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Dentistry Pediatrics / Children's Health Tooth decay among 5 year olds in England continues significant decline

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The number of 5 year olds with tooth decay has dropped to its lowest level in almost a decade, according to a PHE oral health survey.

The oral health survey published by Public Health England (PHE) reveals that less than 25% of the cohort suffers from tooth decay, a 20% drop since 2008.

This continues the downward trend seen since 2008, in the first oral health survey of 5 year olds asking parents to opt-in. In 2008, 31% of 5 year olds suffered tooth decay; in 2012 it was 27%. The pattern of dental health improvement among the age group shows the impact parents and carers can have in establishing good dental care habits from an early age.

Dr Sandra White, Director of Dental Public Health at PHE, said:

This is great news. However, one child with tooth decay is one too many and there is still much inequality in dental health around the country. Tooth decay is painful and too often results in teeth extraction, some under general anaesthetic.

This is further evidence that we can stop tooth decay in its tracks. Limiting sugary food and drink, supporting children to brush their teeth twice a day with fluoride toothpaste and regular trips to the dentist, will help prevent a great many more children suffering at the hands of tooth decay.

According to the survey an estimated 166,467 5 year olds suffer from tooth decay, compared with 177,423 in 2008.

While there has been a significant decline in tooth decay at a national level, there is still a great deal of regional variation. In the North West, a third (33.4%) of 5 year olds suffer from tooth decay, whereas only a fifth (20.1%) do in the in the South East. As with the 2 previous surveys, areas with higher levels of deprivation tend to have higher levels of tooth decay.

The proportion of 5 year olds who have had teeth removed due to decay was 2.5%, compared to 3.5% in 2008 - about 2,000 fewer children. Regional variation shows that only 1.9% of 5 year olds in the East Midlands have had tooth extractions due to decay, compared with 3.9% of children in Yorkshire and the Humber.

The survey also shows the average number of teeth affected by decay per child was 0.8, down from 1.1 in 2008. For the first time, data has also been collected across the survey on ethnicity and dental health.

The last 3 surveys have shown the dental health of 5 year olds is improving. There has been a 9% increase in the proportion of children with no obvious decay since 2008. Further analysis is needed to understand the factors that have contributed to this welcome trend. This will help local authorities identify the steps they can take to extend the improvement in decay levels to all sectors of their populations.


Sharing of a bacterium related to tooth decay among children and their families

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Research presented at the ASM Microbe research meeting provides compelling evidence that children acquire Streptococcus mutans, the bacterium most frequently associated with dental caries, from intra- and extra-familial sources besides their mother.

Children typically have more than one strain (i.e., genotype) of S. mutans and most share at least one strain with mother or a family member. However, 72% of children in this study had 1 or more S. mutans strains not found in participating household family members indicating these strains likely came from outside the home (extra-familial transmission), possibly from other children in the population.

"While the prevailing theory on S. mutans transmission suggests mother-to-child transmission as the primary route of infection, in this study 40 percent of children shared no strains with their mothers," said Stephanie Momeni, a doctoral candidate in the Department of Biology at the University of Alabama at Birmingham. Interestingly, 27 children (22.8 percent) shared 37 strains only with another child in the household (siblings or cousins), demonstrating another dimension to inter-familial transmission.

"Of the children that did not share strains with any household members, 33 percent (53/157) were found to have only 1 isolate, indicating these strains to be rare or transient," said Momeni. This is important since it suggests that approximately one-third of strains analyzed may not be clinically relevant and can confound the search for strains related to the disease. It also suggests these strains are highly transmissible but may not become established strains due to bacterial competition or host immune factors.

S. mutans is the primary bacterium most frequently associated with dental caries and is considered to be transferred from other humans. In total, S. mutans isolates (N=13,145) from 119 African American children having at least 1 household family member were evaluated. More than one family member was evaluated for 76% of children (mean=3.24, range 1-11). The strength of this study is that it evaluates interacting children as well as all participating residential household family members (including extended family). Strain types were determined using a bacterial typing method known as repetitive extragenic palindromic PCR (rep-PCR). For each rep-PCR genotype, children were evaluated as either sharing or not sharing the strain with any household members. Since children in this study had between 1-9 genotypes, a total of 315 genotype cases were evaluated.


Paper-based test could help prevent food poisoning

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Food poisoning is a stomach-churning, miserable condition that sends thousands of Americans to hospital emergency rooms every year. Now scientists report in ACS' journal Analytical Chemistry a simple, paper-based test that could help detect pathogens hitchhiking on food before they reach store shelves, restaurants and, most importantly, our stomachs.

According to one estimate by the U.S. Department of Agriculture, the foodborne bacteria Salmonella alone led to nearly 20,000 hospitalizations and almost 400 deaths in 2013. Economists estimate that the treatment of all these patients and the related productivity losses cost more than $3 billion annually. And those numbers account for just one of the 15 pathogens responsible for most of the food poisoning cases. Current testing for pathogens in food requires complicated machinery and trained personnel. But these tests don't provide the simple results needed in large-scale food manufacturing. So Je-Kyun Park and colleagues set out to find a more practical way to detect foodborne pathogens.

The researchers developed a paper-based test that can handle the multistep reactions necessary for this kind of analysis by controlling the pore size of the paper. When dipped into solutions containing the E. coli strain O157:H7, Salmonella typhimurium or both, lines appeared on the dipstick indicating a positive result within 15 minutes. Because the method requires dipping the device into a solution once and produces an easy-to-read result, it could be performed by workers without special training, the researchers say.

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