dc.description.abstract | Background: Early childhood caries (ECC) is defined as the presence of one or more decayed, missing due to caries, or filled tooth surfaces in the deciduous
dentition in children whose ages are from 71 months and below. However, in younger children aged 3 years, any sign of smooth surface caries is indicative of
severe Early Childhood Caries (severe ECC). In the age group of 3 to 5 years, ECC is also considered once one or more carious, missing (due to caries), or filled smooth surfaces in the primary maxillary anterior teeth. Also a decayed, missing or filled score of ~ 4 (age 3), ~ 5 (age 4), ~6 (age 5) constitutes severe ECC. Some studies have shown that severe ECC affects growth and development of a child; while others have shown that there is no relationship between nutritional status and severe ECC. Currently there is scarce information regarding the nutritional status of children with severe ECC in Kenya.
Objective: To determine and compare the nutritional status of children aged 3 - 5 years with S - ECC with the nutritional status of 3 - 5 year old children who are caries - free.
Study area and Design: This was a comparative cross sectional study based at the Nyanza Provincial General Hospital in Kisumu, Western Kenya region.
Materials and methods:
Sampling and sample size: Purposive sampling was done to select the 196 children aged between 3 to 5 years for this study. There were eighty one children with severe ECC selected from amongst the patients who had sought dental treatment at the dental clinic at the Nyanza Provincial General Hospital. However,
115 children who were caries free were selected from amongst the children attending the maternal child health clinic at NNPGH over a period of three months.
While Oral hygiene status was assessed using the plaque index of Loe and Silness (1964) ,the WHO 1997 caries diagnosis criteria was used to assess dental caries experience. Oental caries was diagnosed when there was Clinically detectable loss of tooth substance and when such loss had been treated with fillings or extraction. Nutritional status was assessed using anthropometric measurements and cut-offs of ᄆ2 standard deviations (SO) were used to identify children at Significant risk for either inadequate ᆱ-2S0) or excessive (>+2S0) growth for the following indicators: weight- for-age (WAZ) , height-for-age (HAZ), weight-for-height (WHZ).
Results: One hundred and ninety six children aged 3 - 5 years among whom 100 were males and 96 were females were recruited for the study. One hundred and forty eight children had fair oral hygiene status and thirty two had good oral hygiene status. Children with severe ECC had poor and fair oral hygiene status when compared to caries - free children. Pearson's chi square test showed that there was a statistically Significant difference with a p - value of 0.027. The mean -dmft of children with severe ECC was 7.5 (ᄆ 1.9 SO). Among males and females the mean dmft was 7.5 (ᄆ1.8S0) and 7.5 (ᄆ1.2S0) respectively.
The prevalence of underweight, wasting, and stunting among both groups of children was 14.3% 3.6%, and 2.6% respectively. Eleven males were underweight and seventeen females were underweight. Among children with severe ECC 14%, 4.9%, 2.5% were underweight, wasted and stunted respectively. 13.9%, 2.6%, 6.1 % of caries - free children were underweight, wasted and stunted respectively.
Conclusion: There was no statistically significant difference in the nutritional status of children with severe ECC and caries - free children for Stunting (p=O.311), Underweight (p=O.859) and Wasting (p=0.451). However, children with Severe - ECC were 1.23 .times more likely to be underweight than caries - free children .
Recommendations: There is a need to create awareness on infant feeding practices and oral hygiene status for all children below 5 years of age. This may be
done through maternal child health clinics. There is also a need to improve accessibility and availability of dental services and to provide nutritional support for
all children below 5 years of age. | en_US |