ABSTRACT
OBJECTIVES: The aim of this birth cohort study was to identify concurrent associations between early childhood caries and putative risk and protective factors. METHODS: Data were collected in seven waves over five years. The study outcome measure, d3-6mfs, was modelled in a set of sequential negative binomial regressions that introduced the variables in steps starting from health determinants most distal to the child and ending with the more proximal ones. The goodness of fit of each model at each step was tested using the quasi-likelihood under independence model criterion (QIC). A final model included all significant factors identified in the sequential modelling. Bacterial composition of the child's saliva was determined by 16S RNA gene sequencing. RESULTS: Overall, 467 children (48.6 % female) participated, of whom 419 (89.7 %) had at least one follow-up visit after baseline. Of the 419 children included in the analyses, 133 (31.7 %) had their saliva samples sequenced for microbiomic determination. Independent protectors of surface cavitation included water fluoridation, and older age of mothers. Risk for d3-6mfs was significantly higher among children whose mothers were current smokers (IRR 3.29, 95 % CI 1.09-9.88, p = 0.034), children who went to bed with a bottle (IRR 2.67, 95-6.88, p = 0.041) and whose saliva sample sequencing over time showed higher percentages of Streptococcus mutans (IRR 1.39, 95 % CI 1.11-1.74, p = 0.005). Model fit was mostly improved by child's proximal variables. Household and mother covariates did not substantially improve model fit. CONCLUSION: This analysis highlights the relevance and importance of child-proximal risk factors in childhood dental cavitation. CLINICAL SIGNIFICANCE: The study findings inform clinical decision making for the management of early childhood caries at both the individual and population level. At an individual and family level these risk factors should be incorporated into caries risk assessment tools for more precise identification of risk and evidence-informed interventions by health professionals.
Subject(s)
Dental Caries/diagnosis , Aged , Australia/epidemiology , Child , Child, Preschool , Cohort Studies , Dental Caries/epidemiology , Female , Humans , Male , Mothers , Streptococcus mutansABSTRACT
BACKGROUND: Diet cariogenicity plays a major role as both a protective and risk factor in the development of early childhood caries (ECC). AIM: Develop a scale measuring the cariogenicity of foods and beverages and employ it to describe the cariogenicity of young children's diets and predict dental caries outcomes. DESIGN: Scores of cariogenicity and consumption frequency were applied to food frequency questionnaire (FFQ) collected from an Australian children's cohort study with three time-points of data. One-way ANOVA, with post hoc Tukey test compared mean cariogenic scale measured at 18 months between the subsample of children with caries classification at age 5 years. RESULTS: At 6 months, children's mean cariogenic score was 10.05, increasing to 34.18 at 12 and 50.00 at 18 months. Mean cariogenic scale score at 18 months was significantly higher in children with advanced disease at 5 years (mean scale score: 59.0 ± 15.9) compared to those that were healthy (mean score 47.7 ± 17.5, P = 0.007) or had mild-moderate disease (mean score 48.2 ± 17.3, P = 0.008). CONCLUSIONS: The cariogenic diet scale provides a useful indication of the increasing cariogenicity of children's diets with age and highlights the incorporation of discretionary choice foods and beverages into the diets of young children much earlier than nutritionally recommended.
Subject(s)
Dental Caries , Diet, Cariogenic , Australia , Child , Child, Preschool , Cohort Studies , Diet , Feasibility Studies , HumansSubject(s)
Dental Care for Children , Dental Caries/etiology , Oral Health , Saliva/microbiology , Australia/epidemiology , Cohort Studies , DMF Index , Dental Caries/epidemiology , Female , Health Behavior , Humans , Infant , Infant, Newborn , Male , Prevalence , Prospective Studies , Rural Population , Social Environment , Surveys and Questionnaires , Urban PopulationABSTRACT
Social Café Meals Programs aim to reduce food insecurity and social exclusion by providing participants access to subsidised meals in mainstream local cafés. This study aimed to explore the program's ability to address social exclusion and food insecurity and the impact of the program on the community. A qualitative evaluation approach was utilised whereby in-depth interviews were conducted with café owners, café staff and current program members of two Social Café Meals Programs operating in the south-eastern suburbs of Melbourne. Twelve program members and six café staff completed an in-depth interview at the local cafés. Data were analysed using a thematic analysis approach focusing on the lived experience of the café owners, staff and program members. Four key themes were identified. The program (i) improved food access for vulnerable groups and (ii) created community cohesiveness. (iii) The café environment was important in facilitating program use by community members. (iv) Café owners felt rewarded for their community contribution via the program. Social Café Meals Programs may provide a solution to improving food security and reducing social exclusion and may be considered as a strategy for improving nutrition and social health for at-risk and vulnerable groups.
