Association between high birth weight and dental caries at 4-5 years of age: a birth-cohort study.

OBJECTIVE: Early childhood caries has become a globally crucial oral health problem over the decades. Most studies have discussed the association between low birth weight and early childhood caries; however, studies focusing on high birth weight have been relatively limited. This study aimed to assess the impact of high birth weight on the incidence and severity of dental caries in 4-5-year-old children. SUBJECTS AND METHODS: Study subjects included 491 children from a birth cohort study at 4-5 years of age. Data on dental caries, prenatal and perinatal factors, and socio-demographic determinants were recorded. Logistic regression models adjusted for potential confounders were performed to analyze the data. Two-sided P-value < 0.05 was considered statistically significant. RESULTS: Of the 491 children, the prevalence of dental caries was 48.7%. High birth weight (≥ 4,000 g) was significantly associated with increased incidence of dental caries (OR, 2.000; CI 95% 1.062-3.765), and the relatively enhanced risk OR was further increased in subjects experiencing caries (dmft ≥ 3) (OR, 2.437; CI 95% 1.306-4.549) compared with the normal birth weight (2,500-3,999 g). CONCLUSIONS: High birth weight is a risk factor for early childhood caries. Particular attention should be paid to children with birth weight more than or equal to 4,000 g.

Application of principles learned in a prevention-focused pediatric dental residency curriculum to professional practice.

PURPOSE: This study examined whether pediatric dentists who participated in a pediatric dental residency program focusing on disease prevention and management training and screening for social determinants of health (SDOH) were applying these principles to their professional practice upon graduation. METHODS: Using a cross-sectional study design, a one-time-only online survey was disseminated to 75 pediatric dentists who graduated from the University of California, Los Angeles's training program between 2012 and 2022. The 21-item survey included questions on demographics, patient population characteristics, and application of preventive dentistry and SDOH to their professional practice. Descriptive statistics and bivariate analyses were used to assess survey items. RESULTS: The survey response rate was 64%. Over two-thirds (67%) of alumni reported accepting Medicaid, 34% saw patients in a medically underserved area and all reported seeing children with special needs in their practice. Strategies used to address SDOH in their practice included providing anticipatory guidance (98%) and educating families on oral disease prevention and screening for SDOH (96%). Alumni accepting patients with Medicaid/public health insurance were more likely to address SDOH in their practice, such as assisting patients with filling out Medicaid paperwork (p < 0.05), conducting outreach to underserved communities (p < 0.05), and using interpreters in their practice (p < 0.01) in comparison with alumni not accepting patients with Medicaid/public health insurance. CONCLUSION: This study demonstrated that a pediatric dental residency program may be successful in training residents to educate children, families, and special needs patients on disease prevention and management in an ethical and culturally sensitive manner and screen for SDOH during patient visits.

Restorative and patient factors associated with repeat general anesthesia for dental treatments in young children: A case-control study.

BACKGROUND: The aim of this study was to assess factors associated with higher odds of undergoing repeat general anesthesia (GA2) for dental treatments. METHODS: The authors studied children up to age 48 months of age enrolled in Medicaid who underwent dental treatment under first general anesthesia (GA1). The authors used a case-control design to compare children who had a GA2 within 48 months of GA1 (case patients) with those who did not (control patients). RESULTS: In total, 60 case patients were age and sex matched to 120 control patients. Mean (SD) age at GA1 was 38 (5.2) months for case participants and 40 (4.7) months for control participants (P = .08). Higher caries involvement of maxillary incisors (P = .04), and lower caries involvment of canines (P = .003), first molars (P = .012), and second molars (P < .001) at GA1 was associated with higher odds of occurrence of GA2. There was a significant inverse association between full-coverage restoration on canines (P = .003), first molars (P = .001), and second molars (P = .002) at GA1 and occurrence of GA2. There was a significant direct association between the use of composites or sealants on second molars in GA1 and occurrence of GA2 (P = .02). The number of extractions at GA1 was not associated significantly with the occurrence of GA2. CONCLUSIONS: The use of full-coverage restorations on primary molars and canines under general anesthesia (GA) was associated with lower odds of occurrence of GA2. Resin restorations and sealants on primary second molars were associated with higher odds of occurrence repeat GA. The findings support preferential use of full-coverage restorations for young children undergoing dental GA. PRACTICAL IMPLICATIONS: Full-coverage restorations should be considered strongly for young children undergoing GA for dental treatments to reduce the risk of requiring GA2.

A Tele-detection and referral pAthways model for early childhood cariEs control- a protocol for a randomized factorial study: the TRACE study.

