The relationship between sweetness preference and dental caries in mother/child pairs from Maringá-Pr, Brazil

Visual attention to food cues and dental caries-Are they associated?

BACKGROUND

The role of diet has a key role in dental caries. Attention to food cues can be an indicator for food choices.

AIM

This study investigates children's visual attention to images with healthy and unhealthy food cues and correlates it with that of their parents and with their dental caries status using eye-tracking technology.

DESIGN

A total of 30 children with and without dental caries and their 30 parents were calibrated to the eye-tracking device (Tobii Nano Pro) to ensure standardisation. Participants viewed matching images of healthy and unhealthy food cues, whereas an eye-tracking device tracked their eye movements. Children had a dental examination and were classified as children with dental caries (n = 15) and their parents (n = 15), and children without dental caries (n = 15) and their parents (n = 15).

RESULTS

In children with dental caries, visual attention duration was longer to healthy foods than to unhealthy foods. Likewise, parents of children with dental caries spent longer time looking at healthy foods than unhealthy foods.

CONCLUSION

Our preliminary findings indicate a significant association between children's visual attention to healthy and unhealthy food cues and their dental caries status. This underscores the need for further investigation into the correlation between children's and their parents' visual attention to food, particularly in the context of children with dental caries. Such exploration holds promise for informing targeted interventions in food choice education.

Is there an association between family structure and the oral health of socially vulnerable children?

The aim of this study was to evaluate the impact of the family structure on the oral health status of socially vulnerable children in the Federal District of Brazil. A total of 471 schoolchildren with a mean age of 8.12 (± 0.90) years were examined for dental caries using the CAST instrument. Dental biofilm and oral pain were also registered. Children's guardians were interviewed about socioeconomic variables and oral hygiene habits. The association between oral pain in the previous 30 days and the child's maximum CAST score were analyzed using the Pearson chi-squared test. Multivariate Poisson regression models with robust variance were used to determine the predictors of presence of biofilm, oral pain, and caries severity. The prevalence of cavitated dentin lesions was 43.74% and, both dentin and enamel lesions, 52.87%; for both dentitions. An association between pain and severe nontreated carious lesions was found (p < 0.0001). The family structure was not related to the presence of dental caries, but a significant association was found between low maternal education and severe carious lesions (PR = 1.41; p = 0.0077) and oral pain (PR = 1.47; p = 0. 0335); not owning a residence and frequency of toothbrushing were also associated with the substantial presence of biofilm (PR = 1.13, p = 0.0493 and PR = 1.18, p = 0.0470; respectively). For socially vulnerable children, variables related to the socioeconomic status of the families were more relevant than the family structure in relation to their oral health status.

Evaluation of Factors Influencing the Oral Health-related Quality of Life among Children with Early Childhood Caries: A Cross-sectional Study

AIM

To evaluate the factors that affect the oral health-related quality of life (OHRQoL) among children with early childhood caries (ECC).

MATERIALS AND METHODS

A total of 340 children aged between 3 and 6 who were diagnosed with ECC were enrolled in the study. Parents accompanying the children completed a questionnaire on the sociodemographic status and filled out the Early Childhood Oral Health Impact Scale (ECOHIS) for the evaluation of OHRQoL. Data were recorded, tabulated, and statistically analyzed.

RESULTS

The study population consisted of 189 (55.6%) boys and 151 girls (44.4%). A total of 96.4% had cavitated lesions; 31.2% of the children had pain at the time of evaluation. A significant association was seen between the Decayed Missing Filled Teeth (DMFT) score of the child (p < 0.001). Pain at the time of evaluation and DMFT status had a significant association with the ECOHIS (p < 0.001).

CONCLUSION

Early childhood caries was found to impact the OHRQoL. Pain, visible dental plaque, family income, and parental education were found to be determinants that affect the OHRQoL.

