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Khan SY, Schroth RJ, Cruz de Jesus V, Lee VHK, Rothney J, Dong CS, Javed F, Yerex K, Bertone M, El Azrak M, Menon A. A systematic review of caries risk in children <6 years of age. Int J Paediatr Dent 2024; 34:410-431. [PMID: 38071403 DOI: 10.1111/ipd.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/11/2023] [Accepted: 11/07/2023] [Indexed: 06/14/2024]
Abstract
BACKGROUND For caries risk assessment (CRA) tools for young children to be evidence-based, it is important to systematically review the literature to identify factors associated with the onset of early childhood caries (ECC). AIM This updated systematic review aimed to identify current evidence on caries risk in young children. DESIGN A comprehensive and systematic literature search of relevant databases was conducted to update a previous systematic review and identify risk factors associated with ECC. Potential risk factors were identified based on strength of association using odds ratios, hazard ratios, relative risk, etc. GRADE was used for rating quality evidence through consensus. RESULTS Twenty-two studies met inclusion criteria for the search from mid-2017 to 2021. Twenty-five publications from the prior systematic review, from 1997 to mid-2017, were also included. Several socioeconomic, behavioral, and clinical variables were identified as ECC risk factors. Factors included the following: age, socioeconomic status, frequency of and supervised toothbrushing, fluoride exposure, breast- and bottle-feeding, feeding habits, absence of a dental home, past caries experience, active non-cavitated lesions, visible plaque, enamel defects, and microbiome. CONCLUSION This study provides updated evidence of risk factors for ECC that could be included in CRA tools.
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Affiliation(s)
- Saima Yunus Khan
- Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - Robert J Schroth
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Shared Health Inc., Winnipeg, Manitoba, Canada
| | - Vivianne Cruz de Jesus
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Victor H K Lee
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Janet Rothney
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cecilia S Dong
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Faraha Javed
- Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - Katherine Yerex
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mary Bertone
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mohamed El Azrak
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anil Menon
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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2
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Roca C, Alkhateeb AA, Deanhardt BK, Macdonald JK, Chi DL, Wang JR, Wolfgang MC. Saliva sampling method influences oral microbiome composition and taxa distribution associated with oral diseases. PLoS One 2024; 19:e0301016. [PMID: 38547181 PMCID: PMC10977688 DOI: 10.1371/journal.pone.0301016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/09/2024] [Indexed: 04/02/2024] Open
Abstract
Saliva is a readily accessible and inexpensive biological specimen that enables investigation of the oral microbiome, which can serve as a biomarker of oral and systemic health. There are two routine approaches to collect saliva, stimulated and unstimulated; however, there is no consensus on how sampling method influences oral microbiome metrics. In this study, we analyzed paired saliva samples (unstimulated and stimulated) from 88 individuals, aged 7-18 years. Using 16S rRNA gene sequencing, we investigated the differences in bacterial microbiome composition between sample types and determined how sampling method affects the distribution of taxa associated with untreated dental caries and gingivitis. Our analyses indicated significant differences in microbiome composition between the sample types. Both sampling methods were able to detect significant differences in microbiome composition between healthy subjects and subjects with untreated caries. However, only stimulated saliva revealed a significant association between microbiome diversity and composition in individuals with diagnosed gingivitis. Furthermore, taxa previously associated with dental caries and gingivitis were preferentially enriched in individuals with each respective disease only in stimulated saliva. Our study suggests that stimulated saliva provides a more nuanced readout of microbiome composition and taxa distribution associated with untreated dental caries and gingivitis compared to unstimulated saliva.
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Affiliation(s)
- Cristian Roca
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Alaa A. Alkhateeb
- Department of Dental Health Sciences, School of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Washington, United States of America
| | - Bryson K. Deanhardt
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jade K. Macdonald
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Donald L. Chi
- Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Washington, United States of America
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington, United States of America
| | - Jeremy R. Wang
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Matthew C. Wolfgang
- Department of Microbiology and Immunology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
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3
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Rouzi M, Jiang Q, Zhang H, Li X, Long H, Lai W. Characteristics of oral microbiota and oral health in the patients treated with clear aligners: a prospective study. Clin Oral Investig 2023; 27:6725-6734. [PMID: 37775585 DOI: 10.1007/s00784-023-05281-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 09/24/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES In this prospective clinical study, the effect of clear aligners on periodontal health and oral hygiene was examined. As the same time, microbial changes of the aligner tray and subgingival microbiota community were investigated. METHODS The study recruited fifteen patients, and clinical parameters were recorded at three different time points: before the initiation of aligner treatment (T0), 1 month after treatment onset (T1), and 3 months after treatment onset (T3). Plaque samples were collected from the inner surface of aligners and subgingival sulcus at each of these time points. The microbial composition of the samples was analyzed using 16S rRNA gene sequencing, and changes were evaluated based on the abundance of amplicon sequence variants (ASVs). RESULTS Reduction in plaque index and improvement in periodontal health were observed. In aligner tray plaque samples, the relative abundance of Streptococcus increased significantly, as well as the richness and diversity of microbiota decreased substantially as the duration of treatment time. In subgingival plaque samples, alpha and beta diversity of microbiota did not change significantly. CONCLUSIONS During the clear aligner treatment, the patients' periodontium remained in a healthy condition, and clear aligner treatment had no significant impact on the composition of subgingival microbiota. The structure of the aligner tray microbiota altered significantly at both phylum and genus levels and attracted a unique and less diverse microbiota community. CLABSINABSICAL RELEVANCE Clear aligner treatment has no significant impact on periodontal health and subgingival microbiota composition of patients.
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Affiliation(s)
- Maierdanjiang Rouzi
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Qingsong Jiang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Haoxin Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Xiaolong Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road Third Section, Chengdu, 610041, China
| | - Hu Long
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road Third Section, Chengdu, 610041, China.
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, 14 Renmin South Road Third Section, Chengdu, 610041, China.
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4
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Muñoz-Urtubia N, Vega-Muñoz A, Estrada-Muñoz C, Salazar-Sepúlveda G, Contreras-Barraza N, Castillo D. Healthy Behavior and Sports Drinks: A Systematic Review. Nutrients 2023; 15:2915. [PMID: 37447239 PMCID: PMC10346316 DOI: 10.3390/nu15132915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
This review article aims to systematically identify the relationship between sports drinks and healthy behavior. This systematic literature review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline criteria, and eligibility criteria were established using the PICOS tool (population, interventions, comparators, outcomes, and study) from about 1000 records of sports drinks articles identified in the various Web of Science Core Collection databases. The literature review stages determined a reduced set of 15 articles relating these drinkable supplements to healthy behavior. This study concludes that water consumption should be emphasized for non-athletes, sports drinks should be labeled to indicate water consumption and carry a warning label, and more randomized clinical trials should be considered to ensure conclusive results for health decision making.
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Affiliation(s)
| | - Alejandro Vega-Muñoz
- Instituto de Investigación y Postgrado, Facultad de Ciencias de la Salud, Universidad Central de Chile, Santiago 8330507, Chile
- Public Policy Observatory, Universidad Autónoma de Chile, Santiago 7500912, Chile
| | - Carla Estrada-Muñoz
- Departamento de Ergonomía, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción 4070386, Chile;
| | - Guido Salazar-Sepúlveda
- Departamento de Ingeniería Industrial, Facultad de Ingeniería, Universidad Católica de la Santísima Concepción, Concepción 4090541, Chile
- Facultad de Ingeniería y Negocios, Universidad de Las Américas, Concepción 4090940, Chile
| | | | - Dante Castillo
- Centro de Estudios e Investigación Enzo Faletto, Universidad de Santiago de Chile, Santiago 9170022, Chile;
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5
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Lewis KH, Hsu FC, Block JP, Skelton JA, Schwartz MB, Krieger J, Hindel LR, Ospino Sanchez B, Zoellner J. A Technology-Driven, Healthcare-Based Intervention to Improve Family Beverage Choices: Results from a Pilot Randomized Trial in the United States. Nutrients 2023; 15:2141. [PMID: 37432293 DOI: 10.3390/nu15092141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 07/12/2023] Open
Abstract
Background: Healthcare-based interventions to address sugary beverage intake could achieve broad reach, but intensive in-person interventions are unsustainable in clinical settings. Technology-based interventions may provide an alternative, scalable approach. Methods: Within an academic health system in the United States that already performs electronic health record-based sugary drink screening, we conducted a pilot randomized trial of a technology-driven family beverage choice intervention. The goal of the intervention was to reduce sugar-sweetened beverage (SSB) and fruit juice (FJ) consumption in 60 parent-child dyads, in which children were 1-8 years old. The pediatrician-initiated intervention consisted of a water promotion toolkit, a video, a mobile phone application, and 14 interactive voice-response phone calls to parents over 6 months. The study was conducted between June 2021 and May 2022. The aim of the pilot study was to assess the potential feasibility and efficacy of the newly developed intervention. Results: Intervention fidelity was excellent, and acceptability was high for all intervention components. Children in both the intervention and the control groups substantially decreased their consumption of SSB and FJ over follow-up (mean combined baseline 2.5 servings/day vs. 1.4/day at 6 months) and increased water consumption, but constrained linear mixed-effects models showed no differences between groups on these measures. Compared to parents in the control group, intervention parents had larger decreases in SSB intake at 3 months (-0.80 (95% CI: -1.54, -0.06, p = 0.03) servings daily), but these differences were not sustained at 6 months. Conclusion: These findings suggest that, though practical to implement in a clinical care setting and acceptable to a diverse participant group, our multicomponent intervention may not be universally necessary to achieve meaningful behavior changes around family beverage choice. A lower-intensity intervention, such as EHR-based clinical screening alone, might be a less resource-intense way for health systems to achieve similar behavioral outcomes. Future studies might therefore explore whether, instead of applying a full intervention to all families whose children overconsume SSB or FJ, a stepped approach, starting with clinical screening and brief counseling, could be a better use of health system resources.
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Affiliation(s)
- Kristina H Lewis
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Fang-Chi Hsu
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Jason P Block
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA 02215, USA
| | - Joseph A Skelton
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Marlene B Schwartz
- Rudd Center for Food Policy and Health, University of Connecticut, Hartford, CT 06103, USA
| | - James Krieger
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA 98195, USA
- Healthy Food America, Seattle, WA 98122, USA
| | - Leah Rose Hindel
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Beatriz Ospino Sanchez
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Jamie Zoellner
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
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6
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Li Y, Saraithong P, Zhang L, Dills A, Paster BJ, Xiao J, Wu TT, Jones Z. Dynamics of oral microbiome acquisition in healthy infants: A pilot study. FRONTIERS IN ORAL HEALTH 2023; 4:1152601. [PMID: 37065420 PMCID: PMC10098328 DOI: 10.3389/froh.2023.1152601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 03/08/2023] [Indexed: 04/18/2023] Open
Abstract
Objectives The human oral microbiota is one of the most complex bacterial communities in the human body. However, how newborns initially acquire these bacteria remains largely unknown. In this study, we examined the dynamics of oral microbial communities in healthy infants and investigated the influence of the maternal oral microbiota on the acquisition of the infant's oral microbiota. We hypothesized that the infant oral microbial diversity increases with age. Methods One hundred and sixteen whole-salivary samples were collected from 32 healthy infants and their biological mothers during postpartum and 9- and 15-month well-infant visits. Bacterial genomic DNA was extracted and sequenced by Human Oral Microbe Identification using Next Generation Sequencing (HOMINGS) methods. The Shannon index was used to measure the microbial diversity of the infant-mother dyads (alpha diversity). The microbial diversity between the mother-infant dyads (beta-diversity) was calculated using the weighted non-phylogenetic Bray-Curtis distance in QIIME 1.9.1. Core microbiome analysis was performed using MicrobiomeAnalyst software. Linear discriminant analysis coupled with effect size analysis was used to identify differentially abundant features between mother and infant dyads. Results A total of 6,870,571 16S rRNA reads were generated from paired mother-infant saliva samples. Overall, oral microbial profiles significantly differed between the mother and infant groups (p < 0.001). The diversity of the salivary microbiomes in the infants increased in an age-dependent manner, whereas the core microbiome of the mothers remained relatively stable during the study period. Breastfeeding and gender did not affect the microbial diversity in infants. Moreover, infants had a greater relative abundance of Firmicutes and a lower abundance of Actinobacteria, Bacteroidetes, Fusobacteria, and Proteobacteria than their mothers. The SparCC correlation analysis demonstrated constant changes in infants' oral microbial community network (p < 0.05). Conclusions This study provides new evidence that the oral cavities of infants are colonized by a distinct group of bacterial species at birth. The acquisition and diversity of changes in oral microbial composition are dynamic during the first year of an infant's life. Before reaching the second birthday, the composition of the oral microbial community could be more similar to that of their biological mothers.
