Behavioural and demographic factors during early childhood and poor dental health at 10 years of age.

The aim was to elucidate whether variables recorded in early childhood would have a long-lasting predictive value of poor dental health at the age of 10 years in a prospectively followed Finnish population-based cohort setting. The second aim was to find new tools for preventive work in order to improve dental health among children. Poor dental health (dmft + DMFT >or= 5) at 10 years of age was associated with child's nocturnal juice drinking at 18 months. It was associated with the following factors at age 3 years: frequent consumption of sweets; infrequent tooth brushing; plaque and caries on teeth. Of family factors, the following were significant: father's young age at birth of the child; mother's basic 9-year education; mother's caries (i.e. several carious teeth per year), and father's infrequent tooth brushing. Early childhood risk factors of poor dental health seem to be stable even after 10 years of life and the changing of teeth from primary to permanent ones. In preventive work, dental health care staff could offer support to those parents with risk factors in their child rearing tasks.

Impact of dental health care on dental health of children with long-term diseases: a nested case-control study.

The objective was to study dental health among nine-year-old long-term ill and disabled children and their matched controls using DMFT/dmft-indices (decayed-missing-filled-teeth, of both permanent and deciduous teeth); to analyze similarities and differences of their family factors; the children's dental health habits which include dietary factors; to assess capabilities of the health care personnel in the identification of the risk groups and in the provision of services; and finally to investigate family satisfaction with the dental health care services provided. One dentist (M-L M) routinely carried out the clinical examinations of the children using the DMFT(dmft)-index. Only cavities extending to dentin were included in the DMF and dmf indices. X-rays were also used. It was found that less than half of the children (46%) had healthy teeth (DMFT and dmft both = 0), with 41% among the study group and 51% among the controls. The DMFS index of the longterm ill children was slightly, but not significantly greater than that of the controls, and these children used dental health care services more but their families were less satisfied with the services. The long-term ill children had less orthodontic care than the controls although they needed it more frequently, and they had a designated candy day significantly more often than the controls. Special diets were associated with long-term ill children, as were the sociodemographic factors of marital status, divorce, or stepfather present. No significant differences existed between the groups in toothbrushing and the use of fluoride products. In the status and health of teeth as measured with the DMFT/dmft indices, there were no statistically significant differences between the group of the long-term-ill children and healthy controls. Estimation of the focusing of care was considered successful concerning dental health, but resource limitations emerged and contributed to parents not being satisfied with the frequency dental care services offered.

Caries experience and caries increments at 10 years of age.

The aim of the study was to examine the caries experience of 10-year-olds as measured with dmft/DMFT, to explain how caries increases by the age of 10 years, and which factors would explain caries increments. The setting was a representative population sample of first-born children in southwestern Finland. Dental health at 10 years of age was found to be good in 45%, fairly good in 40% and poor in 15% of the children. The caries index remained stable in 23% of carious children from 7 to 10 years of age. Daily consumption of sweets at the age of 3 years (OR 2.7; 95% CI 1.5-4.8; p < 0.001) was associated with a caries increment between 7 and 10 years of age (both deciduous and permanent teeth). This daily consumption of sweets and a child's late bedtime (OR 1.9; 95% CI 1.1--3.1; p = 0.023) were explanatory factors in the permanent teeth alone. In the deciduous teeth, mother's previous caries and child's earlier tooth brushing habits were explanatory factors of caries. As hypothesized, all five significant factors remaining in the final logistic regression analysis were family-related. Parental ability to care for and educate a child could be seen in dental health still at the age of 10 years. The family-related factors which were associated with caries should be emphasized much more comprehensively in everyday dental health care practice.

Caries in five-year-old children and associations with family-related factors.

It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful.

Changes in dental health and dental health habits from 3 to 5 years of age.

OBJECTIVES: This study sought to determine how dental health and dental health habits change from 3 to 5 years of age and to consider whether preventive dental health care helped in preventing or halting caries in children. METHODS: The study included 67 maternity health care clinics, 72 well-baby clinics, and 69 dental health care clinics. Of the 1,292 newborn children, 1,003 (90.8%) were included in this study. RESULTS: Preventive dental health care contributed to dental caries being halted in only 13.2 percent of those children who had enamel caries at 3 years of age. The dmft index did not increase in 22.6 percent of those children who had dentinal caries at 3 years of age. For all others, the disease became more severe. Toothbrushing habits of 3-year-old children were very consistent over the two years studied. Children were at a risk for caries when their mothers had nine years of basic education, when they already had plaque and caries at 3 years of age, and when the frequency of eating sweets increased the most during the two-year study period. CONCLUSIONS: Among 3-year-old children, plaque is an indicator of caries risk and therefore should be a key element in health education. Those children who already have evidence of caries at 3 years of age should be the target of preventive dental services because of their increased risk.

