Kariesriskfaktorer och riskindikatorer hos förskolebarn

Abstract

Background and aim: Caries is one of the most common diseases in preschool children. Pain, infections and sleep disturbances in childhood caries can adversely affect body weight and nutritional ability and may raise the risk of the disease continuing into adulthood. Modern dentistry is able assess caries risk and weight risks and protective factors on an individual basis. The general aim of this thesis was to determine risk factors and risk indicators for caries in preschool children through analyses of oral, environmental, and social factors. Patients and Methods: Paper I, II and III followed the dental records for children ages 1-6 years. At age 1, data on oral risk factors, environmental factors and presence of mutans streptococci were retrieved; at ages 1 and 3, caries risk assessment were performed and at ages 3 and 6 years, caries status were collected. Factors associated to caries risk were studied. Paper IV, a registry-based study that retrieved data on caries status from 3 to 6 years of age. The data included caries risk assessment and social factors from ages 3 to 5 years. Caries risk assessment models were designed, adding environmental and social factors, to established caries risk assessment. Results: Presence of mutans streptococci at age 1 year were associated to caries at 3 and 6 years of age. Environmental factors at age 1 year, siblings with caries, and beverage other than water between meals were associated to presence of MS (Paper I) and together with night meals associated to caries at 3- and 6-years of age (Papers II, III). Social factors, foreign background, low parental education level, three or more siblings and living in a one-parent family were associated to caries at 6 years of age. Supplementing a caries risk assessment with environmental and social factors in predictive models improved the ability of the model to predict caries progression, the predictive ability of the assessment improved more at younger ages than at older ages vi (Papers II, III, IV), and was higher when intervals between the risk assessment and oral examination were shorter (Papers III and IV). Conclusion: Risk factors found during an oral examination as well as information about the child's environmental- and social conditions should be included in a caries risk assessment. Environmental and social indicators at one year of age regarding; siblings with caries, night meals and beverage other than water between meals can replace saliva tests to find the risk factor mutans streptococci. Social indicators have a greater impact on younger children's caries risk compared to older children.