BACKGROUND: Early childhood caries (ECC) is one of the most common childhood diseases affecting the primary teeth of children younger than 6 years of age. ECC progression can be reversed in the early stages although these lesions often go undetected. New approaches are needed to detect oral diseases at an early stage when they can be better controlled. The aim of the study is to assess the effectiveness of ECC tele-detection methods combined with referral pathways with and without user fee removal in controlling ECC. METHODS: A randomized factorial trial will be used to compare two tele-dentistry detection methods for ECC (intraoral camera and smartphone camera) and two referral pathways (user fee removal versus conventional care). The study will recruit children younger than 6 years of age in marginalized communities in Alexandria, Egypt. The primary outcome is the percentage of teeth receiving indicated care, while the secondary outcomes are the oral health-related quality of life, acceptance of teledentistry by dentists, procedure time, and child cooperation. Two-way analysis of variance will be used to assess the effect of the two factors as between group variables on the outcomes after 6 and 12 months. The interaction between detection methods and referral pathways will also be assessed, and the effect of confounders will be controlled in a multivariable linear regression model. DISCUSSION: The findings of this study have the potential to inform clinical practice and oral healthcare policies for ECC management. Successful tele-detection and referral pathways could be integrated into oral healthcare systems, leading to improved oral health outcomes for children. TRIAL REGISTRATION: The trial has been registered on ClinicalTrials.gov in August 2023 (initial release) ID: NCT06019884.

Oral Health-Related Quality of Life of Hong Kong Kindergarten Children Receiving Silver Diamine Fluoride Therapy.

The objective of this prospective 12-month observational study is to examine the oral health-related quality of life (OHRQoL) among Hong Kong young children aged 3-4 years old receiving silver diamine fluoride (SDF) therapy for carious upper anterior primary teeth. A parental questionnaire was used to collect each child's sociodemographic background and oral health habits at baseline. Data on parents' satisfaction with their child's dental aesthetics were collected at baseline and during a 12-month visit. The Chinese Early Childhood Oral Health Impact Scale (C-ECOHIS) was used to measure OHRQoL. A trained dentist performed examinations and recorded caries experience (dmft) and oral hygiene (visible plaque index) at baseline and 12 months. SDF was applied to the carious lesions. Out of 286 invited children, 248 (87%, 248/286) participated, and 211 (85%, 211/248) attended the 12-month examination. All SDF-treated carious lesions were discoloured at the 12-month examination. Regression analysis showed that the baseline C-ECOHIS score was associated with dmft (p < 0.001). The baseline and 12-month C-ECOHIS scores were 4.6 ± 5.5 and 5.0 ± 5.6, respectively (p = 0.42). The scores for parental satisfaction with dental aesthetics at baseline and 12 months were 59% to 46% (p < 0.001). Satisfaction was negatively associated with the number of discoloured upper anterior teeth (p < 0.001). In conclusion, SDF discoloured the carious upper anterior teeth of the Hong Kong kindergarten children. However, the discoloured lesions had no significant effects on the OHRQoL of these children. However, more parents became dissatisfied with their child's dental aesthetics after SDF therapy. Hence, clinicians should inform parents well before they perform SDF therapy on children.

Comparison of Salivary Flow Rate, pH, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children.

