No consensus on definition of early childhood caries

Abstract

Question: Are there clear agreed definitions for early or severe childhood caries? Objective To review case definitions and clinical diagnostic criteria for early childhood caries (ECC) and severe ECC (S-ECC).Data sources MEDLINE 1966–1998, references from three previous reviews and one unpublished report.Study selection Studies were selected if they included children aged 1–5 years of age, described diagnostic criteria or case-definitions of S-ECC, and were in English.Results A total of 71 studies collected population data and the rest described children seen in health or dental clinics (see Table 1). Fifty-nine studies did not report on calibration of examiners, but reliability of examiners was reported by 19 studies. Cavitation was the most common diagnostic criterion (44 studies). Whereas 22 studies reported no diagnostic criterion, 27 used a criterion of one or more dmf maxillary incisors, 23 used two or more, and nine used three or more dmf maxillary incisors for their diagnosis. The most frequently used names for S-ECC were “nursing caries” (23 studies), “baby-bottle tooth decay” (14 studies) and rampant caries (nine studies). Studies published in the last 2 years estimated that 1963% of examined children had S-ECC.Conclusions There is wide variation in the diagnostic criteria for ECC and case-definition for S-ECC. A consensus is needed for research and to evaluate preventive interventions.