Breastfeeding Duration and Childhood Caries: A Cohort Study

This cohort study was conducted in Khon Kaen, Thailand, to test the hypothesis that a longer breastfeeding duration increases the risk for dental caries in primary teeth. We collected information on infant feeding practices and potential confounders using a structured questionnaire to interview mothers or caregivers during the second trimester of pregnancy and after birth at 21 days and at 3, 12, 18, 24, and 36 months. Regardless of other liquids and foods, full breastfeeding was defined as feeding breast milk but not formula, while any breastfeeding was feeding breast milk with or without formula. Two calibrated dentists measured dental caries when the children were 3-4 years of age using the decayed, missing, and filled surfaces (dmfs) index following the World Health Organization criteria. Negative binomial regression with a generalized linear model was used to estimate relative risks (RRs) and 95% confidence intervals (CIs) using dmfs as an outcome. Log-binomial regression was performed to model the caries prevalence. Of 556 children, 88.1% had dental caries with a mean dmfs of 14.2. Full breastfeeding for 6-11 months was significantly associated with a lower dmfs (adjusted RR 0.77, 95% CI 0.63, 0.93) and a lower caries prevalence (adjusted RR 0.45, 95% CI 0.22, 0.90). The frequency of sleeping while breast- or bottle-feeding increased the caries risk in a dose-response manner. There was no association between duration of any breastfeeding and dental caries. In conclusion, full breastfeeding for 6-11 months may protect against dental caries in primary teeth. Prolonged breastfeeding was not associated with dental caries in this population.

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Prolonged Breastfeeding and Dental Caries In Children In the Third Year of Life

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4625-43.2.4 ◽

2019 ◽

Vol 43 (2) ◽

pp. 91-96

Author(s):

Andreia Drawanz Hartwig ◽

Ana Regina Romano ◽

Marina Sousa Azevedo

Keyword(s):

Dental Caries ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Breastfeeding Duration ◽

Sucrose Intake ◽

Life Study ◽

Economic Class ◽

The Third ◽

Binomial Regression

Purpose: To assess the association between long-term breastfeeding and dental caries in children during the third year of life. Study design: This retrospective longitudinal study consisted of children who were followed-up by the Maternal and Child Public Oral Health Program. Information regarding socio-economic class, demographic status, daily frequency of sucrose intake, breastfeeding duration and oral hygiene were collected with the aid of a questionnaire. Information on dental caries in the children was collected from dental records. Negative binomial regression models were used to assess the association between breastfeeding duration and dental caries. Results: We included a total of 325 children in the study. The incidence of dental caries was found to be 12.92%. Even after adjustments, children who were breastfed for a period ≥24 months were more likely to have dental caries, when compared with children who were not breastfed or were breastfed for less than 6 months. Children who had a higher frequency of sucrose intake and those with dental plaque were more likely to have dental caries. Conclusion: In this study, a greater incidence of dental caries was found in children who were breastfed for a period ≥ 24 months..

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Breastfeeding and Childhood Dental Caries: Results from a Socially Diverse Birth Cohort Study

Caries Research ◽

10.1159/000514502 ◽

2021 ◽

Vol 55 (2) ◽

pp. 153-161

Author(s):

Agatha W. van Meijeren-van Lunteren ◽

Trudy Voortman ◽

Marlies E.C. Elfrink ◽

Eppo B. Wolvius ◽

Lea Kragt

Keyword(s):

