Javadzadeh Ehsan, Razeghi Samaneh, Shamshiri Ahmadreza, Mohebbi Simin Z
Research Center for Caries Prevention, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Community Oral Health Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
PLoS One. 2025 Feb 25;20(2):e0319083. doi: 10.1371/journal.pone.0319083. eCollection 2025.
A health-promoting and tooth-friendly diet can reduce the risk factors associated with early childhood caries (ECC) and promote overall health in children. This study aimed to identify dietary habits and feeding practices and their associations with ECC among 1-5-year-olds in Iran.
This analytical cross-sectional study utilized data from a survey conducted from August 1, 2020, to January 20, 2021. A three-stage stratified cluster sampling method was employed to recruit participants. Parents provided written informed consent in Persian before enrollment and were then interviewed via a valid and reliable questionnaire inquiring about background information, feeding practices, and dietary habits. Each child underwent a dental examination by one of four trained and calibrated dentists to assess dental plaque and ECC. After appropriate weightings were applied, associations between key covariates and outcome measures were analyzed using multivariable logistic regression modeling and multivariate generalized negative binomial regression modeling. Statistical analysis was performed using SPSS V25 and Stata V14.2 software.
The mean age of the study population was 45.0 (±0.5) months, and 53% (±5%) had ECC. Visible dental plaque was present on the tooth surfaces of 39% ( ± 3%) of the toddlers and 66% ( ± 4%) of the preschoolers. The majority of the children had been breastfed for over 18 months (65%). Most children consumed sugar between meals once a day or less (66%) and fruits once (39%) or twice (37%) a day. ECC experience increased with age and poor oral hygiene across all age groups. Toddlers with a higher frequency of sugar intake between meals had higher dmft and ECC prevalence. The consumption of four to five servings of grain products per day was associated with a five-fold reduction in ECC occurrence (p = 0.047, OR = 0.2). In contrast, the consumption of two servings of fruits per day was associated with a doubling of the dmft score in toddlers (p = 0.015, IRR = 2.0).
This study identified possible dietary risk factors for ECC in Iranian children, such as increased sugar intake and fruit consumption, while balancing diet with grain consumption played a protective role. Considering the role of oral hygiene and the multifactorial nature of the disease may highlight a route toward developing future targeted and effective preventive strategies.
促进健康且有利于牙齿的饮食可降低与幼儿龋齿（ECC）相关的风险因素，并促进儿童的整体健康。本研究旨在确定伊朗1至5岁儿童的饮食习惯和喂养方式及其与ECC的关联。
这项分析性横断面研究利用了2020年8月1日至2021年1月20日进行的一项调查的数据。采用三阶段分层整群抽样方法招募参与者。家长在入组前以波斯语提供书面知情同意书，然后通过一份有效且可靠的问卷进行访谈，询问背景信息、喂养方式和饮食习惯。每个孩子由四位经过培训和校准的牙医之一进行口腔检查，以评估牙菌斑和ECC。在应用适当的权重后，使用多变量逻辑回归模型和多变量广义负二项回归模型分析关键协变量与结果指标之间的关联。使用SPSS V25和Stata V14.2软件进行统计分析。
研究人群的平均年龄为45.0（±0.5）个月，53%（±5%）患有ECC。39%（±3%）的幼儿和66%（±4%）的学龄前儿童牙齿表面有可见牙菌斑。大多数儿童母乳喂养超过18个月（65%）。大多数儿童每天加餐吃糖一次或更少（66%），每天吃水果一次（39%）或两次（37%）。在所有年龄组中，ECC的发生率随着年龄增长和口腔卫生状况差而增加。餐间糖摄入频率较高的幼儿dmft和ECC患病率更高。每天食用四至五份谷物制品与ECC发生率降低五倍相关（p = 0.047，OR = 0.2）。相比之下，每天食用两份水果与幼儿dmft评分翻倍相关（p = 0.015，IRR = 2.0）。
本研究确定了伊朗儿童ECC可能的饮食风险因素，如糖摄入量增加和水果消费，而谷物消费均衡饮食起到了保护作用。考虑到口腔卫生的作用以及该疾病的多因素性质，可能为制定未来有针对性的有效预防策略指明方向。
