Association between mother-infant salivary contacts and caries resistance in children: a cohort study

We selected 327 7-month-old infants and divided them into two groups based on the frequency of salivary close contacts between mother and infant. Five to seven years later, all first-born children (N = 55) whose dental development had been followed regularly, were examined for dental caries and prevalence of salivary mutans streptococci (MS) and lactobacilli. The children with frequent maternal close contacts (F group, N = 21) had significantly less MS in saliva than the children with rare close contacts (R group, N = 34, P = 0.02). Only 19% of the children in F group compared with 56% in R group had experienced caries in their primary molars and/or canines (P < 0.01). A significantly greater proportion of the children in F group (57%) than in R group (27%, P < 0.05) had a high intake of sugar-containing foods and drinks in a 2-day dietary history. The F and R groups did not differ significantly with respect to other children's caries risk factors, or in age, sex, stage of dental development, dental treatment, or the social aspects studied. There were no significant differences between F and R groups in maternal caries experience, salivary MS or lactobacillus counts, or in maternal background factors (age, breast feeding, or education). Frequent transfer of maternal saliva to the mouth of the baby before tooth eruption was negatively associated with oral infection by MS and to caries in the primary dentition, possibly due to protective immune mechanisms.     

Dental caries and Cariostat test in preschool children

The aim of this study was to investigate the caries status and susceptibility of children in preschool age. Sixty one children ages between 3 to 5 years (mean age 4.38 +/- 0.71) participated in this study. Caries status was assessed according to WHO criteria, and caries susceptibility by using the Cariostat test. The mean df-t was found to be 2.28 +/- 0.71 (df-s 6.26 +/- 11.92) and 31 children were caries-free. Cariostat scores were 1.75, 2.00, 2.16 in the 3, 4, and 5 year age groups respectively. There were no significant differences in caries status or Cariostat scores between boys and girls. The df-t for the 5 year age group was significantly higher than that for the 3 year age groups (p < 0.05). The test found 77% of the children to have a high caries risk (Cariostat score > 2.0).     

Dental caries in the deciduous teeth of the children from Gulbarga, Karnataka

A cross-sectional dental examination of 1,560 randomly selected unrelated children of Gulbarga, Karnataka has shown about 30% of the children with deciduous teeth suffering from one or more carious teeth. The proportion of male children with df teeth was larger than female ones; the difference between the two being statistically significant (chi 12 = 8.0387). Its incidence was higher in children of low income group. Muslims (36.2%) were found to be affected more than Hindus (29.6%) and Christians (27.8%). An increase in the frequency of carious children was observed with the increasing age excepting the children aged 12 years and above who have shown a decreasing trend. In both the sexes mandibular teeth were found more susceptible than maxillary ones. No side difference was found in either jaw. Lower second molars were affected more, followed by lower first and upper second molars. Toothwise prevalence of caries by age showed no consistent trend either in maxilla or mandible.     

Oral hygiene as a risk indicator of enamel and dentin caries

Dental researchers have postulated that the risk factors for enamel and dentin caries may not be the same. A review of the literature ascertained that data to support this theory are lacking. OBJECTIVES: To evaluate the risk indicators of enamel and dentin caries of the permanent dentition in a study group who had limited access to fluorides and made limited use of dental services. METHODS: The study was conducted in Goa, India. Data came from a cross-sectional survey of 1189 seventh grade children, which consisted of a clinical dental examination and a self-administered questionnaire to their parents. The cavitated and non-cavitated criteria were used to score for caries, and the Silness-Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The percentage of children caries free in the permanent dentition was 22.2%, the mean+/-s for dmfs, enamel and dentin lesions were 4.20+/-5.10, 2.59+/-2.89 and 1.61+/-3.30 respectively, and the mean plaque score was 1.00+/-0.48. Results of regression analyses showed that the risk indicators of prevalence and severity of caries differed depending on lesion type. The only variable that was consistently a risk indicator of presence and severity of both dentin and enamel caries was poor oral hygiene. Mother's highest level of education and presence of fluorosis were also risk indicators of enamel and dentin caries. The presence of decayed primary teeth was a risk indicator of enamel caries; and fluorosis severity, use of fluoride toothpaste at the time of the survey, and toothbrushing frequency were risk indicators of dentin caries. The observed caries-oral hygiene association seen is explored further.     

