Prevalence, determinants, and sociocultural correlates of early childhood caries among preschool children In Urban Kano, Nigeria

Background: Early childhood caries (ECC) represents a significant public health burden in Nigeria, yet epidemiological data from northern regions remain scarce. This study aimed to determine the prevalence, severity, and key determinants of ECC among preschool children in urban Kano, northern Nigeria. Methods: A community-based cross-sectional study was conducted among 162 children aged 3–5 years in Kano Municipal and Nasarawa Local Government Areas, selected through multistage sampling. Data were collected using structured questionnaires administered to parents/caregivers, clinical oral examinations using both WHO/dmft and International Caries Detection and Assessment System (ICDAS) criteria, and salivary microbial analysis. Bivariate and multivariate logistic regression analyses identified determinants of ECC. Results: The prevalence of ECC was 16.7% (95% CI: 11.3–23.3%) using dmft criteria, with a mean dmft of 2.4 ± 2.5 among affected children. ICDAS assessment revealed a substantially higher prevalence of 33.3%, with early-stage lesions (ICDAS 1 and 2) predominating (28.4% of total sample). Females exhibited higher caries severity (mean dmft 3.3 ± 3.1) compared to males (1.3 ± 0.5). Multivariate analysis identified frequent consumption of sugary snacks and drinks (AOR = 3.06, 95% CI: 1.06–8.83, p = 0.04) and previous dental visits (AOR = 5.90, 95% CI: 1.26–27.55, p = 0.02) as significant determinants of ECC. Bivariate analysis revealed associations with increasing age ( p = 0.05), Hausa ethnicity ( p = 0.02), and Islamic religion ( p = 0.01). Conclusion: ECC prevalence in urban Kano is substantial, with early lesions frequently undetected by traditional dmft indices. The paradoxical association between dental visits and higher caries prevalence indicates predominantly crisis-driven rather than preventive care utilisation. Culturally tailored prevention strategies focusing on dietary modification and early screening using ICDAS are urgently needed in northern Nigeria.