developing caries in order to develop specific preventive measures.
Aim.  This study aims to test dental caries risk indicators for significant associations with caries severity.
Design.  Five separate, small, isolated rural villages in Mexico with varying degrees of caries prevalence were selected for this observational study. A total of 248 children were examined. Risk indicators were assessed via questionnaire and water and salt fluoride analysis. Caries severity was measured by the International Caries Detection and Assessment System (ICDAS-I).
Results.  Prevalence of caries ranged from 95% to 100% for the five villages. Mean total DMFS (decayed, missing, or filled surfaces–permanent teeth) and dmfs (decayed, missing, or filled surfaces–primary teeth) scores ranged from 2.5 to 5.0 and from 11.3 to 16.9, respectively. Multivariable models showed age and drinking soda between meals to be significantly associated with DMFS, and drinking juice and being female were significantly associated with dmfs.
Conclusion.  DMFS and dmfs were high in each village, significantly different between villages, and associated with specific risk indicators.     

The potential role of breast-feeding and other factors in helping to reduce early childhood caries

Objectives: Dental caries is the most common chronic disease in US children. Early childhood caries (ECC) is particularly virulent and can interfere with a child's ability to eat, grow, speak, and communicate. Studies on whether breast‐feeding or bottle‐feeding are more likely to reduce ECC have proven inconclusive. Methods: The study population included 175 children, aged 1 to 5, receiving dental care at the Hughes Spalding Children's Hospital in Atlanta, GA. Participation included a dental exam, chart data abstraction, and a personal interview with the mother. Results : Too few exclusively breast‐fed children prevented the adequate study of breast‐feeding. However, children exclusively bottle‐fed for at least 1.5 years had more decayed or filled tooth surfaces than children breast‐fed part of that time but well short of a year. No bottle at night nor juice at irregular times, the mother's brushing of her child's teeth, and adequate dental care in the mother seemed to reduce ECC. Conclusions : Our results suggest measures that might reduce ECC risk. Medical providers must discuss oral health with new mothers and educate them on the important role they play in keeping their babies' teeth healthy.     

Cross-sectional study of patients treated, with removable partial dentures with special reference to the caries situation

Abstract – Thirty-four patients provided with removable partial dentures (RPDs) were reexamined after 3 yr. Caries that had developed during the period were analyzed with regard to the following potential caries risk factors: Lactobacilli, Streptococcus mutans, flow rate and buffer pH of paraffin stimulated saliva, oral hygiene and daily sucrose intake. Of 436 initially intact surfaces 31 (7.1%) had decayed and/or were restored during the 3-yr period. Caries recurred in 26 (6.2%) out of 422 initially restored surfaces during the same period. The development of new or recurrent caries had no correlation to whether or not the surfaces affected were in contact with the RPDs. No single caries risk factor seemed to be sufficiently closely correlated to the number of caries lesions developed to be used alone in the selection of patients at risk. When the sum of assumed negative factors was used a correlation was found for the group as a whole between the number of negative factors and the development of caries. However predicting the development of caries in any individual case seems to be more complicated.     

Risk indicators for early childhood caries in 2-year-old children in southern China

Background: The aim of this study was to explore the relationship between early childhood caries (ECC) and relevant socio‐economic, behavioural and biological experiences in the life course of children. Methods: A cross‐sectional study of 2‐year‐old children was analysed. A questionnaire collected socio‐economic and behavioural data during the first two years of the participants’ life. Caries experience was recorded at the level of cavitation and oral hygiene was assessed using the Visible Plaque Index (VPI). Microbiological investigation collected information on colony‐forming units (CFU) of Streptococcus mutans (S. mutans). The outcome was ECC. Bivariate and multiple logistic regression analyses were performed. Results: The study included 394 children, with 109 having ECC and 285 being caries‐free. The mean decayed, missing and filled primary teeth (dmft) score of the ECC group was 3.65 ± 3.12, with decayed teeth making up 100% of the score. The results of the final logistic regression analysis showed that ECC was significantly associated with the mother’s schooling at child’s birth [<12 years vs. ≥12 years, OR = 1.80], VPI score [>60% vs. 0–20%, OR = 5.71], and S. mutans [≥10⁵ CFU/ml vs. 0 CFU/ml, OR = 3.80]. Conclusions: Social, behavioural and biological factors during the life course of 2‐year‐old children in southern China are associated with the development of ECC.     

Enzymes in the in‐situ pellicle of children with different caries activity

The present study investigated, for the first time, enzymes in the in‐situ pellicle of children. Furthermore, it was purposed to detect glucosyltransferase (GTF) isoforms in each child's pellicle. Twenty‐four children (5–9 yr of age) participated in the study. Twelve were caries free with no decayed, missing, and filled teeth (dmft), whereas 12 had active caries (dmft ≥ 2, indicating at least two untreated carious lesions). Bovine enamel slabs, fixed on individual upper jaw splints, were utilized for pellicle formation in situ. After 3 and 30 min, samples were tested for amylase, lysozyme, and peroxidase activities; total GTF activity was examined only in the 30‐min pellicle. Gold‐immunolabelling was used to quantify the GTF B, C, and D isoforms in the pellicle by transmission electron microscopy (TEM). All enzymes tested were detected in the children's in‐situ pellicle in an active conformation, and there were no significant differences in their levels of activity between caries‐free and caries‐active children. All GTF isoforms were found to be randomly distributed within all pellicle layers, althoug GTF B was only detected very sporadically. A significantly higher amount of GTF D was detected in the pellicle of caries‐active children. Pellicle formation in children is characterized by uniformity and selectivity. Glucosyltransferase D might represent a possible biomarker for high caries risk in children.     

