An ecological study of the association between environmental indicators and early childhood caries
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RESEARCH NOTE
An ecological study of the association between environmental indicators and early childhood caries Morenike Oluwatoyin Folayan1* , Maha El Tantawi2, Balgis Gaffar3, Robert J. Schroth4, Jorge L. Catillo5, Ola B. Al‑Batayneh6, Arthur Kemoli7, Aída Carolina Medina Díaz8, Verica Pavlic9 and Maher Raswhan10,11for Early Childhood Caries Advocacy Group
Abstract Objectives: A prior study described the association between ecosystem vitality, environmental health, and early childhood caries (ECC). The objective of this study was to determine the association between 24 global environmen‑ tal indicators and ECC in 3–5-year-old children. Results: In 61 countries, 55.5% of 3–5-year-old children had ECC. Eight factors had a small effect-size association with ECC: percentage of area that is marine-protected (partial eta squared; ƞ2 = 0.03); species habitat index (ƞ2 = 0.06); per‑ centage of tree-cover loss (ƞ2 = 0.03); regional marine trophic index (ƞ2 = 0.03); total carbon dioxide emission inten‑ sity (ƞ2 = 0.03); methane emission intensity (ƞ2 = 0.04); nitrous oxide emission intensity (ƞ2 = 0.06); and sulfur dioxide emission intensity (ƞ2 = 0.03). Regression analysis revealed that two of these factors were significantly associated with the prevalence of ECC: methane emission intensity was inversely associated with ECC prevalence (B = − 0.34, 95% CI = − 0.66, − 0.03; p = 0.03), and nitrous oxide had a direct association with ECC prevalence (B = 0.35, 95% CI = 0.04, 0.67; p = 0.03). Keywords: Environmental performance indicators, Early childhood caries, Nitrous oxide emission, Methane emission Introduction Human health benefits from ecosystem biodiversity and from experiencing nature. Strong evidence links biodiversity, nature exposure, and human health [1]. Few empirical studies, however, have assessed possible links of the ecosystem and oral health. One such study investigated the association between ecosystem vitality, environmental health, and early childhood caries (ECC), which is any caries experience of the primary teeth in children
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