Friday 30 October 2020

Lupine Publishers | Early Interventions to Promote Pediatric Oral Health

 Lupine Publishers | Journal of Pediatric Dentistry


It is well established that dental caries is the most prevalent and preventable chronic disease among children [1]. Preschool years are a critical period of development; poor oral health can create lifelong consequences for one’s overall health outcomes. If oral health needs are not addressed earlier, it may negatively impact a child’s ability to eat, sleep, learn or socialize, further damaging the child’s psychological and social dimensions of well-being [1,2]. Another negative outcome is the need for dental surgery as it accounts for 31% of all surgeries among children under the age of 6 [3]. Caries in childhood is a predictor for adult oral health; this may affect other health conditions such as diabetes or cardiovascular disease over time [2]. Caries is a multifactorial chronic disease influenced by biological, lifestyle, and behavior factors [4]. Risk factors for early childhood caries include: bacteria transmission from mother to infant [5]; the social determinants of health [2]; parental knowledge [6], attitudes and behaviors towards oral health (e.g., diet, pacifier use, and daily tooth brushing); prolonged bottlefeeding practices [7], and cultural beliefs around primary or “milk teeth” [8,9]. Oral health is connected to socioeconomic status; those with higher income are more likely to access a dentist and have dental insurance coverage [10]. It is important to identify effective interventions targeting preschool children in order to collaborate with the Family Health Division, other Regional departments, and community partners to meet the emerging oral health needs of our community.

Future Directions

The recommendations made decades ago to promote early childhood oral health by establishing a dental home before the first birthday, and providing education and preventive interventions, are crucial components of effective care [11]. Now, as then, dental professionals play a pivotal role by assessing and monitoring the individualized risk of each pediatric patient and applying the latest evidence-based approaches to disease prevention and treatment [12]. Effective care requires a constant review the literature, ongoing assessment of the rapidly evolving understanding of the oral microbiome and its effect on caries progression and implementing management protocols as early as possible. Beyond the clinic, however, it is equally important for dental teams to provide parents/caregivers with the knowledge and skills to make appropriate dietary and lifestyle choices for their children, while ensuring proper oral hygiene and regular dental visits. It is only through these combined efforts that oral disease can be prevented.

Key Takeaways

a) Establishing a dental home before a child’s first birthday ensures a safe place for comprehensive care and allows clinicians to develop recommendations specific to that patient’s individualized risk.

b) Assessing caries risk and implementing preventive strategies are critical elements of pediatric care, particularly for preschoolers and children with special

c) health care needs.

d) Parents and caregivers must be given the means to mitigate the child’s caries risk through effective self-care and healthy lifestyle choices, and by working with dental teams to verify whether the risk management regimen has been effective.

e) It is only through the combined efforts of dental professionals and parents/caregivers that oral disease can be prevented.

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