同一个体乳牙列龋与恒牙列龋的相关性研究

目的：探讨同一个体乳牙龋与其年轻恒牙龋之间是否具有相关性，是否可以通过乳牙龋预见其恒牙龋的发生。方法：对293名5～6岁替牙期的儿童进行4年的跟踪调查，记录其在1999年和2003年时的乳、恒牙患龋情况，并进行统计学分析。结果：乳牙列龋与恒牙列龋之间相关性存在统计学意义。结论：乳牙列患龋严重的儿童，其恒牙患龋的可能性相对增高，可达乳牙列无龋者的4倍。特别是乳磨牙龋对其恒牙龋更具有预见价值。     

Maternal periodontitis and adverse pregnancy outcomes

Abstract – Objectives: Maternal periodontal diseases have been associated with increased risk of preterm birth and restricted fetal growth among relatively low socioeconomic groups. Whether the association can be generalized to middle‐class populations remains uncertain. We evaluated periodontitis in relation to preterm birth (<37 weeks’ gestation) and small‐for‐gestational‐age (SGA, birth weight below the 10th percentile of birth weight for gestational age) among a group of medically insured women. Methods: We conducted a prospective study among participants of Project Viva, a US cohort study of pregnant women and their offspring from 1999 to 2002. Pregnancy outcomes were obtained from medical records. Self‐reported periodontitis was assessed during the second trimester of pregnancy, and validated against radiographs. Logistic regression analyses were employed to evaluate the association of periodontitis with pregnancy outcomes adjusted for age, race/ethnicity, smoking status, income, frequency of dental check‐ups, prepregnancy body mass index, pregnancy weight gain, gravidity, prior history of preterm birth and history of genitourinary infection. Results: Of the 1635 women, 72.7% were Caucasian, 65.0% had annual household income >$70 000, 3.8% reported having periodontitis, 6.4% delivered preterm, 5.4% delivered SGA babies, and 11.0% had poor pregnancy outcome (either preterm birth or SGA). The odds ratio (OR) associated with periodontitis was 1.74 (95% CI 0.65–4.66) for preterm delivery and 2.11 (95% CI 0.76–5.86) for SGA individually. When preterm delivery and/or SGA were combined, the OR was 2.26 (95% CI 1.05–4.85) relating periodontitis with poor pregnancy outcome. Conclusion: Within the limitations of the study, the results suggest that periodontitis is an independent risk factor for poor pregnancy outcome among middle‐class women.     

Dental caries indices for primary teeth: the need to comply with international recommendations

This paper illustrates inconsistent use of abbreviations in indices employed to assess caries prevalence and incidence in the primary dentition. Possible consequences of this practice are discussed and it is suggested that authors, editoris and referees for dental journals should accept and adhere to internationally agreed upon definitions of these indices. As long as there is disagreement on the use of the dmf and def indices these initials should be defined under "methods".     

Dental caries in a cohort of very young American Indian children

Objectives: This paper reports the prevalence and severity of caries in a group of 16‐month‐old American Indian children. Methods: The study is an ongoing longitudinal study of risk factors for caries in children from a Northern Plains Tribal community. Children were examined for caries and risk factor data collected at approximately 1, 4, 8, 12, and 16 months of age. Surface‐specific caries data were collected and the presence of precavitated “white spot” lesions was recorded at the subject level. Results: The mean age was 15.4 months for the sample of 232 children. Caries prevalence was 31.9 percent, while an additional 29.3 percent had white spot lesions only. Mean dmfs was 1.57, and ranged from 0 to 44 surfaces. Nearly 3 percent of all erupted tooth surfaces were affected and maxillary central incisors had the highest prevalence of caries (22 percent). Conclusions: Among the very youngest children, dental caries prevalence was very high among these American Indian children.     

Prevention of early childhood caries: a public health perspective

This paper proposes strategies for preventing early childhood caries (ECC), preferably for the greatest number of children at the lowest cost. Population-based, public health approaches are more likely to reach the target population groups at risk of developing ECC than individual, private practice-based approaches. Different prevention and early intervention strategies are discussed and the following recommendations are made: 1) Continue to promote community water fluoridation. 2) Evaluate the effectiveness of other public health oriented measures to prevent ECC. 3) Develop a national ECC and rampant caries registry. 4) Link oral health screening and easily implemented, low-cost interventions with immunization schedules and public health nursing activities. 5) Increase opportunities for community-based interventions conducted by dental hygienists. 6) Change insurance reimbursement schedules to provide incentives for dentists to prevent disease. 7) Include dentistry in new child health insurance legislation for children as well as parents of infants and preschool children.     

Early childhood caries: a positive beginning

Early childhood caries (ECC) is among the most prevalent health problems of low-income infants and toddlers, yet little attention and few resources have been allocated to understanding this disease. Since dental caries in infants and toddlers cannot be exclusively ascribed to feeding practices, other concepts regarding its etiology and prevention need to be examined. Furthermore, the establishment of evidence-based policies regarding this basic health problem is critical for the dissemination of consistent standards of care to health care providers and government agencies. To accomplish these objectives, the scientific community, organizations concerned with children's health and the political process need to be energized to find resources and energy to solve this public health challenge.     