CLINICAL SIGNIFICANCE

Early childhood caries significantly reduces the OHRQoL of children and their families. Pain, visible dental plaque, family income, and parental education were found to influence the OHRQoL. Teaching parents the importance of oral health and preventive treatment will help prevent the occurrence of ECC.

Association of Mothers’ Genetic Taste Perception to Eating Habits and Its Influence on Early Childhood Caries in Preschool Children: An Analytical Study

Aims

To examine (1) the association of mothers’ 6-n-propylthiouracil (PROP) sensitivity with snacking habits and caries experience of both the mother and their 2-5-year-old preschool children and (2) the association of feeding habits with caries prevalence in 2-5-year-old children.

Materials and methods

In this analytical cross-sectional study, 2-5-year-old preschool children were clinically examined by a single calibrated examiner and divided into two groups of 80 children with early childhood caries (ECC) and 80 without. Mothers of the children were clinically examined and a second blinded investigator determined their genetic taste type using PROP. Data regarding feeding practices of the child and snacking habits of the mother and child were obtained using questionnaires. The data obtained were statistically analyzed.

Results

Cariogenic snack consumption was more among nontaster mothers and their children (p value < 0.001). More number of children of the nontaster mothers in the ECC group were bottle-fed with sweetened beverages (n = 24) and received sweet snacks as rewards (n = 32). Caries prevalence of 73%, 20%, and 7% was seen in children of nontaster, medium taster, and supertaster mothers, respectively (p value < 0.05). Significant association was found between mother's caries activity, past bottle-feeding, receiving sweet snacks as reward and their child's caries experience.

Conclusion

Mothers’ PROP sensitivity was significantly associated with snacking habits and caries experience of their children. Mothers’ PROP type could be an important factor that may determine and explain the dental caries experience in their 2-5-year-old preschool children.

Clinical significance

Early identification of nontaster mothers may prove beneficial in guiding them and consecutively their children toward healthy dietary habits, leading to lesser incidence of caries and their better overall wellbeing.

How to cite this article

Nellamakkada K, Patil SS, Kakanur M, et al. Association of Mothers’ Genetic Taste Perception to Eating Habits and Its Influence on Early Childhood Caries in Preschool Children: An Analytical Study. Int J Clin Pediatr Dent 2022;15(S-2):S135-S139.

Keyword Trends for Mother-Child Oral Health in Korea Based on Social Media Big Data from Naver

Objectives

The present study examined trends in search keywords related to the oral health of infants and pregnant women using “social media cafés” on the Korean portal site, Naver.

Methods

We obtained data from January 2015 to December 2017, collected by searching for common terms related to oral health, such as “dental caries”, “oral health”, “scaling”, “tooth brushing”, and “oral examination”. Search results for these terms were organized by frequency and visualized by increase in the font size with increasing frequency.

Results

The ranking of keywords on Naver cafés for pregnant women and women with infants was as follows (in descending order): “oral examination”, “tooth filling”, and “tooth brushing”. The “oral health” network was linked to “dental caries”, “oral health education”, and “tooth brushing”. In addition, the analysis of trends of keyword frequencies according to time periods showed that “dental caries” and “oral examination” were of highest interest to the café users.

Conclusions

We found a high interest in keywords related to preventive measures for the oral health of infants and children, but there was a lack of awareness regarding the oral health of pregnant women. These findings suggest that prevention in infants and pregnant women is necessary, and that public awareness regarding education about oral healthcare needs to be raised.

