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Life sciences · Journal article
BMC Oral Health · August 5, 2026
Early or partial results. Treat as a signal, not a conclusion.
This cross-sectional study identified two factors associated with developmental defects of enamel: frequent plastic feeding bottle or pacifier use (OR 4.069) and maternal prenatal supplementation (OR 0.314). A predictive nomogram was constructed with moderate internal discrimination (AUC 0.683), but the authors acknowledge it serves only as a preliminary prototype requiring further development.
Population-based cross-sectional study. 106 children randomly recruited from Department of Pediatric Dentistry, Qingdao Stomatological Hospital Affiliated to Qingdao University; specific age, eligibility criteria, and demographic details not stated in abstract.. Intervention: Assessment of developmental defects of enamel using standardized clinical criteria; exposure assessment via questionnaire.. n = 106. Qingdao Stomatological Hospital Affiliated to Qingdao University, China.
Frequent use of plastic feeding bottle or pacifiers associated with DDE: OR = 4.069 (95% CI: 1.679–9.861, P = 0.002) Routine supplement intake during maternal pregnancy protective: OR = 0.314 (95% CI: 0.122–0.807, P = 0.016) Predictive model AUC = 0.683 with mean cross-validated AUC = 0.685 demonstrating moderate discriminative validity
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Clinicians should view this nomogram as an exploratory tool only. The identified associations (plastic bottle/pacifier use and prenatal supplementation) warrant further prospective investigation; results should not yet guide clinical practice without validation in independent populations.
Cross-sectional study identifying two modifiable factors associated with developmental defects of enamel with moderate discriminative validity (AUC 0.683); internally consistent but exploratory design limits causal inference and generalizability.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should view this nomogram as an exploratory tool only. The identified associations (plastic bottle/pacifier use and prenatal supplementation) warrant further prospective investigation; results should not yet guide clinical practice without validation in independent populations.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
Developmental defects of enamel (DDE) represent a significant public health concern in pediatric populations, contributing to elevated caries susceptibility, aesthetic problems, and impaired masticatory function. This study aimed to identify independent, modifiable associated factors for DDE and to construct a predictive nomogram for individualized risk stratification. A population-based cross-sectional study included 106 children randomly recruited from the Department of Pediatric Dentistry, Qingdao Stomatological Hospital Affiliated to Qingdao University. DDE was diagnosed per standardized clinical criteria in both primary and permanent teeth. Based on existing evidence and published studies, a questionnaire was developed for this study to explore DDE associated factors during the perinatal and early postnatal periods. Univariate logistic regression analysis was employed to screen potential predictors, with significant variables ( P < 0.10) entered into a stepwise multivariate logistic regression model. Model performance was evaluated using discrimination (area under curve [AUC]), calibration, and 10-fold cross-validation (CV) repeated 200 times. A clinical nomogram was developed based on the final regression model. The univariate logistic regression analysis revealed 6 variables associated with DDE at P < 0.10. After multivariate logistic regression analysis, only 2 independent predictors of DDE remained: frequent use of plastic feeding bottle or pacifiers in children (Odds Ratio [OR] = 4.069, 95% confidence interval [CI]: 1.679–9.861, P = 0.002) and routine supplement intake during maternal pregnancy (OR = 0.314, 95% CI: 0.122–0.807, P = 0.016). The predictive model demonstrated moderate discriminative validity (AUC = 0.683) and good internal consistency (mean cross-validated AUC = 0.685). A visual nomogram was constructed to quantify the individual risk of DDE based on these two key factors. This clinical epidemiology study confirms that plastic feeding bottle or pacifier exposure is an associated factor for DDE, while prenatal maternal supplementation may serves as a helpful factor. The developed nomogram provides a laboratory tool for individualized DDE risk preliminary stratification, and only functions as an initial prototype for the further construction and optimization of DDE risk prediction models. Not applicable.
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