Developmental defects of enamel in first permanent molars associated with use of asthma drugs in preschool aged children: A retrospective case-control study.

AIM: To investigate the association between the occurrences of developmental defects of enamel (DDE), in first permanent molars, and bronchodilators and/or corticosteroid intake for asthma-like episodic treatment at preschool age, in 6-12 year old children. METHODS: Children of the case group (n = 70) were followed in the Paediatric Pulmonary Unit and the Unit of Allergology, Asthma and Inflammation at 'Aghia Sofia' Children's Hospital, Athens, Greece and had used asthma drugs during their first 4 years of life. The control group (n = 70) consisted of healthy children who visited the Postgraduate Paediatric Dental Clinic, University of Athens. Information regarding demographic data, medical history, pregnancy, birth weight, duration of breastfeeding, mother's smoking habits and antibiotic use at preschool age was obtained through a structured questionnaire. Details concerning asthma drugs used were extracted from medical records. The children in both groups underwent an oral examination under standard clinical conditions and all surfaces of first permanent molars were assessed for enamel defects using the modified DDE Index. Chi square statistics, Mann-Whitney U test, Spearman correlation coefficient and logistic regression analysis were used for statistical analysis of the data (p ≤ 0.05). RESULTS: DDE were present in 24 children (34.3%) in the case group and only in 6 (8.6%) in the control, with the difference between the two groups being statistically significant (p < 0.001), while the estimated odds ratio was 5.56. Among the children with DDE in the case group, 41.6% had at least one hypoplastic molar with loss of enamel. The type of asthma drug, age at treatment onset and duration of drug use were not significantly associated with the severity or extent of DDE. Among the possible influential factors, gender was the only statistical significant factor. CONCLUSIONS: Children treated with asthma drugs for asthma-like episodes at a preschool age showed an overall increased risk for developing enamel defects in their first permanent molars. Severe hypoplastic lesions with loss of enamel was a frequent finding among affected molars.

Knowledge of preschool teachers in the prefecture of Attica of early childhood oral health. Association with their demographic and personal characteristics.

AIM: To investigate the knowledge of preschool teachers of early childhood oral health (OH) and its association with demographic and educational characteristics as well as with personal oral health habits and attitudes. METHODS: Teachers (594) of preschool children were invited to complete a questionnaire with 40 questions on demographic data, knowledge of early childhood OH issues, personal OH habits and attitudes, and participation in OH educational programmes at preschools. Statistical analysis included descriptive statistics, Spearman correlation coefficients, multiple linear and logistic regression modelling (p ≤ 0.05). RESULTS: The mean age of participants was 40.9 years (SD 7.5), 68.5% of them had children of their own, 72.6% had not attended any OH educational course during their studies, 70% believed that they had insufficient knowledge to implement an OH educational programme, 44.6% had implemented such a programme, 26.8% knew that the first dental visit should be at a child's first birthday and 36.7% knew the correct age that tooth brushing should start. The most significant factors that influenced overall teachers' knowledge on early childhood oral health were: their participation in OH educational programmes (p < 0.001), their belief that OH courses during their studies were necessary (p = 0.01), their confidence on OH knowledge (p = 0.03) and parenthood (p = 0.05). CONCLUSIONS: Based on the results of this study, there was a lack of knowledge among preschool teachers in significant OH issues for that age. Moreover, limitations in implementing OH educational programmes at preschools were attributed mainly to lack of self-confidence in relevant knowledge. Nevertheless, participants acknowledged the significance of OH and were willing to participate in relevant teacher training.

Caries-preventive effectiveness of fluoride varnish as adjunct to oral health promotion and supervised tooth brushing in preschool children: a double-blind randomized controlled trial.

OBJECTIVES: To evaluate the effect of biannual fluoride varnish applications in preschool children as an adjunct to school-based oral health promotion and supervised tooth brushing with 1000ppm fluoride toothpaste. METHODS: 424 preschool children, 2-5 year of age, from 10 different pre schools in Athens were invited to this double-blind randomized controlled trial and 328 children completed the 2-year programme. All children received oral health education with hygiene instructions twice yearly and attended supervised tooth brushing once daily. The test group was treated with fluoride varnish (0.9% diflurosilane) biannually while the control group had placebo applications. The primary endpoints were caries prevalence and increment; secondary outcomes were gingival health, mutans streptococci growth and salivary buffer capacity. RESULTS: The groups were balanced at baseline and no significant differences in caries prevalence or increment were displayed between the groups after 1 and 2 years, respectively. There was a reduced number of new pre-cavitated enamel lesions during the second year of the study (p=0.05) but the decrease was not statistically significant. The secondary endpoints were unaffected by the varnish treatments. CONCLUSIONS: Under the present conditions, biannual fluoride varnish applications in preschool children did not show significant caries-preventive benefits when provided as an adjunct to school-based supervised tooth brushing with 1000ppm fluoride toothpaste. CLINICAL SIGNIFICANCE: In community based, caries prevention programmes, for high caries risk preschool children, a fluoride varnish may add little to caries prevention, when 1000ppm fluoride toothpaste is used daily.