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.     

重庆市学龄前儿童龋病状况调查

目的 了解重庆市学龄前儿童乳牙龋患病情况,同时比较公办幼儿园和民办幼儿园学龄前儿童的乳牙龋患病情况。方法 以重庆市渝中区40所民办幼儿园和16所公办幼儿园的5 030名3~6岁儿童为调查对象,按照第3次全国口腔健康流行病学调查诊断标准进行口腔检查,提取龋病情况资料,包括患龋率、龋均、龋齿充填率等。采用SPSS 21.0软件进行统计学分析。结果 5 030名受检儿童中,最容易患龋的牙位为上颌乳中切牙和下颌乳磨牙。患龋率为54.08％（2 720/5 030）,龋均为2.58,龋齿充填率为0.98%（127/12 993）。随着年龄增长,儿童患龋率和龋均增加（P<0.05）。6岁年龄儿童的龋齿充填率最高（P<0.05）,不同性别的龋齿充填率无统计学差异（P>0.05）。民办幼儿园的患龋率、龋均和龋齿充填率分别为61.04%（1 656/2 713）、3.12和0.35%（30/8 465）,公办幼儿园的患龋率、龋均和龋齿充填率分别为45.92%（1 064/2 317）、1.95和2.14%（97/4 528）,民办幼儿园与公办幼儿园之间有统计学差异（P<0.05）。结论 重庆市学龄前儿童乳牙患龋率较高,龋齿充填率较低,其中民办幼儿园学龄前儿童的口腔健康状况明显差于公办幼儿园。     

Dental caries in preschool Beijing and Connecticut children as described by a new caries analysis system

Abstract – A total of 625 children, 3-4 yr old, 426 from Connecticut Head Start programs and 199 from Beijing area nursery schools, were clinically examined for dental caries. Results were analyzed using the traditional dmfs index as well as a new "Caries Analysis System". This new system differentiated between caries patterns and examined the percentage of affected children (Prevalence), the degree to which these children were affected (Severity) and the proportion of total caries each disease pattern represented (Distribution). The Caries Analysis System revealed differences in caries experience and patterns among the racial/ethnic groups that the dmfs index did not. The Beijing children experienced the greatest Prevalence of all caries patterns; however, the Severity and Distribution of the caries patterns were similar to those of the Connecticut children. Within the group of Connecticut children, White children had the lowest Prevalence but the greatest Severity when compared with the Black and Hispanic children.     

儿童乳牙龋和乳牙黑色素沉着关系研究

目的　评价学龄前儿童乳牙色素沉着患病率以及色素沉着与乳牙龋之间的关系。方法　选取上海市5个公立幼儿园的1 012名学龄前儿童进行调查,1名口腔医师采用WHO推荐的方法进行龋齿的检查,另1名口腔医师检查颊舌面色素沉着。采用SPSS软件对数据进行统计分析。结果　乳牙色素沉着的患病率为12.7%,色素沉着最常见的部位是下颌前牙的舌侧。乳牙色素沉着与年龄和性别无关。城区幼儿园儿童乳牙色素沉着患病率为16%,明显高于郊区儿童6.4%的患病率（P<0.001）。有色素沉着的儿童患龋率和龋失补牙数、龋失补牙面数分别为56.6%、2.94和4.41,明显低于无色素沉着儿童（72.1%,dmft:4.25; dmfs:7.06,P<0.001）。但两组龋齿的牙面分布比例无明显区别。结论　乳牙色素沉着和乳牙龋之间存在负相关关系。     

重庆市学龄前儿童乳牙龋状况及影响因素分析

目的 探讨重庆市3~5岁学龄前儿童乳牙患龋状况及相关影响因素,为学龄前儿童龋病的预防和干预提供相关资料。方法 参考第四次全国口腔健康流行病学调查,对重庆市4个区学龄前儿童进行抽样调查,同时对家长进行问卷调查。利用Epidata 3.1和SPSS 21.0软件进行结果录入和统计学分析。结果 共计1 350名学龄前儿童纳入调查分析,口腔检查相关数据显示乳牙龋好发牙位是上颌乳中切牙和下颌乳磨牙,乳牙患龋率为51.4%（694/1 350）,龋均为2.34,各年龄组间患龋率和龋均差异有统计学意义（P<0.01）,且二者随着年龄增长而上升（P<0.05）。除5岁组男、女龋均有统计学差异外（P<0.05）,其余患龋率和龋均在不同性别间差异均无统计学意义（P>0.05）。61.7%龋坏集中在36.1%个体口腔中。多因素Logistic回归分析显示年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评对乳牙患龋有重要影响（P<0.05）。结论 重庆地区3~5岁儿童超过半数患龋,多数龋齿集中发生在少数患儿口内。乳牙患龋与年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评有关。     

