Determining the prevalence and risk factors for early childhood caries in a community dental health clinic

PURPOSE: The purposes of this study were to: (1) determine the prevalence of early childhood caries (ECC) among young children accessing dental services at a community dental clinic; (2) identify factors associated with the presence of ECC; and (3) determine the percentage of children who received treatment for ECC in this setting and the number who required referral to specialists. METHODS: The study population comprised children younger than 72 months attending the clinic between 1991 and 2004. A chart review was conducted. RESULTS: Eight hundred thirty-four charts met inclusion criteria; 71% had ECC, while the mean deft was 3.7+/-3.9 (SD). The average age at the first visit was 50.0+/-12.7 (SD) months. Those with ECC were significantly older at the first visit (P<.001), and the prevalence increased with family size (P=.011) and number of siblings (P=.019). ECC children were significantly more likely to come from households with lower monthly incomes (P=.033). The prevalence of ECC did not vary according to specific areas in Winnipeg where children resided (P=.20). CONCLUSIONS: Key risk factors for ECC included: (1) the child's sex; (2) low monthly income; (3) whether the child resided with both parents; and (4) a history of foiled dental visits. These data may assist in identifying children at greatest risk for ECC and may help public health agencies develop appropriate prevention strategies, including promoting early dental visits for infants.     

Psychosocial factors and early childhood caries among low-income African-American children in Detroit

Objectives: This study sought to advance knowledge of the social determinants of oral health, by examining how several specific maternal health beliefs, behaviors, and psychosocial factors relate to young children's early childhood caries (ECC) status in a lower‐income African–American population. Methods: Data were collected by the Detroit Dental Health Project (NIDCR grant), a population‐based study of 1021 African–American families with at least one child under 6 years of age and living in 39 low‐income Census tracts in Detroit, Michigan. Analyses were limited to 719 children aged 1–5 years and their biological mothers, and conducted in SUDAAN to account for the complex sampling design. Survey data included health belief scales on mothers’ self‐efficacy, feelings of fatalism, knowledge about appropriate bottle use and children's oral hygiene needs, brushing habits, psychosocial measures of depressive symptoms (CES‐D), parenting stress, and availability of instrumental social support. The child's age, dental insurance status, dental visit history, and 1‐week brushing frequency were also included in the model. Children's ECC status, based on a dental examination, was the main outcome. The dental team used the International Caries Detection and Assessment System (ICDAS) criteria for caries detection. Each child was classified as either caries‐free or having ECC or severe ECC (S‐ECC) based on the case definition of ECC proposed by an expert panel for research purposes with preschool‐aged children. Results: The dental team followed a specific examination protocol and established reliable and consistent ratings of ECC based on the ICDAS criteria. The inter‐rater reliability kappa was 0.83 overall, and the intra‐rater reliability kappa was 0.74 overall. One‐third of the children had ECC, and 20% had severe ECC. Age of the child and lower parenting stress scores were each positively associated with ECC, while higher education and income were protective. Maternal oral health fatalism and knowledge of children's hygiene needs were associated with ECC among preschool‐aged children. ECC was higher among younger children who had past restorative care. Conclusions: These findings call attention to the high prevalence of ECC in this population and the need to consider psychosocial as well as traditional risk factors in developing interventions to reduce oral health disparities.     

