Diana Daniela Daciana Zmărăndache

Background: In Romania, data regarding the oral health of infants and toddlers is scarce. This study aimed to analyze the reasons for the first dental visit among children aged 3 or under and to assess their oral health status and the therapeutic methods applied. Methods: A retrospective cross-sectional study was conducted on 602 children (339 boys and 263 girls), aged ≤ 3 years, who were referred for their first dental visit to the Pediatric Dentistry Department, Faculty of Dentistry, Carol Davila University, Bucharest, Romania. Results: The main reasons for referral were routine check-up (28.23%), asymptomatic carious lesions (21.92%), abscess or swelling (18.43%), and dental trauma (14.78%). Caries was diagnosed in 344 children; 23 (6.68%) had only non-cavitated lesions, 157 (45.64%) had uncomplicated cavitated lesions, and 174 (50.58%) already had complicated caries. Mean values of caries experience indices were significantly higher in rural children (dmf-t = 4.33 ± 4.13; dmf-s = 9.16 ± 11.34) than in urban children (dmf-t = 2.67 ± 3.61; dmf-s = 5.62 ± 8.86) (p = 0.000). The most frequent treatments were routine check-up with oral hygiene and dietary instructions (55.31%), pulp treatments (19.91%), and restorative procedures (15.1%). Conclusions: Many infants and toddlers were referred later than the recommended age and required therapeutic rather than preventive care. More than half had carious lesions, and many of those were already complicated. Significant disparities were observed between rural and urban children from this study group. Targeted public health initiatives are needed to improve early access to dental care.

Background: Early childhood caries (ECC) compromise the nutrition, growth, and quality of life in young children, and their relationship with breastfeeding practices remains disputed. Aim: To determine if prolonged breastfeeding increases the risk of dental caries in children aged under 71 months. Material and Methods: A systematic review of PubMed, Multidisciplinary Digital Publishing Institute, and Evidence-Based Dentistry, was conducted through August 2025, including observational studies, randomized trials, narrative reviews, and meta-analyses on breastfeeding and ECC. Results: Thirty-one studies involving 28,000 children were included. Exclusive breastfeeding for under six months halves ECC probability (OR 0.53–0.58), whereas breastfeeding beyond 12 months and nocturnal feeds increase probability by 60–86% (OR 2.35–7.14). Parental factors—high plaque levels, feeding-to-sleep, and skipped post-feed cleaning—strongly predict ECC (OR 8.51–75.6). Interventions combining feeding counseling with home visits or visual aids reduce ECC incidence by 22–32% (RR 0.68–0.78). Conclusions: Exclusive breastfeeding through six months is protective against ECC, but prolonged or nocturnal feeding heightens risk. Integrating structured oral health education into breastfeeding promotion is recommended.