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1.
Artículo en Inglés | MEDLINE | ID: mdl-31809561

RESUMEN

OBJECTIVES: Dental caries experience, which affects 91% of US adults, is a consequence of a carious process influenced by diet. Although individual foods have been implicated, we hypothesized that dietary patterns might be important predictors of caries presence. METHODS: We analysed data from 4467 people ≥18 years old participating in the 2013-2014 National Health and Nutrition Examination Survey, a nationally representative sample of the US population. Data from 24-hour dietary recalls were classified into standard food categories and reduced to three dietary patterns using principal components (PCs) analysis. We used regression to model the log-transformed decayed, missing and filled teeth (DMFT) score and the prevalence of any caries experience by quartiles of PC scores, controlling for potential confounders. Dietary patterns differed by age with respect to dental caries so 18-30-year-olds (n = 1074) and >30-year-olds (n = 3393) were analysed separately. RESULTS: Similar dietary patterns existed among individuals aged 18-30 and >30 years, but the prevalence of DMFT score >0 and the median of DMFT was greater in those >30:78.7% (95% CI: 76.1, 81.3) vs 92.6% (95% CI: 91.4, 93.7) and 4 (95% CI: 4, 5) vs 12 DMFT (95% CI: 11, 13), respectively. In those 18-30, no dietary pattern was associated with greater prevalence or severity of dental caries experience. Among those >30, the prevalence of DMFT>0 was higher by 2% for those in each subsequent quartile of a diet high in sugar-sweetened beverages and sandwiches (adjusted PR: 1.02, 95% CI: 1.001, 1.03)-thus, the prevalence of dental caries experience was 6% higher among those in the uppermost quartile than in the lowest quartile. For every subsequent quartile in the same pattern, there was a 1.98% higher (95% CI: 0.15, 3.85) DMFT score. However, analysis using the two strongest loading food groups from any of the PCs did not identify any predictors of caries experience. CONCLUSIONS: Dietary patterns were associated with the prevalence of dental caries experience, with differing findings by age. Although effect sizes were small, the population impact may be substantial. While food groups high in sugar were associated with caries prevalence and severity, associations were more apparent in the context of overall diet. Prospective studies are needed to confirm whether particular dietary patterns are causally related to the development of dental caries.

2.
Dent Clin North Am ; 63(4): 595-605, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31470915

RESUMEN

Acid produced during bacterial fermentation of carbohydrates dissolves tooth structure, leading to dental caries. Carbohydrates are a nutrient within foods, individual foods contain multitudinous differing nutrients in varying concentrations, and, ultimately, food choices and eating behaviors are associated with the caries process. Consideration of food choices and eating behaviors is necessary for effective caries prevention. This article (1) defines a healthy diet and eating behaviors as a foundation for caries prevention, (2) identifies food choices and eating behaviors associated with caries, (3) identifies diet-related screening and assessment tools for caries risk, and (4) provides counseling strategies to manage dental caries.


Asunto(s)
Caries Dental , Consejo , Dieta , Sacarosa en la Dieta , Conducta Alimentaria , Humanos
3.
J Dent Educ ; 83(1): 79-87, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30600253

RESUMEN

The aim of this study was to seek the views of a national sample of dental educators regarding the importance of learning domains in dental education, their defined outcomes of those domains, and their perceived effectiveness of their schools in guiding learning in those domains. The study defined the educational domains important for training future dentists as knowledge, technical skills, critical thinking, ethics, social responsibility, and interprofessional education/practice (IPE/IPP). A survey of members of the American Dental Education Association (ADEA) Special Interest Group on the Scholarship of Teaching and Learning was conducted in 2017. In addition to reporting their demographics, participants were asked to rate and rank the importance of each learning domain as well as answer open-ended questions. Of the 89 respondents (response rate 12.5%), 31% were course directors, and 48% had been dental faculty members for more than ten years. Knowledge was ranked as the most important domain, followed by critical thinking, technical skills, clinical decision making, ethics, problem-solving, social responsibility, and finally IPE/IPP. When rating the absolute importance of these domains in the training of dental students, the respondents gave all but IPE/IPP and social responsibility the highest rating. Knowledge and technical skills were rated highest for respondents' confidence in defining student outcomes with similar high ratings for their confidence in guiding this learning. There was little consensus concerning a definition of critical thinking, and a third of the respondents were uncertain of specific learning outcomes for it. Participants expressed even less confidence in defining outcomes for ethics, IPE/IPP, and social responsibility. This baseline information will be used for a future in-depth study to aid in the development of strategies for articulating outcomes, guiding learning, and assessing performance in U.S. dental schools.