Background and objectives: Early childhood caries (ECC) is the most common chronic disease of childhood in many developing countries, which is associated with local, systemic, psychological, and social consequences. Multiple variables are shown to be associated with an increased risk of ECC. The knowledge regarding the role of saliva in the pathophysiological process of ECC still remains controversial and unexplored. Scanty studies focused on probing the role of salivary flow rate, pH, buffering capacity, and secretory immunoglobulin A (sIgA) in unstimulated whole saliva of children with ECC and children without ECC. Aim: To assess the salivary flow rate, pH, buffering capacity, and sIgA levels in children with ECC and caries-free children and to evaluate their role in caries risk assessment.Materials and Methods: The study was carried out among 64 children aged between 24 and 71 months. Clinical examinations were carried out according to the criteria by the World Health Organization, and carious status was recorded. Subjects were categorized as group I with ECC (dmfs-Decayed, Missing or Filled Surfaces (Deciduous dentition) of ≥5), and group II included children without ECC (dmfs = 0). Unstimulated whole salivary samples were collected in a sterile vial and stored at -70°C by draining. Estimations of salivary flow rate, pH, buffering capacity, and sIgA levels were done. Digital pH meters were used for the estimation of pH and buffering capacity. A human IgA enzyme-linked immunosorbent assay (ELISA) kit was used to estimate sIgA levels. Statistical software IBM Statistical Package for the Social Sciences (SPSS) statistics 20.0 (IBM Corporation, Armonk, New York, United States of America) was used to analyze the data. Results: The mean salivary flow rate decreased in group I children with ECC (0.15 ± 0.05) when compared to group II children without ECC (0.67 ± 0.14), which was statistically significant. In caries active children, no statistically significant correlation was found between salivary flow rate and the dmfs scores [r-value (-0.247)] and p-value (0.147). The mean level of salivary pH is decreased in group I children with ECC (4.65 ± 0.4) when compared to group II children without ECC (7.28 ± 0.18). In the caries active group, the levels of salivary pH decrease as the dmfs scores increase, and this correlation is found to be statistically significant (r-value of 0.547 and p-value of 0.002). The mean level of buffering capacity is decreased for caries-active children (5.45 ± 0.49) when compared to caries-free children (8.94 ± 0.42). In caries active children, as the dmfs scores increase, the salivary buffering capacity decreases, and this correlation is found to be not statistically significant (r-value of -0.334 and p-value of 0.161). The mean levels of sIgA in group I children with ECC were higher (10.61 ± 0.90) than that in group II children without ECC (6.11 ± 1.22). In the caries-active group, the salivary sIgA levels were comparatively higher than in the caries-free children. As the dmfs scores increase, the level of the sIgA increases in caries-active children, and this correlation is noted to be highly statistically significant (r-value of 0.769 and p-value 0.008). Conclusion: Children with ECC showed decreased salivary flow rate, pH, buffering capacity, and increased sIgA levels, while children without ECC showed increased salivary flow rate, pH, buffering capacity, and decreased sIgA levels. The salivary parameters, such as salivary flow rate and buffering capacity, showed no correlation with the dmfs score, while salivary pH and sIgA levels have a positive correlation in caries-active children. How to cite this article: Sivakumar A, Narayanan R. Comparison of Salivary Flow Rate, Ph, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children. Int J Clin Pediatr Dent 2024;17(3):334-340.

Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research.

Background and objectives: Early childhood caries (ECC) remains one of the most prevalent diseases mutilating the primary dentition. It is a multifactorial disease that severely affects the quality of life of affected children. One of the risk indicators reported in the literature is the presence of viable mutans streptococci (MS) and protective factors such as salivary immunoglobulin A (SIgA). Hence, it is important to identify such risks and protective factors associated with ECC using simple yet reliable methods supported by advanced technology and a fully automated platform to improve the results. Materials and methods: A retrospective analysis was done on 40 children who were divided into two groups: group I (experimental) and group II (control). Group I comprised 30 healthy children who were further divided into three subgroups of 10 children each. Group IA with decayed, missing, filled teeth/decayed, extracted, filled teeth (dmft/deft) = 1-2, group IB with dmft/deft = 3-4, group IC with dmft/deft ≥5, and group II, comprising 10 healthy children having no caries by using World Health Organization (WHO) 2013 Oral Health Survey criteria. Unstimulated saliva was collected by drooling saliva into a sterile container. The samples were transported to the central research laboratory for SIgA by the immunoturbidimetry method by a fully automated Abbott Architect c system. The data obtained was subjected to statistical analysis. Results: On comparison of SIgA in between varying severities of dental caries and caries-free children between age-group of 3 and 6 years, it was found to be below the grand median 0.20 mg/mL for subgroups IA and control group II. A significant negative statistical correlation (r = -0.948) was present between the SIgA and varying severities of ECC and the control group. Interpretation and conclusion: The low dmft/deft group was found to be relatively closer to the caries-free groups as their mean dmft was 1.50, standard deviation (SD) ± 0.53. A slight change in dmft/deft score and SIgA could be used as a potential biomarker for assessing the severity of ECC in children between age-group of 3 and 6 years. How to cite this article: Sharma V, Bagchi A, Dutta B, et al. Evaluation of Salivary Immunoglobulin A Level and Its Correlation with Severity of Early Childhood Caries: An Original Research. Int J Clin Pediatr Dent 2024;17(3):316-320.

Innovative Aesthetic and Functional Rehabilitation in a Two-and-a-Half-Year-Old Using a Modified Groper's Appliance.

