For the management of dental caries, the dentists should assess how the pathways affect the increase of caries in early childhood. This study of 639 pre-school children revealed the dental caries experience as the primary reason behind the increase of caries.

To examine the pathways that impacts the increase of dental caries in early childhood days.

The dental caries experience, socioeconomic status (SES), and psychosocial features were taken at baseline in a overall 639 pre-school children. Increase in dental caries was evaluated in 467 children at 2 years. Formerly calibrated assessors examined dental caries via the International Caries Detection and Assessment System (ICDAS). To analyze the pathways associated with the increase in caries, the Structural equation modeling (SEM) was used.

At the baseline, dental caries was profoundly affected by the age of the children, tooth plaque, parent's opinion child oral health, and family. Also, the increase of dental caries was directly involved in dental caries. Indirect paths were rendered as insignificant.

Dental caries experience was the key factor of direct influence on the increase of dental caries, emphasizing on the hypothesis of risk buildup with time.