Medically administered antibiotics, dietary habits, fluoride intake and dental caries experience in the primary dentition

Oral hygiene status and oral care motivation in children aged 7-9 years in a Vietnam primary school: A cross-sectional study

INTRODUCTION

Oral hygiene is a crucial factor in oral health, especially in children. To increase the awareness of oral care behaviour among children, oral care motivation plays a critical role in daily dental practices. Therefore, this cross-sectional study was conducted to investigate the current oral hygiene status and evaluate the association between oral care motivation and oral hygiene index in 7-9-year-old children at Primary School in Hanoi, Vietnam.

METHODS

Clinical examinations were performed on 200 randomly selected children to assess the Simplified Oral Hygiene Index (OHI-S). Face-to-face interviews were applied to record students' intrinsic and extrinsic motivation for oral care through a questionnaire, which consisted of questions regarding demographic characteristics and oral care motivation. Data were analyzed using STATA 15.0 software and a p-value < 0.05 was statistically significant.

RESULTS

The mean OHI-S score was 2.48 ± 0.72. Good and fair oral hygiene were observed in 7.5 % and 66 % of participants, respectively. Students' motivation for dental care was predominantly extrinsic, with a mean score of 15.87 ± 1.322. Higher motivation in dental care is statistically significantly associated with oral hygiene index score (Coef=-0.27).

CONCLUSION

These results indicate that students with intrinsic motivation exhibit better oral hygiene practices. Consequently, strengthening oral health educational programs in primary schools based on intrinsic motivation could be helped improve the oral hygiene status and oral care behaviours of children.

Correlation between Dietary Intake of Vitamins and Oral Health Behaviors: A Cross-Sectional Study

This study aimed to investigate whether oral health behaviors were related to the dietary intake of vitamins. In this cross-sectional study, we included respondents of the 2016 national health and nutrition examination survey, and dental diseases from Hyogo Prefecture, Japan. Data on sociodemographic characteristics, findings of blood tests related to metabolic syndrome, dietary intake, oral health status, and behaviors were collected. Participants were divided into two groups based on their oral health behavior: the yes group (performed interdental cleaning or tongue brushing) and the no group (did not perform the behaviors). The study included 218 participants (male: 107, female: 111) aged 64.5 (range, 22-93) years. There were 133 (61.0%) and 85 (39.0%) participants in the yes and no groups, respectively. The daily intake of vitamins A, B₂, B₆, E, and K, folic acid, and niacin in the yes group was significantly higher than that in the no group. Oral health behavior correlated with the intake of vitamin B₂ (p = 0.029), folic acid (p = 0.006), and vitamin K (p = 0.043) after adjusting for possible confounders. Oral health behavior (interdental cleaning or tongue brushing) correlated with the daily intake of vitamins B₂, K, and folic acid.

Eating Habits and Their Relationship to Oral Health

The objective of this research was to compare the healthy behaviors and caries index of young people in school to obtain an overview of their lifestyles, which would enable the development of educational programs for the promotion of oral health. The study design was carried out using a descriptive, cross-sectional, and observational methodology with a mixed approach. 380 twelve-year-old students participated in this research conducted in the city of Riobamba-Ecuador. The techniques used were observational and surveys with their respective instruments, the Dental Clinical History, and the Health Behavior in School-aged Children 2014-Spain questionnaire. The community index of the Decayed, Missing due to caries, and Filled Teeth (DMFT) reflected a high level (6.47) in the study subjects. A variety of foods such as fruits, chips, vegetables, candy, sugar-containing drinks, meat, fish, dairy, and cereals were consumed at least once a week by most students. Two statistically significant associations were demonstrated in this investigation. The first one was between fruit consumption and the DMFT index, the second one was between vegetable consumption and the DMFT index. Both associations showed significant values (p) of 0.049 and 0.028, respectively; these were not determining indicators since caries is a multifactorial pathology, which can develop not only as a product of poor eating habits.

The effect of diet drinks on caries among US children: Cluster analysis

BACKGROUND

The effect of sugared beverages on dental caries has been widely studied in dental literature. A major limitation of these studies was examining the beverages as a single source. To overcome this limitation, a few studies used cluster analysis to group people into similar beverage consumption patterns. These studies did not differentiate between sugared beverages and diet drinks. Therefore the aim of this study is to examine the effect of consuming diet drinks on dental caries among US children by using cluster analysis.

