Factors Associated with Increased Caries Risk in Children of Immigrant Parents

Goran Dahllof1, Fernanda Cuhna Soares1, Anders Hjern2, Annika Julihn1
1 Dental Medicine, Karolinska Institutet, Stockholm, Sweden
2 Clinical Epidemiology, Department of Medicine and Centre for Health Equity Studies, Karolinska Institutet, Stockholm, Sweden

Background: Children to parents with an immigrant background have a significantly higher caries experience and recent studies show that fluoride based preventive program in high risk populations are not effective.

Aim: The hypothesis to be tested in this study is that the prevalence of dental caries is associated with parents’ country of origin and that socioeconomic background factors, maternal health behaviors and adverse birth outcomes can explain these differences.

Design: This register-based cohort study included all children born between 2000 and 2003 and who were residing in Stockholm County, Sweden. Oral examinations were done at age 3 years (n = 74,748) at age 7 years (n=73,658) or both. Data on socioeconomic conditions, maternal health, maternal health behaviors, and birth outcomes were extracted from Swedish national registries. structured equation modeling (SEM) was performed to test relationship between country of birth of the mother (rich and poor countries) and increase deft, and, additionally, if this association was mediated by socioeconomic factors and pre and perinatal conditions.

Results: 7-year-old children who had the highest increase in deft had more often mothers with immigrant background (p<0.001). The increased caries experience in children with immigrant mothers was also mediated by socioeconomic and maternal factors such as family income, number of children in the family, maternal age at delivery and maternal obesity during pregnancy as well as being small for gestational age and the child having a health condition. Conclusion: There was an accumulation of socioeconomic and maternal factors in children to immigrant mothers. Preventive program must acknowledge these factors and give long-term support for disease prevention.

Goran Dahllof