Early childhood caries lesions in preschool children in Kerala, India

Abstract

Purpose: No data are available on possible risk indicators or the prevalence of caries lesions for preschool children under 4 years of age in Kerala, southern India. Therefore, the aims of this study were: (1) to gather data on caries lesion frequency and distribution; (2) to determine any possible associations with feeding habits and oral health care practices.

Methods: A sample of 530 children, aged from 8 to 48 months (mean=2.5+/-0.96 years), who attended 13 day care centers were clinically examined for caries lesions using a disposable mouth mirror, tongue spatula, and a torch light. There were 513 dentate children. The caregiver of each child then completed, by interview, a structured questionnaire.

Results: Among the group of 252 girls and 278 boys, the dmft was 1.84+/-2.87 with 56% of the children being caries-lesion free. Fifty-nine (12%) were considered to have early childhood caries (ECC), based on the criteria that smooth surface caries lesions on all 4 maxillary incisor teeth indicated severe ECC. Breast-feeding was practiced by 99% of the mothers, and 5% did so exclusively. Generally, breast-feeding was on demand. Statistically significant correlations were found between caries lesions and the child's dental condition, as perceived by the mother or caregiver (P<.0001), the dental status of the caregiver (P=.0417), consumption of snacks (P=.0177), giving of sweets as a reward (P<.0001), cleaning of the child's mouth (P<.0001), oral hygiene status of the child (P<.0001) and low socioeconomic status, as measured by income (P<.0001).

Conclusion: From the results of this study of preschool children in Kerala, the groups at high risk from dental caries lesions are: (1) those with poor oral hygiene status; (2) those who consume snacks and are given sweets as rewards; (3) those belonging to a lower socioeconomic class.