Purpose: This was a pilot study to assess the impact of a preventive strategy following full-mouth dental rehabilitation (FMDR) under general anesthesia in children with early childhood dental caries. Methods: Sixty-six patients completed FMDR and were included in the analysis. At the consultation visit, caries risk assessment (CRA) and dental exam information were recorded, and caregivers completed an oral health knowledge (OHK) questionnaire. Patients returned for a post-surgery and recall visit. Caregivers received oral hygiene instructions in a motivational-interviewing style. Results:At the consultation visit all patients were high risk. At the post-surgery visit, only 47% remained high risk (chi-square P Conclusions: Preliminary data demonstrates that the preventive strategy is effective in reducing CRA level in children following FMDR.

Purpose: The purpose was to determine differences in serum vitamin D, parathyroid hormone (PTH), and calcium levels between patients with early childhood caries (ECC) and patients without dental decay. Materials and Methods: Serum vitamin D, PTH, and calcium levels were obtained from 30 children without dental decay who acted as controls and 60 children with ECC. A questionnaire was filled out by the parent/guardian of each participant consisting of questions regarding medical and dental history, exposure to sources of vitamin D and demographic information. Results: The difference in the vitamin D levels of the participants was most strongly associated with race. African American participants demonstrated lower levels of vitamin D than non-African Americans. After adjusting for race- related differences there was no significant difference in the Vitamin D levels in the ECC cases and the healthy controls. Conclusions: The results of this study suggest that vitamin D levels, at least among non-African Americans, are unrelated to caries development. Future research in this area must control for important confounding factors such as skin pigmentation, season of measurement of serum vitamin D, sun exposure, fluoride exposure, water fluoridation status and tooth brushing in order to allow for vitamin D levels to be better tested against caries experience.

Purpose: The purpose of this study is to examine the social determinants of CHIP (Child Health Investment Partnership) of Roanoke Valley children who participated in the preventive oral health program compared to those who did not. Methods: This is a retrospective cohort study of children (n=2,425) enrolled in CHIP of Roanoke Valley from September 2008-September 2014. Bivariate analysis and multivariable logistic regression models were used to compare age, gender, race, locality, parents’ education level, age at enrollment, and length of enrollment for oral health program participants versus those who did not participate. Results: Children who were Hispanic as well as children who enrolled in CHIP at an earlier age were more likely to enroll in the oral health program. Conclusions: By focusing on enrolling children at earlier ages, there is the potential to increase the use of dental care to match the recommended periodicity of dental care for young children.

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.