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Affiliation(s)
- Yihong Li
- Master of Public Health Program, Department of Public and Ecosystem Health, Cornell University, Ithaca, NY, United States
| | - Prakaimuk Saraithong
- Department of Internal Medicine, Medical School University of Michigan, Ann Arbor, MI, United States
| | - Lanxin Zhang
- Department of Molecular and Cell Biology, University of California Berkeley, Oakland, CA, United States
| | - Ashley Dills
- Family Translational Research Group, New York University College of Dentistry, New York, NY, United States
| | - Bruce J. Paster
- Molecular Microbiology & Genetics, The Forsyth Institute, Cambridge, MA, United States
- Department of Oral Medicine, Infection, and Immunity, Harvard School of Dental Medicine, Boston, MA, United States
| | - Jin Xiao
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, United States
| | - Tong Tong Wu
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, United States
| | - Zachary Jones
- Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, NY, United States
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7
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Butera A, Maiorani C, Morandini A, Simonini M, Morittu S, Trombini J, Scribante A. Evaluation of Children Caries Risk Factors: A Narrative Review of Nutritional Aspects, Oral Hygiene Habits, and Bacterial Alterations. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020262. [PMID: 35204983 PMCID: PMC8870668 DOI: 10.3390/children9020262] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/10/2022] [Accepted: 02/13/2022] [Indexed: 11/18/2022]
Abstract
Dental caries is one of the most common diseases—both in adults and children—that occurs due to the demineralization of enamel and dentine by the organic acids formed from bacteria present in dental plaques through anaerobic metabolism of dietary sugars. The aim of this article is to provide a guideline to assess the risk of caries by looking for the main factors involved. Literature research was performed for studies that analyzed the factors most involved in the development of child caries, such as poor oral hygiene, bad eating habits (or food disorders), and an alteration of the oral bacterial flora—with an increase of Streptococci spp., Lactobacilli spp., Candida albicans, Cryptococcus neoformans, and Candida sake. It is therefore essential to assess the risk of caries in children, based on the assessment of risk factors, in order to be able to establish preventive and/or therapeutic approaches that will reduce or stop the development of dental caries. The use of fluoride products, products made from casein phosphopeptide-amorphous calcium phosphate, substituted zinc biomimetic hydroxyapatite products, or products containing self-assembling oligopeptide SAP-P11-4 are useful. In terms of the clinical approach, a communicative approach should be added to learn about the eating habits and the oral hygiene habits of the child and parents; in addition, the use of a simple method to frame the factors involved, and subsequently establish the risk of carious lesions in the child, allows the reduction of the DMFT (Decayed Missing Filled Teeth) or ICDAS (International Caries Detection and Assessment System) index on large scales.
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Affiliation(s)
- Andrea Butera
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.)
| | - Carolina Maiorani
- Unit of Dental Hygiene, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy
- Correspondence: (A.B.); (C.M.)
| | | | - Manuela Simonini
- “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (S.M.); (J.T.)
| | - Stefania Morittu
- “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (S.M.); (J.T.)
| | - Julia Trombini
- “Mamme & Igieniste”, 24125 Bergamo, Italy; (A.M.); (M.S.); (S.M.); (J.T.)
| | - Andrea Scribante
- Unit of Orthodontics and Pediatric Dentistry, Section of Dentistry, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, 27100 Pavia, Italy;
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8
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Schroth RJ, Rothney J, Sturym M, Dabiri D, Dabiri D, Dong CC, Grant CG, Kennedy T, Sihra R. A systematic review to inform the development of a Canadian caries risk assessment tool for use by primary healthcare providers. Int J Paediatr Dent 2021; 31:767-791. [PMID: 33497015 DOI: 10.1111/ipd.12776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/06/2021] [Accepted: 01/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Caries risk assessment (CRA) tools may assist in identifying children at risk of early childhood caries. AIM To complete a systematic review of CRA and develop a Canadian CRA tool for preschool children for use in non-dental clinical settings. DESIGN Systematic searches of relevant databases were conducted. Potential variables were based on strength of associations (odd ratios, relative risk, hazard ratios, etc), frequency of occurrence, and existing CRA tools. Quality of the evidence assessments were performed by at least two review teams through consensus following GRADE. RESULTS Overall, 25 publications met the inclusion criteria, all prospective in design. Based on this review, variables to be considered when developing a new CRA tool for use with preschool children are as follows: age, socioeconomic status, family toothbrushing habits, fluoride exposure, infant feeding practices, dietary habits/behaviours, dental home, caries experience, visible plaque, and enamel defects. The environmental scan identified 22 CRA tools suggesting other additional variables to consider including in a CRA tool, including special healthcare needs, enamel defects, and dental attendance. CONCLUSIONS This review informed the development of a Canadian CRA tool for use by primary healthcare professionals, which may improve access to oral health assessments and increase interprofessional collaboration.
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Affiliation(s)
- Robert J Schroth
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,Section of Pediatric Dentistry, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Janet Rothney
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Melina Sturym
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Darya Dabiri
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Donya Dabiri
- University of Toledo Medical Center, University of Toledo, Toledo, OH, USA
| | - Cecilia C Dong
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Cameron G Grant
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Tara Kennedy
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Rena Sihra
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
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9
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Broomhead T, Ballas D, Baker SR. Neighbourhoods and oral health: Agent-based modelling of tooth decay. Health Place 2021; 71:102657. [PMID: 34543838 DOI: 10.1016/j.healthplace.2021.102657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/12/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
This research used proof of concept agent-based models to test various theoretical mechanisms by which neighbourhoods may influence tooth decay in adults. Theoretical pathways were constructed using existing literature and tested in two study areas in Sheffield, UK. The models found a pathway between shops and sugar consumption had the most influence on adult tooth decay scores, revealing that similar mechanisms influence this outcome in different populations. This highlighted the importance of the interactions between neighbourhood features and individual level variables in influencing outcomes in tooth decay. Further work is required to improve the accuracy and reliability of the models.
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Affiliation(s)
- T Broomhead
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, S10 2TA, United Kingdom.
| | - D Ballas
- Department of Economic Geography, Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD, Groningen, the Netherlands
| | - S R Baker
- Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, S10 2TA, United Kingdom
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10
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Mei L, Shi H, Wei Z, Li Q, Wang X. Risk factors associated with early childhood caries among Wenzhou preschool children in China: a prospective, observational cohort study. BMJ Open 2021; 11:e046816. [PMID: 34518250 PMCID: PMC8438756 DOI: 10.1136/bmjopen-2020-046816] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Early childhood caries (ECC) is a serious health public problem that affects a large proportion of children in China. This study aimed to assess risk factors for the incidence of ECC among Wenzhou (China) preschoolers. DESIGN Prospective, observational cohort study. SETTING Kindergartens (n=6) in Wenzhou, China. PARTICIPANTS 606 children who were 3-4 years of age and newly arrived in the kindergartens in September 2011. METHODS This was a longitudinal observational study with a 2-year follow-up of preschoolers of 3-4 years of age in Wenzhou (Southeast China). Oral health data were collected annually after the baseline survey. The risk factors associated with visible caries and increment of decayed, missing and filled teeth (dmft) were analysed through univariable and multivariable regression using generalised estimating equations. RESULTS The prevalence of ECC was increasing during the follow-up period (59.8% at enrolment, 71.8% at first year, and 76.4% at second year). Older age (b=0.07; 95% CI: 0.05 to 0.09; p<0.001), caregivers (relatives or nannies) (b=-1.20; 95% CI: -2.23 to -0.16; p=0.023), lower annual family income (¥10 000-¥20 000: b=2.04; 95% CI: 1.04 to 3.04; p<0.001; <¥10 000: b=1.78; 95% CI: 0.65 to 2.92; p=0.002) and more frequent consumption of sugary snacks/drinks at night (sometimes: b=0.88; 95% CI: 0.20 to 1.56; p=0.011; always: b=1.19; 95% CI: 0.13 to 2.25; p=0.028) were independently associated with the increments of dmft. Older age (OR=1.04, 95% CI: 1.03 to 1.05, p<0.001) and more frequent consumption of sweet snacks (OR=1.86, 95% CI: 1.06 to 3.27; p=0.030) were independently associated with a higher risk of visible caries. CONCLUSIONS The occurrence and severity of ECC were associated with older age, caregivers (relatives or nannies), lower annual family income and more frequent consumption of sweet snacks. It is imperative to strengthen oral health education for parents and limit sugary foods/snacks.
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Affiliation(s)
- Liqin Mei
- Department of Preventive and Pediatric Dentistry, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hongying Shi
- Department of Preventive Medicine, School of Public Health and Management, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Zhiyuan Wei
- Department of Preventive and Pediatric Dentistry, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Qiao Li
- Department of Preventive and Pediatric Dentistry, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiping Wang
- Department of Preventive and Pediatric Dentistry, School & Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
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Carvalho Silva C, Gavinha S, Vilela S, Rodrigues R, Manso MC, Severo M, Lopes C, Melo P. Dietary Patterns and Oral Health Behaviours Associated with Caries Development from 4 to 7 Years of Age. Life (Basel) 2021; 11:life11070609. [PMID: 34202656 PMCID: PMC8305377 DOI: 10.3390/life11070609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/20/2021] [Accepted: 06/20/2021] [Indexed: 11/17/2022] Open
Abstract
The association between modifiable risk factors and caries in children has been documented; however, most studies have been cross-sectional and have not considered the complexity of dietary factors and oral health habits. This study aimed to investigate the prospective association between dietary patterns and oral health behaviours at 4 years of age and the development of new decayed, missing, and filled teeth (d3–6mft/D3–6MFT) over a period of three years. Participants were children from the Generation XXI population-based birth cohort. At 4 years of age, diet patterns were assessed using a food frequency questionnaire, with three dietary patterns being identified. For the purpose of capturing the new development of caries between 4 and 7 years of age, two dental outcomes were defined in the mixed dentition: “dental caries development” and “severe dental caries development” in the mixed dentition. Bivariate analysis and multivariate logistic regression were used. From 4 to 7 years of age, 51.2% of the children had at least one new d3–6mft/D3–6MFT and 27.4% had more than two new d3–6mft/D3–6MFT. Children belonging to the “energy-dense foods” (OR = 2.19; 95% CI: 1.20–4.00) and “snacking” (OR = 2.19; 95% CI: 1.41–3.41) dietary patterns at 4 years old were associated with severe dental caries development three years later. Preventive strategies should be implemented in an attempt to reduce snacking and the consumption of energy-dense, micronutrient-poor foods to promote children’s oral health.
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Affiliation(s)
- Cátia Carvalho Silva
- Faculdade de Medicina Dentária, Universidade do Porto (U. Porto), Rua Dr. Manuel Pereira da Silva, 93, 4200-393 Porto, Portugal;
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
- Correspondence: or ; Tel.: +351-220901100
| | - Sandra Gavinha
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
| | - Sofia Vilela
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
| | - Rita Rodrigues
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
| | - Maria Conceição Manso
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Praça 9 de Abril, 349, 4249-004 Porto, Portugal; (S.G.); (R.R.); (M.C.M.)
- Environmental and Health Research Unit (FP-ENAS), Universidade Fernando Pessoa Energy, 4249-004 Porto, Portugal
- Associated Laboratory for Green Chemistry (LAQV/REQUIMTE), Universidade do Porto, 4050-313 Porto, Portugal
| | - Milton Severo
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
- Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Carla Lopes
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
- Departamento de Biomedicina, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Paulo Melo
- Faculdade de Medicina Dentária, Universidade do Porto (U. Porto), Rua Dr. Manuel Pereira da Silva, 93, 4200-393 Porto, Portugal;
- EPIUnit-Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, 135, 4050-600 Porto, Portugal; (S.V.); (M.S.); (C.L.)
