209 - Diet and Oral Hygiene in Children Before and After Lockdown

Purpose: To compare changes in pre-school aged children’s diet/feeding behaviors and oral hygiene practices before and after the Covid-19 lockdown and to assess caries outcome in our patient sample during post-lockdown visits.

Methods: Data from pre and post-lockdown visits on diet/feeding behaviors, oral hygiene practices, plaque scores, and caries was collected on 25 pre-school aged children, ages 1-3 years old (8 females and 17 males). Patients were evaluated at baseline (0 months), 6 months, 12 months, 18 months, and 24 months. Parents filled out a questionnaire with 10 diet/feeding behavior questions and 5 oral hygiene questions at each visit. Values were assigned to each question ranging from 0-1. The descriptive statistics (mean and standard deviation) were calculated for the patient sample for each diet/feeding behavior and oral hygiene practice for pre and post lockdown visits. A Wilcoxon matched pairs test was used to detect changes in diet/feeding behaviors and oral hygiene practices during pre and post lockdown. Plaque was assessed and scored at each patient visit and then analyzed to determine any changes during pre and post lockdown. A clinical exam was performed at each patient visit to detect the presence of caries and caries score using the ICDAS classification system during pre and post lockdown.

Results: Two diet/feeding behavior questions related to the use of and frequency of drinking out of a sippy cup (questions B2 and B10) had values of statistical significance during pre and post lockdown (p-values 0.0045 and 0.0051, respectively). The remaining diet/feeding behaviors and oral hygiene practices showed no statistical significance in the changes from pre to post lockdown (p values> 0.05). The results in our patient sample’s pre and post plaque scores were also inconclusive. Our caries analysis demonstrated that 12/25 patients (48%) had caries in the 24- month visit. Of these, 9 patients (36%) had truly converted to having caries at their post lockdown visits after being caries-free at pre lockdown. The most affected teeth were primary 2nd molars> central incisors> 1st molars> lateral incisors> cuspids. By tooth type, the most affected surface on 1st and 2nd molars was the occlusal surface. For the central and lateral incisors and cuspids, the most affected surface was the buccal/facial surface. Additionally, the caries scores in this sample generally increased during post lockdown when compared to pre-lockdown.

Conclusion: The results of the study show that, other than for 2 diet/feeding behaviors, there were no significant changes in children’s overall diet/feeding behaviors and in their oral hygiene practices from pre and post lockdown. Additionally, the results of the pre and post plaque scores in our patient sample were inconclusive. However, there was a noticeable conversion to caries in our patient sample at the post-lockdown visit when compared to pre-lockdown visits, in which 36% had truly converted to having caries at post lockdown. Caries severity in this sample also increased noticeably in the post lockdown. Although there were limitations in this study (small sample size of patients and reliance on self-reporting from parents), this study captured these trends during a historical moment in time that cannot be reproduced.