Pattern and severity of early childhood caries

OBJECTIVES: The aim of this study was to investigate the association between selected social and behavioural variables and the pattern and severity of early childhood caries (ECC) within a community child population. METHODS: A cross-sectional sample of 2515 children aged 4-5 years were examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) indices and a self-administered questionnaire was used to obtain information regarding social, demographic, birth, infant feeding, oral and general health attitudes. Children with caries (847) were divided into anterior or posterior caries pattern groups and severe (dmfs score > or =6) or non-severe (dmfs score <6) caries groups. The data were analysed using a chi-square test and modelled using a logistic regression procedure. RESULTS: Significant variables associated with anterior ECC pattern were ethnicity other than Caucasian (OR = 2.1, 95% CI = 1.4-3.1), sipping from the bottle during the day (OR = 1.9, 95% CI = 1.3-2.7), male gender (OR = 1.6, 95% CI = 1.2-2.2) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2). Significant variables associated with severe ECC form were sipping from the bottle during the day (OR = 2, 95% CI = 1.4-2.8), maternal age at birth < or =24 years (OR = 1.8, 95% CI = 1.3-2.7), ethnicity other than Caucasian (OR = 1.6, 95% CI = 1.1-2.5) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2). CONCLUSIONS: Infant bottle-feeding habits (either allowing a child to sip from a bottle during the day or put to sleep at night) and ethnicity other than Caucasian were significant determinants for both anterior caries pattern and severity of ECC in 4-5-year-old Australian children.     

Risk factors for dental caries in the five-year-old South Australian population

BACKGROUND: This study tested the hypothesis that risk behaviours in disadvantaged groups would explain socio-economic inequality in dental caries prevalence among preschool children. METHODS: Using a case-control study, children with caries experience (one or more decayed, missing or filled primary tooth surfaces) and with no caries experience were sampled with known probabilities from among five year olds attending the South Australian Dental Service (SADS). Dental caries experience of primary teeth was recorded by SADS clinicians. Social and behavioural information was collected using a questionnaire mailed to parents. Prevalence rates, prevalence ratios (PR) and 95 per cent confidence intervals (95% CI) were computed, taking into account sampling probabilities. RESULTS: Questionnaires were obtained for 64.6 per cent of sampled children (n = 1398) and 40.2 per cent (95% CI = 37.8-42.6) of them had caries experience. Five statistically significant risk factors were identified relating to previous feeding, current oral hygiene and parent's own oral health perceptions. The prevalence of four risk factors was greater in low-income households compared with high-income households (P < or = 0.01). In multivariate analysis, after adjusting for age of tooth cleaning onset, age at which toothpaste was introduced was not significantly associated with caries prevalence. Behavioural risk factors did not explain income-related gradients in caries prevalence but modified the level of risk associated with delayed onset of tooth cleaning. Children who delayed tooth cleaning until the age of 24 months or more and who were from low-income households had a 2.7-fold increase in caries prevalence (95% CI = 2.1-3.4). CONCLUSIONS: Caries prevention efforts need to target behaviours in infancy and non-behavioural risk factors among preschoolers in low-income households.     

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.     

Factors associated with prevalence and severity of caries experience in preschool children

