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The Status and Associated Factors of Early Childhood Caries among 3- to 5-year-old Children in Guangdong, Southern China: A Provincial Cross-sectional Survey
Shaohong Huang
Stomatological Hospital, Southern Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9169-484X
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Oral Health.
Background: Dental caries of deciduous teeth (Early Childhood Caries, ECC) has become a crucial oral health problem over the decades in China. The aim of this study was to examine the prevalence and severity of ECC among preschool children from Guangdong Province, Southern China. In addition, to assess the association of ECC with reported oral health-related behaviors.
Methods: A cross-sectional survey of 2592 participants was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method during December 2015 and April 2016. The participants were divided into three groups according to their ages (3-, 4-, and 5-year-olds). According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of ECC was determined by the dmft (decayed-missing-filled tooth) index using a CPI (Community Periodontal Index) probe. A questionnaire about caries-related factors was completed by each of the participants’ parents or grandparents through a face-to-face and one-on-one interview. Then, t -test, Chi 2 tests, One-Way ANOVA served for statistical analysis, and logistic regression analysis as well as covariance analysis were executed to identify potential associated factors for ECC.
Results: The prevalence (% dmft >0) of ECC was 68.3 (95% CI: 66.5-70.1), the mean dmft was 4.36 (95% CI: 4.17-4.55), and the filled rate was 1.2%. In multivariable modeling, associated factors for both prevalence and mean dmft were older age, rural areas, consumption of sweets before sleep, dental visit history, low household income, and low parental education level. Initiating toothbrushing after 3 years of age and being exclusively/ predominantly breastfed indicated only the prevalence; being female and frequently consuming sweetened milk/powdered milk indicated only the mean dmft.
Conclusions: Preschool children in Guangdong Province, especially children from rural areas, experienced a significant amount of ECC. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors. More attention should be given to prevention of ECC from early life. The construction of social support for oral health should be strengthened. Oral health education and promotion, especially of rural areas, should be intensified to reduce the inequality between urban and rural areas.
Keywords
Cross-sectional survey, Early childhood caries, Oral epidemiology, Preschool children, Associated factors
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CURRENT STATUS: Published
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Posted 15 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 09 Sep, 2020
Reviewer #2 agreed
On 28 Aug, 2020
Review #2 received
Received 28 Aug, 2020
Review #1 received
Received 26 Aug, 2020
Reviewer #1 agreed
On 25 Aug, 2020
Reviewers invited
Invitations sent on 23 Aug, 2020
Editor assigned
On 21 Aug, 2020
Submission checks complete
On 20 Aug, 2020
Editor invited
On 20 Aug, 2020
No comments provided
Editorial decision: Major revision
On 31 Jul, 2020
Review #1 received
Received 25 Jul, 2020
Review #2 received
Received 25 Jul, 2020
Review #3 received
Received 21 Jul, 2020
Reviewer #3 agreed
On 06 Jul, 2020
Reviewer #2 agreed
On 04 Jul, 2020
Reviewer #1 agreed
On 02 Jul, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 10 Jun, 2020
First submitted
On 09 Jun, 2020
Submission checks complete
On 09 Jun, 2020
Editor invited
On 09 Jun, 2020
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This preprint is under consideration at BMC Oral Health. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
The Status and Associated Factors of Early Childhood Caries among 3- to 5-year-old Children in Guangdong, Southern China: A Provincial Cross-sectional Survey
Shaohong Huang
Stomatological Hospital, Southern Medical University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-9169-484X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 15 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 09 Sep, 2020
Reviewer #2 agreed
On 28 Aug, 2020
Review #2 received
Received 28 Aug, 2020
Review #1 received
Received 26 Aug, 2020
Reviewer #1 agreed
On 25 Aug, 2020
Reviewers invited
Invitations sent on 23 Aug, 2020
Editor assigned
On 21 Aug, 2020
Submission checks complete
On 20 Aug, 2020
Editor invited
On 20 Aug, 2020
No comments provided
Editorial decision: Major revision
On 31 Jul, 2020
Review #1 received
Received 25 Jul, 2020
Review #2 received
Received 25 Jul, 2020
Review #3 received
Received 21 Jul, 2020
Reviewer #3 agreed
On 06 Jul, 2020
Reviewer #2 agreed
On 04 Jul, 2020
Reviewer #1 agreed
On 02 Jul, 2020
Reviewers invited
Invitations sent on 29 Jun, 2020
Editor assigned
On 10 Jun, 2020
First submitted
On 09 Jun, 2020
Submission checks complete
On 09 Jun, 2020
Editor invited
On 09 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Oral Health.
Background: Dental caries of deciduous teeth (Early Childhood Caries, ECC) has become a crucial oral health problem over the decades in China. The aim of this study was to examine the prevalence and severity of ECC among preschool children from Guangdong Province, Southern China. In addition, to assess the association of ECC with reported oral health-related behaviors.
Methods: A cross-sectional survey of 2592 participants was carried out in Guangdong Province by means of an equal-sized, stratified, multistage random sampling method during December 2015 and April 2016. The participants were divided into three groups according to their ages (3-, 4-, and 5-year-olds). According to the standard for clinical dentition examination of the WHO 2013 criteria, the presence of ECC was determined by the dmft (decayed-missing-filled tooth) index using a CPI (Community Periodontal Index) probe. A questionnaire about caries-related factors was completed by each of the participants’ parents or grandparents through a face-to-face and one-on-one interview. Then, t -test, Chi 2 tests, One-Way ANOVA served for statistical analysis, and logistic regression analysis as well as covariance analysis were executed to identify potential associated factors for ECC.
Results: The prevalence (% dmft >0) of ECC was 68.3 (95% CI: 66.5-70.1), the mean dmft was 4.36 (95% CI: 4.17-4.55), and the filled rate was 1.2%. In multivariable modeling, associated factors for both prevalence and mean dmft were older age, rural areas, consumption of sweets before sleep, dental visit history, low household income, and low parental education level. Initiating toothbrushing after 3 years of age and being exclusively/ predominantly breastfed indicated only the prevalence; being female and frequently consuming sweetened milk/powdered milk indicated only the mean dmft.
Conclusions: Preschool children in Guangdong Province, especially children from rural areas, experienced a significant amount of ECC. Associated factors for ECC included demographics, oral health measures, dietary factors, and socioeconomic factors. More attention should be given to prevention of ECC from early life. The construction of social support for oral health should be strengthened. Oral health education and promotion, especially of rural areas, should be intensified to reduce the inequality between urban and rural areas.
Figure 1
Figure 2
Due to technical limitations, the tables are only available as a download in the supplementary files section.