A study of prevalence of caries and oral health behavior in Japanese children with cleft lip and palate

The aims of this study were to investigate the condition of dental caries in 1–4 years old Japanese children with cleft lip and/or palate, and also to examine the relationships between age, location of the cleft, oral health behavior of cleft children and the incidence of dental caries. The study was carried out through a dental examination of a sample of children and a questionnaire to their parents which included questions about infant feeding practices, frequency of consumption of specific drinks and children's frequency of tooth brushing. A sample of 116, 1–4 years old Japanese children (58 boys and 58 girls) with oral clefts referred to the Department of Pediatric Dentistry Clinic, Showa University, after receiving surgical treatment, participated in this study. Results indicated that the prevalence of caries in cleft children was related to patient age, location of clefts and oral health behavior. A higher level of dental caries was recognized in children with cleft lip and alveolus/palate than in those with cleft lip alone. Incidence of caries increased with patient age. Children who had been fed in a determined time were less affected than those who had been fed at will. Incidence of caries was also high in the children who ingested drinks with sugar than in those who did not. The results of this study suggest that it is important to improve the oral health behavior of cleft children to minimize the risk of caries. Moreover, children with clefts and their parents should as early as possible undergo a preventive program to ensure preservation of primary dentition.     

Determinants of early childhood caries in low-income African American young children

PURPOSE: The aim of this longitudinal study was to evaluate the association between early childhood caries (ECC) and severe ECC (S-ECC) and social, dietary, and behavioral risk factors. METHODS: A representative sample of low-income 0- to 5-year-old children was selected from Detroit. Children and their caregivers were examined for the presence and severity of dental caries. Trained interviewers administered questionnaires assessing social, dietary, and behavioral factors. RESULTS: A total of 1,021 child and caregiver dyads were examined in wave 1. Of these, 788 (77%) were re-examined in wave 2. ECC and S-ECC were highly prevalent in this cohort By 2 years of age, 7% of the children had ECC without S-ECC (ECC-only) and 27% had S-ECC. The regression model found that age of the child and caregiver, child's gender, and caregivers' fatalistic oral health beliefs were significantly associated with higher odds ratios of developing ECC-only and S-ECC. Consumption of soda beverages was associated with developing S-ECC. Religiosity was protective against ECC-and S-ECC. CONCLUSIONS: Early childhood caries and severe early childhood caries are highly prevalent in low-income African American children. Intake of soda beverages by the children and the caregivers' fatalistic oral health beliefs and religiosity were significant determinants of ECC and S-ECC.     

Early childhood caries prevalence and associated risk factors among Saudi preschool children in Riyadh

AimTo determine the prevalence of early childhood caries (ECC) and investigate the effect of associated risk factors on ECC prevalence in preschool children in Riyadh, Saudi Arabia.MethodsThis cross-sectional study included Saudi preschoolers aged 36–71 months. Parents/guardians completed a structured, self-administered questionnaire assessing sociodemographics; medical, dental, and dietary history; and oral hygiene practices. Children were orally examined for dental caries, oral hygiene, and plaque deposition.ResultsA total of 383 children were examined. ECC prevalence was 72.6%, with a mean decayed, missing, and filled teeth (dmft) score of 4.13 (±3.99) and a mean decayed, missing, and filled surfaces (dmfs) score of 7.0 (±9.1). Children from schools in northern Riyadh and those of fathers in professional jobs were less likely to have ECC [(OR: 0.203; 95% CI: 0.082–0.503)] and [(OR: 0.472; 95% CI: 0.256–0.871)], respectively. Children with a nocturnal feeding history and poor oral hygiene were more likely to have ECC [(OR: 2.281; 95% CI: 1.143–4.553)] and [(OR: 5.523; 95% CI: 2.269–13.441)], respectively.ConclusionsThe prevalence of ECC in preschool children in Riyadh is high and affected by parental socioeconomic factors, infant feeding practices, and children’s oral hygiene status.     

Type of oral cleft and mothers' perceptions of care, health status, and outcomes for preadolescent children.

