Early Childhood Caries Risk Research Articles

Study on the association between malnutrition, early childhood caries and caries activity among children aged 3–5 years

BackgroundThis study aims to investigate the association between malnutrition and early childhood caries (ECC) and caries activity among children aged 3–5 years, in order to provide a theoretical basis for preventing and blocking ECC and improving malnutrition.MethodsChildren aged 3–5 years from six kindergartens in Zhao Xian, China were enrolled in this study. The decayed, missing, filled teeth (dmft) of all children were examined and recorded. The Cariostat method was used to detect dental caries activity, collect anthropometric data and measure haemoglobin concentration. Parents were asked to complete a questionnaire on the general characteristics and oral health behaviour of the participants. The “Growth Standards for Chinese Children Under 7 Years Old” was used to assess the nutritional status of all participating children. Wilcoxon rank sum test and multivariate logistic regression analysis were used to analyse and evaluate the relationship between ECC, caries activity and malnutrition.ResultsA total of 635 children who met the criteria were included in this study. After adjusting for confounding factors, logistic regression showed that the risk of ECC was significantly increased in underweight children compared with normal children (OR = 5.43, P < 0. 05); compared with normal children, the risk of ECC decreased in overweight and obese children (OR = 0.31, P < 0.001); underweight children had higher caries severity than normal weight children, and the difference was statistically significant (OR = 2.69, P < 0. 05); stunted children had higher caries severity than normal weight children and the difference was statistically significant (OR = 2.28, P < 0.05); underweight was positively associated with caries activity and the association was statistically significant (OR = 2.33, P < 0. 05); stunting was positively associated with caries activity and the association was statistically significant (OR = 2.1, P < 0.05); overweight and obesity were negatively associated with caries activity and the association was statistically significant (OR = 0.61, P < 0.05).ConclusionsThe risk of ECC among children aged 3–5 years was positively associated with undernutrition and negatively associated with overnutrition. The severity of ECC among children aged 3–5 years was positively associated with undernutrition. The caries activity among children aged 3–5 years was positively associated with undernutrition and negatively associated with overnutrition.

Integrated Health Solutions: Addressing the Co-occurrence of Otitis Media With Effusion and Early Childhood Caries in Preschool Children.

Introduction: Otitis media with effusion (OME) is a common middle ear condition, which frequently affects children and can lead to hearing impairment, speech delays, and developmental issues. Early childhood caries (ECC) is another prevalent pediatric condition defined by the presence of decayed, missing, or filled tooth surfaces in children under six years old. Objectives: This study aims to determine the prevalence of OME and ECC, the association between these two conditions, and the risk and severity of ECC among preschool children with OME. Methodology: A prospective cross-sectional study was conducted at a single tertiary center. A total of 206 preschool children aged six and below with hearing impairment or speech delay were recruited. They were grouped as follows: with OME (n= 129) and without OME (n = 77). Demographic and socioeconomic data were obtained, followed by otoscopy, anterior rhinoscopy, and tympanometric assessment. The subjects were further stratified into having ECC or not by conducting a dental examination for caries detection, whose findings were documented using Dental Charting and Caries Risk Assessment (CRA). Tympanometric width (TW) was also analyzed to measure its association with tympanic membrane appearance. Results: 51.5% (n=106) of children with OME were found to have ECC. They predominantly had mild ECC (49.1%), and most (51%) were at moderate risk for caries based on the CRA (P < 0.001). A significant association between OME and ECC was observed (p < 0.001). Tympanometry results documented a strong correlation between TW greater than 200 daPa and abnormal tympanic membrane findings in OME (P< 0.001). Conclusions: The association between OME and ECC in preschool children necessitates integrated healthcare approaches for early detection and management. Reliable diagnostic tools, such as tympanic width measurement for OME and CRA for ECC, are crucial in addressing these health issues. Early intervention and comprehensive care can mitigate the risks and improve health outcomes for affected children.

Effectiveness of a message service on child oral health practice via a social media application: A randomized controlled trial.

