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Objective: Baby bottle tooth decay is a severe form of early childhood caries. This study aims to elaborate a screening tool for at risk children in order to facilitate primary prevention., Methods: A case-control study was conducted among children suffering from baby bottle tooth decay and children with no dental caries. Cases were children aged 5 years or less at diagnosis who experienced at least four caries with one or more affecting maxillary incisors. Controls were children matched for age and sex. Parents were interviewed by phone about their child's exposure to potential risk factors., Results: We included 88 children suffering from baby bottle tooth decay and 88 children with no dental caries. In multivariate analysis, low social class (OR 6.39 [95% CI, 1.45-28.11]), prolonged bottle feeding or bedtime feeding (OR 153.2 [95% CI, 11.77-1994.96]), and snacking (OR 5.94 [95% CI, 1.35-26.2]) were significantly associated with baby bottle tooth decay. Regular dental visits were a significant protecting factor (OR 0.13 [95% CI, 0.02-0.77]). A score was developed using these significant risk factors and tested on the survey population. The mean score was 13/20 for cases and 4/20 for controls., Discussion: These results are in accordance with the literature, except for brushing teeth, which was not significantly associated with baby bottle tooth decay in our study., Conclusion: A screening scale with a score of 20 points was proposed. Future validation is required. Pediatricians and general practitioners should encourage parents to change their habits., (Copyright © 2012 Elsevier Masson SAS. All rights reserved.)

Introduction: Sucking is innate in both infants and young children. It is termed nutritive when referring to suckling from the breast or bottle-feeding and non-nutritive when applied to sucking of a digit or pacifier. Few studies have attempted to assess the impact of the type of sucking on the size of the dental arches. The aim of this study was to quantify the influence of the mode of nutritive suckling and non-nutritive sucking habits (NNSH) on the measurements of the dental arches., Patients and Methods: This was a transverse descriptive study involving 226 Senegalese children. The mode of feeding and the presence or not of a NNSH (digit or pacifier) were gathered from parents of all children using a structured questionnaire. Quantitative variables regarding intra- and inter-arch relationships were recorded using plaster moulds taken from the children. Statistical analyses were used to compare the different variables according to gender, the mode of feeding and the presence or not of a NNSH., Results: The subjects in the study (123 boys and 103 girls) were aged between 5 and 6years old. The children who had enjoyed mixed feeding (breast/bottle combination) had a great length of the anterior maxillary arch and a significantly greater depth of the palatal arch than children receiving breast-feeding alone. The children with antecedents or a current NNSH had a longer anterior maxillary arch than subjects with no NNSH (P=0.01). Regarding inter-arch relationships, the children with antecedents or a current digit-sucking habit had less overbite than their peers who had no NNSH (P=0.04)., Conclusion: The results of this study show that bottle-feeding, even partial, as well as NNSH are associated with changes in certain dimensions of the maxillary dental arch and in inter-arch relationships. Longitudinal studies are required to investigate further the nature of this association., (Copyright © 2010 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Sucking behaviours have been described in the literature under two facets i.e. nutritive and non nutritive. Nutritive sucking refers to breast feeding, bottle feeding or a combination of both. Non nutritive sucking habits are mentioned when children suck their thumb or another finger(s), a pacifier or any other object. Non nutritive sucking habits (NNSH) are suspected to potentially induce dentoalveolar anomalies and thus may constitute a public dental health problem. Anthropological and historical data suggest that non nutritive sucking habits are associated with modern pattern of life. The aim of this study is to investigate the prevalence and factors associated with NNSH in Senegalese children 5/6 years old. Data of this study were collected using a structured questionnaire administered by the investigators to mothers or caregivers of 443 children (231 boys and 212 girls) aged 5/6 years. Three types of data were collected: data on the social background of the children including place of residence (urban, suburban and rural) and the mother's occupation (workers, employee, executive, housewife), data regarding former and present sucking habits and information on the feeding pattern of the children when they were infants (breast feeding, bottle feeding or a combination of both). The results indicated a prevalence rate of 16.50% and 17.20% respectively for digit and pacifier sucking in this population. Also, a significant association was found between children's non nutritive sucking habits in one hand and the mothers' occupation and feeding pattern on the other hand. Breast fed children are less prone to develop a non nutritive sucking habit than bottle fed children. Longitudinal studies are necessary to verify the nature of these associations. The identification of factors associated with non nutritive sucking habits would permit to develop and target recommendations for the prevention of such habits.

Immigration, a political, economic, demographic, social and ethic, as well as a medical issue, continues. Among migrants, asylum seekers, refugees and undocumented immigrants are characterised by their vulnerability, particularly related to their health status. Western physicians are more and more frequently confronted to "colorful" and often vulnerable patients. They face diseases related to international migrations; and at the same time have to integrate the differences in representations and meanings given to illness by patients of diverse origins. A bio-psychosocial and spiritual approach coupled with an evaluation of pre-migration, migration and post-migration trajectories is therefore useful for the clinician; these complementary approaches have all been integrated in the learning of cultural competencies.

