Next Article in Journal
HHV-6 in Cerebrospinal Fluid in Immunocompetent Children
Previous Article in Journal
Decarbonization of Transport and Oral Health
 
 
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Review

A Scoping Review of Early Childhood Caries Experience Assessment Tools Used for Studies in Nigeria

1
Oral Health Initiative, Nigeria Institute of Medical Research, Yaba, Lagos 101212, Nigeria
2
Department of Periodontics, School of Dentistry, College of Medical Sciences, University of Benin, Benin City 300001, Nigeria
3
Department of Nursing Science, Obafemi Awolowo University, Ile-Ife 220001, Nigeria
4
Department of Preventive Dentistry, University of Medical Sciences, Ondo 351101, Nigeria
5
Department of Preventive and Community Dentistry, Faculty of Dentistry, College of Health Sciences, Obafemi Awolowo University, Ile-Ife 220001, Nigeria
6
Provost’s Group, Regent’s University London, London NW1 4NS, UK
7
Department of Obstetrics and Gynecology, Nnamdi Azikiwe University, Awka 420102, Nigeria
8
Department of Public Health, Faculty of Basic Medical and Health Sciences, Lead City University, Ibadan 110115, Nigeria
9
Department of Implementation Science, Wake Forest University, Winston-Salem, NC 27101, USA
10
Department of Pediatric Dentistry and Dental Public Health, Faculty of Dentistry, Alexandria University, Alexandria 21527, Egypt
11
Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife 220001, Nigeria
12
Department of Medical Laboratory Science, Faculty of Basic Medical Sciences, College of Medicine, University of Lagos, Lagos 101212, Nigeria
*
Author to whom correspondence should be addressed.
BioMed 2023, 3(3), 400-419; https://doi.org/10.3390/biomed3030033
Submission received: 4 August 2023 / Revised: 17 August 2023 / Accepted: 23 August 2023 / Published: 29 August 2023

Abstract

:
This scoping review provides an overview of the tools used to assess for early childhood caries (ECC) in Nigeria. A search of the literature in African Journals Online, Google Scholar, Medline, and Cochrane database was conducted in June 2023 using the PRISMA-ScR guidelines. A combination of keywords related to caries risk assessment, preschool children, and evaluation tools was used for the search. Studies reported in English and assessing ECC were extracted. Descriptive statistics were used to summarise the information on study characteristics, types of caries assessment tools, and study outcome. Caries assessment tools were divided into behavioural, social, and biological. After screening 964 potential studies, 16 were included in the review. ECC assessment tools were categorised into behavioural (snacking, frequency of consumption of refined carbohydrate in-between-meals, dental service utilisation, frequency of tooth brushing, use of fluoridated toothpaste, breast and bottle feeding patterns and duration), biological (birth rank, age, sex, anthropometric measures, molecular characterisation of isolated organisms, presence of plaque), and social (socioeconomic status of the child’s household, mother’s level of education, maternal income, occupation of the father, maternal decision-making ability). Twelve studies used behavioural assessment tools, 11 used biological, and 11 used social tools. Furthermore, 11 (70.1%) used a combination of tools, four (25.0%) used only biological tools, and one (6.2%) used only behavioural tools to assess ECC experience. No study screened for the risk of caries. In conclusion, we identified the need for comprehensive studies to identify the risk indicators of ECC in Nigeria. This will support the development of a caries risk assessment tool appropriate for the country context.

1. Introduction

Despite being preventable, early childhood caries (ECC) is still one of the most prevalent diseases in children [1]. It is primarily attributed to long-term exposure to a diet rich in refined sugar, poor dental hygiene, and suboptimal oral care procedures [2]. In addition, a variety of behavioural and environmental factors make ECC risk more complex. Furthermore, the pain associated with this illness restricts chewing abilities, interferes with sleep, alters mood, and decreases productivity, which all negatively affects the child’s quality of life [1,2]. In low- and middle-income countries, ECC prevalence is still as high as 70% despite being a disease that is preventable [2]. In addition, treating caries is expensive, placing a heavy financial strain on people in countries like Nigeria where out-of-pocket healthcare payment is predominant [1,2]. Preventive interventions are essential since they are more economical than therapy given the scarce resources in places like Nigeria [3,4].
Accurate and early caries risk prediction can greatly enhance caries prevention outcomes in children, leading to timely and appropriate interventions and improved oral health results [5,6]. Caries Risk Assessment (CRA) can effectively identify children at risk of ECC and enhance the process of offering personalised preventive measures promptly [7]. CRA is the determination of the likelihood that caries will occur, or the likelihood that there will be a change in the size or activity of existing lesions during a specific period [8], and can be performed by non-dental health care providers to identify and refer high-risk children before caries development or progression occurs [8]. When the tool assesses a variety of factors, children can be categorised as low, moderate, or high risk for ECC development and managed appropriately [9].
CRA tools also help to enhance objectivity, documentation, and motivation for caries management for preschool children [10]. They are developed for different populations [5] and often include several socio-demographic, behavioural, and clinical factors that are assessed jointly to decide about the caries risk status of the children. Some examples of globally tested tools are the Caries Management by Risk Assessment (CAMBRA), the American Dental Association Caries Risk Assessment, the American Academy of Paediatric Dentistry Caries Risk Assessment, and the computer-based assisted CRA methods (e.g., Cariogram) [11]. These tools have, however, only been used for the screening of ECC in high-income countries like the United States and Europe [12,13]. We did not find any study that screened for ECC using any of CRA in Africa.
Despite the low prevalence but high burden of ECC in Nigeria [4], little is known about the CRA tools used for ECC risk assessment and the consistency of their application [10]. The absence of a validated and accurate CRA tool to assess the risk of ECC in children in Nigeria limits the comparison of data between studies, and the application of evidence-based clinical management of ECC [14]. In addition, the absence of a validated CRA tool for the country makes it challenging to develop a national ECC risk profile with identified geographical areas and sub-populations more affected by inequalities associated with ECC that require special attention to reduce their risk for ECC [15]. This scoping review, therefore, aimed to map the existing literature on the tools used to assess ECC in Nigeria and to highlight the strengths and gaps in the use of these tools to assess the risk of ECC in children.

2. Materials and Methods

The method for this review was developed using the Population/participants, Concept and Context (PCC) framework [16], where the population of interest is preschool children, the concept is the CRA tools, and the context is Nigeria. The methodology was based on the Joanna Briggs Institute (JBI) scoping review methodology [17] to provide a systematic and transparent search strategy to identify relevant studies.

2.1. Research Questions

This review was guided by the research questions: (i) what are the CRA tools used for assessing the risks of ECC among preschool children in Nigeria? (ii) what are the strengths and weaknesses of the CRAs used for assessing the risks of ECC among preschool children in Nigeria?

2.2. Relevant Studies

A systematic search of the literature, from inception till June 2023, on MEDLINE [PubMed], African Journals Online, Google Scholar, and Cochrane Library [CENTRAL] was conducted using the terms shown in Appendix A. A search of related citations and references was also carried out. Non-English articles were excluded if no English translation was available.

