A descriptive analysis of reasons for early childhood caries among a selected group of Sri Lankan preschool children

Introduction: Dental caries is a microbial disease of the calcified tissues of the teeth. When a child has one or more decayed missing (due to caries) or filled tooth surfaces (DMFT) in any primary teeth by 71 months or younger it is defined as early childhood caries (ECC). Objectives: To analyse the dietary habits and oral hygienic practices among a selected group of preschool children who were diagnosed to suffer from ECC, using their primary caregiver responses. Method: A cross sectional study was conducted among primary caregivers of children 1-5 years old with proven dental caries who were referred to the Dental Institute Maharamaga from September to December 2018. Primary caregivers of mentally retarded children and caregivers who were not familiar with the child’s routine were excluded.  Results:Total number of primary caregivers involved in the study was 213. Among them 194 (91%) were mothers. Among the children included in the study, 104 (51.2%) were girls. The children had a mean age of 42 months with the majority belonging to the 49-60 month age group. Majority (60%) of children were introduced to use a toothbrush between 1-2 years of age and only 2 (0.9%) started to use a toothbrush after 2 years of age. The majority (86.9%) of caregivers stated that their children do tooth brushing twice a day and 85.9% stated that they themselves brush their child’s teeth. The majority (98.1%) of caregivers stated that they use toothpaste to brush their child’s teeth and 88% stated that the toothpaste they use contains fluoride. Ninety seven (45.5%) caregivers were still breast feeding at the time of the study and of them 41(42.3%) breast fed during sleep. Only 52 (24.4%) children were bottle fed. Of the carers of bottle-fed children, 56% stated that their children bottle-fed during bedtime. Thirty two (61.5%) caregivers of bottle-fed children used to add sugar to child’s milk bottle. Furthermore, 32 (61.5%) caregivers had not practised mouth washing after bottle-feeding. Conclusions: In this study at the Dental Institute Maharamaga, 213 children had proven ECC despite the majority of caregivers introducing their children to the tooth brush between 1-2 years of age, themselves brushing their children’s teeth twice a day and using toothpaste containing fluoride. Almost all children consumed sugary food items, such as biscuits and sugar containing milk products more than once daily. Two other possible reasons for the high rate of ECC in this study were not washing the children’s mouths after they consumed sugary food and breast feeding during sleep.  Sri Lanka Journal of Child Health, 2020; 49(3): 246-250