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Biomedical subjects

N Tinanoff

Publications and source records attributed to N Tinanoff.

At least 19 recordsLinked to original sources

Evaluation of microbiological screening systems using dental plaque specimens from young children aged 6-36 months.

Using cotton swab specimens of dental plaque from children aged 6-36 months, four commercial chairside tests for oral bacteria were evaluated by comparison with conventional selective culture: mitis salivarius kanamycin bacitracin agar for mutans streptococci and Rogosa SL agar for lactobacilli. Representative colonies of all isolates were identified by commercial identification kits. According to qualitative evaluations, all chairside tests for mutans streptococci were effective in our population. Those for lactobacilli were not as effective, due mainly to a high recovery of yeast contaminants.

Bacterial Typing Techniques↗

Dental caries patterns and oral health behaviors in Arizona infants and toddlers.

OBJECTIVES: The aim of this study was to use tooth eruption sequence, and a tooth- and surface-specific caries analysis method to determine: (1) the temporal relationship between tooth eruption and caries onset; (2) the validity of pre-existing concepts of caries progression; and (3) the relationship of certain putative health behaviors with caries prevalence. METHODS: A total of 2,428 Arizona children aged 6-36-months, who were recruited from WIC programs (a federal program for low-income children at nutritional risk), health fairs and private day care centers, received visual dental caries examinations. Additionally, an oral health behavior survey was administered to the parents of the 1,529 children recruited from the WIC programs. RESULTS: Dental caries was detected soon after tooth eruption, and by 34-36 months of age 25% of this population had caries. Maxillary anterior caries developed as early as 10-12 months of age. Fissure caries of the molars, either by itself or with maxillary anterior caries, was seen as early as 13-15 months of age. Posterior proximal caries was seen as early at 19-21 months, and only was present in conjunction with the other patterns. Over 40% of the 13-36-month-old children whose parents completed the survey still used a bottle. Night-time bottle use was associated with maxillary anterior caries in 24-36-month-old children, but no association was found in younger children or with posterior caries patterns. Survey responses also showed that fewer than 15% of these children reported having had a dental visit. CONCLUSIONS: Dental caries was a significant health issue for these children under 3 years of age, and factors other than bottle feeding may play an important role in its etiology. Prevention of dental caries in children under age three will depend on a better understanding of the etiology as well as improved access to care.

Age Factors↗

Clinical decision-making for caries management in primary teeth.

The aim of this review of clinical decision-making for caries management in primary teeth is to integrate current knowledge in the field of cariology into clinically usable concepts and procedures to aid in the diagnosis and therapy of dental caries in primary teeth. The evidence for this paper is derived from other manuscripts of this conference, computer and hand searches of scientific articles; and policy statements of councils or commissions of various health organizations. Current evidence regarding the carious process and caries risk assessment allows the practitioner to transcend traditional surgical management of dental caries in primary teeth. Therapy can focus on patient-specific approaches that include disease monitoring and preventive therapies supplemented by restorative therapies. The type and intensity of these therapies should be determined utilizing data from clinical and radiograph examinations as well as information regarding caries risk status; evidence of therapy outcomes; assessment and reassessment of disease activity; natural history of caries progression in primary teeth; and preferences and expectations of guardians and practitioners. Changes in the management of dental caries will require health organizations and dental schools to educate students, practitioners, and patients in evidence- and risk-based care.

Anti-Infective Agents, Local↗

Dietary determinants of dental caries and dietary recommendations for preschool children.

OBJECTIVES: The purpose of this review, commissioned by the Administration for Children and Families, the Health Resources and Services Administration, the Health Care Financing Administration, and the Department of Agriculture's Food and Nutrition Service, was to update the evidence of the dietary factors that affect dental caries, and subsequently formulate dietary recommendations for preschool children based on principles of cariology. METHODS: Literature on the dental caries process, dietary factors affecting dental caries initiation and progression, and nutrition education and counseling were reviewed and synthesized. Dietary guidelines for children at various ages were then constructed based on the review. RESULTS: Dental caries in preschool children is due to a combination of factors, including colonization of teeth with cariogenic bacteria, type of foods and frequency of exposure of these foods to the cariogenic bacteria, and susceptible teeth. Caries risk is greatest if sugars are consumed at high frequency and are in a form that is retained in the mouth for long periods. Sucrose is the most cariogenic sugar because it can form glucan that enables firm bacterial adhesion to teeth and limits diffusion of acid and buffers in the plaque. There is emerging interest in the effects of tooth development and its role in the future dental caries risk of the child. CONCLUSIONS: Nutrition education and counseling for the purposes of reducing caries in children is aimed at teaching parents the importance of reducing high frequency exposures to obvious and hidden sugars. Guidelines include: avoiding frequent consumption of juice or other sugar-containing drinks in the bottle or sippy cup, discouraging the behavior of a child sleeping with a bottle, promoting noncariogenic foods for snacks, fostering eating patterns consistent with the Food Guide Pyramid, limiting cariogenic foods to mealtimes, rapidly clearing cariogenic foods from the child's oral cavity either by toothbrushing or by consumption of protective foods, and restricting sugar-containing snacks that are slowly eaten (e.g., candy, cough drops, lollipops, suckers). Along with nutritional factors, a comprehensive approach to preventing dental caries in preschool children must include improved general dietary habits, good oral hygiene, appropriate use of fluorides, and access to preventive and restorative dental care.

