Risk factors for severe ECC in preschoolers with dental caries

Abstract

Objective: to explore the risk factors of severe ECC among the Hong Kong preschool children who have dental caries. Methods: All children attending grade 1 in 16 kindergartens in different districts in Hong Kong were screened. Ethical approval from IRB and parental consent was obtained. Children with at least one carious cavity were selected and clinically examined by a trained examiner using disposable dental mirrors, periodontal probes and an intra-oral LED light in the kindergartens. The visible plaque index (VPI) and the dmfs index were used for recording the oral hygiene and dental caries status, respectively. Information about the children‘s demographic and socio-economic background (such as age, place of birth, parent’s education level, family income), and oral health related behaviors (such as tooth brushing habit, frequency of snacking) was collected by a questionnaire completed by their parents.

Results: A total of 359 children with a mean age of 40.7 months (SD=3.7) were included in this study. Around half (48%) of them had severe ECC (defined as having a dmfs score more than 3) while 52% had a dmfs score of 1 to 3 (non-severe ECC). The mean dmfs scores were 1.4 and 10.0 in non-severe ECC and severe ECC groups, respectively. Over 95% of the decayed teeth in both groups were untreated. Maxillary incisors had the highest caries prevalence at 39%. Results of a backward stepwise logistic regression analysis found that only two variables, namely family income and VPI, remained in the final model (Chi-square=27.2; df=3; p<0.001) while the other studied variables were not statistically significant (p>0.05).

Conclusion: Low family income and poor oral hygiene are risk factors for severe ECC among preschool children with dental caries in Hong Kong.