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12
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Lee JN, Scott JM, Chi DL. Oral health behaviours and dental caries in low-income children with special healthcare needs: A prospective observational study. Int J Paediatr Dent 2020; 30:749-757. [PMID: 32306501 DOI: 10.1111/ipd.12656] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/09/2020] [Accepted: 04/13/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Dental caries is a significant public health problem for low-income children with special healthcare needs (CSHCN). AIM We evaluated associations between oral health behaviours (eg diet, fluoride, dental care) and dental caries for CSHCN enrolled in Medicaid, a health insurance programme for low-income populations that provides comprehensive dental coverage for children. DESIGN We recruited 116 CSHCN ages 7-20 years from Medicaid enrolment files in Washington state, USA. Caregivers completed a 166-item questionnaire, and children received a dental screening. The outcome was dental caries, defined as total pre-cavitated, decayed, missing or filled tooth (PDMF) surfaces. We ran log-linear regression models and generated prevalence rate ratios (PRR). RESULTS The mean age of study participants was 12.4 ± 3.1 years, 41.4% were female, and 38.8% were white. The mean PDMF surfaces were 6.4 ± 9.4 (range: 0-49). Only sugar-sweetened beverage intake was significantly associated with dental caries. CSHCN who consumed >4 sugar-sweetened beverages per week were significantly more likely to have dental caries than those who consumed no sugar-sweetened beverages (PRR: 2.58; 95% CI: 1.37, 4.85; P < .01). CONCLUSION Sugar-sweetened beverages are an important target for future behavioural interventions aimed at preventing dental caries in low-income CSHCN.
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Affiliation(s)
- Jeffrey N Lee
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - JoAnna M Scott
- Department of Research & Graduate Programs, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Donald L Chi
- Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
- Department of Health Services, University of Washington, Seattle, WA, USA
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13
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Jordan KH, McGwin G, Childers NK. Children's detailed non-water beverage consumption habits and longitudinal early childhood caries experiences. J Public Health Dent 2020; 80:271-277. [PMID: 32627195 DOI: 10.1111/jphd.12381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 05/11/2020] [Accepted: 05/26/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Sugar-sweetened beverages and dental caries are prevalent among children. Measurement choices could explain their inconsistent relationships. This study evaluated associations between detailed baseline non-water beverage consumption (NWBC) behaviors and longitudinal early childhood caries (ECC) experiences in young, high-caries risk children. METHODS Researchers followed poor, rural, African Americans, recruited at 8-18 months old from Uniontown, Alabama, through convenience sampling, annually for 5 years (N = 66). Baseline questionnaires obtained demographics, oral hygiene, and daily dietary histories, including beverage types, frequencies, and NWBC behaviors of intake speed (intermittent/rapid), container (bottles/non-bottles), and bedtime beverages (yes/no). Dentists conducted examinations annually to determine decayed, missing, filled (carious) surfaces (dmfs) scores, producing increments (dmfsfinal - dmfsinitial ). Age-adjusted logistic regressions estimated odds ratios (OR) and 95% confidence intervals (95% CI) for ECC (carious: incidence >0 versus caries-free: incidence = 0) with NWBC behavior then NWBC frequency, individually and conditional on NWBC behaviors, exposures. RESULTS NWBC behaviors were not associated with ECC; juice was significant (OR: 2.0, 95% CI: 1.0, 4.2). Adjusting for intake speed, juice persisted as a risk factor (OR: 2.1, 95% CI: 1.0, 4.3), remaining suggestive after controlling for container or bedtime beverages (OR: 2.0, 95% CI: 0.9, 4.3; OR: 1.9, 95% CI: 0.9, 4.0, respectively). Container could be an effect modifier (ORbottle : 3.5, 95% CI: 0.8, 16.2 vs. ORnon-bottle : 1.5, 95% CI: 0.6, 3.7). Milk was not associated with ECC. CONCLUSIONS Independently, NWBC behaviors are insufficient in evaluating NWBC/ECC relationships; beverage type, frequency, and consumption behaviors, collectively, can better evaluate associations.
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Affiliation(s)
- Kelsey H Jordan
- Department of Epidemiology, Ryals School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA.,Division of Population Sciences, Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio
| | - Gerald McGwin
- Department of Epidemiology, Ryals School of Public Health, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Noel K Childers
- Department of Pediatric Dentistry, School of Dentistry, The University of Alabama at Birmingham, Birmingham, AL, USA
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14
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Abstract
OBJECTIVE To assess trends in consumption of soda, sweetened fruit drinks/sports drinks and any sugar-sweetened beverage (SSB) from 2013 to 2016 among all children in California aged 2-5 and 6-11 years and by racial-ethnic group. DESIGN Serial cross-sectional study using the California Health Interview Survey (CHIS). SETTING CHIS is a telephone survey of households in California designed to assess population-level estimates of key health behaviours. Previous research using CHIS documented a decrease in SSB consumption among children in California from 2003 to 2009 coinciding with state-level policy efforts targeting child SSB consumption. PARTICIPANTS Parents of children in California aged 2-11 years (n 4901 in 2013-2014; n 3606 in 2015-2016) were surveyed about the child's consumption of soda and sweetened fruit drinks/sports drinks on the day prior. RESULTS Among 2-5-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB remained stable. Sweetened fruit drink/sports drink consumption was higher than soda consumption in this age group. Latino 2-5- year-olds were more likely to consume any SSB in both 2013-2014 and 2015-2016 compared with Whites. Among 6-11-year-olds, consumption of soda, sweetened fruit drinks/sports drinks and any SSB also remained stable over time. Latino and African-American 6-11-year-olds were more likely to consume an SSB in 2013-2014 compared with White children. CONCLUSIONS SSB consumption among children in California was unchanged from 2013 to 2016 and racial-ethnic disparities were evident. Increased policy efforts are needed to further reduce SSB consumption, particularly among children of Latino and African-American backgrounds.
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15
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Foo LH, Lee YH, Suhaida CY, Hills AP. Correlates of sugar-sweetened beverage consumption of Malaysian preschoolers aged 3 to 6 years. BMC Public Health 2020; 20:552. [PMID: 32334561 PMCID: PMC7183579 DOI: 10.1186/s12889-020-08461-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 03/05/2020] [Indexed: 12/02/2022] Open
Abstract
Background There is little information about the diet, lifestyle and parental characteristics associated with habitual sugar-sweetened beverage (SSB) consumption in Asian children. The aim of the present study was to assess cross-sectional associations between habitual SSB consumption and preschoolers’ diet, physical activity, sedentary behaviour as well as parental and child characteristics in Malaysian preschoolers aged 3 to 6 y. Methods A total of 590 preschoolers, comprising 317 boys and 273 girls were included. Pre-pilot parental questionnaires were used to assess diet, physical activity (PA) and sedentary behaviour practices and anthropometry was assessed in preschoolers and their parents. Results Multiple logistic regression analyses showed that preschoolers with more frequent weekly intake of snacks [OR 2.7; 95% CI, 1.6–4.4; p < 0.001] and monthly fast food consumption [OR 3.5; 95% CI, 1.9–6.3; p < 0.001], were associated with higher SSB intake (≥5 days in a week), after adjustments of potential confounders. Preschoolers with higher daily fruit and vegetable intake had lower SSB intake [OR 0.4; 95% CI, 0.2–0.8; p = 0.011]. A positive association of higher weekly vigorous PA [OR 2.0; 95% CI, 1.1–3.7; p = 0.030] and daily screen-based practices [OR 2.0; 95% CI, 1.2–3.6; p < 0.001] on habitual SSBs intake was also substantiated. Conclusion Multiple diet, physical activity and sedentary behaviour factors were significantly associated with SSB intake among Malaysian preschoolers. Continued effort is required to encourage healthier beverage choices, as well as healthy diet and active lifestyle practices among children during the critical early years of growth and development.
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Affiliation(s)
- Leng Huat Foo
- Programme of Nutrition and Dietetics, School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia.
| | - Ying Huoy Lee
- Programme of Nutrition and Dietetics, School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Che Yahya Suhaida
- Programme of Nutrition and Dietetics, School of Health Sciences, Universiti Sains Malaysia, Health Campus, 16150, Kubang Kerian, Kelantan, Malaysia
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Newnham, Launceston, TAS, 7250, Australia
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16
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Temporal development of the oral microbiome and prediction of early childhood caries. Sci Rep 2019; 9:19732. [PMID: 31874981 PMCID: PMC6930300 DOI: 10.1038/s41598-019-56233-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Accepted: 12/05/2019] [Indexed: 11/08/2022] Open
Abstract
Human microbiomes are predicted to assemble in a reproducible and ordered manner yet there is limited knowledge on the development of the complex bacterial communities that constitute the oral microbiome. The oral microbiome plays major roles in many oral diseases including early childhood caries (ECC), which afflicts up to 70% of children in some countries. Saliva contains oral bacteria that are indicative of the whole oral microbiome and may have the ability to reflect the dysbiosis in supragingival plaque communities that initiates the clinical manifestations of ECC. The aim of this study was to determine the assembly of the oral microbiome during the first four years of life and compare it with the clinical development of ECC. The oral microbiomes of 134 children enrolled in a birth cohort study were determined at six ages between two months and four years-of-age and their mother's oral microbiome was determined at a single time point. We identified and quantified 356 operational taxonomic units (OTUs) of bacteria in saliva by sequencing the V4 region of the bacterial 16S RNA genes. Bacterial alpha diversity increased from a mean of 31 OTUs in the saliva of infants at 1.9 months-of-age to 84 OTUs at 39 months-of-age. The oral microbiome showed a distinct shift in composition as the children matured. The microbiome data were compared with the clinical development of ECC in the cohort at 39, 48, and 60 months-of-age as determined by ICDAS-II assessment. Streptococcus mutans was the most discriminatory oral bacterial species between health and current disease, with an increased abundance in disease. Overall our study demonstrates an ordered temporal development of the oral microbiome, describes a limited core oral microbiome and indicates that saliva testing of infants may help predict ECC risk.
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Stormon N, Ford PJ, Lalloo R. Community-level predictors of Australian children's dental caries and injury. Aust Dent J 2019; 64:263-272. [PMID: 31264710 DOI: 10.1111/adj.12706] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Social determinants of oral health are complex and have been described by conceptual frameworks. A widely embraced model of children's oral health was published by Fisher-Owens et al. (2007), identifying theoretical constructs influencing oral health. The current study aimed to investigate community-level constructs described in the conceptual model. METHODS The Longitudinal Study of Australian Children is a cross-sequential dual cohort study, with a representative sample (n = 10090) of Australian children. Generalized estimating equations were applied to model seven waves of carer-reported oral health and community measures. RESULTS In the final model, children living in Queensland had a 1.48 (CI 1.35-1.62) increased odds of dental caries over time. Children in low socio-economic status (SES) areas (OR 1.32 CI 1.20-1.44) had an increased odds of caries. The state of Queensland (OR 1.24 CI 1.05-1.46) and poor neighbourhood liveability (OR 1.17 CI 1.05-1.31) were predictors of dental injury. CONCLUSION By modelling available community measures, this study found SES and rurality were predictors of caries over childhood. Our results highlight the difficulty of applying conceptual models to oral health. The use of qualitative studies and realist reviews should be considered to complement statistical models to provide contextualized insights into funding, policy and service delivery on children's oral health.
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Affiliation(s)
- N Stormon
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - P J Ford
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
| | - R Lalloo
- School of Dentistry, UQ Oral Health Centre, The University of Queensland, Brisbane, Queensland, Australia
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18
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Jordan KH, Long DL, Mcgwin G, Childers NK. Average area under the curve: An alternative method for quantifying the dental caries experience in longitudinal studies. Community Dent Oral Epidemiol 2019; 47:441-447. [PMID: 31240756 DOI: 10.1111/cdoe.12482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 05/23/2019] [Accepted: 05/29/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Field-traditional decayed, missing, filled surfaces (dmfs) increments require complete follow-up, only using initial and final visits. Repeated dmfs scores complicate sophisticated statistical models, limiting their utility. Elsewhere, area under the curve (AUC) uses all repeated measures to summarize data. This study applied AUC methodology to caries data, creating average AUCs for dmfs trajectories (dmfsaAUC ) and comparing increments and dmfsaAUC values. METHODS Longitudinal data were obtained from high-caries risk (i.e. poor, rural, African American community in Perry County, Alabama) infants, 8 to 18 months at baseline. Baseline and five annual visual oral examinations provided dmfs scores. Differences in baseline and final dmfs scores constituted increments. The trapezoidal rule was applied to dmfs trajectories to calculate AUC values which were adjusted for varying follow-up times, producing dmfsaAUC values. Participants sharing incremental or dmfsaAUC values had their trajectories and second caries measurements compared. Within-participant increment and dmfsaAUC differences were evaluated (paired t test, α = 0.05). Comparative analyses required complete follow-up. RESULTS The dmfsaAUC provided forty-eight additional person-years, increasing the potential sample size by 20% (N = 85). Sixty-six children, 5.7 to 6.3 year-olds at study's end, contributed 121 331 person-days to five-year increment and dmfsaAUC calculations. Trajectories and dmfsaAUC values varied for participants with equivalent increments; comparable trajectories and different increments resulted from participants with similar dmfsaAUC values. Within-participant disease amounts were similar. CONCLUSIONS When desired, dmfsaAUC can replace increments as a more data-inclusive summary of longitudinal caries burden, incorporating intermediate visits, incomplete follow-up and time.