Asunto(s)
Educación en Odontología , Docentes de Odontología , Actitud del Personal de Salud , Competencia Clínica , Educación en Odontología/normas , Humanos , Responsabilidad Social , Estudiantes de Odontología/psicología , Pensamiento
4.
J Acad Nutr Diet ; 119(3): 425-434, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30638821

RESUMEN

BACKGROUND: Sugar-sweetened beverages (SSB) are considered a risk factor for obesity. OBJECTIVE: The objective of the current study was to investigate associations between the predictors of beverage and energy intakes and mean adequacy ratios (MARs), and the outcome of body mass index (BMI) z scores, in a birth cohort using longitudinal models. DESIGN: This was a longitudinal analysis of secondary data. PARTICIPANTS/SETTING: Participants in the Iowa Fluoride and Iowa Bone Development Studies with two beverage intake questionnaires completed between ages 2 and 4.7 years or 5 and 8.5 years or one questionnaire between ages 9 and 10.5, 11 and 12.5, 13 and 14.5, or 15 and 17 years (n=720); two food and beverage diaries completed between ages 2 and 4.7 years or 5 and 8.5 years or completion of the Block's Kids' Food Frequency Questionnaires at age 11, 13, 15, or 17 years (n=623); and anthropometric measures at the corresponding age 5-, 9-, 11-, 13-, 15-, or 17-year examination(s). PREDICTORS: Mean daily 100% juice, milk, SSB, water/sugar-free beverage, and energy intakes and MARs averaged over ages 2 to 4.7, 5 to 8.5, 9 to 10.5, 11 to 12.5, 13 to 14.5, or 15 to 17 years were predictors. OUTCOME: BMI z score was the outcome. STATISTICAL ANALYSES: Linear mixed models were fit for each beverage, energy, and MAR variable, with the beverage, energy, or MAR variable as the predictor and BMI z score as the outcome. Beverage models were adjusted for energy and MAR and baseline socioeconomic status. RESULTS: SSB intake adjusted for energy intake, MAR, and baseline socioeconomic status was associated with BMI z score; each additional 8 oz SSB consumed/day throughout childhood and adolescence increased the BMI z score an average 0.050 units (95% CI 0.022 to 0.079; P=0.001). Adjusted water/sugar-free beverage intake (0.026 units; 95% CI 0.006 to 0.046; P=0.013) was modestly associated with BMI z score, while 100% juice (-0.001 units; 95% CI -0.059 to 0.057; P=0.97) and milk (0.022 units; 95% CI -0.007 to 0.052; P=0.13) intakes were not associated with BMI z scores. CONCLUSIONS: Higher SSB intakes were associated with increased BMI z scores throughout childhood and adolescence in Iowa Fluoride Study participants. Public health initiatives targeting SSB consumption during childhood and adolescence remain relevant.

6.
J Public Health Dent ; 78(4): 352-359, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-30155933

RESUMEN

OBJECTIVES: There is strong affinity between fluoride and calcium, and mineralized tissues. Investigations of fluoride and bone health during childhood and adolescence show inconsistent results. This analysis assessed associations between period-specific and cumulative fluoride intakes from birth to age 11, and age 11 cortical bone measures obtained using peripheral quantitative computed tomography (pQCT) of the radius and tibia (n = 424). METHODS: Participants were a cohort recruited from eight Iowa hospitals at birth. Fluoride intakes from water, other beverages, selected foods, dietary supplements, and dentifrice were recorded every 1.5-6 months using detailed questionnaires. Correlations between bone measures (cortical bone mineral content, density, area, and strength) and fluoride intake were determined in bivariate and multivariable analyses adjusting for Tanner stage, weight and height. RESULTS: The majority of associations were weak. For boys, only the positive associations between daily fluoride intakes for 0-3 years and radius and tibia bone mineral content were statistically significant. For girls, the negative correlations of recent daily fluoride intake per kg of body weight from 8.5 to 11 years with radius bone mineral content, area, and strength and tibia strength were statistically significant. No associations between cumulative daily fluoride intakes from birth to 11 years and bone measures were statistically significant. CONCLUSIONS: In this cohort of 11-year-old children, mostly living in optimally fluoridated areas, life-long fluoride intakes from combined sources were weakly associated with tibia and radius cortical pQCT measures.


