Risk factors associated with early childhood caries – a case control study

  • Marina de Deus Moura Lima Federal University of Piauí
  • Zacarias Soares Brito-Neto Federal University of Piauí
  • Heylane Oliveira Amaral Federal University of Piauí
  • Cacilda Castelo Branco Lima Federal University of Piauí
  • Marcoeli Silva de Moura Federal University of Piauí
  • Lúcia de Fátima Almeida de Deus Moura Federal University of Piauí
Keywords: Dental caries, Child, Risk factors


Objective: The aim of this study was to determine the risk factors associated with early childhood caries (ECC).
Methods: It was an observational retrospective case-control study. The case group consisted of all patients diagnosed with ECC in the records of an active program of maternal and child care. The control group was composed of an equal number of children, matched for gender and age, who attended the program and did not have ECC. The process of data collection consisted of completing a pre-established schedule to analyse variables related to the mother/caregiver and child.Statistical
analysis was performed using the chi-squared and odds ratio (OR), with alpha (α) = 0.05.
Results: History of caries in the mother (OR=2.61; CI 95%=1.45-4.67) and father (OR=1.72; CI 95%=1.02-2.89) were key determinants in the child being diagnosed with ECC.
Conclusions: The risk factors associated with ECC were the following: no oral hygiene acceptance, nocturnal feeding duration of more than 16 months, a daily intake of sugar greater than 4 times a day, a Baume type II maxillary arch, fewer than 3 consultations with the program, and a history of decay in the parents.


American Academy on Pediatric Dentistry; American Academy of Pediatrics. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent. 2008-2009; 30(7):40-3.

Khan MN, Cleaton-Jones PE. Dental caries in African preschool children: social factors as disease markers. J Public Health Dent 1998;58(1):7-11. https://doi.org/10.1111/j.1752-7325.1998.tb02984.x

Davies GN. Early childhood caries-a synopsis. Community Dent Oral Epidemiol 1998;26(1):106-16. https://doi.org/10.1111/j.1600-0528.1998. tb02102.x

Arora A, Scott JA, Bhole S, Do L, Schwarz E, Blinkhorn AS. Early childhood feeding practices and dental caries in preschool children: a multicentre birth cohort study. BMC Public Health, 2011;11, 28. https://doi. org/10.1186/1471-2458-11-28

Acharya S, Tandon S. The effect of early childhood caries on the quality of life of children and their parents. Contemp Clin Dent 2011; 2(2):98-101. https://doi.org/10.4103/0976-237X.83069

Curzon MEJ, Preston AJ. Risk Groups: Nursing bottle caries in the elderly. Caries Res 2004;38(1):24-33. https://doi.org/10.1159/000074359

Warren JJ, Steven ML, Kanellis MJ. Dental caries in the primary dentition: assessing prevalence of cavitated and non-cavitated lesions. J Public Health Dent 2002;62:109-14. https://doi.org/10.1111/j.1752-7325.2002. tb03430.x

Hashim R, Thomson WM, Ayres KM, Lewsey JD, Awad, M. Dental caries experience and use of dental UAE. Int J Paediatr Dent 2006; 16(4):257-62. https://doi.org/10.1111/j.1365- 263X.2006.00746.x

Stephen A, Krishnan R, Ramesh M, Kumar VS. Prevalence of early childhood caries and its risk factors in 18-72 month old children in Salem, Tamil Nadu. J Int Soc Prev Community Dent. 2015;5(2):95-102. https:// doi.org/10.4103/2231-0762.155731

Seow WK. Environmental, maternal and child factors which contribute to early childhood caries: a unifying conceptual model. Int J Paediatr Dent 2012;22(3):157-68. https://doi.org/10.1111/j.1365-263X.2011. 01186.x

Moura LFAD, Moura MS, Toledo OA. Dental caries in children that participated in a dental program providing mother and child care. J Applied Oral Sci 2006;14:53-60. https://doi.org/10.1590/S1678- 77572006000100011

Baume LJ. Physiological tooth migration and its significance for the development of occlusion. I the biogenetic course of the deciduos dentitions. J Dent Res 1950;29(2):123-32. https://doi.org/10.1177/0022 0345500290020301

Nishimura M, Oda T, Kariya N, Matsumura S, Shimono T. Using a caries activity test to predict caries risk in early childhood. J Am Dent Assoc 2008;139(1):63-71.https://doi.org/10.14219/jada.archive.2008. 0022

Tiano AV, Moimaz SA, Saliba O, Saliba NA. Dental caries prevalence in children up to 36 months of age attending daycare centers in municipalities with different water fluoride content. J Appl Oral Sci 2009;17(1):39-44. https://doi.org/10.1590/S1678-77572009000100008

Tiberia MJ, Milnes AR, Feigal RJ, Morley KR, Richardson DS, Croft WG, et al. Risk factors for early childhood caries in Canadian preschool children seeking care. Pediatr Dent 2007;29(3):201-8.

Mattila ML, Rautava P, Sillanpa M, Paunio P. Caries in five-year-old children and associations with family-related factors. J Dent Res 2000;79:875-81. https://doi.org/10.1177/00220345000790031501

Prakash P, Subramaniam P, Durgesh BH, Konde S. Prevalence of early childhood caries and associated risk factors in preschool children of urban Bangalore, India: A cross-sectional study. Eur J Dent. 2012;6(2): 141-52.

Warren JJ, Weber-Gasparoni K, Marshall TA, Drake DR, Dehkordi-Vakil F, Dawson DV, et al. A longitudinal study of dental caries risk among very low SES children. Community Dent Oral Epidemiol 2008; 37(2):116-22. https://doi.org/10.1111/j.1600-0528.2008.00447.

Feldens CA, Giuglibiani ERJ, Vigo A, Vítolo MR. Early feeding practices and severe early childhood caries in four-year-old children from Southern Brazil: A birth cohort study. Caries Research 2010; 44:445-52. https://doi. org/10.1159/000319898

White V. Breastfeeding and the risk of early childhood caries. Evid Based Dent 2008; 9(3):86-88. https://doi.org/10.1038/sj.ebd.6400603

Wakaguri S, Aida J, Osaka K, Morita M, Ando Y. Association between Caregiver Behaviours to Prevent Vertical Transmission and Dental Caries in Their 3-Year-Old Children. Caries Res 2011;45(3):281-6. https://doi. org/10.1159/000327211

Camacho MEI, Pérez LS, Pérez AG, Zepeda MAZ. Relationship between Severe Early Childhood Caries,

Mother´s Oral Health and Mutans Streptococci in a Low-Income Group: Changes from 1996 to 2007. J Clin Pediatr Dent 2009;33(3):241-6. https://doi.org/10.17796/ jcpd.33.3.p031w1w719vp2740

Soviero VM, Bastos EPS, Souza IPR. Dentição decídua: estudo da prevalência dos espaços interproximais em crianças brasileiras. Rev Odontol Univ São Paulo 1999;13(2):159-65. https://doi.org/10.1590/ S0103-06631999000200010

Osório LB, Vizzottoo MB, Marin EA, Lopes LFD. The relationship between Baume’s arch and approximal fillings existence in deciduous dentition. Orthodontic Science and Practice 2008;1(1):54-9.

Limeira AB, Grinfeld S, Colares V, Valença PAM. Relationship between the arcade Baume, primate space and the caries. Full Dent. Sci 2011;2(5): 98-102.

Original Article