Determinants of early childhood caries (ECC) in a rural Manitoba community: a pilot study

PURPOSE: Preschool oral health is often overlooked as an important aspect of childhood health and well-being. The purposes of this study were to: (1) determine the dental status of 3-year-old children in the community of Carman, Manitoba, Canada; and (2) identify the principal determinants of Early Childhood Caries (ECC) in 2 consecutive years. METHODS: All children and mothers attending a preschool health screening fair were invited to participate. Study procedures included a retrospective interview with parents and dental examination of the child. Statistical analyses included ANOVA, chi-square, and multiple regression. A P value of <.05 denoted significance. RESULTS: A total of 61 children participated (mean age=45.7+/-3.4 months). The prevalence of ECC was 44%, while the mean deft was 2+/-3.3. Increased caries activity and ECC were associated with lower maternal level of education (P<.01). Family size was associated with deft scores (P=.03) while the presence of debris was also associated with ECC (P<.05). CONCLUSIONS: ECC prevalence among these 3-year-olds is less than exhibited among other Canadian preschool children. Factors associated with ECC included debris on the primary teeth and low maternal education. Factors most associated with increased caries activity included low maternal education and increased family size. In addition, parents were able to reliably assess their child's dental health status. Larger epidemiological studies of ECC are needed to better assess prevalence and risk factors. Such data may, therefore, assist in identifying those children at greatest risk for ECC. It may also help in the redirection of scarce resources to effective preventive oral health interventions, as these children have an increased caries burden along the continuum of childhood.     

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.     

Caries is the main cause for dental pain in childhood: findings from a birth cohort

Aim: The aim of the study was to evaluate the prevalence of dental pain in preschool children and its association with socioeconomic, demographic, clinical, and behavior variables. Subjects and Methods: The study was nested in a population-based birth cohort from Pelotas, Brazil, started in 2004. A sample of 1,129 children aged 5 years was dentally examined, and their mothers were interviewed. Exploratory variables included demographics, socioeconomic status, mothers' oral health status and associated behaviors, and caries in primary teeth. Data were analyzed using multivariable Poisson regression. Results: The prevalence of dental pain was 16.5% (95% CI: 14.4-18.8). Multivariate analysis showed that dark-skinned children (prevalence ratio, PR = 1.6, 95% CI: 1.1-2.4) from low socioeconomic level (PR 1.9, 1.2-3.0) whose mothers had less than 4 years of education (PR 1.9, 1.0-3.6), from mothers with less than 10 teeth in at least one arch (PR 1.7, 1.2-2.5) and less than 10 in two arches (PR 1.6, 1.0-2.6), and those with high caries prevalence at the age of 5 years (PR 4.8, 3.3-7.1) were more likely to experience dental pain. Conclusions: Unrestored caries is the main factor associated with dental pain in childhood. Socioeconomic aspects and family context in which dental pain occurs should also be taken into account when dental pain preventive measures are implemented.     

Determining the prevalence and risk factors for early childhood caries in a community dental health clinic

PURPOSE: The purposes of this study were to: (1) determine the prevalence of early childhood caries (ECC) among young children accessing dental services at a community dental clinic; (2) identify factors associated with the presence of ECC; and (3) determine the percentage of children who received treatment for ECC in this setting and the number who required referral to specialists. METHODS: The study population comprised children younger than 72 months attending the clinic between 1991 and 2004. A chart review was conducted. RESULTS: Eight hundred thirty-four charts met inclusion criteria; 71% had ECC, while the mean deft was 3.7+/-3.9 (SD). The average age at the first visit was 50.0+/-12.7 (SD) months. Those with ECC were significantly older at the first visit (P<.001), and the prevalence increased with family size (P=.011) and number of siblings (P=.019). ECC children were significantly more likely to come from households with lower monthly incomes (P=.033). The prevalence of ECC did not vary according to specific areas in Winnipeg where children resided (P=.20). CONCLUSIONS: Key risk factors for ECC included: (1) the child's sex; (2) low monthly income; (3) whether the child resided with both parents; and (4) a history of foiled dental visits. These data may assist in identifying children at greatest risk for ECC and may help public health agencies develop appropriate prevention strategies, including promoting early dental visits for infants.     

