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

Abstract

Background: Parents'/guardians' perceptions of their children's oral health are useful proxies of their clinically determined caries status and are known to influence dental care-seeking behavior. In this study, we sought to examine (1) the social and behavioral correlates of fair/poor child oral health reported by guardians and (2) quantify the association of these reports with the prevalence of early childhood caries (ECC), unrestored caries lesions and toothaches.Methods: We used guardian-reported child oral health information (dichotomized as fair/poor vs. excellent/very good/good) obtained via a parent questionnaire that was completed for n = 7,965 participants (mean age = 52 months; range = 36-71 months) of a community-based, cross-sectional epidemiologic study of early childhood oral health in North Carolina between 2016 and 2019. Social, demographic, oral health-related behavioral data, and reports on children's history of toothaches (excluding teething) were collected in the same questionnaire. Unrestored ECC (i.e., caries lesions) was measured via clinical examinations in a subset of n = 6,328 children and was defined as the presence of one or more tooth surfaces with an ICDAS ≥ 3 caries lesion. Analyses relied on descriptive and bivariate methods, and multivariate modeling with average marginal effect (A.M.E.) estimation accounting for the clustered nature of the data. Estimates of association [prevalence ratios (PR) and adjusted marginal effects (AME) with 95% confidence intervals (CI)] were obtained via multilevel generalized linear models using Stata's svy function and accounting for the clustered nature of the data.Results: The prevalence of fair/poor oral health in this sample was 15%–it increased monotonically with children's age, was inversely associated with parents' educational attainment, and was higher among Hispanics (21%) and African Americans (15%) compared to non-Hispanic whites (11%). Brushing less than twice a day, not having a dental home, and frequently consuming sugar-containing snacks and beverages were significantly associated with worse reports (P < 0.0005). Children with fair/poor reported oral health were twice as likely to have unrestored caries lesions [prevalence ratio (PR) = 2.0; 95% confidence interval (CI) = 1.8-2.1] and 3.5 times as likely to have experienced toothaches [PR = 3.5; 95% CI = 3.1-3.9] compared to those with better reported oral health.Conclusions: Guardian reports of their children's oral health are valuable indicators of clinical and public health-important child oral health status. Those with fair/poor guardian-reported child oral health have distinguishing characteristics spanning socio-demographics, oral-health related practices, diet, and presence of a dental home.

Correlation between caries activity and salivary microbiota in preschool children

“…In this study, the average age of children in group H was significantly higher than that in the M and L groups, and the differences among the three groups were significant, which might be due to the fact that the older children had more opportunities to be exposed to cariogenic microorganisms and cariogenic oral environment, and thus increased the risk of high caries activity. The study results of Imes et al (Imes et al, 2021) showed that unhealthy dietary habits such as frequent or excessive intake of sugar-sweetened beverages were significantly related to the occurrence of ECC. The reason may be that frequent sugar intake causes microorganisms in the oral cavity to produce organic acids and exopolysaccharides by metabolize carbohydrates.…”

“…The study results of Imes et al. ( Imes et al., 2021 ) showed that unhealthy dietary habits such as frequent or excessive intake of sugar-sweetened beverages were significantly related to the occurrence of ECC. The reason may be that frequent sugar intake causes microorganisms in the oral cavity to produce organic acids and exopolysaccharides by metabolize carbohydrates.…”

Socio‐behavioural determinants associated with the first dental visit in Saudi children: A cross‐sectional study

“…The relationship between caregivers or guardians and children, along with their associated characteristics, however, can either facilitate or impede oral health and oral health‐promoting behaviours in children 32 . Caregivers or guardians often lack awareness and possess unfavourable attitudes towards child oral health 32,33 . We recommend that studies focus on evaluating the knowledge, attitudes and oral hygiene practice behaviours of caregivers or guardians and that oral healthcare professionals motivate caregivers or guardians to effectively participate in oral health preventative programmes to promote child oral health.…”

“…32 Caregivers or guardians often lack awareness and possess unfavourable attitudes towards child oral health. 32,33 We recommend that studies focus on evaluating the knowledge, attitudes and oral hygiene practice behaviours of caregivers or guardians and that oral healthcare professionals motivate caregivers or guardians to effectively participate in oral health preventative programmes to promote child oral health. Furthermore, this study was undertaken during the coronavirus disease pandemic, which may have influenced children's FDV attendance rates, affecting the socio-behavioural characteristics of families.…”

Role of socioeconomic factors and interkingdom crosstalk in the dental plaque microbiome in early childhood caries

“…This effect can be partially reversed by using fluoride, which alters the dental plaque microenvironment and promotes remineralization of the enamel (Zhang et al, 2022). Host variables, encompassing various demographic, socioeconomic, and behavioral factors, also influence the development of caries (Arora et al, 2011; Imes et al, 2021; Pierce et al, 2019). Therefore, researchers are increasingly interested in investigating the comprehensive role of these risk factors in ECC, such as diet, fluoride exposure, limited access to care, and poor oral hygiene (Adler et al, 2021; Ganesh et al, 2020; Handsley-Davis et al, 2021; Kahharova et al, 2023; Schroth et al, 2009).…”