OBJECTIVE: To evaluate the outcomes of care for children by type of oral cleft. DESIGN: Data were collected through structured telephone interviews during 2003 in Iowa with mothers of 2- to 12-year-old children with oral clefts. Interviews with mothers of children with clubfoot and statewide data on Iowa children were used for comparison. PARTICIPANTS: Participants included mothers of children in Iowa born between 1990 and 2000 with nonsyndromic oral clefts. Children were identified by the statewide Iowa Registry for Congenital and Inherited Disorders. MAIN OUTCOME MEASURES: Rating of cleft care, severity of condition, health status, esthetic outcome, speech, and school performance were evaluated by type of oral cleft. RESULTS: Children with cleft lip and palate were most likely to have their clefts rated as very severe. Children with palatal involvement were reported to have a lower health status and were almost twice as likely to be identified as having a special health care need compared with either children with cleft lip or children statewide. Children with cleft lip had more esthetic concerns; children with palatal involvement had the most speech concerns. CONCLUSIONS: Although mothers generally believed their children had received high-quality care, ratings of the children's current health status and outcomes of care varied significantly by type of cleft (cleft lip, cleft palate, and cleft lip and palate). Differences observed in this population-based study support the proposition that cleft type should be considered when examining outcomes of care for children with oral clefts.     

Caries prevalence and bottle-feeding practices in 2-year-old children with cleft lip, cleft palate, or both in Taiwan.

OBJECTIVE: The purposes of this study were to investigate the caries prevalence in cleft lip, cleft palate, or both in children under the age of 2 years and to evaluate parental attitudes toward bottle-feeding, dental care, and their relationship to baby bottle tooth decay (BBTD) in Taiwan. DESIGN: Randomized and prospective study. SETTING: Institutional setting. PATIENTS AND METHODS: One hundred twenty-three 2-year-old children (68 boys and 55 girls) with cleft lip, cleft palate, or both were selected for this study. A questionnaire that asked questions about knowledge of oral health, knowledge and beliefs about BBTD, children's feeding habits, children's dental care, and parenting attitudes toward children with clefts was completed by the parents or caretakers. Children were divided into bottle-feeding and non-bottle-feeding groups according to the questionnaire responses of parents or caretakers. Each child was examined with a dental mirror and explorer under focused flashlight using defs index to determine the presence of BBTD. RESULTS: Thirty-nine percent (48) subjects reported a bottle-feeding habit; the overall prevalence of BBTD was 15.4%. The habit of bottle-feeding was significantly related to BBTD (p = .019). The defs score for children who were bottle-fed was significantly higher than children who were not bottle-fed (p = .045). Parents or caretakers of both bottle-feeding and non-bottle-feeding children showed no significant differences in their attitudes toward bottle-feeding and feeding habits (p > .05). However, parents of non-bottle-fed children had significantly better dental care than parents of bottle-fed children in brushing frequency (p < .001) and brushing before bed (p < .001). CONCLUSIONS: Children with clefts who took a bottle to bed showed an increased risk of developing BBTD. The parents or caretakers of bottle-fed children also showed a lack of motivation to perform regular preventive dental home care for their children. This suggests that oral health promotion programs should begin in infancy for children with clefts and their parents.     

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。     

Early childhood caries in children aged 6-19 months

OBJECTIVES: To investigate the relationship between socioeconomic factors, behaviors and the severity of early childhood caries (ECC) in 6-19 month-old Thai children. The severity of ECC was estimated using the proportion of ECC teeth to erupted teeth. This was termed the 'Intensity of ECC' (I-ECC) index. METHODS: Cross-sectional questionnaire survey, dental examinations, and mutans streptococci counts were obtained from children and mothers/caregivers who participated in the ECC prevention program. RESULTS: The 520 children from rural areas were categorized into four age groups by the mean number of erupted teeth. In the 15-19-month-old children, the prevalence of ECC was 82.8% (cavitated caries, 40.8%; noncavitated caries, 42.0%) with a mean ECC teeth score of 4.18 +/- 3.19. The mean I-ECC severity score was 0.45 +/- 0.30 in these toddlers. Children from low-income families, those with low education, and mothers/caregivers with decayed teeth had higher I-ECC scores (P < 0.05). Children who were breast fed or had high counts of mutans streptococci also had higher I-ECC scores (P < 0.05). The logistic regression model revealed that only children's mutans streptococci level was a statistically significant predictor of ECC, with an odds ratio = 4.5 (95% CI = 1.8, 11.7). CONCLUSIONS: ECC is not only a public health problem but also a social problem in Thailand, because it relates to family income and education level. The community development approach to assisting disadvantaged Thai children should be combined with an effective preventive program at a very young age. Future longitudinal research should be performed to improve the I-ECC for measuring the severity of ECC.     

