A systematic review of caries risk in children <6 years of age.

BACKGROUND: For caries risk assessment (CRA) tools for young children to be evidence-based, it is important to systematically review the literature to identify factors associated with the onset of early childhood caries (ECC). AIM: This updated systematic review aimed to identify current evidence on caries risk in young children. DESIGN: A comprehensive and systematic literature search of relevant databases was conducted to update a previous systematic review and identify risk factors associated with ECC. Potential risk factors were identified based on strength of association using odds ratios, hazard ratios, relative risk, etc. GRADE was used for rating quality evidence through consensus. RESULTS: Twenty-two studies met inclusion criteria for the search from mid-2017 to 2021. Twenty-five publications from the prior systematic review, from 1997 to mid-2017, were also included. Several socioeconomic, behavioral, and clinical variables were identified as ECC risk factors. Factors included the following: age, socioeconomic status, frequency of and supervised toothbrushing, fluoride exposure, breast- and bottle-feeding, feeding habits, absence of a dental home, past caries experience, active non-cavitated lesions, visible plaque, enamel defects, and microbiome. CONCLUSION: This study provides updated evidence of risk factors for ECC that could be included in CRA tools.

Prevalence and Risk Factors for ECC Among Preschool Children from India along with the Need of its Own CRA Tool- A Systematic Review.

Introduction: Caries in the deciduous dentition of children under six years of age is termed as early childhood caries (ECC). ECC is prevalent among Indian children and identifying modifiable risk factors is important for prevention. This systematic review was undertaken to describe the burden of ECC in India, its prevalence, associated risk factors along with its repercussions on childhood health. Materials and Methods: A search was conducted for published Indian studies on ECC through electronic databases and complemented with hand search. The protocol for the present systematic review was registered at PROSPERO (Ref No.CRD42022306234)Care was taken to include studies which could represent all parts of India- Central, North, South, East and West. Included papers were reviewed for prevalence of ECC and reported risk factors. Results: Overall 37 studies on ECC in India were identified relating to prevalence, 11 reported risk factors and two reported on the association between severe ECC and nutritional health and well-being. The prevalence of ECC in India in these studies varied from16% to 92.2%. This systematic review revealed that ECC is prevalent among Indian children and highlights the need of preventive intervention and early risk assessment by its own caries risk assessment (CRA) tool. Occurrence seems to be firmly connected with age, snacking frequency, feeding and oral hygiene habits and with social determinants of health including parental education level, low socioeconomic status and number of siblings.