Dental caries and associated risk factors in 13- to 18-month-old infants receiving breast or formula milk feeding: A cross-sectional study.

BACKGROUND: The association between breast milk feeding and dental caries risk in children remains controversial. Moreover, it is unclear whether risk factors for caries differ between breast milk-fed and formula milk-fed infants. AIM: To investigate dental caries in 13- to 18-month-old infants receiving breast milk or formula milk feeding and associated risk factors. DESIGN: One hundred and sixty-six 13- to 18-month-old infants were recruited from a tertiary hospital in Bangkok, Thailand. Information on feeding practices, demographics, and potential risk factors was collected using a caregiver questionnaire. Carious lesions were identified by visual and tactile examination. The Chi-squared test, Mann-Whitney U test, and logistic regression model were used for statistical analysis. RESULTS: The prevalence of caries in breast milk- and formula milk-fed infants was 31.8% and 36.0%, respectively, with no statistically significant difference (p = .579). Among all children, having dental plaque deposition on more than one third of the crown (adjusted OR (aOR): 15.11%; 95% CI: 6.11-37.35) and sleeping while milk feeding (aOR: 2.20%; 95%CI: 1.01-4.77) were associated with dental caries. In subgroup analysis, however, sleeping while milk feeding increased caries risk in the formula milk-fed group only (aOR: 2.95%; 95%CI: 1.07-8.12). CONCLUSIONS: The type of milk feeding was not associated with dental caries, whereas dental plaque and sleeping while milk feeding increased the odds of having dental caries in this population.

Reducing mutans streptococci and caries development by Lactobacillus paracasei SD1 in preschool children: a randomized placebo-controlled trial.

OBJECTIVE: To examine a reducing effect of Lactobacillus paracasei SD1 on MS and caries in preschool children. MATERIALS AND METHODS: A total of 124 children, aged 1.5-5 years old, participated and were randomly assigned to the probiotic or control group. The probiotic group received L. paracasei SD1-milk and the control group received standard-milk once daily for 3 months. MS/lactobacilli were enumerated and the caries score was examined. Association between probiotic consumption and bacterial level, or caries progression was assessed by a multivariate logistic regression. This study was registered at the Thai-Clinical-Trials-Registry (TCTR20140903001). RESULTS: Probiotic was found to be a factor associated with the MS level. Children in the probiotic group had a significantly lower risk of an increase in the MS level than in the control group after receiving the probiotic milk at 3- and 4-months with p < .001 and p = .040, respectively. Probiotic significantly reduced the risk for caries compared to the control group (p = .016). There were no adverse effects or non-compliance reported in either group. CONCLUSIONS: Consumption of milk powder containing L. paracasei SD1 resulted in a reduction of both salivary MS and delayed new caries development, and the strain is safe for use in young children. Results suggest that L. paracasei SD1 may be an alternative way for caries prevention in young children.

Longitudinal associations between children's dental caries and risk factors.

UNLABELLED: Dental caries is a common disease in children of all ages. It is desirable to know whether children with primary, mixed, and permanent dentitions share risk factors for cavitated and non-cavitated caries. OBJECTIVE: To assess the longitudinal associations between caries outcomes and modifiable risk factors. METHODS: One hundred and fifty-six children in the Iowa Fluoride Study met inclusion criteria of three dental examinations and caries-related risk factor assessments preceding each examination. Surface-specific counts of new non-cavitated caries and cavitated caries at the primary (Exam 1: age 5), mixed (Exam 2: age 9) and permanent (Exam 3: age 13) dentition examinations were outcome variables. Explanatory variables were caries-related factors, including averaged beverage exposure frequencies, tooth brushing frequencies, and composite water fluoride levels collected from 3-5, 6-8, and 11-13 years, dentition category, socioeconomic status, and gender. Generalized linear mixed models (GLMMs) were used to explore the relationships between new non-cavitated or cavitated caries and caries-related variables. RESULTS: Greater frequency of 100 percent juice exposure was significantly associated with fewer non-cavitated and cavitated caries surfaces. Greater tooth brushing frequency and high socioeconomic status (SES) were significantly associated with fewer new non-cavitated caries. Children had significantly more new cavitated caries surfaces at the mixed dentition examination than at the primary and permanent dentition examinations. CONCLUSIONS: There were common caries-related factors for more new non-cavitated caries across the three exams, including less frequent 100 percent juice exposure, lower tooth brushing frequency and lower SES. Less frequent 100 percent juice exposures might be associated with higher exposures to several other cariogenic beverages.

