Pattern and severity of early childhood caries

OBJECTIVES: The aim of this study was to investigate the association between selected social and behavioural variables and the pattern and severity of early childhood caries (ECC) within a community child population. METHODS: A cross-sectional sample of 2515 children aged 4-5 years were examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) indices and a self-administered questionnaire was used to obtain information regarding social, demographic, birth, infant feeding, oral and general health attitudes. Children with caries (847) were divided into anterior or posterior caries pattern groups and severe (dmfs score > or =6) or non-severe (dmfs score <6) caries groups. The data were analysed using a chi-square test and modelled using a logistic regression procedure. RESULTS: Significant variables associated with anterior ECC pattern were ethnicity other than Caucasian (OR = 2.1, 95% CI = 1.4-3.1), sipping from the bottle during the day (OR = 1.9, 95% CI = 1.3-2.7), male gender (OR = 1.6, 95% CI = 1.2-2.2) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2). Significant variables associated with severe ECC form were sipping from the bottle during the day (OR = 2, 95% CI = 1.4-2.8), maternal age at birth < or =24 years (OR = 1.8, 95% CI = 1.3-2.7), ethnicity other than Caucasian (OR = 1.6, 95% CI = 1.1-2.5) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2). CONCLUSIONS: Infant bottle-feeding habits (either allowing a child to sip from a bottle during the day or put to sleep at night) and ethnicity other than Caucasian were significant determinants for both anterior caries pattern and severity of ECC in 4-5-year-old Australian children.     

学龄前儿童乳牙龋相关因素的分析

目的 评价学龄前儿童的唾液变形链球菌、唾液流速和缓冲力、口腔卫生状况、饮食和口腔卫生习惯、母亲文化程度和职业等因素在乳牙龋发生中的意义.方法 采用病例对照研究方法,对1018名4岁和5岁儿童进行龋齿检查,其中dmft≥6的204人构成高龋组,dmft=0的237人为无龋组.测定两组儿童唾液变形链球菌水平、唾液流速和缓冲力、软垢指数,并由儿童母亲回答统一问卷.结果 共有417名儿童纳入结果的统计中.Logistic回归分析结果显示,唾液变形链球菌(OR=3.019)、软垢指数(OR=2.263)、每天吃甜食次数(OR=1.729)、每天喝甜饮料次数(OR=1.496)、奶瓶内容物含糖(OR=2.255)等因素有意义.结论 唾液变形链球菌水平高、口腔卫生差、高频率摄入甜食、奶瓶喂养时内容物含糖是乳牙龋的重要危险因素.     

维生素D水平与低龄儿童龋风险的相关性分析

目的探讨维生素D水平与低龄儿童龋(early childhood caries,ECC)发生风险的相关性分析,为ECC儿童的一级预防提供依据。方法收集389名6~48月龄儿童的月龄、喂养方式、口腔健康行为等资料,记录龋、失、补指数(decayed?missing?filled teeth,dmft),分为ECC组(n=146)和无龋组(n=243),采集指尖末梢血检测维生素D体内活性形式--25?羟维生素D[25(OH)D],采集牙菌斑行龋活跃性检验检测龋态(Cariostat)值,Logistic回归分析25(OH)D等龋相关因素与ECC发生风险的相关性。结果25(OH)D缺乏、不足、正常的儿童的患龋率差异无统计学意义(c2=2.320,P=0.313)。dmft与25(OH)D水平之间无相关(dmft=1~3,r<0.001,P>0.05;dmft>3,r=0.009,P>0.05)。而月龄(OR=1.082,95%CI:1.045~1.121,P<0.001)、出生后6个月内母乳喂养(OR=2.789,95%CI:1.581~4.921,P<0.001)、吃夜奶或含乳头睡(OR=4.187,95%CI:1.938~9.048,P<0.001)、1.5~3.0的高Cariostat值(OR=4.173,95%CI:2.014~8.646,P<0.001)是ECC的风险因素。结论25(OH)D水平与6~48月龄儿童龋无相关性,而月龄、出生后6个月内母乳喂养、吃夜奶或含乳头睡、高龋活跃性(Cariostat值1.5~3.0)是ECC的风险因素,提倡母乳喂养的同时,应为幼儿树立良好的喂养习惯及口腔卫生习惯。     

