Exploring the Link Between Screen Time and Severity of Early Childhood Caries in Primary Molars: A Cross-Sectional Study

Background Early Childhood Caries (ECC) is a significant yet often overlooked paediatric health concern, particularly in India. Previous studies have linked excessive screen exposure, known as Problematic Screen Exposure (PSE), with caries in children. However, the association between PSE and the severity of ECC in terms of cavitated and non-cavitated lesions remains unexplored. This study investigates the prevalence of PSE among ECC-affected preschool children and examines its correlation with ECC severity. Methods A cross-sectional observational study was conducted among 100 children aged 36–71 months diagnosed with ECC. Data on screen exposure were collected using the "Seven-in-Seven Screen Exposure Questionnaire," validated per American Academy of Paediatrics guidelines. Clinical examinations classified caries severity using the International Caries Detection and Assessment System (ICDAS-II). Statistical analyses, including the Mann-Whitney U test and Spearman’s correlation, assessed relationships between PSE, sociodemographic factors, and ECC severity. Results Fifty-seven percent of participants exhibited high PSE scores. A majority of children (75%) had cavitated lesions. High PSE was associated with higher mean ICDAS scores for molars (p=0.025), although the correlation between PSE and ECC severity was very weak and not statistically significant (r=0.042, p=0.680). Sociodemographic factors, including family size and parental education, were also analysed, with families having three or more children showing elevated ICDAS scores. Oral hygiene practices and dietary habits partially influenced caries severity, with children using non-fluoridated toothpaste exhibiting higher ICDAS scores. Conclusions High PSE may contribute to the progression of ECC, as evidenced by a higher prevalence of cavitated lesions among children with elevated PSE scores. Preventive strategies focusing on reducing PSE and promoting healthy oral hygiene practices may mitigate ECC severity.. Further longitudinal studies are necessary to establish causality and inform targeted prevention strategies.