Risk Factors For Caries Development Research Articles

Fixed appliances orthodontic therapy as a risk factor for caries development: Systematic review.

Orthodontic treatment is often mandatory to improve the patient's health condition. However, the fixed appliance can create additional plaque retention areas, which can increase the risk of caries development. Clinically, one can observe various effects of fixed appliance treatment on caries prevalence. This study aims to analyze to what extent orthodontic therapy with fixed appliances is a risk factor for developing caries in pediatric and adult patients. The keywords used in the search strategy were as follows: ("caries" AND "caries risk" AND "caries experience" AND" "orthodontic treatment" OR "fixed appliance" ") and ("caries experience" AND "orthodontic treatment").From 808 potential articles, 15 were included in the review. In individuals undergoing fixed orthodontic therapy, several factors can increase the risk of car-ies during fixed orthodontic treatment, such as salivary composition, oral dysbiosis and plaque accumulation. On the other hand, factors that reduce caries risk are, i.e., oral hygiene self-awareness and previous orthodontic treatment. In most studies which used the Decayed, Missing, and Filled Teeth (DMFT) index, there were no significant differences between the values obtained before orthodontic treatment and after the treatment. Moreover, it is easier for a patient with aligned teeth to remove plaque.In the young population, fixed orthodontic treatment appears to reduce the incidence of caries. In the adult population, fixed orthodontic treatment increases the risk of dental caries. However, education on proper oral hygiene during orthodontic treatment can reduce the risk of dental caries. The study protocol was registered in the PROSPERO database [PROSPERO CRD42022356628].

The impact of caries status on supragingival plaque and salivary microbiome in children with mixed dentition: a cross-sectional survey

BackgroundSupragingival plaque and saliva are commonly used for microbiome analysis. Many epidemiological studies have identified deciduous teeth caries as a risk factor for caries development in first permanent molar (FPM); nevertheless, to the best of our knowledge, there are no reports on the effects of deciduous teeth caries on the microbiome of healthy FPM. Additionally, it remains unclear whether saliva can be used instead of supragingival plaque for caries microbial studies. Therefore, we aimed to elucidate this issue, and to characterize and compare the oral microbiome of healthy FPMs in children with different caries statuses and that from children with and without caries in a similar microhabitat, by PacBio sequencing. Currently, few studies have investigated the oral microbiome of children using this technique.MethodsThirty children (aged 7–9 years) with mixed dentition were enrolled; 15 had dental caries, and 15 did not. Supragingival plaques of deciduous molars and maxillary FPMs, and non-stimulating saliva samples were collected. DNA was extracted and the v1–v9 regions of 16S rRNA were amplified. Subsequently, PacBio sequencing and bioinformatic analyses were performed for microbiome identification.ResultsThe microbial alpha diversity of the saliva samples was lower than that of the supragingival plaque (p < 0.05); however, no differences were detected between deciduous teeth and FPMs (p > 0.05). In addition, the alpha and beta diversity of children with and without caries was also similar (p > 0.05). Nonmetric multidimensional scaling and Adonis analyses indicated that the microbial structure of salivary and supragingival plaque samples differ (p < 0.05). Further analysis of deciduous teeth plaque showed that Streptococcus mutans, Propionibacterium acidifaciens, and Veillonella dispar were more abundant in children with caries than in those without (p < 0.05); while in FPMs plaque, Selenomonas noxia was more abundant in healthy children (p < 0.05). No differences in microorganisms abundance were found in the saliva subgroups (p > 0.05).ConclusionWe have determined that supragingival plaque was the best candidate for studying carious microbiome. Furthermore, S. mutans, V. dispar, and P. acidifaciens were highly associated with deciduous teeth caries. S. noxia may be associated with the abiding health of FPM; however, this requires additional studies.

