scholarly journals Minimally Invasive Dentistry Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries in Rural and Remote Aboriginal Communities: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Peter Arrow ◽  
Rob McPhee ◽  
David Atkinson ◽  
Tamara MacKean ◽  
Sanjeewa Kularatna ◽  
...  
Keyword(s):  
Early Childhood ◽  
Minimally Invasive ◽  
Early Childhood Caries ◽  
Test Group ◽  
Caries Experience ◽  
Control Group ◽  
Atraumatic Restorative Treatment ◽  
Randomized Controlled ◽  
Aboriginal Children ◽  
Childhood Caries

BACKGROUND The caries experience of Aboriginal children in Western Australia (WA) and elsewhere in Australia is more than twice that of non-Aboriginal children. Early childhood caries (caries among children <6 years) has a significant impact on the quality of life of children and their caregivers, and its management is demanding and commonly undertaken under general anesthesia. A randomized controlled trial using a minimally invasive dentistry approach based on Atraumatic Restorative Treatment (ART) in metropolitan Perth, WA, has demonstrated a significant reduction in the rate of referral to a dental specialist for dental care among children with early childhood caries, potentially reducing the need for treatment under general anesthesia. The tested approach was clinically successful and was without adverse effects on child dental anxiety. The model of ART-based primary care requires further testing and development if similar outcomes for Aboriginal children in remote and rural settings are to be achieved. OBJECTIVE The study aims to develop, implement, and evaluate a remote primary care model to deliver effective primary dental services, encompassing treatment and preventive services, to Aboriginal preschool children (based on minimally invasive approaches including ART). METHODS This is a two-arm parallel cluster randomized controlled study in which a test group will be provided with the intervention treatment at the start of the study and a control group will be provided with the intervention treatment 12 months after study commencement (delayed intervention). Participating communities, stratified by size of community (ie, number of children in the sample frame) and baseline caries experience, will be randomly assigned using a computer-generated block randomized list into immediate (test group) or delayed intervention (control group; provided with standard care). Informed consent will be obtained from all participants. Aboriginal research assistants will explain the study to the parents and assist the parents in completing the questionnaires. Participants in the randomized study will be examined at baseline and at 12 months follow-up by a calibrated examiner. Test group participants will subsequently be contacted and appropriate appointments coordinated for treatment. Control group participants will be provided with standard preventive care by the Aboriginal Health Workers and managed for treatment as per standard procedures. RESULTS Community consultations have been undertaken and 26 communities have agreed to participate. Fieldwork is in progress to recruit study participants. CONCLUSIONS The significance of the study lies in its holistic approach to testing the model of care. Clinical evaluations as well as oral health‒related quality of life evaluations will be undertaken. Cost-effectiveness and cost-utility evaluations will assist in the development of policy options for oral health services for rural and remote communities. The elicitation of caregiver perspectives through focus group interviews will supplement the clinical, psychosocial, and cost-utility evaluations and provide a richer evaluation of the intervention. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12616001537448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371735 (Archived by WebCite at http://www.webcitation.org/70UMxndFZ) REGISTERED REPORT IDENTIFIER RR1-10.2196/10322

scholarly journals Minimally Invasive Dentistry: Parent/Carer Perspectives on Atraumatic Restorative Treatments and Dental General Anaesthesia to the Management of Early Childhood Caries

2021 ◽  
Vol 2 ◽  
Author(s):  
Peter Arrow ◽  
Helen Forrest ◽  
Susan Piggott
Keyword(s):  
Early Childhood ◽  
Minimally Invasive ◽  
General Anaesthesia ◽  
Early Childhood Caries ◽  
Cost Of Care ◽  
Atraumatic Restorative Treatment ◽  
Treatment Needs ◽  
Minimally Invasive Dentistry ◽  
Dental General Anaesthesia ◽  
Childhood Caries

