Maternal health and lifestyle, and caries experience in preschool children. A longitudinal study from pregnancy to age 5 yr

In this study, associations were explored between maternal health and lifestyle during pregnancy and in early motherhood, and preschool children's caries experience. The study was based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and on data from the Public Dental Services. A total of 1348 children were followed from pregnancy to age 5 yr. A clinical dental examination was performed at age 5 yr. Questionnaires were completed by the mothers during pregnancy and in the first 18 months of their child's life, and as part of the dental examination. Results from the multivariate logistic regression analysis showed that having an obese mother (OR = 2.3, 95% CI: 1.3-4.1), a mother who consumed a diet containing more fat (OR = 1.6, 95% CI: 1.1-2.5) or sugar (OR = 1.5, 95% CI: 1.1-2.3) than recommended, a mother with low education (OR = 1.5, 95% CI: 1.1-2.3) or one or both parents of non-western origin (OR = 5.4, 95% CI: 2.8-10.6) were statistically significant risk indicators for caries experience at age 5 yr. In conclusion, maternal weight and intake of sugar and fat in pregnancy were associated with caries experience in preschool children. These characteristics may enable early referral to the dental services and preventive care to be delivered.     

Caries and background factors in Norwegian and immigrant 5-year-old children

Wigen TI, Wang NJ. Caries and background factors in Norwegian and immigrant 5‐year‐old children. Community Dent Oral Epidemiol 2010; 38: 19–28. © 2009 John Wiley & Sons A/S Abstract – Objectives: The purpose of this study was to assess the caries status of 5‐year‐olds in a low caries area, and study associations between dental caries and parent‐related factors: parents’ education, national origin, oral health behaviours and attitudes. Methods: The material consisted of 523 children and was a stratified random sample. Clinical and radiographic examination was performed in 2007. Enamel and dentine caries were recorded at surface level. Parents filled in questionnaires regarding socioeconomic status, their own oral health behaviours and attitudes. Results: Most participants (66%) had no caries experience and 16% had enamel caries only. Dentine caries experience was present in 18% of the children, and 5% had dentine caries experience in five or more teeth. Surfaces with enamel caries constituted half of all surfaces with caries experience. In multiple logistic regression, statistically significant risk indicators for the child having dentine caries experience at the age of five were: having one or both parents of non‐western origin (OR = 4.8), both parents (OR = 3.0) or one parent (OR = 2.1) with low education, parental laxness about the child’s tooth brushing (OR = 2.8), parents’ brushing their own teeth less than twice a day (OR = 2.2) and having parents with frequent sugar intakes (OR = 1.8). Conclusion: Caries prevalence in 5‐year‐olds was strongly associated with parent‐related factors signifying that information on parents’ socioeconomic status, dental behaviours and attitudes should be considered when planning dental services for young children. Our results suggest that the real high risk group is non‐western children whose parents have low education.     

Do enamel and dentine caries at 5 years of age predict caries development in newly erupted teeth? A prospective longitudinal study

Abstract

Objective: To explore caries development in children from 5 to 12?years of age, and to study whether enamel caries and dentine caries at 5?years of age could predict caries prevalence at 12?years of age, controlled for child characteristics.

Methods: The study included 3282 children examined at 5 and 12?years of age. Data were collected by clinical examination and questionnaire. Enamel and dentine caries were registered at surface level. Data were tested by t-test and analysed by bi- and multivariate logistic regression. The study was ethically approved.

Results: In 5-year-olds, 15% of the children had dentine caries experience and 21% had enamel caries. In 12-year-olds, 32% had dentine caries experience and 47% had enamel caries. Children with dentine caries experience at 5?years of age had at 12?years of age developed more surfaces with enamel caries (mean 2.8, SD 4.2) and dentine caries experience (mean 1.8, SD 2.5) than other children (p?<?.05). Dentine caries experience at 12?years of age was associated with having only enamel caries (OR 1.6, CI 1.2–2.0) and dentine caries experience (OR 3.2, CI 2.6–3.9) at 5?years of age. Family status and parental education were related to caries development.

