Mapping Evidence on Early Childhood Caries Prevalence: Complexity of Worldwide Data Reporting
Marwa Abdelrahman, Kuei-Ling Hsu, Mary Anne Melo, Vineet Dhar, Norman Tinanoff
Cross-sectional studies, Dental caries, Global health, Preschool child
Citation Information :
Abdelrahman M, Hsu K, Melo MA, Dhar V, Tinanoff N. Mapping Evidence on Early Childhood Caries Prevalence: Complexity of Worldwide Data Reporting. Int J Clin Pediatr Dent 2021; 14 (1):1-7.
Objective: This review aims to identify variances and research gaps in the early childhood caries (ECC) prevalence within countries and the global community by mapping current evidence.
Materials and methods: We performed a literature search in PubMed/MEDLINE and Web of Science to identify English-language, peer-reviewed epidemiologic studies published from January 1999 to January 2019. Abstracts and full-text articles were dual-screened based on predefined eligibility criteria. We classified outcomes by children's age and countries based on economic status. Ranges of reported caries prevalence and median values by country and age were calculated and evidence-mapped.
Results: Out of 915 studies, 59 studies met the inclusion criteria. The most significant number of reports were from the USA, Brazil, and India. The ranges of prevalence (1–96%) among the studies were large. The calculated median caries prevalence values may better estimate countries’ prevalence than the reported ranges. Early childhood caries prevalence's highest median values were found for South Korea studies (54%) for children <3-year-old and from Bosnia (81%) for children 3–6 years old. No apparent difference was found in the prevalence of ECC from developed and developing countries.
Conclusion: This mapping review reflects the ranges and median values of ECC worldwide. Overall, the reported prevalence of ECC in most countries is very high. No apparent difference was found in the prevalence of ECC from developed and developing countries. Reported ranges of ECC, as well as heterogeneity and methodological issues, hamper comparisons across studies globally.
Clinical significance: The global ECC prevalence ranges are extreme. Median data may provide a structure for future epidemiological studies to optimizing healthcare resources for caries interventions globally.
Drury TF, Horowitz AM, Ismail AI, et al. Diagnosing and reporting early childhood caries for research purposes. A report of a workshop sponsored by the National Institute of Dental and Craniofacial Research, the Health Resources and Services Administration, and the Health Care Financing Administration. J Public Health Dent 1999;59(3):192–197. DOI: 10.1111/j.1752-7325.1999.tb03268.x.
Li Y, Wang W. Predicting caries in permanent teeth from caries in primary teeth: an eight-year cohort study. J Dent Res 2002;81(8):561–566. DOI: 10.1177/154405910208100812.
Gomes MC, Pinto-Sarmento TC, de A, et al. Impact of oral health conditions on the quality of life of preschool children and their families: a cross-sectional study. Health Qual Life Outcomes 2014;12(1):55. DOI: 10.1186/1477-7525-12-55.
Casamassimo PS, Thikkurissy S, Edelstein BL, et al. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc 2009;140(6):650–657. DOI: 10.14219/jada.archive.2009.0250.
Clarke M, Locker D, Berall G, et al. Malnourishment in a population of young children with severe early childhood caries. Pediatr Dent 2006;28(3):254–259.
Acs G, Lodolini G, Kaminsky S, et al. Effect of nursing caries on body weight in a pediatric population. Pediatr Dent 1992;14(5):302–305.
Singh N, Dubey N, Rathore M, et al. Impact of early childhood caries on quality of life: child and parent perspectives. J Oral Biol Craniofac Res 2020;10(2):83–86. DOI: 10.1016/j.jobcr.2020.02.006.
McGrath C, Broder H, Wilson-Genderson M. Assessing the impact of oral health on the life quality of children: implications for research and practice. Community Dent Oral Epidemiol 2004;32(2):81–85. DOI: 10.1111/j.1600-0528.2004.00149.x.
Tinanoff N, Baez RJ, Diaz Guillory C, et al. Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediat Dentis 2019;29(3):238–248. DOI: 10.1111/ipd.12484.
