Pediatric Oral Health
Dental caries is the most prevalent chronic disease in children (and adults) – it is 5-8 times more prevalent than asthma. Early childhood caries can be a rapidly progressive disorder that not only affects primary teeth but also tends to go on to produce severe decay in permanent teeth. There are a variety of interventions that can be implemented in primary care practice that have been demonstrated in controlled studies to reduce the incidence of early decay.
- Identification of kids who are at greatest risk
- 80% of severe decay can be found in 25% of the pediatric population
- Early Childhood caries is a vertically transmitted infection – usually from a primary caregiver
- Adequate dental screening examinations
- Much early decay occurs on the lingual surfaces of the teeth and so will not be picked up on frontal examination.
- Appropriate fluoride use.
- A recent study in North Carolina where family physicians and pediatricians used topical fluoride on Medicaid patients showed a reduction of 35-50% in decay.
- However, the CDC notes that there is no evidence for fluoride supplementation in low-risk children under the age of 6 years.
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- Early referral of high-risk children to a dental provider
- The American Academy of Pediatrics and the American Dental Association recommends that every child at high risk for caries should have an established dental home by age one year.
Oral Health in pregnancy
Severe periodontal disease in pregnancy is associated with a very high incidence of prematurity and low birth weight. Early referral to and treatment by a dental professional can reduce the incidence of these adverse outcomes.
If you would like to learn more, there is an ongoing program to improve oral health care in primary care practice. There are programs for early childhood, middle childhood through adolescence, and for pregnant women. Originally funded by the Endowment for Health, the program now receives funding from the Delta Dental Foundation. Through the Southern NH AHEC, accredited CME can be provided at no cost to help your practice implement measures to improve screening and early treatment of these disorders.
On the Web: www.snhahec.org. click on programs/lunch and learns.
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