Conclusion: Children with caries in primary teeth continued to be caries risk children during the mixed dentition period. In addition to dentine caries experience, enamel caries in primary teeth was a predictor for caries development in young permanent teeth and may be used to improve the caries risk assessment.     

Social and biological early life influences on severity of dental caries in children aged 6 years

OBJECTIVE: To investigate the relationship between social and biological conditions experienced in very early life and dental caries in children aged 6 years. METHODS: The design was a dental caries cross-sectional study nested in a birth cohort study started in Pelotas, Brazil, in 1993. The cross-sectional study was carried out in 1999. A random sample of 400 6-year-old children was selected from among 5249 live births in 1993. The World Health Organization (1997) criteria were used to diagnose dental caries. Results from the oral health study were linked to the data concerning perinatal and childhood health and illnesses and family social conditions collected at birth, 1, 3, 6 and 12 months, and in the sixth year of life. Dental caries was the outcome measured at two levels of severity (very low: dmft < or = 1; high: dmft > or = 4). Unconditional univariate and multiple logistic regression analysis were performed. RESULTS: Self-employed and employees/unemployed, fathers with <8 years of education at time child was born, child's height deficit for age at 12 months; child who did not attend day care centre in sixth year of life; brushing teeth less than once a day, and children with sweet consumption of at least once a day at 6 years were risk factors for high dental caries after controlling for possible confounders. CONCLUSIONS: Harmful social and biological risk factors accumulated in early life contributed to the development of a high level of dental caries in childhood.     

A longitudinal study of caries experience and extraction of permanent first molars in English children

One hundred and twenty eight children in Leeds, England, initially aged 11 years, were examined annually for 6 years. The site of dental caries on 441 permanent first molars was recorded at the first examination. Twelve per cent of the teeth were caries free, 83 % had between one and three DF sites each, and 6 % had four or more DF sites. After 6 years 8 % of the originally caries free teeth had been extracted, compared with 19 % of those that initially had had up to three DF sites and 58 % of those with four or more DF sites at the first examination. With the exception of the distal surface site a consistent pattern of the prevalence of caries was seen in each of the sites in the permanent first molar teeth that were not extracted during the study. In the distal site dental caries became relatively more prevalent as the children grew older. The accumulation of similar information from other populations should provide a useful guide for the prognosis of dental caries in the permanent first molar teeth.     

Streptococcus mutans establishment and dental caries experience in children from 2 to 4 years old

Abstract – 39 children were studied longitudinally at the age of 2, 3, and 4 yr for the colonization of S. mutans in plaque and saliva and for caries experience. S. mutans was found in 38% of the children, and the predominant serotype group was c/e/f. A total of 16 children got caries before the age of 4. Children who harbored S. mutans in their plaque at the age of 2, appeared to be the most caries-active individuals. Their caries index values (number of decayed, missed and filled surfaces, dmfs = 10.6±5.3) at the age of 4 differed significantly from the values of children who harbored S. mutans later (dmfs = 3.4±1.8,P<0.005) or remained free from S. mutans infection (dmfs = 0.3±1.1, P<0.0003). It was thus concluded that the early establishment of S. mutans in the plaque of primary incisors indicated early and extensive caries attack in young primary dentition.     

Dental caries in Faeroese children aged 5-13 years.

Abstract— Before the Act of Free Trade was passed in 1856, dental caries was negligible on the Faeroe Islands. In 1936–37 a survey revealed an increasing prevalence of caries in urban compared with rural areas. The present study was undertaken in order to investigate the prevalence of dental caries among Faeroese children aged 5–13 years in relation to degree of urbanization and presence of a regular School Dental Service. Every third child was selected by a systematic sampling procedure from the total population of children aged 5, 7, 9, 11, and 13 years. 88% of the intended sample was examined in school dental clinics by one dentist according to standardized criteria. It was not possible to demonstrate any differences in mean DMFS and dmfs between children according to degree of urbanization and presence of regular School Dental Service. Furthermore, it was demonstrated that the School Dental Service as practiced at the moment is unable to reduce the amount of unfilled teeth. The very high prevalence of caries, especially in the primary dentition, is discussed in relation to planning of future dental health services on the Faeroe Islands.     