Pasif Sigara İçiciliğinin Çocuklarda Ağız ve Diş Sağlığı Üzerine Etkileri

Cigarette smoke is a basic public health problem, harming not only to the smoker ,but also to those who are found in the same environment.This is the reason that children are under this threat. Today, this issue has gained importance in terms of dentistry. There are studies reporting that smoking during pregnancy affects the development and function of teeth, increases the risk of dental caries, causes cleft lip and palate and hypoplasia of primary teeth. In particular, maternal smoking was accepted as one of the important risk factors for caries development. Cigarette smoke exposure has been shown to be a destructive factor in pediatric patients with a high incidence of caries. Currently, the rate of smoking and tobacco use continues to increase, more research should be done on the effects of oral health on children as well as the general health of children and parents should be informed more on this issue. In this review, the effects of passive smoking on children's oral and dental health are discussed in the light of current literature.

Caries Risk Assessment in Adults Using the Cariogram.

This study identifies the caries risk in adult patients using the Swedish software product Cariogram. Early detection and timely management of risk factors for caries development are crucial for its prevention and non-operative preventative treatment. To identify patients at high risk for caries and implement a prophylactic program aimed at the individual patient based on the assessment of the individual risk factors. The study included 59 women and 41 men aged 19-65 years. Adetailed medical history wasobtained from all patients who underwent thorough clinical examination, evaluation of saliva with Saliva-Check Buffer (GC) test and of Streptococcus mutans and Lactobacillus levels using the CRT Bacteria kit (Ivoclar Vivadent AG products), and assessment of the caries risk using the Cariogram software. The results showed that the most important risk factors were as follows: DMFT, (rs [100] = 0.358, p<0.001), levels of Lacto-bacilli (rs [100] = 0.321, p<0.001), levels of Streptococcus mutans (rs [100] = 0.302, p<0.05), plaque amount (rs [100] = 0.291, p<0.05), food intake frequency (rs [100] = 0.252, p<0.05), and diet content (rs [100] = 0.220, p<0.05). Insignificant correlation coefficients in risk assessment were shown by the application of fluorides (rs [100] = 0.114, p>0.05), saliva rate (rs [100] = 0.018, p>0.05), and saliva buffer capacity (rs [100] = 0.144, p>0.05). Cariogram is a very useful method in clinical practice for evaluation of the caries risk and its preventive, non-operative management.

Caries experience among children born after a complicated pregnancy.

ObjectivesBehavioural and lifestyle factors, as oral hygiene and diet, are well‐established risk factors in the pathogenesis of dental caries, though displaying large differences in susceptibility across individuals. Since enamel formation already starts in utero, pregnancy course and outcome may eventually play a role in enamel strength and caries susceptibility. Therefore, we studied the association between history of pregnancy complications and the caries experience in their six‐year‐old children. The pregnancy complications included small for gestational age (SGA), spontaneous preterm birth (sPTB), gestational hypertension (GH), pre‐eclampsia (PE), individually, and a combination of those, designated as placental syndrome.MethodsThis study was embedded in Generation R, a prospective longitudinal Dutch multiethnic pregnancy cohort study. Information about pregnancy complications was obtained from questionnaires completed by midwives and obstetricians with cross‐validation in medical records. These included SGA, sPTB, GH and PE. Caries experience was assessed with the decayed, missing and filled teeth (dmft) index at a mean age of six years. The association between dental caries experience and a history of pregnancy complications was studied by using hurdle negative binomial (HNB) models.ResultsWe were able to assess the dmft index in 5323 six‐year‐old children (mean age 6.2 years, SD 0.5). We did not find an association between the different pregnancy complications and dental caries experience in childhood, whether for SGA, sPTB, GH, PE, or for the combined outcome placental syndrome (HNB estimates: OR 1.02, 95%CI 0.87 ‐ 1.19; RR 0.90, 95%CI 0.78 ‐ 1.04). Further adjustment of the models with different confounders did not alter the outcome.ConclusionsAlthough it is expected that prenatal stress can be a risk factor for caries development later in life, our findings do not support this hypothesis. Therefore, we believe disparities in caries experience between children are probably not explained by early life events during a critical intrauterine period of development.

