A CPI ainda é considerada um sério problema de saúde bucal. A identificação do risco ao desenvolvimento à cárie em criança baseia-se em informações sobre uma combinação de fatores sóciodemográfico, dietético, higiene bucal e classe social. Sabe-se que estudos epidemiológicos são necessários para se obter dados, a fim de se planejar, executar e avaliar de forma melhor os serviços de atenção odontológica baseada em promoção de saúde. A elaboração de um programa preventivo voltado para a população pré-escolar é de fundamental importância, visto que, são poucos os estudos voltados para esta faixa etária. Portanto, este trabalho, teve como objetivo avaliar clinicamente a saúde bucal de 447 pré-escolares (0 a 71 meses de idade), dos Municípios de Alfenas e Areado MG, pertencentes a escolas públicas e privadas, com e sem assistência odontológica através dos índices de cárie ceos, de biofilme visível (IPV) e, de sangramento gengival (ISG). Além disso, foram coletados os dados indicadores de risco à cárie da amostra envolvida através da aplicação de um questionário. Houve um maior número de crianças na rede pública. Observou-se o fenômeno da polarização e o predomínio de CPI na região posterior. O ISG foi igual a 0 para os dois municípios. O teste t de Student mostrou que o ceos (p=0,0326), e o IPV (0,0000) entre os dois municípios foram significantes. O IPV entre as crianças com e sem assistência odontológica (p=0,0000) e entre as crianças de escolas públicas e privadas de Areado (p=0,023) foram significantes. O teste do qui-quadrado mostrou que o gênero masculino (p=0,00529) e a freqüência das visitas ao Cirurgião Dentista (p=0,0000) influenciaram a experiência de CPI significantemente. A Análise de Regressão Linear Múltipla, com um p=0,000 e R2=26%, mostrou significância entre as variáveis independentes: gênero masculino (p=0,0013), freqüência de escovação (p=0,0000), uso do fio dental (p=0,0485), presença de fumante (p=0,0020) e, nível sócioeconônico (p=0,0187), com a variável dependente (CPI). Para a amostra de 37 a 71 meses dos dois municípios juntos, de acordo com o ceos, observou-se que não houve influência a presença de CPI anterior na experiência de CPI posterior encontrada. / ECC (Early Childhood Caries) is still considered a serious oral health problem. A child caries development risk is identified based on a combination of factors as social-demographic, dietetic, oral hygiene and social class status. Its known that epidemiological studies are necessary to better plan, execute and evaluate services related to deontological health promotion. The elaboration of a preventive program, targeted for preschool is very important as little studies are dedicated to this population. Thus, this work aimed to clinically evaluate the oral health of 447 preschool (from 0 to 71 months old), in the towns of Alfenas and Areado/MG, from public and private schools, with and without deontological assistance. Study was based on dental caries (DMFS), visible plaque (VPI) and gingival bleeding (GBI) indexes. Besides, data collection on caries risk indicators was obtained through a questionary applied to the involved sample. There was a higher number of children from public schools. Polarization phenomenon and the predominance of ECC in the posterior zone were observed. The GBI was equal to 0 for both towns. The t-Student test showed that the dmfs (p=0,0,26) and the VPI (p=0,0000) between the two towns, were significant. In Areado, the VPI among children with and without dental assistance (p=0,0000) and among children from public and private schools (p=0,023), were also significant. The chi-square test showed that male gender (p=0,00529) and the frequency of visits to the dentist (p=0,0000) significantly influenced the ECC experience. The Multiple Linear Regression Analysis with p=0,000 and R² = 26%, was significant between the dependent variable (ECC) and independent variables: male gender (p=0,0013), dental brushing frequency (p=0,0000), dental floss usage (p=0,0485), presence of smokers (p=0,0020) and, social-economic status (p=0,0187). Based on sample analysis of a children group from 37 to 71 months of age, for both towns together, according to DMFS, the presence of ECC in the anterior zone did not influenced the ECC in the posterior zone experience.

No description available.