The repercussions of the early loss of primary teeth, be it from trauma or caries, encompass compromised chewing efficiency, diminished aesthetics, potential development of abnormal oral habits, and difficulty in articulation of labiodental sounds, significantly influencing the child's psychological well-being and behavior. Moreover, the untimely loss of posterior teeth results in the loss of space, potentially leading to malocclusion and functional disruptions. Hence, addressing dental rehabilitation in these cases is both a challenge and a necessity. A toddler aged two and a half was brought to our department with a primary concern of multiple caries. Severe decay with 54, 61, 62, and 64 and missing 51 and 52 were seen. The child experienced pain from decayed back teeth, and the parents were distressed about compromised aesthetics caused by decayed front teeth. Given the child's young age and the sufficient time for permanent teeth to emerge, their concerns were heightened. To address these issues, a modified Groper's appliance was crafted to restore aesthetics and functionality. A supplementary crib-like wire component was incorporated into the appliance to facilitate a simpler and aesthetically pleasing composite crown buildup. Satisfaction with the treatment was evident from both the parents and the child. Subsequent follow-up sessions revealed no adverse effects attributable to the appliance, thus concluding that the additional wire component seamlessly integrated into the appliance offers several advantages, including enhanced aesthetics through composite shade matching for a simplified crown buildup. Particularly in remote areas, where obtaining a set of deciduous acrylic teeth can be challenging, this feature proves to be advantageous. It eliminates the necessity to trim permanent acrylic teeth to achieve a deciduous appearance. Additionally, the time and cost associated with the laboratory fabrication of heat-cure acrylic crowns can be circumvented. This distinctive case report underscores the creation of a modified Groper's appliance for the aesthetic and functional rehabilitation of a child grappling with early childhood caries (ECC). The appliance was well received, and no adverse outcomes were observed.

Role of socioeconomic factors and interkingdom crosstalk in the dental plaque microbiome in early childhood caries.

Early childhood caries (ECC) is influenced by microbial and host factors, including social, behavioral, and oral health. In this cross-sectional study, we analyze interkingdom dynamics in the dental plaque microbiome and its association with host variables. We use 16S rRNA and ITS1 amplicon sequencing on samples collected from preschool children and analyze questionnaire data to examine the social determinants of oral health. The results indicate a significant enrichment of Streptococcus mutans and Candida dubliniensis in ECC samples, in contrast to Neisseria oralis in caries-free children. Our interkingdom correlation analysis reveals that Candida dubliniensis is strongly correlated with both Neisseria bacilliformis and Prevotella veroralis in ECC. Additionally, ECC shows significant associations with host variables, including oral health status, age, place of residence, and mode of childbirth. This study provides empirical evidence associating the oral microbiome with socioeconomic and behavioral factors in relation to ECC, offering insights for developing targeted prevention strategies.

Comparative Evaluation of Total Antioxidant Capacity and pH of Saliva in Children with and without Early Childhood Caries.

BACKGROUND: Early childhood caries (ECC), a type of tooth decay that affects preschool children, is a complex chronic disease resulting from an imbalance of multiple risk factors and protective factors of tooth decay, over time. The antioxidant system in saliva is one of its defense mechanisms against disease agents. The pH of saliva also affects the integrity of the oral cavity, hence caries susceptibility. OBJECTIVE: The study assessed and compared the total antioxidant capacity (TAC) and pH of saliva in children with and without ECC. METHODS: Unstimulated whole saliva, using the passive drool method was obtained from children with and without ECC, matched for age and gender. The samples were analyzed for TAC using the phosphomolybdenum assay technique, and pH with a hand-held digital pH meter. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 21. Association between categorical variables was determined using Chi-square, while analysis of variance (ANOVA) was used to compare the means. The level of significance (p-value) was set at 5% (0.05). RESULTS: A total of 68 children were examined (34 with ECC and 34 without ECC). The mean TAC in the ECC group was (0.53± 0.2) which was higher than the mean TAC of (0.36± 0.1) in the group without ECC. The mean pH (6.17±0.5) in the ECC group was lower than the mean pH (6.74± 0.5) in the caries-free group. The difference was statistically significant, p value<0.001. CONCLUSION: The saliva samples of children with ECC contained higher mean TAC and lower pH values compared to those without, who had lower mean TAC and higher pH values. This suggests a relationship between antioxidant production and cariogenesis. There was a statistically significant positive correlation between TAC and the pH of saliva in children with ECC.

