Risk factors associated with ECC-surface location among low-income young children

Objectives: Early childhood caries (ECC) continues to be a major public health concern, while our knowledge of risk factors associated with ECC by surface type is limited. The purpose of this study was to assess risk factors for smooth-surface caries in primary anterior teeth and smooth-or-pit-fissure-surface caries in posterior teeth in children enrolled at the University of Iowa’s Infant Oral Health Program (IOHP). An additional goal was to identify the strongest future caries-risk indicators collected at IOHP.
Methods: Data were obtained from a chart review of 104 subjects aged 6-48 months at the initial IOHP visit who then became patients at the University of Iowa College of Dentistry (aged ≤72 months at the most recent visit). Statistical analysis consisted of descriptive statistics and bivariate analysis.
Results: Children (51% male, 79.8% non-White) had an average age of 24.5±9.3 months and averaged 15.4±4.5 teeth. About 31% exhibited ECC and 54.5% were classified as high caries-risk at their first IOHP visit. Bivariate analysis revealed that children with cavitated (p=0.0004) and non-cavitated (p=0.0051) lesions, and high caries-risk (p=0.0715) at the initial IOHP visit were more likely to have greater numbers of decayed-and-filled-cavitated-lesions on smooth-surfaces in primary maxillary anterior teeth at follow-up, while children with cavitated lesions (p=0.0099) were more likely to have greater numbers of decayed-and-filled-cavitated-lesions on smooth-or-pit-fissure-surfaces in posterior teeth. Additionally, results showed the strongest caries-risk indicators for future caries (p<0.05) were consumption of cariogenic beverages >2x daily, older age, greater number of teeth, inconsistent daily brushing, and presence of cavitated/non-cavitated lesions, enamel defects, and visible plaque on maxillary incisors.
Conclusions: Previous caries experience was strongly associated with ECC-surface location. Age, number of teeth, dietary/oral hygiene habits, and presence of cavitated/non-cavitated lesions, enamel defects, and visible plaque on maxillary incisors were predictors of future ECC. Further analysis is ongoing.