Small for gestational age and early childhood caries: the BRISA cohort study

This study tests the hypothesis that children 12–30 months born small for gestational age (SGA) aged are more susceptible to severe early childhood caries (S-ECC). We used data on 865 children aged 12–30 months from a prospective cohort study conducted in a city in the northeast of Brazil. The study outcome was S-ECC, defined based on the proportion of decayed tooth surfaces (cavitated or not). The main exposure variable was SGA, defined according to the Kramer criterion and the INTERGROWTH-21st standard. Direct (SGA → S-ECC) and indirect effects were estimated using structural equation modeling, calculating standardized factor loadings (SFL) and P-values (alpha = 5%). The final models showed a good fit. SGA influenced S-ECC in the direct and indirect paths. In the group of SGA children with 12 or more erupted teeth defined according to the Kramer criterion, the direct effect was positive (SFL = 0.163; P = 0.019); while among all SGA children defined according to the INTERGROWTH-21st standard, the direct effect was negative (SFL =  − 0.711; P < 0.001). Age and number of erupted teeth may influence the occurrence of S-ECC in SGA children, as the number of teeth affects the time of exposure to disease risk factors.