Complex Socio-demographic Challenges Outweigh ECC Prevention in South Africa

Objective: This study examines the available literature in terms of Early Childhood Caries (ECC) in South Africa. Methods: Papers identified on the PubMed database were initially included using the key words: “South Africa” and “early childhood caries”; or “nursing caries”; or “baby bottle caries”; or “infant caries”. Papers written between 1978 to current in the English language were selected if they reported South African data pertaining to the epidemiology of ECC, baby feeding practices, sugar, water fluoride levels and socio-demographic determinants, as well as proposed interventions that relates to ECC. Results: The initial research revealed 45 papers, of which 29 met the inclusion criteria. Only one article was based on what could be deemed to be “nationally representative” sample. The prevalence and severity of ECC appear to be very high in South Africa, yet ECC is not recognized as a serious public health concern, with diseases such as HIV being the focus point. The severe forms of ECC are associated with low socio-economic status, and certain racial groupings, which suggest an integrated primary health care approach. However, resources allocated to oral health remain scant and quality research evidence is lacking, which limits the development of an ECC prevention/management strategy. Conclusions: More high quality research is needed, not only to unravel which interventions would be most appropriate to prevent ECC in the socially diverse South African population, but also to bring the seriousness of the public health problem under the attention of the political decision makers amid all the other challenges.