Caries Prevalence in 6-Year-Old Children and Inequalities in Oral Health in the Province of Trento - North Italy

Introduction: The prevalence of dental caries in childhood has seen a significant decrease in the past few decades even if it remains one of the most common chronic childhood diseases. The availability of monitoring systems allows us to know the trend of the disease over time and the aspects to improve. The study analyzes, on the birth cohort of 2011 and assessed in 2017, by family pediatricians, the association of dental caries on deciduous teeth with socio-demographic factors. Materials and Methods: The sources of the data are the annual database of general and oral health surveillance carried out on the basis of the forms filled by the family pediatricians on the occasion of the 6-year health assessment. The factors associated with the risk of decay of deciduous teeth were analyzed with a multiple analysis according to the logistic model. Mother-related and perinatal variables were retrieved using the birth assistance certificate archive. Prevalence estimates and adjusted odds ratios are provided with 95% confidence intervals (CIs). Results: 3505 subjects (1787 males and 1718 females), belonging to the birth cohort of the year 2011, have been evaluated by family pediatricians at the health check del 6th anno. The caries prevalence on deciduous teeth in 6-year-old children is 23% (CI 95% 21.6–24.4), 23.5% in males (CI 21.5–25.5) and 22.5% in females (20.5–24.5). In children with a foreign mother, the prevalence of caries is higher than in children with an Italian mother, equal to 31% (CI 95% 27–35%) and 21.7% (CI 95% 20.3–23.1), respectively. The multiple analysis, carried out on 2783 subjects with valid data, indicates that the presence of a mother of foreign nationality, a mother aged 24 or younger and the practice of non-optimal oral hygiene constitute independent risk factors for decay of deciduous teeth in children of 6 years of age. Discussion: A revisit of the provincial program for the oral health promotion in childhood would seem necessary, improving the relations with schools and the interventions to the most vulnerable groups such as foreigners Women of childbearing age and during pregnancy should also receive special care, considering that the mother’s lifestyle can have significant impact on the health and behavior of the child. Family pediatrician can play an important role, considering that he comes into contact with the child and his family from birth to puberty. It is necessary however integrate this professional into the network of local health services. Conclusion: The health surveillance data provided by family pediatricians combined with birth data allow to evaluate the persistent inequalities in the oral health promotion program in childhood in Trento province.