Asunto(s)
Hueso Cortical , Fluoruros , Adolescente , Densidad Ósea , Niño , Femenino , Humanos , Iowa , Masculino , Minerales
7.
Nutrients ; 10(8)2018 Jul 25.
Artículo en Inglés | MEDLINE | ID: mdl-30044405

RESUMEN

Our objective is to retrospectively describe longitudinal beverage intakes and anthropometric measures according to adolescent beverage patterns. Data were collected from Iowa Fluoride Study participants (n = 369) using beverage questionnaires at ages 2⁻17 years. Weight and height were measured at ages 5, 9, 13 and 17 years. Cluster analyses were used to identify age 13- to 17-year beverage patterns. Treating age and beverage cluster as explanatory factors, sex-specific generalized linear mixed models were used to identify when differences in beverage intakes and anthropometric measures began. Predominant beverage intakes were higher in each of the corresponding clusters by 9⁻12.5 years; females with high milk intakes during adolescence and males with high 100% juice or sugar-sweetened beverage intakes during adolescence reported higher intakes of that beverage beginning at 2⁻4.7 years. Females and males in the 100% juice cluster had lower weights than other clusters beginning at 13 years, while females and males in the neutral cluster were shorter beginning at 13 years. Females in the water/sugar-free beverage cluster had higher body mass indices (BMIs) beginning at 9 years. Females and males in the 100% juice cluster had lower BMIs beginning at 5 and 9 years, respectively. Childhood beverage intakes and growth patterns differ according to adolescent beverage patterns.


Asunto(s)
Antropometría , Bebidas , Adolescente , Fenómenos Fisiológicos Nutricionales de los Adolescentes , Niño , Fenómenos Fisiológicos Nutricionales Infantiles , Preescolar , Registros de Dieta , Conducta Alimentaria , Femenino , Humanos , Masculino , Encuestas y Cuestionarios
8.
J Nutr ; 148(7): 1144-1149, 2018 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-29924327

RESUMEN

Background: Height is an indicator of nutritional status; linear growth faltering has recognized consequences for cognitive, emotional, and chronic disease risk. Although height is routinely studied in developing countries, less attention is given to height in the United States. Objective: The objective of this study was to identify longitudinal associations between childhood and adolescent beverage intakes, nutrient adequacy, or energy intake and height in a birth cohort. Methods: Data for participants through ages 2-17 y (n = 717; 353 males, 364 females) recruited at birth for the longitudinal Iowa Fluoride Study (IFS) were used in the current cohort analyses. Beverage intakes (n = 708) were collected by beverage-frequency questionnaires at 3- to 6-mo intervals, whereas nutrient data (n = 652) were obtained from 3-d food diaries completed at 3- to 6-mo intervals through age 8.5 y and from Block Kids' food-frequency questionnaires at 2-y intervals after age 8.5 y. Nutrient adequacy ratios were calculated with the use of age- and sex-specific Estimated Average Requirements. Height was measured at clinic visits when the participants were approximately ages 5, 9, 11, 13, 15, and 17 y. Linear mixed models were used to identify longitudinal associations between dietary variables and height. A baseline model that adjusted for changing growth patterns during adolescence was established. Dietary and potential confounding variables were added to this baseline model. Results: Milk intake adjusted for mean adequacy ratio, energy intake, and baseline socioeconomic status was associated with height; for each additional 8 ounces (236 mL) of milk consumed per day throughout childhood and adolescence, height increased, on average, by 0.39 cm (95% CI: 0.18, 0.60 cm; P < 0.001). Conclusions: IFS participants' height increased by 0.39 cm for each additional 8 ounces (236 mL) of milk consumed throughout childhood and adolescence. The clinical implications of the mild linear growth faltering observed in healthy youth are unknown. This trial was registered at www.clinicaltrials.gov as 199112665.