Early childhood caries lesions in preschool children in Kerala, India

PURPOSE: No data are available on possible risk indicators or the prevalence of caries lesions for preschool children under 4 years of age in Kerala, southern India. Therefore, the aims of this study were: (1) to gather data on caries lesion frequency and distribution; (2) to determine any possible associations with feeding habits and oral health care practices. METHODS: A sample of 530 children, aged from 8 to 48 months (mean=2.5+/-0.96 years), who attended 13 day care centers were clinically examined for caries lesions using a disposable mouth mirror, tongue spatula, and a torch light. There were 513 dentate children. The caregiver of each child then completed, by interview, a structured questionnaire. RESULTS: Among the group of 252 girls and 278 boys, the dmft was 1.84+/-2.87 with 56% of the children being caries-lesion free. Fifty-nine (12%) were considered to have early childhood caries (ECC), based on the criteria that smooth surface caries lesions on all 4 maxillary incisor teeth indicated severe ECC. Breast-feeding was practiced by 99% of the mothers, and 5% did so exclusively. Generally, breast-feeding was on demand. Statistically significant correlations were found between caries lesions and the child's dental condition, as perceived by the mother or caregiver (P<.0001), the dental status of the caregiver (P=.0417), consumption of snacks (P=.0177), giving of sweets as a reward (P<.0001), cleaning of the child's mouth (P<.0001), oral hygiene status of the child (P<.0001) and low socioeconomic status, as measured by income (P<.0001). CONCLUSION: From the results of this study of preschool children in Kerala, the groups at high risk from dental caries lesions are: (1) those with poor oral hygiene status; (2) those who consume snacks and are given sweets as rewards; (3) those belonging to a lower socioeconomic class.     

Determinants of early childhood caries in a group of inner-city children.

OBJECTIVE: This study aimed to determine the prevalence of early childhood caries (ECC) and severe early childhood caries (s-ECC) in inner-city children in Ghent, Belgium, and to investigate the independent impact of its determinants. METHOD AND MATERIALS: In a non-randomized cross-sectional research design, all children between 24 and 34 months of age attending the final consultation at a participating Child and Family Health Clinic were included (n = 385). Data on oral hygiene and caries were collected by oral examination. Caries prevalence and oral hygiene were determined according to established criteria. Data on oral health habits and socioeconomic status were obtained by a validated questionnaire. All analyses were performed with ECC and s-ECC as response variables. RESULTS: The mean DMFS was 0.83 (SEM = 0.14). ECC was diagnosed in 18.5% of the children and s-ECC was found in 12.2%. Treatment need was 100%. From the multiple regression analysis it became clear that ethnicity and neighborhood significantly determined ECC. From all oral health-related behavioral variables, only daily use of a bottle with sweetened drinks other than milk or water, frequency of brushing, and quality of oral hygiene as expressed by Plaque Index scores remained significantly associated with ECC. CONCLUSION: Children whose mothers had an Eastern European nationality at birth and who live in a deprived neighborhood, daily use a bottle with sweetened drinks other than milk or water, brush less than once a day, and have plaque are at higher risk for ECC and s-ECC.     

