Skip to main content
Download PDF

Exploring the state and influential factors of dental caries in preschool children aged 3–6 years in Xingtai City

BMC Oral Health volume 24, Article number: 951 (2024) Cite this article

Abstract

Objective

To explore the main factors affecting early dental caries among preschool children aged 3–6 years in Xingtai City to formulate effective preventive measures.

Methods

A cross-sectional study was conducted on 570 preschool children aged 3–6 years in Xingtai City through questionnaire surveys and oral examinations to understand their dental caries situation. Multifactorial logistic regression analysis was used to analyse the main influencing factors for the occurrence of dental caries in preschool children.

Results

Univariate analysis showed statistically significant differences in age (χ2 = 2.636, p = 0.008), father’s education level (χ2 = 4.207, p < 0.001), mother’s education level (χ2 = 4.217, p < 0.001), daily tooth brushing frequency (χ2 = 3.160, p = 0.002), age of starting tooth brushing (χ2 = 8.756, p < 0.001), mouth rinsing after meals (χ2 = 89.401, p < 0.001), Streptococcus mutans positivity (χ2 = 133.503, p < 0.001), non-sweet snack consumption frequency (χ2 = 5.962, p < 0.001), snack flavour preference (χ2 = 116.119, p < 0.001), use of fluoridated toothpaste (χ2 = 75.639, p < 0.001), regular oral examinations (χ2 = 98.711, p < 0.001), sugary drink consumption frequency (χ2 = 10.370, p < 0.001) and sweet food consumption frequency (χ2 = 9.261, p < 0.001) between the caries and non-caries groups. Multifactorial analysis revealed that older age (odds ratio [OR] = 5.342, 95% confidence interval [CI]: 1.434–6.631), later initiation of tooth brushing (OR = 3.244, 95% CI: 2.413–5.424), S. mutans positivity (OR = 5.357, 95% CI: 4.529–8.563), high snack consumption frequency (OR = 3.452, 95% CI: 2.634–5.442), high sugary drink consumption frequency (OR = 4.414, 95% CI: 2.534–6.451) and high sweet food consumption frequency (OR = 4.531, 95% CI: 3.421–6.354) were risk factors for dental caries. Higher father’s educational level (OR = 0.724, 95% CI: 0.564–0.891), higher mother’s educational level (OR = 0.641, 95% CI: 0.601–0.813), high daily tooth brushing frequency (OR = 0.572, 95% CI: 0.423–0.864), mouth rinsing after meals (OR = 0.743, 95% CI: 0.643–0.813), use of fluoridated toothpaste (OR = 0.657, 95% CI: 0.553–0.931) and regular oral examinations (OR = 0.443, 95% CI: 0.352–0.747) were protective factors against dental caries (all p < 0.05).

Conclusion

Multiple factors result in early dental caries in preschool children aged 3–6 years; however, the most influential factors are older age and high snack consumption, as well as high sugary and sweet food/drink consumption.

Peer Review reports

Introduction

Oral health constitutes a critical component of overall health. Despite the escalating attention oral health is receiving, dental caries persist as the most prevalent health issue among children, particularly early childhood caries (ECC) [1]. The American Academy of Pediatric Dentistry defines ECC as the presence of one or more carious lesions, tooth loss due to caries or any filled tooth surfaces in primary teeth in children under the age of 6 years [2]. Deciduous teeth, the main masticatory organs in children aged < 10 years, can cause pain and mastication difficulties if affected by ECC and left untreated. Furthermore, developing ECC in these teeth can adversely impact the development of permanent teeth, resulting in malocclusion, potentially affecting weight gain and predisposing children to behavioural and psychological issues, all of which may severely hinder normal growth and psychosomatic health [3,4,5,6]. Due to the high prevalence of ECC among certain populations and the resulting potential impact on health, ECC has been universally recognised as an international public health issue [7, 8]. Early prevention and treatment of dental caries can foster healthy growth in children, improve their quality of life and alleviate the burden of healthcare costs.