Early establishment of healthy oral health behaviours is important to reduce early childhood caries risk. Two-way social media applications can economically assist caregivers. To evaluate the effectiveness of a LINE™ messaging service (MS) on promoting good oral health behaviors in Thai children. One hundred and ninety caregiver-child dyads (children aged 6-36 months) who attended a university dental hospital and two other hospitals were randomly assigned to receive age-appropriate dental health education via MS or through traditional on-site visits. Infographic posters, video clips, and supportive messages were delivered weekly to the MS group. Parental oral health knowledge and children's oral health status and practice were assessed at baseline and 6-month follow-up. The MS group showed significantly better scores in feeding habits (p = .034) and toothbrushing practice (p = .007). Parental knowledge increased in both groups; however, knowledge increased significantly in the control group (p = .001). Both groups exhibited improvements in the debris score but not in caries progression. The caregivers rated both methods as high to the highest satisfaction. The MS yielded comparable outcomes to traditional dental visits in promoting oral health behaviours.

Association between early childhood caries and parental education and the link to the sustainable development goal 4: a scoping review

BackgroundThe goal of the United Nations Sustainable Development Goal (SDG) 4 is to ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. The aim of this scoping review was to map the current evidence on the association between the prevalence of early childhood caries (ECC) and parental education; and to identify possible pathways by which parental education may protect against ECC.MethodsThe two questions that guided this review were: what is the existing evidence on the association between maternal and paternal education and ECC; and what are the pathways by which parental education protects against ECC? The initial search was conducted in January 2023 in PubMed, Web of Science and Scopus. Articles published in English between January 2000 and October 2022 that reported on the association between parental education and ECC were screened, and the extracted data were compiled, summarized, and synthesized. Review papers and non-primary quantitative research papers were excluded from the full-text review. Open coding was applied to develop a conceptual framework.ResultsIn total, 49 studies were included: 42 cross-sectional, 3 case-control and 4 cohort studies. The majority (91.8%) reported on the associations between ECC and maternal (n = 33), paternal (n = 3), and parental (n = 9) level of education, and 13 (26.7%) reported on the association between parental education and the severity of ECC. Mothers with more than primary school education (n = 3), post-secondary/college/tertiary education (n = 23), and more than 4–12 years of education (n = 12) had children with lower risk for ECC. Two studies reporting on parental education found an association between maternal but not paternal education and ECC. The review suggests that achieving the SDG 4.1 may reduce the risk of ECC. Possible pathways by which maternal education protects from ECC were feeding practices, oral hygiene practices, and the use of dental services.ConclusionThe study findings suggests that higher maternal educational level may reduce the risk for the consumption of cariogenic diet, poor oral hygiene practices and poor use of dental services for caries prevention. However, the association between paternal education and ECC was not consistently observed, with significant associations less frequently reported compared to maternal education. Future studies are needed to define the magnitude and modifiers of the impact of maternal education on the risk for ECC.

Protocol for CARES–HAPIN: an ambidirectional cohort study on exposure to environmental tobacco smoke and risk of early childhood caries

IntroductionPrenatal and postnatal exposure to environmental tobacco smoke (ETS) has been linked with early childhood caries (ECC), but the specific molecular mechanisms and pathways remain largely unknown. The Caries Risk...

Relationship between parental adverse childhood experiences and the prevalence of early childhood caries.

The aim of this study was to examine the behavioural health conditions associated with parents' retrospective adverse childhood experiences (ACEs) scores and their children's early childhood caries (ECC) in parent-child dyads. Parents with children younger than 72 months were included in the study. A relational screening model was used. Interaction among ACEs, ECC, nutritional habits and oral hygiene habits were evaluated. Chi-square tests and t-tests were used in the study. Multiple variables were evaluated using the artificial neural network (ANN) model. The mean age of the 535 children included in the study was 46.5 months, and 52% were female. Using the ANN model, there was a statistically significant relationship between the educational status of the mothers in both the ECC and severe ECC (S-ECC) groups and the socioeconomic status of the family (p < 0.05). If the number of snacks consumed daily was three or more, the risk of ECC was statistically significantly higher (chi-square test p = 0.034). The parents' ACEs scores had an impact on both ECC and S-ECC formation (p = 0.001, t-test). The higher the ACEs score, the higher the risk of S-ECC. The mean ACEs scores of the parents were also significantly higher in both the ECC and S-ECC groups compared to those of the parents of children without dental caries (p = 0.001, t-test). It was calculated that ACEs scores were effective at a rate of 18.2% on ECC (p = 0.045, ANN). The ACEs scores of parents have an impact on the oral health of young children and ECC/S-ECC formation. The long-term effects of parental ACEs are reflected in their children's oral health. Therefore, reducing the psychosocial determinants ACEs and providing parental support may help in overcoming barriers to the well-being of young children and may facilitate better oral health.