Influence of anti‐asthmatic medications on dental caries in children in Slovenia

International Journal of Paediatric Dentistry 2013; 23: 188–196 Objective. The study investigated the influence of exposure to anti‐asthmatic medications and of various factors on the caries prevalence in children in Slovenia. Methods. The study population consisted of children aged 2‐ to 17 years (n = 220) under treatment for asthma, who had used anti‐asthmatic medications for at least 1 year; 220 controls were matched for age. Caries status was determined by the number of decayed, missing, and filled surfaces through clinical examination by two calibrated dentists using the International Caries Detection and Assessment System‐II scoring criteria. Questionnaires completed by parents and data from the patients’ medical records provided information on various confounding factors. Results. Asthmatic children had significantly higher (P ≤ 0.01) prevalence of caries on primary and permanent teeth in all age groups, and the proportion of caries‐free children was significantly smaller (P ≤ 0.05). In multivariate regression analysis, asthma diagnosis, child’s age, daily use of inhaled glucocorticoids, length and frequency of medicine application, spacer use, mouth rinsing with water after medicine application, parents’ education, frequent food and drink consumption, and frequency of toothbrushing were associated with caries experience of asthmatic children. Conclusion. Children with asthma who had used anti‐asthmatic medications had higher caries experience in primary and permanent teeth.     

沈阳市幼儿园5岁儿童乳牙龋病流行病学抽样调查报告

目的 调查沈阳市幼儿园5岁儿童乳牙龋患病情况.方法 采用分层等容量随机抽样的方法,抽取沈阳市内5区5岁常住人口440人及其家长,男女各半.检查儿童全口乳牙牙冠龋病情况,统计患龋率、龋均等,将所得数据与本地区1995年的调查数据进行比较;并对家长进行儿童饮食习惯、刷牙情况等的问卷调查.结果 乳牙患龋率为67.05％,龋均为3.10,龋齿充填完好率5.51％,曾接受过龋齿治疗的占8.41％.与1995年沈阳市幼儿园5岁儿童乳牙龋病情况比较,患龋率有所下降(P＜0.001),龋均亦有下降(P＜0.001).问卷调查中有睡前进甜食行为者占41.28％,定期进行口腔健康检查者只占2.04％,在家长监督下有效刷牙率为10.17％,家长对儿童口腔健康状况满意率为82.91％.结论 沈阳市幼儿园5岁儿童乳牙患龋率与1995年相比虽然有所下降,但仍占较高比例.家长对儿童口腔健康认识程度低与高患龋率有关,对家长的口腔健康教育有待加强.     

Caries reduction in Belgian 12-year-old children related to socioeconomic status

This study compares dental caries reduction in Belgian 12-year-old children of different socioeconomic status in 1983 and 1998. Moreover, the relative effect of dental health factors on caries reduction is estimated. In the region of Brussels, children in the 7th grade at the same schools participated in cohort 1983 (n = 533) and in cohort 1998 (n = 496). DMFT, DMFS, and dental fluorosis were clinically recorded. The socioeconomic status of the children was established on the basis of their parents' education and profession. Data on children's home-based and professional dental health care habits were registered. Caries reduction was observed in both privileged and non-privileged children. However, non-privileged children, in cohort 1983 and cohort 1998, had significantly higher DMF scores than privileged children (P < 0.01). Dental fluorosis was more often identified in privileged children than in non-privileged ones. Most of the dental factors relating to children's home based and professional care were associated with caries reduction. Caries reduction was strongly related to socioeconomic status; non-privileged children registered lower than their counterparts.     

Predicting caries in permanent teeth from caries in primary teeth: an eight-year cohort study

Several cross-sectional studies report that caries in primary teeth is correlated with caries in permanent teeth. This eight-year cohort study sought to determine if caries in the primary dentition can predict caries in the permanent dentition of the same individuals and, if so, with what degree of prediction accuracy. A total of 362 Chinese children, from 3 to 5 years old at the time of the 1992 baseline study, were re-examined in 2000. The study found statistically significant associations between caries prevalence in primary and permanent dentitions (p < 0.01). Children having caries in their primary teeth were three times more likely to develop caries in their permanent teeth (relative ratio = 2.6, 95% CI = 1.4-4.7; p < 0.001). Caries on primary molars had the highest predictive value (85.4%). This study demonstrates that caries status in the primary teeth can be used as a risk indicator for predicting caries in the permanent teeth.     

Assessing the relationship between children's oral health status and that of their mothers

BackgroundThe authors conducted a study to describe the relationship between the oral health of young children and that of their mothers.MethodsUsing data from the Third National Health and Nutrition Examination Survey and a related birth certificate–linked file, the authors compiled a sample of 1,184 mother/child pairs for children aged 2 through 6 years. The authors performed logistic and cumulative logistic regression analyses by using children's caries experience and untreated caries status as dependent variables. They evaluated the mothers' untreated caries status and tooth loss status along with other covariates, including age, race/ethnicity and poverty status.ResultsChildren of mothers who had high levels of untreated caries were more than three times as likely (odds ratio [OR], 3.5; 95 percent confidence interval [CI], 2.0–6.2) to have higher levels of caries experience (treated or untreated dental caries) compared with children whose mothers had no untreated caries. A similar relationship was observed between mothers' tooth loss and caries experience among their children. The children of mothers with high levels of tooth loss were more than three times as likely (OR, 3.3; 95 percent CI, 1.8–6.4) to have higher levels of caries experience compared with children of mothers with no tooth loss; for mothers with moderate tooth loss, the OR was 2.3 (95 percent CI, 1.5–3.5).ConclusionsMothers' oral health status is a strong predictor of the oral health status of their children.Practice ImplicationsPreventive plans for children should be based on a caries risk assessment. The results of this study demonstrate that basic information obtained from the child's mother regarding her oral health status is valuable in helping the dentist determine the child's caries risk.