CONTEXTE: La carie de la petite enfance (CPE), un type de carie dentaire qui touche les enfants d'âge préscolaire, est une maladie chronique complexe résultant d'un déséquilibre de multiples facteurs de risque et de facteurs de protection contre la carie dentaire, au fil du temps. Le système antioxydant de la salive est l'un de ses moyens de défense. mécanismes contre les agents pathogènes. Le pH de la salive affecte également l'intégrité de la cavité buccale, d'où la susceptibilité aux caries. OBJECTIF: L'étude a évalué et comparé la capacité antioxydante totale (TAC) et le pH de la salive chez les enfants avec et sans CPE. METHODES: Salive entière non stimulée, en utilisant le La méthode de la bave passive a été obtenue auprès d'enfants avec et sans CPE, appariés en fonction de l'âge et du sexe. Les échantillons ont été analysés pour le TAC à l'aide de la technique de dosage du phosphomolybdène et le pH avec un pH-mètre numérique portatif. Les données ont été analysées á i'aide du paquet statistique pour les sciences sociales (SPSS) version 21. L'association entre les variables catégorielles a été déterminée à l'aide du chi carré, tandis qu'une analyse de variance (ANOVA) a été utilisée pour comparer les moyennes. Le niveau de signification (valeur p) a été fixé à 5 % (0,05). RESULTATS: Un total de 68 enfants ont été examinés. (34 avec ECC et 34 sans ECC). Le TAC moyen dans le groupe ECC était de (0,53 ± 0,2), ce qui était supérieur au TAC moyen de (0,36 ± 0,1) dans le groupe sans ECC. Le pH moyen (6,17 ± 0,5) dans le groupe ECC était inférieur au pH moyen (6,74 ± 0,5) dans le groupe sans carie. La différence était statistiquement significative, valeur p <0,001. CONCLUSION: Les échantillons de salive des enfants atteints de CPE contenaient un TAC moyen plus élevé et des valeurs de pH plus faibles par rapport à ceux sans TAC, qui avaient un TAC moyen plus faible et des valeurs de pH plus élevées. Ceci suggère une relation entre la production d'antioxydants et la cariogenèse. Il existait une corrélation positive statistiquement significative entre le TAC et le pH de la salive chez les enfants atteints de CPE. MOTS CLES: Carie de la petite enfance (CPE), Salive, pH, Capacité antioxydante totale (TAC).

Relationship of dietary nutrients with early childhood caries and caries activity among children aged 3-5 years-a cross-sectional study.

BACKGROUND: Early childhood caries (ECC) is a challenge for pediatric dentists all over the world, and dietary factor is an important factor affecting the occurrence of ECC. Currently, there is limited research on the impact of dietary nutrient intake from Chinese diets on ECC. The purpose of this study is to explore the correlation of dietary nutrients intake with ECC and caries activity (CA) among children aged 3-5 years, and to provide dietary guidance to slow down the occurrence and development of ECC. METHODS: A cross-sectional study was conducted in 2022. A total of 155 children were divided into three groups: caries-free group, ECC group and Severe early childhood caries (SECC) group according to the caries statues. And according to the caries activity test (CAT) value, they were also divided into three group: low CA group (L-CA), middle CA group (M-CA) and high CA group (H-CA). The 24-hour dietary intake information was collected by mobile phone application (APP). The intake of children's daily dietary nutrients were calculated referring to "China Food Composition Tables". RESULTS: In this study, 17, 39,and 99 children were diagnosed with caries-free, ECC, and SECC. There were 33, 36, and 86 children diagnosed with L-CA, M-CA, and H-CA. The risk of ECC was increased with the intake of cholesterol(OR = 1.005) and magnesium (OR = 1.026) and decreased with the intake of iron (OR = 0.770). The risk of SECC was increased with the intake of cholesterol (OR = 1.003). The risk of high CA was increased with the intake of cholesterol (OR = 1.002). The combined application of dietary total calories, carbohydrate, cholesterol, sodium, magnesium and selenium in the diagnosis of ECC had an area under ROC curve of 0.741. CONCLUSIONS: The increased dietary cholesterol intake may be a common risk factor for ECC and high CA in children aged 3-5. The combined application of dietary intake of total calories, carbohydrate, cholesterol, sodium, magnesium and selenium has a higher predictive value for the occurrence of ECC.

PREVALENCE OF CARIES PATTERNS IN THE 21ST CENTURY PRESCHOOL CHILDREN: A SYSTEMATIC REVIEW AND META-ANALYSIS.

OBJECTIVE: This systematic review aimed to describe and evaluate the caries patterns among the 21st century preschool children globally. METHOD: Six electronic databases (Pubmed, Embase, Medline, Web of Science, EBSCOhost, and Scopus) were searched using predetermined terms. Dual independent screening of all retrieved abstracts was performed to identify studies conducted after year 2000 and the caries pattern among preschool children was investigated. Data regarding the prevalence of caries by tooth type and surface were extracted. Meta-analyses, subgroup analyses and meta-regression were carried out with the statistics software Stata using the random-effects model. RESULTS: A total of 2642 records were screened, and 43 observational studies were finally included. Cavitated caries lesions were commonly found in the maxillary incisors and molars in both arches among preschool children. The highest caries prevalence was found in the maxillary central incisors (29.1%, 95%CI: 25.5%-32.7%) and the mandibular second molars (28.5%, 95%CI: 24.7%-32.3%), while the mandibular lateral incisors had the lowest prevalence (1.7%, 95%CI: 1.5%-2.0%). Occlusal surfaces of the mandibular molars were the most frequently affected by caries, whereas caries hardly affected the lingual surfaces of lower anterior teeth. Caries pattern on the left and right sides was symmetrical. The overall caries prevalence was significantly higher in the maxillary teeth. Caries prevalence was higher in the older children, whereas the caries pattern was not significantly different among children from countries with different human and economic development levels. CONCLUSION: Cavitated carious lesions were more commonly observed in the maxillary incisors and molars in both arches. The prevalence of caries varies significantly with child's age and primary tooth type. However, preschool children exhibit a similar pattern of caries, regardless of the time, socioeconomic status or geographical location.

