Exploring natural odour landscapes: A case study with implications for human-biting insects.

The natural world is full of odours-blends of volatile chemicals emitted by potential sources of food, social partners, predators, and pathogens. Animals rely heavily on these signals for survival and reproduction. Yet we remain remarkably ignorant of the composition of the chemical world. How many compounds do natural odours typically contain? How often are those compounds shared across stimuli? What are the best statistical strategies for discrimination? Answering these questions will deliver crucial insight into how brains can most efficiently encode olfactory information. Here, we undertake the first large-scale survey of vertebrate body odours, a set of stimuli relevant to blood-feeding arthropods. We quantitatively characterize the odour of 64 vertebrate species (mostly mammals), representing 29 families and 13 orders. We confirm that these stimuli are complex blends of relatively common, shared compounds and show that they are much less likely to contain unique components than are floral odours-a finding with implications for olfactory coding in blood feeders and floral visitors. We also find that vertebrate body odours carry little phylogenetic information, yet show consistency within a species. Human odour is especially unique, even compared to the odour of other great apes. Finally, we use our newfound understanding of odour-space statistics to make specific predictions about olfactory coding, which align with known features of mosquito olfactory systems. Our work provides one of the first quantitative descriptions of a natural odour space and demonstrates how understanding the statistics of sensory environments can provide novel insight into sensory coding and evolution.

Children's electronic screen time exposure and its relationship to dental anxiety and behavior.

Objectives: The purpose of this study was to assess the association between electronic screen time and dental anxiety and behaviour among children aged six to twelve years during dental examination, prophylaxis, and topical fluoride application. Material and methods: This was a cross-sectional study which included 402 paediatric dental patients aged six to twelve years who came to King Abdulaziz University Dental Hospital in Jeddah, Saudi Arabia. The data was collected from September 2020 to December 2021. Self-constructed questionnaire was used to collect data from the patient and his/her guardian. It was comprised of eight demographic questions as well as 13 multiple-choice questions regarding the patients' screen time. Child dental anxiety was assessed by using Abeer Children Dental Anxiety Scale (ACDAS). Assessment of child's behaviour was done by using Frankl Behavioural Rating Scale. Results: This study had a response rate of 100%. Out of the 402 participants, 248 (61.7%) were found to have anxiety while 154 (38.3%) were not. Of all participants 274 (68.2%) were cooperative and 128 (31.8%) were not. A Significant relationship between anxiety and behavioural problems during a dental visit and the participant's total exposure hours to electronic devices was found (p < 0.001). Children exposed to electronics at the age of two years or before displayed more anxiety and uncooperative behaviour (p < 0.001). Conclusions: early exposure to electronic screens, especially for entertainment purposes and longer exposure can be associated with increased dental anxiety and uncooperative behaviour in children age 6-12 years. Recommendations: Parents should be educated about the risks of permitting their children to use electronic devices and encouraged to replace such devices with activities that incorporate physical activity.

Access to dental care for children with special health care needs: a cross-sectional community survey within Jeddah, Saudi Arabia.

The aim of this study was to investigate the level of dental care access among children with special health care needs (CSHCN) in Jeddah, Saudi Arabia and the barriers hindering this access. Data of this cross-sectional study were obtained from self-administered surveys distributed through seven CSHCN centers. Children with autistic spectrum disorder (ASD), Down syndrome, cerebral palsy, and developmental delay were included. Univariate and bivariate analyses were conducted to describe the data. A total of 602 study participants were included in the analyses. Only 24.9% of the participated caregivers routinely visited the dentist for their CSHCN. Half of CSHCN caregivers found difficulties obtaining dental treatment. This trend was significantly greater in 12-18 years old children (p = 0.013) and in families commuting for more than one hour to dental clinics (p = 0.045). The most common reported barrier was fear of the dentist (61.6%) followed by child uncooperativeness (37.8%) and treatment costs (27.8%). CSHCN lack sufficient dental care for a variety of reasons, primarily fear of dentists, child uncooperativeness, and treatment costs. Dentists require more training and education to facilitate better access to dental care for CSHCN.

Recent Advances in Indirect Pulp Treatment Materials for Primary Teeth: A Literature Review.

