A Multi-Modal Intervention to Improve Identification, Management, and Prevention of Early Childhood Caries in the Primary Care Setting

Author

Rieley M. Hull, Valparaiso University

Date of Award

5-3-2025

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Rebecca L. Peterson

Abstract

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health evaluation, providers determined each patient’s caries risk and developed an action plan, which included fluoride varnish application, risk reduction education with anticipatory guidance, and referral to a dental home. Thirteen participants received a repeat oral health screening at their next office visit and 13 participants received a follow-up phone call to identify new or worsening caries and changes in their risk factors. McNemar’s tests were used to analyze changes in caries and risk factors from baseline to the 12-week follow-up. Of the 26 participants who received a follow-up assessment, 25 (96.2%) showed no evidence of new or worsening caries, and 24 (92.3%) had a reduction in caries risk factors. The overall reduction in caries risk from baseline to the 12-week follow-up was statistically significant (p = .039). Findings from this project suggest that a multi-modal approach, including fluoride varnish application and individualized education, may help clinicians identify high-risk patients and implement preventative strategies to reduce ECC incidence and progression. Clinicians should ensure that education and anticipatory guidance are tailored to each patient’s specific risk factors to optimize outcomes.

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

Recommended Citation

Hull, Rieley M., "A Multi-Modal Intervention to Improve Identification, Management, and Prevention of Early Childhood Caries in the Primary Care Setting" (2025). Evidence-Based Practice Project Reports. 210.
https://scholar.valpo.edu/ebpr/210