Prevalence and Risk Factors of Early Childhood Caries in Rural vs. Urban Communities in Sub-Saharan Africa: A Multi-Country Study

Abstract

Early childhood caries (ECC) represents a significant public health challenge across Sub-Saharan Africa, with disparities between rural and urban populations reflecting broader inequalities in healthcare access, dietary practices, and oral health literacy. This multi-country study examines the prevalence patterns and risk factors associated with ECC in children aged 0-6 years across selected Sub-Saharan African nations, comparing rural and urban settings to identify contextual determinants of disease burden. Drawing from epidemiological data collected between 2015 and 2024, this research synthesizes findings from Nigeria, Kenya, Tanzania, Uganda, and South Africa to provide a comprehensive regional perspective. The analysis reveals that while urban children demonstrate higher sugar consumption patterns, rural populations face greater challenges related to fluoride access and dental service availability. Socioeconomic factors, maternal education levels, feeding practices, and cultural beliefs emerge as critical determinants that interact differently across geographical contexts. Understanding these nuanced patterns is essential for developing targeted prevention strategies that address the specific needs of diverse communities. This study contributes to the limited body of research examining pediatric oral health disparities in resource-limited settings and provides evidence-based recommendations for policymakers, public health practitioners, and dental professionals working to reduce the burden of ECC in Sub-Saharan Africa.