Author
Robert J Schroth
Other affiliations: Boston Children's Hospital, American Academy of Pediatrics, Winnipeg Regional Health Authority ...read more
Bio: Robert J Schroth is an academic researcher from University of Manitoba. The author has contributed to research in topics: Early childhood caries & Medicine. The author has an hindex of 23, co-authored 96 publications receiving 1748 citations. Previous affiliations of Robert J Schroth include Boston Children's Hospital & American Academy of Pediatrics.
Papers published on a yearly basis
Papers
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TL;DR: This article focuses on early childhood caries as an overall proxy for Indigenous childhood oral health because decay during early life sets the foundation for oral health throughout childhood and adolescence.
134 citations
TL;DR: Attitudes on the importance of baby teeth and bottle feeding after one year of age, the effect of rotten teeth on childhood health and night-time nursing emerged as variables most associated with the absence/presence of ECC and deft rates.
Abstract: OBJECTIVES: Prevention strategies are integral to improving the oral health for young Aboriginal children. For such to be effective, it is important to understand the social value that parents and caregivers ascribe to primary teeth. The purpose of this paper is to report caregiver knowledge and attitudes toward preschool oral health and early childhood caries (ECC) from 4 communities in Manitoba. STUDY DESIGN: Cross-sectional study, including a retrospective interview with caregivers. METHODS: Children and their main caregivers served as the sample. Preschoolers underwent a comprehensive dental screening while caregivers completed a questionnaire that explored knowledge and attitudes toward preschool dental health. Caregiver responses were matched with findings from each child's examination. RESULTS: A majority agreed that primary teeth were important, that dental disease could lead to health problems and that a first dental visit should be made by age 1. Caregivers of children with ECC were more likely to believe that caries could not affect a child's health while those who believed primary teeth are important had children with significantly less decay. CONCLUSIONS: Most caregivers believed that primary teeth are important and correctly responded to inquiries about knowledge and attitudes toward oral health. Attitudes on the importance of baby teeth and bottle feeding after one year of age, the effect of rotten teeth on childhood health and night-time nursing emerged as variables most associated with the absence/presence of ECC and deft rates. Incorporating such questioning into caries risk assessments may be a useful means to determine a child's risk for ECC. Keywords: Aboriginal; attitude to health; dental caries; early childhood caries; oral health; preschool child (Int J Circumpolar Health 2007; 66(2):153-167)
107 citations
TL;DR: Children with S-ECC appear to have relatively poor nutritional health compared to caries-free controls, and were significantly more likely to have low vitamin D, calcium, and albumin concentrations and elevated PTH levels.
Abstract: Severe Early Childhood Caries (S-ECC) affects the health and well-being of young children. There is limited research in this area, though evidence suggests that children with S-ECC are at an increased risk of malnutrition. The purpose of this study was to determine the association between vitamin D (25(OH)D) levels and S-ECC. This case–control study was conducted from 2009 to 2011 in the city of Winnipeg, Manitoba, Canada. 144 preschool children with S-ECC were recruited from a local health centre on the day of their slated dental surgery under general anesthetic. 122 caries-free controls were recruited from the community. Children underwent a blood draw for vitamin D (25(OH)D), calcium, parathyroid hormone, and albumin levels. Parents completed an interviewed questionnaire assessing the child’s nutritional habits, oral health, and family demographics. Analyses included descriptive and bivariate statistics as well as multiple and logistic regression. A p value ≤ 0.05 was significant. The mean age of participants was 40.8 ± 14.1 months. Children with S-ECC had significantly lower mean 25(OH)D (68.9 ± 28.0 nmol/L vs. 82.9 ± 31.1, p < 0.001), calcium (p < 0.001), and albumin (p < 0.001) levels, and significantly higher parathyroid hormone (p < 0.001) levels than those caries-free. Children with S-ECC were significantly more likely to have vitamin D levels below recognized thresholds for optimal and adequate status (i.e. <75 and <50 nmol/L, respectively). Multiple regression analysis revealed that S-ECC, infrequent milk consumption, and winter season were significantly associated with lower 25(OH)D concentrations. Low 25(OH)D levels, low household income, and poorer ratings of the child’s general health were significantly associated with S-ECC on logistic regression. Children with S-ECC appear to have relatively poor nutritional health compared to caries-free controls, and were significantly more likely to have low vitamin D, calcium, and albumin concentrations and elevated PTH levels.
