Research Team Develops Tool to Identify High-Risk Factors for Childhood Caries

Dental caries remains one of the most prevalent chronic childhood diseases. In fact, National Institute of Dental and Craniofacial Research statistics indicate that 42% of kids between the ages of 2 and 11 have at least one carious lesion in their primary dentition, and 23% of those are untreated.¹

Martha Ann Keels, DDS, PhD, an associate consulting professor in the Department of Surgery and an adjunct professor in the Department of Pediatrics at Duke University in Durham, North Carolina, and a team of researchers have been working to create tools to help pediatric dentists and pediatricians identify high risk factors so decay can be caught in its earliest stages—or before it even starts.^2,3

VALUABLE ASSESSMENT TOOL

As part of a 3-year study, the researchers recruited 1,323 1-year-old children, of whom 49% were female, 13% were Hispanic, 37% were white, 37% were Black, and 13% were multiracial. Sixty-one percent were covered by Medicaid.^2,3 Following the children since birth, the research involved collecting saliva, analyzing biofilm, considering physical dental deformities, and exploring other factors such as parental dental health and practices. The result was the creation of a 52-item caries risk questionnaire. 

Through comparing responses of primary caregivers from different populations, the questionnaire, available in English and Spanish, was designed to identify top predictors of childhood caries and facilitate risk assessment in the medical community. The study showed that in contrast to children not enrolled in a public insurance program, those covered by Medicaid were much more likely to:

• Go to sleep while nursing or drinking something other than water 
• Eat sugary snacks between meals 
• Consume sugary drinks between meals
• Receive topical fluoride application from a health professional
• Visit the dentist 
• Live in a household without an employed adult 

Along the racial/ethnic divide, questionnaire responses indicated that risk-associated dietary behaviors, such as providing sugary snacks between meals, were more commonly seen among Black and Hispanic children than white children.³

ADDITIONAL FINDINGS

One of the most significant findings was the high level of risk among those children with tight contacts, which don’t allow for easy cleaning of embrasures and interproximal surfaces. Study authors also noted the importance of broadening the understanding of oral bacteria and their impact on caries risk.² The research also demonstrated that while a child’s microbiome begins as a unique entity, it changes over time to resemble the caregiver’s microbiome.^2,3 The hope for Keels and her team is to continue the research for another 5 years, expanding it to include adolescents and an analysis of how mental health impacts oral health.

Currently, numerous strategies and products are available that can be deployed in the fight against childhood caries. Soft brushes, bright colors, kid-friendly flavors, and fun designs are available to engage young children. In the case of tight contacts in particular, interdental brushes floss—and how to use them correctly—are highly beneficial in maintaining oral health.

References

1. National Institute of Dental and Craniofacial Research. Dental Caries in Children Age 2 to 11. Click here.
2. Cordero C. The Duke dentist and her research: saving children’s teeth, one tooth at a time. Duke Research Blog. Click here.
3. Fontana, M, Eckert, GJ, Keels, MA, et al. Predicting caries in medical settings: risk factors in diverse infant groups. J Dent Res. Click here.