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Background/purpose: The prevalence of early childhood caries (ECC) was 56% and 68.97% in Taiwan and Southern Taiwan, respectively. Children with severe caries suffer from health and growth problems, and to prevent the development of severe caries, possible risk factors must be identified. Oral health practices and the knowledge of primary caregivers regarding basic oral health were the main factors associated with the development of severe ECC (S-ECC). The aim of this study was to assess the knowledge and habits of primary caregivers with regard to oral health. Materials and methods: Children, aged 2–5 years old, with S-ECC (n = 101) who visited the Division of Dentistry of Children and Disabled of Kaohsiung Medical University Hospital were recruited for this survey. Habits and knowledge related to oral hygiene were obtained with a standardized questionnaire completed by the primary caregivers of children with S-ECC. The data were analyzed using Microsoft Access software and JMP statistical software. Chi-square test, ANOVA, and linear regression were used for statistical comparison. Results: The test comprised a total of 10 questions, and each correct answer earned 10 points, for a total score of 100. The average score was 46.05. The education level of mothers was strongly associated with the score of oral health knowledge. The oral hygiene habits of caregivers, including cleaning the mouth after meals and using fluoride, were associated with the behavior of children regarding oral hygiene (frequency of brushing teeth and using fluoride). Conclusion: Poor oral hygiene behavior and the knowledge of caregivers are associated with dental hygiene behavior of children with S-ECC. However, such education should be directed toward those with a lower level of education and lower socio-economic status.

Severe early childhood caries (SECC) is a public health problem among preschool children. Malnutrition is a condition commonly prevalent in children with SECC. This study investigated the nutritional status among preschool children with SECC. Children with SECC (n = 101) aged 2–5 years from the Division of Pediatric Dentistry in an academic hospital in Southern Taiwan were recruited for our cross-sectional study. The nutritional status of the children was assessed based on anthropometric measurements and clinical tests. By applying the criteria established by the World Health Organization, we found that 9% and 46% of the children with SECC were diagnosed as being anemic and iron deficient, respectively. Using national standards for the body mass index, 30% of children with SECC were classified as underweight. The relationship between the caries status of the children and anemia was examined using multivariable logistic regression analysis (p