Search

Our investigating 186 infants between the ages of one and six with carious destruction of the maxillary primary incisors, it was learned which risk factors were responsible for the condition known as nursing bottle syndrome. One hundred and twenty-eight infants (68.8 percent) were given a nursing bottle, twelve (6.5 percent) a feeding cup or other bottles with bill- shaped extensions, and forty-one (22.0 percent) both a nursing bottle and vessels with bill-shaped extensions; in all cases the feeding was excessive and prolonged beyond the first year of life. An additional five infants (2.7 percent) were breast-fed excessively beyond the first year. The results confirm the risk of tooth destruction, typical of nursing bottle syndrome, by prolonged and frequent consumption of cariogenic beverages from vessels with bill-shaped extensions. It is important, therefore, that a warning regarding dental health hazards of such feeding methods be issued.

An increasing percent of children are overweight. A review of the prevalence of overweight children in different demographic groups is provided in an effort to alert dentists to the role they could play in preventing medical complications.

Objective: This study estimated the prevalence of early childhood caries (ECC) and related behavioral risk factors in a population of low-income, Mexican-American children in Stockton, California., Methods: We collected data for 220 children ages six years or less using a parent-completed questionnaire and clinical dental examinations during the Su Salud Health and Education Fair in July 1995. We employed five case definitions of ECC: buccal or lingual caries on one or two primary maxillary incisors; caries on any surface of one or two primary maxillary incisors; and five decayed, missing (due to caries), or filled primary teeth., Results: The prevalence of ECC ranged from 12.3 percent to 30.5 percent, depending upon the case definition. More than 17 percent of children age two years had one primary maxillary incisor affected by caries on the buccal or lingual surface; 13.2 percent had two affected. Mean age at weaning from breast--or bottle-feeding and patterns of bottle use during sleep did not differ significantly between children with ECC and those without. There were no clear patterns of cariogenic food frequency and disease status., Conclusions: Our findings question whether feeding patterns with human breast milk, formula, or bovine milk are sufficient etiologic factors for this condition.

Recommendations by the Academy of Pediatric Dentistry urging a dental/oral examination of all infants before one year of age, have had limited impact on the profession and the general public. Significant numbers of pediatric dentistry specialists and general practitioners who provide care for children, disagree with the recommendations. Between the mid 1970s and 1990's, there has been no change in the percent of children less than six years of age who were reported to have visited a dentist in the past year. A review is provided of the dental disease needs and dental service patterns of very young children in the various demographic populations in an attempt to 1) increase practitioner awareness of the continuing needs for services and 2) develop a dialogue between the organizations of the profession and the dentists in practice, regarding directions to be taken in the future.

Nursing caries has been found to be positively associated with children from families of low socioeconomic status. The Harris County Health Department (HCHD) serves a population consisting predominately of low-income, low-educational-level clients who reside in the suburban areas surrounding Houston, Texas. The purpose of this study was to determine the prevalence of early childhood caries and nursing caries among patients of the HCHD dental clinics. The study method was a retrospective chart review of all patients seen at the HCHD dental clinics within the two years before the study. There were 135 children in the sample, with a mean age of fifty-seven months. About half of the children had a quarter (five or more) of their primary teeth filled or decayed. The prevalence of early childhood caries was 76 percent and 44 percent of the children were classified in the group with nursing caries. The prevalence of early childhood caries and nursing caries among patients from low socioeconomic families is still high.

This study attempts to gather information concerning the dental experiences, beliefs, and parenting practices of Native Americans. Five Native American women were trained to conduct interviews in their own language. After pilot testing, seventeen questions were asked. Sixty-two interviews were taperecorded and transcribed. Content analysis was performed on the transcriptions. Results indicate maternal and caretaker upset and displeasure with the dental experiences of adults and children. Fear and pain were prominent. Parenting practices indicate children are expected to clean their own teeth at about a year of age and parental awareness of risks associated with sleeping with a bottle. About half of the mothers and caretakers who used a bottle as a pacifier report engaging in one or more protective activities such as removing the bottle when the child falls asleep. Mothers and caretakers with greater parenting experience are likelier to be aware of these protective activities. In conclusion, results of this study highlight the importance of providing positive dental experiences for mothers and caretakers and the need to be aware of actual parenting practices before making recommendations or counseling mothers or caretakers.

