Transcript Dental Caries in Preschool

Dental Caries in
Preschool-Age Children
K AT I E S CHL AT TMANN
F UN DA MENTAL S OF P UBLI C HEALT H
CON COR DI A UN I V ERSITY
Etiology of Disease
Normal oral flora
Caries process
Caries 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 buildup 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 Progression
1. 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-brushingteeth.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 caries
Malnourished 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 foods
Source: 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
Healthy People 2010 target of 11%
Source: (Dye, Tan, & Smith, n.d.)
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 periodontal
diseases. 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 Oral
Health. 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 of
water fluoridation. Age, 1979(80), 1986-87.
Febres, C., Echeverri, E. A., & Keene, H. J. (1997). Parental awareness, habits, and social factors and their
relationship 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). Surveillance
for dental caries, dental sealants, tooth retention, edentulism, and enamel fluorosis—United States,
1988-1994 and 1999-2002. MMWR Surveill Summ, 54(3), 1-43.
References
National 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.h
tm
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
http://www.drowais.com/dental-conditions/baby-bottle-syndrome.asp
from:
Malmö University. (n.d.) What is dental caries?. Retrieved from: http://www.mah.se/fakulteter-ochomraden/Odontologiskafakulteten/Avdelning-och-kansli/Cariologi/Cariology/What-is-dental-caries/
http://asifdental1.blogspot.com/p/dental-caries.html
http://goeshealth.com/healthy-teeth/tips-to-children-brushing-teeth.html