Analysis of Factors Associated with Early Childhood Caries in Jinan City: A Cross-Sectional Study.

PURPOSE: Early childhood caries (ECC) remains a global public health challenge characterized by high prevalence and low treatment rates. This study investigated factors associated with ECC among 3- to 5-year-old children in Jinan through oral examinations, questionnaires, and caries activity testing, aiming to support early prevention. MATERIALS AND METHODS: A total of 733 children aged 3-5 in Jinan were enrolled. Sociodemographic information, feeding patterns, and oral health behaviors were collected via questionnaires completed by legal guardians. The number of decayed, missing, and filled surfaces (dmfs) was recorded. Oral plaque was collected for Cariostat caries activity testing. Statistical analyses were conducted to identify factors associated with ECC and the relationship between ECC and caries activity. RESULTS: Among 733 participants, the prevalence of ECC was 76.8%. Factors statistically significantly associated with caries severity included age, gender, primary caregiver's educational attainment, frequency of sweet-snack consumption, and the habit of nighttime milk feeding or falling asleep with a nipple (all p 0.05). The proportion of high-risk children (by Cariostat) progressively increased across the caries-free, low-caries, and high-caries groups (p 0.001). CONCLUSION: Low educational attainment of the primary caregiver, inappropriate feeding practices, frequent sugary food intake, and poor oral hygiene habits are risk factors for ECC. Oral health education and promotion of proper oral hygiene habits are therefore needed. Furthermore, the acid‑producing metabolic activity of oral plaque microorganisms increased significantly with caries progression, suggesting that Cariostat test values may serve as a potential indicator of cumulative caries severity in preschool children.