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[Study on availability of dental health services for children in health center--correlation between attendance of 3-year-old children at dental health services and caries prevalence].

The purpose of this study was to evaluate the dental health services for children in a health center. The samples were 316 children who had 3-year-old dental examination at a health center in Tokyo. The analysis was carried out by a computer using the results of the children's oral status and of their mothers', questionnaires and past records showing when and how many times they had attended such activities. The results were as follows: 1. Attendance of children at dental services showed the effectiveness in preventing dental caries, and it was suggested that attendance at least 3 times before the age of 18 months should be the most effective way to decrease the dental caries in the 3-year-olds. 2. According to the questionnaires, time of going to bed, snacks time, and the habit of thumb-sucking at the age of 3 years, and stopping the habit of bottle-feeding and of night breast-feeding at 18 months of age showed a great correlation concerning the number of dental caries in the 3-year-olds. 3. The more often the children had attended the dental services, the more often their behavior for eating snacks and toothbrushing changed for the better. 4. The more the mothers had dental caries, the more was the number of dental caries in their children and moreover their attendance at the dental services was less.

Adult↗

The role of fats in the lifecycle stages: the primary school years.

The most significant influence on a child's eating patterns is family eating behaviour, specifically in encouraging fruit and vegetable intake. The recommended 30% total energy from fat can be achieved by practical changes in eating pattern, such as limiting high fat snack foods to occasional or treat items. Saturated fat intake can be reduced to recommended levels by reducing intake from whole milk and yoghurt, ice-cream, and potato and snack items, and replacing part of this with monounsaturated and polyunsaturated fatty acid sources such as nuts, seeds, margarine or hummus dips.

Child↗

[Epidemiologucal studies on the health condition of the masticatora organ as related to sugar consumption].

In the Republic of Cuba, the authors compared, using the method of dietary interviewing, the oral findings (DMF/T, OHI-S, PDI and plaque pH) of children with primarily caries-free dentitions (25 children), with a DMF/T index up to 2.0 (50 children) and with a DMF/T index of more than 6.0 (50 children) with their eating habits. The nutrition index determined for the sugar consumption in the last-mentioned group was by 38% (meals) and by 48% (between-meal snacks) higher than that found in the group of primarily caries-free children. The other indices were also significantly higher. The group with a DMF/T index up to 2.0 holds an intermediate place. Since all the children originated from the same region and since there were no differences in dental and oral care between the groups, the individual differences in oral hygiene and in diseases of the dental hard structures and of the periodontium must be attributed to the individual sugar consumption, the between-meal snacks seeming to play a dominating role.

Child↗

[Television publicity and food preferences of school age children of the metropolitan region].

BACKGROUND: There is an alarming increase in the prevalence of child obesity in Chile. Lack of exercise and bad feeding habits strongly strongly contribute to the problem. AIM: To investigate the influence of television publicity on school age children food preferences. MATERIAL AND METHODS: A semi structured interview was applied to a representative sample of 786 school age children aged 6 to 11 years old, living in Metropolitan Santiago. Time watching television during week days and the attitude towards food and beverage commercials was analyzed and related to food preferences. RESULTS: Ninety nine percent of school age children watch television during week days and 20% watches more the three hours daily. Snack commercials such as those about potato chips, chocolates, cookies and ice cream, are preferred by 35% of children. Soda commercials are preferred by 33% and yoghurt commercials by 12%. Eighty five percent of children had money to buy food. Of these, 66% bought snacks, 15% bought sodas and 7% yoghurt. The same tendency was observed in school collations. CONCLUSIONS: The high percentage of children, watching television and the influence of commercials in their food preferences, requires an urgent educational strategy to promote healthy feeding habits.

Adolescent↗

The acute effect of D-tagatose on food intake in human subjects.

