上海嘉定区582例2~3岁儿童乳牙龋病及相关因素分析

目的 分析上海嘉定区2～3岁儿童乳牙龋病及相关因素,为开展学龄前儿童的龋病防治工作提供依据,降低乳牙龋病发病率.方法 采用随机整群抽样的方法,对嘉定区2个社区的582例2～3岁儿童进行口腔检查,检查内容包括乳牙萌出情况及龋患情况,并对其家长进行问卷调查,包括幼儿的口腔卫生行为和饮食习惯等,调查数据采用SPSS20.0软件进行统计分析.结果 582例受检儿童中,患龋率48.45％,龋均为2.21,男女患龋率分别为50.00％和46.81％,男性高于女性,差异具有统计学意义(P＜0.001).随着日刷牙次数的增加,乳牙患龋率明显下降(P＜0.05).乳牙龋与喂养方式有关,完全母乳患龋率最低39.55％,人工喂养患龋率最高60.54％.结论 嘉定区2～3岁儿童乳牙龋病严重,每日糖摄入次数,刷牙次数和喂养方式与龋病密切相关,应加强龋病防治措施.     

Early childhood caries: analysis of psychosocial and biological factors in a high-risk population

The influences that link social factors and caries development are not well understood, although mediation by stress has been suggested. The association between caregiver stress and early childhood caries (ECC), in particular, remains unclear. The purpose of this study was to examine the relationships between parenting stress and ECC while controlling for behavioral and biological factors in a high-risk population. One hundred and fifty healthy children aged 18-36 months were examined in a cross-sectional study design. Parental interviews were conducted to obtain demographic, oral health behavior and parenting stress data. Clinical data included parent and child bacterial measures, fingernail fluoride analyses, caries prevalence and presence of child enamel hypoplasia. Bivariate analyses revealed that parenting stress predicted caries. Multivariate analyses demonstrated that a combination of psychosocial, behavioral, temporal and biological variables predicted ECC outcomes. Total parenting stress did not contribute independently to the best prediction model. Our findings suggest the need for the development of a multidimensional stress model that considers the parent-child dyad to elucidate further the link between psychosocial factors and ECC.     

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

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

Oral health of young children in Mississippi Delta child care centers: a second look at early childhood caries risk assessment

Objectives: To identify the predictors of early childhood caries and urgent dental treatment need among primarily African‐American children in child care centers in the Delta region of Mississippi. The purpose of this study was to replicate predictors of caries and urgent dental treatment needs that were identified in an earlier study conducted in Delta child care centers and to assess additional caries risk factors not collected in the original study. Methods: Children in 19 child care centers were examined by the dentists, and the parents provided data on oral health practices, oral health history, and on children's oral health‐related quality of life (QOL). The dentists also assessed visible plaque and tested levels of mutans streptococci. Predictors of caries and treatment need among children 24 to 71 months of age were examined using logistic regression. Results: Two parent predictors of caries identified in the earlier study (parent flossing and soft/sugary drink consumption) were not predictive in the current study. Parent history of abscess continued to predict their child's urgent need for treatment. Young children's level of salivary mutans streptococci, maxillary incisor visible plaque, and parents' reports of child oral health‐related QOL measures predicted the presence of both caries and urgent treatment need. Some expected predictors, such as frequency of child's toothbrushing, were not predictive of caries. Conclusions: Parental abscess and parent's report of the child's oral health‐related QOL are risk indicators for poor oral health outcomes that could be used by nondental personnel to identify young children in need of early preventive intervention and dental referral.     

Dental fear and oral health and family characteristics of Finnish children

Objectives: Our aim was to describe the occurrence of dental fear among Finnish children of different ages and to ascertain how oral health and family characteristics are associated with dental fear. Methods: The subject groups were aged 3, 6, 9, 12, and 15 years in two middle‐sized cities, and the 1474 participants were distributed over fairly equal samples of each age. A questionnaire given to each child to be filled out at home enquired about social background, oral hygiene habits, diet, and dental fear. Oral health status was examined clinically and radiographically by two calibrated dentists. Multiple logistic regression analyses were performed for each age group in order to study the associations between dental fear and selected factors. Results: Dental fear was higher among 12‐ and 15‐year‐old children than among the younger ones. Pain, drilling, and local anesthesia were reported to be the most frightening aspects. Excluding the 12‐year‐olds, children whose family members reported dental fear were more likely to report dental fear than children whose family members did not report dental fear. Six‐ and 12‐year‐olds who had experienced caries were more likely to report dental fear than were caries‐free children. Among 6‐year‐olds, father's education modified the effect of a child's caries experience on child dental fear. Frequent intake of sugary items and a limit on eating candies to only one day per week were associated with higher dental fear. Conclusions: Fear of dental treatment is still fairly common among Finnish children, and the factors associated with it differ with the age of the child.     

