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Geo-mapping Early Childhood Caries (ECC) in India

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Geo-mapping of prevalence and predictors provides a quick visual overview of specific areas vulnerable to caries and aids in designing tailored services. (Photo: Canva)

Wed. 9 February 2022

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Early Childhood Caries (ECC) is a significant concern. Geo-maps have been extensively used abroad for presenting epidemiological data based on caries risk. However, there has been little use of Geo-maps in dentistry across India. The present study aimed to geo-map the spatial distribution of caries risk in Lucknow pre-schoolers and identify associated predisposing factors.

Early Childhood Caries (ECC) is an aggressive and rampant form of dental caries that presents in children aged three to five years with

  • one or more decayed (non-cavitated or cavitated)
  • missing (due to caries), or
  • filled tooth surfaces in any primary tooth.

Geographic Information Systems (GIS) help link various determinants of health, and their spatial representation enables primary care physicians and public health specialists in their decision-making in planning for future care.

GIS maps are an excellent utility tool that can simplify complex information about common oral health diseases and present it to dental researchers and physicians in an easy-to-understand way. GIS maps can estimate oral disease patterns, resource allocation etc., as per the population density, thereby facilitating oral health advocacy.

The study highlighted that children from low-income families get more tooth caries than children from families with medium or good financial conditions.

This paper by KGMU Dental College in Lucknow, India, titled 'Geo-Mapping of Early Childhood Caries Risk: A Community-Oriented Preventive Oral Health Promotional Approach' used geo-mapping to track early risk childhood caries in children across different demographics.

Geo-mapping was used to understand better the spatial distribution of early caries risk to better plan and deliver health promotion and preventive programs.

Study: A cross-sectional study was conducted on 1000 preschool children aged 3 to 5, chosen using systematic random sampling. Each child's residential address was geo-coded. They were clinically examined for dental caries and issued a Decayed Missing Filled Tooth (DMFT index). To obtain socio-demographic data, a pre-tested questionnaire was used. Mann-Whitney and Kruskal-Wallis tests were used to compare median DMFT values.

Caries was discovered in approximately 76% of the participants. DMFT indices differed by gender, income level, and ward— wards closer to the district's centre had a higher prevalence of caries.

Gender:
Of the 1000 study subjects, 57% were male, while 43 were female. The maximum DMFT scores observed in males was 5 and in females was 6.

Family Income:
The majority of the participants were in the age group 4+ and from families with an average monthly income of less than Rs 10,000. The maximum DMFT score observed was significantly lower in children from families with an average monthly income of more than Rs 20,000.

The take-home points from this study:

The paper recommends cost-cutting and improved access to health care to improve primary care and preventive health services.

GIS helps assess patterns of healthcare utilization and community-level attributes to identify geographic regions most in need of primary care access.

Geo-mapping of prevalence and predictors provides a quick visual overview of specific areas vulnerable to caries and aids in designing tailored services.

References: Geo-Mapping of Early Childhood Caries Risk: A Community-Oriented Preventive Oral Health Promotional Approach

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