A double-blind randomized crossover study was performed with nineteen normal-weight men to investigate the effect on subsequent ad libitum food intake of replacing 29 g sucrose with 29 g D-tagatose as sweetener to a breakfast meal. D-Tagatose is a malabsorbed stereoisomer of fructose with potential application as a bulk sweetener. Food intake was measured at lunch offered 4 h after the breakfast meal, during the afternoon with access to abundant snacks, and finally at a supper buffet 9 h after the breakfast. Energy intake at lunch and during the snacking period was similar after ingesting the two sugars, while it was 15% lower after ingesting D-tagatose than with sucrose at supper (P < 0.05). Gastrointestinal factors such as the osmotic effects of unabsorbed D-tagatose causing distension of the gut might have mediated the acute appetite-suppressing effect. The present paper also refers to data from a preceding study in which we observed an increased self-reported energy intake after ingestion of D-tagatose compared with sucrose which, in fact, suggests a relative hyperphagic effect of D-tagatose. However, self-reported food intake may be biased by selective under-reporting and this subsequent study with a more controlled assessment of food intake was therefore conducted. This present study did not support any hyperphagic effect of D-tagatose, but rather suggests that D-tagatose may contribute to a reduced energy intake.

Adult↗

[Evaluation of the nutritional status and feeding patterns of 3-7 year old children --results of a questionnaire].

Questionnaire studies on feeding patterns and nutritional status of 822 pre-school children (age 3-7) in different regions of Poland were performed between June 1999 and January 2000. Nutritional status was evaluated on the basis of anthropometric indices - height, body weight, body mass index (BMI) and BMI z-score. The mode of feeding was evaluated on the basis of recall of 24-hours menus. Average daily food rations and their nutritional value were calculated from the questionnaires data. Quantity and number of meals were also evaluated. In a group of 402 boys the average height was between 75-90 percentiles and body mass (50-75 percentiles). In 420 girls the average height was about the 90 percentile (age 3-4) and between 75-90 percentiles (age 5-7). The study showed that normal BMI z-score was found in 75% of children, underweight in 16.5% overweight and obesity in 8.5%. Feeding patterns showed great than differences. It was found that meat, fat, sweets and sugar content in daily food rations exceeded the recommended for pre-school children, but the vegetables intake was lower than recommended. Vitamins A and C deficiency in average daily rations didn't occur. The fat intake provided 36% of total energy, whereas carbohydrates (without lactose and starch) - about 20%. This can have inhibitory effect on microelements (Fe, Zn) absorption. Attention must be paid to the choice of products and the wrong distribution of total energy intake in daily rations. The habits of snack eating between the meals were reported in 91% of children. These snacks consisted of fruits, chips, french fries, sweets and sandwiches. These products provides 232 kcal +/- 171 kcal/day.

Body Height↗

Factors affecting caries levels amongst 5-year-old children in County Kerry, Ireland.

OBJECTIVE: To investigate the factors associated with high caries levels in 5-year-old children in the Kerry Community Care Area of the Southern Health Board in Ireland. DESIGN: Cross-sectional study. SETTING: County Kerry, Ireland in 1997. SUBJECTS: A random sample of 5-year-old children. METHOD: Six hundred and thirty-six 5-year-old children were examined for caries following WHO diagnostic criteria. Information on possible caries risk factors was collected by means of a parental questionnaire. RESULTS: Using multivariate logistic regression analysis the variables most significantly associated with the presence of caries were water fluoridation status, whether or not the child took the baby feeding bottle to bed, the age at which tooth brushing started and the number of sweet snacks and drinks taken in a day. While there was a wide variation in caries levels between nine geographic areas in Co. Kerry the only significant geographic variation found was between fluoridated and non-fluoridated areas. CONCLUSION: The prevalence of dental caries amongst 5-year-old children in Co. Kerry was highest in those residing in non-fluoridated communities, in those who took a baby feeding bottle to bed, in those who did not commence tooth brushing until after two years of age and in those who had sweet snacks or sweet drinks between meals three or more times per day.

Bottle Feeding↗

Eating and smoking behaviours of school children in southwestern Ontario and Charlottetown, PEI.

