Early Childhood Caries and Its Determinants in Qom Province, Iran
-
Zahra Mirsalehi
,
Samaneh Razeghi
,
Sara Jannatizadeh
,
Ehsan Javadzadeh
,
Mohammad Javad Kharrazifard
,
Simin Zahra Mohebbi
Abstract
Introduction: Early childhood caries (ECC) is a highly prevalent condition that significantly impacts children’s general health and quality of life, while also imposing substantial economic burdens on families and healthcare systems. Its treatment is often complex and costly, sometimes requiring sedation or general anesthesia in young children. This study aimed to determine the prevalence of ECC among children aged 12 to 71 months in Qom province in 2022. Materials and Methods: This cross-sectional descriptive-analytical study included 172 children aged 12–71 months in Qom. Participants were recruited from 15 clusters, including kindergartens and health centers. Children were categorized as toddlers (12–47 months) and preschoolers (48–71 months). Data were collected through clinical oral examinations and structured, face-to-face questionnaires completed by parents or guardians. Caries diagnosis was based on WHO criteria, and plaque was assessed using the Silness & Loe index.Results: The mean dmft score was 1.46 (SE = 0.27). The overall prevalence of ECC was 26.7%, with 13.6% in toddlers and 48.6% in preschoolers. Visible dental plaque was observed in 49% of children (38.6% of toddlers, 65.9% of preschoolers). ECC prevalence and mean dmft scores were significantly higher in rural areas (p < 0.009). A significant association was found between lower fathers’ education and higher DMFT scores (p < 0.05). Children who consumed sugary snacks and drinks had significantly higher dmft scores (p = 0.02) and ECC prevalence (p = 0.02). Conclusion: This study provides a comprehensive snapshot of ECC prevalence and its determinants among 1–5-year-old children in Qom, Iran. The relatively high burden of ECC and its strong association with socio-behavioral determinants such as residence in rural areas, low parental education and poor dietary habits underscore the need for integrated and equity-focused oral health programs. Keywords: Early childhood caries (ECC); Dmft; Dietary habits; Tooth-brushing; Parental education.
1. Colak H, Dülgergil CT, Dalli M, Hamidi MM. Early childhood caries update: A review of causes, diagnoses, and treatments. J Nat Sci Biol Med. 2013;4(1):29-38.
2. Watt RG. From victim blaming to upstream action: tackling the social determinants of oral health inequalities. Community Dent Oral Epidemiol. 2007;35(1):1-11.
3. Folayan M, Olatubosun S. Early Childhood Caries - A diagnostic enigma. Eur J Paediatr Dent. 2018;19(2):88.
4. Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. International Journal of Paediatric Dentistry. 2019;29(3):238-48.
5. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858.
6. 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-e41.
7. 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.
8. Filstrup SL, Briskie D, da Fonseca M, Lawrence L, Wandera A, Inglehart MR. Early childhood caries and quality of life: child and parent perspectives. Pediatr Dent. 2003;25(5):431-40.
9. Folayan MO, El Tantawi M, Aly NM, Al-Batayneh OB, Schroth RJ, Castillo JL, et al. Association between early childhood caries and poverty in low and middle income countries. BMC Oral Health. 2020;20(1):8.
10. Kim Seow W. Environmental, maternal, and child factors which contribute to early childhood caries: a unifying conceptual model. Int J Paediatr Dent. 2012;22(3):157-68.
11. WHO calls on countries to reduce sugars intake among adults and children [Internet]. 2015. Available from: https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children.
12. Mohebbi SZ, Virtanen JI, Vehkalahti MM. A community-randomized controlled trial against sugary snacking among infants and toddlers. Community Dent Oral Epidemiol. 2012;40 Suppl 1:43-8.
13. Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial. BMC Oral Health. 2021;21(1):637.
14. Javadzadeh E, Razeghi S, Shamshiri A, Miri HH, Moghaddam F, Schroth RJ, et al. Prevalence and socio-behavioral determinants of early childhood caries in children 1-5- year- old in Iran. PLoS One. 2023;18(11):e0293428.
15. Evans RW, Feldens CA, Phantunvanit P. A protocol for early childhood caries diagnosis and risk assessment. Community Dent Oral Epidemiol. 2018;46(5):518-25.
16. Fischman SL. Current status of indices of plaque. Journal of clinical periodontology. 1986;13(5):371-4.
17. Javadzadeh E, Razeghi S, Shamshiri A, Miri HH, Moghaddam F, Schroth RJ, et al. Prevalence and socio-behavioral determinants of early childhood caries in children 1–5-year-old in Iran. Plos one. 2023;18(11):e0293428.