RISK PREDICTORS OF EARLY CHILDHOOD CARIES INCREMENT—A SYSTEMATIC REVIEW AND META-ANALYSIS

This systematic review aimed to investigate the risk predictors of caries in primary teeth and evaluate their association with the increment of Early Childhood Caries (ECC) among preschool children. This systematic review included only cohort or case-control studies of at least 2 years duration, over 300 participants and with English full-text. Potentially eligible studies were retrieved from 4 electronic databases (Ovid Embase, Ovid MEDLINE; PubMed, Web of Science) from inception to March 1, 2021. Independent screening and data extraction by 2 reviewers to identify factors associated with ECC increment, including family and socioeconomic factors, dietary and oral health-related habits, and clinical parameters. A total of 18 studies from 163 potential reports were included, involving 1,159,226 preschool children. Lower parental education attainment was found associated with ECC increment (WMD:0.87; 95% CI 0.52, 1.21); whereas immigration status (WMD:-0.38; 95% CI -1.09, 0.34), gender (WMD:-0.02; 95% CI -0.28, 0.24), and dental service utilization (WMD:0.35; 95% CI -0.10, 0.79) were not significant factors for ECC increment. All included studies consistently suggested positive correlations between ECC increment and baseline caries experience, plaque level, cariogenic microorganisms, and prenatal and passive smoking, while mixed findings were detected between ECC increment with dietary and oral hygiene practices. Preschool children whose parents have low education level are more likely to have greater increment of ECC over 2 years. Existing caries lesions, increased dental plaque level, cariogenic microorganisms, prenatal or passive smoking were also consistently identified as risk factors for ECC in all reviewed studies. This systematic review highlights specific risk factors to target for the prevention of ECC and supports implementing more oral health promotion for preschool children with parents of lower educational attainment.     

Dental caries in 0- to 5-year-old Brazilian children: prevalence, severity, and associated factors

OBJECTIVE: This cross-sectional study investigated the prevalence and severity of dental caries and their association with demographic and socio-economic variables in Brazilian preschoolers. METHODS: The study population comprised 1487 0- to 5-year-old children attending government nurseries in Canoas, southern Brazil. Questionnaires regarding information related to the independent variables (age, gender, maternal level of education, and family income) were completed by the parents. Clinical examinations were carried out by five trained examiners and results were expressed using the deft index (World Health Organization criteria), including white spots. The outcomes considered in this study were caries occurrence (deft > 0) and caries severity (deft). RESULTS: Forty per cent of the children (589/1487) presented dental caries [mean deft (SD): 1.53 (2.75)]. Deft increased with age (P < 0.001) and was significantly higher in children from mothers with low educational level (P = 0.001) and low family income (P = 0.001). The greatest increase in caries prevalence and severity occurred between age groups of 1 and 2 years. Logistic regression demonstrated higher odds of dental caries with mother's completing < 4 years education, after adjusting for confounding. CONCLUSION: These findings indicate the need for preventive programmes, which should begin in the first year of life, with special attention given to families with mothers presenting low education levels.     

Parental stress as a predictor of early childhood caries among preschool children in India

International journal of Paediatric Dentistry 2013; 23: 160–165 Background. The health and well‐being of children are linked to their parents’ physical, emotional and social health in addition to child‐rearing practices. Objectives. To investigate the association of parental stress as a risk indicator to early childhood caries (ECC) prevalence among preschool children of Moradabad, India. Methods. A case–control study was conducted among 800 preschool children [400 cases (caries active) and 400 controls (caries free)] aged 4–5 years along with their parents. Using the Parental Stress Index‐Short Form (PSI/SF), we determined the stress of primary caregivers of young children. These children were clinically examined for dental caries using Dentition Status and Treatment needs. Student’s t‐test, Pearson’s correlation and linear regression were used for statistical analysis. Results. An overall mean parenting stress index was found to be 193.48 ± 59.63. Significantly higher mean stress scores were obtained among cases than among controls. Parental stress was significantly correlated with dmft scores and it was found to be one of the best predictors of ECC. Conclusion. This study provides data to suggest that parental stress has a pervasive impact on the children’s oral health. The practitioners should be aware of this possible relationship and be prepared to provide appropriate intervention.     

Prevention of early childhood caries: a public health perspective

This paper proposes strategies for preventing early childhood caries (ECC), preferably for the greatest number of children at the lowest cost. Population-based, public health approaches are more likely to reach the target population groups at risk of developing ECC than individual, private practice-based approaches. Different prevention and early intervention strategies are discussed and the following recommendations are made: 1) Continue to promote community water fluoridation. 2) Evaluate the effectiveness of other public health oriented measures to prevent ECC. 3) Develop a national ECC and rampant caries registry. 4) Link oral health screening and easily implemented, low-cost interventions with immunization schedules and public health nursing activities. 5) Increase opportunities for community-based interventions conducted by dental hygienists. 6) Change insurance reimbursement schedules to provide incentives for dentists to prevent disease. 7) Include dentistry in new child health insurance legislation for children as well as parents of infants and preschool children.     

