J Dent Res Dent Clin Dent Prospects. 2019;13(1):43-50.
doi: 10.15171/joddd.2019.007
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Original Research

Evaluation of parents’ views about etiologic factors of severe early childhood caries: A qualitative study

Arian Hesam Arefi 1, Hoda Shamsaddin 2, Mojgan Balvardi 3, Hamidreza Poureslami 4 * , Masumeh Danesh 4, Mahsa Sayadizadeh 4

1 Department of Orthodontics, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
2 Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
3 Kerman Social Determinants on Oral Health Research Center & Oral and Dental Diseases Research Center & Department of Pediatric Dentistry, Faculty of Dentistry, Kerman University of Medical Science, Kerman, Iran
4 Department of Pediatric Dentistry, Faculty of Dentistry, Kerman University of Medical Science, Kerman, Iran


Background. Severe early childhood caries (S-ECC) is a rapid form of dental caries that firstly affects primary upper incisors of children less <3 years of age and can cause interference in child’s health by pain, nutritional deficiencies and sleep disorders. It seems there are many unknown factors in the etiology as well as progression of S-ECC. The aim of this study was to assess parents' views in this relation.

Methods. In this qualitative study parent’s views and their 1‒3-year-old children were studied when they visited pediatric medical clinics in Kerman. After cleaning the children teeth and examination of them to discover caries, they were placed in 2 groups with or without S-ECC. Then each parent was interviewed separately and their comments were collected and studied. Examinations and interviews continued with parents until they did not express anything new.

Results. Parents of children without S-ECC had better understanding about S-ECC related factors than parents of children with S-ECC and greater number of them (without significant differences) expressed known reasons for occurrence of S-ECC. There were differences among known reasons and proposed reasons mostly in parents of children with S-ECC, although the differences were not significant. Maternal stress and amount of breast milk’s lactose were factors that were reported by some parents while there were unknown factors related to the etiology of S-ECC. Furthermore, no parents mentioned factors like saliva or mode of delivery.

Conclusion. The most important achievement of the study was the attention of some parents to the role of their chronic stress in the occurrence of S-ECC. Another important consideration was that none of the parents mentioned the important role of the quality and quantity of saliva in preventing S-ECC, which should be promoted in the community

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Submitted: 02 Sep 2018
Accepted: 05 Feb 2019
First published online: 08 May 2019
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