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Acta Odontol Scand. 2018 Nov;76(8):595-599. doi: 10.1080/00016357.2018.1490965. Epub 2018 Sep 28.

Influence of mode of delivery, family and nursing determinants on early childhood caries development: a prospective cohort study.

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a Maxillofacial Unit , Halland Hospital , Halmstad , Sweden.
b Department of Pediatrics , The Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden.
c Department of Pediatrics , Halland Hospital , Halmstad , Sweden.
d Faculty of Health and Medical Sciences, Department of Odontology , University of Copenhagen , Copenhagen , Denmark.



Conflicting results exist regarding mode of delivery and caries. We investigated the influence of the mode of delivery and selected family- and nursing factors during the first 2 years of life on the prevalence of dental caries at 5 years.


551 infants were invited to a prospective medical study with focus on growth and overweight prevention. The parents of 346 infants (179 boys and 167 girls) accepted this invitation and at the age of 2-years, 336 of them agreed to dental check-ups and salivary samplings. At the ages of three and five years, 302 (90%) and 292 children (87%) could be re-examined with respect to caries by one of two calibrated examiners. All stages of caries lesions were scored on tooth and surface level. Background maternal and nursing data were collected semiannually through validated questionnaires and interviews.


The caries prevalence (initial + cavitated lesions) was 5.6% at 3 years of age and 18.9% at 5 years. The 5-year-olds delivered with caesarian section displayed a significantly elevated risk of having caries (relative risk [RR] 2.2; 95% confidence interval (CI) 1.4-3.6; p < .05). Parental smoking and siblings with caries were the most influential family determinants (p < .05) while drinking juice to meals at 2 years of age (p < .05) was most outstanding among the nursing factors (p < .05).


In this cohort, the mode of delivery (caesarian section) had a significant impact on the risk of early childhood caries (ECC) but also other family and infant nursing determinants were related to the development of the disease.


Caries; caesarian section; infant feeding; smoking; tooth brushing

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