European Archives of Paediatric Dentistry

, Volume 14, Issue 6, pp 363–368 | Cite as

Dental caries and oral health-related factors in a sample of Greek preschool children

  • V. BokaEmail author
  • A. Trikaliotis
  • N. Kotsanos
  • V. Karagiannis
Original Scientific Article



To assess the caries prevalence and some background factors in 3- to 5.5-year-old children in the municipality of Thessaloniki, Greece.


One calibrated examiner examined the children of all municipal day care centres for dmfs, existence of visible dental plaque and presence of black stain. Examination was made on site using disposable dental mirrors. Questionnaires were given to parents for assessing socio-economic status, oral hygiene habits (brushing frequency, toothpaste use) and sucking/feeding at sleep habits (nursing bottle, its content and pacifier use).


Out of a total of 950 children, both clinical examination and questionnaire data were available for 804 children. The overall mean dmfs was 1.3 (SD = 3.8). The caries prevalence was 22.6 %, while the presence of black stain was evident in 2.4 % of the children. Intra-examiner agreement was estimated with Kendall’s τ b = 0.99. A generalised linear model used to fit a Poisson regression for the analysis of count outcome data (dmfs) and logistic regression was used for binary outcome data (presence or absence of visible dental plaque). Statistically significant association was found between dmfs and the presence of visible dental plaque. The country of origin and education status of the parents were found to be significant factors for dmfs. The presence of black stain was negatively correlated with dmfs.


The mean dmfs was lower than earlier Greek data. Country of origin, education status of the parents and visible dental plaque seemed to be important caries risk factors, while the presence of black stain was a strong caries resistance predictor.


Early childhood caries Oral hygiene habits Preschool children Parental birth country Black stain 



We are grateful to all the children and their mothers and to the kindergarten principals for their cooperation in performing this study. We express our thanks to Prof. Stecksen-Blicks for her critical observations on the manuscript.


