Protective Factors for Early Childhood Caries in 3-Year-Old Children in Poland

Abstract

Background: Early childhood caries (ECC) remains highly prevalent in preschool children worldwide. Dental caries affects every second 3-year-olds in Poland. The aim of the study was to assess protective factors for ECC in 3-year-olds.Methods: A cross-sectional survey was conducted in 2017 among 3-year-olds attending kindergartens in all 16 provinces of Poland. The questionnaire included socioeconomic factors, and oral health behaviors. Decayed, missing due to caries and filled teeth and surfaces were assessed. Caries indices (dmft and dmfs), percentage of caries-free and severe ECC (S-ECC) were calculated. The Student's t-test, Spearman correlation, univariate and multivariate logistic regression (the odds ratios (OR) and adjusted odds ratios (AOR): confounding factors: socioeconomic conditions, oral health behaviors) were performed; p < 0.05.Results: A total of 1,638 children were included. ECC was confirmed in 41.1%; S-ECC in 23.4%. The dmft index was 1.85 ± 3.14, dmfs = 2.99 ± 6.56. Spearman correlation [socioeconomic factors, especially mother's education (r = −0.148, p < 0.001) and family's economic status (r = −0.071, p = 0.004)], despite were statistically significant, indicate very weak relationships with dmft index. After 12th month of life not giving any beverages before bedtime and at night, but water or unsweetened milk only, healthy snacking (sandwiches, fresh fruit), or water on a daily basis decreases the probability of caries development (for S-ECC: OR = 0.37, AOR = 0.47, AOR2 = 0.37; p < 0.01), even if inappropriate dietary behaviors or hygiene practices were simultaneously present. Brushing of a child's teeth twice a day lowered the odds of caries (for S-ECC: OR = 0.78, p = 0.031; AOR = 0.81, p = 0.081; AOR2 = 0.84, p = 0.131), but this effect was less intense when inappropriate dietary behaviors were accounted for. Children of parents with good self-assessment of their teeth were more often caries-free (61.4 vs. 42.9%; p = 0.006) and had lower dmft indices (1.67 vs. 2.93; p = 0.002).Conclusions: Preventing a child after 12th month of life from getting any beverages before bedtime, water or unsweetened milk only, sandwiches and fresh fruit as snacks, or water given to on a daily basis, tooth brushing twice a day decrease the odds of caries in 3-year-olds. Diet appears to have primary significance in the etiology of ECC, since tooth brushing can only partly attenuate the impact of inappropriate dietary behaviors on dental caries. Children are more often caries-free and have lower severity of caries if their parents' dentition is self-assessed as healthy.

Taste preferences of preschoolers and parents’ contribution to shaping their children’s eating habits in the context of obesity development

“…Diet plays a particularly important role in the etiology of early childhood caries. Olczak-Kowalczyk et al [41] revealed that an effective way to reduce the risk of caries development at the age of 3 is appropriate nutritional management starting from the age of 12 months. The child should only drink water or unsweetened milk, and sugar-free snacks and fruit may be served between meals.…”

Association between Vitamin D and Dental Caries in a Sample of Canadian and American Preschool-Aged Children

“…An earlier birth cohort from this city also reported a significant association between low maternal prenatal 25(OH)D concentrations and ECC [10], and even found that prenatal calcium levels and enamel hypoplasia are significantly associated [24]. However, a recent Polish study investigating the relationship between parental reported vitamin D supplementation and caries did not identify a significant relationship [25].…”

Exploring the Relationships between Children’s Oral Health and Parents’ Oral Health Knowledge, Literacy, Behaviours and Adherence to Recommendations: A Cross-Sectional Survey

“…There are significant differences in oral health between members of different European Union states, with a markedly worse epidemiological situation in a few Eastern and Central European countries [ 1 , 5 , 6 , 7 , 8 , 9 ]. The oral health of Polish preschoolers is much worse than that of preschoolers in most other European countries [ 5 , 6 , 10 ]. According to reports from national oral health monitoring programmes commissioned by the Ministry of Health for the years 2016–2020, the prevalence of dental caries increases substantially with age from 41.1% in 3-year-olds to 85.1% in 7-year-olds [ 11 ].…”

“…It is widely known that caries and its complications may severely impact general health and quality of life [ 1 , 5 , 6 , 7 , 10 ]. However, this disease and its negative consequences can be prevented to a large extent.…”

“…Still, prevention of tooth decay is not an easy task. It is strongly influenced by several social, behavioural, economic, and environmental factors, i.e., the social determinants of health [ 1 , 5 , 10 ]. They include, for example, family income, parents’ education, place of residence, mother’s age, number of children in the family, parents’ oral hygiene practices, and parents’ oral health status [ 6 , 10 , 19 , 21 , 22 ].…”