Dental caries, a prevalent oral disease that can occur at any age, is influenced by a multitude of factors, especially among the paediatric population where the prevalence of caries is exceedingly high. Caries not only lead to tooth loss but also accompany conditions such as mastication and swallowing difficulties, pain and secondary complications, including pulpitis, infections and osteomyelitis of the alveolar bone [9]. Research indicates that the probability of caries in children exceeds 50% [10,11,12], with its prevalence fluctuating based on gender, dietary habits, residential area and ethnicity. In addition, the prevalence of caries tends to increase with age. Among the factors influencing the development of ECC, unhealthy dietary habits, improper tooth brushing techniques and inadequate awareness of the detriments of caries are all key determinants [13].

The onset of ECC is associated with multiple factors. Research initially linked ECC to improper or prolonged bottle or breastfeeding [14]. Bottle feeding, especially during night-time sleep, increases the risk of dental caries in children. However, this is neither the sole nor the primary cause of ECC formation. The intake of juices and carbonated beverages also correlates with the occurrence of ECC. Some studies argue that tooth brushing habits and frequency are associated with the onset and progression of caries [15]. The educational level of a child’s parents also correlates with the occurrence and severity of ECC. Parents with lower levels of education tend to have children with higher rates of caries [16]. Additionally, ECC is more common in single-parent families, families where parents have a lower educational level and families where the mother is illiterate [17]. Therefore, the occurrence of ECC is related to feeding methods, dietary habits, oral hygiene behaviours and certain parental characteristics [14,15,16,17].

Delayed treatment of dental caries will not only cause pulpitis and periapical periodontitis but also affect the development of children; it will affect the eruption of permanent teeth and the development of the dental arch. In severe cases, it will induce bacteraemia and endanger a child’s life [18]. Some foreign epidemiological surveys show that oral diseases, especially caries, are correlated with digestive, cardiovascular and immune system diseases [19]. Patients with a hiatus hernia often have severe tooth loss; individuals with gastroesophageal reflux disease exhibit noticeable caries; patients with gastrointestinal disorders and tooth loss have more severe gastric acid reflux than those patients without tooth loss; and patients with anorexia nervosa and bulimia nervosa have noticeable tooth loss in their oral cavities [20,21,22]. These studies suggest a possible link between caries and other diseases, indicating the need for simultaneous treatment of the consequences of both dental caries and systemic diseases [12].

Domestic research on the influencing factors of children’s dental caries primarily focuses on the relationship between children’s caries and gender, age, dietary habits, oral hygiene behaviours and the parents’ attitudes towards children’s oral health and oral health knowledge [23, 24]. There are also surveys analysing the correlation between preschool children’s caries and the educational level of their parents, as well as their parents’ knowledge, attitudes and behaviours related to the prevention and treatment of deciduous tooth caries [11, 24]. Overall, however, research in this area is not comprehensive enough. Based on previous research, the authors of this study hypothesise that multiple factors, including dietary habits, oral hygiene habits, socioeconomic factors (parental education) and the presence of Streptococcus mutans, lead to the high prevalence of ECC in preschool children (3–6 years old) in Xingtai City. It is further hypothesised that good oral hygiene habits (e.g. frequent brushing, flossing, mouthwash), healthy dietary habits (e.g. low sugar intake, frequent consumption of non-sweet snacks), higher parental education and regular dental care are protective factors against ECC. Therefore, this study performs relevant research to provide a reference for optimising the oral health status of preschool children aged 3–6 years in Xingtai City and improving their oral hygiene level.

Study participants and methods

Study participants

This was a cross-sectional study. The participants of this research were preschool children aged 3–6 years in Xingtai City. A three-stage stratified random cluster sampling method was adopted. In the first stage, based on geographical location, a random sampling method was employed to sample from four districts and 12 counties under Xingtai City at a ratio of 1:4, resulting in a total of four sampled areas: Xiangdu District, Licheng County, Longyao County and Pingxiang County. In the second stage, a random sampling method was used to randomly select two preschools from each area, for a total of eight. In the third stage, a random cluster sampling method was applied to select one class from each of the small, medium and large classes in each preschool. Three classes were selected from each school, totalling 24 classes. A questionnaire survey was conducted for all related informants in the homes of the preschool children aged 3–6 years in each class (see Appendix 1 of the supplementary material for questionnaire details). The survey was conducted after the completion of oral health examinations in the children’s garden, filled out by the individuals who usually care for the children and collected immediately after completion. Pass 15.0 software was used to calculate the sample size. The expected prevalence rate was 0.6, the expected effect size was 0.2, the significance level (α) was 0.05, the statistical power was 0.8, and considering the loss to follow-up rate of 0.3, the sample was calculated through the software. The volume requirement was at least 600 cases to meet the above study parameter requirements. A total of 600 people were surveyed, and 600 questionnaires were recovered, of which 570 were determined as valid. The valid recovery rate was 95%, and the non-response rate was 0%. The reasons for questionnaire exclusion were the lack of basic information completed (8), the inconsistency in the logic before and after the questionnaire (12) and the parents’ unwillingness to accept a follow-up examination (10). This study was approved by the Ethics Committee of Hebei Eye Hospital. Written informed consent was obtained from all parents/local guardians of the children.