Introduction: Parents of children treated under dental general anaesthesia (DGA) have reported feelings of concern and anxiety. This study elicited the views of parents/carers (P/C) of children with early childhood caries (ECC) who participated in a randomised trial (core study) which tested the effectiveness of care under DGA or care using alternative minimally invasive Atraumatic Restorative Treatment and the Hall Technique approaches (ART/HT).Methods: P/C of children treated using the ART/HT (test) approach or care under a DGA (control) were interviewed. Focus group semi-structured interviews with P/C were undertaken in community facilities. The transcripts were read and inductively coded into domains to identify emergent themes. The codes were entered into NVivo software to assist data management and were further refined into broad themes.Results: Seven grouped interviews with 14 participants were conducted and one test participant provided a written response. Four groups with eight test participants; two groups with four control participants; and one combined group with one test and one control participant were interviewed. Five broad themes emerged after thematic analysis: (1) Impacts on the child and the family; (2) Child-/family-centred care; (3) Timeliness of care; (4) Affordable care; (5) Accessible care. Impacts were related to that of the effects of the disease, and of the care for the disease. Child-centred/family-centred care (CCC) was a source of appreciation by P/C of both groups when it was experienced. Frustration at the lack of timely care of their child's treatment needs, coupled with the perceived expensiveness of care and difficulties in physically getting to the location for a specialist consultation was expressed by P/Cs in the study.Discussion: The use of the ART/HT enabled the establishment of a relationship between the clinical team and the child and P/C which was central to the delivery of CCC. P/Cs in the DGA arm of the study expressed dissatisfaction more often with the issues of timely care, cost of care and accessibility of care. P/C of both groups were equally satisfied with the treatment, where treatment had been received in a timely, child-centred manner.Conclusion: The findings suggest that minimally invasive approaches which facilitated CCC are acceptable alternative options to the DGA and should be considered for the management of ECC.Australian New Zealand Clinical Trials Registry: ACTRN12616001124426.

Effect of Lactoperoxidase System Containing Toothpaste on Cariogenic Bacteria in Children with Early Childhood Caries

2009 ◽  
Vol 33 (4) ◽  
pp. 299-304 ◽  
Author(s):  
Sapna Jyoti ◽  
N Shashikiran ◽  
V Subba Reddy
Keyword(s):  
Early Childhood ◽  
Early Childhood Caries ◽  
Test Group ◽  
Experimental Period ◽  
Mutans Streptococci ◽  
Control Group ◽  
Thiocyanate Ion ◽  
Lactoperoxidase System ◽  
Childhood Caries

Background and Objectives: Lactoperoxidase system contains Lactoperoxidase, Hydrogen peroxide and Thiocyanate ions, which have inhibitory action against cariogenic oral microflora. The present study was undertaken to assess the effect of lactoperoxidase system containing toothpaste on cariogenic microflora in children with early childhood caries. Methods: Study group included 30 children with Early Childhood Caries. 15 were considered as test group who used the test product Biotene® toothpaste and other 15 as control group who used Colgate Active® as control product. Salivary samples were analyzed for mutans streptococci (MS) and Lactobacilli, and for the levels of Thiocyanate ions. Results: showed significant increase in the levels of Thiocyanate ion in saliva during experimental period. Compared to the control group test group showed significant increase in the levels of thiocyanate ions during experimental and washout period, whereas the number of colonies of MS and Lactobacilli were significantly reduced in test group during experimental period. Conclusion: The levels of thiocyanate ions can be increased in vivo by supplementing the saliva with natural enzymes like lactoperoxidase. This increased concentration of thiocyanate will reduce the number of cariogenic microflora in children with Early Childhood Caries.

scholarly journals Protocol for a family-centered behavioral intervention to reduce early childhood caries: the MySmileBuddy program efficacy trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christie L. Lumsden ◽  
Burton L. Edelstein ◽  
Charles E. Basch ◽  
Randi L. Wolf ◽  
Pamela A. Koch ◽  
...  
Keyword(s):  
Early Childhood ◽  
High Risk ◽  
Behavioral Intervention ◽  
Early Childhood Caries ◽  
Text Messages ◽  
Trial Registration ◽  
Control Group ◽  
Causal Pathways ◽  
Family Centered ◽  
Childhood Caries

Abstract Background Although largely preventable through diet management and topical fluoride use, early childhood caries (ECC) often progresses to severity that necessitates surgical repair. Yet repair often fails to mitigate caries progression. Needed is an effective behavioral intervention to address underlying behavioral causes. Methods This randomized controlled trial will evaluate the efficacy of a behaviorally focused, family-centered intervention, the MySmileBuddy Program (MSB Program), to reduce ECC progression in high-risk preschoolers in New York City. Recruitment will target 858 children ages 24–71 months with ECC and their parents from primary care medical and dental clinics. The study aims to assess the MSB Program’s efficacy to: (1) decrease ECC progression measured 12-months post-randomization; and (2) enhance adoption of a low cariogenic diet and twice-daily fluoridated toothpaste use compared to control group. Potential causal pathways (mediators and moderators) will be explored. The MSB Program equips community health workers (CHWs) with an app that facilitates multilevel risk assessment and provides motivational interviewing-based counseling to inform parents about the caries process, develop personalized goals, and create family-level action plans to achieve targeted behaviors. Social support from CHWs (4 interactions during the 6-month intervention, supplemented by up to 4 in-person/remote contacts throughout the 12-month study period, based on need) is bolstered by automated text messages. Participants will be randomized to a Control Group (paper-based educational handout plus toothbrushes and fluoridated toothpaste for the child) or Intervention Group (MSB Program, two tooth-brushing observations with feedback and instruction, and toothbrushes and toothpaste for the entire family). All children will receive visual ICDAS dental examinations and parents will complete study measures at baseline and 12-months. An incentive up to $150 plus round-trip transit cards ($5.50 value) will be provided. Discussion This study hypothesizes that the MSB Program can reduce ECC progression in a high-risk population. Sufficient incentives and a focus on establishing rapport between participants and CHWs are anticipated to mitigate recruitment and retention challenges. If successful, this study will advance the long-term goal of reducing pediatric oral health disparities by demonstrating the efficacy of an acceptable and feasible intervention that shifts attention from dental repair to behavioral risk mitigation. Trial registration: Trial registration was completed on 4/13/2021 through the U.S. National Library of Medicine ClinicalTrials.gov website (Identifier: NCT04845594).