Asunto(s)
Estatura , Fenómenos Fisiológicos Nutricionales Infantiles , Encuestas sobre Dietas , Leche , Adolescente , Animales , Niño , Preescolar , Estudios de Cohortes , Dieta , Registros de Dieta , Ingestión de Energía , Femenino , Humanos , Masculino
9.
J Public Health Dent ; 78(4): 321-328, 2018 09.
Artículo en Inglés | MEDLINE | ID: mdl-29752831

RESUMEN

OBJECTIVES: To assess longitudinal associations between permanent tooth caries increment and both modifiable and non-modifiable risk factors, using best subsets model selection. METHODS: The Iowa Fluoride Study has followed a birth cohort with standardized caries exams without radiographs of the permanent dentition conducted at about ages 9, 13, and 17 years. Questionnaires were sent semi-annually to assess fluoride exposures and intakes, select food and beverage intakes, and tooth brushing frequency. Exposure variables were averaged over ages 7-9, 11-13, and 15-17, reflecting exposure 2 years prior to the caries exam. Longitudinal models were used to relate period-specific averaged exposures and demographic variables to adjusted decayed and filled surface increments (ADJCI) (n = 392). The Akaike Information Criterion (AIC) was used to assess optimal explanatory variable combinations. RESULTS: From birth to age 9, 9-13, and 13-17 years, 24, 30, and 55 percent of subjects had positive permanent ADJCI, respectively. Ten models had AIC values within two units of the lowest AIC model and were deemed optimal based on AIC. Younger age, being male, higher mother's education, and higher brushing frequency were associated with lower caries increment in all 10 models, while milk intake was included in 3 of 10 models. Higher milk intakes were slightly associated with lower ADJCI. CONCLUSIONS: With the exception of brushing frequency, modifiable risk factors under study were not significantly associated with ADJCI. When possible, researchers should consider presenting multiple models if fit criteria cannot discern among a group of optimal models.


Asunto(s)
Caries Dental , Adolescente , Niño , Preescolar , Índice CPO , Dentición Permanente , Femenino , Fluoruros , Humanos , Iowa , Estudios Longitudinales , Masculino , Factores de Riesgo
10.
J Am Dent Assoc ; 149(2): 148-152, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29389338

RESUMEN

BACKGROUND AND OVERVIEW: Dental erosion occurs after exposure to intrinsic or extrinsic acids. Exposure to intrinsic gastrointestinal acids is associated with anorexia nervosa, bulimia nervosa, rumination syndrome, or gastroesophageal reflux. Extrinsic dietary acids from foods or beverages also can cause erosion, particularly when exposure is prolonged by holding or swishing behaviors. CONCLUSIONS: Clinicians should screen patients exhibiting dental erosion for anorexia nervosa, bulimia nervosa, rumination syndrome, and gastroesophageal reflux disease. Clinicians should screen patients without a medical explanation for their erosion for exposure to acidic foods and beverages, particularly for habits that prolong exposure. PRACTICAL IMPLICATIONS: Identification of intrinsic and extrinsic acid exposures and recommendations to minimize exposures are important to prevent erosion and maintain oral health.


Asunto(s)
Bulimia Nerviosa , Reflujo Gastroesofágico , Erosión de los Dientes , Consejo , Humanos , Evaluación Nutricional
11.
J Dent Educ ; 81(8): 978-985, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-28765442

RESUMEN

Critical thinking skills are essential for the successful dentist, yet few explicit skillsets in critical thinking have been developed and published in peer-reviewed literature. The aims of this article are to 1) offer an assessable critical thinking teaching model with the expert's thought process as the outcome, learning guide, and assessment instrument and 2) offer three critical thinking skillsets following this model: for geriatric risk assessment, technology decision making, and situation analysis/reflections. For the objective component, the student demonstrates delivery of each step in the thought process. For the subjective component, the student is judged to have grasped the principles as applied to the patient or case. This article describes the framework and the results of pilot tests in which students in one year at this school used the model in the three areas, earning scores of 90% or above on the assessments. The model was thus judged to be successful for students to demonstrate critical thinking skillsets in the course settings. Students consistently delivered each step of the thought process and were nearly as consistent in grasping the principles behind each step. As more critical thinking skillsets are implemented, a reinforcing network develops.


