Identification of caries risk in 2-year-olds

Abstract

Objective: The first aim was to describe presence of plaque, caries and oral health behaviours in 2‐year‐old children. The second aim was to measure increments in caries experience from 2 to 5 years of age and to study whether national background, visible plaque, caries and oral health behaviour at 2 years of age were associated with increments in caries experience. Methods: The study population consisted of 392 children, of whom 211 were monitored from 2 to 5 years of age. At age 2 years, parents completed a questionnaire about family background and oral health behaviour. The presence of plaque and caries at tooth level was obtained from dental records. Data were tested with chi‐square statistics and Mann‐Whitney U test. Negative binomial regression analysis was conducted to explore the association between caries increment between 2 and 5 years of age and national background, visible plaque, caries and oral health behaviour at 2 years of age. Results: Caries was found in 4.6% of 2‐year‐olds, and 4.6% had visible plaque. More than half of these children (57.9%) brushed twice daily, toothbrushing was introduced when the child was 7 months or older in 61.0% of the children, and 15.6% consumed sugary snacks daily. Non‐Western children more often had caries, visible plaque and unfavourable oral health behaviour than Western children (P < .05). At age 5 years, 28.9% of the children had caries experience. Non‐Western background, toothbrushing less than twice daily, not using fluoridated toothpaste, not using fluoride lozenges, consuming sugary drinks at night, consuming sugary snacks daily, presence of plaque and caries at 2 years of age were associated with caries increment between 2 and 5 years of age in bivariable analyses. The results from multivariable analysis showed that children who started toothbrushing late, children who brushed less than twice daily at 2 years of age and children of non‐Western background had a higher probability of having caries increment from 2 to 5 years of age than other children. Conclusions: A small proportion of 2‐year‐olds had caries, but these children had several decayed teeth. Substantial differences in oral health and oral health behaviour were found between Western and non‐Western children. The preventive care delivered to the studied children failed to prevent caries increment from 2 to 5 years of age.