Effect of Allergic Diseases on EarlyChildhoodCaries among Singapore Toddlers

Objective: Dental caries is the most common chronic childhood disease (Oral Health in America: A Report of the Surgeon General,2000) and is the leading cause of years lived with disability (Vos et.al.2012,Lancet). Allergy associated symptoms including asthma, eczema and rhinitis have become a major public health problem (Beasley.1998,Lancet). However, it is not known whether caries and allergy are associated in toddlers. This study aimed to evaluate if allergy-associated symptoms are linked with an increased risk of early childhood caries among Singapore toddlers. Method: In the "Growing Up in Singapore Towards healthy Outcomes (GUSTO)" cohort study, 1237 pregnant women were recruited in early pregnancy, follow through their pregnancy and the offspring characterized after birth. At the infant age of3 weeks, 3 months(M), 6M, 9M, 12M, 15M and 18M, questionnaires were used to characterize maternal and infant allergy-associated symptoms. Caries was scored using ICDAS criteria at 24M. A statistical model was built using Poisson regression to assess the relationships between caries and allergy, controlling for potential confounders including mothers’ medical history, educational level, ethnicity, breast or bottle fed during nightime, child's gender, health and medication. Result: The prevalence rate of caries was 17.7% among Singapore toddlers. An increased risk of caries was observed in children with reported eczema [Relative-risk(95%CI)-3.99(1.36-11.75], wheezing with prescribed nebulizer [10.28(1.34-78.82)], breastfed at night-time during the first 18 months [2.64(1.18-5.87)], using topical steroid medication during the first year of life[4.35(1.60-11.86)], and whose mother did not have tertiary education [2.31(1.27-4.20)]. Conclusion: Children with allergy associated symptoms including eczema (18M), wheezing with nebulizer (18M) and using topical steroids (≤12M) may have an increased risk of developing early childhood caries.