This paper aims to provide dental health professionals with practical advice to pass on to patients about diet and dental health. Sugars are the most important dietary factor contributing to dental caries. Different foods carry different dental health risks; those containing non-milk, extrinsic sugars are potentially the most damaging. In the UK, sugared soft drinks and confectionery contribute approximately 50% to total intake of non-milk extrinsic sugars. Patients should be encouraged to reduce the frequency of intake of sugary foods. Intake of acidic foods and drinks contributes to dental erosion and consumption of such foods should also be limited. Dietary advice to dental patients should be positive and personalized if possible and can be in line with dietary recommendations for general health. These are to increase the consumption of starchy staple foods (eg bread, potatoes and unsweetened cereals), vegetables and fruit and to reduce the consumption of sugary and fatty foods. (+info)
Children's oral health in the medical curriculum: a collaborative intervention at a university-affiliated hospital.
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The purpose of this study was to 1) describe the structure of the oral health program in a university-affiliated hospital; 2) evaluate staff's knowledge and attitudes toward oral health; and 3) propose ways to strengthen the incorporation of oral health prevention for children into clinical medical education. Qualitative methods were used to evaluate the program. Structured interviews with seventeen medical center personnel were conducted, and clinic utilization reports provided ICD-9 diagnostic frequency and visits. Clinic staff, pediatric residents, dental and pediatric faculty, hospital administrators, and clinic directors were interviewed. The themes identified during these interviews were motivation, roles, operational and organizational issues, and integration into the larger medical care system. Integration of an early childhood caries prevention program into the clinical medical education curriculum can be accomplished. After implementation of the oral health program described in this paper, dental caries became the eleventh most common diagnosis seen in the clinic when previously it did not appear in the top forty. However, institutional and organizational barriers are significant. Barriers identified were 1) lack of clarity in defining leadership and roles regarding oral health, 2) time and work overload in a busy pediatric clinic, 3) a tracking system was not available to quickly determine which children needed caries prevention procedures and education, and 4) billing and medical record form changes could not be fully established prior to starting the program. (+info)
Oral health promotion for high-risk children: case studies from British Columbia.
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Socio-economics, family stress and parenting style each plays as important a role in the development of early childhood caries as dietary and microbiological factors. Therefore, to be successful, oral health promotion initiatives should be designed and implemented with due consideration of issues such as collaboration with community partners, the role of dental health in overall child health and the involvement of the community in program planning. This article briefly describes 3 programs that have been undertaken in British Columbia either as public health initiatives or as demonstration research projects to improve oral health in young children from diverse communities with a high prevalence of early childhood caries. (+info)
Causes, treatment and prevention of early childhood caries: a microbiologic perspective.
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Early childhood caries (ECC) is a virulent form of dental caries that can destroy the primary dentition of toddlers and preschool children. It occurs worldwide, afflicting predominantly disadvantaged children. High-risk North American populations include Hispanic and Native American children, as well as children enrolled in Head Start, a federally funded program for preschool children living in poverty. The prevalence of EEC among these children ranges from 11% to 72%. ECC is an infectious disease, and Streptococcus mutans is the most likely causative agent; diet also plays a critical role in the acquisition and clinical expression of this infection. Early acquisition of S. mutans is a key event in the natural history of the disease. Acquisition may occur via vertical or horizontal transmission. Primary oral colonization by S. mutans coupled with caries-promoting feeding behaviours results in accumulation of these organisms to levels exceeding 30% of the total cultivable plaque flora which in turn leads to rapid demineralization of tooth structure. Treatment of ECC is costly because the cooperative capacity of babies and preschool children usually necessitates the use of general anesthesia. Treatment usually consists of restoration or surgical removal of carious teeth along with recommendations regarding feeding habits. However, this approach has resulted in unacceptable clinical outcomes, and relapse rates of approximately 40% have been reported within the first year after dental surgery. Primary prevention of ECC has largely been restricted to counselling parents about caries-promoting feeding behaviours. This approach has also had minimal success. Newer strategies addressing the infectious component through use of topical antimicrobial therapy appear promising. (+info)
Oral health profile of education and health professionals attending handicapped children.
