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Su S, Qi T, Wang W, Salama ES, Li Y. Investigation of the oral microbiome of children associated with dental caries: A systematic study. Arch Oral Biol 2023; 154:105776. [PMID: 37540967 DOI: 10.1016/j.archoralbio.2023.105776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/08/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023]
Abstract
OBJECTIVE The present study aims to investigate the variations in dental caries (DC) related microbiome abnormality and metabolomics shift in children. DESIGN The patients were divided into two groups healthy control (C) and highly affected DC children based on inclusion and exclusion criteria. Saliva samples were collected and used for the taxonomic and functional characterization of oral microbiota. RESULTS Metatranscriptomics analysis revealed the alterations and composition of oral microbiota in the C and DC groups. Relative abundance in the C group was associated with Firmicutes, Actinobacteria, and Bacteroidetes. Whereas, the microbial composition in the DC group was found to be considerably altered with increases in the abundance of the Proteobacteria (25%), Fusobacteria (15%), and Cyanobacteria (8%) while decreases in the abundance of Firmicutes (10%) and Bacteroidetes (23%). Alterations in the phylum composition were positively and negatively correlated with several metabolites of sugars (such as fructose, sorbose, ribose, allose, and mannose) and amino acids (such as arginine, lysine, tryptophan, and proline). Moreover, in comparison with the C group, the metabolic shift of the DC group was different with an increase in certain tricarboxylic acid cycle intermediates levels, and a decrease in fatty acid. Such alterations can enhance the growth of oral pathogens and contribute to DC development. CONCLUSIONS The findings of this study suggest that an altered abundance of Actinobacillus, Fusobacterium, and Shuttleworthia can serve as biomarkers of DC in children.
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Affiliation(s)
- Shaochen Su
- Healthy Examination & Management Center, First Hospital of Lanzhou University, Lanzhou, China.
| | - Tao Qi
- Department of Stomatology, First Hospital of Lanzhou University, Lanzhou, China
| | - Wei Wang
- School of Stomatology, Lanzhou University, Lanzhou, China
| | - El-Sayed Salama
- Department of Occupational and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, Gansu Province, China
| | - Yumin Li
- Second Clinical Medical College, Lanzhou University, Lanzhou, China; Key Laboratory of Digestive System Tumors of Gansu Province, Lanzhou, China.
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Kundabala M, Shenoy R, D'Souza V, Jain A, Suprabha B. Preventing early childhood caries through oral health promotion and a basic package for oral care: A pragmatic trial. Contemp Clin Dent 2022; 13:162-168. [PMID: 35846578 PMCID: PMC9285834 DOI: 10.4103/ccd.ccd_873_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 12/17/2020] [Accepted: 01/19/2021] [Indexed: 12/01/2022] Open
Abstract
Introduction: Untreated caries in mothers is one of the common risk factors for early childhood caries (ECC). Aim: The aim of the study was to investigate the impact of an oral health promotion program on ECC. Methodology: We conducted a pragmatic trial at 12 primary health centers in a rural community of India with 311 pregnant women using fluoride toothpaste, oral health information through pamphlets, and referral to urgent dental care or atraumatic dental treatment as the test intervention. Data were collected through structured interviews at baseline and oral examination of the children at 2 years of age. Results: Of the 311 women who participated, 274 children were followed up with at 2 years of age. ECC was low and comparable in both groups. When compared with the control group, significantly, more children from the intervention group were breastfed for over 6 months of age (P = 0.012) and consumed less sugar (P < 0.001). The number of mothers’ decayed teeth (P = 0.01), children's sweet scores (P < 0.001), and the age at which brushing commenced for children (P = 0.04) increased the likelihood of tooth decay in children. Conclusion: The oral health promotion program had some beneficial effects in preventing caries in children when provided to pregnant women.
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Sitthisettapong T, Tasanarong P, Phantumvanit P. Strategic Management of Early Childhood Caries in Thailand: A Critical Overview. Front Public Health 2021; 9:664541. [PMID: 34178924 PMCID: PMC8226079 DOI: 10.3389/fpubh.2021.664541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/05/2021] [Indexed: 11/13/2022] Open
Abstract
The aim of this report was to advocate early childhood caries (ECC) and share strategic management in Thailand, despite over two decades of free Universal Health Coverage including oral healthcare. The recent Thai national oral health survey in 2017 indicates the very high prevalence of ECC, with an average of three carious teeth affected in 53% of 3-year-old children. This is despite the efforts of the Ministry of Public Health that has launched several interventional programs ranging from an upstream policy that prohibits sugar additions in baby formula milk to downstream remediations such as advocating and encouraging toothbrushing with fluoride toothpastes. Nevertheless, ECC is strongly predicated by other key factors including the family and community commitment and participation, as embodied in the current World Health Organization guidelines. These encompass three different tiers of community-level prevention: primary, secondary, and tertiary. Accordingly, the following strategies for ECC management in Thailand should be based at primary care clusters (PCC) in sub-district health centers, with the assistance of inter-professional health teams. These include community education on the importance of deciduous teeth and effective toothbrushing with fluoride toothpaste (primary prevention), regular examination and detection of ECC lesions and early intervention (secondary prevention), insertion of non-invasive preventive restorations using cost-effective atraumatic restorative treatment (ART) or simplified and modified ART (SMART) (tertiary prevention), and, finally, effective follow-up and monitoring systems. It is anticipated that this triple tier approach to ECC management will improve not only the oral health but also the overall children's health.
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Aliakbari E, Gray-Burrows KA, Vinall-Collier KA, Edwebi S, Marshman Z, McEachan RRC, Day PF. Home-based toothbrushing interventions for parents of young children to reduce dental caries: A systematic review. Int J Paediatr Dent 2021; 31:37-79. [PMID: 32333706 DOI: 10.1111/ipd.12658] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/15/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Dental caries is the most prevalent preventable condition in children. A key preventive home-based oral health behaviour is the adoption and maintenance of parental supervised toothbrushing until 8 years of age. AIM To examine interventions promoting parental supervised toothbrushing practices to reduce dental caries in young children (<8 years old). DESIGN Interventions promoting parental involvement in home-based toothbrushing in children under 8 years old and their impact on caries were subjected to review. Electronic databases (MEDLINE, EMBASE, PubMed, Web of Science, PsycINFO, Scopus, and the Cochrane Library), references, and unpublished literature databases were searched for relevant literature. RESULTS Of the 10 176 articles retrieved, forty-two articles were included. The Theoretical Domains Framework was used to code intervention content, with the main domains addressed being knowledge (41/42), skills (35/42), and environmental context and resources (22/42). Sufficient descriptions of the intervention development, delivery, and evaluation were lacking, with only 18 studies being underpinned by theory. Twenty-nine studies explored the impact on caries yielding mixed results. CONCLUSIONS There are few interventions targeting home-based oral health behaviours underpinned by theory and methodological rigour in their development and evaluation. This demonstrates a clear need for future interventions to be guided by complex intervention methodology.
