The association between socioeconomic status, psychopathological symptom burden in mothers, and early childhood caries of their children

Abstract

ObjectivesVarious maternal mental disorders and socioeconomic status [SES] are discussed as risk factors for early childhood caries [ECC]. In our study, we examined a wide range of symptoms of mental disorders with the aim to identify those maternal psychopathological symptom burdens [PSBs] which show relevant associations with ECC. Our second objective was to investigate how SES affects the associations between PSB and ECC.MethodsIn this study, sixty children with ECC (caries group [CG]) and sixty caries-free children [NON-CG] with their mothers were recruited at two sites in Germany. Children aged three or four years were included in the study. Children’s dental status [dmf-t] and plaque index were recorded, and mothers answered a multidimensional SES index (including education, profession and income) as well as screening questionnaires capturing dental anxiety, depressive disorders, generalized anxiety, somatic symptom burden, eating disorders, traumatic childhood experiences, nicotine dependency and alcohol dependency.ResultsMothers of the CG reported significantly higher dental anxiety (dCohen = 0.66), childhood trauma (dCohen = 0.53) and nicotine dependency (dCohen = 0.64) than the NON-CG. However, mediator analyses showed that these effects were partly mediated by the SES. Mothers of the CG had a significantly lower SES (dCohen = 0.93); with education as strongest predictor of dental status. The groups did not differ significantly in symptoms of depressiveness, subjective somatic symptom burden, alcohol dependency, eating disorders, and generalized anxiety.ConclusionsSeveral PSBs are associated with ECC, however the SES as the strongest influencing factor mediates this association. Difficult socioeconomic conditions might predispose for both, ECC and mental illness. Targeted strategies are needed to facilitate the use of preventive measures and dental health services especially in families of lower status. For this purpose, psychosocial risk constellations must be identified. More integrative, multifactorial oriented research is necessary to gain a bio-psycho-social understanding of ECC.

The Burden of Early Childhood Caries in Children under 5 Years Old in the European Union and Associated Risk Factors: An Ecological Study

“…However, children and adolescents have access to free public preventive dental services in the member states of European Union [ 25 ]. Although there is evidence for the effects of the mother’s education level [ 13 ], mother’s nationality [ 38 ], access to dental care [ 55 ], and fluoride exposure [ 56 ], these indicators were not incorporated into our model due to insufficient/lack of longitudinal data. We also would like to highlight that the “under 5” age group used in this analysis does not fully correspond to the age group or age points used by ECC literature (see above), which may affect interpretation of our findings and impede their comparison with other literature data.…”

“…According to a Swedish multilevel analysis, socioeconomic status is a stronger indicator for the risk of dental caries experience than gender or age [ 6 , 12 ]. The mother’s education level and low income are found to strongly correlate with higher ECC experience [ 6 , 13 ]. Sugar-rich food and added sugar have received much attention among dietary risk factors for the development of dental caries in children [ 14 ].…”

Children’s Attitudes and Behaviors about Oral Health and Dental Practices

“…The literature suggests the disadvantaged SES contexts as risk indicators for dental and oral problems. In fact, several studies showed that bad oral health has a significant relation with children’s SES [ 16 , 17 , 18 ]. Early dental problems are usually described as associated with sociodemographic factors, dietary and oral health habits [ 19 ].…”

Socio-Economic Status May Associate Different Risk(s) with Early Childhood Caries (ECC) That Can Cause the Development of Psychomotor Deficiency in Preschool Children Aged 3–6 Years Old: The Results of Preliminary Analysis from a Cohort Study

“…in regular/normal classes of kindergarteners (i.e., no developmentally delayed children involved) analyzed via a crosssectional bi-township design [10][11][12]. Furthermore, other studies in the field have shown that the socio-economic status (SES) has long been considered one of the risk factors or even a predictor for ECC development and/or progress in children, including the levels of family/household incomes, parental education and occupation, access to medical/dental healthcare facilities, etc., all of which may be attributed to the equity issue of caries distribution in the population studied [13][14][15][16][17][18][19][20][21][22][23]. Likewise, SES may also be a domain for the oral health behavior and conceptual access to dental healthcare of the parents and/or caregivers in preschoolers [14][15][16][17].…”

“…However, additional risks suggested for ECC may include biofilmassociated microbial species, improper feeding, dietary or food practices, ethnicity/race, poverty-income classes, environmental/salivary vs. self-image attributes, and maternal psychosocial (i.e., sense of coherence) distress or parental stresses, etc. [15,[17][18][19][20][21]24,25].…”