The association between dental caries and television viewing among Chinese adolescents in Guangxi, China

Socio-economic status, psychosocial factors, health behaviours and incidence of dental caries in 12-year-old children living in deprived communities in Manaus, Brazil

OBJECTIVES

This study examines the relationships between socio-economic status, psychosocial factors, health-related behaviours and the incidence of dental caries among 12-year-old schoolchildren living in deprived communities in Manaus, Brazil.

METHODS

A longitudinal study involving 312 children aged 12 years was conducted in the city of Manaus, Brazil. Baseline data including socio-economic status (number of goods, household overcrowding, parents' schooling, family income), psychosocial factors (sense of coherence [SOC-13], social support [Social Support Appraisals questionnaire]) and health-related behaviours (frequency of toothbrushing, sugar consumption, sedentary behaviour) were collected through structured questionnaires. The number of decayed teeth was clinically assessed at baseline and one-year follow-up. A hypothesised model evaluating the direct and indirect pathways between the variables was tested using confirmatory factor analysis and structural equation modelling.

RESULTS

The incidence of dental caries at the one-year follow-up was 25.6%. Sugar consumption (β = 0.103) and sedentary behaviour (β = 0.102) directly predicted the incidence of dental caries. A higher socio-economic status was directly linked with lower sugar consumption (β = -0.243) and higher sedentary behaviour (β = 0.227). Higher social support directly predicted lower sugar consumption (β = -0.114). Lower socio-economic status (β = -0.046) and lower social support (β = -0.026) indirectly predicted the incidence of dental caries via sugar consumption and sedentary behaviour.

CONCLUSIONS

In the population studied, sugar consumption and sedentary behaviour are meaningful predictors of the incidence of dental caries among schoolchildren living in deprived communities. Indirect pathways of lower socio-economic status and low social support with dental caries incidence via sugar consumption and sedentary behaviour were detected. These findings should be considered in oral interventions and oral health care policies to prevent dental caries among children living in deprivation.

CLINICAL SIGNIFICANCE

Social conditions, social support, sedentary behaviour and sugar consumption directly influence dental caries in children.

The association between dental caries and physical activity, physical fitness, and background factors among Finnish male conscripts

Studies on measured physical fitness and oral health are sparse. The aim of this study was to investigate the associations between self-reported physical activity and measured physical fitness and oral health of young men. The study population consisted of 13,564 Finnish male conscripts who had mandatory clinical oral examinations and physical fitness tests at the beginning of military service in 2011. Finally, around 10,800 conscripts had physical fitness test outcomes available and a total of 8552 conscripts answered a computer-based questionnaire on background factors. Decayed Tooth (DT) and Decayed, Missing, or Filled Tooth (DMFT) indices, outcomes of surveys and fitness tests were used in analyses by cross-tabulation and multivariable logistic regression model (odds ratios [OR] with 95% confidence interval [CI]) were calculated. Regularly exercising conscripts had a reduced need for dental restorative treatment than those reporting no physical activity (p < 0.0001). The proportion of participants with sound dentition (DT = 0) increased steadily with increasing physical activity (39.0-59.4%). Good measured physical fitness was a protective factor against increased dental restorative treatment need. A low prevalence of smoking and low use of alcohol and energy drinks were associated with frequent exercise, whereas consumption of sport drinks and snuff use were common among those who exercised frequently. Good measured physical fitness and self-reported physical activity are associated with reduced caries burden. There is a need for information about the harms of tobacco products and the benefits of a healthy diet, even for the increased energy needs of the physically active.

Exposure to screen time and dental neglect

AIM

Dental neglect is the failure of parents to meet a child's basic oral health needs and causes complications. Long screen time, and its health impact, is an important public health issue. This study is aimed at determining whether there is a relationship between screen time of children and parents and dental neglect.

METHODS

Two hundred and fifteen patients were included in this cross-sectional observational study. A questionnaire including questions exploring demographic data, children's life-styles and, screen time of both parents and children. A dental neglect scale was administered to the parents. The children's intraoral examinations were evaluated using the decayed, missing, filled teeth (dmft) and pulp, ulcers, fistula, abscess (pufa) indices.

RESULTS

Multivariable linear regression analysis showed that dental neglect was statistically significantly associated with brushing teeth unsupervised and infrequently, frequent snacking, rarely doing exercise, screen exposure at an early age and presence of dental plaque (P < 0.05). Long screen time was statistically significantly associated with high dmft scores, reflecting poor oral health. It was found that children who did not attend daycare, had statistically significantly longer exposure to screens, compared to those who attended daycare.