Dental survey at school with the purpose to select children with no actual need of dental treatment

The purpose of this study was to develop an examination method to select children without from children with need of dental treatment. Furthermore the objective was that these examinations could be performed as a survey at school, without utilizing an expensive and fully equipped dental clinic but still maintain the certainty for the individual not to be at increased risk to be declared false caries-free, in comparison with ordinary examination at a dental clinic. The material comprised 88 children 10-13 years old. The children were subject to a survey-examination at school and a few weeks later at a dental clinic by the same examiner. Initially the children were examined at school by two examiners in order to measure the inter-examiner variability. The results showed that 2 of the 88 examined children (2.3%) were judged false healthy at school examination with respect to caries. The inter-examiner variability in diagnosing caries was greater than the intra-examiner variability between survey at school and examination at the dental clinic.     

Contribution of curietherapy in the treatment of ENT tumors

The purpose of this study was to compare dental status and resource requirements in immigrants to Norway, three to 18 years of age, with Norwegians of the same age group. Data on dmft and DMFT, fillings placed and time spent for dental care were registered in the records of 9000 such children in the period 1992-93. Eleven per cent of the children were immigrant children. Immigrant children three to six years of age had fewer sound teeth and more decayed, missing and filled teeth than Norwegian children and the pre-school immigrant children had higher treatment needs. However, the time spent on a pre-school child with an immigrant background was shorter than the time spent on a Norwegian child with the same number of decayed teeth. The differences between immigrants and Norwegians disappeared with higher age. Immigrant children older than six years had dental health and resource requirements similar to those of Norwegian adolescents.     

Initial caries attack and average progression rates in 12-year-old Isle of Wight children

Initial caries attack and progression rates of posterior approximal carious lesions were assessed based on 12-year-old school children residing on the Isle of Wight. Bitewing radiographs of a sub-sample of 165 subjects were randomly selected from the control group of a dentifrice clinical trial which took place between 1984 and 1987. Of the approximal surfaces that were caries-free at the first examination 71 per cent of the same surfaces remained caries-free after three years, an overall initial caries attack rate averaging 10.7 per cent per annum. Of the mesial surfaces of first permanent molars, 455 were initially caries-free, 67 per cent of which remained so after a three year period. The attack rate of this specified surface was 12.4 per cent per annum. The majority of surfaces that were caries-free at the start of the investigation would therefore be expected to remain so at least three years later. Caries progression appeared to be a slow process with only 12 per cent of initially carious outer enamel surface lesions penetrating into dentine after one year. After two years this had increased to 46 per cent and after three years, to 62 per cent. For a similarly defined group of individuals it would appear likely that the majority of early enamel lesions would not reach dentine within two years. For a substantial number of subjects this would extend to at least three years.     

Prevalence of developmental enamel defects and dental caries in rural pre-school Thai children

The prevalence of developmental enamel defects and dental caries was assessed in 344 Karen children aged 1-4 years who were chronically (70 per cent) and acutely malnourished (9.3 per cent) The teeth were cleaned with gauze to facilitate detection of hypoplastic lesions on labial surfaces of maxillary incisors. At least one tooth with defective enamel was seen in 31.9 per cent of children, while enamel hypoplasia was present in 22.7 per cent of children. Enamel defects were found in 21.2 per cent of teeth, with hypoplasia and opacities occurring in 14.6 and 6.6 per cent of teeth, respectively. Gender did not alter the prevalence of defects. The upper central incisors were affected more than lateral incisors. The prevalence of dental caries was 31.9 per cent with a mean dt of 1.1. The prevalence of caries associated with enamel hypoplasia was significantly greater than that associated with opacities and sound enamel (P < 0.0005).     