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Affiliation(s)
- Kelsey H Jordan
- Department of Epidemiology, Ryals School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
| | - D Leann Long
- Department of Biostatistics, Ryals School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Gerald Mcgwin
- Department of Epidemiology, Ryals School of Public Health, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Noel K Childers
- Department of Pediatric Dentistry, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama
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Basson AA, Yoo M, Chi DL. Recruiting Adolescents from Medicaid Enrollment Files into a Neighborhood Oral Health Study. JDR Clin Trans Res 2019; 4:255-261. [PMID: 30931721 DOI: 10.1177/2380084419828726] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Strategies are needed to improve recruitment of low-income adolescents into oral health studies. OBJECTIVES In this study, we assessed the feasibility of recruiting Medicaid-enrolled adolescents into a neighborhood-level oral health study using Medicaid enrollment files and to evaluate the degree of bias in the final recruited study population. METHODS We obtained Medicaid enrollment files from the Oregon Health Authority for 15,440 Medicaid enrollees aged 12 to 17 y from Multnomah, Hood River, and Tillamook counties. We attempted to contact the primary caregiver of each adolescent by telephone, and we tracked contact, recruitment, enrollment, and study completion rates. We further assessed if these rates were different across county-level rurality, neighborhood-level income, and caregiver-level language preference (Spanish vs. English). The Pearson chi-square test was used to compare rates (α = 0.05). We contacted 6,202 caregivers (40.2%), recruited 738 adolescents (11.9%), enrolled 335 (45.4%), and had complete data for 284 (84.8%). The overall enrollment yield from contacted caregivers was 5.4%. Contact rates did not differ significantly by rurality (P = 0.897), but they were significantly lower in the lowest-income neighborhoods (P = 0.023). Recruitment rates were significantly higher for adolescents from rural counties (P = 0.001), but they did not differ by income or language preference. Enrollment rates were significantly higher among adolescents from rural counties (P < 0.001) and were significantly associated with income (P = 0.041), but they were not different by language preference (P = 0.083). Among participants with complete data, there were no differences by rurality or income, but a significantly larger proportion of adolescents with complete data had caregivers with a language preference for Spanish (P = 0.043). RESULTS AND CONCLUSIONS It is feasible to recruit Medicaid-enrolled adolescents into a neighborhood oral health study through the use of Medicaid files. County-, neighborhood-, and caregiver-level factors may influence characteristics of the final study population. Additional research is needed to improve recruitment of Medicaid enrollees into neighborhood oral health studies. KNOWLEDGE TRANSFER STATEMENT Researchers can use the results of this study to plan neighborhood-level oral health studies involving recruitment of low-income adolescents. Findings further underscore the importance of assessing factors related to recruitment to evaluate participant bias and the generalizability of study findings.
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Affiliation(s)
- A A Basson
- 1 Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - M Yoo
- 1 Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
| | - D L Chi
- 1 Department of Oral Health Sciences, University of Washington, Seattle, WA, USA
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Kirthiga M, Murugan M, Saikia A, Kirubakaran R. Risk Factors for Early Childhood Caries: A Systematic Review and Meta-Analysis of Case Control and Cohort Studies. Pediatr Dent 2019; 41:95-112. [PMID: 30992106 PMCID: PMC7100045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose: The purpose of this study was to perform a systematic review to assess current evidence for association between various risk factors and the prevalence or incidence of early childhood caries (ECC). Methods: Two reviewers searched various databases until January 2019. The Newcastle-Ottawa scale was used to perform risk of bias assessment. The included studies were categorized according to the World Bank classification. Data were summarized in a meta-analysis using fixed and random effects inverse-generic meta-analyses. Results: A total of 7,034 records involving 89 studies that evaluated 1,352,097 individuals were included; 23 were high, 46 were moderate, and 20 were of low quality. A total of 123 risk factors were found. Meta-analysis revealed that the strongest risk factors found in the high-income countries were presence of dentinal caries (dmft greater than zero; odds ratio [OR] equals 4.21 [2.18 to 8.16]) and high levels of mutans streptococci (OR equals 3.83 [1.81 to 8.09]). In upper-middle-income countries, presence of enamel defects (OR equals 14.62 [6.10 to 35.03]) was found to be the strongest risk factor. Conclusion: The strongest risk factors associated with early childhood caries was the presence of enamel defects, presence of dentinal caries and high levels of mutans streptococci.
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Affiliation(s)
- M Kirthiga
- Dr. M is an Early Career Research fellow (Wellcome Trust DBT India Alliance), Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu
| | - Muthu Murugan
- Dr. Murugan is Head of Center for Early Childhood Caries Research (CECCRe), Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu;,
| | - Ankita Saikia
- Dr. Saikia is a pediatric dental surgeon, Pedo Planet - Children's Dental Centre, Chennai
| | - Richard Kirubakaran
- Dr. Kirubakaran is a biostatistician, South Asian Cochrane Network and Centre, Christian Medical College, Vellore, Tamil Nadu
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Fan CC, Wang WH, Xu T, Zheng SG. Risk factors of early childhood caries (ECC) among children in Beijing - a prospective cohort study. BMC Oral Health 2019; 19:34. [PMID: 30777062 PMCID: PMC6380003 DOI: 10.1186/s12903-019-0721-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 01/25/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Early childhood caries (ECC) was a serious oral health concern with high prevalence and a low treatment rate in China, and few researches have focused on preschool children. This study aimed to explore the risk factors of ECC in Beijing, China. METHODS Totle of 712 children (mean age: 46.37 ± 5.44 months) participated in this prospective cohort study. Questionnaires and the levels of mutans streptococci in dental plaques and non-stimulated saliva, assessed using Dentocult SM strips, were collected at baseline, respectively. Two calibrated examiners checked for dental caries according to the WHO 1997 criteria at baseline and 1-year follow-up. Negative binomial regression was used for multivariate analysis of factors related to caries development. RESULTS For caries-free children at baseline, only plaque mutans streptococci (PMS) levels were associated with caries development (odds ratio [OR] = 1.68, 95% confidence interval [CI]: 1.08-2.61, P = 0.02). Children with high PMS levels (scored 2 and 3) had higher caries incidence (46.2% vs. 33.8%) and more caries increment (1.87 ± 3.17 vs. 0.90 ± 1.89) than those with low levels (scored 0 and 1). Among all participants, PMS (OR = 1.69, 95% CI: 1.32-2.23, P < 0.001) and previous caries experience (OR = 2.80, 95% CI: 2.20-3.56, P < 0.001) were related to caries increment. CONCLUSIONS For caries-free children, the only significant risk factor for ECC was high PMS levels. For all participants, besides high PMS levels, previous caries experience was another significant risk factor for caries development. TRIAL REGISTRATION The study design, protocol, and informed consent forms were undertaken with the understanding of Declaration of Helsinki and were approved by the Human Research Ethics Committee of the School of Stomatology, Peking University, China (PKUSSIRB-2012042).
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Affiliation(s)
- Can Can Fan
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
- Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, 56 Ling Yuan Road West, Guangzhou, 510055, Guangdong Province, People's Republic of China
| | - Wen Hui Wang
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China
| | - Tao Xu
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.
| | - Shu Guo Zheng
- Department of Preventive Dentistry, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, 22 Zhongguancun Avenue South, Haidian District, Beijing, 100081, People's Republic of China.
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22
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Moynihan P, Tanner LM, Holmes RD, Hillier-Brown F, Mashayekhi A, Kelly SAM, Craig D. Systematic Review of Evidence Pertaining to Factors That Modify Risk of Early Childhood Caries. JDR Clin Trans Res 2019; 4:202-216. [PMID: 30931717 DOI: 10.1177/2380084418824262] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION A systematic review of evidence on the impact of modifiable risk factors on early childhood caries (ECC) was conducted to inform recommendations in a World Health Organization manual on ECC prevention. OBJECTIVES To systematically review published evidence pertaining to the effect of modifiable risk factors on ECC. METHODS Twelve questions relating to infant feeding, diet, oral hygiene, and fluoride were addressed, as prioritized by a World Health Organization expert panel. Questions pertaining to the use of fluoride toothpaste were excluded due to its proven efficacy. The target population was children aged <72 mo. Data sources included Medline, Embase, CINAHL, and PubMed, and all human epidemiologic studies were included. The highest level of evidence was used for evidence synthesis and, where possible, meta-analysis. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) statement, with evidence assessed via the GRADE method. RESULTS Of the 13,831 papers identified, 627 were screened in duplicate; of these, 139 were included. The highest-level evidence indicated that breastfeeding ≤24 mo does not increase ECC risk but suggested that longer-duration breastfeeding increases risk (low-quality evidence). Low-quality evidence indicated increased risk associated with consumption of sugars in bottles. Only 1 study had data on the impact of sugars in complementary foods, which increased risk. Moderate-quality evidence showed a benefit of oral health education for caregivers (odds ratio, 0.39; 95% CI, 0.19 to 0.80, P = 0.009). Meta-analysis of data on the impact on ECC from living in a fluoridated area showed a significant effect (mean difference, -1.25; 95% CI, -1.24 to -0.36; P = 0.006). Limited moderate- and low-quality data indicated a benefit of fluoride exposure from salt and milk, respectively. CONCLUSION The best available evidence indicates that breastfeeding up to 2 y of age does not increase ECC risk. Providing access to fluoridated water and educating caregivers are justified approaches to ECC prevention. Limiting sugars in bottles and complementary foods should be part of this education. KNOWLEDGE TRANSFER STATEMENT This research is being used by the World Health Organization in developing a toolkit on the prevention and management of early childhood caries. The information will guide 1) governments in developing national oral health plans and 2) clinicians when providing preventive advice, including that regarding infant feeding practices. It will help ensure that advice is in line with current World Health Organization guidelines and the best available evidence.
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Affiliation(s)
- P Moynihan
- 1 School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.,2 Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK.,3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - L M Tanner
- 3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - R D Holmes
- 1 School of Dental Sciences, Newcastle University, Newcastle upon Tyne, UK.,2 Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK
| | - F Hillier-Brown
- 4 Faculty of Social Sciences and Health, Durham University, Durham, UK
| | - A Mashayekhi
- 3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - S A M Kelly
- 5 Cambridge Institute of Public Health, University of Cambridge, Cambridge, UK
| | - D Craig
- 3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
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23
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Hurley E, Barrett MPJ, Kinirons M, Whelton H, Ryan CA, Stanton C, Harris HMB, O'Toole PW. Comparison of the salivary and dentinal microbiome of children with severe-early childhood caries to the salivary microbiome of caries-free children. BMC Oral Health 2019; 19:13. [PMID: 30642327 PMCID: PMC6332856 DOI: 10.1186/s12903-018-0693-1] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/12/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The main objectives of this study were to describe and compare the microbiota of 1) deep dentinal lesions of deciduous teeth of children affected with severe early childhood caries (S-ECC) and 2) the unstimulated saliva of these children and 3) the unstimulated saliva of caries-free children, and to compare microbiota compositional differences and diversity of taxa in these sampled sites. METHODS Children with S-ECC and without S-ECC were recruited. The saliva of all children with and without S-ECC was sampled along with the deep dentinal microbiota from children affected by S-ECC. The salivary microbiota of children affected by S-ECC (n = 68) was compared to that of caries-free children (n = 70), by Illumina MiSeq sequencing of 16S rRNA amplicons. Finally, the caries microbiota of deep dentinal lesions of those children with S-ECC was investigated. RESULTS Using two beta diversity metrics (Bray Curtis dissimilarity and UniFrac distance), the caries microbiota was found to be distinct from that of either of the saliva groups (caries-free & caries-active) when bacterial abundance was taken into account. However, when the comparison was made by measuring only presence and absence of bacterial taxa, all three microbiota types separated. While the alpha diversity of the caries microbiota was lowest, the diversity difference between the caries samples and saliva samples was statistically significant (p < 0.001). The major phyla of the caries active dentinal microbiota were Firmicutes (median abundance value 33.5%) and Bacteroidetes (23.2%), with Neisseria (10.3%) being the most abundant genus, followed by Prevotella (10%). The caries-active salivary microbiota was dominated by Proteobacteria (median abundance value 38.2%) and Bacteroidetes (27.8%) with the most abundant genus being Neisseria (16.3%), followed by Porphyromonas (9.5%). Caries microbiota samples were characterized by high relative abundance of Streptococcus mutans, Prevotella spp., Bifidobacterium and Scardovia spp. CONCLUSIONS Distinct differences between the caries microbiota and saliva microbiota were identified, with separation of both salivary groups (caries-active and caries-free) whereby rare taxa were highlighted. While the caries microbiota was less diverse than the salivary microbiota, the presence of these rare taxa could be the difference between health and disease in these children.
