Maternal and infant risk factors for early childhood caries in South Africa: A Systematic Review Protocol (Preprint)

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 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 differs from other countries in similar stages of development. For these reasons, it is important to identify what the unique maternal and infant risk factors of ECC are in the South African context. OBJECTIVE The purpose of this study is to determine the risk factors associated with the incidence/prevalence of early childhood caries (ECC) in South Africa in children under the age of 6 years. METHODS All cross-sectional and cohort studies documenting the risk factors associated with the prevalence and incidence of dental disease and severity (decayed, missing and filled scores) will be included. Seven databases will be searched for eligible studies and those included will be based on a pre-specified inclusion criteria. Only studies conducted on South African children who are aged 6 years and younger, where 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 protocol is registered with PROSPERO, CRD42020216455. 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 from developing ECC. This framework may be used to prevent non-communicable diseases (NCDs) such as obesity and diabetes incidence in children. CLINICALTRIAL PROSPERO, CRD42020216455