Prevalence of early childhood caries and associated risk factors in preschool children of urban Bangalore, India: A cross-sectional study

ABSTRACT

Objectives: Early childhood caries (ECC) is a devastating form of dental decay with multi-factorial origin. The aim of this cross-sectional study is to investigate the prevalence and related risk factors of ECC in preschool children of urban Bangalore (India)

Methods: A random sample of 1,500 children aged between 8 and 48 months were selected from various parts of urban Bangalore. The status of dental caries was recorded according to the World Health Organization (WHO) criteria. Information regarding oral hygiene practices, feeding habits, socio-economic status, birth weight, and educational status of the mother was obtained through a structured questionnaire given to mothers of preschool children. The data was subjected to statistical analysis using the Statistical package for social sciences (SPSS) version 12

Results: The prevalence of ECC in preschool children was 27.5%, while the mean deft was 0.854. ECC increased significantly with age. Children whose mothers had no schooling and those who belonged to low socioeconomic group showed higher caries prevalence. A significant increase in caries prevalence was found in children accustomed to the practice of on-demand breast feeding and bottle feeding at night. Caries also increased significantly when snacks were consumed between meals. However, increased frequency of tooth-brushing, parental supervision, use of a baby toothbrush, and fluoridated dentifrice significantly decreased caries prevalence

Conclusion: ECC is a serious public health problem in this population and measures to increase awareness should be undertaken. The target candidates for oral health promotion programs should include mothers, general dentists, pediatricians, nurses, primary care health workers, care-takers at day-care centers and gynecologists. (Eur J Dent 2012;6:141-152)

Key words

Early childhood caries; - preschool - feeding habits - oral hygiene - prevalence - socio-economic status

