{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:17:24Z","timestamp":1787894244188,"version":"build-2784847793"},"reference-count":19,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000646","name":"Japan Society for the Promotion of Science London","doi-asserted-by":"publisher","award":["20K23229"],"award-info":[{"award-number":["20K23229"]}],"id":[{"id":"10.13039\/501100000646","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100020236","name":"Japan Foundation for Pediatric Research","doi-asserted-by":"publisher","award":["20\u2010013"],"award-info":[{"award-number":["20\u2010013"]}],"id":[{"id":"10.13039\/100020236","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n To examine whether screen time at age 3\u2009years was associated with dentist\u2010assessed dental caries, and whether regular juice consumption modified this association.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This population\u2010based retrospective cohort used linked municipal child health records at 18\u2009months and 3\u2009years in Okinawa, Japan (2014\u20132019). The outcome was any dental caries at age 3\u2009years. Exposures were caregiver\u2010reported screen time (\u2264\u20091, 1\u20132, >\u20092\u2009h\/day), regular juice consumption, caregiver\u2010assisted toothbrushing and breastfeeding at 18\u2009months. Adjusted risk ratios (aRRs) were estimated by modified Poisson regression, adjusting for demographic, household, sleep, dietary and routine factors and baseline caries. Effect modification by regular juice consumption was assessed on multiplicative and additive scales; multiple imputation addressed missing data.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among 60\u2009404 children, 15\u2009608 (25.8%) had caries at age 3\u2009years; of 58\u2009815 caries\u2010free at 18\u2009months, 14\u2009269 (24.3%) developed it. Screen time >\u20092\u2009h\/day carried higher caries risk than \u2264\u20091\u2009h\/day (aRR 1.08; 95% CI 1.04\u20131.12). Regular juice consumption was strongly associated (aRR 1.32; 1.28\u20131.35), whereas caregiver\u2010assisted toothbrushing was protective (0.66; 0.64\u20130.68). The association was modified by regular juice consumption: among non\u2010consumers, aRRs were 1.07 (1.03\u20131.11) and 1.13 (1.08\u20131.18) for 1\u20132 and >\u20092\u2009h\/day, versus 0.98 and 1.00 among regular consumers; the joint association was sub\u2010additive. Multiple\u2010imputation analyses were similar.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Higher screen time was modestly associated with caries, whereas regular juice consumption and absence of caregiver\u2010assisted toothbrushing were major correlates; the screen\u2010time association was most evident among children without regular juice consumption. Prevention may need to address screen\u2010related routines alongside dietary and oral hygiene practices.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/cdoe.70112","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:23:43Z","timestamp":1787891023000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Screen Time, Juice Consumption, Caregiver\u2010Assisted Toothbrushing and Dental Caries at Age 3\u2009Years: A Population\u2010Based Cohort Study in Japan"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7260-731X","authenticated-orcid":false,"given":"Toshifumi","family":"Yodoshi","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Hepatology, Pancreatology and Nutrition, Stead Family Department of Pediatrics University of Iowa Iowa City Iowa USA"},{"name":"Division of Gastroenterology, Hepatology and Nutrition Cincinnati Children's Hospital Medical Center Cincinnati USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"139","DOI":"10.21037\/tp-24-415","article-title":"Global Trends and Challenges in Childhood Caries: A 20\u2010Year Bibliometric Review","volume":"14","author":"Zhai L.","year":"2025","journal-title":"Translational Pediatrics"},{"key":"e_1_2_11_3_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3390\/ejihpe12010001","article-title":"Association Between Insufficient Sleep and Dental Caries Among Preschoolers in Japan: A Cross\u2010Sectional Multicentre Study","volume":"12","author":"Ogawa M.","year":"2021","journal-title":"European Journal of Investigation in Health, Psychology and Education"},{"key":"e_1_2_11_4_1","first-page":"60","article-title":"Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies","volume":"40","author":"AAPD","year":"2018","journal-title":"Pediatric Dentistry"},{"key":"e_1_2_11_5_1","first-page":"65","article-title":"Policy on Dietary Recommendations for Infants, Children, and Adolescents","volume":"40","author":"AAPD","year":"2018","journal-title":"Pediatric Dentistry"},{"key":"e_1_2_11_6_1","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2016-2591","article-title":"Media and Young Minds","volume":"138","author":"Council on Communications and Media","year":"2016","journal-title":"Pediatrics"},{"key":"e_1_2_11_7_1","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1111\/obr.12812","article-title":"The