Early Childhood Caries Collaborative

Chronic Disease Management of Early Childhood Caries

If your dental practice would like to participate as an improvement team in Phase 3 of the ECC Collaborative, we invite you to submit a team application.

Dental Care

September 16, 2013
Dental Care Takes on New Role in Traditional Medical Care Settings
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August 15, 2013
NICHQ and the DentaQuest Institute Commit to Improving Children's Oral Health Across the Country
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At a Glance

What: The third phase of a national improvement initiative designed to foster the rapid spread of an alternative disease management model of early childhood caries (ECC) care, focused on prevention and minimally invasive treatment.

Why: Standards of care for early childhood caries (also known as cavities) often call for restorative and surgical treatment along with general recommendations to change dietary and oral hygiene practices. Young children who are not cooperative—or children with special healthcare needs who require restorative treatment—are commonly sedated or treated under general anesthesia. However, the cost of general anesthesia is high and relapse rates of 37 percent to 79 percent (restorative treatment failures) have been reported in scientific literature. It is now known that restorative treatment of caries alone does not address the disease process.

Who: Up to 40 teams from across the United States

When: August 2013 until February 2015

Funder: This initiative is funded by the DentaQuest Institute.


Early Childhood Caries (ECC) is a chronic, infectious dental disease that causes aggressive tooth decay in very young children. If left untreated, ECC can impact a child's proper development of permanent teeth and lead to eating and speech problems. Like all dental diseases, ECC is almost completely preventable, but standards of care for ECC have historically advocated restorative and surgical treatments where children are commonly sedated or treated under general anesthesia.

In 2008, the DentaQuest Institute established the Early Childhood Caries Collaborative in order to develop an alternative disease managment model for ECC focused on prevention and minimally invasive treatment.

Phase 1 of the initiative focused on developing and testing a risk-based disease management approach to preschool children with ECC. This phase included two teams, both hospital-based dental practices; one team from Boston Children’s Hospital and a second team from St. Joseph Health Services of Rhode Island in Providence, RI. After 30 months, the project results found that children who experienced disease management had lower rates of new cavitated lesions, pain, and referrals for restorative treatment under general anesthesia in the operating room, as compared to baseline historical controls.

Phase 2 took place over an 18-month period between 2011 to early 2013. In this phase, the project expanded to five other sites nationwide. The results from Phase 2 were similar to those found by the teams in Phase 1.

Project Overview

NICHQ will support Phase 3 of the ECC Collaborative. The goals for this phase are to further refine the disease management approach to ECC and reduce the burden of caries disease for the children of participating practices. The iniative aims to accomplish these goals by expanding the project to up to 40 sites from across the country in a new Breakthrough Series Collaborative, which will begin in August 2013 and extend through February 2015. Teams participating in Phase 3 will build on the work of the Phase 2 teams and work together to implement the practices and protocols of disease management for early childhood caries. Training and technical support for the teams will be provided by the ECC Collaborative project staff, quality improvement experts, and national and regional faculty.

If your dental practice would like to participate as an improvement team in Phase 3 of the ECC Collaborative, we invite you to submit a team application.

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