A Cárie Precoce na Infância ou Early Childhood Caries – ECC, caracteriza-se como um tipo peculiar de cárie, de desenvolvimento rápido que afeta a dentição decídua, podendo levar à dor, infecção e perda precoce do elemento dentário. Em estágios avançados, pode ocasionar sérias disfunções, seja na mastigação, fonação, respiração e/ou articulação causando danos para a saúde geral da criança, prejudicando, assim, seu crescimento e desenvolvimento. Este estudo tem como objetivo geral analisar a produção de conhecimento sobre cárie precoce na infância e verificar sua aplicabilidade em programas específicos, buscando melhorr sua prevenção. Através de busca sistematizada selecionaram-se, nas bases de dados MEDLINE, LILACS, BBO e DEDALUS, 53 artigos de Odontologia publicados em 23 periódicos nacionais e internacionais, no período de 1962 a 1999, que tratam do tema ECC, prevenção e promoção da saúde. Analisaram-se os resultados, buscando nos discursos o sentido que trazem e o que desencadeiam, tomando por referência os conceitos de vulnerabilidade e promoção da saúde. Os artigos selecionados agruparam-se em três temas: Fisiopatologia, Epidemiologia, Medidas Preventivas e de Promoção da Saúde. Verificou-se que a maioria dos programas preventivos, coletivos ou individuais, sobre ECC contempla ações preventivas voltadas para mudanças de comportamento, educação alimentar, adequado controle da placa bacteriana e uso sistemático de flúor que, isoladamente, causam pouco impacto naqueles que têm acesso limitado a meios de apoio à saúde. O conceito de vulnerabilidade, permitiu identificar as vulnerabilidades individuais, programáticas e sociais de crianças e mães, ampliando a compreensão dos fatores determinantes da ECC; remetendo-nos a questões éticas, políticas e sociais. Para se ter uma prática transformadora, buscando emancipar as pessoas, é preciso considerar o problema – Prevenção da ECC – de forma mais ampla tomando por base os pressupostos da promoção da saúde, que vão além da prevenção primária. / Early childhood caries – ECC is characterized by a peculiar type of caries which develops fast and affects deciduous dentition. It may lead to pain, infection and the early loss of dental elements. In advanced levels, it may cause serious dysfunction in mastication, phonation, breathing and/or articulation, thus damaging the child’s general health and harming his/her growth and development. This study aims at generally analyzing the production of knowledge on early childhood caries and verifying its applicability in specific programs with the purpose to improve prevention. By means of a systematized search, fifty-three dentistry articles published in 23 national and international periodicals from 1962 to 1999 were selected from the databases MEDLINE, LILACS, BBO and DEDALUS. Such articles concerned ECC, prevention and health promotion. The results were analyzed and the meanings brought by discourse as well as those disclosed by it were searched, taking as reference the concepts of vulnerability and health promotion. The selected articles were grouped into three themes: Physiopathology, Epidemiology, Prevention and Health Promotion Measures and the analysis showed that most of the collective or individual preventive programs on ECC contemplate preventive actions aiming at behavioral change, diet education, adequate control of bacterial plaque and systematic use of fluorine, which have little impact on those who have limited access to means of health support when they are applied isolatedly. The concept of vulnerability enabled to identify children's and mother's individual, programmatic and social vulnerabilities, thus enlarging the understanding of determinant factors of ECC, which led to ethical, political and social questions. In order for transforming practice to be attained as an attempt at emancipating people, it is necessary to consider the problem – ECC prevention – in a broader fashion, based on the assumptions of health promotion, which reach beyond primary prevention.

Objectives: Inadequate maternal vitamin D (25(OH)D) levels during pregnancy may affect primary tooth calcification predisposing enamel hypoplasia (EH), a risk factor for Early Childhood Caries (ECC). The purpose of the study was to determine the relationship between 25(OH)D status of expectant mothers and the incidence of EH and ECC among their infants. Methods: This prospective study recruited expectant mothers during their second trimester of pregnancy. A prenatal questionnaire was completed and serum sample drawn for a 25(OH)D assay. Infant dental exams, scheduled at approximately 12 months of age, determined EH and ECC, at which time the mother completed a second questionnaire. The dental examiner was blinded to each mother's prenatal vitamin D status. Results: 207 women, 90% of whom self-declared Aboriginal heritage, were enrolled at a mean age of 19.0 ± 4.7 years. The mean serum 25(OH)D was 48.1 ± 24.4 nmol/L. 35% had levels ≤ 35 nmol/L, a formerly-defined threshold of deficiency. Only 10% of women had concentrations ≥ 80 nmol/L, denoting adequacy. 135 infants were examined at 16.1 ± 7.4 months of age. EH was identified in 22% of infants, 23% had ECC and (36% ECC when white spot lesions were included). Mothers of children with EH had lower mean serum 25(OH)D concentrations during pregnancy than mothers of children without EH (43.2 ± 21.1 vs. 51.4 ± 27.4 nmol/L, p=.072). Mothers of children with ECC had lower 25(OH)D levels than mothers whose children were caries-free (41.4 ± 20.4 vs. 52.4 ± 27.4 nmol/L, p=.045). The rate of untreated decay was inversely related with maternal vitamin D concentrations (p<.001). Infants with EH were significantly more likely to have ECC (p<.001). Logistic regression identified low maternal calcium levels (p=.034), not having heard of vitamin D (p=.036), and not using margarine daily (p=.024) as being significantly associated with EH in the primary dentition of infants. Backwards logistic regression revealed that EH (p<.001), infant age (p=.002), and lower 25(OH)D levels during pregnancy (p=.019) were significantly associated with ECC. Conclusions: This study shows for the first time that maternal vitamin-D levels may influence primary dentition and the development of ECC in their babies.

