Diarrhea in Babyhood and Hypertension in Pregnancy, Possible Etiologic Factors for Enamel Defects in Primary Dentition

Objectives: The high prevalence of early childhood caries (ECC) is of great interest in China nowadays. Several studies have documented the relationship between ECC and developmental defects of enamel (DDE) in primary dentition. To date, mere studies reported the prevalence of DDE and possible factors in China. The present study aimed to evaluate the prevalence of DDE and its associated factors in preschool children aged from 3 to 6 years in East China.
Methods: A descriptive cross-sectional study was carried out among 1351 preschool children randomly selected from 3 representative districts (2 in urban, 1 in suburban) in Shanghai, China. Caries experience was measured based on World Health Organization (WHO) criteria. A modified developmental enamel defects index was used to diagnose DDE. Questionnaires were completed by the children’s guardians including social-demographic background, maternal disorders and neonatal disease.
Results: The most common type of DDE was opacities at the individual level (26.1%) followed by different types of hypoplasia (19.4%) according to individual DDE score. There were significant association between DDE and caries. In the final logistic regression model, children living in urban areas were more susceptible to DDE than those in suburban. Children with diarrhea experience during the first year of life and children suffering from gestational hypertension showed high risk of DDE acquisition.
Conclusions: In conclusion, the most common type of DDE in primary dentition was identified as opacities in east China. We also identified gestational hypertension and neonatal diarrhea could be possible etiologic factors for DDE in primary dentition. These results suggested the professional care is essential and necessary during pregnancy and early childhood.