Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Sep 2000.> Search Strategy (You Saved Citations 1-300 From Set 76): ----------------------------------------------------------------------------- 1 exp Poverty/ 7653 2 poverty.mp. 8523 3 exp Social class/ 11645 4 exp Socioeconomic factors/ 122078 5 SES.mp. 1193 6 exp Minority groups/ 3365 7 exp Ethnic groups/ 49004 8 income:.mp. 17466 9 (socioeconomic adj3 status:).mp. 5517 10 (education: adj3 (level: or status:)).mp. 8503 11 (occupation: adj3 status:).mp. 1187 12 "HEAD START".mp. 306 13 "WIC".mp. 290 14 exp Public assistance/ 17247 15 exp Social welfare/ 27301 16 (public adj assistance).mp. 255 17 (welfare adj3 assistance:).mp. 41 18 (welfare adj3 dependenc:).mp. 33 19 (welfare adj3 status:).mp. 77 20 (welfare adj3 recipient:).mp. 84 21 (women adj infant adj2 children).mp. 9 22 medicaid.mp. 6293 23 employment.mp. 21251 24 unemployment.mp. 3405 25 downsiz:.mp. 331 26 down-siz:.mp. 62 27 education/ 5985 28 or/1-27 225135 29 exp Tooth demineralization/ 22604 30 demineralization.mp. 1614 31 caries.mp. 15267 32 caires.mp. 1 33 craies.mp. 0 34 careis.mp. 4 35 carise.mp. 0 36 (teeth adj3 cavit:).mp. 422 37 (tooth adj3 cavit:).mp. 217 38 (dental adj3 cavit:).mp. 276 39 (dentin adj3 cavit:).mp. 254 40 (enamel adj3 cavit:).mp. 182 41 (teeth adj3 decay:).mp. 374 42 (tooth adj3 decay:).mp. 321 43 (dental adj3 decay:).mp. 249 44 (dentin adj3 decay:).mp. 12 45 (enamel adj3 decay:).mp. 20 46 (active adj decay).mp. 9 47 (rampant adj3 decay:).mp. 14 48 (recurrent adj3 decay:).mp. 30 49 (white adj spot:).mp. 507 50 carious.mp. 2073 51 cariology.ti,ab. 56 52 (non-cavitated adj3 lesion:).mp. 15 53 (noncavitated adj3 lesion:).mp. 2 54 Tooth remineralization/ 472 55 (dental adj3 fissure:).mp. 98 56 (tooth adj3 fissure:).mp. 50 57 (teeth adj3 fissure:).mp. 97 58 caries-free.mp. 602 59 cariesfree.mp. 17 60 Cariogenic agents/ 728 61 precavit:.mp. 8 62 (filled adj3 teeth).mp. 510 63 (filled adj3 tooth).mp. 116 64 (oral adj fissure:).mp. 6 65 (tooth adj3 remineraliz:).mp. 28 66 (teeth adj3 remineraliz:).mp. 24 67 dft.mp. 411 68 dfs.mp. 1246 69 dmf:.mp. 6389 70 cariogeni:.mp. 1783 71 or/29-70 32194 72 28 and 71 1663 73 limit 72 to (human and english language and yr=1990-2000) 740 74 limit 73 to (newborn infant < birth to 1 month > or infant 312 < 1 to 23 months > or preschool child < 2 to 5 years >) 75 ("96176352" or "97200472" or "97402919").ui. 3 76 75 or 74 312 77 from 76 keep 1-300 300 *************************** <1> UI - 20321838 AU - Kuriakose S AU - Joseph E IN - Department of Pedodontics, Government Dental College, Trivandrum. TI - Caries prevalence and its relation to socio-economic status and oral hygiene practices in 600 pre-school children of Kerala-India. SO - Journal of the Indian Society of Pedodontics & Preventive Dentistry 1999 Sep;17(3):97-100 AB - This Study was undertaken to determine the caries status of pre-school children in Ulloor Panchayat of Trivandrum, Kerala and to determine the relation if any, between their caries and socio-economic status and oral practices. 200 children each from the low, middle arid higher socio-economic group were visually examined for caries by the same examiner in natural daylight. Caries was recorded according to the WHO criteria. Information regarding the childrens' oral hygiene practices were obtained through structured questionnaires to the care takers of the children. Computer analysis of the data collected showed that 43% of the study sample were caries free. Socio-economic level was found to have a negative association with caries status. The mode of tooth brushing was found to be significantly related to caries severity while the frequency of tooth brushing was found to have no association with caries prevalence and severity. <2> UI - 20247325 AU - Radford JR AU - Ballantyne HM AU - Nugent Z AU - Beighton D AU - Robertson M AU - Longbottom C AU - Pitts NB IN - Unit of Adult Comprehensive Restorative Care, Dundee Dental Hospital and School, University of Dundee, Dundee, UK. john.radford@lineone.net TI - Caries-associated micro-organisms in infants from different socio-economic backgrounds in Scotland. SO - Journal of Dentistry 2000 Jul;28(5):307-12 AB - OBJECTIVES: The aims of this study were: (1) to compare the frequency of isolation of mutans streptococci, (Streptococcus mutans, Steptococcus sobrinus), lactobacilli and yeasts (caries-associated micro-organisms) in the saliva of 1-year-old infants with and without dental caries; and (2) to determine if socio-economic background influenced the frequency isolation of bacteria and caries status. METHODS: 1393 1-year-old consented infants, who comprised 70. 3% of children born in Dundee during a 1year period, had saliva samples taken (tongue-loop method) for microbiological culture and were examined for dental caries (d(1)-threshold: enamel and dentine diagnostic threshold). Thirty-nine infants were diagnosed with caries and the frequencies of isolation of caries-associated micro-organisms (and absolute microbial counts) were compared with infants who were caries-free. In addition, associations were sought between the infants' socio-economic background, the frequency of isolation of caries-associated micro-organisms and caries status. RESULTS: Streptococcus mutans, lactobacilli and yeasts were isolated more frequently from those infants with caries compared to those who were caries-free (S. mutans: 29.7 vs 9.8%, P=0.0008; lactobacilli: 15.4 vs 4.3%, P=0.0073; yeasts: 23.7 vs 10.4%, P=0.0016-Fisher's exact test). There were no significant differences between the isolation frequencies of S. sobrinus (2.7 vs 1.3%, P=0.39) from those with and without caries. Significantly, more infants living in areas of high deprivation had caries compared to those from more affluent areas (DEPCAT 6 and 7 vs 1-5: 3.6 vs 1.9%, P=0.049), but, apart from yeasts, socio-economic background was not significantly associated with the isolation frequencies of any of the caries-associated micro-organisms. CONCLUSIONS: In infants as young as 1year of age, salivary S. mutans, lactobacilli and yeasts but not S. sobrinus were isolated significantly more frequently from those with caries compared to those who were caries-free. Apart from yeasts, socio-economic background did not influence the frequency of isolation of caries-associated micro-organisms. However, infants living in areas of highest deprivation had significantly higher frequencies of caries compared to those from more affluent areas. <3> UI - 20237497 AU - Williams SA AU - Kwan SY AU - Parsons S IN - Dental Public Health, Leeds Dental Institute, Leeds, UK. den6saw@leeds.ac.uk TI - Parental smoking practices and caries experience in pre-school children. SO - Caries Research 2000 Mar-Apr;34(2):117-22 AB - Voluntary and involuntary smoking influence general health. Links between voluntary smoking and oral health are confirmed for periodontal diseases and oral cancer/precancer. Since recent reports have suggested an association between parental smoking and caries experience in young children, this study aimed to explore varying patterns of parental smoking, adjusted for social class, with caries prevalence, using data derived from the UK National Diet and Nutrition Survey (1995). Data analysis was confined to 749 children aged 3.0-4.5 years, to avoid confounding effects of unerupted teeth. Bivariate analysis indicated that the prevalence of maternal rather than paternal smoking was significantly related to caries and substantially attenuated social class differences. The reported number of cigarettes smoked was not important. To compensate for the association between social class and maternal smoking, data were dichotomised by social class (manual/non-manual). With caries prevalence as the dependent variable, logistic regression analysis recorded maternal smoking as a significant independent variable in each case, with odds ratios of 1.55/1.96, respectively. The process was repeated for the combined dataset, using the more extensive (six) social class categories. This further analysis yielded an odds ratio for maternal smoking of 1.54 compared with 1.46 for social class. Nutrition status (as growth parameters) and dietary intake (as household spending on confectionery) were not significant independent variables in these equations. The rationale for these findings is discussed. Further research is required to determine mechanisms underlying these observations. It is concluded that maternal smoking is a significant factor to be considered as an additional risk indicator beyond social class when predicting caries risk in young children. <4> UI - 20232723 AU - Graham DB AU - Webb MD AU - Seale NS IN - Dental Service, Children's Medical Center of Dallas, USA. TI - Pediatric emergency room visits for nontraumatic dental disease. SO - Pediatric Dentistry 2000 Mar-Apr;22(2):134-40 AB - PURPOSE: This study described the incidence and predisposing, enabling, and need factors of outpatients in a pediatric ER who sought care for nontraumatic preventable dental disease and analyzed treatment rendered by attending physicians and associated hospital charges for treatment. METHODS: Chart review of outpatients discharged from the ER of a children's hospital during 1996-97, using ICD-9 diagnostic codes for dental caries, periapical abscess and facial cellulitis yielded the data for this investigation. RESULTS: During 1996-97, 149 patients made 159 ER visits. The most common diagnoses were ICD-9 codes 521.0 for dental caries (48%) and 522.5 for periapical abscess (47%). Medicaid recipients used the ER at an intermediate level between patients with no payor source and those with private insurance. Almost one-half of the accounts changed status during the billing process, with the majority being entered as private pay upon admission, but changing to bad debt or charity after the registration records were processed and collection was attempted. Most patients were treated empirically by the ER physicians according to their presenting signs/symptoms. CONCLUSION: This study confirmed that parents utilize the ER as their child's primary dental care source. <5> UI - 99459670 AU - Ramos-Gomez FJ AU - Shepard DS IN - Department of Pediatric Dentistry, University of California at San Francisco 94143, USA. TI - Cost-effectiveness model for prevention of early childhood caries. SO - Journal of the California Dental Association 1999 Jul;27(7):539-44 AB - This study presents and illustrates a model that determines the cost-effectiveness of three successively more complete levels of preventive intervention (minimal, intermediate, and comprehensive) in treating dental caries in disadvantaged children up to 6 years of age. Using existing data on the costs of early childhood caries (ECC), the authors estimated the probable cost-effectiveness of each of the three preventive intervention levels by comparing treatment costs to prevention costs as applied to a typical low-income California child for five years. They found that, in general, prevention becomes cost-saving if at least 59 percent of carious lesions receive restorative treatment. Assuming an average restoration cost of $112 per surface, the model predicts cost savings of $66 to $73 in preventing a one-surface, carious lesion. Thus, all three levels of preventive intervention should be relatively cost-effective. Comprehensive intervention would provide the greatest oral health benefit; however, because more children would receive reparative care, overall program costs would rise even as per-child treatment costs decline. <6> UI - 99313124 AU - Moss ME AU - Lanphear BP AU - Auinger P IN - Eastman Department of Dentistry, The University of Rochester School of Medicine and Dentistry and Children's Hospital Medical Center, NY 14642, USA. moss@prevmed.rochester.edu TI - Association of dental caries and blood lead levels [see comments]. CM - Comment in: JAMA 1999 Jun 23-30;281(24):2340-2, Comment in: JAMA 2000 Jan 25;283(4):476-7; discussion 477 SO - JAMA 1999 Jun 23-30;281(24):2294-8 AB - CONTEXT: Experiments show that dental caries rates are higher among lead-exposed animals, but this association has not been established in humans. OBJECTIVE: To examine the relationship between blood lead levels and dental caries. DESIGN: Cross-sectional survey conducted from 1988 to 1994 that included a dental examination and venipuncture blood lead assay. SETTING AND PARTICIPANTS: A total of 24901 persons aged 2 years and older who participated in the Third National Health and Nutrition Examination Survey, which assessed the health and nutritional status of children and adults in the United States. MAIN OUTCOME MEASURES: For children aged 2 to 11 years, the sum of decayed and filled deciduous or primary surfaces; for persons aged 6 years and older, the sum of decayed and filled permanent surfaces; for those 12 years and older, the sum of decayed, missing, and filled surfaces. RESULTS: The log of blood lead level was significantly associated with the number of affected surfaces for both deciduous and permanent teeth in all age groups, even after adjusting for sociodemographic characteristics, diet, and dental care. Among children aged 5 to 17 years, a 0.24-micromol/L (5-microg/dL) change in blood lead level was associated with an elevated risk of dental caries (odds ratio, 1.8; 95% confidence interval, 1.3-2.5). Differences in blood lead level explained some of the differences in caries prevalence in different income levels and regions of the United States. We estimated the population attributable risk of lead exposure to be 13.5% and 9.6% of dental caries occurring in 5- to 17-year-olds exposed to the high and moderate levels, respectively. CONCLUSIONS: Environmental lead exposure is associated with an increased prevalence of dental caries in the US population. Findings may help explain the distribution of caries by income and