Article

Beyond the DMFT: The Human and Economic Cost of Early Childhood Caries

Department of Dentistry, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205, USA.
Journal of the American Dental Association (1939) (Impact Factor: 2.24). 07/2009; 140(6):650-7. DOI: 10.14219/jada.archive.2009.0250
Source: PubMed

ABSTRACT Early childhood caries (ECC) is the most common disease of childhood and often is accompanied by serious comorbidities affecting children, their families, the community and the health care system. This report describes morbidity and mortality associated with ECC and its treatment.
The authors reviewed the literature for descriptions and quantification of morbidity associated with ECC and organized a wide range of studies into a visual model--the morbidity and mortality pyramid--that begins to convey the breadth and depth of ECC's penetration.
ECC exacts a toll on children, affecting their development, school performance and behavior, and on families and society as well. In extreme cases, ECC and its treatment can lead to serious disability and even death. In finding access to care and managing chronic pain and its consequences, families experience stress and, thus, a diminished quality of life. Communities devote resources to prevention and management of the condition. The health care system is confronted with management of the extreme consequences of ECC in hospital emergency departments and operating rooms.
Traditional epidemiologic measures such as the decayed-missing-filled teeth (dmft) index do not adequately portray the effects of ECC on children, families, society and the health care system.
The impact of prevention and management of ECC requires the attention of health care professionals and decision makers and extends well beyond the dental office to regulatory and child advocacy agencies as well as public health officials and legislators.

4 Followers
 · 
235 Views
  • Source
    • "Alterations in the composition of the oral microbiota are associated with the initiation and development of oral diseases such as dental caries and periodontal disease (Liljemark and Bloomquist, 1996). These diseases can lead to severe pain, impaired quality of life and infections such as cellulitis and osteomyelitis (Casamassimo et al., 2009; US-NLM, 2010a). More importantly, they can predispose patients to potentially fatal diseases such as infective endocarditis (Biswas et al., 2010; Nomura et al., 2013). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Oral diseases, specifically dental caries and periodontal disease, are characterised by increases in pathogenic microorganisms, increased demineralisation and increased inflammation and levels of inflammatory markers. Despite the therapeutic strategies, oral diseases have elevated prevalence rates. Recent work has demonstrated that probiotic bio-therapeutics can decrease oral pathogen counts, including caries-causing Streptococcus mutans and oral inflammation. The aim of this work was to investigate putative probiotic bacteria, selected for S. mutans inhibition and for their oral health-promoting characteristics. The probiotic bacteria were screened for S. mutans inhibition, probiotic bacteriocin activity, salivary pH modulation, probiotic nutrient (sucrose) competition, probiotic co-aggregation with S. mutans, bacterial attachment to oral epithelial keratinocytes, bacterial nitric oxide production and bacterial antioxidant activity. The results indicate that Lactobacillus reuteri strains NCIMB 701359, NCIMB 701089, NCIMB 702655 and NCIMB 702656 inhibited S. mutans to non-detectable levels (<10 cfu/ml). L. reuteri strains also demonstrated the highest antioxidant capacity of the tested strains (7.73-13.99 ┬ÁM Trolox equivalents), suggesting their use as both caries and periodontal disease therapeutics. Although Lactobacillus fermentum NCIMB 5221 inhibited S. mutans at lower levels, it significantly buffered the pH (4.18) of saliva containing S. mutans, co-aggregated with S. mutans (10.09%), demonstrated high levels of sucrose consumption (138.11 mM) and successfully attached to gingival epithelial cells (11%). This study identified four L. reuteri strains and one L. fermentum strain to be further investigated as oral disease biotherapeutics.
    Beneficial Microbes 07/2014; 5(4):1-14. DOI:10.3920/BM2014.0011 · 1.50 Impact Factor
  • Source
    • "Although levels of dental caries have decreased globally during the past decades, caries is still highly prevalent and a major cause of oral pain, and impacts on the quality of life of children in numerous countries (Casamassimo et al., 2009; Krisdapong et al., 2009). Many children have untreated dental decay that causes toothache and impacts on daily life activities such as eating, sleeping, studying and emotional stability (Krisdapong et al., 2009; Lewis and Stout, 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to assess associations between sociodemographic and oral health behavioural factors with dental caries and oral health-related quality of life (OHRQoL) attributed to dental caries in a national representative sample of 12- and 15-year-old Thai children. A representative subsample from the sixth Thailand National Oral Health Survey, 1,063 12-year-olds and 811 15-year-olds, completed a questionnaire on sociodemographic and behavioural information and were orally examined and interviewed about OHRQoL using the Child-OIDP or OIDP indexes. Associations of sociodemographic and behavioural factors with DMFT and Condition-Specific impacts (CS-impacts) attributed to dental caries were investigated using Chi-square tests and regressions. For both groups, DMFT scores were associated with gender, geographic area and recently receiving dental treatment. Geographic area was the only sociobehavioural factor independently associated with CS-impacts. Dental caries accounted for the significant associations of sugary snacks and drinks consumption with CS-impacts. Significant associations of CS-impacts with consuming crispy snacks in 12-year-olds and fizzy drinks in 15-year-olds became non-significant when DT was entered into models. There were considerable geographic differences in DMFT and CS-impacts attributed to dental caries among Thai children.
    Community dental health 06/2013; 30(2):112-8. · 0.87 Impact Factor
  • Source
    • "In children in industrialized countries, dental caries is up to five times more prevalent than the second most prevalent chronic condition, asthma (USHHS, 2000). Dental caries is a major cause of pain and infection which can have severe consequences for the quality of life of the affected children and their families (Casamassimo et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: The rapid changes in social and economic conditions in many populations may have significant impacts on health, including child oral health. Understanding trends and variations between and within countries will assist in the development of effective preventive programs. This review aims (1) to document time-trends in child caries experience of countries with different levels of social and economic development, and (2) to compare factors affecting the caries experience of children in two contrasting countries. A time-trend analytical approach of ecological data from countries with different levels of social and economic development and individual data of the two contrasting Vietnamese and Australian child populations were used. The analysis found a significant decline in caries experience of children, mostly driven by the improvement in populations with high social and economic development. Significant variations in caries experience and in associations with risk factors between and within countries were observed. Socio-economic inequality in child oral health existed within developed countries and between countries with different levels of development. Population programs aimed at improving upstream factors are of priority in further improving child oral health in different populations.
    Journal of dental research 01/2012; 91(6):536-43. DOI:10.1177/0022034511434355 · 4.14 Impact Factor
Show more