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OBJECTIVES To test the hypothesis that parental factors in early childhood influence approximal caries experience in young adults. METHODS A cohort of 494 individuals was followed longitudinally from 1 to 20 years of age. Data were retrieved from parental interviews and questionnaires when the child was 1 and 3 years of age. At age 20, the participants underwent bitewing radiographic examination. Based on the number of approximal caries lesions (Da), stratified into initial (Di ) or manifest caries (Dm ) and approximal fillings (Fa), the participants were divided into two main groups: those with: (a) 0 Dim Fa (n = 244) and (b) >0 Dim Fa (n = 250). A subgroup was also created (≥8 Dim Fa; n = 33). RESULTS Toothbrushing with fluoride toothpaste at 3 years of age less than twice a day (OR 1.6, 95% CI 1.0-2.6) and the participants' mothers' self-estimation of their oral health care as "less than optimal" were important risk factors for developing caries (>0 Dim Fa OR 2.0, 95% CI 1.3-3.1). An interaction effect between toothbrushing at 3 years of age less than twice a day and consumption of caries risk products > 3 times a day further increased the caries experience in young adults (≥8 Dim Fa OR 8.3, 95% CI 1.8-37.8) together with maternal anxiety about dental treatment (OR 7.4 95% CI 1.6-34.6). CONCLUSIONS Parental factors in early childhood are associated with caries experience at 20 years of age.

The aim of this study was to evaluate the effect on oral health, at age 9 years, of daily oral supplementation with the probiotic Lactobacillus reuteri, strain ATCC 55730, to mothers during the last month of gestation and to children through the first year of life. The study was a single-blind, placebo-controlled, multicenter trial involving 113 children: 60 in the probiotic and 53 in the placebo group. The subjects underwent clinical and radiographic examination of the primary dentition and carious lesions, plaque and gingivitis were recorded. Saliva and plaque were sampled for determination of mutans streptococci (MS) and lactobacilli (LB) in saliva and plaque as well as salivary secretory IgA (SIgA). Forty-nine (82%) children in the probiotic group and 31 (58%) in the placebo group were caries-free (p < 0.01). The prevalence of approximal caries lesions was lower in the probiotic group (0.67 ± 1.61 vs. 1.53 ± 2.64; p < 0.05) and there were fewer sites with gingivitis compared to the placebo group (p < 0.05). There were no significant differences between the groups with respect to frequency of toothbrushing, plaque and dietary habits, but to intake of fluoride supplements (p < 0.05). There were no intergroup differences with respect to L. reuteri, MS, LB or SIgA in saliva. Within the limitation of this study it seems that daily supplementation with L. reuteri from birth and during the first year of life is associated with reduced caries prevalence and gingivitis score in the primary dentition at 9 years of age.

Background/Aim: There are few studies of caries development and caries-related factors from early age to young adulthood. The aim of the present study is to analyse caries prevalence in 20-year-olds in relation to their previous caries experience. Method: Oral health from 3 to 20 years of age was followed longitudinally in a cohort of 499 individuals. The clinical and radiographic incidence of caries and restorations in 494 20-year-olds was related to caries data at 3, 6 and 15 years of age. Results: Twenty-six per cent of the 20-year-olds were caries-free. The mean number of initial and manifest lesions and restorations (Di + mFS) was 5.8. Initial lesions comprised 40% of the Di + mFS. Of the occlusal surfaces of molars and premolars, 12 and 4%, respectively, had manifest caries or restorations. Compared with individuals who had been caries-free during childhood (primary dentition) and adolescence, those with a history of caries activity while growing up had statistically significantly more approximal lesions at the age of 20 (DmFSa 0.6 vs. DmFSa 4.6, respectively). Those with manifest caries during childhood but caries-free at 15 years had a low caries prevalence at 20 years of age (DmFSa 1.3). Few new lesions developed after age 15. However, 50% of initial lesions at this age had progressed to manifest lesions at age 20. Conclusion: There is a relationship between caries prevalence at age 20 and early caries experience.

Aim: To describe the frequency of overweight and obesity from birth to 20 years of age and analyse weight at 20 years of age in relation to weight and weight development during early childhood and adolescence. Methods: A longitudinal, population-based study, which followed 496 children from birth to 20 years of age. Information about weight and height was collected from health records at child health centres and school health care. At 20 years of age, weight and height measurements were taken by one of the authors. Results: At 20 years of age, 124 (25%) of the youth were obese or overweight. Of these youths, 60% had normal weight at 5.5 years. Of the teenagers who were overweight ⁄ obese at 15 years, 79% remained overweight ⁄ obese at 20 years of age. Out of the 124 obese at 20, 47% had normal weight at 15 years. No relation was found between rapid weight gain during preschool age and overweight and obesity in 20-year-olds. Conclusions: The majority of those who were overweight ⁄ obese at 20 years of age were recruited after 5.5 years of age, and half of them in their late teens. Thus, during the preschool period, the entire population should be the target of primary prevention from overweight ⁄ obesity and, in the case of teenagers, prevention strategies should be developed for the whole population as well as treatment strategies for teenagers with established overweight ⁄ obesity.