Risk Factors for Early Childhood Caries in Toddlers: An Institution-based Study

Background Tooth decay experience among toddlers and preschoolers is of epidemic proportions worldwide and dental caries still remains an important childhood disease affecting a considerable part of this population. Though the prevalence of Early Childhood Caries (ECC) is associated with several risk factors such as feeding and oral hygiene practices, Streptococcus mutans levels, socioeconomic status (SES), etc., it is suggested that these factors should be studied adequately to aid in the early prevention and management of ECC. Objective The objectives of the study were to: a) evaluate the distribution of ECC, b) study the role of SES in the occurrence of ECC, c) record the variations in feeding and dietary practices along with oral hygiene practices and d) Correlate the sweet score with ECC. Materials and Methods This cross-sectional observational study was conducted over a period of 6 months among 100 toddlers (12-36 months) attending the Pediatric outpatient department of a single medical institution in Chennai, India. The study consisted of an intra-oral examination followed by a face to face interview of the mothers of the children using a validated structured oral health questionnaire. Results SES and ECC were negatively correlated with statistically significant association. Majority of the subjects did not follow any oral hygiene practices before teeth erupted; few subjects used tooth brush and tooth paste after teeth erupted and followed oral hygiene practices once a day. Statistically significant positive correlation with ICDAS scores was noted in relation to the sweet score and the frequency of intake of sweet foods, candy, etc. Cavitated lesions were more common than non-cavitated lesions and majority of the posterior teeth had ICDAS score 4. Conclusion Healthcare providers for children must be well informed on the etiology and risk factors of ECC and guide children for their first dental visit within one year of age.

Structural equation model for parental influence on children's oral health practice and status

BACKGROUND

Children's oral health status (OHS) can be influenced by their oral health practices and many parental factors. This study aimed to investigate pathways from parental factors to oral health practices and status of children in Hong Kong.

METHODS

Using a combination of random and purposive sampling of Hong Kong households, 432 families with children aged 5-7 participated in a cross-sectional survey. Data on socioeconomic status, smoking, and oral health knowledge, attitudes, and practices, as well as OHS of parents and parents' knowledge of and attitudes towards their children's oral health, were collected through a questionnaire. Tooth status, periodontal status, and oral hygiene data were also collected through clinical examination. Correlations of oral health behaviors (OHB) and OHS within families were assessed by confirmatory factor analysis. A conceptual model of the parental influences on children's oral health practices and status was tested by a structural equation model (SEM). Chi-square test, chi-square/df, nonnormed fit index, comparative fit index, and root mean square error of approximation were used to assess the model fit.

RESULTS

Fit indexes for confirmatory factor analysis and SEM showed good fit. Positive correlations of OHB and OHS were found within the families that ranged from 0.74 to 0.98 for OHB and 0.30 to 0.43 for OHS. SEM showed better socioeconomic status of mothers led to better oral health knowledge and attitude (γ = 0.75, P < 0.001) and also towards their children's better oral health knowledge and attitude (γ = 0.44, P < 0.01). Parents' attitudes towards their children's oral health (β = 0.40, P = 0.04) and mothers' OHB (β = 0.60, P < 0.001) were positively associated with OHB of children. Positive OHB of children (β = - 0.48, P < 0.01) in turn led to better oral health.

CONCLUSIONS

Correlations of OHB and OHS between mothers and children were stronger than those of fathers. Children's OHS was directly affected by their mothers' OHB, which in turn were affected by parents' oral health knowledge, attitudes, and practices.

Pediatric Adapted Liking Survey: A Novel, Feasible and Reliable Dietary Screening in Clinical Practice

PURPOSE

Rapid yet useful methods are needed to screen for dietary behaviors in clinical settings. We tested the feasibility and reliability of a pediatric adapted liking survey (PALS) to screen for dietary behaviors and suggest tailored caries and obesity prevention messages.

METHODS

In an observational study, children admitted to a pediatric emergency department (PED) for nonurgent care were approached to complete the PALS (33 foods, 4 nonfoods including brushing teeth). Measured height/weight were used for body mass index (BMI) percentile determination. Feasibility was assessed by response rate and PALS completion time. Reliability was assessed by internal consistency of food groups and test-retest reliability for PED-home reported PALS.

