Early Childhood Caries Risk Influenced by Multiple Factors, Suggests Study
China: In 1–2-year-old children, the risk of early childhood caries (ECC) is shaped by multiple oral health–related factors. Baseline caries status stands out as a strong predictor of future disease and also alters how other risk factors influence outcomes. These findings highlight the value of early identification and timely preventive strategies in improving risk prediction and management of ECC.
A prospective cohort study published in BDJ Open by Miao Shuxi from the Department of Preventive Dentistry, Beijing Stomatological Hospital, Capital Medical University, and colleagues explored determinants of ECC among young children in Beijing. The study followed participants aged 12 to 24 months between 2021 and 2023, with 919 children included in the final analysis and a follow-up rate of nearly 77%. Researchers collected oral health data through parental questionnaires alongside clinical dental examinations, applying advanced statistical models to identify key risk factors.
The researchers reported the following findings:
- Nearly 29.8% of children developed caries during the study period.
- Mean increase in decayed, missing, and filled primary teeth (dmft) was 0.94
- Multiple behavioral and clinical factors were significantly associated with higher caries risk.
- Frequent snacking was linked to increased caries incidence.
- Higher candy consumption was associated with a greater risk.
- Infrequent bedtime tooth brushing increased the likelihood of caries.
- Regular bottle use at bedtime was a significant predictor of caries development.
- Prolonged exposure to sugary liquids contributed to a higher risk.
- Baseline caries status was a strong predictor of future caries outcomes.
- Early detection of caries plays a key role in risk assessment and prevention.
Further insights were gained when children were analyzed based on their initial caries status. Among those who were caries-free at baseline, additional factors influenced risk. These included parental history of caries, behaviors involving saliva sharing (such as sharing utensils), frequency of rinsing the mouth after meals, and the presence of additives in daily drinking water. These findings highlight the influence of both familial and environmental factors on oral health in early childhood.
The study also demonstrated that baseline caries status modified the impact of several risk factors. The effects of parental oral health, saliva-sharing habits, oral hygiene practices, and even prior dental visits varied depending on whether a child already had caries at the start of the study. This interaction suggests that risk is not uniform and should be assessed in a more individualized manner.
Overall, the findings reinforce that ECC is a multifactorial condition influenced by a combination of behavioral, biological, and environmental determinants. By identifying baseline caries status as a key modifying factor, the study provides valuable direction for risk-based prevention. Tailoring early interventions based on individual risk profiles may help improve outcomes and support better oral health from the earliest stages of life.
Reference:
Miao, S., Zhao, M., Ren, W., Chen, W., Zhang, H., & Liu, M. (2026). Influence factors of early childhood caries risk among children aged 1–2 years in Beijing: A prospective cohort study. BDJ Open, 12(1), 44. https://doi.org/10.1038/s41405-026-00432-1
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