Early childhood caries – epidemiology, etiology, risk factors, complications and prevention
Authors:
A. Kovalčík; P. Kamínková; M. Miklasová
Authors‘ workplace:
Klinika zubního lékařství, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice, Olomouc
Published in:
Česká stomatologie / Praktické zubní lékařství, ročník 124, 2024, 2, s. 37-44
Category:
Review Article
doi:
https://doi.org/10.51479/cspzl.2023.011
Overview
Introduction and aim: Dental caries in preschool-age children is a serious problem of modern society with a high prevalence. Early Childhood Caries (ECC) is defined as the presence of one or more cavitated or noncavitated carious lesions, teeth extracted due to caries or teeth treated with filling therapy in children under the age of 71 months. Although it is a preventable disease with known causes, it is the most common chronic disease in children. It substantially affects the quality of life of children and their parents and represents a burden on public health. This condition requires professional care, but it is often left with no therapy. The aim of this review is to summarize the available knowledge on prevalence, etiology, risk factors, complications, and prevention of early childhood caries.
Methods: For this review, publications in English and Czech were searched from the databases PubMed, Web of Science, and Medvik using the key words: ECC, early childhood caries, caries in children.
Results: The prevalence of ECC remains high despite education and preventive measures. The frequency of untreated ECC and associated complications is also substantial.
Conclusion: The issue of early childhood caries is still highly relevant. It is important for both the paediatric dentist and the general dentist to understand the causes of its development and to identify risk factors in the individual patient. Prevention of ECC should start prenatally.
Keywords:
ECC, early childhood caries, caries in preschool-age children
Sources
1. 1. American Academy of Pediatric Dentistry (AAPD).
Policy on early childhood caries (ECC): Classifications, consequences, and preventive strategies. [cit. 11. 8. 2023]. Dostupné z: https://www.aapd.org/media/policies_guidelines/p_eccclassifications.pdf
2. Bittencourt JM, Martins LP, Paiva SM, Pordeus IA, Bendo CB.
Psychosocial associated factors of early childhood caries and oral health-related quality of life: Structural equation model approach. J Dent. 2023; 2023(133):104506. doi: 10.1016/j.jdent.2023.104506
3. GBD 2016
Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1211–1259.
doi: 10.1016/S0140-6736(17)32154-2
4. Merglová V, Ivančaková R.
Zubní kaz v raném dětství. Pediatr praxi. 2010; 10(6): 394–396.
5. Harries EHR, Lord BS.
Comforter caries. Lancet.
1911; 11: 1327–1328.
6. Tinanoff N, Baez RJ, Diaz Guillory C, Donly KJ, Feldens CA, McGrath C, Phantumvanit P, Pitts NB, Seow WK, Sharkov N, Songpaisan Y, Twetman S.
Early childhood caries epidemiology, aetiology, risk assessment, societal burden, management, education, and policy: Global perspective. Int J Paediatr Dent. 2019; 29(3): 238–248. doi: 10.1111/ipd.12484
7. Fass E.
Is bottle-feeding of milk a factor in dental caries? J Dent Child. 1962; 29: 245–251.
8. Blanchet I, Saliba-Serre B, Amiel L, Al-Azawi H, Tardieu C, Camoin A.
Early childhood caries: Detection, prevention and referral. A questionnaire study of general medical practitioners and pediatricians in the south of France. Arch Pediatr. 2023; 30(5): 321–326. doi: 10.1016/j.arcped.2023.05.002
9. Namita RR.
Adolescent rampant caries. Contemp Clin Dent. 2012; 3(Suppl 1): 122–124.
doi: 10.4103/0976-237X.95122
10. Meyer F, Enax J.
Early childhood caries: epidemiology, aetiology, and prevention. Int J Dent. 2018; 2018: 1415873. doi: 10.1155/2018/1415873
11. WHO.
World Health Assembly Resolution paves the way for better oral health care.
[cit. 11. 7. 2023]. Dostupné z: https://www.who.int/news/item/27-05-2021-world-health-assembly-resolution-paves-the-way-for-better-oral-health-care
12. Evans RW, Feldens CA, Phantunvanit P.
A protocol for early childhood caries diagnosis and risk assessment.
