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PEDIATRIC ORAL HEALTH
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Concept of the Dental Home
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Establishing a dental home, by age 1 year or when the first tooth erupts, provides a vital foundation for oral health promotion and prevention of oral disease, such as early childhood caries (ECC). The American Academy of Pediatric Dentistry describes the dental home 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 involves ongoing interactions among patients, parents, dentists, dental professionals, and nondental professionals, which increases awareness of factors influencing oral health.
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Achieving optimal oral health care as part of a dental home requires a general dentist knowledgeable about pediatric oral health or a pediatric dentist as a specialist for children and complex oral health needs. Together, the dentist and primary caregiver can develop a comprehensive preventive program based on disease susceptibility. Similar to preventive guidance as part of a medical home, a preventive oral health plan for children provides anticipatory guidance on age-appropriate measures. This includes oral hygiene practices, importance of fluoride, dietary guidance, dental trauma prevention, and benefits of a dental home. Addressing risk factors for ECC is a vital component of anticipatory guidance during routine visits to medical and dental providers.
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Prenatal & Perinatal Factors & Infant Oral Health Care
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During the prenatal and perinatal periods, medical care providers should provide preventive information to mothers about the potential consequences of their oral health, which may impact their own health and pregnancies. Pregnancy-related gingivitis commonly occurs and, if untreated, may result in periodontal disease. 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.
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During the postnatal period, oral health promotion provides an opportunity for caregivers to establish the foundation for preventive oral health. This enables caregivers to (1) develop oral health goals, (2) their role in reaching these goals, and (3) learn and maintain optimal preventive oral health behaviors. Typically, pediatricians encounter newborns and infants at an earlier age than dental providers, providing an opportunity for early oral health promotion to address risk factors associated with ECC. Pediatricians are encouraged to incorporate caries-risk assessment and anticipatory guidance focused on oral health in their practice.
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Caries-risk assessment estimates the likelihood of developing disease based on the complex interaction of risk factors at multiple levels. Caries-risk assessment forms are available to physicians and other nondental health care providers through the American Academy of Pediatric Dentistry and American Academy of Pediatrics. By 6 months of age, every infant should have a caries-risk assessment performed by a pediatric health care provider. Since the risk of caries increases with age, anticipatory guidance by pediatricians and nondental health care providers is recommended beyond age 3 years as part of routine pediatric ...