Social and biological factors contributing to caries of the maxillary anterior teeth

Resident’s Name: Chad Abby Date: 10/17/2008
Article title: Social and biological factors contributing to caries of the maxillary anterior teeth
Author(s): David M. O’Sullivan, Norman Tinanoff
Journal: Pediatric Dentistry
Volume (number): Volume 15, Number 1
Month, Year: January/February 1993
Major topic: ECC
Minor topic(s): The social and biological factors contributing to caries of the maxillary anterior teeth
Type of Article: Scientific Article
Main Purpose: Define caries prevalence and patterns in anterior teeth, compare them to strep mutans levels, correlate them with parents’ reported inappropriate bottle feeding practices and knowledge of the disease, and contrast them to other caries patterns in the child’s mouth.
Overview of method of research: Clinical examinations and estimates of salivary strep mutans levels were obtained from 481 children, ages 3 and 4, while matching clinical and psychosocial questionnaire data were obtained from 369 child/parent pairs. Information was obtained regarding parents’ oral health, dental knowledge, health opinions, stress and locus of control, as well as their child’s brushing habits and diet.
Findings: Of the 481 children examined 44% had caries, 16% of them had maxillary anterior caries and of those who had maxillary anterior cavities 87% also had posterior caries. Of the maxillary anterior teeth almost half of the children had caries on the mesial surface of the central incisors, lingual surfaces especially on lateral incisors seemed to be more affected than their corresponding buccal surfaces and the distal surface of the lateral incisors and incisal surfaces appeared to be the least affected with caries. There was also a significant difference in recoverable salivary strep mutans between children with and without maxillary anterior caries. 86% of children with anterior caries were reported to have taken a bottle to bed, 69% of those children who did not have anterior caries also were reported to have taken a bottle to bed.
Key points/Summary: It appears that parental knowledge about the detrimental effects of inappropriate or prolonged bottle-feeding had no influence in preventing children from getting anterior caries. More than 90% of parents of children with anterior caries knew that allowing their child to take a bottle to bed would be harmful. Since 69% of children who did not get anterior caries were reported to have taken a bottle to bed suggest that such a question is not a good predictor. A problem with correlating information obtained in this study with maxillary anterior caries is that parental knowledge may have changed between time of onset of the disease and time of interview/ examination. The majority of children in this study with both caries patterns had the highest mutans infection levels. The lower levels of mutans infection in children with only anterior caries suggest that they may have stopped the bottle-to-bed practice at an earlier age (before eruption of the molars).
Assessment of article: No answers were given for the parent interviews only correlations. I would have been interesting to know a correlation between what was put in the bottle i.e. whole milk, strawberry milk, chocolate milk or our patient’s favorite – Coffee Milk