Children’s oral health‐related behaviours and early childhood caries: A latent class analysis

Abstract

Objective: In this cross-sectional study in a large community-based sample of preschool-age children, we sought to identify distinct clusters of modifiable early childhood oral health-related behaviours (OHBs) and quantify their association with clinical and parent-reported measures of early childhood oral health. Methods: We relied upon a questionnaire (n = 8033; 11% in Spanish) and clinical oral health data (n = 6404; early childhood caries [ECC] prevalence = 54%] collected in the context of an epidemiologic study of early childhood oral health among 3to 5-year-old children in North Carolina. Latent class analysis was used to identify clusters of modifiable OHBs based on parents' responses to 6 questionnaire items pertaining to their children's oral hygiene, diet and dental home. The optimal number of clusters was determined based on measures of model fit and interpretability. We examined associations of OHB clusters with clinical and parent-reported child oral health status (ie, ECC prevalence, severity and proportion with untreated disease) using bivariate association tests and multivariable regression modelling with marginal effects estimation accounting for clustered data. We used Mplus v.8.6 (Muthén & Muthén, Los Angeles, CA, USA) and Stata v.16.1 (StataCorp, College Station, TX, USA) for data analyses. Results:We identified 2 OHB clusters, a favourable (74%) and an unfavourable (26%) one. Children in the favourable OHB cluster had better oral hygiene practices (ie, tooth brushing frequency and fluoridated toothpaste use), lower consumption frequency of sugar-containing snacks and beverages, less frequent reports of night-time bottle-feeding history and a higher likelihood of a dental home. Children in the unfavourable cluster had significantly higher ECC prevalence (57% vs 53%), caries burden (mean dmfs = 9.3 vs 7.6), untreated disease (43% vs 33%) and worse parent-reported oral health status than the favourable cluster. Conclusions:Our findings demonstrate the importance and utility of clustering common, modifiable ECC risk factors in population studies -health promotion efforts may centre on groups of people rather than individual behavioural risk factors.

Guardian Reports of Children's Sub-optimal Oral Health Are Associated With Clinically Determined Early Childhood Caries, Unrestored Caries Lesions, and History of Toothaches

“…*94 participants (1.2% of the entire study population) were excluded from presentation and analysis due to missing information in the reported child oral health status questionnaire item. † Derived from latent class analysis of responses to 6 modifiable oral health behavior questionnaire items, as reported by Simancas-Pallares et al (30). *Participants with clinical information only are included in ECC and unrestored disease comparisons, whereas all participants with non-missing questionnaire information are included in the toothache history comparison.…”

“…Answers to the question regarding history of toothaches not due to teething were also treated as a dichotomous response variable. In addition to individual questionnaire item responses on oral health behaviors-OHB (i.e., diet/feeding practices, oral hygiene practices and presence of a dental home), we used a latent class analysis-derived membership variable "favorable vs. unfavorable OHB" that broadly segregates individual participants with oral health-promoting vs. deleterious oral health behaviors (30).…”

Access to information on oral hygiene and mothers' practices of children with microcephaly caused by Zika virus

“…Information about child nutrition can help caregivers adopt healthier, sugar-free diets. [22][23][24][25] Thus, an interdisciplinary collaborative work with a nutritionist may be a promising way to decrease the risk of caries through diet.…”

A Web-Based Rendering Application for Communicating Dental Conditions

“…Between 2016 and 2019, the study investigators collected a vast array of clinical information and biospecimens from a community-based sample of approximately 6500 preschool-age children ages 3-5, attending NC public preschools. A detailed description of the clinical data collection procedures and protocols has been previously reported by Ginnis et al [20] and early analysis reports have been recently reported by Simancas-Pallares et al [21] and Karhade et al [22]. The motivation for the application of SculptorHD presented in this paper is that ECC manifests with distinct clinical presentations [17] that may affect different groups of teeth (e.g., anterior versus posterior, and upper versus lower) and may have different risk factors or etiologies.…”