Pediatrics and neonatology · 2026
Screen time trajectories from 18 months to 3 years and dental caries at age 3 years: a population-based cohort study in Japan.
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Yodoshi Toshifumi
Аннотация
BACKGROUND: Screen habits change rapidly in toddlerhood, but whether changes in screen exposure are associated with early childhood caries and obesity remains unclear.
METHODS: We used linked routine child health check-up records at 18 months and 3 years in Okinawa, Japan (2014-2019). Children were categorized into four screen time trajectory groups based on routine screen time at 18 months (yes/no) and screen time >1 h/day at age 3 (yes/no). The primary analysis included children with no reported screen use at age 3 years as 0 h/day (≤1 h/day). Dental caries and obesity were assessed at the 3-year check-up. Multivariable logistic regression estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI), adjusting for confounders and baseline caries or body mass index.
RESULTS: Among 71,438 children, those who newly exceeded 1 h/day between 18 months and 3 years had higher odds of dental caries at age 3 years than those who maintained low exposure (aOR 1.27; 95% CI, 1.12-1.45). Persistently high exposure was also associated with caries (1.11; 95% CI, 1.02-1.20). Findings were consistent in robustness analyses and were stronger for severe caries (aOR 1.55; 95% CI, 1.31-1.84) and caries counts (incidence rate ratio 1.29; 95% CI, 1.14-1.46). Screen time trajectory was not independently associated with obesity after accounting for baseline body mass index.
CONCLUSION: Escalation of screen time was associated with higher risk of dental caries at age 3 years. Trajectory-based monitoring at toddler health checks may support counseling to keep meals and toothbrushing screen-free.
METHODS: We used linked routine child health check-up records at 18 months and 3 years in Okinawa, Japan (2014-2019). Children were categorized into four screen time trajectory groups based on routine screen time at 18 months (yes/no) and screen time >1 h/day at age 3 (yes/no). The primary analysis included children with no reported screen use at age 3 years as 0 h/day (≤1 h/day). Dental caries and obesity were assessed at the 3-year check-up. Multivariable logistic regression estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI), adjusting for confounders and baseline caries or body mass index.
RESULTS: Among 71,438 children, those who newly exceeded 1 h/day between 18 months and 3 years had higher odds of dental caries at age 3 years than those who maintained low exposure (aOR 1.27; 95% CI, 1.12-1.45). Persistently high exposure was also associated with caries (1.11; 95% CI, 1.02-1.20). Findings were consistent in robustness analyses and were stronger for severe caries (aOR 1.55; 95% CI, 1.31-1.84) and caries counts (incidence rate ratio 1.29; 95% CI, 1.14-1.46). Screen time trajectory was not independently associated with obesity after accounting for baseline body mass index.
CONCLUSION: Escalation of screen time was associated with higher risk of dental caries at age 3 years. Trajectory-based monitoring at toddler health checks may support counseling to keep meals and toothbrushing screen-free.