Elif İNAN, Tülin İleri KEÇELİ, Hülya ÖZEL GÖKMEN, Meryem TEKÇİÇEK

Hacettepe Üniversitesi Diş Hekimliği Fakültesi Pedodonti Kliniğine Başvuran 6-12 Yaşlarındaki Bir Grup Sağlıklı Çocukta Beslenme Durumu ve Diş Çürüğü İlişkisi

Amaç: Bu çalışma, Hacettepe Üniversitesi Diş Hekimliği Fakültesi Pedodonti Kliniğine başvuran 6-12 yaşlarındaki sağlıklı bir grup çocuğun beslenme alışkanlıkları ile diş çürüğü arasındaki ilişkinin incelenmesi amacıyla yapılmıştır. Bireyler ve Yöntem: H.Ü. Diş Hekimliği Fakültesi Pedodonti Kliniğine ağız sağlığı nedeniyle başvuran, yaşları 6-12 arasında değişen, özel bir diyet tedavisi gerektirecek kronik hastalığı olmayan 134 çocuğun (63 erkek, 71 kız), bir diş hekimi tarafından ağız içi muayeneleri yapılmıştır. Katılımcıların ailelerinden, çocukların beslenme alışkanlıkları ve ağız ve diş sağlığına ilişkin bilgiler öğrenilmiş, geriye dönük 24 saatlik besin tüketim kayıtları alınmıştır. Diyetle karbonhidrat, glukoz, fruktoz, sükroz, laktoz, maltoz, nişasta, toplam monosakkarit, disakkarit alımları Beslenme Bilgi Sistemleri (BeBIS 4) programı kullanılarak hesaplanmıştır. Beslenme durumu ile diş çürüğü arasındaki ilişki SPSS 15 istatistik paket programı kullanılarak değerlendirilmiştir. Bulgular:Anne ve babaların sırasıyla %43.3ü ve %29.8i ilköğretim ve altı ve %14.8i ve %32.8i üniversite ve üstü eğitim düzeyine sahiptir. Çocukların %4.5inin bebeklik döneminde hiç anne sütü almadıkları, %46.7sinin ise 6 ay sadece anne sütü aldığı saptanmıştır. Anne sütü alım süresi ile daimi dişte kayıp arasında negatif yönde zayıf bir ilişki bulunmuştur (p=0.38). Çocukların 0-1 yaş döneminde %24.6sının hiç biberon kullanmadığı belirlenmiştir. Biberon kullanma ile süt ve daimi dişlerde çürük diş, kayıp diş, dolgulu diş ve çürük-kayıp-dolgulu diş indeksleri (dmft/DMFT indeksleri) arasında istatistiksel olarak anlamlı bir ilişki bulunamamıştır (p>0.05). Süt dişlerindeki çürük prevelansı %64.9 ve daimi dişlerdeki çürük prevelansı ise %23.9 olarak bulunmuştur. Maltoz ve DMFT indeksi arasında kuvvetli pozitif bir ilişki bulunmuştur (p

The Relationship Between Nutritional Status and Dental Caries in a Group of Healthy Children Aged Between 6 to 12 Years Admitted to Pediatric Dentistry Clinic of Hacettepe University Faculty of Dentistry

Aim: The objective of this study was to investigate the relationship between nutritional status and dental caries in a group of healthy children, aged between 6 to 12 years, referred to Pediatric Dentistry Clinic of Hacettepe University, Faculty of Dentistry. Subjects and Methods: Oral diagnosis of 134 children (63 boys, 71 girls), who did not require any specific dietary needs with regard to chronic diseases were performed by one dentist in the pediatric dentistry clinic. Families completed a questionnaire including questions about demographical characteristics and oral health status of children. 24-hour food recalls were also obtained. The dietary carbohydrate, glucose, fructose, sucrose, lactose, maltose, starch, total monosaccharide, total disaccharide intakes were calculated by using BeBIS4 software program. The relationship between dental caries and nutritional status were performed by using SPSS 15. Results: Mothers and fathers educational level with primary school and below, bachelors degree and above were 43.3%, 29.8% and 14.8%, 32.8%, respectively. Out of total,4.5% of the children were not breastfeed and 46.7% of the children were breastfed for the first 6 months of age. A weak positive relation was found between the duration of breastfeeding and the missing in permanent teeth (p=0.38). 24.6% of the children aged between 0-1 did not used feeding bottle. No significant relation between status of using the bottle-feeding and decayed, missed, filled teeth in primary teeth and permanent teeth and dmft/DMFT index was found (p>0.05). The frequency of decayed teeth was 64.9% and 23.9% for the primary and permanent teeth, respectively. A strong positive relation between maltose and DMFT was found (p<0.01). Also a weak negative relation between glucose, starch and DMFT was found (p<0.05). Conclusion:With the increase of maltose, glucose and starch in the diet, increase in DMFT index was observed among school children.

