Breastfeeding Duration and Childhood Caries: A Cohort Study.

This cohort study was conducted in Khon Kaen, Thailand, to test the hypothesis that a longer breastfeeding duration increases the risk for dental caries in primary teeth. We collected information on infant feeding practices and potential confounders using a structured questionnaire to interview mothers or caregivers during the second trimester of pregnancy and after birth at 21 days and at 3, 12, 18, 24, and 36 months. Regardless of other liquids and foods, full breastfeeding was defined as feeding breast milk but not formula, while any breastfeeding was feeding breast milk with or without formula.

Adverse birth outcomes and childhood caries: a cohort study.

Objectives: To examine the association between adverse birth outcomes and dental caries in primary teeth.

Methods: This study included children in Khon Kaen, Thailand, who participated in the Prospective Cohort Study of Thai Children. Preterm was defined as a birth at <37 weeks gestation, low birthweight (LBW) as birthweight <2500 g, and small-for-gestational age (SGA) as birthweight <10th percentile of expected weight for gestational age.

Prevalence of pain in the orofacial regions in patients visiting general dentists in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry research network.

Background: This study aimed to measure prevalence of pain in the orofacial regions and determine association with demographics, treatment history, and oral health conditions in dental patients visiting clinics in the Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT) research network.

Methods: Data were recorded in a survey with systematic random sampling of patients (n = 1,668, 18 to 93 years old, 56% female) visiting 100 general dentists in the Northwest PRECEDENT research network. Prevalence ratios (PR) of orofacial pain by each variable were estimated by generalized estimating equations for Poisson regression.

Associations of periodontitis and oral manifestations with CD4 counts in human immunodeficiency virus-pregnant women in Thailand.

Objectives: To investigate the associations of CD4 count with chronic periodontitis and human immunodeficiency virus (HIV)-related oral lesions in pregnant HIV-infected Thai women.

Study Design: Two hundred ninety-two HIV-infected pregnant women were interviewed for health information and examined for their periodontal condition and HIV-related oral lesions during weeks 16-34 of gestation. Logistic regression, t tests and Chi-squared tests were used to examine the associations of CD4 count with oral lesions and periodontal conditions.

The summer institute in clinical dental research methods: still going and growing after twenty years.

The first Summer Institute in Clinical Dental Research Methods, a faculty development program at the University of Washington, was offered in the summer of 1992 for sixteen participants. The primary objective of the program was to give clinical faculty members in dentistry an introduction to and an understanding of the fundamental principles and methods used in good clinical research. In the twentieth offering of the institute in 2011, there were thirty-five participants, and over the twenty institutes, there has been a cumulative total of 463 participants who have come from thirty U.

Increased risks of preterm birth and a low-birth-weight baby in Thai human immunodeficiency virus-positive pregnant women with periodontitis.

Background: Many studies have investigated the risks of adverse neonatal outcomes associated with the presence of periodontitis in non-human immunodeficiency virus (HIV)-infected pregnant women. To the best of our knowledge, there has been no study to investigate the risk of neonatal outcomes associated with periodontitis in HIV-infected pregnant women. The aim of this study is to measure the risk of having adverse neonatal outcomes: preterm delivery (<37 weeks of gestation), low birth weight (<2500 g at birth), and preterm and low-birth-weight baby (<37 weeks of gestation and <2500 g at birth) associated with the presence of periodontitis in HIV-infected women.

What's in a dental practice-based research network? Characteristics of Northwest PRECEDENT dentists, their patients and office visits.

Objectives: The authors conducted a study to describe the general dentists, practices, patients and patient care patterns of the dental practice-based research network (PBRN) Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT).

Methods: Northwest PRECEDENT is a dental PBRN of general and pediatric dentists and orthodontists from five U.S.

Urinary porphyrin excretion in children with mercury amalgam treatment: findings from the Casa Pia Children's Dental Amalgam Trial.

Increases in the urinary concentrations of pentacarboxyl- and coproporphyrins and the appearance of the atypical precoproporphyrin have been defined in relation to mercury (Hg) body burden in animal studies, and this change in the porphyrin excretion pattern has been described as a biomarker of occupational Hg exposure and toxicity in adult human subjects. In the present studies, urinary porphyrins were determined in relation to Hg exposure in children and adolescents, 8-18 yr of age, over the 7-yr course of a clinical trial designed to evaluate the neurobehavioral and renal effects of dental amalgam in children. Subjects were randomized to either dental amalgam or composite resin treatments.

Urinary porphyrin excretion in normal children and adolescents.

Background: Urinary porphyrins are diagnostic of various metabolic disorders and xenobiotic exposures, but comprehensive normative data for urinary porphyrin concentrations in children are currently unavailable.