Caries Risk Assessment-Protocols and Paraphernalia

Measures of caries control involve identifying the disease process and the risk factors; this is achieved byfirst performing a caries risk assessment for the patient in order to identify his/her risk factors for cariesdevelopment. With a better understanding of the caries process, there comes a change in operative dentistry.Although there is considerable variability between dentists, there is more emphasis on preventive dentistrythan ever before. The shift in emphasis appears to be occurring in dental schools in which curriculum andpractical skills are focused more on caries risk assessment, modern management of the caries disease. Thispaper reviews about the various caries risk assessment approaches and models and stresses on the need fora risk assessment based approach.

Risk factors for caries development in primary Sjogren syndrome

The aim of this study was to compare the risk factors for caries between patients with primary Sjogren syndrome (SS) and those with non-Sjogren syndrome (NSS) salivary hypofunction and to identify the prevalence of incisal or cervical/root caries in each group. This was a retrospective, cross-sectional study conducted at a single center between 2012 and 2015 for assessment of patients with possible SS. Two-hundred and twenty-five (225) patients (99 SS and 126 NSS) participated in the study. Student t test and Wilcoxon's rank sum test were used to evaluate group differences in continuous variables and the χ2 test was used to determined differences in categorical variables. Significant univariate associations were further assessed by using multivariate ordinal regression models. Patients with SS were more likely to have a greater number of total caries (odds ratio [OR] 1.72 [1.03-2.88]; P = .04). And a focus score greater than 1/4 mm2 was associated with greater number of total caries (OR 2.88 [1.05, 7.93]; P = .04]. Adjusted analysis for salivary flow did not show a significant association between stimulated or unstimulated salivary flow or glandular-specific salivary flow and the total number of carious lesions. Patients with salivary hypofunction secondary to SS do have a greater caries risk compared with patients with salivary hypofunction caused by other factors. In this study cohort, this finding was not associated with salivary flow rates.

Impact of parental migration on oral health outcomes of left-behind school-aged children in Luchuan, southern China

BackgroundWith rapid urbanization in China, an increasing number of rural adults have migrated to cities to seek job opportunities, leaving their school-aged children behind. These left-behind children (LBC) without one or both parents usually receive less attention from their caregivers. Whether the parental migration affects the children’s oral health is not well understood. This study aimed to explore the differences in dental caries status and oral health-related behaviors between children with different parental migration experiences in a rural area of Southern China.MethodsA cross-sectional study was conducted in Luchuan County of Guangxi Province in 2015. A total of 1085 school children aged 8–12 participated in this study. Participants’ demographic characteristics, parental migration information, and eating and oral hygiene habits were collected using a self-administered questionnaire. Dental caries of permanent teeth was examined using the decayed, missing, and filled tooth (DMFT) index recommended by the World Health Organization. Dental caries experience and oral health-related behaviors were compared between LBC and non-LBC, as well as children with different experiences of parental migrations. The impact of various parental migration attributes on LBC oral health outcomes was examined by univariate and multivariate analyses.ResultsAmong the school-aged children examined, 60.9% of them were LBC. Only 29.7% of the children brushed their teeth regularly; 86.5% of them did not know what fluoride toothpaste was. Caries prevalence was 51.4% for LBC and 40.8% for non-LBC (p < 0.001). The LBC experienced a greater DMFT mean (1.20 ± 1.59) compared to the non-LBC (0.85 ± 1.30) (p < 0.001). Oral health-related behaviors were not significantly different between LBC and non-LBC. Dental caries experience and oral health-related behaviors were not related to the type or duration of parental migration. Multiple regression analyses showed that parental migration was one of significant predictors of children’s caries outcome; LBC had a higher risk to caries than non-LBC (95% CI =1.26, 2.09).ConclusionsThese findings indicate that parental migration could be a significant risk factor for caries development among 8- to 12-year-old school children in rural China.

