Evaluation of an Early Childhood Caries Prevention Program at an Urban Pediatric Clinic

Purpose: The purpose of this study was to evaluate a risk-based dental caries prevention program at an urban pediatric primary care clinic serving low-income residents. Methods: A demonstration caries prevention trial lasting 26 months was conducted with 219 6- to 27-month-old children. A "prevention" group of 6- to 15-month-old children (initial visit) were compared at the end of the trial with a "comparison" group at their initial visit. The latter children were patients at the same clinic who were 12 months older (18-27 months). Preventive services included: caries-risk assessments; mutans streptococci (MS) monitoring; fluoride varnish applications; dental health counseling; referral for dental treatment, if indicated; and periodic recalls. Results: Prevention group children at the last recall experienced fewer mean carious dental surfaces (0.1 vs 1.29, P=.01) and over 8-fold less MS (P=.01) than comparison group subjects at their initial visit. The number of precavitated lesions was not significantly different. Conclusions: Administration of prevention measures was shown to reduce dental caries experience in low socioeconomic status infants and toddlers, and oral MS levels were a reliable indicator of future caries status. Outcomes support establishment of caries prevention programs at urban primary core pediatric clinics. (Pediatr Dent 2008;30:499-504) Received September 27, 2007 vertical bar Last Revision January 15, 2008 vertical bar Revision Accepted February 10, 2008