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Early childhood caries (ECC) is the most common chronic disease affecting children, despite being almost 100% preventable. ECC has become associated with a multi-factorial etiology including poor feeding practices, enamel hypoplasia, oral colonization by cariogenic bacteria, and demineralized tooth structure due to metabolism of sugars by tooth-adherent bacteria. ECC can lead to school absences, poor school performance, difficulty sleeping, attention problems, slower social development, and poor overall health. According to U.S. Preventative Services Task Force (USPSTF) guidelines, all children are at potential risk for developing ECC beginning at the time of first tooth eruption. While there are no validated multivariate screening tools to determine which children are at higher risk for ECC, there are a number of individual factors that elevate risk, including lack of preventative oral health care and screening before the age of 3 years old. The American Academy of Pediatrics (AAP) recommends fluoride varnish in the primary care setting every 3-6 months starting at tooth emergence. Thus, primary care providers can play a major role in screening for and preventing ECC by initiating fluoride varnish and providing parents and/or caregivers with information on proper oral hygiene for their children at routine well-child visits.

Clinical Site

UVMMC Hinesburg Family Practice


Vermont, Early Childhood Caries, Pediatric Oral Health, Fluoride Varnish, Water Fluoridation

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Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


Dental Hygiene | Dental Public Health and Education | Medical Education | Oral Biology and Oral Pathology | Pediatric Dentistry and Pedodontics | Primary Care

Integrating Oral Health in Primary Care to Reduce Early Childhood Caries (ECC): Evidence-Based Guidelines and Recommendations