Cohort Study ◽

Dental Caries ◽

Negative Binomial ◽

Feeding Practices ◽

Ethnic Background ◽

Bottle Feeding ◽

Birth Cohort Study ◽

Sugar Intake ◽

Multiethnic Cohort ◽

Increased Risk

Previous studies showed that prolonged breastfeeding increases the risk of caries. However, the observed associations were mainly based on non-European populations, and important confounding and mediating factors like socioeconomic position (SEP) and diet were often neglected. The aim of this study was to investigate the role of breastfeeding and bottle-feeding practices on dental caries during childhood while accounting for SEP, ethnic background, and sugar intake. This study was part of the Generation R Study, a prospective multiethnic cohort study conducted in Rotterdam, The Netherlands. In total, 4,146 children were included in the analyses. Information about feeding practices was derived from delivery reports and questionnaires during infancy. Caries was measured via intraoral photographs at the age of 6 years and defined as decayed, missing, and filled teeth (dmft). Negative binomial hurdle regression analyses were used to study the associations between several infant feeding practices and childhood caries. The prevalence of dental caries at the age of 6 years was 27.9% (n = 1,158). Prolonged breastfeeding (for >12 months) was associated with dental caries (OR 1.35, 95% CI 1.04–1.74) and the number of teeth affected by dental caries (RR 1.27, 95% CI 1.03–1.56). Furthermore, nocturnal bottle-feeding was associated with dental caries (OR 1.52, 95% CI 1.20–1.93). All associations were independent of family SEP, ethnic background, and sugar intake. Results from this Dutch cohort study confirmed the previously observed associations between prolonged breastfeeding and nocturnal bottle-feeding and the increased risk of childhood dental caries, even after proper adjustments for indicators of SEP, ethnic background, and sugar intake. Future studies are encouraged to elaborate further on possible explanations for the observed relationships. Healthcare professionals should be aware and advise caregivers about the potential risk of prolonged breastfeeding on caries development by applying the current recommendations on breastfeeding, oral hygiene, and feeding frequency.

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Determinants of dental caries in children in the Middle East and North Africa region: A systematic review based on literature published from 2000 to 2019

10.21203/rs.3.rs-154776/v1 ◽

2021 ◽

Author(s):

Amal Elamin ◽

Malin Garemo ◽

Anzelle Mulder

Keyword(s):

Middle East ◽

Dental Caries ◽

Infant Feeding ◽

North Africa ◽

World Health ◽

Caries Prevalence ◽

Mena Region ◽

Oral Habits ◽

Socioeconomic Determinants ◽

Increased Risk

Abstract Background Dental caries risk factors have been expanded to not only emphasize biology and dietary and oral habits but also broader social determinants such as socioeconomic factors and the utilization of health services. The aim was to review sociobehavioural/cultural and socioeconomic determinants of dental caries in children residing in the Middle East and North Africa (MENA) region. Methods A search was conducted in the PubMed/Medline database and Google Scholar to identify studies published from 2000–2019 covering children using key search terms. In the initial stages, titles, abstracts and, if needed, full articles were screened for eligibility. In the final stage, all included articles were reassessed and read, and relevant data were extracted. Results Out of 600 initial articles, a total of 77 were included in this review, of which 74 were cross-sectional, 2 were longitudinal and one was a case-control study. The studies included a total of 94,491 participants in 14 countries across the MENA region. A majority used the World Health Organization scoring system to assess dental caries. The caries prevalence ranged between 17.2–88.8%, early childhood caries between 3–57% and decayed missing filled teeth (dmft) varied between 0.6–8.5 across the various age groups. Increased age, low maternal education, low overall socioeconomic status, decreased frequency of tooth brushing, low parental involvement, poor oral habits, infant feeding practices and sugar were among the most prevalent determinants for increased risk of caries in the reviewed studies. Conclusions Dental caries was found to be high among children in many of the studies published from MENA. The key determinants of dental caries were found to include factors related to child characteristics, family background, oral hygiene and infant feeding and eating habits. The high dental caries prevalence emphasises the need to address the prevailing modifiable sociobehavioural and socioeconomic determinants by translating them into effective oral health prevention policies and programmes.

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Breast Milk and Breastfeeding of Infants Born to SARS-CoV-2 Positive Mothers: A Prospective Observational Cohort Study

American Journal of Perinatology ◽

10.1055/s-0041-1731451 ◽

2021 ◽

Author(s):

Bgee Kunjumon ◽

Elena V. Wachtel ◽

Rishi Lumba ◽

Michelle Quan ◽

Juan Remon ◽

...