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Affiliation(s)
- Elnaz Aliakbari
- Specialist in Paediatric Dentistry, Clarendon Dental Spa, Leeds, UK
| | - Kara A Gray-Burrows
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sakina Edwebi
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
| | - Zoe Marshman
- Faculty of Medicine, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | | | - Peter F Day
- Faculty of Medicine and Health, School of Dentistry, University of Leeds, Leeds, UK
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5
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Oge OA, Douglas GVA, Seymour D, Adams C, Csikar J. Knowledge, attitude and practice among Health Visitors in the United Kingdom toward children's oral health. Public Health Nurs 2018; 35:70-77. [PMID: 29359489 DOI: 10.1111/phn.12381] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The purpose of this study was to determine knowledge, attitude, and practical behavior of health visitors regarding children's oral health in the United Kingdom (UK). METHODS A web-based self-administered survey with 18 closed and 2 open ended questions was distributed to a convenience sample of approximately 9,000 health visitors who were currently employed in the United Kingdom and a member of the Institute of Health Visiting. RESULTS A total of 1,088 health visitors completed the survey, resulting in a response rate of 12%. One-third of the health visitors reported that they had not received oral health training previously. Almost all agreed that oral health advice/promotion should be included in their routine health visiting contacts. Previous oral health training/education was associated with an increase in oral health knowledge; confidence in entering a discussion with parents/caregivers and willingness to be involved in dental referral process. CONCLUSIONS The results of our study support the need for health visitors to receive oral health training in oral health promotion including oral health risk assessment, guidance on evidence based up-to-date prevention measures, increasing the dental attendance prevalence at early stages and awareness of including specific oral health guidelines/fact sheets into their regular practice.
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Affiliation(s)
- Ozkem Azmi Oge
- Department of Paediatric Dentistry, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Gail V A Douglas
- The Leeds School of Dentistry, The University of Leeds, Leeds, UK
| | - Diane Seymour
- Dental Public Health, Public Health England, Leeds, UK
| | | | - Julia Csikar
- The Leeds School of Dentistry, The University of Leeds, Leeds, UK.,Dental Public Health, Public Health England, Leeds, UK
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6
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Gavic L, Tadin A, Mihanovic I, Gorseta K, Cigic L. The role of parental anxiety, depression, and psychological stress level on the development of early-childhood caries in children. Int J Paediatr Dent 2018; 28:616-623. [PMID: 30144198 DOI: 10.1111/ipd.12419] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/14/2018] [Accepted: 07/08/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND It is important to understand how the psychological status of parents affects oral health in children. AIM This study aimed to assess the level of depression, anxiety, and stress of parents whose children have early-childhood caries. DESIGN The study included 235 children and their parents who visited the Dental clinic at the School of Medicine of the University of Split between October 2016 and July 2017. The dental status of each child was recorded, while parents filled out the Depression Anxiety Stress Scale questionnaire and the questionnaire related to the demographic characteristics, questions related to child's habits of the tooth brushing, eating sweets. RESULTS Multiple regression analysis showed that the incidence of active caries in the children was statistically significantly related not only to the level of parent depression (β = -0.289; P = 0.040) but also the level of anxiety (β = 0.186; P = 0.038) and stress (β = -0.120; P = 0.036). The dmft index in the examined children was negatively significant associated with the parental level of depression (β = -0.305; P = 0.032). CONCLUSION Considering the results of our research it is essential to emphasize the need for better health education of parents.
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Affiliation(s)
- Lidia Gavic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Antonija Tadin
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Ina Mihanovic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
| | - Kristina Gorseta
- Department of Paediatric Dentistry, School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Livia Cigic
- Study of Dental Medicine, School of Medicine, University of Split, Split, Croatia
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7
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Clarke R, Shaw-Ridley M. Parental Attitudes and Beliefs About Preschooler Preventive Oral Health Behaviors: Implications for Health Promotion. J Immigr Minor Health 2018; 21:731-736. [DOI: 10.1007/s10903-018-0812-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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8
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Menegaz AM, Silva AER, Cascaes AM. Educational interventions in health services and oral health: systematic review. Rev Saude Publica 2018; 52:52. [PMID: 29791531 PMCID: PMC5953546 DOI: 10.11606/s1518-8787.2018052000109] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 08/06/2017] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To analyze the effectiveness of educational interventions performed in health services in the improvement of clinical behaviors and outcomes in oral health. METHODS We have carried out a systematic review of the literature searching the PubMed, Lilacs, and SciELO databases. We have included studies that have investigated interventions performed by health professionals working in health services and who have used educational actions as main approach to improve behavioral and clinical outcomes in oral health. RESULTS The search amounted to 832 articles and 14 of them met all the inclusion criteria. Five studies have only exclusively evaluated the effectiveness of interventions on caries reduction, three have exceptionally evaluated oral health behaviors, and the other articles have evaluated the effectiveness of interventions for both clinical outcomes (dental caries and periodontal conditions) and behaviors in oral health. Most of the studies (n = 9) were based on randomized controlled trials; the other ones have evaluated before and after the intervention. Five studies have reported a significant reduction of dental caries, and five of the six studies evaluating behavioral outcomes have found some positive change. CONCLUSIONS Most studies evaluating behavioral and periodontal outcomes have shown significant improvements in favor of interventions. All studies evaluating caries have shown a reduction in new lesions or cases of the disease in the groups receiving the interventions, although only five of the eleven articles have found a statistically significant difference. Educational interventions carried out by health professionals in the context of their practice have the potential to promote oral health in the population.
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Affiliation(s)
- Aryane Marques Menegaz
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Alexandre Emídio Ribeiro Silva
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
| | - Andreia Morales Cascaes
- Programa de Pós-Graduação em Odontologia, Faculdade de Odontologia, Universidade Federal de Pelotas, Pelotas, RS, Brasil
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9
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Soussou R, Aleksejūnienė J, Harrison R. Waiting room time: An opportunity for parental oral health education. Canadian Journal of Public Health 2017; 108:e251-e256. [PMID: 28910246 DOI: 10.17269/cjph.108.5984] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 08/03/2017] [Accepted: 05/28/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The UBC Children's Dental Program (CDP) has provided free dental treatments to underserved low-income children, but its preventive component needs to be enhanced. The study aims were: 1) to develop a "waiting-room based" dental education program engaging caregivers of these children, and 2) to assess the program's feasibility, acceptability and effectiveness. METHODS In preparation, a situational analysis (SA) included structured interviews with caregivers, and with various stakeholders (e.g., dental students, instructors, health authority) involved in the CDP program. Based on the SA, caregiver-centered education was designed using an interactive power point presentation; after the presentation, each caregiver set personalized goals for modifying his/her child's dental behaviours. Evaluation of the program was done with follow-up telephone calls; the program's effectiveness was assessed by comparing before/after proportions of caregivers brushing their child's teeth, children brushing teeth in the morning and evening, children eating sugar-containing snacks, and children drinking sugar-containing drinks. RESULTS The program proved to be easy to implement (feasible) and the recruitment rate was 99% (acceptable). The follow-up rate was 81%. The SA identified that the caregivers' knowledge about caries etiology and prevention was limited. All recruited caregivers completed the educational session and set goals for their family. The evaluation demonstrated an increase in caregiver-reported short-term diet and oral self-care behaviours of their children. CONCLUSION A dental education program engaging caregivers in the waiting room was a feasible, acceptable and promising strategy for improving short-term dental behaviours of children.
