A protocol for early childhood caries diagnosis and risk assessment

The global Early Childhood Caries (ECC) burden is of concern to the World Health Organisation (WHO), but the quantification of this burden and risk is unclear, partly due to difficulties in accessing young children for population surveys and partly due to diagnostic criteria for ECC experience. The WHO criterion for caries diagnosis is the late stage event of dentine cavitation. Earlier stages of the caries lesion are clinically detectable and should be registered earlier in the life of children and arrested/remineralized before lesions progress to the cavitation stage. A protocol for ECC diagnosis is proposed to guide those engaged in clinical dentistry in their characterization of the ECC lesion. As management of early lesions is a critical step to reduce risk of their progression to later stage lesions, a practical method for assessing ECC risk is proposed also. Risk assessment is very important because it determines (a) urgency for interventions aimed to arrest lesion progression; (b) the frequency of such interventions and (c) the need to enhance the primary prevention of ECC. The guidelines are set out separately for ECC diagnosis for ongoing clinical care and for epidemiologic purposes. Similarly, guidelines are set out for ECC risk assessment and ongoing monitoring.