Early childhood caries in Latino populations: Culturally sensitive prevention strategies

Courtney D. Routh, RDH, MSDH, is the assistant professor of dental hygiene at UT health school of dentistry at Houston. The course director is Victoria V. Patrounova, RDH, MHA.

Early childhood caries (ECC) remains one of the most prevalent chronic conditions affecting children and disproportionately impacts Latino populations in the United States.¹ Higher disease prevalence reflects not only clinical risk factors but also broader social, cultural, and economic inequities that influence access to preventive care, oral health knowledge, and trust in the healthcare system.²

Through community outreach, education, and advocacy, we have witnessed firsthand how cultural, linguistic, and access barriers shape oral health outcomes for Latino families. These experiences reinforced the importance of culturally responsive, prevention-focused approaches that meet families where they are. 

Addressing ECC in Latino communities requires strategies that extend beyond traditional clinical care. Culturally sensitive education, community collaboration, and advocacy for expanded preventive services are essential to reducing disparities and strengthening trust between providers and families.³

Raising awareness 

We wanted to raise awareness of the high prevalence of ECC among Latino children and to promote culturally sensitive, evidence-based prevention strategies that empower families and strengthen communities. This project was developed within the Community Dental Health curriculum at UTHealth Houston School of Dentistry and was informed by our active participation in the Hispanic Student Dental Association (HSDA). 

Objectives:

• Identify national trends demonstrating the rise of ECC among Latino children 

• Assess cultural, social, and economic factors that increase ECC risk in Latino communities 

• Compare the effectiveness of key prevention strategies 

• Demonstrate that community-centered, culturally sensitive programs can reduce gaps in care 

Methods:

This project analyzed ECC trends, risk factors, and prevention strategies using mixed-methods educational research. Qualitative studies focusing on culturally tailored and community-based interventions were reviewed. Findings were synthesized to develop recommendations supporting equity-focused oral health education and prevention. 

Results:

Latino children experience higher rates of ECC compared to non-Hispanic White children.² While insurance status, poverty, and limited access to dental services contribute to these disparities, they do not fully explain the increased disease burden.⁴ Maternal beliefs, oral health knowledge, and cultural factors significantly influence ECC risk.⁵ Key findings include: 

• Community-based programs increase parent engagement and oral health knowledge

• Culturally tailored education improves preventive behaviors and trust in dental care 

• Promotora-led education programs enhance oral health habits

• Early dental visits and caries risk assessments improve early detection 

• Water fluoridation remains a critical protective factor against ECC 

What makes ECC more prevalent in Latino communities? 

ECC among Latino children is not simply a result of dental neglect but reflects broader social, cultural, and economic inequities.⁴ Language barriers, cultural beliefs regarding primary teeth, and limited access to preventive services contribute to higher disease prevalence. Evidence supports the effectiveness of culturally informed communication and community-based outreach in improving preventive behaviors.³ Promotora-led models highlight the value of trusted community members in delivering oral health education that is linguistically and culturally appropriate.³ 

Additionally, technology-supported risk assessment tools can assist providers in identifying high-risk children earlier and delivering targeted preventive care. Expanding bilingual education, supporting universal water fluoridation, and strengthening provider cultural competence are essential components of comprehensive ECC prevention.¹

Together, we can:

• Promote culturally informed communication strategies

• Strengthen collaboration with community organizations

• Expand access to preventive dental services

• Advocate for structural changes that reduce barriers to care

What have we learned? 

ECC in Latino children reflects systemic inequities that extend beyond individual behaviors. Effective reduction of ECC requires culturally sensitive education, expanded preventive services, and community-centered advocacy efforts. Dental professionals play a critical role in addressing oral health disparities by practicing cultural competence, supporting preventive policies, and engaging families through trust-based, inclusive approaches. 

Author's note: This article is based on a student academic poster developed at UTHealth Houston School of Dentistry for Community Dental Health Practice course.  

References  

1. American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): classifications, consequences, and preventive strategies. Pediatr Dent. 2023;45(6):24-30. 

2. Choi SE, White J, Mertz E, Normand SL. Analysis of race and ethnicity, socioeconomic factors, and tooth decay among US children. JAMA Netw Open. 2023;6(6):e2318425. doi:10.1001/jamanetworkopen.2023.18425 

3. Hoeft KS, Barker JC, Shiboski S, Pantoja-Guzmán E, Hiatt RA. Effectiveness evaluation of the Contra Caries Oral Health Education Program for improving Spanish-speaking parents’ preventive oral health knowledge and behaviors for their young children. Community Dent Oral Epidemiol. 2016;44(6):564-576. doi:10.1111/cdoe.12252 

5. Kabani FA, Ortega AN, et al. Acculturation and the oral health of a nationally representative sample of Hispanic children. BMC Public Health. 2020;20:804. doi:10.1186/s12889-020-08901-9 

6. Wilson AR, Barker JC, et al. The impact of maternal self-efficacy and oral health beliefs on early childhood caries among Latino children. Front Public Health. 2017;5:228. doi:10.3389/fpubh.2017.00228