Abstract – Objectives: The aim of the present study was to examine the prevalence and severity of caries experience in the primary dentition of preschool children and to assess the association of disease distribution with oral hygiene levels, reported oral health behaviours and socio‐demographic factors. Methods: Study samples comprised 1250 3‐year‐old and 1283 5‐year‐old pre‐school children from four distinct geographical areas in Flanders. Information on oral hygiene and dietary habits, oral health behaviours and socio‐demographic variables was collected using questionnaires completed by the parents. Clinical examinations were performed using standardized criteria. Caries experience was recorded at the level of cavitation (d₃ level). Simple as well as multivariable logistic regression analyses were performed in order to identify factors associated with prevalence and severity of caries experience. Results: Visible plaque was present in 31% of 3‐year‐olds and 37% of 5‐year‐olds. In 3‐year‐olds, 7% presented with caries experience while this was the case in 31% of 5‐year‐olds. Multivariable logistic regression revealed significant associations, in 3‐year‐olds, of caries experience with presence of dental plaque (OR = 7.93; 95% CI: 2.56–24.55) and reported consumption of sugared drinks at night (OR = 7.96; 95% CI: 1.57–40.51). In 5‐year‐olds, significant associations were seen with age (OR = 7.79; 95% CI: 2.38–25.43), gender (OR = 0.37 with 95% CI: 0.19–0.71 for girls), presence of visible dental plaque (OR = 3.36; 95% CI: 1.64–6.89) and reported habit of having sugar‐containing drinks in between meals (OR = 2.60 with 95% CI: 1.16–5.84 and OR = 3.18 with 95% CI: 1.39–7.28, respectively for 1×/day and > 1×/day versus not every day). In 5‐year‐olds with caries experience (30.8% of total sample), the severity of disease was further analysed (d₃mft between 1 and 4 versus d₃mft 5 or higher). Multivariable analyses showed a significant association with gender [girls more likely to have higher disease levels; OR = 4.67 (95% CI: 1.65–13.21)] and with presence of plaque (OR = 3.91 with 95% CI: 1.23–12.42). Conclusions: Presence of visible plaque accumulation and reported consumption of sugared drinks were associated with prevalence of caries experience in Flemish preschool children. Severity of disease was associated with gender and with presence of plaque. Results underline the importance of plaque control and diet management from very young age on.     

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.     

Impact of low birthweight on early childhood caries in 6–36 months old infants in Uganda: A cross-sectional study

Objective. Focusing on 6–36 months old infants, this study assessed (1) whether socio-economic status, current anthropometric status, presence of enamel hypoplasia, number of erupted teeth, oral hygiene and consumption of sugared snacks varied between children with normal birthweight (NBW) and low birthweight (LBW) and (2) the association between ECC and birthweight whilst adjusting for covariates of ECC, such as current anthropometric status. Method: A cross-sectional study was conducted in Kampala in 2007, involving 816 child/caretaker pairs. All caretakers completed face-to-face interviews. Children were examined for ECC and enamel defects using WHO (1997) criteria and the developmental defects of enamel (DDE) index. Weight at birth was obtained from hospital records and current anthropometric status was assessed using z-scores for weight-for-length (WLZ), length-for-age (LAZ) and weight-for-age (WAZ). Results. Prevalence of LBW (< 2500 g) and ECC were estimated to 11.5% and 18.1%, respectively. Children with LBW and those with ECC presented with more visible plaque, higher sugar consumption and more current underweight (WAZ < ?2) than children with normal birth weight (NBW) and no caries; 26.7% of LBW vs 17.3% (p < 0.001) of NBW children presented with ECC. Enamel defects (OR = 2.8, 95% CI = 1.6–4.8) and presence of visible plaque (OR = 2.4, 95% CI = 1.3–4.1), but not LBW, were associated with ECC in multiple variable logistic regression analyses. Conclusion. Both LBW and ECC were associated with poor oral hygiene, high intake of sugars and current underweight. Enamel defects were associated with ECC. Adjusting for covariates there were no clear association between LBW and ECC. Studies using a prospective study design are needed for further investigation.     

