Objective: This study investigated the effect of geographic location on dental caries in Native American children under age three from a Northern Plains Tribal community.
Methods: Geographic location of study participants was ascertained by postal district and categorized into geographic regions as well as dental clinic accessibility defined as dental services available in that district. The association of location category and dental caries (dmfs and ds) was evaluated cross-sectionally at ages 16 and 36 months of age.
Results: Descriptive statistics demonstrated differences in dental caries distribution by location category. Bivariate analysis of disease by location showed significant spatial differences in dmfs and ds at 36 months (p=0.0027 and p=0.0028) but not 16 months. Bivariate analysis of disease by dental clinic accessibility showed significant spatial difference in ds at 36 months (p=0.0091). Multivariate regression modeling suggests the unique location effect on dental caries experience among other covariates such as dietary, demographic, maternal, and household factors.
Conclusions: Distribution of severe early childhood caries in this sample of young Native American children is nonrandom and varies by location. At 36 months of age in this cohort of Native American children, geographic location is a significant dental caries risk factor. Research and programs designed for children with high risk of severe early childhood caries and should consider a locational variation.