ECC within Primary Health Care System

The first three years of life is a true risk age for ECC due the eruption of 20 new teeth and the child’s total dependence of parental care. Thus, the primary health care system has an essential role in supporting parents to early establish healthy dietary and dental behaviors. The preventive efforts can be organized as a mix of community, individual and vulnerable group strategies and the presentation will provide a current example from Scandinavia. At a first step, a regional geo-mapping of pre-school caries risk, based on current epidemiology, family income, level of education and immigrant status, is performed. Children from areas with a lower caries risk than the average are checked for an individual risk assessment at the age of 1 year. Teeth are examined dry and clean and any sign of early enamel demineralization renders secondary preventive action. Children from areas with a higher caries risk than the average are all offered a collective community oral health program from the age of one year emphasizing self-applied and professional fluorides. For vulnerable groups, such as immigrants and refugees, a tailored outreach approach from ambassadors with cultural and linguistic skills is employed. The current ECC prevalence at 3 years of age varies from 2% in the low-risk areas to 11.5% among the vulnerable groups which partly may be due to a lower the compliance with the primary care programs in the low SES-groups. Thus, the future challenge is to improve the communication on the value of a healthy primary dentition and further support parents to take an active role in oral care.