The use of bitewing radiographs in the management of dental caries: scientific and practical considerations

The objective of this paper is to synthesize published research on the use of radiographs in caries diagnosis in order to produce recommendations for guidelines that are clinically oriented but scientifically based. The options available include the use of various types of radiographic examination alone or in conjunction with other diagnostic aids. The outcomes should facilitate the optimal management of lesions as either preventive care advised (PCA) or operative care advised (OCA). Small initial lesions (PCA) require prompt detection, the application of appropriate preventive care and subsequent monitoring to maintain the most favourable tooth state achievable in the long term. Larger dentinal lesions (OCA) also require prompt detection so that appropriate high-quality operative care can be provided before further loss of tooth substance. Evidence was collected from the literature by updating several recent reviews by the author. The values employed were broadly analogous to those of the Canadian Task Force on the Periodic Health Examination. The use of ionizing radiation is always associated with a degree of risk: therefore all exposures must be kept as low as is reasonably achievable. Present evidence on the balance of risk and benefit indicates that the diagnostic yield for caries diagnosis is high enough to justify individualized examinations, particularly as changes in the morphology of caries have rendered clinical diagnosis of dentinal lesions less sensitive. This issue must be kept under review as alternative diagnostic technologies develop. There is good evidence that initial posterior bitewing radiographs are required for all new dentate patients over five years of age with posterior teeth. This procedure is required as an adjunct to clinical examination for the detection of caries on both the approximal and occlusal surfaces of the teeth. Although a 'blanket' regimen of routine radiographic examination at fixed intervals cannot be advocated, individualized bitewing examinations at varying frequencies determined on the basis of caries risk are supported. At the initial visit, an assessment of caries risk of the individual patient should be made. Varying intervals of first radiographic recall can then be suggested on the basis of differing degrees of risk. At present, risk assessment is imprecise, and risk status may change over time. Therefore, intervals between subsequent radiographic examinations must be re-assessed for each period. The purpose of detecting individual lesions should be to facilitate the planning of appropriate preventive treatment decisions based on lesion severity, caries risk and the patient. Different treatment should be employed for lesions in the PCA and OCA categories. Further rigorous studies are required to evaluate diagnostic methods appropriate for use in individual patient care, epidemiology and clinical research, and to increase the understanding of how findings from these applications inter-relate. Development and validation of reliable methods of caries risk assessment which are usable in general practice is a priority. Investigations of the processes involved in, and the outcomes of, dental decision-making are required to ensure that existing and new methods are used appropriately. Further work should develop and evaluate effective mechanisms of disseminating and implementing research findings by information transfer to dental educators and clinicians.     

Therapeutic effects of the blood-activating and stasis-reducing method in 80 cases of coronary heart disease

Caries risk assessment is a relatively simple, yet cost effective method to evaluate the oral condition likely to produce carious lesions in both children and adults. This procedure can also indicate current caries activity in a patient. The assessment can provide the foundation for a scientifically-based preventive dental practice. The cost and contents of two different caries risk assessment kits are discussed.     

Modalities of fluoride prescription in the caries prevention

Three periods of child dental development carry a high risk of caries: the second year of life, the age of 6 years and adolescence (14-15 years). Besides education on oral hygiene and appropriate diet, fluoride is a major tool of caries prevention. However, it must be considered as a medication and its use must always take into account age and its different possible sources in order to avoid excessive administration.     

A compendium of managed care: past, present, and hints of the future--Part II

This study was designed as a prospective clinical caries prevalence study starting with children at 1.5 years of age. The subjects were 374 children who were born between 1989 and 1991. All subjects visited a public health center in Kunitachi-city, Tokyo, at 1.5 years, 2 years, and 3 years of age. All the children and parents have followed preventive dental care guidance. Dental caries were always examined by one of the authors. The caries prevalences at 1.5 years, 2 years, and 3 years of age were 6.1%, 14.7%, and 31.8%, respectively. The mean dft at 3 years of age in children who developed caries before 2 years of age was significantly greater than that in children caries free at 2 years of age. The findings from the current study showed that children who develop caries before 2 years of age are at greater risk for dental caries.     

