Indian Journal of Dental ResearchIndian Journal of Dental ResearchIndian Journal of Dental Research
HOME | ABOUT US | EDITORIAL BOARD | AHEAD OF PRINT | CURRENT ISSUE | ARCHIVES | INSTRUCTIONS | SUBSCRIBE | ADVERTISE | CONTACT
Indian Journal of Dental Research   Login   |  Users online:

Home Bookmark this page Print this page Email this page Small font sizeDefault font size Increase font size         

 


 
Table of Contents   
ORIGINAL RESEARCH  
Year : 2022  |  Volume : 33  |  Issue : 3  |  Page : 297-300
Prevalence and determinants of early childhood caries among children enrolled in anganwadi centres in Bhilai of Central India: A cross-sectional study


1 Departments of Public Health Dentistry, Government Dental College, Raipur, Chhattisgarh, India
2 Department of Community and Family Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
3 Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
4 Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
5 Department of Orthodontics and Dentofacial Orthopaedics, Government Dental College, Raipur, Chhattisgarh, India
6 Department of Paediatrics and Preventive Dentistry, Government Dental College, Raipur, Chhattisgarh, India

Click here for correspondence address and email

Date of Submission09-Feb-2021
Date of Decision30-Aug-2022
Date of Acceptance02-Sep-2022
Date of Web Publication17-Jan-2023
 

   Abstract 


Introduction: Early childhood caries (ECC), which results in rapid involvement and progression of several teeth, is a growing concern in preschool children. It directly affects a child's overall health and quality of life. Aim: To assess the prevalence and determinants of ECC among children enrolled in Anganwadi centres in Bhilai city of Chhattisgarh. Methodology: This descriptive cross-sectional study was conducted among 360 children enrolled in Anganwadi of Bhilai. An oral examination and findings were recorded in 'dmft' using the WHO oral health assessment form for children 2013. The mothers' knowledge, attitude, and practice were determined by a professionally administered 10-item pre-tested short questionnaire with Cronbach's alpha of 0.86. The data were compiled and analysed using Microsoft Excel vs. 2013 and Statistical Package of Social Science (IBM SPSS version 23; Chicago Inc., USA). Results: The prevalence of ECC was 25.83%, out of which 13.33% in boys and 12.50% in girls. Children of middle school-educated mothers have 35.48% ECC, followed by high school and primary school, that is, 24.73 and 23.66, respectively. Mothers who assisted the children in tooth brushing have less prevalence of ECC (8.15%) as compared to non-assisted (17.8%) (P = 0.044). Conclusion: Although mothers' knowledge was appreciable regarding reasons for tooth decay, still 1/4th of the children were found to be affected by ECC. This necessitates the importance of regular/periodic screening campaigns for the children, implementing institutional preventive programmes, and referral for children to secondary/tertiary healthcare centres.

Keywords: Bottle feeding, child health services, early childhood caries, feeding behaviour, quality of life

How to cite this article:
Chevvuri R, Sharma H, Gupta R, Tiwari A, Singh GB, Singh A. Prevalence and determinants of early childhood caries among children enrolled in anganwadi centres in Bhilai of Central India: A cross-sectional study. Indian J Dent Res 2022;33:297-300

How to cite this URL:
Chevvuri R, Sharma H, Gupta R, Tiwari A, Singh GB, Singh A. Prevalence and determinants of early childhood caries among children enrolled in anganwadi centres in Bhilai of Central India: A cross-sectional study. Indian J Dent Res [serial online] 2022 [cited 2023 Feb 5];33:297-300. Available from: https://www.ijdr.in/text.asp?2022/33/3/297/367874



   Introduction Top


Early childhood caries (ECC) is a significant public health issue, especially in low socio-economic strata, resulting in a substantial effect on preschool children's overall health and quality of life. ECC can, however be controlled by careful management of common risk factors, that is, infant feeding and reduced intake of sugary food products, uniquely concerning those receiving supplementary feeding.[1]

