Position Statement on Early Childhood Caries in Indigenous Communities


In May, the Canadian Pediatric Society (CPS) and the American Academy of Pediatrics (AAP) issued a joint position statement on early childhood caries (ECC) in North American indigenous communities. In Canada, these communities include First Nations, Inuit and Métis populations.

The statement included the following clinical recommendations: 

  • ECC should be considered an infectious disease influenced by a variety of factors, including socioeconomic conditions, parenting practices, and maternal and infant nutrition.
  • Oral health should be discussed during well-child care visits, using motivational interviewing and anticipatory guidance for the parents and caregivers of infants and children regarding oral hygiene and diet.
  • Supervised twice-daily use of fluoridated toothpaste should be promoted in all indigenous and other high-risk children after the first tooth has erupted.
  • Community health nurses, family physicians or pediatricians should perform oral health screening during early childhood health assessments and provide referrals as needed to dental health providers.
  • Women of indigenous communities should be provided access to receive preconception and prenatal screening for oral health, anticipatory guidance for oral health and hygiene, and referral for dental care if required.
  • Primary care providers should be aware of the access to fluoride in the drinking water for the various indigenous communities in their service area.

Dr. Robert Schroth, assistant professor at the University of Manitoba faculty of dentistry, was a member of the CPS-AAP Policy Statement Working Group. Dr. Schroth was also a member of CDA’s Committee on Clinical and Scientific Affairs Early Childhood Caries Task Force.

The joint position statement was reviewed by the Oral Health Section of the CPS—an organization that represents nearly 3000 pediatricians and other child health professionals across Canada. The full position statement can be found at: www.cps.ca/english/statements/II/FNIM11-01.htm.