Epidemiological profile of early childhood caries in a sub-urban population in Nigeria

Background The aim of the study was to determine the prevalence and severity of early childhood caries (ECC) in children 6-71-months; identify the teeth most at risk for ECC; and identify risk indicators associated with significant caries index (SiC) score in different age groups. Methods This was a cross-sectional study that collected data (using a household survey) on the ECC risk indicators (frequency of tooth brushing, consumption of refined carbohydrate in-between-meals, daily use of fluoridated toothpaste, and dental service utilization in the 12 months) in Ile-Ife, Nigeria. We computed the prevalence of ECC using the International Caries Detection and Assessment System (ICDASI (d(1-6))) index; caries severity using the ICDAS-2(d(1-2)) and ICDAS-3(d(3-6)) for non-cavitated and cavitated lesions respectively, decayed missing, filled teeth (dmft), and surfaces (dmfs) and SiC indices; and caries complications using the pulp (p), ulceration (u), fistula (f) and abscesses (a) (pufa) index, for children 6-11-months-old, 12-23-months-old, 23-35-months-old, 35-47-months-old; 48-59-months-old and 60-71-months-old. The differences in the mean dmft, dmfs, pufa scores, and ICDAS 1, 2, and 3 scores, and proportion of children with each ECC risk indicator were computed. Logistic regression analysis was conducted to identify risk indicators for the ECC SiC index score for each age group. Results The prevalence of ECC was 4.7%: 2.9% had non-cavitated lesions and 2.8% had cavitated lesions. The mean (SD) dmft, dmfs and pufa scores were 0.13 (0.92), 0.24 (1.91) and 0.04 (0.46) respectively. The dmft and dmfs scores were highest among the 24-35-months-olds while the SiC score was highest among the 12-23-months-olds. There were no significant differences in dmft, dmfs, and pufa scores between the different age groups. Toothbrushing more than once a day was the only factor associated with the SiC score: it decreases the odds for the SiC score in children 48-59-months-old. The teeth worst affected by ECC were #85 and #61. Conclusion The prevalence, severity and risk indicator for ECC seems to differ for each age group. The granular details on the risk profile of children with ECC in this population with a low ECC prevalence and burden can allow for the planning of age-targeted interventions.