Xue-Li Bao

Bio: Xue-Li Bao is an academic researcher from First Affiliated Hospital of Xinjiang Medical University. The author has contributed to research in topics: Public health & Cross-sectional study. The author has an hindex of 1, co-authored 1 publications receiving 47 citations.

Risk determinants associated with early childhood caries in Uygur children: a preschool-based cross-sectional study

Abstract: The prevalence of early childhood caries (ECC) varies with geographical region and population. The Uygur people, one of 55 officially recognized ethnic minorities in China, have a population of 10,069,346. We performed a preschool-based cross-sectional study of 670 Uygur children from the southern region of Xinjiang, China, to investigate the prevalence and severity of ECC and to identify factors related to the dental health condition of this population. The study population of children ranging in age from 3 to 5 years was invited using a three-stage stratified sampling in Kashgar, the westernmost city in China. The “dmft” index was used to assess dental caries. The diagnosis of ECC or severe ECC was based on the oral health diagnostic criteria defined by the American Academy of Pediatric Dentistry. A questionnaire was completed by the children’s caregivers. The survey included questions concerning the children’s sociodemographic background; feeding and eating habits, particularly frequency of sweet beverage and food consumption; dental hygiene-related behaviors; the general oral health knowledge of caregivers; and the dental healthcare experience of caregivers and their children. A total of 670 Uygur children underwent complete dental caries examination. Most of the children (74.2%) had ECC, with a mean dmft ± SD of 3.95 ± 3.84. The prevalence of severe ECC was 40.1% (N =269), with a mean dmft of 7.72 ± 3.14. More than 99% of caries were untreated. Statistically significant correlations were found between higher ECC prevalence and increased age and lower socioeconomic background, while greater dental health knowledge of the caregiver and positive oral hygiene behaviors were found to be protective. Our findings confirm the multi-factorial etiology of ECC. The prevalence of ECC among preschool-aged Uygur children in Kashgar was high, particularly among those from lower socioeconomic backgrounds. Caries prevalence was associated with oral hygiene behaviors of children and the general oral health knowledge of caregivers. These factors could be modified through public health strategies, including effective publicity concerning general dental health and practical health advice.

Breast and Bottle Feeding as Risk Factors for Dental Caries: A Systematic Review and Meta-Analysis

Abstract: Understanding the role that breastfeeding and bottle feeding play in the development of dental caries during childhood is essential in helping dentists and parents and care providers prevent the disease, and also for the development of effective public health policies. However, the issue is not yet fully understood. The aim of this systematic review and meta-analysis was to search for scientific evidence in response to the question: Do bottle fed children have more dental caries in primary dentition than breastfed children? Seven electronic databases and grey literature were used in the search. The protocol number of the study is PROSPERO CRD 42014006534. Two independent reviewers selected the studies, extracted data and evaluated risk of bias by quality assessment. A random effect model was used for meta-analysis, and the summary effect measure were calculated by odds ratio (OR) and 95% CI. Seven studies were included: five cross-sectional, one case-control and one cohort study. A meta-analysis of cross-sectional studies showed that breastfed children were less affected by dental caries than bottle fed children (OR: 0.43; 95%CI: 0.23–0.80). Four studies showed that bottle fed children had more dental caries (p 0.05). The scientific evidence therefore indicated that breastfeeding can protect against dental caries in early childhood. The benefits of breastfeeding until age two is recommended by WHO/UNICEF guidelines. Further prospective observational cohort studies are needed to strengthen the evidence.

Prevalence of early childhood caries among 5-year-old children: A systematic review.

Abstract: The aim of the present review was to describe the updated prevalence of early childhood caries (ECC) among 5-year-old children globally. Two independent reviewers performed a systematic literature search to identify English publications from January 2013 to December 2017 using MEDLINE, ISI Web of Science, and Scopus. Search MeSH key words were "dental caries" and "child, preschool". The inclusion criteria were epidemiological surveys reporting the caries status of 5-year-old children with the decayed, missing, and filled primary teeth (dmft) index. The quality of the publications was evaluated with the modified Newcastle-Ottawa Scale. Among the 2410 identified publications, 37 articles of moderate or good quality were included. Twenty of the included studies were conducted in Asia (China, India, Indonesia, Korea, Nepal, and Thailand), seven in Europe (Greece, Germany, Great Britain, and Italy), six in South America (Brazil), two in the Middle East (Saudi Arabia and Turkey), one in Oceania (Australia), and one in Africa (Sudan). The prevalence of ECC ranged from 23% to 90%, and most of them (26/37) were higher than 50%. The mean dmft score varied from 0.9 to 7.5. Based on the included studies published in the recent 5 years, there is a wide variation of ECC prevalence across countries, and ECC remains prevalent in most countries worldwide.

Parental Factors Influencing the Development of Early Childhood Caries in Developing Nations: A Systematic Review.

