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Child-rearing practices and nursing caries
J R Serwint1, R Mungo, V F Negrete
1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD.
Objective:
To determine which child-rearing practices are associated with nursing caries.
Design:
Cross-sectional study.
Setting:
Hospital-based general pediatric clinic.
Participants:
Sequential sample of 110 healthy children aged 18 to 36 months.
Outcome Measures:
Feeding practices of children, limit-setting issues, and familial dental health were determined by maternal interview. Nursing caries were diagnosed by dental examination.
Results:
Nursing caries were found in 22 (20%) of the children. Ninety percent of children with and without caries were bottle-feeding at 12 and 18 months of age. Ninety-one percent of children with caries and 84% without were still drinking a nighttime bottle at 18 months (P = .33). The mothers of children with caries were found to have fewer years of education, 8.9 vs 10.8 years (P = .02), and were more likely to have eight or more cavities, 55% vs 19% (P = .002). More infants in the caries group had been breast-fed, 72% vs 46% (P = .02), although length of breast-feeding was similar, 5.4 vs 6.7 months. Fewer children with caries drank fluoridated tap water, 27% vs 54% (P = .05), but there were no differences in topical fluoride use, dental hygiene practices, or visits to the dentist.
Conclusions:
These findings fail to substantiate a straightforward relationship between child-rearing practices and nursing caries and suggest that well-designed prospective studies are needed to clarify the etiology of early caries.