Associations of ethnicity/race and socioeconomic status with early childhood caries patterns

The purpose of this project was to evaluate ethnicity/race, household income and caregiver education level as predictors of (1) any early childhood caries, and (2) each of four proposed patterns of primary dentition caries.

Between February 1994 and September 1995, five examiners visually examined Arizona pre-school children ages 5-59 months old. Self-reported demographic information including family income, caregiver education level and ethnicity/race were obtained at the time of examination. Multivariate analyses were conducted to assess the association of income, education and ethnicity/race with a child having any caries and with each of the proposed caries patterns seen in 3850 examinations.

Income and education were inversely associated with: (1) any early childhood caries, and (2) the maxillary incisor caries pattern. A positive association between these caries patterns and minority ethnicity/race status was also identified. Three additional caries intraoral patterns demonstrated more varied associations with socioeconomic status (SES), ethnicity/race and income and education.

This study supports the association of both ethnicity/race and social status with any early childhood caries. The patterns of caries were each found to be associated with specific and different socioeconomic-demographic indicators. The practical importance of these findings is that global measurement of ECC, without regard to specific caries pattern, leads to the potential for substantial non-differential misclassification of disease. The consequence of this is the potential for important ECC-SES-ethnicity/race associations to be masked. This, in turn, decreases the ability of surveys and investigations to accurately identify sub-groups of the population at greatest risk of developing ECC.