CONCLUSIONS

Early exposure to screens and long-term screen use are associated with adverse outcomes pertaining to children's oral health.

Association between Bifidobacterium and Scardovia Wiggsiae and caries-related factors in severe early childhood caries and caries-free Thai children: a quantitative real-time PCR analysis and a questionnaire cross-sectional study

AIMS

To quantitatively identify Bifidobacterium, S. wiggsiae and S. mutans in plaque samples obtained from children with severe-ECC and caries-free groups and to analyze their association with caries-related factors retrieved from the questionnaire in each group.

STUDY DESIGN

To establish the 2 study groups, clinical examination in 122 Thai children, aged 2-5 years, recorded decayed, missing and filled teeth scores (dmft), in addition to plaque and gingival indices. Sixty one children in the caries-free group and 61 in the S-ECC group were identified. A questionnaire was used to assess the parent's attitudes and behavior regarding the child's oral hygiene care and diet.

METHODS

Pooled overnight supra gingival plaque was collected from each child using a sterile toothpick, released in 1 ml of TE buffer, transported on ice to the Laboratory and stored at  - 20 °C. DNA was extracted from the plaque based on enzymatic lysis and quantitative real-time PCR using fluorescent dye (SYBR green) in addition to Agarose gel electrophoresis were performed. All laboratory and retrieved from the questionnaire data per child were recorded and statistically analysed.

RESULTS

S. wiggsiae (p < 0.005) and S. mutans (p < 0.001) were higher in the S-ECC group. Bifidobacterium, S. mutans, and S. wiggsiae were associated with the dmft score and gingival index (p < 0.001). The dmft scores of children who detected only S. mutans were significantly lower than the dmft scores of children who detected two bacteria; S. mutans + S. wiggsiae (p = 0.028), S. mutans + Bifidobacterium (p = 0.026), and three bacteria; S. mutans + Bifidobacterium + S. wiggsiae (p = 0.007). Children who found all three bacteria (Bi + Sm + Sw) had the highest dmft scores, followed by children who had two bacteria (Bi + Sw, or Bi + Sm, or Sw + Sm). The guardians' education levels, occupations, household income, prolonged bottle feeding, taking of water after bottle or breast feeding, eating sugar-coated crackers or bread with sweetened cream, and premature birth were the factors that related to S-ECC.

CONCLUSION

Levels of S. wiggsiae and S. mutans, guardian's education, family economics, prolonged bottle feeding, eating high sugar-containing snacks and premature birth were associated with S-ECC.

Sedentary behavior, unhealthy food consumption and dental caries in 12-year-old schoolchildren: a population-based study

This study analyzed the association between sedentary behavior (SB), unhealthy food consumption, and dental caries amongst 12-year-old schoolchildren. An epidemiological survey was carried out in the five largest cities (> 80,000 inhabitants) of the State of Mato Grosso do Sul, Brazil. Data were collected on decayed, missing and filled teeth index (DMFT), sociodemographic characteristics, SB, unhealthy food consumption, and water fluoridation status. The analysis was based on the theoretical framework established by J Sisson. Structural equation models were performed to test the association of dental caries experience with sociodemographic, contextual, and behavioral factors. The mean DMFT index in the five cities was 1.02 (95%CI: 0.39-1.66). Higher sedentary behavior (more than 2 hours/day) [standardized coefficient (SC) = 0.21 95%CI: 0.07-0.39] and higher unhealthy food consumption (more than 4 times/week) [SC = 0.23 (0.10-0.45)] were associated with higher DMFT index than their counterparts. Also, cities with fluoridated water were associated with lower DMFT index [SC = -0.85 (-1.20--0.50)]. Families who had a per capita income above the poverty line had a direct association with unhealthy food consumption [SC = -0.24 (-0.38--0.11)]. Unhealthy food consumption mediated the association of sedentary behavior on DMFT index [SC=0.07 (0.02-0.13)]. Sensitivity analysis confirmed the findings. Sedentary behavior mediated by unhealthy food consumption had a significant association with dental caries experience. Public policies must address transdisciplinary actions to reduce sedentary behavior and unhealthy food consumption and promote water fluoridation.