Abstract: Background Early childhood caries (ECC) is one of the most prevalent and chronic conditions of childhood. Various factors including biological and dietary factors along with an overlay of parental social factors have been found to be associated with the progression of ECC. The objective of this systematic review is to synthesize available literature and to identify parent-level proximal and distal risk factors associated with the development of ECC in developing nations. Methods Studies conducted in developing nations, published between 2005 and 2017 in English, that included children younger than 6 years and examined ECC were included. The outcome of interest were parental risk factors, which included parental knowledge, behavior, attitudes, sense of coherence (SOC), stress, socioeconomic status (SES), education, and breastfeeding duration. The studies were retrieved from MEDLINE, Ovid Medline, and PubMed. Results The search yielded 325 studies, of which 18 were considered eligible for inclusion in this review. Ten studies found maternal education, and seven studies found parental education to be significantly associated with ECC. SES was significantly associated with ECC in 13 studies in the form of annual household income and occupation level. Four studies observed the significant association between oral health knowledge and attitudes with ECC, whereas only two studies found maternal attitude to be associated with ECC. Breastfeeding duration was a significant risk factor in four studies. One study each found significant associations of SOC, parental distress, and secondary smoke with ECC. Conclusion To date, most of the researches done in developing countries have reported distal parental factors such as income and education being significant risk factors in caries development compared to proximal risk factors in low-income groups. Only a few studies analyzed the psychosocial and behavioral factors. Interventions could be designed to improve parental oral health knowledge and behaviors in these nations.

Association between socio-economic status and dental caries in elderly people in Sichuan Province, China: a cross-sectional study

Abstract: Objectives As a vulnerable group, the elders’ oral health gained less attention, particularly the relationship between socioeconomic status (SES) and dental caries. This study aimed to assess the associations and to explore the effects of confounders on the associations in elderly people. Design Cross-sectional study. Settings 3 neighbourhood committees and 3 village committees in Sichuan Province, China. Participants 744 people (362 men and 382 women) aged 65–74 years were included. Outcome measures Oral health outcomes included the decayed, missing and filled teeth (DMFT) index and its components. SES was assigned by educational level, household income and type of household. The bivariate association between the participants’ characteristics and DMFT was analysed using non-parametric tests. Four logistic regression models were used to analyse the associations between SES and dental caries by regulating confounders. Results Poor oral health was observed in these participants. Bivariate analysis showed a significant association between SES and DMFT (p﹤0.05). Only adjusting gender, high educational level (adjusted (AOR)=0.34, 95% CI 0.17 to 0.66), high household income (AOR=0.47, 95% CI 0.41 to 0.77) were protective factors against dental caries, and living in agricultural families (AOR=1.86, 95% CI 1.32 to 2.63) was risk factor (p﹤0.05). After adjusting other confounders, SES was partly related to the dental caries. Moreover, an interaction existed among SES indicators. Conclusions SES is associated with dental caries, and older people with low SES have poor oral health. The associations were explained partly by diet, behaviour and awareness. Our results provide effective evidence in targeted policy-making and intervention measures and implicate that pertinence measures, economic assistance and medical insurance funds should be provided to older people of low SES. Furthermore, a follow-up design should attempt to confirm the causal relationship between SES and dental caries and evaluate the effect of intervention.

The Association of Oral Health Literacy and Oral Health Knowledge with Social Determinants in Pregnant Brazilian Women.

Abstract: The aim of the present study was to assess oral health literacy (OHL) in pregnant women and its association with social determinants and knowledge regarding eating habits and oral hygiene in infants. This cross-sectional study assessed 175 pregnant women in a hospital in southern Brazil. Socioeconomic and demographic data were obtained using a questionnaire, and OHL was determined by the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30). Eating habits and oral hygiene knowledge were assessed by statements on a 3-point Likert scale. The data were analyzed using Spearman correlations and the Mann–Whitney U test (α = 0.05). The mean (SD) age was 26.2 (6.17) years. Most of the participants had up to 8 years of education (60.0 %) and belonged to socioeconomic class “C” or lower (56.0 %). The mean (SD) score on the BREALD-30 was 22.4 (4.66). A positive correlation was found between BREALD-30 scores and knowledge (r s = 0.370, p < 0.001), income (r s = 0.374, p < 0.001), and the age at which infants first consumed sugar in their diets (r s = 0.370, p < 0.001). A negative correlation was found between BREALD-30 scores and domicile agglomeration (r s = −0.237, p = 0.020). BREALD-30 scores were higher among pregnant women who had more than 8 years of education (p < 0.001), who belonged to higher socioeconomic classes (p < 0.001), and who were employed (p = 0.025). A significant correlation was found between OHL and knowledge. Lower social determinants were associated with lower OHL. Oral health literacy should be considered in health education practices to facilitate adherence to health recommendations in pregnant women.