METHODS

In this cross-sectional study, the authors analyzed the dietary data of children aged 3 through 10 years, using 2 24-hour recall interviews in the 2011-2014 National Health and Nutrition Examination Survey data. Cluster analysis has been used to overcome the limitations of examining the beverages as a single source. Clusters were identified based on the R² statistic and the local peak of pseudo-F statistics. Survey procedure and sample weights were used to account for the complex National Health and Nutrition Examination Survey sampling design.

RESULTS

Six beverage consumption clusters were identified: high soda, high 100% juice, high juice drinks, high diet drinks, high milk, and high water. Regression analysis showed that the high soda cluster had a tendency to increase caries risk (odds ratio [OR], 1.69, 95% confidence interval [CI], 0.9 to 3.1), while the high diet drinks cluster had neutral effect compared with the high water cluster (OR, 0.94, 95% CI, 0.5 to 1.8).

CONCLUSIONS

The results of this study suggest that diet drinks have no adverse effect on teeth among US children. Additional well-designed longitudinal studies should be conducted to establish the effect of diet drinks on caries when consumed during childhood.

PRACTICAL IMPLICATIONS

Although this study did not show an association between caries and diet drinks, dental practitioners should be cautious about recommending these drinks, as they have been linked to systemic diseases. In addition, the American Academy of Pediatrics and National Academy of Medicine do not recommend that children consume these beverages.

Prevalence of dental caries and associated factors among primary school children: a population-based cross-sectional study in Riyadh, Saudi Arabia

Background

Dental caries is a preventable childhood disease, but public health efforts are hampered due to limited information on associated factors in vulnerable populations. Our study was aimed at estimating the prevalence of dental caries and identifying key associated factors in four major risk domains, including socioeconomic factors, child oral health behavior and practices, child feeding practices, and dietary habits among primary school children in Saudi Arabia.

Methods

A cross-sectional study design was used to recruit 578 male Saudi primary school children, aged 6–8 years, from 12 primary schools in five different regions of Riyadh. Children were clinically screened to detect carious lesions in primary teeth according to World Health Organization’s criteria. Structured self-administered questionnaire was used to collect information on social and individual factors from the parents. The odds ratios and 95% confidence intervals of associated factors for dental caries were computed using logistic regression models; key factors were identified by systematic selection process that accounted for multicollinearity and bias correction.

Results

Dental caries was prevalent among children (83%, 95% confidence interval 79.7–86.0%). Individual factors, including irregular brushing, late adoption of brushing habit, consulting dentist for symptomatic treatment, lack of breast feeding, sleeping with a bottle in mouth, habit of snacking between meals, low consumption of fruits, and frequent consumption of soft drinks and flavored milk, were predominantly associated with dental caries in children, instead of socioeconomic factors (p < 0.05, adjusted R-square 80%).

Conclusion

Dental caries were prevalent in school children, and individual factors were predominantly associated with the disease.

Electronic supplementary material

The online version of this article (10.1186/s12199-018-0750-z) contains supplementary material, which is available to authorized users.

Effects of Starch on Oral Health: Systematic Review to Inform WHO Guideline

A systematic review was conducted to update evidence on the effect of total dietary starch and of replacing rapidly digestible starches (RDSs) with slowly digestible starches (SDSs) on oral health outcomes to inform updating of World Health Organization guidance on carbohydrate intake. Data sources included MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, LILACS, and Wanfang. Eligible studies were comparative and reported any intervention with a different starch content of diets or foods and data on oral health outcomes relating to dental caries, periodontal disease, or oral cancer. Studies that reported total dietary starch intake or change in starch intake were included or where comparisons or exposure included diets and foods that compared RDSs and/or SDSs. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statement, and evidence was assessed with the GRADE Working Group guidelines. From 6,080 papers identified, 33 (28 studies) were included in the RDS versus SDS comparison: 15 (14 studies) assessed the relationship between SDS and/or RDS and dental caries; 16 (12 studies) considered oral cancer; and 2 studied periodontal disease. For total starch, 23 papers (22 studies) were included: 22 assessed the effects on dental caries, and 1 considered oral cancer. GRADE assessment indicated low-quality evidence, suggesting no association between total starch intake and caries risk but that RDS intake may significantly increase caries risk. Very low-quality evidence suggested no association between total starch and oral cancer risk, and low-quality evidence suggested that SDS decreases oral cancer risk. Data on RDS and oral cancer risk were inconclusive. Very low-quality data relating to periodontitis suggested a protective effect of whole grain starches (SDS). The best available evidence suggests that only RDS adversely affects oral health.

