title: Risk factors for severe early childhood caries in children younger than 4 years old in Beijing, China.
abstract: OBJECTIVE
  The purpose of this study was to compare cariogenic factors and acidogenic ability of bacteria between severe early childhood caries (S-ECC) and caries-free children in Beijing, China.
  
  
  METHODS
  The study consisted of 117 S-ECC children and 129 caries-free children < 4 years old. A questionnaire was designed to collect background information, feeding habits, and oral hygiene practices. Dental plaque samples were collected to test acidogenic ability of bacteria.
  
  
  RESULTS
  Compared with the mothers of caries-free children, those of S-ECC children had a lower education level and poorer knowledge of oral hygiene (P < .05). Night-feeding and eating sweets several times a day were significantly more common in S-ECC children than in caries-free children (P < .001). Forty-six S-ECC children but only 2 caries-free children received prechewed food (P < .001). The results of the Cariostat test showed that the majority of the caries-free children (81%) were at a low risk level, and most of the S-ECC children (78%) were at a high risk level (P < .001).
  
  
  CONCLUSIONS
  There was strong relationship between high acidogenic ability of bacteria and S-ECC. A lower maternal education level, poor knowledge of oral hygiene, night-feeding, and excessive sugar intake were important contributors to the development of S-ECC.
authors.affiliation: Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Beijing, China. qinman@gmail.com
authors.forename: Man
authors.initials: M
authors.lastname: Qin
authors.forename: Jing
authors.initials: J
authors.lastname: Li
authors.forename: Sun
authors.initials: S
authors.lastname: Zhang
authors.forename: Wenli
authors.initials: W
authors.lastname: Ma
mesh_terms: D000143:Acids / Q000378:metabolism; D000367:Age Factors; D001419:Bacteria / Q000378:metabolism; D001903:Bottle Feeding; D002675:Child, Preschool; D002681:China; D003731:Dental Caries / Q000209:etiology*; D003732:Dental Caries Activity Tests; D003733:Dental Caries Susceptibility; D003773:Dental Plaque / Q000382:microbiology; D019422:Dietary Sucrose / Q000008:administration & dosage; D004522:Educational Status; D005247:Feeding Behavior; D006801:Humans; D007223:Infant; D008409:Mastication; D009035:Mothers / Q000193:education; D009910:Oral Hygiene; D012307:Risk Factors; D014099:Toothbrushing
chemical_list: D000143:Acids; D019422:Dietary Sucrose