18. Fischman SL. Current status of indices of plaque. J Clin Periodontol. 1986;13(5):371-4, 9-80.
19. Shoaee S, Ghasemi E, Sofi-Mahmudi A, Shamsoddin E, Tovani-Palone MR, Roshani S, et al. Global, regional, and national burden and quality of care index (QCI) of oral disorders: a systematic analysis of the global burden of disease study 1990–2017. BMC Oral Health. 2024;24(1):116.
20. Maklennan A, Borg-Bartolo R, Wierichs RJ, Esteves-Oliveira M, Campus G. A systematic review and meta-analysis on early-childhood-caries global data. BMC Oral Health. 2024;24(1):835.
21. AlMarshad LK, Wyne AH, AlJobair AM. Early childhood caries prevalence and associated risk factors among Saudi preschool children in Riyadh. Saudi Dent J. 2021;33(8):1084-90.
22. Droz D, Guéguen R, Bruncher P, Gerhard J-L, Roland E. Enquête épidémiologique sur la santé buccodentaire d'enfants âgés de 4 ans scolarisés en école maternelle. Archives De Pediatrie - ARCHIVES PEDIATRIE. 2006;13:1222-9.
23. Hernandez M, Chau K, Charissou A, Lecaillon A, Delsau A, Bruncher P, et al. 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.
24. Kato H, Tanaka K, Shimizu K, Nagata C, Furukawa S, Arakawa M, et al. 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.
25. Phillips M, Masterson E, Sabbah W. Association between child caries and maternal health-related behaviours. Community Dent Health. 2016;33(2):133-7.
26. Zhang M, Zhang X, Zhang Y, Li Y, Shao C, Xiong S, et al. 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(1):139.
27. Zhou Y, Lin HC, Lo EC, Wong MC. Risk indicators for early childhood caries in 2-year-old children in southern China. Aust Dent J. 2011;56(1):33-9.
28. Goldfeld S, Francis KL, Hoq M, Do L, O'Connor E, Mensah F. The Impact of Policy Modifiable Factors on Inequalities in Rates of Child Dental Caries in Australia. Int J Environ Res Public Health. 2019;16(11).
29. Marinho VC. Cochrane reviews of randomized trials of fluoride therapies for preventing dental caries. Eur Arch Paediatr Dent. 2009;10(3):183-91.
30. Twetman S, Dhar V. Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries. Pediatr Dent. 2015;37(3):246-53.
31. Plutzer K, Keirse MJ. Influence of first-time mothers' early employment on severe early childhood caries in their child. Int J Pediatr. 2012;2012:820680.
32. Ganesh A, Sampath V, Sivanandam BP, H S, Ramesh A. Risk Factors for Early Childhood Caries in Toddlers: An Institution-based Study. Cureus. 2020;12(4):e7516.
2. Watt RG. From victim blaming to upstream action: tackling the social determinants of oral health inequalities. Community Dent Oral Epidemiol. 2007;35(1):1-11.
3. Folayan M, Olatubosun S. Early Childhood Caries - A diagnostic enigma. Eur J Paediatr Dent. 2018;19(2):88.
4. Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. International Journal of Paediatric Dentistry. 2019;29(3):238-48.
5. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789-858.
6. 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-e41.
7. 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.
8. Filstrup SL, Briskie D, da Fonseca M, Lawrence L, Wandera A, Inglehart MR. Early childhood caries and quality of life: child and parent perspectives. Pediatr Dent. 2003;25(5):431-40.
9. Folayan MO, El Tantawi M, Aly NM, Al-Batayneh OB, Schroth RJ, Castillo JL, et al. Association between early childhood caries and poverty in low and middle income countries. BMC Oral Health. 2020;20(1):8.
10. Kim Seow W. Environmental, maternal, and child factors which contribute to early childhood caries: a unifying conceptual model. Int J Paediatr Dent. 2012;22(3):157-68.
11. WHO calls on countries to reduce sugars intake among adults and children [Internet]. 2015. Available from: https://www.who.int/news/item/04-03-2015-who-calls-on-countries-to-reduce-sugars-intake-among-adults-and-children.
12. Mohebbi SZ, Virtanen JI, Vehkalahti MM. A community-randomized controlled trial against sugary snacking among infants and toddlers. Community Dent Oral Epidemiol. 2012;40 Suppl 1:43-8.
