Prevalence of dental caries and caries-related risk factors in premature and term children

This study evaluated the prevalence of enamel defects and dental caries and their risk factors on primary and permanent dentitions of prematurely-born children and term children. Eighty children were examined, 40 born prematurely (G1) and 40 born term (G2), in the age group between 5 and 10 years. The demographic variables, medical history and oral health behaviors were recorded on a questionnaire. The teeth were examined for presence of deficiencies of the enamel and caries that were registered. The caries were registered, focusing on the indices dmft (decayed, missing, and filled primary teeth) and DMFT (decayed, missing, and filled permanent teeth). The results showed that 75% of the total sample had enamel defects. The logistic regression model showed that other risk factors such as per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases had no correlation with enamel defects and caries. A smaller value of total DMFT (0.95) was found in the group of premature children in comparison to the term children (2.07) p = 0.0164. There was no difference concerning the permanent dentition between the two groups (p = 0.9926). One concludes that prematurity can't be a predisposing factor for the presence of dental caries.     

Prenatal and neonatal risk factors for the development of enamel defects in low birth weight children

Oral Diseases (2010) 16 , 257–262 Objective: To analyse the influence of several prenatal and neonatal risk factors in the development of enamel defects in low birth weight children. Subjects and methods: Children between 4 and 5 years of age (n = 102) were classified into: Group 1) 52 low birth weight (<2500 g); Group 2) 50 normal birth weight (≥2500 g). Medical history, prenatal and neonatal variables were collected. Enamel defects were evaluated with the modified Developmental Defects of Enamel Index. Results: The prevalence of hypoplasia and average number of affected teeth were significantly higher in group 1 than in group 2 (59.6%vs 16% and 1.6 vs 0.3 respectively). Low gestational age was linked to a higher prevalence of hypoplastic (P = 0.027) and combined defects (P = 0.001). Children with neonatal risk factors (low Apgar scores, parenteral nutrition, orotracheal intubation, mechanical ventilation and acidosis) developed defects more frequently (P < 0.05). Defects were symmetrically distributed in children who were not intubated; in those who required intubation they concentrated on the left maxillary teeth (P < 0.05). Smoking during pregnancy, young maternal age and multiple birth were significantly associated to developmental defects. Conclusions: The prevalence of enamel defects in primary dentition is significantly influenced by birth weight, gestational age and several systemic factors. Orotracheal intubation probably plays an important role as a result of laryngoscope trauma on the maxilla.     

Prevalence and distribution of developmental enamel defects in primary dentition of Chinese children 3–5 years old

Abstract A total of 1344 children, 3–5 yr old, from two rural counties, Haidian and Miyun, close to Beijing, China, were examined in 1992. A modified DDE Index was employed in this study, and a pre-designed formula was used to calculate an enamel detect score (EDS) for each individual in the study. Oral examination was performed by one dentist under natural light using a standard mouth mirror and dental probe. Developmental enamel lesions were diagnosed without drying or cleaning the teeth prior to examination. Results from this study showed that primary teeth with defective enamel were seen in 23.9% of the children examined, opacity in 1.6%, and hypoplasia in 22.2%. Among the teeth, maxillary central and lateral incisors were affected by enamel hypoplasia most often (40.8% and 39.2%), followed by maxillary canines (25.7%), maxillary 1st molars (22.1%), and mandibular 1st molars (18.5%). The enamel defects occurred more frequently on the buccal surfaces of teeth than on any other surface. The study did not find a significant association of the children's age, family socioeconomic status, and anthropometric measurements with the distribution of enamel defects. However, there was a significantly higher prevalence of teeth with defects in males compared to females (P < 0.001), as well as mean tooth surfaces with defects (P < 0.05), and mean EDS (P < 0.05). Children born prematurely were shown to have four times more enamel lesions than children who were full term (P < 0.01). Children with low birth weight also showed a statistically significant higher prevalence of enamel defects (P < 0.05) and a greater severity of hypoplastic lesions measured by EDS (P < 0.05) than those with normal birth weight. The results indicate that nutrition during fetal development is important in determining normal development of enamel in primary teeth. Nutritional status (diagnosed by anthropometric measurements) after the critical period was not associated with enamel defects induced earlier in life. The study suggested, therefore, that nutrition is important for maintaining proper development of the teeth only during the critical period when teeth are susceptible to the formation of defects.     

