Prevalence of dental carries and its association with breastfeeding duration among young children in Addis Ababa, Ethiopia

BACKGROUND

Breastfeeding is a crucial feeding practices that significantly contributes to the healthy development of children. However, the effect of breastfeeding duration on caries risk is unclear, as different studies have found different results. This study aims to assess the prevalence of dental caries and its association with breastfeeding duration among young children aged 12-36 months in selected health facilities of Addis Ababa, Ethiopia.

METHODS

A cross-sectional study among 380 children aged 12-36 months from 11 health centers in Addis Ababa was conducted. Questionnaires and dental examinations were used to collect data. Dental caries was measured by the deft (decayed-extracted-filled teeth) index. Binary logistic regression was used to assess the association between dental caries and duration of breastfeeding, after adjusting for the confounders.

RESULTS

The prevalence of dental caries was 53.4% (95% CI: 48.3, 58.5%), with 13.7% having high caries and 39.7% having low caries. Breastfeeding duration was not significantly associated with dental carries, after adjusting for confounders. However, sugar intake, older age, mothers' unemployment, and not being in marital union are risk factors for dental caries development.

CONCLUSIONS

Promotion of healthy diet, especially limiting intake of sugar and sweets, and integration of oral health into primary health care programs are recommended. Further research using longitudinal design or meta-analysis is recommended to establish more concise evidence on the association between breastfeeding duration and dental caries.

Prevalence and risk indicators of early childhood caries among toddlers in Caloocan City, Philippines: a cross-sectional study

BACKGROUND

Limited published data exist on early childhood caries (ECC) among children 2 years old and below. The study aimed to determine ECC prevalence and its association with socio-demographic indicators, feeding practices and oral health behaviours among children aged 2 years and below in the Philippines.

METHODS

A cross-sectional study observed young children aged 4-24 months in primary health centers. Each child's caregiver was interviewed and dental examinations were done on every child by one calibrated dentist using the ICDAS. Poisson regression using robust variance estimator analysis identified significant variables associated with ECC.

RESULTS

Seven hundred three healthy children were observed at a mean age of 13.3 ± 2.4 months. ECC prevalence was 29.2% (95% confidence interval: 26.0-32.7) among toddlers who showed a mean number of 6.7 ± 3.1 erupted teeth. Multiple regression revealed that child's age (prevalence ratio, PR = 1.07), caregiver's educational level (PR = 1.43), continued breastfeeding (PR = 1.36), frequent eating (PR = 1.24), visible plaque observed by the caregiver (PR = 1.34) and in the oral examination (PR = 2.90) were significant to ECC prevalence.

CONCLUSIONS

ECC is alarmingly prevalent in toddlers, marked by early onset and untreated decay. Prioritizing preventive measures in the first two years of life is crucial for understanding dietary impacts and promoting oral hygiene.

A longitudinal study on the impact of breastfeeding with or without formula milk on dental caries

Concerns exist about prolonged breastfeeding increasing dental caries risk, but evidence is mixed. This 2-year cohort study followed 486 toddlers, to examine the association between breastfeeding duration and caries at age 3. Caregivers reported feeding practices and potential confounders every 6 months. "Full breastfeeding" was defined as feeding breastmilk without formula milk regardless of other foods/liquids, whereas "any breastfeeding" was feeding breastmilk with/without formula milk. A calibrated dentist performed dental examinations. We used multivariable log-binomial and negative binomial regressions to estimate relative risks (RRs) and 95% confidence intervals (CIs) for caries prevalence and severity, adjusted for confounders. At 3-year-old, 60.3% of children exhibited caries (mean decayed-and-filled-teeth, dft: 3.3). Notably, full breastfeeding for 6-17 months reduced caries prevalence (RR = 0.84, 95%CI 0.73-0.98 for 6-11 months; RR = 0.78, 95%CI 0.63-0.96 for 12-17 months). Conversely, any breastfeeding ≥ 18 months significantly increased caries risk (RR = 1.45, 95%CI 1.31-1.60). Full breastfeeding ≥ 6 months or any breastfeeding 6-17 months was associated with lower dft scores in children. Our findings suggest a complex relationship between breastfeeding duration and caries. Full breastfeeding for moderate durations (6-17 months) offers protective benefits, while any breastfeeding ≥ 18 months increases risk in this population.

