Abstract
Background: Dental caries in primary dentition affects approximately 500 million children worldwide, which makes it a serious global public health issue. Considering this background and the high caries prevalence in childhood, further research is needed to understand the influence of breastfeeding on caries development.Objectives: Aim of this study was to evaluate the association between breastfeeding duration (exclusive and then subsequent partial breastfeeding) and caries in the primary dentition considering socioeconomic status (SES), age, body mass index (BMI), and oral hygiene as potential confounders.Materials and methods: This cross-sectional study was part of the LIFE Child project and it analyzed data from 597 children aged 1-5 years (50.4% male, 99.7% born in Germany). A PC-based standardized questionnaire was used to collect information on sociodemographic data and breastfeeding behavior. The body mass index (BMI) was adjusted to age from weight and height. Visible plaque index (VPI), malocclusion and caries (dmf-t [decayed, missing due to caries, and filled teeth] according to WHO [World Health Organization] diagnosis criteria) were clinically collected. The statistical analysis was calculated using chi square and t-test, and multivariable logistic regression, respectively. Results: The caries frequency in this sample was 9.9% (n=59/597), the mean dmf-t ± SD (standard deviation) was 0.27 ± 1.1. The duration of exclusive/partial breastfeeding (± SD) was 4.5 ± 4.7 and 9.3 ± 7.7 months, respectively. Children from families with a low SES were breastfed for significantly shorter periods of time (1.2 months for exclusive and 3.3 months for partial breastfeeding, p<0.05). The bivariate analyses showed caries protection when breastfed 6-12 months (odds ratio [OR]=0.5; 95% confidence interval [CI]: 0.3-0.9), but in the multivariable analyses the effect disappeared; significant influencing factors were plaque (OR=9.8, 95% CI: 5.1-18.8), low SES (OR=2.3, 95% CI: 1.0-5.3), and age (OR=2.0, 95% CI: 1.5-2.6). Conclusion: The analyzed parameters showed that poor oral hygiene and low SES are risk factors for caries in the primary dentition. Duration of exclusive/partial breastfeeding had no effect on caries development in this study.Keywords:Breastfeeding, Caries, Cross-sectional study, Socioeconomic status, Dental plaque
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