2002 BSPD Clinical Case Presentations, sponsored by South Yorkshire branch of BSPD

Aims. To determine the oral health of children attending a Clinical Standards Advisory Group (CSAG) audit and to assess whether this varied with the type of cleft. To record the fre-quencies of dental anomalies occurring at the site of the cleft.
Methods. Children with clefts attending the 5-, 10-, 15- and 20-year audit at Broomfield Hospital Essex over a 2-year period were examined using standardized criteria for caries experience, dental anomalies and oral hygiene status. Comparisons were made for the different cleft types.
Results. The mean DMFTat 5 years was 1·83. The DMFT for 10- and 15-year children combined was 0·64. Sixty-two percent of the children had dental anomalies in the region of the cleft. Children with cleft lip and palate had significantly more dental anomalies than cleft palate alone. Children withbilateral cleft lip and palate often had anomalies remote from the cleft.
Conclusions. Dental caries in this population of cleft children was similar to national figures. Hypodontia and hypoplasia were more common in cleft lip and palate than in cleft palate alone. Dental anomalies remote from the cleft site in bilateral clefts suggests that a field change may influence dental development.     

A comparison of a generic and oral health–specific measure in assessing the impact of early childhood caries on quality of life

Lee GHM, McGrath C, Yiu CKY, King NM. A comparison of a generic and oral health–specific measure in assessing the impact of early childhood caries on quality of life. Community Dent Oral Epidemiol 2010; 38: 333–339. © 2010 John Wiley & Sons A/S Abstract – Objectives: The aim of this study was to compare the performance of a generic health‐related quality‐of‐life measure, the Pediatric Quality of Life Inventory Version 4.0 (PedsQL? 4.0) and an oral health–specific quality‐of‐life measure, the Early Childhood Oral Health Impact Scale (ECOHIS) in assessing the impact of severe early childhood caries (S‐ECC) on the children’s quality of life. Methods: A trained and calibrated examiner conducted a clinical oral assessment of 111 children (mean age: 49 ± 12 months): 64 of whom were categorized as having S‐ECC and 47 as being caries‐free. Primary caregivers completed a Chinese version of the PedsQL? 4.0 and the ECOHIS. Clinical examinations were conducted blind of the parental assessments. Results: The ECOHIS scores were significantly higher for the S‐ECC group than for the caries‐free group (P ≤ 0.001). No significant difference was found between the PedsQL? 4.0 scores in relation to caries status, except for the subscale of physical functioning (P = 0.04). Correlation of caries status with the ECOHIS scores was strong (r = 0.66; P < 0.01). No significant correlation was found between PedsQL? 4.0 scores and caries status (r = 0.02; P > 0.05). Conclusions: The oral health–specific measure, ECOHIS, shows better discriminant property between children with S‐ECC and caries‐free children than the generic measure, PedsQL? 4.0. The ECOHIS appears more sensitive than PedsQL? 4.0 in assessing the impact of dental caries on the life quality of preschool children.     

Caries experience and oral health behavior in Chinese children with cleft lip and/or palate.

PURPOSE: The aims of this study were to investigate whether there were different caries levels in 3- to 6-year-old Chinese children who had a cleft lip compared to those with a cleft lip/palate. The goal also was to evaluate parental attitudes toward the feeding habits and oral health care for their children. METHODS: A cross-sectional study was carried out through a dental examination of a sample of children and a questionnaire to their parents. A sample of 104 3- to 6-year-old children (66 boys and 38 girls) with cleft lip, cleft palate or both were selected from those receiving pre-surgical treatment. Each child was examined and a short questionnaire was given to parents of the children. The form included questions about infant feeding practices, frequency consumption of specific drinks and, children's toothbrushing frequency. RESULTS: One hundred and four children were examined. Seventy-five percent had some caries experience and rampant caries was present in 26%. Children with cleft palate had a higher prevalence of rampant caries (30%) compared to those with cleft lip (12%). A multivariate analysis yielded feeding practices and mother's education as the variables significantly associated with caries and rampant caries. CONCLUSIONS: The results of this study show that: 1. Children with a cleft lip/palate have higher levels of dental caries compared to those with a cleft lip alone; 2. The two most important factors for dental caries were: a. whether the child had been bottle-fed and; b. the educational attainment level of the mother.     