Oral health-related quality of life and caries experience of Hong Kong preschool children

Objective: This study aimed to investigate the association between oral health-related quality of life (OHRQoL) and caries experience of Hong Kong preschool children. Methods: Parents or primary caregivers of Hong Kong preschool children were invited to complete a self-administered dental health questionnaire. The study children were examined in their classrooms. The decayed, missing and filled primary teeth (dmft) index was used for documenting the caries status. The questionnaire included the Chinese Early Childhood Oral Health Impact Scale (ECOHIS) and collected sociodemographic information on the parents and children. Logistic regression analysis was used to determine the association between OHRQoL and caries experience of preschool children. Results: A total of 434 preschool children were invited to participate in the study; 336 (77.4%) received a dental examination and returned a parental questionnaire. The mean (SD) age of the study children was 4.7 (0.3) years. An OHRQoL impact (ECOHIS score of >0) for at least one item was reported by 236 (70.2%) parents/caregivers of the children included in the study. The overall mean (SD) ECOHIS score was 5.8 (6.2). A caries prevalence (dmft > 0) of 36.9% and a mean (SD) dmft score of 1.7 (3.2) were calculated for the study children. In the final logistic regression model, children with a higher dmft score had a significantly higher chance of having a poorer OHRQoL (OR = 1.20, 95% CI: 1.07–1.35, P = 0.002), whereas children’s sex, parent’s education levels and the respondent’s relationship to the child were not associated with OHRQoL (P > 0.05). Conclusion: Caries experience is associated with lower OHRQoL of Hong Kong preschool children.Key words: Child, dental caries, early childhood caries, oral health, quality of life     

Early childhood caries prevalence and associated risk factors among Saudi preschool children in Riyadh

AimTo determine the prevalence of early childhood caries (ECC) and investigate the effect of associated risk factors on ECC prevalence in preschool children in Riyadh, Saudi Arabia.MethodsThis cross-sectional study included Saudi preschoolers aged 36–71 months. Parents/guardians completed a structured, self-administered questionnaire assessing sociodemographics; medical, dental, and dietary history; and oral hygiene practices. Children were orally examined for dental caries, oral hygiene, and plaque deposition.ResultsA total of 383 children were examined. ECC prevalence was 72.6%, with a mean decayed, missing, and filled teeth (dmft) score of 4.13 (±3.99) and a mean decayed, missing, and filled surfaces (dmfs) score of 7.0 (±9.1). Children from schools in northern Riyadh and those of fathers in professional jobs were less likely to have ECC [(OR: 0.203; 95% CI: 0.082–0.503)] and [(OR: 0.472; 95% CI: 0.256–0.871)], respectively. Children with a nocturnal feeding history and poor oral hygiene were more likely to have ECC [(OR: 2.281; 95% CI: 1.143–4.553)] and [(OR: 5.523; 95% CI: 2.269–13.441)], respectively.ConclusionsThe prevalence of ECC in preschool children in Riyadh is high and affected by parental socioeconomic factors, infant feeding practices, and children’s oral hygiene status.     

Early childhood caries: prevalence and risk factors in Seoul,Korea

OBJECTIVE: The purpose of this study was to determine the prevalence of early childhood caries (ECC), including noncavitated lesions (d1), in children 6-59 months of age in relation to socioeconomic factors, feeding practices, and oral health behaviors in Seoul, Korea. METHODS: The children attended child care facilities and were selected from 32 primary sampling units. Two dentists examined 470 children. Parents of 383 of the subjects were interviewed by phone regarding caries risk factors. RESULTS: For children 6-59 months of age, the prevalence of ECC and severe ECC were 56.5 percent and 47.0 percent respectively. In bivariate analysis, the children whose nursing bottle contained sweetened solution had higher severe ECC prevalence (P=.035), and children whose parents reported a lower frequency of between-meal snacks showed lower ECC prevalence (P=.046). By logistic regression analysis, age and frequency of between-meal snacks were associated with the prevalence of ECC (P<.05). CONCLUSION: This study demonstrates that the prevalence of ECC was high among children in Seoul. Early educational intervention programs for pregnant women and mothers of young children should be developed based on the risk factors identified in this study.     