Income gradients in oral health according to child age

This study aimed to confirm whether the well‐known income disparities in oral health seen over the life course are indeed absent in 9‐ to 11‐yr‐old children, and to explore the role of access to dental care in explaining the age‐profile of the income gradient in child oral health. We used data from the 2007 United States National Survey of Children's Health. Income gradients in parental reports of children's decayed teeth or cavities, toothache, broken teeth, bleeding gums, and fair/poor condition of teeth were assessed in stratified analyses according to age of child (1–5, 6–8, 9–11, 12–14, and 15–17 yr), using survey logistic regression to control for family‐, parental‐, and child‐level covariates. Health insurance status and use of preventive dental care were the indicators for children's access to dental care. The adjusted ORs for the effect of family income on having decayed teeth or cavities, toothache, and fair/poor condition of teeth were not significant in 9‐ to 11‐yr‐old children. Different age‐patterns were found for broken teeth and bleeding gums. The attenuation of the income gradients in having decayed teeth or cavities, toothache, and fair/poor condition of teeth, previously seen in 9‐ to 11‐yr‐old children, was also seen in 15‐ to 17‐, 12‐ to 14‐, and 6‐ to 8‐yr‐old children, respectively, after controlling for children's access to dental care. This study supports the attenuation of income inequalities in oral health in 9‐ to 11‐yr‐old children. Access to dental care could attenuate income gradients in oral health in other age groups.     

Parental stress as a predictor of early childhood caries among preschool children in India

International journal of Paediatric Dentistry 2013; 23: 160–165 Background. The health and well‐being of children are linked to their parents’ physical, emotional and social health in addition to child‐rearing practices. Objectives. To investigate the association of parental stress as a risk indicator to early childhood caries (ECC) prevalence among preschool children of Moradabad, India. Methods. A case–control study was conducted among 800 preschool children [400 cases (caries active) and 400 controls (caries free)] aged 4–5 years along with their parents. Using the Parental Stress Index‐Short Form (PSI/SF), we determined the stress of primary caregivers of young children. These children were clinically examined for dental caries using Dentition Status and Treatment needs. Student’s t‐test, Pearson’s correlation and linear regression were used for statistical analysis. Results. An overall mean parenting stress index was found to be 193.48 ± 59.63. Significantly higher mean stress scores were obtained among cases than among controls. Parental stress was significantly correlated with dmft scores and it was found to be one of the best predictors of ECC. Conclusion. This study provides data to suggest that parental stress has a pervasive impact on the children’s oral health. The practitioners should be aware of this possible relationship and be prepared to provide appropriate intervention.     

A longitudinal study of early childhood caries risk,dental caries,and life style

The objectives of this longitudinal study were to assess children's caries risk and mean number of decayed teeth and determine their life style factors that influence their caries activity. A total of 283 children were selected based on the following criteria: they had 1.5, 2.5, and 3.5-year-old oral examinations, participated in Cariostat microbial sampling and the mother of a child filled out the questionnaires. Caries experiences of children were 2.1% for the 1.5-year-old, 8.1% for the 2.5-year-old, and 14.8% for 3.5-year-old period, respectively. Caries risk at the 1.5-year-old period showed significant differences (P<0.001) for mean number of decayed teeth when children were at the 2.5-, and 3.5-year-old period. A significant difference (P<0.01) was also seen for caries risk at the 2.5-year-old period. Regarding children's lifestyle factors at the 1.5-year-old period, pre-chewing food and breastfeeding produced significant caries susceptibility in both 2.5- and 3.5-year-old period. Additionally, children's life styles were analyzed to have an impact on caries only at the 2.5-year-old period. For children's life style at the 2.5-year-old period, increased frequency of snack, irregular snack time, and brushing without assistance by the mother put 3.5-year-old children at high risk of developing caries. A caries activity test could predict 2.5-, and 3.5-year-old children's caries risk based on the 1.5-year-old test result. Some children's life styles at an early age showed a higher risk of developing caries at a later age.     