RISK PREDICTORS OF EARLY CHILDHOOD CARIES INCREMENT—A SYSTEMATIC REVIEW AND META-ANALYSIS

This systematic review aimed to investigate the risk predictors of caries in primary teeth and evaluate their association with the increment of Early Childhood Caries (ECC) among preschool children. This systematic review included only cohort or case-control studies of at least 2 years duration, over 300 participants and with English full-text. Potentially eligible studies were retrieved from 4 electronic databases (Ovid Embase, Ovid MEDLINE; PubMed, Web of Science) from inception to March 1, 2021. Independent screening and data extraction by 2 reviewers to identify factors associated with ECC increment, including family and socioeconomic factors, dietary and oral health-related habits, and clinical parameters. A total of 18 studies from 163 potential reports were included, involving 1,159,226 preschool children. Lower parental education attainment was found associated with ECC increment (WMD:0.87; 95% CI 0.52, 1.21); whereas immigration status (WMD:-0.38; 95% CI -1.09, 0.34), gender (WMD:-0.02; 95% CI -0.28, 0.24), and dental service utilization (WMD:0.35; 95% CI -0.10, 0.79) were not significant factors for ECC increment. All included studies consistently suggested positive correlations between ECC increment and baseline caries experience, plaque level, cariogenic microorganisms, and prenatal and passive smoking, while mixed findings were detected between ECC increment with dietary and oral hygiene practices. Preschool children whose parents have low education level are more likely to have greater increment of ECC over 2 years. Existing caries lesions, increased dental plaque level, cariogenic microorganisms, prenatal or passive smoking were also consistently identified as risk factors for ECC in all reviewed studies. This systematic review highlights specific risk factors to target for the prevention of ECC and supports implementing more oral health promotion for preschool children with parents of lower educational attainment.     

The association between postpartum depression and early childhood caries

Abstract

Objective: To determine whether postnatal depression was associated with early childhood caries (ECC).

Methods: This cross-sectional study was nested in a large cohort study named Born in Guangzhou Cohort Study (BIGCS). Mothers were invited to answer the Chinese version of Edinburgh Postpartum Depression Scale (EPDS) at 11–14?months postpartum. Children’s ECC experience was assessed at 24–37?months old. Socio-demographic factors were collected by a self-completed questionnaire. Chi-square test was used for bivariate analysis, and binary logistic regression was used for multivariable analysis.

Results: Totally 337 mother/children pairs were included into this study. Among them, 33 children had caries experience, accounting for 9.8% of the participants. Mothers with EPDS scores between 7 and 10 were associated with worse ECC experience of their children (adjusted OR = 2.948, 95% CI = 1.209–7.190), whereas mothers with EPDS scores higher than 10 were not associated with ECC experience of their children. Mother’s education and the number of children living together were also associated with children’s ECC experience (adjusted OR = 1.822, 95% CI = 1.013–3.275, and adjusted OR = 1.528, 95% CI = 1.086–2.150, respectively). Other factors such as maternal age at the time of conception, family income, mother’s work status, duration of breastfeeding, and children’s gender did not show effect on children’s ECC experience.

Conclusion: Postnatal depression could be associated with children’s ECC experience. In this study, mothers with slightly depression symptoms were more likely to have adverse effects on their children’s ECC experience.     

Oral problems and quality of life of preschool children: self‐reports of children and perception of parents/caregivers

The purpose of this study was to evaluate the association between oral health problems and oral health‐related quality of life (OHRQoL) of preschool children according to both self‐reports and the reports of parents/caregivers. A school‐based, cross‐sectional study was conducted with 769 preschool children and their parents/caregivers. The OHRQoL was evaluated using the Scale of Oral Health Outcomes for Five‐Year‐Old Children (SOHO‐5). Based on logistic regression for complex samples, the following variables were found to be associated with poorer OHRQoL in the parent/caregiver version: toothache (OR = 6.77; 95% CI: 3.95–11.59); consequences of untreated dental caries (OR = 2.69; 95% CI: 1.27–5.70); and anterior open bite (OR = 2.01; 95% CI: 1.13–3.56). The following variables were associated with poorer OHRQoL in the child self‐report version: toothache (OR = 3.34; 95% CI: 2.11–5.29); cavitated lesions (anterior teeth) (OR = 2.20; 95% CI: 1.26–3.84); occurrence of traumatic dental injury (OR = 1.77; 95% CI: 1.19–2.61); and anterior open bite (OR = 1.95; 95% CI: 1.16–3.29). We conclude that children with dental caries (or its sequelae) had poorer OHRQoL. Having experienced a traumatic dental injury and having a malocclusion were also associated with a poorer OHRQoL.     

