Home›Psychiatry› Early childhood caries affects 17% to 57% of children in Africa, umbrella review finds
Early childhood caries affects 17% to 57% of children in Africa, umbrella review findsFactors Influencing Early Childhood Caries in Children Across Africa
Frontiers in MedicinePublished June 26, 2026Study authors: Mohammed Farouk, Wahid Hafsa Oumayma, Oussama BentaharDOI ↗Editorial oversight: Dr. Ji-eun Park, MD · Brain, Mind & Pain
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Key Takeaway
Consider that ECC prevalence in African children varies widely (17%-57%), with dietary and hygiene factors as key determinants.
This umbrella review systematically synthesized evidence from existing systematic reviews and meta-analyses on the prevalence and determinants of early childhood caries (ECC) among children in Africa. The review included studies from across the continent, covering a wide range of potential determinants including dietary, oral hygiene-related, sociodemographic, breastfeeding/bottle-feeding-related, maternal/caregiver-related, biological, health-related, and contextual factors.
Key findings indicate that ECC prevalence in African children ranges from 17% to 57%, with higher estimates reported in North and Southern Africa. The most consistently reported determinants were dietary factors, oral hygiene practices, sociodemographic characteristics, and breastfeeding or bottle-feeding habits. Maternal/caregiver-related, health-related, biological, and contextual determinants were less consistently reported and had lower certainty of evidence.
The authors note that the methodological quality of included reviews ranged from high to critically low, and the certainty of evidence was moderate for prevalence and the most consistently reported determinants, but low for maternal/caregiver-related, health-related, biological, and contextual determinants. These limitations should be considered when interpreting the findings.
For practice, the findings support evidence-informed oral health promotion and prevention strategies across African settings, including caregiver education and integration into maternal and child health programs. However, given the observational nature of the underlying studies and the limitations noted, causal inferences should be avoided.
How this fits prior evidence
This umbrella review extends prior coverage of oral microbiota associations with chronic kidney disease and early childhood caries by providing a comprehensive synthesis of ECC prevalence and determinants specifically in African children. While the prior systematic review highlighted associations without causal proof, this review confirms a wide prevalence range (17% to 57%) and identifies consistently reported determinants such as dietary and oral hygiene factors, addressing a gap in region-specific evidence. The low certainty for some determinants underscores the need for further research.
This review looked at many different studies to understand why so many children in Africa suffer from early childhood caries (ECC). ECC is a common condition where children develop cavities early in life. The research found that the prevalence of these cavities varies widely, ranging from 17% to 57%. These higher rates were more common in North and Southern African regions.
Several factors consistently appear as causes for tooth decay. These include dietary habits, oral hygiene practices, and how infants are fed, such as whether they use bottles or breastfeed. Other factors like social status and caregiver involvement also play a role. However, the evidence for some specific areas, like biological or health-related factors, is not very strong yet.
Because of these findings, experts suggest that better education for caregivers and stronger oral health programs for mothers and children could help. While this study provides a broad look at the problem, it is based on existing reviews rather than new clinical trials. You should talk to a dental professional to create a specific care plan for your child.
What this means for you:
Diet, hygiene, and feeding habits are key factors in childhood tooth decay across various African regions.
Common questions
How common is early childhood caries in Africa?
The study found that the prevalence of early childhood caries (ECC) varies between 17% and 57%. These higher estimates were specifically noted in regions across North and Southern Africa.
What factors lead to tooth decay in children?
The most consistently reported factors include dietary habits, oral hygiene practices, and breastfeeding or bottle-feeding methods. Other factors like sociodemographic status also contribute to the rates of childhood tooth decay.
What can be done to prevent these issues?
The findings suggest that evidence-informed programs, such as caregiver education and integrating oral health into maternal and child health programs, can help promote better dental health for children.
Early childhood caries (ECC) remains one of the most prevalent chronic diseases affecting children worldwide and represents a major public health challenge in many African settings. Understanding its determinants is essential for developing oral health promotion strategies and preventive policies aimed at improving child oral health and reducing inequalities.
This umbrella review followed PRISMA guidelines and was registered in PROSPERO (CRD420261379153). Systematic reviews and meta-analyses published between January 2000 and May 2026 were identified through searches of MEDLINE, Scopus, Web of Science, and Embase. Methodological quality was assessed using AMSTAR 2, risk of bias using ROBIS, overlap using a citation matrix and corrected covered area (CCA), and certainty of evidence using a narrative GRADE approach. Findings were synthesized narratively.
Seven systematic reviews and meta-analyses were included. Methodological quality ranged from high to critically low, while ROBIS identified predominantly low overall risk of bias, although two reviews were judged to be at high risk of bias. The corrected covered area (CCA) was 4.7%, indicating a low degree of overlap among reviews. ECC prevalence ranged from 17% to 57%, with higher estimates reported in North and Southern Africa. The most consistently reported determinants were dietary, oral hygiene-related, sociodemographic, and breastfeeding and bottle-feeding-related factors, whereas maternal/caregiver-related, biological, health-related, and contextual determinants were supported by a smaller body of evidence. Certainty of evidence was moderate for ECC prevalence and the most consistently reported determinants, but low for maternal/caregiver-related, health-related, biological, and contextual determinants. These findings support evidence-informed oral health promotion and prevention strategies across African settings.
ECC remains a substantial oral health burden in Africa and is influenced by interacting behavioral, sociodemographic, caregiver-related, biological, health-related, and healthcare access determinants. Comprehensive oral health promotion strategies should strengthen caregiver education, support healthy dietary and oral hygiene behaviors, improve access to preventive services, and integrate oral health into maternal and child health programs. Such approaches may help reduce ECC burden and oral health inequalities among vulnerable populations.
PROSPERO, identifier CRD420261379153, http://www.crd.york.ac.uk/PROSPERO/view/CRD420261379153.
