Abstract
Purpose
To analyse the evolution of the oral health of 4-year-old children in nursery school between 2001 and 2018 as well as the early predictor and associated risk factors, in different school areas.
Methods
We compared (1) the prevalence of ECC (4 ≥ dmft ≥ 1) and S-ECC (dmft ≥ 5) of 4-year-old children and (2) data obtained by a structured questionnaire completed by their parents from two studies performed in 2001 and 2018. Data were analysed using the Chi2 test and odds ratio (OR).
Results
A total of 322 children and of 425 children randomly selected among Moselle’s public nursery schools in north-eastern France were, respectively, included in the study in 2001 and 2018. The prevalence of ECC was respectively 40.70% and 21.65% in 2001 and 2018 (p < 0.001; OR = 2.48; 95% CI = 1.78–3.47). We also observed a decrease of S-ECC prevalence (10.56% in 2001 vs 5.90% in 2018, p < 0.05, OR = 1.89; 95% CI = 1.07–3.38). The intake of cariogenic food (sweet drink, biscuits, candies, milk, baby bottle) decreased but the knowledge of parents concerning cariogenic food did not improve. The proportion of parents helping their child has not changed in 17 years (82.33% vs 86.52%, p > 0.1) but tooth brushing was initiated earlier in 2018 than in 2001 (p < 0.01). Prescription of systemic fluoride decreased (39.14% vs 3.62%; p < 0.001).
Conclusion
The identification of the food consumption habits and the knowledge of parents concerning oral health should enable strengthening of preventive measures and the initiation of an oral health education programme for children and their family.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Aida J, Ando Y, Oosaka M, Niimi K, Morita M. Contributions of social context to inequality in dental caries: a multilevel analysis of Japanese 3-year-old children. Community Dent Oral Epidemiol. 2008;36:149–56. https://doi.org/10.1111/j.1600-0528.2007.00380.x.
Ameli. « M’T dents » : un examen bucco-dentaire pour les enfants, les adolescents et les jeunes adultes. https://www.ameli.fr/chirurgien-dentiste/exercice-liberal/services-patients/dents. Accessed 18 oct 2022.
American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Oral Health Polices. The reference manual of Pediatric Dentistry. 2019–2020/P.71–73.
Haute Autorité de Santé. Stratégies de prévention de la carie dentaire. 2010. https://www.has-sante.fr/upload/docs/application/pdf/2010-10/corriges_rapport_cariedentaire_version_postcollege-10sept2010.pdf. Accessed 16 dec 2022.
Baggio S, Abarca M, Bodenmann P, Gehri M, Madrid C. Early childhood caries in Switzerland: a marker of social inequalities. BMC Oral Health. 2015;15:82. https://doi.org/10.1186/s12903-015-0066-y.
Baghlaf K, Muirhead V, Moynihan P, Weston-Price S, Pine C. Free sugars consumption around bedtime and dental caries in children: a systematic review. JDR Clin Trans Res. 2018;3(2):118–29. https://doi.org/10.1177/2380084417749215.
Begzati A, Berisha M, Mega K. Early childhood caries in preschool children of Kosovo-a serious public health problem. BMC Public Health. 2010;10:788. https://doi.org/10.1186/1471-2458-10-788.
Boustedt K, Roswaal J, Twetman S, Dahlgren J. Influence of mode of delivery, family, and nursing determinants on early childhood caries development: a prospective cohort study. Acta Odontol Scand. 2018;76(8):595–9. https://doi.org/10.1080/00016357.2018.1490965.
Boustedt K, Roswaal J, Twetman S. Free sugars and early childhood caries development: a prospective cohort study. Eur Arch Paediatr Dent. 2022;23(5):829–33. https://doi.org/10.1007/s40368-022-00745-3.
Branger B, Camelot F, Droz D, Houbiers B, Marchalot A, Bruel H, Laczny E, Clement C. Breastfeeding and early childhood caries. review of the literature, recommendations and prevention. Arch Pediatr. 2019;26(8):497–503.
Campus G, Solinas G, Strohmenger L, Cagetti MG, Senna A, Minelli L, Majori S, Montagna MT, Reali D, Castiglia P, Collaborating Study Group. National pathfinder survey on children’s oral heath in Italy: pattern and severity of caries disease in 4-year-olds. Caries Res. 2009. https://doi.org/10.1159/000211719.
Chaffee BW, Cheng A. Global research trends on early life feeding practices and early childhood caries: a systematic review. J Oral Dis. 2014;2014:675658. https://doi.org/10.1155/2014/675658.
Chiba M, Hashimoto H, Nonoyama T, Kito H, Oguri C, Shimazaki Y. Factors related to early childhood caries in 17- to 23-month-old children in Aichi Prefecture, Japan: a cross-sectional study. Caries Res. 2023;57(1):43–51. https://doi.org/10.1159/000529022.
Collado V, Pichot H, Delfosse C, Eschevins C, Nicolas E, Hennequin M. Impact of early childhood caries and its treatment under general anesthesia on orofacial function and quality of life: a prospective comparative study. Med Oral Patol Oral Cir Bucal. 2017;22(3):e333–41. https://doi.org/10.4317/medoral.21611.
