title: Progress in Early Childhood Caries and Opportunities in Research, Policy, and Clinical Management.
abstract: The 2014 Early Childhood Caries Conference encompassed evidence-based reviews on the state of the science regarding early childhood carries (ECC) epidemiology, etiology, prevention, and disease management. The purpose of this paper was to discuss the work presented at the conference and identify opportunities in research, policy, and clinical management that may improve early childhood caries outcomes and lower costs of care. While great progress has been made since the 1997 ECC Conference, there remains a paucity of high-quality evidence from randomized controlled trials on what are the most effective means to prevent and manage ECC. Analyses of studies indicate that some approaches, such as chlorhexidine, iodine, and remineralizing agents, have not shown consistent findings in preventing ECC. However, evidence exists to yield recommendations in some areas. There are useful risk assessment indicators to identify preschool children at risk for caries. Fluoridated toothpaste and fluoride varnish currently are the most effective chemotherapeutic strategies to prevent ECC. Motivational interviewing, a form of patient-centered counseling, is effective for motivating oral health behaviors and shows promise for reducing caries. Additionally, evidence is emerging that shows the value of chronic disease management approaches and integrating ECC oral health care within medical care settings. Recommendations for future directions in ECC research and policy were also key outcomes of the conference.
authors.affiliation: Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass. USA.
authors.forename: Raul
authors.initials: R
authors.lastname: Garcia
authors.affiliation: Department of Health Policy and Health Services Research, Henry M. Goldman School of Dental Medicine, Boston University, Boston, Mass. USA.
authors.forename: Belinda
authors.initials: B
authors.lastname: Borrelli
authors.affiliation: Department of Orthodontics and Pediatric Dentistry, School of Dentistry, at the University of Maryland, College Park, Md., USA.
authors.forename: Vineet
authors.initials: V
authors.lastname: Dhar
authors.affiliation: Division of Pediatric Dentistry, Department of Craniofacial Science, School of Dental Medicine, University of Connecticut, Storrs, Conn., USA.
authors.forename: Joanna
authors.initials: J
authors.lastname: Douglass
authors.affiliation: Section of Pediatric Dentistry, School of Dentistry, University of California, Los Angeles, Calif., USA.
authors.forename: Francisco Ramos
authors.initials: FR
authors.lastname: Gomez
authors.affiliation: School of Medicine, Yale University, New Haven, Conn., USA.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Hieftje
authors.affiliation: School of Public Health, at the University of Maryland, College Park, Md., USA.
authors.forename: Alice
authors.initials: A
authors.lastname: Horowitz
authors.affiliation: Basic Science and Craniofacial Biology, College of Dentistry, New York University, New York, N.Y., USA.
authors.forename: Yihong
authors.initials: Y
authors.lastname: Li
authors.affiliation: Developmental Biology (Pediatric Dentistry), Harvard School of Dental Medicine, Department of Dentistry, Boston Children's Hospital, Boston, USA.
authors.forename: Man Wai
authors.initials: MW
authors.lastname: Ng
authors.affiliation: Department of Odontology, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Svante
authors.initials: S
authors.lastname: Twetman
authors.affiliation: Division of Pediatric Dentistry, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Maryland, College Park, Md., USA. ntinanoff@umaryland.edu.
authors.forename: Norman
authors.initials: N
authors.lastname: Tinanoff
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000627:therapeutic use; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated; D003731:Dental Caries / Q000517:prevention & control*; D018865:Dental Research; D003793:Dental Restoration, Permanent / Q000379:methods; D005459:Fluorides / Q000627:therapeutic use; D005460:Fluorides, Topical / Q000627:therapeutic use; D015438:Health Behavior; D006291:Health Policy; D006801:Humans; D007223:Infant; D062405:Motivational Interviewing; D009909:Oral Health; D011320:Primary Health Care; D018570:Risk Assessment; D014089:Tooth Remineralization / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D005460:Fluorides, Topical; D005459:Fluorides