Relationship between Nutrition and Development of the Jaws in Children: A Pilot Study

Craniofacial growth and development have been shown to be influenced by various environmental factors that impact child development. This study aims to analyze the different patterns of feeding during early childhood, starting from birth, and assess the variability of nutrition during the first stage of childhood, along with the habits developed, to study their impact on jaw development. The study was conducted on a sample of twenty-five patients aged 3 to 5, following approval from the ethics committee of the Catholic University of Valencia. Informed consent was obtained from the fathers, mothers, and/or legal guardians, who were administered surveys on habits and diet. Cephalometric measurements within the parameters of ideal occlusion were subsequently taken. While previous studies examined this subject, the findings are challenging to evaluate. However, this study identified significant associations (p = 0.001) between clinical measurements and children's eating habits. The growth and development of the craniofacial cavity are influenced by multiple factors, including a child's diet and habits. Nonetheless, further research is required to determine whether diet can be considered a determining factor in proper jaw growth.

Non-Cariogenic Effect of Milk and Dairy Products on Oral Health in Children and Adolescents: A Scoping Review

Diet plays an important role in the etiopathology of dental caries. Milk and dairy products (DPs), especially in children and adolescents, are important sources of protein, calcium and phosphorus and could have an effect on dental and oral health. The aim of this scoping review was to analyze the scientific literature on the non-cariogenic effect of milk and DPs, with a focus on their potential to prevent dental caries in children and adolescents. PubMed, EMBASE, and Web of Science were searched for publications relevant to our topic from January 2013 to 30 September 2023. Thirty-eight studies were included in the qualitative analysis. The included studies highlight the properties of milk and DPs that contribute to enamel remineralization, exhibit antibacterial action, inhibit the growth of cariogenic bacteria, and promote a balanced oral microbiome. With regard to the addition of probiotics (PBs) and fluoride (F) to DPs, the mixed results of the studies analyzed did not allow a clear statement to be made about their non-cariogenic effects. However, several studies show that the addition of PBs can reduce cariogenic bacteria, create a protective barrier against pathogens and support the host's natural defense mechanisms. Further long-term and high-quality studies are needed to understand the impact of milk and its constituents on oral health in order to promote effective caries prevention strategies in children and adolescents.

Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists

Background

In recent years, breastfeeding has been largely promoted due to health benefits for the children and the mothers and social, economic, and environmental advantages. World Health Organization (WHO) recommends breastfeeding for at least 2 years and to be continued for as long as this is desired by the mother-child dyad.Despite its advantages, including protection against caries in the 1st year of life, prevention of malocclusions, and development of more normal breathing patterns, there is a great controversy in the literature regarding breastfeeding involvement in elevated risk for early childhood caries (ECC).Breastfeeding and oral health are strongly related. Breastfeeding can influence oral health and development, but oral findings, such as tethered tissues and natal/neonatal teeth, may negatively affect lactation.

Conclusion

A healthy collaboration between the oral health care provider and the lactation specialist is important in order to identify those oral findings and prevent breastfeeding implications, but also in order to facilitate uneventful breastfeeding by emphasizing oral health care prevention strategies.

Clinical significance

Information on the advantages of certain lactation aspects and the potential risks for ECC is important for the pediatric dentist to be able to form an individualized treatment/prevention plan that will benefit and promote the oral and general health of young patients.

How to cite this article

Papadopoulou P, Boka V, Arapostathis K. Integration of Breastfeeding Consultation and Practices in the Scope of Pediatric Dentistry: Collaboration with Lactation Specialists. Int J Clin Pediatr Dent 2023;16(S-3):S306-S310.

Prolonged breastfeeding and dental caries in preschool children

PURPOSE

To explore breastfeeding from 6 to 18 months of age and to study the association between breastfeeding and caries prevalence at 5 years of age.

METHODS

The study included 1088 children from one Norwegian county and was based on the Norwegian Mother, Father and Child Cohort Study (MoBa). The children had clinical dental examination at 5 years of age, and parents answered a questionnaire, which included information on breastfeeding, oral health behaviour and child characteristic. Multivariate logistic regressions were performed. The study was ethically approved.

RESULTS

Of the studied children, 77% were breastfed at 6 months of age and 16% were still breastfed at 18 months of age. Few children (6%) were breastfed during night at 18 months of age, while 11% received sugary drink during night. No association was found between breastfeeding up to 18 months of age and caries prevalence at 5 years of age (p > .05). Children who at 18 months of age had their teeth brushed less than twice daily (OR 2.4, CI 1.5-3.9), consumed sugary drink once a week or more often (OR 1.7, CI 1.1-2.7) and had non-Western parents (OR 3.4, CI 1.5-8.1) were more likely to have caries experience at 5 years of age than other children.

CONCLUSION

Breastfeeding up to 18 months of age was not associated with caries development during preschool age.

The impact of infant feeding and oral hygiene habits on early childhood caries: A cross-sectional study

Background and Aim

The aim of this study is to evaluate the relationship between the Early Childhood Caries (ECC)/severe-ECC (S-ECC) and prolonged breast-feeding (BF), bottle-feeding, and oral hygiene habits in 0-year-old to 5-year-old Turkish children.