A comparison of orofacial profiles in 5- and 10-year-old Swedish children with and without cleft lip and/or palate.

The objectives of this study were to assess orofacial profiles in 5- and 10-year-old children with cleft lip and/or palate (CL/P) compared to controls and to estimate a possible association between orofacial dysfunction and caries frequency. A total of 133 children with CL/P (77 5-year-olds and 56 10-year-olds) and 308 controls (142 5-year-olds and 166 10-year-olds) were included in the study. Orofacial function was evaluated with Nordic Orofacial Test-Screening (NOT-S), and caries were scored according to the International Caries Detection and Assessment System (ICDAS). The total NOT-S score was higher in children with CL/P compared to controls (mean 3.2 vs 0.9, p < 0.001). The domains frequently scored in CL/P children were speech (82%), face at rest (72%), and facial expression (58%). There was a significantly positive correlation between NOT-S scores and caries frequency. Children with CL/P have impaired orofacial function compared to controls. There seems to be a correlation between orofacial function and caries. Impaired orofacial function seen in children with CL/P can be one of many risk factors for caries development, and it is suggested to be a part of caries risk assessment.

Association between salivary cortisol level and caries in early childhood.

The present study aimed to evaluate the association between caries and oral health status, age, salivary cortisol levels, and parental education in children with and without prior dental caries experience. An observational case-control study was performed including 122 children aged between 3 and 6 years who were clinically examined for caries experience using the sum of decayed, missing, and filled teeth in the primary (dmft index) and permanent (DMFT index) dentition. Oral health status was also evaluated using the Simplified Oral Hygiene index (OHI-S). Parents filled a questionnaire to provide information on other variables. Salivary cortisol levels were estimated 1 h after routine dental brushing. We found that dental caries experience was associated with cortisol level, plaque, age, and high calculus levels. High cortisol levels and age are important risk factors for caries development with odds ratios of 3.05 (95% CI: 1.84-5.06) and 1.59 (95% CI: 1.09-2.58), respectively. Multivariate logistic analysis showed that cortisol level and age were independently associated with caries presence. Caries experience was not associated with education of parents, feeding-hygiene habits of child or birth events. The present findings support the hypothesis that caries is mainly correlated with high salivary cortisol levels. Dental caries experience in children was also positively associated with tartar, plaque, and age.

Caries Experience in Children with and without Molar-Incisor Hypomineralisation: A Case-Control Study

Aim: The aim of this study was to compare the caries experience of children with and without molar-incisor hypomineralisation (MIH). Methods: A case-control study was designed in which 130 children aged between 7 and 13 years with MIH (cases) were matched with 130 children without the condition (controls) according to age, sex, and school. Dental caries and MIH were assessed using the Caries Assessment Spectrum and Treatment (CAST) and European Academy of Paediatric Dentistry (EAPD) criteria, respectively, by three examiners. CAST was converted into DMFT/dmft; the Kruskal-Wallis test was performed to analyse whether dmft/DMFT was influenced by the severity of MIH. Associations between MIH and dental caries were analysed at child and tooth levels: between and within subjects, respectively. To correlate MIH severity and the occurrence of dental caries, the Cochran-Armitage test was used. Results: The mean age of the children was 9.63 ± 1.29 years. The mean dmft for cases was 1.23 ± 1.99 and for controls 1.71 ± 2.22 (p > 0.05). For the DMFT, the mean scores for cases and controls were 0.45 ± 0.90 and 0.07 ± 0.25, respectively (p < 0.001). The between-subject analysis showed no difference in relation to enamel carious lesions; however, the prevalence of dentine carious lesions was significantly higher in children with MIH than in those without the condition. The same pattern was seen for the within-subject analysis. It was observed that the increase in MIH severity resulted in more teeth being affected by dentine carious lesions (p = 0.0003). Conclusion: Children with MIH presented a higher experience of caries in the permanent dentition than those without the condition. MIH was considered a risk factor for caries development.