Obesity and dental caries in children aged 2-6 years in the United States: National Health and Nutrition Examination Survey 1999-2002

Objective: This study assessed the associations between obesity and dental caries in young children participating in a national survey. Methods: Participants included 1,507 children aged 2‐6 years who received dental examinations and had at least 10 primary teeth in the National Health and Nutrition Examination Survey 1999‐2002. Decayed/filled teeth (dft) counts of primary dentition were obtained, and weight and height were measured. Body mass index (BMI; kg/m ² ) was calculated, and participants were categorized using age‐ and gender‐specific criteria as underweight (<5th percent), normal (5th‐85th percent), at risk for overweight (>85th and <95th percent), and overweight (≥95th percent). With appropriate sample weighting, relationships between dft and BMI were assessed using the Kruskal–Wallis test and multivariable logistic regression. Results: Seventy‐four percent of children were classified as normal weight, 11 percent as at risk for overweight, and 11 percent as overweight; 58 percent did not have caries; 30 percent had 1‐5 dft and 12 percent had >5 dft. When caries experience was compared across BMI categories stratified by age and race characteristics, statistically significant association between caries and obesity was found only for 60‐ <72‐month age group. In the comparison between children with normal and at‐risk BMI only, significant associations were also found in the Hispanic and non‐Hispanic Black strata. In multivariable logistic regression models to predict caries experience, family income and age were statistically significant predictors for severe early childhood caries only. Conclusions: There appears to be no significant association between childhood obesity and caries experience after controlling for age, race, and poverty/income ratio. However, further studies are needed to better understand this relationship.     

A prospective study on sucrose consumption, visible plaque and caries in children from 3 to 6 years of age

OBJECTIVES: As data on the association of sugar consumption and dental caries in the industrialized countries give mixed results, we prospectively studied this association in 135 healthy Finnish children (71 boys, 64 girls). METHODS: The dental health and oral hygiene of the children was first examined at the mean age (+/-SD) of 37.4 (+/-2.1) months and again at 73.7 (+/-2.6) months. On both occasions the parents were interviewed about the child's sweet intake and toothbrushing habits, and sucrose consumption was analyzed using 4-day food diaries. RESULTS: The proportion of children with caries experience, enamel and dentin lesions combined, increased from 16% to 40%. Daily sucrose intake of children who developed caries by 6 years of age, whether expressed as absolute (g) or as relative (E%) amounts, was already higher at 3 years of age than that of children who stayed caries-free (P<0.05 and P<0.03, respectively). Furthermore, children who used sweets more than once a week at 3 years of age, consumed more sucrose 3 years later (P<0.01) than those who used sweets once a week or less. The proportion of children with a combination of a sweet intake more than once a week and visible plaque, increased (P<0.05) during the follow-up. The risk ratio of children with the combined risk habit at 3 years of age to develop carious lesions by 6 years of age was 1.7 compared to the rest of the children (95% confidence interval 0.9-3.0). CONCLUSIONS: We conclude that the manifestation of dental caries at 6 years of age seemed to be associated with a higher daily sucrose intake that had started already at 3 years of age. Moreover, a combination of sweet intake more than once a week and visible plaque at 3 years of age may be predictive of dental health 3 years later.     

Community risk indicators for dental caries in schoolchildren: an ecologic study

Abstract A statewide survey of NC schoolchildren found wide variation in dental caries prevalence among sampled classrooms. This study examined factors associated with this variation using classrooms as a surrogate for the larger community, in order to identify community risk indicators (CRI). In all, 172 classrooms (3400 students) in Grades K-6 were available for analysis. Initially, 56 sociodemographic, environmental, health system, and clinical factors were evaluated for their association with caries prevalence (K-3: average dfs-f DMF'S; 4–6: average DMFS) using univariate and bivariate analyses. Of these, 21 factors met our criteria for evaluation using WLS multivariate regression. For Grades K-3 (w=108), population density, parental education, and coastal residence were negatively associated with caries scores, while age, and medical and dental Medicaid expenditures were positive. For Grades 4–6 (n=64), age and fs:dfs ratio were positively associated with caries scores, while population density, population: dentist ratio, and years of natural fluoride exposure were negative. CRIs for both models, when compared to individual models, explained a substantial portion of the variation in caries prevalence, 31% for Grades K-3 and 51% for Grades 4–6. Results suggest that a risk assessment model based on community rather than individual variables is feasible and further refinement may reveal factors useful in identifying high risk communities.     

Do enamel and dentine caries at 5 years of age predict caries development in newly erupted teeth? A prospective longitudinal study

Abstract

Objective: To explore caries development in children from 5 to 12?years of age, and to study whether enamel caries and dentine caries at 5?years of age could predict caries prevalence at 12?years of age, controlled for child characteristics.

Methods: The study included 3282 children examined at 5 and 12?years of age. Data were collected by clinical examination and questionnaire. Enamel and dentine caries were registered at surface level. Data were tested by t-test and analysed by bi- and multivariate logistic regression. The study was ethically approved.

Results: In 5-year-olds, 15% of the children had dentine caries experience and 21% had enamel caries. In 12-year-olds, 32% had dentine caries experience and 47% had enamel caries. Children with dentine caries experience at 5?years of age had at 12?years of age developed more surfaces with enamel caries (mean 2.8, SD 4.2) and dentine caries experience (mean 1.8, SD 2.5) than other children (p?<?.05). Dentine caries experience at 12?years of age was associated with having only enamel caries (OR 1.6, CI 1.2–2.0) and dentine caries experience (OR 3.2, CI 2.6–3.9) at 5?years of age. Family status and parental education were related to caries development.

Conclusion: Children with caries in primary teeth continued to be caries risk children during the mixed dentition period. In addition to dentine caries experience, enamel caries in primary teeth was a predictor for caries development in young permanent teeth and may be used to improve the caries risk assessment.