Disorganized urbanization in Latin America has led to masses of impoverished people to become squatters in the larger urban areas. Using a community development network in the outskirts of Tijuana, in Northern Mexico, this investigation assessed the dental health situation, aiming to establish the underlying behavioral causes of poor oral health in these slums. Using quantitative and qualitative tools, fifty-six mothers (mean age 30.1 +/- 7.2) with their accompanying children (n = 56; mean age 6.1 +/- 3.3; 46.4 percent female) were interviewed and examined. Dental health was poor and characterized by vast unmet treatment needs in adults and children. 22.2 percent of children under three years of age suffered from Early Childhood Caries, strongly linked to inappropriate patterns of bottle use. Dietary patterns for the overall child population included many cariogenic snacks and beverages. A straightforward model to explain behavioral structures incorporates these findings against the background of living in a highly-deprived environment, whereby the allure of more affordable gratifications for self and family is often translated in the form of tokens such as junk food.

Several demographic studies have been done to identify children at risk for Baby Bottle Tooth Decay (BBTD). Discussions have described these children with Baby Bottle Tooth Decay as strong tempered, cranky, restless, and fussy. The parents of these children have acknowledged these behaviors. To determine whether there were differences in temperament, children with Baby Bottle Tooth Decay were compared with children without Baby Bottle Tooth Decay by assessing the nine temperament components described by the Toddler Temperament Scale (TTS) questionnaire. Parents completed the temperament questionnaire and ninety-two children between twelve and thirty-six months old were studied. Scores for the nine temperament components were tabulated and temperament difficulty was determined as defined by the authors of the toddler Temperament Scale. At-test comparison between the two groups revealed no significant difference for the nine temperament components. There was also no difference when comparing clusters of the nine components. The conclusion is that there is no difference in the temperaments between the group of children with Baby Bottle Tooth Decay and the comparison group of children without Baby Bottle Tooth Decay.

A sample of 167 Puerto Rican children whose ages ranged from six months to forty-seven months (mean = 23 months) were studied. Children were examined for Early Childhood Caries with light and mirror and a structured interview was administered to parents and caretakers to identify risk factors. Results indicated that only 37.4 percent of the children were free of decalcification lesions or frank decay. While 53.9 percent of the children had lesions on maxillary incisors, 40.0 percent had molars affected by decalcification lesions and caries. Analysis of risk factors indicate that giving the baby a bottle when crying at night, number of adults and children in the family, use of fluoridated dentifrice, and age of the child were associated with the caries process in these children. Bottle and breast feeding, per se, were not risk factors. Disease patterns suggest other dietary risk factors, such as frequent snacking on food/drinks with sugar.

This study did follow-up examinations of 84 Medicaid-eligible children with nursing caries after they received treatment for nursing caries utilizing general anesthesia. Results at six months suggest that parents are unresponsive to follow-up care and over half of the children seen had new smooth surface caries lesions. While results are preliminary, they suggest that major changes are needed in the tertiary care of children with nursing caries.

The aim of this project was to determine the severity of nursing caries, and to examine contributing behavioral factors, in a group of Vietnamese families in British Columbia, Canada. The data collected became the basis for a community-based oral health promotion program. Information on feeding, dental health practices, and dental caries were collected for 60 mother/child pairs. For children > or = 18 mos, prevalence of nursing caries was 64 percent. Sixty-five percent of all children had a naptime bottle, and 85 percent > or = 18 mos had a "comfort" bottle that was carried around, and drunk from during the day. Milk was the most common beverage. A "comfort" bottle was significantly related to the presence of nursing caries, P = 0.02; a naptime bottle had a less significant association, P = 0.07. Dental knowledge questions revealed that all mothers knew that a child who had a "comfort" bottle could get tooth decay, but 63 percent thought that cavities were not a problem in baby teeth.

This study aimed at comparing S.mutans in pairs of children within families; both children used a sweetened nursing bottle beyond the dietary need, while one child was affected with nursing bottle caries (NBC), the other not. Seven families were selected. The children of a pair showed no dissimilarities as regards dietary habits. Mean patient-age was 3.7 yrs, controls 5.7 yrs. Saliva and plaque were sampled for CFU-counting and clonal (DNA) type-screening of S.mutans. The NBC-patients harbored significantly more S.mutans than the controls (mean 5.8 CFU/ml vs. 2.9 CFU/ml). While the controls were colonized with 2-5 clonal types of S.mutans, in the patients only one type was observed. The results were not consistent for NBC-risk assessment by CFU-counting. An inverse relationship between the number of clonal S.mutans types and NBC is suggested.

In this study, the role of the parent in the phenomenon of nursing bottle caries is investigated. The main goal is to try to assess whether differences exist between parents and their children who suffer from nursing bottle caries and parents and children who are not affected by this form of dental decay. To this purpose, a questionnaire was constructed. Results showed that, in contrast to parents of non-caries children, more parents of caries children give a bottle straight from birth. These bottles more often contain sugared drinks and are given during daytime as well as at night. Children with caries and non-caries children differ in two respects: caries children on the whole are older and they have been sick more often than non-caries children. Finally, habit seems to be the major factor contributing to the use of a bottle to a relatively high age. Discussion focuses on the characterization of "typical" caries parents and their children and the implication for educational programs such a characterization could have.