We conducted in-class written surveys of fourth to eighth grade children's eating and smoking behaviours in southwestern Ontario (n = 870) and Charlottetown (n = 423) in order to facilitate local school boards' and health units' planning of health education initiatives. Using chi-square analysis, we examined sex, grade, provincial and rural-urban differences in behaviours. No rural-urban differences emerged. While students reported few gender differences in food group consumption, more PEI students consumed French fries, snack foods, cakes and cookies, and regular soft drinks daily. Only 60.1% (379/630) of girls and 70.0% (462/660) of boys (chi 2 = 13.8; p < 0.001) ate breakfast every day, falling to 53.2% (115/216) among eighth grade girls, and 32.9% (25/76) among students who smoked. The prevalence of smoking was 4.8% (n = 40) in Ontario and 8.5% (n = 36) in PEI (chi 2 = 6.8; p < 0.01). Compared to non-smokers, a higher proportion of students who smoked consumed snack foods and regular soft drinks daily. The results emphasize the need to promote healthy eating behaviours and anti-smoking messages among school children.

Adolescent↗

[Nutrition education and oral health].

At present, reduction of the consumption of fat is the main issue in nutritional education. However, this can lead to an increased consumption of mono- and disaccharides and, as a result, to increased dental caries. Individual variations in the susceptibility of caries make it necessary to differentiate the advice for the consumption of snacks between meals. Generally, consumption of complex carbohydrates, such as bread or bread products, can be advised as an alternative for fat and sugar containing snacks. Sugar-free products can also be advised, but not unlimited because of the laxative effect of sorbitol. To prevent tooth erosion the frequent consumption of fruits and fruit juices should be discouraged.

Dental Caries↗

[Nutrition education in dentistry].

Reduction of the number of sugar containing snacks is the most important nutritional measure to prevent dental caries. Frequent use of acid food and drinks can lead to erosion of the enamel. Snacks containing as little fat and as much complex carbohydrates and rough materials as possible are preferred. In nutrition education, general principles of health education, such as attention for personal and social circumstances, have to be kept in mind. Prolonged use of the nursing bottle containing sugar-rich drinks must be prevented. Attention is needed for young people who frequently use soft drinks, sportsmen and women, people with a special dietary pattern, 'grazing' people and people with an illness or handicap.

Dental Caries↗

Determination of St. John's wort components in dietary supplements and functional foods by liquid chromatography.

St. John's wort (Hypericum perforatum L.) preparations, a top-selling botanical dietary supplement used primarily as an antidepressant, has recently been used as an ingredient in some food products sold as functional foods. A rapid extraction technique followed by a liquid chromatographic (LC) method was developed to determine 4 characteristic bioactive compounds (pseudohypericin, hypericin, hyperforin, and adhyperforin) from St. John's wort in dietary supplements and functional foods to which it was added. Solid samples, including dried leaf/flower mixture, dietary supplement capsules, tea bags, puff and snack bar, were extracted with methanol by sonication. Noncarbonated, fruit-flavored drinks were centrifuged and mixed with methanol. Compounds were then determined by isocratic, reversed-phase LC with UV detection at 2 wavelengths and further identified or confirmed by photodiode array spectra and LC/mass spectrometry. Within-laboratory method variations (% RSD) were satisfactory. Very low amounts, if any, of the 4 components were found in drink and puff samples, and none was found in the snack bar. The methods developed provide a useful means for the determination of St. John's wort components in dietary supplements and functional foods.

Algorithms↗

Bodily characteristics and lifestyle of Czech children aged 7.00 to 10.99 years, incidence of childhood obesity.

In 1991-2000 in the Czech Republic a survey of the prevalence of obesity was made. The assessment was made by the transversal method in elementary schools in all regions of the Czech Republic. Children aged 7.00 to 10.99 years were investigated. The survey comprised a total of 3362 children (1668 girls and 1694 boys). A total of 12 anthropometric dimensions were recorded and questionnaires addressed to the children and parents were analyzed. From the results ensued that the ratio of obese children of both sexes in the CR (i.e. children with BMI values about the 97th percentile of the reference population) increased. This zone comprised 6.0% boys and 5.6% girls of the investigated group. An important finding was also the increase of mean values of the abdominal circumference of the children in all age groups in both sexes. The ratio of obese children in different communities is related unequivocally to the size of the community., In smaller communities there are more obese children (according to our data 6.9%) and in large towns the ratio of obese children is 2.3%. In large towns there is also a greater proportion of thin children - 12.1%, in small communities 8.6%. It was found that there is a higher percentage of obese children in families where the mother has elementary education as compared with children of mothers with secondary and university education. Mothers with elementary education have 9.6% obese children while university educated mothers have only 3.6% obese children. Analysis of the dietary questionnaires revealed that only 62.9% children in large towns eat breakfast, the position in villages is similar - 63.9%. In the group of children with excessive body weight fewer children have breakfast (only 54.1%), in the group of children with a low body weigh the majority eat breakfast (75.3%). The majority of children have a mid-morning snack at school which they bring from home. As regards school lunch the majority of children from large towns replied that they have lunch at school. the number of rural children who had school lunch was smaller. An afternoon snack is taken by less than half the children in different groups.

