Early childhood caries in northern Philippines

Objectives: To determine prevalence and severity of early childhood caries (ECC) among children in northern Philippines. Further, to describe and determine the impact of child-rearing practices and dental visits on caries status. Methods: Cross-sectional survey of 993 children aged 2-6 years. Caries was diagnosed based on WHO recommendations. Additional behavioral information was obtained from 452 children aged 3-6 years. Results: Caries prevalence and mean dmft (+/-SD) by age were as follows: 2 years = 59% (4.2 +/- 5.3); 3 years = 85% (7.4 +/- 5.5); 4 years = 90% (8.8 +/- 5.6); 5 years = 94% (9.8 +/- 5.5); and 6 years = 92% (10.1 +/- 5.5). Caries rates mirrored those of developing countries with untreated lesions dominating all ages. Mixed breast and bottle feeding was the norm. Almost half were weaned at more than 2 years old. Majority had toothbrushing practices, but mostly without parental assistance. Toothbrushing was initiated at an average age of 2 years. Only a small proportion had a dental visit, mostly for emergency reasons. Among 3-4-year-old children, a significant increase in caries levels were noted for those who started brushing at a later age, had frequent snacks, and had a dental visit for emergency reasons. For children aged 5-6 years, those who went for emergency visits also had significantly more caries. Results indicated an urgent need to (i) increase awareness that ECC is a public health problem in these areas, (ii) advocate use of fluoride as a public health measure, and (iii) increase access to preventive dental services for preschool children.