[Consumption of fruit juices and fruit drinks: impact on the health of children and teenagers, the dentist's point of view]

Child oral health: A plea for interdisciplinarity

A child’s oral health has major implications both for their general health and for their quality of life. Even before birth, the mother’s oral health can affect the development of the baby and pregnancy outcomes. From the very first months of life, feeding habits together with non-nutritive sucking ones, early transmission of pathogenic bacteria, and oral hygiene practices prefigure the child’s future health. The aim of this article is to provide a comprehensive overview of our current knowledge regarding the main oral health issues affecting children, namely dental caries, erosive tooth wear, developmental defects of enamel, maxillofacial growth anomalies, and traumatic dental injuries. Additionally, it aims to examine the oral health prevention and promotion programs that have been implemented in France over several decades. These prevention and promotion initiatives are not only part of a national program but are also being organized at a territorial level, although, unfortunately, they often remain limited to regional, departmental, or municipal scopes. It is essential for all those involved with children, whether they are health care professionals or not, to collaborate effectively to enhance both oral health and overall well-being. This requires fostering an interdisciplinary approach that involves various contributors working together in a complementary way.

Relationship Between Dental Caries and Erosive Tooth Wear in Adolescents

Background

Our aim was to investigate the relationship between caries experience and erosive tooth wear of adolescents.

Methods

We compared the Decayed, Missing, and Filled Teeth (dmft/DMFT) data of 795 adolescents to their erosive tooth wear scores using diet as a covariate and determined if dental caries and erosive tooth wear scores are associated using linear regression analysis. Diet data and oral hygiene habits were collected using self-reported surveys and erosive tooth wear scores were previously collected. We also compared patients' genotypes and phenotypes and looked for an association between erosive tooth wear experience and different single nucleotide polymorphisms (SNPs). A Bonferroni correction was implemented to correct multiple comparisons. Two-group comparisons were made depending on the phenotype definitions implemented, and both chi-square and linear regression analyses were used to test association between genetic variants and caries definitions. All covariates were included in each model.

Results

For four SNPs (rs17159702, rs10246939, rs1800972, and rs1676303), there was an association between a spike in caries experience of DMFT 4 or more between two time points and increased frequency of fruit juice intake. A fifth SNP rs2860216 was shown to be a protective factor toward a spike in caries when coupled with more frequently eating yogurt. We did not find significant associations between our dental caries phenotypes or our demographic data and erosive tooth wear status in our linear regression.

Conclusions

Dental caries and erosive tooth wear are two diseases that differ in mechanism and heritability.

Preferences and Perceived Value of WIC Foods Among WIC Caregivers

OBJECTIVE

To evaluate preferences for and values of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) foods and packages and understand what factors may influence these preferences and values.

DESIGN

Using a mixed-methods approach, surveys and individual in-depth interviews were conducted to measure and understand preferences for specific WIC foods and how much WIC food packages are worth to participants.

SETTING

Eight WIC clinics across Illinois.

PARTICIPANTS

Caregivers of infants enrolled in WIC for at least 3-6 months.

PHENOMENON OF INTEREST

Preferences for WIC foods, WIC food package values, and factors that influence these categories.

ANALYSIS

Frequencies were gathered to analyze survey data and interview transcripts were analyzed using constant comparative analysis to identify emergent themes.

RESULTS

Survey (n = 150) and interview (n = 31) participants valued the food packages in WIC but they valued the infant packages more. The cash value fruit and vegetable voucher increased the perceived value of the program for many participants. Restrictions on food choice preferences (eg, type of milk) detracted value from the program.

CONCLUSIONS AND IMPLICATIONS

This study shows that providing more choice in the program could improve satisfaction with WIC overall. More research is warranted with a more representative sample to assess whether expanded food choice would improve value of and preference for WIC foods.

Determinants of sugar-sweetened beverage consumption in young children: a systematic review

Sugar-sweetened beverage (SSB) consumption is associated with adverse health outcomes. Improved understanding of the determinants will inform effective interventions to reduce SSB consumption. A total of 46,876 papers were identified through searching eight electronic databases. Evidence from intervention (n = 13), prospective (n = 6) and cross-sectional (n = 25) studies on correlates/determinants of SSB consumption was quality assessed and synthesized. Twelve correlates/determinants were associated with higher SSB consumption (child's preference for SSBs, TV viewing/screen time and snack consumption; parents' lower socioeconomic status, lower age, SSB consumption, formula milk feeding, early introduction of solids, using food as rewards, parental-perceived barriers, attending out-of-home care and living near a fast food/convenience store). Five correlates/determinants were associated with lower SSB consumption (parental positive modelling, parents' married/co-habiting, school nutrition policy, staff skills and supermarket nearby). There was equivocal evidence for child's age and knowledge, parental knowledge, skills, rules/restrictions and home SSB availability. Eight intervention studies targeted multi-level (child, parents, childcare/preschool setting) determinants; four were effective. Four intervention studies targeted parental determinants; two were effective. One (effective) intervention targeted the preschool environment. There is consistent evidence to support potentially modifiable correlates/determinants of SSB consumption in young children acting at parental (modelling), child (TV viewing) and environmental (school policy) levels.

Factors influencing obesogenic dietary intake in young children (0-6 years): systematic review of qualitative evidence

BACKGROUND

Obesogenic dietary intake is prevalent in young children and is associated with obesity and other adverse health outcomes in childhood and later in life.

OBJECTIVE

To describe the barriers to and facilitators of obesogenic dietary intake in early childhood, in order to inform interventions and public health policies to prevent obesity.

DESIGN

Systematic review of qualitative literature on factors influencing obesogenic diets in children aged 0-6 years.

DATA SOURCES

MEDLINE, EMBASE, CINAHL, PsycINFO, Web of Knowledge, British Nursing Index, ASSIA and Sociological Abstracts.