Early Childhood Caries-Prevalence, Associated Factors, and Severity: A Hospital-Based Study in Riyadh, Saudi Arabia.

Early childhood caries (ECC) is not merely a problem of the tooth; rather, it has negative impacts on the child's growth and development and oral health-related quality of life. The prevalence of ECC varies widely, and more variance is observed between countries than continents, and it changes over time. The current cross-sectional study aimed to determine ECC's prevalence, associated factors, and severity. This study was conducted in the Dental Clinic Complex, North Riyadh, KSA. The study sample included 306 participants between 36 and 71 months of age. A questionnaire was developed to collect information from participants. The decaying and filled teeth (DMFT) index was used to estimate the prevalence of caries. The study results revealed the prevalence of ECC to be 76% among 36- to 71-month-old children in North Riyadh. ECC is influenced by socioeconomic factors like maternal occupation, education, oral hygiene habits, and dietary patterns. Also, it was found that exclusively breastfed children have lower ECC odds (68.1% vs. 83.6%, p = 0.001), while the intake of more than three between-meal sugar-containing snacks/beverages per day increases the likelihood of ECC (63.5% vs. 79.8%, p = 0.006). The researchers recommend encouraging breastfeeding as it correlates with lower ECC prevalence, in addition to establishing effective oral hygiene practices for preschool children.

The Prevalence of Candida albicans and Malassezia globosa in Preschool Children with Severe Early Childhood Caries: A Case-Control Study.

Background: This cross-sectional study aimed to identify the prevalence of Candida albicans and Malassezia globosa in children with severe early childhood caries and caries-free children in Hong Kong. Methods: This study first recruited a total of 80 children aged between 48 and 72 months old, 40 children with severe early childhood caries, and 40 caries-free children. The children were then further divided into four groups, with 20 children in each group: Group 1: Severe early childhood caries-C. albicans, Group 2: Severe early childhood caries-M. globosa, Group 3: Caries-free-C. albicans and Group 4: Caries-free-M. globosa. Saliva, plaque, and caries lesion samples were collected from participants with severe early childhood caries, while only saliva and plaque samples were collected from caries-free participants. Caries status of the primary molars was assessed using WHO's decayed, missing, and filled tooth index, and the severity of cavitated lesions was determined based on International Caries Diagnosis and Assessment System criteria as caries code 5 or 6. The samples were analyzed using an Internal Transcribed Space and Quantitative Real-Time Polymerase Chain Reaction. Results:C. albicans was more prevalent in saliva and plaque samples of severe early childhood caries than in the caries-free group. Proportion of C. albicans in both saliva and plaque samples differed significantly between severe early childhood caries and caries-free groups (p < 0.05). Within the severe early childhood caries group, the proportion of children with C. albicans varied between 6 and 46%. No significant difference in M. globosa load was found between plaque samples of the severe early childhood caries and caries-free groups (p = 0.159). Conversely, no significant difference in M. globosa load was observed between saliva samples of severe early childhood caries and caries-free groups (p = 0.051). Conclusions: This study demonstrated a strong association between C. albicans and severe early childhood caries. M. globosa was detected in both the caries-free and severe early childhood caries groups, albeit at low levels.

Effectiveness of interventions on improving early-life dental care utilization: a systematic review and meta-analysis.

OBJECTIVES: Although early-life dental care is crucial for preventing early childhood caries and has numerous benefits, the utilization rate of such care remains remarkably low worldwide, especially in families of low socioeconomic status. The aim of this study was to systematically review the scientific evidence relating to the effectiveness of interventions on improving early-life dental care utilization of very young children. METHOD AND MATERIALS: We reviewed scientific evidence relating to these positive changes, with 7 randomized controlled trials after qualitative evaluation. Interventions assessed included prenatal oral health promotion, motivational interviewing, intraoral camera use alongside social work consultations to aid in decreasing barriers to care, monetary incentives for tooth brushing, fluoride varnish applications, and probiotic usage. RESULTS: The intervention was significantly effective in reducing the incidence of dental caries among children, especially in caries risk. Caries reduction was significant when oral health information was provided at frequent intervals prenatally. Caries increment was also reduced when probiotics were introduced when administered daily. Interventions that attempted to increase parental involvement in oral health care by increasing motivation and decreasing barriers had inconclusive results within the study groups. CONCLUSIONS: Considering high rates ECC, early establishment and preservation of a dental home should be a focus in public health measures. Continuous monitoring and parental involvement are key components to maintaining healthy oral conditions. Future studies could explore and test various innovative strategies that utilize technological platforms to engage with parents and promote early-life dental care utilization among the underserved population.