Feeding habits as determinants of early childhood caries in a population where prolonged breastfeeding is the norm

Abstract – Objectives: To investigate the impact of feeding habits and daytime sugar intake on the prevalence of early childhood caries in a population where prolonged breastfeeding is a norm. Methods: A cross‐sectional study was carried out at 18 of 102 public health centers in Tehran. During a 4‐day period at each center, between 20 and 35 children aged 1–3 years were enrolled, resulting in a sample of 504 children. In structured interviews, mothers were asked to give information about their child’s feeding habits, daytime sugar intake, and their family’s background. Sugar intake during the night was operationalized as separately calculated burdens of nighttime breastfeeding and bottle‐feeding. Clinical dental examinations followed the World Health Organization criteria. Data analysis included chi‐square test, t‐test, anova , and logistic regression modeling. Results: Of the children, 56% were solely breastfed (mean duration 16.6 months; 95% CI 16.0–17.2), 42% were both breastfed and bottle‐fed, and 2% were solely bottle‐fed. Mean duration of breastfeeding for the solely breastfed 24‐ to 36‐month olds was 22.8 months (95% CI 21.8–23.9). At bedtime, 69% were breastfed, 11% bottle‐fed, and 20% were not fed at all. With respect to feeding during the night, 72% of children were breastfed, 12% were bottle‐fed with milk, 1% received a bottle with water, while 15% were not fed. Early childhood caries (ECC) occurred in 3–26% of the children, depending on age group (P < 0.001). The burden of milk‐bottle feeding at night was a clear determinant for ECC (OR = 5.5) whereas breastfeeding per se, its duration, the burden of breastfeeding at night, and daytime sugar intake were not. Conclusion: On account of its association with ECC, milk‐bottle feeding at night should be limited, whereas prolonged breastfeeding appears to have no such negative dental consequences.     

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.     

南京市低龄儿童龋风险的影响因素研究

目的 分析低龄儿童龋风险的影响因素,完善低龄儿童龋风险评估模型,以便辅助诊断低龄儿童龋,提供有效的预防及治疗建议。方法 收集来自南京医科大学附属口腔医院儿童牙病预防科临床就诊患者的基线资料,使用CPI探针检查全口牙齿状况,对儿童家长进行问卷调查。所有儿童采集静脉血5 mL。采用单因素及多因素Logistic回归进行相关因素分析。结果 本研究纳入199例龋高风险儿童,多因素logistic回归分析结果显示,血液中总蛋白比值比（Odds ratio,OR）=1.092,95%可信区间（Confidence interval,CI)：1.034~1.155、血清钾（OR=2.175,95%CI：1.056~4.48）、二氧化碳（OR=1.32,95%CI：1.194~1.459）及磷酸肌酸激酶水平（OR=1.007,95%CI：1.001~1.014）与低龄儿童龋风险相关。结论 龋高风险儿童血检生化指标中总蛋白、血清钾、二氧化碳及磷酸肌酸激酶水平均高于无龋儿童,提示这些指标均可能是低龄儿童龋风险的影响因素。     

Early childhood caries status and its associated factors among young children in a rural area of Cambodia

