Dental caries experience: a two-generation study

The life-course framework stresses the importance of social, psychosocial, and biological factors in early life on the development of later disease. From this perspective, the association between edentulousness of mothers and their children's caries risk has not been studied. Therefore, a sample of 6303 mother-child pairs was randomly selected in Quebec (Canada). Mothers (6039 dentate and 264 edentulous) completed a self-administered questionnaire, and their children, aged 5 to 9 years, were clinically examined. Bivariate analyses and multiple logistic regressions showed that edentulous mothers' children are more likely to experience caries on both primary [OR=1.7 (1.3-2.3)] and permanent [OR=1.4 (1.0-2.0)] dentitions when compared with dentate mothers' children. These results are independent of socio-economic status, age, gender, and children's oral-health-related behaviors. Our study is the first to show that edentulous mothers' children constitute a group at risk of caries. It also highlights the need for a better understanding of the mother-child transmission of risk.     

Dental health and treatment in a group of children with congenital heart disease

PURPOSES: The purposes of this study were to: (1) determine the prevalence of dental caries and developmental enamel defects in children with congenital heart (CHD) disease; and (2) evaluate previous dental treatment. METHODS: One hundred and seventy-six 2- to 16-year-old children were examined during their outpatient cardiology appointment. The study group consisted of 86 CHD children. Sixty healthy children formed the control group. RESULTS: Mean dmft and DMFT scores were 1.57 (+/- 3.01 SD) and 0.77 (+/- 1.42) for the study group and 1.81 (+/- 3.64) and 0.38 (+/- 1.16) for the control group, respectively. Eight out of 86 CHD children and 5 out of 60 healthy children had enamel defects on their permanent teeth. No significant differences were demonstrated between the 2 groups. The care index for primary teeth was 10% for the study group and 3% for the control group. In permanent dentition, the care index was 30% and 16%, respectively CONCLUSIONS: Children with and without congenital heart disease had similar levels of dental disease. The care index for primary teeth was higher in CHD children, although the overall level was very low.     

Dental caries experience of children with haemophilia in Northern Ireland

It is generally agreed that persons suffering from haemophilia form a priority group for dental care. The present study compares the prevalence of dental caries in haemophilic children in Northern Ireland with the reported values for similarly aged children in the population. The prevalence of caries experience and of untreated caries were low in the haemophiliacs in both the primary and permanent dentitions. No teeth had been extracted due to caries and a high level of fluoride usage was claimed. The dental care of these patients is carried out at the regional treatment centre and forms an integral part of their medical care.     

Attitudes about dental care among parents whose children suffer from severe congenital heart disease: a case-control study

Summary. Objectives. To examine attitudes and experiences of parents whose children have complex congenital heart disease (CHD) with respect to dental health information and advice, dental care, and service and to compare the results with data from an age‐ and gender‐matched control group without any medical problems. Setting. Faculty of Medicine (Paediatric Cardiology and Paediatric Dentistry), Umeå University, Umeå, Sweden. Sample and method. Each group comprised parents of 33 children; the children's mean age was 9·4 years. All the cases and the controls resided in the county of Västerbotten, northern Sweden. Data were collected with a questionnaire with 20 joint questions to both groups and four additional questions to the CHD group. Results. Of the 20 joint questions, significant differences were displayed in the following areas: the professional group that provided the parents with dental health information and advice (P < 0·01), attitudes to reception at the dental clinic, and experience of sedation before operative dental treatment (P < 0·05). Parents to 11 children with CHD who were patients at a specialist clinic for paediatric dentistry scored the reception at the dental clinic as excellent in nine cases and satisfactory in two, compared to excellent (3), satisfactory (11), decent (4), and poor (4) among those who were patients in general dental practice (P < 0·01). No statistically significant differences in educational level or in parental experience of dental health were noted between the two groups (P > 0·05). Conclusion. Children with CHD in northern Sweden mainly receive their dental health information from a physician or a dentist, and healthy children mainly receive information from a dental hygienist indicating that children with CHD are given priority in the dental care system. Parental attitudes to reception in the dental service differed, and parents of healthy children scored the reception at the dental clinic better than parents of children with CHD. It is suggested that children with severe CHD should receive dental care in clinics for paediatric dentistry, particularly at early ages.     

Dental caries experience of British children in an international context

OBJECTIVES: To document data on current and past levels of dental decay in British children and compare trends with those in other countries, in Europe in particular. METHOD: Data were abstracted from multiple sources and collated and tabulated. RESULTS: The dental health of the majority of British children has improved dramatically since the early 1970s. Twelve-year-old children now have on average less than one decayed, missing (extracted) or filled tooth. Levels of dental decay in UK children at 5 and 12 years are among the lowest in the world. There are still marked inequalities in the dental decay experience of children between the territorial regions of the UK, high and low socio-economic groups, and regular and symptomatic dental attenders. Many children in areas of deprivation are either not motivated to seek dental treatment or experience barriers in obtaining it. In parallel with improvements in the dental health of the majority of children, the proportion of UK adults who have no natural teeth has fallen from 37% to 12% over the past four decades. Total tooth loss is now confined almost entirely to individuals over 45 years of age. Most of the improvements in children's dental health are attributable to environmental factors, in particular the widespread availability of fluoride containing toothpastes since the 1970s. There are clear benefits from fluoridation of public water supplies over and above those attributable to other factors. CONCLUSIONS: The findings suggest initiatives should be directed to bringing children from deprived backgrounds under the umbrella of dental care. To help alleviate the inequalities in dental health, water fluoridation should be implemented, in urban industrial areas in particular, where levels of dental decay are still unacceptably high.     

