1
|
Khan SY, Schroth RJ, Cruz de Jesus V, Lee VHK, Rothney J, Dong CS, Javed F, Yerex K, Bertone M, El Azrak M, Menon A. A systematic review of caries risk in children <6 years of age. Int J Paediatr Dent 2024; 34:410-431. [PMID: 38071403 DOI: 10.1111/ipd.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 10/11/2023] [Accepted: 11/07/2023] [Indexed: 06/14/2024]
Abstract
BACKGROUND For caries risk assessment (CRA) tools for young children to be evidence-based, it is important to systematically review the literature to identify factors associated with the onset of early childhood caries (ECC). AIM This updated systematic review aimed to identify current evidence on caries risk in young children. DESIGN A comprehensive and systematic literature search of relevant databases was conducted to update a previous systematic review and identify risk factors associated with ECC. Potential risk factors were identified based on strength of association using odds ratios, hazard ratios, relative risk, etc. GRADE was used for rating quality evidence through consensus. RESULTS Twenty-two studies met inclusion criteria for the search from mid-2017 to 2021. Twenty-five publications from the prior systematic review, from 1997 to mid-2017, were also included. Several socioeconomic, behavioral, and clinical variables were identified as ECC risk factors. Factors included the following: age, socioeconomic status, frequency of and supervised toothbrushing, fluoride exposure, breast- and bottle-feeding, feeding habits, absence of a dental home, past caries experience, active non-cavitated lesions, visible plaque, enamel defects, and microbiome. CONCLUSION This study provides updated evidence of risk factors for ECC that could be included in CRA tools.
Collapse
Affiliation(s)
- Saima Yunus Khan
- Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - Robert J Schroth
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
- Shared Health Inc., Winnipeg, Manitoba, Canada
| | - Vivianne Cruz de Jesus
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Victor H K Lee
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Janet Rothney
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Cecilia S Dong
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Faraha Javed
- Dr. Ziauddin Ahmed Dental College, Aligarh Muslim University, Aligarh, India
| | - Katherine Yerex
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mary Bertone
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Mohamed El Azrak
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Anil Menon
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
2
|
Sobiech P, Olczak-Kowalczyk D, Spodzieja K, Gozdowski D. The association of maternal smoking and other sociobehavioral factors with dental caries in toddlers: A cross-sectional study. Front Pediatr 2023; 11:1115978. [PMID: 37077335 PMCID: PMC10106726 DOI: 10.3389/fped.2023.1115978] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/01/2023] [Indexed: 04/21/2023] Open
Abstract
Background Severe early childhood caries (S-ECC) is a form of dental caries in toddlers, which can strongly affect general health and quality of life. Studies on factors that can contribute to the development of caries immediately after tooth eruption are sparse. The aim of this study was to assess the role of sociobehavioural factors and pre- and postnatal exposure to tobacco smoke in the aetiology of dental caries in children up to 3 years old. Methods A cross-sectional study was conducted between 2011 and 2017 to assess oral health and teething in urban children 0-4 years of age. The number of teeth and surfaces with white spot lesions (d1,2), as well as decayed (d), missing (m), and filled (f) teeth classified according to ICDAS II was evaluated in a dental office setting. d1,2dmft and d1,2dmfs were calculated. Severe early childhood caries was diagnosed for d1,2dmfs > 0. Parents completed a self-administered questionnaire on socioeconomic factors, maternal health, course of pregnancy, child's perinatal parameters, hygiene and dietary practices, as well as maternal smoking during and after pregnancy. Data on children aged 12-36 months were collected and analysed statistically using the t-test, Spearman rank correlations and Poisson regression. Significance level was set at 0.05. Results Dental caries was found in 46% of 496 children aged 12-36 months. Mean d1,2dmft and d1,2dmfs were 2.62 ± 3.88 and 4.46 ± 8.42, respectively. Tobacco smoking during and after pregnancy was reported by 8.9% and 24.8% of women, respectively. Spearman's rank correlation analysis confirmed a relationship between S-ECC and parental education, maternal smoking, bottle feeding, avoiding springy foods, number of meals, and the age of tooth brushing initiation. Pre- and postnatal exposure to tobacco smoke increased the risk of S-ECC especially in children in age 19-24 months. Maternal smoking was correlated with the level of education and dietary practices. Conclusion Our study confirmed that prenatal smoking is associated with increased risk of severe-early childhood caries (S-ECC) while the association with post-natal smoking is also evident, the increase in risk is not statistically clear. Both maternal smoking and the child's tooth decay are associated with poor parental education and other improper oral health behaviours. The positive impact of quitting smoking on the oral health in children should be part of anti-smoking advice.
