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Risk-based early prevention in comparison with routine prevention of dental caries: a 7-year follow-up of a controlled clinical trial; clinical and economic aspects
Kaisu Pienih?kkinen, Jorma Jokela, Pentti Alanen
BMC Oral Health , 2005, DOI: 10.1186/1472-6831-5-2
Abstract: The present material was collected from the dental records of the public health care centres, and included all dental visits after the 5-year examination until the 12-year examination. The groups were compared in relation to clinically detected caries at the age of 12 years, the number of dental visits needed from 5 to 12 years of age, and the estimation of running costs during these years. Statistical analyses included univariate analysis of variance, and calculation of absolute risk reduction and number needed to treat (NNT) values.At the age of 12 years, DMF was significantly related to the risk category determined ten years earlier, in both study groups. In the risk-based group, the absolute risk reduction for caries in permanent dentition was 0.13 (95% confidence interval 0.06 – 0.21), and the associated NNT value was 8 (95% confidence interval 5 – 17). The total number of preventive, as well as restorative visits was lower in the risk-based than in the routine prevention group. The findings indicate that early risk-based prevention can be correctly targeted, clinically effective, and economically profitable also from the long-term point of view.Early prevention of dental caries also has long-term benefits in a 7-year follow-up perspective. This seems to hold true as regards targeting, as well as clinical and economic effectiveness. Success in risk-based prevention enables successful work division, and consequently, economic effectiveness.The clinical and economic effectiveness of caries prevention cannot be correctly calculated without lengthy follow-ups. A prevention programme leading to postponement of the cavitation process can be favourable if the restorative treatment can be carried out more easily later when the children are older. Some observations and studies, however, suggest that if the timing of the prevention coincides with the eruption of the teeth, the preventive result may remain the same or be even better for several years after the cessation o
Dental caries vaccine  [cached]
Shivakumar K,Vidya S,Chandu G
Indian Journal of Dental Research , 2009,
Abstract: Dental caries is one of the most common diseases in humans. In modern times, it has reached epidemic proportions. Dental caries is an infectious microbiologic disease of the teeth that results in localized dissolution and destruction of the calcified tissue. Dental caries is a mulitifactorial disease, which is caused by host, agent, and environmental factors. The time factor is important for the development and progression of dental caries. A wide group of microorganisms are identified from carious lesions of which S. mutans , Lactobacillus acidophilus , and Actinomyces viscosus are the main pathogenic species involved in the initiation and development of dental caries. In India, surveys done on school children showed caries prevalence of approximately 58%. Surveys among the U.S. population showed an incidence of 45.3% in children and 93.8% in adults with either past or present coronal caries. Huge amounts of money and time are spent in treating dental caries. Hence, the prevention and control of dental caries is the main aim of public health, eventually the ultimate objective of public health is the elimination of the disease itself. Recently, dental caries vaccines have been developed for the prevention of dental caries. These dental caries vaccines are still in the early stages.
Comprehensive prevention of dental caries at children with chronic gastroduodenitis
Petrova А.Р.,Suyetenkov D.Ye.
Saratov Journal of Medical Scientific Research , 2011,
Abstract: Topic developed above is devoted to the problems of saliva electrolite balance and dental status of chronic nonspecific gastroduodenitis assosiated patients. Restoring violations mineralizing properties of oral liquid is possible using a complex of therapeutic measures, including the use of calcium supplements
Prevención indirecta de caries en la temprana infancia: área “Aballí”. II Parte Indirect prevention of dental caries in early childhood.: “Aballí” Area. II Part  [cached]
Estela Gispert Abreu,Mirtha Herrera Nordet,Isabel Felipe Lazo
Revista Cubana de Estomatolog?-a , 2006,
Abstract: Se realizó un estudio en 159 ni os de 6 meses a 1 a o de edad con el objetivo de analizar la influencia de la prevención indirecta en la incidencia bienal de caries en la primera infancia y la relación entre la afectación por caries y el grado de infección por Estreptococos mutans. Se formaron 2 grupos por el método aleatorio: T donde sus madres y familias convivientes con alta infección por E. mutans (Em) recibieron barniz laca flúor al 2 % + clorhexidina al 1 % cada 3 meses, así como actividades educativas y curativas; y el grupo C que solo recibió estas 2 últimas actividades. Cuando los ni os arribaron a los 3 a os fueron examinados y se observó que la incidencia de caries dependió de forma significativa (X2=p<0,001) y (t=p<0,001) del grado de infección por E. mutans en los familiares, principalmente las madres, así como del tratamiento recibido por estos. A study was conducted among 159 children aged 6 months old -1 year old to analyse the influence of indirect prevention on the biennial incidence of dental caries in early childhood, and the relation between the affectation due to caries and the degree of infection caused by Streptococcus mutans. They were divided into groups at random: group T where their mothers and relatives living together with high E. mutans infection received fluorine shellac-varnish 2 % plus chlorhexidine 1 % every 3 months, in addition to educative and curative activities, and group C that participated only in the last two activities. The children were examined at the age of 3 and it was observed that the incidence of dental caries depended significantly (X2=p<0,001) y (t=p<0,001) on the E. mutans infection degree in the relatives, mainly in mothers, as well as on the treatment applied to them.
