Oral health is related to diet in many ways, for example, nutritional influences on craniofacial development, oral cancer and oral infectious diseases. Dental diseases impact considerably on self-esteem and quality of life and are expensive to treat. The objective of this paper is to review the evidence for an association between nutrition, diet and dental diseases and to present dietary recommendations for their prevention. Nutrition affects the teeth during development and malnutrition may exacerbate periodontal and oral infectious diseases. However, the most significant effect of nutrition on teeth is the local action of diet in the mouth on the development of dental caries and enamel erosion. Dental erosion is increasing and is associated with dietary acids, a major source of which is soft drinks. Despite improved trends in levels of dental caries in developed countries, dental caries remains prevalent and is increasing in some developing countries undergoing nutrition transition. There is convincing evidence, collectively from human intervention studies, epidemiological studies, animal studies and experimental studies, for an association between the amount and frequency of free sugars intake and dental caries. Although other fermentable carbohydrates may not be totally blameless, epidemiological studies show that consumption of starchy staple foods and fresh fruit are associated with low levels of dental caries. Fluoride reduces caries risk but has not eliminated dental caries and many countries do not have adequate exposure to fluoride. It is important that countries with a low intake of free sugars do not increase intake, as the available evidence shows that when free sugars consumption is ,15‐20 kg/yr (,6‐10% energy intake), dental caries is low. For countries with high consumption levels it is recommended that national health authorities and decision-makers formulate country-specific and community-specific goals for reducing the amount of free sugars aiming towards the recommended maximum of no more than 10% of energy intake. In addition, the frequency of consumption of foods containing free sugars should be limited to a maximum of 4 times per day. It is the responsibility of national authorities to ensure implementation of feasible fluoride programmes for their country.

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Diet, nutrition and the prevention of dental diseases

Several reports have been published during the past decades showing a lack of care of traumatic dental injuries (TDIs) as well as dentists and lay people having insufficient knowledge on how to man ...

Epidemiology of traumatic dental injuries – a 12 year review of the literature

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management.

Early childhood caries update: A review of causes, diagnoses, and treatments.

Schools provide an important setting for promoting health, as they reach over 1 billion children worldwide and, through them, the school staff, families and the community as a whole. Health promotion messages can be reinforced throughout the most influential stages of children's lives, enabling them to develop lifelong sustainable attitudes and skills. Poor oral health can have a detrimental effect on children's quality of life, their performance at school and their success in later life. This paper examines the global need for promoting oral health through schools. The WHO Global School Health Initiative and the potential for setting up oral health programmes in schools using the health-promoting school framework are discussed. The challenges faced in promoting oral health in schools in both developed and developing countries are highlighted. The importance of using a validated framework and appropriate methodologies for the evaluation of school oral health projects is emphasized.

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Health-promoting schools: an opportunity for oral health promotion

Nevoid basal cell carcinoma (Gorlin) syndrome.

Summary. Introduction. A review of the literature relating to supernumerary teeth is presented along with a survey of 152 cases.

Methods. The study population consisted of 152 children who visited the department of Paediatric Dentistry at the Jordan University Hospital. Patients ranged in age from 5 to 15 years. Supernumeraries were detected by clinical examination and radiographs.

Results. Males were affected more than females with a sex ratio of 2·2 : 1. Seventy-seven percent of the patients had one supernumerary tooth, 18·4% had double teeth, and 4·6% had three or more supernumeraries. Ninety percent of the supernumerary teeth occurred in the premaxilla, of which 92·8% were in the central incisor region and of these latter 25% were located in the midline. The other 10·4% of the supernumeraries were located in the premolar, canine, molar, and lower central incisor regions. Two cases were of non-syndrome supernumerary teeth. Seventy-five percent of the supernumeraries were conical, 83·1% were in the normal vertical position and 26·5% were erupted. Conical-shaped supernumerary teeth had a significantly higher rate of eruption compared to the tuberculate type.

