The Silent Epidemic: Early Childhood Caries

The DentaQuest Institute recently had the opportunity to participate in the National Initiative for Children’s Health Quality’s (NICHQ) Annual Forum for Improving Children’s Healthcare and Childhood Obesity Congress. NICHQ is a great organization doing important work to make sure all children receive the high quality healthcare they need. Dr. Man Wai Ng, Chief of the Department of Dentistry of Children’s Hospital Boston and I gave a presentation about some interesting work we are doing with Early Childhood Caries.

Early Childhood Caries (ECC) – or aggressive tooth decay in very young children – is something that we should never have to talk about. ECC, like all dental disease, is almost completely preventable. But caregivers need to be aware of the right things to do for their children from the moment the youngster gets his or her first teeth. Preventing ECC is why dentists recommend that children get their first oral health check up around their first birthday, why we recommend brushing a child’s teeth every day, and why dentists advise against giving children bottles of anything other than plain water before a nap or bedtime.

Too many children don’t get the preventive care they need and deserve early in life; too many end up in hospital-based dental clinics where the only solution is to treat the dental disease surgically in the operating room. The numbers of children in this situation are surprisingly large and many must wait in pain for months to get time in the hospital’s operating room. Even after treatment, there is often a high rate of recurrence of the cavities. Early childhood caries is painful to the child, and if untreated, can impact the proper development of permanent teeth. The results are eating and speech problems that limit the child’s ability to grow, to thrive, and to enjoy a normal life.

For the past 18 months, Dr. Man Wai Ng of Boston Children’s Hospital, Dr. Dan Kane of St. Joseph Hospital for Specialty Care in Providence, and the DentaQuest Institute have been testing a different model for treating ECC. We’ve been using an evidence-based, risk-based disease management approach adapted from the concept of chronic care management of medical conditions. Our emphasis has been on educating the caregiver as a first line of defense in reversing the cycle of the child’s dental disease. I’m happy to say that we have seen some very positive results. Given the success of this initial effort, we are working on plans to further expand this chronic care model and we look forward to partnering with clinical partners across the country on more effective approaches to prevent and manage oral disease in children.

- Guest blog post by Dr. Alex White, Director of Analytics, DentaQuest Institute.