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Early Childhood Caries in Victorian Preschoolers: A Cross-Sectional Study
Helen Graesser1, Rachel Sore2, John Rogers3
1Dental Health Services Victoria, Carlton, Australia.
Insights
Early childhood caries (ECC) affects over half of preschool children in Victoria, with higher rates in disadvantaged groups. Targeted preventive interventions are crucial for reducing severe caries in these populations.
Area of Science:
- Public Health
- Pediatric Dentistry
- Health Promotion
Background:
- Early Childhood Caries (ECC) poses a significant public health challenge globally.
- Socioeconomic and behavioral factors are known to influence ECC prevalence.
- Health promotion programs aim to improve oral health outcomes in young children.
Purpose of the Study:
- To determine the prevalence of ECC among preschool children in Victoria participating in the Smiles 4 Miles program.
- To identify sociodemographic variables associated with ECC in this population.
Main Methods:
- A cross-sectional study involving 1,845 children aged 3-5 years from 61 preschools.
- Stratified cluster sampling was employed for participant selection.
- Dental caries assessed using the International Caries Detection and Assessment System (ICDAS); sociodemographic and behavioral data collected via parental questionnaires.
- Multivariate logistic regression and Poisson mixed models analyzed associations.
Main Results:
- ECC prevalence was 56.6%, with over one-third having early lesions and 14.2% having both early and cavitated lesions.
- Children from socioeconomically disadvantaged backgrounds exhibited higher caries rates.
- Factors associated with increased cavitated lesions included parental pensioner/health care card status, non-English-speaking background, and Indigenous status.
- Weekly soft drink consumption significantly increased the risk of cavitated lesions.
Conclusions:
- Socioeconomic disadvantage is strongly linked to higher rates of severe early childhood caries.
- There is a critical need for targeted early preventive interventions for disadvantaged children.
- The findings underscore the importance of addressing socioeconomic determinants in pediatric oral health strategies.
Aim:
The objective of this work was to determine the prevalence of early childhood caries (ECC) in children attending preschools that are enrolled in the Smiles 4 Miles health promotion program in Victoria and determine the sociodemographic variables associated with ECC.
Materials And Methods:
A cross-sectional sample of 1,845 3- to 5-year-old children attending 61 preschools was selected by stratified cluster sampling. Dental caries was classified as non-cavitated/early lesions (d1-2), cavitated (d3-6) lesions, and cavitated/non-cavitated (d1-6) lesions using the International Caries Detection and Assessment System. A self-administered parental questionnaire captured sociodemographic and behavioural data. Multivariate logistic regression and Poisson mixed model analysis was used to examine associations amongst sociodemographic variables, child oral health behaviours, and decayed tooth surfaces.
Results:
In all, 56.6% (n = 1,044) of the children had ECC; more than one-third (36.6%) presented exclusively non-cavitated/early lesions, 5.7% solely cavitated lesions, and 14.2% both. Children from socioeconomically disadvantaged backgrounds had higher levels of dental caries. Parental pensioner/health care card status (incidence rate ratio [IRR] = 1.76, 95% CI, 1.57-1.97), non-English-speaking background (IRR = 2.09, 95% CI, 1.80-2.43), and Indigenous status (IRR = 1.91, 95% CI, 1.50-2.43) were associated with higher rates of cavitated lesions. Children who consumed soft drinks once or more per week had 1.66 times more cavitated lesions (95% CI, 1.48-1.86) compared to children who never/rarely consumed soft drinks. Soft drink consumption of once or more per week was associated with parental health care/pensioner card status (odds ratio [OR] = 1.73, 95% CI, 1.36-2.18), non-English-speaking background (OR = 1.58, 95% CI, 1.11-2.27), and Indigenous status (OR = 1.92, 95% CI, 1.04-3.52).
Conclusions:
Higher levels of more severe caries rates in children from socioeconomically disadvantaged background highlight an opportunity for early preventive interventions targeting these groups.
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