Peres Karen Glazer, Nascimento Gustavo G, Peres Marco Aurelio, Mittinty Murthy N, Demarco Flavio Fernando, Santos Ina Silva, Matijasevich Alicia, Barros Aluisio J D
Australian Research Centre for Population Oral Health, Adelaide Dental School, and
Graduate Program in Dentistry, School of Dentistry, and.
Pediatrics. 2017 Jul;140(1). doi: 10.1542/peds.2016-2943.
Few studies have assessed the effect of breastfeeding, bottle feeding, and sugar consumption on children's dental caries. We investigated whether the duration of breastfeeding is a risk factor for dental caries in the primary dentition, independently of sugar consumption.
An oral health study ( = 1303) nested in a birth cohort study was carried out in southern Brazil. The average number of decayed, missing, and filled primary tooth surfaces (dmfs) and severe early childhood caries (S-ECC: dmfs ≥6) were investigated at age 5 years. Breastfeeding was the main exposure collected at birth and at 3, 12, and 24 months of age. Data on sugar consumption were collected at 24, 48, and 60 months of age. Marginal structural modeling was used to estimate the controlled direct effect of breastfeeding (0-12, 13-23, and ≥24 months) on dmfs and on S-ECC.
The prevalence of S-ECC was 23.9%. The mean number of dmfs was 4.05. Children who were breastfed for ≥24 months had a higher number of dmfs (mean ratio: 1.9; 95% confidence interval: 1.5-2.4) and a 2.4 times higher risk of having S-ECC (risk ratio: 2.4; 95% confidence interval: 1.7-3.3) than those who were breastfed up to 12 months of age. Breastfeeding between 13 and 23 months had no effect on dental caries.
Prolonged breastfeeding increases the risk of having dental caries. Preventive interventions for dental caries should be established as early as possible because breastfeeding is beneficial for children's health. Mechanisms underlying this process should be investigated more deeply.
很少有研究评估母乳喂养、奶瓶喂养和糖分摄入对儿童龋齿的影响。我们调查了母乳喂养持续时间是否是乳牙列龋齿的一个危险因素，独立于糖分摄入。
在巴西南部开展了一项嵌套于出生队列研究中的口腔健康研究（n = 1303）。在5岁时调查乳牙龋坏、缺失和充填牙面（dmfs）的平均数量以及重度幼儿早期龋齿（S-ECC：dmfs≥6）情况。母乳喂养是在出生时以及3、12和24月龄收集的主要暴露因素。在24、48和60月龄收集糖分摄入数据。采用边际结构模型来估计母乳喂养（0至12个月、13至23个月和≥24个月）对dmfs和S-ECC的受控直接效应。
S-ECC的患病率为23.9%。dmfs的平均数为4.05。母乳喂养≥24个月的儿童比母乳喂养至12个月龄的儿童有更高的dmfs数量（平均比：1.9；95%置信区间：1.5 - 2.4）以及患S-ECC的风险高2.4倍（风险比：2.4；95%置信区间：1.7 - 3.3）。13至23个月期间的母乳喂养对龋齿没有影响。
延长母乳喂养会增加患龋齿的风险。由于母乳喂养对儿童健康有益，应尽早建立龋齿预防干预措施。对此过程的潜在机制应进行更深入的研究。