Research methods

Oral examinations were performed on all children by dentists specialising in stomatology from the research team’s hospital dental clinic, and blood samples were collected for S. mutans detection. There was a total of six examiners – all dental clinical practitioners – and they received systematic training before conducting the questionnaire survey (i.e. the questionnaire survey process and clinical examination specifications). The examiners conducted mock checks to ensure their examinations were aligned. In the simulated inspection, the inspectors were tested for standard consistency, and the kappa value was 0.89. Caries examinations were conducted under natural light combined with a probe. The diagnostic criteria for caries were as follows [25]: cavities observable in the pits, fissures or smooth surfaces, enamel destruction or softening of the floor or wall of the cavity that can be probed. The decayed, missing and filled teeth (DMFT) index recommended by the World Health Organization is the most commonly used dental caries index in epidemiological studies and measures the prevalence of dental caries based on the presence of cavitation caries lesions. After the examination, the caries average (the sum of DMFT/number of examinees) was calculated based on the diagnostic results [25]. A detection kit was used to wipe the oral tooth surface and mucous membrane with a swab; the swab was then immersed in the culture medium and incubated anaerobically at a constant temperature for 48 h. The number of S. mutans present in the saliva was estimated based on the colour of the culture medium. Streptococcus mutans detection was completed, and the results were provided by the hospital’s testing centre as required.

The survey questionnaire included the following content. (1) General situation: the child’s gender, age, grade, whether they are an only child, whether the mother mainly takes care of the daily life and whether they live with the parents; parents’ age, education and profession. (2) Children’s oral health behaviours: tooth brushing habits, age of starting tooth brushing, mouth rinsing after meals, frequency of eating sweets and drinking sugary beverages. The questionnaires were distributed to the parents of the children by trained full-time staff who also guided the parents in filling them out.

Statistical analysis

Data were summarised using Excel 2019, and statistical analysis was performed using SPSS 26.00. In this study, the number of cases (%) was used for descriptive statistics of the count data, and the chi-squared test (χ2) was used for a comparison between groups, expressed as the odds ratio (OR) (95% confidence interval [CI]). Binary logistic regression analysis was performed using the presence of dental caries (yes = 1, no = 0) as the dependent variable to identify significant suspected risk factors. The significant suspected risk factors in the single-factor analysis were coded. The variable grouping and coding are detailed in Table 1. A stepwise logistic regression analysis was also performed. The partial maximum likelihood estimation backward method (introduction standard p ≤ 0.05, exclusion standard p ≥ 0.10) was used to include and exclude these factors to construct a logistic regression analysis model. When p < 0.05, the difference was statistically significant (both were two-tailed tests).

Table 1 Variable grouping and encoding
Full size table

Results

Basic situation

Among the 570 respondents, 76.8% were mothers, 22.8% were fathers and 0.4% were others. The sampling survey results showed that among the 570 preschool children aged 3–6 years, 290 were boys (50.9%). There were 173 students in grade 1 of kindergarten (30.4%), 194 students in grade 2 of kindergarten (34.0%) and 203 students in grade 3 of kindergarten (35.6%). The age distribution was as follows: 145 were 3 years old (25.4%); 173 were 4 years old (30.4%); 198 were 5 years old (34.7%); and 54 were 6 years old (9.5%). The average age was 3.98 ± 0.95 years. Out of all the children, 421 were only children (73.9%) and 149 had siblings (26.1%). In daily life, 386 were mainly taken care of by their mothers (67.7%). A total of 542 children lived with their parents (95.1%) and 28 did not live with their parents (4.9%).

