IADR Abstract Archives
Caries Risk Factors Vary Between Early Childhood Caries Subtypes
Objectives: Early childhood caries (ECC) has diverse clinical presentations which might reflect variation in the underlying etiology and thus may hamper efforts for its precise diagnosis and optimal management. We sought to investigate differences in common modifiable caries risk factors between clinical subtypes of ECC in a community-based sample of preschool-age children.
Methods: Five ECC clinical subtypes were derived using latent class analysis (LCA) of ICDAS surface-level caries experience (defined at the ICDAS≥3 caries lesion detection threshold) from a community-based sample of 3-5-year-old (mean age=54 months) public preschool-attending children in North Carolina, USA. The existence of these ECC subtypes was verified in two similarly aged samples, including 38,289 caries-affected children from a Swedish population-based cohort and 1,313 children from the US National Health and Nutrition Examination Survey. Caries risk factors included oral health-related diet, oral hygiene, and dental care-seeking behaviors (OHB), examined individually as well as favorable versus unfavorable OHB patterns derived via LCA clustering. Statistical tests accounted for the complex study design by estimating Taylor-linearized variances using Stata 16.1 (StataCorp LLC, College Station, TX).
Results: The analytical sample comprised 3,465 ECC cases. Unfavorable OHB (28% among all cases) were more common among children with the most severe ECC subtypes, i.e., maxillary anterior disease-characterized types III (16% of cases, dmfs=22) and V (8% of cases, dmfs=56) had 33% and 35% unfavorable OHB respectively, versus 27% among the most common, low disease experience type I (49% of cases, dmfs=4). These OHB differences were most pronounced for history of nighttime bottle feeding with anything other than water and having a dental home (both P<0.0005).
Conclusions: Our findings suggest possible differences in behavioral risk factors between ECC clinical subtypes. Upon replication in other populations and settings, these results support the potential utility of clinical disease subtypes in ECC classification, prevention, and management.
Methods: Five ECC clinical subtypes were derived using latent class analysis (LCA) of ICDAS surface-level caries experience (defined at the ICDAS≥3 caries lesion detection threshold) from a community-based sample of 3-5-year-old (mean age=54 months) public preschool-attending children in North Carolina, USA. The existence of these ECC subtypes was verified in two similarly aged samples, including 38,289 caries-affected children from a Swedish population-based cohort and 1,313 children from the US National Health and Nutrition Examination Survey. Caries risk factors included oral health-related diet, oral hygiene, and dental care-seeking behaviors (OHB), examined individually as well as favorable versus unfavorable OHB patterns derived via LCA clustering. Statistical tests accounted for the complex study design by estimating Taylor-linearized variances using Stata 16.1 (StataCorp LLC, College Station, TX).
Results: The analytical sample comprised 3,465 ECC cases. Unfavorable OHB (28% among all cases) were more common among children with the most severe ECC subtypes, i.e., maxillary anterior disease-characterized types III (16% of cases, dmfs=22) and V (8% of cases, dmfs=56) had 33% and 35% unfavorable OHB respectively, versus 27% among the most common, low disease experience type I (49% of cases, dmfs=4). These OHB differences were most pronounced for history of nighttime bottle feeding with anything other than water and having a dental home (both P<0.0005).
Conclusions: Our findings suggest possible differences in behavioral risk factors between ECC clinical subtypes. Upon replication in other populations and settings, these results support the potential utility of clinical disease subtypes in ECC classification, prevention, and management.