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. https://doi.org/10.1542/peds.2013-3725.
Droz D, Guéguen R, Bruncher P, Gerhard JL, Roland E. Epidemiological study of oral dental health of 4-year-old children in French nursery schools. Arch Ped. 2006;13:1222–9. https://doi.org/10.1016/j.arcped.2006.05.017.
Drury TF, Horowitz AM, Ismail AI, Maertens MP, Rozier RG, Selwitz RH. Diagnosing and reporting early childhood caries for research purposes. J Public Health Dent. 1999;59(3):192–7. https://doi.org/10.1111/j.1752-7325.1999.tb03268.x.
Echeverria MS, Schuch HS, Cenci MS, Motta JVDS, Bertoldi AD, Britto Correa M, Huysmans MD, Demarco FF. Early sugar introduction associated with early childhood caries occurrence. Caries Res. 2023. https://doi.org/10.1159/000529210.
Edelstein BL. Access to dental care for head start enrollees. J Public Health Dent. 2000;60:221–9. https://doi.org/10.1111/j.1752-7325.2000.tb03332.x.
Edelstein BE, Vargas CM, Candelaria D, Vemuri M. Experience and policy implications of children presenting with dental emergencies to US pediatric dentistry training programs. Pediatr Dent. 2006;28(5):431–7.
Featherstone JD. Prevention and reversal of dental caries: role of low-level fluoride. Commun Dent Oral Epidemiol. 1999;27:31–40. https://doi.org/10.1111/j.1600-0528.1999.tb01989.x.
Fisher-Owens SA, Gansky SA, Platt LJ, Weintraub JA, Soobader MJ, Bramlett MD, Newacheck PW. Influences on children’s oral health: a conceptual model. Pediatrics. 2007;120:e510–20. https://doi.org/10.1542/peds.2006-3084.
Ganesh A, Sampath V, Sivanandam BP, Sangeetha H, Ramesh A. Risk factors for early childhood caries in toddlers: an institution-based study. Cureus. 2020;12(4):e7516. https://doi.org/10.7759/cureus.7516.
Gao XL, Hsu CY, Xu YC, Loh T, Koh D, Hwarng HB. Behavioral pathways explaining oral health disparity in children. J Dent Res. 2010;89:985–90. https://doi.org/10.1177/0022034510372896.
Harris R, Nicoll AD, Adair PM, Pine CM. Risk factors for dental caries in young children: a systematic review of the literature. Community Dent Health. 2004;21:71–85.
Heima M, Lee W, Milgrom P, Nelson S. Caregiver’s education level and child’s dental caries in African Americans: a path analytic study. Caries Res. 2015;49(2):177–83. https://doi.org/10.1159/000368560.
Hernandez M, Chau K, Charissou A, Lecaillon A, Delsau A, Bruncher P, Droz D. Early predictors of childhood caries among 4-year-old children: a population-based study in north-eastern France. Eur Arch Paediatr Dent. 2021;22(5):833–42. https://doi.org/10.1007/s40368-021-00627-0.
Hibberd CE, Nguyen TD. Abcès cérébral consécutif à une infection dentaire chez un garçon de 11 ans : une étude de cas. J Can Dent Assoc. 2012;78:c49.
Kabil NS, Eltawil S. Prioritizing the risk factors of severe early childhood caries. Dent J (basel). 2017;5(1):4. https://doi.org/10.3390/dj5010004.
Kato H, Tanaka K, Shimizu K, Nagata C, Furukawa S, Arakawa M, Miyake Y. Parental occupations, educational levels, and income and prevalence of dental caries in 3-year-old Japanese children. Environ Health Prev Med. 2017;22(1):80. https://doi.org/10.1186/s12199-017-0688-6.
Keyes PH. The infectious and transmissible nature of experimental dental caries findings and implications. Arch Oral Biol. 1960;1:304–20.
Laaksonen M, Rahkonen O, Karvonen S, Lahelma E. Socioeconomic status and smoking: analyzing inequalities with multiple indicators. Eur J Public Health. 2005;15:262–9. https://doi.org/10.1016/0003-9969(60)90091-1.
Liu Q, Wang M, Guo J, Li J, Li C, Qian M. Effect of socioeconomic status on secondary prevention of stroke. Int J Qual Health Care. 2011;23:405–12. https://doi.org/10.1093/intqhc/mzr021.
Marquillier T, Trentesaux T, Pierache A, Delfosse C, Lombrail P, Azogui-Levy S. Which determinants should be considered to reduce social inequalities in paediatric dental care access? a cross-sectional study in France. PLoS One. 2021;16(8):e0255360. https://doi.org/10.1371/journal.pone.0255360.
Muller Bolla M, Clauss F, Davit-Beal T, Manière MC, Sixou JL, Vital S. Prise en charge bucco-dentaire des enfants et des adolescents. Le Chirurgien-Dentiste de France. 2018;n°1806–180.
Organisation for Economic Co-operation and Development (OECD). Doing Better for Families. 2011 http://www.oecd.org/social/soc/doingbetterforfamilies.htm. Accessed 14 Jan 2023.