Univariate analysis of caries risk factors

In this study, caries lesions were detected in 341 of the 570 preschool children (a prevalence rate of 59.8%). The results showed that there were statistically significant differences between the two groups in terms of age (χ2 = 2.636), father’s education level (χ2 = 4.207), mother’s education level (χ2 = 4.217), daily tooth brushing frequency (χ2 = 3.160), age when started brushing teeth (χ2 = 8.756), the proportion of mouth rinsing after meals (χ2 = 89.401), S. mutans positive (χ2 = 133.503), non-sweet snack consumption frequency (χ2 = 5.962), snack flavour preference (χ2 = 116.119), use of fluoridated toothpaste (χ2 = 75.639), regular oral examinations (χ2 = 98.711), sugary drink consumption frequency (χ2 = 10.370) and sweet food consumption frequency (χ2 = 9.261) (all p < 0.05). No statistically significant differences were found between the two groups in terms of gender, the proportion of only-children, the proportion of mothers taking care of the children in daily life, the proportion of children living with their parents, the proportion of breastfeeding time and the proportion of malnutrition (p > 0.05). See Table 2 for details.

Table 2 Univariate analysis of factors influencing dental caries
Full size table

Multifactorial analysis of caries influencing factors

The regression analysis results showed that older age (OR = 5.342, 95% CI: 1.434–6.631) was an influencing factor. This indicates that older children are 5.342 times more likely to develop dental caries. Another influencing factor was the later initiation of tooth brushing (OR = 3.244, 95% CI: 2.413–5.424), indicating that children who start brushing their teeth later are 3.244 times more likely to have caries compared with those who started earlier. Another influencing factor was S. mutans positivity (OR = 5.357, 95% CI: 4.529–8.563), indicating that children who tested positive for the bacteria are 5.357 times more likely to have caries compared with those who tested negative. Children with a high snack consumption frequency (OR = 3.452, 95% CI: 2.634–5.442) are 3.452 times more likely to have caries compared with those who have a lower snack consumption. In addition, children with a high sugary drink consumption frequency (OR = 4.414, 95% CI: 2.534–6.451) are 4.414 times more likely to have caries compared with those who have a lower consumption. Another influencing factor was high sweet food consumption frequency (OR = 4.531, 95% CI: 3.421–6.354), indicating that children with high sweet food consumption frequency are 4.531 times more likely to have caries compared with those who have a lower consumption. All of these results had p-values of < 0.05 and were risk factors for caries. A high father’s educational level (OR = 0.724, 95% CI: 0.564–0.891) indicates that these children are less likely to have caries (by a factor of 0.724) compared with those who have fathers with a lower education level. A high mother’s educational level (OR = 0.641, 95% CI: 0.601–0.813) is similar to the educational level of fathers; children with mothers who have a higher education level are less likely to have caries (by a factor of 0.641) compared with those who have mothers with a lower education level. High daily tooth brushing frequency (OR = 0.572, 95% CI: 0.423–0.864) indicates that children who brush their teeth more frequently are less likely to have caries (by a factor of 0.572). Children who rinse their mouths after meals (OR = 0.743, 95% CI: 0.643–0.813) are less likely to have caries (by a factor of 0.743) compared with children who do not rinse after meals. The use of fluoridated toothpaste (OR = 0.657, 95% CI: 0.553–0.931) indicates that children who use fluoridated toothpaste are less likely to have caries (by a factor of 0.657) compared with children who use non-fluoridated toothpaste. Children who have regular oral examinations are less likely to have caries (by a factor of 0.443) compared with those who do not (OR = 0.443, 95% CI: 0.352–0.747) (all p < 0.05). These factors are protective against caries, as shown in Table 3.

Table 3 Multifactorial logistic regression analysis of factors affecting early childhood caries
Full size table

Discussion

Dental caries is the most common chronic non-communicable oral disease during childhood [26,27,28], severely affecting children’s growth and development [29]. Despite the past efforts of dentists and researchers to combat dental caries, the prevalence remains high. Statistics show that 60–90% of children worldwide are affected by dental caries [30].