Introduction: Early Childhood Caries (ECC) is a serious public health concern globally especially in developing countries like South Africa. The main source from which infants acquire the causative bacteria - Mutans Streptococci (MS) is their mothers. The mothers with high levels of MS have a greater chance of transmitting the bacteria, particularly if they are involved in practices such as tasting the infant’s food and/or sharing eating utensils. Current research indicates that dental public health programmes fail to prevent ECC because of late intervention. Objective: This study sought to determine the existing knowledge, attitudes and perceptions (KAP) of pregnant women about ECC in a population in Tshwane district, Gauteng province, South Africa and to compare these KAP across socio-economic groups (SES). Methodology: A cross-sectional analytical study involving consenting pregnant women recruited from selected private and public antenatal healthcare facilities in the Tshwane District area was conducted. This study involved the use of a validated self-administered structured questionnaire and an oral epidemiological clinical examination (modified by WHO Oral Health Assessment 1997 Guidelines). One calibrated examiner using a dental explorer and a mouth mirror under natural light carried out the oral examination. Data analysis included descriptive statistics, principal component analysis to obtain a composite score for participant’s attitude towards ECC; and chi-square and independent student’s T-test to compare different groups. Significance level was set at p<0.05. Results: Response rate was 88.9% (n=353). Respondents’ age ranged from 18-44years (Mean age=31years). Only 18.7% of the respondents had complete knowledge of the cause of dental caries i.e. both sugar (diet) and biologic agent (bacterial plaque) whilst over half of the respondents (55.5%) mentioned only one factor. The participants’ knowledge of the cause of ECC was significantly associated with SES. A few mothers-to-be (13.9%) believed in the caries transmission from mother to child. Reported mean age for the child’s first dental visit was 2 years and 8 months. Only a quarter of respondents received oral health education for their unborn child during the antenatal visits. The majority of the pregnant women (93.8%) expressed the desire to receive information during the antenatal visit. The participants’ attitudes towards ECC was significantly associated with SES. The caries prevalence of the pregnant women was high at 64.3%, with mean DMFT of 2.97(SD 3.20). High participant DMFT was significantly associated with reports of ‘rotten teeth’ in their other children. Only 19.3% mothers-to-be had visited a dental care provider in the last 6-months. Conclusion: The knowledge of the pregnant women studied on ECC is incomplete and limited, while their attitudes and perceptions towards ECC was satisfactory. Therefore there is a need for the integration of oral health education with maternal and child health activities in both antenatal and post-natal clinics. There is a need for the oral health professionals to collaborate with other health works to reduce the prevalence of ECC. / Dissertation (MSc Dent)--University of Pretoria, 2019. / Community Dentistry / MSc Dent / Unrestricted

Early Childhood Caries (ECC) is a burden worldwide which has a negative impact on children’s wellbeing and affects aesthetics, speech and mastication. It may lead to loss of space, creating problems that are difficult and expensive to manage in future. The International Association of Paediatric Dentistry (IAPD) declared that more than 600 million children worldwide are affected by ECC. Caries is a multifactorial disease and frequent excessive sugar consumption is noted as a major risk factor in the development of caries. It also contributes to other non-communicable diseases (NCDs) such as diabetes, obesity and cardiovascular disease. The well-established link between dental caries and dietary sugar, specifically sucrose, can be explained due to the fact that it can be fermented by microorganisms. The use of sugar substitutes may be justified as an effective way to prevent dental caries by modifying the metabolism of microorganisms which will lead to a reduction in lactic acid production in the mouth. This study explored the cariogenic potential of sugar substitutes. The aim of the study was to determine and compare the cariogenic potential of commercially available sugar substitutes namely: xylitol, erythritol and stevia. The data collected could be useful in finding a suitable substitute for sucrose, one of the main causative factors of ECC. A total of 52 enamel slabs were prepared from the surfaces of extracted primary teeth and placed in growth media before being inoculated with Streptococcus mutans (S. mutans). The enamel slabs and growth media were used to determine the Colony Forming Units (CFUs) of S. mutans after exposure to xylitol, erythritol and stevia and to determine the acid production of S. mutans in the presence of these sugar substitutes by measuring the acidity (pH) of the growth media. Biofilm formation in the presence of sucrose, xylitol, erythritol and stevia was confirmed by means of Scanning Electron Microscopy (SEM). Considering the CFUs, pH and SEM analysis, this study suggests that xylitol, erythritol and stevia are all less cariogenic alternatives to sucrose. Stevia has been shown to have the lowest cariogenic potential, followed by erythritol and then xylitol. These substitutes should however be used with caution as they still produced a drop in pH close to the critical demineralization level. From the literature studied, it is clear that ECC is a preventable disease. It is the dental professional’s duty to raise awareness with parents, caregivers, other health care professionals and all relevant stakeholders. Parents and patients should be educated to limit sugar intake and to substitute sugar with healthier alternatives such as xylitol, erythritol or stevia, which all proved to be less cariogenic than sucrose. / Dissertation (MSc Dent)--University of Pretoria, 2020. / Community Dentistry / MSc Dent / Unrestricted

No description available.

