Pediatricians and family physicians are often the first healthcare providers to assess and advise on infant and young children’s overall health. Their role in preventing and managing Early Childhood Caries (ECC) is crucial, as dental visits for young children are not as common. Despite understanding the impact of ECC, a recent cross-sectional study revealed a significant gap between knowledge, attitude, and practice among medical professionals in Riyadh city when it comes to oral healthcare for infants and young children. The research, published in The Saudi Dental Journal, provides insight into how pediatricians and family physicians would benefit from additional dental training and education to improve practice in this area.

Early Childhood Caries: A Global Oral Health Concern

ECC is a pressing health problem worldwide. It is the most common chronic disease of childhood, with significant consequences for the well-being of children. The disease can spread rapidly, often with a manifestation before the child reaches the age of three. ECC causes pain, discomfort, and affects the child’s ability to eat, speak, and learn. It not only has an immediate impact but is also predictive of future caries in both the primary and permanent dentitions.

The study conducted in Riyadh highlights the importance of ECC while emphasizing the need for pediatricians and family physicians to be well-equipped to contribute effectively to its prevention. Alshunaiber and colleagues (2019) aimed to assess the practice, knowledge, and attitude of these healthcare providers towards ECC and emphasized the importance of incorporating dental health practices into routine pediatric care.

Discrepancies in Practice Despite Good Knowledge and Attitude

The study’s findings show that while most of the participants reported good dental attitudes and knowledge of ECC, there was a lack of associated dental practice. Specifically, 42.6% of the participants maintained good practice, compared with 86.1% with a good attitude and 65.3% with adequate knowledge. These statistics show a noticeable disconnect between what is known and what is practiced among pediatricians and family physicians.

The questionnaire responses suggested that the primary barrier to implementing oral health activities was the lack of clinical time, reported by 52.5% of participants. Many providers are already stretched thin with their workload, and dedicating time to oral health, which they may perceive as a dentist’s responsibility, can be difficult.

However, a promising 76.7% indicated a need for more dental training and education, with preventive methods being the most requested topic. These healthcare professionals expressed a preference for workshops and seminars as the ideal methods to receive this additional training.

The researchers observed that a proactive approach focused on education and practice integration could empower physicians to better address ECC. Interdisciplinary collaboration between dentistry and general medicine is crucial for early detection, guidance, and preventive care.

The Importance of Integrating Oral Health in General Medical Practice

Studies have consistently reported that early dental visits are less common than general health checkups for infants. Due to this, pediatricians and family physicians become the de facto frontline of defense against ECC. With current recommendations suggesting that the first dental visit should occur within six months of the first tooth eruption or by 12 months of age, medical providers need support to promote oral health during the numerous well-child visits that occur during this period.

Addressing the Challenges

To bridge the practice gap, the study’s findings suggest several approaches:

1. Integration of Oral Health in Medical Curriculum: Enhancing the dental content in pediatric and family medicine training programs could be a way forward. This will better equip healthcare providers with the necessary knowledge and practice to address oral health concerns.

2. Continuing Professional Development: Regular training workshops on the prevention of dental caries, fluoride varnish application, and basic oral health screening would improve the practice among physicians.

3. Interdisciplinary Collaboration: Promoting closer working relationships between dentists and medical professionals can allow for a continuous exchange of knowledge and referrals for specialized dental care.

4. Protocols and Guidelines: Implementing evidence-based protocols for oral health assessments and preventive care during pediatric visits can standardize and improve practice.

5. Time Management and Support Staff Training: Solutions to clinical time constraints, such as training support staff to provide preliminary oral health information and care, could optimize the physician’s time.

Moving Forward: Recommendations for Improved Care

Based on the study’s findings, there is a clear need for action. The authors recommend the following:

1. Implementation of Educational Programs: Conduct training and education for pediatricians and family physicians that specifically address ECC and its prevention.

2. Awareness Campaigns: Increase the awareness among parents and caregivers about the importance of early dental visits and the role of general health practitioners in oral health.

3. Policy Changes: Advocate for policy changes that would provide time and resources for physicians to integrate oral health into their practice.

4. Research and Follow-up: Conduct further research to evaluate the effectiveness of implemented educational programs and practice changes.

5. Collaborative Approach: Encourage partnerships between dental organizations and medical practices to streamline referral processes and provide comprehensive care.


The study conducted in Riyadh sheds light on an area of child healthcare that has room for significant improvement. With pediatricians and family physicians positioned as critical players in the fight against ECC, it is vital to equip them with the necessary tools and knowledge. Through education, integration of practice, and inter-professional collaboration, these healthcare providers can significantly contribute to the prevention and management of ECC, ensuring a healthier future for the youngest population.


1. Alshunaiber, R., Alzaid, H., Meaigel, S., Aldeeri, A., & Adlan, A. (2019). Early childhood caries and infant’s oral health; pediatricians’ and family physicians’ practice, knowledge and attitude in Riyadh city, Saudi Arabia. The Saudi Dental Journal, 31(Suppl 2019), S96-S105. doi: 10.1016/j.sdentj.2019.01.006

2. Çolak, H., Dülgergil, Ç.T., Dalli, M., & Hamidi, M.M. (2013). Early childhood caries update: a review of causes, diagnoses, and treatments. Journal of Natural Science, Biology, and Medicine, 4(1), 29. doi: 10.4103/0976-9668.107255

3. Koya, S., Ravichandra, K.S., Arunkumar, V.A., Sahana, S., & Pushpalatha, H.M. (2016). Prevalence of early childhood caries in children of West Godavari District, Andhra Pradesh, South India: an epidemiological study. International Journal of Clinical Pediatric Dentistry, 9(3), 251. doi: 10.5005/jp-journals-10005-1363

4. Pierce, K.M., Rozier, R.G., & V

DOI: 10.1016/j.sdentj.2019.01.006


1. Early Childhood Caries
2. Pediatric Oral Health
3. Pediatricians Dental Knowledge
4. Family Physicians Oral Health Practices
5. Dental Education for Pediatricians