Evaluation of an interdisciplinary preventive programme for early childhood caries: findings of a regional German birth cohort study.

The aim of this prospective birth cohort study was to evaluate the effect of the interdisciplinary preventive programme (PP) for early childhood caries in 3-year-old children in Germany. From July 2009 to October 2010, all parents of newborns (n=1162) were visited after birth by the communal newborn visiting service of Jena, Thuringia, and advised on general and dental health. In the first year of life, children were invited to a dental examination in Jena University Hospital. Participating children were included in a risk-related recall system with continuous oral care over 3years. Caries-risk assessment tool of the AAPD was used for risk categorizing. High-risk children received fluoride varnish biannual. In 2013, the total birth cohort (participants and non-participants) was invited to evaluate the PP. Dental caries was scored using WHO diagnostic criteria expanded to d1-level without radiography. Data were analysed statistically (multivariate logistic regression). Seven hundred fifty-five children (mean age 3.26±0.51years) were examined. Children in the PP (n=377) showed significantly lower caries prevalence and experience than non-participants (15.6 vs. 37.8%, 0.9±3.3 d1-4mfs vs. 2.6±5.2 d1-4mfs). Lack of vitamin D supplements (OR=1.9, CI 0.99-3.51), familial caries experience (OR=2.2, CI 1.27-3.73) and visible plaque on teeth (OR=6.5, CI 4.41-9.43) were significant risk factors for caries development, whereas regular dental care (OR=0.5, CI 0.38-0.79) had a protective effect. The PP was an effective interdisciplinary approach for preventing early childhood caries in small children. Early dental visits with caries-risk-related preventive dental care are necessary to prevent early childhood caries (ECC). German Clinical Trials Register DRKS00003438, https://drks-neu.uniklinik-freiburg.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003438.

Risk factors for caries development on tooth surfaces adjacent to newly placed class II composites – a pragmatic, practice based study

Risk factors for caries development on tooth surfaces adjacent to newly placed class II composites – a pragmatic, practice based study

Risk factors for caries development on tooth surfaces adjacent to newly placed class II composites – a pragmatic, practice based study

ObjectivesTo assess risk factors for caries development on approximal surfaces in contact with newly placed Class II composite restorations. Methods750 surfaces, either sound or with caries confined to enamel, in contact with newly placed Class II composite restorations, placed by PDS dentists in Norway were evaluated by clinicians, using standardized clinical and radiographic criteria. ResultsAfter the observation period (mean 4.9 year, SD 0.67), 38.8% of the initially sound contact surfaces (n=417) remained sound, 34.0% developed caries confined to enamel and 27.2% developed caries into dentine. Of surfaces with caries confined to enamel present at baseline (n=333), 57.3% remained in enamel, while 42.7% progressed into dentine. Risk factors for dentine caries development were assessed by logistic regression analyses. The risk of developing caries on surfaces that were initially sound at baseline was higher in patients with poor or medium oral hygiene (OR 1.53; CI 1.10–3.68), higher DMFT at baseline (OR 1.12; Cl 1.04–1.20). Maxillary teeth (OR 2.01; Cl 1.14–3.56) and surfaces on the right side of the mouth (OR 1.65; Cl 1.01–2.72) were also risk factors. For surfaces with enamel caries present at baseline, the risk of dentine caries was higher in patients with higher DMFT (OR 1.06; CI 1.00–1.13). In both analyses the treating dentists had a significant impact on the caries development. ConclusionsBoth patient- and dentist related variables are risk factors for caries development on approximal surfaces in contact with newly placed Class II composite restorations. Clinical significanceAll clinicians should be aware of a notable risk of caries development on the adjacent tooth surface, especially when placing approximal restorations in high caries risk patients, and should consider greater use of preventive strategies or non-operative treatment that should be evaluated and repeated at every recall.

Is congenital malformation a risk factor for caries development in Swedish adolescents?

