Parental feeding styles and early childhood caries in Egyptian children: a cross- sectional study

Abstract

Background Early childhood caries (ECC) affects the quality of life for young children and has the potential to increase caries susceptibility in permanent teeth. It is linked to eating or drinking sugary meals, beverages, or snacks. It may also be linked to unhealthy eating habits including emotional eating and instrumental feeding. This study examined the relationship between parental feeding practices and ECC in Egyptian children. Methods A cross-sectional study was carried out from 2022 to 2023. It included children aged 2–6 years old attending with their parents a dental clinic in a public hospital for children in Alexandria, Egypt. Data collection included oral examination to assess ECC using dmfs and oral hygiene using plaque index. Parents were asked to fill out a questionnaire about their children’s feeding and dietary habits using the parental feeding style questionnaire (PFSQ). The PFSQ contains four domains: control over eating, prompting/encouraging to eat, instrumental feeding, and emotional feeding, with 27 items scored from 1 to 5. A higher score indicated greater adoption of a feeding style. Binary logistic regression assessed the relation between having ECC experience (dependent variable) and parental feeding styles and sugary drinks intake (independent variables) controlling for confounders identified using directed acyclic graph (DAG). Results Responses and clinical data were available for 412 children out of 450 children (response rate = 91.7%). Most children (333, 80.8%) had ECC. There were significant differences in parental feeding styles between children with and without ECC. In multivariable regression, ECC was significantly higher in older children (AOR = 2.46, 95% CI: 1.68, 3.59) and in children with more instrumental feeding (AOR = 8.13, 95% CI: 3.67, 18.01) and significantly lower in females (AOR = 0.38, 95% CI: 0.19, 0.76) and children with more prompting/ encouragement to eat (AOR = 0.34, 95% CI: 0.17, 0.67). Conclusion ECC was significantly associated with some parental feeding styles. Identifying parental feeding styles may help target at-risk children by preventive and health education programs.