Prevalence of Early Childhood Caries Among Very Young Urban Boston Children Compared with US Children

Objectives: The aims of this study were to compare prevalence of early childhood caries (ECC) in 1- to 3-year-old children seeing primary-care pediatricians at two urban medical centers in Boston to the prevalence of ECC in similarly aged US children surveyed as part of the Third National Health and Nutrition Examination Survey (NHANES III) and to assess risk factors for ECC among this cohort of children compared with risk factors among similarly aged US children. Methods: Characteristics of 787 1- to 3-year-old children from two urban Boston medical centers were compared with those of 3,644 similarly aged US children surveyed as part of NHANES III. Demographic and social characteristics and ECC prevalence by putative risk factors were compared. A multiple logistic regression model was fit to assess putative risk factors and difference between groups simultaneously. Results: Race, age, previous dental visit, parents' education, and household income were significantly associated with ECC prevalence. Parents' place of birth was a significant effect modifier with lower ECC among Boston children of immigrants than among US children of immigrants. Conclusions: Lower ECC prevalence among urban Boston children of immigrant parents compared with US children of immigrant parents may reflect changing immigrant composition in the United States since NHANES III or a different immigrant composition in the Boston area compared with the United States. This finding reinforces the need for further research of immigrants in order to understand cultural practices that may affect oral health. Finally, low ECC prevalence among very young children reinforces the importance of early intervention in reducing ECC.     

A review of a community program aimed at preventing early childhood caries among Jerusalem infants--a brief communication

Early childhood caries (ECC) has not been adequately investigated in Israel. A previous Jerusalem study has demonstrated a potential effect on toothbrushing among infants. The present study was initiated in order to examine caries prevalence and the potential effect of a community intervention program. OBJECTIVES: This study aims to review an intervention program and assess ECC distribution and associated variables. METHODS: The study sample included 1,500 infants in matched "intervention" and "control" Mother and Child Health centers. The 2-year program, initially including all children at the age of 6 months, focused on the free distribution of toothbrushes and toothpastes. ECC prevalence was determined in a cross-sectional study. RESULTS: At 2.5 years, 596 children were examined (40 percent compliance). About half of the parents reported that they had participated once or not at all over the 2-year period, which demonstrated low program participation. Among the examined children, ECC prevalence was 15.3 percent. No difference in caries levels was found between the program and control groups. The reported level of brushing twice daily was 13.9 percent, while 26.8 percent reported not brushing at all. Eighty-one percent reported going to bed at night with a bottle. Children who drank sugar-sweetened beverages had ECC levels significantly higher than those who drank milk or natural juice (18.8 percent versus 8.9 percent). CONCLUSIONS: The dental health and behavior and lack of intervention success emphasized the need to seek a more effective strategy. Emphasis on toothbrushing might not be the only nor optimal solution for this serious public health problem.     

上海市1296名3~5岁儿童龋病及其相关危险因素分析

目的 了解上海市3~5岁儿童低龄儿童龋患病情况及相关危险因素,为龋病防治提供参考。方法 根据第4次全国口腔健康流行病学调查要求,采用多阶段分层、等容量随机抽样方法,抽取上海市1 296名4个区、12个幼儿园中3~5岁儿童进行龋病检查,对其家长进行口腔健康知识问卷调查。采用SPSS 21.0软件包进行统计学分析。结果 上海市3~5岁儿童的乳牙患龋率、龋均分别为58.07%、2.99,各年龄组及性别间差异均有统计学意义(P<0.05)。龋病相关单因素分析及多因素Logistics回归分析均显示,饮用甜饮料频率高、睡前吃甜食、刷牙频率少于每天1次、开始刷牙年龄大于2岁、家长受教育程度低及口腔健康知识水平差是患龋的危险因素。结论 上海市3~5岁儿童乳牙患龋率较高,加强儿童的饮食习惯及口腔卫生行为教育,提高家长口腔健康知识水平,是防治儿童龋病的有效途径。     

Oral health-related quality of life and early childhood caries among preschool children in Trinidad

Background

Early childhood caries (ECC) is a public health problem in developed and developing countries. The purpose of this study was to describe the relationship between oral health-related quality of life (OHRQoL) and ECC among preschool children in a Caribbean population.