BackgroundThe purpose of this cross-sectional study was to measure prevalence and severity of early childhood caries (ECC), and its associated factors among 1- and 2-year-old children in Kampong Cham province, Cambodia.Materials and methodsData, from a representative sample of 128 children (69 males, 59 females; mean age = 22.98 ± 7.68 months), were collected at seven villages in Khpob Ta Nguon district, Kampong Cham province from May to October in 2018. The dental caries status was recorded following WHO guidelines. The socio-economic status, dietary habits and oral hygiene habits of the children were assessed through an interview questionnaire administered to their primary caregivers.ResultsECC prevalence was 50.0%. The mean dft was 2.46 ± 3.08, and 100% of cavitated lesions were untreated. A logistic regression revealed that 1-year-old children who continued night breast-feeding after 12 months were more likely to have ECC (OR = 5.32, 95%CI = 1.33–21.30), whereas the 2-year-old children who continued night breast-feeding beyond 12 months (OR = 13.36, 95%CI = 2.14–82.31), bottle-feeding after 12 months (OR = 6.10, 95%CI = 1.56–23.87), and children who did not adopt tooth brushing by the 1st birthday (OR = 32.23, 95%CI = 4.51–230.54) were more likely to have ECC.ConclusionThe findings of this study indicate that ECC prevalence and severity among this group of rural Cambodian children were high. Oral health programs focusing ECC prevention from an early age should be conducted in this population.     

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.     

成都地区混合牙列期及恒牙列初期儿童错牙合畸形患病率的调查研究

目的    调查研究成都地区混合牙列期及恒牙列初期儿童错牙合畸形的患病率,分析影响错牙合畸形发生的相关危险因素。方法    通过问卷调查及临床检查的方法,抽样调查5 ~ 13岁处于混合牙列期及恒牙列初期成都地区2056名儿童的错牙合畸形患病情况,统计错牙合畸形患病率并分析其可能的危险因素。结果    调查儿童患龋率为59.78%,龋均为2.33。混合牙列期儿童错牙合畸形患病率为64.64%,恒牙列初期错牙合畸形患病率为71.01%。错牙合畸形发生的危险因素包括龋病（OR = 3.805,95%CI：3.029 ~ 4.778,P < 0.001）、错牙合畸形遗传史（OR = 2.251,95%CI：1.219 ~ 4.156,P = 0.010）、口腔不良习惯（OR = 18.794,95%CI：9.643 ~ 36.629,P < 0.001）及食物精细（过于精细食物OR = 7.016,95%CI：4.557 ~ 10.802,P < 0.001;一般精细食物OR = 3.714,95%CI：2.587 ~ 5.333,P < 0.001）。结论    成都地区混合牙列期及恒牙列初期儿童患龋率及错牙合畸形患病率均处于较高水平;错牙合畸形发生的危险因素包括龋病、错牙合畸形遗传史、口腔不良习惯及食物过于精细。     

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.     

Factors Influencing Early Childhood Caries of Cleft Lip and/or Palate Children Aged 18 to 36 Months in Southern Thailand

Objective: To clarify whether oral health care behavior or oral cleft status influences early childhood caries in southern Thailand cleft children. Design: A comparative cross-sectional study. Patients, Participants: A total of 138 southern Thai children aged 18 to 36 months comprised two groups of 69 participants, one with cleft lip and/or palate and controls with no cleft. Methods: All children were examined for early childhood caries by using the severity (DMFT/tooth) index. A structured interview was conducted among caregivers, and then multiple regression analysis was applied. Results: Children with oral clefts had a larger number of early childhood caries (ECC) and poorer feeding habits than those without. From a structured questionnaire, the caregivers of children with clefts exercised poorer oral health behavior than those of the controls, but the cleft status was not an important factor for caries prevalence when oral health behaviors were controlled. Multivariate analysis showed that sweetened bottled milk consumption, night-time feeding habit, and frequent sugary food consumption were the variables significantly associated with dental caries. Conclusions: Children with oral clefts in southern Thailand had greater caries experience when compared with noncleft subjects. However, cleft status was not significant for ECC, and night-time feeding habit was the most important factor for higher ECC in children with clefts.     

