Association Of Early Childhood Caries Research Articles

Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam.

One of the most prevalent oral diseases affecting preschoolers, early childhood caries (ECC), can significantly lower a child's quality of life. The pain and discomfort that ECC causes will alter the child's eating habits, which will have an impact on both their physical and mental health, as shown by the deviation from the body mass index (BMI). Dental caries and deviation from the normal BMI are both significantly influenced by children's eating habits and socioeconomic status (SES). To determine the association of ECC with BMI, dietary habits, and SES among 3-6-year-old preschool children. A cross-sectional study was conducted among 375 preschool children of 3-6 years of age. The decayed, missing, or filled teeth (deft) index was used to determine the caries status. Measurement of height (m) and weight (kg) was done using a stadiometer and electronic weighing machine. For each child, the BMI (kg/m2) was calculated, and the child's body weight status was assessed using Centers for Disease Control and Prevention (CDC)-based classification. Questionnaires were collected with demographic details, 3 days diet diary, and the SES of parents. The dietary habit and SES were obtained from the healthy eating index-2005 (HEI-2005) score and Modified Kuppuswamy's Scale 2018. All the data were entered and analyzed using Statistical Package for the Social Sciences (SPSS) software V 20.0. The prevalence of ECC was 44.8%. On comparison of mean height, weight, and BMI scores, there was a significant difference in mean weight (p = 0.006) and BMI (p = 0.001) among the two study groups. Children with ECC had a lower HEI-2005 score and belonged to a lower social class compared to caries-free children (p = 0.001). Children with ECC are significantly associated with BMI being overweight, or risk of being overweight; lower grades of SES and lower total score of HEI-2005 with poor diet and diet that needs improvement. Suresh A, Srinivasan D, AR SE, et al. Association of Early Childhood Caries with Body Mass Index, Dietary Habits, and Socioeconomic Status among Preschool Children of Kelambakkam. Int J Clin Pediatr Dent 2023;16(4):565-571.

A scoping review on the association of early childhood caries and maternal gender inequality

AimThe objective of this scoping review is to present current evidence regarding the association between early childhood caries (ECC) and maternal-related gender inequality.MethodsTwo independent reviewers performed a comprehensive literature search using three databases: EMBASE, PubMed, and Web of Science. Literature published in English from 2012 to 2022 was included in the search and was restricted to only primary research by using the following key terms: "dental caries", "tooth decay", "gender", "sex", "preschool", "toddler," and "infant". The included studies were limited to those reporting an association between ECC and maternal aspects related to gender inequality. Titles and abstracts were screened, and irrelevant publications were excluded. The full text of the remaining papers was retrieved and used to perform the review. The critical appraisal of selected studies was guided by the Joanna Briggs Institute (JBI) Critical Appraisal Tools.ResultsAmong 1,103 studies from the three databases, 425 articles were identified based on publication years between 2012 and 2022. After full-text screening, five articles were included in the qualitative analysis for this review. No published study was found regarding a direct association between ECC and maternal gender inequality at the level of individuals. Five included studies reported on the association between ECC and potential maternal-gender-related inequality factors, including the mother’s education level (n = 4), employment status (n = 1), and age (n = 1). Regarding the quality of the included studies, out of five, two studies met all JBI criteria, while three partially met the criteria.ConclusionsBased on the findings of this scoping review, evidence demonstrating an association between gender inequality and ECC is currently limited.

Association of Early Childhood Caries and Multiple Variable Factors in 3-6-year-old Children.

Dental caries is a globally prevailing condition. It is a common finding in all age-groups, whether it is young children or adults. Caries not only affects the oral health of an individual, but also the overall health of the individual. This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in age group of 3 to 6 year old children. The study was planned and conducted in the Department of Pedodontics and Preventive Dentistry, Government College of Dentistry, Indore, Madhya Pradesh, India. The study consisted of 200 samples, including both groups. Group I included 100 patients with ECC and group II included 100 patients caries free. Children of age 3-6 years were randomly selected and evaluated for ECC and parameters like weight, height, number of siblings, birth order, SES status, and mothers' education. Body mass index (BMI) had no significant association with the occurrence of ECC. Statistical significant association was observed between the number of siblings and ECC. The "no caries" was significantly associated with "no sibling" or "one sibling". A significant association between SES status and ECC was observed. The upper and upper middle class had more number of caries free children, whereas the number of participants with ECC was significantly more in the upper lower class. There was a pronounced association between ECC and maternal education. Researches like these help us to broaden our aspects of understanding that caries is not caused by only one factor but a magnitude of factors. It's prevention should take into consideration not only the dietary habits but also on increasing awareness about importance of oral hygiene and how it can be affected by other social varients.This article focuses on the association of ECC with BMI, SES status, maternal education, birth order, and number of siblings in 3-6-year-old children. Sahu P, Agrawal A, Jain D, et al. Association of Early Childhood Caries and Multiple Variable Factors in 3-6-year-old Children. Int J Clin Pediatr Dent 2023;16(1):42-47.