Sedentary Behavior Research in the Chinese Population: A Systematic Scoping Review

Background: The negative effects of sedentary behavior (SB) on public health have been extensively documented. A large number of studies have demonstrated that high prevalence of SB is a critical factor of all-cause mortality. Globally, the frequency of SB research has continued to rise, but little is known about SB in the Chinese population. Therefore, this review was conducted to scope the research situation and to fill the gaps related to the effects of SB in the Chinese population. Methods: Using a scoping review based on York methodology, a comprehensive search of published journal articles and grey literature was carried out through 12 databases. The literature research was conducted by two authors in July 2019, and included journal articles that targeted on the Chinese population were published between 1999 and 2019. The two authors screened the records independently and included those research topics related to SB in the Chinese population. Results: The number of included studies increased from 1 to 29 per year during the analyzed period, during which, a remarkable climb happened from 8 in 2013 to 19 in July 2019. Out of the 1303 screened studies, a total of 162 studies (81 English and 81 Chinese journal articles) met the inclusion criteria in this review. Most of the included studies (66.0%) reported the overall estimated prevalence of SB, in which, 43.2% of studies reported the average time of SB, and 40.0% of studies reported the cutoff point of SB. Besides this, 54.9% and 23.5% of studies focused on the outcomes and correlates/determinants of SB, and the proportions of studies based on testing the validation of measurement tools and on interventions were 3.7% and 4.9%, respectively. Nearly all of the reviewed articles used data from cross-sectional studies (75.9%) and longitudinal studies (13.6%), while intervention trials are less developed. The majority of the studies (64.8%) used self-reported surveys, and only 3.7% studies used device-based measurement tools. Furthermore, 35.8% of the included studies were focused on children and adolescents, while only a few studies investigated infants/toddlers and older adults. Both female and male were examined in most studies, and non-clinical populations were investigated in the context of SB in a relatively large number of studies. Conclusions: The number of research articles on SB in the Chinese population published per year has increased year by year, indicating a growing interest in this research area. More studies using population subgroup samples are needed, particularly among infants/toddlers, older adults, and clinical populations. To provide stronger evidence of the determinants and outcomes of SB, longitudinal studies using device-based measures of SB are required.

Severe dental caries is associated with incidence of thinness and overweight among preschool Chinese children

Objective: To examine the association of incidence and baseline prevalence of severe dental caries with incidences of thinness and overweight among pre-school Chinese children.Materials and methods: A longitudinal study design was used. A total of 772 children recruited from 15 kindergartens in Liaoning Province who completed baseline and follow-up assessments were included. The age range of children at baseline was 24.6-71.1 months. BMI-for-age z-score was calculated to estimate incidence of thinness and overweight. Severe dental caries was indicated by pulpal involvement, ulceration, fistula or abscess (pufa). Baseline prevalence of severe caries included children with pufa ≥1, incidence included those who changed from pufa = 0 to ≥1 at follow-up. Logistic regression was constructed to assess the association of baseline prevalence and incidence of severe caries with each of incidence thinness and overweight.Results: Children with incidence of severe caries had higher odds for incidence thinness (OR: 4.08; 95% CI: 1.08, 15.41). Baseline prevalence of severe caries was not significantly associated with incidence thinness. Participants with severe caries at baseline had higher odds for incidence overweight (OR: 2.33; 95% CI: 1.17, 4.63). The relationship between incidence of severe caries and incidence overweight was insignificant.Conclusions: The findings suggest a U-shaped relationship between severe dental caries and both ends of anthropometric measures among pre-school Chinese children. The findings highlight the importance of integrating oral and general health promotion policies. Primary health care providers are encouraged to incorporate dental screening, counselling and referral for treatment for severe caries to promote appropriate growth and overall health of children.

Association of short sleep duration and long media use with caries in school children

BACKGROUND

Individual lifestyle factors are associated with dental caries in children. The aim of this study was to investigate comprehensively the association between dental caries in elementary school children and lifestyle factors of the children and their parents.

METHODS

Children from five elementary schools in Takaoka city, Toyama Prefecture, Japan (1,699: 848 boys, 851 girls, age range 6-12 years) participated in a survey conducted in March 2016. Questions on socioeconomic status (SES) and lifestyle factors in the children and their parents were included. Children who received treatment for three or more dental caries were defined as having many caries. Logistic regression analysis was performed to evaluate whether these factors were associated with the number of caries.

