{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:23:33Z","timestamp":1787027013493,"version":"build-2736575974"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:00:00Z","timestamp":1733443200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","award":["DE024985"],"award-info":[{"award-number":["DE024985"]}],"id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the social determinants of early childhood caries (ECC), one of the greatest public health risks affecting children, and examine alternative pathways of influence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A physically healthy, socio-demographically high-risk sample of initially caries-free children, aged 1\u20134 years, was prospectively studied for 2 years. At 6-month intervals, assessments were made of caries presence from a standard dental exam; oral microbiology was assayed from saliva samples; oral hygiene behaviors and psychological and psychosocial risk exposure were derived from interviews and questionnaires.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      189 children were enrolled; ECC onset occurred in 48 children over the 2-year study period. A composite measure of psychosocial risk was significantly associated with ECC onset over the course of the study (1.57, 95% CI 1.12\u20132.20,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u2009.001) and significantly associated with multiple risks for ECC, including poor diet\/feeding (.92; 95% CI. 22\u20131.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u2009.01), poor oral hygiene (.39; 95% CI .09\u2013.68),\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u2009.05), and higher concentrations\n                      <jats:italic>Lactobacilli<\/jats:italic>\n                      (.96; 95% CI .43\u20131.49,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u2009.001). Multivariable regression analyses provided indirect support for the hypothesis that psychosocial risk exposure predicts ECC onset via behavioral and oral hygiene pathways.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study provides novel evidence that psychosocial factors influence many of the purported risks for ECC and strong evidence that there are social and psychological determinants of ECC onset.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2024.1478302","type":"journal-article","created":{"date-parts":[[2024,12,5]],"date-time":"2024-12-05T23:31:04Z","timestamp":1733441464000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Psychosocial determinants of oral health outcomes in young children"],"prefix":"10.3389","volume":"12","author":[{"given":"Dorota 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