Mixed dentition cavitated caries incidence and dietary intake frequencies.

PURPOSE: This study examined risk factors for children having new cavitated caries between 5 and 9 years old. METHODS: Subjects were Iowa Fluoride Study cohort children (mostly Caucasian and of relatively high socioeconomic status) with both primary and mixed dentition caries exams and at least 2 diet diaries recorded between 5 and 8 years old (N=198). Using surface-specific transitions, combined counts of new cavitated caries (d(2-3)f and/or D(2-3)F) were determined from 4 primary second molars, 8 permanent incisors, and 4 permanent molars. Food and beverage intake frequencies were abstracted. Other factors were assessed using periodic questionnaires. Logistic regression identified predictors of new cavitated caries. RESULTS: Thirty-seven percent had new cavitated caries. The mean new cavitated caries count for all children was 1.17 surfaces (±2.28 SD). In multivariable logistic regression, the following were significantly associated (P<.10) with having new cavitated caries: noncavitated caries experience at 5 years old (odds ratio [OR]=2.67, P=.03); cavitated caries experience at 5 years old (OR=3.39, P=.004); greater processed starch at snack frequency (OR=3.87, P=.07); being older (OR=1.68, P=.04); and less frequent tooth-brushing (P=.001). CONCLUSION: Results suggested that increased tooth-brushing frequency and reduced consumption of processed starches as snacks may reduce caries incidence in younger school-aged children.

Survival rate and associated factors affecting pulpectomy treatment outcome in primary teeth.

OBJECTIVES: To evaluate the survival rates of pulpectomized primary teeth treated under general anesthesia (GA) or local anesthesia (LA), and to determine which factors affected tooth survival following pulpectomy. MATERIALS AND METHODS: This retrospective study collected data from dental records. Patients under 5 years of age received dental treatment under GA or LA during 2007-2016, with at least one anterior or posterior tooth receiving a pulpectomy, were recruited. Pulpectomy was considered a failure if the tooth required extraction or retreatment due to pulp treatment failure. Survival analysis was used to assess the outcome. The cumulative survival probability was analyzed with the Kaplan-Meier estimator. Cox regression analysis was used to evaluate the associations between tooth survival and possible prognosis factors; sex, age, dental arch (upper/lower), tooth type (anterior/posterior), molar type (first/second molar), molar location (upper/lower molar), root filling material type, restoration type, preoperative radiographic findings and presence of pathologic root resorption. RESULTS: Two hundred and twenty-seven primary teeth were included. At the 5-year follow-up, the survival rates of the pulpectomized teeth treated under GA and LA were 81.4% and 87.4%, respectively, which were not significantly different (p ≥ 0.05). A radiolucency on the preoperative radiograph was the only factor associated with tooth extraction or retreatment following pulpectomy, with a hazard ratio of 3.88 (95% CI = 1.29-11.65). CONCLUSIONS: Pulpectomized primary teeth treated under GA and LA demonstrated high survival rates. Preoperative radiolucency is a possible associated factor that decreases tooth survival following pulpectomy. Why this paper is important Pulpectomy treatment under GA and LA provided high 5-year cumulative survival rates, which were not significantly different. Pulpectomy treatment in teeth with a preoperative radiolucency were 3.9-fold as likely to fail as teeth without pathology. Based on our findings, practitioners could apply these findings and discuss with caregivers about the treatment options, outcomes, and prognosis of pulpectomized teeth.