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Affiliation(s)
- Eimear Hurley
- School of Microbiology, University College Cork, Room 447 Food Science Building, Cork, Ireland.,Cork University Dental School & Hospital, Cork University Hospital, Wilton, Cork, Ireland
| | - Maurice P J Barrett
- School of Microbiology, University College Cork, Room 447 Food Science Building, Cork, Ireland.,APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Martin Kinirons
- Cork University Dental School & Hospital, Cork University Hospital, Wilton, Cork, Ireland
| | - Helen Whelton
- College of Medicine & Health, University College Cork, Cork, Ireland
| | - C Anthony Ryan
- Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland
| | | | - Hugh M B Harris
- School of Microbiology, University College Cork, Room 447 Food Science Building, Cork, Ireland.,APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Paul W O'Toole
- School of Microbiology, University College Cork, Room 447 Food Science Building, Cork, Ireland. .,APC Microbiome Ireland, University College Cork, Cork, Ireland.
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24
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Chi DL, Rosenfeld M, Mancl L, Chung WO, Presland RB, Sarvas E, Rothen M, Alkhateeb A, McNamara S, Genatossio A, Virella-Lowell I, Milla C, Scott J. Age-related heterogeneity in dental caries and associated risk factors in individuals with cystic fibrosis ages 6-20 years: A pilot study. J Cyst Fibros 2018; 17:747-759. [PMID: 30005828 PMCID: PMC6589399 DOI: 10.1016/j.jcf.2018.06.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/26/2018] [Accepted: 06/19/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND The literature conflicts regarding dental caries risk in cystic fibrosis (CF) relative to controls. METHODS Prospective, observational study of age-related heterogeneity in caries rates and potential risk factors in individuals with CF ages 6-20 at a single clinic in Washington state (N=85). Caries rates for enrolled CF participants and historical controls from NHANES were compared using cubic spline regression models. Generalized linear regression models identified correlates of age and caries in CF. RESULTS Children ages 6-9 with CF had significantly lower caries than controls (Holm's P<0.05). There was no difference for ages 10-20 by CF status (Holm's P>0.05). Various biological/intraoral, medical, and behavioral factors were associated with caries and age in CF. CONCLUSIONS Younger children with CF may be protected from caries, but there is apparent loss of protection in early adolescence associated with multiple risk factors. Additional studies are needed to confirm these findings.
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Affiliation(s)
- Donald L Chi
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195, USA.
| | - Margaret Rosenfeld
- Seattle Children's Hospital, Cystic Fibrosis Center, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Lloyd Mancl
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195, USA
| | - Whasun O Chung
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195, USA
| | - Richard B Presland
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195, USA; University of Washington, Department of Medicine, Division of Dermatology, Box 356524, Seattle, WA 98195, USA
| | - Elise Sarvas
- University of Minnesota, School of Dentistry, Department of Pediatric Dentistry, 515 Delaware Street SE, Minneapolis, MN 55455, USA
| | - Marilynn Rothen
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195, USA
| | - Alaa Alkhateeb
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Box 357475, Seattle, WA 98195, USA
| | - Sharon McNamara
- Seattle Children's Hospital, Cystic Fibrosis Center, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Alan Genatossio
- Seattle Children's Hospital, Cystic Fibrosis Center, 4800 Sand Point Way NE, Seattle, WA 98105, USA
| | - Isabel Virella-Lowell
- University of Alabama - Birmingham, Division of Pediatric Pulmonology and Sleep Medicine, 1600 7th Ave S, Birmingham, AL 35233, USA
| | - Carlos Milla
- Stanford University Medical School, 770 Welch Rd, Ste. 350, Palo Alto, CA 94304, USA
| | - JoAnna Scott
- University of Missouri - Kansas City, School of Dentistry, Department of Dental Public, Health and Behavioral Science, 650 E. 25th St., Kansas City, MO 64108, USA
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25
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Morikava FS, Fraiz FC, Gil GS, de Abreu MHNG, Ferreira FM. Healthy and cariogenic foods consumption and dental caries: A preschool-based cross-sectional study. Oral Dis 2018; 24:1310-1317. [PMID: 29878498 DOI: 10.1111/odi.12911] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 05/11/2018] [Accepted: 06/03/2018] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the association of the consumption of healthy and cariogenic foods with the prevalence of untreated dental caries among preschool children. MATERIALS AND METHODS A cross-sectional study was conducted with 427 5-year-old preschoolers. Caries was evaluated through a clinical examination using dmft index. Parents/guardians answered a questionnaire addressing socioeconomic status, eating frequency, and oral hygiene habits. RESULTS The prevalence of untreated caries was 51%. The multiple models demonstrated a seven percent increase in the prevalence of untreated caries with each additional daily contact with cariogenic foods, whereas a four percent reduction in this prevalence rate was found for each additional contact with healthy foods. When the number of daily contacts with cariogenic and healthy foods was incorporated into the same model, the former reached only borderline statistical significance (p = 0.05), whereas the latter maintained an association with lower caries rates (p = 0.01). CONCLUSION A dietary assessment based solely on the frequency of the consumption of cariogenic foods may not be sufficient to understand the occurrence of dental caries in preschool children. It is necessary a more comprehensive evaluation of the dietary pattern, once a healthy diet can present an association with lower prevalence of caries even among preschool children who consume cariogenic foods.
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Affiliation(s)
| | - Fabian Calixto Fraiz
- Department of Stomatology, Federal University of Parana, Curitiba, Paraná, Brazil
| | - Giovana Solheid Gil
- Department of Stomatology, Federal University of Parana, Curitiba, Paraná, Brazil
| | | | - Fernanda Morais Ferreira
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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26
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Bleich SN, Vercammen KA. The negative impact of sugar-sweetened beverages on children's health: an update of the literature. BMC OBESITY 2018; 5:6. [PMID: 29484192 PMCID: PMC5819237 DOI: 10.1186/s40608-017-0178-9] [Citation(s) in RCA: 165] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 12/26/2017] [Indexed: 11/21/2022]
Abstract
While sugar sweetened beverage (SSB) consumption has declined in the last 15 years, consumption of SSBs is still high among children and adolescents. This research synthesis updates a prior review on this topic and examines the evidence regarding the various health impacts of SSBs on children's health (overweight/obesity, insulin resistance, dental caries, and caffeine-related effects). We searched PubMed, CAB Abstracts and PAIS International to identify cross-sectional, longitudinal and intervention studies examining the health impacts of SSBs in children published after January 1, 2007. We also searched reference lists of relevant articles. Overall, most studies found consistent evidence for the negative impact of SSBs on children's health, with the strongest support for overweight/obesity risk and dental caries, and emerging evidence for insulin resistance and caffeine-related effects. The majority of evidence was cross-sectional highlighting the need for more longitudinal and intervention studies to address this research question. There is substantial evidence that SSBs increase the risk of overweight/obesity and dental caries and developing evidence for the negative impact of SSBs on insulin resistance and caffeine-related effects. The vast majority of literature supports the idea that a reduction in SSB consumption would improve children's health.
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Affiliation(s)
- Sara N. Bleich
- Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Kelsey A. Vercammen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, USA
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27
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Zupanič N, Miklavec K, Kušar A, Žmitek K, Fidler Mis N, Pravst I. Total and Free Sugar Content of Pre-Packaged Foods and Non-Alcoholic Beverages in Slovenia. Nutrients 2018; 10:E151. [PMID: 29385691 PMCID: PMC5852727 DOI: 10.3390/nu10020151] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/17/2018] [Accepted: 01/26/2018] [Indexed: 01/22/2023] Open
Abstract
Scientific evidence of the association between free sugar consumption and several adverse health effects has led many public health institutions to take measures to limit the intake of added or free sugar. Monitoring the efficiency of such policies and the amount of free sugar consumed requires precise knowledge of free sugar content in different food products. To meet this need, our cross-sectional study aimed at assessing free sugar content for 10,674 pre-packaged food items available from major Slovenian food stores during data collection in 2015. Together, 52.6% of all analyzed products contained free sugar, which accounted for an average of 57.5% of the total sugar content. Food categories with the highest median free sugar content were: honey and syrups (78.0 g/100 g), jellies (62.9 g/100 g), chocolate and sweets (44.6 g/100 g), jam and spreads (35.9 g/100 g), and cereal bars (23.8 g/100 g). Using year-round sales data provided by the retailers, the data showed that chocolate, sweets, and soft drinks alone accounted for more than 50% of all free sugar sold on the Slovenian market. The results of this study can be used to prepare more targeted interventions and efficient dietary recommendations.
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Affiliation(s)
- Nina Zupanič
- Nutrition Institute, Tržaška cesta 40, Ljubljana SI-1000, Slovenia.
| | - Krista Miklavec
- Nutrition Institute, Tržaška cesta 40, Ljubljana SI-1000, Slovenia.
| | - Anita Kušar
- Nutrition Institute, Tržaška cesta 40, Ljubljana SI-1000, Slovenia.
| | - Katja Žmitek
- Nutrition Institute, Tržaška cesta 40, Ljubljana SI-1000, Slovenia.
- VIST-Higher School of Applied Sciences, Gerbičeva cesta 51a, Ljubljana SI-1000, Slovenia.
| | - Nataša Fidler Mis
- Department of Gastroenterology, Hepatology and Nutrition, University Children's Hospital, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia.
| | - Igor Pravst
- Nutrition Institute, Tržaška cesta 40, Ljubljana SI-1000, Slovenia.
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28
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Sugar in Infants, Children and Adolescents: A Position Paper of the European Society for Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr 2017; 65:681-696. [PMID: 28922262 DOI: 10.1097/mpg.0000000000001733] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The consumption of sugars, particularly sugar-sweetened beverages (SSBs; beverages or drinks that contain added caloric sweeteners (ie, sucrose, high-fructose corn syrup, fruit juice concentrates), in European children and adolescents exceeds current recommendations. This is of concern because there is no nutritional requirement for free sugars, and infants have an innate preference for sweet taste, which may be modified and reinforced by pre- and postnatal exposures. Sugar-containing beverages/free sugars increase the risk for overweight/obesity and dental caries, can result in poor nutrient supply and reduced dietary diversity, and may be associated with increased risk of type 2 diabetes mellitus, cardiovascular risk, and other health effects. The term "free sugars," includes all monosaccharides/disaccharides added to foods/beverages by the manufacturer/cook/consumer, plus sugars naturally present in honey/syrups/unsweetened fruit juices and fruit juice concentrates. Sugar naturally present in intact fruits and lactose in amounts naturally present in human milk or infant formula, cow/goat milk, and unsweetened milk products is not free sugar. Intake of free sugars should be reduced and minimised with a desirable goal of <5% energy intake in children and adolescents aged ≥2 to 18 years. Intake should probably be even lower in infants and toddlers <2 years. Healthy approaches to beverage and dietary consumption should be established in infancy, with the aim of preventing negative health effects in later childhood and adulthood. Sugar should preferably be consumed as part of a main meal and in a natural form as human milk, milk, unsweetened dairy products, and fresh fruits, rather than as SSBs, fruit juices, smoothies, and/or sweetened milk products. Free sugars in liquid form should be replaced by water or unsweetened milk drinks. National Authorities should adopt policies aimed at reducing the intake of free sugars in infants, children and adolescents. This may include education, improved labelling, restriction of advertising, introducing standards for kindergarten and school meals, and fiscal measures, depending on local circumstances.
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Murphy KL, Larsson LS. Interprofessional oral health initiative in a nondental, American Indian setting. J Am Assoc Nurse Pract 2017; 29:733-740. [PMID: 28922571 DOI: 10.1002/2327-6924.12517] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 08/01/2017] [Accepted: 08/08/2017] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Tooth decay is the most common chronic childhood disease and American Indian (AI) children are at increased risk. Pediatric primary care providers are in an opportune position to reduce tooth decay. The purpose of this study was to integrate and evaluate a pediatric oral health project in an AI, pediatric primary care setting. METHODS The intervention set included caregiver education, caries risk assessment, and a same-day dental home referral. All caregiver/child dyads age birth to 5 years presenting to the pediatric clinic were eligible (n = 47). CONCLUSIONS Most children (n = 35, 91.1%) were scored as high risk for caries development. Of those with first tooth eruption (n = 36), ten had healthy teeth (27.8%) and seven had seen a dentist in the past 3 months (19.4%). All others were referred to a dentist (n = 29) and 21 families (72.4%) completed the referral. IMPLICATIONS FOR PRACTICE In fewer than 5 min per appointment (x = 4.73 min), the primary care provider integrated oral health screening, education, and referral into the well-child visit. Oral health is part of total health, and thus should be incorporated into routine well-child visits.
