Parental Factors Influencing the Development of Early Childhood Caries in Developing Nations: A Systematic Review

Abstract

BackgroundEarly childhood caries (ECC) is one of the most prevalent and chronic conditions of childhood. Various factors including biological and dietary factors along with an overlay of parental social factors have been found to be associated with the progression of ECC. The objective of this systematic review is to synthesize available literature and to identify parent-level proximal and distal risk factors associated with the development of ECC in developing nations.MethodsStudies conducted in developing nations, published between 2005 and 2017 in English, that included children younger than 6 years and examined ECC were included. The outcome of interest were parental risk factors, which included parental knowledge, behavior, attitudes, sense of coherence (SOC), stress, socioeconomic status (SES), education, and breastfeeding duration. The studies were retrieved from MEDLINE, Ovid Medline, and PubMed.ResultsThe search yielded 325 studies, of which 18 were considered eligible for inclusion in this review. Ten studies found maternal education, and seven studies found parental education to be significantly associated with ECC. SES was significantly associated with ECC in 13 studies in the form of annual household income and occupation level. Four studies observed the significant association between oral health knowledge and attitudes with ECC, whereas only two studies found maternal attitude to be associated with ECC. Breastfeeding duration was a significant risk factor in four studies. One study each found significant associations of SOC, parental distress, and secondary smoke with ECC.ConclusionTo date, most of the researches done in developing countries have reported distal parental factors such as income and education being significant risk factors in caries development compared to proximal risk factors in low-income groups. Only a few studies analyzed the psychosocial and behavioral factors. Interventions could be designed to improve parental oral health knowledge and behaviors in these nations.

Association of childhood socioeconomic status with edentulism among Chinese in mid-late adulthood

“…Poor family SES negatively correlated with high quality and affordability of oral health services, and thus those children had restricted access to oral health services. Social support is a positive factor for oral health-related quality of life [21], which is consistent with the results of this study, indicating that children who lived in an environment where neighbors were willing to help with close-knit relationships, were less likely to be edentulous in This study identified an unexpected association between parents with high school education or above and edentulism, suggesting that having parents who had high education did not contribute to decrease the prevalence of edentulism, which is inconsistent with previous studies [51]. The age of respondents was 45+ years old, born between 1950s and 1970s, they went through their whole childhood and early adulthood before1978, when China was mainly an agricultural society and industrially undeveloped.…”

Prevalence of dental caries in preschool children born preterm and/or with low birth weight: A systematic review with meta‐analysis of prevalence data

“…Thus, we found a smaller proportion of children with caries compared with caries‐free children. The prevalence of dental caries worldwide ranges from 23% to 90% and is associated with a lower socio‐economic status …”

The Status and Associated Factors of Early Childhood Caries among 3- to 5-year-old Children in Guangdong, Southern China: A Provincial Cross-sectional Survey

“…Parental factors such as education and income are signi cant risk factors in the developing of ECC [25]. Therefore, children from rural areas should be given more attention in order to reduce ECC.…”