An alternative early childhood caries risk surveillance methodology for public policy and practice advancements

Abstract

Objectives Early childhood caries (ECC) negatively impacts many child health outcomes and can lead to greater costs for medical and dental care as well as negatively impact future oral health wellness. ECC risk factors are rooted in many social determinants of health. Addressing ECC at the population‐level is a national public health priority. The purpose of this study was to identify the South Carolina counties with the greatest risk for ECC. As policy‐makers seek to address inequities stemming from early childhood caries, documenting its prevalence is essential. Methods Since no county level ECC rates were published for South Carolina, we identified an opportunity to strengthen ECC surveillance through public use data, so as to properly equip policy‐makers and pediatric providers with an evidence based understanding of the scope of the problem. As a result we sought to develop an overall county level prevalence measure for ECC risk through an ecological analysis of public use data. Results Ten counties with the greatest overall risk for ECC were all rural as hypothesized. Additionally, seven of the 10 highest risk counties fell into what is often referred to as the “Corridor of Shame.” Conclusions We have found an affordable way of measuring county level risk for ECC that allows pediatric advocates and policy‐makers to develop population level interventions to reduce and measure risk with public‐use data.

Trends in social inequalities in early childhood caries using population‐based clinical data

“…3 Associations between social disadvantage (captured through household income, parental education, remoteness) and ECC have been reported across many countries including Australia, Kuwait, Colombia, China, Thailand and the United States. [9][10][11][12][13][14] Young children are a vulnerable subgroup 'within' a vulnerable population because of their inability to communicate oral health needs and their dependence on carers. 15 For that reason, social inequalities in oral health outcomes in young children are a major public health challenge and reflect societal failure.…”

“…ECC is becoming more common in socially disadvantaged sub‐populations across many high income and lower income countries, 2,8 despite the overall decline in dental caries prevalence over the years 3 . Associations between social disadvantage (captured through household income, parental education, remoteness) and ECC have been reported across many countries including Australia, Kuwait, Colombia, China, Thailand and the United States 9–14 . Young children are a vulnerable subgroup ‘within’ a vulnerable population because of their inability to communicate oral health needs and their dependence on carers 15 .…”