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ORIGINAL RESEARCH article

Front. Pediatr.
Sec. Children and Health
Volume 12 - 2024 | doi: 10.3389/fped.2024.1478302
This article is part of the Research Topic Updates in Pediatric Dentistry View all 12 articles

Psychosocial Determinants of Oral Health Outcomes in Young Children

Provisionally accepted
Dorota Kopycka-Kedzierawski Dorota Kopycka-Kedzierawski Patricia G Ragusa Bfa Patricia G Ragusa Bfa Changyong Feng Changyong Feng Kim Flint Kim Flint Gene E Watson Gene E Watson Cynthia L Wong Cynthia L Wong Steven Gill Steven Gill Ronald J Billings Ronald J Billings Tom O'Connor Tom O'Connor *
  • University of Rochester, Rochester, United States

The final, formatted version of the article will be published soon.

    Objective: To examine the social determinants of early childhood caries (ECC), one of the greatest public health risks affecting children, and examine alternative pathways of influence. Methods: A physically healthy, socio-demographically high-risk sample of initially caries-free children, aged 1-4 years, was prospectively studied for 2 years. At 6-month intervals, assessments were made of caries presence from a standard dental exam; oral microbiology was assayed from saliva samples; oral hygiene behaviors and psychological and psychosocial risk exposure were derived from interviews and questionnaires. Results: 189 children were enrolled; ECC onset occurred in 48 children over the 2-year study period. A composite measure of psychosocial risk was significantly associated with ECC onset over the course of the study (1.57, 95%CI 1.12–2.20,p<.001) and significantly associated with multiple risks for ECC, including poor diet/feeding (.92; 95%CI .22–1.61,p<.01), poor oral hygiene (.39; 95%CI .09-.68), p<.05), and higher concentrations Lactobacilli (.96; 95%CI .43–1.49,p<.001). Multivariable regression analyses provided indirect support for the hypothesis that psychosocial risk exposure predicts ECC onset via behavioral and oral hygiene pathways. Conclusions: The study provides novel evidence that psychosocial factors influence many of the purported risks for ECC and strong evidence that there are social and psychological determinants of ECC onset.

    Keywords: ECC Early childhood Caries, MS mutans streptococci, LB Lactobacilli, GEE generalized estimating equations, ICDAS International Caries Detection and Assessment System, cfu colony forming units, ICC Intra Class Correlation

    Received: 09 Aug 2024; Accepted: 12 Nov 2024.

    Copyright: © 2024 Kopycka-Kedzierawski, Ragusa Bfa, Feng, Flint, Watson, Wong, Gill, Billings and O'Connor. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Tom O'Connor, University of Rochester, Rochester, United States

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