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PEDIATRIC ORAL HEALTH

Concept of the Dental Home

Establishment of a dental home during the infant phase provides a vital foundation for oral health promotion and prevention of oral disease, such as early childhood caries. Analogous to the American Academy of Pediatrics concept of a medical home, the dental home has been defined by the American Academy of Pediatric Dentistry as “the ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way.” The dental home encompasses all aspects of oral health that result from the interaction of the patient, parents, dentists, dental professionals, and nondental professionals. A dental home is initiated by the determination of involved individuals and their collaborative interaction to establish awareness of factors influencing the patient’s oral health.

Achieving optimal oral health care as part of a dental home requires a dentist who is knowledgeable about pediatric oral health or a pediatric dentist (a specialist in care for children and those with more complex oral health needs), in partnership with the child’s primary caregiver. Together, the dentist and primary caregiver can develop a comprehensive preventive program based on an assessment of disease susceptibility. Similar to preventive care guidelines as part of a medical home, the preventive oral health plan for children provides anticipatory guidance for caregivers on age-appropriate preventive measures. These include oral hygiene practices, the importance of fluoride, dietary guidance, dental trauma, and the value of a dental home.

Addressing risk factors for early childhood caries is a central component of anticipatory guidance during routine visits to medical and dental providers. Beyond the focus on preventive oral health, the dental home provides access to comprehensive, routine, and urgent dental care, and facilitates referral to other dental and medical providers as indicated. By providing continuously accessible dental care, the time and cost of urgent or emergent dental treatment may be reduced for the family and society.

Prenatal and Perinatal Factors and Infant Oral Health Care

Oral health promotion by health care providers during the prenatal and perinatal periods provides preventive information to mothers and other family members. Mothers may be unaware of the potential consequences of their own oral health, which can impact their systemic health, pregnancies, and the well-being of their children. Also, a mother’s and/or primary caregiver’s oral health knowledge, behaviors, and attitudes have an influence on the oral health trajectory of children. Infant oral health care is the foundation for preventive dental care. The infant oral health program should (1) establish with caregivers the goals of oral health, (2) inform caregivers of their role in reaching these goals, (3) motivate caregivers to learn and practice optimal preventive oral health behaviors, and (4) initiate a long-term dental care relationship with caregivers. These goals are enhanced through anticipatory guidance on topics such as teething, oral hygiene, ...

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