AIM: To provide an overview of the techniques of indirect pulp treatment (IPT) and the new materials used. BACKGROUND: Indirect Pulp Treatment (IPT) is a conservative treatment approach that can be used in primary molars. Pulpotomy has been adopted as the treatment of choice for deep caries in primary molars. IPT showed higher success rates in recent researches. MATERIALS AND METHODS: Electronic search of English scientific papers was accomplished using PubMed, ScienceDirect, and Scopus. Papers published from 1995 to 2019 were included. Search terms used were recent advances, indirect pulp treatment, mineral trioxide aggregate (MTA), biodentine, TheraCal-LC, chlorhexidine gluconate (CHX), resin-modified glass ionomer (RMGI), and calcium hydroxide. REVIEW RESULTS: Seventy two papers were obtained from the electronic search and references of selected studies. Thirty five papers explained recent advances in IPT materials for primary molars. MTA produces more dentinal bridging with superior quality than calcium hydroxide. Similarly, Biodentine can form reparative dentin in a very short period. TheraCal-LC has increased stability and durability with strong physical properties and low solubility. Furthermore, CHX is a chemical disinfectant which can aid in increasing the success rate of IPT when conjugated with other materials. It produced highly successful IPT when combined with RMGI or calcium hydroxide. CONCLUSION: IPT is the preferred treatment approach for preservation of primary dentition. CHX is an emerging material that can provide promising results in IPT when combined with other materials. CLINICAL SIGNIFICANCE: Up to date, no material had replaced the popular use of calcium hydroxide in IPT. The use of CHX with RMGI can increase the success rate while preserving the advantages of the latter as it is considered the liner of choice for primary teeth, making IPT a suitable substitute for pulpotomy in primary molars. HOW TO CITE THIS ARTICLE: Saber AM, El Meligy OA, Alaki SM. Recent Advances in Indirect Pulp Treatment Materials for Primary Teeth: A Literature Review. Int J Clin Pediatr Dent 2021;14(6):795-801.

Comparing zirconia to anterior strip crowns in primary anterior teeth in children: a randomized clinical trial.

BACKGROUND: Providing restorations to anterior teeth in children is a challenging task due to the need for high esthetics, strength, and durability. This study was done to compare prefabricated primary zirconia with resin composite strip crowns on primary maxillary central and lateral incisors with regards to gingival health, plaque accumulation, recurrent caries, restoration failure, and opposing teeth wear over a period of 3, 6 and 12 months. METHODS: Children attending the King Abdulaziz University, Faculty of Dentistry (KAUFD) clinics who needed restorations were screened for inclusion criteria. A total of 120 teeth were treated; 60 with zirconia and 60 with strip crowns. Randomization was done by simple random allocation using SPSS software version 20.0 (Armonk, NY; IBM Corp.). A simple descriptive statistic was used for analysis by Wilcoxon Signed-Rank test and Chi-square test. Level of significance was set at (α = 0.05) and level of confidence at (95%). The presented research was registered retrospectively at ClinicalTrials.gov in 6th of August 2017, under registration number NCT03184012. RESULTS: Zirconia crowns showed significantly less gingival bleeding at the 3- and 6-months follow up periods (p < 0.006, p < 0.001; respectively), less plaque accumulation at all follow up visits (p < 0.001), no restoration failure (p < 0.001), but more wear to opposing teeth (p < 0.02). No significant difference was found between the two crowns with regards to recurrent caries (p < 0.135). CONCLUSION: Based on our data we conclude that overtime teeth covered with zirconia crowns show better gingival health and less bleeding, plaque accumulation as well as less loss of material. On the other hand, zirconia can cause more loss of opposing tooth structure.

An In-vitro study on thermal changes during implant drilling with different irrigation volumes.

OBJECTIVE: Irrigation with saline is one of the essential methods for reducing the heat generated during dental implant osteotomy. High irrigation volume impairs visibility of the surgical field, thus complicates the surgery. In this study, we aimed to determine the optimal irrigation volume for heat reduction during dental implant drilling. MATERIALS AND METHODS: Thirty-two implant osteotomies were prepared on four fresh cow ribs. Heat generated during the final implant drilling was measured both with infrared thermography and thermocouple method. Initial and maximum temperatures were measured at four different irrigation volumes; 32, 44, 56, and 68 ml/min. RESULTS: Both measurement methods showed that the amount of temperature rise is associated with the irrigation volume during implant drilling. There is no further decrease in temperature rise above irrigation volume of 56 ml/min. CONCLUSION: Saline irrigation with 56 ml/min provides sufficient heat reduction during dental implant drilling and higher irrigation volumes are not necessary.