Objective. The aim of this study was to investigate whether various forms of congenital malformations are risk factors for approximal caries development in Swedish adolescents. Materials and methods. This longitudinal register-based cohort study included all adolescents (n = 18 142) of 13 years of age who resided in the county of Stockholm, Sweden, in 2000. The cohort was followed until individuals were 19 years of age. Dental caries (decayed, missing and filled teeth/surfaces (DMFT/S)) were collected from the Public Health Care Administration in Stockholm. Data concerning pre- and perinatal factors and parental socio-demographic determinants were collected from Swedish National Registers. Results. In a logistic regression analysis, neither congenital malformation nor any sub-group of congenital malformation registered at birth were significantly associated with an enhanced risk of approximal caries increment in adolescents between 13–19 years of age. The final multivariate logistic regression model, adjusted for possible maternal and family socio-demographic confounders, showed that congenital malformation of the ‘circulatory system' was significantly associated with a decreased risk of approximal caries increment, between 13–19 years of age (OR = 0.33; 95% CI = 0.12–0.88). Conclusions. Congenital malformation should not be considered as a risk factor for approximal caries development in Swedish adolescents today. Noticeably, adolescents with congenital heart diseases exhibited less risk of developing approximal caries, which was probably related to prevention programs allocated to these children in Sweden.

Childhood stunting and caries increment in permanent teeth: a three and a half year longitudinal study in Peru

Malnutrition has been consistently associated with caries in primary teeth, although an effect on permanent teeth has not been established because of the few longitudinal studies. To explore the association between stunting and caries increment in permanent teeth over 3.5 years. In 2003, 121 children aged 7-9 years were randomly selected from nine underserved communities in Lima (Peru). Parents provided demographic information and a food diary for their children. Clinical examinations included assessments of height, weight, oral hygiene, and dental caries. Stunting was defined using the 2000 CDC and 2007 WHO standards. In 2006, 83 children were re-examined, and the 3.5-year net DMFS increment was calculated. The association between stunting and net DMFS increment was assessed using negative binomial regression. Stunting was related to net DMFS increment after adjustment for sex and age, oral hygiene, sugary snacks between meals, and caries experience in primary and permanent teeth. Consistent results were found when using either the 2000 CDC (incidence rate ratio: 1.61; 95%CI: 1.07, 2.44) or 2007 WHO standards (IRR: 1.79; 95%CI: 1.28, 2.51). Stunting was a significant risk factor for caries increment in permanent teeth over a 3.5-year period, independent of other well-known risk factors for caries development.

Urease activity as a risk factor for caries development in children during a three-year study period: A survival analysis approach

Recent cross-sectional studies suggest that reduced ability to generate alkali via the urease pathway in dental plaque may be an important caries risk factor, but it has not been assessed prospectively. ObjectiveTo evaluate the effect of plaque and saliva urease activity on the risk for developing new caries over a three-year period in children. MethodsA panel of 80 children, three to six years of age at recruitment, was followed prospectively for three years. Plaque urease activity, saliva urease activity and dental caries were measured every six months. Survival analysis methodology was used to evaluate the effect of urease on caries development during the study period adjusted for gender, age, baseline caries levels, sugar consumption, amount of plaque, and mutans streptococci levels. ResultsThe risk for developing new caries increased in a dose-responsive manner with increasing levels of urease activity in saliva (adjusted HRQ4 vs. Q1: 4.98; 95% CI: 1.33, 18.69) and with decreasing urease activity in plaque (adjusted HRQ4 vs. Q1: 0.29; 95% CI: 0.11, 0.76). Multiple measurements of urease activity were conducted to overcome the variability of urease activity in this study. Baseline caries and mutans streptococci in saliva were also important predictors of caries risk. ConclusionsIncreased urease activity in saliva can be an indicator of increased caries risk in children, whilst increased urease activity in plaque may be associated with reduced caries risk. The reproducibility of urease measurements must be improved before these findings can be further tested and clinically applied.