El Tantawi M, Folayan MO, Mehaina M, et al. Prevalence and data availability of early childhood caries in 193 united nations countries, 2007-2017. Am J Public Health 2018;108(8):1066–1072. DOI: 10.2105/AJPH.2018.304466.
Principles of Epidemiology | Lesson 2 - Section 8 [Internet]. 2020 [cited 2020 Sep 10]. Available from: https://www.cdc.gov/csels/dsepd/ss1978/lesson2/section8.html.
Developing countries | Department of Economic and Social Affairs [Internet]. [cited 2020 Jul 28]. Available from: https://www.un.org/development/desa/dpad/tag/developing-countries/.
Markovic D, Soldatovic I, Vukovic R, et al. How much country economy influences ECC profile in Serbian children—a macro-level factor analysis. Front Public Health 2019;;7:285. Available from: https://www.frontiersin.org/articles/10.3389/fpubh.2019.00285/full.
Folayan MO, Alade M, Adeniyi A, et al. Association between early childhood caries and poverty in low and middle income countries. BMC Oral Health 2020;20(1):1–8. DOI: 10.1186/s12903-019-0991-2.
Ramji R, Carlson E, Brogårdh-Roth S, et al. Understanding behavioural changes through community-based participatory research to promote oral health in socially disadvantaged neighbourhoods in Southern Sweden. BMJ Open 2020;10(4):e035732. DOI: 10.1136/bmjopen-2019-035732.
Phantumvanit P, Makino Y, Ogawa H, et al. WHO global consultation on public health intervention against early childhood caries. Community Dent Oral Epidemiol 2018;46(3):280–287. DOI: 10.1111/cdoe.12362.
Masood M, Masood Y, Newton T. Impact of national income and inequality on sugar and caries relationship. Caries Res 2012;46(6):581–588. DOI: 10.1159/000342170.
Goyal A, Grover A, Gauba K, et al. A community-based pragmatic, controlled trial for preventing and reducing oral diseases among 1–6-year-old children visiting Anganwadi centers, under the integrated child development scheme, India. BMC Public Health 2019;19(1):1–8. DOI: 10.1186/s12889-019-7874-y.
Dos Santos Pinto G, de Ávila Quevedo L, Britto Correa M, et al. Maternal depression increases childhood dental caries: a cohort study in Brazil. Caries Res 2017;51(1):17–25. DOI: 10.1159/000449040.
Corrêa-Faria P, Martins-Júnior PA, Vieira-Andrade RG, et al. Factors associated with the development of early childhood caries among Brazilian preschoolers. Braz Oral Res 2013;27(4):356–362. DOI: 10.1590/S1806-83242013005000021.
Corrêa-Faria P, Paixão-Gonçalves S, Paiva SM, et al. Association between developmental defects of enamel and early childhood caries: a cross-sectional study. Int J Paediatr Dent 2015;25(2):103–109. DOI: 10.1111/ipd.12105.
Oliveira LB, Sheiham A, Bönecker M. Exploring the association of dental caries with social factors and nutritional status in Brazilian preschool children. Eur J Oral Sci 2008;116(1):37–43. DOI: 10.1111/j.1600-0722.2007.00507.x.
Rosenblatt A, Zarzar P. The prevalence of early childhood caries in 12- to 36-month-old children in Recife, Brazil. ASDC J Dent Child 2002;69(3):319–324,236.
NHANES - National Health and Nutrition Examination Survey Homepage [Internet]. 2020 [cited 2020 Nov 12]. Available from: https://www.cdc.gov/nchs/nhanes/index.htm.
Schroth RJ, Moffatt MEK. Determinants of early childhood caries (ECC) in a rural Manitoba community: a pilot study. Pediatr Dent 2005;27(2):114–120.
Schroth RJ, Moore P, Brothwell DJ. Prevalence of early childhood caries in 4 Manitoba communities. J Can Dent Assoc 2005;71(8):567.
Nunn ME, Dietrich T, Singh HK, et al. Prevalence of early childhood caries among very young urban Boston children compared with US children. J Public Health Dent 2009;69(3):156–162. DOI: 10.1111/j.1752-7325.2008.00116.x.