Asunto(s)
Educación en Odontología/métodos , Evaluación Educacional , Aprendizaje , Modelos Educacionales , Estudiantes de Odontología/psicología , Pensamiento , Anciano , Toma de Decisiones Clínicas , Evaluación Geriátrica , Humanos , Medición de Riesgo
12.
Community Dent Oral Epidemiol ; 45(6): 538-544, 2017 12.
Artículo en Inglés | MEDLINE | ID: mdl-28671327

RESUMEN

OBJECTIVES: There have been very few longitudinal studies of dental caries in adolescents, and little study of the caries risk factors in this age group. The purpose of this study was to describe different caries trajectories and associated risk factors among members of the Iowa Fluoride Study (IFS) cohort. METHODS: The IFS recruited a birth cohort from 1992 to 1995, and has gathered dietary, fluoride and behavioural data at least twice yearly since recruitment. Examinations for dental caries were completed when participants were ages 5, 9, 13 and 17 years. For this study, only participants with decayed and filled surface (DFS) caries data at ages 9, 13 and 17 were included (N=396). The individual DFS counts at age 13 and the DFS increment from 13 to 17 were used to identify distinct caries trajectories using Ward's hierarchical clustering algorithm. A number of multinomial logistic regression models were developed to predict trajectory membership, using longitudinal dietary, fluoride and demographic/behavioural data from 9 to 17 years. Model selection was based on the akaike information criterion (AIC). RESULTS: Several different trajectory schemes were considered, and a three-trajectory scheme-no DFS at age 17 (n=142), low DFS (n=145) and high DFS (n=109)-was chosen to balance sample sizes and interpretability. The model selection process resulted in use of an arithmetic average for dietary variables across the period from 9 to 17 years. The multinomial logistic regression model with the best fit included the variables maternal education level, 100% juice consumption, brushing frequency and sex. Other favoured models also included water and milk consumption and home water fluoride concentration. The high caries cluster was most consistently associated with lower maternal education level, lower 100% juice consumption, lower brushing frequency and being female. CONCLUSIONS: The use of a clustering algorithm and use of Akaike's Information Criterion (AIC) to determine the best representation of the data were useful means in presenting longitudinal caries data. Findings suggest that high caries incidence in adolescence is associated with lower maternal educational level, less frequent tooth brushing, lower 100% juice consumption and being female.


Asunto(s)
Caries Dental/epidemiología , Adolescente , Algoritmos , Cariostáticos/uso terapéutico , Niño , Preescolar , Escolaridad , Femenino , Jugos de Frutas y Vegetales , Humanos , Incidencia , Iowa/epidemiología , Estudios Longitudinales , Masculino , Factores de Riesgo , Factores Sexuales , Cepillado Dental
13.
J Acad Nutr Diet ; 117(5): 698-706, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28259744

RESUMEN

BACKGROUND: Sugar-sweetened beverages (SSBs) have been associated with obesity in children and adults; however, associations between beverage patterns and obesity are not understood. OBJECTIVE: Our aim was to describe beverage patterns during adolescence and associations between adolescent beverage patterns and anthropometric measures at age 17 years. DESIGN: We conducted a cross-sectional analyses of longitudinally collected data. PARTICIPANTS/SETTING: Data from participants in the longitudinal Iowa Fluoride Study having at least one beverage questionnaire completed between ages 13.0 and 14.0 years, having a second questionnaire completed between 16.0 and 17.0 years, and attending clinic examination for weight and height measurements at age 17 years (n=369) were included. EXPOSURE: Beverages were collapsed into four categories (ie, 100% juice, milk, water and other sugar-free beverages, and SSBs) for the purpose of clustering. Five beverage clusters were identified from standardized age 13 to 17 years mean daily beverage intakes and named by the authors for the dominant beverage: juice, milk, water/sugar-free beverages, neutral, and SSB. OUTCOMES: Weight, height, and body mass index (BMI; calculated as kg/m2) at age 17 years were analyzed. STATISTICAL ANALYSES: We used Ward's method for clustering of beverage variables, one-way analysis of variance and χ2 tests for bivariable associations, and γ-regression for associations of weight or BMI (outcomes) with beverage clusters and demographic variables. Linear regression was used for associations of height (outcome) with beverage clusters and demographic variables. RESULTS: Participants with family incomes <$60,000 trended shorter (1.5±0.8 cm; P=0.070) and were heavier (2.0±0.7 BMI units; P=0.002) than participants with family incomes ≥$60,000/year. Adjusted mean weight, height, and BMI estimates differed by beverage cluster membership. For example, on average, male and female members of the neutral cluster were 4.5 cm (P=0.010) and 4.2 cm (P=0.034) shorter, respectively, than members of the milk cluster. For members of the juice cluster, mean BMI was lower than for members of the milk cluster (by 2.4 units), water/sugar-free beverage cluster (3.5 units), neutral cluster (2.2 units), and SSB cluster (3.2 units) (all P<0.05). CONCLUSIONS: Beverage patterns at ages 13 to 17 years were associated with anthropometric measures and BMI at age 17 years in this sample. Beverage patterns might be characteristic of overall food choices and dietary behaviors that influence growth.