Keyword(s):

Cohort Study ◽

Breast Milk ◽

World Health ◽

Nasopharyngeal Swab ◽

Published Data ◽

New York University ◽

Positive Screen ◽

Milk Samples ◽

Lactating Mothers

Objective There are limited published data on the transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus from mothers to newborns through breastfeeding or from breast milk. The World Health Organization released guidelines encouraging mothers with suspected or confirmed COVID-19 to breastfeed as the benefits of breastfeeding outweighs the possible risk of transmission. The objective of this study was to determine if SARS-CoV-2 was present in the breast milk of lactating mothers who had a positive SARS-CoV-2 nasopharyngeal swab test prior to delivery, and the clinical outcomes for their newborns. Study Design This was a single-center, observational, prospective cohort study. Maternal–newborn dyads that delivered at New York University Langone Hospital Brooklyn with confirmed maternal SARS-CoV-2 positive screen test at the time of admission were recruited for the study. Breast milk samples were collected during postpartum hospitalization and tested for the presence of SARS-CoV-2 genes N1 and N2 by two-step reverse transcription polymerase chain reaction. Additionally, the clinical characteristics of the maternal newborn dyad, results of nasopharyngeal SARS-CoV-2 testing, and neonatal follow-up data were collected. Results A total of 19 mothers were included in the study and their infants who were all fed breast milk. Breast milk samples from 18 mothers tested negative for SARS-CoV-2, and 1 was positive for SARS-CoV-2 RNA. The infant who ingested the breast milk that tested positive had a negative nasopharyngeal test for SARS-CoV-2, and had a benign clinical course. There was no evidence of significant clinical infection during the hospital stay or from outpatient neonatal follow-up data for all the infants included in this study. Conclusion In a small cohort of SARS-CoV-2 positive lactating mothers giving birth at our institution, most of their breast milk samples (95%) contained no detectable virus, and there was no evidence of COVID-19 infection in their breast milk-fed neonates. Key Points

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Marginalized zero-inflated negative binomial regression with application to dental caries

Statistics in Medicine ◽

10.1002/sim.6804 ◽

2015 ◽

Vol 35 (10) ◽

pp. 1722-1735 ◽

Cited By ~ 37

Author(s):

John S. Preisser ◽

Kalyan Das ◽

D. Leann Long ◽

Kimon Divaris

Keyword(s):

Dental Caries ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Binomial Regression

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Changes in Caries Prevalence and Oral Hygiene Skills Among Preschool-Aged Children in Lithuania Between 2000 and 2010

Medicina ◽

10.3390/medicina48070054 ◽

2012 ◽

Vol 48 (7) ◽

pp. 54

Author(s):

Jaunė Razmienė ◽

Giedrius Vanagas ◽

Eglė Bendoraitienė ◽

Vilija Andriuškevičienė ◽

Eglė Slabšinskienė

Keyword(s):

