Prevalence of severe early childhood caries and associated socioeconomic and behavioral factors in Xinjiang, China: a cross-sectional study.

BACKGROUND: This study assessed the prevalence and severity of early childhood caries (ECC) and identified socioeconomic and behavioral correlates of the disease in preschool children living in Xinjiang. METHODS: For this cross-sectional survey, 1727 children aged 3-5 years in Xinjiang were randomly recruited using a three-stage cluster sampling procedure. The "dmft" index according to the WHO 1997 criteria was used to assess ECC and severe ECC (S-ECC). A questionnaire was completed by caregivers. Variables included sociodemographic characteristics, dietary and oral hygiene behaviors, and access to dental services. The statistical associations of variables with ECC, S-ECC, and dmft were evaluated by univariate and multiple logistic regression analyses. RESULTS: The prevalence of ECC was 78.2% and that of S-ECC was 41.2%; mean dmft scores were 5.61 ± 3.56 and 8.17 ± 2.94, respectively. The prevalence of ECC was significantly higher in children from Ining (OR 2.747; 95% CI 2.033-3.713), those whose caregivers had caries (OR 1.78; 95% CI 1.245-2.547), those with a dental visit in the past (OR 2.023; 95% CI 1.429-2.865), and those whose parents had received instructions on oral health care (OR 2.171; 95% CI 1.44-3.272), and increased significantly at age 4 years (OR 2.09; 95% CI 1.506-2.901) and 5 years (OR 2.666; 95% CI 1.855-3.833) and in children who starting tooth brushing at a young age (OR 1.363; 95% CI 1.171-1.587), and decreased significantly in children with a more educated mother (OR 0.817; 95% CI 0.688-1), those from high-income families (OR 0.667; 95% CI 0.582-0.765), those with low consumption of sweets (OR 0.66; 95% CI 0.57-0.763), and those who seldom ate before sleep (OR 0.557; 95% CI 0.437-0.712). CONCLUSIONS: ECC and S-ECC remain a serious problem among preschool children in Xinjiang. Caries rates were associated with sociodemographic and behavioral factors, which could be modified by public health strategies, including protection of primary dentition, extension of insurance to cover oral preventive services, improvement of the oral health care system, and public health education.

Risk determinants associated with early childhood caries in Uygur children: a preschool-based cross-sectional study.

BACKGROUND: The prevalence of early childhood caries (ECC) varies with geographical region and population. The Uygur people, one of 55 officially recognized ethnic minorities in China, have a population of 10,069,346. We performed a preschool-based cross-sectional study of 670 Uygur children from the southern region of Xinjiang, China, to investigate the prevalence and severity of ECC and to identify factors related to the dental health condition of this population. METHODS: The study population of children ranging in age from 3 to 5 years was invited using a three-stage stratified sampling in Kashgar, the westernmost city in China. The "dmft" index was used to assess dental caries. The diagnosis of ECC or severe ECC was based on the oral health diagnostic criteria defined by the American Academy of Pediatric Dentistry. A questionnaire was completed by the children's caregivers. The survey included questions concerning the children's sociodemographic background; feeding and eating habits, particularly frequency of sweet beverage and food consumption; dental hygiene-related behaviors; the general oral health knowledge of caregivers; and the dental healthcare experience of caregivers and their children. RESULTS: A total of 670 Uygur children underwent complete dental caries examination. Most of the children (74.2%) had ECC, with a mean dmft ± SD of 3.95 ± 3.84. The prevalence of severe ECC was 40.1% (N =269), with a mean dmft of 7.72 ± 3.14. More than 99% of caries were untreated. Statistically significant correlations were found between higher ECC prevalence and increased age and lower socioeconomic background, while greater dental health knowledge of the caregiver and positive oral hygiene behaviors were found to be protective. Our findings confirm the multi-factorial etiology of ECC. CONCLUSIONS: The prevalence of ECC among preschool-aged Uygur children in Kashgar was high, particularly among those from lower socioeconomic backgrounds. Caries prevalence was associated with oral hygiene behaviors of children and the general oral health knowledge of caregivers. These factors could be modified through public health strategies, including effective publicity concerning general dental health and practical health advice.