Prevalence of Early Childhood Caries Among Very Young Urban Boston Children Compared with US Children

Objectives: The aims of this study were to compare prevalence of early childhood caries (ECC) in 1- to 3-year-old children seeing primary-care pediatricians at two urban medical centers in Boston to the prevalence of ECC in similarly aged US children surveyed as part of the Third National Health and Nutrition Examination Survey (NHANES III) and to assess risk factors for ECC among this cohort of children compared with risk factors among similarly aged US children. Methods: Characteristics of 787 1- to 3-year-old children from two urban Boston medical centers were compared with those of 3,644 similarly aged US children surveyed as part of NHANES III. Demographic and social characteristics and ECC prevalence by putative risk factors were compared. A multiple logistic regression model was fit to assess putative risk factors and difference between groups simultaneously. Results: Race, age, previous dental visit, parents' education, and household income were significantly associated with ECC prevalence. Parents' place of birth was a significant effect modifier with lower ECC among Boston children of immigrants than among US children of immigrants. Conclusions: Lower ECC prevalence among urban Boston children of immigrant parents compared with US children of immigrant parents may reflect changing immigrant composition in the United States since NHANES III or a different immigrant composition in the Boston area compared with the United States. This finding reinforces the need for further research of immigrants in order to understand cultural practices that may affect oral health. Finally, low ECC prevalence among very young children reinforces the importance of early intervention in reducing ECC.     

Early Childhood Caries in Victorian Preschoolers: A Cross-Sectional Study

AimThe objective of this work was to determine the prevalence of early childhood caries (ECC) in children attending preschools that are enrolled in the Smiles 4 Miles health promotion program in Victoria and determine the sociodemographic variables associated with ECC.Materials and methodsA cross-sectional sample of 1,845 3- to 5-year-old children attending 61 preschools was selected by stratified cluster sampling. Dental caries was classified as non-cavitated/early lesions (d^1-2), cavitated (d^3-6) lesions, and cavitated/non-cavitated (d^1-6) lesions using the International Caries Detection and Assessment System. A self-administered parental questionnaire captured sociodemographic and behavioural data. Multivariate logistic regression and Poisson mixed model analysis was used to examine associations amongst sociodemographic variables, child oral health behaviours, and decayed tooth surfaces.ResultsIn all, 56.6% (n = 1,044) of the children had ECC; more than one-third (36.6%) presented exclusively non-cavitated/early lesions, 5.7% solely cavitated lesions, and 14.2% both. Children from socioeconomically disadvantaged backgrounds had higher levels of dental caries. Parental pensioner/health care card status (incidence rate ratio [IRR] = 1.76, 95% CI, 1.57-1.97), non-English-speaking background (IRR = 2.09, 95% CI, 1.80-2.43), and Indigenous status (IRR = 1.91, 95% CI, 1.50-2.43) were associated with higher rates of cavitated lesions. Children who consumed soft drinks once or more per week had 1.66 times more cavitated lesions (95% CI, 1.48-1.86) compared to children who never/rarely consumed soft drinks. Soft drink consumption of once or more per week was associated with parental health care/pensioner card status (odds ratio [OR] = 1.73, 95% CI, 1.36-2.18), non-English-speaking background (OR = 1.58, 95% CI, 1.11-2.27), and Indigenous status (OR = 1.92, 95% CI, 1.04-3.52).ConclusionsHigher levels of more severe caries rates in children from socioeconomically disadvantaged background highlight an opportunity for early preventive interventions targeting these groups.     

Maternal self-report of oral health in 4-year-old Pacific children from South Auckland, New Zealand: findings from the Pacific Islands Families Study