Dental caries status of children with bronchial asthma

The purpose of the present study was to determine the dental caries status in children with bronchial asthma and to examine the correlation with the severity of asthma and the form of medication being taken. Two hundred and five asthmatic children of both sexes from three to eighteen years old participated in this study. Children were divided into groups: primary, mixed and permanent dentitions. They were also grouped depending on the severity of asthma into mild, moderate and severe asthma and depending on the form of medication being used into inhaler, syrup, tablet and combination group. In the primary dentition group, the asthmatic children had a mean deft of 5.02 +/- 3.05 and a caries prevalence of 75.75%, in the mixed dentition group, the mean deft was 3.45 +/- 2.89 and mean DMFT was 4.83 +/- 3.66 with a caries prevalence of 78.31%. In the permanent dentition the mean DMFT was 5.17 +/- 4.54 and a caries prevalence of 83.15%. Asthmatic children had a high caries prevalence and it increased with the severity of bronchial asthma. The caries prevalence was highest in those taking medication in the form of syrup.     

Dental caries experience and use of dental services among preschool children in Ajman, UAE

OBJECTIVE: The aim of this study was to estimate the prevalence and severity of dental caries in the primary dentition of young children in Ajman, UAE, and investigate its association with sociodemographic characteristics and use of dental services. METHODS: A cluster-sampling approach was used to randomly select children aged 5 or 6 years who were enrolled in public or private schools. Clinical examinations for caries were conducted by a single examiner using World Health Organization criteria. Parents completed questionnaires seeking information on socioeconomic background and dental service utilization. Zero-inflated negative binomial (ZINB) regression modelling was used to identify risk markers and risk indicators for caries experience. RESULTS: The prevalence of dental caries in the sample was high 76.1%. The average dmfs score 10.2. Caries severity was greater among older children and among male children of less educated mothers. Emirati (local) children had higher caries severity than others. Children who had higher level of caries visited the dentist more frequently than other children whose visits were for check-up only. CONCLUSIONS: Dental caries prevalence and severity in young children in Ajman are high, and socioeconomic characteristics and dental utilization are important determinants of their dental caries experience. There is an urgent need for oral health programmes targeted at the treatment and underlying causes of dental caries in these children.     

Socioeconomic inequalities in the distribution of dental caries in Brazilian preschool children

Objectives: This study assessed the inequality in caries distribution and the association between socioeconomic indicators and caries experience of preschool children in a city in Brazil. Methods: A cross‐sectional study in a multistage random sample of 455, 1‐5‐year‐old children was conducted on National Children's Vaccination Day in Santa Maria, Brazil. Calibrated examiners evaluated the prevalence of dental caries and parents provided information about several socioeconomic indicators by means of a semi‐structured questionnaire. Data were analyzed using Poisson regression model. Results: The caries prevalence was 23.5 percent and the means for the decayed, missing and filled primary teeth was 0.8. A high inequality in the caries distribution with Gini coefficient of 0.8 and Significant Caries Index of 2.8 was observed. The oldest children, non‐white, with mothers having low level of education and from low household income had the highest prevalence of dental caries. Conclusion: Socioeconomic factors are strong predictors for the inequality in caries distribution in Brazilian preschool children.     