Parental smoking behavior and caries experience in preschool children

Abstract – Objectives: The study aimed to explore the association between parental smoking behavior and caries experience in young children, taking into account the socioeconomic status and oral health‐related behavior. Methods: Cross‐sectional data from 1250 3‐year‐old and 1283 5‐year‐old children from four geographical areas in Flanders (Belgium) were analyzed. Children were examined at school by trained dentist‐examiners, using standard criteria and calibrated examination methodology. Data on oral hygiene and dietary habits, oral health behavior, sociodemographic variables, and parental smoking behavior were obtained through structured questionnaires, completed by the parents. Results: Visible caries experience (i.e. d₃mft > 0) was seen in 7% of 3‐year olds and 31% of 5‐year olds. In both age groups, 30% of the parents reported smoking behavior. Univariable logistic regression analysis with caries prevalence as the dependent variable, revealed that parental smoking was a significant independent variable. After controlling for age, gender, sociodemographic characteristics, oral hygiene, and dietary habits, the effect of family smoking status was no longer significant in 3‐year‐old children (OR = 1.98; 95% CI: 0.68–5.76). In 5‐year olds the significant relationship between parental smoking behavior and caries experience persisted after adjusting for the other evaluated variables (OR = 3.36; 95% CI: 1.49–7.58). Conclusion: The results of this study illustrate the existence of a significant association between parental smoking behavior and caries experience in 5‐year‐old children.     

Relationship between fluoridation and socioeconomic status on dental caries experience in 5-year-old New Zealand children

This article examines the relationship between fluoridation and socioeconomic status on caries experience, as measured by the dmf index, in 5-yr-old New Zealand children in the city of Dunedin (fluoridated in 1967) and in adjacent non-fluoride communities. The children were subdivided into six socioeconomic status groups (SES 1, professional and managerial-SES 6, unskilled workers), but then for simplicity they were combined to form three groups. A two-way analysis of variance demonstrated that interaction between fluoride history and socioeconomic status was not significant. In all three SES groups, dmf was higher in non-fluoride communities, but the difference was significant only in SES group (5&6) (P less than 0.01). Caries experience increased with decreasing socioeconomic status in both fluoride and non-fluoride communities, but this effect was only significant between SES groups (1&2) and (3&4) in the fluoridated community (P less than 0.05), and between SES groups (3&4) and (5&6) in non-fluoride communities (P less than 0.01). These results are compared with those of similar studies, and it is concluded that so far, the relationship between fluoridation and socioeconomic status on caries experience remains equivocal. A note of caution is sounded regarding the interpretation of such results, and the difficulties faced when comparing studies is discussed.     

广州市海珠区6岁儿童患龋的家庭影响因素

目的:探讨儿童龋病形成的家庭相关因素,为龋病预防提供参考.方法:①采用横断面研究对广州市海珠区1 042名6岁儿童进行口腔检查,了解患龋情况;②对儿童家长进行封闭式问卷调查,主要了解儿童饮食、口腔卫生习惯,家长对口腔保健的知、信、行等内容.结果:1042名受检儿童中,患龋526人,其中男性273人,女性253人,龋损率(50.4％),龋均3.12.儿童日常饮食种类及口腔卫生习惯与其患龋相关;家长口腔保健的知、信、行与儿童患龋相关.结论:减少含糖食品的摄入频率,少吃零食;培养儿童良好的口腔卫生习惯;加大对儿童家长口腔健康教育的力度,是预防儿童龋病的重要措施.     

