Factors associated with early childhood caries in 2-5 year old children attending dental treatment at Muhimbili University dental clinic.

Abstract

Background: Dental caries is an infectious disease resulting in demineralization of tooth hard tissues by acid produced as a result of fermentation of carbohydrates by specific adherent bacteria, primarily mutans streptococci (MS) in a given period of time. Dental caries occurring in children under five years of age is termed early childhood caries (ECC). The 2008/2009 epidemiological reports indicate that close to 50% of children below the age of five years in Dar es Salaam had ECC, and 80% of children who sought care due to oral diseases at the School of Dentistry, Muhimbili University of Health and Allied Sciences (MUHAS) between January–June 2012 had ECC. This information indicates that ECC is a public health problem in Dar es Salaam that needs to be addressed by suitable interventions which require thorough understanding of factors associated with the development and progression of dental caries in children. Aim of the study: To investigate factors associated with ECC. Material and Methods: This was a descriptive cross sectional hospital based study conducted in children aged 2- 5 years who attended dental treatment at pediatrics dental clinic School of Dentistry, MUHAS from September 2012 to March 2013. A total of 182 children and their parents/caregivers were recruited. Children were examined for dental caries using WHO criteria (1997) and oral hygiene status was recorded using modified Silness and Löe Oral Hygiene Index (1964). A structured questionnaire inquired about socio-demographic characteristics of the parents/caregiver and the child, oral hygiene practices of the child, use of toothpaste, feeding practices and use of sugary snacks was used to collect data. Results: Fifty one percent of the examined children were girls. The mean age and dmft were 3.78 (SD 0.91) and 6.79 (SD 4.68) respectively. At the level of bivariate analysis, older children (4-5 years); children reared by single mothers and children with poor oral hygiene had statistically significantly higher dmft than their counterpart (2 = 6.71, p = 0.01; 2 = vi 3.99, p = 0.05; 2= 3.85, p = 0.05) for overall dmft respectively; and (2 = 3.70, p = 0.04; 2 = 7.47, p<0.01; 2 = 5.27, p = 0.02) for anterior dmft respectively. In logistic regression model children aged 4-5 years had higher Odds of having higher overall dmft than those aged 2-3 years [OR=2.77 (1.18-6.45), p=0.02], while children with poor oral hygiene had higher Odds of having higher dmft for anterior teeth than their counterparts with good oral hygiene [OR=2.51 (1.20 5.28),p=0.01]. ―Infants feeding practices”; “assistance in tooth brushing”, “frequency of tooth brushing” and “use of tooth paste” had no significant association of having high/low caries experience. Conclusion: Poor oral hygiene, Child‘s old age, and child being raised by a single mother were associated with higher caries experience. Infant feeding practices, assistance in tooth brushing, frequency of tooth brushing and use of toothpaste were not associated with having high/low caries experience.