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Affiliation(s)
- Randa Soussou
- Faculty of Dentistry, University of British Columbia, J.B. Macdonald Building, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Jolanta Aleksejūnienė
- Faculty of Dentistry, University of British Columbia, J.B. Macdonald Building, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
| | - Rosamund Harrison
- Faculty of Dentistry, University of British Columbia, J.B. Macdonald Building, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
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10
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Sälzer S, Alkilzy M, Slot DE, Dörfer CE, Schmoeckel J, Splieth CH. Socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level. J Clin Periodontol 2017; 44 Suppl 18:S106-S115. [DOI: 10.1111/jcpe.12673] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Sonja Sälzer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Mohammad Alkilzy
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Dagmar E. Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University Amsterdam; Amsterdam The Netherlands
| | - Christof E. Dörfer
- Clinic for Conservative Dentistry and Periodontology; School for Dental Medicine; Christian-Albrechts-University Kiel; Kiel Germany
| | - Julian Schmoeckel
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
| | - Christian H. Splieth
- Clinic for Preventive and Paediatric Dentistry; University of Greifswald; Greifswald Germany
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11
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Virgo-Milton M, Boak R, Hoare A, Gold L, Waters E, Gussy M, Calache H, O'Callaghan E, de Silva AM. An exploration of the views of Australian mothers on promoting child oral health. Aust Dent J 2016; 61:84-92. [PMID: 25892487 DOI: 10.1111/adj.12332] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND An important role for parents and caregivers in the prevention of dental caries in children is the early establishment of health promoting behaviours. This study aimed to examine mothers' views on barriers and facilitators to promoting child and family oral health. METHODS Semi-structured interviews were undertaken with a purposive sample of mothers (n = 32) of young children. Inductive thematic analysis was conducted. RESULTS Parental knowledge and beliefs, past experiences and child behaviour emerged as major influences on children's oral health. Child temperament and parental time pressures were identified as barriers to good oral health with various strategies reported for dealing with uncooperative children at toothbrushing time. Parental oral health knowledge and beliefs emerged as positive influences on child oral health; however, while most mothers were aware of the common causes of dental caries, very few knew of other risk factors such as bedtime feeding. Parents' own oral health experiences were also seen to positively influence child oral health, regardless of whether these were positive or negative experiences. CONCLUSIONS Understanding parental oral health beliefs is essential to overcoming barriers and promoting enablers for good child oral health. Improving child oral health also requires consideration of child behaviour, family influences, and increasing awareness of lesser-known influencing factors.
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Affiliation(s)
- M Virgo-Milton
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - R Boak
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - A Hoare
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - L Gold
- Deakin Health Economics, Deakin Population Health Social Research Centre, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - E Waters
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - M Gussy
- Department of Dentistry and Oral Health, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - H Calache
- Dental Health Services Victoria, Carlton, Victoria, Australia.,Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - E O'Callaghan
- Jack Brockhoff Child Health and Wellbeing Program, Academic Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - A M de Silva
- Dental Health Services Victoria, Carlton, Victoria, Australia.,Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
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12
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Anderson M, Dahllöf G, Twetman S, Jansson L, Bergenlid AC, Grindefjord M. Effectiveness of Early Preventive Intervention with Semiannual Fluoride Varnish Application in Toddlers Living in High-Risk Areas: A Stratified Cluster-Randomized Controlled Trial. Caries Res 2016; 50:17-23. [PMID: 26795957 DOI: 10.1159/000442675] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 11/16/2015] [Indexed: 11/19/2022] Open
Abstract
This study evaluated whether toddlers in an extended preventive program of semiannual fluoride varnish applications from 1 year of age had a lower incidence of caries than those undergoing a standard program. A cohort of 1-year-old children (n = 3,403) living in multicultural areas of low socioeconomic standing in Stockholm participated in a cluster-randomized controlled field trial with two parallel arms. The children attended 23 dental clinics. Using the ICDAS II criteria, the examiners recorded caries at baseline and after 1 and 2 years. The children in the reference group received a standardized oral health program once yearly between 1 and 3 years of age. The children in the test group received the same standard program supplemented with topical applications of fluoride varnish every 6 months. We compared the test group and the reference group for the prevalence and increment of caries. At baseline, 5% of the children had already developed caries (ICDAS II 1-6). We reexamined the children after 1 year (n = 2,675) and after 2 years (n = 2,536). Neither prevalence nor caries increment differed between the groups. At 3 years of age, 12% of the children had developed moderate and severe carious lesions (ICDAS II 3-6), with a mean increment of 0.5 (SD 2.4) in the test group and 0.6 (SD 2.2) in the reference group. In conclusion, semiannual professional applications of fluoride varnish, as a supplement to a standard oral health program, failed to reduce caries development in toddlers from high-risk communities.
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Affiliation(s)
- Maria Anderson
- Division of Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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13
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Wulaerhan J, Abudureyimu A, Bao XL, Zhao J. Risk determinants associated with early childhood caries in Uygur children: a preschool-based cross-sectional study. BMC Oral Health 2014; 14:136. [PMID: 25407041 PMCID: PMC4242481 DOI: 10.1186/1472-6831-14-136] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 10/29/2014] [Indexed: 11/28/2022] Open
Abstract
Background The prevalence of early childhood caries (ECC) varies with geographical region and population. The Uygur people, one of 55 officially recognized ethnic minorities in China, have a population of 10,069,346. We performed a preschool-based cross-sectional study of 670 Uygur children from the southern region of Xinjiang, China, to investigate the prevalence and severity of ECC and to identify factors related to the dental health condition of this population. Methods The study population of children ranging in age from 3 to 5 years was invited using a three-stage stratified sampling in Kashgar, the westernmost city in China. The “dmft” index was used to assess dental caries. The diagnosis of ECC or severe ECC was based on the oral health diagnostic criteria defined by the American Academy of Pediatric Dentistry. A questionnaire was completed by the children’s caregivers. The survey included questions concerning the children’s sociodemographic background; feeding and eating habits, particularly frequency of sweet beverage and food consumption; dental hygiene-related behaviors; the general oral health knowledge of caregivers; and the dental healthcare experience of caregivers and their children. Results A total of 670 Uygur children underwent complete dental caries examination. Most of the children (74.2%) had ECC, with a mean dmft ± SD of 3.95 ± 3.84. The prevalence of severe ECC was 40.1% (N =269), with a mean dmft of 7.72 ± 3.14. More than 99% of caries were untreated. Statistically significant correlations were found between higher ECC prevalence and increased age and lower socioeconomic background, while greater dental health knowledge of the caregiver and positive oral hygiene behaviors were found to be protective. Our findings confirm the multi-factorial etiology of ECC. Conclusions The prevalence of ECC among preschool-aged Uygur children in Kashgar was high, particularly among those from lower socioeconomic backgrounds. Caries prevalence was associated with oral hygiene behaviors of children and the general oral health knowledge of caregivers. These factors could be modified through public health strategies, including effective publicity concerning general dental health and practical health advice. Electronic supplementary material The online version of this article (doi:10.1186/1472-6831-14-136) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | | | - Jin Zhao
- Department of Endodontics, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 830054, People's Republic of China.