Dental Caries ◽

Oral Hygiene ◽

Cross Sectional Study ◽

World Health ◽

Caries Prevalence ◽

Cross Sectional ◽

Significant Difference ◽

Tooth Surfaces ◽

The Difference ◽

Health Organization

The aim of the study was to evaluate the factors associated with the prevalence and severity of dental caries as well oral hygiene habits among 4- to 6-year-old children in Kaunas (Lithuania) in 2000 and 2010. Material and Methods. A repeated cross-sectional study was carried out to reveal the changes in dental caries prevalence in 2000 and 2010. The study population comprised 4- to 6-year-old children living in Kaunas city and attending kindergartens. The study consisted of two parts: questionnaires on oral health behavior and clinical examination of children’s teeth by the World Health Organization methodology. Results. A total of 941 4–6-year-old children were examined in 2000 and 2010. The prevalence of dental caries increased from 85.4% in 2000 to 88.4% in 2010; however, the difference was not significant (P=0.28). A significant increase in the dmf-t index, describing the severity of dental caries, was observed (from 7.42 in 2000 to 12.03 in 2010, P<0.001). The percentage of 4- to 5-yearold girls and 5-year-old boys brushing their teeth regularly decreased in 2010. During the period of the study, a significant change in the accumulation of plaque on children’s tooth surfaces was documented (P=0.001). Conclusions. Comparing 2000 and 2010, no significant difference in the prevalence of dental caries among 4- to 6-year-old children in Kaunas was observed; however, the severity of dental caries differed significantly. A significant decrease in regular toothbrushing skills was documented for 4- and 5-year-old girls and 5-year-old boys. The Silness-Loe oral hygiene index was assessed as satisfactory.

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Dental caries prevalence among 12–15-year-olds in Lithuania between 1983 and 2005

Medicina ◽

10.3390/medicina45010010 ◽

2009 ◽

Vol 45 (1) ◽

pp. 68 ◽

Cited By ~ 5

Author(s):

Simona Milčiuvienė ◽

Eglė Bendoraitienė ◽

Vilija Andruškevičienė ◽

Julija Narbutaitė ◽

Jurgina Sakalauskienė ◽

...

Keyword(s):

Dental Caries ◽

Oral Hygiene ◽

Age Groups ◽

Fluoride Concentration ◽

World Health ◽

Age Group ◽

Caries Prevalence ◽

Number Of Children ◽

T Score ◽

Health Organization

Objective. To analyze the dynamics of prevalence and severity of dental caries among 12- and 15-year-old schoolchildren in six regions of Lithuania. Material and methods. A total of 5910 schoolchildren aged 12 and 15 years were examined. Dental caries was diagnosed according to the criteria of World Health Organization. The prevalence of dental caries was calculated by dividing the number of children with caries by the number of all children examined and expressed as percentage. Severity of dental caries was described by DMF-T index. DMF-T indices of individual persons as well as each age group were determined. Oral hygiene was evaluated by a simplified oral hygiene index. Fluoride concentration in Kretinga was 1.6–2.2 ppm; in the other regions, it varied between 0.2 to 0.4 ppm. Results. The prevalence of dental caries among 12-year-olds was 88.4% in 1983 and 85.5% in 2005; among 15-year-olds, it was 95.5% and 92.9%, respectively. Mean DMF-T score decreased from 4.5 (in 1983) to 3.7 (in 2005) among 12-year-olds and from 6.4 (in 1983) to 5.6 (in 2005) among 15-year-olds. Oral hygiene index decreased from 1.69 in 1983 to 1.34 in 2005 among 12-year-olds and from 1.46 to 1.22 among 15-year-olds, respectively. Conclusions. A tendency towards decrease in the prevalence and severity of dental caries was observed, when caries prevention program was running. Correlation between oral hygiene and DMF-T was observed in both age groups. Decreased prevalence and intensity of dental caries among 12- and 15-year-olds were associated with improved oral hygiene, usage of fluoride toothpaste, and fluoride content in drinking water.

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Association of Dietary Fluoride Intake and Diet Variables with Dental Caries in Adolescents from the ELEMENT Cohort Study

Caries Research ◽

10.1159/000511699 ◽

2021 ◽

Vol 55 (2) ◽

pp. 88-98

Author(s):

Alejandra Cantoral ◽

Teresa V. Muñoz-Rocha ◽

Lynda Luna-Villa ◽

Andres Mantilla-Rodriguez ◽

José L. Ureña-Cirett ◽

...

