Dental Caries in Preschool-Age

ChildrenKATIE SCHLATTMANN

FUNDAMENTALS OF PUBLIC HEALTH

CONCORDIA UNIVERSITY

Etiology of DiseaseNormal oral floraCaries processCaries causing bacteria

Source: http://asifdental1.blogspot.com/p/dental-caries.html

Normal Flora microcolonies of bacteria live on teeth in the organic matrix of proteins, DNA, and carbohydrates (Selwitz et al., 2007). prevent desiccation, protect from host defenses and predators, and offer resistance to antimicrobial agents (Selwitz et al., 2007). normally found on tongue papilla

Caries Process bacteria leaves tongue papilla and inhabits subgingival crevice (Liljemark & Bloomquist, 1996).

fermentation of carbohydrates leads to build-up of weak organic acids (Selwitz et al., 2007).

increase in weak organic acids causes pH levels to drop and demineralization occurs (Selwitz et al., 2007).

demineralization will eventually lead to cavitation

Source: dentalorg.com. (2011).

Caries Progression1. Healthy tooth

2. White spot indication of demineralization

3. Carious lesion, enamel has broken down

4. Filled and decayed tooth, demineralization continues

5. Demineralization continues further

6. Fractured tooth

(Malmö University, n.d.)Source: http://www.mah.se/fakulteter-och-omraden/Odontologiska-fakulteten/Avdelning-och-kansli/Cariologi/Cariology/What-is-dental-caries/

Caries Causing Bacteria Streptococcus mutans Streptococcus sobrinus Veillonella spp. Actinomyces spp. Bifidobacterium spp. Lactobacillus (Tanzer et al., 2001) & (Aas et al., 2008).

Gram stain of S. mutans. Source: Todar, K. (2012)

Social and Behavioral Causes education of mothers dental knowledge social status family structure social networks usage of baby bottles stress and self-esteem levels (Ismail, 1998).

Who is most affected by dental caries? “most common chronic childhood disease of children aged 5 to 17 years” (Bagramian et al., 2009, p. 3). 50% of American children before age 5 have caries (Bagramian et al., 2009). 75% of American children age 17 have at least one cavity (Bagramian et al., 2009).

Source: http://goeshealth.com/healthy-teeth/tips-to-children-brushing-teeth.html

Brief Background of Study The purpose of this study was to determine if a relationship exists between ethnicity, socioeconomic status, and the prevalence of dental caries in preschool age children in the United States. The goal of this study was to interview preschool children’s guardians to get a better understanding of oral health behaviors, daily sugar intake, economic status, and child’s stress levels. Dental screenings that counted the number of decayed, missing, and filled tooth surfaces in conjunction with bacterial colony counts determined the prevalence of dental caries

Fluoride Children without access to water have a greater risk of developing caries (Brunelle, Carlos, & Branch, 1990) allows for remineralization of tooth to occur (Featherstone, 1999) prevents demineralization (Featherstone, 1999) inhibits enzyme activity of bacteria (Featherstone, 1999)

Baby Bottle Tooth Decay tooth decay as a result of inappropriate bottle or breast feeding (Barnes et al., 1992) giving infants a bottle which contains a

cariogenic liquid at bedtime (Barnes et al., 1992) Milk Juice Soda

prolonging bottle feeding past 12 months in age (Barnes et al., 1992)

Source: http://www.drowais.com/dental-conditions/baby-bottle-syndrome.asp

Caries and Nutrition High sugar diets lead to cariesMalnourished children are more likely to have dental caries A study in Latin America discovered that: Malnourished children have more decayed,

extracted, and filled teeth (DEFT) Mean DEFT of 7 Well-nourished children had a DEFT of 5.5

(Alvarez, 1995) The amount of sugar in common foodsSource: http://reachingutopia.com/sugar-in-food/

Socioeconomic Status and Dental Caries 80% of dental caries in children can be localized to 25% of children in the United States” (Edelstein, 2002) Black and Hispanic children are more likely to develop dental caries Native American populations have the highest rate of dental caries 75% of native children ages 2-4 have experienced tooth decay and 90% have

caries by age 15 (Indian Health Services, 2002).

Socioeconomic Status cont. BBTD rate is dependent on ethnicity

Range of 1% - 53.1% Parental over-indulgence to blame (Febres, Echeverri, & Keene, 1997)

children that live at/below federal poverty level are more likely to have caries 55.3% caries incident rate 30.7% caries rate for children that lived at two times the FPL (Beltrán-Aguilar et al., 2005)

Mexican children have higher rate of caries 54.9% caries rate white children had a caries rate of only 37.9% (Beltrán-Aguilar et al., 2005)

Caries Rate in Children Ages 2 – 4 by Race

Source: (Dye, Tan, & Smith, n.d.)