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14
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Cascaes AM, Bielemann RM, Clark VL, Barros AJD. Effectiveness of motivational interviewing at improving oral health: a systematic review. Rev Saude Publica 2014; 48:142-53. [PMID: 24789647 PMCID: PMC4206116 DOI: 10.1590/s0034-8910.2014048004616] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Accepted: 09/22/2013] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To analyze the effectiveness of motivational interviewing (MI) at improving
oral health behaviors (oral hygiene habits, sugar consumption, dental
services utilization or use of fluoride) and dental clinical outcomes
(dental plaque, dental caries and periodontal status). METHODS A systematic search of PubMed, LILACS, SciELO, PsyINFO, Cochrane and Google
Scholar bibliographic databases was conducted looking for intervention
studies that investigated MI as the main approach to improving the oral
health outcomes investigated. RESULTS Of the 78 articles found, ten met the inclusion criteria, all based on
randomized controlled trials. Most studies (n = 8) assessed multiple
outcomes. Five interventions assessed the impact of MI on oral health
behaviors and nine on clinical outcomes (three on dental caries, six on
dental plaque, four on gingivitis and three on periodontal pockets). Better
quality of evidence was provided by studies that investigated dental caries,
which also had the largest population samples. The evidence of the effect of
MI on improving oral health outcomes is conflicting. Four studies reported
positive effects of MI on oral health outcomes whereas another four showed
null effect. In two interventions, the actual difference between groups was
not reported or able to be recalculated. CONCLUSIONS We found inconclusive effectiveness for most oral health outcomes. We need
more and better designed and reported interventions to fully assess the
impact of MI on oral health and understand the appropriate dosage for the
counseling interventions.
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15
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Stecksén-Blicks C, Hasslöf P, Kieri C, Widman K. Caries and background factors in Swedish 4-year-old children with special reference to immigrant status. Acta Odontol Scand 2014; 72:852-8. [PMID: 24823934 DOI: 10.3109/00016357.2014.914569] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE This study assesses the prevalence of caries and some background factors in 4-year-old children in the city of Umeå, northern Sweden, and compares this with data from earlier studies to reveal changes over time. MATERIALS AND METHODS Children from the catchment areas of three Public Dental Health Service clinics in Umeå (n = 224) born during the third quarter of 2008 were invited to undergo a clinical dental examination. Decayed surfaces (including both dentine and enamel, except for enamel lesions on buccal and lingual surfaces), missing and filled surfaces (dmfs) were recorded using the same methods and criteria as in a series of earlier studies performed between 1980-2007. Background data were collected in a case-history and a questionnaire. Results. The proportion of children with caries significantly decreased from 2007 (38%) to 2012 (22%) (p < 0.05). In addition, the distribution of dmfs differed significantly between these years (p < 0.05). More immigrant children had caries (42%) than non-immigrant children (15%) (p < 0.05). For children with caries, there were no significant changes in the distribution of dmfs between 1980-2012 (p > 0.05). An immigrant background was associated with a lower frequency of tooth brushing and a higher intake of ice cream, sweets and chocolate drinks (p < 0.05). CONCLUSION Although the proportion of children with caries declined between 2007-2012, this decline was limited to non-immigrant children. Since 1980 the distribution of dmfs remained unchanged among children with caries. More research on interventions for changing oral health behaviours is needed, specifically for immigrant children.
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Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: A double-blind randomized controlled trial. J Dent 2014; 42:1277-83. [DOI: 10.1016/j.jdent.2014.07.020] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 07/02/2014] [Accepted: 07/31/2014] [Indexed: 11/19/2022] Open
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Plutzer K, Keirse MJNC. Influence of an Intervention to Prevent Early Childhood Caries Initiated before Birth on Children's Use of Dental Services up to 7 Years of Age. Open Dent J 2014; 8:104-8. [PMID: 24949107 PMCID: PMC4062931 DOI: 10.2174/1874210601408010104] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Revised: 05/01/2014] [Accepted: 05/13/2014] [Indexed: 11/22/2022] Open
Abstract
Background : In a previously reported randomised controlled trial, advising first time mothers on the prevention of early childhood caries from before their child was born, decreased the prevalence of early childhood caries at 20 months of age 5-fold. Objective: We examined the effect of the intervention on the frequency and nature of dental visits up to 7 years of age. Methods: Of 649 expectant mothers who participated in the trial, 277 completed a “Child Oral Health Survey” 7 years later. Their answers were compared with those of a comparison group of 277 mothers selected at random among those living in the same area with a first child born in the same year enrolled with the South Australian School Dental Services (SA SDS). Results: Only 1.5% of children had a dental visit before 12 months of age and only 4% before 2 years of age unless a dental problem had arisen. The age at the first visit did not differ among groups, but the reasons for the visit did as did the number of visits and the need for treatment under sedation or anaesthesia. In the trial group, 34% of first visits were for pain, 29% for injury, and 29% for concern with appearance. In the comparison group, pain was the main concern in 49%, injury in 9.5%, and appearance in 25% (p=0.019). Over time, children in the trial had an average of 2.2 visits compared with 3.1 in the comparison group. In the intervention group of the trial, no child had required treatment under sedation or general anaesthesia compared with 2.9% in the control group, and 6.5% in the comparison group. Only 15% of mothers reported that they had received any information on caries prevention from health care professionals other than dental care practitioners. Conclusion: Providing first-time mothers with guidance on the prevention of childhood caries decreased the use of dental services to deal with problems in preschool children.
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Affiliation(s)
- Kamila Plutzer
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia
| | - Marc J N C Keirse
- Department of Obstetrics, Gynaecology and Reproductive Medicine, Flinders University, Adelaide, South Australia, Australia
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Weinstein P, Milgrom P, Riedy CA, Mancl LA, Garson G, Huebner CE, Smolen D, Sutherland M, Nykamp A. Treatment fidelity of brief motivational interviewing and health education in a randomized clinical trial to promote dental attendance of low-income mothers and children: Community-Based Intergenerational Oral Health Study "Baby Smiles". BMC Oral Health 2014; 14:15. [PMID: 24559035 PMCID: PMC3996055 DOI: 10.1186/1472-6831-14-15] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 02/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fidelity assessments are integral to intervention research but few published trials report these processes in detail. We included plans for fidelity monitoring in the design of a community-based intervention trial. METHODS The study design was a randomized clinical trial of an intervention provided to low-income women to increase utilization of dental care during pregnancy (mother) or the postpartum (child) period. Group assignment followed a 2 × 2 factorial design in which participants were randomly assigned to receive either brief Motivational Interviewing (MI) or Health Education (HE) during pregnancy (prenatal) and then randomly reassigned to one of these groups for the postpartum intervention. The study setting was four county health departments in rural Oregon State, USA. Counseling was standardized using a step-by-step manual. Counselors were trained to criteria prior to delivering the intervention and fidelity monitoring continued throughout the implementation period based on audio recordings of counselor-participant sessions. The Yale Adherence and Competence Scale (YACS), modified for this study, was used to code the audio recordings of the counselors' delivery of both the MI and HE interventions. Using Interclass Correlation Coefficients totaling the occurrences of specific MI counseling behaviors, ICC for prenatal was .93, for postpartum the ICC was .75. Participants provided a second source of fidelity data. As a second source of fidelity data, the participants completed the Feedback Questionnaire that included ratings of their satisfaction with the counselors at the completion of the prenatal and post-partum interventions. RESULTS Coding indicated counselor adherence to MI protocol and variation among counselors in the use of MI skills in the MI condition. Almost no MI behaviors were found in the HE condition. Differences in the length of time to deliver intervention were found; as expected, the HE intervention took less time. There were no differences between the overall participants' satisfaction ratings of the HE and MI sessions by individual counselor or overall (p > .05). CONCLUSIONS Trial design, protocol specification, training, and continuous supervision led to a high degree of treatment fidelity for the counseling interventions in this randomized clinical trial and will increase confidence in the interpretation of the trial findings.