Association of early childhood caries and nutritional status: a scoping review.

The most widespread non-communicable disease in the world is dental caries. Early childhood caries (ECC) is the presence of one or more decayed, missing or filled tooth surfaces in any primary tooth in children between birth and 71 months. The disease has been linked to failure to thrive, impaired speech and reduce food consumption due to pain and discomfort. Nutritional status of a child may also be affected by caries. Thus, we conducted a scoping review to review the association between ECC and nutritional status. A total of 492 articles published until December 2022 from three databases were obtained. 20 relevant articles meeting the inclusion criteria were included. From the included articles, dmft index was the most common dental assessment used, while all articles used anthropometric measurements for nutritional assessment except for two articles that used laboratory methods. Based on the results obtained, majority of the articles stated that there was an association between ECC in children with poor nutritional status, while only one study reported an association between ECC and overweight or obese children. Four papers showed no association. A more standardised and consistent study methodology, sample population and protocol in articles selected may help yield more reliable results.

Association of Early Childhood Caries with Bitter Taste Receptors: A Meta-Analysis of Genome-Wide Association Studies and Transcriptome-Wide Association Study.

Although genetics affects early childhood caries (ECC) risk, few studies have focused on finding its specific genetic determinants. Here, we performed genome-wide association studies (GWAS) in five cohorts of children (aged up to 5 years, total N = 2974, cohorts: Center for Oral Health Research in Appalachia cohorts one and two [COHRA1, COHRA2], Iowa Fluoride Study, Iowa Head Start, Avon Longitudinal Study of Parents and Children [ALSPAC]) aiming to identify genes with potential roles in ECC biology. We meta-analyzed the GWASs testing ~3.9 million genetic variants and found suggestive evidence for association at genetic regions previously associated with caries in primary and permanent dentition, including the β-defensin anti-microbial proteins. We then integrated the meta-analysis results with gene expression data in a transcriptome-wide association study (TWAS). This approach identified four genes whose genetically predicted expression was associated with ECC (p-values < 3.09 × 10-6; CDH17, TAS2R43, SMIM10L1, TAS2R14). Some of the strongest associations were with genes encoding members of the bitter taste receptor family (TAS2R); other members of this family have previously been associated with caries. Of note, we identified the receptor encoded by TAS2R14, which stimulates innate immunity and anti-microbial defense in response to molecules released by the cariogenic bacteria, Streptococcus mutans and Staphylococcus aureus. These findings provide insight into ECC genetic architecture, underscore the importance of host-microbial interaction in caries risk, and identify novel risk genes.

Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur.

AimTo determine possible associations of early childhood caries (ECC) with risk factors such as feeding and dietary habits of children and oral hygiene practices by the parents or caregiver in rural and urban school children in Jaipur, India.Materials and methodsAn observational cross-sectional study was designed with a dental examination and a standardized questionnaire. A total of 1,824 children, that is, 848 (46%) rural, and 976 (54%) urban school children were enrolled in the study. The data regarding their diet and feeding habits of children, oral hygiene practices of the parents or caregivers were collected with the help of a standardized questionnaire. The caries status of rural and urban school children was recorded using the decayed, missing, filled teeth (DMFT) index. Data thus collected were compiled, analyzed and were subjected to statistical analysis using Statistical Package for Social Sciences (SPSS v 26.0, IBM). Comparison of frequencies of categories of variables with groups was done using Chi-square test with p < 0.05 was considered to be statistically significant.ResultsThe prevalence of ECC was 34.7% in rural and 45.5% in urban school children of Jaipur (p < 0.01). Caries risk increased with the use of both bottle and breast feeding, habit of milk at night, eating snacks between meals with no habit of rinsing teeth, and decrease in parental supervision during oral hygiene practices. In urban school children there is an increased access to junk food and refined sugar daily as compared to rural school children with more than two times in a week was found statistically highly significant in the study (p < 0.01).ConclusionThe prevalence of ECC was higher in urban school children as compared to rural school children in Jaipur. It was found that risk factors such as diet and feeding habits of children and oral hygiene practices by the parents or caregiver are strongly associated with the prevalence of ECC. It was concluded that the epidemiological data, which have been collected in a very comprehensive way can be utilized more effectively to eliminate the root cause of the disease by improving oral health services in the rural and urban school children in Jaipur, India.How to cite this articleYadav SP, Meghpara M, Marwah N, et al. Association of Early Childhood Caries with Feeding, Dietary Habits, and Oral Hygiene Practices among Rural and Urban School Children of Jaipur. Int J Clin Pediatr Dent 2022;15(3):273-279.