• References

• 1 Davies GN. Early Childhood Caries – a synopsis. Community Dent Oral Epidemiol 1998;26:106-116
• 2 Jose B, King NM. Early Childhood caries lesions in preschool children in Kerala,India. Pediatr Dent 2003;25:594-600
• 3 Ismail AI, Sohn W. A systematic review of clinical diagnostic criteria of Early Childhood Caries. J Public Health Dent 1999;59:171-191
• 4 Huntington NL, Kim IJ, Hughes CV. Caries-risk factors for Hispanic children affected by early childhood caries. Pediatr Dent 2002;24:536-542
• 5 Matee M, van't Hof M, Maselle S, Mikx F, van Palenstein HW. Nursing caries, linear hypoplasia, and nursing and weaning habits in Tanzanian infants. Community Dent Oral Epidemiol 1994;22:289-293
• 6 Kelly M, Bruerd B. The prevalence of baby bottle tooth decay among two native American populations. J Public Health Dent 1987;47:94-97
• 7 American Academy of Pediatric Dentistry Reference Manual 2002 – 03. Policies on Early Childhood Caries; Unique Challenges and Treatment Options. Pediatr Dent 2003;23:24-25
• 8 Ripa LW. Nursing caries: a comprehensive review. Pediatr Dent 1988;10:268-282
• 9 Curson MEJ, Preston MEJ. Risk Groups: Nursing bottle caries/ caries in elderly. Caries Res 2004;38:24-27
• 10 Quinonez R, Santos RG, Wilson S, Cross H. The relationship between child temperament and early childhood caries. Pediatr Dent 2001;23:5-10
• 11 Filho NE, Mayer MPA, Pontes P, Pignatari ACC. Caries prevalence, levels of mutans streptococci, and gingival and plaque indices in 3.0 to 5.0-year-old mouth-breathing children. Caries Res 2004;38:572-575
• 12 Perssini S. Pacifier use and early childhood caries. An evidence-based study of literature. J Can Dent Assoc 2003;69:16-22
• 13 Tinanoff N, O’Sullivan DM. Early Childhood Caries: overview and recent findings. Pediatr Dent 1997;19:12-15
• 14 Wyne AH. Early childhood caries: nomenclature and case definition. Community Dent Oral Epidemiol 1999;27:313-315
• 15 Reisine S, Douglass JM. Psychosocial and behavioral issues in early childhood caries. Community Dent Oral Epidemiol 1998;26:32-44
• 16 Albert RJ, Cantin RY, Cross HG, Castaldi CR. Nursing caries in the Inuit children of the Keewatin. J Can Dent Assoc 1988;54:751-758
• 17 Shaw L, Clark DC, Edger NP. The oral health status of Cree children living in Chisasibi, Quebec. J Can Dent Assoc 1987;53:201-205
• 18 Kagihara LE, Niederhauser VP, Stark M. Assessment, management and prevention of Early Childhood caries. J Am Acad Nurse Pract 2009;21:1-10
• 19 Casamassimo PS, Thikkurissy S, Edelstein B, Maiorini E. Beyond the dmft: The human and Economic cost of Early childhood caries. J Am Dent Assoc 2009;140:650-657
• 20 Acs G, Shulman R, Ng MW, Chussid S. The effect of dental rehabilitation on the body weight of children with early childhood caries. Pediatr Dent. 1999;21:109-113
• 21 Hallett KB, O’Rourke PK. Social and behavioural determinants of early childhood caries. Aust Dent J 2003;48:27-33
• 22 O’Sullivan DM, Tinnanoff N. Social and biological factors contributing to caries of the maxillary anterior teeth. Pediatr Dent 1993;15:41-44
• 23 Peretz B, Kafka I. Baby bottle tooth decay and complications during pregnancy and delivery. Pediatr Dent 1997;19:34-36
• 24 Horowitz HS. Research issues in early childhood caries. Community Dent Oral Epidemiol 1998;26:67-81
• 25 Kalnellis MJ, Damiano PC, Momary ET. Medication costs associated with the hospitalization of young children for restorative treatment under general anesthesia. J Public Health Dent 2000;60:28-32
• 26 Burt BA, Eklund SA. Dentistry, dental practice, and the community. 5th ed. Philadelphia: Saunders 1999:227–228
• 27 Wan AKL, Seow WK, Purdie DM, Bird PS, Walsh LJ, Tudehope DI. Oral colonization of Streptococcus mutans in six–month-old predentate infants. J Dent Res 2001;80:2060-2065
• 28 World Health Organization. Oral Health Surveys – basic methods. Geneva: WHO; 1997
• 29 World Health Organization, Guidelines for mothers of low birth weight children, 2004
• 30 Johnson NW. Dental Caries: Markers of high and low risk groups and individuals. Cambridge University Press, Cambridge, 1991
• 31 Virjee K, Aradhya SMR. Caries pattern in urban and non-urban children 4--5½ year old. J Indian Dent Assoc 1987;59:113-116
• 32 Silver DH. A comparison of 3-year-olds' caries experience in 1973, 1981 and 1989 in a Hertfordshire town, related to family behaviour and social class. Br Dent J 1992;172:191-197
• 33 Wendt LK, Hallonsten AL, Koch G. Dental caries in one-and two-year-old children living in Sweden. Part I–A longitudinal study. Swed Dent J 1991;15:1-6
• 34 Harrison RL, Davis DW. Caries experience of Native children of British Columbia, Canada, 1980–1988. Community Dent Oral Epidemiol 1993;21:102-107
• 35 Damle SG. Epidemiology of Dental Caries in India. In: Pediatric Dentistry. Arya Publishing House, New Delhi 2002;75-96
• 36 Ibrahim S, Nishimura M, Matsumura S, Rodis OMM, Nishida A, Yamanaka K, Shimono T. A longitudinal study of early childhood caries risk, dental caries and lifestyle. Pediatric Dent J 2009;19:174-180
• 37 Livny A, Assali R, Sgan-Cohen HD. Early child hood caries among a Bedouin community residing in eastern outskirts of Jerusalem. BMC Public Health 2007;7:16
• 38 Seow WK. Biological mechanisms of early childhood caries. Community Dent Oral Epidemiol 1998;26:8–27
• 39 Shulman JD. Is there an association between low birth weight and caries in the primary dentition? Caries Res 2005;39:161-167
