Social and Behavioral Determinants of Early Childhood Caries Among Displaced Children in Eastern Libya: A Cross-Sectional Study in the Tawergha IDP Camps of Benghazi

Abstract

Early childhood caries (ECC) is the most common chronic disease among preschool children globally, and preschool children displaced by conflicts have an excessive burden of ECC. Children from the town of Tawergha that have been displaced to IDP camps in Benghazi, Eastern Libya, since the 2011 conflict have not had their ECC assessed yet. The present study aimed to estimate the prevalence and severity of ECC and to explore the associated socio-behavioral factors in these children. Methods: A camp-based cross-sectional study was performed on 100 children aged 24 – 71 months. ECC experience was scored at the tooth level under natural light based on WHO diagnostic criteria to calculate the dmft index, and social, economic, dietary, and oral hygiene behavior of parents were collected through a questionnaire. Associations were analyzed using the chi-square test, and independent variables for ECC were determined using multiple logistic regression (SPSS 26.0; p < 0.05). Results: The overall prevalence of ECC in the study sample was 72.0%, while the mean dmft was 4.68 ± 3.71, mostly due to the decayed component (mean d = 4.14). S-ECC prevalence was 22.0%. Age-wise prevalence showed a marked increase with age, being 55.0% between 24–35 months and reaching 90.0% at 60-71 months. In the adjusted analysis, frequent intake of sugar-containing snacks (aOR = 4.06), nocturnal feeding from the bottle (aOR = 3.82), consumption of sweetened milk at night (aOR = 3.15), insufficient teeth brushing (aOR = 2.74), low maternal education level (aOR = 2.61), and no ever visitation of the dentist (aOR = 1.95) were independently associated with ECC. Conclusion: Preschool children in displaced camps of Tawergha suffer from an extremely high, predominantly untreated burden of ECC due to modifiable feeding, diet, and hygiene habits and socioeconomic vulnerability. These results justify the need for preventive programs in the camps targeted at caregivers.