Collapse
Affiliation(s)
- Piotr Sobiech
- Department of Paediatric Dentistry, Medical University of Warsaw, Warszawa, Poland
| | - Dorota Olczak-Kowalczyk
- Department of Paediatric Dentistry, Medical University of Warsaw, Warszawa, Poland
- Correspondence: Dorota Olczak-Kowalczyk
| | - Karolina Spodzieja
- Department of Paediatric Dentistry, Medical University of Warsaw, Warszawa, Poland
| | - Dariusz Gozdowski
- Department of Experimental Design and Bioinformatics, Warsaw University of Life Sciences, Warsaw, Poland
- Department of Agriculture and Biology, Warsaw University of Life Sciences, Warsaw, Poland
| |
Collapse
|
3
|
Baltaci E, Ozveren N, Batur Kara S. Social and Behavioural Risk Factors of Early Childhood Caries Among Children Aged 4–47 Months: A Cross-Sectional Study. EURASIAN JOURNAL OF FAMILY MEDICINE 2022. [DOI: 10.33880/ejfm.2022110404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: This study aimed to investigate various risk factors for early childhood caries in a paediatric population in Edirne, Turkey.
Methods: This cross-sectional study included 1197 children aged 4–47 months old who visited family health centres for routine control. Questionnaires were used to collect data on parental- and pediatric-related variables potentially associated with early childhood caries. Oral hygiene was scored using the Visual Plaque Index, and decayed teeth, missing teeth, filled surfaces and carious teeth were recorded. We evaluated risk factors for early childhood caries using a hierarchical regression analysis model.
Results: Of the 1197 children, 219 (18.3%) had dental caries. The mean age of the children in the caries group was 33±7 months old, and the mean filled surfaces and carious teeth values were 4.84±3.49 and 8.50±8.30, respectively. Younger age at the time of first tooth eruption, current height percentile higher than 96, poor oral hygiene, older age, having siblings, and paternal age younger than 30 years old at the time of the child’s birth were associated with an increased risk of early childhood caries.
Conclusion: Prevention policies on caries among young children should focus on the first years of a child's life. Non-dental healthcare professionals may play an important role in being the first contact with parents in the healthcare system for anticipatory guidance.
Keywords: oral health, dental caries, preschool children, risk factors, preventive care
Collapse
Affiliation(s)
- Ezgi Baltaci
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University
| | - Neslihan Ozveren
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University
| | - Sinem Batur Kara
- Department of Pediatric Dentistry, Faculty of Dentistry, Trakya University
| |
Collapse
|
4
|
Lam PPY, Chua H, Ekambaram M, Lo ECM, Yiu CKY. RISK PREDICTORS OF EARLY CHILDHOOD CARIES INCREMENT-A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101732. [PMID: 36162891 DOI: 10.1016/j.jebdp.2022.101732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 04/03/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
This systematic review aimed to investigate the risk predictors of caries in primary teeth and evaluate their association with the increment of Early Childhood Caries (ECC) among preschool children. This systematic review included only cohort or case-control studies of at least 2 years duration, over 300 participants and with English full-text. Potentially eligible studies were retrieved from 4 electronic databases (Ovid Embase, Ovid MEDLINE; PubMed, Web of Science) from inception to March 1, 2021. Independent screening and data extraction by 2 reviewers to identify factors associated with ECC increment, including family and socioeconomic factors, dietary and oral health-related habits, and clinical parameters. A total of 18 studies from 163 potential reports were included, involving 1,159,226 preschool children. Lower parental education attainment was found associated with ECC increment (WMD:0.87; 95% CI 0.52, 1.21); whereas immigration status (WMD:-0.38; 95% CI -1.09, 0.34), gender (WMD:-0.02; 95% CI -0.28, 0.24), and dental service utilization (WMD:0.35; 95% CI -0.10, 0.79) were not significant factors for ECC increment. All included studies consistently suggested positive correlations between ECC increment and baseline caries experience, plaque level, cariogenic microorganisms, and prenatal and passive smoking, while mixed findings were detected between ECC increment with dietary and oral hygiene practices. Preschool children whose parents have low education level are more likely to have greater increment of ECC over 2 years. Existing caries lesions, increased dental plaque level, cariogenic microorganisms, prenatal or passive smoking were also consistently identified as risk factors for ECC in all reviewed studies. This systematic review highlights specific risk factors to target for the prevention of ECC and supports implementing more oral health promotion for preschool children with parents of lower educational attainment.
