Bright Futures in Practice: Oral Health Pocket Guide National Maternal and Child Oral Health Resource Center
 

INTRODUCTION

Resistance to tooth decay in infants, children, and adolescents is determined partly by physiology and partly by behaviors. The younger the child when tooth decay begins, the greater the risk of future decay. Therefore, delaying the onset of tooth decay may reduce long-term risk for decay. For this reason, the time to begin preventing oral disease, especially tooth decay, is when teeth begin to erupt.

The first oral examination should occur within 6 months of the eruption of the first primary tooth, and no later than age 12 months. Thereafter the child or adolescent should be seen according to a schedule recommended by the dentist, based on the child’s or adolescent’s individual needs and susceptibility to disease.

When an oral examination by a dentist is not possible, an infant should begin to receive oral health risk assessments by age 6 months by a pediatrician or other qualified health professional. Infants within one of the risk groups listed below should be entered into an aggressive anticipatory guidance and intervention program administered by a dentist as soon as possible. Risk groups are as follows:

  • Infants with special health care needs
  • Infants of mothers with a high rate of tooth decay
  • Infants with demonstrable tooth decay, plaque, demineralization, and/or staining
  • Infants who sleep with a bottle
  • Late-order offspring
  • Infants from families of low socioeconomic status

All infants, children, and adolescents need a dental home. A dental home is a comprehensive, continuously accessible, and affordable source of oral health care under the supervision of a dentist. The first visit establishes the dental home. This visit presents an opportunity to implement preventive health practices and reduce the risk for preventable oral disease.

A dental home should be able to provide the following:

  • An accurate risk assessment for oral diseases and conditions
  • An individualized preventive dental health program based on risk assessment
  • Anticipatory guidance about growth and development issues (e.g., teething; thumb, finger, or pacifier habits; feeding practices)
  • A plan for emergency dental trauma management
  • Information about proper care of teeth and oral soft tissues
  • Information about proper nutrition and dietary practices
  • Comprehensive oral health care in accordance with accepted guidelines and periodicity schedules for pediatric oral health
  • Referrals to other dental specialists, such as endodontists, oral surgeons, orthodontists, and periodontists, when care cannot be provided directly within the dental home

If the infant, child, or adolescent does not have a dental home, help parents find a source of care by doing the following:

  • Provide a referral to a dentist in your community. Contact your state or local pediatric dental society or dental society or pertinent national organizations for a list of such dentists. The following national organizations may be helpful in locating dentists:

American Academy of Pediatric Dentistry
211 East Chicago Avenue, Suite 700
Chicago, IL 60611-2663
(312) 337-2169
To find a pediatric dentist:
http://www.aapd.org/finddentist

American Dental Association
211 East Chicago Avenue
Chicago, IL 60611-2678
(312) 440-2500
To find a dentist:
http://www.ada.org/public/disclaimer.asp

  • Work with local agencies to determine an infant’s, child’s, or adolescent’s eligibility for public assistance programs such as Medicaid or the State Children’s Health Insurance Program or other source of funding for oral health care, and help families enroll in these programs or obtain such funding.