Nunn ME, Braunstein NS, Krall Kaye EA, et al. Healthy eating index is a predictor of early childhood caries. J Dent Res 2009;88(4):361–366. DOI: 10.1177/0022034509334043.
Alaki SM, Burt BA, Garetz SL. The association between antibiotics usage in early childhood and early childhood caries. Pediatr Dent 2009;31(1):31–37.
Phipps KR, Ricks TL, Manz MC, et al. Prevalence and severity of dental caries among American Indian and Alaska native preschool children. J Public Health Dent 2012;72(3):208–215. DOI: 10.1111/j.1752-7325.2012.00331.x.
Iida H, Auinger P, Billings RJ, et al. Association between infant breastfeeding and early childhood caries in the United States. Pediatrics 2007;120(4):e944–e952. DOI: 10.1542/peds.2006-0124.
Ramos-Gomez FJ, Tomar SL, Ellison J, et al. Assessment of early childhood caries and dietary habits in a population of migrant hispanic children in Stockton, California. ASDC J Dent Child 1999;66(6):395–403., 366.
Anderson L, Martin NR, Burdick A, et al. Oral health status of new hampshire head start children, 2007-2008. J Public Health Dent 2010;70(3):245–248. DOI: 10.1111/j.1752-7325.2009.00161.x.
Psoter WJ, Pendrys DG, Morse DE, et al. Associations of ethnicity/race and socioeconomic status with early childhood caries patterns. J Public Health Dent 2006;66(1):23–29. DOI: 10.1111/j.1752-7325.2006.tb02547.x.
Mangla RG, Kapur R, Dhindsa A, et al. Prevalence and associated risk factors of severe early childhood caries in 12- to 36-month-old children of Sirmaur district, Himachal Pradesh, India. Int J Clin Pediatr Dent 2017;10(2):183–187. DOI: 10.5005/jp-journals-10005-1431.
Priyadarshini HR, Hiremath SS, Puranik M, et al. Prevalence of early childhood caries among preschool children of low socioeconomic status in Bangalore city, India. J Int Soc Prev Community Dent 2011;1(1):27–30. DOI: 10.4103/2231-0762.86384.
Tyagi R. The prevalence of nursing caries in davangere preschool children and its relationship with feeding practices and socioeconomic status of the family. J Indian Soc Pedod Prev Dent 2008;26(4):153–157. DOI: 10.4103/0970-4388.44030.
Gopal S, Chandrappa V, Kadidal U, et al. Prevalence and predictors of early childhood caries in 3- to 6-year-old South Indian Children--a cross-sectional descriptive study. Oral Health Prev Dent 2016;14(3):267–273. DOI: 10.3290/j.ohpd.a35619.
Mahejabeen R, Sudha P, Kulkarni SS, et al. Dental caries prevalence among preschool children of Hubli: Dharwad city. J Indian Soc Pedod Prev Dent 2006;24(1):19–22. DOI: 10.4103/0970-4388. 22829.
Singh S, Vijayakumar N, Priyadarshini HR, et al. Prevalence of early childhood caries among 3-5 year old pre-schoolers in schools of Marathahalli. Bangalore Dent Res J (Isfahan) 2012;9(6):710–714.
Sujlana A, Pannu PK. Family related factors associated with caries prevalence in the primary dentition of five-year-old children. J Indian Soc Pedod Prev Dent 2015;33(2):83–87. DOI: 10.4103/0970-4388.155108.
Arangannal P, Mahadev SK, Jayaprakash J. Prevalence of dental caries among school children in Chennai, based on ICDAS II. J Clin Diagn Res 2016;10(4):ZC09–ZC12. DOI: 10.7860/JCDR/2016/14731.7523.
Tanaka K, Miyake Y. Low birth weight, preterm birth or small-for-gestational-age are not associated with dental caries in young Japanese children. BMC Oral Health 2014;14(1):38. DOI: 10.1186/1472-6831-14-38.