Rural Latino immigrant caregivers' conceptions of their children's oral disease

OBJECTIVE: The aim of this study was to examine Latino immigrant caregivers' explanatory models of the causes of early childhood caries (ECC). METHODS: In a rural area, we conducted 71 open-ended qualitative interviews with 26 Mexican immigrant and 12 Salvadoran immigrant caregivers of children under 6 about the causes of ECC. Two researchers independently read each interview and classified each interviewee's response. RESULTS: Caregivers mentioned three biomedical causes of oral disease (sweets, poor oral hygiene, and bottle-feeding) and two lay or popular causes (lack of milk consumption and "bad" genes). Although caregivers were aware that the consumption of sweet foods causes decay they expressed particular confusion about how bottle-feeding causes decay. Nineteen caregivers attributed decay specifically to bottle-feeding, yet 14 believed the cause of decay was the bottle's nipple. Seven Mexican immigrant caregivers attributed their children's decay specifically to a lack of calcium, and six immigrant caregivers to "bad teeth genes." CONCLUSIONS: Conceptions of oral disease derived from the caregivers' own dental experiences, their conceptions of the body, and interactions with dental professionals. The fact that biomedical explanations dominate the list of causes of caries for both groups indicates that the caregivers' explanatory models of oral disease are powerfully shaped by interactions with health professionals. Immigrant caregivers' mistaking of the baby bottle's nipple as the source of decay indicates the need for more effective oral health promotion. Yet the Mexican immigrants' conceptions of a lack of calcium as a major factor in their children's decay may illustrate a strong cultural link between teeth and milk.     

早期儿童龋病危险因素的回归分析

目的：探讨早期儿童龋病（ECC）的主要致病因素。方法：采取整群抽样的方法对984名2－4岁儿童进行问卷调查和临床检查，并对结果进行Logistic回归分析。结果：ECC的患病率为19．2％，Logistic回归分析的结果提示，在ECC的发病过程中，釉质发育缺陷、新生儿早产和口腔卫生不良是重要的危险因素，而儿童含奶嘴睡觉的习惯并不是惟一的危险因素。结论：早期儿童龋病重要的危险因素包括釉质发育缺陷、新生儿早产、口腔卫生不良和含奶嘴睡觉的习惯等。     

Early childhood caries (ECC): a preventive-conservative treatment mode during a 12-month period

PURPOSE: To evaluate a preventive treatment mode for early childhood caries (ECC). POPULATION AND METHODS: The population to be studied included 30 children who, over a 12-month period, presented with ECC to a private dental clinic. Parents preferred non-invasive, preventive treatment over restorations. Parents were given hygiene and proper feeding instructions. Mesial slicing was performed where proximal caries was observed. Children were examined once every two months. They received supervised professional topical fluoride treatment. Plaque level, brushing, stopping the bottle, eating sweets, appearance of new lesions or exacerbation of existing condition were observed and recorded. RESULTS: In the vast majority of patients, the progression of ECC was arrested after the preventive regimen. Three children required restorations. They had failed to limit sugar consumption and to comply with brushing instruction. General improvement was observed in plaque control, brushing habits and sweets consumption. CONCLUSION: Preventive measures may successfully arrest ECC and thereby avoid invasive procedures as well as the need of anesthesia.     

Abstracts from other journals

The aims of this study were to investigate whether there were different caries levels in 3- to 6-year-old Chinese children who had a cleft lip compared to those with a cleft lip/palate. The goal also was to evaluate parental attitudes toward the feeding habits and oral health care for their children. A cross-sectional study was carried out through a dental examination of a sample of children and a questionnaire to their parents. A sample of 104 3- to 6-year-old children (66 boys and 38 girls) with cleft lip, cleft palate or both were selected from those receiving pre-surgical treatment. Each child was examined and a short questionnaire was given to parents of the children. The form included questions about infant feeding practices, frequency of consumption of specific drinks, and children's toothbrushing frequency. One hundred and four children were examined. Seventy-five percent had some caries experience and rampant caries was present in 26%. Children with cleft palate had a higher prevalence of rampant caries (30%) compared to those with cleft lip (12%). A multivariate analysis yielded feeding practices and mother's education as the variables significantly associated with caries and rampant caries. The results of this study show that: 1. Children with a cleft lip/palate have higher levels of dental caries compared to those with a cleft lip alone; 2. The two most important factors for dental caries were: (a) whether the child had been bottle-fed and; (b) the educational attainment level of the mother.     

