Canadian dentists' awareness and views on early childhood caries and its prevention and management

Introduction

The Canadian Dental Association (CDA) recommends children visit a dentist within 6 months of the eruption of their first tooth or by 12 months of age. The aim of this study was to investigate Canadian dentists' awareness and views on early childhood caries (ECC) and its prevention and management.

Methods

This study analyzed a subset of questions relating to dentists' knowledge of ECC and prevention strategies, from a national survey of general and pediatric dentists, commissioned by the CDA in 2013. Analyses included descriptive, bivariate, and multivariate analyses. A p-value of ≤0.05 was considered significant.

Results

Three thousand two hundred thirty-two out of 14,747 dentists responded (response rate of 21.9%), with 95.1% having heard of ECC. Overall, 60.9% of respondents reported that they were comfortable providing treatment to children with ECC. Significant differences were found between the number of years in practice and whether dentists were or were not comfortable providing prevention (19.5 ± 12.6 years vs. 25.4 ± 12.1 years; p < 0.001) or treatment for patients with ECC (19.1 ± 12.7 years vs. 22.5 ± 12.3 years; p < 0.001). Pediatric dentists (OR = 6.92; 95% CI: 2.57, 18.61), female dentists (OR = 1.13; 95% CI: 1.03, 1.24), dentists practicing in smaller urban areas (OR = 1.17; 95% CI: 1.07, 1.28), and dentists who were aware of the CDA's position on ECC (OR = 1.26; 95% CI: 1.13, 1.41) were more likely to be comfortable providing treatment for children with ECC.

Conclusions

While the majority of Canadian dentists have sufficient knowledge of ECC, not all are comfortable providing oral health care services to children at a young age. It is encouraging however, that most dentists are wanting additional oral health resources designed for education on ECC prevention for parents of young children.

Canadian dentists' views on the first dental visit for children

Introduction

Early dental visits set children on an upward trajectory, toward a lifetime of optimal oral health. The purpose of this study was to analyze data from a survey of Canadian dentists to determine their knowledge, attitudes, and behaviors regarding first dental visits.

Methods

The Canadian Dental Association (CDA) surveyed general and pediatric dentists regarding the timing of the first dental visit. Demographic and practice information was collected. Analyses included descriptive analyses, bivariate analyses, and multiple logistic regression with forward stepwise selection. Significance was set at p ≤ 0.05.

Results

Overall, 3,232 dentists participated. The majority were male (58.5%), general dentists (96.6%), in non-metropolitan areas (50.5%), and practiced for 20.6 ± 12.8 years. The mean age recommended for first visits was 20.4 ± 10.8 months. Only 45.4% of dentists recommended a first visit ≤ 12 months. A majority (59.5%) knew that the correct age recommended for first visits was no later than 12 months. Most dentists who had seen a patient ≤ 12 months before did not typically do so (82.3%). General dentists were 61% less likely to recommend first visits by 12 months (OR = 0.39; 95% CI: 0.16, 0.91). Dentists in Central Canada (OR = 1.83; 95% CI: 1.44, 2.32); dentists who typically saw patients ≤ 12 months (OR = 3.41; 95% CI: 2.41, 4.83); those who echoed the importance of visits by 12 months (OR = 19.3; 95% CI: 8.2, 45.71); dentists with staff that encouraged infant/toddler care (OR = 1.76; 95% CI: 1.34, 2.31); and those who knew official North American recommendations for first visits (OR = 5.28; 95% CI: 4.13, 6.76) were all more likely to recommend first visits by 12 months.

Conclusions

A majority of Canadian dentists did not recommend first visits by 12 months of age, despite it being the CDA's official position. Provider characteristics can influence the age that is recommended for first visits. Findings from this study may inform educational campaigns on early childhood oral health targeted toward dentists.

Dental caries and vitamin D status in children in Asia

Dental caries and vitamin D inadequacy are known to affect children worldwide. Vitamin D has a vital role in tooth formation. There is growing evidence linking suboptimal serum vitamin D level with dental caries in children. This paper reviews the literature on both the prevalence of dental caries and of vitamin D deficiency in children in four Asian regions, discusses their associated risk factors, and reviews the global evidence on the association between dental caries and vitamin D in children. Caries prevalence in children ranged from 40% to 97% in Eastern Asia, 38-73.7% in Southern Asia, and 26.5-74.7% in Western Asian countries. Moreover, a higher prevalence of vitamin D deficiency in Asian children was identified, even in countries in equatorial regions, ranging from 2.8% to 65.3% in Eastern Asia, 5-66.7% in Southern Asia, 4-45.5% in Western Asia and 38.1-78.7% in Central Asian countries. Obesity, age, female gender, higher latitude, season, darker skin pigmentation, sunlight protection behaviors, less sunlight exposure and low intake of food containing vitamin D were important factors associated with lower serum vitamin D in Asia. Suboptimal vitamin D level in children may be a significant risk factor for dental caries, and requires further research to ascertain such an association in children in Asia, as well as to understand its exact influence on caries risk and development.