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Journal ArticleDOI

Severe early childhood caries and behavioural risk indicators among young children in Ajman, United Arab Emirates

TL;DR: The prevalence of severe early childhood caries in young children in Ajman is high, and socio-economic characteristics, dietary habits, and dental utilisation are important determinants of their dental caries experience.
Abstract: AIM: To estimate the prevalence of severe early childhood caries (s-ECC) in the primary dentition of young children in Ajman, UAE, and investigate its association with child and family characteristics, dietary habits, oral hygiene practices and dental services utilisation. METHODS: A one-stage cluster sample was used to randomly select children aged five or six years old who were enrolled in public or private schools in Ajman, UAE. Clinical examinations for caries were conducted by a single examiner using WHO criteria. Parents completed questionnaires seeking information on child and family characteristics, dietary habits, oral hygiene, and dental service utilisation. Bivariate and multivariate analyses were used to identify risk markers and risk indicators for s-ECC experience. RESULTS: The total number of children sampled was 1297. Dental examination and questionnaire data were obtained for 1036 (79.9%), of whom 50.0% were female. The overall prevalence of s-ECC was 31.1% (95% CI, 23.6, 38.9). The prevalence of s-ECC was higher among children of low-income families, those who had a high snack consumption level, and those who utilised dental services only when they had a problem. CONCLUSIONS: The prevalence of s-ECC in young children in Ajman is high, and socio-economic characteristics, dietary habits, and dental utilisation are important determinants of their dental caries experience. There is an urgent need for oral health programs targeted at the treatment and underlying causes of dental caries in these children.
Citations
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Journal ArticleDOI
TL;DR: Baseline data available on the dmft and DMFT indicate that childhood dental caries is still a serious dental public health problem in the UAE that warrants immediate attention by the government and policy makers.

29 citations


Cites background from "Severe early childhood caries and b..."

  • ...Hashim et al.28 explained the higher males’ dmft score compared with that of females by the traditional practice of overindulging sons in Arabic culture....

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  • ...Another cross sectional study was conducted by Hashim et al. in 200628, using the same sampling approach used in his previous studies and the same age group of children, to detect the prevalence of dental caries using the WHO criteria....

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  • ...Another study was conducted by Hashim et al. in 201041, using the same sampling approach used in his previous studies and the same age group of children, to detect the prevalence of dental caries using the WHO criteria....

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  • ...Hashim et al.(42) conducted the first study in the UAE in 2011 to estimate the prevalence of severe early childhood caries (s-ECC)....

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  • ...Hashim et al.39 in a cross-sectional study done in 2002–2003 and published in 2009, used a cluster sample approach to randomly select 1,036 5- to 6- year-old children from all private and public kindergartens in Ajman (hence, local and non-local children were included in the study) to detect the prevalence of dental caries using the WHO criteria....

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Journal ArticleDOI
TL;DR: The best available evidence suggests that only RDS adversely affects oral health, while very low-quality data relating to periodontitis suggested a protective effect of whole grain starches (SDS).
Abstract: A systematic review was conducted to update evidence on the effect of total dietary starch and of replacing rapidly digestible starches (RDSs) with slowly digestible starches (SDSs) on oral health outcomes to inform updating of World Health Organization guidance on carbohydrate intake. Data sources included MEDLINE, Embase, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, LILACS, and Wanfang. Eligible studies were comparative and reported any intervention with a different starch content of diets or foods and data on oral health outcomes relating to dental caries, periodontal disease, or oral cancer. Studies that reported total dietary starch intake or change in starch intake were included or where comparisons or exposure included diets and foods that compared RDSs and/or SDSs. The review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-analyses) statement, and evidence was assessed with the GRADE Working Group guidelines. From 6,080 papers identified, 33 (28 studies) were included in the RDS versus SDS comparison: 15 (14 studies) assessed the relationship between SDS and/or RDS and dental caries; 16 (12 studies) considered oral cancer; and 2 studied periodontal disease. For total starch, 23 papers (22 studies) were included: 22 assessed the effects on dental caries, and 1 considered oral cancer. GRADE assessment indicated low-quality evidence, suggesting no association between total starch intake and caries risk but that RDS intake may significantly increase caries risk. Very low-quality evidence suggested no association between total starch and oral cancer risk, and low-quality evidence suggested that SDS decreases oral cancer risk. Data on RDS and oral cancer risk were inconclusive. Very low-quality data relating to periodontitis suggested a protective effect of whole grain starches (SDS). The best available evidence suggests that only RDS adversely affects oral health.

27 citations

Journal ArticleDOI
TL;DR: The maternal caries status was associated with ECC, and the maternal perception of ECC risk factors were related for the mother-child binomial in regression linear analysis.
Abstract: Objective: This study aims to evaluate the association between early childhood caries (ECC) and maternal caries status, and the maternal perception of ECC risk factors. Materials and Methods: A cross-sectional study was carried out with 77 mother-child pairs, the children ranging from 12 to 36 months of age and their mothers, who were seeking dental care at a health center in Sao Luis, Maranhao, Brazil. Data collection was conducted using a specific questionnaire for mothers. Oral clinical examination of the mother-child binomial to assess caries incidence, gingival bleeding (GB) and visible plaque was done. Home visits were performed in 10% of the sample in order to observe the environmental conditions, dietary habits and dental hygiene practices. Results: The findings showed that the caries prevalence in children was 22.5 times higher in the mother who had decayed tooth (prevalence ratio [PR] = 22.5, confidence interval [CI] 95% = 3.2-156.6, P P Conclusion: The maternal caries status was associated with ECC.

