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Early childhood caries prevention: non-dental health professionals' viewpoint

13 August 2020
13 min read
Volume 29 · Issue 15



Dental caries can develop early in life and have harmful consequences. Objective: To examine non-dental practitioners' knowledge of early childhood caries (ECC).


A questionnaire on oral health and caries knowledge was emailed to five types of health professional who work with young children: paediatricians, GPs, midwives, paediatric nurses and paediatric healthcare assistants. Questions concerned: when a child should first visit a dentist; at what age toothbrushing should start; aetiopathogenic factors; early diagnosis; and the effect of breastfeeding.


494 health professionals (79 paediatricians, 59 physicians, 217 midwives, 92 paediatric nurses and 47 paediatric healthcare assistants) participated. Although most (89.86%) discussed oral health with parents, responses on when a child should first see a dentist and when toothbrushing should start varied. Almost half of respondents said they could diagnose caries but not all were confident in this. Aetiological factors in ECC mentioned included oral hygiene, bottle feeding, sugar intake, genetics and a lack of fluoride.


Non-dental practitioners lack knowledge about ECC, so cannot help prevent it. Initiatives including interprofessional training would improve their knowledge of oral health in early childhood.

In the 21st century, dental caries are the most widespread infectious disease and remain the third commonest disease in the world (Petersen, 2009; Kassebaum et al, 2015). The American Academy of Pediatric Dentistry (AAPD) defined early childhood caries (ECC) as the presence of one or more decayed (non-cavitated or cavitated lesions), lost (because of caries) or filled tooth surfaces in any primary tooth in a child aged under six years (AAPD, 2016).

ECC is a significant public health problem with harmful consequences (Kagihara et al, 2009). These include: pain, bacteraemia, sleeping problems, reduced social activities, reduced growth and development, speech and breathing disorders, premature tooth loss, the need for orthodontic treatment, compromised chewing, ear, nose and throat infection, loss of self-esteem and a poorer quality of life (Anil and Anand, 2017); poorer school performance and disrupted attendance at work for parents (Balaban et al, 2012); and high treatment costs for both those affected and society, and future harm to permanent dentition because of an unbalanced oral ecosystem (Samnaliev et al, 2015). ECC has the characteristics of a long-term condition (Krisdapong et al, 2014).

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