Prevalence of early childhood caries among First Nations children, District of Manitoulin, Ontario

Background. Epidemiological studies of Aboriginal communities in Canada and Native American populations in the United States have reported that early childhood caries (ECC) is highly prevalent. The purpose of this study was to determine the prevalence of ECC and dental caries in the First Nations population of 3‐ and 5‐year‐old children in the District of Manitoulin, Ontario to assist in developing effective dental health promotion strategies. Methods. All 3‐ and 5‐year‐old children in elementary schools and day‐care centres in seven First Nation communities were eligible for the survey examination. Three‐year‐old children at home and 5‐year‐old children attending school off‐reserve in six of the communities were also eligible for epidemiological survey examination of oral health status including caries, gingival and soft tissue conditions. Cases of ECC were defined as children with caries or restorations on two or more primary maxillary incisors or canines or those having a total decayed, missing, filled primary teeth (dmft) score of 4 or greater. Results. A total of 87 children (59% 5 years old, 54% females) were examined. Seventy‐four per cent of children had one or more carious lesions. Forty‐five cases of ECC were found, a prevalence of 52%. The mean dmft score for cases was 7·5 (95% CI 6·5–8·4) and 0·8 (95% CI 0·5–1·1) for non‐cases (P < 0·001). Boys in both age groups were more likely to be affected by ECC than girls. Conclusion. Our results indicate that dental caries and ECC are highly prevalent in this population, with ECC cases having 6.7 more dmft than non‐cases.     

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.     

Oral health-related quality of life and early childhood caries among preschool children in Trinidad

Background

Early childhood caries (ECC) is a public health problem in developed and developing countries. The purpose of this study was to describe the relationship between oral health-related quality of life (OHRQoL) and ECC among preschool children in a Caribbean population.

Method

Parents/primary caregivers of children attending nine, randomly selected preschools in central Trinidad were invited to complete an oral health questionnaire and have their child undertake an oral examination. The questionnaire included the Early Childhood Oral Health Impact Scale (ECOHIS). Visible caries experience was assessed using WHO criteria. Logistic regression models were used to determine the factors associated with OHRQoL and ECC.

Results

Three hundred nine parents/caregivers participated in the study (age-range 25–44 years) and 251 children (mean age 3.7 years) completed oral examinations. Adjusting for other factors, the odds for a child aged 4 years of having dental caries were greater than the odds for a child aged 3 years (OR 3.61; 95% CI (1.76, 6.83). The odds for children having difficulty drinking hot or cold drinks were greater for those with dental caries than the odds for children who have no such difficulty. Similarly, the odds for children who had difficulty eating were greater for those with dental caries than the odds ratios for children who had no difficulty eating (OR 8.29; 95% CI (2.00, 43.49). Adjusting for the effects of other factors, the odds of parents/caregivers feeling guilty were greater if their child had experienced dental caries in comparison to parents/caregivers whose child did not have dental caries (OR 3.50; 95% CI (1.32, 9.60). Adjusting for other factors, the odds of parents/primary caregivers having poor quality of life was increased when they had a child with a dmft in the range 1–3 (OR 2.68; 95% CI (1.30, 5.64) dmft?>?4 (OR 8.58; 95%CI (3.71, 22.45), in comparison to those whose child had a dmft?=?0.

Conclusion

In this sample of preschool children OHRQoL was associated with ECC. More negative impacts were found in children with a greater severity of visible caries experience. This suggests the need for strategies to prevent and manage ECC in this Caribbean population.

     

Caries experience and oral hygiene status of blind, deaf and mentally retarded female children in Riyadh, Saudi Arabia.