Dental caries and externalizing behaviour problems in a high‐risk child population

The aim of this study was to assess the association between externalizing behaviour problems and dental caries in children. A further objective was to explore direct and indirect pathways between sociodemographic factors, family functioning and parenting factors, oral health behaviours, externalizing behaviour problems, and dental caries using structural equation modelling. Cross‐sectional data were collected on 251, 5‐ to 8‐yr‐old children from a paediatric dental practice in the Netherlands. Children's decayed, missing, and filled primary teeth (dmft) scores were obtained from their dental records. Validated self‐report questionnaires were used to collect sociodemographic, behavioural, and family‐related data. Externalizing problem behaviour was significantly associated with a higher dmft score [incidence risk ratio (IRR) = 1.19; 95% CI: 1.06–1.34], but this association did not remain significant after adjustment for sociodemographic factors (IRR = 1.11; 95% CI: 0.99–1.26). A valid path model was presented after applying some modifications. Findings from the model suggest that it is plausible that child behaviour problems are directly associated with dental caries via toothbrushing behaviour. The model also provided support that maternal education level, the restrictiveness and warmth of parenting, and the communication of the family, play an indirect role in the association between children's externalizing behavioural problems and dental caries experience.     

Caries prevalence and severity in urban Fijian school children

Objectives. To determine the prevalence and severity of dental caries in a sample of urban Fijian school children. Design. Cross‐sectional. Sample and methods. Children aged between 6 and 8 years who attended one of four primary schools in different localities of Suva completed self‐report questionnaires and were examined for dental caries. Results. A total of 704 children (response rate = 72·4%) returned questionnaires and were examined dentally. The prevalence of dental caries in the primary dentition was 87·6% and in the permanent dentition, 46·7%. The mean dfs and mean DFS were 8·43 (SD 7·82) and 2·38 (SD 1·37), respectively. High caries prevalence and severity were associated with infrequent brushing, snacking on sugar‐containing foods, having seen a dentist before, and having last visited a dentist because of pain. Conclusions. The caries prevalence of the sample was comparable with findings from a national oral health survey conducted in 1985/86, but the caries severity was greater. As in other developing countries, this may be due to an increased availability of refined sugar products without a concurrent rise in oral health awareness. The study findings contribute to the overall picture of Fijian school children's dental health.     

Dental caries status of Cambodian children and the effects of living environment factors

PurposeThe present survey examined the need for dental treatment for caries among Cambodian children as well as the living environments of such children. Then, based on the results we assessed whether education programs aimed at caries prevention are required in Cambodia.MethodsBetween 2010 and 2012, 1893 children (age: 3, 5, or 12 years), who were living in Siem Reap Province or Phnom Penh, the capital of Cambodia, were subjected to oral examinations and a survey. Then, the relationship between the prevalence of caries among the children and living environment factors was examined based on the survey data.ResultsThere was no significant difference in the prevalence of caries between Siem Reap Province and Phnom Penh. The mean prevalence rate of caries and the children's mean df tooth index (dft) and decay-missing-filled tooth (DMFT) scores were higher than those seen in Japan in all age groups. The proportion of treated teeth was low in all age groups, which suggested that a number of children had not consulted dentists. Many of the children regularly ate snacks containing sugar, which are closely associated with caries.ConclusionProviding dental health education for parents and appropriate brushing advice for children would probably reduce the incidence of caries among Cambodian children. It is necessary to establish systems for preventing dental disorders in Cambodia as promptly as possible.     

The attitudes of parents toward the oral health of children and their reflection on the non-cavitated caries lesions

ObjectiveTo determine the extent of non-cavitated caries lesions in preschool children, and compare its relationship with socioeconomic status, oral and dental health practices, knowledge of caries prevention, and nutrition.Materials and methodsNinety-seven parents of 36–72 month-old children completed a questionnaire on the socioeconomic status of the family, parent's knowledge of caries prevention, the children's oral health practices, and nutrition. In the children, the cavitated dental caries were assessed according to World Health Organization (WHO) criteria and non-cavitated caries lesions on occlusal and smooth surfaces were evaluated by Universal Visual Scoring System (UniViSS). Statistical analysis was conducted using the SPSS software program. The relationships between variables were assessed using the chi-square test and logistic (ordinal) regression analysis.ResultsStatistically significant results were obtained relating to the parents' age, number of children, the time of first oral hygiene, frequency of tooth brushing, knowledge of caries prevention, drinks most often consumed by the children, and number of non-cavitated lesions. According to the regression model, the significant variables were caries activity (yes), drinks most often consumed by the children (milk–juice; juice–buttermilk), the frequency of tooth brushing (once a day, twice a day), observed changes in a child's teeth (change in color and breaks in teeth), the number of cavitated caries lesions and decayed, missing and filled teeth (dmft).ConclusionsThe primary factors contributing to non-cavitated caries lesions include the time of first oral hygiene and frequency of tooth brushing. The early diagnosis of non-cavitated caries is essential for preventive measures.     

