Integrating Oral Health

Background

Good oral health is important to the overall health of children. As the most common chronic childhood disease, dental caries is an important issue not just for dentists, but paediatricians as well. Though there have been improvements for older children, dental caries in younger children has not decreased in the last decade. Since most younger children visit a paediatrician more often than a dentist, there is an opportunity for paediatricians to make a significant contribution to improving the oral health, and overall health, of their patients. This AAP Policy Statement discusses various factors contributing to dental caries, its treatment and prevention. It also provides suggestions and guidance for paediatricians to make oral health and prevention an integral part of their practice.

Design

In the United States, the rate of dental caries has actually increased significantly in children 2 to 4 years of age from 19% (1999) to 24% (2004). Children from poor families experience a significantly higher risk. As most families have an established relationship with a paediatrician long before their child’s first dental visit, it is important that paediatricians take an active part in the prevention and treatment of dental caries. By controlling some of the various factors involved in caries formation, paediatricians and parents can actually prevent, stop, or even reverse the process of the disease. Naturally, prevention before the first signs of the disease is the most desirable outcome. It is important that paediatricians understand the science of caries and that they are able to perform a caries risk assessment as well as apply prevention and intervention strategies. Another important factor is the early establishment of a dental home for children. By building and maintaining relationships with local dentists and providing early referrals to dentists, paediatricians can help increase access to dental care for all children. Integrating oral health into the daily practice of paediatrics can have a significant, positive impact on the overall health of young children.

Results

• “Oral health is an integral part of the overall health and well-being of children.”
• Paediatricians should include oral health guidance as a part of patient counselling.
• “The risk of caries is greatest if sugars are consumed at high frequency and are in a form that remains in the mouth for long periods of time.”
• “Discourage putting a child to bed with a bottle.”
• Encourage parents and caregivers to start brushing children’s teeth as soon as teeth erupt.
• “Advise parents/caregivers to monitor brushing until 8 years of age.”
• Paediatricians are encouraged to build and maintain collaborative relationships with local dentists.
• Every child should have a dental home by 1 year of age.
• “With early referral to a dental provider, there is an opportunity to maintain good oral health, prevent diseases and treat diseases early.”

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