OBJECTIVES: To report on the oral health risk in a disadvantaged group of 4-year-old Pacific children and their mothers living in South Auckland, New Zealand. METHODS: The Pacific Islands Families study follows a cohort of Pacific infants born in 2000. Maternal self-report of mother and child's oral health practices and child's filling and extraction experience was undertaken at interview approximately 4 years postpartum. RESULTS: Overall, 1,048 mothers of children were interviewed. Children's reported oral health practices were generally poor, with 47 percent brushing < or =1/day, 47 percent having no adult assistance with brushing, 57 percent routinely snacking or drinking immediately prior to bed, and 26 percent yet to receive their first dental checkup. Maternal practices were also poor, with 34 percent brushing < or =1/day and 50 percent having never seen or last visiting a dentist over 5 years ago. Significant differences were seen in many practices between the major ethnic subgroups. Of children attending the school dental service, 22 percent were reported having at least one filling and/or extraction. In multivariable analyses, variables corresponding to mother's toothbrushing frequency, child snacking or drinking prior to bed, and duration of breastfeeding were significantly associated with reported filling and/or extraction experience; but no difference was seen between the three major maternal ethnic subgroups. CONCLUSIONS: Many mothers and their Pacific children have poor basic oral hygiene and dietary practices that increase the oral health risk in these children. Culturally appropriate and targeted strategies aimed at these modifiable practices need to be widely promoted so that the oral health burden carried by Pacific children can be reduced.     

Relationships Between Caregivers' Responses to Oral Health Screening Questions and Early Childhood Caries

Objective: This study evaluated relationships between caregiver responses to oral health screening questions and caries in young children. Methods: Two samples of caregivers answered identical eight‐item screening questionnaires about their oral health. One sample included children enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) who were 24 to 42 months of age; the other sample included 3‐ to 5‐year‐old children attending a pediatric dental clinic. Using chi‐square and relative risk, questionnaire findings were related to children's caries history based on clinical caries exams. Results: Questions significantly (P < 0.05) related to children's caries in the older sample included caregivers' poorer rating of their oral health, less frequent dental visits, current or recent caries, and history of tooth loss due to caries. However, only questions pertaining to tooth loss were related to caries in the younger sample. Conclusion: Caregivers' reported loss of teeth due to caries was significantly associated with caries development in their children in both samples, and may be a useful means for early identification of children at high risk.     

氟化钠滴剂预防儿童乳牙龋齿的2年临床效果评价

目的　研究氟化钠滴剂对儿童乳牙龋病的预防作用。方法　在成都市13所幼儿园3~4岁儿童中随机抽 取1 200人,平均分为3组,每组400人。第1组(氟滴组)采用氟化钠滴剂点滴;第2组(含氟牙膏组)采用含氟牙膏 刷牙;第3组(对照组)未采用任何统一干预措施。对这3组儿童进行2年的乳牙龋病预防评价。结果　氟滴组第 1、2年的新增龋面均分别为1·35±0·57和1·85±0·57,含氟牙膏组第1、2年的新增龋面均分别为1·53±1·09和 2·75±1·33,对照组第1、2年的新增龋面均分别为2·19±1·12和4·73±2·17。统计分析表明,氟滴组和含氟牙膏组 的新增龋面均低于对照组,二者之间的差异有统计学意义;氟滴组和含氟牙膏组二者新增龋面均的差异无统计学 意义。结论　氟化钠滴剂预防儿童乳牙龋齿的效果明显。     

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: A double-blind randomized controlled trial

Objectives

To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000 ppm fluoride toothpaste.

Methods

424 preschool children, 2–5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity.

Results

The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p = 0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments.

Conclusions

Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000 ppm fluoride toothpaste.

Clinical significance

In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000 ppm fluoride toothpaste is used daily.     

婴幼儿龋病相关因素的初步研究

目的 :了解我国婴幼儿龋病发病的相关因素。方法 :对沈阳市 1860名 8～ 3 6个月的儿童进行患龋情况检查。随机抽取婴幼儿龋组和无龋组各 12 0对母子进行问卷调查及口腔卫生检查。结果 :母亲的文化水平、DMFT及菌斑产酸能力对婴幼儿龋病有影响 (P <0 .0 1) ;婴幼儿期喂养方式与婴幼儿龋病无明显关系 (P >0 .0 5 ) ;断奶时间、含奶瓶或乳头睡觉习惯、甜食习惯与婴幼儿龋病的发生有关系 (P <0 .0 5 ) ;婴幼儿口腔卫生与婴幼儿龋病的发生有关系 (P <0 .0 0 1)。结论 :为了预防婴幼儿龋病应提高母亲素质、宣传正确的饮食方式及注意婴幼儿口腔卫生。     