The Association of Early Childhood Caries with Salivary Antimicrobial Peptide LL37 and Mutans Streptococci.

This study aims to determine the relation of salivary LL37 level and mutans streptococci levels in early childhood caries (ECC). A case-control study was performed in children ≤71 months old. Unstimulated whole saliva was collected and the level of salivary LL37 was measured using an enzyme-linked immunosorbent assay kit. The mutans streptococci oral bacteria were isolated from saliva and identified using a modified SB-20 culture medium (SB-20M). Data were analyzed using descriptive statistics, bivariate, and Spearman's rank correlation analysis. The was a variability of salivary LL37 level among the children and the level was significantly associated with age and races. The median (IQR) value of salivary LL37 in caries-free (CF) children was significantly higher 393.50 (580.55) ng/mL compared to 172.50 (234.65) ng/mL in the ECC group. The ECC children exhibited a significantly higher count of S. mutans and S. sobrinus compared to the CF children. An inverse weak correlation between salivary LL37 and dmft was also observed. The low salivary LL37 level and higher S. mutans and S. sobrinus count in ECC supported the protective role of salivary LL37 against dental caries. Further studies are required to explore the definite relation between salivary LL37 levels and dental caries.

Associations of early childhood caries with salivary beta defensin-3 and childhood anemia: a case\u2013control study

BackgroundHuman beta defensin-3 (HβD-3) is an antimicrobial peptide present in saliva that protects tooth surfaces from microbial attack. These peptides are part of innate immunity so levels may be affected by different systemic diseases like anemia. Therefore, anemia may predispose an affected child to an increased risk of dental caries. The objectives of this study were to determine the association of early childhood caries (ECC) with HβD-3 levels and observe the association of HβD-3 levels with childhood anemia.MethodsA total of 80 children admitted in a pediatric medical ward, age 48–71 months, of either sex were included in the study. The included children were categorized as cases (children with ECC n = 40) and controls (children without ECC n = 40). Children were further segregated into the anemic and non-anemic sub-groups based on the hospital record of hemoglobin level. The salivary concentration of HβD-3 was measured by Enzyme-Linked Immuno-sorbent assay (ELISA). IBM SPSS version 20 software was used for statistical analysis. Two sample t-test and one-way ANOVA were used to compare mean values while spearman was used for correlations at p < 0.05.ResultsThe mean Salivary HβD-3 level in cases (8.87 ± 4.30) was significantly higher (p = 0.042) as compared to controls (7.23 ± 2.57). Salivary HβD-3 level in patients with caries and without anemia was highest (10.80 ± 4.50) whereas salivary HβD-3 level in the presence of caries and anemia was lowest (6.94 ± 3.13) amongst all groups. This difference was statistically significant (p = 0.001). Salivary HβD-3 level was found to be moderately correlated with cases (p = 0.002). An inverse correlation was found between salivary HβD-3 level and anemia (r = -0.479, p = 0.002).ConclusionAnemia may affect the innate immunity of children, and may result in a decreased level of salivary HβD3, thus increasing vulnerability to decay.

Association of weight, height and body mass index with early childhood caries among primary school children of Peshawar.

