Multicountry Study of ECC Prevalence and Severity using ICDAS in Children 1-5 Years in 11 Latin-American Countries


Olga Zambrano11, Rodrigo Giacaman3, Soledad Gomez4, Veronica Cepeda6, Silvia GudiƱo5, Teresa Chirife8, Noemi Bordoni1, Saul Paiva2, Aminta Galvez7, Rita Villena9, Licet Alvarez10, Ana Maria Acevedo12, Hafsteinn Eggertsson13, Eugenio Beltran14
1Pediatric Dentistry, Universidad de Buenos Aires, Argentina
2Pediatric Dentistry, Universidade Federal de Minas Gerais, Brazil
3Pediatric Dentistry, Universidad de Talca, Chile
4Pediatric Dentistry, Pontificia Universidad Javeriana, Colombia
5Pediatric Dentistry, Universidad de Costa Rica, Costa Rica
6Pediatric Dentistry, Universidad Internacional del Ecuador, Ecuador
7Pediatric Dentistry, Ministerio de Salud de Panama, Panama
8Pediatric Dentistry, Universidad Autonoma de Paraguay, Paraguay
9Pediatric Dentistry, Universidad San Martin de Porres, Peru
10Pediatric Dentistry, Universidad de la Republica, Uruguay
11Pediatric Dentistry, Universidad de Zulia, Venezuela
12Pediatric Dentistry, Universidad Central de Venezuela, Venezuela
13Pediatric Dentistry, University of Washington, USA
14Pediatric Dentistry, Executive Director American Public Health Association, USA

Background: To train researchers from 11(eleven) selected countries in Latin America in epidemiological methods and diagnostic criteria for dental caries to determine the prevalence and severity of ECC with ICDAS among children 1 to 5 years old.

Methods: During the first phase, 11 trainees (one paediatric dentist of each country) were trained in a modified ICDAS for epidemiological studies (joined codes 1 and 2) with a Gold Standard trainee (HE). Inter-examiner weighted Kappas: 0.79-0.86, intra-examiner weighted kappas: 0.84-0.97 was obtained, each trainee trained 6-12 examiners in their country during the second phase of the study. The third phase was the epidemiological study in each country. Head-lights, oral mirrors, WHO probes and gauzes to dry each surface were used. Previously was necessary brush the teeth and use dental floss. Knee-knee technique was used to evaluate children under 3years. Only children with signed parental consent were examined. A total amount of 4,025 children were included in the study.

Results: A high prevalence of non-cavitated and cavitated lesions was evident in children at early ages. The mean prevalence of ECC was high in the 11 countries. ICDAS prevalence was high during the second year of life, mean d2-6mfs 57.9% and d3-6mfs 41.1%. At 5y a high range prevalence of ECC 62.5 - 94.1% and 53.3 -85.5% was found for d2-6mfs and d3-6mfs respectively.

Conclusions: There is evidence that ECC was occurring very early in life in the 11 countries. More studies with standardized diagnostic criteria and calibrated examiners are necessary to compare the prevalence of ECC. Finally, effective early preventive interventions need to be developed and tested.

This study was supported in part by IADR Regional Development Program, with the collaboration of 12 Universities of Latin America.