title: Are distinctive risk indicators associated with different stages of caries in children? A cross-sectional study.
abstract: Actual caries figures emphasize the need to identify the risk indicators involved in the disease's development. The hypothesis that certain risk indicators might affect the dynamic evolution of the caries process was assessed; to clarify this premise, a cross-sectional survey was performed in school children.
  
  
  
  A total of 390 subjects aged 6-8 years old were randomly selected. Caries was assessed, and the subjects were stratified as follows: i) highest caries score; ii) most prevalent caries score; and iii) number of affected teeth. Parents/guardians completed a questionnaire regarding vital statistics, socio-economic indicators, dietary habits, oral hygiene habits and oral health behaviours.
  
  
  
  Caries was detected in 42.31% of the subjects. Maternal nationality, parental education level, use of a sweetened pacifier at night, intake of lactose-free milk and toothbrushing frequency were statistically significant associated (p < 0.05) with subjects stratified according to the highest caries score. Parental educational level, maternal occupational status and use of a sweetened pacifier at night were associated (p < 0.05) with affected children stratified according to the most prevalent caries score. Maternal educational level and intake of lactose-free milk were associated with subjects with moderate caries stages compared to being caries-free (p = 0.01 and p = 0.02, respectively). Maternal nationality (p < 0.01) and toothbrushing frequency (p = 0.01) were associated with subjects affected by extensive lesions compared to caries-free children. In subjects affected by initial lesions as the most prevalent figure, gender (male) and paternal occupation status (unemployed) were statistically significant associated (p = 0.03 and p = 0.04, respectively) compared to those affected by highest prevalence of extensive caries lesions. In children with the highest prevalence of moderate caries lesions, maternal education level (p < 0.01), paternal occupational status (p = 0.03) and use of a sweetened pacifier at night (p < 0.01) were statistically significantly associated.
  
  
  
  Maternal nationality, maternal low level of education, intake of lactose-free milk and low toothbrushing frequency were involved in the change from caries-free status to different caries stages. Gender, paternal unemployment, maternal low educational level and use of a sweetened pacifier were correlated with caries progression, showing how distinctive risk indicators were associated with different caries stages.
authors.affiliation: Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy.|WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Cagetti
authors.affiliation: WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Congiu
authors.affiliation: WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy.|Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Cocco
authors.affiliation: Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy.
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Meloni
authors.affiliation: WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy.
authors.forename: Silvana
authors.initials: S
authors.lastname: Sale
authors.affiliation: WHO Collaboration Centre for Epidemiology and Community Dentistry, Milan, Italy. gcampus@uniss.it.|Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Viale San Pietro 43/C, I-07100, Sassari, Italy. gcampus@uniss.it.
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Campus
mesh_terms: D002648:Child; D003430:Cross-Sectional Studies; D003611:Dairy Products; D003731:Dental Caries / Q000453:epidemiology*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D009909:Oral Health / Q000706:statistics & numerical data*; D009910:Oral Hygiene / Q000706:statistics & numerical data; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000706:statistics & numerical data
keywords: Caries staging; Children; Dental caries; Feeding practice; Risk indicators; Socio-economic status