Evaluation of an early childhood caries preventive programme starting during pregnancy-Results after 3 and 6 years.

BACKGROUND: Early childhood caries (ECC) has been found to be up to five times more common among children living in areas of low socio-economic status (SES) than among children in areas of higher SES. AIM: To evaluate an ECC prevention programme from pregnancy to 3 and 6 years of age. DESIGN: A prospective, controlled, intervention cohort study was initiated in 2013 in a low-SES area in Sweden. The intervention group received an individual interdisciplinary ECC prevention programme starting pre-birth, consisting of supportive oral health-promoting talks using motivational interviewing techniques and individual ECC preventive actions. A control group, consisting of pregnant women living in a comparable area, received ordinary routines. RESULTS: Of the 336 pregnant women, 64 mothers (with 64 children) completed the programme, and 394 children were born in the control group. At the sixth year examination, the proportion of children with no caries was similar between the groups (53% resp. 52%, p = .976), whereas the proportion with decayed, missed, filled primary teeth (dmft = 1-5) was slightly lower (23% resp. 36%, p = .063), and the proportion with severe caries disease (dmft > 5) was higher (p = .013) in the intervention group (25%) than in the control group (12%). CONCLUSION: No preventive effect regarding caries can be demonstrated at sixth year of age. Maternal behavioural change in dental care was not sufficient to even out inequalities in oral health in children, eventually due to difficulties in reaching the target group and the lack of effects among the families reached.

The meaning of oral health-related quality of life for elderly persons with dementia.

OBJECTIVE: Studies of oral health developments increasingly include self-reported assessments of how oral health affects quality of life (QoL), referred to as "oral health-related QoL". People with dementia are often excluded in studies of oral health-related QoL and thus our aim in this study was to explore this area in elderly persons with dementia. MATERIAL AND METHODS: Eighteen elderly individuals (aged between 78 and 94 years) with dementia of varying degrees of severity were interviewed with the aid of an interview guide; pictures and objects were used as stimulus material (triggers). The material was analyzed using grounded theory as point of departure, and a professional assessment of the oral health of the participants was used as reference. RESULT: Four categories were identified: the ability to chew and eat, independence, oral problems, and teeth are important. These factors are largely consistent with those that have emerged in earlier studies of the elderly, but in some cases less pronounced in persons with dementia. CONCLUSION: The use of triggers is a positive way to communicate oral health-related QoL among persons suffering from dementia, although the material used in this study needs further evaluation and development.

Dental caries and body mass index by socio-economic status in Swedish children.

OBJECTIVES: The aim of the present study was to evaluate the association between dental caries, childhood body mass index (BMI), and socioeconomic status in Swedish children. METHODS: The study cohort consisted of 2303 10-year-old children with data on socioeconomic status, BMI at 4, 5, 7 and 10 years of age, and caries at 6, 10 and 12 years of age. Anthropometric measures were carried out by trained nurses according to standardized routines. The occurrence of caries was registered from county records, and the children were classified into one of five socioeconomic clusters based on their census registration address. RESULTS: Caries prevalence decreased with increasing socioeconomic status at all ages, whereas childhood BMI and proportion of overweight/obese children were unrelated to socioeconomic status. Obese, but not overweight, children had more caries affected teeth than non-obese, and BMI had an independent, though weak, effect on caries variation in multiple regression. Interestingly, overweight/obese 4-year-olds, who had normal body weight at 5, 7 and 10 years of age, had significantly less caries than children who had normal body weight from 4 to 10 years of age. CONCLUSIONS: Overweight and caries prevalence are significantly associated in Swedish children. However, the association is weak. Nevertheless, the concept that child dental services and child welfare services can benefit from joint programs is supported.

Impact of dry mouth conditions on oral health-related quality of life in older people.

OBJECTIVE: The aim of the present study was to evaluate the impact of dry mouth conditions on oral health-related quality of life in frail old people, residents at community care centers. Further, reliability and validity of a visual analogue scale (VAS) for dry mouth symptoms were determined within the study cohort. BACKGROUND: In old people functional, social and psychological impacts of oral conditions are associated with an overall sense of well being and general health. Subjective dry mouth and reduced saliva flow are common disorders in old people caused by disease and medication. Thus, dry mouth conditions may be determinants for compromised oral health-related quality of life in old people. METHOD: In total, 50 old people living at service homes for the old people were asked to answer questionnaires on subjective dry mouth (VAS) and Oral Health Impact Profile (OHIP14) for oral health-related quality of life. Saliva flow was estimated by absorbing saliva into a pre-weighed cotton roll. RESULTS: The final study cohort comprised 41 old people (aged 83-91 years). Significant associations were identified between both objective and subjective dry mouth and overall or specific aspects of oral health-related quality of life. CONCLUSION: Dry mouth (objective and subjective) is significantly associated with oral health-related quality of life strengthening the value of monitoring dry mouth conditions in the care of frail old people.