RESULTS

The percentage of children with many caries (≥3) was 38.4%. In univariate analysis, being in 5^th or 6^th grade, frequent snacking, short sleep duration, long hours of media use, paternal smoking, and parental skipping of breakfast were significantly associated with many caries. Lack of affluence was marginally significant. In multivariate analysis, the association of short hours of sleep and long hours of media use remained significant. The adjusted odds ratio (OR) for media use of 1-2 h and more than 2 h were 1.79 (95% confidence interval [CI]: 1.30-2.46) and 2.24 (95% CI: 1.61-3.11) respectively. The adjusted OR for less than 8 h of sleep was 1.49 (95% CI: 1.07-2.06).

CONCLUSIONS

Long duration of media use and short duration of sleep were associated with dental caries. Establishing a healthy lifestyle is necessary for preventing dental caries in children.

The influence of television on the food habits of schoolchildren and its association with dental caries

OBJECTIVES

The consumption of food with a high-sugar content is encouraged by the food industry through television (TV) aimed at children and may be associated with dental caries. This study aims to evaluate the influence of TV on the food habits of schoolchildren aged years and its association with dental caries.

MATERIAL AND METHODS

This was an observational, epidemiological, and cross-sectional study. Five neighborhoods of Belem District were selected, and then two schools from each neighborhood were drawn (one private and one public). All sixth and seventh grade students were selected. Data were extracted from questionnaires completed by schoolchildren and their parents and the decayed, missing, and filled teeth (DMFT/dmft) indices of the schoolchildren. The indices were carried out by three examiners previously calibrated (κ > .80). Logistic regression analysis was performed to investigate the association of variables of study with consumption of cariogenic foods and occurrence of dental caries. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated.

RESULTS

Schoolchildren who watched TV for >90 min were more likely to consume cariogenic foods (OR = 2.38; 95% CI [1.57, 3.60]) and have a DMFT + dmft >1 (OR = 2.10; 95% CI [1.37, 3.26]). Those who consumed cariogenic foods while watching TV were more likely to have DMFT + dmft >1 (OR = 14.75; 95% CI [8.24, 6.40]). Parents who bought foods they saw on TV contributed to a higher consumption of cariogenic foods (OR = 3.29; 95% CI [2.07, 5.24]) and DMFT + dmft >1 (OR = 3.93; 95% CI [2.09, 7.37]) among their children.

CONCLUSIONS

TV can influence the eating habits of schoolchildren aged 10 to 12 and the food purchases of their parents, stimulating the consumption of cariogenic foods and contributing to the development of dental caries.

Maintaining Traditions: A Qualitative Study of Early Childhood Caries Risk and Protective Factors in an Indigenous Community

In lower middle-income economies (LMIE), the nutrition transition from traditional diets to sugary foods and beverages has contributed to widespread early childhood dental caries. This qualitative study explores perceived risk and protective factors, and overall experiences of early childhood nutrition and oral health in indigenous Ecuadorian families participating in a community-based oral health and nutrition intervention. Dental exams of 698 children age 6 months through 6 years determined each child's caries burden. A convenience sample of 18 "outlier" families was identified: low-caries children with ≤2 carious teeth vs. high-caries children with ≥10 carious teeth. Semi-structured in-depth interviews with parents/caregivers explored the child's diet, dental habits, and family factors related to nutrition and oral health. Interviews were transcribed and thematically analyzed using grounded theory. In the high-caries families, proximity to highway and stores, consumption of processed-food, and low parental monitoring of child behavior were identified as risk factors for ECC (early childhood caries). In the low-caries families, protective factors included harvesting and consuming food from the family farm, remote geography, and greater parental monitoring of child behavior. The study results suggest that maintaining traditional family farms and authoritative parenting to avoid processed foods/drinks and ensure tooth brushing could improve early childhood nutrition and oral health.

Relationship between dental caries and metabolic syndrome among 13 998 middle-aged urban Chinese

BACKGROUND

The association between dental caries and metabolic syndrome (MetS) is inconsistent. The aim of the present study was to assess the relationship between dental caries and MetS and its components in a middle-aged Chinese population.

METHODS

A cross-sectional analysis was performed of 13 998 participants aged 45-65 years undergoing a health check during 2013-14. An index variable of decayed, missing, and filled teeth (DMFT) was calculated. Logistic regression was used to estimate odds ratios (ORs) and 95 % confidence intervals (CIs) after adjustment for sex, age, education level, dietary habits, alcohol use, smoking, physical activity, and periodontitis.

