Abstract
The association between systemic antibiotics and the composition of oral flora may be the reason why children taking antibiotics have different risks for dental caries compared to those who do not take antibiotics. Karjalainen et al5 showed that in cases of adenoidectomy, children who reportedly took more antibiotics than controls had significantly lower dmfs scores at 3 and 4 years old compared to controls. There was accelerated formation of carious lesions after discontinuation of antibiotics, however, possibly due to the associated use of antihistamines. Also, children with cystic fibrosis (CF) who often take frequent antibiotics to prevent and treat respiratory infections have less plaque, gingivitis, and dental caries than children without CF.6·7 A similar inverse relationship between antibiotic usage and dental caries was found in children with rheumatic fever who received prolonged antibiotic prophylaxis.1,2 At the end of the follow-up period, there were 1,518 children diagnosed with ECC (5% of the total sample), of whom 1,015 had SECC, representing nearly 67% of ECC children and 3% of the total sample. The child's gender was found to be significantly associated with ECC (chi-square= 55.6; P<.001) and SECC (chi-square=27.63; jP<.OQl), with slightly more males than females having ECC and SECC. Among those diagnosed with ECC, chi-square tests of independence showed a significant difference between Caucasian and African American children (chisquare=68.80; P<.00l) and Caucasian and Hispanic children (chi-square=39.12; P<.001), with more Hispanic and African American children having the condition. There was, however, no difference between African American and Hispanic children (chisquare-1.57; P=.21). Also, regarding the proportion of SECC children, chi-square tests of independence showed a significant difference between Caucasian and African American children (chisquare= 46,88; P<.001) and Caucasian and Hispanic children Íchi-square=l7.43; P<.001), with more Hispanic and African American children having the condition. No difference was found, however, between African American and Hispanic children (chi-square=0.02; P=.90). 34. Korenstein K, Echeverri EA, Keene HJ. Preliminary observations on the relationship between mutans streptococci and dental caries experience within black, white, and Hispanic families living in Houston, Texas, Pediatr Dent 1995;17:445-50. Lifelong costs of caries prevention with fluoride use Cost-benefit or cost-cost analyses are becoming Increasingly important in dentistry. Therefore, the aim o! the present study was Io evaluate the economic consequences of caries prévention with fluorldes. German epidemiological data were used in a system dynamics model to assess the lifelong costs of caries in a population. Without fluoride prevention, lifelong treatment for caries resulted In mean costs of E6,976 and a present value of C932 per person (5% discounting). In different scenarios of constant, increasing, or decreasing caries-controlling effects, and of limited (age 6-18 yr) or lifelong application, the combination of fluoride salt, fluoride toothpaste, and fluoride gel were most costeffective. They reduced the costs for caries treatment and prophylaxis to £482, or to a present value of £148 (5% discounting), when applied from age 6-18 yr, and to £211-213 for lifelong use (present value. 5% discounting). In conclusion, a lifelong model of costs of caries demonstrates that the use of fluorides in caries prevention is highly cost-effective.