Feeding and smoking habits as cumulative risk factors for early childhood caries in toddlers, after adjustment for several behavioral determinants: a retrospective study
Open accessAbstract
Background: Several maternal health determinants during the first period of life of the child, as feeding practice, smoking habit and socio-economic level, are involved in early childhood health problems, as caries development. The potential associations among early childhood caries, feeding practices, maternal and environmental smoking exposure, Socio-Economic Status (SES) and several behavioral determinants were investigated. Methods: Italian toddlers (n = 2395) aged 24–30 months were recruited and information on feeding practices, sweet dietary habit, maternal smoking habit, SES, and fluoride supplementation in the first year of life was obtained throughout a questionnaire administered to mothers. Caries lesions in toddlers were identified in visual/tactile examinations and classified using the International Caries Detection and Assessment System (ICDAS). Associations between toddlers’ caries data and mothers’ questionnaire data were assessed using chi-squared test. Ordinal logistic regression was used to analyze associations among caries severity level (ICDAS score), behavioral factors and SES (using mean housing price per square meter as a proxy). Results: Caries prevalence and severity levels were significantly lower in toddlers who were exclusively breastfed and those who received mixed feeding with a moderate–high breast milk component, compared with toddlers who received low mixed feeding and those exclusively fed with formula (p < 0.01). No moderate and high caries severity levels were observed in an exclusively breastfed children. High caries severity levels were significantly associated with sweet beverages (p < 0.04) and SES (p < 0.01). Toddlers whose mothers smoked five or more cigarettes/day during pregnancy showed a higher caries severity level (p < 0.01) respect to those whose mothers did not smoke. Environmental exposure to smoke during the first year of life was also significantly associated with caries severity (odds ratio =7.14, 95% confidence interval = 6.07-7.28). No association was observed between caries severity level and fluoride supplementation. More than 50% of toddlers belonging to families with a low SES, showed moderate or high severity caries levels (p < 0.01). Conclusions: Higher caries severity levels were observed in toddlers fed with infant formula and exposed to smoke during pregnancy living in area with a low mean housing price per square meter.
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The vast majority of cross-sectional studies found evidence for a positive association between SSB consumption and dental caries.
“The vast majority of cross-sectional studies found evidence for a positive association between SSB consumption and dental caries [67, 69–82].”
From The negative impact of sugar-sweetened beverages on children’s health: an update of the literature (2018) · cites this paper as [77]
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Knowledge about Negative Effects of Bottle Feeding on Babies’ Dental Tissues Amongst Mothers
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Self-citationBreastfeeding and Child Oral Health: An Umbrella Review
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Effect of Secondhand Smoking on Dental Caries among Schoolchildren Aged 6–12 Years in Odisha
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- Authors
- Majorana, A., Cagetti, M. G., Bardellini, E., Amadori, F., Conti, G., Strohmenger, L., & Campus, G.
- Affiliations
- University of Brescia (IT)
- University of Milan (IT)
- University of Sassari (IT)
- Corresponding author
- Campus, Guglielmo
- Venue
- BMC Pediatrics
- Published
- 2014-02-15
- Volume
- 14
- Issue
- 1
- Pages
- 45-45
- ISSN
- 1471-2431 (ISSN-L)
- PMC
- PMC3930287
- OpenAlex
- W2122950886
- Cited by
- 84
- References
- 37
- Citations by year
- 2026: 3 · 2025: 8 · 2024: 12 · 2023: 7 · 2022: 8 · 2021: 11 · 2020: 7 · 2019: 7 · 2018: 6 · 2017: 3 · 2016: 4 · 2015: 8
- FWCI
- 6.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Pediatrics (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UnissResearch (Università degli Studi di Sassari) (submittedVersion)
- UnissResearch (Università degli Studi di Sassari) (submittedVersion, cc-by)
- Archivio Istituzionale della Ricerca (Universita Degli Studi Di Milano) (submittedVersion, other-oa)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Topics
- Health Sciences › Dentistry › Periodontics › Dental Health and Care Utilization
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Keywords
- early childhood caries, toddlers, feeding practices, breastfeeding, infant formula, smoking during pregnancy, passive smoking, socioeconomic status, sweetened beverages, fluoride supplementation, caries severity, ICDAS, housing prices
- MeSH terms
- Behavior, Child, Preschool, Dental Caries, Feeding Behavior, Female, Humans, Male, Maternal Behavior, Surveys and Questionnaires, Retrospective Studies, Risk Factors, Smoking, Socioeconomic Factors, Tobacco Smoke Pollution
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