Impact of Enamel Defects on Early Caries Development in Preschool Children

Quantitative defects of the enamel are considered risk factors for caries development at the cavitated level. Since caries risk assessment and control should be implemented as early as possible in order to prevent operative treatment, it seemed interesting to investigate the relationship between enamel defects and caries development in the stages of progression that precede cavitation. The impact of enamel defects and selected child-mother indicators on early caries development was investigated in a cohort of Brazilian preschool children. The null hypothesis that developmental defects of the enamel and dental caries are independent and that an association between them occurs by chance was tested. The sample (n = 1,718) was made up of 2- to 5-year-olds. Developmental defects of enamel and caries on buccal surfaces were identified in 48 and 26% of the children, respectively. Bivariate analyses at the surface level showed neither an association between demarcated/diffuse opacity and caries experience (p ≧ 0.64, GLM), nor between the presence of hypoplastic surfaces and non-cavitated lesions (p = 0.29, GLM). The multivariate analyses indicated that in the mouths of individual children, hypoplastic surfaces were more likely to present filled surfaces and non-cavitated/cavitated lesions than non-hypoplastic surfaces (within-child p = 0.03, GEE). However, children having teeth with hypoplastic surfaces were not at higher caries risk than those children who did not present hypoplastic surfaces (between-child p = 0.23, GEE). The null hypothesis could not be accepted for quantitative defects such as hypoplasia, since they had a significant impact on the within-child prevalence of filled surfaces and non-cavitated/cavitated lesions.

Migration background: a risk factor for caries development during adolescence

The influence of child and parental migration background on the risk of approximal caries increment in Swedish adolescents was investigated. This retrospective longitudinal register-based cohort study included all 13-yr-old adolescents (n = 18,142) who were resident in the County of Stockholm, Sweden, in 2000, and followed them up to 19 yr of age. At follow-up, 15,538 subjects were examined. Caries data [decayed, missing, and filled teeth/surfaces (DMFT/S)], were collected from a dental database. Socio-demographic determinants were collected from Swedish National Registers. After adjustments for socio-demographic confounders, logistic regression analysis revealed that adolescents with foreign-born parents, irrespective of whether the child was born in Sweden or abroad, exhibited a significantly elevated risk for approximal caries increment (DMFSa > 0), and developed, on average, 0.53 and 1.14 more approximal caries lesions, respectively, compared with their counterparts with Swedish-born parents. Furthermore, adolescents born in eastern Europe exhibited an increased risk for approximal caries increment (DMFSa > 0) and developed, on average, 1.06 more approximal caries lesions compared with Swedish-born adolescents. In conclusion, parental migration background must be considered as a risk factor for caries development during adolescence, irrespective of whether or not the adolescent was born in Sweden.

Maternal overweight and smoking: prenatal risk factors for caries development in offspring during the teenage period

This study aimed to investigate pre- and perinatal determinants as risk factors for caries development in offspring. In this longitudinal register-based cohort study, we included all children (n = 18,142), of 13 years of age who resided in the county of Stockholm, Sweden, in 2000. The cohort was followed until individuals were 19 years of age. In total, 15,538 subjects were examined. Dental caries (decayed, missing and filled teeth/surfaces), were collected from the Public Health Care Administration in Stockholm. Data concerning pre- and perinatal factors, as well as parental socio-demographic determinants, were collected from the Swedish Medical Birth Register and Swedish National Registers at Statistics Sweden. Mean approximal caries increment (DMFSa) was 1.34 +/- 2.74. The results showed that the prenatal factors, "maternal smoking" and "maternal overweight" exhibited an increased risk of approximal caries increment, (OR 1.33; 95% CI = 1.22-1.44) and (OR 1.21; 95% CI = 1.07-1.37), respectively. Concerning maternal overweight, the excess risk enhanced in relation to the magnitude of the caries increment and maternal smoking was significant across the various DMFSa outcome cut-off levels. In conclusion, this study demonstrates that the prenatal factors, maternal overweight, as well as smoking, are risk factors for approximal caries development in offspring during the teenage period.