Oral Hygiene and Feeding Practices and their Association with Early Childhood Caries in Kindergarten Children of Klang District, Selangor

Introduction: Dental caries is the most common chronic behavioural disease of childhood, caused by the interaction of bacteria, mainly Streptococcus mutans(MS) and Streptococcus sobrinus, and sugary foods on tooth enamel.

Objective: The objective of this study was to analyze the association between oral hygiene and feeding practices with Early Childhood Caries (ECC) pattern and severity in kindergarten children aged 3-5 years old in Klang District, Selangor.

Methods: A cross-sectional study was conducted on 600 kindergarten children selected using a multi-stage sampling technique. Parents completed a self-administered questionnaire which sought information on demographic and oral hygiene and feeding practices of the children. The children’s dental caries was charted using ICDAS II scoring criteria for dmft index. Statistical analysis was done using descriptive and bivariate statistics. Multiple regression analysis was conducted to determine the significant risk determinants for ECC.

Results: The response rate was 68.1% (n = 409/600). ECC prevalence was 82.6% with mean dmft (SD) and dmfs (SD) of 7.09 (6.0) and 13.00 (15.4) respectively. This study found A-ECC and SECC to be more common. Caries lesion commonly affected maxillary teeth and mandibular molars with least involvement of the mandibular anteriors. Most teeth demonstrated cavitated dentine lesions (ICDAS 4, 5 and 6) when compared to non-cavitated and cavitated enamel lesion (ICDAS 0A and 3). Significant risk determinants were locations, age of children, bottle-feeding practices, toothbrushing habits and sweet drink consumptions (p<0.05).

Conclusions: The prevalence of early childhood caries was relatively high with significant demographic, oral hygiene and feeding practice factors with high treatment needs. Significant risk determinants necessitate more preventive programmes addressing oral health behaviour to improve the oral health and well-being of the children in Klang district, Selangor.