# Global policy approaches to combat early childhood caries: a scoping review with evidence map

## TL;DR

This paper reviews global policies to prevent early childhood caries, finding that high-income countries lead efforts, but low-income regions lack effective strategies.

## Contribution

The study maps global ECC policies and identifies disparities in implementation, emphasizing the need for equity-focused interventions.

## Key findings

- 28 articles identified three policy domains: preventive, regulatory, and integrative strategies.
- Most policies originated from high-income countries, with limited initiatives in low-income regions.
- Gaps include weak healthcare integration and poor monitoring frameworks in ECC policies.

## Abstract

Early Childhood Caries (ECC) is a major global public health concern disproportionately affecting young children, particularly in low-resource settings. Although several clinical and community-based interventions have been implemented, the contribution of policy measures in addressing ECC remains insufficiently explored at the global level.

This scoping review aimed to identify, describe, and map policy approaches adopted across countries for the prevention and management of ECC.

The review followed the Arksey and O'Malley framework and adhered to the PRISMA-ScR guidelines. A comprehensive literature search was conducted in PubMed, CINAHL, Web of Science, and Google Scholar for studies published between 2014 and 2024. Eligible studies focusing on ECC-related policies were included and analyzed thematically.

A total of 28 articles met the inclusion criteria. The identified policy approaches were categorized into three major domains: preventive, regulatory, and integrative strategies. These policies were implemented across high-, middle-, and low-income countries, with the majority originating from high-income settings. Implementation channels included schools, health systems, and mass media campaigns. Major gaps identified were limited policy initiatives in low-income countries, weak integration with primary healthcare, and inadequate monitoring and evaluation frameworks.

While progress has been made in ECC policy development globally, significant disparities persist in implementation and impact. The findings highlight the urgent need for comprehensive, equity-oriented, and system-integrated policy interventions to effectively prevent and control ECC worldwide.

The review protocol is registered at the Open Science Framework database under the Registration https://doi.org/10.17605/OSFIO/2VMEK.