The findings of this investigation reveal that the prevalence of dental caries among preschool children aged 3–6 years in Xingtai City remains considerable; the prevalence also progressively rises with age, aligning with the results of other studies [31]. This finding may be closely associated with children’s dietary preferences and parental habits. Existing research has confirmed S. mutans as the primary pathogen that causes dental caries. This bacteria adheres to the teeth’s surface through both sucrose-dependent and independent mechanisms. Bacterial metabolism results in the production of acidic substances. If a tooth is exposed to an acidic environment for a prolonged period, the prevalence of caries increases [32]. Deciduous teeth emerge during infancy, representing a significant change in the oral environment from the neonatal period. This change provides optimal conditions and space for microbial growth. Microorganisms lingering on newly emerged deciduous teeth increase the prevalence of caries [33]. Dental caries exhibit extensive erosion, high morbidity and subtle early symptoms, but they quickly proliferate at later stages, affecting the normal development of children’s teeth. Under normal conditions, oral physiological status maintains an ecological balance. However, when oral hygiene is poor or sugar intake substantially increases, the number of cariogenic bacteria in the plaque escalates, thereby increasing the prevalence of caries. Studies have proven that excessive daily sugar intake enhances the risk of caries [34]. Additionally, poor habits, such as neglecting to brush teeth before bedtime or rinsing the mouth after meals, significantly increase the risk of dental diseases. This study’s results also indicate that mouth rinsing after meals, snacking, S. mutans infection, daily tooth brushing frequency, age when brushing started, usage of fluoridated toothpaste, preference for sweets or snacks and regular oral examinations are crucial factors influencing the prevalence of dental caries, all of which is consistent with related research findings [35]. Limiting children’s intake of excessive sweets, controlling the daily consumption frequency and quantity of desserts, sugary drinks and snacks, as well as ensuring teeth cleanliness all have beneficial effects in preventing caries. Deciduous teeth are susceptible to caries and are more likely to experience recurrent caries disease after filling or preventative treatment than permanent teeth. Parents should take their children for regular oral examinations every 3–6 months. Regular group check-ups in kindergartens also represent an important aspect of dental caries prevention and treatment for children.

The correlation between the level of parental education and the prevalence of dental caries in children is receiving increased attention. Research indicates that children from families where the parents have a higher level of education have access to a good education and parental guidance, thereby reducing their chances of developing oral diseases [36]. Conversely, in families where parents have a lower level of education, the children are less likely to be equipped with appropriate oral health knowledge, which increases the probability of oral diseases. Herndon postulated that in addition to age, parental education and income are closely related to the prevalence of caries [37]. In addition, Mathur suggested that a low level of maternal education is significantly related to the occurrence of dental caries in children [38]. This study also found a significant correlation between the level of the mother’s education and the prevalence of caries in preschool children aged 3–6 years: the higher the level of the mother’s education is, the lower the prevalence of caries in preschool children aged 3–6 years. This is likely because individuals with a higher level of education often possess good oral health knowledge. This study found that the mother’s educational level is positively correlated with oral healthcare knowledge in preschool children aged 3–6 years. The higher the level of maternal education is, the more oral healthcare knowledge they possess. The results of this study demonstrate that the higher the level of parental education is, the lower the probability that preschool children aged 3–6 years will develop caries.

The strength of the current study is that it used multivariate logistic regression analysis to examine the factors influencing the prevalence of ECC in preschool children. This approach allows for the assessment of the independent effects of various factors while controlling for the effects of other variables. This comprehensive analysis provides a clearer picture of the interplay between multiple risk and protective factors in the development of ECC from which reliable conclusions can be drawn, compared with studies that focus on a single factor at a time. By analysing the combined impact of multiple factors, we can go beyond simply identifying risk factors; insights into how these factors work together to increase or decrease ECC risk are easier to identify.

However, there are some limitations to this study. First, this research did not collect the oral health habits of every preschool child aged 3–6 years, necessitating further studies on the relationship between these habits and the prevalence of caries. Second, this study is based on the data analysis of preschool children aged 3–6 years in Xingtai City. The temporal relationship between exposure and outcome cannot be determined, and the influence of deciduous dental caries on the formation of permanent dental caries may exist. Finally, the research participants were preschool children aged 3–6 years sampled in the Xingtai City area; therefore, the results extrapolated to the population of preschool children aged 3–6 years in China may not be entirely representative.

Conclusion

The prevalence of early dental caries in preschool children aged 3–6 years is influenced by multiple factors, the most influential of which are older age, high consumption of snacks and high sugary and sweet food/drink consumption. Therefore, targeted health promotion and education should be strengthened to help children adopt a rational and standard diet and establish correct oral cleaning habits to reduce the prevalence of dental caries and improve children’s oral health status.

