Prevalence and pattern of caries, plaque and gingivitis in 4-5 year old Jordanian children in Amman and their relationship to a number of indicators and aetiological factors

Objectives: To investigate the association between oral health (in terms of dental caries and gingivitis), and socio-demographic factors, dental plaque, oral hygiene behaviours, infant feeding and dietary practices in 4-5-year-old Jordanian children. Methods: Two-stage random sampling was used to select children enrolled in kindergartens in Amman, Jordan. Clinical examinations were carried out by, one calibrated examiner. Mothers completed questionnaire relating to socio-demographic factors, oral hygiene behaviours, infant feeding and dietary practices of the children. Results: 67% of the children had caries, 31 % had dmft greater than 4.30% had caries in molars and incisors (and/or canines). 83% had 4 or more teeth with plaque and 66 % had gingivitis. Social class and oral hygiene behaviour were important risk indicators for the level of oral cleanliness and presence of gingivitis. Higher percentages of children with 4 or more sites with plaque and with gingivitis had a dmft greater than 4. Prolonged breastfeeding (>18 months), and breast-feeding on demand were significantly associated with caries. The majority of severely affected children attended kindergartens with the lowest tuition fees. Savoury snacks were consumed by 82 % of the children, confectionery by 76% and teas with sugar by 42%. Multivariate analysis showed that age, dental plaque, use of comforters had a significant effect on both caries prevalence and severity. Sleeping beside the mother, consumption of confectionery and eating food high in sugar content had a significant effect on caries prevalence. Breast-feeding on demand was significantly related to caries severity. Regarding gingivitis, plaque and kindergarten fees were the only two variables that were significantly related to gingivitis. Conclusion: Young children in Jordan would benefit from health promotion strategies directed towards appropriate infant feeding, dietary practices and oral hygiene measures. Attention should be given particularly to children attending kindergartens with the lowest tuition fees