The role of feeding practices as a determinant of the pufa index in children with early childhood caries

Objective: To evaluate the prevalence and severity of untreated dental caries among young children (aged <6 years) with early childhood caries (ECC) using the pufa index and to examine the relationship between caries and feeding practices. Study Design: A cross-sectional study of children with ECC was undertaken in two stages: a questionnaire survey based on interviews and an intraoral examination using the defs and pufa indices. Results: The overall prevalence of untreated dental caries in our sample of 238 ECC-affected children was 72.3%. The abscess component (code a) was the most common condition. There was an increase in the ECC patterns and the severity of untreated dental caries with increasing age for all teeth groups. ECC and untreated caries lesions for the various teeth groups and study sites varied inversely with current feeding status. The majority of the children had posterior ECC, and the fewest were affected by ulceration (code u) as a consequence of untreated dental caries. Except for the posterior caries pattern, all other caries patterns and pufa components (code u alone, p<0.05) had a significantly higher prevalence among children with nocturnal feeding practices (p<0.001). Binary logistic regression analyses revealed that older age (p<0.05) and nocturnal feeding practices (p<0.001) were significantly associated with pufa scores>0. Conclusion: These data provide valuable evidence of the effect of nocturnal feeding as an important determinant of the increased prevalence of untreated caries lesions among children with ECC.