Accuracy of pediatricians' screening and referral for early childhood caries after a training program

ABSTRACT

Training of pediatricians on early childhood caries [ECC] screening and referral during their medical pediatric practice has been suggested to promote childhood dental care. To assess the accuracy of pediatricians in detection of ECC and trauma and to estimate the rate of referral after being trained by a pedodontist. The study was conducted at pediatric outpatient clinics of a governmental pediatric hospital in Alexandria, Egypt. Dental examination of 137 children- six to thirty six months of age was carried out independently by a pedodontist and pediatricians to identify cases of ECC and trauma after a training program for physicians about diagnosis of dental caries and referral needs. Fifty dental conditions were detected among 33.6% of the children [46 children] with a rate of 36.5%. The rate of ECC among children was 27.7% with pre-cavitated caries as the most common type [16.1%]. The mean age of children with ECC is significantly higher than that of children without ECC [t =3.23, P =0.002]. The rate of dental trauma was 9%. The positive predictive value of pediatricians' detection of ECC was 100%, the sensitivity was 94.74% and the specificity was 100%. The children referred for dental care by pediatricians represented 88% of those referred by the pedodontist. Pediatricians can achieve high accuracy of identification of cases with ECC and of cases in need for dental referral through inservice training