Research Article
Volume 10 Issue 6 - 2021
Severe Early Childhood Caries (S-ECC) and General Health Status (GHS) in One to Two Year-Old Children Related to Bottle-Feeding, in Urban Indian Population- A Cross-Sectional Study
Priyanka R Acharya1*, Ashwin M Jawdekar2 and Amar N Katre3
1Ex Post-graduate Student and Senior Lecturer, Department of Pediatric and Preventive Dentistry, YMT Dental College and Hospital, Navi Mumbai, India
2Professor and Head, Department of Pediatric and Preventive Dentistry, Bharati Vidyapeeth (Deemed-to-be University) Dental College and Hospital, Navi Mumbai, India
3Professor and Head, Department of Pediatric and Preventive Dentistry, YMT Dental College and Hospital, Navi Mumbai, India
*Corresponding Author: Priyanka R Acharya, Ex Post-graduate Student and Senior Lecturer, Department of Pediatric and Preventive Dentistry, YMT Dental College and Hospital, Navi Mumbai, India.
Received: February 20, 2021; Published: May 28, 2021


Background: Dental caries in children is a public health concern affecting more than 50% of children by 5 years of age in India with a high level of untreated disease. Improper feeding practice is a common risk factor for not only S-ECC but also poor general health; furthermore, S-ECC can be considered an earliest marker of many non-communicable diseases of adulthood. Few studies in Indian literature have assessed association of bottle-feeding with oral and general health, in the age-group of one-two years.

Aim: To assess S-ECC and General Health Status (GHS) in 1 - 2 year-old children in relation to feeding practices.

Objectives: To assess the prevalence of S-ECC and to evaluate the GHS w.r.t respiratory infections, gastrointestinal infections, constipation, developmental and nutritional parameters of children fed with or without bottle in the age group 1 - 2 years.

Methodology: 824 one to two year old children in General hospitals, well baby clinics and other private paediatric set ups were selected. The study tool recorded information such as the child's age, gender, feeding practice, mother’s age, education, socioeconomic status, dmft, anaemia, respiratory infections, GI infections, constipation, developmental milestones and BMI (height and weight) of the child, etc.

Results: Out of the total population, 9.64% exhibited S-ECC. The odds of having S-ECC (OR = 0.15; p < 0.0001), gastrointestinal infections (OR = 0.59; p = 0.0128) were lesser in Non Bottlefed children as compared to bottle-fed and statistically significant. Bedtime bottle feeding amplified the risk of S-ECC in a regression analysis (OR = 2.38; p = 0.0329). Bottle-fed children had a higher risk of having multiple conditions (dental and GHS) together such as, caries with anaemia, caries with GI infections, caries with respiratory infections and caries with delayed milestones; the odds being statistically significant. Also, Children having caries had higher risk of developing anaemia, GI infections and constipation; the odds being statistically significant. Exclusive breast feeding had protective benefits against all conditions.

Conclusion: Bottle-fed children exhibited higher S-ECC and poor GHS w.r.t. gastrointestinal infections. Bottle-fed children also exhibited higher multiple conditions like GI infections, Respiratory infections and delayed milestones in combination with S-ECC.

Keywords: Severe Early Childhood Caries (S-ECC); General Health Status (GHS); Bottle-Feeding


