Feeding practices and dental caries among preschool children in Jeddah and Madinah, Saudi Arabia: a cross-sectional study

Background Dental caries is highly prevalent among Saudi children. Infant feeding practices, including breastfeeding, bottle feeding and night-time feeding, have been proposed as contributing factors, but evidence from Saudi populations remains limited. Methods This hospital-based cross-sectional study included 350 children aged 2–5 years attending King Abdulaziz University Dental Hospital, Jeddah ( n = 180), and Taibah University Dental Hospital, Madinah ( n = 170). Parents (mainly mothers) completed a validated Arabic online questionnaire on demographics, feeding practices and oral hygiene. Children were examined using World Health Organization dmft/dmfs criteria. Data were analyzed using chi-square, Fisher's exact and Mann–Whitney U tests and binary logistic regression. Results Caries was present in 281 children (80.3%; mean dmft 5.55 ± 4.86), with no significant difference between cities ( p = 0.69). Soft drink consumption was associated with caries presence ( p < 0.001) and with higher mean dmft (6.3 ± 4.6 vs. 4.7 ± 4.9, p = 0.001). In logistic regression, the odds of caries were higher among children of mothers with elementary or intermediate education than among those of mothers with postgraduate education (OR = 6.08, 95% CI, 1.41–26.23; p = 0.016). The odds were also higher among children from households earning less than 7,000 SAR than among those from households earning more than 10,000 SAR (OR = 2.71, 95% CI, 1.16–6.37; p = 0.022). Breastfeeding history was more common among children with caries (87.5% vs. 76.8%, p = 0.035) and was associated with higher odds of caries (OR = 2.26, 95% CI, 1.08–4.74; p = 0.032). However, breastfeeding duration and night breastfeeding were not associated with caries. Bottle feeding and night bottle feeding were not associated with caries presence or dmft. Conclusion Dental caries was highly prevalent among preschool children attending university dental hospitals in Jeddah and Madinah and was associated with lower maternal education, lower household income and soft drink consumption. The association with breastfeeding history may reflect residual confounding. Given the cross-sectional, hospital-based design, these findings cannot establish causality and may not be generalizable. They support targeting sugar exposure and socioeconomic factors in prevention without discouraging breastfeeding.