The Queensland Birth Cohort Study for Early Childhood Caries: Results at 7 Years

Abstract

Aims: This study investigated caries predictors in 378 children remaining from a birth cohort of 1,052 at 7 y and compared the efficacy of home visits (HVs) and telephone contacts (TCs) for early childhood caries (ECC) prevention. Methods: The HVs or TCs were made at ages 6, 12, 18, 30, and 42 mo with annual dental clinic examinations at ages 2 to 7 y. At every visit, the parents completed validated questionnaires regarding the children’s family, medical, dental, and dietary histories. Results: The caries prevalence increased from 2% and 6% at ages 2 and 3 y to 15%, 33%, 42%, and 52% at ages 4 to 7 y. The mean caries experience (decayed, missing, and teeth extracted due to caries) of the total cohort increased from 0.1 ± 0.5 at age 2 y to 0.2 ± 1.1 at 3 y, 0.5 ± 1.6 at 4 y, 1.1 ± 2.4 at 5 y, 1.6 ± 2.6 at 6 y, and 2.0 ± 2.7 at 7 y. The prevalence of mutans streptococci (MS) in the total cohort at years 2 to 7 was 22%, 36%, 42%, 42%, 39%, and 44%, respectively. MS was strongly correlated with caries prevalence for all years (all P < 0.001). Statistical modeling employing the generalized estimating equations identified caries predictors as holding a Health Care Card (low socioeconomic status) ( P = 0.009; odds ratio [OR] = 2.05; confidence interval [CI]: 1.20–3.52), developmental defects of enamel (DDEs) ( P < 0.001; OR = 1.09; CI: 1.05–1.14), and MS counts ≤105/mL ( P = 0.001; OR = 1.63; CI: 1.24–2.14). By contrast, HVs were more protective than TCs for caries ( P = 0.008; OR = 0.42; CI: 0.22–0.80). Conclusions: This study provides prospective, clinical evidence that MS, DDEs, and low socioeconomic status are strongly correlated with early childhood caries and that HVs are more efficacious than TCs in ECC prevention. Knowledge Transfer Statement: This 7-y birth cohort study provides longitudinal clinical evidence that mutans streptococci, developmental defects of enamel, and low socioeconomic status are key risk indicators of early childhood caries.

Dental Health Education on Domiciliary Dental Care (DDC): A Systematic Review

“…In older adults, the main reason for accessing DDC services were disability [5,7,[32][33][34], limited income [5,32,34], and older people with cognitive problems such as Alzheimer's patients [33]. In early childhood, caries have been reported to be strongly correlated with low socioeconomic status [35] and limited access to early preventive dental issues [36]. Some research has confirmed that patients who choose DDC programs have much better health than those who do not [32,37].…”

“…Patients who preferred regular DDC services were able to maintain several healthy tooth roots [33]. DDC has also been reported to be effective in maintaining dental health in children, especially in reducing Early Childhood Caries (ECC) compared to telephone contacts [35]. However, DDC also has some disadvantages.…”

Dental enamel defects and dental caries of primary teeth among Indigenous children in Western Australia

“… 4 The worldwide prevalence of hypomineralized EDs of the primary molars has been reported to range from 0% to 41% at the individual level with a pooled prevalence of 7%, and ranged from 0% to 30% at the tooth level, with a pooled prevalence of 4%. 5 The occurrence of dental EDs, particularly demarcated opacities, has been reported to be associated with an increased risk of caries in permanent and primary teeth 6 , 7 , 8 , 9 , 10 , 11 , 12 and findings from a few studies suggest that hypomineralized EDs might predispose teeth to a more rapid progression of caries, thus leading to poorer carious outcomes where access to care may be limited. 7 , 8 Also, hypomineralized EDs of second primary molars have been reported to be associated with poorer oral health‐related quality of life.…”