  1. Adeniyi AA, Ogunbodede OE, Jeboda OS, Folayan OM. Do maternal factors influence the dental health status of Nigerian pre-school children? Int J Paediatr Dent. 2009;19:448–54.CrossRefGoogle Scholar
  2. Alaluusua S, Malmivirta R. Early plaque accumulation—a sign for caries risk in young children. Community Dent Oral Epidemiol. 1994;22:273–6.PubMedCrossRefGoogle Scholar
  3. AAPD. American Academy on Pediatric Dentistry; American Academy of Pediatrics. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent 2010;30(7 Suppl):40–43. Accessed 20 Jul 2012.Google Scholar
  4. Auad SM, Waterhouse PJ, Nunn JH, Moynihan PJ. Dental caries and its association with sociodemographics, erosion, and diet in schoolchildren from Southeast Brazil. Pediatr Dent. 2009;31:229–35.PubMedGoogle Scholar
  5. Bolin AK, Bolin A, Koch G. Children’s dental health in Europe: caries experience of 5- and 12-year-old children from eight EU countries. Int J Paediatr Dent. 1996;6:155–62.PubMedCrossRefGoogle Scholar
  6. Dye BA, Tan S, Smith V, et al. Trends in oral health status: United States, 1988–1994 and 1999–2004. Vital Health Stat. 2007;11:1–92.Google Scholar
  7. EAPD. Guidelines on Prevention of Early Childhood Caries: An EAPD Policy Document. Approved by the European Academy of Paediatric Dentistry Board, November 2008. Accessed 20 Jul 2012.
  8. Elfrink MEC, Schuller AA, Veerkamp JS, et al. Factors increasing the caries risk of second primary molars in 5-year-old Dutch children. Int J Paediatr Dent. 2010;20:151–7.PubMedCrossRefGoogle Scholar
  9. Feldens CA, Giugliani ERJ, Vigo A, Vitolo MR. Early feeding practices and severe early childhood caries in four-year-old children from Southern Brazil: a birth Cohort study. Caries Res. 2010;44:445–52.PubMedCrossRefGoogle Scholar
  10. Ferreira SH, Béria JU, Kramer PF, Feldens EG, Feldens CA. Dental caries in 0- to 5-year-old Brazilian children: prevalence, severity, and associated factors. Int J Paediatr Dent. 2007;17:289–96.PubMedCrossRefGoogle Scholar
  11. Heinrich-Weltzien R, Monse B, van Palenstein Helderman W. Black stain and dental caries in Filipino schoolchildren. Community Dent Oral Epidemiol. 2009;37:182–7.PubMedCrossRefGoogle Scholar
  12. Irigoyen ME, Maupome G, Mejia AM. Caries experience and treatment needs in a 6- to 12-year-old urban population in relation to socioeconomic status. Community Dent Health. 1999;16:245–9.PubMedGoogle Scholar
  13. Ismail AI, Sohn W. A systematic review of clinical diagnostic criteria of early childhood caries. J Public Health Dent. 1999;59:171–91.PubMedCrossRefGoogle Scholar
  14. Kallestal C, Wall S. Socioeconomic effect on caries: incidence data among Swedish 12- to 14-year-olds. Community Dent Oral Epidemiol. 2002;30:108–14.PubMedCrossRefGoogle Scholar
  15. Kalsbeek H, Verrips GH. Dental caries prevalence and the use of fluorides in different European countries. J Dent Res. 1990;69:728–32.PubMedGoogle Scholar
  16. Kawashita Y, Kitamura M, Saito T. Early childhood caries. Int J Dent. 2011;2011:1–7.CrossRefGoogle Scholar
  17. Maragakis GM, Kapetanakou DN, Manios Y. Caries prevalence and location and dental treatment needs in preschoolers in Athens-GENESIS Project. Community Dent Health. 2007;24:264–7.PubMedGoogle Scholar
  18. Milnes AR. Description and epidemiology of nursing caries. J Public Health Dent. 1996;56:38–50.PubMedCrossRefGoogle Scholar
  19. O’Mullane D, Parnell C. Early childhood caries: a complex problem requiring a complex intervention. Community Dent Health. 2011;28(4):254.PubMedGoogle Scholar
  20. O’Sullivan DM, Tinanoff N. Social and biological factors contributing to caries of the maxillary anterior teeth. Pediatr Dent. 1993;15:41–4.PubMedGoogle Scholar
  21. Oulis CJ, Berdouses ED, Vadiakas G, Lygidakis NA. Feeding practices of Greek children with and without nursing caries. Pediatr Dent. 1999;21:409–16.PubMedGoogle Scholar
  22. Oulis C, Theodorou M, Mastrogiannakis T, et al. Oral health status and treatment needs of the Hellenic population—a path finder survey-proposals for improvement. Hellenic Stomatol Rev. 2009;53:97–120 (article in Greek).Google Scholar
  23. Qadri G, Nourallah A, Splieth CH. Early childhood caries and feeding practices in kindergarten children. Quintessence Int. 2012;43(6):503–10.PubMedGoogle Scholar
  24. Riedy CA, Weinstein P, Milgrom P, Bruss M. An ethnographic study for understanding children’s oral health in a multicultural community. Int Dent J. 2001;51:305–12.PubMedCrossRefGoogle Scholar
  25. Saba C, Solidani M, Berlutti F, et al. Black stains in the mixed dentition: a PCR microbiological study of the etiopathogenic bacteria. J Clin Pediatr Dent. 2006;30:219–24.PubMedGoogle Scholar
  26. Schwartz SS, Rosivack RG, Michelotti P. A child’s sleeping habit as a cause of nursing caries. J Dent Child. 1993;60:22–5.Google Scholar
  27. Slots J. The microflora of black stain on human primary teeth. Scand J Dent Res. 1974;82:484–90.PubMedGoogle Scholar
  28. World Health Organisation. Global strategy for the prevention and control of noncommunicable diseases. Geneva 2000.Google Scholar

Copyright information

© European Academy of Paediatric Dentistry 2013

Authors and Affiliations

  • V. Boka
    • 1
    Email author
  • A. Trikaliotis
    • 1
  • N. Kotsanos
    • 1
  • V. Karagiannis
    • 2
  1. 1.Department of Paediatric DentistrySchool of Dentistry, Aristotle University of ThessalonikiThessalonikiGreece
  2. 2.Department of Basic Dental SciencesSchool of Dentistry, Aristotle University of ThessalonikiThessalonikiGreece

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