Risk Factors for the Incidence of Dental Caries in Low, Very Low, and Extremely Low Birth Weight Children: A Cohort Study

Objective: To assess the incidence of caries in a two-year period among low birth weight (LBW), very low birth weight (VLBW), and extremely low birth weight (ELBW) children considering socioeconomic indicators, dietary factors and oral hygiene. Material and Methods: A convenience sample was formed of 42 low birth weight children aged two to five years at baseline. Two examiners diagnosed caries using the World Health Organization criteria. Birth weight, socioeconomic indicators and diet were collected from medical records and questionnaires. Binomial models were used to estimate unadjusted and adjusted rate ratios (RR) and respective 95% confidence intervals for the factors evaluated. Results: Thirty-six children were re-examined after two years. The incidence of dental caries was 36.7%. The dmft index was 0.44 (±1.25) at baseline and increased to 1.36 (±3.85) at follow-up. VLBW children (1,000 to 1,500 g) (RR=0.23; 95%CI: 0.08-0.72) and LBW children (1,500 to 2,500 g) (RR=0.06; 0.01-0.55) had fewer carious lesions compared to ELBW children (<1,000 g). Carious lesions were more frequent among children with a lower income (RR=6.05; 1.05-34.84) and less frequent among those who did not consume sweetened juice, tea or yogurt (RR: 0.21; 0.07-0.62). Conclusion: An inverse dose-response relation was found between birth weight and the incidence of caries. A lower income and the consumption of sweetened beverages were risk factors for the development of caries

Defeito de desenvolvimento do esmalte dentário e cárie da primeira infância em crianças prematuras e com baixo peso ao nascer

Exportado OPUSMade available in DSpace on 2019-08-14T12:18:47Z (GMT). No. of bitstreams: 1 disserta__o_elisa_feuser.pdf: 1067825 bytes, checksum: b93529b3005ae4081995e8d081ec4afd (MD5) Previous issue date: 18O objetivo deste estudo transversal pareado foi avaliar defeito dedesenvolvimento do esmalte dentário e cárie da primeira infância encontrados em um grupo de crianças nascidas prematuras e/ou baixo peso, e sua associação com fatores socioeconômicos, saúde gestacional e fatores pósnatais e comparar os achados com um grupo de crianças nascidas a termo e/ou peso normal. A amostra de conveniência, contou com um grupo de 42 crianças de 2 a 5 anos de idade prematuras e/ou com baixo peso ao nascer, do Ambulatório da Criança de Risco (ACRIAR) do Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brasil (G1). E comoutro grupo de 42 crianças de 2 a 7 anos de idade com peso normal e nascidas a termo de escolas públicas do município de Belo Horizonte (G2). O estudo foi pareado através das variáveis sexo e idade, numa proporção de 1:1. Após a aprovação do Comitê de Ética em Pesquisa em Seres Humanos da UFMG (COEP/UFMG) e a devida calibração do pesquisador para o exame clínico, foi realizado o estudo principal. Cárie da primeira infância foi avaliada de acordo com índice ceo-d e o defeito no desenvolvimento do esmalte pelo índice de DDE. As crianças foram examinadas de acordo com o agendamento e demanda do hospital. Foi aplicado um questionário às mães das crianças incluídas no estudo e foram consultados prontuários médicos para busca de dados do período pós-natal. Para as crianças do grupo G2, os dados foramcoletados através de questionários respondidos pelas mães, além do exame clínico bucal. A coleta de dados foi realizada por uma examinadora, treinada e calibrada. Após a coleta, os dados foram analisados através do programa SPSS. Para as análises bivariadas foi utilizado o teste qui-quadrado e para a análise multivariada a regressão de Poisson. Foi adotado um nível de significância de 5%. Indivíduos do grupo G1 apresentaram um número significativamente maior de dentes com DDE, em comparação aos indivíduos do grupo G2 (p =0,007). As variáveis independentes prematuridade, escolaridade materna, internação, incubadora, intubação, medicamento, e complicações no parto apresentaram um valor de p < 0,20 na associação coma variável dependente DDE. Após a análise multivariada as variáveis quemantiveram associação com o aparecimento de defeito de desenvolvimento de esmalte dentário, foram internação após o nascimento (RP =6,45 (95% IC =1,59 11,36)) e medicação durante este período hospitalar (RP =4,67 (95% IC =1,82 11,90)). Crianças nascidas prematuramente apresentaram mais DDE que aquelas nascidas a termo. Não foram observadas diferenças entre os grupos de crianças nascidas prematuras e a termo para cárie da primeira infância (p =0,803).The aim of this paired cross-sectional study was to assess the oral conditions found in a group of preterm and / or low birth weight infants and their association with socioeconomic factors, gestational health and postnatal factors and to compare the findings with a group of children born to term. The convenience sample consisted of a group of 42 premature and / or low birth weight children from 2 to 5 years of age, from (ACRIAR) of the Hospital das Clínicas of the Federal University of Minas Gerais, Belo Horizonte, Brazil (G1). And with another group of 42 children from 2 to 7 years old with normal weight and born at term from public schools in the city of Belo Horizonte (G2). The study was matched by sex and age, in a ratio of 1: 1. After the approval of the UFMG Ethics Committee in Human Research (COEP / UFMG) and the propercalibration of the researcher for the clinical examination, the main study was carried out. Early childhood caries was evaluated according to the dmft index (OMS, 2012) and the defect in enamel development by DDE index (FDI, 1992). The children were examined according to the scheduling and demand of the hospital. A questionnaire was administered to the mothers of the children included in the study and medical records were searched for data from the postnatal period. For the children of the G2 group, the data were collected through questionnaires answered by the mothers, in addition to clinical oralexamination. Data collection was performed by a single examiner, trained and calibrated. After the data collection, the data were analyzed through the SPSS program. For the bivariate analyzes, the chi-square test was used and the multivariate analysis was the Poisson regression. A significance level of 5% was adopted. Individuals in the G1 group had a significantly higher number of DDE teeth compared to individuals in the G2 group (p = 0.007). The variables independent prematurity, maternal schooling, hospitalization, incubator, intubation, medication, and complications at delivery presented a value of p <0.20 in association with the DDE dependent variable. After the multivariate analysis, the variables that maintained association with the development of tooth enamel development were hospitalization after birth [(PR = 6.45 (95% CI= 1.59-11.36)] and medication during this period [(PR = 4.67 (95% CI = 1.82- 11.90)]. Children born prematurely presented more DDE than those born at term. No differences were observed between the groups of children born premature and term for early childhood caries (p = 0.803)