Mapping Early Childhood Caries Prevention Programmes in Scotland and South-Eastern Europe

Background: Early Childhood Caries (ECC) is a recognised global public health challenge, and the World Health Organisation (WHO) has set out preventive approaches in an implementation manual. Scotland has an established information-sharing partnership with countries in South-Eastern Europe, where the ECC burden is substantial. Aim: This project aimed to map ECC and preventive programmes in Scotland and South-Eastern Europe against WHO criteria and to facilitate discussion, drawing from recent research and assessment of international consensus, to agree on priority interventions. Methods: A dedicated pro-forma gathered structured information on: population statistics; disease burden; workforce capacity; interventions in dental practice, early years education and the community. A recorded online workshop involved presentations and discussions of policy and practice in relation to current and future ECC prevention plans. Workshop discussions were transcribed and analysed using thematic theory-based implementation frameworks, facilitated by QSR NVivo12.0 software. Results: Data were received from Albania, Bulgaria, Croatia, Romania, Scotland and Serbia. The child population and birth rate are generally declining. In 2019, ECC prevalence among 5–6-year-olds was 80% to 84% in South-Eastern Europe countries, while in Scotland, less than a third (26%) of those children had obvious decay experience in their primary teeth in 2020, compared with more than half (55%) in 2003. A key barrier for implementing ECC prevention is a lack of political prioritisation and funding. Further barriers identified included a lack of integration of public and private preventive programmes, low engagement of professional dental associations, and a lack of population knowledge/awareness of the issue. Implementation might be facilitated through wider universal child health initiatives (e.g. vaccination and maternal health programmes). Conclusion: Mapping disease and oral health prevention activities in Scotland and South-Eastern Europe has allowed for assessment of progress and identified barriers and facilitators for future implementation in line with WHO ECC prevention guidelines

5.2 Ethics, equity and global responsibilities in oral health and disease.

The charge of this Section is ethics and global responsibilities in oral health and disease. Oral health is determined by the same factors as those for general health. To a limited extent, the level of oral health care and dental education. The philosophy and organization of the health care system and dental education, therefore, are key determinants of oral health. Dental education has expanded in many countries where there has been an increase in wealth. Unfortunately, there has been no concomitant increase in the number of dental educators. This is a problem throughout the world. This present situation raises certain ethical issues with regard to professional responsibilities. It also raises some important questions for dental education. This Section has chosen to focus its efforts on examining two issues: * What can be done within dental schools? * What can be done external to dental schools - either individually or collectively? The best practices identified are more akin to goals, as it is recognized that, in a world in which there are enormous variations in economic, environmental, social, and cultural features, a single uniform set of practices is impracticable. The central core value identified is the realization by students, and faculty/teaching staff of the quest of life-long learning against a background of the social and ethical responsibilities of health professionals. The conclusion of the group is that biology is not the sole determinant of health. Understanding the role of social, economic, environmental and other factors in determining health status is critical if greater equity in dental education and care are to be achieved.link_to_subscribed_fulltex