The Status and Associated Factors of Early Childhood Caries among 3- to 5-year-old Children in Guangdong, Southern China: A Provincial Cross-sectional Survey

Abstract

Background: Dental caries of deciduous teeth (Early Childhood Caries, ECC) has become a crucial oral health problem over the decades in China. The aim of this study was to examine the prevalence and severity of ECC among preschool children from Guangdong Province, Southern China. In addition, to assess the association of ECC with reported oral health-related behaviors.Methods: A cross-sectional survey of 2592 participants was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method during December 2015 and April 2016. The participants were divided into three groups according to their ages (3-, 4-, and 5-year-olds). Half of the participants were derived from urban areas, while the other from rural areas. According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of ECC was determined by the dmft (decayed-missing-filled tooth) index using a CPI (Community Periodontal Index) probe. A questionnaire about caries-related factors was completed by each of the participants’ parents or grandparents through a face-to-face and one-on-one interview. Then, t-test, Chi2 tests, One-Way ANOVA served for statistical analysis, and logistic regression analysis as well as covariance analysis were executed to identify potential associated factors for ECC.Results: The prevalence (% dmft >0) of ECC was 68.3 (95% CI: 66.5-70.1), the mean dmft was 4.36 (95% CI: 4.17-4.55), and the filled rate was 1.2%. In multivariable modeling, associated factors for both prevalence and mean dmft were older age, rural areas, consumption of sweets before sleep, dental visit history, low household income, and low parental education level. Initiating toothbrushing after 3 years of age and being exclusively/ predominantly breastfed indicated only the prevalence; being female and frequently consuming sweetened milk/powdered milk indicated only the mean dmft.Conclusions: Preschool children in Guangdong Province, especially children from rural areas, experienced a significant amount of ECC. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors. More attention should be given to prevention of ECC from early life. The construction of social support for oral health should be strengthened. Oral health education and promotion, especially of rural areas, should be intensified to reduce the inequality between urban and rural areas.

A Kindergarten-Based Oral Health Preventive Approach for Hong Kong Preschool Children

“…The review retrieved publications from 2006 to 2015 and found that ECC is quite severe and common among Southeast Asian preschool children. Figure 3 summarises the ECC of 5-year-old children in Hong Kong and its nearby countries and regions [ 8 , 9 , 10 ].…”

“… Caries prevalence (%) and caries experience decayed, missing and filled teeth (dmft) of 5-year-old children in Hong Kong and its nearby countries/regions. (adapted from Duangthip et al, 2017; Chen et al, 2019; Li et al, 2020 [ 8 , 9 , 10 ]). …”

“…The review retrieved publications from 2006 to 2015 and found that ECC is quite severe and common among Southeast Asian preschool children. Figure 3 summarises the ECC of 5-year-old children in Hong Kong and its nearby countries and regions [8][9][10]. The overall caries status of preschool children in Southeast Asia (median caries prevalence is 79%, whereas caries experience in dmft score is 5.1) is worse than that of such children in other parts of the world.…”