Impact of shortened dental arches on oral health‐related quality of life

This study described the prevalence of adults with shortened dental arches (SDA) in Brazil, specifically assessing the differences of oral health‐related quality of life [the prevalence and severity of oral impacts on daily performance (OIDP)] by dentition status. We analysed data from the 2010 National Survey of Oral Health in Brazil, including home interviews and oral examinations. The assessment of SDA used two alternative definitions: having 3–5 natural occlusal units (OUs) in posterior teeth or having 4 OUs in posterior teeth. Both definitions included having intact anterior region and no dental prosthesis. The analysis was weighted, and a complex sampling design was used. Negative binomial regression models assessed associations as adjusted for socio‐demographic conditions and dental outcomes. A total of 9779 adults (35–44 years old) participated in the study. A non‐negligible proportion had SDA: 9·9% and 3·8% for the first and second definition, respectively. Individuals with SDA (first definition) ranked higher in OIDP prevalence [count ratio (CR) 1·22; 1·09–1·36, 95% confidence interval (CI)] and severity (CR = 1·43; 1·19–1·72, 95% CI) than those with more natural teeth. This difference was not statistically significant when adjusted for socio‐demographic and dental covariates: OIDP prevalence (CR = 1·04; 0·92–1·17, 95% CI) and severity (CR = 1·09; 0·91–1·30, 95% CI). Analogous results were obtained when the second definition of SDA was adopted. These findings suggest that a considerable contingent of adults may function well without dental prostheses, despite having several missing teeth. This conclusion challenges the traditional approach of replacing any missing tooth and instructs the allocation of more dental resources to preventive, diagnostic and restorative services.     

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

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

Traumatic dental injury among 12‐year‐old South Brazilian schoolchildren: prevalence,severity, and risk indicators

Abstract – An increasing prevalence of traumatic dental injury (TDI) has been reported in the last few decades. The aim of this study was to assess the prevalence and severity of TDI and its association with socio‐demographics and physical characteristics in the anterior permanent teeth of 12‐year‐old Brazilian schoolchildren. A cross‐sectional study was carried out in a population‐based sample of 1528 subjects attending 33 public and nine private schools (response rate of 83.17%). A single calibrated examiner performed the clinical examinations at the schools and recorded the TDI index (Children’s Dental Health Survey criteria), overjet and lip coverage. Height and weight were measured to calculate the body mass index (BMI). Parents/legal guardians answered a questionnaire containing socio‐demographic questions. The relationships among TDI, socio‐demographic variables and physical characteristics were assessed by survey Poisson regression models. The prevalence of TDI was 34.79% (mild trauma = 24.37%; severe trauma = 10.43%). Male schoolchildren (RR = 1.41, 95% CI = 1.23–1.61, P = 0.002) and schoolchildren from low socioeconomic status (RR = 1.32, 95% CI = 1.07–1.64, P = 0.021) were more likely to present at least one tooth with TDI, whereas students attending 7th grade (advanced students) were less likely to experience TDI (RR = 0.59, 95% CI = 0.43–0.82, P = 0.012). Regarding the severity analysis, students of mid‐high (RR = 1.46, 95% CI = 1.09–1.94, P = 0.022), mid‐low (RR = 1.68, 95% CI = 1.01–2.77, P = 0.045) and low (RR = 1.78, 95% CI = 1.11–2.85, P = 0.027) socioeconomic status were more likely to have mild trauma when compared with schoolchildren of high socioeconomic status. No significant association between severe trauma and socioeconomic status was observed. In conclusion, this study showed a high prevalence of TDI in 12‐year‐old Brazilian schoolchildren. Socio‐demographic data and school achievement were associated with TDI.     

Combined effect of anterior malocclusion and inadequate lip coverage on dental trauma in primary teeth

Abstract – Objectives: The main objective of this study was to investigate whether the interaction of malocclusion (open bite or increased overjet) combined with inadequate lip coverage strengthens its association with traumatic dental injury (TDI) in the primary teeth of preschool children compared to the presence of malocclusion alone. Subjects and methods: A cross‐sectional survey was conducted with 376 children aged 36–59 months who attended the National Day of Children’s Vaccination. Presence of TDI, tooth discoloration, and sinus tract were evaluated in the children. Variables associated with occlusion were also evaluated. A Poisson regression analysis was performed to verify the association between the explanatory variables and TDI as well as possible interactions among the variables. Then, the prevalence ratio was calculated. Results: The prevalence of TDI was 27.7%. The maxillary central incisor was the most affected tooth, without differences between the right and left sides. Boys had more dental trauma than girls (P = 0.04). The most common TDI was crown fracture restricted to the enamel (58.4%). Children with a combination of anterior open bite or increased overjet and inadequate lip coverage presented a higher prevalence of TDI than when the malocclusions were presented alone (P < 0.05). The same trends were observed when we included, in the final adjusted model, increased overjet instead of open bite. Conclusions: Anterior malocclusions of primary teeth such as increased overjet and anterior open bite are statistically significantly associated with dental trauma only when inadequate lip coverage is also present.     