Method

Parents/primary caregivers of children attending nine, randomly selected preschools in central Trinidad were invited to complete an oral health questionnaire and have their child undertake an oral examination. The questionnaire included the Early Childhood Oral Health Impact Scale (ECOHIS). Visible caries experience was assessed using WHO criteria. Logistic regression models were used to determine the factors associated with OHRQoL and ECC.

Results

Three hundred nine parents/caregivers participated in the study (age-range 25–44 years) and 251 children (mean age 3.7 years) completed oral examinations. Adjusting for other factors, the odds for a child aged 4 years of having dental caries were greater than the odds for a child aged 3 years (OR 3.61; 95% CI (1.76, 6.83). The odds for children having difficulty drinking hot or cold drinks were greater for those with dental caries than the odds for children who have no such difficulty. Similarly, the odds for children who had difficulty eating were greater for those with dental caries than the odds ratios for children who had no difficulty eating (OR 8.29; 95% CI (2.00, 43.49). Adjusting for the effects of other factors, the odds of parents/caregivers feeling guilty were greater if their child had experienced dental caries in comparison to parents/caregivers whose child did not have dental caries (OR 3.50; 95% CI (1.32, 9.60). Adjusting for other factors, the odds of parents/primary caregivers having poor quality of life was increased when they had a child with a dmft in the range 1–3 (OR 2.68; 95% CI (1.30, 5.64) dmft?>?4 (OR 8.58; 95%CI (3.71, 22.45), in comparison to those whose child had a dmft?=?0.

Conclusion

In this sample of preschool children OHRQoL was associated with ECC. More negative impacts were found in children with a greater severity of visible caries experience. This suggests the need for strategies to prevent and manage ECC in this Caribbean population.

     

Outcome of an oral health outreach programme for preschool children in a low socioeconomic multicultural area

Background. Despite a significant reduction in the prevalence of dental caries, childhood tooth decay is still a public health problem in both developed and developing countries. Objective. The aim of this study was to evaluate the caries preventive effect of an oral health programme for preschool children living in a low socioeconomic multicultural area in the city of Malmö, Sweden. Methods. Eight hundred and four 2‐year‐old children were enrolled and recalled every third month between ages 2 and 3 and semi‐annually between ages 3 and 5 years. From an outreach facility, parents were instructed on oral health with a focus on toothbrushing and diet, and provided fluoride tablets free of charge. Participants completed a clinical examination and a structured interview at age of 5 years, at which point 651 children (81%) remained in the programme. The results of the intervention group were compared with a non‐intervention reference group consisting of 201 5‐year‐old children from the same district. Results. In the intervention group, 96% attended four or more of their scheduled appointments, and mean caries prevalence was significantly lower than in the reference group (5.4 deft vs. 6.9 deft; P < 0.001). The prevented defs fraction was 27%. Parents’ daily assistance with toothbrushing and administering fluoride tablets was significantly better in the intervention group than in the reference group (P < 0.05). Conclusion. This study demonstrated that the early start of oral health programme had a significant beneficial effect on caries prevalence after 3 years.     

Early childhood caries and dental plaque among 1-3-year-olds in Tehran, Iran

The association between plaque and caries in older children and adults has been poor, however, some studies show that there may be a relationship in younger children. The aim was to study the relationships between dental caries and dental plaque among 12-36-month-olds in Tehran, Iran. A cross-sectional study among a stratified random sample of 504 children aged one to three years from 18 public health centres in Tehran. Mothers were interviewed about their child's date and order of birth, gender, primary caregiver, the mother's age and the educational level of both parents. Dental examination was carried out according to the WHO criteria. Early childhood caries (ECC) was defined as the presence of any dmf teeth. Dental plaque was visually inspected on the labial surfaces of upper central incisors. Data analysis included Chi-square test, t -test, anova and logistic regression modelling. The prevalence of ECC ranged from 3 to 33% depending on age group, with a mean dt of 1.1 for 26- to 36-month-olds. No gender-differences existed in ECC prevalence and mean dt. Dental plaque was visible on at least one index tooth for 65-75% of the children. Presence of ECC was related to the presence of dental plaque (OR = 1.5; 95% CI 1.0-2.3) when controlling for background factors by means of logistic regression. The high occurrence of visible plaque and rather high ECC prevalence call for improvement in oral health promotion programs of the children.     

