Oral Health of Indigenous Children and the Influence of Early Childhood Caries on Childhood Health and Well-being

Schroth, Robert J; Harrison, Rosamund; Moffatt, Michael

doi:10.1016/j.pcl.2009.09.010

Cited by 135 publications

(153 citation statements)

References 31 publications

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“…This scenario presupposes that caries was an agent of natural selection before the development of modern dentistry (8,45). We think that this is not unlikely, given the known acute consequences of caries, such as the increased risk of abscess (46) and chronic consequences increase in difficulty eating, particularly in children, and reduced weight/height gain (47,48). Nevertheless, hypotheses about the agents of evolutionary change in humans are very difficult to prove, and we note that, given DMBT1 SAG protein is expressed on other mucosal epithelia and interacts with other microbes, other evolutionary scenarios are possible, such as adaptation to an altered microbiome of the gut.…”

Section: Discussionmentioning

confidence: 99%

Evolution of the rapidly mutating human salivary agglutinin gene ( DMBT1 ) and population subsistence strategy

Polley

Louzada

Forni

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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The dietary change resulting from the domestication of plant and animal species and development of agriculture at different locations across the world was one of the most significant changes in human evolution. An increase in dietary carbohydrates caused an increase in dental caries following the development of agriculture, mediated by the cariogenic oral bacterium Streptococcus mutans. Salivary agglutinin [SAG, encoded by the deleted in malignant brain tumors 1 (DMBT1) gene] is an innate immune receptor glycoprotein that binds a variety of bacteria and viruses, and mediates attachment of S. mutans to hydroxyapatite on the surface of the tooth. In this study we show that multiallelic copy number variation (CNV) within DMBT1 is extensive across all populations and is predicted to result in between 7-20 scavenger-receptor cysteinerich (SRCR) domains within each SAG molecule. Direct observation of de novo mutation in multigeneration families suggests these CNVs have a very high mutation rate for a protein-coding locus, with a mutation rate of up to 5% per gamete. Given that the SRCR domains bind S. mutans and hydroxyapatite in the tooth, we investigated the association of sequence diversity at the SAG-binding gene of S. mutans, and DMBT1 CNV. Furthermore, we show that DMBT1 CNV is also associated with a history of agriculture across global populations, suggesting that dietary change as a result of agriculture has shaped the pattern of CNV at DMBT1, and that the DMBT1-S. mutans interaction is a promising model of host-pathogenculture coevolution in humans.copy number variation | agriculture | DMBT1 | mutation | structural variation

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Section: Discussionmentioning

confidence: 99%

Evolution of the rapidly mutating human salivary agglutinin gene ( DMBT1 ) and population subsistence strategy

Polley

Louzada

Forni

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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“…ECC has been associated with other infectious diseases, such as respiratory tract infections and acute otitis media, in the first year of life, but the relationships are weak and may indicate common risk factors. 3 When left to progress, ECC can become painful and result in altered chewing, eating, and sleeping patterns in addition to potential growth restriction. 3 Early tooth loss as a result of ECC may result in speech difficulties and associated self-esteem issues because of altered appearance.…”

mentioning

confidence: 99%

“…3 When left to progress, ECC can become painful and result in altered chewing, eating, and sleeping patterns in addition to potential growth restriction. 3 Early tooth loss as a result of ECC may result in speech difficulties and associated self-esteem issues because of altered appearance. Children with ECC are known to be at increased risk of decay in both primary and permanent dentition and may also experience malalignment and crowding of permanent teeth that result in poor bite.…”

mentioning

confidence: 99%

Early Childhood Caries in Indigenous Communities

Nations¹,

Inuit²

2011

Pediatrics

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The oral health of Indigenous children of Canada (First Nations, Inuit, and Métis) and the United States (American Indian, Alaska Native) is a major child health issue: there is a high prevalence of early childhood caries (ECC) and resulting adverse health effects in this community, as well as high rates and costs of restorative and surgical treatments under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, including socioeconomic determinants, and requires a combination of approaches for improvement. This statement includes recommendations for preventive oral health and clinical care for young infants and pregnant women by primary health care providers, community-based health-promotion initiatives, oral health workforce and access issues, and advocacy for community water fluoridation and fluoride-varnish program access. Further communitybased research on the epidemiology, prevention, management, and microbiology of ECC in Indigenous communities would be beneficial.