Social and behavioural indicators of caries experience in 5-year-old children

Abstract The aim of this study was to investigate the relative influence of socio-economic status and behaviour on dental health of 5-yr-old children. Dental data from a representative sample of 5-yr-old children from Lothian, Scotland, were analysed in combination with reported behavioural data collected by standardised telephone interviews of the mothers. Dental data was established for 520 children. A total of 324 mothers of these children were interviewed giving a response rate in relation to the original sample frame of 62.3%. Caries experience increased with both decreasing toothbrushing behaviour and a more manual occupational status. The relationship between the parent's occupation and the child's dental health was almost two times as large as the relationship between reported toothbrushing behaviour and the child's dental health. Caries experience increased with both increasing sweet consumption and a more manual occupational status. The relationship between the parent's occupation and the child's dental health was almost four times as large as the relationship between reported sweet consumption and the child's dental health. In conclusion, dental health in 5-yr-old children is related to parent's occupation and toothbrushing and sweet consumption. Occupational status is a much stronger factor than behaviours as reported by mothers.     

A longitudinal study of dental caries risk among very young low SES children

Abstract – Objectives: Early childhood caries (ECC) is a challenging public health problem in the United States and elsewhere; however, there is limited information concerning risk factors in very young children. The purpose of this study was to assess baseline risk factors for 18‐month caries prevalence as part of a longitudinal study of high‐risk children. Methods: About 212 children, 6–24 months of age were recruited from a rural community in Iowa. Subjects were enrolled in the WIC program, which provides nutritional support for low‐income families with children. Dental examinations using d1, d2–3 criteria were conducted at baseline and after 18 months. Caries prevalence was determined at the frank decay level (d2–3 or filled surfaces), as well as at the noncavitated level (d1), and combined (d1, d2–3 or f surfaces). Risk factor data were collected at baseline and after 9‐ and 18‐ months. These data included beverage consumption data, presence of visible plaque, and use of fluoride toothpaste for children as well as mutans streptococci (MS) levels of mothers and children and family sociodemographic factors. Results: About 128 children (60%) remained in the study after 18 months. Among these children, prevalence of d1,d2–3/f level caries increased from 9% to 77%, while d2–3/f level caries increased from 2% to 20%. Logistic regression models for baseline predictors of d2–3f caries at the 18‐month follow‐up found the presence of MS in children (OR = 4.4; 95% CI: 1.4, 13.9) and sugar‐sweetened beverages (OR = 3.0; 95% CI: 1.1, 8.6) to be the only significant risk factors. Sociodemographic factors and the use of fluoride toothpaste were not significant in these models. Conclusions: Results suggest that early colonization by MS and consumption of sugar‐sweetened beverages are significant predictors of ECC in high‐risk populations.     

Life course dental caries determinants and predictors in children aged 12 years: a population-based birth cohort

Abstract – Objective: To investigate the main dental caries life course determinants and predictors of dental caries at age 12. Methods: This study was nested in a population‐based birth cohort started in 1993 in Pelotas, Brazil. A sample of 359 children was followed‐up. Dental examinations and interviews were performed at 6 and at 12 years old. Dental caries (DMFT) at 12 years old was the outcome. Exploratory variables included socioeconomic and demographic variables at birth, children’s nutritional and development characteristics, primary dental caries, oral health related behaviors and dental service use at age 6 and 12. Poisson regression was used in order to provide relative risk ratio estimates. Attributable risk or etiology fraction and population attributable risk for both main early life variables were calculated. Dental caries prediction (DMFT ≥ 1) at 12 years old was tested using logistic regression analyses. Results: Children who presented height‐for‐age deficit at 12 months (RR 1.50 CI: 95% = 1.03–2.18), children who showed a DMFT of 1–3 and 4–19 at 6 years (RR = 2.01; CI: 95% = 1.33–3.03, and RR = 2.66; CI: 95% = 1.81–2.53, respectively) and those children aged 12 in the highest tertile of proportion of teeth experiencing gingival bleeding (RR = 1.58; CI: 95% = 1.11–2.24) presented a higher level of dental caries at age 12. Attributable risk for dental caries at age 12 were 79.1% and 74.2% for deficit in height for age at 12 months and for primary dental caries at age 6 years respectively; population attributable risk for dental caries at age 12 were 3.1% for deficit in height for age at 12 months and 64.9% for primary dental caries at age 6. The level of accuracy in predicting dental caries at age 12 by using life course socioeconomic, behavioral and clinical data was modest. Conclusions: The results of this study support the hypothesis linking social, biological and behavioral exposures and dental caries at 12 years old. In addition, the findings reinforce the lack of accuracy of dental caries predictors therefore limiting the individuals high‐risk approach as a public health strategy.     

