Objectives: The objective of the quantitative research was to estimate the prevalence of Early Childhood Caries (ECC) and severe Early Childhood Caries (s-ECC) and the severity of Early Childhood Caries (ECC) in the primary dentition of young children in Ajman, UAE, and investigate their association with child and family characteristics, dietary habits, fluoride use, oral hygiene practices and dental services utilization. The purpose of the qualitative research was to obtain information that could explain some of the findings of the quantitative stage in order to progress towards determining a strategy to control ECC in this population. Methods: A two-stage cluster sample was used to randomly select children aged 5 or 6 years old who were enrolled in public or private schools in Ajman, UAE. Clinical examinations for caries were conducted by a single examiner using WHO criteria. Parents completed questionnaires seeking information on child and family characteristics, dietary habits, oral hygiene, fluoride use and dental service utilization. Bivariate and multivariate analyses were used to identify risk markers and risk indicators for caries experience. To complement the quantitative findings, the second (qualitative) stage of the research was conducted with six chosen groups of mothers from different educational backgrounds and different nationalities. Each group contained between six and ten mothers - some of whose children had been examined in the quantitative section of the project. The mothers were invited to comment on the significance for them of those risk indicators identified in the earlier section of the research. The manual thematic coding method of analysis was used. Problems concerning the dental health of children were identified based on the results of both stages. Results: The total number of children sampled was 1297. Dental examination and questionnaire data were obtained for 1036 (79.9%), of whom 50.0% were female. The prevalence of ECC in 5- and 6-year-old children was 72.9% (95% CI, 61.8, 83.9) and 80.0% (95% CI, 76.0, 84.4) respectively, with mean dmft scores of 4.0 (sd, 4.1) and 4.9 (sd, 4.3) respectively (P<0.05). The overall prevalence of s-ECC was 31.1% (95% CI, 23.6, 38.9). Multivariate analysis indicated that frequency of snacking between meals per day, snack consumption level and the frequency of brushing had a significant effect on the severity of ECC, while only the snack consumption level and the frequency of brushing had a significant effect on plaque score. There was a strong association between plaque score and the severity of ECC. The total number of mothers who contributed to the qualitative study was 42. The findings of the qualitative stage showed that some mothers had a negative perception toward the primary dentition and unhelpful attitudes towards their children�s diets (through promoting a high consumption of cariogenic food), while the use of fluoride (other than in toothpaste) was rare. However, many mothers were in favor of bottled water fluoridation once they understood the benefits of such a scheme and supported the idea of a dental preventive program beng provided through their children�s schools. Conclusions: The prevalence and severity of ECC in young children in Ajman is high, with child and family characteristics, dietary habits, oral hygiene practices and dental utilization being important determinants. Young children in Ajman would benefit from health promotion strategies directed towards appropriate dietary practices and oral hygiene measures framed within culturally specific guidelines.

published_or_final_version / Dentistry / Doctoral / Doctor of Philosophy

published_or_final_version / abstract / toc / Dentistry / Doctoral / Doctor of Philosophy

Objectives: The objective of the quantitative research was to estimate the prevalence of Early Childhood Caries (ECC) and severe Early Childhood Caries (s-ECC) and the severity of Early Childhood Caries (ECC) in the primary dentition of young children in Ajman, UAE, and investigate their association with child and family characteristics, dietary habits, fluoride use, oral hygiene practices and dental services utilization. The purpose of the qualitative research was to obtain information that could explain some of the findings of the quantitative stage in order to progress towards determining a strategy to control ECC in this population. Methods: A two-stage cluster sample was used to randomly select children aged 5 or 6 years old who were enrolled in public or private schools in Ajman, UAE. Clinical examinations for caries were conducted by a single examiner using WHO criteria. Parents completed questionnaires seeking information on child and family characteristics, dietary habits, oral hygiene, fluoride use and dental service utilization. Bivariate and multivariate analyses were used to identify risk markers and risk indicators for caries experience. To complement the quantitative findings, the second (qualitative) stage of the research was conducted with six chosen groups of mothers from different educational backgrounds and different nationalities. Each group contained between six and ten mothers - some of whose children had been examined in the quantitative section of the project. The mothers were invited to comment on the significance for them of those risk indicators identified in the earlier section of the research. The manual thematic coding method of analysis was used. Problems concerning the dental health of children were identified based on the results of both stages. Results: The total number of children sampled was 1297. Dental examination and questionnaire data were obtained for 1036 (79.9%), of whom 50.0% were female. The prevalence of ECC in 5- and 6-year-old children was 72.9% (95% CI, 61.8, 83.9) and 80.0% (95% CI, 76.0, 84.4) respectively, with mean dmft scores of 4.0 (sd, 4.1) and 4.9 (sd, 4.3) respectively (P<0.05). The overall prevalence of s-ECC was 31.1% (95% CI, 23.6, 38.9). Multivariate analysis indicated that frequency of snacking between meals per day, snack consumption level and the frequency of brushing had a significant effect on the severity of ECC, while only the snack consumption level and the frequency of brushing had a significant effect on plaque score. There was a strong association between plaque score and the severity of ECC. The total number of mothers who contributed to the qualitative study was 42. The findings of the qualitative stage showed that some mothers had a negative perception toward the primary dentition and unhelpful attitudes towards their children�s diets (through promoting a high consumption of cariogenic food), while the use of fluoride (other than in toothpaste) was rare. However, many mothers were in favor of bottled water fluoridation once they understood the benefits of such a scheme and supported the idea of a dental preventive program beng provided through their children�s schools. Conclusions: The prevalence and severity of ECC in young children in Ajman is high, with child and family characteristics, dietary habits, oral hygiene practices and dental utilization being important determinants. Young children in Ajman would benefit from health promotion strategies directed towards appropriate dietary practices and oral hygiene measures framed within culturally specific guidelines.

Thesis (D.P.H.)--University of Michigan, 1994.

Thesis (M.S.)--University of Michigan, 2003. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2003. / Includes bibliographical references.

Akademisk avhandling--Karolinska institutet. Stockholm. / Extra t.p., with thesis statement, inserted. Bibliography: p. 35-36.

Thesis (M.S.)--University of Michigan, 1943.

Thesis (M.S.)--University of Michigan, 1962.