Objective: Dental caries in early childhood is an important public health problem. Previous studies have examined risk factors, but they have been somewhat limited in scope. The purpose of this study was to assess dietary, microbiological, socioeconomic, oral hygiene and fluoride exposure variables as risk factors for high-risk children aged 6 to 24 months.

Methods: 122 mothers with children 6 to 24 months of age were recruited from WIC sites in southeastern Iowa for participation in a longitudinal study of dental caries. Baseline assessments included a series of detailed questions regarding children's beverage consumption, oral hygiene and family socioeconomic status. Dental examinations using d1d2-3 criteria and semi-quantitative assessments of Streptococcus mutans levels of mother and child were also determined using tongue blades and RODAC plates. Counts of the number of teeth with visible plaque were recorded for maxillary and mandibular molars and incisors.

Results: Of the 122 child/mother pairs, 103 of the children had teeth, and of these children the mean age was 14.5 months. Nineteen of the children exhibited either d1 or d2-3 lesions and 21 had detectable S. mutans. Presence of caries (d1 or d2-3) was associated with age (p<0.001), as no children under 12 months had caries, while 44% (15/34) of those >18 months had caries. Among those >12 months, other factors associated with caries included presence of S. mutans in children (p=0.010), high S. mutans levels (>100cfu) (p=0.023), and number of teeth with visible plaque (p<0.001). Sugared beverage consumption was associated with presence of S. mutans, but not with caries. SES was not associated with caries.

Conclusion: Results suggest that microbial measures, including levels of S. mutans and plaque levels, are most closely associated with caries in very young children. Continued study is necessary to more fully assess risk factors for caries as children get older.

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