RESULTS

Of the 13 998 participants, 6164 had dental caries and 7834 did not; 3571 had MetS, whereas 10 427 did not. Participants with severe caries showed a higher prevalence of MetS, abdominal obesity, elevated blood pressure, dyslipidemia, and hyperglycemia than those with mild or no caries (all P < 0.01). Adjusted ORs for MetS for those with two or more dental caries and those with two or more DMFT were 1.12 (95 % CI 1.14-1.74) and 1.09 (95 % CI, 0.89-1.21), respectively (P _trend  < 0.001). Stratified analysis by individual MetS components showed that caries were associated with MetS among subjects with hyperglycemia (OR 1.14 [95%CI, 0.98-1.34]; P < 0.001). However, there was no significant relationship between caries and abdominal obesity, hypertriglyceridemia, low high-density lipoprotein cholesterol, and elevated blood pressure (adjusted ORs [95 % CIs] 0.98 [0.82-1.16], 1.01 [0.85-1.19], 0.84 [0.70-1.00], and 0.96 [0.86-1.13], respectively; all P > 0.05).

CONCLUSIONS

Dental caries were associated with MetS among middle-aged Chinese in the present study.

The short-term effects of television advertisements of cariogenic foods on children's dietary choices

OBJECTIVE

To investigate the short-term influence of the advertising of cariogenic foods on children's dietary preferences, and the possible moderating effect of several factors on this influence.

METHODS

One-hundred and eighty-three children, 11-12 years of age, were exposed to advertisements showing sugary food and non-food items, in a within-subject counterbalanced design. Their preferences for unhealthy and healthy foods, and their ability to recall or recognise the advertisements, were measured following both sessions. Information on their dietary habits, leisure activities and sociodemographic details were obtained through a questionnaire completed by their parents. Their decayed, missing and filled teeth (DMFT) index, body weight and height were also recorded. A generalised linear mixed model was used to examine the differences in food preferences between experimental conditions, and the associations between children's preferences and the other factors assessed.

RESULTS

Exposure to food advertisements significantly decreased the selection of healthy foods. Children with a higher DMFT index chose a higher percentage of unhealthy foods, and children who spent more time watching television chose an increased number of healthy foods, after their exposure to food advertisements. Regardless of condition, girls selected fewer foods than boys. Children with a higher DMFT index selected more unhealthy foods than children with a lower DMFT index. Obese children chose an increased number of healthy foods than those who were overweight and normal weight.

CONCLUSIONS

Food advertisements can divert, for a short time, children's preference over healthy food choices, and could lead to changes in their eating habits, which may put them at higher risk of dental diseases and obesity.

Digit Sucking Habit and Association with Dental Caries and Oral Hygiene Status of Children Aged 6 Months to 12 Years Resident in Semi-Urban Nigeria

Objectives

Non-nutritive sucking (NNS) is a common behavior in childhood. The association between digit sucking, dental caries and oral health has been studied with inconclusive results. The objectives of this study were to determine the prevalence of, and the association between digit sucking, caries and oral hygiene status of children age six months to 12 years, resident in Ile-Ife, Osun State, Nigeria.

Methods

A cross-sectional study was conducted in Ife Central Local Government Area of Osun State. Data were collected through a household survey using a multi-stage sampling procedure from children between six months and 12 years. Details of each child’s socio-demographic characteristics, digit sucking habits, caries status and oral health status were collected. The association between digit sucking, caries status and oral hygiene status was determined using Chi square and Logistic regression.

Results

The mean age of the 992 study participants was 5.8 ± (3.2) years. The prevalence of digit sucking, caries and poor oral hygiene were 7.2%, 10.5% and 2.4% respectively. The mean dmft score was 0.22 ± (0.80), mean DMFT score was 0.04 ± (0.30) while mean Oral Hygiene Index score was 1.27 ± (0.73). Digit sucking increased the odds of having caries (OR: 1.28; CI: 0.58–2.81) but decreased the odds of having poor oral hygiene (OR: 0.58; CI: 0.34–1.01) insignificantly.

Conclusions

Digit sucking was not a significant predictor of caries and oral hygiene status, although the odds of having caries increased while the odds of having poor oral hygiene decreased with digit sucking.