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In researching the effects of ECC on sociability four research articles were reviewed, analyzed on recorded: Acharya and Tandon (2011) ‘The effect of early childhood caries on the quality of life of children and their parents’, Bramantoro et. al. (2015) ‘The Patterns of Dental Caries Influence on the Children’s Quality of Life Aged 3-5 Years Based on the Socioeconomic Characteristics’, Jabin and Chaudhary (2014) ‘Association of Child Temperament with Early Childhood Caries’ and de Oliveira et. al. (2017) ‘Behavior Factors and Temperament in Children with and without Early Childhood Caries: A Comparative.
All four studies done were cross-sectional studies. Acharya and Tandon assessed the effect of Early Childhood Caries (ECC) on Quality Of Life (QOL) of children and their parents, conducted in the Department of Pedodontics and Preventive Dentistry, Manipal College of Dental Sciences. A total of 500 children–parent pairs were selected from various schools and Anganwadis in and around Manipal (Karnataka) and Bhubaneswar (Orissa). The study population was divided into two groups: Group I (Bhubaneswar) and Group II (Manipal group), consisting of 250 subjects each. Bramantoro et al. analyzed the patterns of dental caries and its influence on the children’s quality of life aged 3-5 years based on the socioeconomic characteristics of their mother in Mojokerto Indonesia. This research was conducted in Puskesmas Wates Mojokerto and involved children aged 3-5 years as well as their mother. In total, this research involved 309 children and their mothers. The studies conducted by Jabin and Chaudhary and de Oliveira et al. both looked at ECC and its effects on temperament. Jabin and Chaudhary assessed the association of child temperament with early childhood caries in preschool children of Moradabad city, India, in children from 3-6 years of age in educational setting. Ten schools of Moradabad City were randomly selected from the list to make the sample of 1300 children aged 3 - 6 years attending preschool and their parents were included in the study. While, de Oliveira et al. carried out their study with a convenience sample composed of 120 children of both gender aged two to five years and their respective mothers, divided into two groups, Group 1:60 children without ECC and Group 2:60 children with ECC. The children were selected among the patients attending the same Children’s Dental Clinic in a public health service, who presented as following inclusion criteria: gestational age ≥ 37 weeks; birth weight ≥ 2.500; children who were born and lived in the city since birth; complete mental and physical health, and mothers with similar age (≥ 24 years), educational and socioeconomic levels.
In the study conducted by Archarya and Tandon, target population was children below 71 months of age, with a mean of 51.184 months (Group I) and 52.948 months (Group II). The mean dmft was 5.4240 and the dmfs was 8.0120 in Group I, whereas the mean dmft was 6.0120 and dmfs was 9.8600 in Group II. The use of questionnaires gathered data in relation to the QOL for both the parents and the child. It included physical, psychological and social aspects of QOL. The study revealed that 11.2% children in Group I and 10.8% children in Group II were teased by friends. While the study conducted by Bramantoro et al. the data obtained showed that the average number of teeth suffering from dental caries in those children was seven (7.848; SD = 5.032). It is also known that the average of the children’s quality of life was high enough or close to the maximum value (1.624; SD = 0.338). The results obtained from this study shows that the number of dental caries had a considerable effect on the children’s quality of life aged 3-5 years. It can be seen from the data that more than 50% of the dynamics occurred on the children’s quality of life aged 3-5 years can be explained by the number of dental caries. The influence coefficient obtained was greater than 0.7.
Jabin and Chaudhary’s issued child temperament questionnaires where temperament was assessed based on three variables approach withdrawal, adaptability and threshold of responsiveness. Mean score of these three variables were summed to give the sociability score. The range of possible scores was 3-15. High scores on this would indicate that the child is quite responsive to the environment, adjustable, adaptable and uninhibited. The results showed that children with caries were found less social (48.6%) as compared to non-carious groups (50.5%). The difference was statistically significant (p ≤ 0.005) in all the three components of sociability namely approach, adaptability and threshold of responsiveness. Adaptability segment of sociability has most obvious difference (p = 0.002). Children with caries were found to be less sociable, moderately emotional, less energetic, and highly distractible and are less rhythmic. This means the study population demonstrated high preference for being alone than in company, shows moderate crying/ tantrums, low rates of speaking and moving, have fleeting attention and possess irregular biological functions. De Oliveira et al. also applied a questionnaire in order to obtain data about mother (status marital and employment), family (parents’ live together, monthly household income and number of people in residence) and child (age, number of siblings, birth position, diet and oral hygiene habits, use of dental floss and temperament). Six choices of temperament were given to mothers and were asked to choose the most applicable to child: (1) calm; (2) fussy; (3) crying; (4) demanding; (5) stubborn; (6) other. The temperament of the child was classified as easy if the mother chose the option (1) or difficult if she chose the options (2), (3), (4) or (5). When the mother’s choice was (6), the child was classified by the researcher’s judgment. For example, if a mother answered happy, she was classified as easy. On the other hand, is a mother answered grumpy, she was classified as difficult.
Acharya and Tandon (2011), Bramantoro et al. (2015) and Jabin and Chaudhary (2014) studies all concluded that there is opposite relation between ECC and the children’s sociability. However, Oliveira et al. (2017) results are in disagreement with other studies, there was no difference regarding the temperament of children with and without caries. The researchers identified a few limitations with the research such as the selection and sample size, the selected sample was of convenience and compared. They further mentioned that despite the small sample size, the mothers and the children presented similar characteristics considered as risk factors related to ECC. Mother’s age, socioeconomic and educational levels were similar between the groups. In addition, the children presented characteristics similar to birth, age group and access to dental care from the first appointment in a public service. Considering that these children showed population determinants at risk for ECC, this study evaluated and compared behavioral risk factors and temperament among children with and without ECC.
The world health organization acknowledged the social impact of dental caries resulting in restricted school, home activities and loss of millions of school hours annually. The American dental association identifies that early childhood Caries is a significant public health problem in deprived communities, and is also found throughout the general child population. Early childhood Caries is five times as frequent as asthma and seven times as common as hay fever.
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