Seki M, Yamashita Y. Decreasing caries prevalence in Japanese preschool children is accompanied with a reduction in mutans streptococci infection. Int Dent J 2005;55(2):100–104. DOI: 10.1111/j.1875-595x.2005.tb00041.x.
Nakayama Y, Mori M. Association of environmental tobacco smoke and snacking habits with the risk of early childhood caries among 3-year-old Japanese children. J Public Health Dent 2015;75(2):157–162. DOI: 10.1111/jphd.12085.
Ardenghi TM, Sheiham A, Marcenes W, et al. Maxillary anterior caries as a predictor of posterior caries in the primary dentition in preschool Brazilian children. J Dent Child (Chic) 2008;75(3):215–221.
Santos APP, dos, Soviero VM. Caries prevalence and risk factors among children aged 0 to 36 months. Pesqui Odontol Bras 2002;16(3):203–208. DOI: 10.1590/s1517-74912002000300004.
Moimaz SAS, Borges HC, Saliba O, et al. Early childhood caries: epidemiology, severity and sociobehavioural determinants. Oral Health Prev Dent 2016;14(1):77–83. DOI: 10.3290/j.ohpd.a34997.
Schroth RJ, Cheba V. Determining the prevalence and risk factors for early childhood caries in a community dental health clinic. Pediatr Dent 2007;29(5):387–396.
Du M, Luo Y, Zeng X, et al. Caries in preschool children and its risk factors in 2 provinces in China. Quintessence Int 2007;38(2):143–151.
Li Y, Zhang Y, Yang R, et al. Associations of social and behavioural factors with early childhood caries in Xiamen city in China. Int J Paediatr Dent 2011;21(2):103–111. DOI: 10.1111/j.1365-263X.2010.01093.x.
Zhou Y, Lin HC, Lo ECM, et al. Risk indicators for early childhood caries in 2-year-old children in southern China. Aust Dent J 2011;56(1):33–39. DOI: 10.1111/j.1834-7819.2010.01280.x.
Zhang S, Liu J, Lo ECM, et al. Dental caries status of Bulang preschool children in Southwest China. BMC Oral Health 2014;14(1):16. DOI: 10.1186/1472-6831-14-16.
Slabšinskienė E, Milčiuvienė S, Narbutaitė J, et al. Severe early childhood caries and behavioral risk factors among 3-year-old children in Lithuania. Medicina (Kaunas) 2010;46(2):135–141. DOI: 10.3390/medicina46020020.
Razmienė J, Vanagas G, Bendoraitienė EA, et al. Changes in caries prevalence and oral hygiene skills among preschool-aged children in Lithuania between 2000 and 2010. Medicina (Kaunas) 2012;48(7):364–370. DOI: 10.3390/medicina48070054.
Sowole CA, Sote EO. Early childhood caries: experience in Nigerian children at Lagos. Niger Postgrad Med J 2007;14(4):314–318.
Folayan MO, Kolawole KA, Oziegbe EO, et al. Prevalence, and early childhood caries risk indicators in preschool children in suburban Nigeria. BMC Oral Health 2015;15(1):72. DOI: 10.1186/s12903-015-0058-y. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4486704/.
Olatosi OO, Inem V, Sofola OO, et al. The prevalence of early childhood caries and its associated risk factors among preschool children referred to a tertiary care institution. Niger J Clin Pract 2015;18(4):493–501. DOI: 10.4103/1119-3077.156887.
Ferro R, Besostri A, Olivieri A, et al. Preschoolers’ dental caries experience and its trend over 20 years in a North-East Italian health district. Eur J Paediatr Dent 2007;8(4):199–204.
Hattab FN, Al-Omari MA, Angmar-Månsson B, et al. The prevalence of nursing caries in one-to-four-year-old children in Jordan. ASDC J Dent Child 1999;66(1):53–58.
Dimitrova MM, Kukleva MP, Kondeva VK. Prevalence of early childhood caries and risk factors in children from 1 to 3 years of age in Plovdiv, Bulgaria. Folia Med (Plovdiv) 2002;44(1–2):60–63.
