A systematic review of caries risk in children <6 years of age

Background For caries risk assessment (CRA) tools for young children to be evidence‐based, it is important to systematically review the literature to identify factors associated with the onset of early childhood caries (ECC). Aim This updated systematic review aimed to identify current evidence on caries risk in young children. Design A comprehensive and systematic literature search of relevant databases was conducted to update a previous systematic review and identify risk factors associated with ECC. Potential risk factors were identified based on strength of association using odds ratios, hazard ratios, relative risk, etc. GRADE was used for rating quality evidence through consensus. Results Twenty‐two studies met inclusion criteria for the search from mid‐2017 to 2021. Twenty‐five publications from the prior systematic review, from 1997 to mid‐2017, were also included. Several socioeconomic, behavioral, and clinical variables were identified as ECC risk factors. Factors included the following: age, socioeconomic status, frequency of and supervised toothbrushing, fluoride exposure, breast‐ and bottle‐feeding, feeding habits, absence of a dental home, past caries experience, active non‐cavitated lesions, visible plaque, enamel defects, and microbiome. Conclusion This study provides updated evidence of risk factors for ECC that could be included in CRA tools.