Developmental defects of enamel as biomarkers of early childhood life events: developing methods for their use in life course epidemiology.
Doctoral thesis, UCL (University College London).
Tooth enamel is formed incrementally during specific age periods. Enamel formation is sensitive to changes in its environment and embodies significant changes into the structure of developing enamel that manifest as clinically detectable permanent “defects”. These features make enamel a unique tissue which can aid researchers to obtain or validate existing relevant data on health-related events during gestation and early childhood. Using enamel as a marker for epidemiological studies requires robust methods for recording the time when adverse life event occur by linking the location of defects with the age of enamel formation. The main objectives of thesis were to: 1.determine the best method of assessing enamel defects, 2.develop an accurate method to collect data retrospectively on life events in early childhood, and 3.test whether developmental defects of enamel of permanent incisors accurately indicate adverse events in early childhood. Methods: Age range of stages of enamel formation was calculated from published data. A life-grid method was developed for collecting past childhood life events by questioning parents. Field work was in Shiraz, Iran. Pilot study revealed suitability of methods. A prevalence study (Study I) was conducted on a representative sample of 335 8-11-year-old schoolchildren. Main objectives were addressed in Study II when detailed investigations were carried out on selected subjects from prevalence study. Three methods for detecting defects were compared and then findings were related to life events recorded on the life-grid. Results: Digital photographic method was better than clinical examination and replication methods for detecting DDEs (N=90). The events recorded in early childhood life-grid method were almost identical to recorded health documents (N=30). Final results showed that presence, type, and location of enamel DDEs in permanent incisors can serve as reliable markers of occurrence, nature, timing, and in some degrees severity of adverse events in early childhood (N=87).
|Title:||Developmental defects of enamel as biomarkers of early childhood life events: developing methods for their use in life course epidemiology|
|Additional information:||Authorisation for digitisation not received|
|UCL classification:||UCL > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health Care > Epidemiology and Public Health|
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