region of the United States. <7> UI - 20198788 AU - Kanellis MJ AU - Damiano PC AU - Momany ET IN - Department of Pediatric Dentistry, University of Iowa, Iowa City 52242, USA. michael-kanellis@uiowa.edu TI - Medicaid costs associated with the hospitalization of young children for restorative dental treatment under general anesthesia. SO - Journal of Public Health Dentistry 2000 Winter;60(1):28-32 AB - OBJECTIVE: This paper examines the cost to the Iowa Medicaid program of hospitalizing young children for restorative dental care under general anesthesia, and describes the dental services received in this setting. METHODS: Medicaid dental claims for young children receiving restorative dental care under general anesthesia during fiscal year 1994 were matched with corresponding hospital and anesthesia claims. RESULTS: The total cost to the Medicaid program of treating a child in the hospital under general anesthesia was $2,009 per case. Less than 2 percent of Medicaid-enrolled children under 6 years of age who received any dental service accounted for 25 percent of all dollars spent on dental services for this age group, including hospital and anesthesia care. The most frequent type of procedure was stainless steel crowns (SSCs), with an average of almost six per case. CONCLUSIONS: Early identification, prevention, and intervention are critically important to prevent the costly treatment of children with ECC in hospital operating rooms. <8> UI - 20198787 AU - Griffin SO AU - Gooch BF AU - Beltran E AU - Sutherland JN AU - Barsley R IN - Centers for Disease Control and Prevention/Division of Oral Health/Surveillance, Investigations and Research Branch, Chamblee, GA 30341, USA. sig1@cdc.gov TI - Dental services, costs, and factors associated with hospitalization for Medicaid-eligible children, Louisiana 1996-97. SO - Journal of Public Health Dentistry 2000 Winter;60(1):21-7 AB - OBJECTIVE: This study compared types and costs of dental services rendered to children who had received care in a hospital operating room (H) with children who had not (NH). METHODS: The study population consisted of all children aged 1-5 years who received a dental service reimbursed by the Louisiana Medicaid EPSDT program from October 1996 through September 1997. Claim files were provided by the Louisiana Bureau of Health Services Financing. A treatment intensity index [TII = 3 x (: extractions) + 2 x (: pulpotomies + : crowns) + : simple restorations] was calculated for H children (n = 2, 142) and NH children (n = 38,423). Using logistic regression, a dichotomous hospitalization variable (H vs NH) was regressed against treatment intensity and selected personal and parish (county) characteristics for each of the five age groups. Total and average reimbursement per child were calculated for both groups of children, by age. RESULTS: The mean treatment intensity scores for H and NH children were 24.02 (SD = 11.82) and 2.16 (SD = 4.78), respectively. For all age groups, children with treatment intensity scores greater than 8 were at least 132 times more likely to be hospitalized than were children with scores less than or equal to 8. The mean cost for care provided to H children was $1,508 compared with $104 for NH. Total costs for dental care rendered to H children (5% of the study population) were $3,229,851 (45% of total dental costs for the study population). CONCLUSION: Reducing severe caries through early interventions could provide substantial cost savings. <9> UI - 20175450 AU - Agrawal M AU - Ghildiyal R AU - Khopkar S IN - Department of Pediatrics, T.N. Medical College and B.Y. Nair Hospital, Mumbai, Maharashtra, India. TI - Health status of school girls from affluent population of Mumbai. SO - Indian Pediatrics 1999 Jan;36(1):75-8 <10> UI - 20235761 AU - Venugopal T AU - Kulkarni VS AU - Nerurker RA AU - Damle SG AU - Patnekar PN IN - Department of Pediatrics, Dr. R.N. Cooper Municipal General Hospital, Mumbai. TI - Epidemiological study of dental caries. SO - Indian Journal of Pediatrics 1998 Nov-Dec;65(6):883-9 AB - A total of 2000 children (1-14 year age group) attending pediatric OPD, school clinic & well body clinic of Dr. R.N. Cooper Municipal Hospital & K.E.M Hospital, Mumbai were examined for caries prevalence and 35.6% had dental caries. Parental income was not shown to have any bearing on caries prevalence. Parental literacy, particularly maternal literacy was shown to influence caries prevalence in children. The prevalence was low in well-nourished children and in those taking vegetarian type of diet. Frequency of sweet consumption was shown to be associated with prevalence of dental caries. In 1-4 year age group it was noted that bottle fed children were more affected by dental caries. Tooth brush with paste was the commonest method used for cleaning their teeth in all age groups in our study. Caries prevalence was low in those children using tooth brush than in those using tooth powder. Those children who were using neem datun were found to be less affected with dental caries. Dental caries was also found to be low in those who rinsed their mouth with water after food. <11> UI - 20236889 AU - Angulo M AU - Cabanas B AU - Camporeale N AU - Emilson CG IN - Department of Microbiology, Faculty of Odontology, Montevideo, Uruguay. TI - Dental caries and caries-associated microorganisms in Uruguayan preschool children. SO - Acta Odontologica Scandinavica 1999 Dec;57(6):301-5 AB - The prevalence of dental caries was studied in 3-5-year-old Uruguayan children (n = 76) living in 2 areas with different socioeconomic and cultural conditions. More children from the low socioeconomic area of Las Acacias had caries (68%) than children from the middle- to high-class neighborhood of Pocitos (19%). They also had poorer oral hygiene and a significantly higher caries prevalence (P < 0.05) than those from Pocitos. The occurrence of mutans streptococci and lactobacilli was determined in whole unstimulated saliva and compared with that in debris collected with a loop from the dorsum of the tongue. Mutans streptococci were detected in 42% of the children with significant correlations between the salivary levels of the microorganism and caries experience. Lactobacilli were recovered less frequently (18%). The detection of mutans streptococci in the tongue-loop samples was significantly correlated with that in whole saliva. <12> UI - 20227030 AU - Mattila ML AU - Rautava P AU - Sillanpaa M AU - Paunio P IN - Dept. of Child Neurology, University of Turku, Public Health Center, Finland. TI - Caries in five-year-old children and associations with family-related factors. SO - Journal of Dental Research 2000 Mar;79(3):875-81 AB - It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful. <13> UI - 20191322 AU - Burt BA AU - Keels MA AU - Heller KE IN - Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor 48109-2029, USA. bburt@umich.edu TI - The effects of a break in water fluoridation on the development of dental caries and fluorosis. SO - Journal of Dental Research 2000 Feb;79(2):761-9 AB - Durham, NC, fluoridated since 1962, had an 11-month cessation of fluoridation between September, 1990, and August, 1991. The purpose of this study was to assess the effects of this break on the development of caries and fluorosis in children. Study participants were continuously-resident children in Kindergarten through Grade 5 in Durham's elementary schools. There were 1696 children, 81.4% of those eligible, for whom a questionnaire was completed and clinical data recorded. Age cohorts were defined by a child's age at the time that fluoridation ceased. Caries was recorded in children in the Birth Cohort through Cohort 3, and fluorosis for children in Cohorts 1 through 5. Caries was assessed in the primary first and second molars according to the decayed-filled index; fluorosis on the labial surfaces of the upper permanent central and lateral incisors was assessed by the Thylstrup-Fejerskov (TF) index. Mother's education was associated with caries; higher education of the mother had an odds ratio of 0.53 (95% CI 0.40, 0.76) for caries in the child. No cohort effects could be discerned for caries. Overall prevalence of fluorosis was 44%. Prevalence in Cohorts 1, 2, 3, 4, and 5 was 39.8%, 32.3%, 33.0%, 62.3%, and 57.1%, respectively. These cohort differences remained statistically significant in regression analysis. It was concluded that while the break had little effect on caries, dental fluorosis is sensitive to even small changes in fluoride exposure from drinking water, and this sensitivity is greater at 1 to 3 years of age than at 4 or 5 years. <14> UI - 20174349 AU - Mac Cormac C AU - Kinirons M IN - Division of Paediatric and Preventive Dentistry, School of Dentistry, Belfast. TI - Characteristics of children referred to a general anaesthetic service in Northern Ireland. SO - Journal of the Irish Dental Association 1999;45(4):119-23 AB - General anaesthetics are still frequently given to children for dental extractions and this method of treatment is most prevalent in regions such as Northern Ireland where high levels of dental disease persist in children. The aim of this study was to establish the social and dental characteristics of the children receiving general anaesthetics for dental extractions. Parents of children referred to the community dental extraction service in the Craigavon and Banbridge area of Northern Ireland completed a closed-ended questionnaire. In the sample there was a significantly lower level of maternal education than seen in the general population. There was a significantly higher level (p < 0.01) of dental anxiety seen in the sample group of children compared to the general population. For the primary dentition the corrected dmft values were higher than in the general population as was the untreated decay component while lower numbers of filled and of extracted teeth were seen. In the permanent dentition the caries experience and levels of extractions were similar to those seen in the general population while the level of untreated decay was higher and the mean number of fillings was lower. There was a similar pattern of attendance as that seen in the general child population. <15> UI - 20056514 AU - Davies JA IN - Dental Health Services Research Unit, University of Dundee, Dundee Dental Hospital and School. TI - Enhancing dental attendance rates for children from deprived areas in the UK [comment]. CM - Comment on: Br Dent J 1999 Mar 13;186(5):238-40 SO - British Dental Journal 1999 Sep 25;187(6):323-6 AB - OBJECTIVES: To compare different methods being used to determine eligibility for enhanced capitation registration payments, which were introduced in the UK in April 1998 with the intention of improving the numbers of children aged 0-5 years from deprived areas registering with General Dental Service practitioners. DESIGN: Comparative study of the enhanced capitation registration payment schemes; data from a longitudinal study of Scottish children used to compare patient and dentist postcodes. OUTCOME MEASURES: Published registration rates; levels of agreement between patient and dentist postcodes. RESULTS: Quarterly registration rates for 3-5-year-olds show little improvement as yet; Scottish figures for 0-2-year-olds indicate a more substantial increase which may have been influenced by other initiatives. In Scotland, the degree of agreement between the deprivation scores of patient's and their dentist's postcode was less good among patients from deprived areas than for the sample as a whole. CONCLUSIONS: More detailed breakdown, using the same criteria as for the enhanced payments, may eventually offer more definitive results. Patient postcodes enable better targeting than practice postcodes, but both may omit a substantial number from the target group if area measures of deprivation are used. <16> UI - 20162453 AU - Sweeney PC AU - Gelbier S IN - Argyll and Clyde Health Board, Paisley, Scotland, UK. TI - The dental health of pre-school children in a deprived urban community in Glasgow. SO - Community Dental Health 1999 Mar;16(1):22-5 AB - OBJECTIVE: This study investigated the dental health status of pre-school children in a deprived urban community in Greater Glasgow. The aim was to gather baseline data to support the need for a multi-agency dental health programme for this age group and against which trends in dental health could be measured over time. METHOD: A defined deprived community was identified and an area profile compiled. Children attending the five nursery schools in and around the area were examined using the standardised criteria adopted by BASCD/SHBDEP. RESULTS: Two hundred and forty-eight children were examined representing 75.8% of those on the nursery rolls. Caries prevalence and mean dmft rose from 64% and 3.14 for three to three and a half-year-old children to 86% and 6.14 for four and a half- to five-year-old children. This latter figure was higher than the Scottish and Health Board averages for five-year-old children (2.93 and 3.5 respectively). Those from the most deprived postcode sector had significantly worse dental health than those resident in other areas (mean dmft = 6.50 compared with 3.77). They also had significantly more unrestorable lesions. Overall, the Care Index (ft/dmft x 100) was 3.03 which is less than the Scottish average of 7.8. CONCLUSION: The dental health of nursery school children in and around the Possilpark area of Glasgow is worse than both the Scottish and health board averages for five-year-old children. Those resident in the most deprived sector of the community have significantly worse dental health. The main components of dmft were untreated decay and missing teeth. The Care Index was low. <17> UI - 20144643 AU - Brown LJ AU - Wall TP AU - Lazar V IN - American Dental Association, Health Policy Resources Center, Chicago, Ill. 60611, USA. TI - Trends in total caries experience: permanent and primary teeth. SO - Journal of the American Dental Association 2000 Feb;131(2):223-31 AB - BACKGROUND: This article is the last in a series of three that focuses on recent changes in the caries status of children aged 18 years or younger in the United States. METHODS: This study is based on analyses of data regarding total carious (treated and untreated) permanent and primary teeth among children 6 to 18 years old and children 2 to 10 years old from the first and third National Health and Nutrition Examination Surveys, or NHANES I and NHANES III. The NHANES is periodically conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. RESULTS: The cumulative number of carious permanent teeth, both treated and untreated, among 6- to 18-year-olds decreased 57.2 percent, from 4.44, as measured in NHANES I, to 1.90, as measured in NHANES III. The cumulative number of carious primary teeth, both treated and untreated, among 2- to 10-year-olds decreased 39.7 percent, from 2.29, as measured in NHANES I, to 1.38, as measured in NHANES III. CONCLUSIONS: Since the 1970s, the cumulative number of carious permanent and primary teeth, both treated and untreated, has declined substantially among children in the United States. PRACTICE IMPLICATIONS: Effective prevention has reduced caries in children. As a result, dental practice will be more focused on maintaining intact dentitions than on repairing teeth damaged by disease. <18> UI - 20121575 AU - Ramos-Gomez FJ AU - Tomar SL AU - Ellison J AU - Artiga N AU - Sintes J AU - Vicuna G IN - Department of Pediatric Dentistry, University of California, San Francisco, USA. TI - Assessment of early childhood caries and dietary habits in a population of migrant Hispanic children in Stockton, California. SO - ASDC Journal of Dentistry for Children 1999 Nov-Dec;66(6):395-403, 366 AB - OBJECTIVE: This study estimated the prevalence of early childhood caries (ECC) and related behavioral risk factors in a population of low-income, Mexican-American children in Stockton, California. METHODS: We collected data for 220 children ages six years or less using a parent-completed questionnaire and clinical dental examinations during the Su Salud Health and Education Fair in July 1995. We employed five case definitions of ECC: buccal or lingual caries on one or two primary maxillary incisors; caries on any surface of one or two primary maxillary incisors; and five decayed, missing (due to caries), or filled primary teeth. RESULTS: The prevalence of ECC ranged from 12.3 percent to 30.5 percent, depending upon the case definition. More than 17 percent of children age two years had one primary maxillary incisor affected by caries on the buccal or lingual surface; 13.2 percent had two affected. Mean age at weaning from breast--or bottle-feeding and patterns of bottle use during sleep did not differ significantly between children with ECC and those without. There were no clear patterns of cariogenic food frequency and disease status. CONCLUSIONS: Our findings question whether feeding patterns with human breast milk, formula, or bovine milk are sufficient etiologic factors for this condition. <19> UI - 20146493 AU - Hobdell MH AU - Lalloo R AU - Myburgh NG IN - University of Texas-Houston, Dental Branch 77030, USA. mhobdell@mail.db.uth.tmc.edu TI - The Human Development Index and Per Capita Gross National Product as predictors of dental caries prevalence in industrialized and industrializing countries. SO - Annals of the New York Academy of Sciences 1999;896:329-31 <20> UI - 99381492 AU - Watt R AU - Sheiham A IN - Department of Epidemiology and Public Health, University College London Medical School. TI - Inequalities in oral health: a review of the evidence and recommendations for action [see comments]. [Review] [69 refs] CM - Comment in: Br Dent J 1999 Sep 11;187(5):237-8 SO - British Dental Journal 1999 Jul 10;187(1):6-12 AB - Reducing inequalities in health has become one of the main health policy issues in the late 1990s. The Labour Government set up an independent inquiry into inequalities in health under Sir Donald Acheson to make recommendations on approaches to reducing health inequalities. This paper reviews the evidence on inequalities in oral health in Britain. Dramatic improvements in dental health in children and young adults have taken place in the past 30 years. The levels of caries in permanent teeth of children is low. Widening inequalities in oral health however exist between social classes, regions of England, and among certain minority ethnic groups in pre-school children. The main social class and minority ethnic differences in dental caries is in pre-school children. Wide district and regional differences also exist in prevalence of caries in young children. The area differences relate very strongly to deprivation. In adults the differences in decay experience is less unequal than in children but there are marked social class inequalities in edentulousness. Dental caries decreased in all social classes in the United Kingdom. The main causes of the inequalities are differences in patterns of consumption of non milk extrinsic sugars and fluoridated toothpaste. Improvements in oral health that have occurred over the last 30 years have been largely a result of fluoride toothpaste and social, economic and environmental factors. Oral health inequalities will only be reduced through the implementation of effective and appropriate oral health promotion policy. Treatment services will never successfully tackle the underlying cause of oral diseases. [References: 69] <21> UI - 20113841 AU - Kaste LM AU - Drury TF AU - Horowitz AM AU - Beltran E IN - Department of Stomatology, College of Dental Medicine, Medical University of South Carolina, Charleston 29425, USA. kastelm@musc.edu TI - An evaluation of NHANES III estimates of early childhood caries. SO - Journal of Public Health Dentistry 1999 Summer;59(3):198-200 AB - OBJECTIVES: The purposes of this study were to estimate and evaluate the prevalence for the United States of early childhood caries (ECC) among children 12 to 23 months of age. METHODS: The 1988-94 National Health and Nutrition Examination Survey (NHANES III) public-use data set was analyzed using SUDAAN. Two ECC case definitions were used. Definition :1 was restricted to the caries score called by the examiner. Definition :2 liberally included children identified by definition :1 and those possibly having questionable caries scores. RESULTS: The NHANES III six-year prevalence estimates of caries in the maxillary anterior incisors of children 12 to 23 months of age were 1.0 percent for definition :1 and 1.7 percent for definition :2. Mexican-American and economically disadvantaged children were disproportionally represented with ECC. CONCLUSIONS: The prevalence of ECC among children 12 to 23 months of age is barely detectable at the national level. Alternative study designs and improved case definitions are needed for further advances in ECC. <22> UI - 20113834 AU - Crall JJ AU - Szlyk CI AU - Schneider DA IN - Department of Pediatric Dentistry, University of Connecticut Health Center, Farmington 06030-1610, USA. crall@nso.uchc.edu TI - Pediatric oral health performance measurement: current capabilities and future directions. SO - Journal of Public Health Dentistry 1999 Summer;59(3):136-41 AB - This paper offers an overview of performance measurement in health care, provides a synopsis of the findings and recommendations of an Oral Health Expert Panel organized by the National Committee for Quality Assurance (NCQA) under contract with the Health Care Financing Administration (HCFA), and discusses challenges and possible future directions for pediatric oral health care performance measures development. Existing performance measures for pediatric oral health care are extremely limited; however, several new measures have been proposed and are in various stages of development and testing. Measures capable of being implemented in the short-term focus on access and use of services, rely on administrative data sources, and represent refinements and enhancements of current measures. Measures proposed for future implementation focus more on the effectiveness of care, consumer assessments of care and plan performance, and the value of services provided to enrolled children. Recommendations are targeted toward high-risk children who, for the most part, are covered by public programs (e.g., Medicaid and the Children's Health Insurance Program). Nevertheless, the entire set of recommended measures is considered to be relevant to all pediatric populations and applicable to all forms of dental care coverage, including state-administered programs and commercial third party arrangements. <23> UI - 20114140 AU - Brown LJ AU - Wall TP AU - Lazar V IN - American Dental Association, Health Policy Resources Center, Chicago, Ill. 60611, USA. TI - Trends in untreated caries in primary teeth of children 2 to 10 years old. SO - Journal of the American Dental Association 2000 Jan;131(1):93-100 AB - BACKGROUND: This article is the second in a series of three that focus on recent changes in the caries status of children and adolescents in the United States. METHODS: This study is based on analyses of data regarding untreated carious primary teeth among children 2 to 10 years of age from the first and third National Health and Nutrition Examination Surveys, or NHANES I and NHANES III. The NHANES is conducted periodically by the National Center for Health Statistics of the Centers for Disease Control and Prevention. RESULTS: Overall, the number of carious primary teeth among children 2 to 10 years old decreased from 1.42 as measured in NHANES I to 0.63 as measured in NHANES III. The number of carious primary teeth in children 2 to 10 years old also decreased across four demographic variables: age, sex, race and poverty level. CONCLUSIONS: The number of untreated carious primary teeth among children has declined. Since the 1970s, the absolute difference in untreated caries between disadvantaged children in the United States and the rest of the U.S. child population has narrowed, although not to the same extent as in permanent teeth. PRACTICE IMPLICATIONS: On average, children of preschool and elementary-school age have less untreated caries than in the past. More often, dentists do not need to treat on a first visit. This provides more opportunity to introduce these children to preventive dentistry at an early age. <24> UI - 20110279 AU - Whittle JG AU - Whittle KW IN - South and East Lancashire Health Authorities, UK. TI - Household income in relation to dental health and dental health behaviours: the use of Super Profiles. SO - Community Dental Health 1998 Sep;15(3):150-4 AB - OBJECTIVE: To investigate the relationship between household income defined by Super Profiles, a socio-economic indicator, and dental health and dental health behaviours. BASIC RESEARCH DESIGN: Analytical survey involving a clinical examination and a questionnaire to parents. SETTING: Primary schools in Salford, UK. PARTICIPANTS: Two thousand five hundred and seventy eight 5-year-old children were examined; 1938 (75%) returned questionnaires. MAIN OUTCOME MEASURES: Mean caries experience and ages at first visit to dentist and when toothbrushing commenced. RESULTS: Children in the highest income group had a mean dmft of 1.83 compared with 2.56 in the middle group and 3.43 in the lowest income group. The proportions who had visited a dentist by their second birthday were 71%, 64% and 62% respectively. The corresponding proportions having their teeth brushed by their first birthday were 69%, 58% and 57%. CONCLUSIONS: The study showed a relationship between Super Profiles, and the dental health and dental health behaviours of 5-year-old children. <25> UI - 20076946 AU - Bruening KS AU - Gilbride JA AU - Passannante MR AU - McClowry S IN - Department of Nutrition and Food Management at Syracuse University, NY 13244-1250, USA. TI - Dietary intake and health outcomes among young children attending 2 urban day-care centers. SO - Journal of the American Dietetic Association 1999 Dec;99(12):1529-35 AB - OBJECTIVE: To assess the impact of the Child and Adult Care Food Program (CACFP) on diet and 3 health outcomes--weight-for-height status, dental caries (tooth decay) score, and number of days of illness--among preschool children attending 2 urban day care centers. DESIGN: Dietary intake and health outcome measures were assessed and compared for children attending 2 day-care centers in an urban community. Data were obtained for 14 days of dietary intake, which were analyzed for energy and 15 nutrients and 6 food groups; anthropometric measures, including weight-for-height; dental caries; and days of illness. SUBJECTS/SETTING: Forty 3- to 5-year-old black children from 2 day-care centers participated. One center participates in the CACFP. At the other center, children bring all meals and snacks from home. STATISTICAL ANALYSES PERFORMED: Data from the 2 groups of children were compared using parameteric and nonparametric t tests. RESULTS: Children receiving CACFP meals at day care had significantly higher mean daily intakes of vitamin A (804 +/- 191 vs 595 +/- 268 retinol equivalents), riboflavin (1.45 +/- 0.32 vs 1.21 +/- 0.22 mg), and calcium (714 +/- 180 vs 503 +/- 143 mg) than the children who brought all of their meals and snacks from home. Children who received CACFP meals also consumed significantly more servings of milk (2.9 +/- 0.9 servings vs 1.5 +/- 0.7) and vegetables (1.8 +/- 0.5 vs 1.2 +/- 0.5 servings) and significantly fewer servings of fats/sweets (4.6 +/- 1.3 vs 5.4 +/- 1.1 servings) than children who brought their meals. Weight-for-height status and dental caries scores did not differ between the 2 groups. Children from the center participating in the CACFP