Navigating early childhood caries management in children with autism and developmental disorders: A U.S. perspective

Early Childhood Caries (ECC) is a prevalent and preventable oral health concern among children, presenting unique challenges when managing those with autism and developmental disorders. This paper explores navigating ECC management in this population from a U.S. perspective. Understanding the impact of autism spectrum disorder (ASD) and developmental disorders on oral health is crucial, given their higher risk of ECC due to behavioral, dietary, and hygiene factors. Diagnosis and assessment pose particular challenges, requiring tailored approaches to accommodate sensory sensitivities and communication barriers. Preventive strategies encompass parent/caregiver education, customized oral hygiene instruction, dietary counseling, and fluoride varnish application. Behavioral management techniques, such as desensitization and creating a positive dental experience, are essential for successful treatment. Treatment approaches may involve restorative procedures, considering sedation or anesthesia for children with heightened anxiety or sensory issues, often requiring collaboration with multidisciplinary teams. Long-term management emphasizes maintaining oral health habits and regular dental visits, adjusting to changes in behavior and developmental needs over time. Addressing barriers to care, including access, financial constraints, and provider education, is crucial for effective ECC management in this population. ECC management in children with autism and developmental disorders requires a comprehensive, multidisciplinary approach tailored to individual needs. Future research should focus on refining diagnostic techniques, enhancing preventive interventions, and improving access to dental care services for this vulnerable population. By addressing these challenges, we can strive to improve oral health outcomes and quality of life for children with autism and developmental disorders.

Comparison of Salivary Flow Rate, pH, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children.

Early childhood caries (ECC) is the most common chronic disease of childhood in many developing countries, which is associated with local, systemic, psychological, and social consequences. Multiple variables are shown to be associated with an increased risk of ECC. The knowledge regarding the role of saliva in the pathophysiological process of ECC still remains controversial and unexplored. Scanty studies focused on probing the role of salivary flow rate, pH, buffering capacity, and secretory immunoglobulin A (sIgA) in unstimulated whole saliva of children with ECC and children without ECC. To assess the salivary flow rate, pH, buffering capacity, and sIgA levels in children with ECC and caries-free children and to evaluate their role in caries risk assessment.Materials and Methods: The study was carried out among 64 children aged between 24 and 71 months. Clinical examinations were carried out according to the criteria by the World Health Organization, and carious status was recorded. Subjects were categorized as group I with ECC (dmfs-Decayed, Missing or Filled Surfaces (Deciduous dentition) of ≥5), and group II included children without ECC (dmfs = 0). Unstimulated whole salivary samples were collected in a sterile vial and stored at -70°C by draining. Estimations of salivary flow rate, pH, buffering capacity, and sIgA levels were done. Digital pH meters were used for the estimation of pH and buffering capacity. A human IgA enzyme-linked immunosorbent assay (ELISA) kit was used to estimate sIgA levels. Statistical software IBM Statistical Package for the Social Sciences (SPSS) statistics 20.0 (IBM Corporation, Armonk, New York, United States of America) was used to analyze the data. The mean salivary flow rate decreased in group I children with ECC (0.15 ± 0.05) when compared to group II children without ECC (0.67 ± 0.14), which was statistically significant. In caries active children, no statistically significant correlation was found between salivary flow rate and the dmfs scores [r-value (-0.247)] and p-value (0.147). The mean level of salivary pH is decreased in group I children with ECC (4.65 ± 0.4) when compared to group II children without ECC (7.28 ± 0.18). In the caries active group, the levels of salivary pH decrease as the dmfs scores increase, and this correlation is found to be statistically significant (r-value of 0.547 and p-value of 0.002). The mean level of buffering capacity is decreased for caries-active children (5.45 ± 0.49) when compared to caries-free children (8.94 ± 0.42). In caries active children, as the dmfs scores increase, the salivary buffering capacity decreases, and this correlation is found to be not statistically significant (r-value of -0.334 and p-value of 0.161). The mean levels of sIgA in group I children with ECC were higher (10.61 ± 0.90) than that in group II children without ECC (6.11 ± 1.22). In the caries-active group, the salivary sIgA levels were comparatively higher than in the caries-free children. As the dmfs scores increase, the level of the sIgA increases in caries-active children, and this correlation is noted to be highly statistically significant (r-value of 0.769 and p-value 0.008). Children with ECC showed decreased salivary flow rate, pH, buffering capacity, and increased sIgA levels, while children without ECC showed increased salivary flow rate, pH, buffering capacity, and decreased sIgA levels. The salivary parameters, such as salivary flow rate and buffering capacity, showed no correlation with the dmfs score, while salivary pH and sIgA levels have a positive correlation in caries-active children. Sivakumar A, Narayanan R. Comparison of Salivary Flow Rate, Ph, Buffering Capacity, and Secretory Immunoglobulin A Levels between Children with Early Childhood Caries and Caries-free Children. Int J Clin Pediatr Dent 2024;17(3):334-340.

