What is the prevalence of early childhood caries worldwide?


Uribe SE, Innes N, Maldupa I. The global prevalence of early childhood caries: A systematic review with meta-analysis using the WHO diagnostic criteria. Int J Paediatr Dent. 2021 Mar 18. doi: 10.1111/ipd.12783. Epub ahead of print. PMID: 33735529.


Aim: To estimate the global prevalence of early childhood caries using the WHO criteria.

Design: Systematic review of studies published from 1960 to 2019. Data sources: PubMed, Google Scholar, SciELO and LILACS. Eligibility criteria were articles using: dmft-WHO diagnostic criteria with calibrated examiners, probability sampling, and sample sizes. Study selection: Two reviewers searched, screened and extracted information from the selected articles. All pooled analyses were based on random-effects models. Registration: Prospero-CRD42014009578.

Results: From 472 reports, 214 used WHO-criteria and 125 fitted the inclusion criteria. Sixty-four reports of 67 countries (published 1992-2019) had adequate data to be summarised in the meta-analysis. They covered 29 countries/59018 children. Global random-effects pooled-prevalence was (percentage[95% CI]) 48[43, 53]. Prevalence by continent was Africa 30[19; 45], Americas 48 [42; 54], Asia 52[43; 61], Europe 43[24; 66], and Oceania 82[73; 89]. Differences across countries explain 21.2% of the observed variance.

Conclusions: Early childhood caries is a global health problem, affecting almost half of preschool children. Limitations: Results are reported from 29/195 countries. Implications of key findings: ECC prevalence varied widely, and there was more variance attributable to between-country differences rather than continent or change over time.

Reported prevalence by continent, year and sample size


LocationNo. of StudiesPooled Prevalence (95%CI)
Global6448% (43% to 53%)
Africa730% (19% to 45%)
Americas2748% (42% to 54%)
Asia2752% (43% to 61%)
Europe543% (24% to 66%)
Oceania182% (73% to 89%)
DecadeNo. of StudiesPooled Prevalence (95%CI)
1990s555% (31% to 76%)
2000s2545% (37% to 53%)
20103449% (42% to 55%)