Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study

Barroso, Heloísa Helena; Mourão, Priscila Seixas; Gomes, Rafaela Lopes; Almeida, Maria Tereza Pereira de; Silva, Thaís Santos; Ramos-Jorge, Joana; Ramos-Jorge, Maria Letícia; Fernandes, Izabella Barbosa

doi:10.1590/1806-93042021000100012

Heloísa Helena Barroso

Departamento de Odontologia. Universidade Federal dos Vales do Jequitinhonha e Mucuri. Campus I. Rua da Glória, 187. Centro. Diamantina, MG, Brasil.

https://orcid.org/0000-0003-4746-8244

Priscila Seixas Mourão

Departamento de Odontologia. Universidade Federal dos Vales do Jequitinhonha e Mucuri. Campus I. Rua da Glória, 187. Centro. Diamantina, MG, Brasil.

https://orcid.org/0000-0002-5309-9249

Rafaela Lopes Gomes

Departamento de Odontologia. Universidade Federal dos Vales do Jequitinhonha e Mucuri. Campus I. Rua da Glória, 187. Centro. Diamantina, MG, Brasil.

https://orcid.org/0000-0002-8775-730X

Maria Tereza Pereira de Almeida

Departamento de Odontologia. Universidade Federal dos Vales do Jequitinhonha e Mucuri. Campus I. Rua da Glória, 187. Centro. Diamantina, MG, Brasil.

https://orcid.org/0000-0001-5204-8207

Thaís Santos Silva

Departamento de Odontologia. Universidade Federal dos Vales do Jequitinhonha e Mucuri. Campus I. Rua da Glória, 187. Centro. Diamantina, MG, Brasil.

https://orcid.org/0000-0002-8000-3337

Joana Ramos-Jorge

Departamento de Saúde Bucal da Criança e do Adolescente. Faculdade de Odontologia. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil.

https://orcid.org/0000-0003-1906-3784

Maria Letícia Ramos-Jorge

Departamento de Odontologia. Universidade Federal dos Vales do Jequitinhonha e Mucuri. Campus I. Rua da Glória, 187. Centro. Diamantina, MG, Brasil.

https://orcid.org/0000-0001-8495-9259

Izabella Barbosa Fernandes

Departamento de Saúde Bucal da Criança e do Adolescente. Faculdade de Odontologia. Universidade Federal de Minas Gerais. Belo Horizonte, MG, Brasil.

https://orcid.org/0000-0003-4869-9925

E-mail : priscila.smourao@gmail.com

Author's contribution

Barroso HH, Mourão PS and Ramos-Jorge J participated in the elaboration and critical review of the study's intellectual content. Gomes RL, Almeida MTP, Silva TS performed research planning, study design, acquisition and analysis of study data, bibliographic research. Ramos-Jorge ML and Fernandes IB are responsible for all aspects of the study and writing of the article. All authors approved the final version the article.

Variables	Follow-ups		Dropouts		Cohen's effect size^ Effect size based on Cohen's w: 0.1 for small; 0.3 for medium; 0.5 for large.	p ^* * Chi-square test;
Variables	n	%	n	%		p ^* * Chi-square test;
Mother's schooling (years)					0.030	0.729
≥13	47	35.6	2	33.3
10-12	72	54.5	3	50.0
0-9	13	9.9	1	16.7
Father's schooling (years)					0.036	0.670
≥13	32	24.2	1	16.7
10-12	63	47.7	3	50.0
0-9	37	28.0	2	33.3
Family income (minimum wage)					0.038	0.660
≥2	56	42.4	2	33.3
< 2	76	57.6	4	66.7
Dependent on family income (individuals)					0.009	0.916
1 to 3	41	31.1	2	33.3
4 or 5	68	51.5	3	50.0
6 or more	23	17.4	1	16.7
Family structure					0.039	1.000
Nuclear	78	73.6	5	83.3
Non-nuclear	28	26.4	1	16.7
Gender					0.022	1.000
Female	73	55.3	3	50.0
Male	59	44.7	3	50.0
Age (years old)					0.016	0.851
2	83	62.9	4	66.7
3	49	37.1	2	33.3
Sugar consumption					0.012	1.000
Low consumption	70	53.0	3	50.0
High consumption	62	47.0	3	50.0
Supervised brushing					0.008	1.000
Yes	108	81.8	5	83.3
No	24	18.2	1	16.7
Dental caries					0.041	0.633
Absence of caries	59	44.7	3	50.0
Initial caries	36	27.3	2	33.3
Established/severe caries	37	28.0	1	16.7

	Incidence of severe caries				p ^* * Chi-square test;
	No		Yes
	n	%	n	%
Socioeconomic variables
Mother's schooling at baseline (years)					0.062^* * Chi-square test;
≥ 13	37	78.7	10	21.3
10-12	43	59.7	29	40.3
0-9	8	61.5	5	38.5
Father's schooling at baseline (years)					0.107^* * Chi-square test;
≥ 13	26	81.3	6	18.8
10-12	39	61.9	24	38.1
0-9	23	62.2	14	37.8
Family income at baseline (minimum wages)					0.059^* * Chi-square test;
≥2	42	75.0	14	25.0
< 2	46	60.5	30	39.5
Dependent on family income at baseline (individuals)					0.031^* * Chi-square test;
1 to 3	25	61.0	16	39.0
4 or 5	42	61.8	26	38.2
6 or more	21	91.3	2	8.7
Family structure at baseline					0.011^* * Chi-square test;
Nuclear	72	72.7	27	27.3
Non-nuclear	16	48.5	17	51.5

Characteristics of the child
Gender					0.173^* * Chi-square test;
Female	45	61.6	28	38.4
Male	43	72.9	16	27.1
Age at baseline (months)
Average (DP)	33.3 (8.6)		37.9 (10.3)		0.014^ Mann-Whitney Test.

