Prevalence of severe early childhood caries and associated socioeconomic and behavioral factors in Xinjiang, China: a cross-sectional study

Background: This study assessed the prevalence and severity of early childhood caries (ECC) and identified socioeconomic and behavioral correlates of the disease in preschool children living in Xinjiang. Methods: For this cross-sectional survey, 1727 children aged 3-5 years in Xinjiang were randomly recruited using a three-stage cluster sampling procedure. The dmft index according to the WHO 1997 criteria was used to assess ECC and severe ECC (S-ECC). A questionnaire was completed by caregivers. Variables included sociodemographic characteristics, dietary and oral hygiene behaviors, and access to dental services. The statistical associations of variables with ECC, S-ECC, and dmft were evaluated by univariate and multiple logistic regression analyses. Results: The prevalence of ECC was 78.2% and that of S-ECC was 41.2%; mean dmft scores were 5.61 +/- 3.56 and 8. 17 +/- 2.94, respectively. The prevalence of ECC was significantly higher in children from Ining (OR 2.747; 95% CI 2. 033-3.713), those whose caregivers had caries (OR 1.78; 95% CI 1.245-2.547), those with a dental visit in the past (OR 2.023; 95% CI 1.429-2.865), and those whose parents had received instructions on oral health care (OR 2.171; 95% CI 1.44-3.272), and increased significantly at age 4 years (OR 2.09; 95% CI 1.506-2.901) and 5 years (OR 2.666; 95% CI 1.855-3.833) and in children who starting tooth brushing at a young age (OR 1.363; 95% CI 1.171-1.587), and decreased significantly in children with a more educated mother (OR 0.817; 95% CI 0.688-1), those from high-income families (OR 0.667; 95% CI 0.582-0.765), those with low consumption of sweets (OR 0.66; 95% CI 0.57-0.763), and those who seldom ate before sleep (OR 0.557; 95% CI 0.437-0.712). Conclusions: ECC and S-ECC remain a serious problem among preschool children in Xinjiang. Caries rates were associated with sociodemographic and behavioral factors, which could be modified by public health strategies, including protection of primary dentition, extension of insurance to cover oral preventive services, improvement of the oral health care system, and public health education.