Chronological Age, Dental Age And Nutritional Status Among 3-5-Year-Olds With Early Childhood Caries In Nairobi, Kenya

Abstract

Introduction: Dental caries is becoming an increasingly common occurrence in children aged five years and below. Early childhood caries (ECC) if left untreated, may negatively impact on dietary intake and the child is at risk of being underweight, stunted or both. Broad objective: The broad objective was to determine the relationship between chronological age, dental age, nutritional status and early childhood caries among 3-5-year-old children. Study Setting: The study was carried out at the Lady Northey City County Dental Clinic. Study design: The survey was descriptive and cross-sectional in design and was carried throughout five months. Sampling and sampling technique: Purposive sampling was employed where every child aged 3-5 years presenting with ECC, and had an orthopantomogram (OPG) as a requirement for diagnosis were selected for the study. Data Collection Instruments: Information on socio-demographics, oral hygiene habits and dietary habits was collected using a semi-structured questionnaire. The WHO caries diagnostic criteria (2005) was used for assessment of dental caries. Nutritional status was assessed using anthropometric measurements. The determination of dental age was done using the method by Demirjian. Data Analysis: Analysed using SPSS version 25.0 for windows. The WHO Anthro Statistical Programme was used in the analysis of nutrition data. Statistical tests were performed for different variables to establish relationships between them. Results: The mean chronological age for the 171 children who participated in the study was 4.09±0.54, se=0.042years (range 3 - 4.92 years). The mean estimated dental age for the children was 4.59±0.75, se=0.57. The 136 (79.5%) whose dental age was not delayed had a mean dental age of 4.79 ± 0.62, se=0.05, (range 3.30 - xviii 6.70 years) while 35 (20.5%) whose dental age was delayed had a mean 3.82 ± 0.73, se=0.12, (range 2.20 -4.80 years). The differences in the mean age between those with delayed dental age and those without delay in dental age were statistically significant with a Levene's test for equality of variances with F=4.649, df= (169, 47), p=0.000. There was no significant relationship between dental age and dmft (correlation coefficient r=0.045, p=0.563). The relationship between nutritional status and ECC was not statistically significant using Spearman‘s correlation. A significantly strong and positive association was noted between height for age z score and dental age where a Spearman‘s correlation r=0.314, p=0.000 and weight for age z score r=0.202, p=0.008 at 95% CL. Conclusion: Most of the children‘s dental age was advanced when compared to the chronological age. The dental age had associations with underweight and stunting. There was no relationship between dental age and ECC. Hence the severity of early childhood caries may not be a good indicator of delayed dental age. There was however no relationship between nutritional status and ECC. Recommendations: There may be need to establish a reference dental age dataset for Kenyan children of African descent. When determining the dental age, stunting and underweight should be taken into consideration.