Keyword(s):

Dental Caries ◽

Dietary Intake ◽

Regression Models ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Carbohydrate Intake ◽

Caries Experience ◽

Total Carbohydrate ◽

Fluoride Intake ◽

Binomial Regression

To examine the association of dietary fluoride intake, total carbohydrate consumption and other key dietary variables with dental caries experience among adolescents, a cross-sectional analysis was conducted in a sample of 402 participants from the Early Life Exposures in Mexico to Environmental Toxicants cohort. The presence and severity of dental caries were assessed using the International Caries Detection and Assessment System (ICDAS) to calculate the number of decayed, missing, and filled teeth or surfaces (D1MFT/D4MFT). The dietary intake of fluoride, energy, carbohydrates, and food groups was estimated using a validated food frequency questionnaire (FFQ). Multivariate zero-inflated negative binomial regression models and negative binomial regression models were run to estimate the association of fluoride intake (mg/day) and total carbohydrate intake (g/day) with the D1MFT/D4MFT index. We found that 80% of the adolescents experienced dental caries (D1MFT >0), with 30% presenting cavitated lesions (D4MFT >0). The mean scores for D1MFT and D4MFT were 6.2 (SD 5.3) and 0.67 (SD 1.3), respectively. The median intake of fluoride estimated by the FFQ was 0.015 mg/kg/day. This intake was statistically higher in participants with a D4MFT = 0 compared to those with a D4MFT >0 (0.90 vs. 0.82 mg/day; 0.016 vs. 0.014 mg/kg/day; p < 0.05). For D1MFT, D1MFS, D4MFT, and D4MFS scores, a higher fluoride consumption (mg/day) from foods and beverages was associated with a statistically significant reduction in the number of lesions. The reported frequency of consumption of sugary foods in a whole day was statistically higher in those with D1MFT >0 than in those with D1MFT = 0 (p < 0.05). The total carbohydrate intake (g/day) was positively associated with dental caries experience. We conclude that a higher fluoride intake through foods and beverages is associated with a lower dental caries experience among adolescents; this effect was seen even when the dietary intake of fluoride was 0.015 mg/kg/day, which is lower than the average intake recommendation. In contrast, a higher total carbohydrate intake and the frequency of intake of sugary foods were associated with a higher dental caries experience, with no apparent threshold for the effects.

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Dental caries in young male adults: prevalence, severity and associated factors

Brazilian Oral Research ◽

10.1590/s1806-83242005000400003 ◽

2005 ◽

Vol 19 (4) ◽

pp. 249-255 ◽

Cited By ~ 9

Author(s):

Marcelo Augusto Amaral ◽

Luiza Nakama ◽

Carlos Alberto Conrado ◽

Tiemi Matsuo

Keyword(s):

Dental Caries ◽

Family Income ◽

Dental Treatment ◽

Disease Process ◽

World Health ◽

Caries Experience ◽

Caries Prevalence ◽

Treatment Needs ◽

Cross Sectional ◽

Socioeconomic Variables

The aim of the present study was to determine the prevalence and severity of dental caries as well as the needs for dental treatment in 18-year-old males from Maringá, PR, Brazil. The association of dental caries experience with socioeconomic variables was also tested. A cross sectional study was conducted in a random sample of 241 conscripts of the Brazilian Army. The adopted diagnosis criteria were those proposed by the World Health Organization. A socioeconomic questionnaire was utilized to determine family income and the criterion of the Brazil Economic Classification of the National Association of Research Enterprises. Associations among caries prevalence, DMF-T index, treatment needs and socioeconomic variables were evaluated by means of the Chi-Square, Mann-Whitney and Kruskal-Wallis tests. Caries prevalence was 82.6% and the mean DMF-T index was 4.6. Only a mean of 0.8 tooth per individual presented treatment needs. Significant statistical differences were found in caries prevalence and severity (DMF-T). The worst results were observed in the groups of lower income and purchasing power, indicating a need for the implementation of social policies that address these populations aiming at diminishing the existing differences in the health-disease process indicators. On the other hand, treatment needs were only associated to the Brazil Economic Classification Criterion variable (p < 0.05).

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