Peer-reviewed article
Factors Associated With Parent-Reported Caries in Preschool Children From the KUNO-Kids Health Study-Repeated Cross-Sectional Analysis.
Áine M Lennon, Katharina Fluch-Maier, K-A Hiller, Isabelle Schenke, Nils Gade et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined parent-reported tooth decay in children aged 2 to 5 years using data from a large German birth cohort. The researchers identified multiple risk factors associated with early childhood caries, including parental socioeconomic factors, child behaviours like late weaning and mouth-breathing, and environmental factors such as having siblings with caries or contact with pets. The prevalence of reported tooth decay increased from 0.4% at age 2 to 4.4% at age 5. Results suggest that maternal dental check-up attendance, dietary and oral hygiene practices, and family circumstances play important roles in children's tooth health.
Key points
- Parent-reported caries prevalence increased from 0.4% at age 2 to 4.4% at age 5 years
- Maternal migration background, lower paternal education, unemployment, and infrequent maternal dental check-ups were associated with caries at age 2
- Late weaning and pet contact were consistently associated with caries across multiple age groups
- At age 5, poor dietary and toothbrushing behaviour, low child BMI, and pacifier hygiene were significant risk factors
- Single-parent status, sibling caries, early dentition, and mouth-breathing were associated with caries at different developmental stages
Limitations
The study relies on parent-reported caries rather than clinical dental examination, which may underestimate or misclassify disease prevalence. The cross-sectional analysis at each age cannot establish causality, and attrition in sample size from age 2 to age 5 may affect the representativeness of findings.
Abstract
OBJECTIVES: This questionnaire-based study aimed to assess parent-reported caries (PRC) at ages 2-5 years and identify potential influencing factors using an exploratory, repeated cross-sectional analysis within an ongoing birth-cohort study. METHODS: Parental factors included health, socioeconomic status, maternal age and dental check-up attendance. Child factors included birth mode and weight, antibiotic, probiotic, bottle use, early dentition, weaning age, oral hygiene, diet, body mass index (BMI) and mouth-breathing. Environmental factors included sibling caries, contact with other children, pets, or farms. Families (n = 1296) who completed the 2-year caries questionnaire were included, corresponding numbers were 1276 at 3 years, 993 at 4 years, and 768 at 5 years. A subgroup comprised children who had visited a dentist since their last birthday (n = 735, at 2 years, n = 951, 891 and 662 at 3, 4 and 5 years respectively). RESULTS: PRC rate was 0.4%, 1.3%, 2.7% and 4.4% for ages 2-5. Rates were 0.4%, 1.6%, 3.3% and 4.7% for the subgroup at the same ages. At Age 2, maternal migration background, lower paternal education and unemployment, late weaning, infrequent maternal dental check-ups and pet contact were associated with PRC. Except for paternal education, the same factors remained associated in the subgroup. At Age 3, single-parent status, maternal physical health, late weaning, sibling caries and pet contact were significantly associated with PRC. With the addition of infrequent maternal dental check-ups, the same factors remained associated in the subgroup. At Age 4, early dentition, mouth-breathing aged 1 were associated with PRC. Including late weaning, the same factors remained significantly associated in the subgroup. At Age 5, poor dietary and toothbrushing behaviour aged 2, younger mother, low BMI aged 1, infrequent maternal dental check-ups, pet contact, and pacifier hygiene were associated with PRC. Except dietary behaviour aged 2, with the addition of paternal employment, the same factors were significantly associated in the subgroup. CONCLUSIONS: This study identifies key parental, child, and environmental risk factors for early childhood caries, revealing novel factors for further investigation and targeted prevention.