RESUMEN
UNLABELLED: The departmental service of maternal and infantile protection (PMI) of Moselle (Lorraine region), together with the Paediatric Dentistry Department from Nancy University, organized a study of the dental health of 4-year-old children. AIMS OF THE STUDY: To assess the children dental health; to evaluate parental knowledge of dental health; to identify the factors associated with caries amongst children. MATERIAL AND METHODS: The study was a cross sectional observation. A random sample of 4-year-old children was selected among 11 586 children in nursery schools. The study was based on a clinical examination performed by a dentist and a structured questionnaire completed by parents. RESULTS: The overall proportion of children affected by caries was 37.5%. The mean dmft score was 1.51 (sd = 2.82) and 11.6% of the children had caries which affected their upper incisors, a sign of early childhood caries. Only 6.2% had received dental treatment on at least 1 occasion. There was a clear disparity in dental health: 1 child out of 3 suffered from caries but 1 out of 2 children in priority education districts was affected, compared with only 1 out of 4 children coming from a rural area. The questionnaires completed by parents showed a lack of knowledge of dental health and inadequate use of current prevention facilities. The multivariate logistic regression analysis showed that the variables that were significantly associated with caries in 4 year-old children were the mother's education, the low social background, the level of consumption of drinks containing sugar by both children and parents, the consumption of fluoride, and the level of knowledge about fluoride. CONCLUSION: Preventive measures must be developed in close relationship between pediatricians and dentists. Initial training of health care professionals has to be reinforced. Health care professionals in paediatrics are far more likely to meet mothers and young children than are dentists.