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 of 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 care pediatric clinics.