Early childhood caries (ECC) is a serious form of dental caries that affects the primary dentition of young children, which disproportionately affects poor children from racial/ethnic minority group. In order to prevent ECC, ti is vital that at-risk children and their caregivers be advised and counseled about ways to prevent this disease, and that those children who do develop it can be identified as early as possible, so they can receive necessary restorative treatment and counseling to year, so pediatricians could be natural allies in the battle against ECC by examining their patients for ECC and advising and counseling parents and caregivers about decreasing the child's exposure to risk factors for the disease. We propose an innovative community based intervention trial that will utilize a proven education methodology for enhancing pediatricians' ability to advise and counsel their patients' parents or caregivers regarding decreasing risks for early childhood caries. Such educational programs change physician behaviors and through them, effect changes in parent or caregiver behavior This chain of events is anticipated to decrease the risks and rates of ECC among children. We will provide training and educational programs to specified pediatricians in a practice serving primarily low income African American and Latino children. These programs are designed to increase advising and counseling parents/caregivers about decreasing ECC risk factors, and the use of a brief clinical oral examination and application of fluoride varnish for ECC, while others will provide usual care. In addition, for the intervention group, we will implement an office-based reminder system to facilitate the practice of the previously-taught intervention. To assess the efficacy of the intervention, we will first measure the baseline prevalence of ECC and ECC related risk factors among a cohort of children with initial ages of 12, 24 and 36 months, who present for well- child visits at their pediatricians's office, then we will assess ECC incidence and prevalence one and two years later. We will also assess the pediatrician's use of counseling, examining, or applying fluoride varnish to members of the cohort and control groups of children at baseline, and one and two years later.
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