Children's poor toothbrushing behavior and mothers' assessment of dental health education at well-baby clinics.

The purpose of the study was to investigate which factors in the child's environment are associated with poor toothbrushing behavior in 3-year-old children. Mothers' attitudes towards dental education at well-baby clinics and the relation of this attitude to children's toothbrushing frequency were also studied. The population sample was obtained by means of stratified cluster sampling of all primigravid women in the study area. The data were collected from the women by structured questionnaires and patient cards from dental well-baby clinics. The present study led to the following conclusions: a) new approaches are needed to make rural populations appreciate the benefits of oral hygiene; b) young mothers need support in their personal and in their children's dental health care; c) each family expecting their first child needs a basic amount of counseling. Health-conscious parents must be supported in the maintenance of their health habits; and d) the provider of the basic counseling has no significant role in the formation of health habits.

Dental health habits of young families from southwestern Finland.

The dental care habits of parents and children as well as the associations of these habits were investigated in a follow-up study conducted in the Southwest of Finland. The background factors of the child's use of night-time juice were also studied. The families of the study were a representative sample of local young families with their first child. The study sample was obtained using stratified randomized cluster sampling and confidential questionnaires. Both the mother's and the father's toothbrushing habits were significantly associated with the child's toothbrushing habits with a cumulative effect. The mother's use of sugar was significantly associated with the child's sugar use habit. Infectious diseases at the age of 9-17 months had an increasing effect on the use of juice at night. Fathers and the youngest mothers, especially, need additional support not only for the demanding task of the upbringing of their child but also for the care of their own teeth.

The Finnish Family Competence Study: the effects of living conditions on sucking habits in 3-year-old Finnish children and the association between these habits and dental occlusion.

Sucking habits and their connection with family background was investigated in 3-year-old Finnish children. The association between sucking habits and malocclusion was also studied. The study was based on a survey with stratified randomized cluster sampling, confidential questionnaires, and clinical dental examinations. Dummy (pacifier) use was often associated with a negligent attitude towards the child's toothbrushing. This may imply that these parents need more support, encouragement, and counseling from the well-baby clinic than others. Sucking habits were strongly associated with malocclusion.

Dental health habits of 3-year-old Finnish children.

The aim was to study whether 3-yr-old children's toothbrushing habits are associated with the child's other dental health habits and whether the mother's background influences the child's toothbrushing frequency. The survey used stratified randomized cluster sampling, confidential questionnaires and clinical dental examinations. A random sample of 1443 (91.2%) of a Finnish province's 1582 primiparous women participated in the study at the onset of their pregnancy. Dental health care clinics of the public health care system carried out dental examinations in 1018 (83.5%) 3-yr-old children born of these pregnancies. The variables used in the study included consumption of juice at night and sugar at the age of 1.5 yr and the use of fluoride tablets and sweets at the age of 3. The mother's background factors included age, basic education and occupation. Daily toothbrushing was practised by 78.2% of the children. Addition of sugar to the diet and frequent use of sweets at the age 3 were more common in those who brushed their teeth only occasionally, whereas the use of fluoride tablets was less frequent in them than in those brushing their teeth every day. Of the mothers' background factors, age was the most significant. The youngest mothers paid the least attention to their children's toothbrushing habits. The proportion of those brushing their teeth was 67.9% in rural areas, 78.6% in semi-urban population centers and 80.1% in towns (P = 0.02). The results indicate that the health education provided by dental health care clinics should be focussed on young mothers and rural families.(ABSTRACT TRUNCATED AT 250 WORDS)

The Finnish Family Competence Study: the relationship between caries, dental health habits and general health in 3-year-old Finnish children.

The aim of this study was to examine how dental health related habits, infectious diseases and long-term illness are associated with dental health at the age of 3 in first-born children resident in a Finnish province. The study was designed as a survey using stratified randomised cluster sampling, confidential questionnaires and clinical dental examinations. The results were analysed using polytomous logistic models. In the stepwise analysis the only statistically significant explanatory factors were the use of juice at night and dental cleanliness. Antibiotic treatment or long-term illness was not significantly associated with dental health.

