Family profiles in relation to early childhood caries: a cross-sectional study in France

Abstract

Objective: There are no clearly defined family profiles with an overall view of the predictors of early childhood caries (ECCs). The aim of our study was to identify the profiles of families that are particularly affected by ECCs. We also examined the factors that can be acted on to promote oral health.

Design: In this single-centre cross-sectional study, the researchers examined the mouths of 300 children with caries and recorded the Decayed, Missing and Filled Teeth Index (dmft). These observations were supplemented by a questionnaire completed by the families, focusing in particular on their sociodemographic characteristics (e.g. age, parents' professions and jobs, social assistance and family composition).

Setting: This work was conducted at Lille University Hospital between 2019 and 2024.

Participants: The participants included 300 caregiver-child dyads with children under the age of 6 years.

Primary and secondary outcome measures: Childhood Caries Index (dmft) and family characteristics associated with ECCs.

Statistical analyses: A multiple correspondence analysis was used, followed by a hierarchical clustering on principal components analysis, to identify the family profiles associated with ECC risk.

Result: Of the patients included in the study, 42% were girls, 58% were boys and their mean age was 4 years (±1.1 years). The mean dfmt index was 8.7 (±4.6); 77% of the participants had lesions on the smooth surfaces of the teeth, and 80% of the participants had a severe stage of caries disease. The analysis revealed three high-risk profiles based on the characteristics of the child's mother and the family sibling composition. The first profile was larger families where the focal child was not the eldest. The second profile was families with foreign-born mothers and a low socioeconomic level. The third profile was families with mothers facing geographical and financial difficulties in accessing healthcare.

Conclusion: This study enabled us to identify the profiles of families at risk of caries. These at-risk profiles highlight the need to implement specific interventions acting at different levels and focused on oral health education in interprofessional practice during the key period of the first 1000 days of life. These factors could help to bridge the gap between oral health and general health, improve children's oral health and reduce social health inequalities.

Ethics and dissemination: This human study has been ethically approved by the French Committee for the Protection of Individuals (N° 2019-A00827-50).

Trial registration number: The protocol is recorded on clinicaltrials.gov, with ID: NCT04195607.

Keywords: Child; Cross-Sectional Studies; EPIDEMIOLOGIC STUDIES; ORAL MEDICINE; PREVENTIVE MEDICINE.

Figure 1. Quissell model of the parental characteristics associated with ECCs, following Quissell et al. dmfs, Decayed, Missingdecayed, missing and filled te and filled te and Filled Te and filled teeth; ECC, early childhood caries.

Figure 2. Radar graph representing the three profiles of patients receiving treatment for ECCs. The radar figure shows the characteristics of each profile with its number of participants. The relationship between the colours and the profile numbers is shown below the figure. ECCs, early childhoood caries; LUH, Lille University Hospital.

Figure 3. Dendrogram of variables used to build profiles.

Figure 4. Proposed ecological strategy for ECCs. Figure 4 summarises the main difficulties for families in each profile (in red, and in bold for the most significant), with their associated characteristics (in grey) and suggested ways of ameliorating these difficulties (in green).