Objective: To analyse the relationship between caries determinants in early childhood and caries prevalence in proximal surfaces in adolescents at the age of 15 years. Methods: The present longitud ...

The aim of the present case-control study was to investigate dental caries, various caries-related factors as well as gingival condition, in 12- to 16-year-olds with long-term asthma (n = 20) and a matched healthy control group (n = 20). Data on dietary and oral hygiene habits, numbers of mutans streptococci and lactobacilli in saliva were also obtained. The plaque pH drop after a sucrose rinse was measured up to 40 min at 2 approximal tooth sites. A lower salivary flow rate was found in the asthma group compared to the control group (p < 0.05). The mean (± SD) of DFS, including manifest and initial caries, was 4.9 ± 5.5 in the asthma and 1.4 ± 2.3 (p < 0.01) in the control group. Only 1 adolescent in the asthma group was caries free compared to 13 in the control group. Concerning pH in plaque, adolescents with asthma had a lower initial value (p < 0.01) and final pH (p < 0.05) than the control group. The Cariogram data showed that 55% of the subjects in the control group had ‘a high chance of avoiding caries’ compared to 10% in the asthma group (p < 0.01). The asthmatic adolescents had higher numbers of sites with gingival bleeding (p < 0.01). To conclude, adolescents with long-term asthma had a higher total DFS and caries risk (according to Cariogram), decreased salivary rate, more gingival bleeding and lower plaque pH than adolescents without asthma.

Summary. Three thousand children aged 18 months were screened for dental caries and ongoing breast-feeding at 46 child welfare centres in different parts of Sweden. Of these, 200 children were selected for a more comprehensive examination, involving investigation of dietary, toothbrushing and sucking habits, use of fluoride, and determination of salivary levels of mutans streptococci and lactobacilli. The children were divided into four groups: group 1: children with caries not being breast-fed; group 2: children with caries being breast-fed; group 3: caries-free children being breast-fed; group 4: caries-free gender- and age-matched reference children not being breast-fed. The results showed that 63 of the children (2.1%) had caries and 61 (2.0%) were still being breast-fed. Twelve (19.7%) of the 61 children still being breast-fed had caries compared with 51 (1.7%) of the 2939 children not being breast-fed; the difference was statistically significant. Children with caries and still being breast-fed had a mean defs of 5.3, and those with caries not being breast-fed 4.9; the difference was not statistically significant. Children with caries, irrespective of whether they were being breast-fed or not, had significantly higher numbers of cariogenic food intakes per day than caries-free children. Mutans streptococci were detected in 67% of the children and lactobacilli in 13%. Children with detectable mutans streptococci and lactobacilli had significantly more caries than those without. The results indicate that Swedish children with prolonged breast-feeding have a tendency to establish unsuitable dietary habits which constitutes a risk situation for developing caries at an early age.

Objective. The aim of this study was to investigate oral health and its determinants in 3-year-old and 6-year-old children with asthma. Methods and subjects. Caries and gingivitis were examined in 127 asthmatic (all children with asthma in a selected area and born during a specific time period) and 117 matched, healthy control children.The parents were interviewed regarding various oral-health-related factors. Results. The mean dfs (± standard deviation) in the 3-year-old with asthma was 1.4 ± 3.2 compared with 0.5 ± 1.2 in the controls (P

The aim was to investigate whether oral hygiene habits and parent-related factors, recorded in early childhood, have a predictive value in relation to approximal caries experience (including initial caries lesions) at the age of 15 years (n = 568). Data were selected from examinations, interviews and questionnaires at 1 and 3 years and bitewing radiographs at 15 years. Four levels of cut-off points for the statistical analysis were used: DFa = 0, > 0, ≧4 and ≧8. In the final logistic regression analyses, mother’s self-estimation of her oral health care being less good remained statistically significant and predicted a caries experience of DFa > 0 at 15 years. The following four variables predicted DFa ≧4: (1) female gender, (2) plaque on maxillary incisors at 1 year, (3) mother’s self-estimation of her oral health care being less good and (4) father being less satisfied with his social situation. Two variables predicted DFa ≧8: (1) toothbrushing with fluoride toothpaste just once a day, and (2) father being less satisfied with his social situation. Furthermore, children who failed to attend the examination at 1 year of age had 6.95 ± 5.36 (mean ± SD) DFa at 15 years compared with 3.10 ± 3.85 for children who were examined at 1 year of age (p < 0.01). To conclude, factors explaining good dental health at 15 years of age pertained to both children and parents. Thus, it seems that good oral hygiene habits, established in early childhood, provide a foundation for a low experience of approximal caries in adolescents.