Prevalence of dental caries in Early Head Start children as diagnosed using teledentistry

PURPOSE: This study's purpose was to assess caries prevalence by means of teledentistry in 12- to 60-month old children enrolled in Early Head Start inner-city child core centers. METHODS: Images of the primary dentition were obtained by trained telehealth assistants using on intraoral camera. Images were entered into a Web-based storage and retrieval program. They were transmitted to a secure, remote-site computer and evaluated by a calibrated pediatric dentist. RESULTS: Of 162 children screened, 93 were caries free and 69 had early childhood caries (ECC). Of these, 28 had severe early childhood caries (S-ECC). The mean dfs score for all 162 children was 1.88. The mean dfs score for the 69 ECC children was 4.42. The mean dfs for the subgroup of 28 S-ECC children was 7.61. Caries scores of S-ECC children were statistically significantly different from caries scores of the entire cohort and from caries scores of the ECC children. CONCLUSIONS: This study's results show that: (1) almost half of the preschoolers enrolled in the study were affected by dental caries; (2) only a few children had ever had a dental visit; and (3) teledentistry offers a potentially efficient means of screening high-risk preschool children for signs of early childhood caries.     

Caries is the main cause for dental pain in childhood: findings from a birth cohort

Aim: The aim of the study was to evaluate the prevalence of dental pain in preschool children and its association with socioeconomic, demographic, clinical, and behavior variables. Subjects and Methods: The study was nested in a population-based birth cohort from Pelotas, Brazil, started in 2004. A sample of 1,129 children aged 5 years was dentally examined, and their mothers were interviewed. Exploratory variables included demographics, socioeconomic status, mothers' oral health status and associated behaviors, and caries in primary teeth. Data were analyzed using multivariable Poisson regression. Results: The prevalence of dental pain was 16.5% (95% CI: 14.4-18.8). Multivariate analysis showed that dark-skinned children (prevalence ratio, PR = 1.6, 95% CI: 1.1-2.4) from low socioeconomic level (PR 1.9, 1.2-3.0) whose mothers had less than 4 years of education (PR 1.9, 1.0-3.6), from mothers with less than 10 teeth in at least one arch (PR 1.7, 1.2-2.5) and less than 10 in two arches (PR 1.6, 1.0-2.6), and those with high caries prevalence at the age of 5 years (PR 4.8, 3.3-7.1) were more likely to experience dental pain. Conclusions: Unrestored caries is the main factor associated with dental pain in childhood. Socioeconomic aspects and family context in which dental pain occurs should also be taken into account when dental pain preventive measures are implemented.     

