Early childhood caries among 3-5 year olds and their Caregivers' oral health knowledge, attitude and practice in Kiambaa division, Kenya

Abstract

INTRODUCTION: Early Childhood Caries (ECC) denotes any form of caries occurring in the primary dentition of children before 71 months of age. The prevalence of ECC appears to be on the increase among preschool children in Kenya.Change of diet from the traditional fibrous foods to western refined foods coupledwith poor oral hygiene of the children may be part of the reason for the increase. Oral health knowledge and attitudes of caregivers may influence dietary habits and oral hygiene practices of their children. OBJECTIVE: To determine the prevalence and patterns of ECC among 3-5 year olds and their caregivers' oral health knowledge, attitude and practice in one divisionof Kiambu District, Kenya. MATERIALS AND METHODS: This was a descriptive, cross-sectional study conducted among 3-5 year old children. A list of schools from the District Education office was used as the sampling frame. Stratified random sampling was used. The schools were categorized into private and public. A table of random numbers was used to select schools from each category until the sample size was obtained. A total of 343 children were enrolled in the study. An oral examination of the children was done under natural light using a dental probe and mirror. ECC experience was assessed using decayed, missing, filled teeth (dmft) index in accordance with World Health Organisation (WHO) criteria of 1997. Three hundred and forty three questionnaires were sent to the respective child's caregiver. Information sought included caregivers oral health related knowledge, attitudes and practices. IX DATA ANALYSIS: The data was analysed using SPSS 12.0.1 for Windows version. Descriptive analysis was used to report cross-sectional data. Univariate analyseswere performed using chi-square statistics and one- way ANOVA. RESULTS: Slightly over a half, 201 (59.5%) had dental caries. The mean dmft was 2.462:3.2 SD with the greatest component (95%) being decayed teeth. Mandibular deciduous molars and maxillary incisors were the most frequently affected teeth. Majority (94.4%) of the children brushed at least once daily. Ninety five percent of the children used toothpaste. The caregivers' knowledge on causes and prevention of caries was high. Although 85% of caregivers reported that deciduous teeth were important, 57% preferred extraction of an asymptomatic carious deciduous tooth. CONCLUSIONS: The prevalence of ECC was 59.5% while the dmft was 2.42: 3.2 with a mean decayed component of 2.36. Children from private pre-schools had a statistically higher prevalence of ECC compared to those from public preschools. Oral health knowledge among the caregivers was relatively high but the role of infant feeding practices on ECC was low. RECOMMENDATIONS: Initiate oral health education programmes integrated with ANC, MCH/FP and School Health Education Programmes. Mobilise community oral health workers to perform regular dental check-ups of preschool children to enable prompt referral to the nearest dental health facility. Conduct further research to elicit factors influencing dental health seeking behaviour and dietary habits of the children.