The statistics of this study revealed that approximately half of 3-6-years old study population suffered from dental caries in their primary dentition, hence, it is justifiable to state that we are in line with WHO/FDI goals for 2000, i.e. 50% of 5-6-years old children should be caries free
. In spite of this fact, this percentage is significantly high keeping in perspective the biological consequences and financial burden of treating the disease in question in accordance to our current low-budget healthcare system. However, some local studies
[11, 12, 24, 25] have determined caries prevalence among local preschool children to be somewhat lesser compared to the current estimate, even though the disparity is trivial. Its likely rationale might be either the socio-economic differences of the study group or a difference in the nutrition and dietary habits amongst residents of the two provinces. Conversely, a study conducted in Islamabad
, reported a high dmft score amongst primary dentate children but the study sample included children who were already suffering from caries and visited the hospital for treatment purpose.
More or less equivalent prevalence rates were reported from our bordering country India
[9, 10] probably due to similar socio-demographic, cultural, dietary and oral hygiene behavior patterns among children of defined age-group. However, these estimates are drastically inferior compared to the Arab World
[6, 26–30] as well as certain other developing nations
[8, 16, 31–34] where a healthy proportion of children having deciduous dentition were carrying the burden of dental caries. On the contrary, pre-school children residing in the developed countries have lower caries prevalence
[35–41]. The plausible explanation for such discrepancy can be inequality in economic conditions and resources, effective fluoridation policy, efficiency of healthcare system, availability and consumption of refined sugars, standard of oral health awareness among public, dietary and oral hygiene lifestyles, as well as motivational status of parents and children. The dmft value of sample population had similar universal trends as the above mentioned prevalence of dental caries
[32, 33, 35, 39, 41, 42].
Decayed teeth formed the major component of total dmft score, followed by missing and the least contribution was of filled teeth. Comparable proportions are evident in majority of studies
[1, 30, 41]. The attributed explanation might be that majority of children do not undergo dental restorations primarily because of high treatment cost, lack of affordable dental services and false perceptions of parents regarding significance of retaining primary teeth, while those who undergo treatment prefer extraction rather than restorations.
The male children had a higher dmft value compared to females demonstrating that girls are more conscious about their diet, oral health and hygiene, but the diffe-rence was not significant, recent studies reported likewise
[6, 10, 11, 34, 35, 41]; perhaps due to the fact that at this young age, children are not self-motivated about their dental health and rely mostly on their parents for the maintenance of their oral hygiene. Couple of studies have; however, found a significant difference between dmft scores of preschool boys and girls
Regarding the disease severity among caries positive children, majority had 1–3 teeth involved whereas less than thirteen percent individuals had six or more teeth affected by caries. This severity value is superior compared to an Australian study
 and a valid explanation would be that their overall caries experience was low compared to present research outcome.
Most children maintained a good oral hygiene whereas plaque accumulation was observed in approximately half of them, which is substantially better compared to children of Saudi Arabia
[26, 27] and Laos
 but inferior than Belgian preschool population
The dmft scores of 3-6-years old children increment as the age-bracket advanced
[10, 29, 36, 41]. The feasible rationale of this caries advancement would be that as children grow older; their diet pattern alters from home-made nutritious food to unhealthy snacks and junk food easily available at school canteens, their parent’s involvement in tooth-brushing practices diminish, and also the duration of teeth being exposed to the oral environment prolongs. Presence of dental plaque and poor oral hygiene were observed to be significantly associated with caries prevalence and such negative associations were also established by numerous studies
[15, 26, 44].
With regard to oral hygiene practices of children, only a minor proportion did not brush their teeth whereas only half of the participants brushed once a day in the morning time among which majority used a tooth-paste and two-thirds of them rinsed their mouth after meals. The aforementioned brushing practices are comparable to those reported from Saudi Arabia
 and Belgium
 but notably better than practices of Kosovo children
. Brushing once a day routine might be considered a general hygiene practice or a social norm and sufficient to maintain the kids’ oral hygiene among our population. Large number of children consumed sweetened drinks and confectionaries; this percentage is enormously high compared to Nigerian children
, and this high rate of sweet consumption may be because the children feel emotionally pleased with sweet consumables.
The frequency of tooth-brushing was not significantly associated with dmft score and similar outcome was reported in a Kosovo study
. The explanation of failure to establish a correlation could be possibly due to a large proportion of study participants brushed their teeth only once a day and the responses were not equally distributed. This study observed that use of toothpaste did not have a significant impact on the caries experience despite its fluoride content which has anti-bacterial and remineralization properties
[47, 48]. Caries experience among children consuming flavored sweetened milk did not differ significantly and this observation is in contrast to various studies which have established caries association with sweetened liquids
[15, 45] as sugars can even diminish the protective effects of milk ingredients if added in it. Insignificant associations were also established with tooth-brushing practice, consumption of sweet juices and syrups as well as confectionaries. Consuming milk without any sugar additives had a positive (protective) impact on the caries experience of preschool children and such finding is probably due to the protective contents present in milk such as calcium, phosphates, casein, lactoferrins