Body Mass Index↗

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, 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 bottle or sippy cup; discouraging the behavior of a child sleeping with a bottle; promoting non-cariogenic foods for snacks; fostering eating patterns consistent with Food Guide Pyramid; limiting cariogenic foods to mealtimes; rapidly clearing cariogenic foods from the child's oral cavity either by tooth brushing 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.

Child Nutrition Sciences↗

Effects of oral health education and tooth-brushing on mutans streptococci infection in young children.

PURPOSE: The purpose of this study was to examine the effects of maternal dental health education and tooth-brushing instruction on the levels of mutans streptococci in pre-school children. METHODS: One hundred and seven children (44 boys and 63 girls) with a mean age of 20.5 months, randomly selected from a community child health clinic within a 2-week period, participated in this study. Medical, dental, and dietary information was obtained through a questionnaire. The children's mouths were examined, and plaque samples were obtained by swabbing the teeth and mucosa. A commercial microbiological kit was used to determine the presence of mutans streptococci. The mothers were instructed in tooth-brushing using a soft-scrub method. The children were recalled to the same clinic after a period of 4 weeks to obtain a second evaluation of the mutans streptococci levels. RESULTS: At the first visit, 69 of the 107 children (64%) showed positive infection with mutans streptococci. Ninety (84%) children returned for the recall examination. In the second examination, only 44 (49%) of the 90 children showed positive results for mutans streptococci. The difference in number of children who tested positive is statistically significant (P < .01). At the first visit, children who did not show infection with mutans streptococci were those who reported greater frequency of tooth-brushing (P < .05) and less snacking (P < .05). There were 26 children (29%) who converted from positive to negative results for mutans streptococci infection between the first and second visits (P < .01). This conversion from positive to negative infection was attributed mainly to increased tooth-brushing, as other dental health habits remained the same. CONCLUSIONS: Infection with mutans streptococci in young children is associated with increased snacking frequency and inadequate tooth-brushing. A single dental health education session and tooth-brushing instruction to mothers results in approximately a 25% reduction in mutans streptococci infection in young children from a relatively high socioeconomic status.

Child, Preschool↗

Salivary stimulation by chewing gum and its role in the remineralization of caries-like lesions in human enamel in situ.

Salivary stimulation elicited reflexively by taste and mastication leads to an increase in the pH, buffering power, and supersaturation of saliva, which can affect beneficially the balance between enamel de- and remineralization in early caries. In a previous study in which a sorbitol chewing gum was used as a salivary stimulant for 20 minutes, five times daily after meals and snacks over a three-week period (during which fluoride toothpaste was used daily), significant remineralization of caries-like lesions in human enamel attached to intraoral appliances in human subjects was observed. In view of the continued public preference for sucrose-sweetened chewing gums, the study was repeated using a sucrose gum. The mean results showed a trend toward remineralization with the use of sucrose chewing gum, which was significant in 10 subjects who chewed for 30 minutes but not in 9 who chewed for 20 minutes. The use of chewing gum after meals and snacks (in the presence of fluoride from toothpaste) can thus enhance the remineralizing potential of the mouth, probably as a result of salivary stimulation.

Analysis of Variance↗

A modified plaque pH telemetry method.

