Abstract
Early childhood caries (ECC) remains a substantial public health challenge in developing nations, disproportionately impacting underserved rural populations. This cross-sectional epidemiological study investigated the prevalence, severity, and associated socio-behavioral risk factors of ECC among preschool children residing in rural communities of Southern India. A representative sample of 720 children aged 36 to 71 months was selected using a multistage stratified cluster sampling technique across rural districts. Clinical examinations were conducted by calibrated examiners using the World Health Organization standard diagnostic criteria to assess the decayed, missing, and filled teeth (dmft) index. Structured questionnaires administered to primary caregivers captured socio-demographic details, dietary habits, and oral hygiene practices. The overall prevalence of ECC was 54.3%, with a mean dmft score of 2.86 ± 2.41, predominantly driven by untreated decayed teeth (94.8% of the dmft index). Multivariable logistic regression analysis revealed that prolonged nocturnal bottle-feeding with sweetened milk (Adjusted Odds Ratio [AOR] = 2.68, 95% CI: 1.82–3.94), delayed initiation of tooth brushing beyond two years of age (AOR = 2.14, 95% CI: 1.45–3.16), low maternal educational attainment (AOR = 1.95, 95% CI: 1.31–2.91), and frequent daily consumption of sugary snacks (AOR = 2.42, 95% CI: 1.63–3.59) were significantly associated with ECC occurrence. The high burden of untreated dental decay highlights an urgent need for culturally tailored oral health promotion programs and early preventive interventions integrated into existing primary rural child health infrastructures.
