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FIRST EDITION

Quality Resource Guide

Early Childhood Oral Health in the General Dentistry Office

MetLife designates this activity

for 1.0 continuing education credit

for the review of this

Quality Resource Guide and successful

completion of the post test.

Author Acknowledgements

Rocio B. Quinonez, DMD MS MPH

Associate Professor

Depts. of Pediatric Dentistry and Pediatrics

Schools of Dentistry and Medicine

University of North Carolina at Chapel Hill

Gentry Byrd, DDS

Pediatric Dental Resident

Department of Pediatric Dentistry

School of Dentistry

University of North Carolina at Chapel Hill

Drs. Quinonez and Byrd have no

relevant financial relationships to

disclose.

The following commentary highlights

fundamental and commonly accepted

practices on the subject matter. The

information is intended as a general overview

and is for educational purposes only. This

information does not constitute legal advice,

which can only be provided by an attorney.

New York, NY. All materials subject to

this copyright may be photocopied for the

noncommercial purpose of scientific or

educational advancement.

Published June 2015.

Expiration date:

December 2018.

The content of this Guide

is subject to change as new scientific

information becomes available.

MetLife is an ADA CERP Recognized Provider.

ADA CERP is a service of the American Dental

Association to assist dental professionals

in identifying quality providers of continuing

dental education. ADA CERP does not approve

or endorse individual courses or instructors,

nor does it imply acceptance of credit hours by

boards of dentistry.

Concerns or complaints about a CE provider

may be directed to the provider or to ADA

CERP at www.ada.org/goto/cerp.

Accepted Program Provider FAGD/MAGD

Credit 11/01/12 - 12/31/16

Address comments to:

dentalquality@MetLife.com

MetLife Dental

Quality Initiatives Program

501 US Highway 22

Bridgewater, NJ 08807

Educational Objectives

Following this unit of instruction, the practitioner

should be able to:

Provide an overview of contemporary views of

early childhood oral health.

Deliver essential preventive oral health

messages for infants and toddlers to their

caretakers.

Discuss early childhood milestones and their

applications to clinical practice.

Describe strategies for effective examination

and fluoride application in young children.

Contemporary Views of

Early Childhood Oral Health

espite a general decline in dental disease, a

rise in dental caries has been observed among

preschool aged children.

Early Childhood Caries

(ECC) remains the most common chronic disease of

childhood, five times more prevalent than asthma.

While preliminary findings from the Centers for Disease

Control and Prevention indicate a recent decrease in

untreated dental disease in children, the more relevant

question is what dental providers can do to prevent

ECC, avoid its associated morbidity, and not miss the

opportunity to influence oral health trajectories at an

early age.

2-4

The American Academy of Pediatric Dentistry (AAPD)

has advocated since 1986 that children have their

first dental visit by age 1.

This recommendation is

primarily based on literature supporting the strong

association between maternal and child oral health and,

the chemotherapeutic benefits of fluoride exposure in

early childhood.

5-8

The American Academy of Pediatric

Medicine (AAP) modified their recommendation in 2003

for the first dental visit from age 3 to age 1, paralleling

the AAPD’s guideline. The difference between the

statements from these two organizations is related to

situations of limited access to dentists where the AAP

recommends children at low risk for dental disease

receive preventive oral health services in their medical

home until a dental referral is possible.

9-10

While these guidelines continue to be updated, the

fundamental recommendations on the timing of the first

dental visit have remained unchanged since 2003, and

are now endorsed by various national organizations.

11-12

Children who receive early care are more likely to have

a higher number of preventive visits and decreased

dental costs.

13-15

A recent systematic review of the

importance of preventive dental visits from a young age

indicates that while the evidence of early preventive

care is limited, the benefits are greatest among high risk

children less than 3 years of age or those with active

dental disease.

Despite the documented benefits of early preventive

dental care, a number of barriers are present for providers

wishing to care for young children. These include

lack of appropriate training, comfort in managing the

young child patient, and low reimbursement.

17-19

General

dentists provide the largest amount of young children’s

oral health care. This Quality Resource Guide highlights

the principles of the Baby Oral Health Program (bOHP)*

model of oral health care in early childhood. It provides

the dental team with the fundamentals of preventive

messaging to caretakers of infants and toddlers and

provides developmental-appropriate strategies to

promote comfort in examining and delivering fluoride

varnish to young children.

* bOHP is a free website (

www.babyoralhealthprogram.org

)

that has various resources, including training videos for the dental

team, outlining implementation of an infant and toddler oral

health program into clinical practice.