title: Dental Hygienist-Led Chronic Disease Management System to Control Early Childhood Caries.
abstract: Management of the complex chronic disease of early childhood caries requires a system of coordinated health care interventions which can be led by a dental hygienist and where patient self-care efforts are paramount.
  
  
  
  Even after receiving costly surgical treatment under general anesthesia in the operating room, many children develop new and recurrent caries after only 6-12 months, a sequela that can be prevented. This article describes the chronic disease management (CDM) of dental caries, a science-based approach that can prevent and control caries.
  
  
  
  In this article, we (1) introduce the concept of CDM of dental caries, (2) provide evidence that CDM improves oral health outcomes, and (3) propose a dental hygienist-led team-based oral health care approach to CDM. Although we will be describing the CDM approach for early childhood caries, CDM of caries is applicable in children, adolescents, and adults.
  
  
  
  Early childhood caries disease control requires meaningful engagement of patients and parents by the oral health care team to assist them with making behavioral changes in the unique context of their families and communities. The traditional dentist/hygienist/assistant model needs to evolve to a collaborative partnership between care providers and patients/families. This partnership will be focused on systematic risk assessment and behaviorally based management of the disease itself, with sensitivity toward the familial environment. Early pilot study results demonstrate reductions in the rates of new caries, dental pain, and referral to the operating room compared with baseline rates. Dental hygienists are the appropriate team members to lead this approach because of their expertise in behavior change and prevention.
authors.affiliation: DDS, MPH, Boston Children's Hospital, Boston, MA, USA; DDS, MPH, Developmental Biology (Pediatric Dentistry), Harvard School of Dental Medicine, Boston, MA, USA. Electronic address: Manwai.ng@childrens.harvard.edu.
authors.forename: Man Wai
authors.initials: MW
authors.lastname: Ng
authors.affiliation: DMD, Predoctoral Pediatric Dentistry, Harvard School of Dental Medicine, Boston, MA, USA; DMD, Pediatric Dentistry, Boston Children's Hospital, Boston, MA, USA.
authors.forename: Zameera
authors.initials: Z
authors.lastname: Fida
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003731:Dental Caries / Q000517:prevention & control; D003756:Dental Hygienists; D019468:Disease Management; D006801:Humans; D009909:Oral Health; D010865:Pilot Projects; D024382:Professional Role
keywords: Chronic disease management of caries; Dental hygienist led team-based oral health care; Early childhood caries