Patients and Methods

Dental examinations were performed on 255 patients to determine the prevalence of the ECC and the S-ECC as per the definition of the American Academy of Pediatric Dentistry. To predict the progress rate of caries, noncavitated and cavitated lesion scores were assessed by using the International caries detection and assessment system II criteria. Information on infant feeding practices, oral hygiene habits, maternal characteristics, and demographic features were gathered by means of a questionnaire. The results were statistically evaluated.

Results

There were no associations between BF duration, night-time BF, bottle-feeding, and the ECC. And there were also no associations between BF duration, night-time BF, bottle-feeding, and the S-ECC. Cavitated lesions were more common in children breastfed at night for 18-23 months compared to 12-17 months (P = 0.031). Sweetened bottle was an impact factor on caries experience (P = 0.042). A significant correlation was found for dmft, S-ECC, and the cavitated lesions regarding sugar consumption (P = .001, P = .002, and P = .001, respectively). Early introduction to tooth-brushing and regular dental visits were significantly effective in reducing the ECC (P < .001 and P < .001, respectively).

Conclusion

BF and bottle-feeding practices were not associated with the ECC/S-ECC. Sweetened bottles and sugary foods are strong risk factors for the ECC/S-ECC.

Current knowledge about early childhood caries in the gulf cooperation council with worldwide reflection: Scoping review of the scientific literature (2010-2021)

Early childhood caries (ECC) is one of the most prevalent chronic childhood diseases affecting the primary teeth of children younger than 6 years of age. The disease etiology is complex and includes social, biological, and dietary factors. This review aims to explore the knowledge of ECC prevalence globally and locally within the Gulf Cooperation Council (GCC) countries during the years 2010-2021. Another aim is to explore oral health promotion programs with more focus on the GCC region. A search was conducted in PubMed, Medline, Scopus, the Cochrane Collaboration database, and Google Scholar to identify relevant studies published between 2010 and 2021 using specific keywords. Studies that utilized both the World Health Organization criteria and International Caries Detection and Assessment System for dental caries assessment were included. The included studies indicated considerable variation in the reported prevalence of ECC. While developed countries show low prevalence, countries in the GCC and other Arab countries show a high prevalence of ECC. Many oral health promotion programs were identified globally including oral health education, nutritional programs, the use of fluoride and pit-and-fissure sealants, and inter-professional population-based oral health promotion and prevention programs such as school-based oral health programs, motivational interviewing, and anticipatory guidance. ECC remains a significant problem in many parts of the world including the GCC region. Oral health prevention programs have been established within the GCC region. Nevertheless, the GCC region has some unique characteristics that need to be investigated to contextualize the western model of the dynamics of ECC prevention and promotion programs locally.

Ultra-processed food consumption and dental caries in children and adolescents: a systematic review and meta-analysis

This study summarised the association between ultra-processed food (UPF) consumption and dental caries in children and adolescents through a systematic review and meta-analysis. The search of PubMed, Cochrane, Web of Science and Scopus databases using the 'PECOS' strategy retrieved 1462 eligible articles. Only studies with humans aged ≤ 19 years; that assessed groups of any UPF or specific UPF items; that measured dental caries as the decayed, filled and missing surfaces or teeth indexes, based on the WHO criteria; cross-sectional, case-control, cohort and all types of interventions that examined the adjusted association between UPF consumption and dental caries were included. All studies received qualitative evaluation. Meta-analysis using random-effects models combined multivariable-adjusted OR for case-control and cross-sectional studies and risk ratio (RR) for longitudinal studies of the highest v. lowest category of UPF consumption. Forty-two studies were included in the qualitative synthesis and twenty-seven in the meta-analysis. The pooled RR was 1·71 (95 % CI 1·31, 2·24), and the pooled OR was 1·55 (95 % CI 1·37, 1·75). The highest OR was found among participants who had dental caries prevalence >70 % (OR = 3·67, 95 % CI 2·16, 6·23). Better evidence quality was found among cohort studies that evaluated children <6 years old. The findings suggest that higher UPF consumption is associated with greater dental caries in children and adolescents. Public health efforts to reduce UPF consumption are needed to improve the oral health of children and adolescents.

Dental caries and associated risk factors in 13- to 18-month-old infants receiving breast or formula milk feeding: A cross-sectional study

BACKGROUND

The association between breast milk feeding and dental caries risk in children remains controversial. Moreover, it is unclear whether risk factors for caries differ between breast milk-fed and formula milk-fed infants.

