The Global Prevalence Of Early Childhood Caries: A Systematic Review with Meta-analysis Using the WHO Diagnostic Criteria

AIM: To estimate the global prevalence of early childhood caries using the WHO criteria.

DESIGN: Systematic review of studies published from 1960 to 2019.

DATA SOURCES: PubMed, Google Scholar, SciELO and LILACS. Eligibility criteria were articles using: dmft-WHO diagnostic criteria with calibrated examiners, probability sampling, and sample sizes.

STUDY SELECTION: Two reviewers searched, screened and extracted information from the selected articles. All pooled analyses were based on random-effects models. Registration: Prospero-CRD42014009578.

RESULTS: From 472 reports, 214 used WHO-criteria and 125 fitted the inclusion criteria. Sixty-four reports of 67 countries (published 1992-2019) had adequate data to be summarised in the meta-analysis. They covered 29 countries/59018 children. Global random-effects pooled-prevalence was (percentage[95% CI]) 48[43, 53]. Prevalence by continent was Africa 30[19; 45], Americas 48 [42; 54], Asia 52[43; 61], Europe 43[24; 66], and Oceania 82[73; 89]. Differences across countries explain 21.2% of the observed variance.

CONCLUSIONS: Early childhood caries is a global health problem, affecting almost half of preschool children.

LIMITATIONS: Results are reported from 29/195 countries. Implications of key findings: ECC prevalence varied widely, and there was more variance attributable to between-country differences rather than continent or change over time.