Abstract
BackgroundThis survey was intended to investigate prevalence and severity of early childhood caries (ECC) in a sample of children in Southern Italy and to identify factors that may be related to this condition.MethodsThe study was designed as a cross-sectional survey. The study population (children aged 36–71 months) attending thirteen kindergartens was randomly selected through a two-stage cluster sampling procedure. Parents/guardians of all eligible children were invited to participate filling out a structured self-administered questionnaire, and after having returned the informed consent form an oral examination of the child was performed at school. The questionnaire included information on: socio-demographics about parents/guardians and child, pregnancy and newborn characteristics, oral hygiene habits of child, eating habits particularly on consumption of sweets, access to dental services, and infant feeding practices. The WHO caries diagnostic criteria for deciduous decayed, missing and filled teeth (dmft) and surfaces (dmfs) were used to record ECC and severe-ECC (S-ECC). Univariate and multiple logistic regression analyses were conducted to evaluate statistical associations of social demographics, infant feeding practices, oral hygiene habits, and access to dental services to ECC, S-ECC, dmft and dmfs.Results515 children participated in the study. 19% had experienced ECC, and 2.7% severe-ECC (S-ECC), with a mean dmft and dmfs scores of 0.51 and 0.99, respectively. Mean dmft was 2.68 in ECC subjects, and 6.86 in S-ECC subjects. Statistical analysis showed that prevalence of ECC significantly increased with age (OR = 1.95; 95% CI = 1.3-2.91) and duration of breastfeeding (OR = 1.26; 95% CI = 1.01-1.57), whereas it was significantly lower in children of more educated mothers (OR = 0.64; 95% CI = 0.42-0.96), and higher in those who had been visited by a dentist in the previous year (OR = 3.29; 95% CI = 1.72-6.33).ConclusionsResults of our study demonstrate that even in Western countries ECC and S-ECC represent a significant burden in preschool children, particularly in those disadvantaged, and that most of the known modifiable associated factors regarding feeding practices and oral hygiene are still very spread in the population.
Highlights
This survey was intended to investigate prevalence and severity of early childhood caries (ECC) in a sample of children in Southern Italy and to identify factors that may be related to this condition
Among the infant feeding practices, severity of ECC was significantly related to longer duration of breastfeeding (Fisher’s exact p = 0.002), whereas, unexpectedly, severe ECC (S-ECC) was significantly lower (1.9%) in bottle fed children, compared to those who were not (7.6%) (χ2 = 7.99; p = 0.005)
Among the explored oral hygiene habits, no substantial differences were found according to severity of ECC, except for toothbrushing adult supervision, since S-ECC ranged from 7.7% in no supervised children to 2.2% in the supervised ones, this difference was not statistically significant at the univariate analysis (Fisher’s exact p = 0.128)
Summary
This survey was intended to investigate prevalence and severity of early childhood caries (ECC) in a sample of children in Southern Italy and to identify factors that may be related to this condition. The American Academy of Pediatric Dentistry has defined ECC as “the presence of 1 or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger” [4]. They defined severe ECC (S-ECC) with differences according to age: in children younger than 3 years of age, it is defined as any sign of smooth-surface caries, whereas in children from 3 to 5, it is defined as 1 or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth, or a decayed, missing or filled score (dmft) ≥ 4 at age 3, or a dmft ≥ 5 at age 4, or a dmft ≥ 6 at age 5 [4]
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