Determinants of Early Childhood Caries and their interactions: A Structural Equation Modelling approach

Community Dent Health. 2023 Nov 30;40(4):227-232. doi: 10.1922/CDH_00017Gunasinghe06.

Abstract

Objective: Early Childhood Caries (ECC) has been common among preschoolers in Sri Lanka over decades. A broad spectrum of determinants that act upon different levels is responsible for its development. Therefore, the relationships among these determinants should be studied extensively to control ECC.

Design: Descriptive cross-sectional study with multistage cluster sampling.

Setting: Registered preschools in Gampaha District.

Participants: A total of 1038 three to four-year-olds and their mothers.

Main outcome measures: Direct, indirect, and total effects of the determinants of ECC in structural equation models.

Results: Sweet consumption had direct effects from permissive parenting (β=0.26, p=0.00) and the sweet consumption behaviour of the family (β=0.17, p=0.01). Oral hygiene behaviours had direct effects from permissive parenting (β=-0.46, p=0.00) and maternal oral health related self-efficacy (β=0.23, p=0.00). The dental attendance pattern had total effects from knowledge (β=0.18, p=0.00) and permissive parenting (β=-0.16, p=0.00).

Conclusions: Parenting style, family sweet consumption behaviour and maternal oral health related self-efficacy were the most influential second-line determinants that affected oral health behaviours: sweet consumption, oral hygiene, and dental attendance pattern for the development of ECC.

Keywords: dental caries; preschool children; structural equation modelling.

MeSH terms

  • Child, Preschool
  • Cross-Sectional Studies
  • Dental Caries Susceptibility*
  • Dental Caries* / epidemiology
  • Female
  • Humans
  • Latent Class Analysis
  • Oral Health
  • Prevalence