- About the Institute
- Methods + Approach
- Improvement Initiatives
- Technical Assistance
- Results
- Early Childhood Caries Initiative
- Dental Sealant Initiative
- Dental Disease Management Initiative
- Safety Net Solutions: Practice Management Technical Assistance
- Safety Net Solutions: Dental Information Technical Assistance
- Safety Net Solutions: On-line Learning Center
- Safety Net Solutions: School Based Dental Programs
- DentaQuest
Early Childhood Caries Initiative
The Problem
Early Childhood Caries (ECC), or aggressive tooth decay in very young children, is a chronic, infectious dental disease. And like all dental disease, ECC is almost completely preventable.
When young children don’t get the preventive care they need and deserve early in life, many end up in hospital-based dental clinics where the only solution is to treat the dental disease surgically in the operating room. Early childhood caries is painful to the child, and if untreated, can impact the proper development of permanent teeth. The results are eating and speech problems, and negatively impacted learning in children.
Hospital-based dental clinics care for a disproportionate number of low-income and racial and ethnic minority children with early childhood caries. Many of the children end up being treated surgically, with months-long backlogs for expensive operating room care and a high rate of reoccurrence after treatment.
What We’re Doing
In 2008, the DentaQuest Institute, Children’s Hospital Boston, and St. Joseph Hospital for Specialty Care in Providence, Rhode Island developed a protocol to implement an evidence-based method of managing and preventing early childhood tooth decay in patients seeking treatment at hospital-based dental clinics. Since the fall of 2008, over 450 children have been enrolled, treated and followed.
“We’ve been using an evidence- and risk-based disease management approach adapted from the concept of chronic care management of medical conditions,” explained Brian Souza, Managing Director. “To do this, we are using every point of intervention to engage and educate the child's guardians and then to make sure the child has access to reliable preventive and restorative care by connecting him/her with a dental home for ongoing support and coordination of follow up evaluations. In the process of meeting this objective, we are also tracking the cost per case."
The goal is to reduce the percentage of cavity recurrence in patients treated at the hospital dental clinics by 33%, reduce the percentage of patients who are treated in the operating room by 20%, and reduce the percentage of patients complaining of pain on their most recent visit by 50%.
Principal Investigators for Phase I are Dr. Man Wai Ng, Chief of the Department of Dentistry at Children's Hospital Boston, Dr. Dan Kane, Director of Dentistry at St. Joseph Hospital Providence and Dr. B. Alex White . Gay Torresyap, Clinical Research Coordinator at the DentaQuest Institute, has been coordinating data collection between the two clinical sites.
What We’re Finding
Patient enrollment began in March 2008; the first clinical phase of this study concluded in November 2009. Analysis of Phase I data is showing very positive results.