Background: Dental caries is the single most common disease in children that has no pharmacological treatment. Global population exhibit some evidence of tooth decay affecting both genders, all races, socioeconomic status and age groups. Good oral health of early childhood has a vital role in overall health of school children. Objectives: The aim of this study was to determine association of weight, height, and body mass index (BMI) with early childhood caries (ECC) among primary school children of Peshawar. Study Design: Cross sectional study. Setting: Different Schools of Hayatabad, Peshawar. Period: Four months (January-April 2019). Material and Methods: Total of 240 school children, having sound heath with no systemic disease were included in the study. Children’s weight and height were recorded and body mass index (BMI) was converted to z-scores and percentiles. The association of ECC with BMI, height and weight was determined. Results: The mean age, weight, height, body mass index, dmfs and Z-score was 5.3±0.79 years, 20.34±3.75 kg, 3.47±0.246 feet, 18.06±4.08 kg/m2, 14.84±15.73, and 1.14±1.22 respectively. The association of early childhood caries among primary school children was not significant with age (P=0.424), height (P=0.622) and gender (P=0.061). The association was highly statistically significant with BMI (P&lt;0.001). Conclusion: Children with higher ECC scores were significantly associated with BMI.

Fine-Mapping of Xq25.1–27.2 Shows Association of Early Childhood Caries with Genetic Variants Depending on Dietary Habits, Protecting Children Who Drink Milk before Going to Bed

Early childhood caries (ECC) is a chronic, infectious disease that affects the primary dentition of young children. It is the result of unequal contributions of risk factors and protective factors that influence the disease. The aim of this study was to assess if the X chromosome region previously linked to caries was associated with ECC. Two hundred and fifty-nine unrelated children with no chronic illnesses from 2 to 5 years of age who had no systemic fluoride consumption were evaluated using a cross-sectional design. Data on oral habits were obtained through a questionnaire, and caries experience data were collected by clinical examination. Twenty-three markers in ten genes were studied. Genotyping of the selected polymorphisms was carried out by real-time polymerase chain reaction. Regression analyses were performed comparing individuals with and without caries experience. Of 259 subjects, 123 were caries free. The markers in Xq25.1–27.2 were associated with ECC when children were using milk bottle for longer times (p = 0.01) and had more snacks over the course of a day (p = 0.05). Conversely, the markers in the X chromosome studied here were protective for ECC (p = 0.008) in children consuming milk before going to sleep. The genes located in the X chromosome possibly contribute to ECC and have an impact on ECC depending on the dietary habits.

Association of early childhood caries experience with oral hygiene status and oral health practices of preschool children in Tandale, Tanzania

Background: Early Childhood Caries (ECC) has short and long-term effects on children and parents. The short-term effects include higher risk of new lesions, emergency room visits and hospitalization, increased treatment costs and days with restricted activity. The long-term effects are diminished learning ability and delayed physical growth and development.Objectives: To determine the association of ECC with oral hygiene status and oral health practices among children attending informal preschools in Dar es Salaam, Tanzania.Materials and methods: A descriptive cross-sectional study among 297 preschool children and their caregivers. Schools were selected using a stratified random sampling technique while children were conveniently selected. A questionnaire to interview parents inquired on socio-demographic characteristics, oral hygiene practices and dietary habits. Clinical examination for children’s plaque and dental caries scores was conducted. Data was analyzed using SPSS Version 20. Chi square and logistic regression statistical tests were done to determine the association between variables. The level of significance was set at p ≤ 0.05Results: Small proportion of the children brushed their teeth twice per day (24.6%), consumed sugar containing snacks (23.9%) or sugary drinks (20.9%) more than twice per day. Seventy percent had caries with a decayed missing and filled teeth index (dmft) of 4.19(±4.52 SD). Children brushing less than twice a day (p=0.021) and having high plaque scores (p=0.000) were more likely to develop dental caries than their counterparts.Conclusion: Caries experience among preschool children was positively associated with poor oral hygiene status and brushing teeth less than twice per day.

Correlation between blood group and early childhood caries in children of Vadodara City, Gujarat: A cross-sectional observational study

Context: The dental caries is a result of localized demineralization on tooth surface caused by metabolic events that occur in the dental plaque. Overall prevalence of early childhood caries (ECC) in general population ranges up to 70%. There are various studies conducted to find the association of ECC with various factors, yet very few studies have been conducted to predict and prevent the ECC before its occurrence. Aims: To perceive whether there is any correlation between blood group and ECC in children of Vadodara city. Settings and Design: The cross-sectional observational study was conducted among 120 selected children in a preschool. The students were segregated into two groups, 60 children with caries and 60 children without caries between chronological age of 2–6 years. Subjects and Methods: Blood group of the children was recorded from the blood group card of the patient, and dental caries status was recorded as decayed-extracted-filled teeth status with the help of autoclaved diagnostic instruments (mouth mirror and No. 23 explorer). Statistical Analysis Used: Kruskal–Wallis test, Mann–Whitney test, independent t-test, and Pearson Chi-square test were used for analysis. Results: From the total participants included in the study, blood group O+ showed maximum occurrence of ECC among all other blood groups. Conclusions: Children belonging to Vadodara city with blood group O+ are at high risk of getting ECC.

