Effectiveness of early diagnosis and intervention for early childhood caries

Objectives: To evaluate the effectiveness of an intervention aimed at preventing early childhood caries (ECC) in urban settings .

Methods: The study included 234 children aged 6 to 24 months who underwent a dental examination and an ECC risk assessment. Each child's mother underwent a detailed structured interview, which included feeding type (e.g. breastfeed, bottle-feed), frequency and duration; children's oral hygiene habits; and type of health insurance. The ECC prevention intervention consisted of : i) a specially tailored information session highlighting the level of ECC risk factors exposure of each child, ii) the provision of a leaflet relevant to ECC, and iii) signing of a commitment to undertake a number of measures to prevent ECC. Children living in Quillota were assigned to the test group, while children living in Quilpue were assigned to the control group. A post-test evaluation of their ECC risk and dental status was conducted after 24-months.

Results: A total of 78 test group and 73 control group children participated in the evaluation (retention rate after 24 months = 64.5%). At baseline there were no significant differences in the active caries level [0.28(s.d. 1.0) vs 0.12(s.d. 0.6); p<0.05]. At post-test, children in the test group did not significantly increase caries levels [0.76(s.d. 2.2)]. On the other hand, compared to baseline, increments in active dental caries levels among children in the control group [0.90 (s.d. 1.4)] reached significance at the 0.001 level. Positive outcomes were also achieved regarding EEC risk status. The proportion of children at risk in the test community decreased after twenty-four months of program implementation (from 61.8% to 38.2%; p<0.001), while in the control community this proportion did not change significantly (54.3% vs. 45.7%; p>0.05).

Conclusion: Under the conditions prevailing in Chile, an individually tailored ECC prevention program based on individual risk and implement through the network of community health centers represents an effective preventive alternative to reduce dental caries incidence among preschool children living in non-metropolitan centers. Supported by FONIS SA04I2123.