have significantly fewer days of illness (median 6.5 vs 10.5 days) than children from the nonparticipating center. APPLICATIONS: Nutritious meals provided by the CACFP can improve diets and may promote health among young, urban children. Registered dietitians can contribute to food assistance programs by intervening to enhance the quality of meals served and by examining the impact of participation on measures of diet quality and diet-related health outcomes. <26> UI - 99365534 AU - Blen M AU - Narendran S AU - Jones K IN - Pediatric Dentistry, University of Texas-Houston Health Science Center, USA. TI - Dental caries in children under age three attending a university clinic. SO - Pediatric Dentistry 1999 Jul-Aug;21(4):261-4 AB - PURPOSE: The aim of study was to determine the rates of dental caries and assess the restorative needs of children under three years of age attending an urban university clinic from 1993-1997. METHODS: In this retrospective study, data were abstracted from patient records and included demographic information, caries experience, and restorative needs. RESULTS: Gender distribution of the sample included 55% males and 45% females. The study population was predominantly African-American (51%) and Hispanic (34%), with a mean age of 20 months. A majority of the population had dental benefits through Medicaid (92%). Nearly one-third of the study population and as many as 56% of the children between 24 and 36 months had dental caries. Among those off the bottle (50%), children with severe dental caries had been weaned off the bottle at a significantly older age compared to those without any caries (16.9 vs. 10 months, P = 0.000). CONCLUSIONS: This study provides further validity to the early oral health exam and early dental treatment, not only for preventive measures but also for restorative needs. The relatively high prevalence of early childhood caries could have been prevented by appropriate primary preventive strategies. <27> UI - 99428133 AU - Anonymous TI - Water fluoridation and costs of Medicaid treatment for dental decay--Louisiana, 1995-1996. SO - MMWR - Morbidity & Mortality Weekly Report 1999 Sep 3;48(34):753-7 AB - Treatment costs for dental decay in young children can be substantial, especially if extensive dental procedures and general anesthesia in a hospital operating room (OR) are needed. Because caries in the primary dentition disproportionately affect children from low-income households, the cost for care frequently is reimbursed by state Medicaid programs. To determine whether the average treatment cost for Medicaid-eligible children in Louisiana differed by community fluoridation status, the Louisiana Department of Health and Hospitals (LDHH) and CDC analyzed Medicaid dental reimbursements and Medicaid eligibility records from July 1995 through June 1996 for children aged 1-5 years. Findings suggest that Medicaid-eligible children in communities without fluoridated water were three times more likely than Medicaid-eligible children in communities with fluoridated water to receive dental treatment in a hospital OR, and the cost of dental treatment per eligible child was approximately twice as high. <28> UI - 99360306 AU - Quartey JB AU - Williamson DD IN - Department of Health Promotion and Dental Care Delivery, University of Texas-Houston, USA. TI - Prevalence of early childhood caries at Harris County clinics. SO - ASDC Journal of Dentistry for Children 1999 Mar-Apr;66(2):127-31, 85 AB - Nursing caries has been found to be positively associated with children from families of low socioeconomic status. The Harris County Health Department (HCHD) serves a population consisting predominately of low-income, low-educational-level clients who reside in the suburban areas surrounding Houston, Texas. The purpose of this study was to determine the prevalence of early childhood caries and nursing caries among patients of the HCHD dental clinics. The study method was a retrospective chart review of all patients seen at the HCHD dental clinics within the two years before the study. There were 135 children in the sample, with a mean age of fifty-seven months. About half of the children had a quarter (five or more) of their primary teeth filled or decayed. The prevalence of early childhood caries was 76 percent and 44 percent of the children were classified in the group with nursing caries. The prevalence of early childhood caries and nursing caries among patients from low socioeconomic families is still high. <29> UI - 99360305 AU - Weinstein P AU - Troyer R AU - Jacobi D AU - Moccasin M IN - University Washington, Seattle, USA. TI - Dental experiences and parenting practices of Native American mothers and caretakers: what we can learn for the prevention of baby bottle tooth decay. SO - ASDC Journal of Dentistry for Children 1999 Mar-Apr;66(2):120-6, 85 AB - This study attempts to gather information concerning the dental experiences, beliefs, and parenting practices of Native Americans. Five Native American women were trained to conduct interviews in their own language. After pilot testing, seventeen questions were asked. Sixty-two interviews were taperecorded and transcribed. Content analysis was performed on the transcriptions. Results indicate maternal and caretaker upset and displeasure with the dental experiences of adults and children. Fear and pain were prominent. Parenting practices indicate children are expected to clean their own teeth at about a year of age and parental awareness of risks associated with sleeping with a bottle. About half of the mothers and caretakers who used a bottle as a pacifier report engaging in one or more protective activities such as removing the bottle when the child falls asleep. Mothers and caretakers with greater parenting experience are likelier to be aware of these protective activities. In conclusion, results of this study highlight the importance of providing positive dental experiences for mothers and caretakers and the need to be aware of actual parenting practices before making recommendations or counseling mothers or caretakers. <30> UI - 99317465 AU - Swedberg Y IN - Department of Health and Environment, Faculty of Health Sciences, Linkoping, Sweden. TI - On the reporting of dental health, time for dental care, and the treatment panorama. SO - Swedish Dental Journal - Supplement 1999;133:1-65 AB - The thesis included five methodological studies and one caries epidemiological investigation, the general aim being to study how to measure and report dental health, time for dental care, treatment panorama, and dental care outcomes, within a Public Dental Service organization. The specific aims were to monitor dental clinic activities using a time study method, to apply time study results of a dental health-related patient group system for the 3-19 year age groups, and to compare time study results with corresponding results from computerized systems used for reporting dental care. Other specific aims were to compare longitudinal caries index data results between cohort and cross-sectional samples, to analyse caries index for extreme caries groups among adolescents leaving organized dental care, and--using time series methods--to analyse dental health development of the 15-19 year age groups. Results from the time studies portrayed the dental clinic as a working unit, showed that reported values can represent dental care only for intervention procedures, and indicated that clinic patterns were not adapted to the health situation of the patient groups. Longitudinal cohort attempts gave different values from those of the cross-sectional year classes, which should be the primary focus when presenting caries index mean values in dental health reviews. Caries-free groups from 15 to 19 years of age seem to be stable in their caries development in about 60%-80% of cases; while the 20% groups with the highest index values accounted for about 80% of all approximal lesions. In times of major economic adjustment, dental health for adolescents in Goteborg was an example of sustainable dental health development. A model system for monitoring, analysing, and reporting dental health and dental care outcomes within a dental care-giving organization calls for several conditions, for example, a dental health-related patient group system, and a rationale for the choice of dental team models. These areas could be gathered into a system where contemporary socio-economic factors and dental research results interact with performed dental care, and also with different methods for reporting and evaluating dental health, dental care costs, and the demand for dental care competence. <31> UI - 99272123 AU - Riley JC AU - Lennon MA AU - Ellwood RP IN - Department of Clinical Dental Sciences, University of Liverpool, UK. TI - The effect of water fluoridation and social inequalities on dental caries in 5-year-old children. SO - International Journal of Epidemiology 1999 Apr;28(2):300-5 AB - BACKGROUND: Many studies have shown that water fluoridation dramatically reduces dental caries, but the effect that water fluoridation has upon reducing dental health inequalities is less clear. The aim of this study is to describe the effect that water fluoridation has upon the association between material deprivation and dental caries experience in 5-year-old children. METHODS: It is an ecological descriptive study of dental caries experience using previously obtained data from the British Association for the Study of Community Dentistry's biennial surveys of 5-year-old children. This study examined the following data from seven fluoridated districts and seven comparable non-fluoridated districts in England: 1) dental caries experience using the dmft (decayed, missing, filled teeth) index; 2) the Townsend Deprivation Index of the electoral ward in which the child lived; 3) whether fluoride was present at an optimal concentration in the drinking water or not. RESULTS: A statistically significant interaction was observed between material deprivation (measured by the Townsend Deprivation Index) and water fluoridation (P < 0.001). This means that the social class gradient between material deprivation and dental caries experience is much flatter in fluoridated areas. CONCLUSION: Water fluoridation reduces dental caries experience more in materially deprived wards than in affluent wards and the introduction of water fluoridation would substantially reduce inequalities in dental health. <32> UI - 99243313 AU - Sweeney PC AU - Nugent Z AU - Pitts NB IN - Department of Dental Public Health, Argyll and Clyde Health Board, Paisley, Scotland. lreay@udef.gla.ac.uk TI - Deprivation and dental caries status of 5-year-old children in Scotland. SO - Community Dentistry & Oral Epidemiology 1999 Apr;27(2):152-9 AB - OBJECTIVES: The aim of this study was to investigate the relationship between the dental caries status of 5-year-old children in Scotland and deprivation, as assessed by the Carstairs score and its DEPCAT categories, which are composite descriptors of socio-economic status. METHODS: Anonymous records, including postcode sector of residence, from the 1995/96 Scottish Health Board's Dental Epidemiological Programme 5-year-old survey were linked though a multi-stage process to their corresponding Carstairs scores and DEPCAT categories. The data were analysed to investigate the relationship between d3t, mt, ft, d3mft, proportion 'free' of caries experience and socio-economic status for Scotland. RESULTS: When analysed by DEPCAT the mean d3mft ranged from 1.48 for children resident in the most affluent postcode areas (DEPCAT 1) to 4.87 for those in DEPCAT 7. The mean d3mft from the 1995/96 survey of 5-year-old children in Scotland was 2.93. For the percentage 'free' of caries experience (d3mft = 0) the findings in this study ranged from 62.4% (DEPCAT 1) to 19.8% (DEPCAT 7). The d3t and mt components of d3mft and mean d3mft showed a strong positive association with increasing deprivation. The proportion of 5-year-olds experiencing decay was also significantly associated with a more deprived Carstairs score. The f component showed no association with deprivation. The Care Index (ft/d3mft x 100%) ranged from 10.8% (DEPCAT 1) to 2.9% (DEPCAT 7). CONCLUSIONS: There was a striking association between increasing deprivation and increasing caries experience. Children from the most deprived areas had significantly more untreated decay and missing teeth. In a population with low levels of restorative intervention, no association was found between deprivation and the amount of restorative care received by Scottish 5-year-old children. <33> UI - 99273335 AU - Magraith KS TI - Oral health for the preschool child [letter; comment]. CM - Comment on: Med J Aust 1999 Jan 4;170(1):6-7 SO - Medical Journal of Australia 1999 May 3;170(9):455-6 <34> UI - 99293796 AU - Jones CM AU - Worthington H IN - Wigan & Bolton Health Authority. TI - The relationship between water fluoridation and socioeconomic deprivation on tooth decay in 5-year-old children. SO - British Dental Journal 1999 Apr 24;186(8):397-400 AB - AIM: To examine the relationship between water fluoridation, socioeconomic deprivation and tooth decay in 5-year-olds. SETTING: 10,004 children: 1,051 in naturally fluoridated Hartlepool in 1991/92, 3,816 in fluoridated Newcastle & North Tyneside and 5,137 in non-fluoridated Salford & Trafford in 1993/94. OUTCOME MEASURES: Correlations between mean electoral ward dmft and ward Townsend Scores from the 1991 census. RESULTS: Regardless of the level of water fluoridation significant correlations were found between deprivation and tooth decay. Multiple linear regression models for dmft showed a statistically significant interaction between ward Townsend score, and both types of water fluoridation, confirming the more deprived the area the greater the reduction in tooth decay. At a Townsend