Dental caries experience and factors among preschoolers in southeastern México: a brief communication

OBJECTIVE: To examine the association between dental caries prevalence and selected variables in preschool children. METHODS: A cross-sectional study was carried out with 1,303 preschoolers (ages 3-6 years old), and the mothers completed questionnaires. The children were examined by one of three standardized dental examiners. Logistic regression was performed to identify associations between dental caries and other factors. RESULTS: Mean dmft was 1.54+2.47, with 44.1% of children having dmft>0. Caries prevalence was associated with older children (OR=1.39); medium (OR=1.66) and low (OR=2.41) socioeconomic levels; mediocre (OR=1.71) and inadequate (OR=2.25) hygiene; negative attitude toward oral health (OR=1.51); and the presence of enamel defects (OR=1.74). CONCLUSION: Both overall caries prevalence and dmft index were relatively low. The results of this study substantiate previous reports in the international literature for clinical, behavior, socio-demographic, and socio-economic variables that contribute to dental caries in Mexican children.     

Social aspects of dental caries in the context of mother-child pairs

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social.

Objective

Investigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study.

Material and methods

This research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (χ2) and by discriminant analysis.

Results

The final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001).

Conclusions

The results suggest that the caries experience in children depended less on the family social variables than on the maternal NDT.     

Allergic rhinitis, feeding and oral habits, toothbrushing and socioeconomic status. Effects on development of dental caries in primary dentition

The aim was to determine the effect of feeding and oral habits, toothbrushing, socioeconomic status and allergic rhinitis on the development of dental caries in primary dentition. In a cross-sectional study, data were obtained by means of a structured questionnaire on 1,160 children, 4-5 years old (mean = 4.5 +/- 0.5) and born in 1999, 2000 or 2001. The children also had a physical examination by an allergist and dentists. Dental caries was diagnosed according to WHO criteria. Caries experience was measured as number of deft and defs. Logistic regression analysis assessed the association between dental caries and independent variables. The dental caries prevalence was 17.9%, 28.8% of the children had allergic rhinitis symptoms, digit sucking was reported by 9.8% and pacifier use by 13.6% of the children. The mean number of deft of the sample was 1.02 (SD = 2.37) and that of defs was 1.33 (SD = 3.54). Analysis showed that breast-feeding for >12 months (p < 0.01), toothbrushing frequency (p < 0.01), sugar consumption (p < 0.01) and pacifier use (p < 0.01) each had a significant association with dental caries occurrence in primary dentition. Children with pacifier use and allergic rhinitis had more than double the risk of dental caries development. Allergic rhinitis alone has no effect on dental caries. Healthcare professionals attempting to limit dental caries should consider the effect of prolonged breast-feeding, sugary product consumption between meals and nonnutritive habits on dental caries.     

Association between obesity and dental caries in a group of preschool children in Mexico

Objective: The aim of this study was to determine the association between obesity and caries by utilizing the data of a cohort of preschool children aged 4‐5 years. Methods: Data were obtained from a cohort of 1,160 children. Dental caries detection was performed according to the World Health Organization criteria. The caries index was measured as the number of decayed (d), extracted (e), and filled (f) teeth (t) (deft), or surfaces (defs). The body mass index (BMI) in units of kg/m² was determined, and children were categorized according to age‐ and gender‐specific criteria as normal weight (5th‐85th percentile), at‐risk overweight (≥85th‐<95th percentile), and overweight (≥95th percentile). Odds ratios were determined for at‐risk overweight and overweight children using logistic regression. Results: The prevalence of dental caries was 17.9 percent. A slightly higher percentage of dental caries was found in boys (19.6 percent) than in girls (16.4 percent). From the total sample, the mean BMI was 17.10 ± 3.83. Approximately 53.7 percent of children were classified as normal weight, 14.2 percent as at‐risk overweight, and 32.1 percent as overweight. At‐risk overweight children were higher among girls (17.1 percent) than among boys (11.3 percent). When adjusted for covariates, the logistic regression model showed that there was a significant association between at‐risk overweight children (P < 0.001), overweight children (P < 0.001), and caries in the primary dentition. Mean (SD) deft value of the sample was 1.08 (2.34), while the corresponding defs value was 1.43 (3.29). Conclusion: Obesity appears to be associated with dental caries in the primary dentition of preschool Mexican children.     