ECC results in rapid involvement and progression of many teeth and areas considered relatively less susceptible to tooth decay. ECC is defined as 'The presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child 71 months of age or younger'.[2],[3]

ECC management requires different stages of prevention, beginning as early as possible with teeth brushing using fluoride toothpaste and adjustment of socio-behavioural and dietary influences.[1]

The mother plays a key role in the child's health and is mainly responsible for grooming the child's behavioural pattern.[4],[5]

Anganwadi, started four decades ago by Integrated Child Development Services (ICDS), plays a significant role in child development with the help of various tools for non-formal preschool education. Anganwadi plays a pivotal role in delivering integrated services for children of 0–6 years of age and check-up and referral services for pregnant and lactating mothers of disadvantaged sections.[6]


   Methodology Top


The present descriptive cross-sectional study assessed the prevalence and factors associated with ECC among Anganwadi children in Bhilai city of Chhattisgarh. The ethical approval was obtained from the institutional ethical committee (Letter No.: RCDSR/MDS/SYNOPREG/2016/31A, dated: 12/08/2016) following permission from the project officer, ICDS, Durg District (Letter No.: 2173/ICDS/2016-17, Dated: 09/09/16). This two-month study was conducted in September and October 2016 in '30' randomly selected Anganwadis out of 271 Anganwadi centres.

The sample size was determined using the Cochrane formula and the prevalence of ECC from a previously published study, that is, 36.40%.[7],[8]

N = Zα2 × p × q/e2

N = (1.96)2 × (0.364 × 0.636)/(0.05)2 = 356

The final estimated sample size was 356, rounded up to 360.

The children were included in the study using the following criteria, that is, children present on the day of examination in Anganwadi centres with mothers' consent and uncooperative children and consent refusals were excluded.

Before conducting an oral examination of the child, the mother was interviewed using a professionally administered 10-item short questionnaire, which was pre-tested for reliability with Cronbach's alpha value of 0.86. The questionnaire included mothers' knowledge, attitude, and practice regarding children's oral health, feeding-related habits and socio-demographic data.

Following the mothers' interview, the child was examined for their ECC in the Anganwadi centres' premises; adequate natural daylight and in case of very incipient caries hand-held torch was used. The examination finding was recorded in 'dmft' using the WHO oral health assessment form for children 2013.[9]

Statistical analysis

The collected data were compiled and organized in Microsoft Excel vs. 2013 for windows. The final data set was exported to the Statistical Package of Social Science (SPSS version 23; Chicago Inc., USA). For continuous data, mean and standard deviations were calculated, and for categorical or ordinal data frequencies, the significance level was set to be 0.05.


   Results Top


This descriptive cross-sectional study included 360 enrolled children attending Anganwadi centres, out of which 48.1% were boys and 51.9% were girls. The prevalence of ECC was 25.83%, accounting for 13.33% of boys and 12.50% of girls.

As per the educational qualification of mothers, 34.2% were educated till middle school, followed by high school and primary school. ECC prevalence was found to be 35.48% in children of mothers educated till middle school, followed by high school and primary school, that is, 24.73% and 23.66% respectively [Table 1].
Table 1: Distribution of mother's according to educational qualifications

Click here to view


Mothers working as daily wage workers and household maids were 82.1%, while a mere 2.5% were regular or self-employed. ECC prevalence was found to be 84.95% in children of mothers involved in daily wage/household chores, followed by those who were not employed or were housewives, that is, 10.75%.