Risk of Early Childhood Caries Estimated by Maternal Dental Caries during Pregnancy: A Retrospective Cohort Study.

Public policy promoting prenatal dental care to provide long-term prevention of early childhood caries (ECC) in offspring would require evidence regarding the ECC risk associated with maternal dental caries during pregnancy. This study evaluated that association using a design capable of assessing temporal relationships and considered a directed acyclic graph to guide the adjustment of pertinent confounders. This retrospective cohort study analyzed data from 158 mother-child dyads attending care at Prachathipat Hospital, Pathum Thani, Thailand. Maternal dental caries data at their first visits to prenatal oral care from February 2012 to May 2017 were traced forwardly to match the oral health data of offspring who visited the hospital from May 2013 to March 2018. Univariable and multivariable fractional logit regression models along with the calculation of average marginal effects revealed that children born to two categories of mothers with 1 to 5 and ≥6 carious teeth during pregnancy would averagely develop 4.5 to 5 and 7.9 to 8.8 more carious teeth per 100 teeth than dental caries would occur in offspring of caries-free mothers. This evidence identified the role of maternal dental caries during pregnancy as a significant clinical risk indicator for ECC and supported the provision of prenatal dental care for mothers to prevent ECC in offspring.

Genetic Association between the Risk of Dental Caries and MTR Gene Polymorphism in Chinese Children.

Early childhood caries (ECC) is common in children. Little is known about the genetic association of the methionine synthesis reductase (MTRR) gene rs1801394 and methionine synthetase (MTR) gene rs1805087 polymorphisms with ECC, which was examined in the Chinese Han population. Genotyping was performed using the buccal mucosa from 150 normal and 150 ECC children. For genotype and allele distribution comparison, Chi-square test and multiple logistic regression analysis were performed. The odd ratio (OR) and 95% confidence interval (CI) were calculated. MTR gene rs1805087 AG genotype distribution in the ECC group was clearly different from the control group (P = 0.029), and the ECC risk in cases with AG genotype was 0.525 times lower than those carrying AA genotype (95% CI = 0.292-0.942). Logistic regression analysis after adjustment for other clinical indicators determined that the MTR gene rs1805087 AG genotype was still strongly associated with susceptibility to ECC (OR = 0.499, 95% CI = 0.273-0.913, P = 0.024). Significant association was also seen for sugary food intakes (OR = 1.965, 95% CI = 1.162-3.321, P = 0.012), tooth brushing (OR = 0.569, 95% CI = 0.356-0.924, P = 0.023) and sex (OR = 0.562, 95% CI = 0.349-0.907, P = 0.018) with ECC risk. No notable genetic association was found between MTRR gene rs1801394 polymorphism and ECC risk. MTR gene rs1805087 polymorphism may aggrandize the susceptibility to ECC, and AA genotype appeared to be a dangerous element for the development of ECC.

A scoping review on the association between early childhood caries and life on land: The Sustainable Development Goal 15.