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Affiliation(s)
- Kate L Murphy
- College of Nursing, Montana State University, Bozeman, Montana
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30
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The school environment and sugar-sweetened beverage consumption among Guatemalan adolescents. Public Health Nutr 2017; 20:2980-2987. [PMID: 28803573 DOI: 10.1017/s1368980017001926] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
OBJECTIVE The current study sought to examine Guatemalan adolescents' consumption of sugar-sweetened beverages (SSB), identify which individual-level characteristics are associated with SSB consumption and describe school characteristics that may influence students' SSB consumption. DESIGN Within this observational pilot study, a questionnaire was used to assess students' consumption of three varieties of SSB (soft drinks, energy drinks, sweetened coffees/teas), as well as a variety of sociodemographic and behavioural characteristics. We collected built environment data to examine aspects of the school food environment. We developed Poisson regression models for each SSB variety and used descriptive analyses to characterize the sample. SETTING Guatemala City, Guatemala. SUBJECTS Guatemalan adolescents (n 1042) from four (two public, two private) secondary schools. RESULTS Built environment data revealed that students from the two public schools lacked access to water fountains/coolers. The SSB industry had a presence in the schools through advertisements, sponsored food kiosks and products available for sale. Common correlates of SSB consumption included school type, sedentary behaviour, frequency of purchasing lunch in the cafeteria, and frequency of purchasing snacks from vending machines in school and off school property. CONCLUSIONS Guatemalan adolescents frequently consume SSB, which may be encouraged by aspects of the school environment. Schools represent a viable setting for equitable population health interventions designed to reduce SSB consumption, including increasing access to clean drinking-water, reducing access to SSB, restricting SSB marketing and greater enforcement of existing food policies.
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Beck AL, Fernandez A, Rojina J, Cabana M. Randomized Controlled Trial of a Clinic-Based Intervention to Promote Healthy Beverage Consumption Among Latino Children. Clin Pediatr (Phila) 2017; 56:838-844. [PMID: 28553726 PMCID: PMC5553320 DOI: 10.1177/0009922817709796] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The objective of this study was to evaluate an educational module for Latino parents about the health effects of sweet beverages. Latino parents were randomized to receive the beverage module or a control module. Child beverage consumption was assessed at baseline, 2 weeks, 2 months, and 3 months via a beverage recall survey. At 2-week follow-up, children of intervention participants had a mean reduction in 7-day total sugar-sweetened beverage and 100% fruit juice consumption of 16 ounces while controls had a mean increase of 4 ounces ( P = .01). At 2-month and 3-month follow-up, there was a reduction in mean total sugar-sweetened beverage and 100% fruit juice consumption among both intervention and control children. An educational module on beverages for Latino parents reduced child consumption of sweet beverages at 2-week follow-up. However, study participation appears to have also reduced controls' beverage consumption suggesting that frequent intensive surveys of beverage intake may be an intervention unto itself.
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Affiliation(s)
- Amy L. Beck
- Department of Pediatrics, University of California San Francisco, 3333 California St. Suite 245, San Francisco, CA 94118
| | | | - Jenssy Rojina
- Department of Pediatrics, University of California San Francisco
| | - Michael Cabana
- Department of Pediatrics, University of California San Francisco
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32
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Wang X, Wei Z, Li Q, Mei L. A longitudinal study of early childhood caries incidence in Wenzhou preschool children. BMC Oral Health 2017; 17:105. [PMID: 28676047 PMCID: PMC5496385 DOI: 10.1186/s12903-017-0394-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 06/19/2017] [Indexed: 12/03/2022] Open
Abstract
Background Early childhood caries (ECC) is a serious public health problem in China. Few studies, however, have described the incidence of ECC in China. The purpose of this study was to assess the prevalence and incidence of ECC among preschool children in Wenzhou China. Methods Preschool children aged 3–4 years old were surveyed and followed up when they reached 5–6 years of age in the city of Wenzhou in southeast China. The rates of dental caries were determined with prevalence, and incidence density for risk of caries of a person (IDp) and of a tooth surface (IDs). Results The prevalence and decayed, missing, and filled primary teeth (dmft) score of 3–4, 4–5, and 5-6 years old children were 59.8% and 2.9, 71.8% and 4.2, and 76.4% and 4.6, respectively. The IDp was 29.7 and 14.8 persons/100 person-year during the first and second year. The IDs was 5.9 and 2.7 newly affected surfaces/100 surface-year, respectively. The percentage of molars with caries experience increased obviously; the percentage of maxillary central incisors and mandibular incisors with caries experience increased during the first follow-up, whereas it declined during the second follow-up; the others increased gradually. Conclusions The prevalence and incidence of dental caries in Wenzhou preschool children were very high with most of the carious teeth left untreated. The molars were the most affected teeth during the observation period.
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Affiliation(s)
- Xiping Wang
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Zhiyuan Wei
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Qiao Li
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China
| | - Liqin Mei
- Department of Preventive and Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, 325027, China.
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Kabil NS, Eltawil S. Prioritizing the Risk Factors of Severe Early Childhood Caries. Dent J (Basel) 2017; 5:E4. [PMID: 29563410 PMCID: PMC5806985 DOI: 10.3390/dj5010004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 12/15/2016] [Accepted: 12/20/2016] [Indexed: 11/21/2022] Open
Abstract
Severe early childhood caries remains the most common chronic disease affecting children. The multifactorial etiology of caries has established a controversy about which risk factors were more significant to its development. Therefore, our study aimed through meticulous statistical analysis to arrange the "well agreed upon" common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program. The study prioritized or reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to three or more, night feeding, child self-employed brushing, mother's caries experience, two siblings, on demand feeding, once/day sugary food, sharing utensils, one sibling, male gender, father's education, late first dental visit, brushing time, mother's education, no dental visit, decreased brushing frequency, and no night brushing.
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Affiliation(s)
- Noha Samir Kabil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Ain Shams University, Cairo 11566, Egypt.
| | - Sherif Eltawil
- Department of Pediatric Dentistry and Dental Public Health, Faculty of Oral & Dental Medicine, Cairo University, Giza 12613, Egypt.
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Alkhateeb AA, Mancl LA, Presland RB, Rothen ML, Chi DL. Unstimulated Saliva-Related Caries Risk Factors in Individuals with Cystic Fibrosis: A Cross-Sectional Analysis of Unstimulated Salivary Flow, pH, and Buffering Capacity. Caries Res 2016; 51:1-6. [PMID: 27846621 PMCID: PMC5337435 DOI: 10.1159/000450658] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/02/2016] [Indexed: 11/19/2022] Open
Abstract
Salivary flow rate, pH, and buffering capacity are associated with dental caries, but studies from the cystic fibrosis (CF) literature are inconclusive regarding these salivary factors and caries. The aim of this study was to evaluate these factors and their associations with dental caries in individuals with CF. Unstimulated whole saliva was collected from individuals aged 6-20 years at Seattle Children's Hospital CF Clinic, USA (n = 83). Salivary flow rate was measured in milliliters per minute. Salivary pH was assessed using a laboratory pH meter. Buffering capacity was assessed by titration with HCl. The outcome measure was caries prevalence, defined as the number of decayed, missing, or filled primary and permanent tooth surfaces. Spearman's rank correlation coefficient and the t test were used to test for bivariate associations. Multiple variable linear regression models were used to (1) run confounder-adjusted analyses and (2) assess for potential interactions. There was no significant association between salivary flow rate or buffering capacity and caries prevalence. There was a significant negative association between salivary pH and caries prevalence, but this association was no longer significant after adjusting for age. There was no significant interaction between salivary flow rate and buffering capacity or between antibiotic use and the 3 salivary factors. Our results indicate that unstimulated salivary factors are not associated with dental caries prevalence in individuals with CF. Future studies should investigate other potential saliva-related caries risk factors in individuals with CF such as cariogenic bacteria levels, salivary host defense peptide levels, and medication use.
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Affiliation(s)
- Alaa A. Alkhateeb
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Seattle, Washington 98195, U.S.A
| | - Lloyd A. Mancl
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Seattle, Washington 98195, U.S.A
| | - Richard B. Presland
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Seattle, Washington 98195, U.S.A
- University of Washington, School of Medicine, Division of Dermatology, Seattle, Washington 98195, U.S.A
| | - Marilynn L. Rothen
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Seattle, Washington 98195, U.S.A
| | - Donald L. Chi
- University of Washington, School of Dentistry, Department of Oral Health Sciences, Seattle, Washington 98195, U.S.A
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Du Q, Yu M, Li Y, Du H, Gao W, Mei H, Liu S. Permanent caries experience is associated with primary caries experience: a 7-year longitudinal study in China. Community Dent Oral Epidemiol 2016; 45:43-48. [PMID: 27642152 DOI: 10.1111/cdoe.12257] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 08/12/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the association between caries experience in primary teeth and caries experience in permanent teeth in a longitudinal study. METHODS Teeth were examined at 5 years of age and a follow-up examination was conducted 7 years later at 12 years of age in all children from Jiading District, Shanghai, China. A total of 1885 participants were recruited in the study; 1683 students were followed up and 202 students (10.7%) were lost to follow up. Data were analyzed using the chi-square test, t-test and risk ratio. RESULTS The followed-up samples comprised 883 boys (52.5%) and 800 girls (47.5%). At initial examination, the prevalence of dental caries was 67.4% in boys and 66.5% in girls (χ² = 0.2, P = 0.70), with mean decayed, missing and filled teeth (dmft) scores of 3.5 ± 0.1 and 3.4 ± 0.1, respectively (t = 0.1, P = 0.90). At follow-up, the prevalence of dental caries was 33.9% in boys and 37.9% in girls (χ² = 2.9, P = 0.11), with mean DMFT scores in permanent teeth of 0.7 ± 0.0 and 0.8 ± 0.1, respectively (t = 1.2, P = 0.24). The group of 5-year-olds with caries had a significantly higher prevalence of caries in permanent teeth (45.5%) at 12 years of age than the group of 5-year-olds without caries (16.0%) (χ2 = 141.1, P < 0.001, risk ratio = 1.5). Caries risk in permanent teeth was significantly higher with greater dmft scores (χ2 for trend = 31.1, P < 0.001). CONCLUSIONS Caries in primary teeth is a major risk factor for caries in permanent teeth. The likelihood of caries in permanent teeth is higher with greater dmft scores in primary teeth.
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Affiliation(s)
- Qin Du
- School of Public Health and Department of Clinical Epidemiology, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Jiading District Dental Hospital, Shanghai, China
| | - Ming Yu
- Jiading District Dental Hospital, Shanghai, China
| | - Yueling Li
- Jiading District Dental Hospital, Shanghai, China
| | - Haojing Du
- Jiading District Dental Hospital, Shanghai, China
| | - Wenlan Gao
- Department of Dentistry, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hao Mei
- School of Public Health and Department of Clinical Epidemiology, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Center of Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Shijian Liu
- School of Public Health and Department of Clinical Epidemiology, Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Nur BG, Tanrıver M, Altunsoy M, Atabay T, Intepe N. The prevalence of iron deficiency anemia in children with severe early childhood caries undergoing dental surgery under general anesthesia. PEDIATRIC DENTAL JOURNAL 2016. [DOI: 10.1016/j.pdj.2016.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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von Philipsborn P, Stratil JM, Burns J, Busert LK, Pfadenhauer LM, Polus S, Holzapfel C, Hauner H, Rehfuess E. Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012292] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Peter von Philipsborn
- Technical University Munich; Faculty of Medicine; Stuntzstrasse 12 81677 Munich Germany
| | - Jan M Stratil
- University of Tuebingen; Faculty of Medicine; Wilhelmstrasse 127 Tuebingen Germany 72076
| | - Jacob Burns
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Laura K Busert
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Lisa M Pfadenhauer
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Stephanie Polus
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
| | - Christina Holzapfel
- Technische Universität München Klinikum rechts der Isar; Institute for Nutritional Medicine; Munich Germany
| | - Hans Hauner
- Technische Universität München Klinikum rechts der Isar; Institute for Nutritional Medicine; Munich Germany
| | - Eva Rehfuess
- Ludwig-Maximilians-University Munich; Institute for Medical Informatics, Biometry and Epidemiology; Marchioninistr. 15 Munich Bavaria Germany
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Robertson LD, Beltrán-Aguilar E, Dasanayake A, Phipps KR, Warren JJ, Hennessy TW. A novel staging system for caries severity in the primary dentition. J Public Health Dent 2016; 77:6-12. [PMID: 27307188 DOI: 10.1111/jphd.12164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Accepted: 04/15/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Caries in the primary dentition (CIPD) has a high prevalence in U.S. children compared to other diseases, with substantial disparities among different population groups. Few reports correlate CIPD prevalence with clinical impairment of children's quality of life, such as tooth pain, speech delay or trauma to the child from operative restorations, which we collectively term morbidity. Likewise, current case definitions (ECC, S-ECC) and disease metrics (mean dmfs/dmft) are not helpful in assessing morbidity for individual or groups of children. We describe a construct to stage caries severity for children ages 0 -5, called "CIPD Levels." This metric is based on small interval age-group dmft scores, and has a direct link to current and predicted morbidity for the child. It is modeled after staging systems for medical diseases in which the various stages or levels are correlated with the probability of morbidity or mortality. METHODS We created a matrix in which CIPD Levels 0-4 are assigned for dmft scores 0-7 depending on a child's age. CIPD Level-4 is the highest level, and frequently results in clinical adverse outcomes, including pain and extensive restorations. We next tested this matrix with data from a high-risk population. RESULTS Among children with any cavitated caries at age <24 months, 82.8% reached the adverse outcomes threshold (CIPD Level-4) at age 36 months. For children with dmft = 0 at 24 months, 71.4% did not reach CIPD Level-4 at age 36 months. CONCLUSION Our new metric is useful for quantifying disease burden from caries for high-risk children.
