Epidemiological survey of early childhood caries in Cambodia

Abstract

Background The Southeast Asian Forum for Early Childhood Caries identified the need for more epidemiological surveys involving preschool children. To date, the only data on Early Childhood Caries in Cambodia come from convenience samples and only using the basic dmft index without measurement of the early signs of disease. Methods A cross-sectional survey on an epidemiological sample of Cambodian preschool children was conducted in conjunction with the fourth follow-up of the Cambodian Health and Nutrition Monitoring Study. Children were examined in a field setting using both the South East Asian Index for Early Childhood Caries as well as the ‘pulpally involved, ulcerated, fistula, abscess’ (pufa) index. Caregivers also participated in a short questionnaire covering dietary habits, oral health knowledge and behaviors, as well as the Family Impact Scale (FIS) for Oral-Health-Related Quality-of-Life. Results The sample included 3985 participants between birth and 4-years of age, across three provinces. There was an even sex distribution (50.7% male). Overall 56.6% of participants had one or more carious lesions and 5.4% had one or more pulpally-involved teeth. There were some significant differences by age and location. Among those in the 3-year-old age group 84.9% had at least one decayed tooth, and 16.1% had one or more pulpally-involved teeth. There were differences in oral health knowledge and behaviors by province; those in Phnom Penh reported more favorable responses. Consumption of non-nutritious foods also differed between provinces with those in Phnom Penh consuming a higher mean number of sweet beverages per day. Those children with at least one pulpally involved tooth had a ten times greater chance of realizing an impact across the FIS. Conclusions Cambodian preschool children have a severe burden of dental caries and a high proportion of families are impacted by this problem. There were differences in oral health knowledge and behaviors according to province and this translated into differences in caries experience. The data from this study support the need for urgent action to address the issue of ECC in Cambodia.

Family Impacts of Severe Dental Caries among Children in the United Kingdom

“…These findings are consistent with earlier research, which demonstrated an association between childhood caries and negative family impacts [20][21][22][23][24][25][26]. However, all earlier research used the DMFT index, which also captures mild (usually asymptomatic) disease stages.…”

“…Childhood dental caries, when left untreated, is usually associated with dental pain and inability to eat or sleep [14][15][16][17], which in turn can negatively impact the child's daily activities, including school attendance [18,19]. Several studies have shown that untreated caries among children can have a negative impact on their families as parents feel upset and guilty, take time off work to take care of the child, and endure financial difficulties [20][21][22][23][24][25][26]. However, most of these studies did not account for important confounders during analysis, such as the family structure [20][21][22][23][24][25][26] and socioeconomic circumstances [23][24][25][26], which are known determinants of both childhood dental caries and family life.…”

“…Several studies have shown that untreated caries among children can have a negative impact on their families as parents feel upset and guilty, take time off work to take care of the child, and endure financial difficulties [20][21][22][23][24][25][26]. However, most of these studies did not account for important confounders during analysis, such as the family structure [20][21][22][23][24][25][26] and socioeconomic circumstances [23][24][25][26], which are known determinants of both childhood dental caries and family life. Furthermore, most studies that examined the relationship between dental caries and impacts on family used the count of decayed, missing, and filled teeth (DMFT index).…”

Assessment of risk factors for early childhood caries at different ages in Shandong, China and reflections on oral health education: a cross-sectional study

“…Age has been evidenced to be an independent risk factor of ECC by many studies [13,20,25], and this finding was corroborated in current study. Most researches, however, evaluate 3-5-year-old children as whole with few studies access the risk factors for each age.…”

“…[17]. Compared to some other developing countries in Asia, Thailand (age 5: 78.5%) [18], Indonesia (age 0-5: 70.0%) [19], Myanmar (age 5-6: 81.3%) and Cambodia (age 3: 84.9%) [20], all have higher rates of ECC. While in developed countries like Japan and Singapore, the ECC rates are down to 44.4% and 49% respectively [21,22], which is significantly lower than the results of 63% obtained by statistics worldwide [23] and has already achieved the goal of less than 50% prevalence of ECC for the year of 2020 raised by WHO [24].…”