Pegon-Machat E, Jourdan D, Tubert-Jeannin S. Inégalités en sante orale: determinants de l’acces a la prevention et aux soins en France. Sante Publique. 2018;30(2):243–51. https://doi.org/10.3917/spub.182.0243.
Phillips M, Masterson E, Sabbah W. Association between child caries and maternal health-related behaviours. Community Dent Health. 2016;33:133–7.
Pitts NB, Ekstrand KR. International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS)—methods for staging of the caries process and enabling dentists to manage caries. Community Dent Oral Epidemiol. 2013;41:41–52. https://doi.org/10.1111/cdoe.12025.
Plutzer K, Keirse MJNC. Influence of first-time mothers ‘early employment on severe early childhood caries in their child. Int J Pediatr. 2012;8:26–32. https://doi.org/10.1155/2012/820680.
Poster WJ, Pendrys DG, Morse DE, Zhang H, Mayne ST. Associations of ethnicity/race and socioeconomic status with early childhood caries patterns. J Public Health. 2006;66:23–9. https://doi.org/10.1111/j.1752-7325.2006.tb02547.x.
Priesnitz MC, Celeste RK, Pereira MJ, Pires CA, Feldens CA, Kramer PF. Neighborhood determinants of caries experience in preschool children: a multilevel study. Caries Res. 2016;50:455–61. https://doi.org/10.1159/000447307.
Roland E, Droz D. Bilan carieux des enfants de 4 et 6 ans. J Odonto Stomatol Ped. 1999;9:3–8.
Seow WK. Early childhood caries. Pediatr Clin N Am. 2018;65:941–54. https://doi.org/10.1016/j.pcl.2018.05.004.
Sun X, Bernabe E, Liu X, Gallagher JE, Zheng S. Early life factors and dental caries in 5-year-old children in China. J Dent. 2017;64:73–9. https://doi.org/10.1016/j.jdent.2017.06.007.
Toumba KJ, Twetman S, Splieth C, Parnell C, van Loveren C, Lygidakis NΑ. Guidelines on the use of fluoride for caries prevention in children: an updated EAPD policy document. Eur Arch Paediatr Dent. 2019;20(6):507–16. https://doi.org/10.1007/s40368-019-00464-2.
Tsai C, Li A, Brown S, Deveridge C, El Gana R, Kucera A, Irving M, Kumar H. Early childhood caries sequelae and relapse rates in an Australian public dental hospital. Int J Paediatr Dent. 2023;33(1):1–11. https://doi.org/10.1111/ipd.12969.
Walsh T, Worthington HV, Glenny AM, Marinho VCC, Jeroncic A. Fluoride toothpastes of different concentration for preventing dental caries (review). Cochrane Database Syst Rev. 2019. https://doi.org/10.1002/14651858.CD007868.pub3.
WHO (Word Health Organization). WHO highlights oral health neglect affecting nearly half of the world’s population. 2022. https://www.who.int/fr/news/item/18-11-2022-who-highlights-oral-health-neglect-affecting-nearly-half-of-the-world-s-population. Accessed 6 dec 2022
Wong MC, Clarkson J, Glenny AM, Lo EC, Marinho VC, Tsang BW, Walsh T, Worthington HV. Cochrane reviews on the benefits/risks of fluoride toothpastes. J Dent Res. 2011;90(5):573–9. https://doi.org/10.1177/0022034510393346.
Zaror C, Matamala-Santander A, Ferrer M, Rivera-Mendoza F, Espinoza-Espinoza G, Martínez-Zapata MJ. Impact of early childhood caries on oral health-related quality of life: a systematic review and meta-analysis. Int J Dent Hyg. 2022;20(1):120–35. https://doi.org/10.1111/idh.12494.
Zhang M, Zhang X, Zhang Y, Li Y, Shao C, Xiong S, Lan J, Wang Z. Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study. BMC Oral Health. 2020;20:139. https://doi.org/10.1186/s12903-020-01104-8.
Zhou Y, Lin HC, Lo C, Wong MC. Risk indicators for early childhood caries in 2-year-old children in southern China. Aus Dent J. 2011;56:33–9. https://doi.org/10.1111/j.1834-7819.2010.01280.x.
Acknowledgements
We thank the nurses, the teachers, the children and their parents, the medicine doctors, Dr Jean Louis Gerhard, Dr Damien Gonthier and Olivier Cottet DASEN of Moselle who authorised the investigators to intervene in schools.
Funding
No funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
The authors declare no conflict of interest.
Ethical approval
The study was approved by the Ethical committee (protocol number: 18076-1232-18.08.21.60332) and the Nancy-Metz regional education authority.
Consent to participate
Written informed consent was obtained from the parents of the children.
Consent to publication
All authors are agreed upon the manuscript content and consent to publication.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Bombarde, M., Chau, K., Droz, D. et al. Comparative study of the dental health of 4-year-old children in north-eastern France between 2001 and 2018. Eur Arch Paediatr Dent (2024). https://doi.org/10.1007/s40368-024-00893-8
Received:
Accepted:
Published:
DOI: https://doi.org/10.1007/s40368-024-00893-8