OBJECTIVE: To determine the caries experience and oral hygiene status in blind, deaf and mentally retarded female children in Riyadh, Saudi Arabia. METHOD: All (N=218) the 6-7-year-old and 11-12-year-old blind, deaf and mentally retarded female children registered with the Presidency of Girls' Education schools in Riyadh were examined for dental caries and oral hygiene in a dental operatory setting. RESULTS: All (100%) the blind 6-7-year-old had caries with a mean dmft score of 6.58 (SD 2.02). The caries prevalence in blind 11-12-year-olds was 88.2% with a mean DMFT score of 3.89 (SD 2.67). Among 6-7-year-old blind children 8.3 %, and in 11-12-year-old blind children 29.4% had good oral hygiene. The caries prevalence in deaf 6-7-year-olds was 95.7% with a mean dmft score of 7.35 (SD 3.51). The caries prevalence in 11-12-year-old deaf children was 93% with a mean DMFT of 5.12 (SD 3.45). Less than one-fifth (17.4%) of the 6-7-year-old deaf children and only 7.0% of 11-12-year-old deaf children had good oral hygiene. The caries prevalence in mentally retarded 6-7-year-old was 93.9% with a mean dmft of 8.00 (SD 4.1). All the mentally retarded 11-12-year-old had carious teeth with a mean DMFT score of 5.81 (SD 2.95). Only 3.1% of the mentally retarded 6-7-year-old and none of the mentally retarded 11-12-year-olds had good oral hygiene. CONCLUSIONS: Caries prevalence and severity in all the three groups of female special children were very high, and the number of children with good oral hygiene was very low.     

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.     

Prevalence of early childhood caries in 3- to 5-year-old children in Philadelphia district, Mpumalanga Province.

INTRODUCTION: Early Childhood Caries (ECC) can be defined as dental caries in preschool children. There is a lack of data on the prevalence of ECC at a global, national, regional and district level. Hence the severity and extent of the disease is unknown. OBJECTIVES: The purpose of the study was to establish the prevalence of ECC among 3- to 5-year-old children from the Philadelphia district in Mpumalanga. METHODS: A cross sectional study was conducted on 269 children aged between 3 and 5 years. The caries status was determined using the decayed, missing and filled teeth (dmft) index as described by WHO 1997. RESULTS The percentage caries free individuals were 74.6%, 44.2% and 46.6% and the dmft values were 0.93, 2.69 and 2.18 for 3-, 4- and 5-year-olds respectively. The mean mt and ft values for 3- and 4-year-olds was zero. Among the 5-year-olds, the mean mt and ft values was 0.01 and 0.02 respectively. CONCLUSION: For a rural community the prevalence of ECC is high. Virtually all caries in preschool children from this community is left untreated. There is a need for a properly planned preventive strategy for this community.     

Severe dental caries is associated with incidence of thinness and overweight among preschool Chinese children

Abstract

Objective: To examine the association of incidence and baseline prevalence of severe dental caries with incidences of thinness and overweight among pre-school Chinese children.

Materials and methods: A longitudinal study design was used. A total of 772 children recruited from 15 kindergartens in Liaoning Province who completed baseline and follow-up assessments were included. The age range of children at baseline was 24.6–71.1 months. BMI-for-age z-score was calculated to estimate incidence of thinness and overweight. Severe dental caries was indicated by pulpal involvement, ulceration, fistula or abscess (pufa). Baseline prevalence of severe caries included children with pufa ≥1, incidence included those who changed from pufa = 0 to ≥1 at follow-up. Logistic regression was constructed to assess the association of baseline prevalence and incidence of severe caries with each of incidence thinness and overweight.

Results: Children with incidence of severe caries had higher odds for incidence thinness (OR: 4.08; 95% CI: 1.08, 15.41). Baseline prevalence of severe caries was not significantly associated with incidence thinness. Participants with severe caries at baseline had higher odds for incidence overweight (OR: 2.33; 95% CI: 1.17, 4.63). The relationship between incidence of severe caries and incidence overweight was insignificant.

