Associations of Ethnicity/Race and Socioeconomic Status with Early Childhood Caries Patterns

Abstract

This study supports the association of both ethnicity/race and social status with any early childhood caries. The patterns of caries were each found to be associated with specific and different socioeconomic-demographic indicators. The practical importance of these findings is that global measurement of ECC, without regard to specific caries pattern, leads to the potential for substantial non-differential misclassification of disease. The consequence of this is the potential for important ECC-SES-ethnicity/race associations to be masked. This, in turn, decreases the ability of surveys and investigations to accurately identify sub-groups of the population at greatest risk of developing ECC.

Natural history of dental caries in very young Australian children

“…Early childhood caries has the distinct pattern of affecting first the anterior maxillary teeth, then the fissures of the molars, and finally the proximal surfaces of the molars with the lower anterior teeth least affected27. Our data as expected show more advanced lesions in anterior maxillary teeth when the children are older and more new non‐cavitated lesions associated with the molars.…”

Factors Associated With Dental Care Utilization in Early Childhood

“…Our finding that children from low-income families were less likely to visit a dentist and more likely to have dental cavities complements the existing literature. [22][23][24] Barriers to dental care among low-income families may include financial cost, access to transportation, school absence policies, and a belief that dental health may not be important to overall wellbeing. 25,26 Recently the Canadian Pediatric Society issued a position statement recommending all levels of government to hold dental care to the same standards of accessibility, universality, and comprehensiveness as other services under the Canadian Health Act.…”

Hypoplasia-associated Severe Early Childhood Caries – A Proposed Definition

“…A more severe form of caries affecting children under the age of 3 yrs with decay to the smooth surfaces is referred to as Severe Early Childhood Caries (S-ECC) (Drury et al, 1999;Ismail and Sohn, 1999). Two challenges exist with these definitions: (1) They describe numbers of teeth or surfaces affected (greater than 1) but fail to distinguish differences in patterns or etiologies (Johnsen, 1984;Johnsen et al, 1987;Psoter et al, 2006); and (2) they imply that, by nature of its numerical definition, caries in early childhood might be a continuum, with S-ECC as just a more severe form of ECC. Moreover, the distinction between S-ECC and ECC is not universally acknowledged (Davies, 1998;Seow et al, 2009).…”

“…s the numbers of children living at or below the poverty level increase in the US and globally, the incidence of early childhood caries rises, despite falling caries prevalence within the general child population (US Department of Health and Human Services, 2000;Oliveira et al, 2006;Psoter et al, 2006;Vargas and Ronzio, 2006). This rising "epidemic" of caries correlates roughly with the rising number of children living in poverty and poor health.…”