The Sustainable Development Goal 15 (SDG15) deals with protecting, restoring, and promoting the sustainable use of terrestrial ecosystems, sustainably managing forests, halting and reversing land degradation, combating desertification and halting biodiversity loss. The purpose of this scoping review was to map the current evidence on the association between SDG 15 and Early Childhood Caries (ECC). This scoping review was reported in accordance with the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. Formal literature searches were conducted in PubMed, Web of Science, and Scopus in March 2023 using key search terms. Studies with the criteria (in English, with full text available, addressing component of life on land, focusing on dental caries in humans, with results that can be extrapolated to control ECC in children less than 6 years of age) were included. Retrieved papers were summarised and a conceptual framework developed regarding the postulated link between SDG15 and ECC. Two publications met the inclusion criteria. Both publications were ecological studies relating environmental findings to aggregated health data at the area level. One study concluded that the eco-hydrogeological environment was associated with human health, including caries. The other reported that excessive calcium was associated with the presence of compounds increasing groundwater acidity that had an impact on human health, including caries. The two ecological studies were linked to SDG 15.1. It is also plausible that SDG 15.2 and SDG 15.3 may reduce the risk for food insecurity, unemployment, gender inequality, zoonotic infections, conflict and migration; while SDG 15.4 may improve access to medicinal plants such as anticariogenic chewing sticks and reduction in the consumption of cariogenic diets. There are currently no studies to support an association between ECC and SDG15 although there are multiple plausible pathways for such an association that can be explored. There is also the possibility of synergistic actions between the elements of soil, water and air in ways that differentially affect the risk of ECC. Studies on the direct link between the SDG15 and ECC are needed. These studies will require the use of innovative research approaches.

Factores asociados a la caries en infancia temprana

Introduction: Caries in early childhood is very common since there are different risk factors such as diet that are possible contributors to the appearance of dental caries in childhood. Design: A systematic review of studies that were evaluated was carried out, which were published between 2015 and 2021. Data sources: A search was performed through PubMed. The eligibility criteria were articles that used: diagnostic criteria for carious teeth, with indication of extracted and filled (ceo-d) criteria used by the World Health Organization (WHO) with calibrated examiners, probabilistic sampling and sample sizes. Study selection: Five previously calibrated reviewers searched, chose and extracted information from the chosen articles. All analyzes together were based on random effects models. Results: 14 articles were included. Some studies indicate that age becomes a risk factor for preschool children to have childhood cavities, which requires more constant tooth brushing and a greater Area Under the Curve (AUC) composed of the daily frequency. consumption of juices could be associated with dental cavities. Conclusions: Early childhood caries (ECC) is a dental disease caused by many factors that affects the primary teeth of children under 6 years of age. This is a very common disease in childhood and can have a negative impact on the well-being of children, while others indicate that breastfeeding is associated with a higher risk of ECC and may also be associated with a lower risk of ECC.

Association between maternal oral bacteria with early childhood caries development in their children

Objective: The objective of this prospective study was to investigate the association between maternal oral bacteria and the development of early childhood caries (ECC) in their children over a two-year period. Methods: A cohort of mothers and their children was recruited during the prenatal period. Maternal oral samples were collected to assess the presence and abundance of specific cariogenic bacteria, including Streptococcus mutans and Lactobacillus species, using polymerase chain reaction (PCR) techniques. The children were followed up at regular intervals from birth until two years of age. Oral examinations were conducted to assess the presence and severity of ECC. Statistical analyses was performed to determine the association between maternal oral bacteria and ECC development in their children. Results: The study included 98 mother-child pairs, with an average follow-up period of 24 months. The results demonstrated a significant association between maternal oral bacteria and ECC development in their children. Maternal colonization of cariogenic bacteria, particularly S. mutans, was found to be a strong predictor of ECC development in their offspring, even after adjusting for confounding factors such as maternal oral hygiene, socioeconomic status, and child's diet. Higher levels of S. mutans in maternal oral samples were associated with an increased risk of ECC in children at two years of age. Conclusion: This prospective study provides evidence for an association between maternal oral bacteria and the development of early childhood caries in their children over a two-year period. Maternal colonization of cariogenic bacteria, especially Streptococcus mutans, was found to be a significant risk factor for ECC development. These findings highlight the importance of maternal oral health and the need for preventive measures targeting maternal oral bacteria to reduce the transmission and subsequent development of ECC in children. Early interventions, including oral hygiene education and preventive strategies, should be implemented to promote maternal oral health and improve oral health outcomes in children.