106 citations
TL;DR: Inadequate maternal vitamin D levels during pregnancy may affect tooth calcification, predisposing enamel hypoplasia and early childhood caries among offspring during the first year of life.
Abstract: OBJECTIVES: Inadequate maternal vitamin D (assessed by using 25-hydroxyvitamin D [25OHD]) levels during pregnancy may affect tooth calcification, predisposing enamel hypoplasia and early childhood caries (ECC). The purpose of this study was to determine the relationship between prenatal 25OHD concentrations and dental caries among offspring during the first year of life. METHODS: This prospective cohort study recruited expectant mothers from an economically disadvantaged urban area. A prenatal questionnaire was completed and serum sample drawn for 25OHD. Dental examinations were completed at 1 year of age while the parent/caregiver completed a questionnaire. The examiner was blinded to mothers’ 25OHD levels. A P value ≤ .05 was considered significant. RESULTS: Overall, 207 women were enrolled (mean age: 19 ± 5 years). The mean 25OHD level was 48 ± 24 nmol/L, and 33% had deficient levels. Enamel hypoplasia was identified in 22% of infants; 23% had cavitated ECC, and 36% had ECC when white spot lesions were included in the assessment. Mothers of children with ECC had significantly lower 25OHD levels than those whose children were caries-free (41 ± 20 vs 52 ± 27 nmol/L; P = .05). Univariate Poisson regression analysis for the amount of untreated decay revealed an inverse relationship with maternal 25OHD. Logistic regression revealed that enamel hypoplasia ( P P = .002), and lower prenatal 25OHD levels ( P = .02) were significantly associated with ECC. CONCLUSIONS: This study found that maternal prenatal 25OHD levels may have an influence on the primary dentition and the development of ECC.
104 citations
Journal Article•
TL;DR: It is important for pediatricians, family physicians and other health service providers encountering very young children and expectant mothers to be cognizant of ECC and its ramifications, as their education efforts represent the first line of defence.
Abstract: Background: Early childhood caries (ECC) is a devastating form of dental decay affecting many Canadian children, especially those from northern First Nations communities. ECC is multifactorial in origin, and the notion that the principal etiology is inappropriate feeding modalities is no longer tenable. Methods: This study was conducted in the community of Garden Hill First Nation, Manitoba, to assess the prevalence of dental decay in young children, to assess risk factors for ECC and to determine the influence of vitamin D supplementation (a modified form of stosstherapy using 100,000 IU vitamin D), both prenatally and at 6 weeks of age, on the oral health of children. The study involved a cross-sectional dental examination of children, an interview with mothers and a maternal chart review. Results: A total of 98 children participated: their mean age was 46.4 ± 6.3 months. The mean number of decayed, extracted and filled teeth (deft) was 13.7 ± 3.2. Caries rates were significantly greater among children who had had sugar added to the feeding bottle. Behaviours typically associated with ECC and caries activity, such as poor oral hygiene and late weaning from the bottle, were also exhibited among residents. Although 50% of children had enamel hypoplasia, no statistically significant differences in the amount of enamel hypoplasia and caries were found between those who received modified stosstherapy and those who did not. Not receiving stosstherapy was associated with later eruption time of the first primary tooth (7.2 vs. 5.0 months). Interviews revealed that, during pregnancy, many of the mothers only infrequently consumed foods rich in calcium and vitamin D, elements that are essential to the development of strong bones and teeth. Conclusions: The mean deft for these First Nations preschoolers was high and 50% had enamel defects. Although daily vitamin D supplementation of 400 IU during pregnancy has been known to reduce primary tooth enamel defects, the supplementation previously administered to participants in this study was not found to result in reduced enamel defects or caries. The high caries burden among children from this community reveals the need for effective prevention methods. It is important for pediatricians, family physicians and other health service providers encountering very young children and expectant mothers to be cognizant of ECC and its ramifications, as their education efforts represent the first line of defence.
