Multicountry Study of ECC Prevalence and Severity using ICDAS in Children 1-5 Years in 11 Latin-American Countries

Background: To train researchers from 11(eleven) selected countries in Latin America in epidemiological methods and diagnostic criteria for dental caries to determine the prevalence and severity of ECC with ICDAS among children 1 to 5 years old.

Methods: During the first phase, 11 trainees (one paediatric dentist of each country) were trained in a modified ICDAS for epidemiological studies (joined codes 1 and 2) with a Gold Standard trainee (HE). Inter-examiner weighted Kappas: 0.79-0.86, intra-examiner weighted kappas: 0.84-0.97 was obtained, each trainee trained 6-12 examiners in their country during the second phase of the study. The third phase was the epidemiological study in each country. Head-lights, oral mirrors, WHO probes and gauzes to dry each surface were used. Previously was necessary brush the teeth and use dental floss. Knee-knee technique was used to evaluate children under 3years. Only children with signed parental consent were examined. A total amount of 4,025 children were included in the study.

Results: A high prevalence of non-cavitated and cavitated lesions was evident in children at early ages. The mean prevalence of ECC was high in the 11 countries. ICDAS prevalence was high during the second year of life, mean d2-6mfs 57.9% and d3-6mfs 41.1%. At 5y a high range prevalence of ECC 62.5 - 94.1% and 53.3 -85.5% was found for d2-6mfs and d3-6mfs respectively.

Conclusions: There is evidence that ECC was occurring very early in life in the 11 countries. More studies with standardized diagnostic criteria and calibrated examiners are necessary to compare the prevalence of ECC. Finally, effective early preventive interventions need to be developed and tested.

This study was supported in part by IADR Regional Development Program, with the collaboration of 12 Universities of Latin America.