AIM

To investigate dental caries in 13- to 18-month-old infants receiving breast milk or formula milk feeding and associated risk factors.

DESIGN

One hundred and sixty-six 13- to 18-month-old infants were recruited from a tertiary hospital in Bangkok, Thailand. Information on feeding practices, demographics, and potential risk factors was collected using a caregiver questionnaire. Carious lesions were identified by visual and tactile examination. The Chi-squared test, Mann-Whitney U test, and logistic regression model were used for statistical analysis.

RESULTS

The prevalence of caries in breast milk- and formula milk-fed infants was 31.8% and 36.0%, respectively, with no statistically significant difference (p = .579). Among all children, having dental plaque deposition on more than one third of the crown (adjusted OR (aOR): 15.11%; 95% CI: 6.11-37.35) and sleeping while milk feeding (aOR: 2.20%; 95%CI: 1.01-4.77) were associated with dental caries. In subgroup analysis, however, sleeping while milk feeding increased caries risk in the formula milk-fed group only (aOR: 2.95%; 95%CI: 1.07-8.12).

CONCLUSIONS

The type of milk feeding was not associated with dental caries, whereas dental plaque and sleeping while milk feeding increased the odds of having dental caries in this population.

Risk Factors of Early Childhood Caries Among Preschool Children in Eastern Saudi Arabia

This study aimed to determine the risk factors of early childhood caries (ECC) among preschool children from eastern Saudi Arabia. In this cross-sectional study, 241 carers and their children from 10 daycares were recruited and asked to complete a questionnaire aimed at assessing their sociodemographic profile and oral health-related behaviors. This was followed by a dental examination of the children by two calibrated dentists. Caries status was recorded using the dmft index. Chi-square and logistic regression tests were used to analyze the data (p < 0.05). The mean dmft of the children was 4.39 (SD ± 4.25). According to logistic regression analysis, children who were bottle-fed between 7 and 12 months (Adjusted Odds Ratio (AOR): 0.110) or breastfed between 13 and 18 months (AOR: 0.028) were less likely to have ECC than those with a prolonged feeding duration (>18 months). Also, those with smoking carers (AOR: 0.176) were less likely to have ECC than those with nonsmoking carers. On the other hand, children who had working carers, mainly mothers, in the education sector (AOR: 11.105), were more likely to have ECC (p < 0.05). The risk factors associated with the presence of ECC among preschool children in eastern Saudi Arabia include the mother's occupation and the carer's smoking status, as well as feeding practices (particularly bottle feeding). These factors can be modified by encouraging carers to completely wean their children (particularly from the bottle) by 18 months of age and advising working mothers to perform tooth brushing for their children in the morning before they go to work and in the evening before the children go to bed.

Breastfeeding and Childhood Dental Caries: Results from a Socially Diverse Birth Cohort Study

Previous studies showed that prolonged breastfeeding increases the risk of caries. However, the observed associations were mainly based on non-European populations, and important confounding and mediating factors like socioeconomic position (SEP) and diet were often neglected. The aim of this study was to investigate the role of breastfeeding and bottle-feeding practices on dental caries during childhood while accounting for SEP, ethnic background, and sugar intake. This study was part of the Generation R Study, a prospective multiethnic cohort study conducted in Rotterdam, The Netherlands. In total, 4,146 children were included in the analyses. Information about feeding practices was derived from delivery reports and questionnaires during infancy. Caries was measured via intraoral photographs at the age of 6 years and defined as decayed, missing, and filled teeth (dmft). Negative binomial hurdle regression analyses were used to study the associations between several infant feeding practices and childhood caries. The prevalence of dental caries at the age of 6 years was 27.9% (n = 1,158). Prolonged breastfeeding (for >12 months) was associated with dental caries (OR 1.35, 95% CI 1.04-1.74) and the number of teeth affected by dental caries (RR 1.27, 95% CI 1.03-1.56). Furthermore, nocturnal bottle-feeding was associated with dental caries (OR 1.52, 95% CI 1.20-1.93). All associations were independent of family SEP, ethnic background, and sugar intake. Results from this Dutch cohort study confirmed the previously observed associations between prolonged breastfeeding and nocturnal bottle-feeding and the increased risk of childhood dental caries, even after proper adjustments for indicators of SEP, ethnic background, and sugar intake. Future studies are encouraged to elaborate further on possible explanations for the observed relationships. Healthcare professionals should be aware and advise caregivers about the potential risk of prolonged breastfeeding on caries development by applying the current recommendations on breastfeeding, oral hygiene, and feeding frequency.