score of zero (the English average) there was a predicted 43% reduction in decay in 5-year-olds in fluoridated areas. CONCLUSIONS: Tooth decay is strongly associated with social deprivation. The findings confirm that the implementation of water fluoridation has halved tooth decay in 5-year-old children and that the dental caries divide between rich and poor is reduced. <35> UI - 99184725 AU - Watson MR AU - Horowitz AM AU - Garcia I AU - Canto MT IN - Baltimore College of Dental Surgery Dental School, University of Maryland, 21201-1586, USA. mwatson@umaryland.edu TI - Caries conditions among 2-5-year-old immigrant Latino children related to parents' oral health knowledge, opinions and practices. SO - Community Dentistry & Oral Epidemiology 1999 Feb;27(1):8-15 AB - OBJECTIVES: To collect baseline data prior to initiating a community-based, oral health promotion program in an inner city Latino community in Washington DC, populated by Central American immigrants. METHODS: In 1995, an oral survey of a convenience sample of children 2-5 years of age (n = 142) and a survey of the knowledge, opinions and practices (KOP) of their parents (n = 121) were completed. Clinical data of children were matched with parent respondents of the KOP survey. Data were analyzed for statistical associations using univariate odds ratios, Fisher's exact tests, and multiple logistic regression. RESULTS: Only 53% of the children were caries free. Eighteen percent of all children were in need of immediate dental care and 26% were in need of early or non-urgent dental care. Only 7% of the parents knew the purpose of sealants and 52% knew the purpose of fluorides. Further, only 9% thought that brushing with toothpaste can prevent tooth decay The strongest predictors of dental caries in this population, after adjusting for child's age and mother's education, were recency of mother's residence in the United States and report of an uncooperative child when attempting toothbrushing. CONCLUSIONS: Regimens of caries prevention have been successful in reducing dental decay for a large segment of the US population, yet this disease remains prevalent especially among low socioeconomic groups. The oral health status of the children and the oral health KOP of the parents in this community are disturbingly deficient. <36> UI - 99230647 AU - Albert DA IN - Division of Community Health, Columbia University School of Dental and Oral Surgery, USA. TI - Sealant use in public and private insurance programs [see comments]. CM - Comment in: N Y State Dent J 1999 Feb;65(2):24-5 SO - New York State Dental Journal 1999 Feb;65(2):30-3 AB - Dental sealants are a safe and efficacious method for preventing caries in pits and fissures. An increase in sealant use has been observed in the NHANES III survey. However this increase still accounts for less than one fifth of children aged 5-17 having sealants on their teeth. Reimbursement and coverage of sealants by public and private insurance programs have lagged behind the widespread acceptance of this methodology by the profession. Medicaid preventive services are poorly used by patients and the profession: and the inclusion of sealants in traditional, indemnity, fee-for-service commercial plans has been inconsistent. Managed care programs include dental sealants, but lack financial incentives to increase their use. <37> UI - 99241534 AU - Pine CM IN - University of Dundee, Scotland, UK. TI - Deprivation and inequalities in women's health: smoking, an oral cancer, and child dental health. SO - Journal of Dental Education 1999 Mar;63(3):276-80 <38> UI - 99213083 AU - Hughes T AU - Bawden JW IN - Department of Pediatric Dentistry, School of Dentistry, University of North Carolina-Chapel Hill, USA. TI - A survey of private pediatric dental practices in North Carolina. SO - Pediatric Dentistry 1999 Mar-Apr;21(2):104-8 AB - PURPOSE: In response to concerns about current and future demands for specialized pediatric dental care in North Carolina, a survey of private pediatric dental practices was conducted. METHODS: Data were collected on the demographics and other practice variables. Information was also collected on the ages, caries activity, Medicaid status, estimated treatment needs, fluoridation status, and location of residence (urban/rural) of all new patients seen in each practice during three designated, consecutive days in November 1996. RESULTS: The survey response rate was 76%. The data indicated that most pediatric dentists in North Carolina are quite busy. A total of 519 new patients were seen during the three-day survey period. The mean age was 4.7 years and 22% had advanced caries. Forty seven percent were caries free. Most of the disease was found in the primary dentitions of young children. CONCLUSIONS: The findings indicate that the specialized pediatric dental care system in North Carolina is operating close to its capacity and is overtaxed in many areas of the state. <39> UI - 99213081 AU - Seow WK AU - Amaratunge A AU - Sim R AU - Wan A IN - Pediatric Dentistry, University of Queensland. TI - Prevalence of caries in urban Australian aborigines aged 1-3.5 years. SO - Pediatric Dentistry 1999 Mar-Apr;21(2):91-6 AB - PURPOSE: This study investigated the prevalence and etiological factors associated with caries in a group of young Australian aboriginal children from 1 to 3.5 years of age. METHODS: One hundred and forty-seven healthy infants, aged from 1 to 3.5 years, attending a community health center in Brisbane, a nonfluoridated state capital city, were randomly selected for the study. RESULTS: The caries prevalence was 39% by subjects and 32% by the total number of teeth present. The mean number of decayed, filled teeth (dtf) was 2.5 +/- 0.4, which is more than twice the figure for 3-year-old children in Australia. Furthermore, the filled (f) component represented only 1% of the total dft, suggesting very low treatment levels. Increased caries experience of the infants was strongly associated with high dental plaque scores, high levels of Streptococcus mutans infection, and sleep-time consumption of milk containing added sugar. CONCLUSION: The results suggest that urban Australian aboriginal infants are at high risk for caries, and that preventive strategies are urgently required. <40> UI - 99202138 AU - Tickle M AU - Williams M AU - Jenner T AU - Blinkhorn A IN - South Cheshire Health, Chester. TI - The effects of socioeconomic status and dental attendance on dental caries' experience, and treatment patterns in 5-year-old children. SO - British Dental Journal 1999 Feb 13;186(3):135-7 AB - OBJECTIVE: To compare the dental caries' experience and treatment received by 5-year-old children registered with a GDP. DESIGN: Retrospective case note review of all 5-year-old children registered with seven GDPs. SETTING: The study was carried out in 1996/7 in Wirral and North Cheshire in the north west of England. SUBJECTS AND MATERIALS: Clinical, demographic and attendance data were collected from each practice using a common data abstraction form. Subjects were categorised according to regular/irregular attenders, and into five groups ranging from affluent to deprived using the Super Profiles geodemographic classification. The relationships between disease experience, treatment, attendance and socioeconomic status were compared using cross-tabulations, t-tests and multiple linear regression. RESULTS: The dental records of 430 5-year-old children were available for analysis. Irregular attenders had significantly higher dmft, dt and mt, and fewer filled teeth. Only 29% of disease experience of regular attenders was treated by restoration. Both socioeconomic status and visiting behaviour exerted significant independent effects on dmft, but dental attendance alone had a significant effect on ft. CONCLUSIONS: Significant inequalities remain in the disease experience and service use of young children. Regularly attending children have less than a third of their diseased teeth restored. Consensus is needed across the profession on the care of the diseased deciduous dentition. <41> UI - 99154229 AU - Lopez L AU - Berkowitz R AU - Zlotnik H AU - Moss M AU - Weinstein P IN - Department of Oral Diagnosis, Surgical Sciences, School of Dentistry, University of Puerto Rico. TI - Topical antimicrobial therapy in the prevention of early childhood caries [see comments]. CM - Comment in: Pediatr Dent 1999 May-Jun;21(3):158 SO - Pediatric Dentistry 1999 Jan-Feb;21(1):9-11 AB - PURPOSE: Early childhood caries (ECC) is microbiologically characterized by heavy infection of mutans streptococci (ms) on dental surfaces. Accordingly, it is reasonable to speculate that suppression of dental ms levels would decrease risk for ECC. On this basis, randomized double blind, placebo controlled pilot study was performed to test this concept. METHODS: The study population consisted of 31 subjects (age: 12 to 19 mos; sex: 18F/13M) who were clients of a Women, Infants, and Children (WIC) clinic in Puerto Rico. Inclusion criteria included: (1) unremarkable medical history; (2) presence of 4 maxillary primary incisors (PMI) with no visible defects; (3) clinically caries free; (4) use of a nursing bottle at naptime and/or bedtime which contained a cariogenic substrate; (5) two consecutive ms positive cultures (utilizing Mitis-Salivarius-Bacitracin (MSB) agar) from pooled PMI plaque. The subjects were randomized into 2 groups. The 15 subjects in the experimental group and the 16 subjects in the control group were evaluated every 2 months during the study period. At each evaluation, the subjects had 10% povidone iodine (experimental group) or placebo (control group) applied to their dentition. The placebo was commercial instant tea (without lemon or sweetener) and deionized water. Treatment failure was defined as the appearance of a white spot lesion(s) on any of the PMI during the study period. RESULTS: The mean duration of observation to treatment failure was 155 days; the mean duration of observation for treatment success was 217 days. Five of the 16 control subjects and 0 of the 15 experimental subjects experienced treatment failure (Fisher's exact test: P = 0.04). The Kaplan-Meier estimate for incidence of treatment failure in the placebo group was 48% over 357 days (P = 0.02). CONCLUSION: These observations suggest that topical antimicrobial therapy reduces risk for the development of ECC in high-risk children. <42> UI - 99110704 AU - Gibson S AU - Williams S IN - Nutrition Consultant Guildford, Surrey, UK. sigrid.gibson@compuserve.com TI - 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. SO - Caries Research 1999;33(2):101-13 AB - 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. <43> UI - 20018865 AU - Toi CS AU - Cleaton-Jones PE AU - Daya NP IN - Dental Research Institute of the Medical Research Council, Johannesburg, South Africa. TI - Mutans streptococci and other caries-associated acidogenic bacteria in five-year-old children in South Africa. SO - Oral Microbiology & Immunology 1999 Aug;14(4):238-43 AB - Correlations between mutans streptococci and caries are inconsistent; some studies show that early caries may occur with other bacterial species possessing the ability to survive, interact and compete with mutans streptococci. This study looked at the relationship between mutans streptococci, Lactobacillus, Actinomyces and Veillonella in saliva and plaque collected from four tooth sites in two ethnic groups, with and without caries. All samples were collected and cultured onto selective media. Colonies were enumerated and identified using biochemical tests. Pearson correlations showed low yet statistically significant correlations between plaque mutans streptococci counts and the number of decayed surfaces (ds) and decayed, missing and filled surfaces (dmfs) of primary teeth in blacks and in coloreds (historical race classification). Salivary mutans streptococci counts correlated with ds and dmfs in coloreds. No relationship was found between ds, dmfs and Lactobacillus, Actinomyces or Veillonella numbers. Significant associations were evident between plaque mutans streptococci and Veillonella and Lactobacillus in black children with caries and between plaque mutans streptococci and Actinomyces and Lactobacillus and Veillonella in colored children. Hence, oral microbes are in constant flux but have interrelationships in children with caries. <44> UI - 99448351 AU - Frencken JE AU - Sithole WD IN - Department of Preventive and Community Dentistry, University of Nijmegen, The Netherlands. TI - National oral health survey Zimbabwe 1995: quality of restorations. SO - SADJ 1998 Sep;53(8):435-8 AB - In 1995, a second national oral health survey was carried out, ten years after the first. Application of a multi-stage sampling procedure resulted in 3709 persons being examined. The restorations were assessed using the criteria described by Kroeze et al (1990). Only ditches on the tooth/restoration margins that were wider than 0.4 mm were considered to be carious. The background variables studied were age, gender, type of location, socioeconomic status (SES) and level of education. The prevalence of restorations in all persons examined was 3.4 per cent. Restorations were found much more often among urban (95.5 per cent) than rural people (4.5 per cent) and also among those living in high (75 per cent) compared to low SES suburbs (25 per cent). Amalgam was more often used (89 per cent) than composite resin (10 per cent). The most frequently observed type of restoration was Class I (45 per cent) followed by Class II (39 per cent) and Class III (7 per cent). The prevalence of satisfactory restorations was 83.9 per cent. Failures were due to 'fractured restorations' (6.3 per cent), 'caries at the margin' and 'breakdown of restoration margin', both 4 per cent. Amongst adults, multiple-surface amalgam restorations failed more often