Dental caries and dental registration status in nursery school children in Newry, Northern Ireland

Abstract 294 children aged 2–4 yr attending nursery schools in Northern Ireland were examined for dental caries and dental registration status under the capitation system in general dental practice. Their mean age was 3 yr 10 months. Sixty eight per cent were caries free, mean dmft was 1.10 and dt, mt and ft scores were 0.74, 0.28 and 0.09, respectively. With increasing age the prevalence of caries increased, though the very low care index (d/dmft) did improve in the older children. Seventy per cent reported being registered for dental care and their levels of dental caries were significantly higher than those who were not yet enrolled (P < 0.001). For those not enrolled for dental care the main perceived barriers to seeking care related to lack of symptoms (33.6%) and apathy (31.6%) while few reported fear as a barrier (4.5%).     

Correlation between caries experience in primary and permanent dentition in birth-cohorts 1950–70

Abstract – Caries experience in the primary molars and canines at 8 yr of age and in the permanent dentition at 16 was correlated in every fourth birth-cohort between 1950 and 1970 in a Danish community. Correlations between 0.44 and 0.56 were found. Cross-tabulation of the data also revealed close association, but prediction of individual high caries risk children based solely on screening for caries experience in the primary dentition is hardly cost-effective.     

应用氟化泡沫预防幼儿龋齿的防龋效果观察

目的：抽样调查东西湖区儿童使用氟化泡沫预防龋齿的效果。方法：对东西湖区8所幼儿园进行随机抽样,实验组儿童采用氟化泡沫护齿,每年2次,对照组儿童不做任何处理,2年后观察两组儿童之间患龋率及新龋发生率。结果：2年后实验组患龋率及新龋发生率均低于对照组,差异有统计学意义。结论：氟化泡沫能有效预防学龄前儿童龋病发展。     

Salivary mutans streptococci and dental caries patterns in pre-school children

Abstract Recent studies have suggested that the identification of caries as discrete patterns may be valuable in describing and predicting caries experience on an individual basis. The purpose of this study was to assess the association between levels of salivary mutans streptococci and the prevalence, incidence and distribution of caries patterns in the primary dentition. A cohort of pre-school children (n=146, mean age 3.8 yr) were examined for dental caries and sampled for salivary mutans streptococci (SMS) at baseline and once annually for 2 yr. Children's tooth surfaces were categorized into four patterns: pit/fissure, maxillary anterior, posterior proximal, and buccal/lingual smooth surface. Salivary mutans streptococci were enumerated using a tongue blade technique, and were categorized as low (0 CPU), moderate (1–50 CPU) and high (>50 CPU). At year 2, children with high baseline SMS had the 1) highest prevalence of caries (87%) and the highest dmfs (9.15); 2) highest prevalence of each pattern, and 3) greatest number of patterns. Among children with the pit/fissure pattern, those with high baseline SMS had the greatest pit/fissure dmfs after 2 yr. Results show that baseline SMS levels were associated with both cross-sectional and longitudinal caries experience, numbers of caries patterns, and the prevalence and severity of those patterns.     

颌骨囊肿刮除术并发症的预防与处理

 颌骨囊肿刮除术是牙源性颌骨囊肿的常规治疗手段，但囊肿刮除术中、术后的并发症常影响骨腔的愈合以及患者的生活质量。常见并发症有术后感染、囊肿复发、病理性骨折、感觉异常等。这些并发症的发生与囊肿大小、患病部位、手术方式、是否有植入物等有密切关系。避免或减少这些并发症对提高临床疗效、改善患者生活质量有非常重要的意义。文章结合该领域研究现状和笔者的经验，介绍颌骨囊肿刮除术相关并发症的预防与处理。     

深圳地区学龄前儿童龋活跃性的研究分析

目的:通过对深圳地区学龄前儿童患龋状况的调查,采用龋病活跃性试验(CAT)检测幼儿龋病活跃性,了解学龄前儿童龋发病情况及龋活跃性与患儿性别、年龄之间的关系。方法:选择深圳地区某幼儿园3~5岁189名幼儿,进行口腔龋齿检查并记录患龋状况,同时采用CAT试剂检测其龋活跃性,分析幼儿患龋状况、CAT、性别及年龄之间的关系。结果:①患龋状况:总患龋率73.02%;总龋失补牙数(dft)3.96±4.06;总龋蚀指数(CSI):11.80±15.53;②性别及各年龄组间dft、CSI无显著性差异(P>0.05);③CAT 3度与其他度之dft、CSI差异有统计学意义(P<0.05)。CAT度数越高,患龋状况越严重;④CAT分度与dft、CSI高度相关(r=0.378,r=0.360,P<0.05)。结论:CAT各度间患龋状况有显著性差异,与患龋状况有高度相关性,提示CAT能反映机体之患龋状况。     