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Affiliation(s)
| | | | - Ananda Dasanayake
- Graduate Program in Clinical Research, New York University College of Dentistry, New York, NY, USA
| | - Kathy R Phipps
- Oral Epidemiologist, Private Consultant, Morro Bay, CA, USA
| | - John J Warren
- Department of Preventive & Community Dentistry, University of Iowa, Iowa City, IA, USA
| | - Thomas W Hennessy
- Arctic Investigations Program, Centers for Disease Control and Prevention (CDC), Anchorage, AK, USA
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Total, Free, and Added Sugar Consumption and Adherence to Guidelines: The Dutch National Food Consumption Survey 2007-2010. Nutrients 2016; 8:70. [PMID: 26828518 PMCID: PMC4772034 DOI: 10.3390/nu8020070] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 01/21/2016] [Accepted: 01/25/2016] [Indexed: 12/25/2022] Open
Abstract
A high sugar intake is a subject of scientific debate due to the suggested health implications and recent free sugar recommendations by the WHO. The objective was to complete a food composition table for added and free sugars, to estimate the intake of total sugars, free sugars, and added sugars, adherence to sugar guidelines and overall diet quality in Dutch children and adults. In all, 3817 men and women (7-69 years) from the Dutch National Food Consumption Survey 2007-2010 were studied. Added and free sugar content of products was assigned by food composition tables and using labelling and product information. Diet was assessed with two 24-h recalls. Diet quality was studied in adults with the Dutch Healthy Diet-index. Total sugar intake was 22% Total Energy (%TE), free sugars intake 14 %TE, and added sugar intake 12 %TE. Sugar consumption was higher in children than adults. Main food sources of sugars were sweets and candy, non-alcoholic beverages, dairy, and cake and cookies. Prevalence free sugar intake <10 %TE was 5% in boys and girls (7-18 years), 29% in women, and 33% in men. Overall diet quality was similar comparing adults adherent and non-adherent to the sugar guidelines, although adherent adults had a higher intake of dietary fiber and vegetables. Adherence to the WHO free sugar guidelines of <5 %TE and <10 %TE was generally low in the Netherlands, particularly in children. Adherence to the added and free sugar guidelines was not strongly associated with higher diet quality in adults.
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PINTO GDS, HARTWIG AD, ELIAS R, AZEVEDO MS, GOETTEMS ML, CORREA MB, DEMARCO FF. Maternal care influence on children’s caries prevalence in southern Brazil. Braz Oral Res 2016; 30:S1806-83242016000100262. [DOI: 10.1590/1807-3107bor-2016.vol30.0070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 03/31/2016] [Indexed: 11/22/2022] Open
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Emond JA, Smith ME, Mathur SJ, Sargent JD, Gilbert-Diamond D. Children's Food and Beverage Promotion on Television to Parents. Pediatrics 2015; 136:1095-102. [PMID: 26553181 PMCID: PMC4657602 DOI: 10.1542/peds.2015-2853] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/22/2015] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Nutritionally poor foods are heavily advertised to children on television. Whether those same products are also advertised to parents on television has not been systematically examined. METHODS This study is a content analysis of advertisements for children's packaged foods and beverages aired over US network, cable, and syndicated television for 1 year (2012 to 2013). The target audience of each advertisement was defined as children or parents based on advertisement content, where parent-directed advertisements included emotional appeals related to family bonding and love. Advertisement characteristics and patterns of airtime were compared across target audience, and the proportion of total airtime devoted to advertisements targeting parents was computed. RESULTS Fifty-one children's food or beverage products were advertised over the study year, 25 (49%) of which were advertised directly to parents. Parent-directed advertisements more often featured nutrition and health messaging and an active lifestyle than child-directed advertisements, whereas child-directed advertisements more frequently highlighted fun and product taste. Over all products, 42.4% of total airtime was devoted to advertisements that targeted parents. The products with the most amount of airtime over the study year were ready-to-eat cereals, sugar-sweetened beverages, and children's yogurt, and the proportion of total advertisement airtime for those products devoted to parents was 24.4%, 72.8%, and 25.8%, respectively. DISCUSSION Television advertisements for children's packaged foods and beverages frequently targeted parents with emotional appeals and messaging related to nutrition and health. Findings are of concern if exposure to such advertisements among parents may shape their beliefs about the appropriateness of nutritionally questionable children's foods and beverages.
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Affiliation(s)
- Jennifer A. Emond
- Cancer Control Research Program, Norris Cotton Cancer Center, and,Departments of Epidemiology and
| | - Marietta E. Smith
- Department of General Medicine, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | | | - James D. Sargent
- Cancer Control Research Program, Norris Cotton Cancer Center, and,Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire;,Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Diane Gilbert-Diamond
- Cancer Control Research Program, Norris Cotton Cancer Center, and,Departments of Epidemiology and
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Warren JJ, Blanchette D, Dawson DV, Marshall TA, Phipps KR, Starr D, Drake DR. Factors associated with dental caries in a group of American Indian children at age 36 months. Community Dent Oral Epidemiol 2015; 44:154-61. [PMID: 26544674 DOI: 10.1111/cdoe.12200] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2014] [Accepted: 10/04/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This article reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study. METHODS Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children, and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28, and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary, and behavioral factors. Nonparametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts). RESULTS Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only noncavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added-sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (P < 0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts. CONCLUSIONS By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size, and maternal factors, but further analyses are needed to better understand caries in this population.
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Affiliation(s)
- John J Warren
- Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA, USA
| | - Derek Blanchette
- Dows Institute for Dental Research, University of Iowa, Iowa City, IA, USA
| | - Deborah V Dawson
- Dows Institute for Dental Research, University of Iowa, Iowa City, IA, USA
| | - Teresa A Marshall
- Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA, USA
| | | | | | - David R Drake
- Dows Institute for Dental Research, University of Iowa, Iowa City, IA, USA
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Meier T, Senftleben K, Deumelandt P, Christen O, Riedel K, Langer M. Healthcare Costs Associated with an Adequate Intake of Sugars, Salt and Saturated Fat in Germany: A Health Econometrical Analysis. PLoS One 2015; 10:e0135990. [PMID: 26352606 PMCID: PMC4566993 DOI: 10.1371/journal.pone.0135990] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/28/2015] [Indexed: 01/30/2023] Open
Abstract
Non-communicable diseases (NCDs) represent not only the major driver for quality-restricted and lost life years; NCDs and their related medical treatment costs also pose a substantial economic burden on healthcare and intra-generational tax distribution systems. The main objective of this study was therefore to quantify the economic burden of unbalanced nutrition in Germany—in particular the effects of an excessive consumption of fat, salt and sugar—and to examine different reduction scenarios on this basis. In this study, the avoidable direct cost savings in the German healthcare system attributable to an adequate intake of saturated fatty acids (SFA), salt and sugar (mono- & disaccharides, MDS) were calculated. To this end, disease-specific healthcare cost data from the official Federal Health Monitoring for the years 2002–2008 and disease-related risk factors, obtained by thoroughly searching the literature, were used. A total of 22 clinical endpoints with 48 risk-outcome pairs were considered. Direct healthcare costs attributable to an unbalanced intake of fat, salt and sugar are calculated to be 16.8 billion EUR (CI95%: 6.3–24.1 billion EUR) in the year 2008, which represents 7% (CI95% 2%-10%) of the total treatment costs in Germany (254 billion EUR). This is equal to 205 EUR per person annually. The excessive consumption of sugar poses the highest burden, at 8.6 billion EUR (CI95%: 3.0–12.1); salt ranks 2nd at 5.3 billion EUR (CI95%: 3.2–7.3) and saturated fat ranks 3rd at 2.9 billion EUR (CI95%: 32 million—4.7 billion). Predicted direct healthcare cost savings by means of a balanced intake of sugars, salt and saturated fat are substantial. However, as this study solely considered direct medical treatment costs regarding an adequate consumption of fat, salt and sugars, the actual societal and economic gains, resulting both from direct and indirect cost savings, may easily exceed 16.8 billion EUR.
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Affiliation(s)
- Toni Meier
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
- * E-mail:
| | - Karolin Senftleben
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Peter Deumelandt
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Olaf Christen
- Institute of Agricultural and Nutritional Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Katja Riedel
- BRAIN Biotechnology Research And Information Network AG, Zwingenberg, Germany
| | - Martin Langer
- BRAIN Biotechnology Research And Information Network AG, Zwingenberg, Germany
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Ghazal T, Levy SM, Childers NK, Broffitt B, Cutter GR, Wiener HW, Kempf MC, Warren J, Cavanaugh JE. Factors associated with early childhood caries incidence among high caries-risk children. Community Dent Oral Epidemiol 2015; 43:366-74. [PMID: 25777317 PMCID: PMC4911172 DOI: 10.1111/cdoe.12161] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2014] [Accepted: 02/09/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To assess the relationships between different behavioral factors and Early Childhood Caries (ECC) in African-American pre-school children. METHODS Ninety-six African-American children aged 3-22 months old at baseline were recruited from a high caries risk, non-fluoridated African-American community in Uniontown, Alabama. The children had dental examinations annually following World Health Organization (WHO) criteria at mean ages 1.1, 2.0, 3.1 and 4.0 years. All children received fluoride varnish application at each study visit. Parents provided oral hygiene and dietary information semiannually by completing questionnaires. Area-under-the-curve (AUC) with the trapezoidal rule was used to summarize longitudinal exposure data. Bivariate and multivariable relationships between ECC incidence and behavioral risk factors were assessed using logistic regression and negative binomial modeling for dichotomous and count dependent variables, respectively, with the independent variables defined at age 1, age 3 and as the AUC. RESULTS Greater frequency of toothbrushing and greater AUC composite of daily frequency of consumption of 100% juices were associated with lower incidence of dental caries (P-values = 0.01 and 0.049, ORs = 0.34 and 0.37, respectively). Greater AUC of daily frequency of consumption of sweetened foods and history of a previous visit to a dentist by age 3 were associated with greater incidence of ECC (ORs = 9.22 and 4.57, P-values = 0.002 and 0.03, respectively). CONCLUSION For these children living in a non-fluoridated community, more frequent consumption of sweetened food, less frequent consumption of 100% juice, less frequent toothbrushing, and reporting a previous visit to a dentist were significantly associated with greater ECC incidence.