Dental caries: a dynamic disease process

Abstract Dental caries is a transmissible bacterial disease process caused by acids from bacterial metabolism diffusing into enamel and dentine and dissolving the mineral. The bacteria responsible produce organic acids as a by-product of their metabolism of fermentable carbohydrates. The caries process is a continuum resulting from many cycles of demineralization and remineralization. Demineralization begins at the atomic level at the crystal surface inside the enamel or dentine and can continue unless halted with the end-point being cavitation. There are many possibilities to intervene in this continuing process to arrest or reverse the progress of the lesion. Remineralization is the natural repair process for non-cavitated lesions, and relies on calcium and phosphate ions assisted by fluoride to rebuild a new surface on existing crystal remnants in subsurface lesions remaining after demineralization. These remineralized crystals are acid resistant, being much less soluble than the original mineral.     

Periodontal conditions in patients with coronary heart disease: a case-control study

Aim: This study examined periodontal conditions in patients with coronary heart disease (CHD) and subjects with no history of CHD. Material and Methods: Participants were 161 patients (40–75) with severe angina pectoris (diagnosed as CHD by coronary angiography) who subsequently underwent percutaneous coronary intervention and 162 control subjects with no history of CHD. Periodontal status was recorded. Bone loss was determined on radiographs. Periodontal disease experience was classified into five groups according to Hugoson & Jordan. Results: Periodontal disease experience groups 4 and 5 were more common in the CHD group (25%) compared with the control group (8%). The mean bone level (the distance from the CEJ to the most coronal level of the alveolar bone) was 3.0±1.0 mm in CHD subjects and 2.6±0.8 mm in controls. CHD patients had significantly lower numbers of natural teeth, higher numbers of periodontal pockets 4–6‐mm and higher bleeding on probing (%). In a stepwise regression analysis, the factor periodontal disease experience groups 4+5 gave an odds ratio of 5.74 (2.07–15.90) for having CHD after controlling for smoking and age. Conclusion: Severe periodontal disease expressed by several clinical and radiographic parameters was more prevalent among subjects with CHD than among controls. Analysis, the factor periodontal disease experience groups 4+5 gave an odds ratio of 5.74 (2.07–15.90) for having CHD after controlling for smoking and age.     

Prevalence of dental caries and periodontal disease in patients with inflammatory bowel disease: a case-control study

AIM: Previous reports suggest a higher incidence of dental caries in patients with inflammatory bowel disease (IBD) and similarities in the immunopathogenesis of IBD and periodontitis. This study assessed the prevalence of periodontal disease and caries in patients with IBD. METHODS: In the present case-control study, 62 patients seeking treatment of IBD and 59 matched healthy controls of a dental practice were clinically examined. Oral soft-tissue alterations, the decayed, missing and filled tooth surface (DMF-S) index, dentine caries, plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL) were evaluated in each patient and in the controls. RESULTS: Patients with IBD showed a significantly higher number of oral manifestations compared with controls. The DMF-S index showed no significant differences, but there was a significantly higher number of subjects with dentine caries in patients with IBD. The mean PPD in patients with IBD was 2.08 versus 2.23 mm in controls (p=0.014). Compared with controls, patients with IBD had more sites with CAL of at least 4 mm (81% versus 64% in controls, p=0.07) and 5 mm (63% versus 46%, p=0.07), respectively. CONCLUSIONS: The results of this case-control study demonstrate a higher frequency of dentine caries in patients with IBD but the periodontal findings showed no distinct differences between cases and controls.     

Dental caries experience among children with Down's syndrome and their sibs.

The dental caries experience of a sample of 212 children with Down's syndrome was contrasted with that of 124 of their unaffected sibs. The affected children had a caries experience less than one-third that of the sibs. The experience of the sibs, however, was not different from that of other normal children. This differential caries experience could not be explained by differences between the groups in their exposure to risk of the disease.     

Dental disease indices and caries related oral microflora in children with phenylketonuria

The purpose of this study was to investigate the dental caries, plaque and gingivitis indices and caries related oral flora in children with classic phenylketonuria. Forty-one children at The Great Ormond Street Hospital for Children and controls were included in the study. The main findings were: No significant difference in the decayed, missing and filled surfaces of the primary and permanent teeth between the phenylketonuria children and the controls. A significantly greater mean plaque score for the control children compared with the phenylketonuria children (p < 0.01) for the permanent teeth only. A significantly greater number of white opacities in the permanent teeth of the phenylketonuria group compared with the control group (p < 0.02). No significant differences in the caries related microflora.