Early Childhood Caries

Determining the Risk Factors and Assessing The Prevention Strategies for Nursing Intervention

Jo-Ann Marrs, EdD, APRN-BC; Sharon Trumbley, MSN, WHNP; Gaurav Malik


Pediatr Nurs. 2011;37(1):9-15. 

In This Article

Abstract and Introduction


The daily reality for children with untreated oral disease is often persistent pain, inability to eat comfortably or chew well, embarrassment at discolored and damaged teeth, and distraction from play and learning" (U.S. Department of Health and Human Services [DHHS] Office of disease Prevention and Health Promotion, 2001, p. 108).

Dental caries is the most common communicable disease of childhood, affecting 41% of children in the United States (American Academy of Pediatrics [AAP], 2009; Centers of Disease Control and Prevention [CDC], 2005a). In Oral Health inAmerica: A Report of the Surgeon General (DHHS, 2001), the Surgeon General found that oral diseases are progressive and cumulative, and they become more complex over time. They can affect our ability to eat, the foods we choose, how we look, and the way we communicate. If the damage is severe enough, the toddler can lose front teeth, resulting in developmental delays in speech, delays in physical growth, and psychological trauma (American Academy of Pediatric Dentistry [AAPD], 2010a, 2010b; U.S. DHHS, 2001; National Maternal and Child Oral Health Resource Center, 2004; von Burg, Sanders, & Weddell, 1995). A common consequence of untreated dental caries is pain; however, in the long run, oral health is believed to be a reflection of general health and well being, and possibly related to many chronic diseases, as well as loss of productivity at school and home.

An especially virulent form of caries is early childhood caries (ECC), affecting infants and toddlers from 12 to 18 months of age. However, if appropriate measures are applied early enough (beginning during pregnancy and infancy), this painful condition can be prevented (Douglass, Douglass, & Silk, 2004; Finn & Wolpin, 2005). The first dental examination is now recommended between six months and one year of age (AAPD, 2010c), but this is often unrealistic, especially among the poor and underinsured. Therefore, there is a huge need for preventive efforts by nurses and other health care providers who care for infants and young children. The purpose of this article is to review the literature on the risk factors and prevention strategies for ECC, and to discuss the role of nurses in preventing this disease process.


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