Psychosocial factors and early childhood caries among low-income African-American children in Detroit

Objectives: This study sought to advance knowledge of the social determinants of oral health, by examining how several specific maternal health beliefs, behaviors, and psychosocial factors relate to young children's early childhood caries (ECC) status in a lower‐income African–American population. Methods: Data were collected by the Detroit Dental Health Project (NIDCR grant), a population‐based study of 1021 African–American families with at least one child under 6 years of age and living in 39 low‐income Census tracts in Detroit, Michigan. Analyses were limited to 719 children aged 1–5 years and their biological mothers, and conducted in SUDAAN to account for the complex sampling design. Survey data included health belief scales on mothers’ self‐efficacy, feelings of fatalism, knowledge about appropriate bottle use and children's oral hygiene needs, brushing habits, psychosocial measures of depressive symptoms (CES‐D), parenting stress, and availability of instrumental social support. The child's age, dental insurance status, dental visit history, and 1‐week brushing frequency were also included in the model. Children's ECC status, based on a dental examination, was the main outcome. The dental team used the International Caries Detection and Assessment System (ICDAS) criteria for caries detection. Each child was classified as either caries‐free or having ECC or severe ECC (S‐ECC) based on the case definition of ECC proposed by an expert panel for research purposes with preschool‐aged children. Results: The dental team followed a specific examination protocol and established reliable and consistent ratings of ECC based on the ICDAS criteria. The inter‐rater reliability kappa was 0.83 overall, and the intra‐rater reliability kappa was 0.74 overall. One‐third of the children had ECC, and 20% had severe ECC. Age of the child and lower parenting stress scores were each positively associated with ECC, while higher education and income were protective. Maternal oral health fatalism and knowledge of children's hygiene needs were associated with ECC among preschool‐aged children. ECC was higher among younger children who had past restorative care. Conclusions: These findings call attention to the high prevalence of ECC in this population and the need to consider psychosocial as well as traditional risk factors in developing interventions to reduce oral health disparities.     

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

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

Impact of oral diseases and disorders on oral health-related quality of life of preschool children

Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bönecker M, Raggio DP. Impact of oral diseases and disorders on oral health‐related quality of life of preschool children. Community Dent Oral Epidemiol 2011; 39: 105–114. © 2010 John Wiley & Sons A/S Abstract – Background: The presence of oral diseases and disorders can produce an impact on the quality of life of preschool children and their parents, affecting their oral health and well‐being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. Objective: To assess the impact of early childhood caries (ECC), traumatic dental injuries (TDI) and malocclusions on the oral health‐related quality of life (OHRQoL) of children between 2 and 5 years of age adjusted by socioeconomic factors. Methods: Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (six domains) on their perception of the children’s OHRQoL and socioeconomic conditions. Two calibrated dentists (κ > 0.8) examined the severity of ECC according to dmft index, and children were categorized into: 0 = caries free; 1–5 = low severity; ≥6 = high severity. TDI and malocclusions were examined according to Andreasen & Andreasen (1994) classification and for the presence or absence of three anterior malocclusion traits (AMT), respectively. OHRQoL was measured through ECOHIS domain and total scores, and poisson regression was used to associate the different factors with the outcome. Results: In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (P < 0.001). TDI and AMT did not show a negative impact on OHRQoL nor in each domain (P > 0.05). The increase in the child’s age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (P < 0.05). The multivariate adjusted model showed that the high severity of ECC (RR = 3.81; 95% CI = 2.66, 5.46; P < 0.001) was associated with greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR = 0.93; 95% CI = 0.87, 0.99; P < 0.001). Conclusions: The severity of ECC and a lower family income had a negative impact on the OHRQoL of preschool children and their parents.     

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.     

