Evaluation of Treatment Approaches Adopted by General Dentists for Early Childhood Caries

Early childhood caries (ECC) remains a major challenge in pediatric oral healthcare because of its high prevalence and complex treatment needs. The present study aimed to compare the treatment options adopted by general dentists for the management of ECC and to evaluate the influence of dentist experience, child age, and caries severity on treatment selection.

This cross-sectional, observational study was conducted among 150 general dentists between October 2021 and March 2022. Each dentist was observed during five consecutive consultations involving children aged two to five years diagnosed with ECC, resulting in 750 observed cases. Treatment modalities were categorized as fluoride varnish/remineralization therapy, atraumatic restorative treatment (ART), conventional restorations, preformed metal crowns, and extraction. Using a standardized observation checklist, data were recorded on dentist experience, child age, the dmft index (where d represents decayed primary teeth, m indicates missing teeth due to caries, f denotes filled primary teeth, and t stands for teeth), and parental presence. All analyses were performed using chi-square tests.

Among the participating dentists, 112 (74.7%) practiced in private clinics, whereas parental presence during consultations was observed in 531 (70.8%) cases. Dentists with less than five years of experience more frequently selected fluoride varnish/remineralization (n = 74, 30.8%) and ART (n = 64, 26.7%), whereas dentists with more than 10 years of experience preferred preformed metal crowns and extractions (p < 0.001). Younger children aged two to three years predominantly received preventive treatments, whereas older children aged four to five years more commonly underwent conventional restorations and preformed metal crowns (p < 0.001). Increasing dmft severity was significantly associated with invasive treatment approaches, including extractions in the high dmft group (p < 0.001).

Treatment selection for ECC varied significantly according to dentist experience, age, and severity. Preventive and minimally invasive approaches are commonly adopted in younger children and in less severe cases, whereas invasive procedures increase with the severity of the disease. These findings highlight the importance of evidence-based minimally invasive strategies in pediatric dental practice.