Bacteria↗

The relationship between bottle usage/content, age, and number of teeth with mutans streptococci colonization in 6-24-month-old children.

OBJECTIVES: Mutans streptococci (MS) are the primary pathogens involved in the development of early childhood caries. However, factors that may affect their acquisition in the mouths of young children are not well understood, and the period of initial colonization remains controversial. This study investigated the relationship of age, number of teeth, and bottle usage/content with regard to the isolation of MS in 6-24-month-old children. METHODS: A total of 122 children from low-income families attending a nutritional supplement program, and their mothers, participated in this study. Children were examined for dental caries and number of erupted teeth and were sampled for MS. Mothers were administered a questionnaire to obtain details of baby bottle use, including what food items were put in the bottle during the last week. RESULTS: MS was detected in more than one-third of the 6-24-month-olds. Unlike some studies that suggest a later period of infectivity, approximately 20% of children under 14 months of age, including 4 of 22 infants aged 6-9 months, were colonized with MS. When examined separately, age, number of teeth, and bottle usage/content were each found to be related to the presence of MS. Mutans streptococci colonization was more likely with increasing age and number of teeth, and children whose bottles contained sweetened beverages were more likely to be colonized than children whose bottles contained milk. Logistic regression models that controlled for both age and number of teeth indicated that children who consumed sweetened beverages in their baby bottle had a statistically significant, four-fold increase in the odds of colonization by MS relative to children who consumed milk. CONCLUSIONS: The finding that approximately 20% of the children under 14 months of age were infected with MS indicates that colonization in this sample of low-income preschool children may begin earlier than suggested by some investigations. Additionally, the risk of MS colonization appears lower among infants who consume milk rather than sweetened beverages in the bottle.

Age Factors↗

Introduction to the Early Childhood Caries Conference: initial description and current understanding.

The objective of this paper is to introduce the issues discussed at the Early Childhood Caries Conference, held October 18-19, 1997, in Bethesda, Maryland. Early childhood caries (ECC) is of epidemic proportions in some US minority populations and in many developing countries. However, the inadequate information and research on dental caries in infants and toddlers appears to have fostered acceptance of some incorrect assumptions regarding its etiology and prevention. To reexamine the current knowledge of ECC, leaders in this field have critically reviewed the biological and psychosocial mechanisms, public health implications, prevention, research and policy needs. An additional goal of the conference was to convey the health implications and societal costs of this highly prevalent childhood disease to the public, health care providers and policy-makers.

Bottle Feeding↗

Early childhood caries: a positive beginning.

Early childhood caries (ECC) is among the most prevalent health problems of low-income infants and toddlers, yet little attention and few resources have been allocated to understanding this disease. Since dental caries in infants and toddlers cannot be exclusively ascribed to feeding practices, other concepts regarding its etiology and prevention need to be examined. Furthermore, the establishment of evidence-based policies regarding this basic health problem is critical for the dissemination of consistent standards of care to health care providers and government agencies. To accomplish these objectives, the scientific community, organizations concerned with children's health and the political process need to be energized to find resources and energy to solve this public health challenge.

Child↗

Colonization of mutans streptococci in 8- to 15-month-old children.

OBJECTIVE: The age at which a child becomes colonized with mutans streptococci (MS) is important for understanding early childhood caries. The aim of this study was to explore the relationship of age with MS colonization in infants. METHODS: Inner-city children (n = 149) between the ages of 8 months and 15 months, inclusive, who reportedly were still using a baby bottle, were sampled for MS. RESULTS: Evidence of MS colonization was seen as early at 10 months of age. For children 12 months old or younger (n = 80), 25 percent had detectable levels of MS; in the 15-month age group, 60 percent were colonized. CONCLUSION: This study suggests that prevention of MS colonization in some populations may need to be initiated prior to the child's first birthday.