The functional differences between breast-feeding and bottle-feeding may have a significant effect on dento-facial development and on the genesis of some severe malocclusions. Orthodontists should be aware of this sometimes under-estimated aspect of development. They should, in conformity with their role as professional health care providers, advise long-term breast feeding as a way of preventing certain disorders or, at least, reducing their severity.

This case report represents a child that needed, at the age of 3, dental treatment under narcosis due to nursing bottle caries including multiple extractions. Six months later the few remaining teeth were again seriously affected by decay. Due to the medical history of urological problems, abnormal aspect of hair and skin and abnormal forms of primary teeth (only reported by the parents), there was a presumption of ectodermal dysplasia, so the patient was referred to the department of medical genetics. Genetic research is still going on. We decided to restore the remaining teeth in ambulant care with plastic restorations and stainless steel crowns. On demand of the parents, we decided to provide the child with a removable denture to increase his self-confidence. The child has now reached the age of 6 and has well accepted the removable denture. These served furthermore as an appliance to maintain space and prevent tooth migration. Removable dentures in young children can be a successful intermediate solution by lack of primary teeth.

In the 1990s, many programs and actions were set up for promoting breastfeeding in Africa, more or less successfully in different countries. The main achievements of these programs were the training of health professionals and the apparent ending of the distribution of formula in Health services. The impact of these programs on breastfeeding practices in countries with prevalent prolonged mixed feeding is less obvious, as many programs did not emphasize "best practices". Health messages delivered on this topic have been poor, because they were often conceived at the international level rather than adapted to African contexts, and because the consensus about the promotion of breastfeeding is so strong that the programs have rarely undergone a critical evaluation. The HIV/AIDS pandemic could be an opportunity to rethink these programs. "Baby friendly" Health services are now considered as the most knowledgeable to deal with breastfeeding in the context of HIV, through the reinforcement of the promotion of "best feeding practices" and through the follow-up of formula-feeding for some HIV-positive mothers. To prevent HIV transmission, health messages will have to promote some practices that are useful for HIV-negative, as well as HIV-positive, mothers, such as exclusive breastfeeding, the prevention, early diagnosis and treatment of abscesses and mastitis, and the management of weaning - all strategies that were undervalued until now. For children of HIV-positive mothers and for orphans, Health services will have to set up a medical follow-up of artificial feeding. These new goals mean that breastfeeding promotion programs will have to develop complementary strategies with an emphasis on care, coordinated with other vertical programs such as AIDS and malnutrition programs.

The prevalence of allergic diseases in childhood is regularly increasing, in particular asthma, which morbidity is important. Despite the persistence of a significative bronchial inflammation the severity of the disease may present with discrete symptoms. The recognition of asthma and its treatment is then insufficient and consequently potentially fatal asthma attacks may occur and there is a chronic remodeling of the airways. Allergenic sensitization occurs mainly during the first years of life and is related to the environment to which the child is exposed. The effect of early prevention was extensively studied in the past. A regimen with hydrolyzed cow's milk proteins during the first months of life decreases the incidence of milk allergy and atopic dermatitis, but does not seem to decrease the long term prevalence of allergies. Infectious agents are suspected to influence the type of cytokines produced by helper T cells and thus to promote or to prevent allergen sensitization. It has been shown recently that the influence of the environment during the first years of life is critical for the development of the IgE responses to allergens and as consequence for allergic manifestations. A better understanding of these mechanisms should allow to determine the reason(s) for the increase of allergic prevalence and improve the efficacy of preventive measures.

In spite of a spectacular drop of dental caries in children during the last ten years, the young child polycaries syndrome has not disappeared. Baby Bottle Tooth Decay is a dental pathology of temporary teeth affecting very young children, related to prolonged and frequent use of baby bottle with high carbohydrates content. The important destruction of the temporary teeth hard tissues, and the rapid extension of the lesions carry a high risk of infectious and orthodontic complications with repercussion on the permanent teeth. It is important that pediatricians actively participate to its prevention and early detection.

This article describes the clinical and therapeutic aspects of multi-caries in young children. These rampant cervical caries usually begin with the eruption of the first teeth. Two typical cases are presented in which the prolonged use of nursing bottle at bedtime and the use of pacifiers dipped into honey are responsible for the development of multi-caries. Although such patient can be treated successfully, efforts should be made to promote preventive measures and parents education.

Prolonged frequent bottle feeding with sugar rich liquids leads to early multiple dental caries. This dental disease known as the baby bottle syndrome may have serious long-term local as well as general consequences. A general anesthesia is frequently necessary in order to treat the extensive dental lesions in affected young children. Paediatricians have a major role to play in the prevention of this disease: 1) by teaching parents appropriate preventive measures on nutrition, early oral and dental hygiene and fluoride supplementation; 2) by regularly looking for early signs of rampant caries and by alerting parents when they are found.