Is attention-deficit hyperactivity disorder a risk factor for dental caries? A case-control study

Experience in practice has suggested that children with attention-deficit hyperactivity disorder (ADHD) tend to have higher numbers of diseased, missing and filled teeth (DMFT score) than children without the condition. To date, however, this impression has not been systematically investigated. A case-control study of children in Otago, New Zealand (case DMFT > or = 5; control DMFT <5; case status determined from School Dental Service dental records) was conducted by postal survey and reference to the School Dental Service records. Cases and controls were matched on age, sex, ethnicity, and school socio-economic status. The purpose of the study was to assess whether having ADHD was associated with higher odds of having high caries experience. Questionnaires were returned for a total of 128 case-control pairs. Conditional logistical regression analysis showed that, after controlling for fluoride history, medical problems, diet, and self-reported oral hygiene, children with ADHD had nearly 12 times the odds of having a high DMFT score than children who did not have ADHD (OR = 11.98; 95% CI 1.13, 91.81). No other factors were significant predictors. Dental practitioners and parents should consider ADHD to be a condition that may affect children's dental caries experience.     

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.     

Early Childhood Caries in Victorian Preschoolers: A Cross-Sectional Study

AimThe objective of this work was to determine the prevalence of early childhood caries (ECC) in children attending preschools that are enrolled in the Smiles 4 Miles health promotion program in Victoria and determine the sociodemographic variables associated with ECC.Materials and methodsA cross-sectional sample of 1,845 3- to 5-year-old children attending 61 preschools was selected by stratified cluster sampling. Dental caries was classified as non-cavitated/early lesions (d^1-2), cavitated (d^3-6) lesions, and cavitated/non-cavitated (d^1-6) lesions using the International Caries Detection and Assessment System. A self-administered parental questionnaire captured sociodemographic and behavioural data. Multivariate logistic regression and Poisson mixed model analysis was used to examine associations amongst sociodemographic variables, child oral health behaviours, and decayed tooth surfaces.ResultsIn all, 56.6% (n = 1,044) of the children had ECC; more than one-third (36.6%) presented exclusively non-cavitated/early lesions, 5.7% solely cavitated lesions, and 14.2% both. Children from socioeconomically disadvantaged backgrounds had higher levels of dental caries. Parental pensioner/health care card status (incidence rate ratio [IRR] = 1.76, 95% CI, 1.57-1.97), non-English-speaking background (IRR = 2.09, 95% CI, 1.80-2.43), and Indigenous status (IRR = 1.91, 95% CI, 1.50-2.43) were associated with higher rates of cavitated lesions. Children who consumed soft drinks once or more per week had 1.66 times more cavitated lesions (95% CI, 1.48-1.86) compared to children who never/rarely consumed soft drinks. Soft drink consumption of once or more per week was associated with parental health care/pensioner card status (odds ratio [OR] = 1.73, 95% CI, 1.36-2.18), non-English-speaking background (OR = 1.58, 95% CI, 1.11-2.27), and Indigenous status (OR = 1.92, 95% CI, 1.04-3.52).ConclusionsHigher levels of more severe caries rates in children from socioeconomically disadvantaged background highlight an opportunity for early preventive interventions targeting these groups.     

Bacterial, behavioral and environmental factors associated with early childhood caries

The goals of this cross-sectional study were to characterize and compare demographic, behavioral, and environmental factors potentially associated with early childhood caries (ECC) and to assess salivary levels of mutans streptococci (MS) and lactobacilli (LB) in underserved, predominantly Hispanic children. One hundred forty-six children aged 3 to 55 months with a range of caries experience were identified and examined. ECC was primarily associated with the presence of MS and lack of access to dental care. Salivary MS levels among young children with ECC were higher than would be expected in a dentally healthy population, but lower than levels reported among older children at high risk for caries. After adjustment for age, children with log10 MS > or = 3.0 or log10 LB > or = 1.5 were about five times as likely (OR=4.9, 95% CI=2.0, 12.0) to have ECC than those with lower bacterial levels. This study demonstrated a significant association between relatively low cariogenic bacterial levels and dental caries in infants and toddlers. Antibiotic use, exposure to lead, and anemia were not significantly associated with the number of decayed and filled surfaces or decayed and filled teeth. ECC correlated significantly with child's age and lack of dental insurance of the children, as well as inversely with both family income and the educational level of the mother of the child.     