Potential role of the peroxynitrate-poly(ADP-ribose) synthetase pathway in a rat model of severe hemorrhagic shock

PURPOSE: The purpose of this study was to assess the performance of sealants placed by senior dental students as part of a comprehensive dental care program that included periodic patient recall. METHODS: The dental records of 100 patients ranging in age from 6 to 13 years were selected for review to determine the treatments provided for first permanent molars over time. Criteria for inclusion were: 1) at least five documented recall examinations and 2) all four first permanent molars had to have been treated with an occlusal pit and fissure sealant. The data collected included: 1) the age of the patient at the time of initial sealant placement; 2) the subsequent treatment provided to the first permanent molars, including retreatment with sealant or restoration and the date the services were provided; 3) the last date of follow-up examination in the pediatric dental program. RESULTS: A total of 400 molars were followed for an average of 54 months. Fifty-two percent of all molars received no further treatment after initial placement of sealant. Approximately 35% received retreatment with sealant only. The total number of molars receiving sealant material only was 343 (86%). The total number of teeth that were judged to require restoration was 57 (14%). No relationship was noted between the patient's age at placement of the occlusal sealant and sealant performance. CONCLUSION: In a dental school clinic, occlusal sealants were effective at preventing caries in a comprehensive care program that included periodic recall.     

Caries prevalence in the deciduous dentition of a mediaeval population from the south-west of Scotland

The prevalence, distribution and location of dental caries were studied in the deciduous dentition of 185 skeletons aged between 6 months and 13 years from a large, mostly mediaeval, cemetery, where successive phases of use could be distinguished. The main phases dated from 1240 to 1440 AD. During this period, no consistent trend or pattern of caries was identified, but there was a significantly higher caries prevalence in the age band 6-12.9 years than in the age band 0.1-5.9 years. The caries prevalence in the juveniles from the earlier Northumbrian, or Anglo-Saxon, phase of the cemetery was higher than in any mediaeval phase group, with mostly approximal surfaces affected. In the mediaeval population, first deciduous molars generally showed lower caries prevalence than second deciduous molars, significantly lower for the older age band, and maxillary molars consistently showed lower levels than mandibular molars. The highest caries rate, shown by mandibular second molars in the older age band, was 7.9%. In deciduous molars, the occlusal surface was most frequently affected by caries, whereas in the permanent molars of the same population the approximal surfaces had shown the highest level of attack. The overall caries prevalence in deciduous teeth in the mediaeval population of Whithorn was 2.3% of the teeth present, lower than the levels found in previous Scottish and English population groups, including a small assemblage of children from the Scottish sites of Elcho, Southwick and Kirkhill.     

Dental caries in nineteenth century upper Canada

This study examines the presence of dental caries in a large sample of adult skeletons from the 19th century cemetery of St. Thomas' Anglican Church in Belleville, Ontario. The cemetery was used from 1821 to 1874. Caries prevalence and frequencies of diseased and missing teeth were calculated both by observing summary statistics of individual rates and by the total sample of teeth. Postmortem tooth loss is low in this sample and antemortem tooth loss is highest in first mandibular molars, all other molars and then premolars. Age at death, but not sex, was found to be significantly related to the overall Caries Rate while both age and sex were significantly associated with the Diseased-Missing Index. The increase in diseased and missing teeth in older individuals is expected while the sex difference is not explained by simple dietary factors. When compared to reports on British and American samples, caries and antemortem tooth loss in the St. Thomas' sample is most similar to a pre-1850 British group and higher than American samples. Although there is undoubtedly a complex of factors contributing to caries prevalence in this sample, more data are required from large historic samples, particularly from the American northeast and late 19th century Britain, to have a clearer understanding of the influence of diet, cultural, and environmental factors affecting caries rates in historic populations.     

