Early Childhood Caries and Feeding Habits as associated risk factor among Preschool Children in Yaounde

Sandrine Rolande DJOUMETE
Pediatrics, University of Yaounde I
June, 2016


Introduction: Early childhood caries (ECC) is a virulent form of caries beginning early in
life, soon after dental eruption on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on dentition. Children experiencing caries as infants or toddlers have a much greater problem of subsequent caries in both the primary and permanent dentitions. It constitutes a public health problem in both developing and industrialized countries with biological, social and behavioural determinants.
This cross-sectional study was undertaken to determine the prevalence of ECC and its association with feeding habits among other risk factors in preschool children aged 6
to 71 months consulting at the pediatric units of some hospitals and those registered in some
nursery schools of the Mfoundi division, Yaoundé municipality.
Methods: The study population of 419 children ranging in age from 6 to 71 months was
selected using a simple multistage sampling in Yaoundé, the capital of Cameroon. The dmft
index as recommended by the World Health Organization was used to assess dental caries and the diagnosis of ECC was based on the oral health criteria defined by the American Academy Pediatric Dentistry. A structured questionnaire was completed by each child’s caregiver. The survey questionnaire translated in French gathered information on the children’s demographic
background; socio-economic status; feeding practices and habits, duration of breastfeeding,
consumption and frequency of consumption of food and sugary beverages in particular; oral
health-related behaviours; and the medical history of the children. Data was then processed using SPSS software Version 20.0. Proportions were compared using Khi-square and Fisher exact test. Differences were considered statistically significant when p<0.05.
Results: The prevalence of ECC in preschool children was 55.4%, while the mean dmft was
2. ECC was severe in children from the Northern regions of Cameroon and this severe form was significantly correlated with age. Multivariate logistic analysis showed correlation of ECC with associated risk factors. The variables significantly associated with ECC were age (P<0.001), manner of feeding (P<0.001), duration of breastfeeding (P<0.001), snacking inbetween meals (P<0.001), sugary drinks consumption (P<0.001)and the frequency of
consumption (P<0.001), dairy products consumption and the frequency of consumption
(P<0.001) , and frequency of candies consumption (P<0.05), intake of syrupy medication and the frequency of intake (P<0.001), fluoride-ZYMADUO-supplements at birth (P<0.001), the level of education of the caregiver (P<0.05), family size (P<0.05), method of tooth cleaning
(P<0.001), onset and frequency of tooth cleaning (P<0.001) and the person responsible for child’s oral health care (P<0.001).
However, other variables like child’s gender, place of residence, medical history, family
monthly income, breastfeeding on demand and at night, onset of bottle feeding, the pretasting
of the child’s food by the caregiver, fruit consumption, use of pacifier and visible plaque did not have a statistically significant relationship with ECC (P<0.05).
Conclusion: From the results of this study, it is concluded that the prevalence of ECC is high
among preschool children in Yaoundé. Furthermore, the groups at high risk from dental caries
lesions are: those who receive breast milk on demand and at night (1), those who snack inbetween
meals (2), those who consume sugary drinks and confectioneries very often (3), those
with poor oral health practices (4), and those who are not given fluoride supplements at birth
(5). In sight of these, public oral health strategies should be targeted at mothers,
paediatricians, gynaecologists, nurses, primary health care providers and caregivers in nursery