High caries prevalence and risk factors among young preschool children in an urban community with water fluoridation

Background Singapore is unique in that it is a 100% urban community with majority of the population living in a homogeneous physical environment. She, however, has diverse ethnicities and cultures as such; there may be caries risk factors that are unique to this population. Aim The aims were to assess the oral health of preschool children and to identify the associated caries risk factors. Design An oral examination and a questionnaire were completed for each consenting child–parent pair. Results One hundred and ninety children (mean age: 36.3 ± 6.9 months) were recruited from six community medical clinics. Ninety-two children (48.4%) were caries active. The mean d123t and d123s scores were 2.2 ± 3.3 and 3.0 ± 5.6, respectively. Higher plaque scores were significantly (P < 0.0005) associated with all measures of decay (presence of decay, dt, ds). The risk factors for severity of decay (i.e., dt and ds) include child's age, breastfeeding duration, and parents' ability to withhold cariogenic snacks from their child. Conclusions The high caries rate suggests that current preventive methods to reduce caries in Singapore may have reached their maximum effectiveness, and other risk factors such as child's race, and dietary and breastfeeding habits need to be addressed.