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Affiliation(s)
- Philip Weinstein
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
| | - Peter Milgrom
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
| | - Christine A Riedy
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
| | - Lloyd A Mancl
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
| | - Gayle Garson
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
| | - Colleen E Huebner
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
| | - Darlene Smolen
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
| | | | - Ann Nykamp
- Northwest Center to Reduce Oral Health Disparities, Department of Oral Health Sciences, Box 357475, University of Washington, Seattle, WA 98195-7475, USA
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Jayabal J, Mahesh R. Current state of topical antimicrobial therapy in management of early childhood caries. ISRN DENTISTRY 2014; 2014:762458. [PMID: 24701354 PMCID: PMC3950430 DOI: 10.1155/2014/762458] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Accepted: 01/09/2014] [Indexed: 11/18/2022]
Abstract
The treatment of early childhood caries can have a significant economical burden and treatment relapses are frequent. Effective intervention by means of topical antimicrobial agents can reduce the burden of early childhood caries. The main aim in prevention and treatment should focus on inhibition of the growth of oral bacteria. This is a comprehensive review of the literature on the various antimicrobial agents which are proven to be effective in management of this carious progression. The review identified that there is a significant data to suggest use of antimicrobial agents in management of early childhood caries. Antimicrobial agents aid in better management of patients with early carious lesion. The relapse rates are less, when the treatment is combined with the use of antimicrobial agent.
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Affiliation(s)
- JayaBaarathi Jayabal
- Department of Pedodontics and Preventive Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu 600077, India
| | - Ramakrishnan Mahesh
- Department of Pedodontics and Preventive Dentistry, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu 600077, India
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Masterson EE, Barker JC, Hoeft KS, Hyde S. Shades of Decay: The Meanings of Tooth Discoloration and Deterioration to Mexican Immigrant Caregivers of Young Children. HUMAN ORGANIZATION 2014; 73:82-93. [PMID: 26279585 PMCID: PMC4537173 DOI: 10.17730/humo.73.1.861831136642q074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The objective of this article is to investigate parental understanding of tooth discoloration and decay and their related care seeking for young, Mexican-American children. The research design entailed semi-structured, face-to-face interviews conducted in Spanish with a convenience sample of 37 Mexican immigrant mothers of young children in a low-income urban neighborhood. Five major color terms - white, off-white, yellow, brown, and black - were used to describe tooth discoloration, the causes of which were mainly unrecognized or attributed to poor oral hygiene and exposure to sweet substances. Mothers also described three major levels of deterioration of the structural integrity of teeth due to caries, from stains to decayed portions to entirely rotten. A trend was observed between use of darker discoloration terms and extensive carious lesions. Teeth described as both dark in color and structurally damaged resulted in seeking of professional care. The paper concludes with the finding that Spanish terms used to describe tooth discoloration and carious lesions are broad and complex. Mexican immigrant mothers' interpretations of tooth discoloration and decay may differ from dental professionals' and result in late care seeking. Increased understanding between dental practitioners and caregivers is needed to create educational messages about the early signs of tooth decay.
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Affiliation(s)
- Erin E Masterson
- Department of Epidemiology at the University of Washington's School of Public Health
| | - Judith C Barker
- Department of Anthropology, History & Social Medicine and Department of Preventive & Restorative Dental Sciences at the University of California San Francisco (UCSF)
| | - Kristin S Hoeft
- Department of Preventive & Restorative Dental Sciences and a doctoral candidate in the Epidemiology & Translational Science Program at UCSF
| | - Susan Hyde
- Division of Oral Epidemiology and Dental Public Health in the Department of Preventive & Restorative Dental Sciences at UCSF
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Wagner Y, Greiner S, Heinrich-Weltzien R. Evaluation of an oral health promotion program at the time of birth on dental caries in 5-year-old children in Vorarlberg, Austria. Community Dent Oral Epidemiol 2013; 42:160-9. [DOI: 10.1111/cdoe.12072] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 08/02/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Y. Wagner
- Department of Preventive Dentistry and Paediatric Dentistry; Jena University Hospital; Jena Germany
| | - S. Greiner
- Department of Preventive Dentistry and Paediatric Dentistry; Jena University Hospital; Jena Germany
| | - R. Heinrich-Weltzien
- Department of Preventive Dentistry and Paediatric Dentistry; Jena University Hospital; Jena Germany
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22
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Meyer K, Khorshidi-Böhm M, Geurtsen W, Günay H. An early oral health care program starting during pregnancy—a long-term study—phase V. Clin Oral Investig 2013; 18:863-72. [DOI: 10.1007/s00784-013-1059-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 07/16/2013] [Indexed: 11/27/2022]
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Häggblom A, Naimi-Akbar A, Lith A, Karlsson L. Approximal caries increment in adolescents after a visual aid in combination with a comprehensive open discussion. Acta Odontol Scand 2013; 71:676-82. [PMID: 22900665 DOI: 10.3109/00016357.2012.715189] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To achieve greater motivation for behavioural changes; educating, motivating and supporting the patient's ability to change lifestyle factors related to the caries disease are important tasks in the prevention of the disease. The aim of this study was to evaluate whether a visual aid (Visual Caries Dialogue, VCD) in combination with a comprehensive open discussion has a beneficial effect on approximal caries development among a population of young adolescents. MATERIALS AND METHODS The study subjects were randomized to either an intervention group (n = 118), where VCD was conducted, or a control group (n = 112) receiving traditional oral healthcare information, at the annual dental health examination. The number of caries lesions reaching through the entire enamel (D2) and dentin caries reaching through the enamel into the dentin (D3) were recorded from bitewing radiographs each year, from 2001-2004. Differences between the study groups regarding at least two new approximal surfaces with caries (D2-D3) were tested using logistic regression. RESULTS The caries increment was lower in the intervention group compared to the control group. During the 3-year follow-up, 18 (15.3%) patients in the intervention group and 40 (35.7%) patients in the control group demonstrated a DS-approximal increment of at least two surfaces with a risk ratio of 2.34 (95% CI = 1.43-3.83). CONCLUSION Visual Caries Dialogue in combination with a comprehensive open discussion reduced approximal caries increment among young individuals. The method provides an innovative simple and low-cost way of delivering information to patients and guides busy dental healthcare personnel in the approach.