A scoping review of the links between early childhood caries and clean water and sanitation: the Sustainable Development Goal 6.

INTRODUCTION: The United Nation's Sustainable Development Goal (SDG) 6 calls for universal access to clean water, sanitation and hygiene (WASH), which are crucial elements of health and well-being and fundamental for a life in dignity. Early childhood caries (ECC) is a preventable disease affecting health and quality of life of millions of young children worldwide. This scoping review aims to explore the connection between ECC and access to clean water and sanitation. METHODS: This scoping review, registered on the Open Science Framework and following PRISMA-ScR guidelines, conducted a thorough search in databases (PubMed, Web of Science, Embase, Google Scholar, SciELO) and websites (via Google) in November 2023. The search, without date limitations, targeted studies in English and Spanish linking ECC to SDG6. Exclusions were made for studies solely focusing on ECC without a direct connection to clean water and sanitation. Descriptive statistics summarized the retrieved papers. RESULTS: The initial search yielded 303 articles. After removing duplicates, 264 articles remained for title and abstract screening after which 244 were excluded and one report was added through citation searching. The 21 remaining articles underwent full text review. There were no studies on a direct association between access to clean water and sanitation and the prevalence of ECC. There were nine studies that showed indirect associations between ECC and access to clean water and sanitation through the links of: water and sanitation access as a marker for poverty (n = 1), water consumption as a feeding practice (n = 4), and the effectiveness of water fluoridation (n = 4). These were used to develop a conceptual model. CONCLUSIONS: While it is conceivable that a direct link exists between ECC and access to clean water and sanitation, the available body of research only offers evidence of indirect associations. The exploration of potential pathways connecting water access to ECC warrants further investigation in future research.

Effectiveness of risk-based caries management among Chinese preschool children: a randomized controlled single-blind trial.

BACKGROUND: Early childhood caries (ECC) remain a serious oral health problem on a global scale. Risk-based caries management (RBCM) implemented in some parts of the world has been effective in preventing ECC. However, there is a lack of prospective research on the application of RBCM among Chinese children, and little is known about its effectiveness. The purpose of this study was to evaluate the effectiveness of RBCM in preventing caries among children aged 3-5 years in Wanzhou District, Chongqing Municipality, China. METHODS: Three- to five-year-old children from four kindergartens in Wanzhou were randomly selected for baseline dental examination and caries risk assessment (CRA) and randomly assigned to the experimental group (EG) or the control group (CG) according to the kindergarten. The EG received caries prevention measures of different intensities based on the child's caries risk level. The CG received full-mouth fluoride twice a year according to standard prevention, regardless of their caries risk. One year later, another dental examination and CRA were conducted, to observe changes in the decayed, missing, and filled teeth (dmft) index and caries risk, and to analyze potential factors that may affect the incidence of new caries. RESULTS: Complete data were collected from 291 children (EG, N = 140, 84.8%; CG, N = 181, 83.4%). A total of 25.7% of the EG and 50.3% of the CG children developed new caries, with newly added dmft scores of 0.54 ± 1.12 and 1.32 ± 1.72, respectively (P < 0.05). Multivariate logistic regression indicated that children living in rural areas, assigned to the CG, and rated as high-risk at baseline were more likely to develop new caries (P < 0.05). The proportion of children with an increased caries risk in the EG was significantly lower than that in the CG (P < 0.05). CONCLUSIONS: RBCM effectively prevented new caries in 3- to 5-year-old Wanzhou children and reduced the proportion of children at increased risk of caries. It is an effective approach for preventing ECC. CLINICAL TRIAL REGISTRATION: This trial was registered in the Chinese Clinical Trials Register. The registration number was ChiCTR230067551 (11/01/2023).

Risk Factors of Early Childhood Caries among Preschool Children in Madipakkam, Chennai: Cross-Sectional Survey.