Efficacy of Probiotic Milk for Caries Regression in Preschool Children: A Multicenter Randomized Controlled Trial

This multicenter double-blind randomized controlled trial aimed to determine the efficacy of daily or triweekly consumption of reconstituted milk powder, containing <i>Lactobacillus paracasei</i>SD1, in preschool children for caries prevention. A 6-month intervention was conducted in 487 children (aged 37.6 ± 9.2 months) with ≤4 decayed teeth from 8 childcare centers. Using stratified block randomization, participants were randomly allocated into 3 groups, comprising: (1) daily probiotic, receiving probiotic milk once daily, (2) triweekly probiotic, randomly receiving probiotic milk 3 days a week and the placebo milk for the remaining 4 days, and (3) placebo, receiving milk without probiotics. Each tooth surface was assessed for caries status using the modified Nyvad criteria at baseline (T0), 6 (T6) and 12 (T12) months after T0. Study outcomes were caries transition, including caries progression and regression during the T0–T6, T6–T12 and T0–T12 periods. Negative binomial regression with a generalized linear model was used to estimate the caries outcomes, which were reported as incidence rate ratios (IRRs) and 95% confidence intervals (CIs). At baseline, caries prevalence and mean decayed surfaces were 81.9% and 7.29 ± 7.60, respectively. Three groups were balanced at baseline with an overall dropout rate of 25.2%. After adjusting for age, sex, and the number of noncavitated and cavitated caries at baseline, a decreased caries risk during T0–T6 was shown in both the daily and triweekly probiotic groups (adjusted IRR 0.83, 95% CI 0.72–0.96 in both groups) and during T0–T12 (adjusted IRR 0.84, 95% CI 0.76–0.94, and adjusted IRR 0.86, 95% CI 0.76–0.96, respectively) compared to the placebo group. In contrast, significantly increased regressive surfaces were demonstrated during T0–T6 by adjusted IRR 1.76 (95% CI 1.25–2.48) and 2.01 (95% CI 1.42–2.85) and during T0–T12 by adjusted IRR 1.98 (95% CI 1.50–2.61) and 1.92 (95% CI 1.45–2.55) for the daily and triweekly groups, respectively. In conclusion, probiotic milk consumption either daily or triweekly can modestly prevent new caries, but considerably reverse carious lesions, suggesting that a daily or triweekly dose interval is sufficient to reverse carious lesions.

Associations between Child Snack and Beverage Consumption, Severe Dental Caries, and Malnutrition in Nepal

The global nutrition transition and increased consumption of sugar-sweetened beverages and ultra-processed snacks have contributed to increasing rates of child obesity and dental caries in developing countries. In Nepal, where child malnutrition rates are high, the relationship between malnutrition and dental caries is poorly understood. This cross-sectional study aims to assess this relationship among a convenience sample of 273 children age six months to less than 12 years in three communities in Nepal, using parent/caregiver interviews, child dental exams, and anthropometric measurements. Fisher’s exact test and independent t-tests examined associations between dietary practices and severe caries and between severe caries and malnutrition, respectively. Children consumed sugar-sweetened beverages and processed snacks frequently: 80% consumed tea with sugar, 60% consumed sweet snacks, and 65% consumed processed savory snacks daily. Overall, 74% of children had untreated tooth decay, and 21% exhibited stunting malnutrition, 14% were underweight, and 6% presented wasting. Significant associations were found between daily consumption of sweets and processed snacks with severe caries and between severe caries and poorer nutritional status. These findings underscore the need to incorporate nutrition and oral health promotion and dental treatment into maternal–child health services and schools and to strengthen policies to reduce children’s access to junk food.

Oral Health Birth Cohort Studies: Achievements, Challenges, and Potential

Birth cohorts are those among observational studies that provide understanding of the natural history and causality of diseases since early in life. Discussions during an International Association for Dental Research symposium in London, United Kingdom, in 2018, followed by a workshop in Bangkok, Thailand, in 2019, concluded that there are few birth cohort studies that consider oral health and that a broader discussion on similarities and differences among those studies would be valuable. This article aims to 1) bring together available long-term data of oral health birth cohort studies from the low, middle, and high-income countries worldwide and 2) describe similarities and differences among these studies. This work comprises 15 studies from all 5 continents. The most studied dental conditions and exposures are identified; findings are summarized; and methodological differences and similarities among studies are presented. Methodological strengths and weaknesses are also highlighted. Findings are summarized in 1) the negative impact of detrimental socioeconomic status on oral health changes over time, 2) the role of unfavorable patterns of dental visiting on oral health, 3) associations between general and oral health, 4) nutritional and dietary effects on oral health, and 5) intergenerational influences on oral health. Dental caries and dental visiting patterns have been recorded in all studies. Sources of fluoride exposure have been documented in most of the more recent studies. Despite some methodological differences in the way that the exposures and outcomes were measured, some findings are consistent. Predictive models have been used with caries risk tools, periodontitis occurrence, and permanent dentition orthodontic treatment need. The next steps of the group's work are as follows: 1) establishing a consortium of oral health birth cohort studies, 2) conducting a scoping review, 3) exploring opportunities for pooled data analyses to answer pressing research questions, and 4) promoting and enabling the development of the next generation of oral health researchers.