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Affiliation(s)
- Anita Häggblom
- Division of Dental Biomaterials and Cariology, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
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Deichsel M, Rojas G, Lüdecke K, Heinrich-Weltzien R. Frühkindliche Karies und assoziierte Risikofaktoren bei Kleinkindern im Land Brandenburg. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012; 55:1504-11. [DOI: 10.1007/s00103-012-1537-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Influence of first-time mothers' early employment on severe early childhood caries in their child. Int J Pediatr 2012; 2012:820680. [PMID: 23097671 PMCID: PMC3477572 DOI: 10.1155/2012/820680] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 09/12/2012] [Accepted: 09/12/2012] [Indexed: 11/18/2022] Open
Abstract
Aim. To examine whether mothers' early employment status is related to the development of severe early childhood caries in their child.
Methods. Questionnaire survey of 429 first-time mothers in metropolitan Adelaide, South Australia, and dental examinations of their child at 20 months of age.
Results. At 20 ± 2.5 months of age, 5.6% of children exhibited caries defined as one or more demineralized or cavitated lesions on the upper incisors. Of the mothers, 52.2% had no paid employment, 39.6% were part-time and 8.2% full-time employed. Overall, mothers' participation in the workforce had no influence on the frequency of severe early childhood caries in their child, but there was a significant interaction with family structure. For mothers without employment there was no difference between single, and two-parent families, but children with an employed single mother more frequently had caries than those with a working mother in a two-parent family (P < 0.04). However, there were no significant differences in children's reported general health.
Conclusions. The data indicate a need to explore strategies that may assist single mothers and especially those in the workforce to prevent severe early childhood caries in their child.
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Strömberg U, Holmn A, Magnusson K, Twetman S. Geo-mapping of time trends in childhood caries risk--a method for assessment of preventive care. BMC Oral Health 2012; 12:9. [PMID: 22510486 PMCID: PMC3474168 DOI: 10.1186/1472-6831-12-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Accepted: 04/17/2012] [Indexed: 11/23/2022] Open
Abstract
Background Dental caries is unevenly distributed within populations with a higher burden in low socio-economy groups. Several attempts have been made to allocate resources to those that need them the most; there is a need for convenient approaches to population-based monitoring of caries risk over time. The aim of this study was to develop the geo-map concept, addressing time trends in caries risk, and demonstrate the novel approach by analyzing epidemiological data from preschool residents in the region of Halland, Sweden. Methods The study population consisted of 9,973 (2006) and 10,927 (2010) children between 3 to 6years of age (~77% of the eligible population) from whom caries data were obtained. Reported dmfs>0 for a child was considered as the primary caries outcome. Each study individual was geo-coded with respect to his/her residence parish (66 parishes in the region). Smoothed caries risk geo-maps, along with corresponding statistical certainty geo-maps, were produced by using the free software Rapid Inquiry Facility and the ESRI ArcGIS system. Parish-level socioeconomic data were available. Results The overall proportion of caries-free (dmfs=0) children improved from 84.0% in 2006 to 88.6% in 2010. The ratio of maximum and minimum (parish-level) smoothed relative risks (SmRRs) increased from 1.76/0.44=4.0 in 2006 to 2.37/0.33=7.2 in 2010, which indicated an increased geographical polarization of early childhood caries in the population. Eight parishes showed evidential, positional changes in caries risk between 2006 and 2010; their corresponding SmRRs and statistical certainty ranks changed markedly. No considerable parallel changes in parish-level socioeconomic characteristics were seen during the same time period. Conclusion Geo-maps based on caries risk can be used to monitor changes in caries risk over time. Thus, geo-mapping offers a convenient tool for evaluating the effectiveness of tailored health promotion and preventive care in child populations.
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Affiliation(s)
- Ulf Strömberg
- Department of Research and Development, Halland Hospital, SE-301 85, Halmstad, Sweden.
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Merrick J, Chong A, Parker E, Roberts-Thomson K, Misan G, Spencer J, Broughton J, Lawrence H, Jamieson L. Reducing disease burden and health inequalities arising from chronic disease among Indigenous children: an early childhood caries intervention. BMC Public Health 2012; 12:323. [PMID: 22551058 PMCID: PMC3413605 DOI: 10.1186/1471-2458-12-323] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2012] [Accepted: 05/02/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study seeks to determine if implementing a culturally-appropriate early childhood caries (ECC) intervention reduces dental disease burden and oral health inequalities among Indigenous children living in South Australia, Australia. METHODS/DESIGN This paper describes the study protocol for a randomised controlled trial conducted among Indigenous children living in South Australia with an anticipated sample of 400. The ECC intervention consists of four components: (1) provision of dental care; (2) fluoride varnish application to the teeth of children; (3) motivational interviewing and (4) anticipatory guidance. Participants are randomly assigned to two intervention groups, immediate (n = 200) or delayed (n = 200). Provision of dental care (1) occurs during pregnancy in the immediate intervention group or when children are 24-months in the delayed intervention group. Interventions (2), (3) and (4) occur when children are 6-, 12- and 18-months in the immediate intervention group or 24-, 30- and 36-months in the delayed intervention group. Hence, all participants receive the ECC intervention, though it is delayed 24 months for participants who are randomised to the control-delayed arm. In both groups, self-reported data will be collected at baseline (pregnancy) and when children are 24- and 36-months; and child clinical oral health status will be determined during standardised examinations conducted at 24- and 36-months by two calibrated dental professionals. DISCUSSION Expected outcomes will address whether exposure to a culturally-appropriate ECC intervention is effective in reducing dental disease burden and oral health inequalities among Indigenous children living in South Australia.
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Affiliation(s)
- Jessica Merrick
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, Adelaide, Australia
| | - Alwin Chong
- Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Eleanor Parker
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, Adelaide, Australia
| | - Kaye Roberts-Thomson
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, Adelaide, Australia
| | - Gary Misan
- University of South Australia, Adelaide, Australia
| | - John Spencer
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, Adelaide, Australia
| | - John Broughton
- Ngai Tahu Maori Health Research Unity, University of Otago, Dunedin, New Zealand
| | | | - Lisa Jamieson
- Australian Research Centre for Population Oral Health, University of Adelaide School of Dentistry, Adelaide, Australia
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Barfod MN, Christensen LB, Twetman S, Lexner MO. Caries prevalence in Danish pre-school children delivered vaginally and by caesarean section. Acta Odontol Scand 2012; 70:190-3. [PMID: 21905982 DOI: 10.3109/00016357.2011.610816] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The mode of delivery may significantly influence the diversity and composition of the oral microflora and facilitate early acquisition of mutans streptococci. The aim was to compare caries prevalence and experience in 3-year-old children delivered vaginally and by caesarean section (C-section). MATERIALS AND METHODS The study had an observational cohort protocol based on extracted information from governmental databases and nationwide registers concerning birth, social and educational levels and dental status. Children born at the Copenhagen University Hospital in 2005 were eligible and the final study group with complete information consisted of 594 children, 443 delivered vaginally and 151 by C-section. RESULTS The total caries prevalence was 8% and no significant difference was displayed between the groups. When only the children with caries (dmfs > 0) were compared, those delivered by C-section had a higher mean value in comparison with those delivered vaginally (dmfs 6.8 vs 3.2), but the difference was not statistically significant. There was a significant relationship between caries prevalence and low family income in the total study group (OR = 5.8, p < 0.05). CONCLUSIONS Within the limitations of this observational cohort study, caries prevalence in 3-year-old children was not related to the mode of delivery. However, the tendency of more severe caries in the C-section group justifies further studies, preferably with a prospective design.