Prevalence of enamel defects in primary and permanent teeth in a group of schoolchildren from Granada (Spain)

Objective: The purpose of this study was to determine and compare the prevalence and presentations of developmental defects of the enamel (DDE) in the primary and permanent dentitions of a group of healthy schoolchildren residing in Granada (Spain). Study Design: A total of 1,414 healthy schoolchildren were examined using modified DDE criteria for recording enamel defects. Results: The prevalence of DDE of any type was 40.2% in primary dentition and 52% in permanent dentition (p<0.033). Of the 31,820 primary and permanent teeth examined in the study, 699 (4.1%) primary and 1,232 (8.3%) permanent teeth had some form of DDE. Diffuse opacity was the most common type of DDE observed in primary teeth, and demarcated opacity in the permanent teeth. Enamel hypoplasia was the least prevalent defect in both dentition types. Conclusions: The study population showed a high prevalence of DDE in primary as well as in permanent dentition, reflecting the current increasing trend of this condition, which should be considered as a significant public health problem. Key words:Developmental enamel defects, enamel hypoplasia, demarcated opacity, diffuse opacity.     

Enamel defects in children with coeliac disease.

AIM: This was to investigate the prevalence of enamel developmental defects in a group of children with a history of coeliac disease. METHODS: A study group of children attending the Dept. Paediatrics (Leeds General Infirmary), born between 1985 and 1986 and subsequently diagnosed and treated for coeliac disease (CD) were recruited. A group of age/sex-matched children attending the Paediatric Dentistry department were used as a control group (Cont). Examinations were carried out for enamel defects and opacities (DDE index), dmf, dmfs, DMF and DMFS (BASCD method), and a full medical and dental history were obtained. RESULTS: Significantly more children in the CD group had a greater number of enamel defects than controls for both primary (p=<0.02) and permanent (p=<0.001) dentitions. Opacities in both primary and permanent teeth were statistically significantly greater in the CD group than controls (p=<0.04 and p=<0.001 respectively). Dental caries in both primary and permanent dentitions was less in the CD group compared with the control group of children. CONCLUSION: Coeliac disease was associated with an increased prevalence of developmental enamel defects.     

Prevalence of enamel defects and associated risk factors in both dentitions in preterm and full term born children

Objectives

The aim of this study was to evaluate the prevalence of enamel defects and their risk factors on primary and permanent dentitions of prematurely born children and full-term born children born at Regional Hospital of Asa Sul, Brasília, DF, Brazil.

Material and Methods

Eighty 5-10-year-old children of both genders were examined, being 40 born prematurely (G1) and 40 born full term (G2). The demographic variables, medical history and oral health behaviors were retrieved using a questionnaire and data obtained from clinical examination were recorded. The teeth were examined and the presence of enamel defects was diagnosed according to the DDE Index and registered in odontograms. Subsequently, the defects were categorized in four groups according to one of the criteria proposed in 1992 by the FDI Commission on Oral Health, Research and Epidemiology. Kruskal-Wallis, Chi-square, Kappa, Mann-Whitney tests and logistic regression were used for statistical analysis.

Results

75% of total sample had enamel defects. There was a major prevalence of hypoplasia of the enamel in G1 (p<0.001). There was a significant relationship between low weight and presence of the imperfections on the enamel in G1 on the primary dentition. The logistic regression model showed that the other risk factors such as monthly per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases were not associated with enamel defects and caries.

Conclusions

Pre-term labor can be a predisposing factor for the presence of the enamel hypoplasia in the primary dentition.     

The oral health of children with clefts of the lip, palate, or both.