This study, part of a project that provided a baby cup to WIC children in Washington State, reports the feeding and brushing behaviors at six and twelve months and the influence of cultural and familial variables. Results show there are large differences in feeding and brushing practices among ethnic groups, i.e., Asian mothers reported the greatest reliance on the bottle at twelve months. Marital status was related to feeding practices, i.e., single women were more likely to put the baby to bed with a bottle at six and twelve months and were more likely to use a cup at twelve months. The presence of additional children at home was related to infrequent brushing and lower rates of cup use at twelve months. Awareness of ethnic and familial variables such as marital status and number of children may be useful in formulating specific recommendations when counseling mothers and other caretakers.

The paper is based on data obtained from a study of all new patients under six years of age, seeking consultation in a period of thirty months because of nursing-bottle syndrome. The information was obtained from questionnaires completed by the parents of the children. The children attended the Odontological Pediatric Service of the children's hospital in Nice, France. The syndrome affected 10.73 percent of the children under six years of age presenting to the service for consultation. Included in the discussion are the risk-prone family, the medical history and general state of health of the child at risk, feeding habits, oral hygiene, and use of fluorides.

Early diagnosis of nursing-bottle caries is so difficult because its first stage is difficult to detect, and occurs at an age the child does not visit a dentist regularly. Also, the first stage does not appear alarming. If for the parent serious complaints from the child arise, irreversible defects already have developed. The developmental stages of nursing-bottle caries are clearly linked to the eruption pattern of the primary teeth. The maxillary primary incisors are affected first, followed by the maxillary first molars. In all stages, a stabilized condition, arrested caries, can occur, if circumstances change. A correct diagnosis of the etiology of caries in toddlers and preschoolers is mandatory as a basis for introducing proper preventive measures. Further study is mandatory to clarify the cause and effect of the disease-pattern.

Seventy-seven infants, ages twelve to thirty-six months, were examined in a Women Infant Children (WIC) program at the Tulalip Health Center, Marysville, Washington. All parents/caregivers completed questionnaires, which consisted of twenty-nine questions regarding children's feeding, general care, and dental health behavior. After completing questionnaires, dental examinations were conducted with mouth mirror and explorer by one dentist. Results indicated overall caries prevalence of 46.8 percent (26 percent for twelve to eighteen months, 56 percent for eighteen to twenty-four months and 56 percent for twenty-four to thirty-six months groups). The overall average number of carious teeth per child (deft) was 2.09 (0.83, 2.17 and 2.86, in order). Caries in children was significantly associated with following factors; bottle fed now (63.9 percent vs 29.3 percent, p = .00), giving bottle as baby falls sleep (82.4 percent vs 61.0 percent, p = .03), and 3 times or more snacks between meals (73.5 percent vs 40.0 percent, p = .01). Similarly, brushing behavior was related to caries. These results suggest that the present population was at risk for caries and that feeding patterns beyond bottle use appear to be behavioral risk factors in the prevalence of infant caries in this population.

One hundred thirty-three farm worker children with an average age of 17 months participated in a study of a fluoride varnish in WIC programs in the Yakima Valley of Central Washington. After parents were interviewed, the child was examined and a fluoride varnish applied to the maxillary incisors. At the six-month recall 62 children and their parents returned. Results indicated a significant decrease in decalcification from 35 percent to 21 percent and an increase in decay from 3 percent to 16 percent. The rate of decay was lower than the 30 percent found in this age-group in this population. Of 130 sound teeth at baseline, 13 percent were decayed or decalcified in six months; of 73 decalcified teeth at baseline, 51 percent were found to be sound in six months. Additional experimentation with fluoride varnish is warranted.

Seventy-seven parents/caretakers of children, averaging 24.4 months from four WIC clinics in King County, Washington, observed a five-minute video-tape. These parents/caretakers were then asked to examine their own children, using a mirror and a brochure with illustrations of the progression of disease. Following completion of a questionnaire, a trained dental student or dentist examined the child and completed the same questionnaire. Over 80 percent of parents/caretakers responded the same as dentists. Dentists identified disease in 35.1 percent of the sample. Kappa = 59, Z = 4.4, and p < .001. Results support the training of nondental personnel to screen early childhood caries.

Caries risk factors in rural Japan were identified for 637 children age eighteen months. Oral examinations, behavioral risk questionnaires and caries activity tests (Cariostat) were utilized. Results indicated an overall 13.7 percent prevalence of decay and strong correlations between Cariostat and caries status. Of the behavioral risk factors, weaning from breast feeding was most closely related with caries status. All factors resulted in correct classifications of Cariostat score and caries status. These results suggest that a screening of high risk infants can be accomplished by using the questionnaire and Cariostat test.

