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Identification of caries risk factors in toddlers
M Fontana1, R Jackson, G Eckert
1Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, 1011 North University Ave., Room 2029B, Ann Arbor, MI 48109 USA. mfontan@umich.edu
Insights
Identifying early childhood caries risk factors like family history, diet, and income is crucial for targeted prevention. These predictors help primary care settings focus interventions effectively.
Area of Science:
- Pediatric Dentistry
- Public Health
- Epidemiology
Background:
- Early childhood caries (ECC) poses a significant public health challenge, necessitating effective risk assessment tools.
- Primary healthcare settings are ideal for early detection and intervention of ECC.
- Predicting caries progression is vital for optimizing preventive and referral strategies.
Purpose of the Study:
- To identify risk factors for predicting caries progression in toddlers.
- To inform cost-effective targeting of preventive and referral strategies in primary care.
Main Methods:
- A cohort of 329 toddlers (mean age 26 months) in Indiana, USA, was studied over one year.
- Data collected via a 107-item caregiver interview on behaviors, beliefs, medical/dental health, and access to care.
- Clinical assessments included bacterial levels, gingivitis, plaque, and caries experience.
Main Results:
- Multivariable logistic regression identified family caries experience, transmission behaviors, diet, health beliefs, and lower income as predictors of caries progression.
- Predictors and their significance varied by race/ethnicity.
- Inclusion of clinical variables did not substantially enhance predictive accuracy.
Conclusions:
- Family caries history, transmission behaviors, dietary habits, health beliefs, and socioeconomic status are key predictors of caries progression in toddlers.
- Risk factor models for ECC should consider racial/ethnic differences.
- Clinical measures alone do not significantly improve prediction beyond socio-behavioral and familial factors.
Abstract:
The purpose of this study was to identify risk factors to predict caries progression in toddlers in primary-healthcare settings for the cost-effective targeting of preventive and referral strategies. We examined 329 children (26 ± 6 mos old) twice, one year apart, in Indiana, USA. A 107-item structured interview was used to collect information from the primary caregiver and child on factors/beliefs/perceptions/behaviors that could affect caries development, transmission of bacteria, medical-dental health, and access to care. Bacterial levels, gingivitis, dental plaque, and caries experience were assessed. Multiple-variable logistic regression models of caries progression toward cavitation included family caries experience, transmission-related behaviors, dietary factors, health beliefs, and lower income, but differed in selected predictors/predictive power by race/ethnicity. Addition of clinical variables did not significantly improve the prediction.
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