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Risk Indicators for Noncavitated and Cavitated Carious Lesions in Preschool Children
Sheetal Manchanda1, Pei Liu1, Gillian Hiu Man Lee1
1Paediatric Dentistry, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR.
Insights
Poor oral hygiene and snacking frequency are key risk factors for early childhood caries. Poor parental knowledge and attitude also contribute to cavitated lesions in young children.
Area of Science:
- Pediatric Dentistry
- Public Health
- Oral Health Research
Background:
- Early childhood caries (ECC) is a significant public health concern affecting preschool children globally.
- Identifying risk indicators for noncavitated and cavitated lesions is crucial for targeted prevention strategies.
Purpose of the Study:
- To evaluate risk indicators associated with noncavitated and cavitated dental caries lesions in preschool children.
- To identify factors contributing to the development of early childhood caries.
Main Methods:
- A cross-sectional study involving 741 preschool children aged 3-4 years.
- Data collection included parental questionnaires on oral health behaviors and knowledge, and clinical assessments of caries and plaque using the International Caries Detection and Assessment System-II and Visible Plaque Index (VPI).
- Least Absolute Shrinkage and Selection Operator (LASSO) regression was employed to identify significant risk indicators.
Main Results:
- The prevalence of noncavitated (NC) and cavitated lesions (CL) was 29.1% and 49.4%, respectively, with an overall ECC prevalence of 78.5%.
- Children with CL showed a higher frequency of between-meal snacking (56.2%) compared to caries-free (41.7%) and NC (41.1%) groups.
- Significant risk indicators for CL included poor oral hygiene (VPI score) and poor parental oral health knowledge and attitude; only VPI score was significant for NC.
Conclusions:
- Poor oral hygiene is a primary risk indicator for noncavitated lesions in preschool children.
- Poor oral hygiene combined with inadequate parental oral health knowledge and attitude significantly increases the risk of cavitated lesions.
- These findings highlight the importance of improving oral hygiene practices and parental education for ECC prevention.
Objective:
The aim of this study was to evaluate the risk indicators associated with noncavitated and cavitated lesions in preschool children.
Methods:
The cross-sectional study included 3- to 4-year-old healthy children (N = 741) recruited in a randomised controlled clinical trial. After obtaining written informed consent, parents completed a questionnaire about their child's sociodemographic background and oral health-related behaviours and parents' oral health-related knowledge and attitude. Caries and plaque were evaluated using International Caries Detection and Assessment System-II and Visible Plaque Index (VPI), respectively. Children were grouped according to their oral health status as being caries-free (CF), having only noncavitated lesions (NC), or having cavitated lesions (CL). The least absolute shrinkage and selection operator (LASSO) sparse multinomial regression was used to study the variables using 1 standard error above the minimum criterion set at P < .05.
Results:
The prevalence of children with NC and CL was 29.1% and 49.4%, respectively, with a prevalence of early childhood caries being 78.5%. The proportion of children who brushed twice or more than twice a day was highest in CF (71.7%), followed by NC (58.3%), and was least in CL (57.7%). A higher percentage of CL children (56.2%) had twice or more than twice the frequency of between-meal snacking than CF (41.7%) and NC (41.1%) (P < .001) children. The variables included with non-zero coefficients in the model were mean parental oral health knowledge, attitude score, and children's mean VPI score, and all were significant for CL; however, in NC, only VPI score was found to be significant.
Conclusions:
Poor oral hygiene is the risk indicator associated with the presence of NC in preschool children, whilst poor oral hygiene and poor parental oral health knowledge and attitude are associated with the presence of cavitated lesions.
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