Molecular Screening of VAX1 Gene Polymorphisms Uncovered the Genetic Heterogeneity of Nonsyndromic Orofacial Cleft Among Saudi Arabian Patients.

OBJECTIVE: Nonsyndromic orofacial cleft (NSOFC) including cleft lip with or without cleft palate (CL±P) and cleft palate (CP) are multifactorial developmental disorders with both genetic and environmental etiological factors. In this study we investigated the association between CL±P and CP, and two polymorphisms previously determined using genome-wide association studies, as well as the association between consanguinity and CL±P and CP. METHODS: DNA was extracted from saliva specimens from 171 triads consisting of affected individuals and their parents, as well as 189 control triads (matched for age, gender, and location) that were recruited from 11 referral hospitals in Saudi Arabia. Two polymorphisms, rs4752028 and rs7078160, located in the VAX1 gene were genotyped using real-time polymerase chain reaction. A transmission disequilibrium test was carried out using the Family-Based Association Test and PLINK (genetic tool-set) to measure the parent-of-origin effect. RESULTS: Significant differences were found between affected individuals and the control group. In the case of the rs4752028 risk allele in cleft, the phenotypes were: CL±P (fathers: odds ratio [OR] 2.16 [95% CI 1.38-3.4]; mothers: OR 2.39 [95% CI 1.53-3.71]; and infants: OR 2.77 [95% CI 1.77-4.34]) and CP (fathers: OR 2.24 [95% CI 1.15-4.36] and infants: OR 2.43 [95% CI 1.25-4.7]). For CL±P and the rs7078160 risk allele, the phenotypes were: (fathers: OR 1.7 [95% CI 1.05-2.86]; mothers: OR 2.43 [95% CI 1.49-3.97]; and infants: OR 2.34 [95% CI 1.44-3.81]). In terms of consanguinity, we found significant association between consanguinity and the rs4752028 polymorphism minor allele among CL±P compared with controls (p = 0.001). CONCLUSION: This is the first study to find a relationship between these two loci on 10q25 (rs4752028 and rs7078160) and NSOFC in a population with high levels of consanguinity.

Comparing Dental Stress in New Child Patients and Returning Patients Using Salivary Cortisol, Immunoglobulin-A and Alpha- Amylase.

OBJECTIVES: this study was aimed at comparing dental stress in children having their first dental visit to those returning for dental treatment using salivary biomarkers of stress including salivary cortisol (s-cortisol), Immunoglobulin-A (s-IgA) and alpha-amylase (s-α-amylase). Additionally, the study was aimed at monitoring the change in stress in new patients as they progressed from the waiting to the clinical areas. STUDY DESIGN: salivary samples were collected from 40 children who had not been to a dentist before and similar samples were collected from 40 children who were returning for completion of dental treatment. Salivary cortisol, s-IgA and s-α-amylase concentrations were obtained by Enzyme-linked Immunosorbent Assay (ELISA). RESULTS: salivary cortisol levels were higher for new patients at the waiting area compared to that at the dental chair (p=0.05). Salivary alpha-amylase significantly increased in new patients while being seated in the dental chair. Returning patients had higher s-α-amylase (p=0.001) and s-IgA (p=0.016) compared to new patients. Returning patients had the lowest level of s-cortisol when providers were faculty pediatric dentists than with students and interns (p=0.035). CONCLUSIONS: children coming in for their first dental visit may experience dental stress at the waiting area before being seated for dental examination. Returning children may experience higher levels of stress compared to new child patients possibly due to previous dental exposure.

Prevalence of obesity in elementary school children and its association with dental caries.

OBJECTIVES: To investigate the prevalence of obesity among elementary school children and to examine the association between obesity and caries activity in the mixed dentition stage. Methods: This cross-sectional study was conducted in King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between September 2014 and June 2015 using a multi-stage stratified sample of 915 elementary school children (482 boys, 433 girls) in Jeddah, Saudi Arabia. Anthropometric measurements, consisting of height, weight, body mass index (BMI), and waist circumference (WC), were obtained. Children were classified as underweight/healthy, overweight, or obese and as non-obese or obese according to their BMI and WC, respectively. Each child's caries experience was assessed using the decay score in the primary and permanent teeth. Results: Based on BMI, 18% of children were obese, 18% were overweight, and 64% were underweight/normal. Based on WC, 16% of children were obese, and 84% were non-obese. Girls had a significantly higher prevalence of obesity based on WC measurements (p less than 0.001), but not BMI. Children enrolled in private schools had a significantly higher prevalence of obesity (p less than 0.05) than those in public schools. For primary and permanent teeth combined, children with higher BMI and WC had a lower prevalence of caries (p less than 0.05). Conclusion: The prevalence of obesity was high among male and female elementary school children. Overall caries activity was inversely proportional to BMI and WC.

