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.