Providing dental teams and our medical and community partners with information about fluoride varnish.
Links to PowerPoint presentations, online courses, dental support centers, and other helpful information to support the ECC Collaborative in your community.
Early Childhood Caries (ECC, early childhood tooth decay) is an infectious disease that can start as
soon as an infant’s teeth erupt. ECC can progress rapidly and may have a lasting detrimental impact
on a child’s health and well-being. ECC is a serious health problem.1 ECC is defined as any caries
experience in a child under 6 years of age.2 The 1999 Oral Health Survey of American Indian and Alaska
Native Dental Patients found that 79% of children between the ages of 2-5 years had experienced dental
caries, and 68% of this age group had untreated decay at the time of the dental examination.3
The Indian Health Service (IHS) Early Childhood Caries (ECC) Collaborative is a multi-faceted program designed to
enhance knowledge about early childhood caries prevention and early intervention among not only dental providers,
but also all healthcare providers and the community. The collaborative provides the entire healthcare team with the
tools to begin a successful ECC program. Increasing access to oral health care and evidence-based prevention is a
collaborative effort that must include the oral health care team, medical providers, Community Health Representatives,
Head Start staff, and Women, Infant, and Children (WIC) program staff. The Collaborative also provides the framework to
dental providers for ECC early intervention focusing on "caries stabilization".
National Maternal and Child Oral Health Resource Center. Promoting Awareness,
Preventing Pain: Facts on Early Childhood Caries (ECC). 2004. Available online
American Academy of Pediatric Dentistry. 2008. Full definition available online at
Indian Health Service, U.S. Department of Health and Human Services, 2000. The
1999 Oral Health Survey of American Indian and Alaska Native Dental Patients:
Findings, Regional Differences and National Comparisons, Rockville, MD: Indian
One of the original objectives of the Early Childhood Caries (ECC) Initiative was to increase access by 25 percent among 0 to 5 year-olds. The 2010 Basic Screening Survey Report showed that 20 percent of one year-olds and 40 percent of two year-olds had already experienced caries. Preliminary information from the ECC Virtual Learning Community Program indicates that while we are seeing promising increases in the rates of sealants, fluoride varnish and even Interim Therapeutic Restorations, increasing access to dental care among 0 to 2 year-olds continues to hover around 10 percent ECC organizers believe, " . . . access to dental care, especially in the hard-to-reach 0-2 year-old population, is the key to the long-range success of the ECC Collaborative. "We cannot prevent ECC if we aren’t seeing 0-2 year olds, it’s that simple!