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Affiliation(s)
- Mette Nelun Barfod
- Department of Cariology and Endodontics, Faculty of Health Sciences, Institute of Odontology, University of Copenhagen, Denmark.
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Plutzer K, Spencer AJ, Keirse MJNC. Reassessment at 6-7 years of age of a randomized controlled trial initiated before birth to prevent early childhood caries. Community Dent Oral Epidemiol 2011; 40:116-24. [PMID: 22022927 DOI: 10.1111/j.1600-0528.2011.00643.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVES To assess whether the effect of providing mothers with guidance during pregnancy and when the child was 6 and 12 months old, which had drastically reduced the prevalence of early childhood caries at 20 months of age, would be sustained at 6-7 years of age. METHODS Children, whose mothers had been enrolled in a randomized controlled trial during pregnancy and a comparison group of similar school children, were examined for the presence of caries by the South Australian School Dental Services (SA SDS) at 6-7 years of age. RESULTS Of 625 eligible trial participants, 277 (44%) participated in the follow-up and dental records were available for 187 of them (30%). Loss to follow-up and reasons for it were similar in the intervention and control groups. At 6-7 years of age, 33% of children in the trial had caries compared with 42% in the SA SDS comparison group (n = 263). All measures of caries severity (d(3)mft, d(3)mfs and SiC(30)) were lower, but not significantly so, in the intervention than in the control group. Children in the comparison group of school children had more severe caries than those in the trial (P < 0.01) and in the intervention group especially (P < 0.005). Children in both randomized groups suffered significantly less toothache than those in the comparison group (P < 0.001). CONCLUSIONS Providing new mothers with guidance on caries prevention helps to reduce early childhood caries and has a sustainable effect up to school age.
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Affiliation(s)
- Kamila Plutzer
- Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, Adelaide, South Australia, Australia.
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de Paula VA, Ferreira DC, Carmo FL, Rosardio AS, Dos Santos KR, Maia LC, Primo LG. Short communication: polymicrobial community in teeth associated with severe early-childhood caries. Eur Arch Paediatr Dent 2011; 12:264-6. [PMID: 21993067 DOI: 10.1007/bf03262819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This was to characterise the microbial diversity in the complex dental plaque of children with severe early-childhood caries (S-ECC), using the denaturing gel gradient electrophoresis (DGGE) technique. METHODS The DGGE technique was used as a diagnostic tool to analyse samples from the oral cavity of a patient with S-ECC. Dental plaque samples from a 3-year-old child with S-ECC were taken from the primary central maxillary incisor (biofilm on vestibular surface), primary maxillary molar (biofilm on vestibular surface), primary central maxillary incisor (dentine), primary maxillary molar (dentine) and saliva and then analysed by PCR-DGGE. RESULTS Three bands occurred in all samples, moreover, 86% of similarity was observed in the pattern of bands between incisor and molar teeth biofilm samples, including four similar bands. CONCLUSION DGGE is a valuable tool for differentiating the microbial composition of the oral plaque in S-ECC children.
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Affiliation(s)
- V A de Paula
- Dept. Paediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Rio de Janeiro, Brazil.
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O'Connell JM, Griffin S. Overview of methods in economic analyses of behavioral interventions to promote oral health. J Public Health Dent 2011; 71 Suppl 1:S101-18. [PMID: 21656966 PMCID: PMC4813801 DOI: 10.1111/j.1752-7325.2011.00236.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Broad adoption of interventions that prove effective in randomized clinical trials or comparative effectiveness research may depend to a great extent on their costs and cost-effectiveness (CE). Many studies of behavioral health interventions for oral health promotion and disease prevention lack robust economic assessments of costs and CE. OBJECTIVE To describe methodologies employed to assess intervention costs, potential savings, net costs, CE, and the financial sustainability of behavioral health interventions to promote oral health. METHODS We provide an overview of terminology and strategies for conducting economic evaluations of behavioral interventions to improve oral health based on the recommendations of the Panel of Cost-Effectiveness in Health and Medicine. To illustrate these approaches, we summarize methodologies and findings from a limited number of published studies. The strategies include methods for assessing intervention costs, potential savings, net costs, CE, and financial sustainability from various perspectives (e.g., health-care provider, health system, health payer, employer, society). Statistical methods for estimating short-term and long-term economic outcomes and for examining the sensitivity of economic outcomes to cost parameters are described. DISCUSSION Through the use of established protocols for evaluating costs and savings, it is possible to assess and compare intervention costs, net costs, CE, and financial sustainability. The addition of economic outcomes to outcomes reflecting effectiveness, appropriateness, acceptability, and organizational sustainability strengthens evaluations of oral health interventions and increases the potential that those found to be successful in research settings will be disseminated more broadly.
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Affiliation(s)
- Joan M O'Connell
- Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Denver, Aurora, CO 80045, USA.
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Petti S. Why guidelines for early childhood caries prevention could be ineffective amongst children at high risk. J Dent 2010; 38:946-55. [DOI: 10.1016/j.jdent.2010.09.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2010] [Revised: 09/06/2010] [Accepted: 09/07/2010] [Indexed: 11/30/2022] Open
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Targino AGR, Rosenblatt A, Oliveira AF, Chaves AMB, Santos VE. The relationship of enamel defects and caries: a cohort study. Oral Dis 2010; 17:420-6. [DOI: 10.1111/j.1601-0825.2010.01770.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Waldman HB, Perlman SP. Disability and rehabilitation: do we ever think about needed dental care? A case study: the USA. Disabil Rehabil 2010; 32:947-51. [PMID: 19852701 DOI: 10.3109/09638280903349529] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To foster an awareness of the need for oral health care as a component of a programme for rehabilitation of individuals with disabilities. METHOD A case study of the USA is used to illustrate the evolving community residential settings for individuals with disabilities and the resulting complexities in the delivery of health services. Examples of oral health conditions frequently present in individuals with disabilities are provided. RESULTS National and local reports indicate that barriers exist in the delivery of oral health services for individuals with intellectual/developmental and later life disabilities. CONCLUSION Oral health care is a component of rehabilitation, as long as attendant pain erodes energy and aspirations of individuals with disabilities. Dental practitioners face many of the same complex difficulties encountered by other health practitioners in the provision of services for individuals with disabilities. The need is for the practitioners in the many health fields to play an important role in developing an awareness of, and referrals for, necessary oral health care.