13. Deghatipour M, Ghorbani Z, Mokhlesi AH, Ghanbari S, Namdari M. Community-based interventions to reduce dental caries among 24-month old children: a pilot study of a field trial. BMC Oral Health. 2021;21(1):637.
14. Javadzadeh E, Razeghi S, Shamshiri A, Miri HH, Moghaddam F, Schroth RJ, et al. Prevalence and socio-behavioral determinants of early childhood caries in children 1-5- year- old in Iran. PLoS One. 2023;18(11):e0293428.
15. Evans RW, Feldens CA, Phantunvanit P. A protocol for early childhood caries diagnosis and risk assessment. Community Dent Oral Epidemiol. 2018;46(5):518-25.
16. Fischman SL. Current status of indices of plaque. Journal of clinical periodontology. 1986;13(5):371-4.
17. Javadzadeh E, Razeghi S, Shamshiri A, Miri HH, Moghaddam F, Schroth RJ, et al. Prevalence and socio-behavioral determinants of early childhood caries in children 1–5-year-old in Iran. Plos one. 2023;18(11):e0293428.
18. Fischman SL. Current status of indices of plaque. J Clin Periodontol. 1986;13(5):371-4, 9-80.
19. Shoaee S, Ghasemi E, Sofi-Mahmudi A, Shamsoddin E, Tovani-Palone MR, Roshani S, et al. Global, regional, and national burden and quality of care index (QCI) of oral disorders: a systematic analysis of the global burden of disease study 1990–2017. BMC Oral Health. 2024;24(1):116.
20. Maklennan A, Borg-Bartolo R, Wierichs RJ, Esteves-Oliveira M, Campus G. A systematic review and meta-analysis on early-childhood-caries global data. BMC Oral Health. 2024;24(1):835.
21. AlMarshad LK, Wyne AH, AlJobair AM. Early childhood caries prevalence and associated risk factors among Saudi preschool children in Riyadh. Saudi Dent J. 2021;33(8):1084-90.
22. Droz D, Guéguen R, Bruncher P, Gerhard J-L, Roland E. Enquête épidémiologique sur la santé buccodentaire d'enfants âgés de 4 ans scolarisés en école maternelle. Archives De Pediatrie - ARCHIVES PEDIATRIE. 2006;13:1222-9.
23. Hernandez M, Chau K, Charissou A, Lecaillon A, Delsau A, Bruncher P, et al. 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.
24. Kato H, Tanaka K, Shimizu K, Nagata C, Furukawa S, Arakawa M, et al. 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.
25. Phillips M, Masterson E, Sabbah W. Association between child caries and maternal health-related behaviours. Community Dent Health. 2016;33(2):133-7.
26. Zhang M, Zhang X, Zhang Y, Li Y, Shao C, Xiong S, et al. 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(1):139.
27. Zhou Y, Lin HC, Lo EC, Wong MC. Risk indicators for early childhood caries in 2-year-old children in southern China. Aust Dent J. 2011;56(1):33-9.
28. Goldfeld S, Francis KL, Hoq M, Do L, O'Connor E, Mensah F. The Impact of Policy Modifiable Factors on Inequalities in Rates of Child Dental Caries in Australia. Int J Environ Res Public Health. 2019;16(11).
29. Marinho VC. Cochrane reviews of randomized trials of fluoride therapies for preventing dental caries. Eur Arch Paediatr Dent. 2009;10(3):183-91.
30. Twetman S, Dhar V. Evidence of Effectiveness of Current Therapies to Prevent and Treat Early Childhood Caries. Pediatr Dent. 2015;37(3):246-53.
31. Plutzer K, Keirse MJ. Influence of first-time mothers' early employment on severe early childhood caries in their child. Int J Pediatr. 2012;2012:820680.
32. Ganesh A, Sampath V, Sivanandam BP, H S, Ramesh A. Risk Factors for Early Childhood Caries in Toddlers: An Institution-based Study. Cureus. 2020;12(4):e7516.
| Files | ||
| Issue | Vol 12, No 3 (Summer 2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Early childhood caries (ECC); Dmft; Dietary habits; Tooth-brushing; Parental education. | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Mirsalehi Z, Razeghi S, Jannatizadeh S, Javadzadeh E, Kharrazifard MJ, Mohebbi S. Early Childhood Caries and Its Determinants in Qom Province, Iran. J Craniomaxillofac Res. 2025;12(3):185-194.