Knowledge and attitude of pediatricians and Family Physicians in Chennai on Pediatric Dentistry: A survey

Background:

The aim of this study was to study the knowledge and attitude of the pediatricians and family physicians on the dental counterpart, i.e. pediatric dentistry and the objective of this study were to determine what can improve the knowledge and attitude on pediatric dentistry and suggest certain methodologies to more participation of physicians in improving oral health.

Materials and Methods:

A systematic random survey of 400 pediatricians and 400 family physicians received a questionnaire pertaining to individual details, approach towards pediatric dentistry, knowledge level and the training on oral health received.

Results:

Most of pediatricians and family physicians acknowledged the importance of pediatric dentistry. Less of pediatricians and more of family physicians predicted the parents may pose a barrier for referral. More number of pediatricians were aware of the oral benefits of breast feeding when compared to the family physician. Most of the practitioners in both groups were less aware of the first dental visit including ECC. Acknowledgement of the role in cleft lip and palate was more or less same in both groups of practitioners were as the effect of systemic disease on oral health was recognized by more number of pediatricians. Only a small percentage in both the groups acknowledged the cariogenicity of medicated syrups, which was substantiated by the fact that only a small number of physicians underwent dental training and most of them were accepting to undergo training.

Conclusion:

When basic medical training is provided in dental school, medical schools can also provide dental training. Dental lectures can also be incorporated into CME programs and recognition of pediatric dentistry by providing referral to needy patients have been suggested.

Topical effect of a medically prescribed pediatric antibiotic on dental biofilm: a cross-over, in situ study

Objective

This study aimed to investigate the possible topical effect of a broad-spectrum antibiotic on dental biofilm formed in situ in the absence or presence of sucrose.

Methods

A crossover study was conducted in three phases of 14 days each, during which 11 volunteers wore palatal devices containing 6 enamel blocks covered with meshes to allow biofilm formation. Dental blocks were extraorally submitted to a 20% sucrose solution at three different frequencies of exposure (0, 3 and 8 times/day), and to a suspension of amoxicillin/clavulanate potassium (A/CP) or a placebo (P) suspension at an 8-hour time interval application regimen. On the 14^th day of each phase, biofilms were collected for microbiological (conventional culture) and molecular (Denaturing Gradient Gel Electrophoresis – DGGE) analyses.

Results

In the absence of sucrose exposure (SE) and at the 3-time daily frequency, dental biofilms treated with A/CP showed lower total biofilm weight and lower counts of total microbiota than the ones treated with P (p>0.05). A/CP presented higher counts of Candida spp. when compared with P in the presence of SE, especially at the 8-time daily frequency (p<0.05). Considering the DGGE analysis, the mean number of bands was higher for P (p>0.05), regardless of SE. However, DGGE profiles demonstrated large interindividual variability.

Conclusion

Both conventional culture and DGGE have demonstrated some differences on total microbiota of dental biofilms when exposed to the A/CP or P suspensions, mainly in the absence of sucrose, which suggests a possible topical effect of the sugar-free A/CP suspension on dental biofilm.

Association between socioeconomic factors and the choice of dentifrice and fluoride intake by children

It is questionable whether socioeconomic factors influence the choice of marketed children’s dentifrices and whether these products are associated with greater fluoride (F) intake in children. The present cross-sectional study involving 197 children (mean age: 40.98 ± 6.62 months) was carried out in Montes Claros, Brazil. Parents completed a questionnaire on socioeconomic status and the tooth brushing habits of their children. The children brushed their teeth and saliva residues were collected for F analysis. F intake from dentifrice was determined with an ion-specific electrode. Univariate analysis and logistic regression were used to test whether the type of dentifrice (children’s or family) and F dose (<0.05 and ≥0.05 mg F/Kg of body weight/day) were associated with the independent variables (p < 0.05). No differences were found between children’s and family dentifrices regarding daily F intake (0.046 and 0.040 mg F/Kg/day, respectively; p = 0.513). The following were strong predictors for the use of a children’s dentifrice: studying at a private kindergarten (OR: 6.89; p < 0.001); age that the child begun to tooth brush <2 years (OR: 2.93; p = 0.041), and the interaction between the variables “use of the same dentifrice as parents” and “type of tooth brush used” (OR: 27.20; p < 0.001). “The amount of dentifrice used” and “frequency of tooth brushing” (p ≤ 0.004) had a statistically and synergistic effect over the daily F dose. The present study found a social influence over the choice of dentifrice: children with a high socioeconomic status tend to use a children’s dentifrice. The amount of dentifrice used can strongly increase the risk of exposure to higher doses of F, regardless of the type of dentifrice.

