Analysis of regional disparities in influencing factors of early childhood caries in China in 2005 and 2015

PENG Yang-fan; LIU Jian; ZHENG Shu-guo; SUN Xiang-yu

doi:10.19538/j.kq.2023.06.012

Abstract：Objective To analyze the prevalence and influencing factors of early childhood caries in China in 2005 and 2015,and to explore regional disparities and changes of influencing factors.Methods The study was conducted in Pe-king University School and Hospital of Stomatology from September 2022 to March 2023.Based on the databases of oral examination and questionnaire survey of 5-year-old chil-dren from the third and fourth national oral health survey in China in 2005 and 2015(abbreviated as"2005 survey"and"2015 survey",respectively),a total of 17 indepen-dent variables including region and potential influencing factors of four aspects(socio-demographic characteristics,early childhood factors,oral health behavior,and self-percep-tion of oral health)were selected.The caries status of 5-year-old children was used as the dependent variable to con-struct a negative binomial regression model to identify the influencing factors of caries in young children.The regional distribution differences of influencing factors and their changes in the decade from 2005 to 2015 were analyzed.Results A total of 24 014 children aged 5 years old were included,including 11099 from 2005 survey and 12915 from 2015 sur-vey.There were significant differences in the prevalence of dental caries among different regions in 2005 and 2015(all P＜0.05).In 2015,the caries prevalence rates of 5-year-old children in the eastern and northeastern regions were 78.4％and 85.7％,respectively,which were significantly higher than those in the central region(64.5％)and western re-gion(70.3％)(both P＜0.05).Except for the central region,the caries status in the eastern,northeastern and western re-gions in 2015 were worse than those in 2005(all P＜0.05).The independent influencing factors of caries in preschool children in China included:region,urbanicity,guardian's education level,family income level per capita,feeding pat-tern,the age of starting toothbrushing,sweet intake frequency,sweet intake before bedtime,last dental visit,toothache ex-perience in the past year,self-evaluation of oral health,and oral health cognition level.The proportions of participants under circumstances of urban residents,guardian with education level of high school or above,family income of low to medium level or above,less than 2 times of sweet food intake per day,dental attendance in the past 12 months,dental pain present in the past 1 year,and better oral health cognition in the eastern and northeastern regions were higher than those in the central and western regions(all P＜0.05).Compared with 2005 survey,the proportion of people with guard-ian education level of high school or above(except for the northeastern region),family income per capita of low to medi-um level or above,artificial feeding,children's toothbrushing age starting at 3 years old or earlier and dental visit experi-ence in the past 6 months increased significantly in all regions(all P＜0.05).The proportion of children who consumed sweets≥2 times per day increased significantly in all regions except the western region,whereas the proportion of chil-dren who never consumed sweets before bedtime decreased significantly.The proportion of children who had toothache(sometimes or often)in the past year(except for the western region)increased significantly.The change in distribution of these above influencing factors in the decade from 2005 to 2015 exhibited statistical significance(all P＜0.05).Conclu-sion Compared with the status in 2005,the change in prevalence of dental caries in most regions of China in 2015 shows an unoptimistic tendency,and the distribution of influencing factors and the change during the decade show evi-dent regional disparities.