Attitudes towards oral health among parents of 6‐year‐old children at risk of developing caries

Vermaire JH, Hoogstraten J, van Loveren C, Poorterman JHG, van Exel NJA. Attitudes towards oral health among parents of 6‐year‐old children at risk of developing caries. Community Dent Oral Epidemiol 2010; 38: 507–520. © 2010 John & Wiley & Sons A/S Abstract – Objectives: Parental attitudes are likely to play a role in achieving and maintaining a desired level of oral health in children. To be useful in individually delivered caries prevention programmes, parental attitudes should be identified at individual level. Q‐methodology has been proved successful in identifying attitudes in a wide range of disciplines but in dentistry Q‐studies are scarce. In this study Q‐methodology was used to identify parents’ prevailing attitudes towards the oral health of their children. Methods: Thirty‐nine parents ranked 37 statements regarding the dental health behaviour they apply to their 6‐year‐old child. They later explained their rankings during a short interview. In Q‐methodology, rather than reporting one average composite attitude and opinion, various combinations of opinions and attitudes concerning these statements are identified using by‐person factor analysis. Results: Based on their beliefs, attitudes and cognitions, five categories of parents were found: (i) conscious and responsible, (ii) trivializing and fatalistic, (iii) appearance‐driven and open‐minded, (iv) knowledgeable but defensive and (v) conscious and concerned. Conclusions: Q‐methodology appears to be a fruitful way to structure the complexity of parents’ opinions and attitudes towards their children’s dental health. It appears that Q‐methodology provides comprehensive clusters of individual attitudes, based on various levels of responses to a wide range of questions. The five identified profiles may be useful in developing tailor‐made prevention strategies in caries prevention.     

Caries increment in children aged 3-5 years in relation to parents' dental attitudes: Oslo, Norway 2002 to 2004

Abstract – Objectives: To assess the relationship between parents’ dental attitudes and the caries increment in their children from the age of 3 to 5 years. Methods: Data based on parental questionnaires and dental examinations were collected from children participating in a follow‐up study from age 3 years (n = 354) in 2002 to 5 years (n = 304) in 2004. The children were categorized as western‐native (WN) and immigrants (IM). The items used were significantly related to caries experience in a multicentre study [ 1 Community Dent Health, vol. 21, pp. 121–30]. The responses to attitudinal items were weighted as positive if they would promote good dental health, and negative if not. Composite attitudinal variables relating to hygiene, diet and indulgence were calculated as a summation of the weighted responses to selected items. Regression analyses (bivariate and multiple) were performed to assess associations during the period between the attitudinal predictors/other control variables and caries increment (Δd_3‐5mfs). Results: Bivariate logistic regression analyses revealed that ‘Attitude to Diet’ and ‘Parental Indulgence’ were clearly related to caries increment. The more exposed children were to negative parental attitudes, the higher the OR. ‘Attitude to Diet’ also persisted in a multiple logistic regression model, showing a higher OR value than caries experience. ‘Immigrant Status’ was the most potent predictor of caries increment. Parents were found to be more indulgent among IM than among WN groups. Conclusion: Parental dental attitudes are clearly shown to be associated with caries increment in early childhood. The relationship is of such strength that it deserves to be taken into account in future preventive dental strategies.     

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.     

Dental caries and childhood obesity: roles of diet and socioeconomic status

Objective: Our objective was to determine (a) if caries and obesity were associated in a pediatric population and (b) if so, then to explore diet and socioeconomic status as additional risk factors. Methods: Subjects were recruited at birth and are members of the Iowa Fluoride Study. Data such as parental age, parental education levels and family incomes were obtained by questionnaire at recruitment. Children's primary dentition was examined and their weight and height measured at 4.5–6.9 years of age. Parental weight and height were measured when children were 7.6–10.9 years of age. Beverage and nutrient intake patterns were obtained from 3‐day food and beverage diaries completed at 1, 2, 3, 4 and 5 years of age. Results: Children with caries had lower family incomes, less educated parents, heavier mothers and higher soda‐pop intakes at 2, 3 and for 1–5 years than children without caries (P < 0.05). ‘Overweight’ children had less educated fathers and heavier parents than ‘normal’ weight children (P < 0.05). Children ‘at risk’ of overweight had higher caries rates than ‘normal’ or ‘overweight’ children (P < 0.05). In stepwise logistic regression models to predict caries experience, soda‐pop intakes were displaced by mother's education, leaving ‘at risk’ of overweight and mother's education in the final model. Conclusion: Caries and obesity coexist in children of low socioeconomic status. Public health measures to improve dietary education and access to appropriate foodstuffs could decrease the risk of both diseases.     