than single-surface ones. It is concluded that the prevalence of restorations found was very low. There is a need to extend the provision of preventive and restorative oral health care by a more equitable distribution of oral health personnel and by making more finance available to rural and low-SES suburban areas. <45> UI - 99384474 AU - Mahony DL AU - Martinelli A IN - Department of Maternal-Child Health, Boston College School of Nursing, Chestnut Hill, MA 02167, USA. TI - A five-year-old with a dental abscess: a case study. SO - Clinical Excellence for Nurse Practitioners 1998 Jul;2(4):202-5 AB - Dental caries remain one of the most common disorders of childhood in the United States. Often nurse practitioners (NPs) will see children who are suffering from the complications of a dental carie, such as a dental abscess and/or cellulitis. This article describes the case of a 5-year-old girl who presented at an evening clinic with tooth pain, fever, and facial swelling. Three treatment choices are discussed: (1) 400 mg of amoxicillin (Augmentin), by mouth, with comfort measures, and return to the clinic in the morning; (2) 2 g of ceftriaxone by injection, with comfort measures, and return to the clinic in the morning; (3) or hospitalize via emergency department for intravenous fluids and antibiotics. The treatment that was chosen not only takes into account the disease process, but also the impact of this choice on the family. A model for the progression of dental caries in low-income groups with recommendations for prevention is also presented. <46> UI - 99319181 AU - Mattila ML AU - Paunio P AU - Rautava P AU - Ojanlatva A AU - Sillanpaa M IN - Department of Public Health, University of Turku, Finland. TI - Changes in dental health and dental health habits from 3 to 5 years of age. SO - Journal of Public Health Dentistry 1998 Fall;58(4):270-4 AB - OBJECTIVES: This study sought to determine how dental health and dental health habits change from 3 to 5 years of age and to consider whether preventive dental health care helped in preventing or halting caries in children. METHODS: The study included 67 maternity health care clinics, 72 well-baby clinics, and 69 dental health care clinics. Of the 1,292 newborn children, 1,003 (90.8%) were included in this study. RESULTS: Preventive dental health care contributed to dental caries being halted in only 13.2 percent of those children who had enamel caries at 3 years of age. The dmft index did not increase in 22.6 percent of those children who had dentinal caries at 3 years of age. For all others, the disease became more severe. Toothbrushing habits of 3-year-old children were very consistent over the two years studied. Children were at a risk for caries when their mothers had nine years of basic education, when they already had plaque and caries at 3 years of age, and when the frequency of eating sweets increased the most during the two-year study period. CONCLUSIONS: Among 3-year-old children, plaque is an indicator of caries risk and therefore should be a key element in health education. Those children who already have evidence of caries at 3 years of age should be the target of preventive dental services because of their increased risk. <47> UI - 99193226 AU - Smith PJ AU - Moffatt ME IN - Department of Community Health Sciences, Winnipeg, Manitoba, Canada. TI - Baby-bottle tooth decay: are we on the right track?. [Review] [60 refs] SO - International Journal of Circumpolar Health 1998;57 Suppl 1:155-62 AB - The baby-bottle tooth decay (BBTD) risk factor literature was critically assessed for strength of evidence, and the prevention literature for the identification of which risk factors are being addressed. "Inappropriate" feeding practices (non-nutritive sucking, prolonged bottle/breast feeding, nap-time feeding) are believed to cause BBTD. The association of these practices with BBTD is inconsistent and the strength of association varies greatly. These practices increase exposure to lactose, a cariogenic carbohydrate, but the current causation model fails to explain why the majority of children with these risk factors do not develop BBTD. The association of BBTD with low socioeconomic status is stronger and more consistent. Prevention has focused almost exclusively on education directed at changing the postnatal feeding practices despite the fact that teeth begin formation in utero. Prenatal deficiencies of calcium and vitamin D can lead to enamel defects, and enamel defects in turn predispose teeth to caries. Baby-bottle tooth decay is especially prevalent in Aboriginal people, for whom studies have consistently reported diets deficient in vitamin D and calcium. BBTD may be a consequence of the poor socioeconomic conditions and malnutrition. Perhaps more attention should be given to primary prevention. [References: 60] <48> UI - 99218799 AU - Parajas IL AU - Palacios CG TI - Community participation in dental health. SO - Journal of the Philippine Dental Association 1998 Mar-May;49(4):22-8 <49> UI - 99139136 AU - Marshall N TI - What has general dental practice got to offer?. SO - Community Dental Health 1998 Dec;15 Suppl 1:301-3 <50> UI - 99139135 AU - Pitts NB IN - Dental Health Services Research Unit, University of Dundee, UK. TI - Inequalities in children's caries experience: the nature and size of the UK problem. SO - Community Dental Health 1998 Dec;15 Suppl 1:296-300 AB - OBJECTIVE: To discuss, as part of a symposium on 'Dental Care for the Disadvantaged Child', the inequalities in caries experience between a minority of children who demonstrate substantial dental disease and have, as a consequence, a considerable need for dental care and the majority who have little disease. METHOD: 1) Analysing data from regular NHS surveys of the dental health of British children in a number of defined age groups and examining socio-economic factors which operate and influence levels of dental caries to answer questions such as "Do we understand which children need and get appropriate dental care?". 2) Considering how appropriate future needs may be identified and addressed, and the gap between academic acceptance of new methodology and use by dental professionals may be narrowed. CONCLUSIONS: Integrated approaches to prevention should be focused on those children who have the greatest need in addition to the provision of appropriate, clinically effective, preventive and operative care for all children. <51> UI - 99086082 AU - Powell LV IN - Restorative Dentistry, University of Washington, Seattle 98126, USA. lvpowell@u.washington.edu TI - Caries prediction: a review of the literature. [Review] [48 refs] SO - Community Dentistry & Oral Epidemiology 1998 Dec;26(6):361-71 AB - For over a decade researchers have been looking for the formula that will allow caries prediction. The purpose of this summary is to review recent multifactorial prediction models for adults and children with the aim of identifying the most successful and consistent methods. Conclusions from this review include the following: Clinical variables, especially past caries experience, are confirmed as the most significant predictors of future caries development. The status of the most recently erupted/exposed surface is the most successful measure of past caries experience. Bacterial levels are included in the most accurate prediction models. Sociodemographic variables are most important to caries prediction models for young children and older adults. [References: 48] <52> UI - 99011831 AU - Nainar SM IN - Department of Pediatric Dentistry, University of Connecticut School of Dental Medicine, USA. TI - Longitudinal analysis of dental services provided to urban low-income (Medicaid) preschool children seeking initial dental care. SO - ASDC Journal of Dentistry for Children 1998 Sep-Oct;65(5):339-43, 355-6 AB - This retrospective longitudinal study analyzed profile and cost of dental services provided to urban low-income (Medicaid) preschool children seeking initial dental care. Clinical and sociodemographic data for Medicaid children, ages five years and under at the time of their first dental visit, were obtained from the dental records of an urban community health center clinic located in a fluoridated area. The sample consisted predominantly of minority children (males = 54; females = 43) who were initially seen during a continuous six-month period in 1991. The children were then observed for a period of one year from the date of first service. At the initial dental visit, the children had a mean age of 3.7 years and dmft of 4.4 with two-thirds of them exhibiting dental caries. The children made an average of 2.3 visits with more than two-fifths of them receiving at least one treatment service during the year. Children four years of age and older at the initial visit, had greater caries prevalence, higher mean dmft, made more dental visits and incurred greater annual expenditure. Greater proportion of females and older children (> or = 4 years) received restorations and extractions. It is concluded that treatment for dental caries is a significant dental service provided to urban low-income (Medicaid) preschool children seeking initial dental care. The results of this study suggest that preschool programs should target these children and promote an initial dental visit before four years of age particularly among females. <53> UI - 99035979 AU - Eklund SA AU - Pittman JL AU - Smith RC IN - University of Michigan, School of Public Health, Department of Epidemiology, Ann Arbor, Mich. 48109-2029, USA. TI - Trends in per-patient gross income to dental practices from insured patients, 1980-1995. SO - Journal of the American Dental Association 1998 Nov;129(11):1559-65 AB - The authors discuss changes that occurred in per-patient gross income to dental practices from insured patients between 1980 and 1995. The current young-adult cohort appears to provide lower per-patient practice incomes compared with earlier young-adult cohorts. These changes may be the result of differences in the need for restorative care among young adults who benefited from the childhood caries decline of the 1970s and 1980s. If this reduced use of restorative services pattern persists as this young-adult cohort and succeeding cohorts age, the effect on dental practices could be substantial. <54> UI - 98456640 AU - McDerra EJ AU - Pollard MA AU - Curzon ME IN - Department of Pediatric Dentistry, Leeds Dental Institute, England. TI - The dental status of asthmatic British school children. SO - Pediatric Dentistry 1998 Jul-Aug;20(4):281-7 AB - PURPOSE: This study was performed to determine the prevalence of dental disease in British school children with asthma. METHODS: A convenience sample of 100 asthmatic children (aged 4-16 years) was examined for dental caries, periodontal condition, and tooth surface loss. School children, equated for age, sex, race, and socioeconomic status were chosen for comparison. Children were divided into two age ranges; 4-10 and 11-16 years. A significant difference was found in DMFT (0.96 vs. 0.31) and DMFS (1.37 vs. 0.37) between the 4-10-year-old asthmatic children compared with healthy control children. RESULTS: In the 11-16-year age range, the asthmatic children had a DMFT and DMFS of 2.48 and 3.39 compared with the control children who had a DMFT and DMFS of 1.11 and 1.97 respectively. Asthmatic children had significantly more plaque, gingivitis, and calculus compared with the control group. There was a significant difference in the severity and number of teeth affected by tooth surface loss affecting labial surfaces of the anterior teeth and occlusal surfaces of the posterior teeth of asthmatic children. CONCLUSIONS: It was concluded that asthmatic children have more decay affecting their permanent teeth, poorer periodontal status, and more tooth surface loss than healthy controls. <55> UI - 99009623 AU - Brugman E AU - Verrips GH AU - Danz MJ AU - Kalsbeek H IN - TNO Prevention and Health, Leiden, The Netherlands. TI - Dental prevention among Turkish and Moroccan parents in The Hague. SO - Community Dental Health 1998 Jun;15(2):109-14 AB - OBJECTIVE: The aim of this study was to determine the extent to which dental prevention among Turkish parents differs from that among Moroccan parents in one of the large cities in the Netherlands. DESIGN: Turkish and Moroccan mothers with a child of approximately six months old, who visited the well baby clinics in the Schilderswijk area of The Hague, were asked to participate in a dental care project. As part of the initial data collection in this project, 170 Turkish and 153 Moroccan mothers were interviewed at home by a woman who spoke their native languages. The interview contained questions about dental prevention, such as fluoride use, feeding bottle use, visits to the dentist, brushing, information about oral care, and about relevant background characteristics. RESULTS: More Moroccan than Turkish mother reported that they did not use a feeding bottle for the baby, went to the dentist twice a year, brushed their own teeth at least twice a day and started to brush their children's teeth at an early age. The Moroccan mothers were more committed to dental prevention than Turkish mothers, even after correction for background characteristics such as education, language skills and the number of years spent in the Netherlands. CONCLUSIONS: Ethnic groups should not be seen as a single group for dental prevention. It is recommended that Turkish parents in particular be encouraged to go to the dentist twice a year, to start brushing their children's teeth at an early age and to wean their children off use of a feeding bottle in bed. <56> UI - 98413383 AU - Maupome G IN - Department of Oral Health Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, Canada. TI - An introspective qualitative report on dietary patterns and elevated levels of dental decay in a deprived urban population in northern Mexico [published erratum appears in ASDC J Dent Child 1998 Nov-Dec;65(6):437]. SO - ASDC Journal of Dentistry for Children 1998 Jul-Aug;65(4):276-85, 230 AB - Disorganized urbanization in Latin America has led to masses of impoverished people to become squatters in the larger urban areas. Using a community development network in the outskirts of Tijuana, in Northern Mexico, this investigation assessed the dental health situation, aiming to establish the underlying behavioral causes of poor oral health in these slums. Using quantitative and qualitative tools, fifty-six mothers (mean age 30.1 +/- 7.2) with their accompanying children (n = 56; mean age 6.1 +/- 3.3; 46.4 percent female) were interviewed and examined. Dental health was poor and characterized by vast unmet treatment needs in adults and children. 