Evaluation of the frequency of two effective factors in severe early childhood caries (SECC), (vitamin D deficiency and smoking parents) among children referred to Tabriz Dental Faculty Hospital during the years 2021 to 2022

Abstract

Introduction: Dental caries is one of the most common chronic infectious and multifactorial childhood diseases worldwide, and its complications are one of the greatest challenges in dentistry. Various studies have shown that vitamin D deficiency and parents' smoking can play a role as two influential factors in the development of S-ECC, and considering that in Iran, both factors mentioned above have a high prevalence, it is necessary to determine the relationship between them and S-ECC. Methods and Materials: This study was conducted on all children under 36 months suffering from S-ECC referred for dental treatments under general anesthesia in 2021-2022. In total, 445 patients were included in the study, and the children were categorized by considering each variable and evaluated. Firstly, we conducted descriptive analyses to summarize the distribution of vitamin D levels, parents' smoking status, and age categories. Frequencies and percentages were calculated to present the distribution of these variables. A contingency table analysis was performed to explore the association between vitamin D levels and parents' smoking status. The chi-squared test was used to assess the independence between these categorical variables. Similarly, the relationship between vitamin D levels and age categories was investigated using contingency table analysis. Furthermore, we conducted a log-linear model to examine the three-way association among age categories, parents' smoking status, and vitamin D levels to obtain deviance values, degrees of freedom, and p-values associated with each variable and their interactions. In addition, Bayesian analyses were performed to provide a more comprehensive understanding of the relationships. Bayesian contingency table tests were applied to explore associations between vitamin D levels and parents' smoking status and between vitamin D levels and age categories. Bayesian log-linear regression models were also utilized to examine the complex relationships between these variables. All statistical analyses were performed with a significance level set at alpha=0.05, and the results were interpreted based on this threshold. The use of JASP 17 software facilitated a robust and detailed analysis of the dataset, enhancing the validity of the findings presented in this study. Results: According to chi-squared tests, in children with severe early childhood caries, there was no statistically significant relationship between vitamin D levels and parents' smoking status, but the relationship between age groups and vitamin D levels was highly significant. According to the log-linear model, parental smoking status, age category, and vitamin D levels impacted the model, and what is important is that the interaction between age category and vitamin D levels was highly significant, indicating their combined effect. According to Bayesian analysis, the Bayesian contingency tables suggest evidence in favor of an association between vitamin D levels and parents' smoking status. The Bayesian analysis enhanced our comprehension of the potential relationship between age categories and vitamin D levels within the dataset. This report delved into Bayesian log-linear regression models for exploring relationships between variables within the dataset. Model comparison between two models: The analysis indicated strong evidence in favor of this model: Parental smoking + age cat + vitamin D levels + age cat *vitamin D levels Conclusion: The present study showed that parents' smoking, vitamin D levels, and age category affected the model. Also, in children with severe early childhood caries, there was no significant relationship between vitamin D levels and parents' smoking, but the relationship between age category and vitamin D levels was highly significant.