Methods: Subjects were participants in a prospective, randomized, controlled clinical trial of dental materials safety, 8 to 12 y at inception, who were followed longitudinally for 7 y after baseline with an extensive battery of neurobehavioral, neurological, renal function and urinary porphyrin assessments. Porphyrins were quantified by HPLC.

The serial use of child neurocognitive tests: development versus practice effects.

When serial neurocognitive assessments are performed, 2 main factors are of importance: test-retest reliability and practice effects. With children, however, there is a third, developmental factor, which occurs as a result of maturation. Child tests recognize this factor through the provision of age-corrected scaled scores.

Biomarkers of kidney integrity in children and adolescents with dental amalgam mercury exposure: findings from the Casa Pia children's amalgam trial.

Mercury is toxic to the kidney, and dental amalgam is a source of mercury exposure. Few studies have evaluated the effects of dental amalgam on kidney function in a longitudinal context in children. Here, we evaluated urinary concentrations of glutathione S-transferases (GSTs) alpha and pi as biomarkers of renal proximal and distal tubular integrity, respectively, and albumin as a biomarker of glomerular integrity in children and adolescents 8-18 years of age over a 7-year course of dental amalgam treatment.

Preparing practicing dentists to engage in practice-based research.

Background: The authors describe an educational program designed to prepare practicing dentists to engage in practice-based research in their practices--a trend receiving more emphasis and funding from the National Institute of Dental and Craniofacial Research (NIDCR).

Methods: The Northwest Practice-based REsearch Collaborative in Evidence-based DENTistry (PRECEDENT), an NIDCR-funded network of which the authors are members, developed a one-day educational program to educate practitioners in principles of good clinical research. The program has four components built around the following questions: "What is the question?"; "What are the options?"; "How do you evaluate the evidence?"; and "How do you conduct a study?"

Results: The intensive one-day program initially offered in early 2006, which concluded with applications of research principles to research topics of interest to practitioners, was well-received.

Longitudinal urinary creatinine excretion values among preadolescents and adolescents.

To present longitudinal urinary creatinine excretion data for developmentally normal children 9-17 years of age. Only extremely limited data have been presented of a longitudinal nature for this age group. Overall, 507 children who participated in a prospective, randomized, controlled trial of dental materials safety were followed longitudinally for 7 years with renal measures, including creatinine excretion.

The contribution of dental amalgam to urinary mercury excretion in children.

Background: Urinary mercury concentrations are widely used as a measure of mercury exposure from dental amalgam fillings. No studies have evaluated the relationship of these measures in a longitudinal context in children.

Objective: We evaluated urinary mercury in children 8-18 years of age in relation to number of amalgam surfaces and time since placement over a 7-year course of amalgam treatment.

Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial.

Background: Failure of dental restorations is a major concern in dental practice. Replacement of failed restorations constitutes the majority of operative work. Clinicians should be aware of the longevity of, and likely reasons for the failure of, direct posterior restorations.

The association of dental caries with blood lead in children when adjusted for IQ and neurobehavioral performance.

Unlabelled: Associations between childhood lead exposures and dental caries in children have been reported for over 30 years, with widely varying findings and conclusions, and using measures of lead exposure which ranged from food sources and water to tooth, hair or blood lead concentrations.

Objectives: This study examined the relationship of lead exposure and dental caries in a population of normatively healthy children.

Methods: This cross-sectional study used a population of 507 children aged 8-12 who were participating in a clinical trial of dental materials to examine the relationship between lead and caries.

Neurobehavioral effects of dental amalgam in children: a randomized clinical trial.

Context: Dental (silver) amalgam is a widely used restorative material containing 50% elemental mercury that emits small amounts of mercury vapor. No randomized clinical trials have determined whether there are significant health risks associated with this low-level mercury exposure.

Objective: To assess the safety of dental amalgam restorations in children.

Group sequential testing in dental clinical trials with longitudinal data on multiple outcome variables.

In this article, methods are proposed for design and analysis of clinical trials that gather longitudinal data on multiple outcome variables. A valid test of the null hypothesis of no treatment group differences can be obtained for any choice of a working alternative hypothesis and a working covariance matrix for the outcome variables. Increased power can be achieved by accurate modeling of the true treatment effect and covariance structure.

Issues in design and analysis of a randomized clinical trial to assess the safety of dental amalgam restorations in children.

The Casa Pia Study of the Health Effects of Dental Amalgams in Children is a randomized clinical trial designed to assess the safety of low-level mercury exposure from dental amalgam restorations in children. It is being carried out in 507 students (8 to 12 years of age at enrollment) of the Casa Pia school system in Lisbon, Portugal, by an interdisciplinary collaborative research team from the University of Washington (Seattle) and the University of Lisbon, with funding from the National Institute of Dental and Craniofacial Research. Since the goal of the trial is to assess the safety of a treatment currently in use, rather than the efficacy of an experimental treatment, unique design issues come into play.