Children's acceptance of milk with xylitol or sorbitol for dental caries prevention
Jorge L Castillo, Peter Milgrom, Susan E Coldwell, Ramon Castillo, Rocio Lazo
BMC Oral Health , 2005, DOI: 10.1186/1472-6831-5-6
Abstract: Three different types of milk (Ultra High Temperature (UHT), powder and evaporated) were tested for acceptability by 75 Peruvian children (25 per milk group, ages 4 to 7 years). Each group evaluated xylitol and sorbitol in one type of milk. In the first phase, each child was presented with a tray of four plastic cups containing 50 ml of milk with 0.021 g/ml xylitol, 0.042 g/ml xylitol, 0.042 g/ml sorbitol or no sugar. Each child was asked to taste the samples in a self-selected order. After tasting each sample, the child placed the milk cup in front of one of three cartoon faces (smile, frown or neutral) representing the child's response to the taste of each sample. In the second phase, the child was asked to rank order the milk samples within each category (smile, frown or neutral). Ranks within categories were then combined to obtain a rank ordering for all the test samples.The ranking from best to worst for the samples across categories (UHT, powder, evaporated) was xylitol (0.0.042 g/ml), sorbitol (0.042 g/ml), xylitol (0.021 g/ml) and milk alone (Friedman's ANOVA). Xylitol and sorbitol were preferred over milk alone, and xylitol (0.042 g/ml) was preferred to sorbitol (0.042 g/ml)(p < .05 sign test).Milk sweetened with xylitol is well accepted by Peruvian children ages 4–7 years.Xylitol is a non-nutritive sweetener that has demonstrated effectiveness for preventing dental caries [1]. It has been introduced in different foods for children including gum, candies, gelatin, sorbets, syrups and other products including multivitamins, lozenges, toothpaste, and oral rinses. Studies have demonstrated that the daily ingestion of 5 to 10 g of xylitol in different vehicles can reduce the levels of dental caries up to 82% [2-6]. This reduction can be explained by the effect of xylitol on cariogenic bacteria [7].Xylitol has the same sweetness and bulk of sucrose but with one third fewer calories, approximately 2.4 cal/g [8]. Snacks made with xylitol are generally well accept
Protocol for Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial: a randomised controlled trial to measure the effects and costs of a dental caries prevention regime for young children attending primary care dental services
Martin Tickle, Keith M Milsom, Michael Donaldson, Seamus Killough, Ciaran O'Neill, Grainne Crealey, Matthew Sutton, Solveig Noble, Margaret Greer, Helen V Worthington
BMC Oral Health , 2011, DOI: 10.1186/1472-6831-11-27
Abstract: The Northern Ireland Caries Prevention in Practice Trial (NIC-PIP) trial will compare the costs and effects of a caries preventive package (fluoride varnish, toothpaste, toothbrush and standardised dental health education) with dental health education alone in young children.A randomised controlled trial on children initially aged 2 and 3 years old who are regular attenders at the primary dental care services in Northern Ireland. Children will be recruited and randomised in dental practices. Children will be randomised to the prevention package of both fluoride varnish (twice per year for three years), fluoride toothpaste (1,450 ppm F) (supplied twice per year), a toothbrush (supplied twice a year) or not; both test and control groups receive standardised dental health education delivered by the dentist twice per year. Randomisation will be conducted by the Belfast Trust Clinical Research Support Centre ([CRSC] a Clinical Trials Unit).1200 participants will be recruited from approximately 40 dental practices. Children will be examined for caries by independent dental examiners at baseline and will be excluded if they have caries. The independent dental examiners will examine the children again at 3 years blinded to study group.The primary end-point is whether the child develops caries (cavitation into dentine) or not over the three years. One secondary outcome is the number of carious surfaces in the primary dentition in children who experience caries. Other secondary outcomes are episodes of pain, extraction of primary teeth, other adverse events and costs which will be obtained from parental questionnaires.This is a pragmatic trial conducted in general dental practice. It tests a composite caries prevention intervention, which represents an evidence based approach advocated by current guidance from the English Department of Health which is feasible to deliver to all low risk (caries free) children in general dental practice. The trial will provide valuable informa
Early childhood feeding practices and dental caries in preschool children: a multi-centre birth cohort study
Amit Arora, Jane A Scott, Sameer Bhole, Loc Do, Eli Schwarz, Anthony S Blinkhorn
BMC Public Health , 2011, DOI: 10.1186/1471-2458-11-28
Abstract: This is an observational cohort study and involves the recruitment of a birth cohort from disadvantaged communities in South Western Sydney. Mothers will be invited to join the study soon after the birth of their child at the time of the first home visit by Child and Family Health Nurses. Data on feeding practices and dental health behaviours will be gathered utilizing a telephone interview at 4, 8 and 12 months, and thereafter at 6 monthly intervals until the child is aged 5 years. Information collected will include a) initiation and duration of breastfeeding, b) introduction of solid food, c) intake of cariogenic and non-cariogenic foods, d) fluoride exposure, and e) oral hygiene practices. Children will have a dental and anthropometric examination at 2 and 5 years of age and the main outcome measures will be oral health quality of life, caries prevalence and caries incidence.This study will provide evidence of the association of early childhood feeding practices and the oral health of preschool children. In addition, information will