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Breast-feeding and early childhood caries: an assessment among Brazilian infants
1Department of Preventive and Social Dentistry, University of Pernambuco, Recife, Brazil. rosen@nlink.com.br
Insights
Early childhood caries is highly prevalent in low-income Brazilian children, strongly linked to sugary snacks and diet, not feeding type. Introducing fluoride toothpaste at 12 months is recommended for prevention.
Area of Science:
- Pediatric Dentistry
- Public Health Nutrition
- Epidemiology
Background:
- Early childhood caries (ECC) poses a significant global health burden.
- Socio-economic factors are known to influence oral health outcomes in young children.
- Understanding feeding practices and dietary habits is crucial for ECC prevention strategies.
Purpose of the Study:
- To assess the prevalence of ECC in 12-36-month-old children from low socio-economic backgrounds in Recife, Brazil.
- To investigate the association between ECC and feeding types (natural, sugared milk, bottle/glass feeding).
- To explore the relationship between supplementary diet, sugary snack frequency, and ECC occurrence.
Main Methods:
- A visual clinical examination of teeth was conducted under natural light.
- Data on feeding habits, sugary meal frequency, and diet were collected through parental interviews.
- The study included 468 children aged 12-36 months, with calibrated examiners and a kappa value of 8.0.
Main Results:
- The prevalence of ECC was 28.4% (133/468 children).
- Bottle-feeding with sugared milk (69.9% of subjects) and frequent sugary meals (5+ per day, 33.6% prevalence) were associated with higher ECC rates.
- No significant association was found between breastfeeding and ECC prevalence.
Conclusions:
- ECC prevalence in this population is high, comparable to other Brazilian cities but exceeding global averages.
- ECC was strongly associated with age, frequent sugary snacks, and cariogenic diets, but not significantly with feeding type.
- The authors recommend fluoride toothpaste introduction at 12 months due to high ECC rates and lack of fluoridated water.
Objectives:
The purpose of the present study was to evaluate early childhood caries among 12-36-month-old children from families living in poor socio-economic conditions in the city of Recife, Brazil, its association with the type and duration of feeding (e.g. natural, sugared, bottle and glass), as well as the relationship between a supplementary diet and the occurrence of this type of caries.
Methods:
The present study consisted of a visual clinical examination of teeth that had been previously cleaned with gauze. This was carried out under natural light in a waiting room. Four calibrated examiners performed the examination and the kappa test value was 8.0. The parents or guardians were interviewed for the following information: name, address, age, type of feeding, number of sugary meals, sugar intake and habitual diet. Some 468 children were included in this study. Their ages ranged from 12 to 36 months. The sample was comprised of 222 (47.4%) males and 246 females (52.6%).
Results:
Of the 468 children included in this study, 133 (28.4%) had caries. Only 59 (12.6%) of the children examined had been breast-fed, 20 (33.9%) of whom presented with caries. Three hundred and twenty-seven (69.9%) subjects had been bottle-fed with sugared milk, 86 (26%) of whom had caries. Two hundred and eight children had five or more sugary meals per day, 70 (33.6%) of whom had caries. No statistically significant relationship was seen between breast-feeding and the prevalence of tooth decay.
Conclusions:
The results of the present study show that the prevalence of early childhood caries in 12-36-month-old children from poor backgrounds in Recife is in accordance with the rate found in other Brazilian cities and is extremely high compared with that of the world population as a whole. Early childhood caries was not clearly related to the type of feeding in this sample. The prevalence of early childhood caries increased with age, and the number of sugary snacks between meals and a cariogenic diet were strongly related to early childhood caries. The lack of fluoridated water and high rates of early childhood caries in lead the authors to suggest that fluoride dentifrice should be introduced at 12 months of age as a fluoride supplement and an important aid in the prevention of childhood caries. Additional studies in different cultures and societies need to be undertaken before a definitive conclusion can be drawn.
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