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Kids and Cavities, Fillings and Food

Posted Oct 13 2009 10:04pm

dental-work-finizio-flickr-cc1

Finizio/Flickr

What’s the best material for treating filling cavities in your children’s teeth? According to a recent research review in The Cochrane Library, nobody really knows.

So far, there is a not a clear winner among the types of fillings used to repair childhood cavities, according to a new review.

In fact, there are so few useful studies on the topic that there is not enough evidence “to make any recommendations about which filling material to use,” said Veerasamy Yengopal, who led the review.

* * *

The three studies examined by the reviewers included 81 children between the ages of 4 and 9 years old. In each study, the children had at least one cavity on each side of their mouth filled with a different material, so that researchers could compare different fillings for one person. The materials included a metal-mercury amalgam, a resin-modified glass composite filling and a filling that combines a plastic-ceramic material with elements of the glass filling.

The researchers found no significant differences among the materials, whether in terms of how well the materials lasted or whether the children were free from tooth pain at the end of the studies.

Of course, had they considered issues of biocompatibility and toxicity, those studies would have certainly found that toxic mercury amalgam is entirely inappropriate to put in a child’s mouth.

But the question we want to raise is this: why isn’t more research being done on restorative materials in primary teeth? One possibility was offered by the Chair of Pediatric Dentistry at the University of Washington, Dr. Joel Berg:

“Manufacturers replace their products so frequently; by the time that outcome and controlled data can be collected on a product, it might not be on the market any longer,” said Berg.

This seems a little disingenuous. While formulations do change, there is no reason why this should prevent studies of broad classes of restorative materials that could be used to fill carious primary teeth. We would insist, however, that amalgam not be placed in the teeth of any children. It is simply not ethical.

Meantime, while we have this large gap in dental research, we continue to see studies like this, just published in the Journal of Dental Research: “Healthy Eating Index Is a Predictor of Early Childhood Caries”:

Early childhood caries (ECC) is a preventable form of dental caries that affects very young children, particularly among low-income families and certain racial/ethnic minorities. The current study examined the relationship of dietary quality, as measured by the Healthy Eating Index (HEI), to the prevalence of ECC in 2- to 5-year-old children. Data from the Third National Health and Nutrition Examination Survey (NHANES III) were used for the study. We used logistic regression to compute adjusted odds ratios (OR) for ECC and 95% confidence intervals (CI). Children with the best dietary practices (uppermost tertile of the HEI) were 44% less likely to exhibit severe ECC compared with children with the worst dietary practices (lowest tertile of the HEI). A healthy eating pattern geared for promotion of optimal child development and prevention of chronic disease in later life may also reduce the risk of early childhood caries, particularly severe early childhood caries.

What shocking news: kids who eat better get fewer cavities than kids who eat poorly.


Bookmark and Share

dental-work-finizio-flickr-cc1

Finizio/Flickr

What’s the best material for treating filling cavities in your children’s teeth? According to a recent research review in The Cochrane Library, nobody really knows.

So far, there is a not a clear winner among the types of fillings used to repair childhood cavities, according to a new review.

In fact, there are so few useful studies on the topic that there is not enough evidence “to make any recommendations about which filling material to use,” said Veerasamy Yengopal, who led the review.

* * *

The three studies examined by the reviewers included 81 children between the ages of 4 and 9 years old. In each study, the children had at least one cavity on each side of their mouth filled with a different material, so that researchers could compare different fillings for one person. The materials included a metal-mercury amalgam, a resin-modified glass composite filling and a filling that combines a plastic-ceramic material with elements of the glass filling.

The researchers found no significant differences among the materials, whether in terms of how well the materials lasted or whether the children were free from tooth pain at the end of the studies.

Of course, had they considered issues of biocompatibility and toxicity, those studies would have certainly found that toxic mercury amalgam is entirely inappropriate to put in a child’s mouth.

But the question we want to raise is this: why isn’t more research being done on restorative materials in primary teeth? One possibility was offered by the Chair of Pediatric Dentistry at the University of Washington, Dr. Joel Berg:

“Manufacturers replace their products so frequently; by the time that outcome and controlled data can be collected on a product, it might not be on the market any longer,” said Berg.

This seems a little disingenuous. While formulations do change, there is no reason why this should prevent studies of broad classes of restorative materials that could be used to fill carious primary teeth. We would insist, however, that amalgam not be placed in the teeth of any children. It is simply not ethical.

Meantime, while we have this large gap in dental research, we continue to see studies like this, just published in the Journal of Dental Research: “Healthy Eating Index Is a Predictor of Early Childhood Caries”:

Early childhood caries (ECC) is a preventable form of dental caries that affects very young children, particularly among low-income families and certain racial/ethnic minorities. The current study examined the relationship of dietary quality, as measured by the Healthy Eating Index (HEI), to the prevalence of ECC in 2- to 5-year-old children. Data from the Third National Health and Nutrition Examination Survey (NHANES III) were used for the study. We used logistic regression to compute adjusted odds ratios (OR) for ECC and 95% confidence intervals (CI). Children with the best dietary practices (uppermost tertile of the HEI) were 44% less likely to exhibit severe ECC compared with children with the worst dietary practices (lowest tertile of the HEI). A healthy eating pattern geared for promotion of optimal child development and prevention of chronic disease in later life may also reduce the risk of early childhood caries, particularly severe early childhood caries.

What shocking news: kids who eat better get fewer cavities than kids who eat poorly.


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