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

Magister Scientiae Dentium - MSc(Dent) / AIM:The aim of this study was to review the data available from the Department of Health(DOH), on pre-school paediatric patients treated under Dental General Anaesthesia(DGA), at public health facilities in the Western Cape (WC) in order to ascertain the type and nature of treatment provided.METHODOLOGY:This retrospective descriptive study reviewed the records on the Department of Health(DoH) Database of 16 732 pre-school patients treated under dental general anaesthesia in the period 1 January 2005 until 31 December 2007. A questionnaire was also completed telephonically with 22 dentists from the district dental health clinics.Summary descriptive statistics were calculated from data collected and comparisons were drawn between services available at the health districts and academic hospitals.RESULTS:Of the 58 255 procedures recorded for pre-school patients in the district health clinics in the Western Cape, 99.94% were for extractions provided and 0.5% for restorations.The average number of teeth extracted was 10.4 (SD ±3.9).The average rate of DGA per 1000 of the population was 1.06. Only 9% (2) of dentists at district clinics reported that pre-DGA prevention was provided and 5% (1) reported including post-DGA prevention. The Academic Hospital at Tygerberg Oral Health Centre was the only facility in the Western Cape that provided comprehensive dental treatment for pre-school patients which included restorations, extractions, pre and post DGA prevention. Red Cross Children’s Hospital provided treatment for pre-school patients under DGA that included extractions, pre- and post DGA, but no restorative treatment. CONCLUSION:The demand for DGA in pre-school patients in the WC was high. The lack of prevention associated with DGA in the public health service is the most likely reason the retreatment rate under DGA was reported by dentists as being 77%. There was an absence of protocol regarding DGA for pre-school patients in the public health service.RECOMMENDATIONS:Guidelines formulated were recommended for use in the public service for pre-school patients being treated under DGA and includes the provision of preventive interventions such as regular topical fluoride applications, oral hygiene instruction and dietary advice.