Community Dent Oral Epidemiol. 2018;
46(5): 518–525.
doi: 10.1111/cdoe.12405
13. Uribe SE, Innes N, Maldupa I.
The global prevalence of early childhood caries: A systematic review with meta-analysis using the WHO diagnostic criteria.
Int J Paediatr Dent. 2021; 31: 817–830.
doi.org/10.1111/ipd.12783.
14. Chen KJ, Gao SS, Duangthip D, Lo ECM, Chu CH.
Prevalence of early childhood caries among 5-year-old children: A systematic review.
J Investig Clin Dent. 2019; 10(1): e12376.
doi: 10.1111/jicd.12376
15. Severino M, Caruso S, Ferrazzano GF, Pisaneschi A, Fiasca F, Caruso S, De Giorgio S.
Prevalence of Early Childhood Caries (ECC) in a paediatric italian population:
An epidemiological study. Eur J Paediatr Dent. 2021; 22(3): 189–198.
doi: 10.23804/ejpd.2021.22.03.3
16. Tušek I, O'Rourke B, Lekić C, Tušek J, Tušek B.
Early childhood caries in multilingual community. Cent Eur J Public Health.
2020; 28(4): 286–291.
doi: 10.21101/cejph.a6345
17. Radácsi A, Dergez T, Csabai L, Stáczer N, Katona K, Balásné Szántó I, Sándor B.
A súlyos korai gyermekkori fogszuvasodás előfordulása és összefüggései pécsi bölcsődések között [Prevalence and correlation of severe early childhood caries among preschool children in Pécs]. Orv Hetil. 2021; 162(22): 861–869.
doi: 10.1556/650.2021.32049
18. Fernández CN, Borjas MI, Cambría-Ronda SD, Zavala W.
Prevalence and severity of early childhood caries in malnourished children in Mendoza, Argentina. Acta Odontol Latinoam. 2020; 33(3): 209–215.
19. Liu M, Song Q, Xu X, Lai G.
Early childhood caries prevalence and associated factors among preschoolers aged 3–5 years in Xiangyun, China:
A cross-sectional study. Front Public Health. 2022; 10: 959125.
doi: 10.3389/fpubh.2022.959125
20. Handzel J.
Prevence časného zubního kazu dítěte. Pediatr praxi. 2008; 9(1): 61–62.
21. Merglová V, Ivančaková R.
Zubní kaz a jeho prevence v časném dětském věku. 1. vydání. Praha: Česká stomatologická komora; 2009.
22. Lenčová E, Broukal Z.
Prevalence zubního kazu u českých předškolních dětí. Čes stomatol Prakt zubní lék. 2012; 112(6): 168–172.
23. Bartošová M, Kukletová M, Izakovičová Hollá L.
Kariogenní mikroflóra u dětí s kazem časného dětství a u jejich matek.
Čes stomatol Prakt zubní lék. 2021;
121(1): 19–27.
24. Kukletová M, Izakovičová Hollá L, Broukal Z, Musilová K, Kukla L.
Vztah mezi ukazateli orálního zdraví u 13–15letých dětí skupiny ELSPAC Brno a stupněm vzdělání jejich rodičů.
Čes stomatol Prakt zubní lék. 2013;
113(1): 7–13.
25. Schmoeckel J, Gorseta K, Splieth CH, Juric H.
How to intervene in the caries process: early childhood caries – a systematic review.
Caries Res. 2020; 54(2): 102–112.
doi: 10.1159/000504335
26. Lu Y, Lin Y, Li M, He J.
Roles of Streptococcus mutans-Candida albicans interaction in early childhood caries: a literature review. Front Cell Infect Microbiol. 2023; 13: 1151532.
doi: 10.3389/fcimb.2023.1151532
27. Merglová V.
Stanovení rizika vzniku kazu v časném dětství. Čes stomatol Prakt zubní lék. 2007; 107(4): 85–89.
28. Koberová Ivančaková R, Merglová V.
Dětské zubní lékařství. 1. vydání. Praha: Advertis; 2014.
29. Xu X, Shan B, Zhang Q, Lu W, Zhao J, Zhang H, Chen W.
Oral microbiome characteristics in children with and without early childhood caries.