RESULTS

PALS was completed by 144 children (96% of approached) - 54% male (average age = 11 ± 3 years) with diversity in family income (43% publicly insured), race/ethnicity (15% African American, 33% Hispanic, 44% Caucasian) and adiposity (3% underweight, 50% normal, 31% overweight, 17% obese, 8% extremely obese). The average completion time was 3: 52 min, and conceptual food groups had reasonable internal reliability. From 57% (n = 82) with PED-home completion, PALS had a good/excellent test-retest reliability. Relative preferences for sweets versus brushing teeth identified unique groups of children for tailored prevention messages (high sweet/brushing preference, sweets > brushing, brushing > sweets). Females with higher adiposity reported significantly greater preference for sweet/high-fat foods, independently of demographic variables; the relationship was nonsignificant in males and with the other food groups.

CONCLUSION

The PALS appears to be a fast, feasible and reliable dietary screener in a clinical setting to assist in forming tailored diet-related messages for dental caries and obesity prevention.

Prioritizing the Risk Factors of Severe Early Childhood Caries

Severe early childhood caries remains the most common chronic disease affecting children. The multifactorial etiology of caries has established a controversy about which risk factors were more significant to its development. Therefore, our study aimed through meticulous statistical analysis to arrange the "well agreed upon" common risk factors in order of significance, to aid the clinician in tailoring an adequate preventive program. The study prioritized or reshuffled the risk factors contributing to severe early childhood caries and placed them in the order of their significance as follows: snacking of sugary food several times a day, increased number of siblings to three or more, night feeding, child self-employed brushing, mother's caries experience, two siblings, on demand feeding, once/day sugary food, sharing utensils, one sibling, male gender, father's education, late first dental visit, brushing time, mother's education, no dental visit, decreased brushing frequency, and no night brushing.

Using association rule mining to identify risk factors for early childhood caries

BACKGROUND AND OBJECTIVE

Early childhood caries (ECC) is a potentially severe disease affecting children all over the world. The available findings are mostly based on a logistic regression model, but data mining, in particular association rule mining, could be used to extract more information from the same data set.

METHODS

ECC data was collected in a cross-sectional analytical study of the 10% sample of preschool children in the South Bačka area (Vojvodina, Serbia). Association rules were extracted from the data by association rule mining. Risk factors were extracted from the highly ranked association rules.

RESULTS

Discovered dominant risk factors include male gender, frequent breastfeeding (with other risk factors), high birth order, language, and low body weight at birth. Low health awareness of parents was significantly associated to ECC only in male children.

CONCLUSIONS

The discovered risk factors are mostly confirmed by the literature, which corroborates the value of the methods.

Factors Associated with Oral Health Status in American Indian Children

The literature reports psychosocial, environmental, and cultural factors related to Early Childhood Caries (ECC), but few studies have included American Indian/Alaska Native (AI/AN) populations. AI/AN children have the highest prevalence of ECC among any population group in the United States. This study examined socio-demographic characteristics of children and their parents/caregivers and psychosocial characteristics of parents/caregivers as risk factors for baseline oral health status of preschool children in the Navajo Nation, as part of a 3-year cluster randomized clinical trial to evaluate the effectiveness of trained community workers providing a fluoride varnish and oral health promotion intervention to. The study recruited 1,015 children at 52 Head Start Centers. Baseline ECC data were collected by calibrated dental hygienists for 981 of the children ages of 3-5 years, and a Basic Research Factors Questionnaire (BRFQ) was completed by their parents/caregivers. Bivariable analysis revealed that dmfs was higher in older children; in males; in children with male parents/caregivers; and when the parent/caregiver had less education and income, worse oral health behavior in caring for their children's teeth, and higher scores for external powerful others and external chance locus of control, greater perceived susceptibility and barriers, and lower scores for community risky behavior. In a multiple linear regression model, the variables that remained statistically significant were child's age and gender, and oral health behavior score of the parent/caregiver. Intervening to improve parent/caregiver oral health behavior in caring for the teeth of children potentially could in AI/AN children.

