Child temperament and early childhood caries: is there a link?

A systematic search was conducted across multiple databases (MEDLINE via PubMed, EMBASE, Scopus, LILACS, Web of Science, and EBSCO) up to January 2023. Any case-control, cohort, or cross-sectional study which assessed child temperament and early childhood caries (ECC) in children aged six years or younger were included. Literature reviews, studies with insufficient data, non-English publications, and those focusing on older children or adults were excluded. Data extraction was conducted independently by two authors, with a third author resolving any disagreements. Risk of bias was assessed using the Newcastle-Ottawa assessment scale (case-control and cohort studies) and the Appraisal tool for Cross-Sectional Studies (cross-sectional studies). The quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Statistical analysis to evaluate heterogeneity included the chi-square test and the I-square index. A total 5072 studies resulted in the inclusion of 15 studies, encompassing data from 6,667 participants. Seven studies were of high quality and eight, moderate. Meta-analyses of seven studies revealed a significant association between certain temperament traits (e.g., higher levels of emotionality and lower levels of sociability) and ECC. In particular, difficult temperament was associated with ECC (OR 2.63 95%CI: 1.37–5.04) The study concluded that child temperament is a significant factor in the risk of developing ECC. Specifically, children with higher emotionality and lower sociability are at greater risk. Interventions targeting child temperament through child behaviour and parental management strategies may be effective in reducing ECC.