Caries Risk Factors Associated with Early Childhood Caries

Objectives: The objective of this study was to investigate the relationships between the caries risk factors and early childhood caries (ECC) experience among children visiting the University of Iowa Pediatric Dental Clinic (UIPDC).
Methods: Data were collected during a retrospective chart review of patients, ages one through five years, presenting for initial dental examinations in the UIPDC by third year dental students from 01/01/2017 to 05/01/2019. Caries risk assessment (CRA) information was collected using a CRA form completed at the initial dental examination. ECC experience was defined in this population by anyone who had frank caries, white spot lesions, and/or previous restorations. The statistical analyses consisted of descriptive statistics, bivariate analyses, and logistic regression (alpha=0.05).
Results: A total of 398 subjects (30.4% had ECC experience, 50% females) who fulfilled all the inclusion criteria were included in the study. Of the 121 subjects who had ECC, the mean age was 4.0±1.4 years vs. 2.5±1.3 years for those with no ECC. Bivariate analysis revealed that increased age of the child, irregular dental care, low SES, caregiver with low dental health literacy, child's consumption of between-meal cariogenic snacks, and teeth not brushed everyday were significantly associated with presence of ECC. The logistic regression analysis showed that children in the ECC group were more likely to be older (OR=1.84; p<0.001), have enamel defects (OR=2.92; p=0.022) and poor oral hygiene (OR=9.32; p<0.001), consumed cariogenic beverages more than 2 times per day (OR=2.19; p=0.005), and have a parent or sibling with decay (OR=1.92; p=0.048).
Conclusions: Results of the study suggest several of the caries risk factors significantly associated with ECC experience. Efforts for practitioners to promote education regarding proper oral hygiene, limit cariogenic snacks/beverages, manage enamel defects, and encourage regular dental care should be continued.