Mother’s Characteristics and Socioeconomic Status as Possible Risk Factors for Children’s Caries in Jordan

Risk of Early Childhood Caries Estimated by Maternal Dental Caries during Pregnancy: A Retrospective Cohort Study

OBJECTIVE

 Public policy promoting prenatal dental care to provide long-term prevention of early childhood caries (ECC) in offspring would require evidence regarding the ECC risk associated with maternal dental caries during pregnancy. This study evaluated that association using a design capable of assessing temporal relationships and considered a directed acyclic graph to guide the adjustment of pertinent confounders.

MATERIALS AND METHODS

 This retrospective cohort study analyzed data from 158 mother-child dyads attending care at Prachathipat Hospital, Pathum Thani, Thailand. Maternal dental caries data at their first visits to prenatal oral care from February 2012 to May 2017 were traced forwardly to match the oral health data of offspring who visited the hospital from May 2013 to March 2018.

RESULTS

 Univariable and multivariable fractional logit regression models along with the calculation of average marginal effects revealed that children born to two categories of mothers with 1 to 5 and ≥6 carious teeth during pregnancy would averagely develop 4.5 to 5 and 7.9 to 8.8 more carious teeth per 100 teeth than dental caries would occur in offspring of caries-free mothers.

CONCLUSION

 This evidence identified the role of maternal dental caries during pregnancy as a significant clinical risk indicator for ECC and supported the provision of prenatal dental care for mothers to prevent ECC in offspring.

The Impact of Socioeconomic Factors on Pediatric Oral Health: A Review

This narrative review examines the impact of socioeconomic status (SES) on pediatric oral health, emphasizing disparities in dental caries prevalence and oral health-related quality of life (OHRQoL) among children from different socioeconomic backgrounds. Utilizing an extensive literature search through PubMed, Google Scholar, and the chat.consensus.app plugin, we synthesized findings from studies published up to December 2023. The review highlights a consistent association between lower SES and adverse pediatric oral health outcomes, influenced by parental education, household income, food security, and neighborhood conditions. It also underscores the importance of the life-course perspective, showing how early-life socioeconomic disadvantages can have long-lasting effects on oral health. Furthermore, the review points to the critical role of school-based oral health education programs and the complex interplay between mental health, SES, and pediatric oral health. By examining the impact of socioeconomic factors across different childhood stages and the effectiveness of educational interventions, this review calls for targeted interventions and policy initiatives aimed at reducing socioeconomic inequalities in pediatric oral health. The findings advocate for a multifaceted approach to improve oral health outcomes for children across socioeconomic backgrounds, ensuring equitable access to oral health care and promoting overall well-being.

Polish pregnant women's knowledge on early childhood caries prevention and oral hygiene in children

BACKGROUND

Early childhood caries (ECC) is one of the most common chronic diseases among children. In Poland 86.9% of six-year-olds have ECC. One of the factors determining adherence to ECC prophylaxis and oral hygiene is mothers' knowledge. The aim of this study was to assess the level of knowledge demonstrated by pregnant women about ECC prevention and oral hygiene, and to analyse the determinants of this knowledge.

METHODS

A quantitative survey was conducted using Computer Assisted Telephone Interview technique on a randomly selected representative sample of 1,000 women over the age of 18 in their second and third trimesters of pregnancy. The significance level was established at 0.05 and p-values were presented as: p < 0.05, p < 0.01 and p < 0.001.

RESULTS

The highest percentage of wrong or "I don't know" answers were related to questions about: the number of free dental check-ups for children (76.8%), the date of the child's first visit to the dentist (66.5%), the age when the child has mixed dentition (72.2%). Women with higher education had better knowledge than women with lower or secondary education. Women with good and very good financial situation showed a higher level of knowledge compared to women with average, bad and very bad financial situation.

CONCLUSIONS

When developing prevention strategies and educational programs as part of prenatal care for women to reduce the incidence of ECC, it is important to take into account the identified areas that need support and specific target groups (mothers with lower socioeconomic status).

