A wide variety of behavioural management techniques are available to paediatric dentists which must be used as appropriate for the benefit of each child patient, and which, importantly, must take into account all cultural, philosophical and legal requirements in the country of dental practice of every dentist concerned with dental care of children.
RESEARCH dental health educationAim To determine the effect of dental health education (DHE) on caries incidence in infants, through regular home visits by trained DH Educators over a period of 3 years. Method A randomly selected cohort of 228 children born between 1st January and 30th September 1995, in a low socioeconomic/high caries suburb of Leeds (UK) were divided into the following groups: A) DHE focused on diet; B) DHE focused on oral hygiene instruction (OHI) using fluoride toothpaste; and C) DHE by a combined diet and OHI message. DHE was given using an interview and counselling for at least 15 minutes at home every 3 months for the first 2 years and twice a year in the third year of the study. A fourth group D was given diet and OHI, at home, once a year only. All children and mothers were examined for caries and oral hygiene . A fifth group E (control) received no DHE and were never visited but examined at 3 years of age only. Results In the groups of children visited regularly only two developed caries and three had gingivitis (all in group A). In group E, however, 33 % of children had caries and nine (16%) had gingivitis. The differences in caries levels and caries risk factors between study and control groups were statistically significant (P < 0.001). Mothers of the study groups also showed an improvement in their own levels of gingivitis, debris and calculus scores by the second and third examinations (P < 0.001). Conclusion Regular home visits to mothers with infants, commencing at or soon after the time of the eruption of the first deciduous teeth, was shown to be effective in preventing the occurrence of nursing caries.
The aim of this study was to conduct a review of the literature to assess the relationship between quantity and pattern of sucrose use and dental caries. Using hand and electronic methods (MEDLINE, EMBASE) the literature was searched for epidemiological papers concerning any relationship of sugars and dental caries published since 1856. Superficial hand searching was carried out between 1856 and 1940, detailed hand searching 1940-1966 and electronic 1966-2007. Selection criteria were set based on, but not confined to, Cochran style standards. Investigations were categorized as A, fulfilling all criteria; B1, relevant fulfilling 19 of 23 criteria; B2, relevant but fulfilling only between 12 and 18 of the selection criteria; and C, all other papers. There were 95 papers meeting most (more than 12) or all of the selected criteria. Only 1 paper was graded A; 31 as B1. There were in addition some 65 as B2 and all the rest as C, which were discarded. There were a wide variety of study designs and those graded A or B1 comprised 23 ecological cross-sectional, 7 cohort and 2 case control studies. Summary results showed that 6 papers found a positive, significant relationship of sugar quantity to dental caries, 19 of 31 studies reported a significant relationship of sugar frequency of use to dental caries. The balance of studies does not demonstrate a relationship between sugar quantity, but a moderately significant relationship of sugar frequency to dental caries.
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