J Clin Pediatr Dent. 2023; 47(2): 58–67.
doi: 10.22514/jocpd.2023.012
30. Branger B, Camelot F, Droz D, Houbiers B, Marchalot A, Bruel H, Laczny E, Clement C.
Breastfeeding and early childhood caries. Review of the literature, recommendations, and prevention. Arch Pediatr. 2019; 26(8): 497–503.
doi: 10.1016/j.arcped.2019.10.004
31. Echeverria MS, Schuch HS, Cenci MS, Motta JVDS, Bertoldi AD, Britto Correa M, Huysmans MDNJM, Demarco FF.
Early sugar introduction associated with early childhood caries occurrence.
Caries Res. 2023; 57(2): 152–158.
doi: 10.1159/000529210
32. Sæthre HB, Wang NJ, Wigen TI. Prolonged breastfeeding and dental caries in preschool children. Acta Odontol Scand.
2023; 21: 1–6.
doi: 10.1080/00016357.2023.2211154
33. WHO.
Breastfeeding. [cit. 11. 8. 2023].
Dostupné z: https://www.who.int/health-topics/breastfeeding#tab=tab_2
34. Mathias FB, Cademartori MG, Buffarini R, Barros F, Bertoldi AD, Demarco FF, Goettems ML.
Breastfeeding, consumption of ultraprocessed foods, and dental caries at 4 years of age: A birth cohort study.
Int J Paediatr Dent. 2023; 1–11.
doi:10.1111/ipd.13087.
35. Linhartová P, Kukletová M, Hollá L. Vztah mezi kojením a výskytem závažného kazu raného dětství. Čes stomatol Prakt zubní lék. 2018; 118(3): 59–67.
doi: 10.51479/cspzl.2018.007
36. Cui L, Li X, Tian Y, Bao J, Wang L, Xu D, Zhao B, Li W.
Breastfeeding and early childhood caries: a meta-analysis of observational studies.
Asia Pac J Clin Nutr. 2017; 26(5): 867–880.
doi: 10.6133/apjcn.082016.09
37. Ferro R, Besostri A, Olivieri A, Benacchio L.
Early childhood caries in a preschool-based sample in northeast Italy: socioeconomic status and behavioral risk factors.
Int J Clin Pediatr Dent. 2022; 15(6): 717–723.
doi: 10.5005/jp-journals-10005-2469
38. Bulut G, Kilinc G.
The impact of infant feeding and oral hygiene habits on early childhood caries: A cross-sectional study.
Niger J Clin Pract. 2023; 26(6): 810–818.
doi: 10.4103/njcp.njcp_904_22
39. Yadav SP, Meghpara M, Marwah N, Nigam AG, Godhani S, Chalana S. Association of early childhood caries with feeding, dietary habits, and oral hygiene practices among rural and urban school children of Jaipur. Int J Clin Pediatr Dent. 2022; 15(3): 273–279.
doi: 10.5005/jp-journals-10005-2396
40. Suprabha BS, D'Souza V, Shenoy R, Karuna YM, Nayak AP, Rao A.
Early childhood caries and parents' challenges in implementing oral hygiene practices: a qualitative study. Int J Paediatr Dent. 2021; 31(1): 106–114.
doi: 10.1111/ipd.12696
41. Gudipaneni RK, Patil SR, Assiry AA, Karobari MI, Bandela V, Metta KK, Almuhanna R.
Association of oral hygiene practices with the outcome of untreated dental caries and its clinical consequences in pre- and primary school children: A cross-sectional study in a northern province of Saudi Arabia.
Clin Exp Dent Res. 2021; 7(6): 968–977.
doi: 10.1002/cre2.438
42. Koberová Ivančaková R, Merglová V. Důsledky zanedbání a nevhodného ošetření zubního kazu v časném dětství.
Čes stomatol Prakt zubní lék. 2020;
120(1): 26–31.
doi: 10.51479/cspzl.2020.006
43. Sischo L, Broder HL.
Oral health-related quality of life: what, why, how, and future implications.
J Dent Res. 2011; 90(11): 1264–1270.
doi: 10.1177/0022034511399918
44. Zaror C, Matamala-Santander A, Ferrer M, Rivera-Mendoza F, Espinoza-Espinoza G, Martínez-Zapata MJ.
Impact of early childhood caries on oral health-related quality of life: A systematic review and meta-analysis. Int J Dent Hyg. 2022; 20(1): 120–135.
doi: 10.1111/idh.12494
45. Anil S, Anand PS.
Early childhood caries: Prevalence,
risk factors, and prevention. Front Pediatr. 2017; 5: 157.
doi: 10.3389/fped.2017.00157
46. Gunay B, Kaya MS, Ozgen IT, Guler EM, Kocyigit A.
Evaluation of the relationship between pain inflammation due to dental caries and growth parameters in preschool children.