Clustering of children's oral diseases in families and villages in a rural setting in Egypt

BACKGROUND

This study assessed the clustering of children' caries experience, plaque accumulation and gingival inflammation in families and villages in Northwestern Egypt and the factors related to the severity of these conditions.

METHODS

This was a secondary analysis of a 2019 household survey of children in villages around Alexandria, Egypt. Clinical examination assessed primary and permanent teeth caries experience (dmft/ DMFT using the World Health Organization criteria), plaque accumulation (Plaque Index (PlI)) and gingival inflammation (Gingival Index (GI)). A child questionnaire assessed child's age, sex, the frequency of toothbrushing (at least twice daily versus less) and frequency of consuming eight types of sugary products (daily sugar consumption score, sum of sugary products consumed daily). Mothers' questionnaire assessed the number of children in the family, mother's education (at least high school versus less), at least twice daily toothbrushing and daily sugar consumption similar to the child. Multilevel regression analyses assessed clustering, calculated by the intraclass correlation coefficient (ICC) of the three conditions in families and villages. Regression estimates (B) and 95% confidence intervals (CIs) of individual and family factors were calculated.

RESULTS

Complete data were available for 450 children (246 families, seven villages], mean = 9.9 years-old and 56% females. The mean caries experience score = 3.6, mean plaque index = 1.5 and mean gingival index = 1.2. Caries experience, plaque accumulation and gingival inflammation were not clustered in villages (ICC < 0.01) but clustered in families (ICC = 0.10, 0.44 and 0.29). Child factors significantly improved model fit for caries experience and gingivitis (p < 0.001) but not plaque accumulation (p = 0.90). Family factors did not improve any model fit (p > 0.05). Child's age was significantly associated with caries experience (B= -0.48, p < 0.001) and gingival inflammation (B = 0.032, p < 0.001). Children who brushed their teeth twice daily had significantly more caries experience (B = 1.04, p = 0.01).

CONCLUSION

The three oral conditions were not clustered in villages but clustered in families. Plaque accumulation showed the greatest within-family clustering. Family factors were not associated with the three conditions and individual factors indicated the need for interventions to promote preventive behaviors and identify families at risk of oral conditions.

Subgroup detection-based dental caries status and inequalities trend exploration: A nationwide, 10-year-repeated cross-sectional study

Background

The goal of this study was to identify potentially important factors for the dental health though heterogeneous effects of risk factors within Chinese adolescent populations with different characteristics by analyzing the repeated cross-sectional data collected in the 3rd (2005) and 4th (2015) National Oral Health Survey.

Methods

We studied the relationships between the decayed, missing and filled permanent teeth (DMFT) score, which was a discrete value, with the caries risk factors (region, census type, gender, only child or not, parents' education level, tooth bushing, dentist visit history, knowledge score, sugar intake, and pit-and-fissure sealants status), though the Poisson mixture regression model, which could identify subgroups among the full population and estimate the heterogeneous effects of risk factors simultaneously. We performed a series of tests and trend analysis based on the model fitting results to explore the primary causes for the dental caries issue clearly and intuitively.

Results

A total of 39,049 teenagers aged 12 years were involved in the analysis. The Poisson mixture regression model clustered all individuals into three subgroups, where the mean values (standard deviations) of DMFT were 0.18 (0.56), 1.31 (1.49), and 2.91 (1.89), respectively. Model fitting results indicated that the heterogeneous effects of the involved risk factors were significant. In addition, we also found significant differences in the distributions and trends of DMFT within different categories of selected risk factors (region, census type, gender and dentist visiting history) from the projection analysis results. The estimated and projected proportions showed that the proportion of high caries risk population in the southwestern region increased by 31.8%, and will become even more severe as it will be the major component of high caries risk population in 2025.

Conclusions

We found that the trends for the developments and changes of dental caries within populations with different characteristics were inequality. The regional difference is the primary factor for diversified changes in DMFT. The findings in this study provide support for intervention and prevention policies for the deterioration of dental caries risk within different adolescent populations.