PDF

___

1.Baysal A. Beslenme. 10. Baskı Ankara, Hatiboğlu Yayınevi; 2004. 2.Samaranayake LP. Essential microbiology for dentistry. 2nd ed. Toronto, Churchill Livingstone; 2002. 3.Robert MW. Dental health of children: where we are today and remaining challenges. J Clin Pediatr Dent 2008;32(3):231-234. 4.Schroth RJ, Cheba V. Determining the prevalence and risk factors for early childhood caries in community dental health clinic. Pediatr Dent 2007;29(5):387-396. 5.World Health Organization. Diet, Nutrition and the Prevention of Chronic Diseases: Report of a Joint WHO/FAO Expert Consultation. WHO:Geneva, 2003. 6.Enwonwu CO. Interface of malnutrition and periodontal diseases. Am J Clin Nutr 1995;61(Suppl.):430-436. 7.Rugg-Gunn AJ. Nutrition and Dental Health. 1st ed. Oxford, Oxford Medical Publications; 1993. 8.T.C. Sağlık Bakanlığı. Diş Çürüğü ve Önlenmesi, Sağlık ve Sağlığın Korunması Modülleri. Ankara, Sağlık Eğitimi Genel Müdürlüğü; 2008. Erişim: http:// sbu.saglik.gov.tr/Ekutuphane/kitaplar/t6.pdf. 9.Bebispro für Windows, Sturttgart, Germany; Turkish version (BeBis 4) (2006). Program Uses data from Bundeslebenmitte Ischlüssel (BLS) 11.3 and USDA 15, İstanbul. 10.Laaksonen M, Rahkonen O, Karvonen S, Lahelma E. Socioeconomic status and smoking: analysing inequalities with multiple indicators. Eur J Public Health 2005;15:262269. 11.Astrøm AN, Kiwanuka SN. Examining intention to control preschool childrens sugar snacking: a study of carers in Uganda. Int J Paediat Dent 2006;16:1018. 12. Skeie MS, Riordan PJ, Klock KS, Espelid I. Parental risk attitudes and caries related behaviours among immigrantand western native children in Oslo. Community Dent Oral Epidemiol 2006;34:103113. 13. Wigen TI, Skaret E, Wang NJ. Dental avoidance behaviour inparent and child as risk indicators for caries in 5-year-old children. Int J Paediat Dent 2009;19:431 437. 14. Wigen TI, Wang NJ. Caries and background factors in Norwegian and immigrant 5-year-old children. Community Dent Oral Epidemiol 2010;38:1928. 15. World Health Organization. Nutrient adequacy of exclusive breastfeeding for the term infant during the first six months of life. WHO: Geneva, 2002. 16. Mennella JA, Beauchamp GK. Flavor experiences during formula feeding are related to preferences during childhood. Early Hum Dev 2002;68:7182. 17. Kawashita Y, Kitamura M, Saito T. Early childhood caries.Int J Dent 2011. Jul 28 [E-pub ahead of print], doi: 10.1155/2011/725320. 18. Feldens CA, Giugliani ERJ, Vigo A, Vitolo MR. Early feeding practices and severe early childhood caries in four-year-old children from Southern Brazil: a birth cohort study. Caries Res 2010;44:445-452. 19. Hallonsten AL, et al. Dental caries and prolonged breastfeeding in 18-month-old Swedish children. Int J Paediat Dent 1995; 5:149-155. 20. Petti S, Cairella G, Tarsitani G. Rampant early childhood dental decay: an example from Italy. J Public Health Dent 2000;60:159166. 21. Hiroko I, Auinger P, Billings RJ, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics 2007;120:e944e952. 22. American Dental Association. Statement on early child hood caries. Available at: http://www.ada.org/2057. aspx. Accessed January 5, 2013. 23. American Academy of Pediatric Dentistry. Guideline on infant oral health care. Pediatr Dent 2011;33(6):124 128. 24. Preventive oral health intervention for pediatricians. Pediatrics 2008;122(6):13871394. 25. Wigen TI, Skaret E, Wang NJ. Dental avoidance behaviour inparent and child as risk indicators for caries in 5-year-old children. Int J Paediat Dent 2009;19:431 437. 26. Gao XL, Hsu CYS, Xu YC, Loh T, Koh D, Hwarng HB. Behavioral pathways explaining oral health disparity in children. J Dent Res 2010;89:985990. 27. Senesombath S, Nakornchai S, Banditsing P, Lexomboon D. Early childhood caries and related factors in Vientiane, Lao PDR. Southeast Asian J Trop Med Public Health 2010;41:717725. 28. Skeie MS, Riordan PJ, Klock KS, Espelid I. Parental risk attitudes and caries related behaviours among immigrant and Western native children in Oslo. Community Dent Oral Epidemiol 2006;34:103113. 29. Namal N, Vehit H, Can G. Risk factors for dental caries in Turkish preschool children. J Indian Soc Pedod Prev Dent 2005;23:115-118. 30. Federation Dentaire Internationale/World Health Organization. Global goals for oral health in the year 2000. Int Dent J 1982;32 (1):74-77. 31. Namal N, Yüceokur AA, Can G. Significant caries index values and related factors in 56-year-old children in Istanbul, Turkey. East Mediterr Health J 2009;15:178 184. 32. Aida J, Ando Y, Oosaka M, Niimi K, Morita M. Contributions of social context to inequality in dental caries: a multi level analysis of Japanese 3-year- old children. Community Dent Oral Epidemiol 2008;36:149156. 33. Brandao IM, Arcieri RM, Sundefeld ML, Moimaz SA. Early childhood caries: the influence of socio behavioral variables and health locus of control in a group of children from Araraquara, Sao Paulo, Brazil. Cad Saude Publica 2006;22:12471256. 34. Begzati A, Berisha M, Meqa K. Early childhood caries in preschool children of Kosovo-a serious public health problem. BMC Public Health 2010;10:788. 35. Cogulu D, Ersin NK, Uzel A, Eronat N, Aksit S. A long- term effect of caries-related factors in initially caries- free children. Int J Paediat Dent 2008;18:361367. 36. Elfrink MEC, Schuller AA, Veerkamp JSJ, Poorterman JHG, Moll HA, Moll BJ, et al. Factors increasing the caries risk of second primary molars in 5-year-old Dutch children. Int J Paediat Dent 2010;20:151157. 37. Connie CM. Nutrition and dental caries. Dent Clin N Am 2003;47:319336. 38. Lingstrom P, van Houte J, Kashket S. Food starches and dental caries. Crit Rev Oral Biol Med 2000;11(3):366 380.