Early Childhood Caries Is Causally Attributed to Developing Psychomotor Deficiency in Pre-School Children: The Resultant Covariate and Confounder Analyses in a Longitudinal Cohort Study.

Background: Causality has recently been suggested to associate early childhood caries with psychomotor deficiency in preschoolers, where their causal interactions via other risk determinants remain unclear. Methods: To analyze such causality, we randomly recruited 123 three-to-six-year-old children in a three-year longitudinal study, where the caries/dmft measures, age/gender, BMI, amended comprehensive scales for psychomotor development (CCDI-aspects), parental education/vocation, and diet were collected for assessment of their inter-relationships. Subsequently, t-tests, multiple/linear-regressions, and R2-analyses were utilized to compare the differences of variables between age/gender, BMI, and dmft vs. relationships among all variables and CCDI-aspects. Results: In the regression modeling, there were significant differences between gender vs. age (p < 0.05; not BMI) regarding established associations between caries and CCDI manifests for psychomotor deficiency. As for diet vs. socio-economic status, there were significant differences when caries/dmft were at lower- vs. higher-scales (<4 and 6−10), associated with expressive language and comprehension-concept (p~0.0214−0.0417) vs. gross-motor and self-help (p~0.0134−0.0486), respectively. Moreover, diet vs. socio-economic-status contributed significantly different CCDI-spectra via expressive language and comprehension-concept (adjusted-R2~0.0220−0.2463) vs. gross-motor and self-help (adjusted-R2~0.0645−0.0994), respectively, when the caries detected were at lower- vs. higher-scales (<4 and 6−10), in contrast to those depicted without both SES diet variables (adjusted-R2~0.0641−0.0849). Conclusion: These new findings confirm that early childhood caries is causally attributed to developing psychomotor deficiency in preschoolers, whereas biological gender/age, not BMI, may act as viable confounders during interactions, in contrast to diet and socio-economic status, via differential low−high scales of caries activity with significant interference, respectively. Collectively, ECC-psychomotor interactions may underpin some distinct biologic vs. socio-mental/psyche attributes towards different determinants for vulnerable children.