In the late seventies an increasing number of children showing extensive and severe idiopathic hypomineralization of the enamel of incisors and permanent first molars was reported within the Public Dental Services in Sweden. An epidemiologic study was initiated to analyze the prevalence, extension and severity in Swedish children born in 1970 and in the years before and after. 2252 children born in 1966-74 were examined according to well defined criteria on enamel hypomineralization. It was found that 15.4% of the children born in 1970 showed such changes. The corresponding figures for children born in 1966, 1969, 1971, 1972 and 1974 were 6.3, 7.3, 7.1, 5.2 and 4.4, respectively.

No abstract

BackgroundPrevious studies have suggested that children with oral clefts may have higher caries prevalence in comparison with non-cleft controls but the relative importance of the potential risk factors is not clear. The aim of this study was to compare the caries risk profiles in a group of cleft lip and/or palate (CL(P)) children with non-cleft controls in the same age using a computerized caries risk assessment model.MethodsThe study group consisted of 133 children with CL(P) (77 subjects aged 5 years and 56 aged 10 years) and 297 non-cleft controls (133 aged 5 years and 164 aged 10 years). A questionnaire was used to collect data concerning the child’s oral hygiene routines, dietary habits and fluoride exposure. Oral hygiene was assessed using Quigley-Hein plaque Index and the caries prevalence and frequency was scored according to the International Caries Detection and Assessment System. Whole saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rate. The risk factors and risk profiles were compared between the groups with aid of Cariogram and the estimated risk for future caries was categorized as “high” or “low”.ResultsChildren with CL(P) (the entire study group) had significantly higher counts of salivary lactobacilli (p < 0.05) and displayed less good oral hygiene (p < 0.05). More 10-year-old children in the CL(P) group had low secretion rate but this difference was not significant. The average chance to avoid caries ranged from 59 to 67 % but there were no significant differences between the groups. The odds of being categorized with high caries risk in the CL(P) group was significantly elevated (OR = 1.89; 95 % CI = 1.25–2.86). In both groups, children in the high risk category had a higher caries experience than those with low risk.ConclusionChildren with CL(P) displayed increased odds of being categorized at high caries risk with impaired oral hygiene and elevated salivary lactobacilli counts as most influential factors. The results suggest that a caries risk assessment model should be applied in the routine CL(P) care as a basis for the clinical decision-making and implementation of primary and secondary caries prevention.

The profile of the salivary microflora in 5-year-old children with and without oral clefts was basically similar and displayed only marginal differences with respect to commensal bacteria.

Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.