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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, socio-economic 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.

SUBMITTER: Pierce A

PROVIDER: S-EPMC6861386 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Project description:The objective of this investigation was to describe maternal psychosocial, behavioral, and acculturation factors associated with early childhood caries in a sample of urban Latino mother-child dyads. A cross-sectional survey was conducted with 100 mothers whose children (under the age of 6 y) were patients at the Dental Center at Children's Hospital Colorado in Aurora, Colorado. All children participating in the study received an oral examination to measure decayed, missing, filled, surfaces (dmfs). Participating mothers were given the option to sign the consent form and complete the survey in English or Spanish, according to their preferred language. The survey used demographic, behavioral, knowledge, and several psychosocial variables. Bivariate analysis was conducted with dmfs as a dependent variable. The associations between independent variables and dmfs were modeled using negative binomial regression. Mean ± SD dmfs for the entire sample was about 11 ± 16.85. The mothers who spoke Spanish had children with significantly (P = 0.046) higher dmfs scores (15.2) compared to mothers who spoke English (7.56). Preference of Spanish language was significantly associated with self-efficacy (P = 0.0043), oral health knowledge (P = 0.0024), and 3 subscales of the health belief model: perceived severity (P = 0.057), perceived barriers (P = 0.0002), and perceived susceptibility (P = 0.008). Both in the univariate and the multivariate models, oral health behavior and preferential use of Spanish remained significantly associated with higher dmfs scores. Results of this study demonstrate that maternal oral health behaviors and preferred language are significant factors associated with early childhood caries in urban Latino children. Knowledge Transfer Statement: Results of this study indicate that maternal oral health behaviors and the level of acculturation are significantly associated with caries in urban Latino children. Caries prevention efforts in this population could use this information to tailor oral health messaging according to the level of acculturation in mothers.

Project description:BackgroundThe prevalence of early childhood caries (ECC) varies with geographical region and population. The Uygur people, one of 55 officially recognized ethnic minorities in China, have a population of 10,069,346. We performed a preschool-based cross-sectional study of 670 Uygur children from the southern region of Xinjiang, China, to investigate the prevalence and severity of ECC and to identify factors related to the dental health condition of this population.MethodsThe study population of children ranging in age from 3 to 5 years was invited using a three-stage stratified sampling in Kashgar, the westernmost city in China. The "dmft" index was used to assess dental caries. The diagnosis of ECC or severe ECC was based on the oral health diagnostic criteria defined by the American Academy of Pediatric Dentistry. A questionnaire was completed by the children's caregivers. The survey included questions concerning the children's sociodemographic background; feeding and eating habits, particularly frequency of sweet beverage and food consumption; dental hygiene-related behaviors; the general oral health knowledge of caregivers; and the dental healthcare experience of caregivers and their children.ResultsA total of 670 Uygur children underwent complete dental caries examination. Most of the children (74.2%) had ECC, with a mean dmft ± SD of 3.95 ± 3.84. The prevalence of severe ECC was 40.1% (N =269), with a mean dmft of 7.72 ± 3.14. More than 99% of caries were untreated. Statistically significant correlations were found between higher ECC prevalence and increased age and lower socioeconomic background, while greater dental health knowledge of the caregiver and positive oral hygiene behaviors were found to be protective. Our findings confirm the multi-factorial etiology of ECC.ConclusionsThe prevalence of ECC among preschool-aged Uygur children in Kashgar was high, particularly among those from lower socioeconomic backgrounds. Caries prevalence was associated with oral hygiene behaviors of children and the general oral health knowledge of caregivers. These factors could be modified through public health strategies, including effective publicity concerning general dental health and practical health advice.

Project description:Young Indigenous children in North America suffer from a higher degree of severe early childhood caries (S-ECC) than the general population, leading to speculation that the etiology and characteristics of the disease may be distinct in this population. To address this knowledge gap, we conducted the first microbiome analysis of an Indigenous population using modern molecular techniques. We investigated the caries-associated microbiome among Canadian First Nations children with S-ECC. Thirty First Nations children <72 mo of age with S-ECC and 20 caries-free children were recruited in Winnipeg, Canada. Parents or caregivers completed a questionnaire on general and dental health, diet, and demographics. The plaque microbiome was investigated by sequencing the 16S rRNA gene. Sequences were clustered into operational taxonomic units and taxonomy assigned via the Human Oral Microbiome Database, then analyzed at the community level with alpha and beta diversity measures. Compared with those who were caries free, children with S-ECC came from households with lower income; they were more likely to live in First Nations communities and were more likely to be bottle-fed; and they were weaned from the bottle at a later age. The microbial communities of the S-ECC and caries-free groups did not differ in terms of species richness or phylogenetic diversity. Beta diversity analysis showed that the samples significantly clustered into groups based on caries status. Twenty-eight species-level operational taxonomic units were significantly different between the groups, including Veillonella HOT 780 and Porphyromonas HOT 284, which were 4.6- and 9-fold higher, respectively, in the S-ECC group, and Streptococcus gordonii and Streptococcus sanguinis, which were 5- and 2-fold higher, respectively, in the caries-free group. Extremely high levels of Streptococcus mutans were detected in the S-ECC group. Overall, First Nations children with S-ECC have a significantly different plaque microbiome than their caries-free counterparts, with the S-ECC group containing higher levels of known cariogenic organisms.

