Arzu PINAR ERDEM, Elif SEPET, Hilmi SABUNCU, İlknur ÖZCAN, Tamer ERDEM

FARKLI ÇÜRÜK RİSK GRUPLARINDA YENİ ÇÜRÜK GELİŞİMİNİN İNCELENMESİ

Bu çalışmanın amacı, İstanbul Üniversitesi Dişhekimliği Fakültesi Pedodonti kliniğine başvuran farklı çürük risk gruplarında olan 117 çocuk hastada yeni çürük gelişimini tespit etmek ve anlamlı çürük risk faktörlerini belirlemektir. Çocuk hastalarda ilk olarak çürük risk grupları belirlendi ve kontrol randevularında yeni çürük gelişimleri saptandı. Sonuç ölçümleri olarak diş çürüğü artışı ile multipl lojistik regresyon analizi düzenlendi. Yeni çürük oluşumu saptanan çocuklarda, diş fırçalama sıklığının günde birden az ve atıştırma sıklığının günde ikiden fazla olması risk faktörleri (OR=1.58 ve 1.89, sırasıyla) olarak belirlendi. Düşük risk grubunda total yeni çürük oluşumunun, orta ve yüksek risk grubundakilerden anlamlı derecede az olduğu saptandı (p < .05). Orta ve yüksek risk grubunda total yeni çürük yüzeyi oluşumunun düşük risk grubundakilerden anlamlı decede fazla olduğu belirlendi (p < .05). Çürük risk gruplarında, tedavi uygulamalarının yanı sıra hastalığın kontrol altına alınması hedeflenmelidir. Çürük sayısı artışının önlenmesi için, yüksek risk grubundaki çürük geliştiren çocukların belirlenmesi, neden olan risk faktörlerinin elimine edilmesi ve kişiye özgü koruyucu uygulama programlarına yönlendirilmesi hedeflenmelidir.

Anahtar Kelimeler:

Diş çürüğü riski, risk faktörleri, çocuk, Kohort çalışma

DETERMINING THE FUTURE CARIES DEVELOPMENT IN DIFFERENT CARIES RISK GROUPS

The aims of this study were to evaluate the development of new lesions in 117 children from different caries risk groups andto determine significant risk factors in a pediatric clinic of Istanbul University Faculty of Dentistry. The initial caries riskassessment was performed and follow-up visits were used to determine the future caries development. A multiple logisticregression analysis was performed with net caries increment as outcome measure. Brushing less than once a day and theconsumption of more than two between-meal snacks per day were confirmed as risk factors (OR=1.58 and 1.89, respectively)in children who developed new caries. The total amount of new caries lesions in low-risk group was significantly less than in moderate and high-risk groups (p <.05). The total amount of new caries surfaces in high and moderate groups wassignificantly higher than in low-risk subjects (p <.05). The results suggest that in high risk subjects, operative treatments mustbe combined with control of the disease activity. In order to prevent caries increament, it is important that children at highrisk of developing caries are identified and targeted for specific individual or group preventive measures.

Keywords:

Caries risk, risk factors, children, Cohort-study,

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Brambilla E, Garcia-Goday F, Strohmenger L . Principles of diagnosis and treatment of high- caries-risk subjects. Dental Clinics of North America, 2000; 44: 507-540.
Reich E, Lussi A, Newbrun E. Caries-risk assessment. Int Dent J, 1999; 49: 15-26.
Tinanoff N . Dental caries risk assessment and prevention Dent Clin N Am, 1995; 39: 709-719.
Messer L B . Assessing caries risk i n children. Aus Dent J, 2000; 45: 10-16.
WHO. Diet nutrition and the Prevention uf the Chronic Diseases. Report of a WHO Studt Group. Technical Repot sereies. V o l 797. Geneva: World Health Organization, 1990.
WHO. Recent advances i n Oral Health. Report of a WHO Expert Committee. Technical Report series. V o l 826. Geneva: World Health Organization, 1992.
Fontana M , Jackson R, Eckert G, Swigonski N , Chin J, Zandona AF, Ando M , Stookey GK, Downs S, Zero DT. Identification of Caries Risk Factors i n Toddlers.J Dent Res, 2011; 90 (2): 209-214.
Hausen H . Caries prediction: State of art. Community Dent Oral Epidemiol, 1997; 25: 87ı 96.
Beck JD. Risk revisited. Community Dent Oral Epidemiol, 1998; 26: 220-225.
Disney JA, Graves RC, Stamm JW, Bohannan H M , Abernathy JR, Zack D D . The University of North Carolina Caries Risk Assessment study: Further developments in caries risk prediction. Community Dent Oral Epidemiol, 1992; 20: 64-75.
Powell L V . Caries prediction: A review of the literature. Community Dent Oral Epidemiol, 1998; 26: 361-371.
Axelsson P. Diagnosis and risk prediction of dental caries. Illinois: Quintessence Pub. Co, 2000, p. 156-158.
American Academy of Pediatric Dentistry (AAPD) (2010). Guideline on Caries-risk Assessment and Management for Infants, Children, and Adolescents. Adopted 2002, revised 2006. Available at:www.aapd.org/ media/Policies_Guidelines/P_CariesRiskAssess. pdf (URL accessed 08/06/2011).
Gillcrist JA, Brumley DE, Blacford JU. Community socioeconomic status and children's dental health. J A m Dent Assoc, 2001; 132: 216-222.
Vannobbergen J, Martens L , Lesafre E, Bogaerts K, Declerck D. The value of a baseline caries risk assessment model in the primary dentition for the prediction of caries incidence in the permanent dentition. Caries Res, 2001; 35: 442-450.
Peterson-Sweeney K, Stevens J. Optimizing the Health of Infants and Children: Their Oral Health Counts Journal of Pediatric Nursing, 2010; 25: 244-249.
Campus G, Lumbau A, Lai S, Solinas G, Castiglia P. Socio-economic and behavioural factors related to caries i n twelve-year-old Sardinian children. Caries Res, 2001; 35: 427ı 434.
L i Y , Wang W. Predicting caries i n permanent teeth from caries i n primary teeth: A n eight-year Cohort study. J Dent Res, 2002; 81: 561-566.
Carlsson P. Distribution of mutans streptococci in populations with different levels of sugar consumption. Scand J Dent Res, 1989; 97: 120ı 125.
Gratrix D, Holloway PJ. Factors of deprivation associated with dental caries i n young children. Comm Dent Health, 1994; 11: 66-70.
Koch G, Poulsen S, Twetman S. Caries prevention i n child dental care; in Koch G, Poulsen S (ed). Pediatric Dentistry-A Clinical Approach. Munksgaard: Copenhagen, 2001, p. 139-145.
Bjarnason S, Kohler B. Caries risk assessment in adolescents. Swed Dent J, 1997; 21: 41-48.
Wandera A, Bhakta S, Barker T. Caries prediction and indicators using a pediatric risk assessment teaching tool. J Dent Child, 2000; 67: 408-412.
Harris R, Nicoll AD, Adair PM, Pine CM. Risk factors for dental caries i n young children: a systematic review of the literature. Community Dental Health, 2004; 21 (Supplement): 71-85.
Grindefjord M , Dahloff G, Nilsson B. Prediction of dental caries development i n 1- year-old children. Caries Res, 1995; 29: 343ı 348.
Mattila M L , Rautava P, Paunio P, Ojanlatva A, Hyssala L , Helenius H , Sillanpaa M . Caries experience and caries increments at 10 years of age. Caries Res, 2001; 35: 435-441.
Verrips GH, Klasbeek H , Eijkman M A . Ethnicity and maternal education as risk factors for dental caries and the role of dental behavior. Community Dent Oral Epidemiol, 1993; 21: 209-214.
American Dental Association. Caries diagnosis and risk assessment: a review of preventive strategies and management. J A m Dent Assoc, 1995; 126: 1-24.
Shaw L . U.K. National Clinical Guidlines in Paediatric Dentistry. International Journal of Paediatric Dentistry, 1997; 7: 267-272.
Rethman T. Trends i n preventive care: Caries risk assessment and indications for sealants. JADA, 2000; 131: 8S-12S.