title: Factors associated with dental caries in a group of American Indian children at age 36 months.
abstract: OBJECTIVE
  Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This article reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study.
  
  
  METHODS
  Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children, and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28, and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary, and behavioral factors. Nonparametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts).
  
  
  RESULTS
  Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only noncavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added-sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (P < 0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts.
  
  
  CONCLUSIONS
  By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size, and maternal factors, but further analyses are needed to better understand caries in this population.
authors.affiliation: Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA, USA.
authors.forename: John J
authors.initials: JJ
authors.lastname: Warren
authors.affiliation: Dows Institute for Dental Research, University of Iowa, Iowa City, IA, USA.
authors.forename: Derek
authors.initials: D
authors.lastname: Blanchette
authors.affiliation: Dows Institute for Dental Research, University of Iowa, Iowa City, IA, USA.
authors.forename: Deborah V
authors.initials: DV
authors.lastname: Dawson
authors.affiliation: Department of Preventive and Community Dentistry, University of Iowa, Iowa City, IA, USA.
authors.forename: Teresa A
authors.initials: TA
authors.lastname: Marshall
authors.affiliation: Dental Public Health Consultant, Morro Bay, CA, USA.
authors.forename: Kathy R
authors.initials: KR
authors.lastname: Phipps
authors.affiliation: Indian Health Service, Rapid City, SD, USA.
authors.forename: Delores
authors.initials: D
authors.lastname: Starr
authors.affiliation: Dows Institute for Dental Research, University of Iowa, Iowa City, IA, USA.
authors.forename: David R
authors.initials: DR
authors.lastname: Drake
mesh_terms: D002675:Child, Preschool; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: children; dental caries; oral health disparities; risk factors