Original Publication
Open Access

Protecting All Children's Teeth (PACT): Caries

Published: September 12, 2013 | 10.15766/mep_2374-8265.9534

Included in this publication:

  • Caries - Course 4 PACT for MedEdPortal.ppt
  • PACT Instructor's Guide.doc

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Protecting All Children's Teeth (PACT) was created by the AAP Oral Health Initiative to educate medical students, residents, pediatric primary care providers, and others interested in infant, child, and adolescent health about the importance of oral health in overall health. The curriculum provides in depth coverage of child oral health, oral health guidance, and preventive care to increase comfort in recognizing dental disease and conditions and communicate with dental professionals. The 13 modules of the PACT training program comprehensively address oral health promotion, disease prevention, diagnosis, and treatment of oral health disease in children.

This resource explains the process of caries that, if untreated, can progress to a cavity. As dental caries is the most common chronic disease of childhood and disproportionately affects poor and minority populations, it is important for medical providers to prevent, identify, and appropriate triage caries.

In pediatrics, there is a subset of patients who develop caries before 5 years of age. This process is termed Early Childhood Caries, or ECC.

The PACT Oral Health Curriculum has been in use since 2007 by physicians in training at the medical school and residency levels, as well as those in clinical practice. The content has been used Pediatric, Family Medicine and Emergency Medicine physician training programs, as well as by Physician Assistants, Nurse Practitioners, Nurses, Dentists and Dental Hygienists in training and clinical practice.

The AAP is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AAP designates the PACT educational activity for a maximum of 11.0 AMA PRA Category 1 Credits™.

Educational Objectives

  1. To define caries and Early Childhood Caries (ECC).
  2. To name the primary bacteria involved in the caries process.
  3. To discuss the contribution of carbohydrate metabolism in caries development.
  4. To state the important protective benefits of saliva.
  5. To list risk factors and describe the oral manifestations of ECC.
  6. To describe the 5 stages of ECC and identify early lesions on physical exam.
  7. To discuss the impact of ECC on overall health and well-being.
  8. To recall 5 major methods of preventing ECC. As this presentation is part of a complete oral health curriculum, educators and learners are encouraged to view the additional 12 courses in power-point or on-line format.

Author Information

  • Melinda Clark, MD: Albany Medical College
  • David Krol: Robert Wood Johnson Foundation

None to report. 

The web-design of the PACT program was funded by the AAP Oral health Initiative, with support from the Maternal and Child Health Bureau (MCHB).

Prior Presentations
None to report.


Clark M, Krol D. Protecting all children's teeth (PACT): caries. MedEdPORTAL. 2013;9:9534. https://doi.org/10.15766/mep_2374-8265.9534

This publication is co-sponsored by the American Dental Education Association.