Childhood caries as influenced by maternal and child characteristics in pre-school children of Kerala-an epidemiological study

Purpose:The most common chronic disease of childhood is early childhood caries which is five times more prevalent than asthma and seven times higher than that of allergic rhinitis. Most children do not receive dental care until they are three years old, yet by the time more than thirty percent of children from lower socioeconomic groups already have caries. To determine the prevalence and severity of early childhood caries among pre-school children, to describe the child characteristics associated with the development of early childhood caries and to find the association of early childhood caries and maternal risk factors.Materials and Methods:This descriptive study was carried out among children attending the immunization clinic of Sree Avittam Thirunal Hospital, Medical College, Trivandrum and children attending the randomly selected Anganwadies and Day care centres in Trivandrum, the capital of Kerala, wherein there are migrants from all over the State. A total of 350 children aged 12-36 months and their mothers were studied. The mother was first interviewed by a structured questionnaire; then the child's and mothers clinical examination was carried out covering caries experience and oral hygiene status.Results:Among 350 children studied the prevalence of dental caries in this study population was found to be 50.6 %(177). Statistically significant associations were found between the severity of decay and the child's age(P<0.001), female gender(P<0.05),low socioeconomic status (P<0.05), feeding frequency (P<0.05), type of feeding(P<0.01), fell asleep with nipple in mouth (P<0.05), duration of breast feeding(P<0.001), consumption of cariogenic type of snacks(P<0.01), age of commencement of tooth brushing(P<0.05), brushing frequency(P<0.05), oral hygiene status of child(P<0.001), DMFS scores of mothers (P<0.001), and oral hygiene status of mother (P<0.001).

Dental caries in 3‐year‐old children and smoking status of parents

An association has been suggested between environmental tobacco smoke and oral disease. The present study examined the relationship between early childhood caries (ECC) and parental smoking, particularly paternal smoking, using records of 711 36-month-old children. The smoking status of parents as an independent variable was entered in the multivariable logistic regression model for caries experience as the dependent variable with confounders: sex, residential location, and possible risks of ECC such as order of birth, type of main drink, frequency of daily intake of sugar-containing snacks, daily toothbrushing by parents and use of fluoridated toothpaste. About 65% of children were caries free. Children whose parents did not smoke (CN), those in whom only the father smoked (CF), and those whose mother smoked regardless of the smoking status of the father (CM) comprised 33%, 33% and 34% respectively. The adjusted mean number [95% CI] of decayed teeth and caries experience prevalence for CN, CF and CM were 1.2 [0.8, 1.6], 1.6 [1.2, 2.0] and 2.1 [1.7, 2.5], and 25.6%, 35.3% and 45.7% respectively. The relationship between caries experience and parental smoking was significant on multivariable analysis. The adjusted OR [95% CI] of CF and CM relative to CN was 1.52 [1.01, 2.30] and 2.25 [1.51, 3.37] respectively. These results indicate the association of ECC with parental smoking, although the association with paternal smoking was weaker than with maternal smoking.

The association of early childhood caries and race/ethnicity among California preschool children.

This paper explores the role of race/ethnicity in the occurrence of early childhood caries (ECC) among California Head Start (HS) and non-HS preschool children. Using oral examination and questionnaire data from the 1993-94 California Oral Health Needs Assessment of Children, we computed the prevalence of ECC using various definitions and fitted logistic regression models to explore the effect of race/ethnicity on ECC, separately for HS and non-HS children, adjusting for bedtime feeding habits and other covariates. Among 2,520 children, the largest proportion with a history of falling asleep sipping milk/sweet substance was among Latinos/Hispanics (72% among HS and 65% among non-HS) and HS Asians (56%). HS Asians and Latinos/Hispanics had the largest prevalence of ECC (30%-33%) and untreated caries (49%-54%). The estimated risk for ECC was more than three times higher in HS Asians compared to HS whites and among non-HS African Americans and Asians compared to non-HS whites controlling for socioeconomic status variables. The risk of ECC was also significantly higher among children who fell asleep while sipping milk or any sweet substance compared to those who did not. Studies of the cultural/behavioral patterns that may be specific to ethnic subgroups with the highest risk for ECC seem essential to the development of effective prevention strategies.