The dental health of three-year-old children in Greater Glasgow, Scotland.

OBJECTIVE: To report on the dental health of three-year-old children in Greater Glasgow, and to examine the amount of dental caries associated with deprivation in this young age group. DESIGN: Dental inspections in nursery schools. SUBJECTS AND METHODS: The national inspection programme using BASCD criteria was extended to include an additional group of nursery attending three-year-olds in Greater Glasgow in 2006/7 and 2007/8. Caries experience was analysed by logistic regression models and ROC plots. RESULTS: Fourteen percent of this population was sampled in 2006/7 and 19% in 2007/8 (usable data n = 1,711 in 2006/7, 2,428 in 2007/8). Mean d(3)mft was 1.1 in 2006/7 and 1.0 in 2007/8. The prevalence of caries experience was 26% in 2006/7 and 25% in 2007/8 (33% and 32%, respectively, for children in deprived areas). The adjusted odds-ratio for caries experience for children living in the most deprived areas was 2.90 (2.31, 3.64), p <0.001. There was a high rate of caries in the upper anterior teeth. CONCLUSION: It was feasible to conduct large scale caries surveys of three-year-olds in a nursery setting. Poor dental health and inequality commence early in life. Caries prevention should be targeted toward deprived families from birth.

Childsmile: the national child oral health improvement programme in Scotland. Part 1: Establishment and development.

This paper is the first of two reviewing the Childsmile programme. It sets out to describe the development and implementation of this national oral health improvement programme for children in Scotland over its initial three-year period (January 2006 to December 2008) and into its second phase of development. It outlines the context in which the initiative was conceived, the initial development of its various components, and how monitoring and evaluation are shaping the delivery and direction of the programme.

Dental caries in 5-year-old children attending multi-ethnic schools in Greater Glasgow--the impact of ethnic background and levels of deprivation.

OBJECTIVE: To examine levels of dental caries of 5-year-olds attending multi-ethnic schools in Greater Glasgow and to explore the effects of deprived backgrounds and ethnic identity on their dental health. DESIGN: Between October 2001 and February 2002 a cross-sectional dental epidemiology survey of a sample of 721 5-year-olds was undertaken in schools having at least 25 per cent of pupils from black or minority ethnic groups. Background data on participating children were obtained from school records, including: ethnic origin, mothers' ability to speak English, religion, and demographics. Statistical analyses included two way analysis of variance to determine the effect of ethnicity after adjusting for socio-economic factors. RESULTS: Complete data were available for 649 (90%) children. The sample broadly divided into white (52%), Pakistani (33%), and other minority ethnic groups (15%). Based on repeat observations, diagnosis reliability was good (Kappa = 0.77). The caries experience of Pakistani children (d3mft = 4.1; 95% CI 3.6 to 4.6) was significantly higher (p < 0.001) than the white children (d3mft = 2.3; 95% CI 1.9 to 2.6). Only 25% (95% C1 17 to 34) of the Pakistani children had no obvious decay, significantly lower (p < 0.001) than their white contemporaries (48%, 95% CI 39 to 58). Pakistani ethnic origin was associated with significantly higher levels of dental caries (p < 0.001), after adjusting for socio-economic deprivation. CONCLUSION: Children from deprived backgrounds have worse dental caries levels than their affluent counterparts and, over and above this effect, minority ethnic children of Pakistani background have higher levels than their white peers.

Glasgow nursery-based caries experience, before and after a community development-based oral health programme's implementation.

OBJECTIVE: To develop and evaluate NHS-based strategies likely to improve dental health and reduce inequalities in pre-5-year-old's oral health in Greater Glasgow, Scotland, by ecological study of community-based oral health promotion programmes in two of the area's most socio-economically deprived communities. BASIC RESEARCH DESIGN: Following an initial health service-based Oral Health Needs Assessment (OHNA) in a severely deprived community, culturally relevant dental health promotion interventions were initiated with multidisciplinary collaborative networks. Ecological studies to monitor dental health involved cross-sectional caries epidemiology of nursery children aged 36-59 months at baseline (1995/96), after two (1997/98) and four years (1999/00), in the G22 (pilot) and G33 post code areas. These areas had similar socio-economic status (SES), i.e. severe social deprivation. RESULTS: At the outset, mean dmft scores in the pilot area for the age groups 36-47 months and 48-59 months were respectively 3.9 (95% CI 2.8 5.1) and 5.9 (95% CI 5.1-6.8), with the proportions of caries-free children being 38% and 17%, respectively. Reductions in mean dmft of 46% for the 36-47 month-olds and 37% for the 48-59 month-olds occurred in the pilot public health programme area over the four-year period; the proportions of caries-free children increased to 51% and 40%, respectively. During the first two years of the programme, increases in the mean dmft of 36-47 month- and 48-59 month-olds in the G33 (comparator) area were recorded. However, this trend was reversed significantly two years later following the introduction of a similar community development-based caries-prevention programme. CONCLUSION: While not being able to attribute causation, a programme of community development to promote the dental health of pre-school children residing in two socio-economically disadvantaged areas of Glasgow was associated with significant improvements in the dental health of these pre-school populations.

