Biological and behavioral determinants of early childhood caries: Recent evidence

Authors

DOI:

https://doi.org/10.33448/rsd-v15i1.50498

Keywords:

Early childhood caries, Saliva, Cariogenic diet, Oral microbiome, Pediatric dentistry.

Abstract

Introduction: Early Childhood Caries (ECC) is a multifactorial condition resulting from the interaction of biological, behavioral, dietary, and microbiological factors. Changes in salivary pH, flow rate, and buffering capacity directly influence the balance between enamel demineralization and remineralization, thereby modulating disease risk. In parallel, diets rich in sucrose favor the acid metabolism of Streptococcus mutans and Lactobacillus spp., the main bacteria associated with caries. This article aims to compile and analyze recent evidence on the biological (saliva, pH, buffering capacity, microbiome) and behavioral (diet, hygiene, habits) determinants involved in ECC, highlighting their implications for clinical practice in Pediatric Dentistry. Methodology: This review brings together recent studies that investigate the biological and behavioral determinants of early childhood caries, emphasizing the role of saliva, the oral microbiome, and diet as central factors in the etiology of the disease. Results and Discussion: The results of this review confirm that early childhood caries is a multifactorial condition arising from the dynamic interaction between biological, behavioral, and environmental factors. Findings related to salivary pH, buffering capacity, salivary flow, cariogenic diet, and the microbiome show significant consistency with what has been widely discussed in the international literature. Final Considerations: It is concluded that understanding the determinants of early childhood caries is essential for clinical practice in Pediatric Dentistry. The literature analyzed indicates that reducing caries prevalence depends primarily on early, educational interventions capable of modifying behaviors and restoring the ecological balance of the oral cavity.

References

Barros, R. N. de. (2021). Saúde mental de estudantes universitários: o que está acontecendo nas universidades? (Dissertação de Mestrado, Universidade Federal da Bahia).

Bowen, W. H., & Koo, H. (2011). Biology of Streptococcus mutans–derived glucans in dental biofilm formation. Journal of Dental Research, 90(12), 1393–1397.

Bueno, C. H. R., & Castro, M. L. (2020). Consequências do estresse na saúde bucal: revisão de literatura. Revista Científica.

Cruz, M. C. F. N., et al. (2008). Condições bucais relacionadas ao estresse: revisão dos achados atuais. Revista da Faculdade de Odontologia de Porto Alegre, 49(1), 25–30.

De Jesus, C. B. D. (2023). Manifestações orais associadas ao estresse, ansiedade e depressão em estudantes universitários (Trabalho de Conclusão de Curso, Universidade Estadual de Londrina).

Fejerskov, O., & Kidd, E. (2015). Dental caries: The disease and its clinical management (3rd ed.). Wiley-Blackwell.

Fernandes, M. M., et al. (2016). Avaliação nutricional da alimentação escolar e sua relação com riscos para cárie dentária. Revista de Nutrição, 29(2), 235–245.

Ferreira, I. V., et al. (2022). Relação entre a recorrência do herpes simples e o estresse durante a pandemia. HU Revista, 48(3), 1–7.

Fung, K., et al. (2017). Oral health and salivary characteristics in children with Down syndrome. Pediatric Dentistry, 39(3), 173–179.

Gross, E. L., et al. (2012). Bacterial 16S sequence analysis of severe early childhood caries. Journal of Clinical Microbiology, 50(9), 3032–3040.

Hegde, A. M., et al. (2014). Oral findings in children with Down syndrome. Journal of Clinical Pediatric Dentistry, 38(3), 235–239.

Humphrey, S. P., & Williamson, R. T. (2001). A review of saliva: Normal composition, flow, and function. Journal of Prosthetic Dentistry, 85(2), 162–169.

Lázaro, A., et al. (2021). Salivary pH and buffering capacity in children with early childhood caries. Journal of Clinical Pediatric Dentistry, 45(1), 1–7.

Lemos, L. V., et al. (2020). Prevalência e fatores associados à cárie precoce na infância em populações vulneráveis. Ciência & Saúde Coletiva, 25(9), 3473–3482.

Marsh, P. D. (2006). Dental plaque as a biofilm and a microbial community: Implications for health and disease. BMC Oral Health, 6(Suppl 1), S14–S20.

Milgrom, P., et al. (2011). Early childhood caries: A team approach to prevention and management. Journal of Public Health Dentistry, 71(Suppl 1), S109–S111.

Pachori, Y., et al. (2018). Evaluation of salivary pH changes after consumption of sugary snacks. International Journal of Pediatric Dentistry, 28(4), 300–306.

Ribeiro, C. C. C., & Cury, J. A. (2000). Teores de sacarose de alimentos e sua relação com o potencial cariogênico. Revista da Associação Paulista de Cirurgiões-Dentistas, 54(5), 391–395.

Tannoff, B., & Reisine, S. (2009). Update on early childhood caries. Pediatrics, 124(6), 276–288.

Tanner, A. C. R., et al. (2018). Microbiota in early childhood caries: The complex interplay of bacteria associated with early childhood caries. Journal of Dental Research, 97(3), 302–313.

Fenandes, J. M. B., Vieira, L. T. & Castelhano, M. V. C. (2023). Revisão narrativa enquanto metodologia científica significativa: reflexões técnico-formativas. REDES – Revista Educacional da Sucesso. 3(1), 1-7. ISSN: 2763-6704.

Pereira, A. S. et al. (2018). Metodologia da pesquisa científica. [free ebook]. Santa Maria. Editora da UFSM.

Rother, E. T. (2007). Revisão sistemática x revisão narrativa. Acta Paulista de Enfermagem. 20(2), 5-6.

Snyder, H. (2019). Literature review as a research methodology: An overview and guidelines. Journal of Business Research, Elsevier. 104(C), 333-9. Doi: 10.1016/j.jbusres.2019.07.039.

Pitts, N., Baez, R., Diaz-Guallory, C., et al. (2019). Early childhood caries: IAPD Bangkok Declaration. International Journal of Paediatric Dentistry, 29(3), 384–386.

Published

2026-01-14

Issue

Section

Health Sciences

How to Cite

Biological and behavioral determinants of early childhood caries: Recent evidence. Research, Society and Development, [S. l.], v. 15, n. 1, p. e3115150498, 2026. DOI: 10.33448/rsd-v15i1.50498. Disponível em: https://rsdjournal.org/rsd/article/view/50498. Acesso em: 23 jan. 2026.