Early
Childhood Caries (ECC) Reduction by Pediatrician Intervention
Early
childhood caries (ECC) is a serious form of dental caries that
affects the primary dentition of young children, which disproportionately
affects poor children from racial/ethnic minority groups. In order
to prevent ECC, it is vital that "at risk" children and their caregivers
be advised and counseled about ways to prevent this disease, and that
those children who do develop ECC are identified as early as possible
so that they can receive necessary restorative treatment and counseling
in a timely fashion. Hence, pediatricians should form the first line
of defense against ECC and should be natural allies to the dental health
community in the battle against ECC by examining their patients for
ECC, advising and counseling parents and caregivers about decreasing
the child's exposure to risk factors for the ECC, and referring children
already stricken with ECC to dental care professionals for further treatment.
In this project, an innovative community-based intervention trial will
be utilized that is designed around a proven educational methodology
for enhancing pediatricians' ability to advise and counsel the parents
or caregivers of their patients regarding risk factors for early childhood
caries (ECC) and strategies for reducing these risk factors. Effective
educational programs can change physician behaviors and as a result,
effect changes in parent or caregiver behavior. By providing a first
line of action with pediatricians, this chain of events is anticipated
to decrease risk behaviors associated with ECC, and thus, reduce rates
of ECC among "at risk" children. As part of this project,
we will provide training and educational programs to specified pediatricians
in a practice serving primarily low income African American and Latino
children. These programs are designed to increase advising and counseling
parents/caregivers about decreasing ECC risk factors. Matched controls
from a similar large hospital-based pediatric group will be assessed
for comparison. In
addition, for the intervention group, we will implement an office-based
reminder system to facilitate the practice of the previously-taught
intervention.
To
assess the efficacy of the intervention, we will first measure the baseline
prevalence of ECC and ECC related risk factors among a cohort of children
with initial ages of 12, 24 and 36 months, who present for well-child
visits at their pediatricians's office, then we will assess ECC incidence
and prevalence one and two years later. We will also assess the pediatrician's
use of counseling to members of the cohort and control groups of children
at baseline, and one and two years later. Clinical assessments will
also be used to determine the effectiveness of the pediatrician intervention
group compared to the control group in reducing ECC.