Longitudinal study of salivary IgA in children from 1 to 4 years old with reference to dental caries

Abstract – The concentration of salivary IgA was measured and clinical examinations performed annually in 39 children over a period of 36 months. The age of the children ranged from 1 to 4 yr during the observation period. The geometric mean value of salivary IgA increased rapidly between the age of 1 and 2, from 0.021 g/l (log mean −1.68±0.33) to 0.052 g/l (log mean −1.28±0.24). After this age the mean level of salivary IgA remained fairly constant during the observation period. When the study population was divided into two groups: the caries-free group and the caries-susceptible group, it was found that in the caries-free group the mean salivary IgA value increased rapidly during the second year of life, then more slowly after the age of 2. In the caries-susceptible group the increase in the mean value between the ages of 1 and 2 was marked and at the age of 2 the values were significantly higher compared to those of the caries-free group. The concentrations did not, however, remain high, but fell to lower level and at the age of 4 there was a marked overlap in the values of the groups.     

Dental caries experience of preschool children from the North Brisbane region

BACKGROUND: To report the dental caries experience of preschool children within the north Brisbane region and to investigate the association between selected social and demographic variables and disease presence. METHODS: A cross-sectional sample of 2515 children aged four to six years was examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) and percentage caries free indices. A self-administered questionnaire obtained information regarding selected social and demographic variables. The data were analysed using the chi-square and one way analysis of variance procedures at the 5 per cent level of significance. RESULTS: Overall, 1668 (66.3 per cent) children were disease free at the examination and mean dmft was 1.4+/-2.77 and dmfs was 2.28+/-6.00. Dental caries occurred more frequently and severely in children from non-Caucasian background (p<0.000), family language other than English (p=0.001) and lower socio-economic status (p<0.000). CONCLUSIONS: Significant associations between child ethnicity, language spoken at home, socio-economic status and caries presence have been identified. Epidemiological data can be used for improved public oral health service planning and resource allocation within the region.     

Oral health-related quality of life and caries experience of Hong Kong preschool children

Objective: This study aimed to investigate the association between oral health-related quality of life (OHRQoL) and caries experience of Hong Kong preschool children. Methods: Parents or primary caregivers of Hong Kong preschool children were invited to complete a self-administered dental health questionnaire. The study children were examined in their classrooms. The decayed, missing and filled primary teeth (dmft) index was used for documenting the caries status. The questionnaire included the Chinese Early Childhood Oral Health Impact Scale (ECOHIS) and collected sociodemographic information on the parents and children. Logistic regression analysis was used to determine the association between OHRQoL and caries experience of preschool children. Results: A total of 434 preschool children were invited to participate in the study; 336 (77.4%) received a dental examination and returned a parental questionnaire. The mean (SD) age of the study children was 4.7 (0.3) years. An OHRQoL impact (ECOHIS score of >0) for at least one item was reported by 236 (70.2%) parents/caregivers of the children included in the study. The overall mean (SD) ECOHIS score was 5.8 (6.2). A caries prevalence (dmft > 0) of 36.9% and a mean (SD) dmft score of 1.7 (3.2) were calculated for the study children. In the final logistic regression model, children with a higher dmft score had a significantly higher chance of having a poorer OHRQoL (OR = 1.20, 95% CI: 1.07–1.35, P = 0.002), whereas children’s sex, parent’s education levels and the respondent’s relationship to the child were not associated with OHRQoL (P > 0.05). Conclusion: Caries experience is associated with lower OHRQoL of Hong Kong preschool children.Key words: Child, dental caries, early childhood caries, oral health, quality of life