Family income of most of the children suffering from ECC was in the range of Rs 1866 to Rs 5546 (i.e. 13.05%), and 11.95% belonged to the income range of Rs 5547 to Rs 9248 [Table 2].
Table 2: Distribution of participants according to monthly income

Click here to view


Mothers who assisted the children in tooth brushing have less prevalence of ECC (8.15%) as compared to non-assisted (17.8%) (P = 0.044) [Table 3].
Table 3: ECC status according to brushing assisted by mother

Click here to view


The assessment of the knowledge of participants' mothers revealed that 27.2% did not give importance to milk dentition, and 60% did not assist in brushing their child's teeth. When asked about tooth decay, 92.5% believed that frequent intake of sweets and not cleaning teeth are responsible for tooth decay. Above 90% of mothers believe that consumption of sugars and sticky foods is the reason for tooth decay. Brushing twice a day was thought to prevent tooth decay and preserve healthy teeth [Table 4].
Table 4: Responses to questionnaire for knowledge and attitude

Click here to view


Although 90% of mothers emphasize brushing twice daily to maintain decay-free teeth, 1.9% practiced twice daily brushing. Taking the child to the dentist for a regular check-up was a meagre finding, that is, 2.2%. The practice of bottle feeding by mothers was scarce, that is, 3.3% percent, out of which only 1.10% were feeding at the sleep time [Table 5].
Table 5: Responses to questionnaire for practice

Click here to view



   Discussion Top


Early childhood caries is a primary growing concern affecting infants and preschool children globally. It is a multifactorial disease mainly attributed to a complex interaction of diet, environmental factors, microorganisms, and the morphology of teeth.[3],[10]

Addressing this disease problem needs attention and care with the interaction of the child, oral healthcare provider, and mother. The awareness and attitude of parents, especially mothers, towards maintaining their children's optimal oral health during infancy plays a significant role in the subsequent status of their oral health and well-being.[11] The empowerment of mothers regarding their child's oral health skills and decision-making can play an influential role in oral health promotion.[12]

The current study revealed that the prevalence of ECC among the children in Anganwadi centres was 25.83%, which is less compared to other studies done in Central India, that is, 36.4% and 33.48%.[8],[13] The lower prevalence can be attributed to the minimal contribution of bottle feeding (i.e. mere 3.3%) and appreciable knowledge of mothers regarding tooth decay.

The prevalence of ECC in both genders was almost similar, with the difference being 0.8% only. These results are identical to the study conducted by Gaidhane et al.,[13] which reported an almost equal percentage of ECC in boys and girls with 31.37% and 32.20%, respectively.[13]

The prevalence of ECC was higher in children of mothers educated till middle school compared to those with mothers educated till high school and primary school. This can be attributed to the fact that less education led to daily wage employment in nature and resulted in more working hours and less attention to child oral health. It was also evident that children with mothers involved in daily wage/household chores had a much higher prevalence of ECC, that is, 84.95%, compared to those whose mothers were unemployed or were housewives, that is, 10.75%.[14]

Mothers who assisted the children in tooth brushing have statistically less prevalence of ECC than non-assisted. In early childhood, the child is less aware of the importance of oral health and methods to avoid oral and dental diseases. And this is the age where the mother plays a pivotal role in the child's development and health. Hence, any assistance provided by the mother in early childhood can improve these outcomes, which were also evident from the above findings.[15]

In the present study, it was evident that although the mothers' knowledge regarding the importance of milk teeth and oral hygiene practice was appreciable, still every 4th child was affected by ECC. This can be explained by the fact that while their knowledge was reasonable, this insight was not used to implement practices due to the lack of time and nature of employment.


   Conclusion Top


Although mothers' knowledge was good regarding reasons for tooth decay, still 1/4th of the children were found to be affected by ECC. This necessitates the importance of regular/periodic screening campaigns for the children and the implementation of institutional preventive programmes and referral for children to secondary/tertiary healthcare centres.

The prevalence of dental caries was higher among the Anganwadi children, indicating the lack of implementation knowledge, under utilization of oral health services and urgent treatment needs. The complicated mixture of many determinants and risk factors needs further research to obtain reliable information for explanatory models to identify at-risk infants.

Hence from this research's findings, we recommend that Anganwadi centres primarily focus on a child's general nurture but lack oral healthcare, which is the most important aspect of children's up bringing and quality of life.