Can Multiple Mini-Interviews Predict Academic Performance of Dental Students? A Two-Year Follow-Up.

Prior research has shown that students' previous grade point average (GPA) is the best predictor for future academic success. However, it can only partly predict the variability in dental school performance. The aim of this study was to assess the predictive value of multiple mini-interviews (MMI) as an admission criterion by comparing them with the academic performance of dental students over a two-year period. All incoming undergraduate dental students at the King Abdulaziz University Faculty of Dentistry (KAUFD) during academic year 2013-14 were invited to participate in MMI. Students rotated through six objective structured clinical exam (OSCE)-like stations for 30 minutes total and were interviewed by two trained faculty interviewers at each station. The stations were focused on noncognitive skills thought to be essential to academic performance at KAUFD. The academic performance of these students was then followed for two years and linked to their MMI scores. A total of 146 students (71 males and 75 females) participated in an interview (response rate=92.9%). Most students scored in the acceptable range at each MMI station. Students' total MMI score, ambitions, and motives were significant predictors of GPA during the two years of follow-up (p<0.038 and p<0.001, respectively). In this study, MMI was found to be able to predict future academic performance of undergraduate dental students.

Oral Health Quality of Life in Children with Cerebral Palsy: Parental Perceptions.

OBJECTIVE: To assess the parents' perception of the oral health-related quality of life (OHRQOL) in children with Cerebral Palsy (CP) and compare it with normally developing children. STUDY DESIGN: 63 children with CP were recruited from 8 disability centers, and 99 healthy controls were recruited from 5 elementary schools. The ages of the children in both groups were from 6-12 years. The Franciscan Hospital for Children Oral Health-Related Quality of Life (FHC-OHRQOL) was used to measure the OHRQOL and an oral examination was conducted in the schools/centers of the children to assess the teeth, gingival health, and oral hygiene. RESULTS: The FHC-OHRQOL showed a significant difference in 3 out of 4 sections indicating lower OHRQOL in the CP group. The examination showed no significant difference in the dental and gingival health and in the level of oral hygiene. CONCLUSION: The OHRQOL of children with CP is significantly lower than that of normally developing children although the oral health status of children with CP is not significantly different from that of normally developing children.

The evaluation of palatal bone thickness for implant insertion with cone beam computed tomography.

The palate is an alternative anchoring site for orthodontic implants and screws. The use of osseointegrated implants in the intermaxillary suture has recently been described as a fast, effective, and low-cost technique for patients with atrophy of the maxillae. The aim of this study was to use cone beam computed tomography (CBCT) to evaluate the thickness of the bone surrounding the intermaxillary suture in relation to the insertion of osseointegrated implants. CBCT images of 144 patients (72 males, 72 females) aged 35-86 years were evaluated. The vertical bone height of the intermaxillary suture was measured using coronal and sagittal Images 5, 10, 15, 20, and 25 mm posterior to the incisive foramen. The mean bone thicknesses from the anterior to the posterior region were 5.59, 4.38, 3.91, 3.95, and 3.94 mm, respectively. Bone thickness was significantly different among the five anteroposterior areas of the suture, but there were no significant differences between males and females, or among age groups. The highest part of the intermaxillary suture was in the anterior region. Three-dimensional imaging is recommended to accurately identify palate bone thickness for implant placement.

Can Socioeconomic status indicators predict caries risk in schoolchildren in Saudi Arabia? a cross-sectional study.