OBJECTIVES: Despite continued efforts to decrease environmental lead exposure, it remains a public health concern in the U.S. The aim of this study was to investigate the influence of lead exposure on dental caries risk among different populations. METHODS: We used data from Detroit Dental Health Project (DDHP), a cohort study of a representative sample of low-income African–American families in Detroit, Michigan, to investigate the influence of lead toxicity on dental caries risk among children, and to assess the effect of blood lead level on the caries experience among their caregivers. Data from Dental Longitudinal Study (DLS), a closed-panel prospective cohort study of oral health and aging, was used to assess the cross-sectional and longitudinal relationships between bone lead level as a cumulative measure of lead exposure and dental caries among older men. The outcome measure for cross-sectional analyses was dmfs/DMFS, which is the number of decayed surfaces, missing, and filled surfaces for each subject. Then adjusted new dmfs/DMFS increments were used for the longitudinal analyses. Descriptive and bivariate analyses were conducted on dental caries outcome by lead biomarkers. Multiple regression and GEE models were conducted controlling for confounding. RESULTS: History of lead toxicity (≥ 10µg/dl) and children’s caries risk was significantly associated in both cross-sectional analysis (PR = 1.50, p-value=0.003) and longitudinal analysis (IRR= 1.36, p-value=0.02). These associations were independent of confounding factors such as age, brushing frequency, soda consumption, income, and child and caregiver’s caries experience. On other hand, no significant associations were found between blood lead level and dental caries experience among African American adults (β=2.3, p-value=0.5), nor between high tibia/patella lead level and dental caries incident among older adult (β=0.1, p-value=0.7 for tibia, and β=0.3, p-value=0.1 for patella) . CONCLUSION: The results suggest that children with a history of lead toxicity are at a higher risk of developing dental caries compared to other children. However, there is no significant association between lead exposure and dental caries among adults. Therefore, children with a history of lead toxicity should be given special consideration in caries risk assessment and caries prevention programs. / 2019-09-26T00:00:00Z

No description available.