口腔健康教育对改善中学生维护口腔健康意识的效果评价

目的评价以学校为基础的口腔健康教育改善中学生口腔健康状况的效果。方法将随机抽取的四川省德阳市农村地区2所中学的初一学生按学校分为试验组和对照组,每组200名学生。对试验组学生进行以学校为基础的口腔健康知识教育,同时要求试验组学生在家长的监督下使用含氟牙膏刷牙。对照组不采取任何干预措施。在试验前和1年后对2组学生进行龋病、口腔卫生状况检查,并对口腔健康知识、态度和行为进行问卷调查。结果1年后,与基线相比,试验组的龋均和龋面均无明显变化（P>0.05）,而对照组的龋均和龋面均明显升高（P<0.05）;试验组的简化口腔卫生指数（OHI-S）下降（P<0.05）,而对照组的OHI-S上升（P<0.05）;试验组学生对“使用含氟牙膏能预防蛀牙”和“甜食致龋”的认识增加率高于对照组学生（P<0.05）;试验组学生每天至少刷牙2次、使用含氟牙膏、拜访牙医的增加率高于对照组（P<0.05）。结论以学校为基础的口腔健康教育和使用含氟牙膏的综合口腔卫生项目对促进农村地区中学生口腔健康有积极的作用。     

上海市3岁儿童婴幼儿龋患病现状和特点分析

目的调查上海市3岁儿童婴幼儿龋（early childhood caries,ECC）患病现状和特点,为上海市婴幼儿的龋病防治工作提供参考依据。方法采用多阶段分层随机抽样方法抽取上海市中心和非中心城区600名3岁儿童进行检查,并对检查结果进行统计学分析。结果受检600名儿童龋均为2.17±3.18,龋面均为2.99±5.30,龋蚀严重度指数为6.53±10.91;ECC患病率为49.00%,重度婴幼儿龋（severe early childhood caries,SECC）患病率为27.83%（167/600）,SECC患龋儿童占患龋总人数的56.80%（167/294）。中心城区和非中心城区儿童ECC患病率分别为42.33%和55.67%,差异有统计学意义（χ2=10.671,P=0.001）。非中心城区儿童ECC龋均明显高于中心城区,差异有统计学意义（F=4.307,P〈0.05）;非中心城区儿童ECC龋蚀严重度指数明显高于中心城区,差异有统计学意义（F=4.400,P〈0.05）。ECC龋齿充填构成比为3.92%,中心城区和非中心城区分别为5.44%和2.74%,差异有统计学意义（χ2=6.211,P=0.013）。上海市3岁儿童ECC龋蚀牙位分布以上颌乳中切牙和下颌乳磨牙为主。结论上海市3岁儿童ECC患病状况严重,应加强对上海市婴幼儿龋病的早期干预。     

Changing use and knowledge of fluoride toothpaste by schoolchildren, parents and schoolteachers in Beijing, China

OBJECTIVE: To assess the oral hygiene practices, current use of and knowledge about fluoride toothpaste among schoolchildren, parents, and schoolteachers; to describe the attitudes of parents and schoolteachers in relation to improving schoolchildren's oral health. DESIGN: Cross-sectional study. PARTICIPANTS: 1,557 schoolchildren, 1,132 parents, and 352 schoolteachers were recruited by multistage stratified sampling procedure in a district of Beijing, China. METHODS: Self-completed questionnaire. RESULTS: The percentage of schoolchildren, parents, and schoolteachers who actually used fluoride toothpaste was 88%, 86%, and 87%, respectively, and 74-78% of the respondent groups brushed their teeth twice a day or more. 64% of schoolchildren, 73% of parents, and 74% of schoolteachers confirmed the caries preventive effect of fluoride toothpaste. Toothpaste recommended by oral health professional organisations was preferred by respondents - particularly by schoolchildren - when purchasing toothpaste (86%). 93% of parents and 56% of schoolteachers recognised their important role in promoting children's oral health; however, their lack of knowledge seemed to be a major obstacle in fulfilling this role. CONCLUSIONS: The use of fluoride toothpaste in Beijing appears to have increased during the past decade. In addition to mass communication comprehensive school-based oral health programmes are needed to continuously promote the use of fluoride toothpaste among schoolchildren.     