A new correction procedure for calibrating dental caries frequency

The incisors and canines and the premolars and molars show differential resistance to cariogenic factors. The anterior teeth have a lower caries frequency than the posterior teeth. However, these tooth classes are lost differentially in postmortem stages due to their anatomical structures. This differential postmortem tooth loss distorts proportions between the anterior and posterior tooth classes. The disproportionality can affect the calculation of total caries prevalence. In this paper, we propose a new calibration procedure which removes this disproportionality and call it the proportional correction factor. For this procedure, the caries rates of anterior and posterior teeth are corrected by multiplying the anterior teeth by three-eighths and the posterior teeth by five-eighths. These fractions are derived from the human dental formula which contains three anterior and five posterior teeth by side. The correction factor is more effective if the proportion of anterior to the posterior teeth is extremely distorted. When this procedure is used with the caries correction factor, it provides a useful way to approach to an almost true caries prevalence.     

Dental caries in pre-school children: associations with social class, toothbrushing habit and consumption of sugars and sugar-containing foods. Further analysis of data from the National Diet and Nutrition Survey of children aged 1.5-4.5 years

This project examined the relative significance of dietary sugars, toothbrushing frequency and social class as predictors of caries experience (caries vs. no caries) among 1,450 British pre-school children who took part in the National Diet and Nutrition Survey. This cross-sectional survey was based on a representative sample of children aged 1.5-4.5 years studied in 1992/3. Children were classified into four groups according to social class and toothbrushing habit. Diet/caries associations were examined for biscuits and cakes, sugar confectionery, chocolate confectionery and soft drinks, and the percentage of energy from non-milk extrinsic sugars, using data on amount and frequency of consumption from 4-day weighed dietary records. In stepwise logistic regressions, the strength of the association between social class and caries experience was twice that between toothbrushing and caries, and nearly three times that between sugar confectionery and caries (other dietary variables were not significant). The association of caries with sugar confectionery (both in amount and frequency) was only present among children whose teeth were brushed less than twice a day. Toothbrushing frequency appeared to have a stronger impact on caries prevention in non-manual compared with manual children. Household expenditure on confectionery was associated with caries only among children from the manual group. The findings suggest the hypothesis that regular brushing (twice a day) with a fluoride toothpaste may have greater impact on caries in young children than restricting sugary foods.     

Night-to-night variability in CPAP use over the first three months of treatment

Caries of the pits and fissures of permanent teeth continues to be a problem for children, newly erupted permanent molars being particularly at risk. Oral hygiene measures have been shown to be able to reduce the incidence of caries. The aim of this study was to compare the caries-preventive effects on newly erupted first permanent molars of a professional tooth cleaning and oral health education program (test) with a standard preventive program (control), comprising selective fissure sealing and application of topical fluorides. School Dental Service clinics of the Health Department of Western Australia, in Perth, were assigned to four test or four control clinics. Schoolchildren, mean age 6.3 +/- 0.3 (s) years with sound, newly erupted first permanent molars were included in the study (207 test, 197 control). After 12 months, 186 test and 163 control children were examined by an examiner who was 'blind' to the test or control status of the children. Caries of the first permanent molars developed in 34 test and 35 control children; the estimated risk ratio was 0.86 (95% CI 0.56, 1.30). Children in the test group had an average DFT score of 0.26 +/- 0.62 compared with 0.29 +/- 0.64 DFT in the control group (t-test, P = 0.67). The 12-month results suggest that there was no statistically significant difference between the caries-preventive effects of a professional tooth cleaning and oral health education program and a program based on selective fissure sealing and application of topical fluorides.     

RNA editing, introns and evolution

Caries activity tests are an essential part of any programme concerned with the study or treatment of dental caries. Most of the caries activity tests require expensive kits or specially prepared media or facilities for incubation which limits their use in clinical practice. The present study sample consisted of twenty five children with dental caries and twenty five controls, free of caries, gingivitis and other oral ailments. The test is simple and consists of rinsing the mouth with 10 ml of sterile milk, 3 ml of which is mixed with 0.12 ml of 0.1% methylene blue dye and observed for colour change. The present study demonstrated the potential uses of this test in a pediatric dental clinic setup.