Healthy People 2010 target of 11%

Solution to the Problem Educate parents on:

Baby bottle tooth decay Oral care The effects of high sugar diets

Ensure access to fluorinated water

Ensure access to dental care for all

International Caries Detection and Assessment System II (ICDAS) focuses on early lesion detection increases the opportunity to arrest and reverse tooth

damage requires more rigorous training than that of a surgical

approach seen in most dental practices (Milgrom et al., 2009).

(National Institute of Dental and Craniofacial Research, n.d.)http://www.nidcr.nih.gov/OralHealth/OralHealthInformation/ChildrensOralHealth/ToothDecayProcess.htm

References Featherstone, J. D. (1999). Prevention and reversal of dental caries: role of low level fluoride. Community dentistry and oral epidemiology, 27(1), 31-40.

Dye, B. A., Tan, S., & Smith, V. QuickStats: Percentage of Children Aged 2--4 Years Who Ever Had Caries in Primary Teeth,* by Race/Ethnicity and Sex---National Health and Nutrition Examination Survey, United States, 1988--1994 and 1999--2004.

Selwitz, R. H., Ismail, A. I., & Pitts, N. B. (2007). Dental caries. The Lancet, 369(9555), 51-59.

Liljemark, W. F., & Bloomquist, C. (1996). Human oral microbial ecology and dental caries and periodontaldiseases. Critical Reviews in Oral Biology & Medicine, 7(2), 180-198.

Aas, J. A., Griffen, A. L., Dardis, S. R., Lee, A. M., Olsen, I., Dewhirst, F. E., ... & Paster, B. J. (2008). Bacteria of dental caries in primary and permanent teeth in children and young adults. Journal of clinical microbiology, 46(4), 1407-1417.

Tanzer, J. M., Livingston, J., & Thompson, A. M. (2001). The microbiology of primary dental caries in humans. Journal of dental education, 65(10), 1028-1037.

Todar, K. (2012). Todar's Online Textbook of Bacteriology. Retrieved from: http://textbookofbacteriology.net/index.html

References Milgrom, P., Zero, D. T., & Tanzer, J. M. (2009). An examination of the advances in science and technology of

prevention of tooth decay in young children since the Surgeon General's Report on OralHealth. Academic pediatrics, 9(6), 404-409.

Ismail, A. I. (1998). Prevention of early childhood caries. Community dentistry and oral epidemiology, 26(S1), 49-61.

Brunelle, J. A., Carlos, J. P., & Branch, E. (1990). Recent trends in dental caries in US children and the effect ofwater fluoridation. Age, 1979(80), 1986-87.

Febres, C., Echeverri, E. A., & Keene, H. J. (1997). Parental awareness, habits, and social factors and theirrelationship to baby bottle tooth decay. Pediatric dentistry, 19, 22-27.

Bagramian, R. A., Garcia-Godoy, F., & Volpe, A. R. (2009). The global increase in dental caries. A pending public health crisis. Am J Dent, 22(1), 3-8.

Beltrán-Aguilar, E. D., Barker, L. K., Canto, M. T., Dye, B. A., Gooch, B. F., Griffin, S. O., ... Wu, T. (2005). Surveillancefor dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis—United States,1988-1994 and 1999-2002. MMWR Surveill Summ, 54(3), 1-43.

ReferencesNational Institute of Dental and Craniofacial Research. (2013). The Tooth Decay Process: How to Reverse It and Avoid a Cavity. Retrieved from: http://www.nidcr.nih.gov/OralHealth/OralHealthInformation/ChildrensOralHealth/ToothDecayProcess.htm

Hunter, D. (2013, June 26). Sugar In Food – A Surprising Amount In Everything!. Retrieved from: http://reachingutopia.com/sugar-in-food/.

Edelstein, B. L. (2002). Disparities in oral health and access to care: findings of national surveys. Ambulatory pediatrics, 2(2), 141-147.

Indian Health Service, U.S. Department of Health and Human Services. (2000). The 1999 Oral Health Survey of American Indian and Alaska Native Dental Patients: Findings, Regional Differences and National Comparisons, Rockville, MD: Indian Health Service.

http://www.drowais.com/dental-conditions/baby-bottle-syndrome.asp, (n.d.). Baby bottle syndrome. Retrieved from: http://www.drowais.com/dental-conditions/baby-bottle-syndrome.asp

Malmö University. (n.d.) What is dental caries?. Retrieved from: http://www.mah.se/fakulteter-ochomraden/Odontologiska-fakulteten/Avdelning-och-kansli/Cariologi/Cariology/What-is-dental-caries/

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