Ethnic Differences In Caries Susceptibility In A Multi-ethnic Asian Cohort

Objectives: Tooth decay in young children (early childhood caries, ECC) is a highly prevalent diet-related, infectious multifactorial oral disease. However, published comparative information on ethnic differences in caries experience among Asian populations is nearly non-existent. Hence, this study was aimed to investigate the role of ethnicity in variations in caries development among preschool children.
Methods: Data was collected from a mother-offspring cohort, Growing Up in Singapore Towards Healthy Outcomes (GUSTO), which recruited healthy pregnant mothers and followed them through pregnancy and their offspring into childhood. Detailed interviewer-administered questionnaires were periodically conducted to collect general and health-related information of mothers and their infants/toddlers, including child’s feeding patterns, oral hygiene practices and parental oral health-related knowledge-attitude-practices. At 3 years of age, oral examinations were performed in 721 children by dentists trained using a standardized approach to determine the children’s oral hygiene (Silness-Loe Plaque index) and ECC status (modified ICDAS II criteria). Univariable and multivariable regression analysis was used to assess the ethnicity-ECC relationship.
Results: ECC lesions were observed in 42.9% (309/721) of children at 3 years of age. After adjusting for potential confounders, a two-fold higher ECC risk was observed in Chinese and Malay children, compared to Indian children. Ethnic differences in pre-, peri-, and post-natal factors were noted.
Conclusions: Indian children are at lower risk of caries development, compared to Chinese and Malay children, possibly due to variations in the pathogenic pathways leading to ECC.