Fast jedes Kind wird von Geburt an gestillt. Es ist bekannt, dass in der Muttermilch nicht nur Nähr- und Mineralstoffe enthalten sind, sondern auch bioaktive Substanzen. Diese sind sehr wichtig für das Kind, da sie dessen Entwicklung unterstützen. Neben bekannten positiven Einflüssen auf die Entwicklung des Immunsystems werden zunehmend weitere Effekte auf das Kind untersucht. Von allen Effekten scheint der mögliche Einfluss auf Karies als einziger negativer Aspekt identifizierbar zu sein. Da Karies eine multifaktorielle Erkrankung ist, ist dieser Effekt aber nicht leicht darstellbar. Studienergebnisse mit einer schlechten Adjustierung nach Störfaktoren führten in den letzten Jahren zu sehr widersprüchlichen Ergebnissen. Damit nahm die Unsicherheit darüber zu, wie lange ein Kind ohne erhöhtes Kariesrisiko stillbar ist. Stillen kann ausschließlich erfolgen und dann partiell fortgeführt werden, indem zusätzlich feste Nahrung zugeführt wird. Beim partiellen Stillen kann der Anteil an Nahrung und Milch variieren, hier sind dann Faktoren wie Stillfrequenz und nächtliches Stillen maßgeblich. So wurde postuliert, dass bereits eine Stilldauer von weniger als 12 Monaten zu einem erhöhten Kariesrisiko führen kann, wenn partielles Stillen – parallel zu fester Nahrung – hochfrequent praktiziert wird. Andere Studien fanden ein erhöhtes Kariesrisiko erst ab einer Stilldauer von mehr als 12 Monaten. Viele Studien kamen auch zu dem Schluss, dass Stillen keinen Effekt auf die Kariesentwicklung hat. Ziel der Studie war es, den Zusammenhang zwischen Stillen und Karies aufzuzeigen, da die Untersuchung dieses Zusammenhangs von enormer epidemiologischer Bedeutung ist. Physiologisches Stillen gilt dabei hypothetisch als ein vor Karies schützender Faktor. Der Fokus lag in der Untersuchung darauf, ob ausschließliches Stillen eventuell karies-protektive Effekte bringt, bevor zusätzliche Nahrung eingeführt wird. Dabei erfolgte eine Adjustierung nach wichtigen Störgrößen wie SES (sozioökonomischer Status), Alter, BMI (Body Mass Index) und Mundhygiene. Im Zeitraum von 2011 bis 2014 wurden im Rahmen der LIFE-Child Studie 2.684 Kinder aus Leipzig und Umgebung untersucht. Die Probanden wurden umfassend befragt (über die Eltern) sowie medizinisch und zahnärztlich untersucht. In die Studie eingeschlossen wurden Kinder im Alter von 1 bis 5 Jahren, für die auswertbare Daten vorlagen. Es resultierte ein Probandenpool von 597 Kindern (1 bis 5 Jahre), respektive 297 Kindern (2 bis 5 Jahre) im Rahmen einer Sensitivitätsanalyse. Die Karieshäufigkeit in der Stichprobe betrug 9,9% (n=59/597), der mittlere dmf-t-Index ± SD (Standardabweichung) war 0,27 ± 1,1. Fast alle Kinder (95%) wurden wenigstens kurzzeitig gestillt, die Dauer von ausschließlichem/partiellem Stillen (± SD) betrug im Mittel 4,5 ± 4,7 bzw. 9,3 ± 7,7 Monate. Kinder aus Familien mit niedrigem SES wurden signifikant kürzer gestillt (1,2 Monate weniger für ausschließliches und 3,3 Monate weniger für partielles Stillen, p<0,05). In den bivariaten Analysen gab es einen Schutz des Stillens (6 bis 12 Monate) vor Karies (Odds Ratio [OR] = 0,5; 95% Konfidenzintervall [KI:] 0,3-0,9), in den multivariablen Analysen spielte Stillen aber keine Rolle mehr, hier waren Plaque (OR = 9,8; 95% KI: 5,1-18,8), niedriger SES (OR = 2,3; 95% KI: 1,0-5,3) sowie Alter (OR = 2,0; 95% KI: 1,5-2,6) signifikante Einflussfaktoren. Ein kieferorthopädischer Befund oder ein erhöhter BMI-Wert hatten keinen Einfluss auf die Kariesentwicklung. Ab einem Alter von 12 Monaten werden Effekte des Stillens auf das Kariesrisiko von anderen Faktoren wie SES, Mundhygiene oder Ernährungsfaktoren stark überlagert. Aufgrund der geringen Probandenanzahl von über 12 Monaten partiell gestillten Kindern war anhand der Studiendaten daher keine Aussage über das Risiko des Stillens bei einer verlängerten Stilldauer möglich. Schlussfolgernd ergibt sich, dass schlechte Mundhygiene, niedriger SES und das Alter des Kindes Risikofaktoren für ECC in dieser Studie sind. Die Dauer von ausschließlichem/ partiellem Stillen beeinflusste dagegen das Vorkommen von kavitierender Karies in der untersuchten Kohorte nicht signifikant. Eine Risikoerhöhung für kavitierende Karies im Rahmen des physiologischen Stillens bis 12 Monate kann also definitiv ausgeschlossen werden.:I Inhaltsverzeichnis I II Abkürzungsverzeichnis III III Abbildungsverzeichnis IV IV Tabellenverzeichnis V 1. Einleitung 1 1.1 Definition und Einordnung der ECC in die Weltgesundheit 1 1.2 Soziodemografische Risikofaktoren für ECC 3 1.2.1 Sozioökonomischer Status (SES) 3 1.2.2 Alter 5 1.2.3 Biofilmkontrolle 6 1.2.4 Fluorid 9 1.3 Einfluss des Stillens auf die Gesundheit 11 1.3.1 Bedeutung und Zusammensetzung der Muttermilch 11 1.3.2 Einfluss auf die allgemeine Gesundheit 15 1.3.2 Einfluss auf die orale Gesundheit 18 2. Zielstellung 22 3. Materialien und Methoden 23 3.1 Studiendesign 23 3.2 Studienpopulation 23 3.3 Untersuchungsablauf 24 3.4 Zahnärztliche Untersuchung 26 3.5 Einflussvariablen und Zielgrößen 27 3.5.1 Soziodemografie 27 3.5.2 Body-Mass-Index 30 3.5.3 Karies 32 3.5.4 Zahn- und Kieferfehlstellungen 33 3.5.5 Mundhygiene 35 3.5.6 Stilldauer und -modus 35 3.6 Statistische Analyse 36 4. Ergebnisse 37 4.1 Ergebnisse für Probanden von 1 bis 5 Jahren 37 4.1.1 Beschreibung der Stichprobe 37 4.1.2 Bivariate Analysen 38 4.1.3 Multivariate Analyse des Risikofaktors Stillen für ECC 41 4.2 Sensitivitätsanalyse: Probanden von 2 bis 5 Jahren 42 4.2.1 Beschreibung der Stichprobe 42 4.2.2 Bivariate Analysen 42 4.2.3 Multivariate Analyse des Risikofaktors Stillen für ECC 46 5. Diskussion 47 5.1 Diskussion der Ergebnisse 47 5.2 Diskussion der Methodik 51 6. Schlussfolgerungen 55 7. Zusammenfassung der Arbeit 56 8. Literaturverzeichnis 59 9. Selbstständigkeitserklärung 73 10. Lebenslauf 74 11. Publikation 75 12. Danksagungen 1