The efficacy of a school-based caries preventive program: a 4-year study

Abstract:  This longitudinal study aimed at testing the efficacy of a school-based caries preventive program, by comparing dental caries status of two groups, a study group (436 children) and a control group (420 children) over a period of 4 years. The study group received a preventive program which consisted of intensive oral hygiene instructions sessions, and supervised daily tooth brushing using fluoridated tooth paste in schools. The control group received only oral hygiene instructions sessions. Annual dental examination to record dental caries status, using Decayed Missed Filled Teeth Index (DMFT) and deft, was conducted for both groups over a period of 4 years. At the end of the fourth year the efficacy of the program was tested by comparing the DMFT and deft indices for the two groups using Pearson chi-square test and Cochran–Mantel–Haenzele test. The level of significance was set at P  < 0.05. The results after 4 years showed that the caries status of the children in the study group was better than that of the control group. The difference was statistically significant ( P -value 0.001). The estimates of relative risk values also showed that children in the control group are 3.1 and 6.4 times at higher risk of having dental caries than those in the study group for age group 12 and 6 respectively. This study proves that supervised daily tooth brushing using fluoridated toothpaste is successful in controlling dental caries in children.     

Dental caries among urban schoolchildren in Madagascar

Abstract An epidemiological survey of prevalence and severity of dental caries was carried out in an urban population of children in Madagascar. The study population comprised 1257 children in the age groups 4–5 yr to 14–15 yr equally distributed by sex. The children were examined according to the recording system for the Danish Child Dental Services. The caries experience in the primary dentition as well as in the permanent dentition was high. For example, among 6-yr-olds a mean number of 11.8 defs and 5.2 deft was observed and 82% of the children were affected by caries in primary teeth. In particular, primary molars in the mandibular and incisors in the maxilla were affected and approximate caries was frequent. Among 12-yr-olds mean DMFS was 4.0 and DM FT 2.4 and 75% of the children had caries in permanent teeth. In permanent teeth caries was located predominantly to mandibular molars and occlusal surfaces. In both dentitions almost all decay was untreated, indicating lack of dental treatment available due to the shortage of dental manpower. The establishment of a child dental service system is a matter of urgency. Dental health education and primary health care should be organized.     

Ethnicity and the 'TJZ' decision

The aim of this study was to assess differences in oral health and dental behaviour in a cohort of five-year-old children born in 1982 and a cohort of eleven-year-old children born in 1976, in different ethnic and socio-economic groups, in the period from 1987 to 1990. To this end a secondary analysis was performed on data collected in a study monitoring the oral health of sick fund insured youths in The Netherlands. Large differences in dental health and dental health behaviour were found between ethnic and socio-economic strata. Thus, in the 1982 cohort, the caries prevalence and incidence were highest in the stratum of children of Turkish or Moroccan mothers with a low or unknown education. In the 1976 cohort, the caries prevalence and incidence were highest in children of Dutch parents with a low or unknown education. It is concluded that both stratification variables were caries risk indicators.     

Caries in preschool children and its risk factors in 2 provinces in China.

OBJECTIVE: To determine the current prevalence and severity of caries in primary dentition in a preschool population in 2 provinces in China, and to investigate the relationship between caries experience and sociodemographic factors, parental characteristics, dietary habits, and oral hygiene practice. METHOD AND MATERIALS: A cross-sectional survey was conducted on a representative sample of Chinese preschool children aged 3 to 5 years. Clinical examinations were carried out on 2,014 children using the method and criteria established by the World Health Organization. Structured questionnaires for information related to the sociodemographic background, oral hygiene practices, and dietary habits of the children were completed by their mothers. RESULTS: Overall, 45% of children were caries free, and 14% had rampant caries. The mean dmft and dmfs values were 2.57 and 4.25, respectively. The caries prevalence and severity increased with age. The children from rural areas brushed their teeth less regularly and had a higher level of caries experience than those from urban areas. Significant predictors of caries experience were location, area, age, mother's education level, and consumption of fruit juice from a feeding bottle. CONCLUSIONS: These data indicate that a high proportion of young Chinese children had dental caries and that most decayed teeth were left untreated. The prevalence and severity of caries was associated with socioeconomic status and dietary factors in this sample of children.     

