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Caries prevalence and enamel defects in 5-and 10-year-old children with cleft lip and/or palate: A case-control study
Institute Postgrad Dent Educ, Sweden.
Institute Postgrad Dent Educ, Sweden.
UiT Arctic University of Norway, Norway.
University of Copenhagen, Denmark.
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2016 (English)In: Acta Odontologica Scandinavica, ISSN 0001-6357, E-ISSN 1502-3850, Vol. 74, no 2, 90-95 p.Article in journal (Refereed) Published
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Text
Abstract [en]

Objective. To determine the prevalence of dental caries and enamel defects in 5- and 10-year-old Swedish children with cleft lip and/or palate (CL(P)) in comparison to non-cleft controls. Materials and methods. The study group consisted of 139 children with CL(P) (80 subjects aged 5 years and 59 aged 10 years) and 313 age-matched non-cleft controls. All children were examined by one of two calibrated examiners. Caries was scored according to the International Caries Detection and Assessment System (ICDAS-II) and enamel defects as presence and frequency of hypoplasia and hypomineralization. Results. The caries prevalence among the 5-year-old CL(P) children and the non-cleft controls was 36% and 18%, respectively (p < 0.05). The CL(P) children had higher caries frequency (initial and cavitated lesions) in the primary dentition than their controls (1.2 vs 0.9; p < 0.05). A significantly higher prevalence of enamel defects was found in CL(P) children of both age groups and anterior permanent teeth were most commonly affected. Conclusions. Preschool children with cleft lip and/or palate seem to have more caries in the primary dentition than age-matched non-cleft controls. Enamel defects were more common in CL(P) children in both age groups.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD , 2016. Vol. 74, no 2, 90-95 p.
Keyword [en]
Cleft palate; cleft lip and palate; dental caries; hypomineralization; hypoplasia
National Category
Clinical Medicine
Identifiers
URN: urn:nbn:se:liu:diva-124077DOI: 10.3109/00016357.2015.1044562ISI: 000366811600002PubMedID: 25972142OAI: oai:DiVA.org:liu-124077DiVA: diva2:897247
Note

Funding Agencies|FORSS Medical Research Council of Southeast Sweden; Futurum Academy of Health and Care Jonkoping County Council; Swedish Dental Association; Swedish Society of Paediatric Dentistry

Available from: 2016-01-25 Created: 2016-01-19 Last updated: 2017-05-03
In thesis
1. Children with orofacial clefts: dental caries and health-related quality of life
Open this publication in new window or tab >>Children with orofacial clefts: dental caries and health-related quality of life
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background. The current understanding on caries and enamel developmental defects prevalence and frequency, caries risk, health-related quality life (HRQoL) and stress response in young children with cleft lip and/or palate (CL/P) are sparse. In this thesis these aspects were investigated in 5- and 10- year-old children with CL/P in comparison to non-cleft children in the same ages.

Design. The studies in this thesis have a cross-sectional case-control design. Participants. The study group consisted of 139 children with CL/P (80 children aged 5 years and 59 aged 10 years) and 313 non-cleft controls (144 children aged 5 years and 169 aged 10 years).

Method. Caries was scored according to International Caries Detection and Assessment System (ICDAS II) and developmental enamel defects were measured as presence and frequency of hypoplasia and hypomineralization. Oral hygiene was assessed using Quigley-Hein plaque index. Stimulated saliva samples were analyzed for mutans streptococci, lactobacilli, buffering capacity and secretion rates. Information regarding children’s oral hygiene routines, dietary habits and fluoride exposure were collected with questionnaires. Caries risk was evaluated with algorithm-based software, Cariogram while HRQoL was perceived with KIDSCREEN-52. Stress response was analyzed with cortisol concentration in saliva at three different time points using a commercial competitive radioimmunoassay.

Results. Caries prevalence (36% versus 18%) and caries frequency (1.2 dmfs versus 0.9 dmfs) was significantly higher in 5-year-old children with CL/P in comparison to non-cleft controls. In 10-yearolds no significant difference was found between children with CL/P and non-cleft controls in caries prevalence (47% versus 38%) or in caries frequency (0.7 DMFS versus 0.5 DMFS). Children with CL/P had significantly higher prevalence of enamel defects, higher counts of salivary lactobacilli and less good oral hygiene. The odds of being categorized with high caries risk were elevated in children with CL/P. Children with CL/P had similar HRQoL and salivary cortisol concentrations as non-cleft controls. However, 10-year-old boys with CL/P had significantly higher cortisol concentrations in the evening than non-cleft boys.

Conclusions. Preschool children with CL/P seem to have more caries in the primary dentition than non-cleft controls. Children with CL/P had increased odds of being categorized as high caries risk individuals compared to controls. Some of the contributing factors seem to be higher prevalence of enamel defects, impaired oral hygiene and elevated salivary lactobacilli. Furthermore, as measured with the help of cortisol concentrations in saliva, children with CL/P were not more stressed than noncleft controls and their HRQoL was comparable to a European norm population. It appears that regular comprehensive preventive oral care in children with CL/P is effective in preventing caries development in permanent teeth. However, children with CL/P are at risk of caries development and preventive oral care should be implemented and started earlier than today.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. 68 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1547
Keyword
Children, cleft lip and/or palate, dental caries, caries risk, hypomineralization, hypoplasia, health-related quality of life, cortisol in saliva, stress.
National Category
Dentistry Otorhinolaryngology Pediatrics Public Health, Global Health, Social Medicine and Epidemiology Surgery Other Medical Sciences not elsewhere specified
Identifiers
urn:nbn:se:liu:diva-132623 (URN)10.3384/diss.diva-132623 (DOI)9789176856567 (ISBN)
Public defence
2016-12-09, Berzeliussalen, Campus US, Linköping, 09:00 (Swedish)
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Supervisors
Available from: 2016-11-17 Created: 2016-11-17 Last updated: 2017-05-02Bibliographically approved

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