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Vol. 7, Issue 1
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Indian Health Service Launches Early Childhood Caries Initiative

Photo of Denatl Professional Teaching Children to Crush Their TeethWhat happens when Indian Health Service (IHS) dental teams join forces with doctors, nurses, community health representatives and groups such as Head Start and the Women, Infants, and Children Program (WIC) to attack the problem of early childhood caries in American Indian and Alaska Native children?

A powerful new public health partnership is formed, one that will take a bold and innovative approach to reducing the alarmingly high prevalence of tooth decay among American Indian and Alaska Native children ages five and under.

The IHS Division of Oral Health (DOH) is launching the Early Childhood Caries (ECC) Initiative in March 2010, with the goal of improving response to early childhood caries by 25 percent in three years. This exciting, interdisciplinary initiative mobilizes entire communities to promote prevention and early intervention of dental caries in young children instead of relying solely on dental care providers working for IHS DOH. By reaching out to include other important members of the Native community such as health care providers, Tribal organizations, Head Start programs, community health representatives, public health nurses and WIC, the unique campaign promises to change the way dental treatment is delivered in Native communities, according to Timothy L. Ricks, DMD, MPH.

Dr. Ricks is cochairman of the eight-member steering committee formed by IHS DOH Director Christopher G. Halliday, DDS, MPH, to develop the prevention initiative. The resulting interdisciplinary campaign strives to improve access to dental care to young children and promote the prevention and treatment of caries in this population. The need is great: 76 percent of Native children between the ages of two and five have experienced dental caries, compared to just 28 percent of children of the same age in the general population.

“Past efforts at reducing childhood caries have had minimal effects, but this initiative takes a holistic approach that we hope will produce better results,” says Dr. Ricks, an 11-year IHS veteran and the Nashville Area Dental Officer and National IHS Dental Public Health Consultant. “We’re enlisting the power of people who are active in the community by formally inviting our medical and community partners to join us in identifying children who need dental care and seeing to it that they get that care.

“With their assistance, we plan to improve prevention of tooth decay in infants and young children through increased community outreach, education and application of fluoride varnishes by medical and community partners as well as dental teams. We also hope to improve our ability to reach children who already have dental problems with the help of partners who can identify and refer these children to dental clinics for stabilization of their caries with pain-free interim therapeutic restorations (ITR) and dental sealants.”

To help mobilize and inform medical and community partners, IHS DOH has developed a comprehensive array of supportive resources. Printed materials tailored to specific medical or community partners will explain the details of the program and describe how each group can assist in the ECC Initiative. Online courses will inform community partners about applying fluoride varnish and caries stabilization. A PowerPoint presentation and a Web page designed to publicize ECC Initiative best practices will help in the effort to educate and engage community members in the anti-caries campaign. Progress associated with the initiative will be measured by establishing a national oral health surveillance system using the Basic Screening Survey to help compare results in one locale to results in other states and clinics.

The ECC Initiative is scheduled to be up and running, with all materials available to dental clinics and community partners, by March 2010. In addition to working toward benchmark improvements in early childhood caries, the initiative hopes to see a 50 percent improvement in young children’s access to dental health care by 2015. The effort demonstrates IHS’ commitment to promote the overall oral health of Native communities and Tribes, Dr. Ricks says.

“It’s satisfying to know you can help an entire community rather than just a few patients who have the resources to pay for care,” he explains. “We’re doing dentistry for the common good — working with an underserved population in great need of dental services. The IHS has been at the forefront of public health in Indian Country since 1955. We really make a difference in people’s lives and that’s what makes working at IHS so professionally and personally rewarding.”

Visit the ECC Web site for the most updated news and information about the ECC initiative.