Associations Between Temperament and Dental Caries Status in Thai Children.

PURPOSE: To examine the relationships between (1) the levels of each temperament traits and the levels of milk-feeding frequency, oral hygiene care and dental caries, and (2) the difference in mean numbers of decayed surfaces among temperament types. MATERIALS AND METHODS: Four hundred and ninety-three (493) 12-month-old infants were assessed for temperaments and characteristics of child-rearing practices. The data were analysed with their dental caries status at 18 months of age. The chi-squared test, Student's t test, ANOVA and Kruskal-Wallis tests were used to assess the association between temperament traits and the following variables; dental caries, oral cleaning habits and feeding frequency. Logistic regression models were used to identify the effect of temperament traits and other factors on dental caries status. RESULTS: The trait of adaptability was found to associate with feeding frequency at night, while those of activity and approach/withdrawal were significantly associated with regularity of oral cleaning habits by the children's caregiver. Three of the nine temperament traits - biological rhythmicity, approach/withdrawal and mood - were significantly associated with dental caries in bivariate analysis. Biological rhythmicity and approach/withdrawal traits were significantly associated with a higher chance of having caries after adjusting for regularity of oral cleaning habits and frequency of night feeding. CONCLUSION: Biological rhythmicity, approach/withdrawal and mood traits were related to caries in these young children.

Oral manifestations, salivary flow rates and Candida species in Thai HIV-infected patients.

BACKGROUND: Effects of various Highly Active Antiretroviral Therapy (HAART) regimens on oral heath are unclear. Objectives: We aimed to evaluate effects of HAART on oral manifestations, salivary flow rates (SFR) and Candida species in HIV-infected patients who took mostly non-protease inhibitor-based HAART regimens. MATERIAL AND METHODS: A cross-sectional study was performed on HIV-infected patients taking and never taken HAART who attended Thai Red Cross AIDS Research Centre (n = 48). Non-HIV subjects were recruited as control (n = 20). Oral conditions and salivary flow rates were evaluated using oral examination and measurement of unstimulated and stimulated saliva. In addition, Candida colonization counts (colony forming units; CFUs) and Candida species from the collected saliva were evaluated using CHROMagar. RESULTS: The most common oral manifestation in HIV-infected subjects taking HAART was hyperpigmentation. Unstimulated and stimulated SFR among the three groups were not statistically significant. Candida colonization was detected in 64%, 65% and 35% of HIV-infected subjects taking HAART, HAART-naïve, and non-HIV subjects, respectively. While 20% and 35% of HIV-infected subjects with and without HAART, respectively, had Candida CFUs higher than 500/ml, all non-HIV carriers had Candida CFUs lower than 500/ml. The most common Candida colonization species was C. albicans in HAART and non-HIV groups. Interestingly, HAART-naïve group was colonized more by non-albicans species. CONCLUSIONS: HAART has minimal effects on oral health. While HAART may not prevent Candida colonization, it might lead to reduction of non-albicans species. Because maintaining low Candida counts is important, HAART administration and antifungal sensitivity test should be considered in HIV-infected patients. Key words:HIV, Candida, HAART, Oral manifestation, Salivary flow rates.

A longitudinal study of early childhood caries in 9- to 18-month-old Thai infants.

