Document Type : Original Article


1 Department of Paediatric and Preventive Dentistry, MM College of Dental Sciences and Research, Mullana, Ambala, Haryana, India

2 Department of Public Health Dentistry, Sharad Pawar Dental College and Hospital, DMIMS (Deemed to be University), Wardha, Maharashtra, India


BACKGROUND: Early childhood caries is like an epidemic, especially in the developing world,
hence exploring its appropriate factors in causing the disease the need of the hour. Hence, the aim
of the present study was to evaluate social and behavioral determinants of early childhood caries
within the region of Ambala, Haryana.
MATERIALS AND METHODS: The present survey elaborated oral examination among 398 study
participants within the age group of 4–5 years. Carious tooth was recorded using Gruebbel’s deft DEFT
index using clean mouth mirror and probe. A questionnaire comprising 21 questions in English as
well as Hindi was prepared. There was an interviewer who took the interview of parents or caregivers.
The questionnaire consisted of questions which were aimed at gaining information regarding infants
feeding practice, social factors, and dental health behavior. The results of the study were tabulated,
and inferential statistics were applied using ANOVA test along with regression (multiple logistic)
RESULTS: The occurrence of caries was affected by the behavioral factors such as breastfeeding
habits, bottle feeding habits, age of beginning of solid foods in children. There was no influence of
age of beginning of taking fluid from cup. Besides social factors like annual family income, education
of mothers, age of mother at the time of birth of children, age of children, order of children in the
family had a significant effect over the occurrence and severity and extent of caries. Factors such
as gender of children and profession of mother did not have had a significant role in early childhood
caries. Dental health habits such as tooth brushing frequency, brushing under supervision, frequency
of toothbrushing, quantity of toothpaste used had a significant effect over the frequency, and acerbity
of caries in early infanthood.
CONCLUSION: It can be concluded from this study that there is a significant correlation between
several social and behavioral determinants and early childhood caries.


  1. Reisine S, Litt M, Tinanoff N. A biopsychosocial model to predict
    caries in preschool children. Pediatr Dent 1994;16:413‑8.
    2. Tinanoff N, O’Sullivan DM. Early childhood caries: Overview
    and recent findings. Pediatr Dent 1997;19:12‑6.
    3. Schröder U, Granath L. Dietary habits and oral hygiene as
    predictors of caries in 3‑year‑old children. Community Dent Oral
    Epidemiol 1983;11:308‑11.
    4. Holt RD, Joels D, Bulman J, Maddick IH. A third study of caries
    in preschool aged children in Camden. Br Dent J 1988;165:87‑91.
    5. Silver DH. A comparison of 3‑year‑olds’ caries experience in 1973,
    1981 and 1989 in a Hertfordshire town, related to family behaviour
    and social class. Br Dent J 1992;172:191‑7.
    6. Verrips GH, Kalsbeek H, Eijkman MA. Ethnicity and maternal
    education as risk indicators for dental caries, and the role of dental
    behavior. Community Dent Oral Epidemiol 1993;21:209‑14.
    7. Grindefjord M, Dahlof G, Ekstrom G, Hojer B, Modeer T. Caries
    prevalence in 2.5 year old children. Caries Res 1993;27:505‑10.
    8. Litt MD, Reisine S, Tinanoff N. Multidimensional causal model
    of dental caries development in low‑income preschool children.
    Public Health Rep 1995;110:607‑17.
    9. Evans DJ, Rugg‑Gunn AJ, Tabari ED, Butler T. The effect of
    fluoridation and social class on caries experience in 5‑year‑old
    Newcastle children in 1994 compared with results over the
    previous 18 years. Community Dent Health 1996;13:5‑10.
    10. Hallett KB. Early childhood caries and infant feeding practice. In:
    MPH Thesis. Brisbane: The University of Queensland; 1998.
    11. Ramos‑Gomez FJ, Tomar SL, Ellison J, Artiga N, Sintes J, Vicuna G.
    Assessment of early childhood caries and dietary habits in a
    population of migrant Hispanic children in Stockton, California.
    ASDC J Dent Child 1999;66:395‑403, 366.
    12. Vanobbergen J, Martens L, Lesaffre E, Bogaerts K, Declerck D.
    Assessing risk indicators for dental caries in the primary dentition.
    Community Dent Oral Epidemiol 2001;29:424‑34.
  2. 13. Hallett KB. Early childhood caries ‑ A new name for an old
    problem. Ann R Australas Coll Dent Surg 2000;15:268‑75.
    14. Hallett KB, O’Rourke PK. Dental caries experience of preschool
    children from the North Brisbane region. Aust Dent J 2002;47:331‑8.
    15. PalmerJD, Anderson RJ, Downer MC. Guidelines for prevalence
    studies of dental caries. Community Dent Health 1984;1:55‑66.
    16. Anonymous. Oral Health Surveys. Basic Methods. 3rd ed. Geneva:
    World Health Organization; 1987.
    17. Jain M, Namdev R, Bodh M, Dutta S, Singhal P, Kumar A. Social
    and Behavioral Determinants for Early Childhood Caries among
    Preschool Children in India. J Dent Res Dent Clin Dent Prospect
    2015; 9 (2):115‑120 | doi: 10.15171/joddd. 2014.023
    18. Rothman KJ. Modern Epidemiology. Boston: Little, Brown and
    Company; 1986. p. 300‑2.
    19. Kleinbaum DG. Logistic Regression; A Self Learning Text.
    New York: Springer ‑ Berley; 1994. p. 134‑7.
    20. Weinstein P, Domoto P, Wohlers K, Koday M. Mexican‑American
    parents with children at risk for baby bottle tooth decay: Pilot
    study at a migrant farmworkers clinic. ASDC J Dent Child
    21. Naidu R, Nunn J, Swift ED. Oral health‑related quality of life and
    early childhood caries among preschool children in Trinidad.
    BMC Oral Health. 2016;16:128
    22. Seow WK, Amaratunge A, Bennett R, Bronsch D, Lai PY. Dental
    health of aboriginal pre‑school children in Brisbane, Australia.
    Community Dent Oral Epidemiol 1996;24:187‑90.
    23. Hallett KB, O’Rourke PK. Social and behavioural determinants
    of early childhood caries. Aust Dent J. 2003;48(1):27‑33. doi:
    10.1111/j. 1834‑7819.2003.tb00005.x.
    24. Febres C, Echeverri EA, Keene HJ. Parental awareness, habits, and
    social factors and their relationship to baby bottle tooth decay.
    Pediatr Dent 1997;19:22‑7.
    25. Sen S, Deolia S, Chhabra KG, Chakraborty R, Chhabra C, Rathi A.
    Analysis of food frequency and acquired dietary allowance (ADA)
    in relation to dental caries and dental erosion affecting dental
    postgraduate students of Sawangi: A cross sectional study.
    J Family Med Prim Care 2019;8:2084‑8.
    26. Chhabra KG, Shetty PJ, Prasad KV, Mendon CS, Kalyanpur R. The
    beyond measures: Non flouride preventive measures for dental
    caries. J Int Oral Health 2011;3:1‑8.