Caries prevalence and severity, and quality of life in Brazilian 2- to 4-year-old children

Gradella CMF, Bernabé E, Bönecker M, Oliveira LB. Caries prevalence and severity, and quality of life in Brazilian 2‐ to 4‐year‐old children. Community Dent Oral Epidemiol 2011; 39: 498–504. © 2011 John Wiley & Sons A/S Abstract – Objective: The purpose of this study was to assess the impact of caries and severe caries on preschool children’s quality of life. Methods: Data from 765 2‐ to 4‐year‐old children attending a statutory National Day of Children’s Vaccination in Macapá (Northern Brazil) were analysed. Caries and severe caries were indicated by the dmfs and pufa indices, respectively. Parents completed a questionnaire including questions on socioeconomic factors and the impact of oral conditions on their children’s quality of life using the Brazilian version of the Parental Perceptions Questionnaire for preschool children. Logistic regression was used to test the unadjusted and adjusted associations of caries and severe caries with different aspects of children’s quality of life. Results: Sixty‐two and five per cent of children had dental caries (dmfs index > 0) and severe caries (pufa index > 0), respectively. In the adjusted models, having caries was significantly related to toothache and problems eating certain foods as well as to be absent from school and ashamed to smile, whereas having severe caries was significantly related to toothache and problems eating certain foods only. Neither caries nor severe caries was related to stop playing with other children. Conclusions: This study shows that caries and severe caries may have a considerable impact on some aspects of preschool children’s quality of life.     

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

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

Changes in young children's OHRQoL after dental treatment under general anaesthesia

International Journal of Paediatric Dentistry 2012; 22: 258–264 Objective. To use the Parental‐Caregivers Perceptions Questionnaire (P‐CPQ) and Family Impact Scale (FIS) to determine whether dental treatment of young Auckland children under general anaesthesia (GA) improved oral‐health‐related quality of life (OHRQoL) for them and their families. Design. A pretest/post‐test design, with a consecutive clinical sample of parents/caregivers of children (10 years or younger) treated under GA. More than half of the children were Māori or Pacific Islanders. Results. Of the 157 children in the baseline sample, 144 (91.7%) were followed up. The overall P‐CPQ score showed a large decrease following treatment, along with an increase in the number scoring 0 (no impact). Similar relative changes were observed in the oral symptoms and emotional well‐being subscales, whereas the other two subscales showed moderate decreases. All post‐treatment FIS scores were lower than pre‐treatment ones; all showed moderate effect sizes. The greatest relative changes were seen in the parental/family activity and parental emotions subscales. Conclusions. The dental treatment of young children under GA is associated with considerable improvement in their OHRQoL. The P‐CPQ and the FIS are valid and responsive to treatment‐associated changes in young children with early childhood caries (ECC).     

Oral health inequalities between young Aboriginal and non‐Aboriginal children living in Ontario,Canada

Abstract – Objectives: To investigate (i) oral health inequalities between off‐reserve Aboriginal and non‐Aboriginal children entering junior kindergarten (JK) in the Thunder Bay District, Northwest Ontario, Canada, (ii) oral health inequalities between kindergarten‐aged (4 years old) Aboriginal children living on reserves in the Sioux Lookout Zone (SLZ), Northwest Ontario and those living off‐reserve in the Thunder Bay District and (iii) early childhood caries (ECC) trends among SLZ children between 2001 and 2005. Methods: Cross‐sectional oral health data (dmft/s Indices) for 416 (2003/2004), 687 (2004/2005) and 544 (2005/2006) 3‐ to 5‐year olds attending JK in the Thunder Bay District were collected by calibrated dental hygienists with the District’s Health Unit. Secondary analysis of oral health status data from two studies conducted in the SLZ between 2001 and 2005 provided the dmft of random samples of children younger than 6 years of age living in 16–20 First Nations communities. Results: When compared with non‐Aboriginal children aged 3–5 years attending the same schools in the Thunder Bay District between 2003 and 2006, off‐reserve Aboriginal children had 1.9 to 2.3 times the risk of having ECC (dmft > 0), 2.9 to 3.5 times the risk of a dmft > 3 and 1.8 to 2.5 times the risk of untreated decayed teeth after adjusting the prevalence ratios for child’s age and sex, school’s risk level and clustered‐correlated data. The mean dmft of on‐reserve Aboriginal 4‐year olds in 2005 was 11.2 and 5.9 for their off‐reserve Aboriginal counterparts. In 2001, the mean dmft scores (95% confidence interval) of 2‐, 3‐ and 4‐year‐old Aboriginal children in the SLZ were: 9.1 (8.3–9.9), 12.4 (11.8–13.1), 13.1 (12.1–14.2). In 2005, similarly aged SLZ children had a mean dmft of: 6.2 (5.2–7.1), 8.9 (8.2–9.6), 11.2 (10.5–11.9), representing significant reductions in caries severity (32%, 28% and 14.5%, respectively). Conclusions: Significant disparities in caries experience exist between off‐reserve Aboriginal and non‐Aboriginal children living in the same locales and between Aboriginal children living on‐ and off‐reserve in northwestern Ontario. The study showed decreased trends in the severity of ECC for children in the SLZ occurring over the 5‐year period. Despite this progress, the oral health of young Aboriginal children in Ontario continues to lag far behind that of non‐Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities.     