22.2 percent of children under three years of age suffered from Early Childhood Caries, strongly linked to inappropriate patterns of bottle use. Dietary patterns for the overall child population included many cariogenic snacks and beverages. A straightforward model to explain behavioral structures incorporates these findings against the background of living in a highly-deprived environment, whereby the allure of more affordable gratifications for self and family is often translated in the form of tokens such as junk food. <57> UI - 98410985 AU - Norhayati binti Moktar M AU - Noor Hayati MI AU - Nor Fariza N AU - Rohani AK AU - Halimah AS AU - Sharom MY AU - Zainal Abidin AH IN - Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur. hayati@medic.ukm.my TI - Health status of Orang Asli (aborigine) community in Pos Piah, Sungai Siput, Perak, Malaysia. SO - Southeast Asian Journal of Tropical Medicine & Public Health 1998 Mar;29(1):58-61 AB - A study of health status of Orang Asli population (based on physical examination findings) was conducted in 4 villages in Pos Piah, Sungai Siput Perak, Malaysia. In all 356 individuals between 4 months-72 years old (178 males and 178 females) participated in this study. Poor general health status, physical and mental handicaps were seen in 7.8%, 0.3% and 0.3% of the population, respectively. About one-fifth of the population had dental caries. Splenomegaly, hepatomegaly and hepatosplenomegaly were among the commonest abnormalities with the occurrence rates of 19.8%, 13.7% and 6.7%, respectively, being detected in the population. About one-fifth of the population showed signs suggestive of protein-energy deficiency; whilst less than 5% showed signs indicative of riboflavin, iodine and iron deficiencies. Vitamin A deficiency was the commonest nutritional deficiency identified in this community with almost 38.4% of them showing signs of the deficiency. The commonest skin infection was scabies. <58> UI - 99024252 AU - van Loveren C AU - Buijs JF AU - Bokhout B AU - Prahl-Andersen B AU - Ten Cate JM IN - Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry (ACTA), Amsterdam, The Netherlands. TI - Incidence of mutans streptococci and lactobacilli in oral cleft children wearing acrylic plates from shortly after birth. SO - Oral Microbiology & Immunology 1998 Oct;13(5):286-91 AB - Children with a palatal cleft can be treated with preoperative infant orthopedics including an acrylic plate that is applied shortly after birth to obturate the cleft. It is advised to wear these plates until the 18th month of age. Such a plate, being a hard non-shedding surface, may be expected to facilitate early colonization of mutans streptococci. The first aim of the present investigation was to assess the incidence of mutans streptococci and lactobacilli in children with cleft lip and/or palate during the first 2 years of life. The second aim was to study whether preoperative orthopedics, that is, the wearing of an acrylic plate, had facilitated the establishment of mutans streptococci and lactobacilli. The third aim was to determine other factors associated with colonization of these organisms in these children. Sixty-two Caucasian Dutch children with cleft lip and/or palate participated in this study. Twenty-four of these children were treated with preoperative infant orthopedics and had been wearing an acrylic plate from within a few days after birth. At regular control visits plaque and saliva samples and samples from the surface of the acrylic plate were taken, while a dental examination was performed to document the emergence of the primary teeth, caries status, gingival condition and oral hygiene procedures. Saliva samples were also taken from the accompanying parents. At the visit at the age of 18 months, the parents were interviewed using a structured questionnaire. At this age, the prevalence of mutans streptococci and lactobacilli was compared to that in a control group of non-cleft children. The oral cleft children wearing an acrylic plate from shortly after birth were colonized earlier with mutans streptococci and lactobacilli than the non-plate oral cleft children. In the children wearing acrylic plates, the prevalence of lactobacilli decreased with age, while the prevalence of mutans streptococci increased. At the age of 18 months the prevalence of mutans streptococci was comparable in both groups of oral cleft children and in the control children. There was no relation between the numbers of mutans streptococci in the saliva of the mothers and their children. The presence of mutans streptococci in the saliva of the oral cleft children was significantly associated with between-meal snacking and with the presence of lactobacilli. <59> UI - 98335822 AU - Redmo Emanuelsson IM AU - Wang XM IN - Department of Cariology, Faculty of Odontology, Lund University, Malmo, Sweden. Ing-Mari.Redmo:Emanuelsson@ODcariol.lu.se TI - Demonstration of identical strains of mutans streptococci within Chinese families by genotyping. SO - European Journal of Oral Sciences 1998 Jun;106(3):788-94 AB - The aim of this study was to investigate the intra-familial distribution of mutans streptococci in some Chinese families. Eighteen families consisting of mother, father and a 3-yr-old child without any older siblings participated. Clinical examination and interview were performed to obtain information about level of mutans streptococci in saliva, caries prevalence scored by DMFT or deft, general health, diet regimens, breast-feeding time, principal caretaker of the child and the parents' profession. At the same appointment, two pooled plaque samples from each subject were collected with the tips of sterile tooth picks. From these plaque samples, mutans streptococci were isolated on MSB-agar plates and identified by serotyping. Pure isolates were obtained from all subjects of 11 families. These isolates were genotyped using restriction endonuclease HaeIII. The results showed that in 4 families the mothers shared genotype with the child, and in 3 families it was the father and the child who harboured a similar genotype. In 2 families, all subjects harboured an identical genotype. Further, the spouses in one parental pair showed an identical genotype, and, finally, in one family all subjects harboured their unique genotypes. None of the investigated factors could explain the differences in the intra-familial distribution of mutans streptococci. The pattern of similar genotypes in these Chinese families differs from that reported for western families. <60> UI - 98439241 AU - Vargas CM AU - Crall JJ AU - Schneider DA IN - National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md. 20782, USA. TI - Sociodemographic distribution of pediatric dental caries: NHANES III, 1988-1994 [see comments]. CM - Comment in: J Am Dent Assoc 1998 Nov;129(11):1526 SO - Journal of the American Dental Association 1998 Sep;129(9):1229-38 AB - This article examines the extent to which caries prevalence and untreated caries vary in children by ethnicity and household income level. Data from the Third National Health and Nutrition Examination Survey, 1988-1994, for 10,332 children 2 to 18 years of age indicate that lower-income children and Mexican-American and African-American children are more likely to have a higher prevalence of caries and more unmet treatment needs than their higher-income and non-Hispanic white counterparts. <61> UI - 98334277 AU - Horowitz HS TI - Research issues in early childhood caries [see comments]. [Review] [89 refs] CM - Comment in: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):82-3 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):67-81 AB - Research is needed to establish what nomenclature and case definition for early childhood caries (ECC) are most relevant to health care professionals and to the public. Profiles or indexes for predicting the prevalence of ECC in communities should be developed on the basis of the socioeconomic factors, immigrant status and ethnic/racial backgrounds of populations. Future research should target risk factors of ECC, particularly prenatal and perinatal histories, nutritional status and microbiologic factors. Determining the relation of malnutrition of infants and young children, low birthweight, complicated pregnancies and traumatic births with the development of enamel linear hypoplasia deserves research attention. Factors that affect how and when infants and young children are colonized by mutans streptococci also need further study. The evaluation of chemotherapeutic preventive agents will likely yield more fruitful interventions for prevention than trying to change behaviors. Research in young children to prevent ECC, however, has particular ethical considerations. Withholding treatments or administering placebos to vulnerable subjects is not acceptable. Consequently, future clinical research likely will determine the relative rather than the absolute effectiveness of preventive regimens; the former requires large sample sizes and may necessitate multi-center studies. Human studies may be hampered by problems of recruitment, compliance and transiency of subjects. Because federal support for research on dental caries has declined in recent years, a special initiative that focuses specifically on ECC may be necessary to obtain adequate funding for research on the disease. [References: 89] <62> UI - 98334284 AU - Tinanoff N AU - Kaste LM AU - Corbin SB IN - Department of Pediatric Dentistry, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030-1610, USA. tinanoff@idx.uchc.edu TI - Early childhood caries: a positive beginning. SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):117-9 AB - Early childhood caries (ECC) is among the most prevalent health problems of low-income infants and toddlers, yet little attention and few resources have been allocated to understanding this disease. Since dental caries in infants and toddlers cannot be exclusively ascribed to feeding practices, other concepts regarding its etiology and prevention need to be examined. Furthermore, the establishment of evidence-based policies regarding this basic health problem is critical for the dissemination of consistent standards of care to health care providers and government agencies. To accomplish these objectives, the scientific community, organizations concerned with children's health and the political process need to be energized to find resources and energy to solve this public health challenge. <63> UI - 98334282 AU - Lopez GM IN - grantomate@aol.com TI - Response to Edelstein: policy issues in early childhood caries [comment]. CM - Comment on: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):96-103 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):104-5 AB - This paper is a response to Dr Edelstein's paper on policy related to early childhood caries (ECC) and makes specific recommendations for policy that would have impact on ECC. The review by Dr Edelstein shows that currently there is little policy addressing the problems of ECC. The following specific policy suggestions are made: 1) Health Care Finance Administration should require the same accountability for well child dental checkups as they do for well child medical checkups; 2) The Special Supplemental Nutrition Program for Women, Infants and Children should include an oral health component in the physical evaluation visit; 3) The Centers for Disease Control and Prevention should set up a surveillance system for ECC; 4) continuing education courses should offer classes to health care workers in infant oral health; and 5) research must be aimed at practical preventive and treatment modalities. <64> UI - 98334279 AU - Weinstein P IN - Dental Public Health Sciences, University of Washington, Seattle 98195-7475, USA. philw@u.washington.edu TI - Public health issues in early childhood caries [see comments]. [Review] [61 refs] CM - Comment in: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):91-5 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):84-90 AB - Early childhood caries (ECC) is primarily a disease of poor, minority population children who generally have limited access to dental services. Public health dental clinics have not made the prevention and control of ECC a priority, and the services provided have not controlled ECC. New training and early screening are recommended. Additionally, repeated accessing of mothers and children through prenatal and postnatal medical visits is recommended. At such visits behavioral and chemotherapeutic strategies need to be utilized. Examples from a demonstration project in the Commonwealth of Northern Marianas are presented. [References: 61] <65> UI - 98334275 AU - Ismail AI IN - Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, The University of Michigan, Ann Arbor 48109-1078, USA. ismailai@umich.edu TI - Prevention of early childhood caries. [Review] [96 refs] SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):49-61 AB - This paper reviews the methods used for the