2.3. Study Selection

Publications identified through the search strategy were downloaded into Endnote, imported into Rayyan, and duplicates were removed. Three researchers performed title and abstract screening independently using pre-defined inclusion and exclusion criteria. Studies were included if there was an agreement between two or all the reviewers. The same three researchers completed the full-text review. Uncertainty regarding whether publications met the inclusion criteria was resolved via consensus among the three researchers.

2.4. Inclusion Criteria

Peer reviewed full length articles focusing on CRA tools for preschool children in Nigeria, published in English, were included in this review. There was no restriction on study design or date of publication.

2.5. Exclusion Criteria

Letters to the editor, commentaries on studies, and studies whose full lengths cannot be accessed were excluded. In addition, retrieved documents without data on children <72 months of age were excluded. Other data sources, such as websites or books, were excluded.

2.6. Data-Charting Process

A data-charting form was developed by two authors (AOE and AOA) to extract relevant variables. All authors independently extracted data and continuously updated the data-charting form. Each study’s data were extracted by two separate authors blinded to each other’s results to ensure accurate data extraction. Authors charted variables related to literature characteristics (e.g., authors, year of publication), study design, sample size, category of tool, population characteristics (e.g., part or region of the country), and variables related to the research questions (e.g., ECC risk factors, ECC protective factors). The range of behavioural, social, and biological assessment tools used for caries assessment was also charted.

2.7. Expert Consultation

The developed chart was shared with experts in the field of ECC (MET and MOF) and a Cochrane-trained expert on systematic review, meta-analysis, and scoping review (GUE) to validate the process and to ensure the extracted data were comprehensive.

2.8. Data Analysis

The results of the scoping review were reported according to the Preferred Reporting Items for Systematic reviews and Meta Analyses extension for Scoping Reviews (PRISMA-ScR) checklist [18]. The tools used for caries risk assessment were classified into tools using biological, behavioural, and social indicators. In addition, the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross-sectional studies, case-control studies, and cohort studies [19] was used for critical appraisal of the quality of all included studies. The extent to which the studies addressed the possibility of bias in eight areas of study design, conduct, and analysis was analysed. Each of the eight domains received a score from 0 (poor quality) to 2 (high quality), and a total quality score was calculated by summing the individual domain scores. Total scores ranged from 0 to 16, with higher scores indicating higher quality. Three researchers independently assessed each included publication and any uncertainty regarding the quality of publications was resolved through discussion among the team.

3. Results

The search resulted in 1040 records, which were downloaded into Endnote and imported into Rayyan. After de-duplication, 964 records remained. After reviewing titles and abstracts, and screening, 33 articles were eligible for full-text screening. On screening the full articles, 17 articles were excluded either because the data were not specific to the study group of interest or they were not specific to Nigeria, leaving 16 articles [20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35] for this review. Figure 1 shows the flow diagram of the publication screening process.
Table 1 shows that the 16 extracted articles were conducted among preschool children in the south-west geopolitical zone of Nigeria: seven (43.8%) in Ile-Ife [20,23,25,28,30,31,32], seven (43.8%) in Lagos [21,24,27,29,34,35], one (6.2%) in Enugu [26], and one (6.2%) in Benin [33]. Two (12.5%) studies analysed urban and rural differences in the prevalence of ECC [22,35].
Four (25.0%) of the studies were hospital-based [21,28,33,35], one (6.2%) was school-based [21], and 11 (68.8%) were population-based [20,22,23,24,25,27,29,30,31,32,35]. All the studies were cross-sectional, and all but two [20,31] assessed ECC at the cavitated level.
Altogether, 34 tools were used to assess ECC risk in the 16 studies. These were 12 tools using behavioural indicators, 11 tools using social indicators, and 11 tools using biological indicators. Furthermore, 11 (70.1%) of the studies used a combination of tools, four (25.0%) used only biological indicators [25,29,32,34], and one (6.2%) used only behavioural indicators [31].
Table 1 shows that the behavioural indicators were associated with ECC risk: Frequency of sugar consumption [23,28,35], long duration of breastfeeding [21,23,33], exclusive breastfeeding [24], sleeping with bottle in the mouth [21], and supervised tooth brushing [21]. On the contrary, the following behavioural indicators were not associated with ECC experience: tooth brushing frequency [21,22,23,26,27,33,35], night feeding [23,24,33,35], frequency of sugar consumption [20,26,33], duration and content of bottle feeding [20,23,27], use of toothpaste [19,21,22], form of breast feeding [23,28], dental service utilisation [20,26], duration of breast feeding [28,35], supervised tooth brushing [22], tooth cleaning tool [27], onset of tooth cleaning [21], tooth brushing method [27], and oral rehydration therapy [31]. The only behavioural indicator found to be protective against ECC was tooth brushing more than once a day [20].
Table 2 shows the behaviour indicators used for caries risk assessment among preschool children in Nigeria. Of the 11 studies that assessed the relation between ECC risk and behaviour, eight explored tooth brushing frequency [20,21,22,23,26,27,33,35], six explored sugar consumption [20,23,26,28,33,34], five explored breast feeding duration [21,24,28,33,35], five explored night feeding [21,22,24,32,35], four explored forms of breast feeding (exclusive, partially exclusive or non-exclusive) [21,23,24,28], three explored the use of toothpaste [20,22,23], two explored bottle feeding [24,28], dental service utilisation [20,26], two tooth cleaning tools [25,32], and supervised tooth brushing [21,22] each, and one explored tooth cleaning methods [27] and oral rehydration therapy [31].
Table 3 shows the range of social indicators used for ECC risk assessment in Nigeria. Of the 11 studies that assessed the relation between ECC risk and social factors, nine explored age [20,21,22,23,24,27,28,33,35], seven explored sex [22,23,24,27,28,33,35], four explored socioeconomic status [23,26,27,35], three explored birth rank [23,27,28], two explored residential location [22,35], and one explored maternal psychosocial factors [30], maternal decision-making abilities [30], maternal education, [30], maternal income [30], maternal employment status [30], and maternal knowledge [23], respectively.
Table 1 shows the social factors associated with ECC risk were older age [20,21,22,26,27,28], and higher socioeconomic status [26,35]. Age [23,24,33,35], sex [22,24,27,28,33,35], residential location [22,35], socioeconomic status [23,27], birth rank [23,27,28], maternal psychosocial factors [30], maternal decision-making abilities [30], maternal education, [30], maternal income [30], maternal employment status [33], and maternal age [23,24] were not associated with ECC risk. The two protective social factors were being female [23] and maternal oral health knowledge [23].
Table 4 shows the biological indicators used for ECC risk assessment in Nigeria. Of the 12 studies, five explored plaque score [23,25,26,27,35], three explored anthropometric variables [25,29,33], and one explored enamel defects [24], maternal caries status [30], maternal illness [21], use of medication [21], CD4 count [32], HIV exposure [32], spontaneous membrane rupture during delivery [32], S. mutans count [34], and S. sobrinus count [34].
Table 1 shows the biological indicators associated with ECC risk were plaque score [22,23,27], wasting [29], overweight [32], birth weight [21], enamel defects [29], maternal caries status [30], HIV infected [32], low CD4 count [32], and S. sobrinus count [34]. Biological indicators not associated with ECC were plaque [35], stunting [32], underweight [32], wasting [32], medical illness [21], use of medication [21], and S. mutans count [34]. In addition, children with fair oral hygiene had lower risk for ECC [24].
Table 5 shows the outcome of the critical appraisal of the quality of studies included in the review. All the studies described the study participants and setting in detail, used objective, standardised criteria to measure ECC, and used appropriate statistical analysis to reach their conclusions. However, only 15 (93.8%) of the 16 studies included information on the eligibility criteria of the study participants, and 15 (93.8%) had information about how the exposure variables were measured validly. In addition, of the 15 epidemiological studies that needed to adjust for confounders, only three (20.0%) studies clearly defined their confounding variables and six (40.0%) identified strategies to deal with confounding variables.