The effect of NaF and SMFP toothpastes on three-year caries increments in adolescents.

A three-year double blind clinical caries trial was undertaken to compare the anticaries efficacy of three types of active agent, namely sodium fluoride (NaF), sodium monofluorophosphate (SMFP) and the combination of NaF plus sodium trimetaphosphate (TMP), using two fluoride levels (1000 ppm F and 1500 ppm F). The prime objective of the study was to determine whether there was any difference in the anticaries efficacy between NaF and SMFP. The second objective was to assess the effect on caries protection of the incorporation of TMP into a NaF dentifrice formulation. The study was carried out to FDI protocol and involved 4,294 children aged 11-12 years at outset. These participants had been selected from a pool of 6,212 potential subjects on the basis of caries experience and dental eruption pattern. They were stratified by sex, examiner, presence of calculus and caries, and allocated at random to one of the six toothpastes under study. Clinical examinations were carried out at baseline and thereafter annually for 3 years. Bitewing radiographs of a subset of children were taken at baseline and at the end of the study. The outcome measure for the study, DMFS increment, was defined as the increase in caries over three years, taking into account changes occurring on individual tooth surfaces. After three years, clinical-only data for 3,517 children were available for the calculation of caries indices. The mean three-year DMFS increment for subjects using a dentifrice containing NaF alone was 6.4 per cent lower than for those using a dentifrice containing SMFP. The difference between the NaF+TMP users and the SMFP users was 8.1 percent.(ABSTRACT TRUNCATED AT 250 WORDS)

Incisor enamel mottling prevalence in child cohorts which had or had not taken fluoride supplements from 0-12 years of age.

Blind photographic assessments were made of the permanent incisors of 322 children who had participated in two successful fluoride drop/tablet hygienist-based preventive dentistry programmes. Two groups of four dental and two lay assessors unanimously scored 57% of dentitions as mottling-free. The dental observers unanimously scored 37 children (12%) with some symmetrical homologous tooth-type mottling, although only 13 decisions (4%) were scored "unacceptable easthetically". The lay assessors rated 77 children (24%) with mottling, 15% being easthetically displeasing. However, no significant mottling differences were noted between cohorts which had commenced oral fluoride supplementation at birth and those which either commenced as late as 7 years of age, or which had never taken any such supplementation. Thus other fluoride sources must have been responsible for the non-drop/tablet diffuse symmetrical mottling noted, the most likely being highly fluoridated dentifrices ingested by youngsters unable to control the volume dispensed and swallowed. Hence the evidence does not suggest that this proven caries-inhibiting F- drop/tablet regime dosage should be reduced. There is, however, a clear and continuing need for both the dental profession and the public to be made more aware of the problem of uncontrolled fluoride ingestion from other sources.

Tetrapyrrole utilization by Bacteroids ruminocola.

Reduced versus oxidized difference spectra of whole cells and pyridine hemochromogens of heme-requiring isolates of Bacteroides ruminicola are altered when deuteroporphyrin or mesoporphyrin replaces protoheme as a growth factor. During growth in the presence of either deuteroporphyrin or mesoporphyrin, whole cells exhibit peaks at 545 t547, 515 to 518, and 412 to 413 nm. Pyridine hemochromogen spectra confirm the presence of meso -or deuteroheme in cells grown in the presence of meso- or deuteroporphyrin. No evidence was found for the conversion of either meso- or deuteroporphyrin to protoheme. Cells grown in the presence of the manganese of magnesium chelates of protoheme form iron-containing hemes. Neither spontaneous decomposition of noniron metalloporphyrin chelates nor spontaneous formation of hemes from Fe2+ and metal-free porphyrins was detected. Protoheme-synthesizing isolates of B. ruminicola fail to use preformed metal-free porphyrins, but form both protoheme- and deuteroheme-containing cytochromes when grown in the presence of manganese deuteroheme. Versatility in tetrapyrrole utilization by B. ruminicola appears to reflect the ability of the organism to mediate the removal of nonferrous ions and to insert Fe2+ into the tetrapyrrole nucleus. The orgamism also forms functional b-type cytochromes with prosthetic groups other than protoheme.