Risk factors for caries-free time: longitudinal study in early childhood.

Maria Beatriz Barreto De Sousa Cabral,Maria Isabel Pereira Vianna,Maria Cristina Teixeira Cangussu,Fabiana Raynal Floriano,Eduardo Luiz Andrade Mota

doi:10.11606/s1518-8787.2017051006558

Abstract

ABSTRACTOBJECTIVE To estimate time in days from the beginning of follow-up up to the development of dental caries in children under 30 months and to assess risk factors potentially affecting the development of the disease.METHODS The study population of the cohort study were children attending public, private, and charitable day care centers in Salvador, Northeastern Brazil, followed up for fourteen months. We used the multivariate Cox regression to estimate risk and Kaplan-Meier method to estimate the caries-free time.RESULTS Of the 495 children studied, 112 developed caries (22.6%). Mean caries-free time was 248.6 (SD = 96.2) days. The comparasion of curves by age group (> 24 months) and children attending public day care showed more caries in a shorter period (p < 0.00). The following variables were important risk factors for increased rate of caries: district of origin (HR = 1.88, 95%CI 1.27–2.77), category of day care (HR = 3.88, 95%CI 2.04–7.38), age (HR = 1.77, 95%CI 1.15–2.74), bottle-feeding before sleep time after the age of 12 months (HR = 1.62, 95%CI 1.04–2.51), presence of active white spots (HR = 2.70, 95%CI 1.07–6.80), and living in non-masonry house (HR = 1.68, 95%CI 1.02–2.76). The highest hazard ratio (HR = 4.60, 95%CI 2.80–7.42) was found for previous caries experience.CONCLUSIONS Social variables were considered as of high risk for the development of dental caries.

Highlights

A serious persistent public health problem issue, affects different groups from various socioeconomic backgrounds and predominantly specific age groups with severe presentations in early childhood that may lead to tooth loss[1]
A decline in the prevalence of caries in schoolchildren was seen in the last decade in Brazil after the implementation of collective actions, such as fluoridation of the public water system, topical use of fluoride in school programs, fluoride addition to toothpastes, and extended coverage of health services[2,3,4]
The assessment of the exposure factor associated with the time span from the beginning of follow-up to the development of caries showed that caries-free time was shorter for children from the Cabula-Beiru health district, who attended public day care, aged more than 24 months, black or biracial, with mothers or fathers with low schooling who were either unemployed or had low-skilled jobs and had lower family income, who were often bottle fed before bedtime over 24 months of age or bottle fed during sleep time over 12 months of age, with sugar in their diet, with frequent use of drugs, who had bacterial plaques or active white spots, Elegible population (n = 640)

Summary

Introduction

A serious persistent public health problem issue, affects different groups from various socioeconomic backgrounds and predominantly specific age groups with severe presentations in early childhood that may lead to tooth loss[1]. Caries remains a critical challenge in other age groups, such as younger children who have shown greatly morbidity, expressed by different prevalence rates[3,4,5,6,7,8,9]. Caries in younger children have specific destructive characteristics and undesirable consequences, such as pain and infection. These manifestations can lead to inadequate nutritional patterns and impair their physical development. The esthetic issue should be emphasized, which may affect social interaction and result in social withdrawal and shyness[8,10,11,12]

Methods

Results

Conclusion