4. Discussion

This scoping review reveals that the assessment of ECC risk was only carried out in two of the six geopolitical zones in Nigeria. These assessments were conducted using cross-sectional studies that were mainly population-based. Various indictors were utilised to assess ECC risk, including behavioural indicators such as snacking habits, frequency of refined carbohydrate consumption between meals, dental service utilisation, tooth brushing frequency, use of fluoridated toothpaste, breastfeeding and bottle-feeding patterns, and duration. Additionally, biological indicators like birth rank, age, sex, dental defects, anthropometric measures, molecular characterisation of isolated organisms, and plaque accumulation were used. Social indicators such as the child’s socioeconomic status, mother’s education level, maternal income, father’s occupation, and maternal decision-making ability were also used, either individually or in combination.
This scoping review showed that there was no consensus on behavioural indicators that were associated with an increased risk of ECC, except brushing more than once a day, which was identified as a protective indictor. Similarly, dental services utilisation was not associated with the risk of ECC in the two studies that included it as a risk indicator. Moreover, no consensus was reached on the social indictors that were risks for ECC, while being female and having maternal knowledge of oral health were found to be protective indicators. On the other hand, biological indicators like HIV exposure, low CD4 count, high S. sobrinus count, and enamel defects were identified as risk indicators for ECC. The association between malnutrition, oral hygiene, and ECC risk was not clearly established across most studies. Furthermore, most of the studies lacked clear definitions of their confounding factors, and did not propose strategies to address potential confounding factors, compromising the robustness of the analysis.
One strength of this study is that it highlights a critical gap in ECC management in Nigeria. Despite having a low prevalence of ECC in Nigeria [37,38], the burden of untreated caries remains high [39], especially considering the large population of infants, toddlers, and preschool children in the country [40]. Therefore, there is an urgent need for an effective CRA tool that can be utilised by adjunct dental staff to prevent and diagnose ECC. Countries like Canada [9], the UK [41], India [42], and others [43,44] are promoting the use of context-specific CRA tools by laypersons to ensure early access to oral examinations by the age of one. Early intervention for ECC management is crucial, as the risk significantly increases by the age of 2 and becomes even higher in the 3–5-year age group [38]. This study also highlighted that the risk of ECC increases with age in Nigeria, emphasizing the need for the development of an appropriate CRA tool for the country.
The data generated in Nigeria regarding the indicators associated with ECC contribute to ongoing debates in the public sphere. Like findings from other studies, it was observed that prolonged breastfeeding combined with poor oral hygiene practices can increase the risk of ECC [23,39]. Conversely, effective plaque control disrupts the bacterial biofilm, reduces substrate availability for cariogenic bacteria, minimises acid production, and lowers the risk of ECC [11,22]. An effective CRA tool will consider factors such as diet, fluoride exposure, salivary flow, previous caries experience, and the presence of cariogenic bacteria [11]. However, in Nigeria, there is limited information on the association between fluoride exposure and the risk of ECC, as well as limited information on cariogenic bacteria that are risk indicators for ECC. There are also no studies on the association between ECC and salivary flow. In addition, the evidence for the link between ECC and the frequency of daily sugar consumption is contradictory. While the two studies that showed links between maternal knowledge of oral health, maternal caries status, dental defects, and the risk of ECC are supported by existing evidence [45,46,47], the non-significant association between S. mutans count and ECC is contentious, as prior studies had shown this link [48]. Also contentious is the finding that fair oral hygiene is protective against ECC. These are some of the reasons why robust evidence is needed to objectively identify ECC risk and protective factors in Nigeria.
The development of a CRA tool for Nigeria requires a strong foundation of research-based evidence, like the process followed in the development of the Canadian CRA [9,49]. However, at present, the country-specific evidence needed to support the development of a CRA is limited. The robustness of the studies conducted have been majorly limited by the studies not defining their confounders nor identifying strategies to adjust their study findings for the effect of confounders. It is crucial to strategically address this data analysis gap and facilitate the conduct of research that provides high-quality evidence to support the development of a cost-effective and easy to use CRA tool. Such research should explore the use of digital risk assessment tools and artificial intelligence-based models and algorithms [50,51].
The development of a national CRA for ECC screening should be based on shifting the task of screening for ECC to community healthcare workers working based on the national task shifting and task sharing policy for essential healthcare services in Nigeria [52]; and the need to promote minimum intervention dentistry based on the draft National Policy on Mercury phase down. The successful application of the minimum intervention dentistry strategy to manage ECC relies heavily on caries risk assessment [53,54,55]. It also contributes to achieving the sustainable development goals (SDG 3) [56].

5. Conclusions

This scoping review demonstrated that ECC risk assessment in Nigeria has been limited to only two regions in the country and assessment has relied on the use of behavioural, biological, and social indicators. No standardised CRA tool was used in any of the studies. In addition, consensus is lacking on the factors that are associated with risk for ECC, though suggestive protective behaviours and social indicators were identified. Additionally, the associations of the frequency of sugar consumption, duration of breastfeeding, forms of breastfeeding, night feeding, malnutrition, and oral hygiene with the risk of ECC were inconclusive. There is the need for studies using more comprehensive, and standardised tools with nationally representative samples and proper consideration of confounding factors to enhance the understanding of risk factors for ECC and improve its preventive strategies.

Author Contributions

Conceptualisation, A.O.E., A.O.A., U.C.N. and F.O.N.; methodology, A.O.E., A.O.A., U.C.N. and F.O.N.; software, F.T.A., O.R.A., A.O.E., A.O.A., U.C.N. and F.O.N.; validation, F.T.A., O.R.A., A.O.E., A.O.A., U.C.N. and F.O.N.; formal analysis, A.O.E., A.O.A., U.C.N. and O.T.A.; investigation, A.O.E., A.O.A., U.C.N.; resources, F.T.A., O.R.A., A.O.E., A.O.A., U.C.N., F.O.N., G.U.E. and M.O.F.; data curation, A.O.E., M.O.F., M.E.T., G.U.E., J.L. writing—original draft preparation, A.O.E.; writing—review, A.O.A., U.C.N., F.O.N., O.T.A., J.L., U.N., G.U.E. and M.O.F.; visualisation, A.O.E., A.O.A., U.C.N. O.R.A. and F.T.A.; supervision, F.O.N., O.T.A., J.L, U.N., G.U.E. and M.O.F.; project administration, F.T.A., F.O.N., O.T.A. and M.O.F.; funding acquisition, F.T.A. and M.O.F. All authors have read and agreed to the published version of the manuscript.

Funding

This research was funded by the Oral Health Initiative, Nigeria Institute of Medical Research, Nigeria, grant number [OHI/COH2023/0001]. The Article Processing Charge (APC) was funded by the Institutional Open Access Program (Wake Forest School of Medicine).

