A longitudinal study of dental caries risk among very young low SES children.
OBJECTIVE
Early childhood caries (ECC) is a challenging public health problem in the United States and elsewhere; however, there is limited information concerning risk factors in very young children. The purpose of this study was to assess baseline risk factors for 18-month caries prevalence as part of a longitudinal study of high-risk children.


METHODS
About 212 children, 6-24 months of age were recruited from a rural community in Iowa. Subjects were enrolled in the WIC program, which provides nutritional support for low-income families with children. Dental examinations using d1, d2-3 criteria were conducted at baseline and after 18 months. Caries prevalence was determined at the frank decay level (d2-3 or filled surfaces), as well as at the noncavitated level (d1), and combined (d1, d2-3 or f surfaces). Risk factor data were collected at baseline and after 9- and 18- months. These data included beverage consumption data, presence of visible plaque, and use of fluoride toothpaste for children as well as mutans streptococci (MS) levels of mothers and children and family sociodemographic factors.


RESULTS
About 128 children (60%) remained in the study after 18 months. Among these children, prevalence of d1,d2-3/f level caries increased from 9% to 77%, while d2-3/f level caries increased from 2% to 20%. Logistic regression models for baseline predictors of d2-3f caries at the 18-month follow-up found the presence of MS in children (OR=4.4; 95% CI: 1.4, 13.9) and sugar-sweetened beverages (OR=3.0; 95% CI: 1.1, 8.6) to be the only significant risk factors. Sociodemographic factors and the use of fluoride toothpaste were not significant in these models.


CONCLUSIONS
Results suggest that early colonization by MS and consumption of sugar-sweetened beverages are significant predictors of ECC in high-risk populations.
Warren
John J
JJ
Department of Preventive and Community Dentistry, The University of Iowa, Iowa City, IA 52242-1010, USA. john-warren@uiowa.edu
Weber-Gasparoni
Karin
K
Marshall
Teresa A
TA
Drake
David R
DR
Dehkordi-Vakil
Farideh
F
Dawson
Deborah V
DV
Tharp
Katie M
KM
D001903:Bottle Feeding / Q000009:adverse effects; D002327:Cariostatic Agents / Q000627:therapeutic use; D003731:Dental Caries / Q000191:economics* / Q000453:epidemiology* / Q000209:etiology; D003773:Dental Plaque / Q000382:microbiology; D019422:Dietary Sucrose / Q000009:adverse effects; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008137:Longitudinal Studies; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology; D018709:Statistics, Nonparametric; D013295:Streptococcus mutans / Q000302:isolation & purification; D014100:Toothpastes / Q000737:chemistry; D014481:United States / Q000453:epidemiology
D002327:Cariostatic Agents; D019422:Dietary Sucrose; D014100:Toothpastes; D005459:Fluorides