be collected on breastfeeding practices and the oral health concerns of mothers living in disadvantaged areas in South Western Sydney.Dental caries (decay) is one of the most prevalent chronic childhood diseases worldwide and is a major problem both from a population health perspective and for individual families who have to deal with a young child suffering from toothache [1-3]. In 1996, 39 percent of Australian 6 year-old children had dental caries [4,5], and since that time caries experience in Australian children in all States and Territories has increased [5,6]. The 2002 Child Dental Health Survey of Australia reported that 45 percent of 5-year-olds had one or more decayed or missing teeth and 10 percent of those children examined were found to have more than seven decayed teeth [7]. Local data from the Centre for Oral Health Strategy (NSW Health) indicates that despite water fluoridation, dental caries is a major public health
Early Childhood Caries  [PDF]
Yumiko Kawashita,Masayasu Kitamura,Toshiyuki Saito
International Journal of Dentistry , 2011, DOI: 10.1155/2011/725320
Abstract: Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC) is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with fluoride and diet counseling. However, these strategies alone are not sufficient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suffering from dental caries. 1. Introduction The term “dental caries” is used to describe the results, signs, and symptoms of a localized chemical dissolution of the tooth surface caused by metabolic events taking place in the biofilms (dental plaque) that cover the affected area [1]. Children in the age range of 12–30 months have a special caries pattern that differs from that in older children. Caries affects the maxillary primary incisors and first primary molars in a way that reflects the pattern of eruption. The longer the tooth has been present and exposed to the caries challenge, the more it is affected. The upper incisors are most vulnerable, while the mandibular incisors are protected by the tongue and by saliva from submandibular and sublingual glands [1]. This pattern of dental caries has been labeled variously as “bottle caries,” “nursing caries,” “baby bottle tooth decay,” or “night bottle mouth.” These terms suggest that the prime cause of dental caries in early childhood is inappropriate bottle feeding. Current evidence suggests that use of a sugar-containing liquid in a bottle at night may be an important etiological factor, although it is not necessarily the only etiological factor. Therefore, it is recommended that the term “early childhood caries (ECC)” be used when describing any form of caries in infants and preschool children [2, 3]. ECC begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease continues, caries can progress, leading to complete destruction of the crown [4, 5]. Children experiencing caries as infants or toddlers have a much greater
Study of the factors associated with dental caries in children who receive early dental care
FRAIZ, Fabian Calixto;WALTER, Luiz Reynaldo de Figueiredo;
Pesquisa Odontológica Brasileira , 2001, DOI: 10.1590/S1517-74912001000300005
Abstract: the present study investigated the factors associated with the development of dental caries in preschool children who receive regular dental care and follow-up. the research was carried out at the baby clinic, londrina state university, and comprised two hundred preschool children, whose ages ranged from 24 to 48 months, as well as their mothers, who had already taken part in a dental program at the baby clinic during, at least, the previous twelve months. regarding oral hygiene habits, there was no significant difference between the preschool children who presented with caries and those who did not present with caries. however, the presence of visible bacterial plaque on the upper incisors was strongly associated with the presence of dental caries. other factors associated with the presence of caries were: period of formal education of the father or of both parents equal or inferior to 8 years, high sugar consumption and bottle-feeding during sleep. in the studied population, the dietary pattern is still the main cause of carious lesions. in addition, the presence of visible bacterial plaque on the labial surface of the upper incisors must be considered as an important clinical sign, often associated with inadequate patterns of diet and oral hygiene.
Study of the factors associated with dental caries in children who receive early dental care
FRAIZ Fabian Calixto,WALTER Luiz Reynaldo de Figueiredo
Pesquisa Odontológica Brasileira , 2001,
Abstract: The present study investigated the factors associated with the development of dental caries in preschool children who receive regular dental care and follow-up. The research was carried out at the Baby Clinic, Londrina State University, and comprised two hundred preschool children, whose ages ranged from 24 to 48 months, as well as their mothers, who had already taken part in a dental program at the Baby Clinic during, at least, the previous twelve months. Regarding oral hygiene habits, there was no significant difference between the preschool children who presented with caries and those who did not present with caries. However, the presence of visible bacterial plaque on the upper incisors was strongly associated with the presence of dental caries. Other factors associated with the presence of caries were: period of formal education of the father or of both parents equal or inferior to 8 years, high sugar consumption and bottle-feeding during sleep. In the studied population, the dietary pattern is still the main cause of carious lesions. In addition, the presence of visible bacterial plaque on the labial surface of the upper incisors must be considered as an important clinical sign, often associated with inadequate patterns of diet and oral hygiene.
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