Social and Behavioral Determinants for Early Childhood Caries among Preschool Children in India

Abstract

Background and aims. Early Childhood Caries (ECC) is a public health problem with biological, social and behavioural determinants and the notion that the principal etiology is inappropriate feeding modalities is no longer tenable. Hence this study was undertaken to assess the relationship between ECC and socio-demographic factors, dietary habits, oral hygiene habits and parental characteristics.Materials and methods. The study involved a dental examination of 1400 children aged 0-71 months, recording caries using Gruebbel’s deft index and a structured questionnaire to interview parents or caretakers. The tabulated data was statistically analyzed using t-test and ANOVA at 5% level of significance.Results. The variables significantly associated with ECC were age (P<0.001), geographical location (P<0.05), duration of breast/bottle feeding (P<0.001), use of sweetened pacifiers (P<0.001), frequency of snacking (P<0.05), frequency of tooth brushing (P<0.001), the person responsible for child’s oral health care (P<0.05) and education level of parents (P<0.05). However, other variables like child’s gender, number of siblings, types of snack the child preferred and age at which tooth brushing was instituted did not have statistically significant relationship with ECC (P>0.05).Conclusion. ECC is preventable and manageable with proper information and skills. It is important for healthcare professionals, family physicians and parents to be cognizant of the involved risk factors as their preventive efforts represent the first line of defense.

Association of early life health conditions, nutritional status, and feeding practices with caries prevalence in preschool children

“…In both cases, there was an association between caries and the mother's educational level, nutritional status, child age, and presence of clinically visible plaque. The same associations were identified by others researches in different countries [12,14].…”

“…Several studies have demonstrated the correlation between the frequency of sucrose intake at early ages and the prevalence of caries [12,22]. The influence of dietary habits has been particularly evident in the case of severe early childhood caries.…”

“…The variables selected for this study were: a) Dental caries -dmft index, and clinical examinations were performed according to WHO methodology, in a room with ambient light, using spatula or a tongue depressor (12). Before the clinical examination, the children brushed their teeth with a fluoridated toothpaste; b) Perinatal conditions -birth weight data were obtained through a questionnaire answered by mothers with the help of the children's record of health history (Child Care Card from Brazilian Ministry of Health).…”

“…The association between accumulated social and biological risks and the occurrence of oral diseases has been the subject of research [12,22]. Therefore, it has been identified the influence of the phenomena that occur in the perinatal period or in early childhood in determining dental caries many years later, such as low birthweight, some diseases or deficit in the height-to-age relationship in the first year of life, which is a synthetic indicator of nutritional status [19,23].…”

“…There is a positive association between sucrose intake and caries experience [22], especially if it occurs between meals or during sleep, when the protective effect of saliva is reduced due to decreased salivary flow. Children with high intake of sucrose, both in quantity and frequency, tend to show higher number of cariogenic bacteria and higher risk of developing caries, especially when they do not receive regular exposure to fluoride [12]. The proposed risk models for early childhood caries showed that the contributing factors are some common variables involved in nutrition habits such as bottle-feeding, prolonged night-time breast-feeding and the consumption of sweet drinks [30].…”