Early predictors of childhood caries among 4-year-old children: a population-based study in north-eastern France.

Background: Untreated early childhood caries (ECC) can trigger a number of negative consequences, including pain, chewing difficulties, insufficient physical development and low academic performance. Therefore, ECC impacts the oral health-related to quality of life. That is why it is important to assess the ECC prevalence and to determine the associated risk factors.

Aim: The aim of this study was to investigate the relationship between early predictor factors and dental caries among 4-year-old French children, considering the socioeconomic factors, dietary and oral hygiene practices, the access and the follow-up by paediatric dentist.

Design: The study was a cross-sectional observation. A random sample of 4-year-old children was selected among 596 Moselle's public nursery schools in north-eastern France. Data were gathered from clinical dental examinations and a structured questionnaire completed by parents.

Results: In total, 425 subjects with completed questionnaires and clinical examinations were included. The prevalence of ECC and S-ECC (Severe-ECC), including only cavitated lesions, d3mft, were 15.8% and 5.9%, respectively. Multivariable logistic regression modelling identified four main factors associated with a high risk of ECC that were sweet intake (adjusted odds ratio OR = 3.43, 95% CI = 1.57-7.53), brushing habits (OR = 2.25, 95% CI = 1.23-4.21), childcare arrangement (OR = 2.27, 95% CI = 1.23-4.21) and maternal educational level (OR = 1.87, 95% CI = 1.06-3.31). These four factors have a cumulative effect. Only 4% of children presented teeth restoration.

Conclusions: This study highlighted the impact of the family environment on the oral health status of the preschool children. The identification of the risk factors should allow to strengthen preventive measures and initiate oral health education program for children and their family.