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.     

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.     

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。     

Impact of dental caries on quality of life among preschool children: emphasis on the type of tooth and stages of progression

The aim of this cross‐sectional study was to evaluate the impact of dental caries on the quality of life of preschool children and their parents/caretakers, with an emphasis on the type of tooth and stage of progression. A randomly selected sample of preschool children, 3–5 yrs of age, underwent an oral examination for the assessment of dental caries using the International Caries Detection and Assessment System II (ICDAS II) criteria. Parents/caretakers answered two questionnaires, one on the oral health‐related quality of life (OHRQoL) of the child [the Early Childhood Oral Health Impact Scale (ECOHIS)], and the other on the socio‐economic characteristics of the family. Statistical analyses were performed using the chi‐square test, Kruskal–Wallis test, Mann–Whitney U‐test, and Poisson regression. A total of 451 preschool children participated in the study. The majority of carious lesions exhibited severe decay (60.6%) and were found in both anterior (incisors/canines) and posterior (molars) teeth. The final Poisson model revealed negative impacts on quality of life from more advanced stages of dental caries, both in incisors/canines and molars. Child's age and household income were also associated with impact on quality of life. Carious lesions in more advanced stages of progression in anterior and posterior teeth were associated with a negative impact on the quality of life of preschool children.     

Hardness and microstructure of Ti-15Mo-5Zr-3Al alloy for dental casting

The purpose of the study was to assess the outcome of school‐based oral health education (OHE) and a sugar‐free chewing gum program on the oral health status of children in terms of reduced caries increment and gingival bleeding over a period of 2 years. Nine primary schools randomly chosen from one district were divided into three groups: OHE group (Group E), sugar‐free chewing gum in addition to OHE group (Group G), and the control group (Group C). All children of grade 1 (aged 6–7 years) were recruited (n?=?1342). After 2 years, 1143 children remained in the study group at follow‐up. The overall drop‐out rate was about 15%. Data on dental caries and gingival bleeding were collected by clinical examination. The results showed that the mean increment of DMFS in Group G was 42% lower than in groups E and C (P?P?P?P?相似文献   

Socioeconomic and clinical factors associated with caregivers' perceptions of children's oral health in Brazil

Piovesan C, Marquezan M, Kramer PF, Bönecker M, Ardenghi TM. Socioeconomic and clinical factors associated with caregivers’ perceptions of children’s oral health in Brazil. Community Dent Oral Epidemiol 2011; 39: 260–267. © 2010 John Wiley & Sons A/S Abstract – Objectives: We assessed how socioeconomic and clinical conditions could affect parents’ perceptions of their child’s oral health. Methods: A cross‐sectional study was conducted in a sample of 455 children, aged 1–5 years, representative of Santa Maria, a southern city in Brazil. Participants were randomly selected among children attending a National Day of Children’s Vaccination. Clinical examinations provided information on the prevalence of caries, dental trauma, and occlusion. The caregivers’ perception of children’s oral health and socioeconomic status were assessed by means of a questionnaire. A Poisson regression model using robust variance (Prevalence ratio: PR; 95% CI, P ≤ 0.05) was performed to assess the association between the predictor variables and outcomes. Results: Parents were more likely to rate their child’s oral health as ‘poor’ if the former earned a lower income and the latter had anterior open bite and dental caries. Parents of black children with anterior open bite and dental caries were more likely to rate their child’s oral health as ‘worse than that of other children’. Conclusions: Clinical and socioeconomic characteristics are significantly associated with parents’ perceptions of their child’s oral health. Understanding the caregivers’ perceptions of children’s oral health and the factors affecting this could be useful in the planning of public health polices, in view of the inequity in the oral health pattern.