PURPOSE: To determine the prevalence and identify significant socioeconomic predictors of dental caries among children aged 9 and 14 in Jeddah, Saudi Arabia. MATERIALS AND METHODS: A random sample of 24 elementary and middle schools in Jeddah was selected. All 3rd and 8th graders were screened (N = 1655) for caries. A parent questionnaire was administered to collect information on selected socioeconomic indicators. Untreated caries was the outcome of interest. Categorical variables were reported as frequencies and percentages; crude and adjusted odds ratios of caries association with SES were produced with 95% confidence intervals and P-values. RESULTS: A total of 1655 students were examined. The overall caries experience was 83.13%. Untreated caries prevalence in primary and permanent teeth of all students was 63.01% and 56.7%, respectively. In primary teeth, mother's education, family income and having medical insurance were significant unadjusted predictors of caries. Family income was the only adjusted predictor of caries in primary teeth. In permanent teeth, most SES indicators were significant in the univariate analysis. However, mother's education was the only adjusted variable associated with caries. CONCLUSIONS: The prevalence of caries is rising and aggregate measures of SES did not distinguish between children with or without caries, particularly among younger children. The most powerful individual SES predictors of caries were family monthly income and parents' education. Until a more valid aggregate measure of SES is available, community wide approaches to caries prevention and risk reduction for all young children should be utilised to reduce SES-related caries risk.

Dental pain in children with intellectual disabilities: caregivers' perspective.

Purpose. Description of pain is generally difficult in children, and more so in those with intellectual disabilities (ID). Aim. This study is aimed at evaluating dental pain from caregivers' perspective in children with ID. Methods. The study sampled 86 children (33 with ID, 53 normally developing) ages ranges from birth to 16 years old among those visiting the School of Dentistry, King Abdulaziz University, Saudi Arabia. Caregivers were asked about their awareness of dental pain in their wards using the Dental Discomfort Questionnaire (DDQ+). The children were examined for dental caries and periodontal status. Results. The mean DDQ+ in children with ID (4.55 ± 3.46) was not significantly different from that in healthy children (4.19 ± 3.26, P = 0.7). Children with ID had more salivation (P = 0.01) and were putting their hands inside their mouths more often (P = 0.003). Conclusions. Caregivers can recognize dental pain-related behaviors in children with ID such as excessive salivation and putting hands inside the mouth more often.

Can parents assess dental pain in children with cognitive impairment?

It is often said that the "gold standard" for pain assessment in both children and adults is verbal report. This means that the individual is best at describing his or her pain experience. This however does not take into account individuals who lack the ability to communicate their feelings including those with cognitive immaturity such as infants and very young children, people with cognitive impairment and adults with dementia. This is even complicated by the fact that children who experience the most pain are those who are least able to verbally describe it; those with greater physical and cognitive disability. This paper reviews past and current beliefs on the experience and expression of pain in children with cognitive impairment and how parents can be used as useful tools in diagnosing their pain.

An extreme lateral lumbar disc herniation mimicking L4 schwannoma.

OBJECTIVE: We herein describe a case with an extraspinal mass distorting the right L4 dorsal root ganglion. Initially presumed to be a nerve root schwannoma, the lesion turned out to be a free disc fragment. METHODS AND RESULTS: A 46-year-old woman presented with a history of mild low back and intense right leg pain. The leg pain was like electrical discharges. Right knee extension was weak together with hyperalgesia and loss of heat sensation in the right LA dermatome. The right patellar reflex was absent. Electromyography showed acute and chronic denervation of muscles innervated by the right L4 nerve root. MR scan showed a right L4-5 extraforaminal mass distorting the L4 dorsal root ganglion. The mass enhanced homogeneously after gadolinium injection and was thought to be a tumor. It was surgically removed using a midline incision and intraspinal, followed by extraspinal dissection. Under the operating microscope, the mass extended between an intact lateral longitudinal ligament and a swollen dorsal root ganglion. Histopathologic examination ruled out a tumor and showed that the mass consisted of degenerated disc material surrounded by a large peripheral zone of neovascularization. CONCLUSION: Extraforaminal periganglionic free, encapsulated disc fragments may mimic tumoral masses, from which they may not be distinguished on MRI.

The association between antibiotics usage in early childhood and early childhood caries.

PURPOSE: The objectives of this study were to learn if the intake of systemic antibiotics during the first year of age (period of primary teeth development) was associated with an increased risk for early childhood caries during the following years; and after the first year of age (following the formation of primary teeth) was associated with a lower risk for early childhood caries during the following years. CONCLUSIONS: Children who used systemic antibiotics during the first year of age had a significantly greater risk for early childhood caries (ECC) during follow-up compared to children who did not use antibiotics. After the first year of life, only children who used systemic antibiotics at 13 to 18 months old showed a significant increase in the risk of ECC. A child's racial background was a determining factor in the association between antibiotic intake and ECC.

Ultrasonography and Doppler ultrasonography in the evaluation of intraosseous lesions of the jaws.