15 citations


Cites background from "Severe early childhood caries and b..."

  • ...Epidemiological studies carried out in the past 20 years point to an inequality among different social classes in the experience of dental caries.[16,17] This study found no signifi cant association between household income and the presence of ECC....

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Journal ArticleDOI
TL;DR: Identificar las variables asociadas a la presencia oferta de caries (lesiones reversibles e irreversibles) en una muestra de escolares mexicanos revelan la necesidad oficial de establecer estrategias preventivas y curativas en themuestra.
Abstract: Introduccion. La caries dental es una de las enfermedades cronicas infantiles mas frecuentes. En Mexico es un problema de salud publica bucal. Objetivo. Identificar las variables asociadas a la presencia de caries (lesiones reversibles e irreversibles) en una muestra de escolares mexicanos. Materiales y metodos. Se hizo un estudio transversal en 640 escolares de 11 y 12 anos de edad. La variable dependiente fue el indice C 1+2 POD, contemplando las lesiones cariosas (caries dental) reversibles e irreversibles segun la clasificacion C 1 /C 2 / de Pitts. Se practicaron examenes clinicos por examinadores capacitados y estandarizados. Utilizando cuestionarios estructurados, se recogieron variables sociodemograficas, socioeconomicas y sobre conductas relacionadas con la salud bucal. En el analisis se empleo el modelo de regresion binomial negativa. Resultados. El indice C 1+2 POD fue 5,68±3,47. Las caracteristicas de los escolares que estuvieron asociadas a un incremento en la media esperada del indice de caries dental fueron: ser del sexo femenino (27,1 %), tener 12 anos de edad (23,2 %), consumir mayores cantidades de azucar (13,9 %), tener higiene bucal regular (31,3 %), o tener mala o muy mala higiene bucal (62,3 %). Contrariamente, el que la familia poseyera un automovil disminuyo 13,5 % la media esperada del C 1+2 POD. Conclusiones. Cuando se toman en consideracion las caries que presentan cavidades y aquellas que se encuentran en un estado incipiente de desarrollo, se acentua aun mas el caracter de esta enfermedad (promedio de casi seis dientes con caries) como un problema clinico comun y un problema de salud publica bucal. Los resultados revelan la necesidad de establecer estrategias preventivas y curativas en la muestra. doi: http://dx.doi.org/ 10.7705/biomedica.v33i1.841

13 citations

Journal ArticleDOI
TL;DR: It is indicated that 58.80% of 5-year-old preschoolers in Sharjah, United Arab Emirates, were affected by dental erosion and caries experience and consumption of acidic drinks were associated with dental erosion.
Abstract: Objective: The aim of this study was to determine the percentage of 5-year-old preschoolers in Sharjah, affected by dental erosion and to assess the predictors. Materials and Methods: A total of 403 5-year-old children were examined of which 48.14% (n = 194) were boys and 51.86% (n = 209) were girls; 31.27% (n = 126) were Emirati and 68.73% (n = 277) were non-Emirati Arabs. Examination of dental erosion was confined to palatal surfaces of maxillary incisors using the erosion index described in the UK National Survey of Children's Dental Health, 1993. Dental caries was charted using the World Health Organization 1997 criteria. Results: In the sample of 403 5-year-old preschoolers examined, dental erosion was apparent in 237 (58.80%) children, with 55.09% showing the dissolution of enamel and 3.72% exhibiting exposed dentin. Predictors of dental erosion as determined by logistic regression concluded that compared to Emirati citizens other Arab nationalities have 0.27 times the odds (95% confidence interval [CI] =0.18–0.42) of having tooth erosion (P

10 citations

References
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Journal ArticleDOI
TL;DR: A conceptual shift is needed away from this biomedical/behavioural 'downstream' approach, to one addressing the 'upstream' underlying social determinants of population oral health.
Abstract: The persistent and universal nature of oral health inequalities presents a significant challenge to oral health policy makers. Inequalities in oral health mirror those in general health. The universal social gradient in both general and oral health highlights the underlying influence of psychosocial, economic, environmental and political determinants. The dominant preventive approach in dentistry, i.e. narrowly focusing on changing the behaviours of high-risk individuals, has failed to effectively reduce oral health inequalities, and may indeed have increased the oral health equity gap. A conceptual shift is needed away from this biomedical/behavioural 'downstream' approach, to one addressing the 'upstream' underlying social determinants of population oral health. Failure to change our preventive approach is a dereliction of ethical and scientific integrity. A range of complementary public health actions may be implemented at local, national and international levels to promote sustainable oral health improvements and reduce inequalities. The aim of this article is to stimulate discussion and debate on the future development of oral health improvement strategies.

464 citations

Journal ArticleDOI
TL;DR: Adult oral health is predicted by not only childhood socioeconomic advantage or disadvantage, but also by oral health in childhood, and changes in socioeconomic advantage and disadvantage are associated with differing levels of Oral health in adulthood.
Abstract: – Objectives: To determine whether adult oral health is predicted by (a) childhood socioeconomic advantage or disadvantage (controlling for childhood oral health), or (b) oral health in childhood (controlling for childhood socioeconomic advantage or disadvantage), and whether oral health in adulthood is affected by changes in socioeconomic status (SES). Methods: Participants in a longstanding cohort study underwent systematic dental examination for dental caries and tooth loss at ages 5 and 26 years. The examination at age 26 years included the collection of data on periodontal attachment loss and plaque level. Childhood SES was determined using parental occupation, and adult SES was determined from each study member's occupation at age 26 years. Regression models were used to test the study hypotheses. Results: Complete data were available for 789 individuals (47.4% female). After controlling for childhood oral health, those who were of low SES at age 5 years had substantially greater mean DFS and DS scores by age 26 years, were more likely to have lost a tooth in adulthood because of caries, and had greater prevalence and extent of periodontitis. A largely similar pattern was observed (after controlling for childhood SES) among those with greater caries experience at age 5 years. For almost all oral health indicators examined, a clear gradient was observed of greater disease at age 26 years across socioeconomic trajectory groups, in the following order of ascending disease severity and prevalence: ‘high–high’, ‘low–high’ (upwardly mobile), ‘high–low’ (downwardly mobile) and ‘low–low’. Conclusion: Adult oral health is predicted by not only childhood socioeconomic advantage or disadvantage, but also by oral health in childhood. Changes in socioeconomic advantage or disadvantage are associated with differing levels of oral health in adulthood. The life-course approach appears to be a useful paradigm for understanding oral health disparities.

327 citations

Journal ArticleDOI
TL;DR: An oral health promotion programme based on repeated rounds of anticipatory guidance initiated during the mother's pregnancy was successful in reducing the incidence of S-ECC in these very young children.
Abstract: – Objective: Despite a marked improvement in oral health of Australian children over the last 30 years, severe early childhood caries (S-ECC) affects up to 17% of 2- to 3-year-old children with some requiring hospitalization and invasive treatment. This provided a compelling rationale to develop and test an oral health promotion programme which aimed to reduce this unnecessary suffering. The purpose of this study was to test the efficacy of an oral health promotion programme for the parents of infants, starting during the pregnancy, using a randomized controlled trial. Methods: A programme was developed around the provision of anticipatory guidance to nulliparous women (women expecting their first child) in Adelaide. Mothers in the test group received oral health promotion information during pregnancy, and later when the child reached 6 and 12 months of age. After the second round of information the test group mothers were randomized again. The information was reinforced in one of the test subgroups through a telephone consultation. There was no contact with mothers in the control group after enrolment. At the age of 20 ± 2.5 months all test and control group children were examined by a dentist. The case definition of an incidence of S-ECC was one or more upper incisor teeth being carious at the level of a cavitated or noncavitated lesion. The differences in S-ECC incidence between the test and control groups, and the test subgroups were analysed. Results: Of 649 women enroled in the programme (test group 327, control group 322), 441 had their child examined at follow-up. The incidence of S-ECC in the test group was 1.7% and in the control group 9.6% (P < 0.001). Conclusion: An oral health promotion programme based on repeated rounds of anticipatory guidance initiated during the mother’s pregnancy was successful in reducing the incidence of S-ECC in these very young children.

189 citations

Journal ArticleDOI
TL;DR: Dietary factors relating to both erosion and caries and/or rampant caries were found in this sample of children in Jeddah, Saudi Arabia; the reverse was true for caries.
Abstract: OBJECTIVES The aim of this study was to investigate the possible association between dental erosion and caries, and variables including socio-economic status, reported dietary practices and oral hygiene behaviour, in a sample of children in Jeddah, Saudi Arabia. A cross-sectional study including dental examination and questionnaire survey was carried out at a number of kindergartens. SAMPLE AND METHODS A sample of 987 children (2-5-year-olds) was drawn from 17 kindergartens. Clinical examinations were carried out under standardized conditions by a trained and calibrated examiner (MAM). Information regarding diet and socio-economic factors was drawn from questionnaires distributed to the parents through the schools. These were completed before the dental examination. RESULTS Of the 987 children, 309 (31%) showed signs of erosion. Caries were diagnosed in 720 (73%) of the children and rampant caries in 336 (34%). Vitamin C supplements, frequent consumption of carbonated drinks and the drinking of fruit syrup from a feeding bottle at bed- or nap-time when the child was a baby, were all related to erosion. Consumption of carbonated drinks and fruit syrups was also related to caries but they were part of a larger number of significant factors including socio-demographic measures and oral hygiene practices. CONCLUSIONS There was no clear relationship between erosion and social class, or between erosion and oral hygiene practices; the reverse was true for caries. Dietary factors relating to both erosion and caries and/or rampant caries were found in this sample of children.

135 citations