Institutional Review Board Statement

Not applicable.

Informed Consent Statement

Not applicable.

Data Availability Statement

The data presented in this study are openly available in Medline, Cochrane Library, and African Journals Online.

Conflicts of Interest

The authors declare no conflict of interest.

Appendix A

Search strategy
The search strategy for PubMed, which was altered appropriately using specific terms for the other databases, is as follows:
1. Medline (PUBMED) (940 results)
• #1- (Dental Cavity[Title/Abstract) OR (Dental Decay[Title/Abstract)) OR (Dental Cavities[Title/Abstract)) OR (Cavities, Dental[Title/Abstract)) OR (Cavity, Dental[Title/Abstract)) OR (Carious Lesions[Title/Abstract)) OR (Carious Lesion[Title/Abstract)) OR (Lesion, Carious[Title/Abstract)) OR (Lesions, Carious[Title/Abstract)) OR (Decay, Dental[Title/Abstract)) OR (Carious Dentin[Title/Abstract)) OR (Carious Dentins[Title/Abstract)) OR (Dentin, Carious[Title/Abstract)) OR (Dentins, Carious[Title/Abstract)) OR (Dental White Spot[Title/Abstract)) OR (Spot, Dental White[Title/Abstract)) OR (Spots, Dental White[Title/Abstract)) OR (White Spot, Dental[Title/Abstract)) OR (White Spots, Dental[Title/Abstract)) OR (Dental White Spots[Title/Abstract)
• #2- (risk assess[Title/Abstract] OR risk assessed[Title/Abstract] OR risk assessment[Title/Abstract] OR risk assessing[Title/Abstract] OR risk, assessment[Title/Abstract] OR risk, assessments[Title/Abstract] OR risk, assessments[Title/Abstract] OR risk assessor[Title/Abstract] OR risk assessors[Title/Abstract] OR risk management[Title/Abstract] OR risk managing[Title/Abstract)
• #3- (children[Title/Abstract] OR preschool children[Title/Abstract)
• #4- (Nigeria [Title/Abstract] OR Federal republic of Nigeria[Title/Abstract)
#1 AND #2 AND #3 NOT #4 --- (n = 1040)
2. Cochrane Library (n = 10)
ID     Search
#1     caries
#2     carious lesion
#3     dental caries
#4     dental cavities
#5     carious lesions
#6     dental cavity
#7     dental decay
#8     risk
#9     risk assessment
#10   tool
#11   indices
#12   methods
#13   children
#14   Early childhood
#15   Nigeria
#16   #1OR#2OR3OR#4OR#5OR#5OR#6OR#7
#17   #8OR#9
#18   #10OR#11OR#12
#19   #13OR#14
#20   #15AND#16AND#17AND#18AND#19 (n = 10)
3. African Journals Online (AJOL) (n = 74)
Search term: Risk assessment tool for early childhood caries in Nigeria
4. Grey Literature (n = 2)