The aim of the present investigation was to study the prevalence of approximal caries lesions and fillings in posterior teeth at 15 years of age in a prospectively followed Swedish population (n = 568), with special reference to their caries experience at the age of 3 years. Only approximal surfaces were recorded, since all children in the Community of Jönköping have had fissure sealing performed on all caries-free permanent molars. At 15 years of age, the mean number of approximal tooth surfaces with initial caries lesions (Dia), manifest caries lesions and fillings (DmFa) and total caries experience and fillings (Di + mFa) – recorded on bitewing radiographs – was 2.78 , 0.45 and 3.23, respectively. One third of the adolescents had no approximal caries or fillings; the Dia constituted 86% of the Di + mFa. Children with manifest caries at 3 years of age had a higher risk of developing approximal caries in their permanent teeth than caries-free children at the same age (41 vs. 17%). Furthermore, children who were caries-free at 3 years of age were more likely to remain caries-free at 15 years of age compared to children with manifest caries (37 vs. 17%). All these differences were statistically significant (p < 0.001). Additionally, early childhood caries experience (developed before 3 years of age) had a greater predictive value than late childhood caries experience (developed between 3 and 6 years of age) concerning approximal caries at 15 years of age.

The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries-free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow-up, when the subjects were 26-27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty-three sealed first molars and 161 sealed second molars were available for inspection. At the follow-up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 13% caries or restoration in the occlusal fissures or buccal pits. At the 15-year follow-up of the second molars, the corresponding figures were 65%, 30%, and 5%, respectively. Of the restored or carious molars, significantly more were found in the mandible than in the maxilla (P

The aim of the present field study was to evaluate a new strategy for the dental care of pre-school children which includes an early caries risk assessment and early preventive care. One hundred and sixty-seven children were studied from 1 to 6 years of age (intervention group). A group of 125 children from the same clinic (historical control) was used as a comparison group. On the basis of the clinical examinations of the children and the interviews with the parents when the children were 3 years of age, the children in the intervention group were divided into four different risk groups: no (n = 95), low (n = 33), moderate (n = 30), and high caries risk (n = 9). Only 8 of the 95 children who had been placed in the no caries risk group at 3 years of age developed manifest carious lesions in their primary cuspids and molars by 6 years of age. At 6 years of age 81% in the intervention group were free of manifest carious lesions, compared with 55% in the comparison group (P0.001). Furthermore, the mean numbers of defs were 0.6 for children in the intervention group and 2.7 in the comparison group. Thus, this field study indicates that early primary prevention (before the onset of caries attack) and a structured and systematic approach to dental care for pre-school children result in good oral health for the children and may be economically profitable for a society with organized public dental service for pre-school children.

The aims of this study were 1) to investigate whether oral hygiene and dietary habits established at 1 year of age are maintained at 2 years of age and 2) to analyze caries-related factors with regard to oral health between the age of 1 and 3 years by using the salutogenic theory-that is, focusing on behavioral factors that do not result in impairment of health. Altogether 289 children were examined at 1, 2, and 3 years of age, and their parents were interviewed about the children's oral hygiene and dietary habits at 1 and 2 years of age. The result shows that caries-related habits, such as oral hygiene and dietary habits, established during infancy are maintained throughout early childhood. The principles of the salutogenic theory were found to be applicable when studying caries-related habits and oral health. Thus, if a dietary risk behavior is established at 1 year of age, the chance of remaining caries-free until 3 years of age is highest if good oral hygiene habits, including the use of fluoride toothpaste, are present at 2 years of age. We therefore conclude that comprehensive knowledge of a child's future dental health can be obtained by using chairside information-that is, interview of the parents and clinical examination of the children.

The purpose of this study was to describe the dietary habits of infants and toddlers living in Sweden with special reference to caries prevalence at 2 and 3 years of age and to immigrant status. The study was designed as a prospective, longitudinal study starting with 671 children aged 1 year. At 3 years, all children were invited to a further examination. A total of 298 individuals, randomly selected from the original group, were also examined at 2 years. The accompanying parent was interviewed about the child's dietary habits. Children with caries at 2 and 3 years of age and immigrant children had, when they were 1 year old, consumed caries-risk products and been given nocturnal meals and sweetened liquid in a feeding bottle more often than caries-free 2- and 3-year-olds and non-immigrant children. Although a great variation in dietary habits was found in infants and toddlers, the use of sugar-containing products is widespread in Sweden even in early childhood.