学龄前儿童龋病高发的危险因素

龋病在我国是学龄前儿童的高发疾病,了解其发生的危险因素可以进行龋风险评估,降低龋高发儿童的龋病发生率。本文对学龄前儿童龋病高发的危险因素进行综述。     

Dietary determinants of dental caries and dietary recommendations for preschool children

OBJECTIVES: The purpose of this review, commissioned by the Administration for Children and Families, the Health Resources and Services Administration, the Health Care Financing Administration, and the Department of Agriculture's Food and Nutrition Service, was to update the evidence of the dietary factors that affect dental caries, and subsequently formulate dietary recommendations for preschool children based on principles of cariology. METHODS: Literature on the dental caries process, dietary factors affecting dental caries initiation and progression, and nutrition education and counseling were reviewed and synthesized. Dietary guidelines for children at various ages were then constructed based on the review. RESULTS: Dental caries in preschool children is due to a combination of factors, including colonization of teeth with cariogenic bacteria, type of foods and frequency of exposure of these foods to the cariogenic bacteria, and susceptible teeth. Caries risk is greatest if sugars are consumed at high frequency and are in a form that is retained in the mouth for long periods. Sucrose is the most cariogenic sugar because it can form glucan that enables firm bacterial adhesion to teeth and limits diffusion of acid and buffers in the plaque. There is emerging interest in the effects of tooth development and its role in the future dental caries risk of the child. CONCLUSIONS: Nutrition education and counseling for the purposes of reducing caries in children is aimed at teaching parents the importance of reducing high frequency exposures to obvious and hidden sugars. Guidelines include: avoiding frequent consumption of juice or other sugar-containing drinks in the bottle or sippy cup, discouraging the behavior of a child sleeping with a bottle, promoting noncariogenic foods for snacks, fostering eating patterns consistent with the Food Guide Pyramid, limiting cariogenic foods to mealtimes, rapidly clearing cariogenic foods from the child's oral cavity either by toothbrushing or by consumption of protective foods, and restricting sugar-containing snacks that are slowly eaten (e.g., candy, cough drops, lollipops, suckers). Along with nutritional factors, a comprehensive approach to preventing dental caries in preschool children must include improved general dietary habits, good oral hygiene, appropriate use of fluorides, and access to preventive and restorative dental care.     

Decreasing caries prevalence in Japanese preschool children is accompanied with a reduction in mutans streptococci infection

OBJECTIVE: To evaluate the association between decreasing caries prevalence in Japanese preschool children and mutans streptococci (MS) infection. METHODS: The prevalence of caries and salivary MS was examined in 1- to 3-year-old preschool children in 1995 (n = 135) and 2000 (n = 118). RESULTS: The caries prevalence for 3-year-old subjects significantly declined from 65.1% to 37.5% (p < 0.01), reflecting the data seen in Japanese national oral health surveys in 1993 and 1999. Salivary MS detection for 3-year-old subjects significantly declined from 68.3% to 37.5% (p < 0.05). On the other hand, the decrease in the prevalence of caries and salivary MS was not significant in 1- and 2-year-olds. The correlation between caries experience (dft) and the salivary MS score for 3-year-old subjects with low caries prevalence in the later examination (r(s) = 0.479, p < 0.001) was comparable with that in 1995 (r(s) = 0.462, p = 0.001). CONCLUSIONS: The recent decrease in decay in Japan is accompanied with a reduction in MS infection in the deciduous dentition. MS levels are closely related to caries prevalence in preschool children regardless of the extent of caries.     

The Association of Early Dental Caries Patterns with Caries Incidence in Preschool Children

Objectives : This study assessed the development of caries in preschool children over two years according to baseline caries pattern. Methods : Connecticut Head Start children (n=142, mean age=3.8 years) were examined for dental caries at baseline (spring 1991) and once annually for two years. Children were categorized at baseline as caries-free, having pit and fissure (PF) caries, or having maxillary anterior (MA) caries. Results : After two years, children who presented at baseline with MA or PF caries had a mean posterior dmfs of greater than seven and four times, respectively, that of children who were caries-free at baseline. When dental caries of the primary dentition was categorized by specific posterior patterns (i.e., posterior proximal [PPJ] and buccal/lingual [BL]), change in dmfs for the PP and BL patterns in the group that presented with pit/fissure caries at baseline were nearly four and three times greater, respectively, than for those in the caries-free group. The group that presented with maxillary anterior caries at baseline had PP and BL caries increments eight times those of children who began caries-free. Conclusion : Dental caries presentation in 3- to 4-year-old children can identify those children and tooth surfaces that will be at the greatest risk for future caries development.