Data availability

Data is provided within the manuscript or supplementary information files “Appendix 1 Childhood Caries Questionnaire”.

References

  1. Brecher EA, Lewis CW. Infant oral health. Pediatr Clin North Am. 2018;65(5):909–21. https://doi.org/10.1016/j.pcl.2018.05.016.

    Article  PubMed  Google Scholar 

  2. Tschampl CA, Wanted. Less prevalence of and more data on early childhood caries. Am J Public Health. 2018;108(8):980–1. https://doi.org/10.2105/AJPH.2018.304539.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Romaire MA, Bell JF, Huebner CE. Variations in children’s dental service use based on four national health surveys. Pediatrics. 2012;130(5):e1182–9. https://doi.org/10.1542/peds.2012-1210.

    Article  PubMed  Google Scholar 

  4. Tinanoff N, Reisine S. Update on early childhood caries since the Surgeon General’s report. Acad Pediatr. 2009;9(6):396–403. https://doi.org/10.1016/j.acap.2009.08.006.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Maserejian NN, Trachtenberg F, Link C, Tavares M. Underutilization of dental care when it is freely available: a prospective study of the New England Children’s Amalgam Trial. J Public Health Dent. 2008;68(3):139–48. https://doi.org/10.1111/j.1752-7325.2007.00074.x.

    Article  PubMed  Google Scholar 

  6. Flores G, Lin H. Trends in racial/ethnic disparities in medical and oral health, access to care, and use of services in US children: has anything changed over the years? Int J Equity Health. 2013;12:10. https://doi.org/10.1186/1475-9276-12-10.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Vanobbergen J, Martens L, Lesaffre E, Bogaerts K, Declerck D. The value of a baseline caries risk assessment model in the primary dentition for the prediction of caries incidence in the permanent dentition. Caries Res. 2001;35(6):442–50. https://doi.org/10.1159/000047488.

    Article  CAS  PubMed  Google Scholar 

  8. Evans CA. The role of dental schools in the issues of access to care. J Am Coll Dent. 2008;75(4):42–6.

    PubMed  Google Scholar 

  9. Maciel SM, Marcenes W, Sheiham A. The relationship between sweetness preference, levels of salivary mutans Streptococci and caries experience in Brazilian pre-school children. Int J Paediatr Dent. 2001;11(2):123–30. https://doi.org/10.1046/j.1365-263x.2001.00259.x.

    Article  CAS  PubMed  Google Scholar 

  10. Wang X. Survey on the Status of Children’s Dental Caries and Family Oral Health Behaviors in Zunyi City[D]. Zunyi Medical University; 2013.

  11. Yuan S, Lu J. Survey and Analysis of Dental Caries Filling Rate in Primary School students in Jing’an District, Shanghai. Beijing J Stomatology. 2006;04:286. https://doi.org/10.3969/j.issn.1006-673X.2006.04.020.

    Article  Google Scholar 

  12. Gao W. Analysis of Dental Caries Incidence and Intervention in Children’s Institutions in Jiangwan Area[D]. Fudan University; 2012.

  13. Hu J. Survey on the growth and health status of children in 10 Provincial Demonstration kindergartens in Changchun[D]. Jilin University; 2011.

  14. Darmawikarta D, Chen Y, Carsley S, Birken CS, Parkin PC, Schroth RJ, Maguire JL. TARGet kids! Collaboration. Factors associated with dental care utilization in early childhood. Pediatrics. 2014;133(6):e1594–600. https://doi.org/10.1542/peds.2013-3725.

    Article  PubMed  Google Scholar 

  15. Xu Q, Yao Z, Tong H, Li G, Li C, Fu H. Relationship between preschooler’s primary tooth caries and parental knowledge-behavior-knowledge of oral health in Hudong community in Pudong new area. Chin J Gen Practitioners. 2014;13(8):649–54. https://doi.org/10.3760/cma.j.issn.1671-7368.2014.08.011.

    Article  Google Scholar 

  16. Herndon JB, Tomar SL, Catalanotto FA, Vogel WB, Shenkman EA. The effect of Medicaid primary care provider reimbursement on access to early childhood caries preventive services. Health Serv Res. 2015;50(1):136–60. https://doi.org/10.1111/1475-6773.12200.

