Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study
Abstract Background: The high prevalence of early childhood caries (ECC) is widespread around the world, and oral health education (OHE) plays a vital role in preventing ECC. Numerous studies on ECC risk factor assessment have assisted us in enriching the content of OHE. The objective of this study was to further assess independent risk factors for ECC at different ages to provide evidence and insights for OHE.Methods: Children aged 3-5 years old (N=1301) in Shandong Province were enrolled in this cross-sectional study. Data about oral health status and guardians’ oral health knowledge, attitude, and practice (KAP) were extracted from the 4th National Oral Health Survey of China. The associations between ECC prevalence and various KAP variables were tested with chi-square tests, bivariate analysis and multivariable logistic regression analyses.Results: The ECC prevalence in Shandong Province was 64.6%, and the dmft mean was 3.15. The independent variables with an increased risk for ECC were age, feeding method within 6 months of birth, bedtime sugar frequency, experience of toothache over the past year and dental visits. Feeding methods primarily contributed to the high risk of the 3-year-old group, while sugar habits mainly contributed to that of the 5-year-old group. The association between brushing and ECC was not confirmed in this study, and some positive knowledge and attitude variables were unexpectedly positively correlated with a high risk of ECC. Conclusion: These data provide evidence to suggest that the ECC-related risk factors at different ages are inconsistent, which provides some insights for OHE. Specifically, in addition to promoting preventive dental visit, we should highlight the effects of feeding methods in the early stages of deciduous dentition and sugar habits in the late stages of deciduous dentition on ECC, as well as encourage supplemental training for food oral health practices.