Doğan D, Dülgergil CT, Mutluay AT, et al. Prevalence of caries among preschool-aged children in a central Anatolian population. J Nat Sci Biol Med 2013;4(2):325–329. DOI: 10.4103/0976-9668.116995.
Namal N, Vehit HE, Can G. Risk factors for dental caries in Turkish preschool children. J Indian Soc Pedodont Prevent Dentis 2005;23(3):115. DOI: 10.4103/0970-4388.16881.
Leroy R, Bogaerts K, Martens L, et al. Risk factors for caries incidence in a cohort of Flemish preschool children. Clin Oral Investig 2012;16(3):805–812. DOI: 10.1007/s00784-011-0579-y.
Tsai AI, Chen C-Y, Li L-A, et al. Risk indicators for early childhood caries in Taiwan. Community Dent Oral Epidemiol 2006;34(6):437–445. DOI: 10.1111/j.1600-0528.2006.00293.x.
Nørrisgaard PE, Qvist V, Ekstrand K. Prevalence, risk surfaces and inter-municipality variations in caries experience in Danish children and adolescents in 2012. Acta Odontol Scand 2016;74(4):291–297. DOI: 10.3109/00016357.2015.1119306.
Jin B-H, Ma D-S, Moon H-S, et al. Early childhood caries: prevalence and risk factors in Seoul, Korea. J Public Health Dent 2003;63(3):183–188. DOI: 10.1111/j.1752-7325.2003.tb03497.x.
Droz D, Guéguen R, Bruncher P, et al. Epidemiological study of oral dental health of 4-year-old children in french nursery schools. Arch Pediatr 2006;13(9):1222–1229. DOI: 10.1016/j.arcped.2006. 05.017.
Livny A, Assali R, Sgan-Cohen HD. Early childhood caries among a bedouin community residing in the eastern outskirts of Jerusalem. BMC Public Health 2007;7(1):167. DOI: 10.1186/1471-2458- 7-167.
Wagner Y, Greiner S, Heinrich-Weltzien R. Evaluation of an oral health promotion program at the time of birth on dental caries in 5-year-old children in Vorarlberg, Austria. Community Dent Oral Epidemiol 2014;42(2):160–169. DOI: 10.1111/cdoe.12072.
Dabiri D, Fontana M, Kapila Y, et al. Community-based assessment and intervention for early childhood caries in rural El Salvador. Int Dent J 2016;66(4):221–228. DOI: 10.1111/idj.12228.
Elidrissi SM, Naidoo S. Prevalence of dental caries and toothbrushing habits among preschool children in Khartoum State, Sudan. Int Dent J 2016;66(4):215–220. DOI: 10.1111/idj.12223.
Hoffmeister L, Moya P, Vidal C, et al. Factors associated with early childhood caries in Chile. Gac Sanit 2016;30(1):59–62. DOI: 10.1016/j.gaceta.2015.09.005.
Hysi D, Caglar E, Droboniku E, et al. Dental caries experience among Albanian pre-school children: a national survey. Community Dent Health 2017;34(1):46–49. DOI: 10.1922/CDH_3940Hysi04.
Wyne AH. Caries prevalence, severity, and pattern in preschool children. J Contemp Dent Pract 2008;9(3):24–31. DOI: 10.5005/jcdp-9-3-24.
Senesombath S, Nakornchai S, Banditsing P, et al. Early childhood caries and related factors in Vientiane, Lao PDR. Southeast Asian J Trop Med Public Health 2010;41(3):717–725.
Masumo R, Bardsen A, Mashoto K, et al. Prevalence and socio-behavioral influence of early childhood caries, ECC, and feeding habits among 6-36 months old children in Uganda and Tanzania. BMC Oral Health 2012;12(1):24. DOI: 10.1186/1472-6831-12-24.
Šačić L, Marković N, Arslanagić Muratbegović A, et al. The prevalence and severity of early childhood caries in preschool children in the federation of Bosnia and Herzegovina. Acta Med Acad 2016;45(1):19–25. DOI: 10.5644/ama2006-124.152.