Supernumerary teeth: review of the literature and a survey of 152 cases

Summary. Objectives.  The objectives of the study were: (i) to assess the level of dental knowledge and attitudes towards child dental care among parents in Jordan, (ii) to analyse the oral health care habits of schoolchildren and parents, and (iii) to evaluate the oral hygiene habits and use of professional dental services of children in relation to socio-demographic conditions.

Design.  Cross-sectional, self-administered questionnaires for parents.

Sample and methods.  National representative sample of 6–16-year-olds living in urban areas (n = 1556, children and parents, response rate 92%, 48·7% boys, 51·3% girls).

Results.  In all, 80% of the parents knew about the harmful effect of sugar and 79% thought that poor oral hygiene may induce dental caries. In addition to proper oral hygiene (79%) and restriction of sugar/sweets (42%), 36% of the parents emphasized regular dental visits for the prevention of dental disease in children. However, most children saw a dentist for symptomatic reasons only (86%), while 11% attended for dental check-ups. At their last visit to the dentist, 49% of the children had tooth extraction and only 8% had preventive services (fissure sealing). Toothbrushing at least twice a day was reported for 31% of the children; 14% of children aged 6–9 years had assistance from adults in brushing. Dental care habits of children were highly affected by dental visiting habits of parents, and variations by level of education of parents were also found.

Conclusions.  The discrepancy between dental knowledge and attitudes of parents and oral health care practices indicate the need for oral health education. School-based oral health promotion programmes should be established in Jordan to influence the oral health behaviour of children and parents and to avoid further deterioration in their oral health.

Oral health behaviour of schoolchildren and parents in Jordan

Objective To describe the prevalence of dental caries among Jordanian preschool children and risk factors for caries. Design Preschool children aged 1 to 5 years from randomly selected nurseries and kindergartens in Amman were surveyed in September 2001. A questionnaire to investigate factors that might have affected dental caries level was completed by parents. Dental caries was diagnosed as recommended by the World Health Organization. Results The mean dmft scores at 1, 2, 3, 4, and 5 years were 0.19, 1.15, 1.7, 2.13, and 3.22 respectively. Overall, 52% of children were caries-free. Caries level was significantly related to feeding practices, snacking habits, oral health practices and pattern of dental visiting as well as to socio-economic background, parents, education level and awareness. Conclusion The dental caries level was slightly higher than that of children in industrialised countries but lower than that of children in the neighbouring Arab countries. However, the early caries development seen in children from the lower socio-economic classes, because they are at high risk for caries in Jordan, reinforces the need for preventive programmes before eruption of the teeth. Access to dental care must be improved to enable any preventive strategies to be implemented.

Early childhood caries and risk factors in Jordan.

This paper provides three different estimators for Pr(X < Y) when X and Y have a bivariate exponential distribution. The asymptotic variances of the three estimators are also derived. A test for the equality of the means of X and Y and confidence limits for the difference of the two means are presented. Our results are directly applicable in a reliability context with underlying bivariate exponential distribution.

Some inference results on pr(x < y) in the bivariate exponential model

OBJECTIVES: To assess the prevalence and related factors of incisor trauma among 12-year-old Jordanian schoolchildren. DESIGN: Cross-sectional study among schoolchildren. A sample of 1.878 schoolchildren aged 12 years, 940 boys and 938 girls, were randomly selected from 128 schools in urban and rural areas. Ellis classification was used to record the dental injuries on incisors. RESULTS: Of the children examined 13.8% showed dental trauma. Difference in prevalence between boys (17.1%) and girls (10.6%) was statistically significant (p Language: en

Mahmoud Hamdan

Papers

Supernumerary teeth: review of the literature and a survey of 152 cases

Oral health behaviour of schoolchildren and parents in Jordan

Early childhood caries and risk factors in Jordan.

Some inference results on pr(x < y) in the bivariate exponential model

Traumatic injuries to permanent anterior teeth among 12-year-old schoolchildren in Jordan.