The review highlighted the complex aetiology of early childhood caries (ECC). Contemporary evidence suggests that potentially effective interventions should occur in the first 2 years of a child's life. Dental attendance before the age of 2 years is uncommon; however, contact with other health professionals is high. Primary care providers who have contact with children well before the age of the first dental visit may be well placed to offer anticipatory advice to reduce the incidence of ECC.

There is currently insufficient evidence in the literature to establish aetiological factor/s relevant for MIH. Improvements in study design, as well as standardization of diagnostic and examination protocols, would improve the level and strength of evidence.

Background:  Little is known about the oral health of children under the age of four years. The determinants of early childhood caries (ECC) in this young age group are also not well understood despite a growing recognition that early interventions may deliver the greatest benefits. The aim of this study was to examine the oral health‐related knowledge, attitudes and reported behaviours of parents of children aged 12–24 months living in rural areas of Victoria, Australia.Methods:  A robust theoretical model was utilized to identify oral health‐related behaviours and their antecedent and reinforcing conditions within the context of this specific population group. Two hundred and ninety‐four parent/child dyads were recruited through their maternal and child health nurses as part of a larger intervention trial. Parents completed a self‐report questionnaire.Results:  Knowledge regarding risk and protective factors amongst parents was variable and sometimes at odds with contemporary evidence. Knowledge of the role of early infection with S. mutans was very low, with high levels of behaviours that may promote early transmission reported. Tooth cleaning was reported by most parents at least sometimes, however a large proportion lacked confidence and this was significantly related to the frequency of the cleaning. Parents were confused about the fluoride status of their water supplies. Most parents believed fluoride toothpaste reduced the risk of ECC but did not know whether it should be used with toddlers.Conclusions:  The results of this study have implications for efforts to prevent dental decay in this very young age group. Health care professionals other than dentists need support to provide information and promote confidence with regard to optimal fluoride exposure. Attention should also be given to the contribution of early contact with particular bacteria in oral health education and promotion programmes.

Background: While inequalities in oral health are generally well documented, it is less clear whether such patterns are evident from early childhood. Using four measures of potential inequality, this study examined patterns in oral health for Australian children at ages 2-3 and 6-7 years. Methods: Cross-sectional data from two cohorts of children in the Longitudinal Study of Australian Children (LSAC) were used to explore associations between reported oral health and four indicators of social disadvantage: socio-economic position (SEP), residential remoteness, Indigenous status and non-English speaking background. Results: For both cohorts, lower SEP and Indigenous status were associated with higher odds of poor oral health on all three indicators, and less accessible location was associated with increased odds for caries. Non-English speaking background was associated with increased odds for caries experience in 2-3 year olds and non-use of dental services in the older cohort. Inequalities were larger in the older cohort for socio-economic position and toothbrushing. Conclusions: Marked social disparities in oral health appear as early as 2 years of age and remain evident in school-age children. Interventions to reduce such disparities should start as early as possible.