Caries prevalence and background factors in Swedish 4-year-old children - a 40-year perspective

BACKGROUND

Periodic and well-controlled studies of caries and background factors are important for organizing dental care and how prevention should be addressed.

AIMS

The aims of this study were to compare data on caries prevalence and background factors in 4-year-old children from 2007 with data collected periodically between 1967 and 2002 with the same methods and criteria, and to compare immigrant and non-immigrant children concerning caries prevalence and background factors.

DESIGN

A cross-sectional study in 4-year-old children living in Umeå, northern Sweden (n = 218), was performed. Caries recordings included both cavitated and non-cavitated caries lesion, and bite-wing radiographs were used on indications. Data on oral hygiene, use of fluorides, general health, and medication and sugar consumption were collected using the same questions and questionnaire as in the previous studies.

RESULTS

In 2007, 38% of the children displayed caries compared to 46% in 2002. The distribution of decayed, missing, or filled surfaces-primary teeth values was statistically significantly different in 2007 compared to 2002 (P < 0.05). The intake frequency of sugary between-meal products was generally lower, and toothbrushing frequency was higher in 2007 compared with data from the 2002 study. In children with immigrant background, the frequency of toothbrushing was statistically significantly lower, and snacking was more common (P < 0.05). Sixteen per cent had immigrant background and 59% had caries compared to 32% in the rest of the cohort (P < 0.01).

CONCLUSION

Important changes in caries prevalence of 4-year-old children have taken place since 2002 concurrently with a decreased intake of sugary between-meal products and increased toothbrushing frequency. Immigrant background had a significant association with caries prevalence in 2007.

High sucrose intake is associated with poor quality of diet and growth between 13 months and 9 years of age: the special Turku Coronary Risk Factor Intervention Project

BACKGROUND

Previous studies have suggested that interventions to lower dietary fat content and improved fat quality lead to a compensatory increase in sucrose content.

OBJECTIVE

The purpose of this work was to determine what associations exist between sucrose intake and intake of nutrients, intake of specific foods, and growth in children aged 13 months to 9 years of age in the prospective, randomized Special Turku Coronary Risk Factor Intervention Project.

SUBJECTS AND METHODS

Nutrient intake and food consumption were evaluated annually at ages 13 months through 9 years by using food records. Altogether, 543 children were divided into 3 groups according to mean sucrose intake: constantly high sucrose intake (highest 10%), constantly low sucrose intake (lowest 10%), and average sucrose intake (80%). Absolute and relative weights and heights were recorded at 7, 13, and 24 months of age and annually thereafter until 9 years old.

RESULTS

The high sucrose-intake group exceeded the recommended sucrose intake (<10% of energy intake, World Health Organization) already at the age of 2 years. Energy and total fat intake did not differ between the sucrose-intake groups. Children with low and average sucrose intake consumed more protein and had a better dietary fat quality than children with high sucrose intake. They also tended to receive more vitamin E, niacin, calcium, iron, zinc, and dietary fiber than children who consumed a high sucrose diet. Children in the low sucrose-intake group consumed more grains, vegetables, and dairy products than the other children. Sugar intake had no direct association with obesity, but weight, height, and BMI of children differed between the sucrose-intake groups between 7 months and 9 years of age.

CONCLUSIONS

In children aged 13 months to 9 years, long-term low sucrose intake is associated with better nutrient intake and growth than high sucrose intake.

The roles of meal, snack, and daily total food and beverage exposures on caries experience in young children

OBJECTIVES

This study describes associations among caries experience and meal, snack and daily total exposures to beverages and foods in children.

METHODS

Subjects (n = 634) were members of the Iowa Fluoride Study. Beverage and food exposures were abstracted from 3-day diaries at 1, 2, 3, 4 and 5 years and calculated for 1-5 years. Eating events were defined as 30-minute intervals and categorized as meals or snacks based on time of consumption and nature of the foods. Beverage and food exposures were categorized by carbohydrate content. Dental examinations were conducted at 4.5-6.8 years; caries experience was dichotomized (any vs. none). Logistic regression models were developed to determine if caries experience differed for the fourth vs. first quartile of exposure after adjustment for age at dental exam and fluoride intake.

