Early Childhood Caries in Preschool Children: A Multidimensional Analysis From Biological Mechanisms to Socioecological Interventions.

OBJECTIVE

To analyze the "technology-disease burden paradox" of early childhood caries (ECC)-its rising global prevalence despite preventive advances-by examining multidimensional factors from biological mechanisms to socioecological interventions.

METHODS

This narrative review synthesized evidence from epidemiological, biological, behavioral, and policy studies (2010-2024) identified through systematic searches in PubMed, Web of Science, and Scopus. Inclusion criteria focused on children under 6 years of age and English-language studies reporting etiology, risk factors, or interventions.

RESULTS

ECC prevalence exceeds 60% in many low- and middle-income countries, versus < 40% in high-income settings. Key findings include: synergistic enamel demineralization by S. mutans and Candida (OR = 1.67); behavioral risks such as nocturnal feeding (OR = 3.54) and screen time > 2 h/day (↑60% caries); and effective policy interventions like fluoride varnish (42% reduction in caries) and sugar taxes.

CONCLUSIONS

Controlling ECC requires integrating the Socioecological Model with Sustainable Development Goals, prioritizing equity-focused upstream policies and interdisciplinary collaboration (e.g., dentistry and data science). The "Zero-Caries Childhood" vision must shift from disease management to health promotion, incorporating emerging environmental considerations.