Disease Management of Early Childhood Caries: ECC Collaborative Project

Table 2

ECC Phase 2: disease management protocol.

Existing risk category	New clinical findings	Fluoride varnish interval	Self-management goals	Restorative treatment	DM return interval	Other
Low	(i) No disease indicators of caries; (ii) Completely remineralized (arrested) carious lesions	6–12 months	(i) Twice daily brushing with F toothpaste^†; (ii) Stannous fluoride^‡ on cavitated lesions		6–12 months
Medium	(i) No disease indicators* but has risk factors** and/or inadequate protective factors***; (ii) Disease indicators present with some remineralization	3–6 months	(i) Twice or more daily brushing with F toothpaste^†; (ii) Stannous fluoride^‡ on cavitated lesions; (iii) Dietary changes	(i) Sealants; (ii) ITR; (iii) Conventional Restorative	3–6 months	(i) Xylitol gum or candies or wipes; (ii) Calcium phosphate paste
High	(i) Active caries (disease indicators present); (ii) No remineralization occurring; (iii) Heavy plaque	1–3 months	(i) Twice or more daily brushing with F toothpaste^†; (ii) Stannous fluoride^‡ on cavitated lesions; (iii) Dietary changes	(i) ITR; (ii) Sealants; (iii) Conventional restorative	1–3 months	(i) Xylitol gum or candies; (ii) Calcium phosphate paste

ECC: early childhood caries; DM: disease management; ITR: interim therapeutic restoration.
∗Examples of disease indicators include demineralization, cavitated lesions, existing restorations, enamel defects, deep pits, and fissures.
**Examples of risk factors include patient/maternal/family history of decay, plaque on teeth, and frequent snacks of sugars/cooked starch/sugared beverages.
***Examples of protective factors include fluoride exposure (topical and/or systemic) and xylitol.
†Brush with a smear of 1000 ppm F toothpaste.
‡Apply a smear of 1000 ppm stannous fluoride to the cavitated lesions.