Collapse
Affiliation(s)
- Phoebe P Y Lam
- Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR Hong Kong
| | - Helene Chua
- Auckland District Health Board, Auckland, New Zealand
| | - Manikandan Ekambaram
- Paediatric Dentistry, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Edward C M Lo
- The University of Hong Kong, Pokfulam, Hong Kong SAR, Hong Kong
| | - Cynthia K Y Yiu
- Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR Hong Kong.
| |
Collapse
|
5
|
Schroth RJ, Rothney J, Sturym M, Dabiri D, Dabiri D, Dong CC, Grant CG, Kennedy T, Sihra R. A systematic review to inform the development of a Canadian caries risk assessment tool for use by primary healthcare providers. Int J Paediatr Dent 2021; 31:767-791. [PMID: 33497015 DOI: 10.1111/ipd.12776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 01/06/2021] [Accepted: 01/21/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Caries risk assessment (CRA) tools may assist in identifying children at risk of early childhood caries. AIM To complete a systematic review of CRA and develop a Canadian CRA tool for preschool children for use in non-dental clinical settings. DESIGN Systematic searches of relevant databases were conducted. Potential variables were based on strength of associations (odd ratios, relative risk, hazard ratios, etc), frequency of occurrence, and existing CRA tools. Quality of the evidence assessments were performed by at least two review teams through consensus following GRADE. RESULTS Overall, 25 publications met the inclusion criteria, all prospective in design. Based on this review, variables to be considered when developing a new CRA tool for use with preschool children are as follows: age, socioeconomic status, family toothbrushing habits, fluoride exposure, infant feeding practices, dietary habits/behaviours, dental home, caries experience, visible plaque, and enamel defects. The environmental scan identified 22 CRA tools suggesting other additional variables to consider including in a CRA tool, including special healthcare needs, enamel defects, and dental attendance. CONCLUSIONS This review informed the development of a Canadian CRA tool for use by primary healthcare professionals, which may improve access to oral health assessments and increase interprofessional collaboration.
