227 - AAPD Member Self-Reported Early Childhood Caries Management in Pre-Cooperative Children

Abstract:

Purpose: To evaluate ways in which American Academy of Pediatric Dentistry (AAPD) members report managing early childhood caries (ECC) in pre-cooperative children.

Methods: In this initial assessment, qualitative data from a subset (n=119; 20 educators, 99 non-educators) of the over 5000 AAPD members that participated in a Zoom-based interview study assessing ECC management approaches were analyzed. Open-ended responses to, “For pre-cooperative children – that is children who are developmentally too young to tolerate conventional restorative treatment – how do you and your staff currently manage ECC?” were coded in order reported as: Restorative, Minimal, Monitor, Behavioral, Pharmacology, Antibiotic. Prompted responses were excluded, yielding 18 educator and 95 non-educator responses analyzed.

Results: Among educators, Restorative was the highest first-mentioned management (by 33%), followed by Pharmacology and Behavioral approaches (both reported first by 22%), then Minimal and Monitor (11%). The top first reported approach among non-educators was Pharmacology (45%), followed by Restorative (24%), Behavioral (17%), Monitor (9%) and Minimal (3%). Overall, Behavioral management was mentioned by 39% of all respondents (in any order), while Restorative was mentioned by 80% (89% educators; 78% non-educators) . None reported Antibiotic management. AAPD members that graduated more recently, have practiced for fewer years, as well as those who serve a larger portion of patients on public insurance cited behavioral management more often.

Conclusion: Despite potential limitations related to selection bias and skewed subset analyzed, most reported restorative management, with fewer reporting behavioral. Given the chronic nature of this behaviorally-mediated disease and that educators reported behavioral first more frequently, findings suggest a need to promote behavior-based management, particularly among non-educators.

Identify Supporting Agency and Grant Number:

Research supported by a National Institutes of Health/ National Institute of Dental and Craniofacial Research (NIH/NIDCR) grant (5U01DE026739-02).