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J Contemp Dent Pract. 2010 Oct 14;11(5):001-8.

The prevalence and risks of early childhood caries (ECC) in Toronto, Canada.

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To determine the prevalence and risks of early childhood caries (ECC) among children less than 71 months of age in Toronto, Canada, and to evaluate the association between parental/caregiver depression and ECC.


A secondary analysis of data previously collected by the Toronto Public Health as part of the 2003 Toronto Perinatal and Child Health Survey was performed. The 90-item survey was conducted over the telephone to 1,000 families with children from zero years (birth) to six years of age. Parents/caregivers were asked about factors related to the development and health of their children. For this study, only children younger than six years of age (less than 71 months) were included (n=833). The primary outcome of interest was self-reported and measured by the response to the question of whether a physician/dentist had ever told the parent/caregiver his/her child had ECC.


The prevalence of ECC was 4.7 percent (37 of 791 children). The child's age, his/her history of dental visits, teeth brushing, the use of fluoridated toothpaste, the parent's/caregiver's depressive tendencies, the language spoken at home, and the household annual income were all significant in the bivariate analysis. Multiple logistic regression identified four factors associated with ECC: the child's age (being three years of age or older), having at least one parent/caregiver with depression, not speaking English at home, and having an annual household income less than $40,000 in Canadian dollars (CAD).


While a child's age, home language, and household income are known risks for ECC, the finding that parental/caregiver depression may be related to ECC is new.


Multiple risk factors are involved in the development of early childhood caries. Of particular importance are demographic (e.g., child's age), social (e.g., annual household income), and psychosocial factors (e.g., parental/caregiver depression) that are indirectly linked to ECC. More attention needs to be placed on understanding the role and process by which these factors influence the development of ECC.

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