OBJECTIVE: To examine the rate and pattern of early childhood caries (ECC) development and to investigate the transitional changes of the carious lesions during a follow-up period of 3-9 months. METHODS: A longitudinal observational community-based survey of 599 children, 9-18 months old. The children's dental examinations were first carried out at the age of 9 months with re-examination at 12 and 18 months by five dentists using standardized methods. The affected rates of dental caries were determined for prevalence, incidence density for risk of caries per person (IDp) and risk by surface (IDs). Changes in dental status over time were explored from unerupted (U) to sound (S), including enamel caries (D1), dentine caries (D2) and caries involving pulp (D3) by computing transitional probabilities. RESULTS: The prevalence of caries was 2.0%, 22.8% and 68.1% among 9-, 12- and 18-month olds, respectively. The IDp observed for newly affected children 9-12 and 12-18 months old was 10.32 and 15.70 persons/100 person-months, respectively. The IDs for children 9-12 months old was 2.17 newly affected surfaces/100 surface-months whereas it was 2.22 surfaces/100 surface-months for children 12-18 months old. The buccal surface of maxillary incisors was the most affected (44.9%) followed by lingual, mesial and distal surfaces, respectively. The transitional probability of caries progression ranged between 1.79% and 15.38% during the follow-up period from 9 to 12 months old. It was 3.43-39.60% from 12 to 18 months old. CONCLUSIONS: An extremely high caries-affected rate was found among the study children even before the age of 18 months. The buccal surface of the maxillary incisors was the most affected. The teeth acquired caries at 3-6 months after initial eruption and carious lesions developed continuously over time.

The associations between dietary intakes from 36 to 60 months of age and primary dentition non-cavitated caries and cavitated caries.

OBJECTIVE: To examine risk factors for non-cavitated caries, as well as cavitated caries. METHODS: Subjects were participants in the Iowa Fluoride Study cohort. Dietary data were collected at 36, 48, and 60 months old using 3-day dietary diaries, and a dental examination was conducted at about age 5. We compared the frequencies of dietary intakes of three groups: a) children having only d1 caries (n = 41); b) children having only cavitated (d2+f) caries (n = 46); and c) children having both d1 and d2+f caries (n = 49) with a forth group; d) those of caries-free children (n = 257). RESULTS: Multinomial and binomial logistic regression was used, where the categorical outcome was based on the 4 caries groups, and the caries-free group was designated as the reference. In the final model, sevenvariables were associated with the caries outcome. Lower milk consumption frequency at meals and greater presweetened cereal consumption frequency at meals were significantly associated with a greater likelihood of being in the d1 group. Greater regular soda pop consumption frequency and greater added sugar consumption frequency at snacks were significantly associated with being in the cavitated caries (d2+f and/or d1 d2+f) groups. Lower socioeconomic status and less frequent toothbrushing increased the likelihood of being in the d1 group. CONCLUSIONS: The results suggest that different food and beverage categories are associated with being in the d1 group compared with the cavitated caries groups. More frequent toothbrushing, greater milk consumption at meals, and avoiding presweetened cereal consumption at meals might reduce the risk of developing non-cavitated caries.

A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life.

UNLABELLED: Aesthetic perceptions and oral health-related quality of life concerning dental fluorosis have been assessed in several studies during the past two decades. However, no comprehensive review article summarizing the studies investigating this issue has been published. OBJECTIVE: To assess the relationships between perceptions of dental appearance/oral health-related quality of life (OHRQoL) and dental fluorosis. METHODS: The PubMed database was searched using the Medical Subject Headings (MeSH) for English-language studies from 1985 to March 2009. Thirty-five articles qualified for inclusion and then were classified into three categories based on the type of study approach: (i) respondent review of photographs and assessment concerning satisfaction/acceptance, (ii) respondent assessment of study subject's teeth concerning satisfaction/acceptance, and (iii) respondent assessments of the psychosocial/OHRQoL impact. RESULTS: There were varied results from earlier studies focused on satisfaction/acceptance of very mild to mild fluorosis. More recent studies with methodological improvements to assess impact on quality of life clearly showed that mild fluorosis was not a concern. Furthermore, mild fluorosis was sometimes associated with improved OHRQoL. Severe fluorosis was consistently reported to have negative effects on OHRQoL. CONCLUSION: Because dental fluorosis in the United States and other nations without high levels of naturally-occurring fluoride is mild or very mild, with little impact on OHRQoL, dental professionals should emphasize the appropriate use of fluorides for caries prevention and preventing moderate/severe fluorosis.