Clin Oral Investig.
2023; 27(7): 3721–3730.
doi: 10.1007/s00784-023-04988-2
47. Lui DT, Wahab RMA, Kuppusamy E, Hamzaid NH, Hassan MR, Yazid F. Association of early childhood caries and nutritional status: a scoping review.
J Clin Pediatr Dent. 2023; 47(3): 11–25.
doi: 10.22514/jocpd.2023.021
48. Nadelman P, Bedran N, Magno MB, Masterson D, de Castro ACR, Maia LC. Premature loss of primary anterior teeth and its consequences to primary dental arch and speech pattern: A systematic review and meta-analysis. Int J Paediatr Dent. 2020;
30(6): 687–712.
doi: 10.1111/ipd.12644
49. Nadelman P, Gárate KM, Oliveira A, Pithon MM, de Castro ACR, Maia LC.
Dental arch perimeter changes as a result from premature loss of primary anterior teeth due to trauma: A case series in infant and pre-school children.
Int J Paediatr Dent. 2021; 31(5): 598–605.
doi: 10.1111/ipd.12738
50. Gandhi JM, Gurunathan D.
Short- and long-term dental arch spatial changes following premature loss of primary molars: A systematic review.
J Indian Soc Pedod Prev Dent. 2022;
40(3): 239–245.
doi: 10.4103/jisppd.jisppd_230_22
51. Kaplová E.
Kaz raného dětství a jeho následky na stálém chrupu. Čes stomatol Prakt zubní lék. 2014; 114(1): 3–8.
doi: 10.51479/cspzl.2014.025
52. McGoldrick N, Burns J, Muir M.
Is there an association between prenatal oral healthcare and early childhood caries prevention? Evid Based Dent. 2019; 20(2): 64–65.
doi:10.1038/s41432-019-0027-4
53. Toumba KJ, Twetman S, Splieth C, Parnell C, van Loveren C, Lygidakis NΑ. Guidelines on the use of fluoride for caries prevention in children: an updated EAPD policy document. Eur Arch Paediatr Dent. 2019; 20(6): 507–516.
doi: 10.1007/s40368-019-00464-2
54. American Academy of Pediatric Dentistry (AAPD).
The importance of the Age One Dental Visit. [cit. 2. 12. 2023]. Dostupné z: https://www.aapd.org/globalassets/media/policy-center/year1visit.pdf
55. European Academy of Paediatric Dentistry (EAPD).
Guidelines on Prevention of Early Childhood Caries: An EAPD Policy Document.
[cit. 2. 12. 2023]. Dostupné z: https://www.eapd.eu/uploads/1722F50D_file.pdf
56. Česká společnost pro dětskou stomatologii.
Doporučení a postupy v prevenci zubního kazu u dětí a mládeže. [cit. 2. 12. 2023]. Dostupné z https://www.csds.stomatolog.cz/dokumenty/DP_prevence_zubniho_kazu.pdf
57. Mallineni SK, Alassaf A, Almulhim B, Alghamdi S.
Influence of tooth brushing and previous dental visits on dental caries Status among Saudi Arabian children. Children. 2023; 10(3): 471. https://doi.org/10.3390/children10030471
58. Alhareky M, Nazir MA.
Dental visits and predictors of regular attendance among female schoolchildren in dammam, Saudi Arabia. Clin Cosmet Investig Dent. 2021; 13: 97–104.
doi: 10.2147/CCIDE.S300108
Labels
Maxillofacial surgery Orthodontics Dental medicineArticle was published in
Czech Dental Journal
![Issue 2](https://www.prolekare.cz/media/cache/resolve/journal_issue/media/image_pdf/98d26f110610dd3a2e7743b24c9e1fd9.jpg)
2024 Issue 2
Most read in this issue
- Early childhood caries – epidemiology, etiology, risk factors, complications and prevention
- A multidisciplinary approach to diagnosis and treatment of plasma cell neoplasm of a lower jaw
- Zveme vás na mezinárodní kongres Pražské dentální dny 2024
- Jubileum profesora MUDr. Jana Kiliana, DrSc.