Caries and background factors in Norwegian and immigrant 5-year-old children

Wigen TI, Wang NJ. Caries and background factors in Norwegian and immigrant 5‐year‐old children. Community Dent Oral Epidemiol 2010; 38: 19–28. © 2009 John Wiley & Sons A/S Abstract – Objectives: The purpose of this study was to assess the caries status of 5‐year‐olds in a low caries area, and study associations between dental caries and parent‐related factors: parents’ education, national origin, oral health behaviours and attitudes. Methods: The material consisted of 523 children and was a stratified random sample. Clinical and radiographic examination was performed in 2007. Enamel and dentine caries were recorded at surface level. Parents filled in questionnaires regarding socioeconomic status, their own oral health behaviours and attitudes. Results: Most participants (66%) had no caries experience and 16% had enamel caries only. Dentine caries experience was present in 18% of the children, and 5% had dentine caries experience in five or more teeth. Surfaces with enamel caries constituted half of all surfaces with caries experience. In multiple logistic regression, statistically significant risk indicators for the child having dentine caries experience at the age of five were: having one or both parents of non‐western origin (OR = 4.8), both parents (OR = 3.0) or one parent (OR = 2.1) with low education, parental laxness about the child’s tooth brushing (OR = 2.8), parents’ brushing their own teeth less than twice a day (OR = 2.2) and having parents with frequent sugar intakes (OR = 1.8). Conclusion: Caries prevalence in 5‐year‐olds was strongly associated with parent‐related factors signifying that information on parents’ socioeconomic status, dental behaviours and attitudes should be considered when planning dental services for young children. Our results suggest that the real high risk group is non‐western children whose parents have low education.     

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。     

Parental influence and the development of dental caries in children aged 0–6 years: A systematic review of the literature

ObjectiveA well established body of research documents the role of individual factors, such as biology and diet, in the aetiology of early childhood caries (ECC). Recently empirical attention has shifted to the relationships between broader ecological influences (e.g., education, ethnicity and income) and ECC; however, how such determinants interplay in the aetiology of ECC remains unclear. An intermediary mechanism that warrants greater empirical attention is parental influences. This oversight is interesting given the primacy of the parent in governing the child's proximate environment and the likelihood of the child endorsing adaptive or maladaptive health attitudes, beliefs and behaviours. The objective of this paper was to conduct a systematic review of the evidence for parental influences on the development of caries in children aged 0–6 years.DataAll studies testing associations between dental caries and socio-demographic factors, feeding practices, parent attributes, behaviours, oral health, attitudes, knowledge and beliefs in children aged 0–6 years, published between 2006 and 2011.SourceMedline, ISI, Cochrane, Scopus, Global Health and CINAHL databases.Study selectionFifty-five studies were included from an initial identification of 1805 studies.ConclusionsTo date, most research has focused on the association between caries and socio-demographic and feeding factors with few studies exploring parents’ attributes, attitudes, knowledge and beliefs, and none exploring possible pathways between the multiple layers of influences potentially accounting for how determinants of ECC operate and traverse individual, familial, community, and socio-cultural contexts. Collaboration between Psychologists and Dentists may accelerate the identification and understanding of mechanisms that underlie risk associated with ECC.     