A scoping review on the links between sustainable development goal 14 and early childhood caries

BackgroundThe Sustainable Development Goal (SDG) 14 addresses life below the waters, an important source of protein and contributor to global food security and economic development. Our aim was to explore possible evidence on the links between life below water and early childhood caries (ECC).MethodsThis scoping review identified articles on the link between life below water and caries according to the PRISMA-ScR guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were systematically searched in January 2023, using specific search terms. Studies written in English, with full text available, addressing life under water, focusing on dental caries in humans, with results that can be extrapolated to control ECC in children less than 6 years of age were included in the review. Descriptive statistics were used to summarize the retrieved papers and graphical presentation was used for visualization.ResultsThere were 224 publications retrieved of which 13 studies, published between 1960 and 2022, were included in the analysis. The papers originated from Asia (7/13), North America (3/13), Europe (1/13), and 2/13 had multi-country authorship. Also, four laboratory studies extracted agents from marine products to determine their efficacy in preventing caries formation and preventing/slowing plaque formation; four letters discussed the caries prevention potential of sea salt as a source of fluoride; and two review articles about the positive effects of extracted marine products for caries prevention. Most (11/13) studies addressed target 14.1 concerned with enriching the marine environment with nutrients and minerals; two addressed target 14.4 focused on ensuring fish stocks are within biologically sustainable levels; two addressed target 14.7 aimed at increasing the economic benefits through sustainable use of marine resources such as fisheries; and one focused on target 14.5 aimed at conserving marine areas by increasing protected areas. In addition, one ecological study assessed the association between the ecosystem and ECC.ConclusionsCurrently, there is little known about the impact of protection of marine and coastal ecosystem from pollution and ocean acidification on the risk of ECC. Further evidence on possible associations between life below water and ECC management is needed.

Influence of Artificial Intelligence-Driven Diagnostic Tools on Treatment Decision-Making in Early Childhood Caries: A Systematic Review of Accuracy and Clinical Outcomes.

Early detection and accurate prediction of the risk of early childhood caries (ECC) are essential for effective prevention and management. This systematic review aims to assess the performance and applicability of machine learning algorithms in ECC prediction and detection. A comprehensive search was conducted to identify studies utilizing machine learning algorithms to predict or detect ECC. The included (n = 6) studies demonstrated high accuracy, sensitivity, specificity, and area under the receiver operating characteristic (AUC) values related to predicting and detecting ECC. The application of machine learning algorithms contributed to enhanced clinical decision-making, targeted preventive measures, and improved ECC management. The studies also highlighted the importance of considering multiple factors, including demographic, environmental, and genetic factors, when developing dental caries prediction models. Machine learning algorithms hold significant potential for ECC prediction and detection, having promising performance outcomes. Due to the heterogeneity of the studies, no meta-analysis could be performed. Moreover, further research is needed to explore the feasibility, acceptability, and effectiveness of integrating these algorithms into dental practice. This approach would ultimately contribute to enabling more effective and personalized dental caries management and improved oral health outcomes for diverse populations.

Nuclear and extended families to risk of early childhood caries

Nuclear and extended families to risk of early childhood caries

Evidence pertaining to modifiable risk factors for oral diseases: an umbrella review to Inform oral health messages for Australia.

The aim of this umbrella review was to collate and appraise the evidence base regarding modifiable risk factors for the prevention of oral diseases to inform the update of the Oral Health Messages for Australia. Eleven questions related to modifiable risk factors and dental disease were investigated. Electronic databases (Medline, Embase and PubMed) were searched from January 2010 to October 2022. Systematic reviews evaluating interventions/exposures in healthy subjects from high-income countries, where Westernized practices, oral health promotion and healthcare systems are similar to Australia, were included. Quality appraisal of included systematic reviews was guided by the AMSTAR tool. Of the 3637 articles identified, 29 articles met eligibility criteria. High-quality systematic reviews were identified for questions relating to diet, infant feeding, dental check-ups and oral hygiene. Free sugars consumption above 5% of energy intake, infrequent toothbrushing, smoking/vaping and alcohol intake were consistently associated with poorer oral health outcomes. Breastfeeding up to the age of 24 months was not associated with an increased risk of early childhood caries. The use of interdental cleaning devices and mouthguards during contact sports are likely to be effective in preventing dental disease.

