Early Childhood Caries and Its Associated Factors among 9- to 18-Month Old Exclusively Breastfed Children in Thailand: A Cross-Sectional Study

Abstract

Objective: The objective of this study was to investigate the early childhood caries (ECC) status and its risk factors in 9- to 18-month-old exclusively breastfed children in Thailand. Methods: Generally healthy 9- to 18-month-old children who had been exclusively breastfed were recruited. Information on children's oral hygiene practices and breastfeeding behaviors was collected through parental interviews using a questionnaire. Children's oral health status was assessed following the WHO caries diagnostic criteria, modified to record the noncavitated lesions. Multivariate logistic regression analysis was adopted to investigate its association with feeding and oral hygiene practices. Results: In total, 513 mother and child dyads (47% boys) were recruited. The prevalence of ECC was 42.5%. The mean (SD) d(1)mft and d(1)mfs scores (d(1) included noncavitated and cavitated carious teeth/tooth surfaces) were 1.1 (1.4) and 1.3 (2.0), respectively. Multivariate logistic regression analysis revealed that older children with higher plaque scores (OR = 75.60; 95% CI: 40.19-142.20) who were breastfed to sleep (OR = 2.85; 95% CI: 1.48-5.49) and never had their teeth cleaned (OR = 8.51; 95% CI: 1.53-47.14), had a significantly higher chance of having ECC (p < 0.05). Conclusion: Prevalence of ECC is high among exclusively breastfed children aged 9-18 months in Thailand. ECC prevalence is significantly associated with the age of children, the level of dental plaque, breastfeeding to sleep, and oral cleaning. Among all factors, the level of dental plaque is the most significant factor associated with ECC among breastfed children.