The Burden of Early Childhood Caries in Canadian Children and Associated Risk Factors

Abstract

Introduction: Early childhood caries (ECC) is any caries in the primary dentition occurring in children under the age of six. ECC is common in many population groups in Canada. Objective: The purpose of this review was to describe the burden of ECC in Canada, the prevalence and associated risk factors for ECC, and its impact on childhood health based on the existing published literature. Methods: A review was conducted to assess published Canadian studies on ECC identified through searches of electronic databases. Databased searched included PubMed, Medline, Cinahl, and the library catalog of the University of Manitoba. Known publications on ECC that were not identified by the electronic search were also considered. Only the studies that reported the prevalence of ECC or caries in preschool aged children were considered. In-depth assessments were restricted to those studies that employed logistic regression analysis to investigate relationship between ECC and risk factors or nutritional status and quality of life. Results: A total of 36 studies were identified that related to ECC in Canadian children. Overall, 27 related to prevalence and 12 reported on risk factors, four related to the association between severe ECC and nutritional health and well-being, while only one related to the oral microbiome composition. Published studies reveal that the prevalence of ECC can be as high as 98% in some parts of Canada. Commonly identified risk factors include age, sex, socioeconomic status, parental beliefs, family characteristics, debris/plaque, enamel hypoplasia, and behavioral (oral health or feeding behaviors) tendencies. Conclusions: Current literature reveals that many Canadian children are affected by ECC. The development of ECC appears to be strongly associated with social determinants of health including low household income and the level of parental education or employment status. Associations were also observed between ECC and the child's age at first dental visit and parental beliefs about child's oral health. Children with enamel hypoplasia are also at significantly greater odds for experiencing caries. Future research should include assessments of developmental defects of enamel to better understand the association between enamel hypoplasia and ECC.

Caries prevalence among 18 years old, an epidemiological survey in Israel

“…Additionally, Levy et al had showed a statistically significant association between low intellectual capabilities and higher dental treatment needs among IDF soldiers, and implied for an association with parental education, similarly to other published studies and to the current study results [14,16,17]. Parental education level had been previously found to be associated with oral health outcomes, and specifically, with caries prevalence in many studies [18][19][20]. The odds of having any caries experience (DMFT > 0) were found to be significantly greater in those with low parental educational or occupational background [21], thus, the results of the current study support former evidence.…”

“…Mean DMFT was 4.2-5.98 (with standard deviation of 3.9-4.8) for a wide range inhomogeneous age group of 18-29-year-old participants. In a very local survey, mean DMFT among [18][19] Israeli military recruits was 6.09 ± 5.29 with 17.2% caries free rate [3]. Since these publications, no representative national epidemiological survey regarding caries prevalence in Israel among 18 years old has been published yet, nor did any additional study of caries prevalence among this age group, although this age group is defined by the World Health Organization (WHO) as an index group.…”

Systematic review suggests a relationship between moderate to late preterm birth and early childhood caries

“…There are several possible direct and indirect explanations for a relationship between preterm birth and early childhood caries. Preterm birth is strongly associated with enamel defects, 26,27 and such hypomineralizations are predisposing for caries development 28 . Preterm birth and immature immunity are also linked to an early oral colonisation of Streptococcus mutans and other acid‐tolerating strains with cariogenic properties 29,30 .…”

“…Preterm birth is strongly associated with enamel defects, 26,27 and such hypomineralizations are predisposing for caries development. 28 Preterm birth and immature immunity are also linked to an early oral colonisation of Streptococcus mutans and other acid-tolerating strains with cariogenic properties. 29,30 Early-in-life treatment with antibiotics can affect the composition of the developing microbiota with a disturbed abundance of commensal genera.…”

Associated factors to caries experience of children undergoing general anaesthesia and treatment needs characteristics over a 10 year period

“…Overall, within the present study the influencing factors were considered within a cohort of children with increased dental treatment demand who can be considered as a high-risk group. Socioeconomic factors at the community and family level, such as ethnicity are well-recognized determinants of oral health and identified as risk factors in several studies reviewed [ 32 – 34 ]. Parental education and employment status are also known to influence caries development [ 35 ].…”