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“…Unlike previous dental MI studies targeting infants whose oral health is predominantly taken care of by their parents [15,21,22], this study focuses on preschoolers who are at a stage of forming their own health habits [12]. While the impact of early intervention (from infancy or even prenatal) is supported by sizeable scientific evidence [15,21,33,34], preschool age represents another window for behavioral intervention, because children’s food preference is being shaped [35], their toothbrushing habits are being reinforced [4], and parents are often receptive to health messages during this period of time [9,36]. Interventions in this age group are both promising and challenging.…”

Section: Discussionmentioning

confidence: 99%

“…Like many other chronic diseases, dental caries is a multifactorial disease highly determined by one’s ‘lifestyles’ [9,10]. It is preventable by adopting healthy behaviors, such as regular toothbrushing, favorable dietary habits and regular dental check-up.…”

Section: Introductionmentioning

confidence: 99%

Innovative interventions to promote positive dental health behaviors and prevent dental caries in preschool children: study protocol for a randomized controlled trial

Gao

McGrath

et al. 2013

Trials

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BackgroundDental caries (tooth decay) is highly prevalent and is largely attributable to unhealthy self-care behaviors (diet and oral hygiene). The conventional (health) education (CE), focusing on disseminating information and giving normative advice, often fails to achieve sustained behavioral changes. This study incorporates two innovative elements into CE: (i) motivational interviewing (MI), a client-centered counseling for changing behaviors, and (ii) an interactive caries risk assessment (RA) tool, which is devised to facilitate dental counseling and may enhance MI in several ways. Through a randomized, controlled, evaluator-blinded trial, three intervention schemes (CE, CE + MI, and CE + MI + RA) will be compared for their effectiveness in eliciting dentally healthy behaviors and preventing caries in preschool children.Methods/DesignThis study targets 3-year-old children who are at a critical stage for embedding health habits. Children with unfavorable dental behaviors (insufficient toothbrushing and/or frequent snacking) and their parents will be recruited from 12 participating kindergartens. Parent-child dyads (n = 690) will be randomly assigned into three groups. In the first group (CE), oral health information and advice will be delivered to parents through pamphlets. In the second group (CE + MI), in addition to the pamphlets, individual MI counseling with each parent will be performed by one of two trained dental hygienists. In the third group (CE + MI + RA), besides pamphlets and MI, interactive RA will be integrated into MI to motivate parents and facilitate their informed decision making and goal planning. At baseline and after 12 and 24 months, parents will complete a questionnaire and children will undergo a dental examination. The effectiveness of the intervention schemes will be compared over 12 and 24 months. The primary outcome will be caries increment in children and proportion of caries-free children. Secondary outcomes will be changes in parental efficacy for protecting children’s oral health and changes in children’s dental behaviors.DiscussionMotivating and empowering parents to cultivate dentally healthy habits of young children presents both promises and challenges. With careful methodological considerations, this study is expected to provide scientific evidence for public health workers, dentists, and dental auxiliaries (nurses and hygienists) to choose appropriate interventions to advance children’s oral health.Trial registrationHKCTR-1455

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Oral Health of Indigenous Children and the Influence of Early Childhood Caries on Childhood Health and Well-being

Cited by 135 publications

References 31 publications

Evolution of the rapidly mutating human salivary agglutinin gene ( DMBT1 ) and population subsistence strategy

Evolution of the rapidly mutating human salivary agglutinin gene ( DMBT1 ) and population subsistence strategy

Early Childhood Caries in Indigenous Communities

Innovative interventions to promote positive dental health behaviors and prevent dental caries in preschool children: study protocol for a randomized controlled trial

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