    Article  PubMed  Google Scholar 

  17. Maher L, Phelan C, Lawrence G, Torvaldsen S, Dawson A, Wright C. The early childhood oral health program: promoting prevention and timely intervention of early childhood caries in NSW through shared care. Health Promot J Austr. 2012;23(3):171–6. https://doi.org/10.1071/he12171.

    Article  PubMed  Google Scholar 

  18. Heaton B, Crawford A, Garcia RI, Henshaw M, Riedy CA, Barker JC, Wimsatt MA. Native oral Health Project. Oral health beliefs, knowledge, and behaviors in Northern California American Indian and Alaska Native mothers regarding early childhood caries. J Public Health Dent. 2017;77(4):350–9. https://doi.org/10.1111/jphd.12217.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Ahovuo-Saloranta A, Hiiri A, Nordblad A, Mäkelä M, Worthington HV. Pit and fissure sealants for preventing dental decay in the permanent teeth of children and adolescents. Cochrane Database Syst Rev. 2008;4CD001830. https://doi.org/10.1002/14651858.CD001830.pub3.

  20. Rozier RG, Sutton BK, Bawden JW, Haupt K, Slade GD, King RS. Prevention of early childhood caries in North Carolina medical practices: implications for research and practice. J Dent Educ. 2003;67(8):876–85.

    Article  PubMed  Google Scholar 

  21. Brown A, Lowe E, Zimmerman B, Crall J, Foley M, Nehring M. Preventing early childhood caries: lessons from the field. Pediatr Dent. 2006;28(6):553–60.

    PubMed  Google Scholar 

  22. Nunn ME, Dietrich T, Singh HK, Henshaw MM, Kressin NR. Prevalence of early childhood caries among very young urban Boston children compared with US children. J Public Health Dent. 2009;69(3):156–62. https://doi.org/10.1111/j.1752-7325.2008.00116.x.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Shen Y, Liu F, Jiang Y, Zeng Q, Chang C, Wang Y. Cross-sectional study on oral health behaviors among children aged 5-year old in Mianyang City,Sichuan. Chin J Health Educ. 2015;10940–2. https://doi.org/10.16168/j.cnki.issn.1002-9982.2015.10.006.

  24. Wei L, Wang J. Associations between early childhood caries,diet, oral hygiene and parental attitude of oral hygiene. Chin J Conservative Dentistry. 2007;467–9. https://doi.org/10.3969/j.issn.1005-2593.2007.08.010.

  25. World Health Organization. Oral health surveys: basic methods[M]. World Health Organization; 2013.

  26. Llena C, Calabuig E, Sanz JL, Melo M. Risk factors Associated with Carious lesions in Permanent First molars in children: a seven-year retrospective cohort study. Int J Environ Res Public Health. 2020;17(4):1421. https://doi.org/10.3390/ijerph17041421.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Valpreda L, Carcieri P, Cabras M, Vecchiati G, Arduino PG, Bassi F. Frequency and severity of dental caries in foster care children of Turin, Italy: a retrospective cohort study. Eur J Paediatr Dent. 2020;21(4):299–302. https://doi.org/10.23804/ejpd.2020.21.04.8.

    Article  CAS  PubMed  Google Scholar 

  28. Almerich-Torres T, Montiel-Company JM, Bellot-Arcís C, Iranzo-Cortés JE, Ortolá-Siscar JC, Almerich-Silla JM. Caries Prevalence Evolution and Risk factors among Schoolchildren and adolescents from Valencia (Spain): Trends 1998–2018. Int J Environ Res Public Health. 2020;17(18):6561. https://doi.org/10.3390/ijerph17186561.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Zhang M, Wang Y, Xue C. Prevalence of dental caries and its influence on the growth and development of pupils in Sichuan Tianfu New Area in 2020. Health Med Res Pract. 2022;19(10):11–4. https://doi.org/10.11986/j.issn.1673-873X.2022.010.003.

    Article  Google Scholar 

  30. Kale S, Kakodkar P, Shetiya S, Abdulkader R. Prevalence of dental caries among children aged 5–15 years from 9 countries in the Eastern Mediterranean Region: a meta-analysis. East Mediterr Health J. 2020;26(6):726–35. https://doi.org/10.6719/emhj.20.050.