• 40 Lai PY, Seow WK, Tudehope DI, Rogers Y. Enamel hypoplasia and dental caries in very-low birth weight children: a casecontrolled, longitudinal study. Pediatr Dent 1997;19:42-49
• 41 Fearne JM, Bryan EM, Brook AH, Williams DM. Enamel defects in the primary dentition of children born weighing less than 2000gms. Br Dent J 1990;168:433-437
• 42 Rodrigues CS, Sheiham A. The relationships between dietary guidelines, sugar intake and caries in primary teeth in low income Brazilian 3-year-olds: a longitudinal study. Int J Paediatr Dent 2000;10:47-55
• 43 Chen M. Oral health of disadvantaged populations. In: Cohen L, Gift H, eds. Disease prevention and Oral Health promotion. Copenhagen: Munksgaard, 1995
• 44 Jin B, Ma D, Moon H, Paik D, Hahn S, Horowitz AM. Early Childhood Caries: Prevalence and risk factors in Seoul, Korea. J Pub Health Dent 2003;63:183-188
• 45 Schroth RJ, Moore P, Brothwell DJ . Prevalence of early child hood caries in four Mannitoba communities. J Can Dent Assoc 2005:71;567
• 46 Petti S, Cairella G, Tarsitani G. Rampant Early Childhood Dental Decay: an example from Italy. J Pub Health Dent 2000;60:3
• 47 Dini EL, Holt RD, Bedi J. Caries and its association with infant feeding and oral health related behaviours in 3-4 years old Brazilian children. Community Dent Oral Epidemiol 2000;28:241-248
• 48 Iida H, Auinger P, Billings RJ, Weitzman M. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics 2007;120:944-952
• 49 Valaitis R, Hesch R, Passarelli C, Sheehan D, Sinton J. A systematic review of the relationship between breastfeeding and early childhood caries. Can J Public Health 2000;91:411-417
• 50 Weinstein P, William F.S, Fraser-Lee N, Shimono T, Tsubouchi J. Epidemiologic study of 19-month–old Edmonton, Alberta children. Caries rates and risk factors. ASDC J Dent Child 1998;52:60
• 51 Oulis BJ, Verdouses ED, Vadiakas G, Lygidakis AJ. Feeding practices of Greek children with and without nursing caries. Pediatr Dent 1999;21:409-416
• 52 Febres C, Echeverri EA, Keene HJ. Parental awareness, habits, and social factors and their relationship to baby bottle tooth decay. Pediatr Dent 1997;19:22-27
• 53 Schwartz SS, Glenn Rosivack R, Michelotti P. A child’s sleeping habit as a cause of nursing caries. ASDC J Dent Child 1993;53:22-25
• 54 Nunn ME, Braunstein NS, Krall Kaye EA, Dietrich T, Garcia RI, Henshaw MM. Healthy Eating Index is a predictor of Early Childhood Caries. J Dent Res 2009;88:361-366
• 55 Dye BA, Shenkin JD, Ogden CL, Marshall TA, Levy SM, Kanellis MJ. The relationship between healthful eating practices and dental caries in children aged 2-5 years in the United States, 1988-1994. J Am Dent Assoc 2004;135:55-66
• 56 Slavkin HC. Streptococcus mutans, early childhood caries and new opportunities. J Am Dent Assoc 1999;130:1787-1792
• 57 Johansson I, Saeiinstrom AK, Rajan BP, Parameswaran A. Salivary flow and dental caries in Indian children suffering from chronic malnutrition. Caries Res 1992;26:38-43. 58. Marques APF, Messer LB. Nutrient intake and dental caries in the primary dentition. Pediatr Dent 1992;14:314-321
• 58 Teotia SPS, Teotia M. Dental caries: a disorder of high fluoride and low dietary calcium interactions. Fluoride 1994;27:59-66
• 59 Peressini S. Pacifier use and early childhood caries: an evidence-based study of the literature. J Can Dent Assoc 2003;69:16-19
• 60 Schroder U, Granath L. Dietary habits and oral hygiene as predictors of caries in 3 -year-old children. Community Dent Oral Epidemiol 1983;11:308-311
• 61 Tsai Ai, Johnsen DC, Lin YH, Hsu KH. A study of risk factors associated with nursing caries in Taiwanese children aged 24-48 months. Int J Pediatr Dent 2001;11:147-149
• 62 Loe H. Oral hygiene in prevention of dental caries and periodontal diseases. Int Dent J 2000;50:129-139
• 63 Dilley GJ, Dilley DH, Machen JB. Prolonged nursing habit: a profile of patients and their families. ASDC J Dent Child 1980;March:26-31
• 64 King NM, Isabel IM, Wu Tsai JSJ. Caries prevalence and distribution and oral health habits of zero-to four old children in Macau, China. ASDC J Dent Child 2003;70:3-5
• 65 Vanobbergen J, Martens L, Lesaffre E, Bogaerts K, Declerck D. Assessing risk indicators for dental caries in the primary dentition. Community Dent Oral Epidemiol 2001;29:424-434
• 66 Davies GM, Worthington HV, Ellwood RP. A randomised controlled trial of the effectiveness of providing free fluoride toothpaste from the age of 12 months on reducing caries in 5-6 year old children. Community Dent Health 2002;19:131-136
• 67 Tavener JA, Davies GM, Davies RM, Ellwood RP. The prevalence and severity of fluorosis in children who received toothpastecontaining either 440 or 1,450 ppm F from the age of 12 months in deprived and less deprived communities. Caries Res 2006;40:66-72
• 68 Yasin-Hamekar S. Nursing Caries – A Review. Clinical Preventive Dentistry 1988;10:3-7
• 69 Milgrom PM, Huebner CE, Ly KA. Fluoridated toothpaste and the prevention of early childhood caries: a failure to meet the needs of our young. J Am Dent Assoc 2009;140:628-630
• 70 Weinstein P, Harrison R, Benton T. Motivating mothers to prevent caries: Confirming the beneficial effect of counseling. J Am Dent Assoc 2006;137:789-793
• 71 Mani SA, Aziz AA, John J, Ismail NM. Knowledge, attitude and practice of oral health promoting factors among caretakers of children attending day-care centers in Kubang Kerian, Malaysia: A Preliminary study. J Indian Soc Pedod Prevent Dent 2010;28:78-83