Disease Management of Early Childhood Caries: ECC Collaborative Project.
Until recently, the standard of care for early childhood caries (ECC) has been primarily surgical and restorative treatment with little emphasis on preventing and managing the disease itself. It is now recognized that surgical treatment alone does not address the underlying etiology of the disease. Despite costly surgeries and reparative treatment, the onset and progression of caries are likely to continue. A successful rebalance of risk and protective factors may prevent, slow down, or even arrest dental caries and its progression. An 18-month risk-based chronic disease management (DM) approach to address ECC in preschool children was implemented as a quality improvement (QI) collaborative by seven teams of oral health care providers across the United States. In the aggregate, fewer DM children experienced new cavitation, pain, and referrals to the operating room (OR) for restorative treatment compared to baseline historical controls. The teams found that QI methods facilitated adoption of the DM approach and resulted in improved care to patients and better outcomes overall. Despite these successes, the wide scale adoption and spread of the DM approach may be limited unless health policy and payment reforms are enacted to compensate providers for implementing DM protocols in their practice.
Boston Children's Hospital, Harvard School of Dental Medicine, Boston, MA 02115, USA.
Man Wai
0000-0001-7020-4429
MW
Ng
Section of Pediatric Dentistry, UCLA School of Dentistry, Los Angeles, CA 90095, USA.
Francisco
0000-0002-4961-2150
F
Ramos-Gomez
Neighborcare Health, 6200 13th Avenue South, Seattle, WA 98103, USA.
Martin
0000-0003-3261-3226
M
Lieberman
Department of Pediatric Dentistry, University of North Carolina School of Dentistry, Chapel Hill, NC 27599, USA.
Jessica Y
JY
Lee
Health Policy Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27510, USA.
Richard
0000-0001-5627-6282
R
Scoville
DentaQuest Institute, 2400 Computer Drive, Westborough, MA 01580, USA.
Cindy
0000-0002-2920-5996
C
Hannon
Simmons School of Social Work, 300 The Fenway, Boston, MA 02115, USA.
Peter
0000-0002-8097-5339
P
Maramaldi