title: Case-control study of early childhood caries in Australia.
abstract: The aim of this case-control study of 617 children was to investigate early childhood caries (ECC) risk indicators in a non-fluoridated region in Australia. ECC cases were recruited from childcare facilities, public hospitals and private specialist clinics to source children from different socioeconomic backgrounds. Non-ECC controls were recruited from the same childcare facilities. A multinomial logistic modelling approach was used for statistical analysis. The results showed that a large percentage of children tested positive for Streptococcus mutans if their mothers also tested positive. A common risk indicator found in ECC children from childcare facilities and public hospitals was visible plaque (OR 4.1, 95% CI 1.0-15.9, and OR 8.7, 95% CI 2.3-32.9, respectively). Compared to ECC-free controls, the risk indicators specific to childcare cases were enamel hypoplasia (OR 4.2, 95% CI 1.0-18.3), difficulty in cleaning child's teeth (OR 6.6, 95% CI 2.2-19.8), presence of S. mutans (OR 4.8, 95% CI 0.7-32.6), sweetened drinks (OR 4.0, 95% CI 1.2-13.6) and maternal anxiety (OR 5.1, 95% CI 1.1-25.0). Risk indicators specific to public hospital cases were S. mutans presence in child (OR 7.7, 95% CI 1.3-44.6) or mother (OR 8.1, 95% CI 0.9-72.4), ethnicity (OR 5.6, 95% CI 1.4-22.1), and access of mother to pension or health care card (OR 20.5, 95% CI 3.5-119.9). By contrast, a history of chronic ear infections was found to be protective for ECC in childcare children (OR 0.28, 95% CI 0.09-0.82). The biological, socioeconomic and maternal risk indicators demonstrated in the present study can be employed in models of ECC that can be usefully applied for future longitudinal studies.
authors.affiliation: School of Dentistry, The University of Queensland, Brisbane, Qld., Australia. k.seow@uq.edu.au
authors.forename: W K
authors.initials: WK
authors.lastname: Seow
authors.forename: H
authors.initials: H
authors.lastname: Clifford
authors.forename: D
authors.initials: D
authors.lastname: Battistutta
authors.forename: A
authors.initials: A
authors.lastname: Morawska
authors.forename: T
authors.initials: T
authors.lastname: Holcombe
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D003744:Dental Enamel Hypoplasia / Q000453:epidemiology; D003773:Dental Plaque / Q000453:epidemiology; D004037:Diet, Cariogenic; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D015233:Models, Statistical; D009035:Mothers / Q000523:psychology; D009910:Oral Hygiene; D011581:Psychological Tests; D011793:Queensland / Q000453:epidemiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D013295:Streptococcus mutans / Q000302:isolation & purification; D011795:Surveys and Questionnaires