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Influence of mode of delivery, family and nursing determinants on early childhood caries development: a prospective cohort study

Journal article
Authors Katarina Boustedt
Josefine Roswall
S. Twetman
Jovanna Dahlgren
Published in Acta Odontol Scand
Volume 76
Issue 8
Pages 595-599
ISSN 1502-3850 (Electronic) 0001-6357 (Linking)
Publication year 2018
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 595-599
Language en
Keywords Caries, caesarian section, infant feeding, smoking, tooth brushing
Subject categories Clinical Medicine


INTRODUCTION: Conflicting results exist regarding mode of delivery and caries. We investigated the influence of the mode of delivery and selected family- and nursing factors during the first 2 years of life on the prevalence of dental caries at 5 years. MATERIALS AND METHODS: 551 infants were invited to a prospective medical study with focus on growth and overweight prevention. The parents of 346 infants (179 boys and 167 girls) accepted this invitation and at the age of 2-years, 336 of them agreed to dental check-ups and salivary samplings. At the ages of three and five years, 302 (90%) and 292 children (87%) could be re-examined with respect to caries by one of two calibrated examiners. All stages of caries lesions were scored on tooth and surface level. Background maternal and nursing data were collected semiannually through validated questionnaires and interviews. RESULTS: The caries prevalence (initial + cavitated lesions) was 5.6% at 3 years of age and 18.9% at 5 years. The 5-year-olds delivered with caesarian section displayed a significantly elevated risk of having caries (relative risk [RR] 2.2; 95% confidence interval (CI) 1.4-3.6; p < .05). Parental smoking and siblings with caries were the most influential family determinants (p < .05) while drinking juice to meals at 2 years of age (p < .05) was most outstanding among the nursing factors (p < .05). CONCLUSIONS: In this cohort, the mode of delivery (caesarian section) had a significant impact on the risk of early childhood caries (ECC) but also other family and infant nursing determinants were related to the development of the disease.

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