title: Factors associated with early childhood caries incidence among high caries-risk children.
abstract: OBJECTIVE
  To assess the relationships between different behavioral factors and Early Childhood Caries (ECC) in African-American pre-school children.
  
  
  METHODS
  Ninety-six African-American children aged 3-22 months old at baseline were recruited from a high caries risk, non-fluoridated African-American community in Uniontown, Alabama. The children had dental examinations annually following World Health Organization (WHO) criteria at mean ages 1.1, 2.0, 3.1 and 4.0 years. All children received fluoride varnish application at each study visit. Parents provided oral hygiene and dietary information semiannually by completing questionnaires. Area-under-the-curve (AUC) with the trapezoidal rule was used to summarize longitudinal exposure data. Bivariate and multivariable relationships between ECC incidence and behavioral risk factors were assessed using logistic regression and negative binomial modeling for dichotomous and count dependent variables, respectively, with the independent variables defined at age 1, age 3 and as the AUC.
  
  
  RESULTS
  Greater frequency of toothbrushing and greater AUC composite of daily frequency of consumption of 100% juices were associated with lower incidence of dental caries (P-values = 0.01 and 0.049, ORs = 0.34 and 0.37, respectively). Greater AUC of daily frequency of consumption of sweetened foods and history of a previous visit to a dentist by age 3 were associated with greater incidence of ECC (ORs = 9.22 and 4.57, P-values = 0.002 and 0.03, respectively).
  
  
  CONCLUSIONS
  For these children living in a non-fluoridated community, more frequent consumption of sweetened food, less frequent consumption of 100% juice, less frequent toothbrushing, and reporting a previous visit to a dentist were significantly associated with greater ECC incidence.
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA.
authors.forename: Tariq
authors.initials: T
authors.lastname: Ghazal
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA.|Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors.forename: Steven M
authors.initials: SM
authors.lastname: Levy
authors.affiliation: Department of Pediatric Dentistry, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Noel K
authors.initials: NK
authors.lastname: Childers
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Broffitt
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Cutter
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Howard W
authors.initials: HW
authors.lastname: Wiener
authors.affiliation: School of Nursing and Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Mirjam C
authors.initials: MC
authors.lastname: Kempf
authors.affiliation: Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, IA, USA.
authors.forename: John
authors.initials: J
authors.lastname: Warren
authors.affiliation: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors.forename: Joseph E
authors.initials: JE
authors.lastname: Cavanaugh
mesh_terms: D000367:Age Factors; D000407:Alabama / Q000453:epidemiology; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D004040:Dietary Carbohydrates / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use; D000067030:Fruit and Vegetable Juices / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D014099:Toothbrushing / Q000706:statistics & numerical data
chemical_list: D004040:Dietary Carbohydrates; D005460:Fluorides, Topical
keywords: early childhood caries; high risk; oral hygiene