Body mass index and dental caries in New Zealand pre-school children: A population-based study.

AIM: Pre-school dental caries is a significant public health problem and may be associated with the growth and nutritional status of children. This study aimed to investigate the association between body mass index (BMI) and early childhood caries (ECC) among pre-school children. METHODS: This population-based retrospective study involves all 5-year-old children who resided in northern New Zealand and received school entry dental examinations between 1 January 2014 and 31 December 2015. ECC status was determined with the decayed missing filled teeth (dmft) score obtained from a routinely collected regional dental data set. Objectively measured BMI information was obtained from the 'Before School Check' (B4SC) Programme. Logistic regression analyses were used to assess the association between BMI and the occurrence of ECC (dmft score ≥ 1). Ethnic subgroup analyses were also conducted. RESULTS: Of the 27 333 children involved in this analysis, 11 173 (40.9%) had ECC with a mean dmft score of 1.85, and 3948 (14.4%) were overweight and 2964 (10.8%) were obese at school entry. The prevalence of ECC was higher in overweight and obese children but in subgroup analyses by ethnicity, this positive association was observed in European children only (adjusted odds ratio for overweight children compared to normal weight children: 1.16; 95% CI: 1.02, 1.32 and adjusted odds ratio for obese children: 1.20; 95% CI: 1.00, 1.45). CONCLUSION: ECC is highly prevalent in New Zealand children and associated with higher BMI in children of European ethnicity.

Dental caries and previous hospitalisations among preschool children: findings from a population-based study in New Zealand.

BACKGROUND: Early childhood caries (ECC) is a significant public health problem, and may be associated with other health conditions. AIM: To investigate whether an association exists between ECC and previous hospitalisations due to avoidable medical conditions, including injury-related admissions among preschool children. METHODS: This population-based retrospective study involves all five-year old children who resided in one of the two contiguous regions in northern New Zealand (Northland and Auckland) and received school entry dental examinations between 1 January 2014 and 31 December 2015. Eligible children were identified from the regional dental datasets (Titanium® software), and their ECC status was determined by using decayed missing filled teeth (dmft) scores. Information on hospitalisations for avoidable medical conditions, which occurred during the first six years of life, was obtained through linkage to hospital discharge data. Logistic regression analysis was performed to assess the associations between ECC and previous hospitalisations. RESULTS: 11,173 of the 27,333 eligible children (40.9%) had ECC (dmft ≥1). Children from non-European ethnic origins (Maori, Pacific and Asian groups) and those from the Northland, areas without community water fluoridation or deprived neighbourhoods, were more likely to have ECC. ECC was significantly associated with injury-related admissions (adjusted odds ratio: 1.17; 95% CI: 1.07, 1.27), but not with admissions for other medical and respiratory conditions. CONCLUSION: ECC was highly prevalent in New Zealand children, and associated with injury-related hospital admissions. The findings underscore more efforts to tackle ECC and associated health conditions.

Attitudes to immunisation: a survey of health professionals in the Rotorua District.

AIM: To examine the personal attitudes and practice of health professionals regarding childhood vaccinations in order to provide guidance to local professional education strategies. METHODS: A questionnaire was circulated to those involved in the implementation of the childhood immunisation schedule in the Rotorua District. Responses were stratified: a) community vs hospital; b) nurses, midwives, doctors, others. RESULTS: 85% responded, of whom 94% supported vaccinations. 91% considered science the most important basis for recommendations; 91% considered current scientific support adequate. 11% thought immunisations held unacceptable dangers; 17% were unsure. 41% of nurses, 45% of midwives, and 21% of doctors were unsure whether the MMR vaccine was associated with autism or Crohn's disease. Professional training, reading and personal experience were identified most often as having an influence on opinions, while the media and Internet ranked least often. Amongst respondents who had children, 96% reported vaccination (no significant difference between professional groups, but lower rates for children of hospital providers). CONCLUSIONS: Strong national support of vaccinations was demonstrated in this survey of professionals involved with vaccination in one district. Significant underlying uncertainties or concerns were identified regarding risks, the MMR vaccine, and ethical tensions between community protection and perceived individual risk. Continuing education and dialogue through professional training and medical literature are indicated to address these concerns.