Early Childhood Caries Amongst Pre-School Children and their Caregivers’ Perceptions of Oral Health in a Kenyan Rural Setting

Background: Although previous studies have reported varied findings on the relationship between ECC and caregivers’ oral health knowledge, it is possible that the knowledge, attitude and practice of the caregiver may influence the general oral health of the children under their care. The objective of the study was to determine the prevalence and patterns of ECC among 3-5 year olds and their caregivers’ oral health knowledge, attitude and practice in Kiambaa division, Kenya.

Methods: The study was conducted in Kiambaa division, Kenya and included 3 to 5 year-old children attending pre-schools. A total of 336 children were enrolled and examined for caries using WHO guidelines. Additionally, a pre-tested self-administered questionnaire was sent home to the respective caregiver to elicit their oral health knowledge, attitudes and practices.

Univariate analyses were performed using Chi square statistics and a p value less than 0.05 was considered significant. Ethical approval was obtained and a written consent was sought and obtained from the caregiver. Prior to the study, calibration for the principal investigator was done in respect to caries diagnosis and Kappa values of 0.89 (n=10) and 0.92 (n=10) were obtained.

Results: Slightly over a half, 201 (59.5%) had dental caries. The mean dmft was 2.46+3.2 SD with the greatest component (95%) being decayed teeth. Majority (94.4%) of the children brushed at least once daily with 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%. Oral health knowledge among caregivers was relatively high but the effect of infant feeding practices on dental caries was low. Although the majority of the children brushed their teeth, less than half of them received assistance from their caregivers.