Diet and nutrition in pediatric dentistry

Association between nocturnal breastfeeding and snacking habits and the risk of early childhood caries in 18- to 23-month-old Japanese children

BACKGROUND

Early childhood caries (ECC) is one of the most prevalent chronic diseases among children. The aim of this cross-sectional study was to investigate the association between nocturnal breastfeeding, snacking habits, or other risk factors and ECC in 18- to 23-month-old Japanese children.

METHODS

Study subjects were 1675 children aged 18 to 23 months. A self-administered questionnaire was completed by parents or guardians of the children. The survey contents included such things as number of decayed, missing, and filled teeth per child, smokers in the home, nocturnal breastfeeding habit, snack times, kinds of snacks consumed ≥ 4 days a week, kinds of drinks consumed ≥ 4 days a week, parents brushing their child's teeth daily, and the use of fluoride toothpaste. Logistic regression analysis was performed to estimate the odds of ECC.

RESULTS

The average number of decayed, missing and filled teeth was 0.10. The prevalence of dental caries was 3.3%. Nocturnal breastfeeding habits were reported in 357 subjects (21.3%). After excluding items of multicollinearity, significant associations were observed between ECC and nocturnal breastfeeding, drinking or eating sweets after dinner every day, and the intake of candy, soda and/or isotonic drinks ≥ 4 days a week.

CONCLUSIONS

This study suggests that nocturnal breastfeeding and snacking habits are correlated with ECC.

Feeding practice among 6-36 months old in Tanzania and Uganda: reliability and relationship with early childhood caries, ECC

OBJECTIVE

To assess the reproducibility of caregivers' responses to dietary recall from birth and 24-h dietary recall with respect to infants' intake of sugared snacks and to assess whether those assessment methods provide comparable results for groups of infants. Re-test reliability and clinical covariates of time to first exposure of sugared snacks and time to termination of breastfeeding were also examined. It was hypothesized that time to first exposure/termination would vary according to socio-demographic profile and ECC.

METHOD

Interviews and clinical oral examinations were carried out in Kampala and Manyara, including 1221 and 816 child-caregiver pairs. Reproducibility was assessed using Cohen's kappa and Intra Class Correlation Coefficient, ICC. Adjusted Cox regression was used to model time to first exposure of sugared snacks and time to termination of breastfeeding.

RESULTS

Cohen's kappa for intake of sugar items ranged from 0.40-1.0, with no differences observed between average intakes at test-re-test. Mean sugar score based on 24-h recall increased significantly by increasing quartiles of the sugar score based on recall from birth. Cox regression revealed that the odds ratio, OR, for early exposure to various sugared snacks and the ORs for early termination of breastfeeding were significantly smaller in infants with than without ECC.

CONCLUSION

Fair-to-good reproducibility was established. Infant's sugar consumption emerge as early as 6 months of age. Survival of any breastfeeding and non-exposure to sugared snacks was most prolonged among infants with ECC. This has implications for interventions needed to improve feeding habits of infants and toddlers.

Comparative evaluation of the influence of television advertisements on children and caries prevalence

Introduction

Children watch television during most of their free time. They are exposed to advertisers’ messages and are vulnerable to sophisticated advertisements of foods often detrimental to oral and general health.

Objectives

To evaluate the influence of television advertisements on children, the relationship with oral health and to analyze the content of those advertisements.

Methodology

A questionnaire-based study was performed among 600 schoolchildren of Mangalore, Karnataka, followed by oral examination. Based on the survey, favorite and non-favorite channels and viewing times were analyzed. Advertisements on children’s favorite and non-favorite channels were then viewed, analyzed, and compared.

Results

Higher caries prevalence was found among children who watched television and asked for more food and soft drinks. Cariogenic food advertisements were popular on children’s favorite channels.

Conclusion

Television advertisements may strongly influence children’s food preferences and eating habits, resulting in higher caries prevalence. Advertisements regarding healthy food, oral hygiene maintenance, prevention of diseases such as caries should be given priority for the benefit of the health of children.

Contemporary fluid intake and dental caries in Australian children

In Australia, caries experience of 6-year-old and 12-year-old children has increased since the mid to late 1990s. Previously, caries rates had declined, attributable to community water fluoridation. The recent caries increase has been attributed speculatively to changes in fluid intake, including increased consumption of sweet drinks and bottled waters. Increasing urbanization and globalization have altered children's diets worldwide, promoting availability and access to processed foods and sweet drinks. Studies in Australia and internationally have demonstrated significant associations between sweet drink intake and caries experience. Despite widespread fluoride availability in contemporary Australian society, the relationship between sugar consumption and caries development continues and restricting sugar intake remains key to caries prevention. Caries risk assessment should be included in treatment planning for all children; parents should be advised of their child's risk level and given information on oral health promotion. Readily-implemented caries risk assessment tools applicable to parents and clinicians are now available. Public health information should increase awareness that consuming sweet drinks can have deleterious effects on the dentition as well as the potential for promoting systemic disease. Restricting sales of sweet drinks and sweet foods and providing healthy food and drinks for purchase in schools is paramount.

Position of the American Dietetic Association: Oral Health and Nutrition

It is the position of the American Dietetic Association that nutrition is an integral component of oral health. The American Dietetic Association supports the integration of oral health with nutrition services, education, and research. Collaboration between dietetics and dental professionals is recommended for oral health promotion and disease prevention and intervention. Scientific and epidemiological data suggest a lifelong synergy between nutrition and the integrity of the oral cavity in health and disease. Oral health and nutrition have a synergistic bidirectional relationship. Oral infectious diseases, as well as acute, chronic, and terminal systemic diseases with oral manifestations, impact the functional ability to eat as well as diet and nutrition status. Likewise, nutrition and diet may affect the development and integrity of the oral cavity as well as the progression of oral diseases. As we advance in our discoveries of the links between oral and nutrition health, practitioners of both disciplines must learn to provide screening, baseline education, and referral to each other as part of comprehensive client/patient care. Dietetics practice requires registered dietitians to provide medical nutrition therapy that incorporates a person's total health needs, including oral health. Inclusion of both didactic and clinical practice concepts that illustrate the role of nutrition in oral health is essential in both dental and dietetic education programs. Collaborative endeavors between dietetics and dentistry in research, education, and delineation of health provider practice roles are needed to ensure comprehensive health care. The multifaceted interactions between diet, nutrition, and oral health in practice, education, and research in both dietetics and dentistry merit continued, detailed delineation.

Carbonated soft drinks and dental caries in the primary dentition

We analyzed fluid intake data among children aged 2-10 years from a 24-hour dietary recall interview in the NHANES III (1988-94) to investigate the effect of high consumption of carbonated soft drinks on caries in the primary dentition. We used cluster analysis to determine fluid consumption patterns. Four distinct fluid consumption patterns were identified: high carbonated soft drinks, high juice, high milk, and high water. About 13% of children had a high carbonated soft drink consumption pattern; they also had a significantly higher dental caries experience in the primary dentition than did children with other fluid consumption patterns. A fluid intake pattern comprised mainly of milk, water, or juice was less likely to be associated with dental caries. Findings of this study suggest that high consumption of carbonated soft drinks by young children is a risk indicator for dental caries in the primary dentition and should be discouraged.