Early Childhood Caries the Leading Cause of Day Surgery for Canadian Children


Early childhood caries (ECC) account for about one-third of all day surgeries performed on Canadian children between the ages of 1 and 5, according to a study 1 by the Canadian Institute for Health Information (CIHI). The CIHI report highlights the prevalence of oral health neglect in Canadian children and raises awareness of a health care issue that can be avoided.

“Tooth decay is preventable,” says Dr. Peter Doig, president of CDA. “Infants should visit the dentist by age one, and regularly thereafter. These early visits can identify and address signs of tooth decay, promote good oral health habits, and are an investment in lifelong health.”

The study reviewed 2 years of data on rates of ECC-related day surgery, performed almost exclusively under general anesthesia. Each year, roughly 19,000 children had dental surgery—mostly for fillings and extractions—and spent an average of 82 minutes in the operating room. Across the country, rates of day surgery operations, expressed as number of operations per 1000 children, ranged from a low of 8.4 in Ontario to a high of 97.2 in Nunavut. Quebec elected not to participate in the study.

The report also found the risk of day surgery for ECC was associated with where children live:

  • Neighbourhoods with a high proportion of Aboriginal residents had rates almost 9 times higher than neighbourhoods with a low proportion of Aboriginal residents.
  • The least affluent neighbourhoods, as measured by an index that captures residents’ income, employment and education, had rates almost 4 times higher compared to the most affluent neighbourhoods.
  • Rural areas had rates about 3 times higher than urban neighbourhoods.

In addition to the risks associated with undergoing day surgery for ECC under general anesthesia, the report outlines other costly implications. The estimated annual hospital-related costs totalled $21.2 million, not including costs associated with dental surgeons and anaesthesiologists. Travel time was considerable for families—more than one-fifth of families spent 2 or more hours travelling to care. Also, the use of hospital resources for ECC resulted in extended wait times for other urgent pediatric care.

The study’s authors say the report underestimates the impact of ECC on the well-being of children because only procedures performed as day surgery were included. Demand for ECC-related day surgery is greater than the capacity of many hospitals. For example, their report cites statistics from British Columbia that show some children had to wait almost 28 weeks for pediatric dental surgery.

Visit the CIHI website to read the full report. The CDA position statement on early childhood caries can be found on the CDA website.


  1. Canadian Institute for Health Information. Treatment of Preventable Dental Cavities in Preschoolers: A Focus on Day Surgery Under General Anesthesia [accessed 2013 Oct 24]. Available: www.cihi.ca