Background: To investigate the association between selected social and behavioural (infant feeding and preventive dental practices) variables and the presence of early childhood caries in preschool children within the north Brisbane region. Methods: A cross sectional sample of 2515 children aged four to five years were examined in a preschool setting using prevalence (percentage with caries) and severity (dmft) indices. A self-administered questionnaire obtained information regarding selected social and behavioural variables. The data were modelled using multiple logistic regression analysis at the 5 per cent level of significance. Results: The final explanatory model for caries presence in four to five year old children included the variables breast feeding from three to six months of age (OR=0.7, CI=0.5, 1.0), sleeping with the bottle (OR=1.9, CI=1.5, 2.4), sipping from the bottle (OR=1.6, CI=1.2, 2.0), ethnicity other than Caucasian (OR=1.9, CI=1.4, 2.5), annual family income $20,000-$35,000 (OR=1.7, CI=1.3, 2.3) and annual family income less than $20,000 (OR=2.1, CI=1.5, 2.8).Conclusions: A statistical model for early childhood caries in preschool children within the north Brisbane region has been constructed using selected social and behavioural determinants. Epidemiological data can be used for improved public oral health service planning and resource allocation within the region.Key words: Early childhood caries, epidemiology, preschool children, social factors, behavioural factors.(Accepted for publication 18 June 2002.) Researchers have attempted to expand basic microbiological models for ECC development to include various social, demographic and behavioural factors such as ethnicity, family income, maternal education level, family status, tooth brushing habits and parental knowledge and beliefs.2,3 Although the predictive power of the variables studied was inconsistent, the high disease experience within selected community groups reflects the importance of factors other than the presence of Mutans streptococci alone in contributing to ECC development. Other crosssectional models demonstrate the complex interaction between socio-economic status (SES), ethnicity, immigrant status, infant feeding, fluoride exposure, oral hygiene and ECC presence in preschool children. [4][5][6][7][8][9][10][11][12][13] However, because most studies of ECC have been conducted among specific ethnic, immigrant and lower socio-economic communities, extrapolation of current risk assessment models to the general population is problematic. The collective and individual effect of these factors in determining ECC presence has not been reported previously in an Australian child population.Recent epidemiological data of ECC confirm that the disease is prevalent among disadvantaged children from lower socio-economic, immigrant and indigenous community groups within the non-fluoridated north Brisbane region. 11,14,15 However, relatively little information is known about those social and behavioural risk factors that contrib...

Background: To report the dental caries experience of preschool children within the north Brisbane region and to investigate the association between selected social and demographic variables and disease presence. Methods: A cross-sectional sample of 2515 children aged four to six years was examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) and percentage caries free indices. A self-administered questionnaire obtained information regarding selected social and demographic variables. The data were analysed using the chi-square and one way analysis of variance procedures at the 5 per cent level of significance. Results: Overall, 1668 (66.3 per cent) children were disease free at the examination and mean dmft was 1.4±2.77 and dmfs was 2.28±6.00. Dental caries occurred more frequently and severely in children from non-Caucasian background (p<0.000), family language other than English (p=0.001) and lower socio-economic status (p<0.000). Conclusions: Significant associations between child ethnicity, language spoken at home, socio-economic status and caries presence have been identified. Epidemiological data can be used for improved public oral health service planning and resource allocation within the region.

Caries risk assessment forms the cornerstone for the successful application of a minimum intervention dentistry philosophy in the management of dental caries. Patients, particularly those with evidence of active dental caries at baseline, require a caries risk assessment to identify those risk factors that will most likely contribute to the progression of the carious disease process. Once identified, these factors should be eliminated or at least moderated to ensure the disease progression is stabilized before conservative and rehabilitative dental procedures are undertaken. Each individual will present with a slightly different caries risk profile and the principles of a patient centred approach to manage each case should be applied to the individual diagnostic and treatment planning phases of dental care. Current chairside technologies such as caries susceptibility and activity tests can be utilized to provide baseline and follow-up data to assist the dental practitioner in this task. However, clinician intuition or 'gut feeling' has been found to be a better prognostic indicator for future dental caries experience than present caries prediction instruments in most cases. As caries risk data are accumulated and refined at a population, community and individual level, the sensitivity and specificity of the caries risk assessment modelling will improve as will the positive predictive power of the final statistical model algorithm. It is likely that online caries predictive tools will be available for general dental practitioners in the not too distant future to help clinicians formulate accurate caries risk profiles for their patients.

Background: Increasing numbers of preschool children are being referred for specialist dental management in a paediatric hospital. Most cases have severe early childhood caries and require comprehensive management under general anaesthesia. The present study investigated risk factors for disease presence at initial consultation. Methods: A convenience sample of 125 children under four years of age from the north Brisbane region were examined and caries experience recorded using dmft and dmfs indices. A selfadministered questionnaire obtained information regarding social, demographic, birth, neonatal, infant feeding and dental health behaviour variables. The data were analysed using the chi-square and one-way analysis of variance procedures. Results: Ninety-four per cent of referred children had severe ECC with mean dmft of 10.5±3.8 and mean dmfs of 27.1±15.1. Prevalence of severe ECC was significantly higher in children allowed a sweetened liquid in the infant feeding bottle (99 per cent) and allowed to sip from an infant feeding bottle during the day (100 per cent). Mean dmfs was significantly higher in children allowed to sleep with a bottle (28.7) and sip from a bottle during the day (29.9), children from a non-Caucasian background (31.8), those children that commenced regular toothbrushing between 6 to 12 months of age (28.1), had no current parental supervision of daily toothbrushing (34.2) and had not taken daily fluoride supplements (27.8), vitamin supplements (27.8) or prescription medicine previously (27.6). Conclusions:The behavioural determinants for severe early childhood caries presence in hospitalreferred children were similar to those identified in the regional preschool population. S C I E N T I F I C A RT I C L EAbbreviations and acronyms: COHS = Children's Oral Health Service; dmft = decayed, missing and filled tooth; dmfs = decayed, missing and filled surface; ECC = early childhood caries; S-ECC = severe ECC.

When severe caries occurs in mandibular permanent incisor teeth, the clinician should consider the possibility of associated submandibular gland aplasia or salivary hypofunction. Early diagnosis of submandibular gland disease is essential, as operative problems involving restoration of mandibular incisor teeth are considerable. Furthermore, progressive severe dental caries can present a dilemma for the clinician in affected individuals, despite intensive preventive and restorative therapy. A case report describing severe progressive dental caries and enamel demineralization of the permanent mandibular incisor teeth in a young girl is presented. Further investigation revealed absence of functional bilateral submandibular salivary glands contributing to the rapid breakdown of the teeth despite intensive preventive measures.