Previous plaque-pH telemetry studies reported the acidogenicity of various foods and dietary patterns to estimate potential cariogenicity. To avoid patient discomfort, improve compliance, and minimize electrode malfunctions, we have simplified our telemetry method and compared it to our previously published model. A removable partial prosthesis with a glass electrode set in the approximal space left by a missing first molar was used in 2 subjects. In the modified method, subjects suspended oral hygiene for 3 days, the prosthesis was then installed on the 3rd day, and accumulated plaque was spread on the electrode and covered with gauze for retention. In comparative tests, the same subjects wore the prosthesis in the mouth during plaque accumulation. Test sessions compared the plaque pH response to 4 treatments: a 10% sucrose rinse, a 10% sorbitol rinse, a snack roll with marmalade and coffee, and the snack followed by gum chewing. Overall, pH curves were similar (mean baselines and minimas) and no significant differences in mean pH response were noted between the 2 methods. The modified method improved subject participation, demonstrated greater reliability, and showed Stephan curves comparable to conventional methods.

Cariogenic Agents↗

The effect of different dental health programmes on young adult individuals. A longitudinal evaluation of knowledge and behaviour including cost aspects.

The goal of this study was to report the long-term effect of different dental health programmes on young adult individuals' knowledge and behaviour relative to oral health. Over a 3 years period, the effect of three different dental health programmes on caries, gingivitis/periodontitis, and knowledge and behaviour concerning oral health in 400 Swedish young adults was evaluated. During the following 2 years, additional prophylactic measures--now based on the individual's symptoms and the prophylaxis previously received--were conducted and evaluated. Five years later still one follow-up was made. The evaluations were based on clinical and radiographic examinations and on a questionnaire survey whose purpose was to study the short- and long-term effects of the different preventive measures, including cost aspects. At the end of the 3 years period, the three test groups exhibited better knowledge and significantly improved behaviour compared with the control group concerning approximal cleaning, from approximately 50% of the individuals at the baseline examination to approximately 90% at the end of the period. Improvement was observed as early as the first year. There were no differences between the test groups. The intensified, individual-related prophylaxis carried out in the following 2 years did not significantly increase knowledge in the test groups; a significant increase in approximal cleaning, however, was found in the control group during this time. At the 10-year follow-up, the individuals' knowledge was undiminished while behaviour concerning approximal cleaning had sunk from 90% to approximately 70% of the individuals. A slight behavioural change concerning number of snacks was found in the course of the study with a shift towards fewer snacks per day. In conclusion, it can be said that simple prophylactic models have an effect on and maintain young adult individuals' knowledge and behaviour concerning oral health and that new knowledge is remembered for long periods of time while changes in behaviour are maintained less well. Moreover, it was found that the scope of the prophylactic programme measured in time and cost had little effect on the long-term result.

Adult↗

Early childhood caries lesions in preschool children in Kerala, India.

PURPOSE: No data are available on possible risk indicators or the prevalence of caries lesions for preschool children under 4 years of age in Kerala, southern India. Therefore, the aims of this study were: (1) to gather data on caries lesion frequency and distribution; (2) to determine any possible associations with feeding habits and oral health care practices. METHODS: A sample of 530 children, aged from 8 to 48 months (mean=2.5+/-0.96 years), who attended 13 day care centers were clinically examined for caries lesions using a disposable mouth mirror, tongue spatula, and a torch light. There were 513 dentate children. The caregiver of each child then completed, by interview, a structured questionnaire. RESULTS: Among the group of 252 girls and 278 boys, the dmft was 1.84+/-2.87 with 56% of the children being caries-lesion free. Fifty-nine (12%) were considered to have early childhood caries (ECC), based on the criteria that smooth surface caries lesions on all 4 maxillary incisor teeth indicated severe ECC. Breast-feeding was practiced by 99% of the mothers, and 5% did so exclusively. Generally, breast-feeding was on demand. Statistically significant correlations were found between caries lesions and the child's dental condition, as perceived by the mother or caregiver (P<.0001), the dental status of the caregiver (P=.0417), consumption of snacks (P=.0177), giving of sweets as a reward (P<.0001), cleaning of the child's mouth (P<.0001), oral hygiene status of the child (P<.0001) and low socioeconomic status, as measured by income (P<.0001). CONCLUSION: From the results of this study of preschool children in Kerala, the groups at high risk from dental caries lesions are: (1) those with poor oral hygiene status; (2) those who consume snacks and are given sweets as rewards; (3) those belonging to a lower socioeconomic class.

Caregivers↗