Henceforth, some of the centres must be upgraded as Anganwadi Oral Healthcare Centres (AOHC) to screen children for oral health issues so that prompt preventive and treatment measures can be implemented to improve the quality of life of children.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. (2017). WHO expert consultation on public health intervention against early childhood caries: report of a meeting, Bangkok, Thailand, 26-28 January 2016. World Health Organization. Accessed from: https://apps.who.int/iris/handle/10665/255627 [Last accessed on 2021 Jan 24].  Back to cited text no. 1
    
2.
de Souza PM, Proença MA, Franco MM, Rodrigues VP, Costa JF, Costa EL. Association between early childhood caries and maternal caries status: A cross-section study in São Luís, Maranhão, Brazil. Eur J Dent 2015;9:122–6.  Back to cited text no. 2
    
3.
Anil S, Anand PS. Early childhood caries: Prevalence, risk factors, and prevention. Front Pediatr. 2017;5:157.  Back to cited text no. 3
    
4.
Andrade MR, Canabarro A, Moliterno LF. Experience of dental caries in mother/child pairs: Association between risk indicators and dental caries. Rev Gaúcha Odontol. 2012;60:179–85.  Back to cited text no. 4
    
5.
Agarwal V, Nagarajappa R, Keshavappasb, Lingesha RT. Association of maternal risk factors with early childhood caries in schoolchildren of Moradabad, India. Int J Paediatr Dent. 2011;21:382–8.  Back to cited text no. 5
    
6.
Integrated Child Development Services (ICDS) Scheme. Accessed from: Untitled Page (icds-wcd.nic.in). [Last accessed on 2021 Jan 24].  Back to cited text no. 6
    
7.
Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35:121–6.  Back to cited text no. 7
    
8.
Tyagi P. The Prevalence and pattern of dental caries in pre-school children. People's JSci Res 2009;2:1–4.  Back to cited text no. 8
    
9.
WHO. Oral Health Surveys, Basic Methods. 5th ed. Geneva: WHO; 2013.  Back to cited text no. 9
    
10.
Nunn ME, Braunstein NS, Krall Kaye EA, Dietrich T, Garcia RI, Henshaw MM. Healthy eating index is a predictor of early childhood caries. J Dent Res. 2009;88:361–6.  Back to cited text no. 10
    
11.
Saied-Moallemi Z, Virtanen JI, Ghofranipour F, Murtomaa H. Influence of mothers' oral health knowledge and attitudes on their children's dental health. Eur ArchPaediatr Dent 2008;9:79–83.  Back to cited text no. 11
    
12.
Folayan MO, El Tantawi M, Vukovic A, Schroth R, Gaffar B, Al-Batayneh OB, et al. Women's economic empowerment, participation in decision-making and exposure to violence as risk indicators for early childhood caries. BMC Oral Health. 2020;20:54.  Back to cited text no. 12
    
13.
Gaidhane AM, Patil M, Khatib N, Zodpey S, Zahiruddin QS. Prevalence and determinant of early childhood caries among the children attending the Anganwadis of Wardha district, India. Indian J Dent Res. 2013;24:199–205.  Back to cited text no. 13
    
14.
Kato H, Tanaka K, Shimizu K, Nagata C, Furukawa S, Arakawa M, et al. Parental occupations, educational levels, and income and prevalence of dental caries in 3-year-old Japanese children. Environ Health Prev Med 2017;22:80.  Back to cited text no. 14
    
15.
Nisar N. Role of mothers in prevention of dental caries: A systematic review. J Dent Health Oral Disord Ther 2015;3:314–7.  Back to cited text no. 15
    

Top
Correspondence Address:
Dr. Ramakrishna Chevvuri
Department of Public Health Dentistry, Government Dental College, Raipur - 492 001, Chhattisgarh
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijdr.ijdr_128_21

Rights and Permissions



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]



 

Top
 
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  
 


    Abstract
   Introduction
   Methodology
   Results
   Discussion
   Conclusion
    References
    Article Tables

 Article Access Statistics
    Viewed440    
    Printed24    
    Emailed0    
    PDF Downloaded15    
    Comments [Add]    

Recommend this journal