Magister Scientiae Dentium - MSc(Dent) / Early Childhood Caries (ECC) is a public health problem both in developing and developed countries. Its widespread prevalence among children makes it ideal for assessing the risk factors and identifying specific strategies that could be implemented to prevent the disease. The aim of the present study was to determine the risk factors associated with early childhood caries among 5 – 48 month children in Mariental, Namibia. The objectives were to determine (i) the prevalence and severity of early childhood caries in 5 – 48 months old children (ii) the risk of early childhood caries associated with feeding practices, social and cultural behaviour, sugar consumption, dental health awareness, fluoride and risk behaviour. The study design used was cross-sectional and descriptive. A convenience sample was used as mothers visited the post-natal clinic or the hospital for treatment of other ailments or problems. The sample size comprised 230 mothers and their children and only mothers and their biological children in the age range 5- 48 months were included in the survey. Data was collected by using an open- and closed-ended questionnaire that included questions regarding the child‘s dietary and nutritional habits, oral hygiene habits, socio-economic status and beliefs. Mothers and their biological children were examined for presence or absence of dental caries and the findings were recorded on a modified WHO data sheet. The mean age of the children was 24 months, the mean deft 1.5 and the Significant Caries Index (SiC) was 4.5. There was an increase in caries prevalence (add caries prevalence) with increasing age both among girls and boys. The mean DMFT of the mothers was 7.1, their SiC was 17.11 and more than three quarters had at least one tooth missing which was extracted due to caries and just under a quarter had one or more decayed teeth. Despite the fact that most of the mothers reported knowing the importance of good oral hygiene, brush their own teeth and cleaning their children‘s mouth both mothers and their children had high DMFT or deft indices. This is due to a multiplicity of factors – the majority of the mothers were both uneducated and unemployed and have difficulty in making or taking appropriate choices conducive to healthy lifestyles in turn affecting their behaviours and oral hygiene practices.

With over 20 million Americans living in food deserts, it is no wonder why the children who living in these areas are consuming more processed foods. Processed foods and lack of proportional diet can have an adverse effect on the oral health of children and adults leading to tooth decay. Early Childhood Caries (ECC) is the most chronic disease in children and it is especially chronic within children who come from disadvantage backgrounds. The objective of this study is to explore the multiple paradigms of tooth decay that exist within the minority population of children. The mechanism behind what leads to tooth decay will be evaluated in conjunction with other factors such as: disparities within minority children, insurance coverage, and agriculture to demonstrate the high prevalence of ECC within minority children. What goes in a child’s mouth can really determine the state of their oral healthcare, however more times than not children lack the responsibility and depend heavily upon their guardian to get their dental needs met. The development of ECC can lead to more severe problems if left untreated, and currently there is a high prevalence of untreated ECC in predominantly minority neighborhoods where families are typically low income. Low-income means they are less likely to have a primary dentist leading to more untreated ECC, however it is also important to look at the federally funded programs. The government has been able to take strides in helping provided coverage for these at-risk children. ECC is chronic and can be detrimental to a child’s healthcare. What goes in the child’s mouth is also important in that in low-income neighborhoods there are deserts full of no organic options. This can have an adverse effect on the child’s help by their famine nutritional needs. There is a need for new policy to be implemented in order to increase the rate at which children go to the dentist as well as gain access to avoidable options. Although there were limits within this study, there are many suggested improvements and directions for future research to address. In conclusion, although the data reported here supports the conclusion that more evidence is needed that will lead to significant policy reform to eliminate the high prevalence of ECC especially within children coming from minority backgrounds. Positive progress is being made due to the constant support from both the government and community resources as well as dental practitioners who are focused on making a difference in the oral health and overall well-being of children.

