Impact of early childhood caries on mental development ​

ECC: A Growing Public Health Concern ​

ECC, defined by the American Academy of Paediatric Dentistry (AAPD) as the presence of decayed, missing, or filled tooth surfaces in children under 71 months of age, is a widespread issue affecting children globally.

A review from August 2025 in The International Dental Journal reports an alarmingly high prevalence of ECC in the Asia-Pacific region. Seven out of ten children under the age of five are affected, indicating a significant dental health concern for young children in these areas.

Beyond pain, infection, and functional impairments, ECC also leads to developmental delays and social exclusion. This study directly examined the association between ECC and mental development, providing deeper evidence in this research area.

The Study

The research involved 150 children aged 36–48 months, categorised into three groups: those with severe ECC (sECC), those with ECC, and caries-free children. The study included 48% girls and 52% boys.

All children were evaluated using the Turkish versions of the Ages & Stages Questionnaire (ASQ®-TR) for mental development and the Ages & Stages Questionnaire-Social Emotional (ASQ®-SE-TR) for emotional well-being.

The ASQ®-TR measured communication, gross motor skills, fine motor skills, problem-solving, and personal-social development. The ASQ®-SE-TR measured social-emotional skills, self-regulation, compliance, affect, and peer interaction.

​Key Findings

• Children with sECC in all age groups had a higher risk of developmental delays and social-emotional problems than caries-free peers.
• Notably, 48-month-old children with sECC faced the highest risks for developmental delays and caries. Two out of five had this risk. One out of three had lower developmental skills.
• At 42 months, children faced the highest risk for developmental disability.
• Boys had higher risks of developmental delays and problems than girls in all age groups.
• The girls showed a higher risk for socio-emotional developmental delays, except in the 36-month-old group, where scores were low.
• The research also emphasised the effect of parental education and socioeconomic status on development. Children with less-educated parents were more likely to have developmental delays and social-emotional challenges. ​

 

Clinical Implications: What Can You Do as a Clinician?

The study emphasises the importance of early intervention and preventive strategies to address ECC. One of the most effective ways to evaluate young children at risk of ECC is to use a multidisciplinary approach.

Key paediatric care requires early intervention, preventing oral disease, managing eruption and space issues, correcting adverse oral and breathing habits, addressing early orthodontic needs in cases of craniofacial anomalies, supporting nutrition and respiratory health, and monitoring posture. Also, prioritising the child's mental and cognitive development.

Applying this in practice enables clinicians to deliver scientific and practical support for children's growth and development. Researchers call for comprehensive oral health programs to protect children during critical developmental years and enhance their quality of life.

 

What’s Ahead?

As the first study of its kind to use standardised screening tools such as ASQ®-TR and ASQ®-SE-TR, it opens the door to further research in this critical area of pediatric health.

​This study marks an important step in linking oral health to children's mental development. A multidisciplinary approach is needed to tackle ECC and support mental and social-emotional development. Addressing ECC early enables dental professionals to secure healthy smiles and brighter futures worldwide. ​

 

References:

1. Dereli̇oğlu, S.Ş., Özkan, Ç., Gökdaş, B.P. et al. Impacts of early childhood caries on the mental development. BMC Oral Health 25, 2005 (2025). https://doi.org/10.1186/s12903-025-07328-w
2. Faith Miaomiao Zheng, Chun-Pin Lin, Olabode Ijarogbe, Elham Kateeb, Hiroshi Ogawa, Syed Mahmood Shah, Fernando Fernanodez, Ting-Chen Chen, Ting-Yi Renn, Chun Hung Chu, Wei-Jen Chang, Managing Early Childhood Caries in Asia-Pacific Region, International Dental Journal, Volume 75, Supplement 2, 2025, 100945, ISSN 0020-6539, https://doi.org/10.1016/j.identj.2025.100945
3. Qi Su, Zhiying Zhou. Multidisciplinary management points in early childhood treatment.Journal of Clinical Pediatric Dentistry,2025,49(6):22-31 DOI:10.22514/jocpd.2025.123 

 

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