Caries experience in preschool children referred for specialist dental care in hospital

Abstract

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.

Correlation Between Malnutrition and Dental Caries in Children

“…The prevalence of dental caries is high in children from lower socioeconomic groups and are often poorly nourished and suffer delayed growth and development compared with their healthy peers 11 . In these populations, prenatal and perinatal malnutrition are often the causes of enamel hypoplasia, reduced salivary secretion and low buffering capacity 12 .…”

Socioeconomic significance and prevention of early childhood caries

“…According to the American Academy of Pediatric Dentistry the most probable explanation is early 'vertical' and 'horizontal' transmission of mutant streptococci among male children and mothers or close male relatives 31 . However, the recorded data is not consistent with respect to the impact of the total number of children in the family on the occurrence of the disease 32,33 . Analysis of ECC occurrence in preschool institutions and other environments has shown that the prevalence of ECC is twice lower among children in kindergarten, even though there is a greater possibility of transmission of mutant streptococci from one child to another within a group 29 .More severe forms of the disease were common among children who were not in kindergarten 29 , and the reason for this is the importance of regular consumption of meals 34 and intensive medical and educational work with children in preschool institutions, which includes not only teachers but dentists as well 29 .…”

“…Američka akademija za dečju stomatologiju, kao najverovatniji razlog, navodi raniju "vertikalnu" i "horizontalnu" transmisiju mutantnog streptokoka između majke i muške dece, odnosno između bliskih srodnika muškog pola 31 . Međutim, podaci iz literature nisu konzi-stentni kada je u pitanju uticaj ukupnog broja dece u porodici na razvoj ovog oboljenja 32,33 . Analiza pojave KRD-a u predškolskim ustanovama i izvan njih ustanovila je dva puta manju prevalenciju kod dece koja borave u vrtiću i pored dokazane veće mogućnosti širenja mutantnog streptokoka sa jednog deteta na drugo u kolektivu 29 .…”

“…Zapaženo je linearno povećanje prevalencije i težih oblika KRD-a, sa smanjenjem ukupnog godišnjeg porodičnog prihoda 29,32,33 . Veća materijalna izdvajanja imućnijih roditelja za kvalitativno-kvantitativno izbalansiranu ishranu, profilaksu fluorom i oralnu higijenu, najverovatnije su razlog niže zastupljenosti oboljenja kod njihove dece 29 .…”

“…A linear in crease in the prevalence and moresevere forms of ECC has been followed by a decrease of the total annual family income 29,32,33 . The most probable reason for low prevalence of this disease among wealthy children is the fact that their parents spend more on their wellbalanced nutrition in terms of quality and quantity as well as on fluorideprophylaxisandoralhygiene 29 .…”