Addressing Early Childhood Caries in Australia through chronic disease management

Abstract

Aim or Purpose: To implement and evaluate a disease management program to reduce new and recurrent dental disease, pain, treatment and general anaesthetic (GA) needs in young, at-risk children across four local health districts (LHDs) in New South Wales, Australia, based on the work of Ng and Colleagues (2014) Materials and Methods: Ethics approval was obtained from the Research Ethics Office at Royal Prince Alfred Hospital (X19-0393 & 2019/ETH12467). Clinicians across four LHDs were trained in a chronic caries disease management protocol. 215 patients were recruited for the prospective arm of the study between January and December of 2020 and 186 patient records dated from January 2013 to November 2019 were selected for the retrospective arm.Key outcomes of new cavitation, new episodes of pain and referral to GA were assessed in high risk patients (aged less than 72 months) treated under this protocol over a 24 month period and compared to retrospective cohorts for each LHD. Data was entered into a REDCap electronic database and analysed using SPSS software. Results: The implementation of the chronic disease management clinical protocol demonstrated a positive impact on key outcomes related to Early Childhood Caries (ECC). Conclusions: Chronic disease management is an effective, evidence-based, multifaceted approach for the management of ECC. Despite the considerable obstacles encountered due to the Covid-19 pandemic, this study demonstrated a positive effect of the clinical protocol in a high risk population by reducing the impact of ECC.