Early Childhood Caries Is Causally Attributed to Developing Psychomotor Deficiency in Pre-School Children: The Resultant Covariate and Confounder Analyses in a Longitudinal Cohort Study

Chen-Yi Liang; Andy Yen-Tung Teng; Yen Chun Liu

doi:10.3390/ijerph19116831

Early Childhood Caries Is Causally Attributed to Developing Psychomotor Deficiency in Pre-School Children: The Resultant Covariate and Confounder Analyses in a Longitudinal Cohort Study

Int J Environ Res Public Health. 2022 Jun 2;19(11):6831. doi: 10.3390/ijerph19116831.

Authors

Chen-Yi Liang¹, Andy Yen-Tung Teng^{2

3}, Yen Chun Liu⁴

Affiliations

¹ Department of Childhood Education and Nursery, Chia Nan University of Pharmacy & Science, No. 60, Sec. 1, Erren Rd., Rende Dist., Tainan City 71710, Taiwan.
² Center for Osteoimmunology and Biotechnology Research (COBR), School of Dentistry, College of Dental Medicine, Kaohsiung Medical University (KMU) & KMU-Hospital, Kaohsiung City 807, Taiwan.
³ Laboratory of Molecular Microbial Immunity, Division of Periodontology, The Eastman Institute for Oral Health, School of Medicine & Dentistry, University of Rochester, Rochester, NY 14620, USA.
⁴ Center for Osteoimmunology and Biotechnology Research, Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University, No. 100, Shih-Chuan First Road, Kaohsiung City 807, Taiwan.

Abstract

Background: Causality has recently been suggested to associate early childhood caries with psychomotor deficiency in preschoolers, where their causal interactions via other risk determinants remain unclear. Methods: To analyze such causality, we randomly recruited 123 three-to-six-year-old children in a three-year longitudinal study, where the caries/dmft measures, age/gender, BMI, amended comprehensive scales for psychomotor development (CCDI-aspects), parental education/vocation, and diet were collected for assessment of their inter-relationships. Subsequently, t-tests, multiple/linear-regressions, and R2-analyses were utilized to compare the differences of variables between age/gender, BMI, and dmft vs. relationships among all variables and CCDI-aspects. Results: In the regression modeling, there were significant differences between gender vs. age (p < 0.05; not BMI) regarding established associations between caries and CCDI manifests for psychomotor deficiency. As for diet vs. socio-economic status, there were significant differences when caries/dmft were at lower- vs. higher-scales (<4 and 6−10), associated with expressive language and comprehension-concept (p~0.0214−0.0417) vs. gross-motor and self-help (p~0.0134−0.0486), respectively. Moreover, diet vs. socio-economic-status contributed significantly different CCDI-spectra via expressive language and comprehension-concept (adjusted-R2~0.0220−0.2463) vs. gross-motor and self-help (adjusted-R2~0.0645−0.0994), respectively, when the caries detected were at lower- vs. higher-scales (<4 and 6−10), in contrast to those depicted without both SES diet variables (adjusted-R2~0.0641−0.0849). Conclusion: These new findings confirm that early childhood caries is causally attributed to developing psychomotor deficiency in preschoolers, whereas biological gender/age, not BMI, may act as viable confounders during interactions, in contrast to diet and socio-economic status, via differential low−high scales of caries activity with significant interference, respectively. Collectively, ECC-psychomotor interactions may underpin some distinct biologic vs. socio-mental/psyche attributes towards different determinants for vulnerable children.

Keywords: causal interactions; confounders and co-variables; early childhood caries vs. dmft; longitudinal cohort study; pre-school kindergartners; psychomotor deficiency vs. CCDI aspects.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child
Child, Preschool
Cohort Studies
Cross-Sectional Studies
DMF Index
Dental Caries Susceptibility*
Dental Caries* / epidemiology
Dental Caries* / etiology
Humans
Longitudinal Studies
Prevalence

Grants and funding

The internal funds of the entire project for the studies were made available partly from the operating grants available at the EIOH via AYTT and a pilot project of dental hygiene promotion program at the Association for Dental Sciences, Taiwan, to YCGL, and separate internal funds available at the COBR via AYTT & YCGL.