Correlation of Feeding Practices and Dental Caries among Preschool Children of Jazan, KSA: A Cross-sectional Study

OBJECTIVE

Breastfeeding is integral for the healthy development of infants during the first year of life. The objective of this study was to investigate the feeding practices and their effect on dental health among Saudi children in rural Jazan, the southern region of Saudi Arabia.

MATERIALS AND METHODS

A cross-sectional study was conducted among 330 participants from two villages namely Baish and Abu-Areesh of Jazan Province, Kingdom of Saudi Arabia. Mothers whose children were above 2 years of age agreed for a face-to-face interview to discuss about feeding practices followed for their children. Later, these children underwent a complete dental examination.

RESULTS

In this study, it was found that a majority of mothers, 203 (61.15%) of them breastfed their children for less than a year, 105 (31.8%) of them breastfed for 2 to 4 years, and the remaining 22 (6.6%) of them breastfed for more than 4 years. Two hundred and forty-nine (75.15%) moms reported that they added sugar to milk while feeding and 259 (78.4%) mothers reported using sugar with pacifiers. Increased incidence of caries was seen with a statistically significant difference in children who were fed during sleep (p = 0.038), when the infant's teeth were not brushed after feeding (p = 0.004), and when sugar was added while feeding (p = 0.001).

CONCLUSION

Prevalence of dental caries was high in children who were fed during sleep and also in those kids using pacifiers containing sugar. Oral hygiene practices were also inadequate and positively associated with dental caries. These findings are suggestive of developing general and oral health interventions for children and also educating mothers on appropriate feeding practices.

HOW TO CITE THIS ARTICLE

Dahas ZAH, Khormi HAJ, Vishwanathaiah S, et al. Correlation of Feeding Practices and Dental Caries among Preschool Children of Jazan, KSA: A Cross-sectional Study. Int J Clin Pediatr Dent 2020;13(4):327-331.

Early Childhood Caries and Its Associated Factors among 9- to 18-Month Old Exclusively Breastfed Children in Thailand: A Cross-Sectional Study

Objective: The objective of this study was to investigate the early childhood caries (ECC) status and its risk factors in 9- to 18-month-old exclusively breastfed children in Thailand. Methods: Generally healthy 9- to 18-month-old children who had been exclusively breastfed were recruited. Information on children's oral hygiene practices and breastfeeding behaviors was collected through parental interviews using a questionnaire. Children's oral health status was assessed following the WHO caries diagnostic criteria, modified to record the noncavitated lesions. Multivariate logistic regression analysis was adopted to investigate its association with feeding and oral hygiene practices. Results: In total, 513 mother and child dyads (47% boys) were recruited. The prevalence of ECC was 42.5%. The mean (SD) d1mft and d1mfs scores (d1 included noncavitated and cavitated carious teeth/tooth surfaces) were 1.1 (1.4) and 1.3 (2.0), respectively. Multivariate logistic regression analysis revealed that older children with higher plaque scores (OR = 75.60; 95% CI: 40.19-142.20) who were breastfed to sleep (OR = 2.85; 95% CI: 1.48-5.49) and never had their teeth cleaned (OR = 8.51; 95% CI: 1.53-47.14), had a significantly higher chance of having ECC (p < 0.05). Conclusion: Prevalence of ECC is high among exclusively breastfed children aged 9-18 months in Thailand. ECC prevalence is significantly associated with the age of children, the level of dental plaque, breastfeeding to sleep, and oral cleaning. Among all factors, the level of dental plaque is the most significant factor associated with ECC among breastfed children.

Breastfeeding and early childhood caries. Review of the literature, recommendations, and prevention

CONTEXT

Early childhood caries is a chronic disease that affects a child's general state of health. The question of a link between primary tooth caries and breastfeeding has been addressed for many years, with contradictory results. The concomitant decay of primary teeth, effective establishment, or not, of oral hygiene, and alimentary diversification away from breastfeeding are all confounding factors in this topic. The aim of our study was to analyze the links between breastfeeding and the appearance of caries, as described in the scientific literature and in the recommendations of specialist societies.

METHODS

A review of publications written in English and French was carried out, searching for the terms early childhood caries, decay and breastfeeding, focusing on literature reviews and meta-analyses dating from the past 10 years. The PubMed database of the US National Library of Medicine National Institutes of Health (NBCI) was used. Furthermore, a review of specialist dental and pediatric societies was conducted.

RESULTS

Breastfeeding until the age of 1 year is not associated with an increased risk of dental caries, and may even provide protection compared with feeding with formula milk. By contrast, infants who are breastfed beyond the age of 12 months demonstrate an increased risk of caries. However, the results derive from heterogeneous studies that do not always take into account contradictory factors such as eating habits of the mother or infant (feeding during the night, number of meals per day, eating sweet foods etc.), dental hygiene, or the sociocultural context. Moreover, the most recent recommendations of pediatric and dental societies advise breastfeeding until the age of 2 years, suggesting that this be accompanied by toothbrushing and better nutrition by reducing the frequency and consumption of sugary foods, aimed at helping parents choose prolonged breastfeeding.

CONCLUSION

Extended breastfeeding is a protective factor for childhood caries under 1 year of age. Beyond 1 year, it is difficult to conclude between protection and aggravation of caries because of the multiplicity of confounding factors such as dietary patterns, which vary depending on countries and families, and problems of oral hygiene. In practical terms, when breastfeeding continues beyond 1 year, consultation with a dentist is necessary for examination and preventive advice regarding dietary practices (especially sugar intake), oral hygiene, or supplementary fluoride.

Prolonged Breastfeeding and Dental Caries In Children In the Third Year of Life

PURPOSE

To assess the association between long-term breastfeeding and dental caries in children during the third year of life.

STUDY DESIGN

This retrospective longitudinal study consisted of children who were followed-up by the Maternal and Child Public Oral Health Program. Information regarding socio-economic class, demographic status, daily frequency of sucrose intake, breastfeeding duration and oral hygiene were collected with the aid of a questionnaire. Information on dental caries in the children was collected from dental records. Negative binomial regression models were used to assess the association between breastfeeding duration and dental caries.

RESULTS

We included a total of 325 children in the study. The incidence of dental caries was found to be 12.92%. Even after adjustments, children who were breastfed for a period ≥24 months were more likely to have dental caries, when compared with children who were not breastfed or were breastfed for less than 6 months. Children who had a higher frequency of sucrose intake and those with dental plaque were more likely to have dental caries.

CONCLUSION

In this study, a greater incidence of dental caries was found in children who were breastfed for a period ≥ 24 months..

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

Background

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

Methods

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

Results

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

Conclusion

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

Electronic supplementary material

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

The role of human milk and sucrose on cariogenicity of microcosm biofilms

This study investigated the effect of human milk, alone and associated with sucrose, in the cariogenicity of biofilms in a microcosm biofilm model and compared with the cariogenicity of sucrose and bovine milk. Microcosm biofilms were grown in enamel discs in 24-well plates. Six growth conditions were studied: DMM (chemically defined artificial saliva - negative control), DMM with 1% of sucrose (DMM+s) (positive control), human milk with DMM, human milk with DMM+s, bovine milk with DMM, and bovine milk with DMM+s. After 5 days, the outcome variables surface hardness change (%SHC), microbiological composition of biofilms, and pH of supernatant were analyzed. All groups had significantly lower hardness loss compared to the DMM group with 1% of sucrose. Human and bovine milk associated with sucrose showed higher hardness loss. The supernatant pH values after 6 hours of different treatments were similar for the groups sucrose and human milk associated with sucrose (p>0.05). After 18 hours at rest in pure DMM, an increase in the pH of the supernatant was observed. Higher values of total microorganisms count were found for sucrose and bovine milk groups compared to the group supplemented only by DMM. Bovine milk group showed greater amount of total aciduric microorganisms in comparison to human milk group. Within the limits of this study, it can be infered that both human and cow milks have some cariogenic potential, although differing from sucrose in terms of mineral loss.

Early Childhood Caries

Early childhood caries (ECC) is a common childhood disease with highest prevalence found in poor, socially disadvantaged, and minority groups. The main risk factors for ECC are frequent sugar consumption, lack of tooth brushing, and enamel hypoplasia. Contributory factors include environmental and psychosocial stresses that modify caregiver behaviors. Strategies for prevention include preventing mutans streptococci transmission, restricting dietary sugars, tooth brushing, topical fluoride applications, and early dental examinations. This article provides an overview of ECC based on current understanding of its cause, prevention, and management.

Discordance in Couples Pregnancy Intentions and Breastfeeding Duration: Results from the National Survey of Family Growth 2011-2013

Background

Parental disagreement in pregnancy intention elevates the risk of adverse health events for mother and child. However, research surrounding parental pregnancy intention discrepancies and breastfeeding duration is limited. This study aims to examine the relationship between couple's discordant pregnancy intention and breastfeeding duration.

