Identification of the Research Problem
Early childhood Caries (ECC) is defined as decay in the primary dentition. ECC is a complex and multifactorial chronic disease that is impacted by the social determinants of health, biomedical factors such as diet, oral bacteria, and tooth morphology (CDA, 2010). If left untreated ECC can lead to abscesses, pain, and future malocclusion affecting affect a child's quality of life, growth, and nutritional status. Within most Canadian pediatric hospital’s treatment of ECC is the most common surgical procedure, accounting for approximately one-third of all day surgeries performed on children one to four years of age (CDA 2017; Pierce et al., 2019).
The Canadian Dental Association recommends that children visit a dentist when the first tooth erupts, or by twelve months of age, to establish a dental home and reduce ECC risk factors (CDA 2017, Nowak et al., 2014). Primary healthcare providers are in an optimal position, often seeing children and families regularly, to play a significant role to encourage the importance of early preventative dental care & the formation of a dental home (Kagihara, Et al, 2009).
Main Categories
The main concepts I will study are: The prevalence, risk factors (both socially & biomedically), and long-term effects of ECC on both the primary and permanent dentition. The Canadian Dental Association’s (CDA) recommendations & guidelines for first year, first tooth dental visits. The known knowledge & current practice of ECC & 1st tooth first year within primary healthcare (both formal education & personal beliefs/practice).
Theoretical/Conceptual Model
The Health Beliefs Model, HBM, was developed to understand the failure of individuals to adapt disease prevention strategies/screening for early detection. The HBM attempts to predicts the likelihood of an individual adopting a recommended behaviour based on the individual threat of a disease/illness, along with their belief in the effectiveness of the recommended behaviour. There are 6 constructs of the HBM (LaMorte 2019):
Perceived susceptibility – An individual’s perceived risk of acquiring the disease.
Perceived severity – An individual’s perception of the seriousness of contracting the disease.
Perceived benefit – An individual’s perception of the effectiveness of actions available to reduce the likelihood of contracting a disease.
Perceived barriers – An individual’s reaction to the obstacles of a recommended health benefit.
Cue to action – The stimuli needed to trigger the decision-making process to accept a recommended health action. This can be internal or external stimuli.
Self-efficacy – The level of an individual’s confidence in their ability to successfully perform a health action/behaviour.
Search Strategy
My main search resources have been Pubmed and Google Scholar. I have found several resources surrounding ECC, and the importance of early dental intervention. Thus far I have not found a significant amount of literature surrounding primary healthcare’s role & knowledge. This displays a need for further research & investigation. Key words: ECC, childhood dental, primary care dental, early dental referral.
Draft Thesis Statement
Evaluation of current practice within primary healthcare providers regarding the prevention of Early Childhood Caries (ECC) by utilizing current CDA recommendations such as referral of first visit, first tooth, and early establishment of a dental home.
References
Canadian Dental Association (2010). Early Childhood Caries. https://www.cda-adc.ca/en/about/position_statements/ecc/
Canadian Dental Association. (2017). First Visit, First tooth. https://www.firstvisitfirsttooth.ca
Kagihara, L.E., Niederhauser, V.P., & Stark, M. (2009) Assessment, management, and prevention of early childhood caries. American Academy of Nurse Practitioners. https://doi.org/10.1111/j.1745-7599.2008.00367.x
Lamorte, W.M., (2019). Behavioural Change Model: The Health Belief Model. Boston University School of Public health. https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/behavioralchangetheories2.html
Nowak, A.J., Casamassimo, P.S., Scott, J., & Moulton, R. (2014) Do Early Dental Visits Reduce Treatment and Treatment Costs for Children? Journal of Pediatric Dentistry. 36(7).
Pierce, A., Singh, S., Lee, J., Grant, C., Cruz de Jesus, V., & Schroth, R. J. (2019). The Burden of Early Childhood Caries in Canadian Children and Associated Risk Factors. Frontiers in Public Health. 7, 328. https://doi.org/10.3389/fpubh.2019.00328
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