Seventeen children with nursing bottle caries and their caretakers were studied to assess whether a preventive program would arrest the progression of the caries. Prior to the study the caretakers were asked questions regarding their child's oral hygiene practices and nursing habits, as well as the caretaker's demographic characteristics. All caretakers were given instructions on how to control the use of their child's nursing bottle and how to brush their child's teeth twice daily with 0.4 percent stannous fluoride gel. After the instruction the children and caretakers were placed on 3-month recalls. Compliance was determined through a self-evaluation questionnaire assessing preventive behaviors. In general, the caretakers were unmarried 20- to 30-year-old women subsisting on welfare with one child. The majority of the caretakers were aware of the potential dangers of the child sleeping with milk or sweet liquids in the bottle. The study was discontinued after three month because caries noticeably progressed in all but two of the children, and only two caretakers complied fully with the prevention program.

Data from a continuing series of surveys by the national Interview Survey confirm further increases in use of pediatric dental services through 1989. The surveys show that by 1989 almost a third of children between two and four years of age visited a dentist in the previous year. For children between two and fourteen, and between five and fourteen, 60.5 percent and 69.5 percent, respectively, had visited a dentist in the previous year. Most significant has been the decrease in the percent of children who never visited a dentist, in the past twenty-five years. In the mid 1960s, approximately a quarter of children between five and fourteen years had never visited a dentist. Twenty-five years later, the percentage was reduced to 8.6 percent. There were also decreases in the percent of very young children (less than five years and between two and four): 78 percent and 55 percent, respectively, in the 1980s. There are, however, major reasons for concern. The percentage of children living in poverty continued to increase in the 1990s. In 1990 cases of measles, mumps, rubella, and pertussis increased. Twenty-two countries had lower infant mortality rates than the U.S. Increasing rates of nursing caries and fluorosis are appearing.

Caries is associated with fermentable carbohydrates in the diet. Dietary content can be related to personal and cultural preferences, availability of food, or physiologic tolerances. Twenty-seven percent of black children ages 12 to 24 months, in the Baltimore area were reported with symptoms of lactose intolerance. The incidence of lactose intolerance increased to 33 percent by age six years. At the same time, clinical observations of this same population suggested a high prevalence of nursing caries. One purpose of this study was to determine whether parents of black children with nursing caries perceived in their children more severe symptoms of lactose intolerance, which they related to milk products, than did parents of caries-free black children. A second purpose was to determine whether there were differences in feeding habits and types of fluids given children with nursing caries compared with caries-free children. A questionnaire concerning symptoms consistent with lactose intolerance, feeding habits, and fluid-selection was administered to the following groups: parents of 30 black children, ages 18 to 54 months, who were caries-free and parents of 30 black children, ages 18 to 54 months, diagnosed with nursing caries. Chi-square analysis or t-test analysis were performed on results accepting p < 0.05 as significant.(ABSTRACT TRUNCATED AT 250 WORDS)

A survey was conducted to determine the relationship between infant bottle drinking patterns and "nursing caries". The sleeping habits of the child, the contents of the bottle, the age at which the child was weaned from the bottle, and the age at which toothbrushing commenced were evaluated. Information was obtained through a parental questionnaire and a clinical examination. The results indicate that children who fell asleep while feeding from the bottle had significantly more cases of "nursing caries" than did children who discarded the bottle before falling asleep. Children who discarded the bottle before falling asleep, however, had significantly more cases of "nursing caries" than did children who were not given the bottle at all at bedtime. All other factors were not significant in increasing or decreasing the incidence of "nursing caries".

Treatment of severe BBTD in very young children often requires the use of general anesthetic. In 1987, the cost was estimated at $700-$1,000; add another $1,000, if hospitalization is needed. Informal surveys of dentists across the country indicate that in 1991-1992, the cost of treatment has increased substantially.

This study investigated parental perceptions of children who had extensive nursing caries that necessitated the extraction of the four maxillary incisors. The study investigated social skills, speech development, school progress, and personality changes in these children as perceived by their parents. The majority of parents saw no noticeable behavior change after the extractions; classified post-extraction behavior as normal; believed that their child had no problems making new friends; and perceived that their child had no difficulty speaking or learning to speak without the maxillary incisors.

After one year in function, the crowns appear to wear well, are well-retained, and remain esthetically pleasing. The glass ionomer filling materials show a great potential in restoring severely carious incisors with direct bond crowns.

Infants' oral muscles are exercised strenuously in suckling. Breastfeeding contributes an important influence on the thrust and growth of the mandible, in addition to imparting maternal immunological components in the nutritious milk. Infant feeding practices may affect the life-long health of the child. Appropriate, health-promoting practices, such as breastfeeding, should be encouraged by healthcare professionals.