Background: Early childhood caries (ECC) is a major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and preschool children worldwide. Aim: A survey to identify the factors influencing the ECC among preschool children in Madipakkam, Chennai. Methodology: A descriptive cross-sectional survey was conducted among 3-5-year-old preschool children in Madipakkam, Chennai. Three schoolchildren participated in the study. In total, 313 children aged three to five years took part in the study. A closed-ended questionnaire was used to collect general information to assess their feeding habits and oral hygiene practices. Results: Dental caries experience (dmft and deft) was high among children who were bottle-fed compared to children who were breastfed. The children who were breastfed for less than six months had more caries than other children who were breastfed for more than six months. Conclusion: Factors such as age and BMI did not show any association with ECC. Other factors such as feeding habits, snacking, oral health behavior, parental assistance in brushing, and regular dental visits are found to be associated with the ECC. Most of the risk factors studied in this study are modifiable. Therefore parents and children should be educated about the risk factors of ECC and mechanisms to control it.

Effectiveness of nanosilver fluoride and silver diamine fluoride in arresting early childhood caries: a randomized controlled clinical trial.

BACKGROUND: One of the most prevalent health problems affecting children worldwide is untreated caries in primary teeth. Agents to arrest caries are used to manage untreated decay in children in disadvantaged communities. Nano Silver Fluoride (NSF) overcomes the staining problems of Silver Diamine Fluoride (SDF). This study compared the clinical cariostatic effect of NSF to 38% SDF for arresting caries lesions. METHODS: The study included 360 children younger than 4 years, with at least one active lesion, ICDAS score ≥ 3, recruited from nurseries in a rural area in Alexandria, Egypt, in 2022. They were randomly assigned to receive a single application of NSF at baseline, or two applications of SDF at baseline and after 6 months. The arrest of active carious lesions was assessed after 6 and 12 months using ICDAS criteria, and parents' satisfaction with child appearance was also assessed. Chi-Square test was used to compare the groups and multi-level multiple logistic regression was used to assess the effect of the intervention on caries arrest at lesion level and binary logistic regression was used to assess the effect at patient level. RESULTS: 1853 active lesions were included in children whose mean (SD) age was 42.3 (8.2) months. The arrest rate was significantly higher in the NSF than the SDF group at lesion level (78.4% and 65.0% at 6 months and 71.3% and 56.3% at 12 months, p < 0.001). In regression analysis, NSF had significantly higher odds of caries arrest than SDF at lesion level (at 6 months, AOR = 2.57, 95% CI: 1.55, 4.26 and at 12 month, AOR = 3.27, 95% CI: 1.89, 5.67). Parents of children receiving NSF had significantly greater satisfaction with their children's dental appearance than those receiving SDF: (97.2% and 76.1%, respectively, p < 0.001). CONCLUSION: NSF demonstrated greater effectiveness in arresting caries in preschool children without inducing black staining of teeth and with greater parental satisfaction than SDF. NSF can be an alternative to SDF in arresting caries especially in underprivileged communities. TRIAL REGISTRATION: The trial was registered in the clinicaltrials.gov registry (#NCT05255913)-16/02/2022.

Retrospective Study Regarding the Correlation between Dental Anxiety and Color Preferences in Children with Severe Early Childhood Caries.

BACKGROUND: Severe early childhood caries (S-ECC) is recognized as a significant chronic disease which affects the quality of life starting at very young ages and has a very rapid evolution towards pulp complication and loss of dental tissue. Children with a high caries index DMFT are more likely to develop high levels of dental anxiety, which will influence the degree of cooperation during dental procedures. Emotions play an important role in the psychosomatic development of children, and all the factors that contribute to the modeling of these emotional states must be known and taken into consideration. AIM: The aim of this study was to assess the association between dental anxiety in children with S-ECC and the color preferences for the components of the dental environment to reduce the levels of dental anxiety during medical visits. MATERIAL AND METHOD: For this study, 91 children between 3 and 6 years of age diagnosed with S-ECC were selected from the Pediatric Dentistry Department of UMFST from Targu Mures and from a private dental office. The level of dental anxiety was determined by measuring the pulse rate, and a questionnaire was completed to establish the color preferences for the dental office environment and the dentist's attire. For this purpose, six different colors and their variants with three shades less intensity were chosen by using RGB (Red, Green, and Blue) identification codes for each color. RESULT: The results showed that there was a statistically significant difference between the age of the subjects and dental anxiety levels, but there was no significant correlation between the DMFT score and dental anxiety. Also, the results showed that there was no significant difference between girls and boys when choosing the colors preferred by them for the dental office, but when comparing the colors that represented happiness, significant statistical difference was found between the girls' and boys' groups (p = 0.0039). For all the subjects, the colors associated with happiness were light yellow and pink, while the colors associated with anxiety were red and dark blue. CONCLUSION: The data obtained showed that dental anxiety is strongly influenced by age, and an important role in inducing positive emotions is played by the dental environment if dressed in specific colors in order to reduce dental anxiety and create familiar conditions, especially for young children with S-ECC.