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. 2020 Sep 25;20(1):265.
doi: 10.1186/s12903-020-01253-w.

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

Jianbo Li  1 , Weihua Fan  1 , Yueshan Zhou  1 , Linmei Wu  1 , Wei Liu  2 , Shaohong Huang  3
Affiliations

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

Jianbo Li et al. BMC Oral Health. .

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.

Keywords: Associated factors; Cross-sectional survey; Early childhood caries; Oral epidemiology; Preschool children.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
The frequency distribution of dmft. The purple column illustrates the percentage of children (dmft) of 3-year-olds. The green column illustrates the percentage of children (dmft) of 4-year-olds. The brown column illustrates the percentage of children (dmft) of 5-year-olds
Fig. 2
Fig. 2
The distribution of teeth with ECC by tooth position. The blue column illustrates the proportion of teeth with ECC among 3-year-olds. The orange column illustrates the proportion of teeth with ECC among 4-year-olds. The gray column illustrates the proportion of teeth with ECC among 5-year-olds
See this image and copyright information in PMC

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