Dentin caries risk indicators in 1-year-olds. A two year follow-up study

Background: Early childhood caries (ECC) risk factors are suspected to vary between regions with different caries prevalence.

Aim: Identify ECC risk factors for 1-year-olds predicting dentin caries at 3 years of age in a region with low caries prevalence.

Design: Caries risk was assessed by dental hygienist or dental assistant in 779 one-year-olds. The oral mutans streptococci (MS) score was performed from a tooth surface or (in pre-dentate children) from oral mucosa. A parental questionnaire with questions regarding family factors (siblings with or without caries), general health, food habits (night meals, breastfeeding, other beverage than water), oral hygiene habits and emerged teeth were answered by parents of the 1-year-olds. Dentin caries was assessed when the children were 3-year-olds. Simple and multiple logistic regression analyses were used for identification of caries-associated factors.

Results: An increased caries risk was assessed in 4.4% of the 1-year-olds. Dentin caries was found in 2.6% of the 3-year-olds. Caries risk at 1 year was associated with caries at 3 years (OR?=?6.5, p?=?.002). Multiple regression analysis found the variables Beverages other than water (OR?=?7.1, p?Caries in sibling (OR?=?4.8, p?=?.002), High level of MS (score 2–3) (OR?=?3.4, p?=?.03) and Night meal (OR?=?3.0, p?=?.03) to be associated with caries. The single variables Beverage other than water between meals and Caries in sibling were more reliable than Caries risk assessed performed by dental personnel.

Conclusions: Behavioural, family and microbial factors are important when assessing caries risk among 1-year-olds in a region with low caries experience.     

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 prescription and outcomes of fissure sealants applied to a group of high caries risk children by general dental practitioners working in the North West of England

OBJECTIVE: To describe the use and outcomes of fissure sealants applied to the first permanent molars (FPMs) of children with high caries risk. DESIGN: Retrospective cohort study. SETTING: General dental practices in North West England. PARTICIPANTS: 677 children between the ages of 5 and 14 years who had dmfs > or =2, and regularly attended 50 general dental practitioners. OUTCOMES: Analyses were performed at patient level. Logistic regression models, taking into account the clustering of subjects within dental practices, were fitted to identify whether the decision to fissure seal FPMs was significantly associated with gender, socio-economic status, number of carious primary teeth and percentage of carious primary teeth filled. Similar logistic regression models were fitted for caries experience in FPMs. RESULTS: Poorer children were significantly (p < 0.05, OR = 0.84, 95% CI = 0.71, 0.99) less likely to receive fissure sealants than affluent children, whilst girls (p < 0.01, OR = 1.54, 95% CI = 1.12, 2.12) were more likely to have sealants than boys. The total number of carious primary teeth was also a significant (p < 0.01, OR = 1.15, 95% CI = 1.06, 1.25) independent predictor of dentists' decisions to fissure seal FPMs. For each carious primary tooth, the odds of having caries in FPMs increased by 1.16 (95% CI = 1.06, 1.26). Analysis showed that pit and fissure caries in FPMs was not affected by the presence or absence of fissure sealants. CONCLUSIONS: The decision to fissure seal FPMs is affected by caries experience in the primary dentition. Girls and affluent children were more likely to receive fissure sealants. It appears that the placement of fissure sealants by general dental practitioners was not effective in preventing pit and fissure caries in these high-risk children.     

Risk factors for dental caries in the five-year-old South Australian population

BACKGROUND: This study tested the hypothesis that risk behaviours in disadvantaged groups would explain socio-economic inequality in dental caries prevalence among preschool children. METHODS: Using a case-control study, children with caries experience (one or more decayed, missing or filled primary tooth surfaces) and with no caries experience were sampled with known probabilities from among five year olds attending the South Australian Dental Service (SADS). Dental caries experience of primary teeth was recorded by SADS clinicians. Social and behavioural information was collected using a questionnaire mailed to parents. Prevalence rates, prevalence ratios (PR) and 95 per cent confidence intervals (95% CI) were computed, taking into account sampling probabilities. RESULTS: Questionnaires were obtained for 64.6 per cent of sampled children (n = 1398) and 40.2 per cent (95% CI = 37.8-42.6) of them had caries experience. Five statistically significant risk factors were identified relating to previous feeding, current oral hygiene and parent's own oral health perceptions. The prevalence of four risk factors was greater in low-income households compared with high-income households (P < or = 0.01). In multivariate analysis, after adjusting for age of tooth cleaning onset, age at which toothpaste was introduced was not significantly associated with caries prevalence. Behavioural risk factors did not explain income-related gradients in caries prevalence but modified the level of risk associated with delayed onset of tooth cleaning. Children who delayed tooth cleaning until the age of 24 months or more and who were from low-income households had a 2.7-fold increase in caries prevalence (95% CI = 2.1-3.4). CONCLUSIONS: Caries prevention efforts need to target behaviours in infancy and non-behavioural risk factors among preschoolers in low-income households.     

Factors associated with prevalence and severity of caries experience in preschool children

Abstract – Objectives: The aim of the present study was to examine the prevalence and severity of caries experience in the primary dentition of preschool children and to assess the association of disease distribution with oral hygiene levels, reported oral health behaviours and socio‐demographic factors. Methods: Study samples comprised 1250 3‐year‐old and 1283 5‐year‐old pre‐school children from four distinct geographical areas in Flanders. Information on oral hygiene and dietary habits, oral health behaviours and socio‐demographic variables was collected using questionnaires completed by the parents. Clinical examinations were performed using standardized criteria. Caries experience was recorded at the level of cavitation (d₃ level). Simple as well as multivariable logistic regression analyses were performed in order to identify factors associated with prevalence and severity of caries experience. Results: Visible plaque was present in 31% of 3‐year‐olds and 37% of 5‐year‐olds. In 3‐year‐olds, 7% presented with caries experience while this was the case in 31% of 5‐year‐olds. Multivariable logistic regression revealed significant associations, in 3‐year‐olds, of caries experience with presence of dental plaque (OR = 7.93; 95% CI: 2.56–24.55) and reported consumption of sugared drinks at night (OR = 7.96; 95% CI: 1.57–40.51). In 5‐year‐olds, significant associations were seen with age (OR = 7.79; 95% CI: 2.38–25.43), gender (OR = 0.37 with 95% CI: 0.19–0.71 for girls), presence of visible dental plaque (OR = 3.36; 95% CI: 1.64–6.89) and reported habit of having sugar‐containing drinks in between meals (OR = 2.60 with 95% CI: 1.16–5.84 and OR = 3.18 with 95% CI: 1.39–7.28, respectively for 1×/day and > 1×/day versus not every day). In 5‐year‐olds with caries experience (30.8% of total sample), the severity of disease was further analysed (d₃mft between 1 and 4 versus d₃mft 5 or higher). Multivariable analyses showed a significant association with gender [girls more likely to have higher disease levels; OR = 4.67 (95% CI: 1.65–13.21)] and with presence of plaque (OR = 3.91 with 95% CI: 1.23–12.42). Conclusions: Presence of visible plaque accumulation and reported consumption of sugared drinks were associated with prevalence of caries experience in Flemish preschool children. Severity of disease was associated with gender and with presence of plaque. Results underline the importance of plaque control and diet management from very young age on.