Child's habits
Breastfeeding duration (months)					<0.001^* * Chi-square test;
Up to 24	55	83.3	11	16.7
More than 24	33	50.0	33	50.0
Bottle duration (months)					0.448^* * Chi-square test;
Up to 24	52	64.2	29	35.8
More than 24	36	70.6	15	29.4
Sugar consumption at baseline					0.388^* * Chi-square test;
Low consumption	49	70.0	21	30.0
High consumption	39	62.9	23	37.1
Supervised brushing at baseline					0.632^* * Chi-square test;
Yes	73	67.6	35	32.4
No	15	62.5	9	37.5
Clinical factors					<0.001^* * Chi-square test;
Dental caries at baseline
Absence of caries	50	84.7	9	15.3
Initial caries	23	63.9	13	36.1
Established/severe caries	15	40.5	22	33.3

Variables	N	%	Unadjusted RR (CI95%)	p	Model 1 RR (CI95%)	p	Model 2 RR (CI95%)	p	Model 3 RR (CI95%)	p	Model 4 RR (CI95%)	p
Socioeconomic factors

Mother's schooling at baseline (years)												NS
≥ 13	47	35.6	1		1
10-12	72	54.5	1.89 (1.02-3.51)	0.043	1.31 (0.60-2.86)	0.496
0-9	13	9.8	1.80 (0.74-4.36)	0.188	1.27 (0.46-3.52)	0.650
Father's schooling at baseline (years)												NS
≥ 13	32	24.2	1		1
10-12	63	47.7	2.03 (0.92-4.46)	0.077	1.53 (0.63-3.67)	0.345
0-9	37	28.0	2.01 (0.87-4.63)	0.098	1.34 (0.48-3.72)	0.579
Family income at baseline				0.093		0.669						NS
≥2	56	42.4	1		1
< 2	76	57.6	1.57 (0.92-2.68)		1.15 (0.61-2.14)
Dependent on family income at baseline (individuals)												NS
1 to 3	41	31.1	1		1		1
4 or 5	68	51.5	0.98 (0.60-1.59)	0.935	1.04 (0.64-1.67)	0.881	0.99 (0.61-1.59)	0.990
6 or more	23	17.4	0.22 (0.05-0.88)	0.033	0.25 (0.06-0.94)	0.041	0.07 (0.07-1.01)	0.266
Family structure at baseline				0.007		0.009		0.003		0.005		0.014
Nuclear	99	75.0	1		1		1		1		1
Non-nuclear	33	25.0	1.88 (1.19-2.99)		1.83 (1.16-2.88)		1.97 (1.26-3.08)		1.89 (1.21-2.96)		1.73 (1.11-2.69)

Child's characteristics
Gender				0.182				0.177				NS
Female	73	55.3	1				1
Male	59	44.7	0.70 (0.42-1.17)				0.72 (0.44-1.16)
Age at baseline (months)
Average (DP)	34.9 (9.5)		1.03 (1.01-1.05)	0.004			1.03 (1.01-1.05)	0.008	1.02 (0.99-1.04)	0.153		NS
Child's habits

Breastfeeding duration (months)				< 0.001						0.002		0.008
Up to 24	66	50.0	1						1		1
More than 24	66	50.0	3.00 (1.66-5.41)						2.62 (1.42-4.84)		2.24 (1.23-4.08)
Bottle duration (months)				0.455
Up to 24	81	61.4	1
More than 24	51	38.6	0.82 (0.49-1.37)
Sugar consumption at baseline				0.389
Low consumption	70	53.0	1
High consumption	62	47.0	1.23 (0.76-2.00)
Supervised brushing at baseline				0.624
Yes	108	81.8	1
No	24	18.2	1.15 (0.64-2.07)

Clinical factors

Dental caries at baseline
Absence of caries	59	44.7	1								1
Initial caries	36	27.3	2.36 (1.12-4.97)	0.023							2.14 (1.06-4.31)	0.032
Caries established/severe	37	28.0	3.89 (2.01-7.52)	<0.001							2.74 (1.37-5.49)	0.004

Breastfeeding up to 24 months (reference) x Breastfeeding for more than 24 months	RR (CI95%)	p
Unadjusted	3.00 (1.66-5.41)	≤0.001
Adjusted for sex	2.94 (1.63-5.31)	≤0.001
Adjusted for age	2.69 (1.43-5.07)	0.002
Adjusted for mother's schooling	2.83 (1.53-5.22)	≤0.001
Adjusted for father's schooling	2.81 (1.49-5.30)	0.001
Adjusted for family income	2.86 (1.53-5.34)	0.001
Adjusted for dependent on family income	2.93 (1.66-5.19)	≤0.001
Adjusted for family structure	2.97 (1.67-5.28)	≤0.001
Adjusted for tooth brushing	3.04 (1.68-5.51)	≤0.001
Adjusted for bottle	3.01 (1.65-5.49)	≤0.001
Adjusted for sugar consumption	3.05 (1.72-5.42)	≤0.001
Adjusted for dental caries at baseline	2.27 (1.23-4.21)	0.009
Adjusted for all variables	2.17 (1.21-3.88)	0.009

[1] E-mail : priscila.smourao@gmail.com

Brasil

Brasil

Influence of breastfeeding duration on the incidence of dental caries in preschoolers: a cohort study

Abstract

Objectives:

Methods:

Results:

Conclusion: