Early-childhood-caries in Qatar: Prevalence and Proposal for Improvement

Objectives: Dental caries is the most prevalent chronic disease in early childhood in most communities worldwide. Several studies conducted in the Gulf Cooperation Council countries have documented a high prevalence of early childhood caries (ECC). To date, no studies have been conducted in Qatar to examine the prevalence and severity of ECC. There are no structured oral health preventive programs for preschoolers in Qatar.  Objectives were to conduct a cross-sectional study of caries prevalence and severity and dental anomalies of preschoolers attending 16 kindergartens in Qatar, as part of a larger project examining issues around implementation of a primary care oral health promotion project, The Beautiful Smile Project.

Methods: Stratified cluster random sampling was used to select 400, 4-5 year-old children from randomly- selected kindergartens.  Clinical examinations, questionnaires, interviews and focus groups were utilised. Caries experience was measured using World Health Organisation (WHO) caries criteria (dmft); enamel defects were scored by the modified developmental defects of enamel index (DDE). Questionnaires concerning knowledge and attitudes towards preschoolers’ oral health were distributed to 400 mothers (response rate: 79%) and 358 health professionals (69%). Semi-structured interviews and focus groups exploring acceptance of the Project were conducted with 20 key informants, 129 health professionals and 12 mothers (overall attendance 98%).  

Results: The mean dmft, caries prevalence, and significant caries index of preschoolers were 7.6 (±5.0), 89%, 13.6 respectively; 27% had demarcated enamel opacities. Interviews and focus groups revealed barriers to Project implementation including parental practices, oral health attitudes, health services staffing, and training deficiencies. However, clinicians were willing to collaborate and supportive leadership was evident.

Conclusions: The prevalence of ECC was high in preschoolers in Qatar. There are several barriers that need to be overcome, and avenues that can be utilised, in order to implement a preventive Project for ECC in Qatar.