Background: Early childhood caries (ECC) is the most common chronic disease in children, aged 2–5 years, and is considered a priority action area by the World Dental Federation (FDI).1,2 The prevalence of ECC in children in India is extremely high and calls for immediate action.3 There is an urgent need for evidence-based oral health care and for the development of policies that support education, prevention, and healthy behaviors, specifically a national policy that recommends every child be seen by a dentist before the age of 1 year. Oral health is a matter of quality of life, overall health, social justice, and human rights.
Materials and methods: There is a need to advocate for and promote a mandatory age-one visit to assess a child\'s risk level for ECC and establish a primary prevention plan. Effective oral health assessments for infants include six steps: caries risk assessment; knee-to-knee positioning of the child; toothbrush prophylaxis; a clinical examination; fluoride varnish treatment; and anticipatory guidance, counseling, and self-management goals.
Recommendations: In order to increase oral health literacy and improve the oral health of children, certain recommendations should be prioritized and adhered to. These include the inclusion of risk assessment, anticipatory guidance, and self-management goals, an emphasis on ECC and oral health education, prioritizing primary prevention of ECC through healthy behaviors and the promotion of a mandatory age-one visit policy, interprofessional collaboration, and continued research of ECC inequalities and how to address them.
World Dental Federation. Perinatal and Infant Oral Health. https://www.fdiworlddental.org/resources/policy-statements-and-resolutions/perinatal-and-infant-oral-health. Adopted September 2014. Accessed December 4, 2019.
Pitts N, Baez R, Diaz-Guallory C, et al. Early Childhood Caries: IAPD Bangkok Declaration. Int J Paediatr Dent 2019;29:384–386.
Ganesh A, Muthu MS, Mohan A, et al. Prevalence of early childhood caries in India – A systematic review. Indian J Pediatr 2019;86:276–286. DOI: 10.1007/s12098-018-2793-y.
Ramos-Gomez FJ, Crystal YO, Domejean S, et al. Minimal intervention dentistry: part 3. Paediatric dental care--prevention and management protocols using caries risk assessment for infants and young children. Br Dent J 2012;213(10):501–508. DOI: 10.1038/sj.bdj.2012.1040.
Ramos-Gomez FJ, Crystal YO, Ng MW, et al. Pediatric dental care: prevention and management protocols based on caries risk assessment. J Calif Dent Assoc 2010;38(10):746–761.
Douglass J M, Li Y, Tinanoff N. Association of mutans streptococci between caregivers and their children. Pediatr Dent 2008;30:375–387.
Ramos-Gomez F. Bacterial salivary markers’ role in ECC risk assessment in infants. J Dent Res 2006;85B:poster 0516.
Jackson SL, Vann WFJr, Kotch JB, et al. Impact of poor oral health on children's school attendance and performance. Am J Public Health 2011;101(10):1900–1906. DOI: 10.2105/AJPH.2010.200915.
Ramos-Gomez F. Understanding oral health disparities in the context of social justice, health equity, and children's human rights. J Am Dent Assoc 2019;150(11):898–900. DOI: 10.1016/j.adaj.2019.09.004.
Sinner B, Beck K, Engelhard K. General anesthetics and the developing brain: An overview. Anesthesia 2014;69(9):1009–1022.
Berkowitz RJ, Amante A, Kopycka-Kedzierawski DT, et al. Dental caries recurrence following clinical treatment for severe early childhood caries. Pediatr Dent 2011;33(7):510–514.
American Academy of Pediatric Dentistry. Perinatal and infant oral health care. Reference manual 2018–2019. Pediatr Dent 2018; 40(6):216–220.
Centers for Disease Control and Prevention. Prevention. Picture of America. Available at https://www.cdc.gov/pictureofamerica/pdfs/picture_of_america_prevention.pdf. Accessed March 17, 2020.
International Association of Paediatric Dentistry. Children 0-2 years of age: Frequently Asked Questions. http://www.iapdworld.org/parents/super_pages.php?ID=parents1#6. Accessed December 4, 2019.
Ramos-Gomez F. Six Step Protocol for a Successful Infant Oral Care Visit. Pediatric Dentistry Today 2009. 38–40.
Ramos-Gomez F, Ng MW. Into the future: keeping healthy teeth caries free: pediatric CAMBRA protocols. J Calif Dent Assoc 2011;39(10):723–733.
American Academy of Pediatrics. Oral Health Risk Assessment Timing and Establishment of the Dental Home. Pediatrics 2013;111(5):1113–1116.
International Association of Paediatric Dentistry and Alliance for a Cavity-Free Future. Action on Early Childhood Caries from multiple stakeholders is needed now in four key areas. Infographic. An output from the IAPD Global Summit on Early Childhood Caries, 2018.
Taylor CA, Bell JM, Breiding MJ, et al. Traumatic brain injury-related emergency department visits, hospitalizations, and deaths – United States, 2007 and 2013. MMWR Surveill Summ 2017;66(9):1–16. DOI: 10.15585/mmwr.ss6609a1.
Tinanoff N, Kanellis MJ, Vargas CM. Current understanding of the epidemiology mechanisms, and prevention of dental caries in preschool children. Pediatr Dent 2002;24:543–551.