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. 1995 Sep-Oct;110(5):607–617.

Multidimensional causal model of dental caries development in low-income preschool children.

M D Litt 1, S Reisine 1, N Tinanoff 1
PMCID: PMC1381639  PMID: 7480616

Abstract

Despite the decline in the incidence of dental caries in the United States over the past several years, the condition remains a significant problem for the nation's poor children. Efforts to identify the factors responsible for caries development in samples of children of low socioeconomic status have primarily focused on a limited number of variables, and those have been predominantly biological (mutans streptococci, for example). Resulting models of caries development have usually shown good sensitivity but poor specificity. They have had limited implications for treatment. In an effort to produce a comprehensive model of caries development, 184 low-income preschool children were clinically assessed for mutans streptococci and for decayed, missing, or filled surfaces of deciduous teeth twice, first at age 4 years (baseline) and again a year later (year 1 assessment). As the clinical assessments were being done, caretakers were being interviewed to obtain data from five domains: demographics, social status, dental health behaviors, cognitive factors such as self-efficacy (self-confidence) and controllability, and perceived life stress. Data were analyzed using a structural equations modeling approach in which variables from all domains, plus baseline decayed missing and filled surfaces and baseline mutants, were used together to create a model of caries development in the year 1 assessment. Results confirmed earlier work that suggested that caries development at a 1-year followup was strongly dependent on earlier caries development. Early caries development in this sample was determined in part by mutans levels and by dental health behaviors. These behaviors themselves were accounted for partly by a cognitive factor.(ABSTRACT TRUNCATED AT 250 WORDS)

