Milgrom P, Riedy C A, Weinstein P, Tanner A C, Manibusan L, Bruss J
Department of Dental Public Health Sciences, University of Washington, Seattle 98195, USA.
Community Dent Oral Epidemiol. 2000 Aug;28(4):295-306. doi: 10.1034/j.1600-0528.2000.280408.x.
Caufield et al. (1) have suggested that the acquisition of mutans streptococci in young children most likely takes place during a "window of infectivity" from 19 to 31 months of age.
This study determined the prevalence of dental caries and bacterial infection in a randomly selected sample of 199 children 6 to 36 months old from the island of Saipan in the Common-wealth of the Northern Mariana Islands, USA. The relationships between caries and Streptococcus mutans infection, hypoplasia, diet and oral hygiene behavior were investigated.
The overall estimated prevalence of caries was high: 46.8% of the children had white spot lesions and 39.1% had enamel cavitation. Colonization was seen in very young children; S. mutans was detected in 25% of the predentate children. The results of multi-variable modeling support the hypothesis that bacterial infection, diet, and hypoplasia are important in the etiology of dental caries in this population. Adjusted for age and ethnicity, children with a high level of S. mutans detected were 5 times more likely to have dental caries than children with a lower level of S. mutans detected. Hypoplasia and a high cariogenicity score (diet) were also significant independent predictors. The odds of having any white spot lesions or enamel cavitation were 9.6 times greater for children with any hypoplasia, and 7.8 times greater for children with high cariogenicity scores relative to those with lower scores after adjusting for level of S. mutans, age and ethnicity. Sleeping with a bottle, maternal sharing of utensils, and high snacking frequency were not significant predictors of caries in this population.
考菲尔德等人（1）提出，幼儿变形链球菌的感染很可能发生在19至31个月大的“感染窗口期”。
本研究确定了从美国北马里亚纳群岛联邦塞班岛随机抽取的199名6至36个月大儿童样本中龋齿和细菌感染的患病率。研究了龋齿与变形链球菌感染、发育不全、饮食和口腔卫生行为之间的关系。
龋齿的总体估计患病率很高：46.8%的儿童有白斑病变，39.1%的儿童有牙釉质龋洞。在非常年幼的儿童中发现了定植；在25%的乳牙未萌出儿童中检测到变形链球菌。多变量建模结果支持以下假设：细菌感染、饮食和发育不全在该人群龋齿病因中很重要。在调整年龄和种族因素后，检测到变形链球菌水平高的儿童患龋齿的可能性是检测到变形链球菌水平低的儿童的5倍。发育不全和高致龋性评分（饮食）也是显著的独立预测因素。在调整变形链球菌水平、年龄和种族因素后，有任何发育不全的儿童出现任何白斑病变或牙釉质龋洞的几率是没有发育不全儿童的9.6倍，致龋性评分高的儿童相对于评分低的儿童出现任何白斑病变或牙釉质龋洞的几率是7.8倍。在该人群中，含奶瓶睡觉、母亲共用餐具和高零食频率不是龋齿的显著预测因素。
