Early childhood caries in Indigenous communities

The oral health of Indigenous children of Canada (First Nations, Inuit, and Métis) and the United States (American Indian/Alaska Native) is a major child health disparity when compared with the general population of both countries. Early childhood caries (ECC) occurs in Indigenous children at an earlier age, with a higher prevalence, and at much greater severity than in the general population. ECC results in adverse oral health, affecting childhood health and well-being, and may result in high rates of costly surgical treatment under general anesthesia. ECC is an infectious disease that is influenced by multiple factors, but the social determinants of health are particularly important. This policy statement includes recommendations for preventive and clinical oral health care for infants, toddlers, preschool children, and pregnant women by primary health care providers. It also addresses community-based health-promotion initiatives and access to dental care for Indigenous children. This policy statement encourages oral health interventions at early ages in Indigenous children, including referral to dental care for the use of sealants, interim therapeutic restorations, and silver diamine fluoride. Further community-based research on the microbiology, epidemiology, prevention, and management of ECC in Indigenous communities is also needed to reduce the dismally high rate of caries in this population. For the full text document, visitwww.cps.ca/en/documents Lead Authors: Steve Holve, MD; Patricia Braun, MD, MPH; James D. Irvine, MD; Kristen Nadeau, MD, MS; Robert J. Schroth, DMD, MSc, PhD American Academy of Pediatrics, Committee on Native American Child Health, 2018–2019 Shaquita L. Bell, MD, Chairperson; Daniel J. Calac, MD; Allison Empey, MD; Kristen J. Nadeau, MD, MS; Jane A. Oski, MD, MPH; (Ret) CAPT Judith K. Thierry, DO, MPH; Ashley Weedn, MD Liaisons: Joseph T. Bell, MD – Association of American Indian Physicians; Angela Kueck, MD – American College of Obstetricians and Gynecologists; Rebecca S. Daily – American Academy of Child and Adolescent Psychiatry; Radha Jetty, MD – Canadian Paediatric Society; Melanie Mester, MD – American Academy of Pediatrics, Section on Pediatric Trainees; Nelson Branco, MD – American Academy of Pediatrics, Indian Health Special Interest Group Chairperson Consultants: Diana Dunnigan, MD Staff: Madra Guinn Jones, MPH American Academy of Pediatrics, Section on Oral Health Executive Committee, 2018–2019 Patricia Braun, MD, MPH, Chairperson; Susan Fisher-Owens, MD, MPH; Qadira Huff, MD, MPH; Jeffrey Karp, DMD, MS; Anupama Tate, DMD; John Unkel, MD, DDS, MS; David Krol, MD, MPH, Immediate Past Chairperson Staff: Ngozi Onyema-Melton, MPH Canadian Paediatric Society, First Nations, Inuit and Métis Health Committee 2018–2019 Radha Jetty, MD, Chairperson; Roxanne Goldade, MD – Board Representative; Brett Schrewe, MD; Véronique Pelletier, MD; Ryan J.P. Giroux, MD; Margaret Berry, MD; Leigh Fraser-Roberts, MD Liaisons: Patricia Wiebe, MD, MPH – Indigenous Services Canada, First Nations and Inuit Health Branch*; Laura Mitchell, BA, MA – Indigenous Services Canada, First Nations and Inuit Health Branch*; Shaquita Bell, MD – American Academy of Pediatrics, Committee on Native American Child Health; Melanie Morningstar – Assembly of First Nations; Karen Beddard – Inuit Tapiriit Kanatami; Marilee Nowgesic , RN – Indigenous Nurses Association of Canada; Vides Eduardo, MD - Métis National Council; Lisa Monkman, MD – Indigenous Physicians Association of Canada Consultants: James Irvine, MD; Kent Saylor, MD *The views expressed in this article/publication or information resource do not necessarily represent the positions, decisions or policies of the First Nations and Inuit Health Branch liaisons or their organization.

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