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Affiliation(s)
- Tariq Ghazal
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Steven M Levy
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA
| | - Noel K Childers
- Department of Pediatric Dentistry, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Barbara Broffitt
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Gary R Cutter
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Howard W Wiener
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mirjam C Kempf
- School of Nursing and Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John Warren
- Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA
| | - Joseph E Cavanaugh
- Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA
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Yokomichi H, Tanaka T, Suzuki K, Akiyama T, Yamagata Z. Macrosomic Neonates Carry Increased Risk of Dental Caries in Early Childhood: Findings from a Cohort Study, the Okinawa Child Health Study, Japan. PLoS One 2015. [PMID: 26207737 PMCID: PMC4514765 DOI: 10.1371/journal.pone.0133872] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Although many studies have discussed health risks in neonates with a low birth weight, few studies have focused on the risks in neonates with a high birth weight. The objective of this study was to determine whether differences in the incidence of dental caries in early childhood are associated with birth weight status. METHODS A total of 117,175 children born in Okinawa Prefecture, Japan from 1997 to 2007 were included in this study. Medical professionals collected information about birth records, growth and development, parental child-rearing practices and dental health at 3 months, 18 months and 3 years of age. The risk of dental caries among neonates with macrosomia (birth weight ≥4000 g) was compared with that among neonates with normal weight (2500-3999 g). Sensitivity analyses included 'large for gestational age' (LGA, birth weight above the 90th percentile for gestational age), which was relative to 'appropriate for gestational age' (birth weight between 10th and 90th percentiles). Relative risks and relative risk increases were estimated by multivariate Poisson regression. RESULTS At 3 years of age, the relative risk increases for dental caries after adjusting for confounding factors were 19% [95% confidence interval (CI), 11%-28%, P < 0.001] for macrosomic neonates and 12% (95% CI, 9%-16%, P < 0.001) for LGA neonates. CONCLUSION Macrosomia and LGA were associated with an increased risk of dental caries in early childhood. Particular attention should be paid to abnormally large neonates.
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Affiliation(s)
- Hiroshi Yokomichi
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Taichiro Tanaka
- Department of Social Medicine, Faculty of Medicine, Toho University, 5-21-16, Ohmorinisi, Ohta Ward, Tokyo, Japan
| | - Kohta Suzuki
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | - Tomoki Akiyama
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
| | | | - Zentaro Yamagata
- Department of Health Sciences, Division of Medicine, Graduate School Department of Interdisciplinary Research, University of Yamanashi, 1110 Shimokato, Chuo City, Yamanashi, Japan
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Neiswanger K, McNeil DW, Foxman B, Govil M, Cooper ME, Weyant RJ, Shaffer JR, Crout RJ, Simhan HN, Beach SR, Chapman S, Zovko JG, Brown LJ, Strotmeyer SJ, Maurer JL, Marazita ML. Oral Health in a Sample of Pregnant Women from Northern Appalachia (2011-2015). Int J Dent 2015; 2015:469376. [PMID: 26089906 PMCID: PMC4451284 DOI: 10.1155/2015/469376] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2015] [Accepted: 04/15/2015] [Indexed: 11/17/2022] Open
Abstract
Background. Chronic poor oral health has a high prevalence in Appalachia, a large region in the eastern USA. The Center for Oral Health Research in Appalachia (COHRA) has been enrolling pregnant women and their babies since 2011 in the COHRA2 study of genetic, microbial, and environmental factors involved in oral health in Northern Appalachia. Methods. The COHRA2 protocol is presented in detail, including inclusion criteria (healthy, adult, pregnant, US Caucasian, English speaking, and nonimmunocompromised women), recruiting (two sites: Pittsburgh, Pennsylvania, and West Virginia, USA), assessments (demographic, medical, dental, psychosocial/behavioral, and oral microbial samples and DNA), timelines (longitudinal from pregnancy to young childhood), quality control, and retention rates. Results. Preliminary oral health and demographic data are presented in 727 pregnant women, half from the greater Pittsburgh region and half from West Virginia. Despite similar tooth brushing and flossing habits, COHRA2 women in West Virginia have significantly worse oral health than the Pittsburgh sample. Women from Pittsburgh are older and more educated and have less unemployment than the West Virginia sample. Conclusions. We observed different prevalence of oral health and demographic variables between pregnant women from West Virginia (primarily rural) and Pittsburgh (primarily urban). These observations suggest site-specific differences within Northern Appalachia that warrant future studies.
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Affiliation(s)
- Katherine Neiswanger
- School of Dental Medicine, Department of Oral Biology, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Daniel W. McNeil
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- School of Dentistry, Department of Dental Practice & Rural Health, Eberly College of Arts and Sciences, Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA
| | - Betsy Foxman
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- School of Public Health, Department of Epidemiology, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Manika Govil
- School of Dental Medicine, Department of Oral Biology, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA
| | - Margaret E. Cooper
- School of Dental Medicine, Department of Oral Biology, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA
| | - Robert J. Weyant
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- School of Dental Medicine, Department of Dental Public Health, University of Pittsburgh, 3501 Terrace Street, Pittsburgh, PA 15213, USA
| | - John R. Shaffer
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- Graduate School of Public Health, Department of Human Genetics, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Richard J. Crout
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Periodontics, West Virginia University, Room G110-B HSC, N. Medical Center Drive, Morgantown, WV 26506, USA
| | - Hyagriv N. Simhan
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital, University of Pittsburgh Medical Center, 300 Halket Street, Pittsburgh, PA 15213, USA
| | - Scott R. Beach
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- University Center for Social and Urban Research, 3343 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Stella Chapman
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- School of Dentistry, Department of Dental Practice & Rural Health, Eberly College of Arts and Sciences, Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA
| | - Jayme G. Zovko
- School of Dental Medicine, Department of Oral Biology, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Linda J. Brown
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- School of Dentistry, Department of Dental Practice & Rural Health, Eberly College of Arts and Sciences, Department of Psychology, West Virginia University, 53 Campus Drive, P.O. Box 6040, Morgantown, WV 26506, USA
| | - Stephen J. Strotmeyer
- University Center for Social and Urban Research, 3343 Fifth Avenue, Pittsburgh, PA 15213, USA
| | - Jennifer L. Maurer
- School of Dental Medicine, Department of Oral Biology, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
| | - Mary L. Marazita
- School of Dental Medicine, Department of Oral Biology, University of Pittsburgh, Bridgeside Point Suite 500, 100 Technology Drive, Pittsburgh, PA 15219, USA
- Center for Oral Health Research in Appalachia (COHRA), University of Pittsburgh, Pittsburgh, PA 15219, USA
- Graduate School of Public Health, Department of Human Genetics, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, USA
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Understanding how Latino parents choose beverages to serve to infants and toddlers. Matern Child Health J 2015; 18:1308-15. [PMID: 24077961 DOI: 10.1007/s10995-013-1364-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
To determine Latino parents' beliefs on the health effects of beverages on infants and toddlers, their sources of information on beverages and perceived barriers to following guidelines for healthy beverage consumption by children. We conducted 29 interviews with parents of Latino children ages 6-36 months. Parents were recruited in three community health centers in Northern California. The interviews were recorded, transcribed and analyzed using standard qualitative methods. The following dominant themes emerged. Parents believed that water and milk were healthy beverages for children and that sugar-sweetened beverages (SSBs) were unhealthy. Views on 100% fruit juice were mixed. Parents distinguished between homemade beverages such as "agua fresca" which they considered healthy, despite containing added sugar, and beverages from stores which were viewed as unhealthy. Participants' main source of information on beverages was the federal nutrition program for Women, Infants, and Children (WIC). Parents were confused, however, as to why WIC provides juice yet counseled parents to avoid giving their children juice. Parents preferred to receive information on beverages from experts. Differing practices among family members regarding which beverages they provide to children was the most important barrier to following beverage guidelines. Our study suggests that Latino parents are receptive to counseling on beverages from expert sources. Such counseling should address both store-bought and homemade beverages. The WIC program is a key source of information on beverages for Latino parents; thus counseling offered by WIC should be evidence-based and avoid mixed messages.
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Park S, Lin M, Onufrak S, Li R. Association of Sugar-Sweetened Beverage Intake during Infancy with Dental Caries in 6-year-olds. Clin Nutr Res 2015; 4:9-17. [PMID: 25713788 PMCID: PMC4337927 DOI: 10.7762/cnr.2015.4.1.9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 09/12/2014] [Accepted: 09/12/2014] [Indexed: 11/19/2022] Open
Abstract
To examine whether sugar-sweetened beverage (SSB) intake during infancy is associated with dental caries by age 6, a longitudinal analysis of 1,274 U.S. children was conducted using data from the 2005-2007 Infant Feeding Practices Study II and the 2012 Follow-up Study at 6 years of age. The exposure variables were maternal-reported SSB intakes during infancy (i.e., any SSB intake during infancy, age at SSB introduction during infancy, and average frequency of SSB intake during 10-12 months of age). The outcome variable was maternal-reported dental caries of their 6-year-old in his/her lifetime. Multivariable logistic regression analyses were used to calculate adjusted odds ratios (aOR) for associations of SSB intake during infancy with having dental caries among 6-year-olds after controlling for baseline characteristics of children and mothers and child's tooth brushing habits and sweet food intake at follow-up. Based on maternal recall, almost 40% of 6-year-olds had dental caries in their lifetime. Adjusted odds of having dental caries was significantly associated with higher frequency of SSB intake during 10-12 months (aOR=1.83 for ≥3 times/week, vs. none). Any SSB intake during infancy and age at SSB introduction during infancy were not associated with dental caries. In conclusion, frequent SSB intake during 10-12 months of age significantly increased the likelihood of having dental caries among 6-year-olds. Late infancy may be an important time for mothers to establish healthy beverage practices for their children. These findings can be used to inform efforts to reduce dental caries among children.
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Affiliation(s)
- Sohyun Park
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Mei Lin
- Division of Oral Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Stephen Onufrak
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Ruowei Li
- Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
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Ghazal T, Levy SM, Childers NK, Broffitt B, Cutter G, Wiener HW, Kempf M, Warren J, Cavanaugh J. Prevalence and incidence of early childhood caries among African-American children in Alabama. J Public Health Dent 2014; 75:42-8. [PMID: 25213319 PMCID: PMC4355321 DOI: 10.1111/jphd.12069] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 07/10/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aims to assess the prevalence and incidence of early childhood caries (ECC) in African-American children. METHODS A cohort of 96 African-American children approximately 1 year of age at baseline were recruited in Uniontown, Alabama, and followed for 3 years. Oral examinations were conducted annually by one of three trained/calibrated dentists using portable equipment, without radiographs, following WHO criteria. RESULTS The prevalence of decayed/missing/filled surfaces (dmfs) was: 1.1 percent (all d) at approximately age 1 (n = 90, six children were excluded for having no erupted teeth); 12.8 percent (d = 10.5 percent & f = 4.7 percent) at age 2 (n = 86); 39.3 percent (d = 21.4 percent, m = 2.4 percent & f = 22.6 percent) at age 3 (n = 84); and 65.8 percent (d = 28.8 percent, m = 5.5 & f = 46.6 percent) at age 4 (n = 73). The percentages of incisors, canines, first molars, and second molars with dmfs were: 0.1 percent, 0.0 percent, 0.0 percent, and 0.0 percent, at age 1; 2.4 percent, 0.1 percent, 0.8 percent, and 0.6 percent at age 2; 8.2 percent, 0.8 percent, 7.6 percent, and 6.3 percent at age 3; and 10.2 percent, 2.2 percent, 12.6 percent and 16.7 percent at age 4, respectively. The three, 1-year, person-level incidence rates were 12.8 percent (age 1 to age 2), 38.6 percent (age 2 to age 3), and 56.2 percent (age 3 to age 4). From baseline, the 2-year incidence was 39.3 percent and 3-year incidence was 65.8 percent, whereas the 2-year caries incidence from age 1 to age 3 was 66.7 percent (n = 72). CONCLUSION The majority of children developed caries during the 3-year follow-up, which is much higher than the 32 percent prevalence of caries among African-American children under age 6 years in National Health and Nutrition Examination Survey from 1999 to 2002.
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Affiliation(s)
- Tariq Ghazal
- College of Dentistry, University of Iowa, Preventive and Community Dentistry, 801 Newton Rd #451, Iowa City, Iowa, United States
| | - Steven M. Levy
- University of Iowa, College of Dentistry, 328 Dental Science Building North, Iowa City, Iowa, United States
| | - Noel K. Childers
- School of Dentistry at University of Alabama, Pediatric Dentistry, 1530 3rd Avenue South, SDB 304, SDB, Birmingham, Alabama, United States
| | - Barbara Broffitt
- University of Iowa, Preventive & Community Dentistry, N329 DSB, Iowa City, Iowa, United States
| | - Gary Cutter
- College of Public Health, University of Alabama at Birmingham, Department of Biostatistics, Birmingham, Alabama, United States
| | - Howard W. Wiener
- College of Public Health, University of Alabama at Birmingham, Department of Epidemiology, Birmingham, Alabama, United States
| | - Mirjam Kempf
- School of Nursing, Health Behavior, Birmingham, Alabama, United States
| | - John Warren
- University of Iowa, Preventive & Community Dentistry, N-337 Dental Science Bldg., Iowa City, Iowa, United States
| | - Joseph Cavanaugh
- College of Public Health, University of Iowa, Biostatistics, Iowa City, Iowa, United States
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