Objectives: Inadequate maternal vitamin D (25(OH)D) levels during pregnancy may affect primary tooth calcification predisposing enamel hypoplasia (EH), a risk factor for Early Childhood Caries (ECC). The purpose of the study was to determine the relationship between 25(OH)D status of expectant mothers and the incidence of EH and ECC among their infants. Methods: This prospective study recruited expectant mothers during their second trimester of pregnancy. A prenatal questionnaire was completed and serum sample drawn for a 25(OH)D assay. Infant dental exams, scheduled at approximately 12 months of age, determined EH and ECC, at which time the mother completed a second questionnaire. The dental examiner was blinded to each mother's prenatal vitamin D status. Results: 207 women, 90% of whom self-declared Aboriginal heritage, were enrolled at a mean age of 19.0 ± 4.7 years. The mean serum 25(OH)D was 48.1 ± 24.4 nmol/L. 35% had levels ≤ 35 nmol/L, a formerly-defined threshold of deficiency. Only 10% of women had concentrations ≥ 80 nmol/L, denoting adequacy. 135 infants were examined at 16.1 ± 7.4 months of age. EH was identified in 22% of infants, 23% had ECC and (36% ECC when white spot lesions were included). Mothers of children with EH had lower mean serum 25(OH)D concentrations during pregnancy than mothers of children without EH (43.2 ± 21.1 vs. 51.4 ± 27.4 nmol/L, p=.072). Mothers of children with ECC had lower 25(OH)D levels than mothers whose children were caries-free (41.4 ± 20.4 vs. 52.4 ± 27.4 nmol/L, p=.045). The rate of untreated decay was inversely related with maternal vitamin D concentrations (p<.001). Infants with EH were significantly more likely to have ECC (p<.001). Logistic regression identified low maternal calcium levels (p=.034), not having heard of vitamin D (p=.036), and not using margarine daily (p=.024) as being significantly associated with EH in the primary dentition of infants. Backwards logistic regression revealed that EH (p<.001), infant age (p=.002), and lower 25(OH)D levels during pregnancy (p=.019) were significantly associated with ECC. Conclusions: This study shows for the first time that maternal vitamin-D levels may influence primary dentition and the development of ECC in their babies.

OBJECTIVES: This dissertation was divided into two studies. The aim of the first study was to investigate whether there is an association between diet quality of preschool children and their caregivers. The aim of the second study was to examine the relationship of children diet quality and dental caries risk. METHODS: The study utilized a longitudinal population-based data of a representative sample of low-income African American families in Detroit, Michigan. Analyses were limited to 522 children aged 3-5 years old and their primary caregivers. For caregivers, dietary histories were obtained at wave I using the Block 98.2 food frequency questionnaire. For children, dietary histories were obtained at wave I and wave II using the Block Kids Food Questionnaire. Healthy Eating Index-2005 was used to evaluate overall diet quality. Dental caries in primary teeth were measured by the ICDAS criteria. The mean number of decayed surfaces (noncavitated and cavitated), missing, and filled surfaces for each child was estimated. Statistical analyses were conducted using SAS 9.4 and STATA 14 to account for the complex sampling design. RESULTS: The first study found that the mean total HEI-2005 scores were 57.47 for caregivers at wave I, 56.04 for children at wave I, and 57.39 for children at wave II indicating that the diet quality of this population needs improvement. Significant, positive relationship was found between caregivers-child overall diet quality at wave I (β=0.35; p <0.0001) and wave II (β=0.31; p <0.0001). The second study found that children who had high diet quality or improved their diet quality throughout the study period had significantly lower dental caries incidence compared to those with low diet quality scores (IRR = 0.59 and 0.55, respectively) (CI = 0.36-0.96 and 0.35-0.86 , respectively). CONCLUSION: Our findings suggest that caregiver’s and children’s diet quality are associated. Therefore, caregiver’s diet quality should be considered in efforts to improve diets of their children. Additionally, preschooler children in our study with improved diet quality showed lower caries incidence. These results suggest that strategies and intervention to prevent dental caries among children should focus on improving overall diet quality. / 2018-09-28T00:00:00Z