90 citations
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TL;DR: An Explanation and Elaboration of the PRISMA Statement is presented and updated guidelines for the reporting of systematic reviews and meta-analyses are presented.
Abstract: Systematic reviews and meta-analyses are essential to summarize evidence relating to efficacy and safety of health care interventions accurately and reliably. The clarity and transparency of these reports, however, is not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users.
Since the development of the QUOROM (QUality Of Reporting Of Meta-analysis) Statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realizing these issues, an international group that included experienced authors and methodologists developed PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions.
The PRISMA Statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this Explanation and Elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA Statement, this document, and the associated Web site (http://www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
25,711 citations
TL;DR: The meaning and rationale for each checklist item is explained, and an example of good reporting is included and, where possible, references to relevant empirical studies and methodological literature are included.
Abstract: Systematic reviews and meta-analyses are essential to summarise evidence relating to efficacy and safety of healthcare interventions accurately and reliably. The clarity and transparency of these reports, however, are not optimal. Poor reporting of systematic reviews diminishes their value to clinicians, policy makers, and other users. Since the development of the QUOROM (quality of reporting of meta-analysis) statement—a reporting guideline published in 1999—there have been several conceptual, methodological, and practical advances regarding the conduct and reporting of systematic reviews and meta-analyses. Also, reviews of published systematic reviews have found that key information about these studies is often poorly reported. Realising these issues, an international group that included experienced authors and methodologists developed PRISMA (preferred reporting items for systematic reviews and meta-analyses) as an evolution of the original QUOROM guideline for systematic reviews and meta-analyses of evaluations of health care interventions. The PRISMA statement consists of a 27-item checklist and a four-phase flow diagram. The checklist includes items deemed essential for transparent reporting of a systematic review. In this explanation and elaboration document, we explain the meaning and rationale for each checklist item. For each item, we include an example of good reporting and, where possible, references to relevant empirical studies and methodological literature. The PRISMA statement, this document, and the associated website (www.prisma-statement.org/) should be helpful resources to improve reporting of systematic reviews and meta-analyses.
13,813 citations
TL;DR: This Explanation and Elaboration document explains the meaning and rationale for each checklist item and includes an example of good reporting and, where possible, references to relevant empirical studies and methodological literature.
8,021 citations
TL;DR: It is suggested that if assessment of overdoses were left to house doctors there would be an increase in admissions to psychiatric units, outpatients, and referrals to social services, but for house doctors to assess overdoses would provide no economy for the psychiatric or social services.
Abstract: admission. This proportion could already be greater in some parts of the country and may increase if referrals of cases of self-poisoning increase faster than the facilities for their assessment and management. The provision of social work and psychiatric expertise in casualty departments may be one means of preventing unnecessary medical admissions without risk to the patients. Dr Blake's and Dr Bramble's figures do not demonstrate, however, that any advantage would attach to medical teams taking over assessment from psychiatrists except that, by implication, assessments would be completed sooner by staff working on the ward full time. What the figures actually suggest is that if assessment of overdoses were left to house doctors there would be an increase in admissions to psychiatric units (by 19°U), outpatients (by 5O°'), and referrals to social services (by 140o). So for house doctors to assess overdoses would provide no economy for the psychiatric or social services. The study does not tell us what the consequences would have been for the six patients who the psychiatrists would have admitted but to whom the house doctors would have offered outpatient appointments. E J SALTER
4,497 citations
TL;DR: The updating of the QUOROM Statement is described, to ensure clear presentation of what was planned, done, and found in a systematic review, and the name of the reporting guidance was changed to PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses).
3,513 citations