Thesis (DR. P.H.)--University of Michigan.

Thesis (DR. P.H.)--University of Michigan.

Thesis (M. D. S.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 78-95).

Thesis (M.S.)--University of Michigan, 2002. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2002. / Includes bibliographical references.

published_or_final_version / Dentistry / Master / Master of Dental Surgery

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Introduction: Early childhood caries (ECC) is common among Hong Kong preschool children. It is a disease caused by dental plaque bacteria and may be controlled by good toothbrushing habits. However, preschool children are often too young to perform effective tothbrushing, and therefore parental toothbrushing is recommended for them. The oral hygiene status of Hong Kong preschool children is usually not good and parental toothbrushing is not common. Fluoride varnish is effective in preventing dental caries in school children and adolescents but its effectiveness in preventing dental caries in preschool children is still inconclusive. Objective: To investigate the effectiveness of hands-on training in parental toothbrushing, with or without semi-annual applications of a 5% sodium fluoride varnish in preventing ECC. Methods: Children aged 8-23 months were recruited and randomly allocated to one of three groups: Group 1 - positive control, a brief oral health education to parents; Group 2 - oral health education to parents, hands-on training in parental toothbrushing, and home visits every six months to reinforce parental toothbrushing; Group 3 - application of a 5% sodium fluoride varnish onto the child’s teeth during home visits in addition to the intervention provided to Group 2. Clinical examination of the children and a questionnaire survey of the parents were conducted at baseline. Interventions for the children and parents were delivered according to their group assignment. Evaluation of the main outcome, development of new dental caries, was conducted after 24 months through clinical examination. Information on children’s oral health-related behaviors and parents’ knowledge of and attitude towards their child’s oral health was collected using a questionnaire at the 24-month follow-up. Results: Out of the 450 children recruited at baseline, 415 (92%) children were examined after 24 months and all examined children’s parents completed the questionnaire. Including both noncavitated and cavitated carious lesions, the incidences of ECC in Gp1 to Gp3 were 11.9%, 11.8%, and 17.5%, respectively (p > 0.05) and; the mean dmfs scores in Gp1 to Gp3 were 0.3, 0.2, and 0.4, respectively (p > 0.05). Proportions of parents who practiced parental toothbrushing twice a day were 62.7%, 60.4%, and 65.7% in Gp1, Gp2, and Gp3, respectively (p > 0.05). Results from a logistic regression analysis showed that children who were older, who had poorer oral hygiene, who had high frequency of sugary snack intake, who had visited a dentist during the study, and whose parents had lower education level would have a higher chance to develop new dental caries during the 24-month study period. Conclusion: Hands-on training in parental toothbrushing, reinforced by face-to-face interview every 6 months, with or without a semi-annual application of 5% sodium fluoride varnish, may not have any additional effect on preventing development of dental caries in young children compared to the standard oral health education provided to parents in Hong Kong. The child’s socio-demographic background, oral hygiene status, and frequency of sugary snack intake are related to ECC. / published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

Background Dental caries on primary and permanent teeth is a common chronic disease worldwide with negative effects on children`s quality of life, both in the present and future. Sugar intake is a risk factor for caries. However, the association between sugar-sweetened beverages (SSBs) and dental caries is unclear. Methods A systematic review of relevant literature was performed in PubMed, Cochrane Library and ScienceDirect to locate every journal article in English assessing the association between SSBs and dental caries up to May 2014. Quality assessment criteria were formed by 10 essential items in STROBE statement. Results Fourteen studies were included in the present review, of which 11 were cross-sectional studies and 3 were cohort studies. Study participants were recruited from dentistry units, schools or communities. Interview-based or self-reported questionnaires for parents or caregivers were measurement tools for exposure variables. Clinical/dental examination was used to assess the outcome variables in participating children. Decayed, missing, and filled system was used among studies to record caries status. Sources of potential bias may be measurement on exposure and outcome as well as sources and methods of participants selection. Confounding existed due to nature of observational study and possible confounders included age, gender, education and location of children as well as socioeconomic position and oral health awareness of parents. Synthesis of results suggested that there may be a positive association between SSBs and dental caries, providing evidence for policymaking and recommendations for further studies. Conclusions Sugar-sweetened beverages intake could be considered as positively associated with childhood dental caries. Prevention strategy on individual level and population level on dental caries should put more attention on SSBs. Further experimental studies or research with advanced epidemiological instruments are needed for more confident recommendations on preventive strategies. / published_or_final_version / Public Health / Master / Master of Public Health

Thesis (M.Sc.Dent.) -- University of Adelaide, Dental School, 2002. / Includes bibliographical references (leaves 232-247).