  1. Petersen PE. “The World Oral Health Report 2003: Continous improvement of the oral health in the 21st century – the approach of the WHO Global Oral Health Programme”. Community Dentistry and Oral Epidemiology 1 (2003): 3-24.
  2. Casamassimo PS., et al. “Beyond the dmft: the human and economic cost of early childhood caries”. The Journal of the American Dental Association6 (2009): 650-657.
  3. India Ministry of Health and Family Affairs, Govt. of India”. National Oral Health Survey and Fluoride Mapping (2002 -03) (2004).
  4. Olatosi OO and Sote EO. “Causes and pattern of tooth loss in children and adolescents in a Nigerian Tertiary Hospital”. Nigerian Quarterly Journal of Hospital Medicine4 (2012): 258-262.
  5. Casamassimo P. “Hooked, Editorial”. Paediatric Dentistry 1 (1997): 6.
  6. Hallett KB and O'Rourke PK. “Social and behavioural determinants of early childhood caries”. Australian Dental Journal1 (2003): 27-33.
  7. Freedman MR and Alvarez KP. “Early childhood feeding: assessing knowledge, attitude, and practices of multi-ethnic child-care providers”. Journal of the American Dietetic Association3 (2010): 447-451.
  8. Ole Fejerskov., et al. “Dental Caries: The Disease and its clinical Management”. 3rd Edn.
  9. Sheiham A and James WP. “Diet and dental caries: the pivotal role of free sugars reemphasized”. Journal of Dental Research 10 (2015): 1341-1347.
  10. Bolling K. “Infant Feeding Survey”. The Information Centre (2005).
  11. WHO recommendations on postnatal care of the mother and newborn”. 1. Postnatal care – standards. 2. Maternal welfare. 3. Infant, Newborn. 4. Guideline. World Health Organization. ISBN 978 92 4 150664 9 (NLM classification: WQ 500) (2013).
  12. Lumeng J. “What Can We Do to Prevent Childhood Obesity?” Zero to Three 3 (2005): 13-19.
  13. Fisher JO., et al. “Parental influences on young girls’ fruit and vegetable, micronutrient, and fat intakes”. Journal of the American Dietetic Association 1 (2002): 58-64.
  14. Ministry of human resource development, Department of women and child development (Food and nutrition board), Govt. of India”. National Guidelines on Infant and Young Child Feeding (2004).
  15. Renfrew MJ., et al. “Formula feed preparation: helping reduce the risks; a systematic review”. Archives of Disease in Childhood 10 (2003): 855-858.
  16. Lakshman R., et al. “Mothers’ experiences of bottle-feeding: a systematic review of qualitative and quantitative studies”. Archives of Disease in Childhood8 (2009): 596-601.
  17. Carvalho MF., et al. “Home-made feeding bottles have inadequacies in their nutritional composition regardless of socioeconomic class”. Journal of Tropical Pediatrics4 (2013): 286-291.
  18. Andıran F., et al. “Cows milk consumption in constipation and anal fissure in infants and young children”. Journal of Paediatrics and Child Health5 (2003): 329-331.
  19. Parkin PC., et al. “Severe iron-deficiency anaemia and feeding practices in young children”. Public Health Nutrition4 (2016): 716-722.
  20. Gaffney KF., et al. “Prolonged baby bottle feeding: a health risk factor”. Pediatric Nursing 3 (2004): 242-246.
  21. Kim HY., et al. “Prolonged bedtime bottle-feeding and respiratory symptoms in infants”. Asia Pacific Allergy 1 (2011): 30-35.
  22. Bennett WE., et al. “Early cow’s milk introduction is associated with failed personal–social milestones after 1 year of age”. European Journal of Pediatrics 7 (2014): 887-892.
  23. Filstrup SL., et al. “Early childhood caries and quality of life: child and parent perspectives”. Pediatric Dentistry 5 (2003): 431-440.
  24. UpdatingIncomeRanges for Kuppuswamy’s Socio-Economic Status Scale for the Year (2014).
  25. Whitehead M., et al. “Developing the policy response to inequities in Health: a global perspective. ill;.- Challenging inequities in health care: from ethics to action”. New York: Oxford University Press (2001): 309-322.
  26. Petersen PE. “The World Oral Health Report 2003: continuous improvement of oral health in the 21st century–the approach of the WHO Global Oral Health Programme”. Community Dentistry and Oral Epidemiology1 (2003): 3-24.
  27. Sheiham A and Watt RG. “The common risk factor approach: a rational basis for promoting oral health”. Community Dentistry and Oral Epidemiology6 (2000): 399-406.
