Prolonged breastfeeding and dental caries in preschool children.

PURPOSE: To explore breastfeeding from 6 to 18 months of age and to study the association between breastfeeding and caries prevalence at 5 years of age. METHODS: The study included 1088 children from one Norwegian county and was based on the Norwegian Mother, Father and Child Cohort Study (MoBa). The children had clinical dental examination at 5 years of age, and parents answered a questionnaire, which included information on breastfeeding, oral health behaviour and child characteristic. Multivariate logistic regressions were performed. The study was ethically approved. RESULTS: Of the studied children, 77% were breastfed at 6 months of age and 16% were still breastfed at 18 months of age. Few children (6%) were breastfed during night at 18 months of age, while 11% received sugary drink during night. No association was found between breastfeeding up to 18 months of age and caries prevalence at 5 years of age (p > .05). Children who at 18 months of age had their teeth brushed less than twice daily (OR 2.4, CI 1.5-3.9), consumed sugary drink once a week or more often (OR 1.7, CI 1.1-2.7) and had non-Western parents (OR 3.4, CI 1.5-8.1) were more likely to have caries experience at 5 years of age than other children. CONCLUSION: Breastfeeding up to 18 months of age was not associated with caries development during preschool age.

Scandinavian multicenter study on the treatment of 168 patients with 230 intruded permanent teeth - a retrospective cohort study.

BACKGROUND/AIM: The aim of the study was to evaluate the survival of intruded permanent teeth related to treatment in a large number of patients, with special focus on development of pulp necrosis and replacement resorption (ankylosis-related resorption). MATERIALS AND METHODS: The material consisted of 168 patients (mean age 9.6 years) with 230 intruded permanent teeth from dental trauma clinics in Copenhagen, Denmark, Stockholm, Sweden, and Oslo, Norway. The degree of intrusion was classified as mild (1-<3 mm), moderate (3-7 mm), and severe (>7 mm). Root development was categorized with respect to root formation and development of the apex into three groups of increasing tooth maturity: very immature, immature, and mature. RESULTS: Awaiting re-eruption was the treatment of choice in 107 teeth (47%), orthodontic repositioning in 28 (12%) and surgical repositioning in 95 (41%) teeth. Pulp necrosis was diagnosed in 173 teeth (75%), infection-related root resorption in 57 (25%) and replacement resorption in 50 teeth (22%). Very immature teeth, teeth diagnosed with mild intrusion, and teeth awaiting re-eruption had significantly (P < 0.05) fewer complications. In a stepwise discriminant function analysis, choice of treatment, root development, and degree of intrusion were significantly (P < 0.05) associated with the development of replacement resorption. Root development and degree of intrusion were significantly (P < 0.05) associated with the development of pulp necrosis. CONCLUSION: This study indicates that root development and degree of intrusion may be important for the development of pulp necrosis as well as replacement resorption, whereas choice of treatment only seems to influence the development of replacement resorption in intruded permanent teeth. Awaiting re-eruption resulted in the lowest risk for developing replacement resorption.

Health nurses' experiences and attitudes regarding collaboration with dental personnel.

BACKGROUND: Collaboration between primary care personnel and dental personnel to prevent early childhood caries has been established in several countries. The purpose of this study was, firstly, to describe health nurses' experiences and attitudes regarding collaboration with dental personnel, and secondly, to identify characteristic of health nurses and health centres associated with the collaboration. METHODS: Health nurses working with children answered a questionnaire. In total, 163 of 296 health nurses (55 %) reported demographic information, referral routines, frequency of and reasons for referral of young children to dental personnel, contact with dental personnel and satisfaction with the collaboration. Data were analysed using multivariate logistic regression. RESULTS: The majority of health nurses (83 %) were familiar with referral routines and 31 % reported referring children to dental personnel monthly or more often. The most frequent reasons for referral were clinical caries (52 %), dental discolouration (38 %) and dental trauma (34 %). Few health nurses (18 %) had contact with dental personnel monthly or more often. Two-thirds of health nurses (71 %) reported being satisfied with the collaboration with dental personnel. Results of multivariate analysis showed that health nurses were more likely to refer children when the proportion of immigrant children under care in the health centres was high than when proportion of immigrant children was low (OR 6.4, CI 2.7-14.9). Health nurses working in small health centres were more likely to be satisfied with the collaboration than health nurses working in large health centres (OR 3.2, CI 1.4-7.0). Health nurses 45 years or older were more likely to possess knowledge of referral routines than younger health nurses (OR 2.7, CI 1.1-6.4). CONCLUSIONS: The results indicated that the majority of health nurses possessed knowledge of collaboration routines and were satisfied with the collaboration. The proportion of immigrant children under care in the health centres, the size of the health centres and the age of health nurses were factors influencing the collaboration between primary care personnel and dental personnel.