OBJECTIVES: To evaluate the efficacy of ultrasonography and colour and power Doppler ultrasonography for diagnosis of intraosseous lesions of the jaws and to correlate the contents of the lesion with the histological findings. METHODS: This study included 20 patients referred to the oral surgery clinic for treatment. All patients had intraosseous jaw lesions in the maxilla or mandible. Ultrasonographic examinations were performed and, according to the ultrasonography findings, the jaw lesions were classified into three groups: cystic, semisolid and solid. Additionally, colour and power Doppler ultrasonography examinations were performed to evaluate blood flow in all patients. After the ultrasonography examination, the patients underwent surgical treatment. The correlation between ultrasonography and Doppler ultrasonography findings of the lesions and histological findings was investigated. RESULTS: 22 lesions were identified in 20 patients. Of the five lesions with histological findings of inflammatory granulation tissue, ultrasonography identified four of them that showed a solid appearance. Vascularization was detected in both internal and external areas of these lesions with colour and power Doppler ultrasonography. Of the 17 odontogenic cystic lesions, the ultrasonography examination showed a simple cystic appearance in 5 lesions, a complex cystic appearance in 3 lesions, a semisolid appearance in 6 lesions and a solid appearance in 1 lesion. Two lesions were inconclusive on ultrasonographic examination. CONCLUSIONS: Ultrasonography can provide accurate information on the content of intraosseous lesions of the jaws before any surgical procedure. Additionally, Doppler ultrasound can show vascularization of the lesion. However, there was no correlation between the ultrasound findings and the definitive histological diagnosis.

Bilateral trigeminal neuralgia and charcot-marie-tooth disease: diagnosis and successful microsurgical treatment of bilateral neurovascular compression.

BACKGROUND: The association of Charcot-Marie-Tooth (CMT) disease and trigeminal neuralgia (TN) is rare. CMT and bilateral TN is even rarer. Our literature review has revealed only 4 previous cases with CMT and bilateral TN. We report the case of a 23-year-old man with a prior diagnosis of CMT and unilateral deafness who initially presented with excruciating and lancinating right-sided facial pain. PATIENT AND METHOD: Initially treated with percutanous ablation elsewhere with only short-lasting relief, the patient was on toxic doses of medication when he presented to us. Neuro-imaging using magnetic resonance imaging showed vascular compression as the possible cause of pain. At initial surgery, two artery loops were found compressing the right nerve superomedially and an artery and a vein was found compressing the nerve inferomedially. Relief was instantaneous and for 1 year there was no recurrence of right facial pain. Left-sided pain which had been minimal before microvascular decompression (MVD) became intolerable immediately after right-sided surgery, yet responded to mild doses of carbamazepine for almost a year. At one year, the patient had to undergo MVD for the left trigeminal nerve with complete relief over both sides of his face without any medication. RESULTS: The patient remains pain-free on both sides at 1-year follow-up after the second MVD. CONCLUSIONS: The underlying neuropathy in CMT makes the trigeminal nerve more vulnerable to vascular compression than usual. The bilateral compression of the trigeminal nerve-pons junction in our patient suggests that the external pressure probably adds to the internal defects in central myelin formation, structure or maintenance. Nevertheless, the mid-term follow-up after MVD clearly shows that the causal treatment for TN can be successfully applied to patients with TN plus CMT.

Middle ear and respiratory infections in early childhood and their association with early childhood caries.

PURPOSE: The purpose of this study was to examine the risk of early childhood caries (ECC) in children who had middle ear infections (MEI) or respiratory tract infections (RTI) during early childhood. METHODS: Medicaid data from Michigan were analyzed for all continuously enrolled children born in 2001 for whom enrollment, medical, and dental claims were filed during 2001-2004. Proportional hazards survival models were used to assess the risk of ECC in children who had MEl or RTI during the first year of life. RESULTS: Included in the study were 29,485 children (51% males and 49% females). By first year of life, 47% and 69% of children had a claim for MEI and RTI, respectively. Children with at least one claim for MEI or RTI were at 29% higher risk for developing ECC compared to those with no claims (P < .001). Hispanic children with 8 or more claims showed 91% greater risk for developing ECC than those with less than 8 claims (P = .01). CONCLUSIONS: The occurrence of middle ear infections or respiratory tract infections during the first year of life is associated with a significantly increased risk for developing early childhood caries during subsequent years. Race and ethnicity are possible predictors for ECC in the studied models.