The Big PictureEarly childhood caries in Canada
Section snippets
Background
Severe early childhood caries (ECC) requiring treatment under general anesthesia is found in many children in Canada. This indicates clearly the oral health status of these children who, by age 6 years, have experienced decay of the primary teeth. General anesthesia is required for the more complex cases; for children who cannot cooperate because they lack sufficient psychological or emotional maturity or have mental, physical, or medical disabilities; when acute infection, allergy, or anatomic
Methods
Data on day surgery for children under age 6 years with severe ECC were gathered from the Canadian Institute for Health Information Discharge Abstract Database and National Ambulatory Care Reporting System for the years from 2010/11 through 2013/14 (4 years). Quebec did not participate but all the other provinces and territories of Canada did. Data considered included sex, age, proportion of immigrants in the neighborhood, Aboriginal concentration, material deprivation index (MDI), and rural or
Results
A total of 57,249 day surgeries were done to treat severe ECC in the 4-year period, making it the most common day surgery in Canada for this age group, representing 31.0% of all pediatric day surgeries. The overall rate was 12.1 per 1000 children age 12 to 59 months.
Pooled and annual day rates differed by province and territory, with the highest in Nunavut (110.9 per 1000 children) and the lowest in Ontario (8.2 per 1000 children). The provinces of Saskatchewan, Manitoba, and
Discussion
ECC surgery was identified as the most common day surgery among children age 12 to 59 months throughout Canada (but not considering Quebec). Although the data were insufficient to indicate if the rates for this treatment approach are increasing, it is apparent that the problem is most severe among indigenous children and those living in rural regions of Canada. Higher rates of ECC surgery were noted among children from the least affluent neighborhoods compared to those from the most affluent
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Schroth RJ, Quiñonez C, Shwart L, et al: Treating early childhood caries under general anesthesia: A national review of Canadian data. J Can Dent Assoc 82:g20, 2016
Reprints available from RJ Schroth, Dept of Preventive Dental Science, College of Dentistry, Depts of Pediatrics and Child Health and Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, Univ of Manitoba, 507-715 McDermot Ave, Winnipeg MB R3E 3P4; e-mail: [email protected]