The effect of exclusive breastfeeding, exclusive bottle-feeding, mixed feeding, and oral Rothia on early childhood caries
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Date
2024-06-24
Authors
Szeto, Andrea
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Abstract
Objective: To investigate the association between feeding practices (exclusive breastfeeding, exclusive bottle-feeding, and mixed) with early childhood caries (ECC) and the association between the prevalence of oral Rothia, at the species and genus level, with ECC.
Methods: A total of 438 children (178 caries-free, 260 with ECC) were included in this case-control study. A comprehensive questionnaire that included a section on feeding history, was completed by the parent or caregiver of each participant. Based on the feeding history responses, participants were classified as either exclusively breastfed, exclusively bottle-fed, or mixed (both bottle-fed and breastfed). A supragingival plaque sample was collected from each participant and then assessed with 16S rRNA sequencing for Rothia genus and species’ relative abundances. The association between feeding practices and Rothia prevalence with ECC, accounting for confounding variables, was analyzed using multivariable logistic regressions.
Results: A low relative abundance of Rothia aeria was significantly associated with ECC (p<0.05), whereas there were no significant associations found between the relative abundance of Rothia dentocariosa or Rothia mucilaginosa with caries status (p>0.05). While the odds of association between a low relative abundance of Rothia (genus) and ECC was 1.63, this relationship failed to reach the threshold of significance (p=0.054). Feeding practices were not significantly associated with ECC after adjusting for confounding variables. However, bedtime bottle use, bedtime snacking, living in a rural/remote area, being an older age, the use of fluoridated toothpaste, and having less-educated guardians were significantly associated with ECC (p<0.05)
Conclusions: Findings in this study suggest that low relative abundances of R. aeria and Rothia (genus) are associated with ECC. Feeding practices were not key risk factors for ECC in this sample, as other factors related to the social environment and bedtime habits were more strongly associated. Since the current literature is limited, prospective studies examining Rothia and feeding practices with ECC would be beneficial to understand the causal relationship between Rothia and ECC and to help reach a consensus on the effect of different feeding practices on ECC risk.
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Keywords
early childhood caries, Rothia