OBJECTIVE: The purpose of this study was to assess the prevalence of dental caries, developmental defects of enamel, and related factors in children with clefts. DESIGN: This cross-sectional prevalence study used standard dental indices for assessment. SETTING: Children underwent a dental examination under standard conditions of seating and lighting in the outpatient department of a dental hospital as part of an ongoing audit to monitor clinical outcomes. PARTICIPANTS: Ninety-one children aged 4, 8, and 12 years were included in the study. OUTCOME MEASUREMENTS: Dental caries were assessed by use of the decayed, missing, and filled index for primary teeth (dmft); Decayed, Missing, and Filled index for permanent teeth (DMFT) according to the criteria as used in the national survey of children's dental health in the United Kingdom. Developmental defects were assessed using the modified Developmental Defects of Enamel Index (Clarkson and O'Mullane, 1989). Dental erosion was assessed using the criteria derived for the national survey of children's dental health. RESULTS: Caries prevalence increased with age; 63% of patients at 4 years and 34% at 12 years were caries free. The mean dmft for the 4-year-olds was 1.3 with a mean DMFT for the 12-year-olds of 1.8. All the 4-year-olds had evidence of erosion of enamel in the primary teeth (incisors and first molars) and 56% of the 12-year-olds had erosion of permanent teeth (incisors and first permanent molars). Developmental defects of enamel became more prevalent with age, with at least one opacity in 56% of 4-year-olds and 100% of 12-year-olds. Hypoplasia was not found in the primary dentition but affected permanent teeth in 38% of 8-year-olds and 23% of the 12-year-olds. CONCLUSION: This study has shown that dental disease is prevalent in these patients. These assessments not only provide a baseline on oral health parameters in young people with clefts but underline the need for a more aggressive approach to prevention of oral disease to optimize clinical outcome.     

低出生体重儿、早产儿龋齿、釉质发育缺陷发病率及与釉质硬度关系的研究

目的:研究低出生体重儿、早产儿乳牙龋齿、釉质发育缺陷的发病率并探讨其与釉质硬度的关系.方法:选取低出生体重儿、早产儿及正常出生体重儿各200例进行乳牙龋齿、釉质发育缺陷统计调查.同时收集口腔科门诊治疗中的上述两类儿童的自然脱落的釉质发育正常的乳前牙各10颗做显微硬度测试,并与正常出生体重儿乳牙进行比较研究.结果:低出生体重儿、早产儿乳牙龋齿、釉质发育缺陷的发病率明显高于正常出生体重儿,但发育正常的乳牙釉质硬度与正常出生体重儿无显著差异.结论:低出生体重儿、早产儿乳牙龋齿发病率高与其釉质发育缺陷发病率高显著相关,而且仅与釉质发育缺陷的乳牙有关,与釉质发育正常的乳牙无关.     

Common dental conditions associated with dental erosion in schoolchildren in Australia

PURPOSE: The purpose of the investigation was to determine factors associated with dental erosion in a group of schoolchildren in Queensland, Australia. METHODS: Dental examinations were carried out on 714 children aged 5.5 to 14.6 years from 8 randomly selected Australian schools. A total of 3,165 primary and 2,976 permanent teeth were scored for dental erosion using a modified erosion index. Dental caries experience was determined from clinical examination and bitewing radiographs. Enamel defects were recorded using the developmental defects of enamel index. RESULTS: There were 225 children (32%) who exhibited no erosion and 489 (68%) who had erosion of at least one tooth. Erosion was found in 78% of subjects with primary teeth and 25% of subjects with permanent teeth (P<.001). Children with erosion in the primary and permanent dentition were more likely to have: (1) a lower socioeconomic status (primary dentition, P<.001 and permanent dentition (P<.001); (2) enamel hypoplasia in permanent dentition (P=.001); (3) dental caries in the primary dentition (P=.001); and (4) permanent dentition (P=.002). CONCLUSIONS: In Australian schoolchildren, the prevalence of dental erosion in the primary dentition is approximately 3 times greater than in the permanent dentition. Dental erosion is strongly associated with caries experience and enamel hypoplasia.     

Risk factors in the occurrence of enamel defects of the first permanent molars among schoolchildren in Western Australia