Evaluation of a generic quality of life instrument for early childhood caries-related pain

Abstract – Objective: This prospective study evaluated the reliability and validity of the Infant and Toddler Child Quality of Life Questionnaire (ITQOL) by comparing quality of life (QOL) of two groups of children afflicted with early childhood dental caries with a caries‐free group. Methods: A convenience sample of 150 children divided into three groups (mean age [months] 51 ± 15) was studied. Group I (OR) had extensive dental caries and were waiting for several months for treatment under general anesthesia. Group II were children who sought emergency services for acute odontogenic pain/abscess, and group III were children who were caries‐free new patients. Parents/caretakers were administered the ITQOL, which assesses a child’s physical, emotional and social well being from the parent/guardian’s perspective. Results: The ITQOL had high success in item validity with good reliability. Significant differences in QOL were noted for scales of pain and discomfort, behavior and moods, global behavior, and impact on parental time (P ≤ 0.05) among the three groups. No significant differences were noted for scales of growth and development, general health and impact on parents’ emotional and mental health. Conclusions: The ITQOL proved to be a useful instrument for characterizing QOL in this dental caries‐afflicted sample. Overall, children with chronic and acute dental caries had a poorer QOL than caries‐free children in areas of behavior, mood, pain and parental impact.     

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.

     

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.     

The oral health of children considered very high risk for infective endocarditis

International Journal of Paediatric Dentistry 2010; 20: 173–178 Background. Children with previous experience of infective endocarditis or with prosthetic heart valve are considered at very high risk for infective endocarditis. Aim. The aim of this study was to compare the dental health of a group of these children with a group of healthy controls and to determine parental awareness of the importance of good oral health. Design. Oral examination was carried out in 28 children with previous infective endocarditis or a prosthetic heart valve to assess oral health. Findings were compared to a healthy control group of 28. Questionnaires were distributed to the parents to assess awareness of oral health. Results. There was no significant difference in DMFT scores of study and control group (2.43 +/‐ 3.72 and 1.36 +/‐ 2.5 respectively) or in DMFT scores of study and control group (1.5 +/‐ 1.73 and 1.15 +/‐ 1.42 respectively), 36% of the study group had untreated caries. Parental knowledge of the link between oral health and infective endocarditis was excellent. Conclusions. There were no significant differences between the oral health of cardiac children and healthy children although the dmft and DMFT scores of the study group were high. Of concern was the proportion of children with untreated caries in spite of good dental awareness and attendance.     

A 2-year community-randomized controlled trial of fluoride varnish to prevent early childhood caries in Aboriginal children

Abstract – Objective: To measure the effectiveness of fluoride varnish (FV) (Duraflor^®, 5% sodium fluoride, Pharmascience Inc., Montréal, QC, Canada) and caregiver counseling in preventing early childhood caries (ECC) in Aboriginal children in a 2‐year community‐randomized controlled trial. Methods: Twenty First Nations communities in the Sioux Lookout Zone (SLZ), Northwest Ontario, Canada were randomized to two study groups. All caregivers received oral health counseling, while children in one group received FV twice per year and the controls received no varnish. A total of 1275, 6 months to 5‐year‐old children from the SLZ communities were enrolled. In addition, a convenience sample of 150 primarily non‐Aboriginal children of the same age were recruited from the neighboring community of Thunder Bay and used as comparisons. Longitudinal examinations for the dmft/s indices were conducted by calibrated hygienists in 2003, 2004 and 2005. Results: Aboriginal children living in the SLZ or in Thunder Bay had significantly higher caries prevalence and severity than non‐Aboriginal children in Thunder Bay. FV treatment conferred an 18% reduction in the 2‐year mean ‘net’ dmfs increment for Aboriginal children and a 25% reduction for all children, using cluster analysis to adjust for the intra‐cluster correlation among children in the same community. Adjusted odds ratio for caries incidence was 1.96 times higher in the controls than in the FV group (95% CI = 1.08–3.56; P = 0.027). For those caries‐free at baseline, the number (of children) needed to treat (NNT) equaled 7.4. Conclusions: Findings support the use of FV at least twice per year, in conjunction with caregiver counseling, to prevent ECC, reduce caries increment and oral health inequalities between young Aboriginal and non‐Aboriginal children.