Objective
Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk.
Research Design
We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452).
Intervention
We provided communication skills training using the approach of patient centered counseling, edited the electronic medical record to prompt counseling, and provided parents/caregivers with an educational brochure.
Outcome Measures
We assessed changes in provider knowledge about ECC after the intervention, and examined providers' counseling practices and incidence of ECC over time by site, controlling for baseline ECC, patient sociodemographics and parents'/caregivers' practice of risk factors (diet, oral hygiene, tooth-monitoring), among 1045 children with complete data.
Results
Provider knowledge about ECC increased after the intervention training (percentage correct answers improved from 66% to 79%). Providers at the intervention site used more counseling strategies, which persisted after adjustment for sociodemographic characteristics. Children at the intervention site had a 77% reduction in risk for developing ECC at follow up, after controlling for age and race/ethnicity, sociodemographics and ECC risk factors; P ≤ 0.004.
Conclusions
The multifaceted intervention was associated with increased provider knowledge and counseling, and significantly attenuated incidence of ECC. If validated by additional studies, similar interventions could have the potential to make a significant public health impact on reducing ECC among young children.
We assessed the oral health status of 216 refugee torture survivors seeking care at an urban torture treatment center in the United States. Results showed that patients' dental health ranged from poor to fair; 76% had untreated cavities, and approximately 90% required immediate or near-immediate dental care. Torture treatment centers, in addition to offering safe environments for educating and examining patients, are ideal settings to provide basic oral health services without the risk of retraumatization. (Am J
Cinnamic aldehyde has been identified as the active fungitoxic constituent of cinnamon (Cinnamomum zeylanicum) bark oil. The fungitoxic properties of the vapours of the oil/active constituent against fungi involved in respiratory tract mycoses, i.e., Aspergillus niger, A. fumigatus, A. nidulans A. flavus, Candida albicans, C. tropicalis, C. pseudotropicalis, and Histoplasma capsulatum, were determined in vitro as minimum inhibitory concentration (MIC), minimum lethal concentration (MLC), inoculum density sustained, and exposure duration for fungicidal action at MIC and higher doses, as well as effect of incubation temperatures on fungitoxicity. It is concluded that these inhalable vapours appear to approach the ideal chemotherapy for respiratory tract mycoses.
Objectives: The aims of this study were to compare prevalence of early childhood caries (ECC) in 1-to 3-year-old children seeing primary-care pediatricians at two urban medical centers in Boston to the prevalence of ECC in similarly aged US children surveyed as part of the Third National Health and Nutrition Examination Survey (NHANES III) and to assess risk factors for ECC among this cohort of children compared with risk factors among similarly aged US children. Methods: Characteristics of 787 1-to 3-year-old children from two urban Boston medical centers were compared with those of 3,644 similarly aged US children surveyed as part of NHANES III. Demographic and social characteristics and ECC prevalence by putative risk factors were compared. A multiple logistic regression model was fit to assess putative risk factors and difference between groups simultaneously. Results: Race, age, previous dental visit, parents' education, and household income were significantly associated with ECC prevalence. Parents' place of birth was a significant effect modifier with lower ECC among Boston children of immigrants than among US children of immigrants. Conclusions: Lower ECC prevalence among urban Boston children of immigrant parents compared with US children of immigrant parents may reflect changing immigrant composition in the United States since NHANES III or a different immigrant composition in the Boston area compared with the United States. This finding reinforces the need for further research of immigrants in order to understand cultural practices that may affect oral health. Finally, low ECC prevalence among very young children reinforces the importance of early intervention in reducing ECC.
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