Abstract – Background: The prevalence of enamel defects in the first permanent molars among children in Western Australia is higher than that reported for some European countries. The cause(s) of the defects, both white diffuse opacities and demarcated opacities, with or without hypoplasia, continue to be investigated. A recent review identified childhood illnesses and exposure to environmental toxins as putative causal factors for the occurrence of demarcated opacities (usually in association with hypoplasia). Diffuse opacities have been reported to be associated with exposure to the antibiotic amoxicillin, adjusted for otitis media and fluoride. The aim of this study was to examine the possible risk factors for enamel defects in the first permanent molars among children in Western Australia. Methods: Children attending pre‐primary schools (1999–2000 year of birth) in metropolitan Perth, Western Australia, were invited to participate in the study. In 2005, before the child’s first permanent molars had erupted, parents completed a questionnaire about the mother’s health during pregnancy, and their child’s health for the first 3 years. The first permanent molars were classified for type and extent of enamel defects using the modified Developmental Defects of Enamel (DDE) index. Caries experience and the presence of enamel defects on the deciduous molars and canines were also recorded using the WHO criteria. Bivariate, multinomial logistic and logistic regression analyses were used to test the factors for their influence on the occurrence of the enamel defects. Results: Five hundred and fifty children were examined for the occurrence of enamel defects on the first permanent molars. Multinomial logistic regression indicated that neonatal health conditions, prematurity (OR 2.75) and other health conditions (OR 2.40) were significant risk factors for the occurrence of diffuse enamel defects. Infection during the neonatal period was a strong risk factor for the occurrence of demarcated enamel defects (OR 6.88). Increased deciduous tooth caries experience increased the risk of demarcated enamel defects by 10% (OR 1.10) and living further from a heavy industrial area increased the risk of diffuse enamel defects nearly twofold (OR 1.93). Conclusions: Neonatal health factors were found to be important risk factors for the occurrence of enamel defects in first permanent molars. The effects of residential location and the association between deciduous tooth caries experience and enamel defects require further investigations.     

Breast-feeding and other mother-child factors associated with developmental enamel defects in the primary teeth of Brazilian children

PURPOSE: The purpose of this study was to examine the association between developmental defects in the enamel (DDE) of the primary teeth and low birth weight or prematurity. METHODS: A case-control study was carried out in Itajaí, Southern Brazil, involving 3- to 5-year-old children. The case group was composed of 102 children presenting at least 1 dental surface with DDE. The control group comprised 113 children without DDE matched by sex and age and enrolled in the same day care centers. All teeth were clinically examined using the Modified Index of Developmental Defects of Enamel. The outcome variable of the study was DDE in at least 1 dental surface, and the independent variables were: (1) birth weight; (2) gestational age; and (3) breast-feeding. Maternal schooling and health problems of the mother during pregnancy and of the child during the first year of life were collected as potential confounding factors. Simple and conditional multiple logistic regression analyses were performed, providing crude and adjusted odds ratio and 95% confidence intervals. RESULTS: Prematurity (OR=2.6; 95% CI=1.0-6.4) and children who did not breast-feed (OR=3.2; 95% CI=1.2-8.4) were associated with defects in tooth enamel after adjusting for possible confounding variables. CONCLUSIONS: In this study, premature children and those who did not breast-feed could be considered at risk for developing defects in tooth enamel.     

Developmental defects of enamel in a group of New Zealand children: their prevalence and some associated etiological factors

Abstract The prevalence of developmental defects of enamel was assessed in 243 children aged 12–14 yr using the FDI Index. The teeth were not cleaned or dried prior to examination for which fibre optic lighting was used. At least one tooth with defective enamel was seen in 63% of children with a demarcated white opacity present in 44% of children. The enamel was abnormal in 11.7% of teeth, diffuse patchy opacities and demarcated while opacities occurring in 4.4 and 4.2%, respectively. Although defects were found most frequently in the maxillary central incisors, the ranking order of prevalence and the distribution for demarcated and diffuse opacities was quite different. Sex, residence, and the common childhood illnesses did not alter the prevalence of defects which was, however, increased significantly in 22 children with a history of a serious illness or accident (0.01 > P > 0.001). The prevalence of the diffuse opacities was significantly increased with increased exposure to fluoride either in tablets nr in the drinking water (0.01 > P > 0.001).     

Dental caries prevalence and treatment needs of 5- to 12-year-old children in relation to area-based income and immigrant background in Greece

Objectives: To investigate the association between certain socio‐demographic characteristics and dental health status of 5‐ to 12‐year‐old children attending public kindergarten and primary schools in Piraeus, Greece. Methods: Gender, age, place of residence, immigrant background and area‐based income were associated with dental caries prevalence, treatment needs and oral hygiene level in 5,116 children. Results: The mean number of decayed, missing and filled deciduous teeth (dmft) and Unmet Restorative Treatment Needs Index (UTN) at 6‐year‐olds were 1.54 and 84.6% respectively, and the DMFT and UTN at 12‐year‐olds were 1.35 and 71.8%. Caries experience/severity significantly increased with age, whereas treatment needs and oral hygiene level decreased (P < 0.001). Immigrant background and low area‐based income was associated with poorer oral health outcomes. The above associations retained statistical significance after multivariate analysis. Children who live in areas with lower average income present 1.20 to 2.14 greater risk of having higher caries severity and poorer oral hygiene in comparison to those living in more affluent areas, and children with an immigrant background have 1.68 to 4.34 higher likelihood to present higher dmft and DMFT values, higher unmet treatment needs, and poorer oral hygiene levels compared to their Greek counterparts above and beyond the effect of the other risk factors assessed. Conclusions: The present study revealed a socio‐demographic gradient in oral health status and treatment needs of children in Piraeus, Greece.     