To describe the frequency of overweight and obesity from birth to 20 years of age and analyse weight at 20 years of age in relation to weight and weight development during early childhood and adolescence.A longitudinal, population-based study, which followed 496 children from birth to 20 years of age. Information about weight and height was collected from health records at child health centres and school health care. At 20 years of age, weight and height measurements were taken by one of the authors.At 20 years of age, 124 (25%) of the youth were obese or overweight. Of these youths, 60% had normal weight at 5.5 years. Of the teenagers who were overweight/obese at 15 years, 79% remained overweight/obese at 20 years of age. Out of the 124 overweight/obese at 20, 47% had normal weight at 15 years. [Corrections added after online publication on April 18, 2012: 'Out of the 124 obese at 20' has been changed to 'Out of the 124 overweight/obese at 20']. No relation was found between rapid weight gain during preschool age and overweight and obesity in 20-year-olds.The majority of those who were overweight/obese at 20 years of age were recruited after 5.5 years of age, and half of them in their late teens. Thus, during the preschool period, the entire population should be the target of primary prevention from overweight/obesity and, in the case of teenagers, prevention strategies should be developed for the whole population as well as treatment strategies for teenagers with established overweight/obesity.

Objective. To study oral health in young adults with long-term, controlled asthma. Material and methods. Twenty 18- to 24-year-olds with a mean duration of asthma of 13.5 [standard deviation (SD) 5.4] years and 20 matched healthy controls were included. A clinical examination was performed and the prevalences of caries, erosions, gingival inflammation, cervicular fluid and periodontal pockets and the plaque formation rate were registered. The salivary flow rate and the numbers of mutans Streptococci and Lactobacilli in saliva were determined. Plaque pH was measured after a sucrose rinse for up to 40 min at two approximal sites. The participants were interviewed regarding dietary and oral hygiene habits. Results. The mean (SD) DFS, including manifest and initial caries, was 8.6 (10.6) in the asthma group and 4.0 (5.2) in the control group (P = 0.09). Initial caries lesions were more common in the asthma group than in the control group: 6.0 (8.1) and 1.3 (2.0), respectively (P = 0.02). The asthma group had more gingivitis (P = 0.01) and a lower stimulated salivary secretion rate than the controls (P = 0.01). The asthmatics also had a somewhat, although not statistically significant, lower initial pH value in plaque and a more pronounced pH drop compared with the controls. In the asthma group, 65% reported frequent mouthbreathing, compared with 10% of the controls (P = 0.01). No differences were found in tooth-brushing or dietary habits between the groups. Conclusion. Young adults with long-term, controlled asthma had more initial caries, more gingival inflammation and a lower stimulated salivary secretion rate than individuals without asthma.

OBJECTIVE: The aim of this study was to investigate caries and its determinants in preschool children with and without asthma, followed from 3 to 6 years. METHODS AND SUBJECTS: Caries, plaque, and gingivitis were examined at 3 and 6 years of age in 64 asthmatic children and 50 matched, healthy control children. Furthermore, at 6 years radiographic examination and saliva sampling were conducted. The parents were interviewed about various oral health-related factors. RESULTS: Initial caries increment between 3 and 6 years of age was statistically significant higher for children with asthma compared with children without asthma (P < 0.05). Asthmatic children had more bleeding gingivitis and a higher consumption of sugary drinks than healthy children at 3 years of age (P < 0.05). At both 3 and 6 years of age, the asthmatic children were more frequently mouth breathers than healthy children, only statistically significant for 6-year olds (P < 0.05). CONCLUSION: Preschool children with asthma at 3 years of age run a higher risk of developing caries lesions until 6 years of age compared with children without asthma. Children with asthma have a higher prevalence of bleeding gingivitis, a higher intake of sugary drinks and are more frequently mouth breathers than preschool children without asthma.

