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 was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method. 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: There were 2592 3- to 5-year-old preschool children. 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: The preschool children in Guangdong Province experienced a significant amount of ECC. More attention should be given to children’s dental health for deciduous teeth. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors.