Effective caries prevention strategies: Bringing Ecuador to Kentucky, USA

In 2007, Kentucky claimed the highest rate of early childhood caries in the USA. A local dentist, on hearing this embarrassing statistic was moved to action because, under the charitable auspices of Partners for the Americas, he had created an extensive school-based community oral health program, recruiting novel volunteers, in Ecuador (urban, remote rural, rainforest), providing oral hygiene materials, instruction, and fluoride varnish applications. This decade-long Ecuador program continues to show positive impact.

Replicating the Ecuador program in Clark County, support was received from Clark County Community Foundation and Clark County Health Department creating a five-year Clark County Dental Health Initiative (CCDHI). By 2008, fully-organized professional volunteers began an educational program coupled with fluoride varnish applications for all public and private school children – plus pre-school facilities. Four-year data indicated that the decay rate for children in the 6th grade (final year of primary school) has fallen from 50.24% (dmfs) to 11.8% (dmfs). This presentation outlines crucial elements for implementing a successful volunteer, school-based program and provides final results of the five-year CCDHI.

The fluoride varnish selected for the Ecuador and the Kentucky programs was EnamelPro® with amorphous calcium phosphate (ACP) for its added remineralization potential.