Conclusions: The findings suggest a U-shaped relationship between severe dental caries and both ends of anthropometric measures among pre-school Chinese children. The findings highlight the importance of integrating oral and general health promotion policies. Primary health care providers are encouraged to incorporate dental screening, counselling and referral for treatment for severe caries to promote appropriate growth and overall health of children.     

维生素D水平与低龄儿童龋风险的相关性分析

目的探讨维生素D水平与低龄儿童龋(early childhood caries,ECC)发生风险的相关性分析,为ECC儿童的一级预防提供依据。方法收集389名6~48月龄儿童的月龄、喂养方式、口腔健康行为等资料,记录龋、失、补指数(decayed?missing?filled teeth,dmft),分为ECC组(n=146)和无龋组(n=243),采集指尖末梢血检测维生素D体内活性形式--25?羟维生素D[25(OH)D],采集牙菌斑行龋活跃性检验检测龋态(Cariostat)值,Logistic回归分析25(OH)D等龋相关因素与ECC发生风险的相关性。结果25(OH)D缺乏、不足、正常的儿童的患龋率差异无统计学意义(c2=2.320,P=0.313)。dmft与25(OH)D水平之间无相关(dmft=1~3,r<0.001,P>0.05;dmft>3,r=0.009,P>0.05)。而月龄(OR=1.082,95%CI:1.045~1.121,P<0.001)、出生后6个月内母乳喂养(OR=2.789,95%CI:1.581~4.921,P<0.001)、吃夜奶或含乳头睡(OR=4.187,95%CI:1.938~9.048,P<0.001)、1.5~3.0的高Cariostat值(OR=4.173,95%CI:2.014~8.646,P<0.001)是ECC的风险因素。结论25(OH)D水平与6~48月龄儿童龋无相关性,而月龄、出生后6个月内母乳喂养、吃夜奶或含乳头睡、高龋活跃性(Cariostat值1.5~3.0)是ECC的风险因素,提倡母乳喂养的同时,应为幼儿树立良好的喂养习惯及口腔卫生习惯。     

Caries prevalence in 2-year-old children in the city of Zurich

OBJECTIVES: To establish caries prevalence in 2-year-olds in the city of Zurich; and to investigate the relationship between caries prevalence and dietary habits, and oral hygiene practices in native children and children with immigrant background. METHOD: 1,000 randomly selected 2-year-olds were invited to participate in a clinical examination, at which parents were interviewed about the child's oral hygiene and dietary habits. Caries diagnosis was based on visual inspection of all tooth surfaces and included both initial (d1) and cavitated (d2) lesions. Univariate and multivariate logistic regressions for two subgroups of children (children of Swiss and foreign-born mothers) were performed in order to assess the association between predictor variables and caries. RESULTS: 771 children were examined (participation rate 78%; mean age 2.4 years (age range 2.06-2.90 years)). Although the majority (94%) was born in Switzerland, 61% of children had immigrant backgrounds (mother not born in Switzerland). Cavitated teeth (d2mft) were observed in 12.6% of children (95% CI: 10.4-15.1%). Caries including initial lesions (dl2mft) affected 25.3% of children (95% CI: 22.4-28.5%). There were 34 (4.4%) children with severe caries (all maxillary incisors cavitated). For children with caries, the mean d2mft was 4.3 (+/- 2.8). Children with foreign-born mothers (mothers not born in Switzerland) exhibited a significantly higher caries prevalence than those with Swiss-born mothers (17.4% versus 5.0% with d2mft > 0). CONCLUSIONS: Children with foreign-born mothers exhibited significantly higher caries prevalence rates than those with Swiss-born mothers. Poor oral hygiene and night-time bottle use were identified as risk indicators for caries in all children. Further risk indicators identified in children of foreign-born mothers were a preference for sugar-containing non-milk drinks, no pacifier use, child's age and male gender.     

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