Does early establishment of favorable oral health behavior influence caries experience at age 5 years?

OBJECTIVE: The purpose was to study associations between tooth brushing frequency, use of fluoride lozenges and consumption of sugary drinks at 1.5 years of age and having caries experience at 5 years of age. METHODS: This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and by the Public Dental Services. A total of 1095 children were followed from pregnancy to the age of 5 years. Questionnaires regarding oral health behavior were completed by the parents at 1.5 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. RESULTS: In multiple logistic regression, having caries experience at 5 years of age was associated with; at 1.5 years of age having the teeth brushed less than twice daily (OR = 2.1, CI = 1.3-3.6) and being offered sugary drinks at least once a week (OR = 1.8, CI = 1.1-2.9) when controlled for family characteristics and oral health behavior at 5 years of age. CONCLUSIONS: Tooth brushing frequency and consumption of sugary drinks in early childhood were related to caries development during pre-school age, independent of family characteristics and oral health behavior at 5 years of age. The results indicate that early established habits regarding tooth brushing and consumption of sugary drinks have long-term effects on caries development. Parents encountering difficulties in establishing favorable oral health behavior in children's first years of life should receive special attention from health personnel.

Maternal health and lifestyle, and caries experience in preschool children. A longitudinal study from pregnancy to age 5 yr.

In this study, associations were explored between maternal health and lifestyle during pregnancy and in early motherhood, and preschool children's caries experience. The study was based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and on data from the Public Dental Services. A total of 1348 children were followed from pregnancy to age 5 yr. A clinical dental examination was performed at age 5 yr. Questionnaires were completed by the mothers during pregnancy and in the first 18 months of their child's life, and as part of the dental examination. Results from the multivariate logistic regression analysis showed that having an obese mother (OR = 2.3, 95% CI: 1.3-4.1), a mother who consumed a diet containing more fat (OR = 1.6, 95% CI: 1.1-2.5) or sugar (OR = 1.5, 95% CI: 1.1-2.3) than recommended, a mother with low education (OR = 1.5, 95% CI: 1.1-2.3) or one or both parents of non-western origin (OR = 5.4, 95% CI: 2.8-10.6) were statistically significant risk indicators for caries experience at age 5 yr. In conclusion, maternal weight and intake of sugar and fat in pregnancy were associated with caries experience in preschool children. These characteristics may enable early referral to the dental services and preventive care to be delivered.

Dental avoidance behaviour in parent and child as risk indicators for caries in 5-year-old children.

AIM: The aim of this study was to explore associations between avoidance behaviour and dental anxiety in both parents and children and caries experience in 5-year-old children. It was hypothesised that parents' dental avoidance behaviour and dental anxiety were related to dental caries in 5-year-old children. DESIGN: Data were collected from dental records and by clinical and radiographic examination of 523 children. The parents completed a questionnaire regarding education, national background, dental anxiety, dental attendance, and behaviour management problems. Bivariate and multivariate logistic regression was conducted. RESULTS: Children having one or more missed dental appointments (OR = 4.7), child behaviour management problems (OR = 3.3), child dental anxiety (OR = 3.1), and parents avoiding dental care (OR = 2.1) were bivariately associated with caries experience at the age of 5 years. In multivariate logistic regression, having one or more missed dental appointments (OR = 4.0) and child behaviour management problems (OR = 2.4) were indicators for dental caries in 5-year-old children, when controlling for parents education and national origin. CONCLUSION: Parents that avoid bringing their child to scheduled dental appointments and previous experiences of behaviour management problems for the child indicated risk for dental caries in 5-year-old children.

Tooth brushing frequency and use of fluoride lozenges in children from 1.5 to 5 years of age: a longitudinal study.