The impact of gender on caries prevalence and risk assessment

Dental caries remains a common disease worldwide. There is evidence indicating that many caries risk factors provide a gender bias, placing women at a higher caries risk. Generally, dental caries disproportionally affects the poor and racial or ethnic minorities worldwide, with women suffering more from the disease. Differences in access to care as reflected by untreated caries rates also reflect gender disparities. There is a lack of evidence in regard to gender differences and dental caries. Therefore, there is an urgent need to develop the evidence necessary to meet the oral health needs of both women and men worldwide.

Environmental, maternal, and child factors which contribute to early childhood caries: a unifying conceptual model

OBJECTIVES

Although the general pathways connecting the external social environment and child risk factors of early childhood caries (ECC) have been previously identified, the maternal and other links to ECC are not well understood. The aim of this paper is to propose a unifying conceptual model that ties together the broad social environmental, maternal, and child factors that are commonly associated with ECC.

METHODS

The aetiological factors of ECC are first reviewed individually to demonstrate their connections with ECC risk followed by presentation of the unifying conceptual model.

RESULTS

In severe ECC cases, there is usually a background of social disadvantage associated with low socioeconomic status, ethnicity or immigrant status, and low maternal educational level. These factors are commonly associated with economic and familial stresses which may in turn result in maternal psychological distress. The distress may be compounded by difficult temperaments of the children and can lead to dysfunctional parenting behaviours that place a child at risk for ECC.

CONCLUSIONS

The proposed conceptual model provides a framework that connects the social, psychological, and behavioural mediating factors involved in ECC. It demonstrates that the causative pathways involved are best explored using a combination of quantitative and qualitative research.

Sugar consumption and preference among Mexican, Chinese, and Nigerian immigrants to Texas

This pilot study investigated the relationship between sugar consumption/ preference and the length of residence in the U.S. among certain immigrant groups. The study sample consisted of 213 volunteers from community organizations and church groups, of Nigerian (45%), Mexican (31%), and Chinese (24%) descent. Data were collected on demographics, sugar consumption/preference (24-hour dietary recall), and oral health status. The age of respondents varied from 18 to 93 years with a mean age of 37.0 ± 11.7 years. The mean length of residence was 9.2 ± 7.2 years, and the mean sugar consumption was 122.4 ± 114.6 g/day. Immigrants from Mexico and Nigeria reported consuming more servings of sweets per day than the Chinese (p= .006); Mexican immigrants had the highest level of sugar preference (p= .001). No significant differences were observed between the length of residence and either sugar consumption or sugar preference. Greater availability of sugar and sweet snacks does not always result in increased sugar consumption or sugar preference.

Association between caregiver behaviours to prevent vertical transmission and dental caries in their 3-year-old children

BACKGROUND

It has been suggested that oral organisms in children are mainly those transmitted from their mothers. That may account for the relationship between caries levels in children and their parents. However, few studies have investigated the effect of trying to prevent vertical transmission of oral organisms on dental caries levels in children, and the findings in the studies are controversial. The aim of this study was to investigate the association between measures to prevent vertical transmission of oral organisms and the caries experience in 3-year-old children.

METHODS

Data were collected from dental examinations for 3-year-old children and a self-administered questionnaire for their caregivers. Absence of maternal sharing of utensils and mouth-to-mouth feeding between caregivers and children was used as the variable about behaviour to prevent vertical transmission of oral organisms. Sex, age in months, dietary behaviour, oral health behaviour and sociodemographic factors were used as covariates.

RESULTS AND CONCLUSION

Data for 3,035 children (73.5% of the subjects) were analysed. Caregivers who practised vertical transmission prevention tended to have better oral health behaviours. Multivariate logistic regression analysis did not show any significant association between behaviour to prevent vertical transmission and caries experience (OR = 1.10, 95% CI = 0.86-1.41). This study suggests that caregiver behaviour to prevent vertical transmission was not effective in reducing levels of childhood caries.