    Article  PubMed  Google Scholar 

  31. Zhang M, Gao F, Dong X, Cao D, Jin J, Wang R. Survey on the Status of Deciduous Dental Caries in 3–6 Year Old Children in Lianhu District, Xi’an and Analysis of related influencing factors. Practical Prev Med. 2020;27(5):615–8. doi: CNKI:SUN:SYYY.0.2020-05-029.

    Google Scholar 

  32. Yay M, Çelik Z, Aksoy A, Alibaz-Öner F, Inanç N, Ergun T, Direskeneli H, Mumcu G. Oral health is a mediator for disease severity in patients with Behçet’s disease: a multiple mediation analysis study. J Oral Rehabil. 2019;46(4):349–54. https://doi.org/10.1111/joor.12750.

    Article  PubMed  Google Scholar 

  33. Xie L, Guo D, Deng N, Li Y, Zhang Z, Deng W. Survey on the current status of oral health knowledge, attitude, and Behavior of parents of Preschool Children in Haikou City. Chin J Health Educ. 2019;35(1):82–4. https://doi.org/10.16168/j.cnki.issn.1002-9982.2019.01.019.

    Article  Google Scholar 

  34. Yao Y, Ou X, Zhou X, Zhou Y, Luo D, Lai J. Analysis of the difference between the prevalence of Caries and Eating Patterns of Preschool Children Aged 3 to 5 in the North and South of Jiangxi Province. Chin Gen Med. 2019;22(25):3099–103. https://doi.org/10.12114/j.issn.1007-9572.2019.00.451.

    Article  Google Scholar 

  35. Smyth RSD, Amlani M, Fulton A, Sharif MO. The availability and characteristics of patient-focused YouTube videos related to oral hygiene instruction. Br Dent J. 2020;228(10):773–81. https://doi.org/10.1038/s41415-020-1527-5.

    Article  PubMed  Google Scholar 

  36. Ng MW, Ramos-Gomez F, Lieberman M, Lee JY, Scoville R, Hannon C, Maramaldi P. Disease Management of Early Childhood caries: ECC Collaborative Project. Int J Dent. 2014;2014:327801. https://doi.org/10.1155/2014/327801.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Herndon JB, Tomar SL, Catalanotto FA. Effect of training pediatricians and family physicians in early childhood caries prevention. J Pediatr. 2015;166(4):1055–e611. https://doi.org/10.1016/j.jpeds.2014.12.040.

    Article  PubMed  Google Scholar 

  38. Mathur VP, Dhillon JK, Logani A, Agarwal R. Development and validation of oral health-related early childhood quality of life tool for north Indian preschool children. Indian J Dent Res. 2014;25(5):559–66. https://doi.org/10.4103/0970-9290.147078.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

No funding or sponsorship was received for this study or publication of this article.

Funding

This work was supported by Xingtai Science and Technology Bureau project [grant no.: 20191046].

Author information

Authors and Affiliations

  1. Department of Oral Medicine, Hebei Eye Hospital, 399 East Quanbei Street, Xingtai, 054001, Hebei, China

    Hua Xu, Xiaolan Ma, Xuefang Chen, Qian Zou & Jiandong Ban

  2. Department of Oral and Maxillofacial Surgery, Hebei Eye Hospital, Xingtai, 054001, China

    Junrong Wang

Authors
  1. Hua Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiaolan Ma
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Junrong Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Xuefang Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Qian Zou
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jiandong Ban
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Conception and design: Xu H. Administrative support: Ma XLand Wang JR. Provision of study materials or patients: Chen XF and Zou Q. Collection and assembly of data: Ban JD. Data analysis and interpretation: Xu H, Ma XL and Zou Q. Manuscript writing: All authors. Final approval of manuscript: All authors.

Corresponding author

Correspondence to Jiandong Ban.

Ethics declarations

Ethics approval and consent to participate

This study was conducted in accordance with the Declaration of Helsinki. This study was approved by the Ethics Committee of Hebei Eye Hospital. Written informed consent was obtained from all parents/local guardians and their children.

Consent for publication

The manuscript is not submitted for publication or consideration elsewhere.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xu, H., Ma, X., Wang, J. et al. Exploring the state and influential factors of dental caries in preschool children aged 3–6 years in Xingtai City. BMC Oral Health 24, 951 (2024). https://doi.org/10.1186/s12903-024-04663-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1186/s12903-024-04663-2

Keywords

BMC Oral Health

ISSN: 1472-6831

Contact us