Applying the PRECEDE Model to Early Childhood Dental Caries During the First 1000 Days: A Contextual Model of 1000ECDC in Venezuela to Inform the ‘Smiley Baby’ Project

Dental Caries remain a major public health concern among children, the first 1000 days being particularly critical. Understanding its multifactorial etiology is essential for designing effective health promotion strategies. The purpose of this study was to apply the PRECEDE model as a conceptual framework to describe the social, behavioral, and environmental determinants associated with the onset of dental caries during the first 1,000 days of life (1000ECDC). The model was developed through the diagnostic phases of the PRECEDE framework: Social, Epidemiological, Behavioral and Environmental, and Educational and Ecological. Data were drawn from a health education pilot study (Smiley Baby Project) involving 10 Latino mother-child dyads, complemented by a literature review. The model revealed that >60% of participating children had advanced lesions (x̄dmft-index=2.64), reflecting high disease severity and compromised quality of life. Maternal behavioral risk factors were observed across two critical stages (prenatal and postnatal) and included suboptimal dietary behaviors, inadequate oral health care practices, and limited access to preventive services. Predisposing factors encompassed low maternal oral health knowledge, prevalent misconceptions, and cultural norms minimizing the significance of early oral health. Family-level influences included household oral health status and psychosocial stress. Fragmentation between dental and medical systems further impeded access to care. 1000ECDC represents a complex, behaviorally rooted health issue. The PRECEDE model provides a comprehensive, theory- and evidence-informed framework to guide the development of targeted, early-life oral health promotion interventions.