Age Factors↗

The association of early dental caries patterns with caries incidence in preschool children.

OBJECTIVES: This study assessed the development of caries in preschool children over two years according to baseline caries pattern. METHODS: Connecticut Head Start children (n = 142, mean age = 3.8 years) were examined for dental caries at baseline (spring 1991) and once annually for two years. Children were categorized at baseline as caries-free, having pit and fissure (PF) caries, or having maxillary anterior (MA) caries. RESULTS: After two years, children who presented at baseline with MA or PF caries had a mean posterior dmfs of greater than seven and four times, respectively, that of children who were caries-free at baseline. When dental caries of the primary dentition was categorized by specific posterior patterns (i.e., posterior proximal [PP] and buccal/lingual [BL]), change in dmfs for the PP and BL patterns in the group that presented with pit/fissure caries at baseline were nearly four and three times greater, respectively, than for those in the caries-free group. The group that presented with maxillary anterior caries at baseline had PP and BL caries increments eight times those of children who began caries-free. CONCLUSION: Dental caries presentation in 3- to 4-year-old children can identify those children and tooth surfaces that will be at the greatest risk for future caries development.

Bicuspid↗

Temporal changes in dental caries levels and patterns in a Native American preschool population.

OBJECTIVES: The purposes of this study were to assess current dental caries experience and levels of mutans streptococci in Apache children in 1993 and to determine how caries levels and patterns were different from 15 years before. METHODS: Four-year-old Head Start children (n = 127) were examined for dental caries and sampled for salivary mutans streptococci in 1993. Dental caries information on 113 4-year-old children from the same location was obtained from a chart audit of the 1978-79 Head Start dental examinations. RESULTS: Neither the caries prevalence (95%) nor the prevalence of caries patterns differed between the 1978-79 and 1993 cohorts. However, the level of treatment received in 1993 was greater than that in 1978-79. Children with nursing caries (64%) had a greater severity of fissure caries and a greater prevalence of posterior proximal caries compared with caries-positive children without nursing caries. The mean dmfs and dmft on the children categorized in the high mutans streptococci range were greater than those of children categorized in the moderate range. CONCLUSIONS: The caries prevalence found in these preschool Native Americans is among the highest reported for this age group and does not differ from that found at this location 15 years before. It appears that children with nursing caries in this population are at greater risk for posterior caries patterns.

Arizona↗

Dental treatment of Papillon-Lefèvre syndrome: 15-year follow-up.

A 9-year-old girl was initially treated for the periodontal component of Papillon-Lefèvre syndrome by extraction of all patient's erupted teeth, after unsuccessful clinical treatment with two different antibiotics. Follow-up dental records at age 24 showed the patient to have generalized gingivitis and poor oral hygiene; however, no additional teeth were lost or mobile. Radiographically, the alveolar crests, lamina dura, and periodontal ligament spaces appeared normal for a subject with missing teeth. Initially, the patient had depressed polymorphonuclear leukocyte (PMN) chemotaxis and adherence, as well as evidence of periodontal infection with Actinobacillus actinomycetemcomitans, (A.a.). The 6 and 15-year follow-ups showed normal PMN function and no detectable A.a. The improvement of the patient's PMN function was coincident with lack of detection of certain periodontopathic bacteria. If the PMN dysfunction of PLS is secondary to the infection, the reasons for the initiation of the disease still need to be clarified.

Actinobacillus Infections↗

Caries prevalence and patterns in 3-6-year-old Beijing children.

A total of 400 Beijing children, 3-6-yr-old, equally distributed by age and sex, were examined for dental cares. Results were analyzed with the traditional dmfs/t index and with the Caries Analysis System. The system differentiated between caries patterns and examined the percentage of affected children (Prevalence), the degree to which these children were affected (Severity), and the proportion of total caries each disease pattern represented (Distribution). Over 67% of the children experienced caries, a level comparable to other reports from China and other developing countries, but 50% greater than those seen in United States preschool children. Nearly all children with caries experienced fissure caries. In 3-yr-olds maxillary anterior caries was the next most prevalent pattern with 43% affected, whilst in the 6-yr-olds, posterior proximal caries was the second most prevalent pattern with 68% affected. Since maxillary anterior caries was so prevalent, and because the presence of this pattern has been shown to be a risk factor for future caries, preventing the maxillary anterior pattern may markedly reduce caries in this population.

Age Distribution↗