Methods

Data from the 2011–2013 National Survey of Family Growth was analyzed. Parental pregnancy intention was categorized as “intended by both parents,” “unintended by both parents,” “father intended and mother unintended,” and “father unintended and mother intended.” Breastfeeding duration was categorized as “never breastfed,” “breastfed less than six months,” and “breastfed at least six months.” Multinomial logistic regression, odds ratios, and 95% confidence intervals were calculated.

Results

Couples with a concordant unintended pregnancy were more likely to have a child who was never breastfed or breastfed less than six months compared to couples with a concordant intended pregnancy. Similarly, couples with a discordant pregnancy were more likely to have a child who was never breastfed or breastfed less than six months.

Conclusions

Findings from this study show a relationship between couples' pregnancy intentions and subsequent breastfeeding behaviors. Healthcare professionals should be cognizant of parents' differing opinions surrounding pregnancy intention and the implications on breastfeeding outcomes.

Feeding frequency in infancy and dental caries in childhood: a prospective cohort study

OBJECTIVES

Feeding patterns in infancy are plausible contributors to dental caries later in childhood, yet relatively few cohort studies have examined potential dietary risk factors at this age. This study aimed to investigate the associations between feeding frequency at age 12 months and caries prevalence at age 3 years.

METHODS

In this prospective birth cohort of 345 Brazilian children, all foods and drinks consumed at age 12 months, including bottle-use and breastfeeding, were recorded using two 24-hour infant dietary recalls with mothers. The prevalence of early childhood caries (ECC) and severe ECC (S-ECC) at age 38 months were compared in groups defined according to 12-month feeding frequency, using regression models to adjust for sociodemographic characteristics and total carbohydrate intake.

RESULTS

Independent of other variables, compared with children with infrequent bottle-use and breastfeeding at 12 months, at 38 months the ECC prevalence was 1.8-times higher in children breastfed more than three times/day (P = 0.001), 1.4-times higher in children bottle-fed more than three times/day (P = 0.07) and 1.5-times higher with combined high frequency of bottle and breastfeeding together (P = 0.04), but the association with consumption of other foods or drinks more than five times/day [risk ratio (RR) = 1.2; P = 0.10] was not statistically significant. Prevalence of S-ECC was significantly associated with frequent breastfeeding (RR = 2.4; P < 0.001) and with greater frequency of consumption of other foods or drinks (RR = 1.7, P = 0.001).

CONCLUSIONS

High-frequency feeding in late infancy, including both bottle use and breastfeeding, were positively associated with dental caries in early childhood, suggesting possible early-life targets for caries prevention.

A scoping review of epidemiologic risk factors for pediatric obesity: Implications for future childhood obesity and dental caries prevention research

RESEARCH QUESTIONS

What are the non-modifiable (socioeconomic, genetic) and modifiable factors (physical activity, dietary behaviors) related to childhood (under age 12) obesity? How can this knowledge be applied to oral health professionals' efforts to prevent or manage dental caries in children?

OBJECTIVES

Studies have identified risk factors for childhood obesity. The purpose of this scoping review was to develop a conceptual model to identify non-modifiable and modifiable risk factors for childhood obesity and to illustrate how these findings are relevant in developing interventions aimed at preventing obesity and dental caries in children.

METHODS

The authors searched PubMed and Embase and limited the study to English-language publications. A total of 2,572 studies were identified. After de-duplication, 2,479 studies remained and were downloaded into a citation-management tool. Two authors screened the titles and abstracts for relevance. Two hundred and sixty studies remained and were retrieved for a full-text review, and 80 studies were excluded, resulting in 180 studies included in the scoping review. An inductive content analytic methods was used to organize all statistically significant obesity risk factors into seven domains, which were classified as non-modifiable or modifiable; then a conceptual model of common risk factors associated with childhood obesity and dental caries was developed.

RESULTS

Non-modifiable obesity risk factors include biological and developmental (e.g., genes, developmental conditions, puberty), sociodemographic and household (e.g., race/ethnicity, socioeconomic status, parent education, unemployment), cultural (e.g., degree of acculturation), and community (e.g., neighborhood composition). Modifiable risk factors included behavioral (e.g., diet, physical activity, weight), psychosocial (e.g., maternal stress, family functioning, parenting practices, child temperament), and medical (e.g., parent smoking, maternal health, child health).

CONCLUSIONS

Identifying common risk factors has important implications for future oral health research aimed at preventing childhood obesity and dental caries. Epidemiologic knowledge gleaned from the literature can be used to develop rigorous interventions and programs aimed at preventing these highly prevalent diseases and improving health outcomes for children.