A case-control study to determine the risk factors, markers and determinants for the development of nursing caries in the four-year-old population of North York

grantor: University of TorontoNursing caries is a distinctive pattern of severe tooth decay seen in infants and toddlers. Improper infant bottle feeding habits are considered to be the most frequent cause of this condition, however it has also been reported in children who have used sweetened pacifiers and those that reportedly were breast-fed exclusively. The purpose of this study was to examine if socio-cultural and behavioural factors were related to the development of nursing caries in the child population of North York. This would assist dental public health managers to developing appropriate health promotion and disease prevention strategies for those families with children at the greatest risk for the development of nursing caries. A total of 3,310 four-year old children from 151 schools were screened. There were 281 nursing caries cases identified. Of these 192 (68 per cent) were active cases, and 89 (32 per cent) were treated cases. Data were collected using a self completed questionnaire that was mailed-out, using a three-stage technique. The final sample analyzed contained 71 active cases, 29 treated cases and 107 control children. Eight variables were found to be statistically significantly related to the development of nursing caries in this study population; dental knowledge, frequency of brushing, maternal birthplace, child's birthplace, family income, dental insurance, use of dental services, and the primary source of child care information. When the data were examined using logistic regression, four risk factors were found to be important with respect to the development of nursing caries in the four-year-old population of North York; dental knowledge, use of personal sources of child care information, dental service utilization by the child's father and lack of workplace insurance. The results of this study support the hypothesis, that there are socio-cultural and behavioural factors related to the development of nursing caries, which could be addressed through public health effortsM.Sc