Determinants of ECC in Sardinian preschool children

OBJECTIVE: The aim of the study was to assess the influence of determinants on the presence of caries in pre-school children. BASIC RESEARCH DESIGN: A matched case-control study (1:2) was designed: 55 children (32 males, 23 females) with at least one buccal or lingual caries lesion on one primary maxillary incisor were selected (caries affected=1) and compared to randomly selected controls (no caries=0) paired for age and gender. Several variables concerning oral hygiene habits, use of fluoride supplementation, dietary habits, socio-economic status of the family and lifestyle factors were considered as risk predictors for early childhood caries (ECC). A conditional logistic regression model was used to perform matched case-control analysis. RESULTS: Bottle feeding at night (OR=1.90; 95%CI=1.03-3.50) and socio-economic level (OR=1.69; 95%CI=1.01-2.81) were positively associated with case status. CONCLUSIONS: We conclude that ECC seemed to be associated with bottle feeding at night and a low socio-economic level.     

南京市低龄儿童龋相关危险因素初步研究

目的:研究南京市低龄儿童龋相关危险因素.方法:调查南京市某幼儿园共342例3～5岁儿童口腔健康状况,通过问卷调查收集基线资料,采用横断面研究方法探讨各因素的影响.结果:205例诊断为低龄儿童龋,患龋率为60.0％,其中119例诊断为重度低龄儿童龋,患病率为34.8％.简化软垢指数、菌斑指数、菌斑产酸能力、深点隙裂沟、母...     

The association of early childhood caries and race/ethnicity among California preschool children

OBJECTIVES: This paper explores the role of race/ethnicity in the occurrence of early childhood caries (ECC) among California Head Start (HS) and non-HS preschool children. METHODS: Using oral examination and questionnaire data from the 1993-94 California Oral Health Needs Assessment of Children, we computed the prevalence of ECC using various definitions and fitted logistic regression models to explore the effect of race/ethnicity on ECC, separately for HS and non-HS children, adjusting for bedtime feeding habits and other covariates. RESULTS: Among 2,520 children, the largest proportion with a history of falling asleep sipping milk/sweet substance was among Latinos/Hispanics (72% among HS and 65% among non-HS) and HS Asians (56%). HS Asians and Latinos/Hispanics had the largest prevalence of ECC (30%-33%) and untreated caries (49%-54%). The estimated risk for ECC was more than three times higher in HS Asians compared to HS whites and among non-HS African Americans and Asians compared to non-HS whites controlling for socioeconomic status variables. The risk of ECC was also significantly higher among children who fell asleep while sipping milk or any sweet substance compared to those who did not. CONCLUSION: Studies of the cultural/behavioral patterns that may be specific to ethnic subgroups with the highest risk for ECC seem essential to the development of effective prevention strategies.     

上海市1296名3~5岁儿童龋病及其相关危险因素分析

目的 了解上海市3~5岁儿童低龄儿童龋患病情况及相关危险因素,为龋病防治提供参考。方法 根据第4次全国口腔健康流行病学调查要求,采用多阶段分层、等容量随机抽样方法,抽取上海市1 296名4个区、12个幼儿园中3~5岁儿童进行龋病检查,对其家长进行口腔健康知识问卷调查。采用SPSS 21.0软件包进行统计学分析。结果 上海市3~5岁儿童的乳牙患龋率、龋均分别为58.07%、2.99,各年龄组及性别间差异均有统计学意义(P<0.05)。龋病相关单因素分析及多因素Logistics回归分析均显示,饮用甜饮料频率高、睡前吃甜食、刷牙频率少于每天1次、开始刷牙年龄大于2岁、家长受教育程度低及口腔健康知识水平差是患龋的危险因素。结论 上海市3~5岁儿童乳牙患龋率较高,加强儿童的饮食习惯及口腔卫生行为教育,提高家长口腔健康知识水平,是防治儿童龋病的有效途径。