Factors associated with early childhood caries among children living in sugar palm plantation communities, phetchaburi province, thailand

Early childhood caries (ECC) is a common problem in Thailand. In this study, we aimed to determine factors associated with ECC among children aged 3 years living in sugar palm plantation communities in Phetchaburi Province, Thailand in order to inform efforts to prevent ECC in this study population. Study participants were children aged 3 years who presented to any one of 11 Primary Healthcare Centers or 1 Community Hospital serving sugar palm plantation communities in Phetchaburi Province for medical care during February-April 2020. These children were divided into cases and controls with a ratio of 1:1 and the two groups were compared to obtain our study results. Cases were defined as children who had a decayed, missing and filled teeth (DMFT) index >0 based on an oral examination by a dental hygienist. Controls were children who had a DMFT index = 0. Cases and controls were both gender-matched. Cases were divided into groups by severity of ECC by DMFT score, where: a DMFT score of 1-2 was defined as a mild case, a DMFT score of 3-4 as a moderate case and a DMFT score of >4 as a severe case. The caregiver of each subject was interviewed using a questionnaire asking about demographic characteristics, breast -and bottle-feeding history, toothbrushing practices, use of fluoridated toothpaste, history of having a fluoride varnish and consumption of foods or beverages containing sugar. We compared cases and controls using conditional logistic regression analysis. A total of 171 cases and 171 controls were included in the study with 96 females in each group of cases and controls. 28.1%, 26.9% and 45.0% of cases had mild, moderate and severe ECC, respectively. The factor significantly positively associated with developing ECC was consuming food or beverages containing sugar (adjusted odds ratio (aOR) = 2.0; 95% CI: 1.2-3.3; p= 0.006) and the factor significantly negatively associated with developing ECC was subject toothbrushing by the caregiver (aOR = 0.3; 95% CI: 0.1-0.6; p=0.001). In summary, the factor significantly positively associated with ECC was consuming food or beverages containing sugar. The factor significantly negatively associated with ECC was subject toothbrushing by the caregiver. We conclude, programs to reduce ECC in the study population need to limit consumption of sugary foods and beverages and encourage caregivers to brush their child's teeth or supervise their toothbrushing. Further studies are needed to determine how best to conduct these education programs, what the current prevalence of ECC in the study population is and after the program intervention what the prevalence of ECC is in order to evaluate its efficacy.