  28. Kathmandu RY. “The burden of restorative dental treatment for children in Third World countries”. International Dental Journal1 (2002): 1-9.
  29. Watt RG. “Strategies and approaches in oral disease prevention and health promotion”. Bulletin of the World Health Organization9 (2005): 711-718.
  30. World Health Organisation. Oral Health Surveys: Basic Methods”. 5th Edition. France: World Health Organisation (2013).
  31. Bagramian RA., et al. “The global increase in dental caries. A pending public health crisis”. American Journal of Dentistry 1 (2009): 3-8.
  32. International Caries Detection and Assessment System Coordinating Committee”. Rationale and Evidence for the International Caries Detection and Assessment System (ICDAS II) (2016).
  33. Tiano AV., et al. “Dental caries prevalence in children up to 36 months of age attending daycarecenters in municipalities with different water fluoride content”. Journal of Applied Oral Science1 (2009): 39-44.
  34. Martinesa F., et al. “Factors influencing the development of otitis media among Sicilian children affected by upper respiratory tract infections”. Brazilian Journal of Otorhinolaryngology 159 (2015): 1-8.
  35. Detsomboonrat P and Pisarnturakit PP. “Dental caries and related oral health factors among 9 to 18 month old thai children”. The Southeast Asian Journal of Tropical Medicine and Public Health 4 (2015): 786-797.
  36. World Health Organization. The world health report 2002: reducing risks, promoting healthy life”. Geneva: WHO (2002).
  37. Singh RK and Patra S. “Extent of anaemia among preschool children in EAG States, India: a challenge to policy makers”. Anemia (2014).
  38. Bharati S., et al. “Socioeconomic determinants of iron-deficiency anemia among children aged 6 to 59 months in India”. Asia Pacific Journal of Public Health 2 (2015): 1432-1443.
  39. Milankov O., et al. “What kind of milk can prevent infant’s sideropenicanemia: Comparative study”. Medicinskipregled 5-6 (2014): 167-171.
  40. Culhane-Pera KA., et al. “Cultural feeding practices and child-raising philosophy contribute to iron-deficiency anemia in refugee Hmong children”. Ethnicity and Disease 2 (2001): 199-205.
  41. Chellan R and Paul L. “Prevalence of iron-deficiency anaemia in India: results from a large nationwide survey”. Journal of Population and Social Studies [JPSS] 1 (2010): 59-80.
  42. Redmond EC., et al. “Contamination of bottles used for feeding reconstituted powdered infant formula and implications for public health”. Perspectives in Public Health 2 (2009): 85-94.
  43. Stuebe A. “The risks of not breast feeding for mothers and infants”. Reviews in Obstetrics and Gynecology4 (2009): 222.
  44. Cui LL., et al. “Breastfeeding and early childhood caries in children: an update meta-analysis of observational studies”. Asia Pacific Journal of Clinical Nutrition (2016).
  45. Peres KG., et al. “Impact of Prolonged Breast feeding on Dental Caries: A Population-Based Birth Cohort Study”. Paediatrics1 (2017): e20162943.
  46. Rugg-Gunn AJ., et al. “Effect of human milk on plaque pH in situ and enamel dissolution in vitro compared with bovine milk, lactose, and sucrose”. Caries Research4 (1985): 327-334.
  47. Erickson PR and Mazhari E. “Investigation of the role of human breast milk in caries development”. Pediatric Dentistry 21 (1999): 86-90.
  48. Irwin Mandel. “Caries Prevention: Current Strategies, New 50 Directions”. Journal of the American Dental Association 127 (1996): 1477-1488.
  49. Kramer MS and Kakuma R. “Optimal duration of exclusive breast feeding”. The Cochrane Database of Systematic Reviews 8 (2012): CD003517.
  50. Sauls HS. “Potential effect of demographic and other variables in studies comparing morbidity of breast-fed and bottle-fed infants”. Pediatrics4 (1979): 523-527.
  51. Bauchner H., et al. “Studies of breast-feeding and infections: how good is the evidence?”. The Journal of the American Medical Association7 (1986): 887-892.
Citation: Priyanka R Acharya., et al. “Severe Early Childhood Caries (S-ECC) and General Health Status (GHS) in One to Two Year-Old Children Related to Bottle-Feeding, in Urban Indian Population- A Cross-Sectional Study”. EC Paediatrics 10.6 (2021): 52-66.

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