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Selected References

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  1. Beck J. D., Weintraub J. A., Disney J. A., Graves R. C., Stamm J. W., Kaste L. M., Bohannan H. M. University of North Carolina Caries Risk Assessment Study: comparisons of high risk prediction, any risk prediction, and any risk etiologic models. Community Dent Oral Epidemiol. 1992 Dec;20(6):313–321. doi: 10.1111/j.1600-0528.1992.tb00690.x. [DOI] [PubMed] [Google Scholar]
  2. Brown D. F., Wright F. A., McMurray N. E. Psychological and behavioral factors associated with dental anxiety in children. J Behav Med. 1986 Apr;9(2):213–218. doi: 10.1007/BF00848479. [DOI] [PubMed] [Google Scholar]
  3. Demers M., Brodeur J. M., Mouton C., Simard P. L., Trahan L., Veilleux G. A multivariate model to predict caries increment in Montreal children aged 5 years. Community Dent Health. 1992 Sep;9(3):273–281. [PubMed] [Google Scholar]
  4. Demers M., Brodeur J. M., Simard P. L., Mouton C., Veilleux G., Fréchette S. Caries predictors suitable for mass-screenings in children: a literature review. Community Dent Health. 1990 Mar;7(1):11–21. [PubMed] [Google Scholar]
  5. Edelstein B., Tinanoff N. Screening preschool children for dental caries using a microbial test. Pediatr Dent. 1989 Jun;11(2):129–132. [PubMed] [Google Scholar]
  6. Eriksen H. M., Bjertness E. Concepts of health and disease and caries prediction: a literature review. Scand J Dent Res. 1991 Dec;99(6):476–483. doi: 10.1111/j.1600-0722.1991.tb01057.x. [DOI] [PubMed] [Google Scholar]
  7. Formicola A. J., Witte E. T., Curran P. M. A study of personality traits and acute necrotizing ulcerative gingivitis. J Periodontol. 1970 Jan;41(1):36–38. doi: 10.1902/jop.1970.41.41.36. [DOI] [PubMed] [Google Scholar]
  8. Freeman L., Martin S., Rutenberg G., Shirejian P., Skarie M. Relationships between DEF, demographic and behavioral variables among multiracial preschool children. ASDC J Dent Child. 1989 May-Jun;56(3):205–210. [PubMed] [Google Scholar]
  9. Freeman R., Goss S. Stress measures as predictors of periodontal disease--a preliminary communication. Community Dent Oral Epidemiol. 1993 Jun;21(3):176–177. doi: 10.1111/j.1600-0528.1993.tb00748.x. [DOI] [PubMed] [Google Scholar]
  10. Galgut P. N., Waite I. M., Todd-Pokropek A., Barnby G. J. The relationship between the multidimensional health locus of control and the performance of subjects on a preventive periodontal programme. J Clin Periodontol. 1987 Mar;14(3):171–175. doi: 10.1111/j.1600-051x.1987.tb00962.x. [DOI] [PubMed] [Google Scholar]
  11. Holm A. K. Education and diet in the prevention of caries in the preschool child. J Dent. 1990 Dec;18(6):308–314. doi: 10.1016/0300-5712(90)90129-3. [DOI] [PubMed] [Google Scholar]
  12. Holmes T. H., Rahe R. H. The Social Readjustment Rating Scale. J Psychosom Res. 1967 Aug;11(2):213–218. doi: 10.1016/0022-3999(67)90010-4. [DOI] [PubMed] [Google Scholar]
  13. Johnsen D. C. Characteristics and backgrounds of children with "nursing caries". Pediatr Dent. 1982 Sep;4(3):218–224. [PubMed] [Google Scholar]
  14. Johnson B. D., Engel D. Acute necrotizing ulcerative gingivitis. A review of diagnosis, etiology and treatment. J Periodontol. 1986 Mar;57(3):141–150. doi: 10.1902/jop.1986.57.3.141. [DOI] [PubMed] [Google Scholar]
  15. Kimmel L., Tinanoff N. A modified mitis salivarius medium for a caries diagnostic test. Oral Microbiol Immunol. 1991 Oct;6(5):275–279. doi: 10.1111/j.1399-302x.1991.tb00491.x. [DOI] [PubMed] [Google Scholar]
  16. Lahti S., Tuutti H., Honkala E. The relationship of parental dental anxiety and child's caries status. ASDC J Dent Child. 1989 May-Jun;56(3):191–195. [PubMed] [Google Scholar]
  17. Leverett D. H., Featherstone J. D., Proskin H. M., Adair S. M., Eisenberg A. D., Mundorff-Shrestha S. A., Shields C. P., Shaffer C. L., Billings R. J. Caries risk assessment by a cross-sectional discrimination model. J Dent Res. 1993 Feb;72(2):529–537. doi: 10.1177/00220345930720021001. [DOI] [PubMed] [Google Scholar]
  18. Leverett D. H., Proskin H. M., Featherstone J. D., Adair S. M., Eisenberg A. D., Mundorff-Shrestha S. A., Shields C. P., Shaffer C. L., Billings R. J. Caries risk assessment in a longitudinal discrimination study. J Dent Res. 1993 Feb;72(2):538–543. doi: 10.1177/00220345930720021101. [DOI] [PubMed] [Google Scholar]
  19. Ludenia K., Donham G. W. Dental outpatients: health locus of control correlates. J Clin Psychol. 1983 Nov;39(6):854–858. doi: 10.1002/1097-4679(198311)39:6<854::aid-jclp2270390607>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  20. Marcenes W. S., Sheiham A. The relationship between work stress and oral health status. Soc Sci Med. 1992 Dec;35(12):1511–1520. doi: 10.1016/0277-9536(92)90054-t. [DOI] [PubMed] [Google Scholar]
  21. McCaul K. D., Glasgow R. E., Gustafson C. Predicting levels of preventive dental behaviors. J Am Dent Assoc. 1985 Oct;111(4):601–605. doi: 10.14219/jada.archive.1985.0169. [DOI] [PubMed] [Google Scholar]
  22. Odman P. A., Lange A. L., Bakdash M. B. Utilization of locus of control in the prediction of patients' oral hygiene performance. J Clin Periodontol. 1984 Jul;11(6):367–372. doi: 10.1111/j.1600-051x.1984.tb01334.x. [DOI] [PubMed] [Google Scholar]
  23. Reisine S., Litt M. Social and psychological theories and their use for dental practice. Int Dent J. 1993 Jun;43(3 Suppl 1):279–287. [PubMed] [Google Scholar]
  24. Reisine S., Litt M., Tinanoff N. A biopsychosocial model to predict caries in preschool children. Pediatr Dent. 1994 Nov-Dec;16(6):413–418. [PubMed] [Google Scholar]
  25. Seppä L., Hausen H. Frequency of initial caries lesions as predictor of future caries increment in children. Scand J Dent Res. 1988 Feb;96(1):9–13. doi: 10.1111/j.1600-0722.1988.tb01401.x. [DOI] [PubMed] [Google Scholar]
  26. Seppä L., Hausen H., Pöllänen L., Helasharju K., Kärkkäinen S. Past caries recordings made in Public Dental Clinics as predictors of caries prevalence in early adolescence. Community Dent Oral Epidemiol. 1989 Dec;17(6):277–281. doi: 10.1111/j.1600-0528.1989.tb00635.x. [DOI] [PubMed] [Google Scholar]
  27. Shields W. D. Acute necrotizing ulcerative gingivitis. A study of some of the contributing factors and their validity in an Army population. J Periodontol. 1977 Jun;48(6):346–349. doi: 10.1902/jop.1977.48.6.346. [DOI] [PubMed] [Google Scholar]
  28. Sutton P. R. The early onset of acute dental caries in adults following mental stress. N Y State Dent J. 1965 Dec;31(10):450–456. [PubMed] [Google Scholar]
  29. Thibodeau E. A., O'Sullivan D. M., Tinanoff N. Mutans streptococci and caries prevalence in preschool children. Community Dent Oral Epidemiol. 1993 Oct;21(5):288–291. doi: 10.1111/j.1600-0528.1993.tb00776.x. [DOI] [PubMed] [Google Scholar]
  30. Tuutti H., Lahti S. Oral health status of children in relation to the dental anxiety of their parents. J Pedod. 1987 Winter;11(2):146–150. [PubMed] [Google Scholar]
  31. Weiss J., Diserens D. Health behavior of dental professionals. Clin Prev Dent. 1980 Nov-Dec;2(6):5–8. [PubMed] [Google Scholar]
  32. Winter G. B. Prediction of high caries risk--diet, hygiene and medication. Int Dent J. 1988 Dec;38(4):227–230. [PubMed] [Google Scholar]
  33. Wolfe G. R., Stewart J. E., Hartz G. W. Relationship of dental coping beliefs and oral hygiene. Community Dent Oral Epidemiol. 1991 Apr;19(2):112–115. doi: 10.1111/j.1600-0528.1991.tb00123.x. [DOI] [PubMed] [Google Scholar]

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