Dental caries in the Netherlands at the turn of the century

In this paper an overview is given of recent studies concerning the prevalence of dental caries in children and adults in The Netherlands. Compared to the oral status in the past, the prevalence in children is still low. The decrease of caries is now also visible in adults up to the age of 45 years. The caries experience of people in older age categories is still high. A significant relationship was found between caries prevalence in children and level of school education of the mother and between caries experience of adults and their level of school education. A relatively high caries prevalence was found in children whose mothers were born in Turkey or Morocco. On the other hand, adults born in these countries had a lower caries experience than native Dutch adults.     

Parental reports of the oral health-related quality of life of children with cerebral palsy

ABSTRACT: BACKGROUND: The severity of physical and mental impairments and oral problems, as well as socioeconomic factors, may have an impact on quality of life of children with cerebral palsypalsied (CP).) children. The aim of this research was to assess the impact of impairments and oral health conditions, adjusted by socioeconomic factors, on the Oral Health-Related Quality of Life (OHRQoL) of children with CP using their parents as proxies. METHODS: Sixty children, between 6-14 years of age were selected. Their parents answered a children's OHRQoL instrument (5 domains) which combines the Parental-Caregivers Perception Questionnaire (P-CPQ) and Family Impact Scale (FIS). The severity of dental caries, type of CP, communication ability, gross motor function, seizures and socioeconomic conditions were assessed. RESULTS: Considering the total score of the OHRQoL instrument, only the reduction of communication ability and dental caries severity had a negative impact on the OHRQoL (p<0.05). Considering each domain of the instrument, the severity of the type of CP and its reduction of communication ability showed a negative impact on oral symptoms and functional limitations domains (p<0.05). Seizures have a negative impact on oral symptoms domain (p=0.006). The multivariate fitted model showed that the severity of dental caries, communication ability and low family income were negatively associated with the impact on OHRQoL (p#0.001). CONCLUSIONS: The severity of dental caries, communication ability, and family income are conditions strongly associated with a negative impact on OHRQoL of children with CP.     

The overtime effect of social position on dental caries experience in a group of old-aged Danes born in 1914

OBJECTIVES: The purpose of this study was to analyze the life-course effects of education, occupation, and income at ages 70, 75, 80, and 85 years, respectively, on dental caries experience of 85-year-olds. METHODS: The present study includes follow-up data from a population-based study, which comprised a sample of 176 individuals aged 85 years. Data on social position were collected at ages 70, 75, 80, and 85 years by means of structured personal interviews. Clinical oral health examinations were conducted to obtain data on dental caries at age 85. Dental caries was recorded at tooth surface level and caries experience was expressed by the DMF Index: the decayed tooth surfaces (D component), missing tooth surfaces (M component), and filled tooth surfaces (F component). RESULTS: The participants in the present study demonstrated a high level of dental caries experience; the prevalence rate for active dental caries (D-S) was 80 percent. Older adults with low education, low occupational status, and poor income tended to have more active dental caries compared to their counterparts. In contrast, individuals with high education (F-S = 35.5) and high occupational status (F-S = 36.0) had significantly more filled surfaces than persons with low education (F-S = 24.0) and low occupational status (F-S = 25.6). Individuals with high income at ages 75, 80, and 85 years had more filled surfaces (F-S = 31.9, 33.2, 34.1) compared to persons with low income (F-S = 25.5, 23.5, 22.8). CONCLUSION: The study identified social inequalities across age among the very old individuals in relation to dental caries experience.