Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2024 Feb;74(1):35-41.
doi: 10.1016/j.identj.2023.08.001. Epub 2023 Oct 13.

Early Childhood Caries and Dental Public Health Programmes in Hong Kong

Faith Miaomiao Zheng  1 , Iliana Gehui Yan  1 , Ivy Guofang Sun  1 , Duangporn Duangthip  1 , Edward Chin Man Lo  1 , Chun Hung Chu  2
Affiliations
Review

Early Childhood Caries and Dental Public Health Programmes in Hong Kong

Faith Miaomiao Zheng et al. Int Dent J. 2024 Feb.

Abstract

The objective of this study was to investigate the relationship amongst early childhood caries (ECC), economic development, and dental public health programmes in Hong Kong. We searched exhaustively qualitative and quantitative data on the oral health policy, dental service, public health strategies of caries control and epidemiologic surveys on ECC. We then performed meta-regression to explore the impact of the Human Development Index (HDI), gross domestic product (GDP) growth, water fluoridation, oral health promotion, dental school establishment, free education, and dental workforce on ECC prevalence in 5-year-olds. We found that the first government oral health survey was conducted in 1960, when Hong Kong experienced significant growth, as the HDI indicated. The survey revealed that 97% of 6- to 8-year-old children experienced ECC. Water fluoridation was implemented in 1961 at 0.7 ppm (0.9 ppm in winter) to prevent caries. The government offered free 9-year education in 1978. In 1981, the government established a dental school to improve a low dentist-to-population ratio of 1:9000. The ECC prevalence amongst 5- to 6- year-old children was reduced from 84% in 1968 to 63% in 1986. The Department of Health created an oral health education division in 1989. The ECC prevalence for 5-year-old children was further reduced to 44% in 1997. The ECC prevalence amongst 5-year-old children was stabilised at 51% both in 2001 and 2011. However in 2021, the prevalence of untreated ECC increased to 57% during the outbreak of COVID-19. Meta-regression analysis showed that ECC prevalence was not linked to GDP growth but decreased with improvements in HDI, the provision of 9-year free education, the establishment of a dental school, fluoridation of water supply, and implementation of territory-wide oral health promotion. In conclusion, better education, living conditions, and dental public health programmes have improved children's oral health in Hong Kong.

Keywords: Caries; Childhood; Children; Fluoride; Prevention; Water fluoridation.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest None disclosed.

Figures

Fig 1
Fig. 1
Water fluoridation and early childhood caries (ECC) prevalence from 1960 in Hong Kong.
Fig 2
Fig. 2
Early childhood caries (ECC) experience and oral health–related events from 1960 in Hong Kong.
See this image and copyright information in PMC

References

    1. American Academy of Pediatric Dentistry. Definition of early childhood caries (ECC). 2008. Available from: https://www.aapd.org/assets/1/7/d_ecc.pdf. Accessed 20 May 2023
    1. Colak H, Dulgergil CT, Dalli M, Hamidi MM. Early childhood caries update: a review of causes, diagnoses, and treatments. J Nat Sci Biol Med. 2013;4(1):29–38. - PMC - PubMed
    1. Anil S, Anand PS. Early childhood caries: prevalence, risk factors, and prevention. Front Pediatr. 2017;5:157. - PMC - PubMed
    1. Duangthip D, Gao SS, Lo EC, Chu CH. Early childhood caries among 5- to 6-year-old children in Southeast Asia. Int Dent J. 2017;67(2):98–106. - PMC - PubMed
    1. Department of Health. Oral health survey 2011. 2012. Available from:https://www.toothclub.gov.hk/en/en_pdf/Oral_Health_Survey_2011/Oral_Heal.... Accessed 20 May 2023