scholarly journals Risk factors associated with early childhood caries – a case control study

2016 ◽  
Vol 31 (2) ◽  
pp. 83
Author(s):  
Marina De Deus Moura Lima ◽  
Zacarias Soares Brito-Neto ◽  
Heylane Oliveira Amaral ◽  
Cacilda Castelo Branco Lima ◽  
Marcoeli Silva de Moura ◽  
...  
Keyword(s):  
Risk Factors ◽  
Early Childhood ◽  
Early Childhood Caries ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Factors Associated ◽  
History Of ◽  
Control Study ◽  
Childhood Caries

Objective: The aim of this study was to determine the risk factors associated with early childhood caries (ECC).Methods: It was an observational retrospective case-control study. The case group consisted of all patients diagnosed with ECC in the records of an active program of maternal and child care. The control group was composed of an equal number of children, matched for gender and age, who attended the program and did not have ECC. The process of data collection consisted of completing a pre-established schedule to analyse variables related to the mother/caregiver and child.Statisticalanalysis was performed using the chi-squared and odds ratio (OR), with alpha (α) = 0.05.Results: History of caries in the mother (OR=2.61; CI 95%=1.45-4.67) and father (OR=1.72; CI 95%=1.02-2.89) were key determinants in the child being diagnosed with ECC.Conclusions: The risk factors associated with ECC were the following: no oral hygiene acceptance, nocturnal feeding duration of more than 16 months, a daily intake of sugar greater than 4 times a day, a Baume type II maxillary arch, fewer than 3 consultations with the program, and a history of decay in the parents.

scholarly journals Association of Feeding Methods and Streptococcus mutans Count with Early Childhood Caries: A Cross-sectional Study

2017 ◽  
Vol 10 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Manjunath P Puranik ◽  
Deepa Bullappa ◽  
KR Sowmya ◽  
T Nagarathnamma
Keyword(s):  
Early Childhood ◽  
Streptococcus Mutans ◽  
Early Childhood Caries ◽  
Cross Sectional Study ◽  
Caries Experience ◽  
Sectional Study ◽  
Cross Sectional ◽  
Mothers And Children ◽  
Feeding Methods ◽  
Childhood Caries

ABSTRACT Introduction Early childhood caries (ECC) is a virulent form of dental caries that can destroy the primary dentition of toddlers and preschool children. The aim was to determine the relationship of feeding methods and oral Streptococcus mutans count in 3- to 5-year-old children with ECC. Materials and methods A cross-sectional study was conducted in children aged 3 to 5 years. Participating mothers were interviewed regarding child's demographic profile, educational level and socioeconomic status of parents, past medical and dental history of the mother and child, child's feeding habits, and dietary habits and oral hygiene practices of mother and child. Clinical examination for dental caries was done using the World Health Organization criteria (1997). Salivary samples of mother–child pair were collected to determine the pH, flow rate, and S. mutans count. Statistical tests, such as Student's t-test, analysis of variance, and Pearson's correlation were applied. Results Out of 150 mother–child pair, statistically significant difference in the caries experience was found between mothers and children with high and low S. mutans count. Moderate but statistically significant negative correlation was found between mean decayed, missing, and filled teeth of mothers and mean decayed, extracted and filled teeth (deft) of children with high S. mutans count. Regarding deft, there was no statistically significant difference between children who were exclusively breast fed (7.85 ± 2.94), exclusively bottle-fed (8.67 ± 3.98), and both breast and bottle-fed (7.77 ± 2.91). Conclusion The mean caries experience of mothers and children was 2.66 ± 2.01 and 7.82 ± 2.94 respectively, with decayed component being maximum. Moderate and significant correlation (r = 0.5) was found between S. mutans of mothers and children in saliva. Significant negative correlation was found between mothers and children with high S. mutans count (r = –0.0284; p = 0.046). How to cite this article Bullappa D, Puranik MP, Sowmya KR, Nagarathnamma T. Association of Feeding Methods and Streptococcus mutans Count with Early Childhood Caries: A Cross-sectional Study. Int J Clin Pediatr Dent 2017;10(2):119-125.

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