title: Medically administered antibiotics, dietary habits, fluoride intake and dental caries experience in the primary dentition.
abstract: OBJECTIVE
  Dental caries continues to be a major public health problem in the US and other nations, particularly among younger children. Unfortunately, understanding of factors contributing to caries in this age group is incomplete and further studies are necessary. The purpose of this study was to assess factors related to extensive caries experience among children aged 4-7 years, including antibiotic use, dietary patterns, fluoride intakes, and tooth brushing habits.
  
  
  METHODS
  The case-control study was nested within a longitudinal cohort study of children's oral health. The larger cohort study collected data on fluoride intakes and behavioral factors, including antibiotic use and dietary patterns of children periodically from birth. A single dental examination was completed for each child at a time between the ages of 4-7 years. A case-control design was used to compare children with severe caries experience (6 or greater dmfs) to those with no caries experience. Cases (n = 39) included all who met the criteria and had sufficient longitudinal data (n = 39) while a control group was selected to have comparable mean age, exam dates, and an equal number of boys and girls.
  
  
  RESULTS
  Backward elimination logistic regression controlling for demographic variables showed severe caries experience to be related to greater regular pop/other sugared beverage intake, greater frequency of starch foods, and greater frequency of eating occasions. Mother's education and fluoride intake from water were inversely related to severe caries experience. Antibiotic use was generally higher in the control group, but was not significantly different than in the severe caries group.
  
  
  CONCLUSIONS
  Although we cannot rule out the possibility that antibiotics may be associated with increased or decreased caries risk, our data suggest that they play only a minor role in caries prevention compared to fluoride. Dietary sugar continues to be a significant risk factor for caries in the primary dentition.
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, 200 Hawkins Drive #01105 PFP, The University of Iowa, Iowa City, IA 52242, USA.
authors.forename: Boipelo P
authors.initials: BP
authors.lastname: Mariri
authors.forename: Steven M
authors.initials: SM
authors.lastname: Levy
authors.forename: John J
authors.initials: JJ
authors.lastname: Warren
authors.forename: George R
authors.initials: GR
authors.lastname: Bergus
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Marshall
authors.forename: Barbara
authors.initials: B
authors.lastname: Broffitt
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001628:Beverages / Q000009:adverse effects; D002327:Cariostatic Agents / Q000008:administration & dosage*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000209:etiology* / Q000517:prevention & control*; D004037:Diet, Cariogenic; D004040:Dietary Carbohydrates / Q000009:adverse effects; D004522:Educational Status; D005247:Feeding Behavior; D005260:Female; D005459:Fluorides / Q000008:administration & dosage*; D006801:Humans; D007182:Income; D007484:Iowa; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009035:Mothers; D015999:Multivariate Analysis; D011795:Surveys and Questionnaires; D014094:Tooth, Deciduous; D014099:Toothbrushing
chemical_list: D000900:Anti-Bacterial Agents; D002327:Cariostatic Agents; D004040:Dietary Carbohydrates; D005459:Fluorides