CONTEXT: Early childhood caries (ECC) remains a major public health concern in India, with feeding-at-sleep behaviors recognized as important behavioral risk factors. The feeding at sleep time (FeAST) scale was developed to quantify such behaviors, but its applicability across diverse Indian sociocultural settings remains uncertain. AIMS: To evaluate the external validity of the FeAST scale in identifying ECC risk among 12-36-month-old toddlers in Bhubaneswar, Odisha, and to examine the association between socioeconomic status and ECC. SETTINGS AND DESIGN: A hospital-based cross-sectional study conducted in a tertiary care teaching hospital in Bhubaneswar, Eastern India. MATERIALS AND METHODS: A total of 387 toddlers aged 12-36 months and their caregivers were recruited. Feeding behaviors were assessed using the original FeAST questionnaire, generating scores for combined breastfeeding (CBR), combined bottle-feeding (CBO), and other feeding constructs (OFC). ECC status was determined through oral examination. SES was classified using the updated B. G. Prasad Scale (2025). STATISTICAL ANALYSIS: Receiver operating characteristic analysis with a minimal cutoff score was used to determine diagnostic accuracy. Chi-square test assessed associations between ECC and SES. Statistical significance was set at P < 0.05. RESULTS: ECC prevalence was 32.9%. CBR (AUC = 0.446) and CBO (AUC = 0.481) demonstrated poor discriminatory ability, while OFC showed modest performance (AUC = 0.577). No significant association was found between ECC and SES ( P = 0.511). CONCLUSIONS: The FeAST scale demonstrated limited diagnostic validity in this Eastern Indian cohort, indicating the need for regional recalibration incorporating contextual feeding and oral hygiene behaviors.
Taraphder et al. (2026) studied this question.