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      Early childhood caries in Switzerland: a marker of social inequalities

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          Abstract

          Background

          Early childhood caries (ECC) is a marker of social inequalities worldwide because disadvantaged children are more likely to develop caries than their peers. This study aimed to define the ECC prevalence among children living in French-speaking Switzerland, where data on this topic were scarce, and to assess whether ECC was an early marker of social inequalities in this country.

          Methods

          The study took place between 2010 and 2012 in the primary care facility of Lausanne Children’s Hospital. We clinically screened 856 children from 36 to 71 months old for ECC, and their caregivers (parents or legal guardians) filled in a questionnaire including items on socioeconomic background (education, occupation, income, literacy and immigration status), dental care and dietary habits. Prevalence rates, prevalence ratios and logistic regressions were calculated.

          Results

          The overall ECC prevalence was 24.8 %. ECC was less frequent among children from higher socioeconomic backgrounds than children from lower ones (prevalence ratios ≤ 0.58).

          Conclusions

          This study reported a worrying prevalence rate of ECC among children from 36 to 71 months old, living in French-speaking Switzerland. ECC appears to be a good marker of social inequalities as disadvantaged children, whether from Swiss or immigrant backgrounds, were more likely to have caries than their less disadvantaged peers. Specific preventive interventions regarding ECC are needed for all disadvantaged children, whether immigrants or Swiss.

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          Most cited references37

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          Parental influence and the development of dental caries in children aged 0-6 years: a systematic review of the literature.

          A well established body of research documents the role of individual factors, such as biology and diet, in the aetiology of early childhood caries (ECC). Recently empirical attention has shifted to the relationships between broader ecological influences (e.g., education, ethnicity and income) and ECC; however, how such determinants interplay in the aetiology of ECC remains unclear. An intermediary mechanism that warrants greater empirical attention is parental influences. This oversight is interesting given the primacy of the parent in governing the child's proximate environment and the likelihood of the child endorsing adaptive or maladaptive health attitudes, beliefs and behaviours. The objective of this paper was to conduct a systematic review of the evidence for parental influences on the development of caries in children aged 0-6 years. All studies testing associations between dental caries and socio-demographic factors, feeding practices, parent attributes, behaviours, oral health, attitudes, knowledge and beliefs in children aged 0-6 years, published between 2006 and 2011. Medline, ISI, Cochrane, Scopus, Global Health and CINAHL databases. Fifty-five studies were included from an initial identification of 1805 studies. To date, most research has focused on the association between caries and socio-demographic and feeding factors with few studies exploring parents' attributes, attitudes, knowledge and beliefs, and none exploring possible pathways between the multiple layers of influences potentially accounting for how determinants of ECC operate and traverse individual, familial, community, and socio-cultural contexts. Collaboration between Psychologists and Dentists may accelerate the identification and understanding of mechanisms that underlie risk associated with ECC. Copyright © 2012 Elsevier Ltd. All rights reserved.
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            A systematic review of risk factors during first year of life for early childhood caries.

            Early childhood caries (ECC) describes dental caries affecting children aged 0-71 months. Current research suggests ECC has important aetiological bases during the first year of life. Gaps in knowledge about disease progression prevent the effective and early identification of 'at risk' children. To conduct a systematic review of research studies focusing on (a) acquisition and colonization of oral bacteria and ECC and (b) risk and/or protective factors in infants aged 0-12 months. Ovid Medline and Embase databases (1996-2011) were searched for RCT, longitudinal, cross-sectional and qualitative studies. Two investigators undertook a quality assessment for risk of bias. Inclusion criteria were met for (a) by four papers and for (b) by 13 papers; five papers were rated medium or high quality. Bacterial acquisition/colonization and modifying factor interrelationships were identified, but their role in the caries process was not clarified. Key risk indicators were infant feeding practices (nine papers), maternal circumstances and oral health (6) and infant-related oral health behaviours (4). This review confirmed that factors occurring during the first year of life affect ECC experience. Despite heterogeneity, findings indicated maternal factors influence bacterial acquisition, whereas colonization was mediated by oral health behaviours and practices and feeding habits. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.
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              Early childhood caries: current evidence for aetiology and prevention.

              Despite the fact that it is largely preventable, dental caries (decay) remains one of the most common chronic diseases of early childhood. Dental decay in young children frequently leads to pain and infection necessitating hospitalization for dental extractions under general anaesthesia. Dental problems in early childhood have been shown to be predictive of not only future dental problems but also on growth and cognitive development by interfering with comfort nutrition, concentration and school participation. To review the current evidence base in relation to the aetiology and prevention of dental caries in preschool-aged children. A search of MEDLINE, CINALH and Cochrane electronic databases was conducted using a search strategy which restricted the search to randomized controlled trials, meta-analyses, clinical trials, systematic reviews and other quasi-experimental designs. The retrieved studies were then limited to articles including children aged 5 years and under and published in English. The evidence of effectiveness was then summarized by the authors. The review highlighted the complex aetiology of early childhood caries (ECC). Contemporary evidence suggests that potentially effective interventions should occur in the first 2 years of a child's life. Dental attendance before the age of 2 years is uncommon; however, contact with other health professionals is high. Primary care providers who have contact with children well before the age of the first dental visit may be well placed to offer anticipatory advice to reduce the incidence of ECC.
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                Author and article information

                Contributors
                +41 21 692 37 11 , stephanie.baggio@unil.ch
                abarca.m@outlook.com
                patrick.bodenmann@hospvd.ch
                mario.gehri@chuv.ch
                carlos.madrid@chuv.ch
                Journal
                BMC Oral Health
                BMC Oral Health
                BMC Oral Health
                BioMed Central (London )
                1472-6831
                22 July 2015
                22 July 2015
                2015
                : 15
                : 82
                Affiliations
                [ ]Life Course and Inequality Research Centre, University of Lausanne, Lausanne, Switzerland
                [ ]Private practice, University of Lausanne, Lausanne, Switzerland
                [ ]Vulnerable Population Unit, Department of Ambulatory Care and Community Medicine, University of Lausanne & Lausanne University Hospital, Lausanne, Switzerland
                [ ]Children’s Hospital, Lausanne University Hospital, Lausanne, Switzerland
                [ ]Stomatology and Dentistry Unit, Lausanne University Hospital, Lausanne, Switzerland
                Article
                66
                10.1186/s12903-015-0066-y
                4511018
                25559722
                c75cb038-92ae-4ddb-a13e-5838c3f75107
                © Baggio et al. 2015

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 May 2015
                : 13 July 2015
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2015

                Dentistry
                dental health,early childhood caries,social inequalities,socioeconomic background
                Dentistry
                dental health, early childhood caries, social inequalities, socioeconomic background

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