Oral Health Policies to Tackle the Burden of Early Childhood Caries: A Review of 14 Countries/Regions

Abstract

Aim: Early childhood caries (ECC) has significant public health implications but has received inadequate global attention. There is limited information regarding the success of oral health policies implemented to address the challenges of ECC. This review aimed to summarize such policies to tackle ECC from different countries/regions.Method: Independent collaborators from 14 countries/regions (Australia, Brazil, Cambodia, China, Hong Kong, Egypt, India, Indonesia, Japan, Nigeria, Thailand, UK, USA, and Venezuela) collected the data. The ECC status, dental workforce, oral health policies on ECC prevention in different countries/regions were summarized by each country.Results: The findings indicated that ECC prevalence varied in different countries/regions. The lowest prevalence of ECC among 5-year-old children was found in Nigeria (7%), and the highest was found in Indonesia (90%). The existing dental workforce and resources are limited in most countries. The smallest dentist to population ratio was reported by Nigeria at 1:48,400, whereas the highest ratio was in Brazil (1:600). Out of 14, three (21%) countries namely India, Venezuela and Cambodia had no national oral health policies addressing ECC and four (29%) countries (Cambodia, China, India, Venezuela) had no publicly funded dental care program for 0–5-year-old children. Water fluoridation is available in four countries/regions (Australia, Brazil, Hong Kong, USA).Conclusion: ECC remains a global health challenge and dental workforce is limited. National/regional programs to tackle ECC are not yet prioritized in many countries/regions. Evidence to support demonstration projects is limited. Further research on the cost-effectiveness of interventions strategies is required for policymakers.

Early Childhood Caries in 4- to 5-Year-Old Children in Erzurum, Turkey

“…In such low income countries, taking into consideration the lack of dental workforce and high ECC prevalence, recommending the provision of conventional dental treatment to millions of children is impractical. Novel and effective treatment protocols that can be easily fulfilled with less equipment and simple methods are required in countries with high ECC prevalence and low dentist/population ratios (32). Similar to the situation remarked by Chen et al (32) in their review, only 6 pediatric dentists and 12 research assistants have led the efforts against ECC in Erzurum where the pediatric dentist/population ratio is 1/11,300 for children aged 0-14 years.…”

Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries

“…Furthermore, temporary palliative dental treatment, as opposed to definitive care, contributes to the persistence of chronic dental symptoms [38][39][40]. This misutilization of oral healthcare has been attributed in part to prohibitive costs of care, prompting the need to restructure the traditional model of dentistry and the delivery of oral healthcare services [15,41,42].…”

The cost- effectiveness of early dental visit in infants and toddlers focused on regional deprivation in South Korea: A retrospective cohort study

“…Early childhood caries (ECC) is defined as at least one caries lesion in a child younger than 5 years of age [ 1 , 2 ] and is recognized as a critical public health problem. Research findings show that the prevalence rate of ECC varies from population to population [ 2 – 5 ]. In the United States, the prevalence of dental caries among children 2–5 years of age was 27.9% between 1999 and 2004 [ 3 ].…”

“…It has been reported that 50% of Australian children under 12 years of age experience dental caries [ 4 ]. In Japan, the prevalence of dental caries was 25.9% among children 3 years of age [ 2 ]. The prevalence rate of disadvantaged groups in developing countries was as high as 85% [ 5 ].…”

“…Previous studies reported that ECC not only affected oral health but also led to more pervasive consequences, such as costly treatment and issues with overall health, growth, and school performance [ 2 , 7 , 8 ]. ECC could negatively affect the quality of life for families [ 1 , 2 , 7 ] and could cause a significant economical and societal burden; however, it is preventable and potentially reversible in its early stages [ 9 , 10 ]. With timely and early intervention, it is possible to prevent and eliminate future dental caries and thus reduce dental-related costs.…”