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.

Dental Caries and Associated Factors in 3–5-Year-Old Children in Guizhou Province, China: An Epidemiological Survey (2015–2016)

“…The difference between the urban and rural areas was not found to be significant, which may be related to the small economic disparity between the urban and rural areas based on administrative divisions randomly selected in Guizhou, where the overall economy is not developed (11). Compared with the prevalence rate of 50.3% (dmft = 1.92) among 5-year-old children in the Third Oral Epidemiological Survey in 2005, both caries prevalence and severity are on the rise, and this phenomenon also appears in the eastern regions of China such as Jiangsu Province and Guangdong Province (12), central regions such as Henan Province, and the western regions such as Sichuan Province (13). However, the trend of change of caries in deciduous teeth during the decade of 2005-2015 in Beijing faced a rapid increase where the rate of caries was curbed after intervention (14).…”

Factors Affecting Future Caries Occurrence Among Preschoolers in Northern Guangdong: A Longitudinal Study

“…Maxillary central incisors had the highest caries incidence among all the teeth in the caries-free participants at baseline, which also explains the results shown in Figure 3 that those without baseline caries were most likely to have two teeth decayed simultaneously once new caries occurred. It has been suggested that focusing on the prevention of caries of maxillary central incisors in baseline caries-free children may improve the caries-free rate of preschoolers 2 , 19 and improve the efficiency of caries prevention. Caries of the central incisors are caries that affect smooth surfaces.…”

“…Caries in deciduous teeth, unlike those in permanent teeth, usually affect smooth surfaces, followed by pits and fissures. 2 Caries of the maxillary central incisors are often nursing caries. 20 However, children with caries at baseline are a high-risk group, and the caries incidence of mandibular first deciduous molars was obviously the highest, and the caries incidence in the other teeth was not low either.…”

“…1 A survey of caries prevalence in children aged 3-5 years in Guangdong Province found that 84.8%, 79.8% and 72.3% of caries cases were centralized in one-third of children aged 3, 4 and 5 years, respectively. 2 The caries incidence in children is not average, but there are children with a higher risk of caries. In recent years, there have been numerous studies on the risk of caries; [3][4][5][6] these studies were conducted with the hope of identifying groups at high risk of caries so that public health resources for caries prevention can be appropriately allotted to the high-risk groups and to improve the efficiency of caries prevention.…”

Epidemiological profile of early childhood caries in a sub-urban population in Nigeria

“…The significant caries index (SiC) is computed based on the mean dmft of one-third of the sample with the highest caries experience scores [ 22 , 23 ]. It is useful for identifying variations in decay proportions alongside the dmft [ 24 ], especially in countries where the overall decay experience is low [ 24 , 25 ]. SiC resolves the problem related to skewed caries distribution when using the dmft/dmfs.…”