Fewer Children in Families Associated with Lower Odds of Early Childhood Caries: A Sample from Three Countries

Childhood caries experience is influenced by family characteristics and oral health practices in the context of many social-commercial determinants. The aim of this study was to explore the relationship between families’ number of children, oral health practices and child caries experience in a convenience sample of 1374 children aged 6 months through 6 years and their families from Ecuador, Nepal, and Vietnam. Data were collected by mother interviews and child dental exams. Multivariate logistic and Zero-Inflated-Poisson regression analyses assessed associations between number of children, oral health practices and decayed, missing or filled teeth (dmft). Families had a mean of 2.2 children (range 1–12); 72% of children had tooth decay, with mean dmft of 5.4. Adjusting for child age, sex, and urban/rural location, a greater number of children in the family was associated with significantly less likelihood of unhealthy bottle feeding practices, having a toothbrush/toothpaste and parent helping child brush, and being cavity-free; higher number of dmft, and greater likelihood of having a dental visit. Early childhood oral health promotion should include focus on oral hygiene and healthy feeding—particularly breastfeeding and healthy bottle feeding practices—as well as access to family planning services and support for childcare.