Reducing early childhood caries by 77 percent

Training clinicians helps reduce rates of early childhood cavities

Researchers at Boston University School of Medicine (BUSM) have found that pediatricians provided with the proper communication, educational and information technology tools and training could reduce the rates of children developing early childhood caries (ECC) or cavities by 77 percent. This study appears in the October issue of the Journal Medical Care.

ECC, the most common chronic illness among children, can lead to serious complications if untreated, including abscesses requiring costly surgery. Infection and pain caused by ECC can also impair growth, weight gain and limit school attendance.

BUSM researchers provided pediatric clinicians with communication skills training to help them more effectively counsel parents and caregivers to reduce children's ECC risk. Pediatricians as well as clinical nurses participated in a one hour study training session, and they were also provided with educational brochures to give to parents. The electronic medical record was also adapted to prompt clinicians to remember to counsel. After the educational program, a simultaneous recruitment of children affected with ECC was conducted at a comparison site, where the clinicians did not receive training.

Parents and caregivers of children aged six months to five years were asked to participate in a clinical exam and interview that consisted of a series of questions inquiring about the parent or caregiver's discussion with the child's doctor or nurse. This interview assessed the degree the clinician covered the topics on which they had been trained to counsel regarding ECC risk reduction. This process was repeated approximately one year later.

The findings show that providers at the intervention site had greater knowledge and conducted more counseling, and patients at that site had significantly reduced odds of developing ECC over time. "Pediatric clinicians at Boston Medical Center are committed to children's oral health, and to addressing the deficit in clinical preparation to help prevent ECC," explained lead author, Nancy R. Kressin, PhD, an associate professor of General Internal Medicine at Boston University School of Medicine. "We developed and implemented a multi-faceted pediatric practice based intervention where children especially vulnerable to ECC received enhanced care to prevent this disease from occurring or reoccurring, and it had marked effects on reducing children's rates of developing ECC" said Kressin.

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This study was funded by the National Institutes of Health the National Institute of Dental and Craniofacial Research.