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The purpose of this study was to evaluate the knowledge and attitudes toward oral health of education and health professionals working in a children care program for handicapped children from 0 to 6 years of age, run by a public municipal institution in Rio de Janeiro. Using a printed questionnaire, 67 professionals (teachers, attendants and health professionals) were interviewed. The results were compared to the children's oral hygiene habits, by directly observing their daily nursery routine. Although 97.0% said that oral health could play a part in general health, only 37.3% of the professionals answered correctly on this matter. As for methods for preventing caries, although 92.5% said that they were aware of them, only 17.9% went to the dentist for preventive treatment. Although the majority (81.3%) indicated oral hygiene as a way of preventing caries, observation showed that this practice is not always put into effect in the program's day nursery. Regarding when to start toothbrushing in children, 75.0% of the teachers and 94.4% of the health professionals said that they were aware of the need to begin brushing before one year of age, although this reply was given by only 52.5% of the attendants (chi-square, p = 0.006). In view of these results, it was concluded that attitudes toward oral health were not always coherent with the knowledge that these professionals express. (+info)
Associations between health promoting schools' policies and indicators of oral health in Brazil.
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No detailed analyses have been undertaken on the effects of Health Promoting Schools on oral health status. The objective of this study was to assess whether the oral health of 12-year-old children in supportive schools, where health promoting policies had been developed, was better than that of children in non-supportive schools. A sample of 1823 12-year-old children in 33 public (government-funded) schools were selected in deprived areas of Curitiba, Brazil. Principal component analysis, multiple regression, meta-analysis and meta-regression were used in the data analysis. Schools with a comprehensive curriculum were more likely to have a higher percentage of caries-free children (beta = 6.27, p = 0.02) and fewer children with dental trauma (beta = -5.04, p = 0.02). The commitment towards health and safety at school was strongly associated with dental trauma, as 9.7% fewer children had dental trauma (p = 0.00) in schools that demonstrated a commitment towards health and safety. At the school level, mother's education and family income were independently associated with children's caries experience and dental trauma, respectively. Children in supportive schools had better oral health than those in non-supportive schools. Our results suggest that some benefit can be obtained for the improvement of the oral health of children living in deprived areas if they attend supportive schools. (+info)
Effect of caries preventive measures directed to expectant mothers on caries experience in their children.
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The aim of this prospective study was to determine the effectiveness of caries preventive measures started during pregnancy on the caries experience of first-time mothers and their infants. Eighty-one pregnant women with low social background were selected on the basis of the presence of active carious lesions and were randomly divided into control (38) and experimental (43) groups. The initial dental status (DMFS and white spot lesions) was established through clinical examination. The prophylactic measures were repeated during pregnancy and 6 and 12 months after delivery. Both groups received primary care intervention. They were instructed in relation to the etiologic factors of dental caries and received oral hygiene kits. Oral hygiene instructions were reinforced through interactive brushing. The experimental group also received antimicrobial treatment (topical application of NaF and iodine solution immediately after prophylaxis and 3 and 5 days later) and restorative care using glass ionomer cement. By the time the children were 2 years of age, 33.3% of the infants in the control group and 14.7% in the experimental group had caries activity. A significant difference in caries prevalence was observed between children with and without visible dental plaque. The mean number of tooth surfaces with carious lesions (including areas of demineralization) was higher among the children in the control group compared to the experimental group (6.3 x 3.2), however, with no statistical significance. Maternal caries increase was a significant factor influencing the caries experience of the children. These data support the evidence of an association between caries prevalence in young children and clinical (dental plaque) and maternal factors. (+info)
Factors influencing use of dental services in rural and urban communities: considerations for practitioners in underserved areas.
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Individuals' utilization of dental services depends upon an array of factors, including access to care, financial restrictions, attitudes toward dental care, and dental fear. These factors, in turn, may vary across geographic locations and demographic groups. The goals of this study were to assess the use of dental services in both rural and urban areas of Kentucky and to examine challenges facing practitioners in rural areas. Individuals sampled from a rural population and patients in rural and urban dental clinics completed questionnaires about use of dental services, self-rated dental health, and dental fear. While these variables were strongly interrelated, differences emerged across locations. Patients in the urban area reported having more dental insurance but not better dental health. Patients in more rural areas reported seeking more emergency dental treatment but not more dental fear. While these factors are important considerations across locations, dental practitioners in rural areas in particular should be aware of barriers to dental care facing individuals in these areas. They have unique opportunities to provide education to their patients regarding the importance of dental care and the role of oral health in overall physical health. (+info)