References

  1. Anil, S.; Anand, P.S. Early Childhood Caries: Prevalence, Risk Factors, and Prevention. Front. Pediatr. 2017, 5, 157. [Google Scholar] [CrossRef] [PubMed]
  2. Mansur, E.K.M. Primary Prevention of Dental Caries: An Overview. Int. J. Clin. Prev. Dent. 2020, 16, 143–148. [Google Scholar] [CrossRef]
  3. Lawal, F.; Alade, O. Dental caries experience and treatment needs of an adult female population in Nigeria. Afr. Health Sci. 2017, 17, 905–911. [Google Scholar] [CrossRef] [PubMed]
  4. Uguru, N.; Onwujekwe, O.; Ogu, U.U.; Uguru, C. Access to Oral health care: A focus on dental caries treatment provision in Enugu Nigeria. BMC Oral Health 2020, 20, 145. [Google Scholar] [CrossRef]
  5. Sadegh-Zadeh, S.-A.; Qeranqayeh, A.R.; Benkhalifa, E.; Dyke, D.; Taylor, L.; Bagheri, M. Dental Caries Risk Assessment in Children 5 Years Old and under via Machine Learning. Dent. J. 2022, 10, 164. [Google Scholar] [CrossRef]
  6. Fontana, M.; Carrasco-Labra, A.; Spallek, H.; Eckert, G.; Katz, B. Improving Caries Risk Prediction Modeling: A Call for Action. J. Dent. Res. 2020, 99, 1215–1220. [Google Scholar] [CrossRef]
  7. Kriegler, K.; Blue, C.M. Caries Management by Risk Assessment vs. Traditional Preventive Strategies: Effect on Oral Health Behaviors and Caries Diagnoses: A Retrospective Case-Control Observational Design. Clin. Case Rep. 2021, 9, e04751. [Google Scholar] [CrossRef]
  8. American Academy of Pediatric Dentistry. Caries-risk assessment and management for infants, children, and adolescents. In The Reference Manual of Pediatric Dentistry; American Academy of Pediatric Dentistry: Chicago, IL, USA, 2022; pp. 266–272. [Google Scholar]
  9. Schroth, R.J.; Kyoon-Achan, G.; Levesque, J.; Sturym, M.; DeMaré, D.; Mittermuller, B.-A.; Lee, J.; Lee, V.H.K. A mixed methods approach to obtaining health care provider feedback for the development of a Canadian pediatric dental caries risk assessment tool for children <6 years. Front. Oral Health 2023, 4, 1074621. [Google Scholar] [CrossRef]
  10. Jørgensen, M.R.; Twetman, S. A systematic review of risk assessment tools for early childhood caries: Is there evidence? Eur. Arch. Paediatr. Dent. 2020, 21, 179–184. [Google Scholar] [CrossRef]
  11. Featherstone, J.D.B.; Crystal, Y.O.; Alston, P.; Chaffee, B.W.; Doméjean, S.; Rechmann, P.; Zhan, L.; Ramos-Gomez, F. Evidence-Based Caries Management for All Ages-Practical Guidelines. Front. Oral Health 2021, 2, 657518. [Google Scholar] [CrossRef]
  12. Zou, J.; Du, Q.; Ge, L.; Wang, J.; Wang, X.; Li, Y.; Song, G.; Zhao, W.; Chen, X.; Jiang, B.; et al. Expert consensus on early childhood caries management. Int. J. Oral Sci. 2022, 14, 1–14. [Google Scholar] [CrossRef] [PubMed]
  13. Featherstone, J.D.B.; Crystal, Y.O.; Alston, P.; Chaffee, B.W.; Doméjean, S.; Rechmann, P.; Zhan, L.; Ramos-Gomez, F. A Comparison of Four Caries Risk Assessment Methods. Front. Oral Health 2021, 2, 656558. [Google Scholar] [CrossRef] [PubMed]
  14. Yoon, R.K.; Smaldone, A.M.; Edelstein, B.L. Early childhood caries screening tools: A comparison of four approaches. J. Am. Dent. Assoc. 2012, 143, 756–763. [Google Scholar] [CrossRef] [PubMed]
  15. Ramos-Gomez, F. Understanding oral health disparities in the context of social justice, health equity, and children’s human rights. J. Am. Dent. Assoc. 2019, 150, 898–900. [Google Scholar] [CrossRef]
  16. University of South Australia. Apply PCC. Available online: https://guides.library.unisa.edu.au/ScopingReviews/ApplyPCC (accessed on 21 February 2023).
  17. Peters, M.D.J.; Godfrey, C.M.; Khalil, H.; McInerney, P.; Parker, D.; Soares, C.B. Guidance for conducting systematic scoping reviews. JBI Evid. Implement. 2015, 13, 141–146. [Google Scholar] [CrossRef]
  18. Tricco, A.C.; Lillie, E.; Zarin, W.; O’Brien, K.K.; Colquhoun, H.; Levac, D.; Moher, D.; Peters, M.D.J.; Horsley, T.; Weeks, L.; et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann. Intern. Med. 2018, 169, 467–473. [Google Scholar] [CrossRef]
  19. The Joanna Briggs Institute, The Joanna Briggs Institute Critical Appraisal Tools for Use in JBI Systematic Reviews: Checklist for Prevalence Studies. 2017. Available online: https://jbi.global/critical-appraisal-tools (accessed on 17 July 2023).
  20. Folayan, M.O.; Oginni, A.B.; El Tantawi, M.; Finlayson, T.L.; Adeniyi, A. Epidemiological profile of early childhood caries in a sub-urban population in Nigeria. BMC Oral Health 2021, 21, 415. [Google Scholar] [CrossRef] [PubMed]
  21. Olatosi, O.; Inem, V.; Sofola, O.; Prakash, P.; Sote, E. The prevalence of early childhood caries and its associated risk factors among preschool children referred to a tertiary care institution. Niger. J. Clin. Pr. 2015, 18, 493–501. [Google Scholar] [CrossRef]
  22. Abiola, A.A.; Eyitope, O.O.; Sonny, O.J.; Oyinkan, O.S. Dental caries occurrence and associated oral hygiene practices among rural and urban Nigerian pre-school children. J. Dent. Oral Hygiene 2010, 1, 64–70. [Google Scholar]
  23. Folayan, M.O.; Kolawole, K.A.; Oziegbe, E.O. Prevalence, and early childhood caries risk indicators in preschool children in suburban Nigeria. BMC Oral Health 2015, 15, 72. [Google Scholar] [CrossRef]
  24. Folayan, M.; Sowole, C.; Owotade, F.; Sote, E. Impact of Infant Feeding Practices on Caries Experience of Preschool Children. J. Clin. Pediatr. Dent. 2010, 34, 297–301. [Google Scholar] [CrossRef] [PubMed]
  25. Folayan, M.O.; El Tantawi, M.; Oginni, A.B.; Alade, M.; Adeniyi, A.; Finlayson, T.L. Malnutrition, enamel defects, and early childhood caries in preschool children in a sub-urban Nigeria population. PLoS ONE 2020, 15, e0232998. [Google Scholar] [CrossRef] [PubMed]
  26. Onyejaka, N.K.; Amobi, E.O. Risk Factors of Early Childhood Caries among Children in Enugu. Nigeria. Braz. Res. Pediatr. Dent. Integr. Clin. 2016, 16, 381–391. [Google Scholar]
  27. Sowole, A.; Sote, E.; Folayan, M. Dental caries pattern and predisposing oral hygiene related factors in Nigerian preschool children. Eur. Arch. Paediatr. Dent. 2007, 8, 206–210. [Google Scholar] [CrossRef]
  28. Folayan, M.O.; Sowole, C.A.; Kola-Jebutu, A.; Owotade, F.J. Risk factors for rampant caries in children from southwestern Nigeria. Afr. J. Med. Med Sci. 2012, 41, 249–255. [Google Scholar]
  29. Olatosi, O.; Alade, A.; Naicker, T.; Busch, T.; Oyapero, A.; Li, M.; Pape, J.; Olotu, J.; Awotoye, W.; Hassan, M.; et al. Dental Caries Severity and Nutritional Status of Nigerian Preschool Children. JDR Clin. Transl. Res. 2022, 7, 154–162. [Google Scholar] [CrossRef]
  30. Alade, M.; Folayan, M.O.; El Tantawi, M.; Oginni, A.B.; Adeniyi, A.A.; Finlayson, T.L. Early childhood caries: Are maternal psychosocial factors, decision-making ability, and caries status risk indicators for children in a sub-urban Nigerian population? BMC Oral Health 2021, 21, 73. [Google Scholar] [CrossRef]
  31. Folayan, M.O.; Finlayson, T.; Oginni, A.B.; Alade, M.A.; Adeniyi, A.A.; El Tantawi, M. Is oral rehydration therapy associated with early childhood caries in children resident in Ile-Ife, Osun State, Nigeria? Int. J. Paediatr. Dent. 2023, 33, 74–81. [Google Scholar] [CrossRef]