A systematic review of clinical diagnostic criteria of early childhood caries

OBJECTIVE: This paper reviews case definitions and clinical diagnostic criteria of early childhood caries (ECC) and severe ECC (S-ECC) in children aged 1 to 5 years old. The acronym S-ECC as used in this paper refers to nursing caries, baby bottle tooth decay, rampant caries, labial caries, maxillary anterior caries, and other terms used to refer to severe dental caries in preschool children. METHODS: A search was carried out for articles published in peer-reviewed journals and indexed in MEDLINE using the following terms: nursing caries, baby bottle tooth decay, early childhood caries, rampant caries in preschool children, labial caries, maxillary anterior caries, and nursing bottle caries. MEDLINE's MeSH terms "dental caries" and "deciduous teeth" were used to search for other relevant studies. Reports were selected if they included children 1 to 5 years of age and described diagnostic criteria or case definitions of S-ECC. Three previous reviews were searched for other relevant reports. One unpublished report was included in this review and data from NHANES III were analyzed to provide information on caries patterns in preschool children in the United States. The first author read all the abstracts from the MEDLINE search and tagged relevant reports for photocopying. He also abstracted all the information from the reports. The first author calibrated the second author, who independently read all included and excluded reports. Disagreements were resolved by consensus. RESULTS: Out of 126 studies, 32 were excluded and 94 (93 published and 1 unpublished) were included in this review. Eighty-one of the 94 published studies were cross-sectional surveys or clinical studies, 7 were case-control clinical studies, 2 studies were controlled clinical trials, and 4 were cohort or field trials. About two-thirds of the included studies did not report on calibration of examiners. Information on reliability of examiners was reported by 19 of the 94 studies. The included studies varied widely in the name used to identify S-ECC, case definitions, and diagnostic criteria. "Cavitation" was the most common criterion used to define dental caries. Several studies measured early or noncavitated carious lesions. Twenty-seven studies used the presence of 1 dmf maxillary incisor to classify a child with S-ECC. Another 23 and 9 studies defined S-ECC by the presence of 2+ or 3+ dmf maxillary incisors, respectively. Dental caries in preschool children clusters in pits and fissures and on smooth tooth surfaces of primary molars and maxillary incisors. CONCLUSIONS: This review found a wide variation in the case definitions and diagnostic criteria used to diagnose ECC or define S-ECC. Dental caries in the maxillary incisors is one of several patterns of dental caries that may occur in primary teeth of preschool children. A consensus is needed on case definitions and diagnostic criteria that can assist researchers to test preventive interventions and study the etiology and epidemiology of ECC.     

重庆市学龄前儿童乳牙龋状况及影响因素分析

目的 探讨重庆市3~5岁学龄前儿童乳牙患龋状况及相关影响因素,为学龄前儿童龋病的预防和干预提供相关资料。方法 参考第四次全国口腔健康流行病学调查,对重庆市4个区学龄前儿童进行抽样调查,同时对家长进行问卷调查。利用Epidata 3.1和SPSS 21.0软件进行结果录入和统计学分析。结果 共计1 350名学龄前儿童纳入调查分析,口腔检查相关数据显示乳牙龋好发牙位是上颌乳中切牙和下颌乳磨牙,乳牙患龋率为51.4%（694/1 350）,龋均为2.34,各年龄组间患龋率和龋均差异有统计学意义（P<0.01）,且二者随着年龄增长而上升（P<0.05）。除5岁组男、女龋均有统计学差异外（P<0.05）,其余患龋率和龋均在不同性别间差异均无统计学意义（P>0.05）。61.7%龋坏集中在36.1%个体口腔中。多因素Logistic回归分析显示年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评对乳牙患龋有重要影响（P<0.05）。结论 重庆地区3~5岁儿童超过半数患龋,多数龋齿集中发生在少数患儿口内。乳牙患龋与年龄、家长的最高学历、甜饮料（包括碳酸饮料等）摄入频率、过去1年是否有牙痛或不适、是否看过牙、牙齿和口腔健康状况自评有关。     

Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts

The aim of this study was to investigate the caries-related microorganisms in saliva and the prevalence of Early childhood caries (ECC) in 15- to 35-month-old Turkish children and their associations with the characteristics of the mothers, socioeconomic criteria, and feeding habits of the children. METHODS: Saliva samples of 101 children were studied to determine the numbers of Streptococcus mutans, lactobacilli, and Candida albicans. A questionnaire regarding the characteristics of the mothers, socioeconomic criteria, and feeding habits of the children was carried out before the dental examinations of the mother-child pairs. RESULTS: The regression analyses revealed DMFS scores of the mothers as an impact factor for the children's caries experience. The prolonged usage of feeding bottle with sweetened milk, pacifier use, and maternal sharing were strongly associated with the colonization of S. mutans, lactobacilli, and C. albicans, respectively. A significant correlation was also found between maternal education and S. mutans. CONCLUSION: Data indicated that the mother's DMFS scores, education, and feeding habits were strong risk indicators for the colonization of caries-related micro-organisms and ECC.