RESUMO
BACKGROUND: Early childhood caries (ECC) is a rapidly progressing form of dental infection and a significant public health problem, especially among socially and economically disadvantaged populations. This study aimed to assess the risk factors for ECC among a cohort of Sub-Saharan African children and to determine the role of genetics in the etiology of ECC. METHODS: A sample of 691 children (338 with ECC, 353 without ECC, age < 6 years) was recruited from schools in Lagos, Nigeria. Socio-demographic, dental services utilization and infant dietary data were obtained with interviewer-administered questionnaire. Oral examination was conducted using the WHO oral health diagnostic criteria. Saliva samples were collected from the children for genetic analysis. Single nucleotide polymorphisms were selected from previous study for genotyping. Genetic association analyses to investigate the role of genetics in the etiology of ECC was done. Bivariate comparisons and Multivariate logistic regression analyses were conducted to assess associations between ECC and predictor variables, p < 0.05. RESULTS: Of the 338 children with ECC, 64 (18.9%) had Severe-Early Childhood Caries (S-ECC). Children aged 48-59 months comprised the highest proportion of subjects with ECC (165; 48.8%) and S-ECC (24; 37.5%) while female subjects had higher dt (3.13 ± 2.56) and dmft values 3.27 ± 2.64. ECC was significantly more prevalent among children who were breastfed at night ≥ 12 months (OR 3.30; CI 0.39, 4.75), those with no previous dental visit (OR 1.71; CI 0.24, 2.77), those who used sweetened pacifiers (OR 1.85; CI 0.91, 3.79) and those who daily consumed sugar-sweetened drinks/snacks (OR 1.35; CI 0.09, 18.51). A suggestive increased risk for ECC (OR 1.26, p = 0. 0.0397) was observed for the genetic variant rs11239282 on chromosome 10. We also observed a suggestive reduced risk for ECC (OR 0.80, p = 0.03) for the rs131777 on chromosome 22. None of the genetic variants were significant after correction for multiple testing (Bonferroni p value p = 0.004). CONCLUSIONS: Prolonged night-time breastfeeding, poor utilization of dental services and daily consumption of sugar were risk factors for ECC. Larger sample size is needed to confirm the results of the genetic analysis and to conduct genome wide studies in order to discover new risk loci for ECC.
Assuntos
Suscetibilidade à Cárie Dentária , Cárie Dentária , África Subsaariana , Criança , Pré-Escolar , Estudos Transversais , Cárie Dentária/epidemiologia , Cárie Dentária/genética , Feminino , Estudo de Associação Genômica Ampla , Humanos , Lactente , Nigéria , Projetos Piloto , Prevalência , Fatores de RiscoRESUMO
OBJECTIVE: To explore the association between tooth wear and quality of life among adults in the United Kingdom, independently of sociodemographic factors and other common oral conditions. METHODS: We used data from 5654 dentate adults who participated in the 2009 Adult Dental Health Survey. Tooth wear was assessed during clinical examination and classified as none, mild, moderate and severe based on the worst affected tooth recorded. The numbers of teeth with mild, moderate and severe tooth wear were used as alternative measures. Oral impacts on quality of life were measured using the short form of the Oral Health Impact Profile (OHIP-14). The associations between tooth wear measures and OHIP-14 total and domain scores were tested in negative binomial regression models adjusting for sociodemographic and clinical factors. RESULTS: Overall, 62% of participants had mild, 13% moderate and 2% severe tooth wear. Adults with severe tooth wear had a crude OHIP-14 total score higher than those without tooth wear (Rate Ratio: 1.90; 95% Confidence Interval: 1.32-2.75). This association was attenuated after adjustment for confounders, particularly for other oral conditions (1.25; 95% CI: 0.90-1.73). Moreover, adults with severe tooth wear reported higher OHIP-14 domain scores in psychological discomfort (1.15; 95% CI: 1.06-1.25) and psychological disability (1.18; 95% CI: 1.10-1.30) than those without such condition. There was also evidence of a dose-response relationship; with higher OHIP-14 domain scores according to the number of teeth with severe tooth wear. CONCLUSION: This nationwide study among UK adults shows that severe tooth wear was negatively associated with psychological impacts on people's life. CLINICAL SIGNIFICANCE: Dentist should consider not only the patients' clinical characteristics, but also their impacts on quality of life and provide preventive or restorative management accordingly.