  32. Folayan, M.O.; Arije, O.; El Tantawi, M.; Kolawole, K.A.; Obiyan, M.; Arowolo, O.; Oziegbe, E.O. Association between early childhood caries and malnutrition in a sub-urban population in Nigeria. BMC Pediatr. 2019, 19, 433. [Google Scholar] [CrossRef]
  33. Coker, M.; El-Kamary, S.S.; Enwonwu, C.; Blattner, W.; Langenberg, P.; Mongodin, E.; Akhigbe, P.; Obuekwe, O.; Omoigberale, A.; Charurat, M. Perinatal HIV Infection and Exposure and Their Association with Dental Caries in Nigerian Children. Pediatr. Infect. Dis. J. 2018, 37, 59–65. [Google Scholar] [CrossRef]
  34. Oluwo, A.O.; Nwaokorie, F.O.; Oredugba, F.A.; Sote, E.O. Comparative Analysis of Streptococcus mutans and Streptococcus sobrinus from Dental Plaque Samples of Nigerian Pre-school Children with and Without Caries. West Afr. J. Med. 2021, 38, 972–978. [Google Scholar]
  35. Folayan, M.O.; Sowole, A.; Owotade, F.J. Residential location and caries risk of preschool children in Lagos, Nigeria. Afr. J. Med. Med. Sci. 2012, 41, 43–48. [Google Scholar]
  36. Page, M.J.; McKenzie, J.E.; Bossuyt, P.M.; Boutron, I.; Hoffmann, T.C.; Mulrow, C.D.; Shamseer, L.; Tetzlaff, J.M.; Akl, E.A.; Brennan, S.E.; et al. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ 2021, 372, n71. [Google Scholar] [CrossRef] [PubMed]
  37. El Tantawi, M.; Folayan, M.O.; Mehaina, M.; Vukovic, A.; Castillo, J.L.; Gaffar, B.O.; Arheiam, A.; Al-Batayneh, O.B.; Kemoli, A.M.; Schroth, R.J.; et al. Prevalence and Data Availability of Early Childhood Caries in 193 United Nations Countries, 2007–2017. Am. J. Public Health 2018, 108, 1066–1072. [Google Scholar] [CrossRef]
  38. World Health Organization. The Global Oral Health Report: Towards Universal Health Coverage for Oral Health. Available online: https://www.who.int/publications/i/item/9789240061484 (accessed on 15 June 2023).
  39. Folayan, M.O.; Chukwumah, N.M.; Onyejaka, N.; A Adeniyi, A.; O Olatosi, O. Appraisal of the national response to the caries epidemic in children in Nigeria. BMC Oral Health 2014, 14, 76. [Google Scholar] [CrossRef]
  40. Unicef. Situation of Women and Children in Nigeria. Challenges Faced by Women and Children in Nigeria. Available online: https://www.unicef.org/nigeria/situation-women-and-children-nigeria (accessed on 21 July 2023).
  41. Yeung, C.A. Dental caries: Caries risk assessment tools. Br. Dent. J. 2018, 224, 2. [Google Scholar] [CrossRef]
  42. Thakur, J.H.; Subhadra, H.N.; Jawdekar, A. Evaluation of CRAFT as a Tool for Caries Risk Assessment in 3- to 6-year-old Children and its Validation against Alban’s Test: A Pilot Study. Int. J. Clin. Pediatr. Dent. 2019, 12, 538–542. [Google Scholar]
  43. Pitts, N.; Ekstrand, K.R. ICDAS foundation. International Caries Detection and Assessment System (ICDAS) and its International Caries Classification and Management System (ICCMS)–methods for staging of the caries process and enabling dentists to manage caries. Community Dent. Oral Epidemiol. 2013, 41, e41–e52. [Google Scholar] [CrossRef]
  44. Ismail, A.I.; Pitts, N.B.; Tellez, M. The International Caries Classification and Management System (ICCMS™) An example of a caries management pathway. BMC Oral Health 2015, 15 (Suppl. 1), S9. [Google Scholar] [CrossRef]
  45. BaniHani, A.; Tahmassebi, J.; Zawaideh, F. Maternal knowledge on early childhood caries and barriers to seek dental treatment in Jordan. Eur. Arch. Paediatr. Dent. 2021, 22, 433–439. [Google Scholar] [CrossRef]
  46. de Souza, P.M.D.E.S.; Proença, M.A.M.; Franco, M.M.; Rodrigues, V.P.; Costa, J.F.; Costa, E.L. Association between early childhood caries and maternal caries status: A cross-section study in São Luís, Maranhão, Brazil. Eur. J. Dent. 2015, 9, 122–126. [Google Scholar] [CrossRef] [PubMed]
  47. Castañeda-Sarmiento, S.; Koecklin, K.H.U.; Hernandez, M.B.B.; Santos, G.P.; Luyo, J.C.B.; Sotomayor, J.C.S.; Ruiz-Yasuda, C.; Apaza, Z.R.; Adasme, D.P.; Ricse, D.A.T.; et al. Association between developmental defects of enamel and early childhood caries in children under 6 years old: A systematic review and meta-analysis. Heliyon 2022, 8, e10479. [Google Scholar] [CrossRef]
  48. Parisotto, T.M.; Steiner-Oliveira, C.; Silva, C.M.; Rodrigues, L.K.A.; Nobre-Dos-Santos, M. Early childhood caries and mutans streptococci: A systematic review. Oral Health Prev. Dent. 2010, 8, 59–70. [Google Scholar] [PubMed]
  49. Schroth, R.J.; Rothney, J.; Sturym, M.; Dabiri, D.; Dabiri, D.; Dong, C.C.; Grant, C.G.; Kennedy, T.; Sihra, R. A systematic review to inform the development of a Canadian caries risk assessment tool for use by primary healthcare providers. Int. J. Paediatr. Dent. 2021, 31, 767–791. [Google Scholar] [CrossRef] [PubMed]
  50. Chan, A. Can AI Be Used for Risk Assessments? ISACA, 2023. Available online: https://www.isaca.org/resources/news-and-trends/industry-news/2023/can-ai-be-used-for-risk-assessments (accessed on 10 July 2023).
  51. Kang, I.-A.; Njimbouom, S.N.; Lee, K.-O.; Kim, J.-D. DCP: Prediction of Dental Caries Using Machine Learning in Personalized Medicine. Appl. Sci. 2022, 12, 3043. [Google Scholar] [CrossRef]
  52. Nigeria Ministry of Health. Task-shifting and Task-Sharing Policy for Essential Health Care Services in Nigeria. Government Strategies, Plans, and Documents. 2016. Available online: https://fp2030.org/resources/task-shifting-and-task-sharing-policy-essential-health-care-services-nigeria (accessed on 21 July 2023).
  53. Doméjean, S.; Banerjee, A.; Featherstone, J.D.B. Caries risk/susceptibility assessment: Its value in minimum intervention oral healthcare. Br. Dent. J. 2017, 223, 191–197. [Google Scholar] [CrossRef]
  54. Hallett, K.B. The application of caries risk assessment in minimum intervention dentistry. Aust. Dent. J. 2013, 58, 26–34. [Google Scholar] [CrossRef]
  55. Walsh, L.J.; Brostek, A.M. Minimum intervention dentistry principles and objectives. Aust. Dent. J. 2013, 58 (Suppl. 1), 3–16. [Google Scholar] [CrossRef]
  56. Saikia, A.; Aarthi, J.; Muthu, M.S.; Patil, S.S.; Anthonappa, R.P.; Walia, T.; Shahwan, M.; Mossey, P.; Dominguez, M. Sustainable development goals and ending ECC as a public health crisis. Front Public Health 2022, 10, 931243. [Google Scholar] [CrossRef]
Figure 1. Flow diagram of studies included in scoping review [36]. * Only these databases were used for this study; ** Studies were excluded for the following reasons: Wrong population (n = 540), Wrong outcome (n = 327), Wrong publication type (n = 52), Publication in foreign language (n = 12).
Figure 1. Flow diagram of studies included in scoping review [36]. * Only these databases were used for this study; ** Studies were excluded for the following reasons: Wrong population (n = 540), Wrong outcome (n = 327), Wrong publication type (n = 52), Publication in foreign language (n = 12).
Biomed 03 00033 g001
Table 1. Characteristics of included studies.
Table 1. Characteristics of included studies.
s/nAuthors, Date (Location)Study DesignSample SizeVariable AssessedCategory of Tool Age RangeECC Risk IndictorsECC Protective IndicatorsIndicators Not Associated with ECC
1Folayan et al., 2021 [20]
(Ile-Ife)
Cross-sectional
Population-based
1549Cavitated and non-cavitated caries
Age
Tooth brushing frequency
Sugar consumption frequency
Use of fluoridated toothpaste
Dental service utilisation in 12 months
 