Asunto(s)
Bebidas , Estatura , Índice de Masa Corporal , Peso Corporal , Sacarosa en la Dieta/administración & dosificación , Adolescente , Animales , Estudios Transversales , Dieta , Encuestas sobre Dietas , Conducta Alimentaria , Femenino , Preferencias Alimentarias , Frutas , Humanos , Renta , Iowa , Estudios Longitudinales , Masculino , Leche , Madres , Obesidad/epidemiología , Factores Sexuales
14.
Community Dent Oral Epidemiol ; 44(2): 154-61, 2016 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26544674

RESUMEN

OBJECTIVES: Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This article reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study. METHODS: Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children, and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28, and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary, and behavioral factors. Nonparametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts). RESULTS: Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only noncavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added-sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (P < 0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts. CONCLUSIONS: By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size, and maternal factors, but further analyses are needed to better understand caries in this population.


Asunto(s)
Caries Dental/epidemiología , Indios Norteamericanos/estadística & datos numéricos , Preescolar , Índice CPO , Femenino , Humanos , Estudios Longitudinales , Masculino , Prevalencia , Factores de Riesgo , Estados Unidos/epidemiología
15.
J Oral Microbiol ; 7: 27182, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25840611

RESUMEN

BACKGROUND: Severe-early childhood caries (S-ECC) is one of the most common infectious diseases in children and is prevalent in lower socio-economic populations. American Indian children suffer from the highest levels of S-ECC in the United States. Members of the mutans streptococci, Streptococcus mutans, in particular, are key etiologic agents in the development of caries. Children typically acquire S. mutans from their mothers and early acquisition is often associated with higher levels of tooth decay. METHODS: We have conducted a 5-year birth cohort study with a Northern Plains Tribe to determine the temporality and fidelity of S. mutans transmission from mother to child in addition to the genotypic diversity of S. mutans in this community. Plaque samples were collected from 239 mother/child dyads at regular intervals from birth to 36 months and S. mutans were isolated and genotyped by arbitrarily primed-polymerase chain reaction (AP-PCR). RESULTS: Here we present preliminary findings from a subset of the cohort. The focus for this paper is on initial acquisition events in the children. We identified 17 unique genotypes in 711 S. mutans isolates in our subset of 40 children, 40 mothers and 14 primary caregivers. Twelve of these genotypes were identified in more than one individual. S. mutans colonization occurred by 16 months in 57.5% of the children and early colonization was associated with higher decayed, missing and filled surface (DMFS) scores (p=0.0007). Children colonized by S. mutans shared a common genotype with their mothers 47.8% of the time. While multiple genotypes were common in adults, only 10% of children harbored multiple genotypes. CONCLUSION: These children acquire S. mutans at an earlier age than the originally described 'window of infectivity' and often, but not exclusively, from their mothers. Early acquisition is associated with both the caries status of the children and the mothers.

16.
J Am Dent Assoc ; 146(1): 61-4, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-25569500

RESUMEN

BACKGROUND AND OVERVIEW: The World Health Organization has recommended a reduction in free sugars intake throughout one's life span to decrease the burden of noncommunicable diseases, including caries and obesity. The author defines sugars' nomenclature, describes sugars' roles in food, and identifies current sugars intake. CONCLUSIONS: The oral health care practitioner can identify added sugars intake and provide guidance to patients to decrease their intake of added sugars while improving nutrient intake and reducing caries risk. PRACTICAL IMPLICATIONS: Intake of added sugars increases the burden of chronic diseases in the United States. The oral health care practitioner is in a position to provide dietary guidance to patients to reduce both oral and systemic diseases.


