Apgar score and dental caries risk in the primary dentition of five year olds

The association between low birth weight and/or preterm birth and dental caries -A systematic review and meta-analysis

BACKGROUND

Studies on the association between adverse birth outcomes and dental caries in children have shown conflicting results, so the aim of this systematic review and meta-analysis was to investigate the association between adverse birth outcomes and dental caries in children.

METHODS

We systematically searched articles in four electronic databases (Web of Science, PubMed, Cochrane Library and Embase) published prior to August 2021. The odds ratio (OR) (or converted OR) and the corresponding 95% confidence intervals (95% CI) were processed. The certainty of evidence was assessed using GRADE's risk bias assessment tool. Random effects model was used for this meta-analysis.

RESULTS

A total of thirty-one observational studies met the inclusion criteria. The pooled estimates indicated that children exposed to low birth weight (LBW)/preterm birth (PTB) did not experience higher dental caries in primary teeth. Subgroup analyses showed that children with LBW (OR: 1.30, 95% CI: 1.03-1.63) were prone to have dental caries in primary teeth for cross-sectional studies, but no significant differences for prospective studies. PTB children experienced more primary caries in high-income countries (OR: 1.31, 95% CI: 1.00-1.70) than in low- and middle-income countries.

CONCLUSIONS

The current evidence did not suggest a significant association between LBW and dental caries in children for primary teeth. Children with PTB in high-income countries had a higher prevalence of primary dental caries. Further prospective studies should adjust for confounding factors (age, oral health and family finances) to determine the definitive association between LBW/PTB and dental caries.

Evaluation of Children Caries Risk Factors: A Narrative Review of Nutritional Aspects, Oral Hygiene Habits, and Bacterial Alterations

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.

[Therapeutic education and oral health, an opportunity for the child]

Early childhood caries is an infectious disease of bacterial origin. It is mainly associated with social inequalities in oral health and affects children from the least privileged backgrounds. Because of its recurrent nature, it is the most common chronic disease in preschool children. Since it shares common risk factors with a number of other chronic conditions (diabetes, obesity), promoting global oral health is essential to achieving a favorable general health status.

Association of characteristics of delivery and medical conditions during the first month of life with developmental defects of enamel

Background

Developmental defects of enamel (DDE) may be influenced by health problems and illness in children. The aim of the study was to identify the main characteristics of birth (delivery) and adverse medical conditions during the first month of life that may be related to DDE in permanent teeth.

Methods

1000 schoolchildren between the ages of 9 and 11 years were selected for this cross-sectional study by multistage randomization from four educational zones in Shiraz in 2013. Intraoral examination was used to diagnose DDE according to World Health Organization screening guidelines and the Modified DDE Index. The data on seven birth factors as well as health and nutritional conditions during the first month of life were collected by a questionnaire completed by the parents, and were analyzed with the chi-squared test, Spearman’s correlation and binary logistic regression.

Results

469 (48.2%) out of 974 schoolchildren had at least one permanent tooth with DDE. The defects were significantly related with Apgar score at birth <7 (p = 0.003) and illness during the first month (p = 0.035). The frequency of DDE was significantly lower in the third child in families compared to the first and second child (p = 0.005). However, DDE showed no significant relationship with gestational age, delivery type, birth weight, gender or type of feeding during early infancy.

Conclusions

Three associated factors were identified (birth Apgar score, illness during the first month of life, birth order) for DDE in permanent teeth. No specific illness was found to be significantly associated with DDE.

Time until first dental caries for young children first seen in Federally Qualified Health Centers: a retrospective cohort study

OBJECTIVES

The study assessed the time until first dental caries for young children seen at five Federally Qualified Health Centers (FQHC) in Iowa and the relationship with the frequency and gaps (in months) of dental episodes, the number of topical fluoride treatments, and the number of dentists caring for the subject.

METHODS

Forty children were randomly selected at each FQHC (n = 200). All children were continuously enrolled in the Medicaid program and had their first dental visit prior to age 6. Dental chart findings, claims data for the child and family, and birth certificate information were merged into one dataset. Dental visits were followed for a minimum of 36 months, including dental visits external to the FQHCs. Using time until first caries as the dependent variable, the data were subject to left, interval, and right censoring and were analyzed via Weibull regression.

RESULTS

Slightly more than half of the 200 children experienced caries. Regression analysis indicated that the hazard of first dental caries increased by approximately 2% with each additional month that transpired between preventive recall examinations. In addition, children with older siblings who had a dental visit at the same center during the previous year prior to the subject's first visit were more likely to have a longer time until first dental caries.

CONCLUSIONS

Timing of dental care episodes was associated with caries experience in young children from low income families. Dental professionals should focus on regularity of dental care to prevent or delay caries experience in young children.

Reusing electronic patient data for dental clinical research: a review of current status

OBJECTIVES

The reuse of electronic patient data collected during clinical care has received increased attention as a way to increase our evidence base. The purpose of this paper was to review studies reusing electronic patient data for dental research.

DATA SOURCES

1527 citations obtained by searching MEDLINE and Embase databases, hand-searching seven dental and informatics journals, and snowball sampling.

STUDY SELECTION

We included studies reusing electronic patient data for research on dental and craniofacial topics, alone or in combination with medical conditions, medications and outcomes. Studies using administrative or research databases and systematic reviews were excluded. Three reviewers extracted data independently and performed analysis jointly

RESULTS

The 60 studies reviewed covered epidemiological (32 studies), outcomes (16), health services research (10) and other (2) topics; were primarily retrospective (58 studies); varied significantly in sample size (9-153,619 patients) and follow-up period (1-12 years); often drew on other data sources in addition to electronic ones (25); but rarely tapped electronic dental record (EDR) data in private practices (3). Type of research was not associated with data sources used, but research topics/questions were. The most commonly reported advantages of reusing electronic data were being able to study large samples and saving time, while data quality and the inability to capture study-specific data were identified as major limitations.

CONCLUSIONS

Dental research reusing electronic patient data is nascent but accelerating. Future EDR design should focus on enhancing data quality, begin to integrate research data collection and implement interoperability with electronic medical records to facilitate oral-systemic investigations.

CLINICAL SIGNIFICANCE

Measuring and improving the quality of dental care requires that we begin to reuse electronic patient data collected in practice for clinical research. Practice data can potentially serve as a useful complement to data collected in traditional research studies.