The American Academy of Pediatric Dentistry (AAPD) and the American Dental Association (ADA) encourages the idea of establishing a “Dental Home” no later than the age of one. This is an ongoing relationship with the Primary Dental Care Provider and the patient, that includes a comprehensive oral health care plan. This ensures that the child’s oral health care is overseen and managed in a coordinated, comprehensive, continually accessible and family centered way. A Dental Home also ensures appropriate referral to dental specialists when further services are needed outside of the patient’s Primary Dental Care Provider.
A DENTAL HOME SHOULD PROVIDE THE FOLLOWING:
1. Comprehensive oral health care, including acute care and preventive services.
2. Comprehensive assessment for oral diseases and conditions.
3. An individualized preventive dental health health program based upon a caries-risk assessment and a periodontal disease risk assessment.
4. Anticipatory guidance about growth and development issues (ie., teething, digit or pacifier habits).
5. A plan for acute dental trauma.
6. Information about proper care of the child’s teeth and gums. This would include the prevention, diagnosis, and treatment of disease of the supporting and surrounding tissues and the maintenance of health, function and esthetics of those structures and tissues.
7. Referrals to dental specialists when care cannot directly be provided within the dental home.
KEY MESSAGES FOR PARENTS:
1. First visit by the child’s first birthday. A child should visit the dentist within six months of the eruption of the first tooth or by age one. Early examination and preventive care will protect your child’s smile now and in the future.
2. Dental problems can begin early. A big concern is Early Childhood Caries (also known as baby bottle tooth decay or nursing decay). Children risk severe decay from using a bottle during naps or at night or when they nurse continuously from the breast.
3. The earlier the dental visit, the better the chance of preventing dental problems. Children with healthy teeth chew food easily, are better able to learn to speak clearly, and smile with confidence. Start children now on a lifetime of good dental habits.
4. Encourage children to drink from a cup as they approach their first birthday. Children should not fall asleep with a bottle in their mouths. At-will nighttime breast-feeding should be avoided after the first primary teeth begin to erupt. Drinking juice from a bottle should be avoided. When juice is offered, it should be in a cup.
5. Children should be weaned from the bottle at 12-14 months of age.
6. Thumb sucking is perfectly normal for infants; most stop by age 2 and it should be discouraged after age 4. Prolonged thumb sucking can create crowded, crooked teeth or bite problems. Dentists can suggest ways to address a prolonged thumb sucking habit.
7. Never dip a pacifier into honey or anything sweet before giving it to a baby.
8. Limit frequency of snacking; this can increase a child’s risk of developing cavities.
9. Parents should ensure that young children use an appropriate sized toothbrush with a small brushing surface and only a pea-sized amount of fluoride toothpaste at each brushing. Young children should always be supervised while brushing and taught to spit out rather than swallow toothpaste. Unless advised to do so by a dentist or other health professional, parents should not use fluoride toothpaste for children less than 2 years of age.
10. Children who drink primarily bottled water may not be getting the fluoride they need.
11. From six months to age 3, children may have sore gums when teeth erupt. Many children like a clean teething ring, cold spoon, or cold wet washcloth. Some parents simply rub the baby’s gums with a clean finger.
12. Parents and caregivers need to take care of their own teeth so that cavity causing bacterias are not as easily transmitted to children. Don’t clean pacifiers and eating utensils with your own mouth before giving them to your children, this transmits bacteria from the adult to the child.
Dental cavities continue to be the most chronic disease of childhood. Fluoride has been a major factor in the decline in prevalence and severity of cavities in the US. There is confirmation from evidence based reviews that professionally applied treatments are effective in reducing and preventing future tooth decay.
Fluoride works to prevent dental cavities by inhibiting tooth demineralization and bacterial metabolism, and enhancing remineralization. Newer studies also suggest that fluoride interferes with bacterial adherence to the teeth. It plays a major role in maintaining good teeth and preventing oral disease. The topical effect provides the majority of the benefit.
Fluoride Recommendations-
1. From the time that the first tooth emerges until 3yrs of age, fluoride toothpaste the size of a grain of rice should be used to brush the teeth both morning and night.
2. For children older than 3 years, or when a child can effectively spit, a pea sized amount of fluoride toothpaste should be applied morning and night.
3. Routine topical fluoride treatments by a Primary Dental Care provider.
The safety of fluoride has been demonstrated in numerous research studies by the Centers for Disease Control and Prevention (CDC).
