The contribution of life course determinants to early childhood caries: a 2-year cohort study

Abstract

Background: Early childhood caries (ECC) is a serious problem in China. There are few data available on the risk factors contributing to ECC in children under the age of 3 years. In this study we investigate the risk factors for ECC in the life course of a cohort of 8-month-old children. Methods: A total of 225 children aged 8 months were recruited from a rural community in the city of Guangzhou in southern China. Information was collected at baseline and once every 6 months. The questionnaire was designed to collect socioeconomic and behavioural information. Dental caries was recorded by surface and oral hygiene was assessed using the visible plaque index. The presence of Streptococcus mutans (S. mutans) in dental plaque was determined using microbiological tests. The incidence density of ECC was calculated and generalised estimating equation analysis was performed to identify the risk factors. Results: The incidence density among 8 to 14-, 14 to 20-, 20 to 26- and 26 to 32-month-old children was found to be 0, 0.02 +/- 0.19, 0.05 +/- 0.26 and 0.20 +/- 0.59 (surfaces/100 surface-months), respectively. Multivariable analysis showed that mothers who had a low level of education, families with higher monthly income, enamel hypoplasia of the teeth, lower than average height, a high proportion of visible plaque, and the presence of S. mutans were risk predictors for ECC of the children. Conclusions: There appears to be a relationship between socioeconomic, behavioural and biological factors and ECC. Early life factors play an important role in the development of ECC.