Sweets, snacks, and dental caries: South African interracial patterns.

Sucrose has been thought to cause dental caries; sweets and snacks being primarily responsible, together with plaque and their respective interactions. Dietary questionnaires revealed that in 3 to 5 yr olds, protein in black, colored, Indian, and white groups provided 12 to 15% of total intake, fats 10 to 17%, and carbohydrates 69 to 78%. At 16 to 17 yr old, patterns remained essentially similar. Sucrose provided about one-quarter of intake, sweets and snacks less than one-tenth, but dental caries prevalence increased rapidly from black to white. This raised several questions regarding current concepts of caries causation. Are genetic, immunological and other dietary factors also responsible for caries levels experienced?

Trends in sugar intake: do these parallel changes in caries prevalence among S. African preschoolchildren?

Mean sugar intake in South Africa has fallen in Black rural groups and remained more or less constant for their urban counterparts; for Indian groups it has risen, but fallen in White groups. The amounts of sugar in mean snack/sweet intakes have not shown the same degree of fall and have remained relatively constant in all but Indian groups where there has been a definite fall in consumption. Caries prevalences (percentages of children with caries) have risen in all but White groups. It can be concluded that quantitative changes in sugar consumption and caries prevalences do not parallel each other.

Dental caries and sucrose intake in five South African preschool groups.

Dental caries, debris (DI-S) and sugar intake were determined for 766 rural Black, urban Black, coloured, Indian and White children, using standardized techniques. In general sucrose intake, both quantity and frequency was low in rural Black children yet these children had relatively few caries-free individuals and higher than expected mean dmft scores. Comparison with earlier studies in the same localities has shown a worsening of dental caries in all groups except the White, in which the situation has improved. Sucrose consumption declined in rural Black, and White groups, remained steady in urban Black children and increased in coloured and Indian groups.

Patterns of breast and bottle feeding and their association with dental caries in 1- to 4-year-old South African children. 1. Dental caries prevalence and experience.

In order to study associations between breast and bottle feeding and dental caries a questionnaire on feeding habits was completed by trained interviewers for 1,263 children aged 1 to 4 years from five South African communities. Of these, 73 to 94 per cent had been breast fed for mean periods of 9 to 16 months. The types of infant feeding practised (breast, bottle or mixed) varied little within the groups although each group differed significantly from the others for the preferred feeding practice. Using responses to a dietary interview the children were subdivided into those breast fed for 12 months or longer (n = 546), those who had mixed breast and bottle feeding (n = 527) and those who were bottle fed only (n = 190). Caries prevalence increased with the age of the child, more in bottle fed than other groups. Within all feeding groups caries prevalence was lowest among white children and in social class I. The dmfs and dmft scores showed irregular patterns and were significantly influenced by feeding group and the interaction between race and social class.

PIP: The importance of breast feeding in industrialized societies is increasing. As such, it is important to establish whether or not breast feeding on demand for a prolonged period is associated with nursing caries so that the necessary prevention measures may be implemented in both developing and developed countries. The authors present findings from an investigation of breast and bottle-feeding practices and their relationships to dental caries in infants and pre-school children in the Transvaal. The relationship between feeding groups, age, race, social class, and dental decay was explored. Mothers or child carers of 1263 children aged 1-4 years from 5 South African communities were interviewed. 73-94% of the children had been breast fed for mean periods of 9-16 months. Although types of infant feeding varied little within groups, preferred feeding practice differed significantly between groups. 546 children were breast fed for 12 months or longer, 527 had mixed breast and bottle feeding, and 190 were bottle fed only. The prevalence of caries increased with the age of the child and more among the bottle fed than others. The prevalence of caries was lowest among white children and in social class I within all feeding groups.

Patterns of breast and bottle feeding and their association with dental caries in 1- to 4-year-old South African children. 2. A case control study of children with nursing caries.

In a case control study, 109 children with nursing caries (> or = 2 decayed, missing, or filled labial or palatal surfaces of primary incisor teeth) were matched for age, race, gender, and social class to 109 children without nursing caries from the same study areas. Mean dmfs and dmft scores were statistically higher in the nursing caries group but no statistically significant differences were found for feeding patterns between the groups in relation to the prevalence of nursing caries. In the present study nursing caries was found to be unrelated to the length of type of feeding (breast or bottle).

Infant growth in a rural Tswana community.

The growth of 205 rural Black infants was monitored from 6 to 27 months of age. Although the babies were short at birth, their mean birth weight was comparable to National Center for Health Statistics ( NCHS ) standards. However, their weight, maintained during the first 7 months, thereafter faltered . Stature remained below the 50th percentile and mean head circumference followed the standard curve. Growth faltering was found in this indigent population. The prevalence of stunting fell rapidly during the first 7 months, but rose again. Few babies showed wasting during the 1st year, but the proportion rose during the 2nd year. More babies were below the standard weight for age during the 2nd year than during the 1st year. Mothers, although short by Western standards, had adequate energy intakes. Most gave birth to babies short in stature but of 'normal' weight and head circumference. A few mothers were malnourished but a far greater proportion were obese. A greater number of mothers who showed wasting gave birth to normal-weight than underweight babies.

Birthweights of babies born at home in a black rural community of Bophuthatswana, southern Africa.

In Africa, data on incidence of babies' low birthweight are based virtually exclusively on information derived from deliveries in hospitals. The incidence of low birthweight is about double that prevailing in developed countries. However, in a rural region in southern Africa, after painstakingly overcoming local strongly entrenched custom, it was found possible to organize the measurement of newborn babies born at home. It was found that the incidence of low birthweight was about half of that among babies born in hospitals--that is the proportion was similar to that of developed populations.

Comparison of milk consumption and its contribution to total sugar intake in South African and other schoolchildren.

Mean daily milk, lactose and energy intakes were measured in groups of South African school pupils of 9-16 years. Recommended dietary allowances (RDA) were not reached by any of the groups. In comparison, groups of Canadian, Nigerian and German schoolchildren of similar ages fell into two categories, namely high milk consumers and low milk consumers. Lactose and energy intakes for high consumers were 77% of the RDA, compared with 30-40% for low consumers. The lactose contribution to daily energy intake for Canadian children was 10.7% and for South African groups about 5%. Thus for South African children lactose contribution to total sugar intake may be half that of Canadian children. Exact proportions need to be defined.