Early childhood caries in an urban health department: an exploratory study

The purpose of this investigation was to assess the prevalence of early childhood caries (ECC) as a function of various ECC case definitions, in a population of children ages one to five, attending a Women, Infants, and Children (WIC) or well-child clinic at an urban health department. Additionally, the study examines the association of sociodemographic factors, caregiver's oral health perceptions, resources, feeding and oral care behaviors, and prenatal and perinatal histories as risk factors for early childhood caries.

A convenience sample of 74 children ages one to five years and their parent(s) or guardian(s) enrolled in the WIC and Well Child Services Program at the Kansas City Health Department participated in this study. Caries experience and developmental enamel defects of children were assessed utilizing the deft and linear enamel hypoplasia (LEH) indices. Additionally, the children's parents of guardians were asked to complete a questionnaire to collect data on predisposing risk factors.

The proportion of all children with evidence of Type I ECC was high (31.5%), with all ethnic minority groups having a large proportion with caries. Four of the predisposing risk factor variables were related (p < 0.05) to presence of ECC-child's age, gender, age at weaning, and frequency of sweet drinks. Child's age and age at weaning were related to a significant increase in risk for caries when these effects were adjusted by the effect of other risk factor variables. The odds of having caries were increased by 2.3 times (95%, CI 1.4, 3.9) for each increase in child's age by year, and by 2.8 times (95%, CI 1.5, 5.2) for each incremental increase in age category for the child at weaning.

This investigation lends further support to the contention that quantifying the occurrence of ECC is likely dependent and complicated by diverse case definitions. Caregiver's perceptions of their child's oral health were generally accurate, thereby supporting proponents for educational and preventive strategies aimed at the parent/guardian.