Early Childhood Caries: Analysis of Psychosocial and Biological Factors in a High–Risk Population

Abstract

The influences that link social factors and caries development are not well understood, although mediation by stress has been suggested. The association between caregiver stress and early childhood caries (ECC), in particular, remains unclear. The purpose of this study was to examine the relationships between parenting stress and ECC while controlling for behavioral and biological factors in a high–risk population. One hundred and fifty healthy children aged 18–36 months were examined in a cross–sectional study design. Parental interviews were conducted to obtain demographic, oral health behavior and parenting stress data. Clinical data included parent and child bacterial measures, fingernail fluoride analyses, caries prevalence and presence of child enamel hypoplasia. Bivariate analyses revealed that parenting stress predicted caries. Multivariate analyses demonstrated that a combination of psychosocial, behavioral, temporal and biological variables predicted ECC outcomes. Total parenting stress did not contribute independently to the best prediction model. Our findings suggest the need for the development of a multidimensional stress model that considers the parent–child dyad to elucidate further the link between psychosocial factors and ECC.

Aleitamento materno e cárie do lactente e do pré-escolar: uma revisão crítica

“…mothers, 39 of parents with low educational level, especially of illiterate mothers. 7,26,28,33,37,39,40 In this population, prenatal and perinatal malnutrition or undernourishment are the cause of enamel hypoplasia; oral hygiene is usually poor; exposure to fluorine is probably insufficient 12,39 and there is a greater preference for sugary foods. 36,41 Several diseases are associated with ECC, among them, malnutrition, 9,24,34,35,42 asthma, recurrent infections, chronic diseases, in addition to medication use.…”

“…70,82 These habits have been correlated with a higher prevalence of ECC. 82 The duration of breastfeeding and exclusive breastfeeding is longer in women from upper social classes, in those who are better educated, [83][84][85] in older mothers and in those with a steady relationship 52 and, dental hygiene is also more appropriate in this group 12,39 in opposition to underprivileged classes, in which ECC is more common. Early introduction of foods, the use of baby bottles and preference for sugary foods are more frequently observed in underprivileged classes.…”

Severe early childhood caries: an integral approach

“…Crianças que apresentam defeito de desenvolvimento de esmalte são mais vulneráveis ao desenvolvimento da doença cárie se expostas às situações descritas 25 .…”

Cárie precoce e severa na infância: uma abordagem integral

“…23,24 Children who have enamel hypoplasia are more vulnerable to the development of caries if they are exposed to the above mentioned situations. 25 Immunosuppression increases the susceptibility to caries. [26][27][28] Children who need oncological or rheumatological treatment might be more susceptible.…”