REVIEW METHODS

Qualitative studies meeting the inclusion criteria were synthesised. Data were analysed by creating a thematic framework, underpinned by the socioecological model, which included familiarisation of data across the studies, indexing, charting, mapping and interpretation.

RESULTS

20 studies from the USA (10), Europe (6) and Australia (4) included the views of 1067 participants (901 parents/caregivers, 37 children, 87 teachers, 15 dieticians and 27 nursery staff). Study designs included focus groups (n=16), individual interviews (n=6) and ethnography (n=1) with some studies using more than one design. Despite wide differences in the study context and focus, several consistent themes emerged. Parental factors increasing young children's obesogenic diets were: negative parent/family/peer modelling, lack of knowledge, time constraints, using food as reward, affordability and concerns about child's health. Child preferences also increased intake. Environmental factors increasing intake include: availability, advertising, societal, cultural and preschool/childcare influences.

CONCLUSIONS

Future intervention strategies should aim to promote modelling of positive behaviours, create home and preschool environments that promote healthy diets, and simultaneously target factors at the family and preschool/childcare levels.

TRIAL REGISTRATION NUMBER

This review is one of a series of systematic reviews on the determinants of obesogenic behaviours in young children, registered with the International Prospective Register for Systematic Reviews (PROSPERO), CRD42012002881.

The impact of dietary and lifestyle factors on the risk of dental caries among young children in Qatar

AIM

The aim of the current study was to investigate the relationship between dietary intake, type of feeding during infancy, other lifestyle and sociodemographic factors, and dental caries.

DESIGN

A cross-sectional study.

SETTING

The study was carried out on children younger than 16 years of age who visited Primary Health Care Centers. The study was carried out over a period from October 2010 to June 2011 in Qatar.

PARTICIPANTS

A random sample of 1752 children aged 6-15 years old who visited the Primary Health Care Centers was approached, and parents of 1284 children provided their consent and fulfilled the inclusion criteria (corresponding to a response rate of 73%).

METHODS

The study was based on a questionnaire that included variables such as sociodemographic information, lifestyle, family history, and feeding patterns during infancy, information on oral hygiene practices, and clinical examination. The status of dental caries was recorded on the basis of the WHO criteria.

RESULTS

The prevalence of dental caries [decayed, missed, or filled tooth (DMFT)] in the permanent dentition among children was 73% [95% confidence interval (CI): 71-75%], with a mean DMFT value of 4.5 (SD: 4.2). The numbers of children consuming sea food, cod liver oil, and vitamin-D-fortified milk less than once a week were significantly higher in the dental caries group compared with those without caries (11.7 vs. 8.3%; P=0.05, 92.4 vs. 87.5%; P=0.005, and 10.6 vs. 6.3%; P=0.011, respectively). Multivariable logistic regression analysis showed that being female [adjusted odds ratio (OR): 1.41; 95% CI: 1.07-1.84], having a BMI greater than the 95th percentile versus less than the 85th percentile (adjusted OR: 2.12; 95% CI: 1.17-3.84), a monthly household income of at least 10 000 QAR (adjusted OR: 2.61; 95% CI: 1.69-4.02), consumption of cod liver oil less than once a week (adjusted OR: 2.13; 95% CI: 1.35-3.37), 1-year increase in age (adjusted OR: 1.05; 95% CI: 1.01-1.11), being formula fed during infancy (adjusted OR: 2.27; 95% CI: 1.59-3.21), and frequency of tooth brushing once a day or less (adjusted OR: 1.36; 95% CI: 1.01-1.83) were associated independently with the risk of dental caries among children in Qatar.

CONCLUSION AND RECOMMENDATIONS

Being female, overweight or obese, and monthly household income higher than US$2747 (≥10,000 QAR) were independent risk factors for dental caries. However, consumption of cod liver oil (at least once a week) and frequency of tooth brushing (more than once a day) were protective against dental caries. Health awareness and education on frequent tooth brushing, adequate nutrition, and obesity prevention should be promoted to avoid dental caries among children.

The effects of beverages on plaque acidogenicity after a sugary challenge

BACKGROUND

Caries prevention traditionally has emphasized the restriction of cariogenic foods and beverages, but it has placed less emphasis on how the choice, combination and sequence of consumed foods and beverages may help reduce plaque acidogenicity. The authors conducted a study to examine whether whole milk, 100 percent apple juice or tap water affect dental plaque acidity in people after a sugary challenge.

METHODS

Twenty adults participated in a randomized controlled crossover study. Participants consumed four combinations of foods: 20 grams of dry sugary Froot Loops (FL) (Kellogg's, Battle Creek, Mich.) cereal, 20 g of FL followed by 50 milliliters of milk (FL/milk), 20 g of FL followed by 50 mL of juice (FL/juice) and 20 g of FL followed by 50 mL of water (FL/water). The authors used a touch microelectrode to take plaque pH readings at the interproximal space just below the contact area between the maxillary premolars on both left and right sides at two and five minutes after FL consumption and at two to 30 minutes after milk, juice or water consumption.

RESULTS

Consumption of FL plaque pH (standard deviation [SD]) was 5.83 (0.68) at 30 minutes, whereas plaque pH (SD) in the FL/milk group was 6.48 (0.30), which was significantly higher than that for FL/juice (5.83 [0.49]) or FL/water (6.02 [0.41]) (P < .005) at 35 minutes.

CONCLUSION

Drinking milk after a sugary cereal challenge significantly reduced plaque pH drop due to the sugary challenge.

PRACTICAL IMPLICATIONS

When discussing the cariogenicity of foods and beverages with patients, dentists and other health care professionals should emphasize that the order of ingesting sugary and nonsugary foods is important and may affect their oral health.