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Affiliation(s)
- H Barry Waldman
- Department of General Dentistry, Stony Brook University, School of Dental Medicine, Westchester Hall, Stony Brook, New York, USA.
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Hoeft KS, Barker JC, Masterson EE. Urban Mexican-American mothers' beliefs about caries etiology in children. Community Dent Oral Epidemiol 2010; 38:244-55. [PMID: 20156233 DOI: 10.1111/j.1600-0528.2009.00528.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Caries is a severe condition which disproportionately affects Latino children in the US. This study sought contextual understanding of urban, low-income Mexican-American mothers' beliefs, perceptions, knowledge and behavior surrounding causes of caries. METHODS In urban San José, CA, a qualitative study was conducted with a convenience sample of Mexican-American mothers of young children about their beliefs and knowledge about the causes of caries. Audio-taped in-depth interviews with open-ended questions, primarily in Spanish, were translated to English and then transcribed verbatim. Texts were independently read and thematically analyzed by two researchers. RESULTS Even while expressing uncertainty, all 48 mothers mentioned specific causes of caries, most frequently citing candy or juice consumption (85%), poor oral hygiene (65%) and use of the bottle (52%). Mothers rarely recognized cariogenic foods beyond candy, did not know or perform recommended oral hygiene routines, and demonstrated confusion and uncertainty about exactly how baby bottles are detrimental to teeth. Nearly half of these mothers also mentioned secondary cavity causes, such as genetics, lack of calcium, not going to the dentist or lack of fluoride. Mothers did not mention the role of bacteria. While mothers recognized that oral hygiene can counteract the detrimental effects of candy consumption, they did not recognize its beneficial effects in other contexts. Nor did they know about other preventive activities. CONCLUSIONS Mothers recognized the three major important factors causing caries: sugar consumption, poor oral hygiene and bottle use. However, their knowledge is limited in depth and specificity which restricts development of caries prevention behaviors. More comprehensive education is needed, including about caries prevention (oral hygiene) behaviors, which could lead to an increased sense of self-efficacy with respect to their children's oral health.
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Affiliation(s)
- Kristin S Hoeft
- Department of Preventive & Restorative Dental Sciences and Center to Address Disparities in Children's Oral Health, University of California San Francisco, San Francisco, CA, USA Department of Anthropology, History & Social Medicine and Center to Address Disparities in Children's Oral Health, University of California San Francisco, San Francisco, CA, USA
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Milgrom P, Tut OK. Evaluation of Pacific Islands Early Childhood Caries Prevention Project: Republic of the Marshall Islands. J Public Health Dent 2010; 69:201-3. [PMID: 19486466 DOI: 10.1111/j.1752-7325.2009.00117.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This communication reports an outcomes evaluation of the Pacific Islands Early Childhood Caries Prevention Project. METHODS The evaluation includes children in three conditions: a) topical fluoride varnish three times per school year; b) varnish plus twice-per-day toothbrushing; and c) intervention 2 plus three-times-per-day xylitol containing gummy bear snacks at school and home visits to encourage parental involvement. For this evaluation, groups 2 and 3 have been combined. RESULTS One year after project implementation, mean decayed, extracted, or filled primary teeth was 10.3 [standard deviation (SD)= 4.3] teeth for group 1, and 8.2 (SD = 4.0) teeth for the combination of groups 2 and 3 (P < 0.05). Twenty-four percent of group 1 had cavitated lesions in any permanent molar versus 12.8 percent in groups 2 and 3 combined (P > 0.05). CONCLUSION Evaluation confirms the outcome of a program including both in-school twice-daily toothbrushing with fluoridated toothpaste and frequent applications of fluoride varnish.
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Affiliation(s)
- Peter Milgrom
- Dental Public Health Sciences, University of Washington, Box 357475, Seattle, WA 98195-7475, USA.
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Meurman P, Pienihäkkinen K, Eriksson AL, Alanen P. Oral health programme for preschool children: a prospective, controlled study. Int J Paediatr Dent 2009; 19:263-73. [PMID: 19320915 DOI: 10.1111/j.1365-263x.2009.00967.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND New perspectives are needed for oral health programmes (OHPs). The aim was to evaluate the preventive effect of a risk-based OHP in comparison with a traditional programme. DESIGN An age cohort of 794 Finnish children, 446 in the intervention group and 348 in the control group, was followed from 18 months to 5 years of age. The children were screened for mutans streptococci (MS) in the dental biofilm. The main outcome measure was the proportion of children with dental caries (decayed, missing, or filled primary teeth > 0) at the age of 5 years. The intervention, targeted to MS-positive subjects in the intervention group only, was based on repeated health education to the caretakers and xylitol lozenges for the child. Dental hygienists carried out the programme. RESULTS OHP was effective in white-collar families [numbers needed to treat (NNT) = 3, 95% CI 2-11]. Factors significantly associated with caries at 5 years were MS colonization at 18 months, occupation of caretaker, but also gender when incipient carious lesions were included in the index. CONCLUSION Early risk-based OHP, targeted to the families of MS-positive children, can reduce the risk for caries in white-collar families. For blue-collar families, different kinds of methods in caries prevention and support are needed.
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Affiliation(s)
- Pia Meurman
- University of Turku, Institute of Dentistry, Turku, Finland.
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Vadiakas G. Case definition, aetiology and risk assessment of early childhood caries (ECC): a revisited review. Eur Arch Paediatr Dent 2009; 9:114-25. [PMID: 18793593 DOI: 10.1007/bf03262622] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM To provide a review of the existing literature on early childhood caries (ECC) with particular reference on the nomenclature, case definition, epidemiology, etiology and risk assessment. METHODS An electronic search was used to identify and critically review papers that have been published and are pertinent to the above issues, evaluate and compile the reported evidence. RESULTS The term ECC has been adopted to more accurately describe dental caries that affects primary dentitions, replacing previously used terminology that associated the disease with the nursing habit. Suggested ECC case definition uses caries patterns as defining criteria, however, further refinement to include different clinical expressions of a varying severity is necessary. Significant percentages of preschool child populations are affected by ECC today, with the disease concentrating disproportionately in deprived families. Early colonization by mutans streptococci (MS) is associated with increased ECC development, with bacteria being transmitted in both vertical and horizontal ways. Dietary factors related to sugar consumption predispose to early MS colonization and establishment and increase the risk for ECC development, being part of the causal chain. Inappropriate bottle and breast-feeding behaviors also increase the risk, without showing a direct causal relationship. High risk children belong to ethnic minority groups and to low income families with poor parental behaviors and attitudes. CONCLUSIONS Further high-quality studies are needed to explore the role bacteria other than MS may play in caries initiation and progression, elucidate the interaction of the saliva immune defence system with a potentially defective tooth, and investigate the effect distant behavioral factors have on the causal chain that leads to ECC development.
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Affiliation(s)
- G Vadiakas
- Dept. of Paediatric Dentistry, Dental School, University of Athens, Greece.
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