Doctor Talk Might Help Cut Cavities
November 11, 2009

By Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Encouraging children's doctors and nurses to talk to parents about tooth decay in young children might help to prevent it, a study has found.

Early childhood caries are cavities in the baby teeth of children. It occurs in very young children (under the age of five). Children can need multiple fillings, and sometimes teeth need to be pulled. This type of tooth decay is more common in lower-income children, and in racial or ethnic minorities.

Dental professionals say that children should visit a dentist before their first birthday. Many children don't. However, about 9 of every 10 children do see a doctor at least once a year. Researchers thought that educating children's doctors about tooth decay in young children might help to prevent it.

The study involved two clinics in Boston. At the first clinic, researchers provided one hour of training in patient-centered counseling to doctors and nurses. They edited electronic medical records to prompt pediatricians to counsel parents and caregivers about early decay. And they provided parents with a brochure about the disease.

At the second clinic, staff received no training, reminders or brochures. Children received their usual care.

Just over 1,000 children were involved in the study. They ranged in age from 6 months to 5 years. The children's caregivers were interviewed at the start of the study, and again one year later. They were asked whether decay-related topics were covered during the office visit. At the time of both interviews, children also were examined for tooth decay.

At the start of the study, about 6% of children at each clinic had tooth decay. Children at the first clinic were much less likely to develop tooth decay during the one-year study. At the end of the year, 18% of children at the first clinic had tooth decay. About 32% of children at the second clinic had it.

Researchers also found that doctors' and nurses' knowledge of early childhood caries increased after training. Scores on a quiz averaged 66% before training and 79% afterward.

After a year, staff at the first clinic provided more decay-related counseling than those at the second clinic, who received no training. They were much more likely to talk with parents about certain aspects of dental health. These included:

• Helping children brush their teeth until the age of 6
• Limiting sugary foods and drinks
• Cleaning teeth every night
• Explaining what cavities are
• Reviewing ways to prevent cavities

Even with their training and the electronic reminders, doctors at the first clinic counseled only 20% to 40% of patients. Most of the pediatricians said they did not have problems incorporating the counseling into a regular office visit.

The study appears in the November issue of the journal Medical Care.