Objectives To evaluate the risk factors and risk indicators associated with early childhood caries in South Africa. Design A systematic review of aetiology was performed. From 1366 papers found, 23 studies met the eligibility criteria and were included. All study designs were included. Healthy children under six who live in South Africa were eligible for the study. The study was registered with PROSPERO, registration number CRD42020216455. Data extraction Eligible studies were selected, and data extracted independently by two reviewers. Published data on socio-economic status, dietary factors, oral hygiene knowledge and practices, breastfeeding and bottle-feeding practices, oral bacterial flora and other risk indicators were collected. Two authors appraised the studies independently using the Joanna Briggs Critical Appraisal tools. Data analysis Heterogeneity was assessed using the I2 statistics, and due to heterogeneity, extracted data were mostly presented narratively. Results Meta-analysis was performed using random-effects models and concluded that parents of children who had a tertiary education had a 1.77 [1.22–2.57] odds of experiencing dental caries compared to the children of parents with a secondary education. However, the unclear risk of bias of most included cross-sectional studies precluded definitive conclusions. Conclusions More high-quality cohort studies need to be performed to evaluate actual risk factors for ECC in a South African setting. Parental/caregiver oral educational knowledge needs promoting before the emergence of their children’s teeth. The social determinants of health need to be incorporated in future studies, and suitable targeted interventions need to be developed and implemented to mitigate early childhood caries in South Africa.

Background Early childhood caries (ECC) is a common disorder characterized by the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces of primary teeth in children 71 months old or younger. South Africa has a diverse population in terms of culture, education, income, and occupation. This diversity is due to the consequences of historical racial discrimination, poverty, unemployment, lack of accessibility to health services, and quality of education. These factors make South Africa unique, and the disease and risk profiles for this country differ from those of other countries at similar stages of development. For these reasons, it is important to identify the unique maternal and infant risk factors for ECC in the South African context. Objective The purpose of this study is to determine the risk factors associated with the incidence and prevalence of ECC in South Africa in children under the age of 6 years. Methods All cross-sectional and cohort studies documenting risk factors associated with the prevalence and incidence of dental disease and severity (decayed, missing, and filled scores) will be included. We will search 7 databases for eligible studies, and those included will be based on prespecified inclusion criteria. Only studies conducted with South African children who are aged 6 years and younger in which dental caries risk factors are documented will be included. There is no restriction on the time or language of publication. Included articles will be scrutinized for quality by using a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be performed. Results The literature search was conducted in November 2020. Conclusions The results of this study will provide a framework to inform medical and dental personnel to highlight mothers and infants at risk of developing ECC. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020216455; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=216455 International Registered Report Identifier (IRRID) DERR1-10.2196/26701

Background Young children are at the highest risk of developing dental caries as they have a lack of autonomy over their diet and oral hygiene practices. Dental caries develops over time due to demineralization of tooth substance (enamel), which results from acid production during sugar metabolism by bacteria. Early onset of dental caries often results in asymptomatic presentation, but if left untreated, it can result in severe pain, infection, and dentoalveolar abscesses. Early childhood caries (ECC) is defined as dental caries in children aged 6 years and younger and is a significant public health problem in South Africa. According to the Global Burden of Disease study, untreated dental caries of primary teeth affects 532 million children. Untreated dental caries has many detrimental effects which can affect the physical development and reduce the quality of life of affected children. Furthermore, long-term untreated dental caries can result in school absenteeism, low BMI, and poor educational outcomes. Objective The purpose of this study was to determine the prevalence and severity of ECC in South Africa in children under the age of 6 years. Methods All cross-sectional studies documenting the prevalence and severity of dental disease (decayed, missing, and filled teeth scores) will be included. Various databases will be searched for eligible studies. Only studies conducted on South African children aged 6 years and under will be included. There will be no restriction on the time or language of publication. The quality of all eligible studies will be analyzed by a risk of bias tool developed by the Joanna Briggs Institute. The results will be presented narratively, and if possible, a meta-analysis will be conducted. Results The protocol is registered with PROSPERO. The literature search was initially conducted in November 2018 and was repeated in November 2020. Conclusions The results of this study will be used to advise stakeholders of the prevalence and severity of dental disease in children under 6 years of age in South Africa. Trial Registration PROSPERO CRD42018112161; International Registered Report Identifier (IRRID) DERR1-10.2196/25795

Objective: To determine the rate of dental caries and periodontal rates in Mozambican population. Material and Methods: The sample size was 722, categorized in age groups of 6,12, 15-19 and 35-44 in public schools and markets randomly selected in five provinces of Mozambique (Maputo, Gaza, Manica, Tete and Zambezia), in urban and rural areas. Clinical examinations were performed by calibrated examiners using WHO, DMFT/dmft and CPI indexes. Data analysis was descriptive and analytical, using a Chi-square test and Pearson's correlation (P <0.05). Results: The adults aged 35-44 presented higher dental caries (DMFT=1.94) than those aged 6 years (dmft = 1.16), 12 years (DMFT=0.60), and 15-19 years (DMFT=0.87). Dental caries was more prevalent in urban area (1.89) than rural area (1.33) with statistical difference p=0.004. The dental caries was the highest at Manica Province n=68 (85%) and lowest in Tete Province n=70 (31%). Regarding to periodontal status, the most prevalent disease, was Calculus in adults of 35-44 n=95 (59.4%), and the prevalence of individual free of periodontal disease was n=182 (34.3%). Conclusion: When assessing this population for dental caries and periodontal status, the 35-44 years old presented the highest rate of both diseases at all age.

Background The prevalence of Early Childhood Caries (ECC) in South Africa was last determined in 2002 in a national survey. Since then only few scattered studies were conducted across pocketed communities in the country. There appears to be an increasing trend in dental caries prevalence in South Africa. Since South Africa has one of the highest burden of HIV in the world, less focus was spent on Non-Communicable Diseases (NCDs), it was only when HIV patients developed NCD’s did the government start evaluating NCDs. However, oral health is still not given enough attention within the health sphere. It is the hope of this systematic review to showcase the extent of dental caries amongst the future leaders of our country. Objectives The systematic review presents the prevalence and severity of early childhood caries between age groups and provinces in South Africa from 1975 to 2014. Design A systematic review of prevalence was performed. Settings and participants: All studies performed on children under the age of six who lived in South Africa were eligible to be included. Primary and Secondary outcome measures The prevalence of ECC and the dmft scores were the primary and secondary outcome measures. Results Twenty-one studies were included in the present review. The overall prevalence was 44.94% (95% confidence interval (C.I.) 39.73–50.15%) and the overall dmft score was 2.422 (95% C.I. 2.148–2.696). Conclusions The dmft score was the lowest in the Limpopo Province and highest in the Eastern Cape. ECC prevalence increased post-apartheid possibly on account of lifestyle changes due to the exodus from rural to urban and peri-urban areas. Registration The protocol of this systematic review was registered with PROSPERO, CRD42018112161, in November 2018.