{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T23:26:45Z","timestamp":1793834805998,"version":"4.6.1"},"reference-count":30,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T00:00:00Z","timestamp":1771718400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"National Health Mission"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Community Dental Health"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:p>\n                    The family is a fundamental unit of society and provides care to the needs of its members. This study aims to assess the independent contributions of nuclear and extended families through direct and indirect pathways towards the risk of early childhood caries among 5-year-old children from low socio-economic status families in Central India. Cross-sectional study with two-stage sampling of 313 randomly selected school children. The American Association of Pediatric Dentistry defined criteria were used for diagnosing early childhood caries (ECC) and severe early childhood caries (S-ECC). It was hypothesised that the type of family would impact ECC and S-ECC by acting on individual-level variables such as frequency of cleaning teeth, dietary patterns, and utilisation of dental services. Examiner-administered interviews collected information about demographic details and oral hygiene practices. Generalized structural equation modelling (GSEM) examined the relationship between exogenous variables, including nuclear and extended families with ECC and SECC. Path coefficients and the standard error with a 95% confidence interval were reported. ECC and SECC was present among 186 (59.4%) and 47 (15%) children. Nuclear families, more frequent between meal sugar consumption and lower utilization of dental care were associated with ECC (odds ratios of 2.43, 2.78, and 8.65, respectively (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001)). Nuclear families were also associated with SECC. Type of family directly (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001) and indirectly (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.05) predicted ECC via three or more times sugar consumption and lower utilization of dental services. Nuclear families were associated with ECC and SECC among children. Therefore, the health professionals need to understand the influence of the type of family and the associated pathway to tackle and reduce the burden of ECC.\n                  <\/jats:p>","DOI":"10.1177\/0265539x261429987","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T07:47:06Z","timestamp":1771832826000},"page":"523-530","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Independent contributions of nuclear and extended families to risk of early childhood caries among children from low socio-economic status in India"],"prefix":"10.1177","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8830-9955","authenticated-orcid":false,"given":"Abhinav","family":"Singh","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4273-1699","authenticated-orcid":false,"given":"Bharathi","family":"M Purohit","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences (AIIMS)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Purohit","sequence":"additional","affiliation":[{"name":"Postgraduate Institute of Medical Education and Research"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilima","family":"Nilima","sequence":"additional","affiliation":[{"name":"All India Institute of Medical Sciences (AIIMS)"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,22]]},"reference":[{"key":"e_1_3_4_2_1","volume-title":"The Reference Manual of Pediatric Dentistry, 79-81","author":"American Academy of Pediatric Dentistry","year":"2020","unstructured":"American Academy of Pediatric Dentistry (2020) Policy on early childhood caries (ECC): classifications, consequences, preventive strategies. In: The Reference Manual of Pediatric Dentistry, 79-81. American Academy of Pediatric Dentistry."},{"key":"e_1_3_4_3_1","volume-title":"Disseminating Evidence-based Practice for Children and Adolescents: A Systems Approach to Enhancing Care","author":"American Psychological Association Task Force on Evidence-Based Practice for Children and Adolescents","year":"2018","unstructured":"American Psychological Association Task Force on Evidence-Based Practice for Children and Adolescents (2018) Disseminating Evidence-based Practice for Children and Adolescents: A Systems Approach to Enhancing Care. 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