Project description:OBJECTIVES:Various maternal mental disorders and socioeconomic status [SES] are discussed as risk factors for early childhood caries [ECC]. In our study, we examined a wide range of symptoms of mental disorders with the aim to identify those maternal psychopathological symptom burdens [PSBs] which show relevant associations with ECC. Our second objective was to investigate how SES affects the associations between PSB and ECC. METHODS:In this study, sixty children with ECC (caries group [CG]) and sixty caries-free children [NON-CG] with their mothers were recruited at two sites in Germany. Children aged three or four years were included in the study. Children's dental status [dmf-t] and plaque index were recorded, and mothers answered a multidimensional SES index (including education, profession and income) as well as screening questionnaires capturing dental anxiety, depressive disorders, generalized anxiety, somatic symptom burden, eating disorders, traumatic childhood experiences, nicotine dependency and alcohol dependency. RESULTS:Mothers of the CG reported significantly higher dental anxiety (dCohen = 0.66), childhood trauma (dCohen = 0.53) and nicotine dependency (dCohen = 0.64) than the NON-CG. However, mediator analyses showed that these effects were partly mediated by the SES. Mothers of the CG had a significantly lower SES (dCohen = 0.93); with education as strongest predictor of dental status. The groups did not differ significantly in symptoms of depressiveness, subjective somatic symptom burden, alcohol dependency, eating disorders, and generalized anxiety. CONCLUSIONS:Several PSBs are associated with ECC, however the SES as the strongest influencing factor mediates this association. Difficult socioeconomic conditions might predispose for both, ECC and mental illness. Targeted strategies are needed to facilitate the use of preventive measures and dental health services especially in families of lower status. For this purpose, psychosocial risk constellations must be identified. More integrative, multifactorial oriented research is necessary to gain a bio-psycho-social understanding of ECC.

Project description:BackgroundEarly childhood dental caries (ECC), a serious public health problem lacks information on the association between ECC, risk factors and nutritional status among children in Tanzania. Therefore, this study aimed to determine the prevalence of ECC, risk factors and nutritional status among 3-5-year-old preschool children and to assess its correlation with the form, visible plaque scores in upper anterior teeth, total sugar exposure, anthropometric measures, and socio demographic attributes.MethodsThis cross-sectional study was conducted on 831 children registered in public preschools in Kisarawe District. Assessment of ECC used the WHO (2013) criteria and anthropometric measures used the WHO Child Growth Standards (2006). Structured questionnaires were completed by children's parents through an interview. Collected information on socio-demographic attributes including oral hygiene and sugar exposure to their children was analyzed.ResultsOnly 459 children (55.2%) were recognized as caries-free. Dental caries experience in terms of decayed, missing and filled teeth (dmft) index was 2.51. Children with visible plaque were the majority (56.1%). The dmft score index was negatively and significantly associated with weight-for-age z-score [Coefficient: -0.11 (95% CI: -0.76, -0.11)] and positively significantly associated with visible plaque score index [Coefficient: 0.16 (95% CI: 0.18, 0.52)] and total sugar exposure [Coefficient: 0.19 (95% CI: 0.15, 0.38)] in the adjusted model. The prevalence of underweight was 4.2% [95% CI: (3.0-5.8)] and severe underweight was 0.2% [95% CI: (0.1-0.9)] while prevalence of stunting was 1.6% [95% CI: (0.9-2.7)] and severe stunting was 0.4% [95% CI: (0.1-1.1)].ConclusionThis study demonstrated a significant negative relationship between ECC and children's anthropometric measures indicated by weight-for-age, and positive relationship with sugar exposure and poor oral hygiene indicated by visible plaque on upper anterior teeth. Controlling risk factors will reduce the occurrence of ECC thereby catering for a healthy population of well-nourished children.

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

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