I began learning about & found an interest in health promotion when I was in school for my Bachelor of Dental Hygiene. We had a few courses focused on advocacy & accessibility to care. After these courses I developed a greater interest in health promotion. The last course I took for my MHST journey was a course on health policy, that really began to open my eyes to health promotion & the amount of work/advocacy that goes into creating policies to improve health!
A topic I have focused on in previous courses and something I feel is crucial to lifelong oral health is ECC – Early Childhood Caries. I have focused on its prevention, treatment, and how it should be a multidisciplinary approach within healthcare. Oral healthcare in general is beginning to become increasingly recognized as overall health, as there is more research displaying the connection. However, there is still a significant amount of work to do to get ‘mainstream’ healthcare, and government to recognize and advocate for its importance.
ECC is defined as decay affecting the primary teeth. Its treatment accounts for 30% of all day surgeries (under general anesthetic) and is the most prevalent surgery in pediatric hospitals (CIHI 2013). It is a largely preventable, complex, multifactorial disease that is influenced by biomedical factors, and the social determinants of health (CDA 2010). It affects Indigenous children, children whose family have a low level of education, low SES, and those who reside in rural areas at a disproportion rate to other children (Health Canada, 2010).
Why is this important? It’s just cavities in baby teeth? They will get more teeth to replace them? ECC affects quality of life throughout the entire lifespan, leading to self-esteem issues, and decreased communication & social skills (WHO 2019). The primary dentition is needed for proper mastication (and nutrition), esthetics, phonetics, and maintaining space for the permanent dentition to erupt properly (Anil & Anand, 2017). Untreated decay can lead to abscess and pain, affecting the ability to eat, sleep, and complete daily life activities. Left untreated dental abscesses and infections can become life-threatening (WHO 2019). Learning the skills to complete proper oral hygiene as a child, as well as having a positive dental experience sets a child up for adequate lifelong oral health.
One of the biggest challenges I face is people taking my issue of ECC seriously and giving it the attention it deserves. To many, dentistry is still not considered as a component of overall health and is pushed to the back burner. This is especially true for the primary dentition as there are teeth to replace them. The importance of the primary dentition is something I discuss with patients, and others in healthcare frequently. This is something that will take a significant amount of evidence-based health promotion research to ensure all stakeholders can realize the importance.
ECC advocacy is something I hope to pursue ‘outside of the classroom’ to make real change in the way oral health is perceived, advocated for & implemented policies. I look forward to gaining the knowledge to fully utilize health promotion strategies to better advocate for oral health inequalities.
Anil, S., & Anand, P. (2017). Early Childhood Caries: Prevalence, Risk Factors, and Prevention. Frontiers in Pediatrics. 5:157. doi:10.3389/fped.2017.00157
Canadian institute for Health Information. (2013). Treatment of Preventable Dental Cavities in Preschoolers. https://cdn.ymaws.com/www.alphaweb.org/resource/collection/822EC60D-0D03-413E-B590-AFE1AA8620A9/CIHI_Caries_Surgery_2013.pdf
CDA Board of Directors. (2010). Position Paper on the Access to Oral Health Care for Canadians. http://www.cda-adc.ca/_files/position_statements/accessToCarePaper.pdf
Health Canada. (2010). Report on the Findings of the Oral Health Component of the Canadian Health Measures Survey: 2007-2009. https://www.caphd.ca/sites/default/files/CHMS-E-tech.pdf
World Health Organization. (2019). Ending Childhood Dental Caries. WHO Implementation Manual.https://apps.who.int/iris/rest/bitstreams/1266137/retrieve
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