 
Social
Behavioural
 
Behavioural
 
Behavioural
 
Behavioural
6–71 monthsdmft and dmfs highest among the 24–35-months-olds
 
SiC score highest among the 12–23-months-olds
Tooth brushing frequency (more than once per day)Sugar consumption frequency
Use of fluoridated toothpaste
Dental service utilisation in 12 months
2Olatosi et al., 2015 [21]
(Lagos)
Cross-sectional
Hospital-based
302Cavitated caries
Sugar consumption
Duration of breastfeeding
Breastfeeding at night
On demand breast feeding
Duration of bottle feeding
Sleep with bottle
Sugarmate drinks
Method of tooth cleaning
Onset of tooth cleaning
Frequency of tooth cleaning
Tooth cleaning supervisor
Birth weight of child
Medical illness
Use of medication
Socioeconomic status
Age, sex
 
Behavioural
Behavioural
 
Behavioural
Behavioural
 
Behavioural
 
Behavioural
Behavioural
Behavioural
 
Behavioural
Behavioural
 
 
Behavioural
 
Biological
Biological
Social
Social
Social
6–71 months
 
Age
Duration of breastfeeding
Sleep with bottle
Sugarmate drinks
Sugar consumption
Tooth cleaning supervisor
Method of tooth cleaning
 
NABreastfeeding at night
On demand breast feeding
Duration of bottle feeding
Onset of tooth cleaning
Tooth cleaning frequency
Birth weight of child
Medical illness
Use of medication
Socioeconomic status
Age, sex
3Adeniyi et al., 2009 [22]
(Lagos)
Cross-sectional
Population-based
404Cavitated caries
Age
Sex
Residence
(Rural vs. urban)
Plaque score
Toothpaste
(Children vs. adult)
Tooth brusher
(Child vs. caregiver)
Tooth-brushing frequency
 
Social
Social
Social
 
Biological
Behavioural
 
Behavioural
 
Behavioural
18–60 monthsAge
Plaque score
NASex
Residence
(Rural vs. urban)
Toothpaste
(Children vs. adult)
Tooth brusher
(Child vs. caregiver)
Tooth-brushing frequency
4Folayan et al., 2015 [23]
(Ile-Ife)
Cross-sectional
Population-based
497Cavitated caries
Age, sex, birth rank Socioeconomic status
Maternal age at childbirth
Maternal knowledge of oral health
Tooth brushing frequency
Sugar consumption frequency
Use of fluoridated toothpaste
Night feeding
Forms of breastfeeding (exclusive, almost exclusive or mixed) Plaque score
 
Social
Social
Social
 
Social
 
Behavioural
 
Behavioural
 
Behavioural
 
Behavioural
Behavioural
 
 
Biological
6–71 monthsSugar consumption frequency
Plaque score
Female
Maternal knowledge of oral health
Age
Socioeconomic status
Use of fluoridated toothpaste
Birth rank
Night feeding
Tooth brushing frequency
Forms of breastfeeding (exclusive, almost exclusive, or mixed) Maternal age at childbirth
5Folayan et al., 2010 [24]
(Lagos)
Cross-sectional
Population-based
396Cavitated caries
Age and sex
Forms of breastfeeding (exclusive, almost exclusive or mixed) Duration of breastfeeding
Night feeding habits
Duration and content of bottle feeding
 
Social
Behavioural
 
 
Behavioural
 
Behavioural
Behavioural
6–71 monthsBreastfeeding longer than 18 months
Exclusively breastfeeding
NAAge and sex
Night feeding habits
Duration and content of bottle feeding
6Folayan et al., 2020 [25]
(Ile-Ife)
Cross-sectional
Population-based
1549Cavitated caries
Anthropometric variables (stunting, wasting underweight)
Enamel defects
 
Biological
 
 
Biological
0–5 years0–2-year-olds Amelogenesis imperfecta Fluorosis
3–5-year-olds
Enamel hypoplasia Amelogenesis imperfecta Fluorosis
0–5-year-olds
Enamel hypoplasia fluorosis
NAAnthropometric variables (stunting, wasting underweight)
7Onyejaka et al., 2015 [26]
(Enugu)
Cross-sectional
School-based
429Cavitated caries
Socioeconomic status
Dental service utilisation
Tooth brushing frequency
Sugar consumption frequency
Plaque score
 
Social
Behavioural
Behavioural
 
Behavioural
 
Biological
3–5 yearsAge
High socioeconomic status
Fair oral hygiene Dental service utilisation
Tooth brushing frequency
Sugar consumption frequency
8Sowole et al., 2007 [27]
(Lagos)
Cross-sectional
Population-based
 
389Cavitated caries
Socioeconomic status, age, sex, birth rank
Tooth cleansing methods
Tooth brushing frequency
Tooth cleansing tool
Plaque score
 
Social
 
Behavioural
 
Behavioural
 
Behavioural
Biological
6–71 monthsAge
Plaque score
NASocioeconomic status, sex, birth rank
Tooth cleansing methods
Tooth brushing frequency
Tooth cleansing tool
9Folayan et al., 2012 [28]
(Ile-Ife)
Cross-sectional study
Hospital-based
205Cavitated caries
Age, sex, birth rank
Duration of breast and bottle feeding
Forms of breastfeeding (exclusive, almost exclusive or mixed)
Frequency of daily sugar consumption
Duration of bottle feeding
 
Social
Behavioural
 
Behavioural
 
 
Behavioural
 
Behavioural
1–16 yearsAge
Frequency of daily sugar consumption
NASex
Birth rank
Duration of breast and bottle feeding
Forms of breastfeeding (exclusive, almost exclusive, or mixed)
10Olatosi et al., 2021 [29]
(Lagos)
Cross-sectional
School-based
273Cavitated caries
Anthropometric variables (stunting, wasting, underweight, BMI)
 
Biological
1–6 yearsWastingNANA
11Alade et al., 2021 [30]
(Ile-Ife)
Cross-sectional
Population-based
 
1549Cavitated caries
Maternal psychosocial factors (dental anxiety, general anxiety, sense of coherence, parenting stress, fatalism, social support, depressive symptoms, and executive dysfunction), Maternal decision-making abilities Maternal education Maternal income
Maternal caries status
 
Social
 
 
 
 
 
 
 
Social
 
Social
Social
Biological
6–71 monthsMaternal caries statusNAMaternal psychosocial factors (dental anxiety, general anxiety, depressive symptoms, sense of coherence, fatalism, parenting stress, social support, and executive dysfunction), Maternal decision-making abilities Maternal education Maternal income
12Folayan et al., 2023 [31]
(Ile-Ife)
Cross-sectional
Population-based
 
1564Cavitated and non-cavitated caries
Oral rehydration therapy
 
 
Behavioural
6 month–5 year
 
NANAOral rehydration therapy
13Folayan et al., 2019 [32]
(Ile-Ife)
Cross-sectional
Population-based
370Cavitated caries
Anthropometric variables (stunting, wasting, overweight, underweight)
 
Biological
6–71 monthOverweight Stunting
Underweight
Wasting
14Coker et al., 2018 [33]
(Benin)
Cross-sectional
Hospital-based
335Cavitated caries
Age and sex
Maternal age, education and employment status
CD4 count
HIV exposure (HIV infected; HIV exposed but uninfected; and HIV unexposed and uninfected)
Spontaneous membrane rupture during delivery
Duration of breastfeeding
Tooth cleaning frequency
Sugar consumption
Sleeping with bottle or breast
 
Social
Social
 
 
Biological
 
 
 
 
Biological
 
Behavioural
 
Behavioural
 
Behavioural
 
Behavioural
6–72 monthsHIV infected
Low CD4 count
Older age
Longer duration of breastfeeding Spontaneous membrane rupture during delivery.
NASex
Maternal age, education and employment status
Tooth cleaning frequency
Sugar consumption
Sleeping with bottle or breast
15Oluwo et al., 2021 [34]
(Lagos)
Cross-sectional study
Hospital-based
80Cavitated caries
Streptococcus mutans count
Streptococcus sobrinus count
 