Xylitol pediatric topical oral syrup to prevent dental caries: a double-blind randomized clinical trial of efficacy

OBJECTIVES

To evaluate the effectiveness of a xylitol pediatric topical oral syrup to reduce the incidence of dental caries among very young children and to evaluate the effect of xylitol in reducing acute otitis media in a subsequent study.

DESIGN

Double-blind randomized controlled trial.

SETTING

Communities in the Republic of the Marshall Islands.

PARTICIPANTS

One hundred eight children aged 9 to 15 months were screened, and 100 were enrolled. Intervention Children were randomized to receive xylitol topical oral syrup (administered by their parents) twice a day (2 xylitol [4.00-g] doses and 1 sorbitol dose) (Xyl-2 x group) or thrice per day (3 xylitol [2.67-g] doses) (Xyl-3x group) vs a control syrup (1 xylitol [2.67-g] dose and 2 sorbitol doses) (control group).

MAIN OUTCOME MEASURES

The primary outcome end point of the study was the number of decayed primary teeth. A secondary outcome end point was the incidence of acute otitis media for reporting in a subsequent report.

RESULTS

Ninety-four children (mean [SD] age, 15.0 [2.7] months at randomization) with at least 1 follow-up examination were included in the intent-to-treat analysis. The mean (SD) follow-up period was 10.5 (2.2) months. Fifteen of 29 of the children in the control group (51.7%) had tooth decay compared with 13 of 32 children in the Xyl-3x group (40.6%) and eight of 33 children in the Xyl-2x group (24.2%). The mean (SD) numbers of decayed teeth were 1.9 (2.4) in the control group, 1.0 (1.4) in the Xyl-3x group, and 0.6 (1.1) in the Xyl-2x group. Compared with the control group, there were significantly fewer decayed teeth in the Xyl-2x group (relative risk, 0.30; 95% confidence interval, 0.13-0.66; P = .003) and in the Xyl-3x group (0.50; 0.26-0.96; P = .04). No statistical difference was noted between the 2 xylitol treatment groups (P = .22).

CONCLUSION

Xylitol oral syrup administered topically 2 or 3 times daily at a total daily dose of 8 g was effective in preventing early childhood caries.

Salutogenic factors that may enhance lifelong oral health in an elderly Japanese population

OBJECTIVES

The objective of this study was to assess which factors affected the maintenance of more than 20 teeth in Japanese patients aged 80 years and older, using a life-course perspective.

SUBJECTS AND METHODS

The oral examination was carried out by dentists. The questionnaire asked about family background, background during various stages of growing up, tooth brushing, snacking, job history, health examination, war experience, number of children, oral health condition and dietary preferences. Some of the questions asked about conditions when they were a primary school student, 20 years old, 40 years old and 60 years old. Multivariable logistic-regression analysis was used to adjust for sex at significant life stages.

RESULTS

The group with mothers who did not prefer sweet food had an approximately four times greater chance of having >or=20 teeth compared with the group with mothers who preferred sweet food. Those participants who did not prefer sweet food themselves were approximately three to five times more likely to be in the >or=20 tooth group compared with those who preferred sweet food at all stages of their life course. Non-smokers and those who quit smoking were three times more likely to be in the >or=20 tooth group than those who smoked throughout the years from 20 to 60 years of age.

CONCLUSIONS

Factors associated with the maintenance of a sufficient number of functioning teeth were: not having a mother with a preference for sweet food, not having a preference for sweet food themselves and not smoking over a long period.

Heritability estimates for dental caries and sucrose sweetness preference

OBJECTIVE

The aim of this study was to determine heritability estimates for dental caries traits and sucrose sweetness preference.

