U-shaped association between maternal age at delivery and dental caries in offspring

Prediction model for early childhood caries risk based on behavioral determinants using a machine learning algorithm

BACKGROUND

An easily accessible caries risk prediction model (CRPM) based on nonbiological predictors is lacking. Developing a CRPM for community screening is essential for children's dental health promotion by a public health approach.

OBJECTIVE

This study aimed to develop and validate a caries risk prediction model (CRPM) for children using a machine learning algorithm based on dental care behavioral factors and other nonbiological factors using a 3-month multicenter cohort.

METHODS

Children aged 12 months to 60 months were recruited at three primary care settings and three kindergartens in Chengdu, China. Dental examination was conducted for all enrolled children by calibrated pediatric dentists at baseline and three months later. All parents of the enrolled children were asked to complete a questionnaire with dental-related information. Machine learning algorithms, including random forest, logistic regression, and adaptive boosting, were used to develop a prediction model. Sensitivity, specificity, accuracy, precision, negative predictive value and F-score were reported to estimate the internal validation of the models.

RESULTS

A total of 481 out of 745 children without a history of caries experience at baseline remained for analysis. In the total sample population, 236 (49.1%) children were female, and the mean age was 31.2 months. During the follow-up exams, 66 (13.6%) children had new-onset caries. The child's age, height, weight, family caries status, brush teeth two minutes per time, fluoride toothpaste usage, brushing twice per day, parental monitoring brushing teeth, mother delivery method, brushing child's teeth every day, child number counts, and night feeding frequency in the last month were measured and included in a prediction model. Of the prediction models, the highest area under the curve of RF was 0.91 (95% CI: 0.87- 0.94), followed by 0.86 (95% CI: 0.81-0.91) of LR and 0.81 (95% CI: 0.76-0.86) of AdaBoost.

CONCLUSION

In this CRPM, new onset of dental caries in three months among children aged < 60 months could be predicted by answering twelve nonbiological questions. A good model performance was shown within the internal validation. Dental home care could be improved by referring the CRPM result before new caries onset.

Individual, Family, and Socioeconomic Contributors to Dental Caries in Children from Low- and Middle-Income Countries

Introduction: Collective evidence on risk factors for dental caries remains elusive in low- and middle-income countries (LMICs). The objective was to conduct a systematic review and meta-analysis on risk factors for dental caries in deciduous or permanent teeth in LMICs. Methods: Studies were identified electronically through databases, including Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials, PubMed/MEDLINE, and CINAHL, using “prevalence, dental caries, child, family, socioeconomic, and LMIC” as the keywords. A total of 11 studies fit the inclusion criteria. Quality assessment of the included studies was performed using the Newcastle-Ottawa Scale (NOS). The MedCalc software and Review Manager 5.4.1 were used. Results: From 11,115 participants, 38.7% (95% CI: 28.4−49.5%) had caries and 49.68% were female. Among those with caries, 69.74% consumed sugary drinks/sweets (95% CI: 47.84−87.73%) and 56.87% (95% CI: 35.39−77.08%) had good brushing habits. Sugary drinks had a two times higher likelihood of leading to caries (OR: 2.04, p < 0.001). Good oral hygiene reduced the risk of caries by 35% (OR: 0.65, p < 0.001). Concerning maternal education, only secondary education reduced the likelihood of caries (OR: 0.96), but primary education incurred 25% higher risks (OR: 1.25, p = 0.03). A 65% reduction was computed when caregivers helped children with tooth brushing (OR: 0.35, p = 0.04). Most families had a low socioeconomic status (SES) (35.9%, 95% CI: 16.73−57.79), which increased the odds of caries by 52% (OR: 1.52, p < 0.001); a high SES had a 3% higher chance of caries. In the entire sample, 44.44% (95% CI: 27.73−61.82%) of individuals had access to dental services or had visited a dental service provider. Conclusion: Our findings demonstrate that high sugar consumption, low maternal education, and low and high socioeconomic status (SES) increased the risk of dental caries in LMICs. Good brushing habits, higher maternal education, help with tooth brushing, and middle SES provided protection against caries across LMIC children. Limiting sugars, improving oral health education, incorporating national fluoride exposure programs, and accounting for sociodemographic limitations are essential for reducing the prevalence of dental caries in these settings.

Correlation Between Maternal Smoking During Pregnancy and Dental Caries in Children: A Systematic Review and Meta-Analysis

Background: Dental caries is a long-standing oral health problem for children all over the world. The available evidence shows that the association between maternal smoking during pregnancy and childhood caries is still controversial. Therefore, the aim of this systematic review and meta-analysis was to determine whether there was a correlation of prenatal smoking and dental caries in children.

Methods: PubMed, EMBASE, Cochrane, Web of Science, and Scopus databases were searched for observational studies assessing the relationship between maternal smoking during the pregnancy and childhood caries. According to the predesigned eligibility criteria and items, studies selection, and data extraction were conducted, respectively. The effect estimates were pooled using a fixed-effect model or a random-effect model. Newcastle-Ottawa Scale (NOS) was adopted to evaluate the methodological quality of the included studies. All analyses were carried out through Stata 12.0 software.

Results: Our systematic review included a total of 11 studies, of which 6 cross-sectional studies and 3 longitudinal studies were included in the final meta-analysis. The pooled estimates indicated maternal smoking during pregnancy was significantly associated with dental caries in children both in cross-sectional studies (OR = 1.57, 95% CI = 1.47–1.67) and longitudinal studies (RR = 1.26, 95% CI = 1.07–1.48). Sensitivity analyses confirmed the overall effect estimates were robust.

Conclusions: There is a significant correlation of maternal smoking during pregnancy and childhood caries. However, the causal relationship between them cannot be determined. More prospective and extensive studies on this theme is needed for verification. Even so, it is necessary for pregnant women and women of reproductive age to quit smoking. Strategies must be developed to raise public awareness about the impact of prenatal smoking on children's oral health.