Stunting and Periodontal Disease

Background: Stunting is a condition where a child's height is insufficient for their age. Stunting in children under the age of five, which can be caused by chronic malnutrition, poses a danger of death. Objective: Stunting can have an impact on dental and oral health by increasing the risk for early childhood caries and delaying tooth eruption, also reducing the number of permanent teeth. Conversely, stunting may be impacted by poor dental health. Literature Study: Periodontal disease can have impact on pregnant women’s fetal growth such as premature birth and low birth weight babies both directly and indirectly. Subsequently, premature babies can increase the risk of stunting. Discussion: One of the stunting behind mechanisms was the discovery of differences in bacterial variations between stunted and normal children. Oropharyngeal bacteria, such as Porphyromonas gingivalis usually found in severe periodontitis, were detected in pregnant women which is likely to disrupt the host's immune homeostasis. Disorders in pregnant women can interfere with the process of tooth development in the fetus. Conclusion: Periodontal therapy in for periodontitis expecting mother, should have decrease the risk of adverse effect of pregnancy such as premature birth and low birth weight, and decrease the risk of having stunting children.

Decarbonization of Transport and Oral Health

The decarbonization of transport is a global initiative aimed at reducing greenhouse gas emissions and addressing the risks of global warming. This article explores the potential connections between the decarbonization of transport and oral health, highlighting the need for further research in this area. Emissions from vehicle exhausts, such as carbon dioxide, methane, and nitrous oxide, may have a modest impact on the risk of early childhood caries and other oral health diseases like periodontal diseases, oral cancer, and dental caries. Active transportation, which promotes regular exercise, has beneficial effects on overall health, including stimulating salivary protein production and reducing the risk of diabetes and cardiovascular diseases, both of which are linked to poor oral health. Transitioning to electric vehicles can also reduce noise pollution, positively impacting mental well-being, which is associated with improved oral hygiene practices. Furthermore, the development of sustainable infrastructure, including efficient public transportation systems, can enhance access to dental services. Further research is needed to establish stronger evidence for these connections and to explore how the global decarbonization of transport agenda can incorporate oral health considerations.

Preschool Children Feeding Patterns And Early Childhood Oral Health Impact In Tanah Merah, Kelantan, Malaysia

Introduction: Poor feeding patterns increase risk of Early Childhood Caries (ECC), which can cause negative impacts on oral health-related quality of life (OHQoL) of preschool children and parents. This study aims to assess feeding patterns of preschool children and OHQoL of the children and their parents in Tanah Merah. Methods: A cross-sectional study was conducted involving 134 preschool children aged 5-6 years old from eight private preschools, chosen by multi-staged stratified cluster sampling. Parents answered adopted self-administered questionnaire on feeding patterns and oral health-related impacts. Mann-Whitney U test and Kruskal-Wallis test were used to compare the median between groups of feeding patterns. Results: A total of 122 parents responded. Majority of the children had history of bottle-feeding (97.5%) and being given solid food during infancy (61.2%). Many children were still using bottle to drink (38.5%). Majority were still given formula milk at least three times daily (51.1%) and were feed with bottle to put to sleep (97.9%). The Child Impact Section (CIS), Family Impact Section (FIS) and Overall ECOHIS mean scores were 2.39 (SD=3.41), 0.71 (SD=1.45) and 3.10 (SD=4.41), respectively. Most common impact reported in CIS was ‘oral pain’ (26.2%) whereas in FIS, ‘parents felt guilty’ (7.4%). None of feeding patterns were found significantly different in terms of ECOHIS score median (p-value&gt;0.05). Children OHQoL reporting by proxy should be treated as complementary. Conclusion: Many preschool children were involved in prolonged, frequent and nocturnal bottle-feeding. No significant difference in median ECOHIS scores found according to feeding patterns.