Biological
 
Biological
1–5 yearsS. sobrinus countNAS. mutans count
 
16Folayan et al., 2012 [35]
(Lagos)
Cross-sectional study
Population-based
369Cavitated caries
Age, sex
Socioeconomic status
Residential location
Duration of breast feeding
Night feeding practice
Frequency of tooth cleaning
Plaque score
 
Social
Social
Social
Behavioural
 
Behavioural
Behavioural
 
Biological
6–71 monthsHigher with higher socioeconomic status
Night feeding practice
NAAge, sex
Residential location
Duration of breast feeding
Tooth cleaning frequency
Plaque score
dmft: decay, missing, filled tooth. dmfs: decay, missing, filled surface; SiC: significant Index of Caries.
Table 2. Behavioural indicators used for early childhood caries risk assessment among preschool children in Nigeria.
Table 2. Behavioural indicators used for early childhood caries risk assessment among preschool children in Nigeria.
s/nAuthors, Date (Location)Use of ToothpasteSupervised Tooth BrushingTooth Cleaning MethodTooth Cleaning ToolsTooth Brushing FrequencyOral Rehydration TherapySugar Consumption Breast Feeding DurationForms of Breast Feeding Night FeedingBottle FeedingDental Service Utilisation
1Folayan et al., 2021 [20]X---X-X----X
2Olatosi et al., 2015 [21]-X-XX-XXXX--
3Adeniyi et al., 2009 [22]XX--X-------
4Folayan et al., 2015 [23]X---X-X-XX--
5Folayan et al., 2010 [24]-------XXXX-
6Onyejaka et al., 2015 [26]----X-X----X
7Sowole et al., 2007 [27]--XXX-------
8Folayan et al., 2012 [28]------XXX-X-
9Folayan et al., 2023 [31]-----X------
10Coker et al., 2018 [33]----X-XX-X--
11Folayan et al., 2012 [35]----X--X-X--
Table 3. Social indicators used for ECC risk assessment among preschool children in Nigeria.
Table 3. Social indicators used for ECC risk assessment among preschool children in Nigeria.
s/nAuthors, Date (Location)Age SexResidential LocationSocioeconomic Status Birth RankMaternal Knowledge of Oral Health Maternal Psychosocial FactorsMaternal Decision MakingMaternal Education Maternal IncomeMaternal Employment Status
1Folayan et al., 2021 [20]X----------
2Olatosi et al., 2015 [21]X----------
3Adeniyi et al., 2009 [22]XXX--------
4Folayan et al., 2015 [23]XX-XXX-----
5Folayan et al., 2010 [24]XX---------
6Onyejaka et al., 2015 [26]---X-------
7Sowole et al., 2007 [27]XX-XX------
8Folayan et al., 2012 [28]XX--X------
9Folayan et al., 2023 [31]------XXXX-
10Coker et al., 2018 [33]XX------X-X
11Folayan et al., 2012 [35]XXXX-------
Table 4. Biological indicators used for ECC risk assessment among preschool children in Nigeria.
Table 4. Biological indicators used for ECC risk assessment among preschool children in Nigeria.
s/nAuthors, Date (Location)Plaque ScoreAnthropometryEnamel Defect Maternal Caries StatusMedical IllnessUse of MedicationCD4 CountS. mutans CountS. sobrinus CountHIV ExposureSpontaneous Membrane Rupture during Delivery
1Olatosi et al., 2015 [21]----XX-----
2Adeniyi et al., 2009 [22]X----------
3Folayan et al., 2015 [23]X----------
4Folayan et al., 2020 [25]-XX--------
5Onyejaka et al., 2015 [26]X----------
6Sowole et al., 2007 [27]X----------
7Olatosi et al., 2021 [29]-X---------
8Alade et al., 2021 [30]---X-------
9Folayan et al., 2019 [32]-X---------
10Coker et al., 2018 [33]------X--XX
11Oluwo et al., 2021 [34]-------XX--
12Folayan et al., 2012 [35]X----------
Table 5. Critical appraisal of included studies.
Table 5. Critical appraisal of included studies.
s/nAuthors, Date Were the Criteria for Inclusion in the Sample Clearly Defined?Were the Study Participants and the Setting Described in Detail?Was the Exposure Measured in a Valid and Reliable Way?Were Objective, Standard Criteria Used for Measurement of the Condition?Were Confounding Factors Identified?Were Strategies to Deal with Confounding Factors Stated?Were the Outcomes Measured in a Valid and Reliable Way?Was Appropriate Statistical Analysis Used?
1Folayan et al., 2021 [20]YesYesYesYesUnclearNoYesYes
2Olatosi et al., 2015 [21]NoYesNoYesNoNoYesYes
3Adeniyi et al., 2009 [22]YesYesYesYesNoNoYesYes
4Folayan et al., 2015 [23]YesYesYesYesNoYesYesYes
5Folayan et al., 2010 [24]NoYesYesNoNoNoYesYes
6Folayan et al., 2020 [25]YesYesYesYesYesYesYesYes
7Onyejaka et al., 2015 [26]YesYesYesYesNoNoYesYes
8Sowole et al., 2007 [27]NoYesYesYesNoNoYesYes
9Folayan et al., 2012 [28]YesYesYesYesNoNoYesYes
10Olatosi et al., 2021 [29]YesYesYesYesYesYesYesYes
11Alade et al., 2021 [30]YesYesYesYesYesYesYesYes
12Folayan et al., 2023 [31]YesYesYesYesNoNoYesYes
13Folayan et al., 2019 [32]YesYesYesYesNoYesYesYes
14Coker et al., 2018 [33]YesYesYesYesNoYesYesYes
15Oluwo et al., 2021 [34]YesYesYesYesNot applicableNot applicableYesYes
16Folayan et al., 2012 [35]YesYesYesYesNoNoYesYes
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Share and Cite

MDPI and ACS Style

Ehizele, A.O.; Afolabi, A.O.; Nnawuihe, U.C.; Alade, O.T.; Lusher, J.; Eleje, G.U.; Abodunrin, O.R.; Akinsolu, F.T.; Nwaozuru, U.; Tantawi, M.E.; et al. A Scoping Review of Early Childhood Caries Experience Assessment Tools Used for Studies in Nigeria. BioMed 2023, 3, 400-419. https://doi.org/10.3390/biomed3030033

AMA Style

Ehizele AO, Afolabi AO, Nnawuihe UC, Alade OT, Lusher J, Eleje GU, Abodunrin OR, Akinsolu FT, Nwaozuru U, Tantawi ME, et al. A Scoping Review of Early Childhood Caries Experience Assessment Tools Used for Studies in Nigeria. BioMed. 2023; 3(3):400-419. https://doi.org/10.3390/biomed3030033

Chicago/Turabian Style

Ehizele, Adebola Oluyemisi, Adebukunola Olajumoke Afolabi, Ukachi Chiwendu Nnawuihe, Omolola Titilayo Alade, Joanne Lusher, George Uchenna Eleje, Olunike Rebecca Abodunrin, Folahanmi Tomiwa Akinsolu, Ucheoma Nwaozuru, Maha El Tantawi, and et al. 2023. "A Scoping Review of Early Childhood Caries Experience Assessment Tools Used for Studies in Nigeria" BioMed 3, no. 3: 400-419. https://doi.org/10.3390/biomed3030033

Article Metrics

Back to TopTop