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It’s Not Just About Baby Teeth: Preventing Early Childhood Caries

Early Childhood Caries (ECC) is a serious disease that is about much more than cavities on baby teeth.
In Canada, it is a growing public health problem with adverse long-term effects on children’s physical,
emotional and intellectual well-being. The failure to invest in preventive care has resulted in reactive,
rather than proactive, measures against this disease. These measures are expensive and a needless drain
on costs in the public health-care system.
Children with severe ECC end up in hospital; in fact, in Canada, this disease is the most common reason
children undergo day surgery. From 2010 to 2012, one in 100 children under age five required day
surgery for ECC, with approximately 19,000 of these surgeries performed each year on children under
age six. Canadian hospital costs for ECC day surgery in children aged one to five ranged from $1,271 to
$1,963 per child, totalling $21.2 million between 2010 and 2012. Children from low-income families, along
with aboriginal, immigrant and refugee children are disproportionately affected by dental disease, with
between 50 per cent and 90 per cent of suffering from some form of ECC. This compares to an average
of 57 per cent of children affected in the general population.
A recent Alberta study indicates that when municipalities cease fluoridating their water supplies, children
suffer increased levels of tooth decay. This has reignited the discussion around whether municipalities
should add fluoride to the drinking water, or reinstate it in places where the water used to be fluoridated.
While fluoridation can be an effective prevention strategy, this study also shows that fluoride alone is not
enough. To reduce the costs and developmental consequences associated with severe ECC and improve
well-being, oral health policies focused on disease prevention and health promotion are still necessary.
This briefing paper provides background on the etiology, risk factors and prevalence of ECC in Canada to
provide scope for the magnitude of this preventable disease in children. To address the avoidable socio-
economic costs, three areas require policy development.

 

 

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