Dental health behavior in fathers of young families in Finland.

The purpose of this study was to examine dental health behavior in young fathers by means of a questionnaire for subjective evaluation of dental status, frequency of caries and visits to the dentist. Cariogenic diet was estimated by the consumption of sweets, confectionary and soft drinks. The participation rate 18 months after the birth of the family's first child was 73.1%. The mean age of the respondents was 28.1 yr (range 17-49; SD 4.6). When background factors were considered, it was observed that cariogenic diet was more often mentioned by participants from the lower social groups. The standard of the wife's knowledge level was an important indicator of dental care behavior in the fathers. If the wife's knowledge level was high, the father assessed the future condition of his child's teeth as good.

Effects of chlorhexidine-fluoride gel treatments in mothers on the establishment of mutans streptococci in primary teeth and the development of dental caries in children.

In a longitudinal 3-year study, 151 children were followed for the colonization of the primary dentition by mutans streptococci (MS) and for the development of dental caries. At the age of 1 year, the child-mother pairs were divided into three groups on the basis of the levels of MS in maternal saliva. In the experimental group, the mothers had MS levels higher than 10(5) CFU/ml, and they were given chlorhexidine (1%)-sodium fluoride (0.2%) gel treatments twice a year for 3 years. Two control groups were formed. In control group 1, the mothers also had high levels of MS, but no gel was given. In control group 2, the mothers had low (< 10(5) CFU/ml) baseline levels of salivary MS, and no chlorhexidine-fluoride gel was used. In the total study population, 16, 42, and 54% of the children were colonized by MS by the age of 2, 3, and 4 years, respectively. Most children harbored only Streptococcus mutans, but 2 had both S. mutans and Streptococcus sobrinus, and 2 had only S. sobrinus. Twenty-eight percent of the MS-positive children developed caries by the age of 4 years, whereas 4 out of 27 children with dental caries did not have any detectable MS in their plaque samples. Both the colonization by MS and the caries incidence were highest in control group 1 and lower in the experimental group and in control group 2. These observations suggest that the reduction of maternal salivary MS at the time of tooth emergence may delay, or perhaps even prevent, the colonization of MS in the children's primary dentition with a concomitant decline in caries incidence, even in a population with an already low prevalence of dental caries.

Increase of vaccination coverage by mass media and individual approach: intensified measles, mumps, and rubella prevention program in Finland.

In the 1970s, mass vaccination projects were started in various parts of the world against measles and congenital rubella, with eradication as the final goal. In many developing and industrial countries, including Finland, the elimination of measles failed because of low vaccination coverage. In Finland, a combined measles, mumps, and rubella (Virivac) vaccination program was started in 1982. Computerized recording of the vaccinated children was considered necessary and was integrated with the population registry to identify the hard-to-reach families. Several interventions improved compliance: a mass media campaign and notification of nonvaccinated children to local health professionals and parents. All successive campaigns increased vaccination coverage significantly, with the notification of parents about their nonvaccinated child being especially effective. A vaccination coverage of over 96% was achieved, which theoretically prevents measles, mumps, and rubella transmission.

The Finnish family competence study: dental oral self-care behaviour and awareness of gingivitis/calculus in fathers of young families.

The purpose of this study was to examine oral self-care behaviour and the prevalence of gingivitis and dental calculus in fathers of young families using a questionnaire. The participation rate at 18 months after the birth of the first child was 73.1%. The mean age of the respondents (n = 917) was 28.1 years (range 17-49; SD 4.6). Dental health and dental care were assessed by asking about the existence of gingivitis and dental calculus. Oral hygiene habits were analysed by asking about the use of toothpicks and dental floss and the regularity of toothbrushing. Gingivitis and dental calculus were found to be related to age and to educational and occupational status. The older respondents used dental floss and toothpicks more often and brushed their teeth more regularly than those in the younger age group. When the wife's knowledge was poor, the respondent's oral hygiene habits were also poor. If the wife's knowledge level was good, the young father's oral hygiene was good, too. Parents transfer their own oral health care habits to their children. Respondents whose parents had a high socio-economic status exhibited good oral hygiene habits. The Maternity Health Care Clinic and Well-Baby Clinic network can also influence oral health care habits. The relevant parts of general prophylactic guidance given at these clinics should be included in dental health programmes.