Background: Early Childhood Caries (ECC) is one of the most common chronic illnesses among young children, affecting around 23% of children 2-5 years old, leading to pain, discomfort, and poor quality of life. It is a multi-factorial disease that develops through the combined effects of bacteria, tooth morphology, fermentable carbohydrates, time, and various social factors. Several studies have investigated the associations between dental caries and non-traditional factors acquired during the first years of life including; mode of delivery, breastfeeding, and Environmental Tobacco Smoke (ETS). However, the literature on these associations has been inconsistent. Objective: To investigate the unadjusted and adjusted associations between the presence of Early Childhood Caries (ECC) and Severe-ECC (S-ECC), and three non-traditional factors: breastfeeding, mode of delivery, and ETS, among children 1-5 years old. Methods: A cross-sectional design was employed, and a sample of 112 caregiver/ child dyads was recruited from the ongoing flow of patients at Temple University Maurice H. Kornberg School of Dentistry (TUKSoD). After consent, subjects completed a questionnaire and received a standard intra-oral examination and the American Academy of Pediatric Dentistry (AAPD) Caries-risk Assessment Tool (CAT) by a student doctor. The study was approved by the Temple University Institutional Review Board (Protocol # 23885). Chi-square tests, two-sample t-tests and bivariate logistic regressions were used to assess the unadjusted associations. Two multivariable logistic models were developed for ECC and S-ECC and included demographics, overall CRA, and the three non-traditional risk factors. Results: The prevalence of ECC and S-ECC were 61% and 30%, respectively. The following variables were significant in the unadjusted analysis for both ECC and S-ECC: child’s age, maternal educational attainment, overall AAPD CAT classification, sugary snacks per day, presence of plaque on child’s teeth and ETS. Exposure to ETS was associated with an increased adjusted odds ratio for ECC (aOR=5.39 [95% CI: 1.14-25.33], P=0.033), but not for S-ECC. Furthermore, C-section birth was associated with a decreased adjusted odds ratio for both ECC and S-ECC, respectively (ECC: aOR=0.132 [95% CI: 0.02-0.72], P=0.02; S-ECC: aOR=0.141 [95% CI: 0.026-0.748], P=0.021). With inclusion of the AAPD CAT, demographics, and the three non-traditional factors, the overall model accuracy at predicting ECC was 82.2%. Conclusions and Clinical Relevance: In this study of urban, predominantly African American, and low income children, ECC was found associated with two non-traditional factors, ETS and mode of delivery, suggesting that including them in CRA may improve prediction of future dental caries, and aid in the prevention and treatment of disease. Results from this study support the notion that ECC is a multi-factorial disease, and highlights the importance of adopting oral health education among caregivers. / Clinical Research and Translational Medicine

No description available.