In a ongoing research project, OMIC (Oral Microbiota in children), a sub study was made toevaluate the use of fluoride, knowledge and attitude among parents of the 200 participatingchildren.The children have been followed since birth and their parents answered questionnaires at 3,18 months and 3 years in the main study. At the 5-year inspection in the main study theparents were asked to fill in another questionnaire for the fluoride sub study.In this study the parents were asked to answer questions about their own and their children’suse of fluoride products and their view of the risk with using these products. Questions abouttoothpaste and tooth brushing were also included.All parents used fluoridated toothpaste and a third also used complementary products. In thisgroup of children there was no difference in caries experience between the ones using nonfluorideagainst fluoride toothpaste. Children who brushed their teeth themselves had morecaries than children who got help from a grown-up.In conclusion the results from our material do not support our hypothesis which is that thelack of information regarding efficacy and safety of fluoride toothpaste over the years and theimpact from social media has resulted in lower use of fluoride toothpaste to children becauseof the impact from the parents.The survey need to be done in a more heterogeneous population for clearer results. It isimportant to remember that parental support is a huge factor to improve oral health inchildren.

A Cárie Precoce na Infância ou Early Childhood Caries – ECC, caracteriza-se como um tipo peculiar de cárie, de desenvolvimento rápido que afeta a dentição decídua, podendo levar à dor, infecção e perda precoce do elemento dentário. Em estágios avançados, pode ocasionar sérias disfunções, seja na mastigação, fonação, respiração e/ou articulação causando danos para a saúde geral da criança, prejudicando, assim, seu crescimento e desenvolvimento. Este estudo tem como objetivo geral analisar a produção de conhecimento sobre cárie precoce na infância e verificar sua aplicabilidade em programas específicos, buscando melhorr sua prevenção. Através de busca sistematizada selecionaram-se, nas bases de dados MEDLINE, LILACS, BBO e DEDALUS, 53 artigos de Odontologia publicados em 23 periódicos nacionais e internacionais, no período de 1962 a 1999, que tratam do tema ECC, prevenção e promoção da saúde. Analisaram-se os resultados, buscando nos discursos o sentido que trazem e o que desencadeiam, tomando por referência os conceitos de vulnerabilidade e promoção da saúde. Os artigos selecionados agruparam-se em três temas: Fisiopatologia, Epidemiologia, Medidas Preventivas e de Promoção da Saúde. Verificou-se que a maioria dos programas preventivos, coletivos ou individuais, sobre ECC contempla ações preventivas voltadas para mudanças de comportamento, educação alimentar, adequado controle da placa bacteriana e uso sistemático de flúor que, isoladamente, causam pouco impacto naqueles que têm acesso limitado a meios de apoio à saúde. O conceito de vulnerabilidade, permitiu identificar as vulnerabilidades individuais, programáticas e sociais de crianças e mães, ampliando a compreensão dos fatores determinantes da ECC; remetendo-nos a questões éticas, políticas e sociais. Para se ter uma prática transformadora, buscando emancipar as pessoas, é preciso considerar o problema – Prevenção da ECC – de forma mais ampla tomando por base os pressupostos da promoção da saúde, que vão além da prevenção primária. / Early childhood caries – ECC is characterized by a peculiar type of caries which develops fast and affects deciduous dentition. It may lead to pain, infection and the early loss of dental elements. In advanced levels, it may cause serious dysfunction in mastication, phonation, breathing and/or articulation, thus damaging the child’s general health and harming his/her growth and development. This study aims at generally analyzing the production of knowledge on early childhood caries and verifying its applicability in specific programs with the purpose to improve prevention. By means of a systematized search, fifty-three dentistry articles published in 23 national and international periodicals from 1962 to 1999 were selected from the databases MEDLINE, LILACS, BBO and DEDALUS. Such articles concerned ECC, prevention and health promotion. The results were analyzed and the meanings brought by discourse as well as those disclosed by it were searched, taking as reference the concepts of vulnerability and health promotion. The selected articles were grouped into three themes: Physiopathology, Epidemiology, Prevention and Health Promotion Measures and the analysis showed that most of the collective or individual preventive programs on ECC contemplate preventive actions aiming at behavioral change, diet education, adequate control of bacterial plaque and systematic use of fluorine, which have little impact on those who have limited access to means of health support when they are applied isolatedly. The concept of vulnerability enabled to identify children's and mother's individual, programmatic and social vulnerabilities, thus enlarging the understanding of determinant factors of ECC, which led to ethical, political and social questions. In order for transforming practice to be attained as an attempt at emancipating people, it is necessary to consider the problem – ECC prevention – in a broader fashion, based on the assumptions of health promotion, which reach beyond primary prevention.