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Bakgrund: Early childhood caries (ECC) är en kariesform som drabbar barn i tidig ålder. Sjukdomen karaktäriseras av ett snabbt progressionsförlopp och drabbar ofta släta ytor på de primära tänderna. Syfte: Syftet med litteraturstudien var att beskriva förekomsten och identifiera riskfaktorer till early childhood caries (ECC) bland barn mellan 0-6 år i Europa. Metod: Materialet som användes i litteraturstudien är vetenskapliga publikationer som huvudsakligen inhämtats från den medicinska databasen PubMed. Resultatet bygger på en sammanställning av 15 vetenskapliga artiklar som publicerats mellan 2000-2014. Resultat: Förekomsten av ECC varierade från 13.0-85.0 % i olika länder och populationer i Europa. Lägst respektive högst förekomst sågs hos barn i Sverige. ECC associerades med mat-och munhygienvanor samt med flera socioekonomiska faktorer, där föräldrars utbildning, arbetssituation och etnicitet var av störst betydelse. Amning och användning av nappflaska var beteendefaktorer som visade ett samband med ökad förekomst av ECC. Slutsats: ECC förekommer i både väst- och östeuropeiska länder. Kost- och munhygienvanor är av stor betydelse för utvecklingen av ECC, men sjukdomen har även en association med flera beteende- och socioekonomiska faktorer. / Background: Early childhood caries (ECC) is a form of dental caries that affects children at an early age. The disease is characterized by a rapid progression and it usually affects smooth surfaces of the primary teeth. Aim: The aim of this study was to describe the prevalence and identify risk factors for early childhood caries (ECC) among children between 0-6 years in Europe. Method: The material used in this review is scientific publications mainly collected from the medical database PubMed. The results are based on a compilation of 15 scientific articles published between 2000-2014. Results: The prevalence of ECC ranged from 13.0-85.0 % in different countries and populations in Europe. The lowest and highest occurrence of ECC was observed among children in Sweden. ECC was associated with dietary and oral hygiene habits, along with several socioeconomic factors, where the parent’s educational level, employment status and ethnicity were the most significant factors. Breastfeeding and the use of baby bottle were behavioral factors that showed an association with increased prevalence of ECC. Conclusion: ECC exists in both Western and Eastern European countries. Dietary and oral hygiene habits are very important for the development of ECC, but the disease has also a relation with several behavioral and socioeconomic factors.

<p>The American Academy of Pediatric Dentistry (2005/06) defines Early Childhood Caries (ECC) as the presence of 1 or more decayed (noncavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger. ECC can cause significant problems in preschool children and is a source of considerable societal costs. The South African national oral health survey conducted between the year 1999 and 2002 reported on the caries prevalence in young children. The caries prevalence was 50% in 4-5 year old children with a mean dmft of 2.4 (van Wyk and van Wyk, 2004).The aim of the study is to assess early childhood caries in children 12-24 months in the Mitchell's Plain district of the Western Cape.Objectives are to determine: a) The prevalence and pattern of early childhood caries. b) The relation between early childhood caries and infant feeding practices. c) The relation between early childhood caries and oral hygiene practices of the child.</p> <p>This study is a cross sectional study of ECC of children 12-24 months of age. Parent/child pair attending the Well Baby Clinic at Eastridge/Mitchell's Plain were informed about the study and invited to participate on a voluntary basis. The data collected consisted of a dental examination of 120 children (stratified by age: 60 in 12-18 months age group and 60 in 19-24 months age group) and a questionnaire completed by the accompanying parent/guardian. The dental examination was conducted using the WHO guidelines (Geneva 1997). Child age, tooth status (sound, decayed, filled, extracted, unerupted), and visible dental plaque on maxillary incisors (Spitz et al, 2006) were recorded.The prevalence of ECC for the sample was 23.3% (dmft =0.88). The maxillary incisors had the highest prevalence of decay (14%) followed by the maxillary molars (4%). There was a significant association (p=.006) between duration (12 months and more) of bottle use and presence of caries (40% caries prevalence). There is no significant difference between the different feeding practices (breast, bottle or both) and the presence of caries. There is a high prevalence of Early Childhood Caries (23.3%) in the 12-24 month age group. Early Childhood Caries was related to prolonged (&gt / 12 months) bottle feeding. The association between the presence of dental plaque and ECC was the most significant factor (p= .000).</p>