DESIGN

Participants included 115 pairs of twins 4-7-years-old. Caries exams followed NIDCR criteria where the severity of the lesion was also determined. Twins ranked their preference for five concentrations of sucrose/grape juice solutions (0.15-1.17M) with a Face Scale. Variables submitted to analysis: (1) surface-based caries prevalence rate (SBCPR); (2) lesion severity index (LSI); (3) sucrose sweetness preference score (SSPS). Heritability analyses were performed with the SOLAR software package.

RESULTS

Heritability estimates adjusted for age and gender were: SBCPR-h(2)=64.6 (p<.00001), LSI-h(2)=61.7 (p<.00001) and SSPS-h(2)=55.2 (p<.00001). Treating SPSS as a covariate in the SBCPR and LSI models did not alter heritability estimates.

CONCLUSIONS

These results suggest that variation in dental caries traits and sucrose sweetness preference have a significant genetic contribution that is mediated independently.

Diverse tastes: Genetics of sweet and bitter perception

Humans will eat almost anything, from caribou livers to rutabagas, but there are some types of foods, and their associated taste qualities, that are preferred by large groups of people regardless of culture or experience. When many choices are available, humans chose foods that taste good, that is, create pleasing sensations in the mouth. The concept of good taste for most people encompasses both flavor and texture of food, and these sensations merge with taste proper to form the concept of goodness. Although we acknowledge the universality of the goodness (sweet) or badness (bitter) of basic taste qualities, we also find that people differ, sometimes extremely so, in their ability to perceive and enjoy these qualities and, by extension, food and drink. The reasons for these differences among people are not clear but are probably due to a combination of experience beginning at an early age, perhaps in utero; learning, for example, as with conditioned taste aversions; sex and maturity; and perceptual differences that arise from genetic variation. In this review, we focus on individual variations that arise from genetic differences and review two domains of science: recent developments in the molecular biology of taste transduction, with a focus on the genes involved and second, studies that examine biological relatives to determine the heritability of taste perception. Because the receptors for sweet, savory (umami), and bitter have recently been discovered, we summarize what is known about their function by reviewing the effect of naturally occurring and man-made alleles of these receptors, their shape and function based on receptor modeling techniques, and how they differ across animal species that vary in their ability to taste certain qualities. We discuss this literature in the context of how taste genes may differ among people and give rise to individuated taste experience, and what is currently known about the genetic effects on taste perception in humans.

Pattern and severity of early childhood caries

OBJECTIVES

The aim of this study was to investigate the association between selected social and behavioural variables and the pattern and severity of early childhood caries (ECC) within a community child population.

METHODS

A cross-sectional sample of 2515 children aged 4-5 years were examined in a preschool setting using decayed, missing, filled teeth/surface (dmft/dmfs) indices and a self-administered questionnaire was used to obtain information regarding social, demographic, birth, infant feeding, oral and general health attitudes. Children with caries (847) were divided into anterior or posterior caries pattern groups and severe (dmfs score > or =6) or non-severe (dmfs score <6) caries groups. The data were analysed using a chi-square test and modelled using a logistic regression procedure.

RESULTS

Significant variables associated with anterior ECC pattern were ethnicity other than Caucasian (OR = 2.1, 95% CI = 1.4-3.1), sipping from the bottle during the day (OR = 1.9, 95% CI = 1.3-2.7), male gender (OR = 1.6, 95% CI = 1.2-2.2) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2). Significant variables associated with severe ECC form were sipping from the bottle during the day (OR = 2, 95% CI = 1.4-2.8), maternal age at birth < or =24 years (OR = 1.8, 95% CI = 1.3-2.7), ethnicity other than Caucasian (OR = 1.6, 95% CI = 1.1-2.5) and sleeping with a bottle at night (OR = 1.5, 95% CI = 1.1-2.2).

CONCLUSIONS

Infant bottle-feeding habits (either allowing a child to sip from a bottle during the day or put to sleep at night) and ethnicity other than Caucasian were significant determinants for both anterior caries pattern and severity of ECC in 4-5-year-old Australian children.