Pediatric Clinicians Can Help Reduce Rates of Early Childhood Caries

Effects of a Practice Based Intervention

Bibliographic Data

ID9101919
AuthorsNancy R Kressin (0000-0003-2767-4286, Boston University, corresponding author), Martha E Nunn (0000-0003-2798-6634, Boston University, corresponding author), Harpreet Singh (0000-0002-8001-4191), Harpreet Kaur Sekhon Inderjit Singh (0000-0001-7549-2933, Boston University, corresponding author), Michelle B Orner (0000-0001-9227-7047, Tufts University, corresponding author), Lori Pbert (0000-0003-4525-1359, University of Massachusetts Chan Medical School), Catherine Hayes (0000-0002-1576-4623, Tufts University, corresponding author), Corinna Culler (0000-0003-4680-0436, Boston University, corresponding author), Stephan R Glicken, Stephan Glicken (Boston University), Sean Palfrey (Boston University), Paul L Geltman (0000-0002-9704-7782, Boston University, corresponding author), Cynthia Cadoret (0000-0001-6713-2823, Boston University, corresponding author), Michelle M Henshaw, Michelle Henshaw (0000-0003-2586-8466, Boston University, corresponding author)
Year2009
Volume47
Issue11
Pages1121-1128
Publication date2009-11-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181b58867
PMID19786919
PMCIDPMC2920219
OpenAlexW1982897592
LanguageEN
Citations received4
References cited21

OBJECTIVE: Early childhood caries (ECC) is a serious and preventable disease which pediatric clinicians can help address by counseling to reduce risk. RESEARCH DESIGN: We implemented a multifaceted practice-based intervention in a pediatric outpatient clinic treating children vulnerable to ECC (N = 635), comparing results to those from a similar nearby clinic providing usual care (N = 452). INTERVENTION: We provided communication skills training using the approach of patient centered counseling, edited the electronic medical record to prompt counseling, and provided parents/caregivers with an educational brochure. OUTCOME MEASURES: We assessed changes in provider knowledge about ECC after the intervention, and examined providers' counseling practices and incidence of ECC over time by site, controlling for baseline ECC, patient sociodemographics and parents'/caregivers' practice of risk factors (diet, oral hygiene, tooth-monitoring), among 1045 children with complete data. RESULTS: Provider knowledge about ECC increased after the intervention training (percentage correct answers improved from 66% to 79%). Providers at the intervention site used more counseling strategies, which persisted after adjustment for sociodemographic characteristics. Children at the intervention site had a 77% reduction in risk for developing ECC at follow up, after controlling for age and race/ethnicity, sociodemographics and ECC risk factors; P <or= 0.004. CONCLUSIONS: The multifaceted intervention was associated with increased provider knowledge and counseling, and significantly attenuated incidence of ECC. If validated by additional studies, similar interventions could have the potential to make a significant public health impact on reducing ECC among young children

Early childhood caries · Ethnic group · Family medicine · Hygiene · Incidence (geometry) · Intervention (counseling) · MEDLINE · Oral health · Oral hygiene · Psychological intervention · Dental Anxiety and Anesthesia Techniques · Dental Health and Care Utilization · Dentistry · Medicine · Nursing · Oral microbiology and periodontitis research