Effectiveness of an oral health education and caries prevention program in kindergartens in China

OBJECTIVES: To evaluate the effect of a 2-year oral health education and caries prevention program implemented in kindergartens in China. METHODS: Seven hundred and thirty-one 3-year-old children were recruited from 10 kindergartens in Miyun County, Beijing, China. The kindergartens were randomly divided into two groups. Oral health education was provided to teachers in the test kindergartens every 3 months. Oral health education sessions were conducted for the test children monthly and for their parents semiannually. Children in the test kindergarten brushed their teeth twice daily with fluoridated toothpaste (1100 ppm F-) in their kindergarten under the supervision of teachers during weekdays. No oral health education session and no supervised tooth brushing activities were carried out in the control kindergartens. A clinical examination of the study children and a questionnaire survey of their parents were conducted at baseline and after a 2-year program. RESULTS: Five hundred and fourteen children remained in the study after 2 years. The mean caries increments of the test group (n = 258) and the control group (n = 256) were 2.47 and 3.56 dmfs, respectively. The reduction in dmfs increment was 30.6% (P = 0.009). At the evaluation, a significantly higher percentage of children in the test group than in the control group reported brushing their teeth twice a day (87.6% vs. 69.0%; P < 0.001). Parents of children in the test group had better oral health knowledge and attitude than the parents of children in the control group. CONCLUSION: This oral health education program was effective in establishing good oral health habits among preschool children and in increasing oral health knowledge of their parents, in conjunction with supervised daily tooth brushing with fluoridated toothpaste, which could reduce the development of new dental caries in preschool children in China.     

Prevalence of early childhood caries among 5‐year‐old children: A systematic review

The aim of the present review was to describe the updated prevalence of early childhood caries (ECC) among 5‐year‐old children globally. Two independent reviewers performed a systematic literature search to identify English publications from January 2013 to December 2017 using MEDLINE, ISI Web of Science, and Scopus. Search MeSH key words were “dental caries” and “child, preschool”. The inclusion criteria were epidemiological surveys reporting the caries status of 5‐year‐old children with the decayed, missing, and filled primary teeth (dmft) index. The quality of the publications was evaluated with the modified Newcastle‐Ottawa Scale. Among the 2410 identified publications, 37 articles of moderate or good quality were included. Twenty of the included studies were conducted in Asia (China, India, Indonesia, Korea, Nepal, and Thailand), seven in Europe (Greece, Germany, Great Britain, and Italy), six in South America (Brazil), two in the Middle East (Saudi Arabia and Turkey), one in Oceania (Australia), and one in Africa (Sudan). The prevalence of ECC ranged from 23% to 90%, and most of them (26/37) were higher than 50%. The mean dmft score varied from 0.9 to 7.5. Based on the included studies published in the recent 5 years, there is a wide variation of ECC prevalence across countries, and ECC remains prevalent in most countries worldwide.     

Caries incidence after topical application of varnishes containing different concentrations of sodium fluoride: 3-year results

Abstract— Previous studies have shown that topical application of the fluoride varnish Duraphat reduces caries incidence. The aim of the present study was to compare the caries inhibiting effect of a new fluoride varnish (Carex) containing 1.8% fluoride (F) with that of Duraphat (2.26%F). Informed consent was obtained from the guardians of 495 children 10-12 yr old in Voss Dental Health District (low F area). The children were randomly allocated to two groups. One group of subjects received 6-monthly application of Duraphat (n=185), the other Carex (n=165). Ethical considerations precluded the use of a placebo varnish. All participants received dental examinations including one pair of posterior bitewing radiographs and necessary dental care annually. One trained examiner interpreted bitewing radiographs blindly. Total 3-yr net DFS increment for 24 posterior approximal surfaces was 2.63 (SD = 3.81) in the Duraphat group and 2.12 (SD = 3.50) in the Carex group. DMFS increments based on 40 posterior occlusal and approximal surfaces were 5.21 (SD = 5.79) and 4.04 (SD = 4.92), respectively. Thus the results indicate a comparable efficacy for Carex and Duraphat at the caries activity level exhibited by these study participants.