Asunto(s)
Dieta/estadística & datos numéricos , Carbohidratos de la Dieta/administración & dosificación , Terminología como Asunto , Adulto , Niño , Caries Dental/prevención & control , Carbohidratos de la Dieta/efectos adversos , Humanos , Política Nutricional , Obesidad/prevención & control
17.
J Public Health Dent ; 75(4): 265-73, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-23134446

RESUMEN

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.


Asunto(s)
Caries Dental/etiología , Dieta , Diente Primario , Preescolar , Humanos , Factores de Riesgo
18.
J Am Dent Assoc ; 145(12): 1254-61, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25429039

RESUMEN

BACKGROUND: The results of several studies conducted in the United States show no association between intake of 100 percent fruit juice and early childhood caries (ECC). The authors examined this association according to poverty and race/ethnicity among U.S. preschool children. METHODS: The authors analyzed data from the 1999-2004 National Health and Nutrition Examination Survey (NHANES) for 2,290 children aged 2 through 5 years. They used logistic models for caries (yes or no) to assess the association between caries and intake of 100 percent fruit juice, defined as consumption (yes or no), ounces (categories) consumed in the previous 24 hours or usual intake (by means of a statistical method from the National Cancer Institute). RESULTS: The association between caries and consumption of 100 percent fruit juice (yes or no) was not statistically significant in an unadjusted logistic model (odds ratio [OR], 0.76; 95 percent confidence interval [CI], 0.57-1.01), and it remained nonsignificant after covariate adjustment (OR, 0.89; 95 percent CI, 0.63-1.24). Similarly, models in which we evaluated categorical consumption of 100 percent juice (that is, 0 oz; > 0 and ≤ 6 oz; and > 6 oz), unadjusted and adjusted by covariates, did not indicate an association with ECC. CONCLUSIONS: Our study findings are consistent with those of other studies that show consumption of 100 percent fruit juice is not associated with ECC.


Asunto(s)
Bebidas , Caries Dental/epidemiología , Frutas , Bebidas/efectos adversos , Preescolar , Caries Dental/etnología , Femenino , Frutas/efectos adversos , Humanos , Lactante , Masculino , Encuestas Nutricionales , Pobreza , Factores de Riesgo , Estados Unidos/epidemiología
20.
Pediatr Dent ; 36(3): 222-7, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24960389

RESUMEN

PURPOSE: Currently, research is lacking regarding the use of spill-proof beverage containers (SPBCs). The purpose of this study was to assess the relationship between daytime SPBCs use for sugared beverages, caries, socioeconomic status, and other covariates in high-caries risk 12- to 49-month-old children attending a Women, Infants and Children (WIC) program. METHODS: Data were analyzed using baseline information from 415 Iowa WIC-enrolled children who participated in a psychoeducational study. Mothers completed a series of detailed questionnaires regarding their SES and their child's beverage consumption. Dental examinations using d1d2.3 (noncavitated and cavitated carious lesions) criteria were completed for the children. Bivariate relationships for consumption of any sugared beverage using SPBCs were assessed and followed by multivariable modeling using logistic regression (alpha=0.05). RESULTS: Only 18 children (four percent) reported using SPBCs for any sugared beverage during the night versus 290 (70 percent) during the day. Daytime consumption of sugared beverages from SPBCs was less likely to be reported in older children (P<.001) and in African American children when compared to both Hispanics (P>.001) and Caucasians (P=.001). CONCLUSIONS: Iowa WIC children primarily consume sugared beverages using spill-proof beverage containers during the day; children who were younger and Hispanic or Caucasian were more likely to use SPBCs to consume sugared beverages.


Asunto(s)
Bebidas , Utensilios de Comida y Culinaria/clasificación , Sacarosa en la Dieta/administración & dosificación , Asistencia Alimentaria , Adulto , Afroamericanos , Factores de Edad , Preescolar , Índice CPO , Susceptibilidad a Caries Dentarias , Escolaridad , Grupo de Ascendencia Continental Europea , Conducta Alimentaria , Femenino , Hispanoamericanos , Humanos , Lactante , Iowa , Masculino , Edad Materna , Madres/educación , Pobreza , Clase Social , Adulto Joven
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