RESULTS

Higher snack (1, 2, 3, 4, 1-5 years) and daily total (2, 3, 4, 1-5 years) eating events increased caries risk (P < 0.05). Higher exposures to 100% juice at snacks (2 years) and soda pop at meals (2, 1-5 years), snacks (2, 3, 4, 1-5 years) and daily total (2, 3, 4, 1-5 years) increased caries risk (P < 0.05). Higher exposures to food sugars (3, 1-5 years) and starches (4, 5, 1-5 years) at meals decreased caries risk, while higher exposures to sugars (4, 1-5 years) at snacks increased caries risk (P < 0.05).

CONCLUSIONS

Dietary methods used to investigate diet-caries relationships can influence the outcome. The cariogenicity of food, but not beverages, is associated with the timing of exposure.

Detection of approximal caries in 5-year-old Swedish children

The aim was to assess how accurately some commonly used risk factors/risk markers (predictors) for caries development could identify children with and without approximal caries as judged from bitewing radiography. Two hundred and sixty-seven consecutive 5-year-old children from two Swedish cities participated. Three experienced dentists examined the children. The predictors were the overall dmfs (decayed, missing and filled surfaces) value (canines and molars), the number of occlusal dmfs, the frequency of intake of between-meal sugary products, visible plaque on free smooth surfaces of second primary molars, toothbrushing habits and (before bitewing examination) an overall judgement by the examining dentist. The mean dmfs value without bitewing examination was 0.40 (SD = 1.22). Twelve percent of the children had at least one dentin lesion and 33% at least one enamel lesion that were detected from bitewing examination only. The gain from adding bitewing examination to clinical examination amounted to a mean of 1.2 approximal enamel and/or dentin lesions. The ability to correctly identify children with approximal caries from the predictors was limited; sensitivity ranged from 0.27 to 0.75 and specificity ranged from 0.41 to 0.93. The single best predictor was the dentist's overall judgement with an average precision of 73%; average sensitivity for the presence of enamel and dentin lesions was 0.48 and for the presence of dentin lesions 0.66. The rest of the predictors added little to the predictive power. It is concluded that 33% of the 5-year-olds, representing a low caries prevalence population, benefited from bitewing examination. The ability to identify these children from the predictors was, however, limited.

Caries experience and background factors in 4-year-old children: time trends 1967-2002

In cross-sectional studies conducted in 1967, 1971, 1976, 1980, 1987, 1992, 1997 and 2002, 4-year-old children in Umeå, a city in northern Sweden, were examined for dental caries and background factors such as oral hygiene habits, use of fluorides, and sugar consumption. The same methods and criteria have been used in each of the studies from 1967 to 2002. The number of children with caries had declined from 87% in 1967 to 42% in 1987, but then the decline levelled out. In 2002, 46% of the children had caries with a mean dmfs value of 2.0 +/- 3.6. Six percent of the children had 10 or more dmfs. Immigrant children had a higher caries prevalence (p < 0.01). A significant difference in the dmfs values was found in children according to tooth-brushing frequency (p < 0.01). Although the consumption of sugary products between meals increased between 1987 and 1997, no changes were noted from 1997 to 2002. In conclusion, no important changes in caries prevalence have taken place during the last 15 years. The frequency of tooth-brushing and immigrant background had a significant association with caries prevalence.

Sucrose intake since infancy and dental health in 10-year-old children

The dental health of children in western countries has improved without a concomitant decrease in the mean sucrose consumption. Our aim was to analyse the association of long-term sucrose consumption with dental health in children representing the highest (n = 33, 18 boys) and the lowest 5 percentiles (n = 33, 21 boys) of sucrose intake, in a study where food consumption was prospectively recorded from infancy to 10 years of age. The sum of decayed, missing and filled teeth in the primary (dmft) and permanent (DMFT) teeth was assessed. Children's sucrose intake in the high intake group was constantly higher than in their counterparts (p < 0.001), and already exceeded 10% of energy intake (E %) at 2 years of age. The mean +/- SD of the dmft + DMFT scores was higher in the high than in the low sucrose intake group (3.9 +/- 3.9 and 1.9 +/- 2.5, respectively; p = 0.032). We conclude that a persistently high sucrose intake increases the risk of dental caries in children.