The prevalence of overweight and obesity in children is steadily increasing in many countries. Dental caries and obesity are both multifactorial diseases and are associated with dietary habits.The purpose of this study was to investigate the relationship between body weight status in adolescents and snacking habits in early childhood to approximal caries prevalence at 15 years of age.This study is part of a series of surveys of oral health in children followed from the ages of 1 year to 15 years. Body adiposity status was estimated at 13.5-16.4 years using the International Obesity Task Force cut-off values [age-specific body mass index (isoBMI)]. Information about snacking habits in early childhood was collected from interviews conducted at 1 year and 3 years. Approximal caries information was obtained from bitewing radiographs at 15 years. Data related to isoBMI and approximal caries were available in 402 teenagers.Adolescents with isoBMIor = 25 (n = 64) had an approximal caries prevalence that was a mean of 1.6 times higher than those with isoBMI25 (n = 338) (4.64 vs. 2.94; P = 0.014). Furthermore, children's snacking habits at an early age were associated with approximal caries at 15 years.Overweight and obese adolescents had more approximal caries than normal-weight individuals. Moreover, the frequent consumption of snacking products during early childhood appears to be a risk indicator for caries at 15 years. Future preventive programmes should therefore include, on a multidisciplinary level, strategies to prevent and reduce both obesity and dental caries at an early age.

The aim of the present study was to evaluate the prevalence of caries and caries associated variables in 15-year-olds in relation to foreign background and to examine differences in the prevalence of caries in immigrant adolescents according to their length of residence in Sweden. All 15-year-old adolescents (n=143) at one public school in the city of Jönköping, Sweden were asked to participate in the study. The adolescents were divided into two groups according to their background: immigrants and non-immigrants. Data on caries prevalence were extracted from the dental records of the examination made when the participants were 15 years old. The proportions of immigrants and non-immigrants free from carious lesions were equal. Immigrant adolescents, however, had on average more enamel carious lesions. Adolescents born in Sweden of immigrant parents or who had arrived before 1 year of age had a caries prevalence similar to those of non-immigrant adolescents, whereas children who had immigrated to Sweden after 7 years of age had a caries prevalence that was 2-3 times higher. As the caries carious lesions in immigrant adolescents is mainly restricted to the enamel, and possibly reversible, early introduction of preventive programmes seems essential.

In most Swedish counties, epidemiological data on the permanent dentition are collected on patients between 7 and 19 years of age. However, for the primary dentition, epidemiological data are only available for the 3-6-year-old age groups. As far as we know, no studies have investigated the relation between caries prevalence in the early primary dentition and caries prevalence or treatment performed in the late primary dentition. Thus, the purpose of the present study was to investigate the relationship between dental treatment in the primary dentition of Swedish children 7-12 years of age and caries experience in the primary dentition at 6 years of age. This retrospective study is based on record data from a randomly selected sample comprising 10% of all children born in 1987 in Jönköping County (n=433). Of these children, 381 had been treated regularly at the Public Dental Service clinics between 7 and 12 years of age and were included in the study. It was found that children with previous caries experience at 6 years of age received significantly more treatment during the studied period compared to children who were caries free at the same age. The children with caries experience required a mean of 3.5 times more treatments compared to caries-free children. The present study underlines the importance of early detection and prevention of caries in the primary dentition if optimal dental health is to be expected in the late primary dentition.

In most Swedish counties, epidemiological data on the permanent dentition are collected on all patients aged 7-19 years. For the primary dentition, epidemiological data are only reported for the 3-6-year-old age groups. The purpose of the present study was to investigate what treatments had been made in the primary dentition during the period when the children were 7 to 12 years old. The sample size constituted 10% of all children born in 1987 and regularly treated at Public Dental Service clinics in Jönköping County between 7 and 12 years of age. Data were extracted from the dental records. The most common treatments--new restorations and replacements of restorations--comprised 72% of all treatment. Replacements of restorations constituted 31% of all restorations performed between 7 and 12 years of age, and a majority (81%) of these had been made when the children were 7-9 years old. The mean defs value at 6 years of age was 1.9. The mean number of treatments performed per child between 7 and 12 years of age was 2.5. The result of the present study indicates that more treatments in the primary dentition are performed after 6 years of age than before.

The purpose of this study was to describe oral hygiene factors in infants and toddlers living in Sweden with special reference to caries prevalence at 2 and 3 yr of age and to immigrant status. The study was designed as a prospective, longitudinal study starting with 671 children aged 1 yr. At 3 yr, all the children were invited to a further examination. A total of 298 children, randomly selected from the original group, were also examined at 2 yr. The accompanying parent was interviewed about the child's oral health habits. Children who were free of caries at 3 yr had had their teeth brushed more frequently at 1 and 2 yr of age, had used fluoride (F)-toothpaste more often at 2 yr of age, and had a lower prevalence of visible plaque at 1 and 2 yr of age than children with caries. Immigrant children had had their teeth brushed less frequently, had used less F-toothpaste, and had a higher prevalence of visible plaque at 1 yr of age than nonimmigrant children. Early establishment of good oral hygiene habits and regular use of F-toothpaste seem to be important for achieving good oral health in pre-schoolchildren.