Early Childhood Caries: Policy and Prevention (Early Childhood Caries: IAPD Bangkok declaration)

The International Association of Paediatric Dentistry (IAPD), in their 2019 Bangkok Declaration, emphasized the need for all children under the care of health professionals and community workers to receive guidance on preventing Early Childhood Caries (ECC). They advocate that this guidance should ideally lead to a dental referral. The IAPD currently recommends that dental visits should begin with the eruption of the first tooth or by the child's first birthday. This early dental consultation is crucial for parents to receive professional advice and learn about optimal dental care and preventive practices for their children.

The prevention of Early Childhood Caries (ECC) can be categorized into three specific levels:

1.Primary Prevention of ECC:

Aim: To prevent the onset of caries entirely.
Methods: Providing anticipatory guidance, establishing a dental home early, scheduling frequent oral health visits from a young age, and promoting good oral hygiene practices.
Key Action: Applying fluoride varnish during the child’s first dental visit at one year old.

2. Secondary Prevention of ECC:

Aim: To identify and treat non-cavitated, carious lesions while they are still reversible.
Methods: Using fluoride treatments, combination therapy approaches, setting self-management goals, etc., to prevent these early lesions from progressing.

3.Tertiary Prevention of ECC:

Aim: To repair and restore teeth that have cavitated, carious lesions.
Methods: Employing treatments like Silver Diamine Fluoride (SDF), glass ionomers, and other restorative dental materials.

Among these, primary prevention is the most crucial as it aims to stop the disease before it starts. Effective primary prevention can minimize or even eliminate the need for secondary and tertiary interventions later on.