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

Abstract

Background: 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. Objective: This scoping review aimed to identify, describe, and map policy approaches adopted across countries for the prevention and management of ECC. Methods: 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. Results: 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. Conclusion: 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. Systematic Review Registration: The review protocol is registered at the Open Science Framework database under the Registration https://doi.org/10.17605/OSFIO/2VMEK.