Effect of Screen Advertising on Children's Dietary Intake: A Systematic Review and Meta\u2010Analysis","volume":"20","author":"Russell S. J.","year":"2019","journal-title":"Obesity Reviews"},{"key":"e_1_2_11_8_1","doi-asserted-by":"crossref","DOI":"10.1111\/obr.13441","article-title":"The Influence of Unhealthy Food and Beverage Marketing Through Social Media and Advergaming on Diet\u2010Related Outcomes in Children\u2010A Systematic Review","volume":"23","author":"Mc Carthy C. M.","year":"2022","journal-title":"Obesity Reviews"},{"key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1007\/s00431-025-06093-w","article-title":"Introduction of Fruit Juice and Sugar\u2010Sweetened Beverages Before 6 Months of Age and Early Childhood Caries at 3.5\u2009Years: The ELFE Cohort Study","volume":"184","author":"Kerguen J.","year":"2025","journal-title":"European Journal of Pediatrics"},{"key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.jdent.2019.06.004","article-title":"Screen Time, Dietary Patterns and Intake of Potentially Cariogenic Food in Children: A Systematic Review","volume":"86","author":"Shqair A. Q.","year":"2019","journal-title":"Journal of Dentistry"},{"key":"e_1_2_11_11_1","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.1186\/s12903-024-04979-z","article-title":"Problematic Screen Exposure and Oral Health in Preschool Children: A Comparison Study","volume":"24","author":"Mustulo\u011flu \u015e.","year":"2024","journal-title":"BMC Oral Health"},{"key":"e_1_2_11_12_1","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1186\/s12903-025-06135-7","article-title":"Exploring the Link Between Screen Time and Severity of Early Childhood Caries in Primary Molars: A Cross\u2010Sectional Study","volume":"25","author":"Kalaivanan D.","year":"2025","journal-title":"BMC Oral Health"},{"key":"e_1_2_11_13_1","doi-asserted-by":"crossref","first-page":"163","DOI":"10.3345\/cep.2025.01998","article-title":"Associations of Routine Breakfast and Napping Habits With Early Adiposity Rebound by Age 3\u2009Years: A Population\u2010Based Cohort Study in Japan","volume":"69","author":"Yodoshi T.","year":"2026","journal-title":"Clinical and Experimental Pediatrics"},{"key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1111\/apa.17489","article-title":"More Than Half of Japanese 3\u2010Year\u2010Olds Exceeded the World Health Organization Screen Time Guidelines","volume":"114","author":"Yodoshi T.","year":"2025","journal-title":"Acta Paediatrica"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.sdentj.2023.12.001","article-title":"Nutritional Factors Associated With Early Childhood Caries: A Systematic Review and Meta\u2010Analysis","volume":"36","author":"Sandy L. P. A.","year":"2024","journal-title":"Saudi Dental Journal"},{"key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1016\/j.adaj.2024.04.005","article-title":"Maternal Perceptions of Assisting Preschool\u2010Aged Children With Toothbrushing","volume":"155","author":"Peralta E.","year":"2024","journal-title":"Journal of the American Dental Association"},{"key":"e_1_2_11_17_1","unstructured":"WHO \u201cContinued Breastfeeding for Healthy Growth and Development of Children \u201d(2026) https:\/\/www.who.int\/tools\/elena\/bbc\/continued\u2010breastfeeding."},{"key":"e_1_2_11_18_1","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1111\/apa.13118","article-title":"Breastfeeding and the Risk of Dental Caries: A Systematic Review and Meta\u2010Analysis","volume":"104","author":"Tham R.","year":"2015","journal-title":"Acta Paediatrica"},{"key":"e_1_2_11_19_1","doi-asserted-by":"crossref","DOI":"10.3390\/nu16091355","article-title":"Association of Breastfeeding and Early Childhood Caries: A Systematic Review and Meta\u2010Analysis","volume":"16","author":"Shrestha S. K.","year":"2024","journal-title":"Nutrients"},{"key":"e_1_2_11_20_1","doi-asserted-by":"crossref","first-page":"42424","DOI":"10.1038\/s41598-025-26515-x","article-title":"Breastfeeding and Early Tooth Eruption as Predictors of Dental Caries Occurrence Throughout Childhood","volume":"15","author":"Mikasa Y.","year":"2025","journal-title":"Scientific Reports"}],"container-title":["Community Dentistry and Oral Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.70112","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/cdoe.70112","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cdoe.70112","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:23:46Z","timestamp":1787891026000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cdoe.70112"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,27]]},"references-count":19,"alternative-id":["10.1111\/cdoe.70112"],"URL":"https:\/\/doi.org\/10.1111\/cdoe.70112","archive":["Portico"],"relation":{},"ISSN":["0301-5661","1600-0528"],"issn-type":[{"value":"0301-5661","type":"print"},{"value":"1600-0528","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,27]]},"assertion":[{"value":"2026-03-03","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-18","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"cdoe.70112"}}