Abstract

BackgroundActual caries figures emphasize the need to identify the risk indicators involved in the disease’s development. The hypothesis that certain risk indicators might affect the dynamic evolution of the caries process was assessed; to clarify this premise, a cross-sectional survey was performed in school children.MethodsA total of 390 subjects aged 6–8 years old were randomly selected. Caries was assessed, and the subjects were stratified as follows: i) highest caries score; ii) most prevalent caries score; and iii) number of affected teeth. Parents/guardians completed a questionnaire regarding vital statistics, socio-economic indicators, dietary habits, oral hygiene habits and oral health behaviours.ResultsCaries was detected in 42.31% of the subjects. Maternal nationality, parental education level, use of a sweetened pacifier at night, intake of lactose-free milk and toothbrushing frequency were statistically significant associated (p < 0.05) with subjects stratified according to the highest caries score. Parental educational level, maternal occupational status and use of a sweetened pacifier at night were associated (p < 0.05) with affected children stratified according to the most prevalent caries score. Maternal educational level and intake of lactose-free milk were associated with subjects with moderate caries stages compared to being caries-free (p = 0.01 and p = 0.02, respectively). Maternal nationality (p < 0.01) and toothbrushing frequency (p = 0.01) were associated with subjects affected by extensive lesions compared to caries-free children. In subjects affected by initial lesions as the most prevalent figure, gender (male) and paternal occupation status (unemployed) were statistically significant associated (p = 0.03 and p = 0.04, respectively) compared to those affected by highest prevalence of extensive caries lesions. In children with the highest prevalence of moderate caries lesions, maternal education level (p < 0.01), paternal occupational status (p = 0.03) and use of a sweetened pacifier at night (p < 0.01) were statistically significantly associated.ConclusionsMaternal nationality, maternal low level of education, intake of lactose-free milk and low toothbrushing frequency were involved in the change from caries-free status to different caries stages. Gender, paternal unemployment, maternal low educational level and use of a sweetened pacifier were correlated with caries progression, showing how distinctive risk indicators were associated with different caries stages.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-016-3865-4) contains supplementary material, which is available to authorized users.

Highlights

  • Actual caries figures emphasize the need to identify the risk indicators involved in the disease’s development

  • The results showed that several risk indicators interacted with disease evolution, mainly parental socio-economic and child behavioural indicators

  • Socio-economic indicators and casual factors acted in synergy in affected subjects, and as the lesions progressed, diet became increasingly important in the process

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Summary

Introduction

Actual caries figures emphasize the need to identify the risk indicators involved in the disease’s development. The caries decrease has resulted in a polarization of the distribution of the disease, and today, high caries figures are observed only in a small proportion of the population [1, 4]. When the mean number of decayed, missing and filled teeth improves, the number of caries-free individuals increases, and polarization becomes more pronounced [6]. This skewed distribution emphasizes the need to identify caries risk indicators that are involved in the development of the disease to plan targeted preventive programmes that consider that health is linked to health promotion, when care resources are limited [7]

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