Collapse
Affiliation(s)
- Robert J Schroth
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada.,Section of Pediatric Dentistry, Winnipeg Regional Health Authority, Winnipeg, MB, Canada
| | - Janet Rothney
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Melina Sturym
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Darya Dabiri
- School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Donya Dabiri
- University of Toledo Medical Center, University of Toledo, Toledo, OH, USA
| | - Cecilia C Dong
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Cameron G Grant
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Tara Kennedy
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| | - Rena Sihra
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada.,Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
6
|
Hultquist AI, Brudin L, Bågesund M. Early childhood caries risk assessment in 1-year-olds evaluated at 6-years of age. Acta Odontol Scand 2021; 79:103-111. [PMID: 32697607 DOI: 10.1080/00016357.2020.1795247] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim was to identify caries risk factors in 1-year-olds predicting dentine caries in 6-year-olds. MATERIALS AND METHODS Caries risk assessment was performed in 804 one-year-olds. Their parents answered a questionnaire, regarding family factors, general health, food habits and oral hygiene. Clinical examinations and caries risk assessments at 1, 3 and 6 years of age were performed. Simple and multiple regression analyses were used for identification of caries-associated factors. RESULTS Caries risk was found in 5% of the 1-year-olds, and 12% of the 3-year-olds. Dentine caries was found in 3% of the 3-year-olds and in 16% of the 6-year-olds. Caries risk assessment was associated with caries at 6 years of age (OR = 5.1, p < .001). Multiple logistic regression analysis found the following variables associated with caries at 6 years of age: Caries in sibling (OR = 2.1, p = .012), Beverage other than water (OR = 2.1, p < .001), Night meal (OR = 1.9, p = .002), Presence of mutans streptococci (MS) (OR = 1.6, p = .033) and Male gender (OR = 1.5, p = .053). An overall caries risk assessment was more reliable than any single caries risk factor. CONCLUSIONS Caries risk assessment for 1-year-olds in a region with low caries prevalence has limited accuracy to predict dental caries at 6 years of age. Caries risk often changes over time and should be reassessed on a regularly basis. The presence of MS in 1-year-olds did not increase the prognostic accuracy at 6 years of age.
Collapse
Affiliation(s)
- Ann Ingemansson Hultquist
- Västervik Public Dental Service, Kalmar County Council, Kalmar, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Lars Brudin
- Department of Clinical Physiology, Region Kalmar Council, Kalmar, Sweden
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Mats Bågesund
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Center for Orthodontics and Pediatric Dentistry, Norrköping, Sweden
| |
Collapse
|
7
|
Chanpum P, Duangthip D, Trairatvorakul C, Songsiripradubboon S. Early Childhood Caries and Its Associated Factors among 9- to 18-Month Old Exclusively Breastfed Children in Thailand: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3194. [PMID: 32375351 PMCID: PMC7246726 DOI: 10.3390/ijerph17093194] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 04/29/2020] [Accepted: 05/02/2020] [Indexed: 12/22/2022]
Abstract
Objective: The objective of this study was to investigate the early childhood caries (ECC) status and its risk factors in 9- to 18-month-old exclusively breastfed children in Thailand. Methods: Generally healthy 9- to 18-month-old children who had been exclusively breastfed were recruited. Information on children's oral hygiene practices and breastfeeding behaviors was collected through parental interviews using a questionnaire. Children's oral health status was assessed following the WHO caries diagnostic criteria, modified to record the noncavitated lesions. Multivariate logistic regression analysis was adopted to investigate its association with feeding and oral hygiene practices. Results: In total, 513 mother and child dyads (47% boys) were recruited. The prevalence of ECC was 42.5%. The mean (SD) d1mft and d1mfs scores (d1 included noncavitated and cavitated carious teeth/tooth surfaces) were 1.1 (1.4) and 1.3 (2.0), respectively. Multivariate logistic regression analysis revealed that older children with higher plaque scores (OR = 75.60; 95% CI: 40.19-142.20) who were breastfed to sleep (OR = 2.85; 95% CI: 1.48-5.49) and never had their teeth cleaned (OR = 8.51; 95% CI: 1.53-47.14), had a significantly higher chance of having ECC (p < 0.05). Conclusion: Prevalence of ECC is high among exclusively breastfed children aged 9-18 months in Thailand. ECC prevalence is significantly associated with the age of children, the level of dental plaque, breastfeeding to sleep, and oral cleaning. Among all factors, the level of dental plaque is the most significant factor associated with ECC among breastfed children.
Collapse
Affiliation(s)
| | | | - Chutima Trairatvorakul
- Department of Pediatric Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand;
| | | |
Collapse
|
8
|
Espinoza-Espinoza G, Muñoz-Millán P, Vergara-González C, Atala-Acevedo C, Zaror. C. Prevalence of early childhood caries in non-fluoridated rural areas of Chile. JOURNAL OF ORAL RESEARCH 2016. [DOI: 10.17126/joralres.2016.064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|