Socio-behavioral associates of Early Childhood Caries among preschool children aged three to four years in Gampaha district, Sri Lanka: A cross sectional study

Abstract Background Early Childhood Caries (ECC) is a highly prevalent disease among preschoolers in Sri Lanka, and its prevalence has stagnated over the decades. Therefore, it is important to determine the socio-behavioural associations of ECC among preschoolers to reduce the country’s ECC burden. Methods A cross-sectional study using a multistage cluster sampling technique with a probability proportionate to size sampling was conducted to select three- to four-year-old preschoolers to determine the socio-behavioural associations of ECC among three to four-year-old preschoolers in the Gampaha district. Results The prevalence of ECC was 56.3% (95% CI: 53.1–59.3). Below mentioned factors were significantly associated with ECC. Consuming sweets between meals had a higher odds ratio compared to consuming sweets after main meals (OR = 1.72, 95% CI:1.25–2.35), consumption of sweets every day had a higher odds ratio compared to consumption of sweets several times a week or less (OR = 2.89, 95% CI: 2.02–4.13), consumption of sweetened drinks every day had a higher odds ratio compared to consumption of sweetened drinks several times a week or less (OR = 1.73, 95% CI: 1.07–2.79), and the presence of maternal caries had a higher odds ratio compared to the absence of maternal caries (OR = 1.74, 95% CI: 1.12–2.69). The use of adult fluoridated toothpaste compared to not using adult fluoridated toothpaste (OR = 0.64, 95% CI:0.48–0.85), tooth brushing twice per day compared to not brushing twice per day (OR = 0.67, 95% CI:0.51–0.89), and supervised toothbrushing compared to not supervised toothbrushing (OR = 0.61, 95% CI: 0.41–0.93) were negatively associated with ECC. Conclusions ECC is highly associated with sweet consumption patterns and oral hygiene behaviours among preschoolers in Gampaha District. Therefore, interventions should focus on the oral health behaviours of preschoolers to reduce their ECC burden.