OBJECTIVES: The purpose of the analyses was to study development, stability and changes in oral health behaviour - tooth brushing frequency, use of fluoride lozenges and fluoridated toothpaste in children from 1.5 to 5 years of age - and to study associations between oral health behaviour and family characteristics. METHODS: This study was based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and data from the Public Dental Services. A total of 771 children were followed from 1.5 to 5 years of age. Questionnaires regarding oral health behaviour in children were completed by the parents three times during preschool age. RESULTS: More than half of the children (52%) had their teeth brushed twice daily at 1.5 years of age, increasing to 61% at 3 years and 76% at 5 years of age. At 1.5 years of age, 37% of the children used fluoride lozenges daily, increasing to 74% at 3 years and 75% at 5 years of age. The majority of the children who had started brushing twice daily and used fluoride lozenges daily at 1.5 years of age continued these behaviours until the age of 5 years. At 1.5 years of age, children who brushed twice daily were more likely to use fluoride lozenges daily than children who brushed less frequently (P = 0.03). Multiple logistic regression showed that the probability of a child having its teeth brushed twice daily continuously during preschool age was higher when both parents were of western origin [odds ratios (OR) 4.0, confidence intervals (CI) 1.3-11.9] than when one or both parents were of non-western origin. Children with one older sibling brushed more frequently (OR 1.4, CI 1.0-1.9) and used fluoride lozenges more often (OR 1.6, CI 1.1-2.2) during preschool age than children without older siblings. CONCLUSIONS: Oral health behaviour established in early life was stable during preschool age. The results indicate that tooth brushing frequency and use of fluoride lozenges were not in accordance with the present recommendations based on the scientific literature. The teeth of Norwegian preschoolers were brushed less frequently than recommended, and more children than recommended were using fluoride lozenges.

Family characteristics and caries experience in preschool children. A longitudinal study from pregnancy to 5 years of age.

OBJECTIVE: The purpose of the study was to explore associations between family status, family income, family size, mother's age at child birth, mother's education and parents' national background and caries experience in 5-year-old children. METHOD: This study is based on data from the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health and the Public Dental Services. A total of 1348 children were followed from pregnancy to the age of 5 years. Questionnaires were completed by mothers twice during pregnancy and when the children were 3 and 5 years of age. Clinical and radiographic examination of the children was performed at the age of 5 years. RESULTS: Caries experience in the 5-year-old children was low; 89% had no caries experience (d(3-5) mft = 0). In multiple logistic regression having one or both parents of non-western origin (OR 3.4, CI 1.6-7.3), having had a change in family status from pregnancy to 5 years of age (OR 2.0, CI 1.1-3.4) and having mother with low education (OR 1.9, CI 1.3-2.8) were statistically significant risk indicators for having caries experience at the age of five. CONCLUSION: Family characteristics in pregnancy and early life were associated with caries experience in 5-year-old children. Primary care personnel meeting young children with one or several of these characteristics should consider referring the child to dental personnel to enable early initiation of health-promoting activities.

Caries and background factors in Norwegian and immigrant 5-year-old children.

OBJECTIVES: The purpose of this study was to assess the caries status of 5-year-olds in a low caries area, and study associations between dental caries and parent-related factors: parents' education, national origin, oral health behaviours and attitudes. METHODS: The material consisted of 523 children and was a stratified random sample. Clinical and radiographic examination was performed in 2007. Enamel and dentine caries were recorded at surface level. Parents filled in questionnaires regarding socioeconomic status, their own oral health behaviours and attitudes. RESULTS: Most participants (66%) had no caries experience and 16% had enamel caries only. Dentine caries experience was present in 18% of the children, and 5% had dentine caries experience in five or more teeth. Surfaces with enamel caries constituted half of all surfaces with caries experience. In multiple logistic regression, statistically significant risk indicators for the child having dentine caries experience at the age of five were: having one or both parents of non-western origin (OR = 4.8), both parents (OR = 3.0) or one parent (OR = 2.1) with low education, parental laxness about the child's tooth brushing (OR = 2.8), parents' brushing their own teeth less than twice a day (OR = 2.2) and having parents with frequent sugar intakes (OR = 1.8). CONCLUSION: Caries prevalence in 5-year-olds was strongly associated with parent-related factors signifying that information on parents' socioeconomic status, dental behaviours and attitudes should be considered when planning dental services for young children. Our results suggest that the real high risk group is non-western children whose parents have low education.