Prevalence of traumatic dental injuries in preschool children in Kuwait – a screening study

Abstract – Aims: This is the first study in Kuwait to determine the prevalence, etiology, classification of trauma, teeth involved, place of injury and treatment received after dental trauma in preschool children. Material and methods: A total of 500 preschool children presenting at a dental screening day in all governorates of Kuwait were clinically examined for signs of trauma to their primary teeth. The parents were then interviewed and a prevalidated questionnaire was completed with the demographic data of the participant and history of the dental trauma. Results: A total of 243 (48.6%) males and 257 (51.4%) females were screened. The age range was 2–6 years (mean age of 4.31 ± 1.03 years). Fifty‐six children (68 teeth) suffered trauma to their primary teeth making a prevalence of 11.2%. Majority of dental traumas occurred at home (n = 49, 87.5%) followed by at street (n = 4, 7.1%) and at school (n = 3, 5.4%). The most common reason of oral trauma was falls (n = 53, 94.6%).The most commonly affected tooth was the maxillary right primary central incisor (n = 29, 42.6%) followed by the maxillary left primary central incisor (n = 26, 38.2%). There were 20 teeth with enamel fractures (29.4%), 18 teeth had enamel‐ dentin fractures (26.5%) and 10 teeth had complicated crown fractures (14.7%). There were 17 luxated teeth (25%) and only three primary teeth (4.4%) were avulsed. The only statistically significant relation found in this study was between the type of trauma and the type of the treatment provided. Of the traumatized teeth, 23 (33.8%) did not receive any type of dental or medical care. Conclusion: In spite of the low prevalence of dental trauma in Kuwaiti preschool children, it is highly recommended to plan a community wide trauma prevention campaign targeting parents, children and medical/dental care providers.     

Increased number of teeth predict acquisition of mutans streptococci in infants

This longitudinal study of 194 very‐low birthweight (VLBW) and 184 normal birthweight (NBW) infants hypothesized that the causal pathway between birth group (VLBW or NBW) and mutans streptococci (MS) acquisition (presence) at 18–20 months is mediated by biological, behavioral, and caregiver MS levels. Biological (number of teeth at 8 and 18–20 months and enamel hypoplasia) and behavioral (brushing/cleaning, sweet snacks, breastfeeding, and dental access) factors were assessed using dental examinations and caregiver questionnaire responses at 8 and 18–20 months. Infant MS acquisition and caregiver MS levels were assessed from saliva and plaque samples collected at 8 and 18–20 months. Structural equation modeling evaluated the causal pathway with latent variables for biology and behavior. Mutans streptococci presence was similar between birth groups at 18–20 months (40% in VLBW infants and 49% in NBW infants), but was significantly higher for NBW infants at 8 months. Increased number of teeth at 8 and 18–20 months was associated with biological risk. Infants whose caregivers had a 1‐point higher score on MS had a significantly (1.5) higher odds of MS presence. Caregiver behavior was not associated with MS presence. Early‐intervention efforts should focus on delaying initial acquisition and improving caregiver awareness of taking care of erupting primary teeth.     

Enamel defects in primary and permanent teeth of children born prematurely

The objective of this study was to determine the prevalence of enamel defects in both primary and permanent dentitions of the same preterm children, and to elucidate the role of early dietary mineral and vitamin D intake in the etiology of the enamel defects. The status of the primary and permanent teeth was evaluated in 32 preterm children and in 64 control children. The prevalence of enamel defects in children born preterm was clearly higher as compared with controls in both the primary (78% vs 20%, P<0.001) and permanent (83% vs 36%, P<0.001) dentitions. Neither the mineral supplementation used nor a vitamin D dose of 1000 IU/day, as compared with a lower dose of 500 IU/day, reduced the prevalence of enamel defects in the primary or permanent dentitions. Further studies are needed to clarify whether achieving near optimum intra-uterine mineral retention would lower the prevalence of subsequent enamel defects in infants born prematurely.