prevention of early childhood caries (ECC). The education of mothers or caregivers to promote healthy dietary habits in infants has been the main strategy used for the prevention of ECC. This review found that education has a modest impact on the development of ECC. While education should be promoted especially in high risk communities and population groups (low-income families and native populations), it should not be the only preventive strategy of ECC. Early screening for signs of caries development, starting from the first year of life, could identify infants and toddlers who are at risk of developing ECC and assist in providing information to parents about how to promote oral health and prevent the development of tooth decay. High risk children include those with early signs of ECC, poor oral hygiene, limited exposure to fluorides, and frequent exposure to sugary snacks and drinks. These children should be targeted with a professional preventive program that includes fluoride varnish application, fluoridated dentifrices, fluoride supplements, sealants, diet counseling, and chlorhexidine. Prevention of ECC also requires addressing the social and economic factors that face many families where ECC is endemic. [References: 96] <66> UI - 98334273 AU - Reisine S AU - Douglass JM IN - Department of Behavioral Sciences and Community Health, University of Connecticut School of Dental Medicine, Farmington 06030-3910, USA. reisine@nsol.uchc.edu TI - Psychosocial and behavioral issues in early childhood caries [see comments]. [Review] [130 refs] CM - Comment in: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):45-8 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):32-44 AB - Rampant caries in infants and young children has long been recognized as a clinical syndrome referred to by various names, including nursing caries, nursing bottle syndrome, night bottle mouth, and baby bottle tooth decay. The common theme among these terms is the perceived central role of inappropriate use of the baby bottle in the etiology and progression of carious lesions. Use of the baby bottle is not the only, and may not be the most important, factor in caries development. Because of questions about the role of the baby bottle in caries among young children, the Centers for Disease Control and Prevention recently suggested that the term for this clinical syndrome be replaced with early childhood caries (ECC). The purpose of this paper is to evaluate the literature on the influence of psychosocial and behavioral factors in early childhood caries. Prevalence of caries and maxillary anterior decay varies greatly in developed and undeveloped countries and among socioeconomic groups in developed countries. However, relatively little is known about the onset and progression of the disease or the antecedents of ECC, such as high risk behaviors, cultural norms, health beliefs and attitudes, or health care delivery factors. Furthermore, studies that do exist are limited by small and possibly biased samples and a lack of clear case definition. Future research should aim to develop a clear case definition of ECC, differentiate patterns of caries and conduct community-based epidemiological studies in order to obtain accurate estimates of the etiology and epidemiology of ECC in the general population, as well as in high risk groups. [References: 130] <67> UI - 98331801 AU - Rupp RP TI - Conditions to be considered in the differential diagnosis of child abuse and neglect. [Review] [65 refs] SO - General Dentistry 1998 Jan-Feb;46(1):96-100 AB - Dentists and dental personnel have an obligation to report occurrences of child abuse and neglect (CAN). The general types of abuse and neglect are defined, as is dental neglect. Dental neglect is the "willful failure of parent or guardian to seek and follow through with treatment necessary to ensure a level of oral health essential for adequate function and freedom from pain and infection." Dentists and dental staff should be trained in recognizing and reporting abuse and neglect. In this training, consideration should be given to dental and medical conditions which mimic CAN. These include tooth fractures, nursing caries syndrome, rampant dental decay, skeletal injuries, dermatologic conditions, and genetic and certain congenital defects. The article reviews literature on the subject and includes photographs of conditions which could be mistaken for CAN. [References: 65] <68> UI - 98280449 AU - Lopez Del Valle L AU - Velazquez-Quintana Y AU - Weinstein P AU - Domoto P AU - Leroux B IN - University of Puerto Rico. TI - Early childhood caries and risk factors in rural Puerto Rican children. SO - ASDC Journal of Dentistry for Children 1998 Mar-Apr;65(2):132-5 AB - A sample of 167 Puerto Rican children whose ages ranged from six months to forty-seven months (mean = 23 months) were studied. Children were examined for Early Childhood Caries with light and mirror and a structured interview was administered to parents and caretakers to identify risk factors. Results indicated that only 37.4 percent of the children were free of decalcification lesions or frank decay. While 53.9 percent of the children had lesions on maxillary incisors, 40.0 percent had molars affected by decalcification lesions and caries. Analysis of risk factors indicate that giving the baby a bottle when crying at night, number of adults and children in the family, use of fluoridated dentifrice, and age of the child were associated with the caries process in these children. Bottle and breast feeding, per se, were not risk factors. Disease patterns suggest other dietary risk factors, such as frequent snacking on food/drinks with sugar. <69> UI - 98271367 AU - Khan MN AU - Cleaton-Jones PE IN - University of the Witwatersrand, Dental Research Institute, Johannesburg, South Africa. TI - Dental caries in African preschool children: social factors as disease markers. SO - Journal of Public Health Dentistry 1998 Winter;58(1):7-11 AB - OBJECTIVE: This study investigated the associations between dental caries prevalence and severity and social factors in 3- to 5-year-old African children. METHODS: Dental caries was diagnosed in natural light using WHO criteria, minors, and explorers. Socioeconomic information was obtained by questionnaire. RESULTS: The percentages of 3-, 4-, and 5-year-olds with any caries experience were 47 percent, 58 percent, and 63 percent, respectively. Mean dmfs scores (SD) were 2.2(3.6), 3.0(3.8), and 3.7(4.1), respectively. Family education was associated with caries prevalence (P = .03) and severity (P = .008) in a multivariable regression model. CONCLUSION: In the indigenous African group studied, family education is a disease marker to target in future caries risk evaluations. <70> UI - 98219844 AU - Nurko C AU - Aponte-Merced L AU - Bradley EL AU - Fox L IN - University of Alabama at Birmingham, USA. TI - Dental caries prevalence and dental health care of Mexican-American workers' children. SO - ASDC Journal of Dentistry for Children 1998 Jan-Feb;65(1):65-72 AB - The purpose of this study was to determine the prevalence of dental caries and the use of dental services in a pediatric population of Mexican-American migrant workers. The results were compared with the Mexican-American child population from the Hispanic Health and Nutrition Examination Survey (HHANES). One hundred thirty three-to-sixteen-year-old children participated in the study. The children who were born in Mexico and those who spoke Spanish had seen the dentist less often and had a higher incidence of decayed teeth than those who were born in the US and than those who spoke English (p < 0.05). The children from low-income families had visited the dentist less frequently and did so at an older age than those from high income families (p < 0.05). When compared with HHANES, the children in this study visited the dentist at an older age, had been to the dentist less often, were less likely to have dental insurance, and had a higher incidence of dental caries than the children from HHANES (p > 0.05). This study demonstrated a general lack of dental health knowledge, a disproportionate prevalence of decayed teeth and unmet dental need in the Mexican-American migrant workers' children. <71> UI - 98193620 AU - Drum MA AU - Chen DW AU - Duffy RE IN - Division of Science, Education, and Analysis, Maternal and Child Health Bureau, Rockville, MD, USA. TI - Filling the gap: equity and access to oral health services for minorities and the underserved. SO - Family Medicine 1998 Mar;30(3):206-9 AB - BACKGROUND AND OBJECTIVES: Family physicians and other primary care providers play a pivotal role in preventing oral disease, especially among minority and underserved populations who have limited access to dental services and poorer oral health status. Oral diseases/conditions, such as caries, baby bottle tooth decay, gingivitis, periodontitis, oral pharyngeal malignancies, and orofacial trauma, are prevalent and costly, yet largely preventable. Given their role in promoting and protecting overall health and their historical role in serving minority and underserved families, family physicians occupy a unique position to assure equity, access, and improvement in oral health for all Americans. <72> UI - 98170788 AU - Al-Hosani E AU - Rugg-Gunn A IN - Department of Child Dental Health, Newcastle University Dental School, Newcastle upon Tyne, UK. TI - Combination of low parental educational attainment and high parental income related to high caries experience in pre-school children in Abu Dhabi. SO - Community Dentistry & Oral Epidemiology 1998 Feb;26(1):31-6 AB - Children aged 2, 4 and 5 years were examined for dental caries using WHO criteria, in the Emirate of Abu Dhabi, UAE, in 1996. The children were from the three administrative regions of Abu Dhabi, Al Ain and Western Region. Sampling of health centres and kindergartens was stratified by urban or rural location. Parents completed a questionnaire, and children were classified into high, middle or low groups on the basis of their parents' education and income. All 20 kindergartens and 22 health centres sampled agreed to participate. The participation rate of sampled children was high and complete data were available for 640 children--217 aged 2 years, 204 aged 4 years, and 219 aged 5 years. Similar numbers of boys and girls were included. The prevalence of dental caries was very high--36% to 47% at age 2 years, 71% to 86% at age 4 years and 82% to 94% at age 5 years. The mean dmft at age 5 years was 8.4 in Abu Dhabi, 8.6 in Al Ain and 5.7 in Western Region. Few teeth had been filled. Apart from age, the parents' education and income were found to be statistically significantly related to caries experience (P<0.05), while gender, ethnicity (UAE or non-UAE), region, and urban or rural living, were not related to dental caries experience (P>0.3). While high parental educational attainment was related to lower caries experience, conversely, high parental income was related to higher caries experience. Caries experience was higher than that recorded approximately 6 years previously and is a cause of concern. <73> UI - 98170785 AU - Mohan A AU - Morse DE AU - O'Sullivan DM AU - Tinanoff N IN - Department of Pediatric Dentistry, School of Dental Medicine, University of Connecticut Health Center, Farmington 06030-1610, USA. TI - The relationship between bottle usage/content, age, and number of teeth with mutans streptococci colonization in 6-24-month-old children. SO - Community Dentistry & Oral Epidemiology 1998 Feb;26(1):12-20 AB - OBJECTIVES: Mutans streptococci (MS) are the primary pathogens involved in the development of early childhood caries. However, factors that may affect their acquisition in the mouths of young children are not well understood, and the period of initial colonization remains controversial. This study investigated the relationship of age, number of teeth, and bottle usage/content with regard to the isolation of MS in 6-24-month-old children. METHODS: A total of 122 children from low-income families attending a nutritional supplement program, and their mothers, participated in this study. Children were examined for dental caries and number of erupted teeth and were sampled for MS. Mothers were administered a questionnaire to obtain details of baby bottle use, including what food items were put in the bottle during the last week. RESULTS: MS was detected in more than one-third of the 6-24-month-olds. Unlike some studies that suggest a later period of infectivity, approximately 20% of children under 14 months of age, including 4 of 22 infants aged 6-9 months, were colonized with MS. When examined separately, age, number of teeth, and bottle usage/content were each found to be related to the presence of MS. Mutans streptococci colonization was more likely with increasing age and number of teeth, and children whose bottles contained sweetened beverages were more likely to be colonized than children whose bottles contained milk. Logistic regression models that controlled for both age and number of teeth indicated that children who consumed sweetened beverages in their baby bottle had a statistically significant, four-fold increase in the odds of colonization by MS relative to children who consumed milk. CONCLUSIONS: The finding that approximately 20% of the children under 14 months of age were infected with MS indicates that colonization in this sample of low-income preschool children may begin earlier than suggested by some investigations. Additionally, the risk of MS colonization appears lower among infants who consume milk rather than sweetened beverages in the bottle. <74> UI - 98129963 AU - Vemmer T TI - Water fluoridation and tooth decay in 5 year olds. Samples were unequal and too small [letter; comment]. CM - Comment on: BMJ 1997 Aug 30;315(7107):514-7 SO - BMJ 1998 Jan 17;316(7126