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PEDIATRIC ORAL HEALTH

Concept of the Dental Home

Establishment of 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. 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 involves ongoing interactions between the patient, parents, dentists, dental professionals, and nondental professionals, which increases awareness of the 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 that cares for children and their 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 on age-appropriate preventive measures. This includes 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 & Perinatal Factors & 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 about the potential consequences of their own oral health, which may impact their systemic health, pregnancies, and the well-being of their children. This information should include the importance of maintaining an adult dental home for preventive care and management of oral disease. Pregnancy-related gingivitis commonly occurs and, if untreated, may result in periodontal disease. Untreated dental caries can lead to pain and infection. 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 establish with caregivers (1) the goals of oral health, (2) their role in reaching these goals, (3) motivate them to learn and practice optimal preventive oral health behaviors, and (4) a long-term dental care relationship.

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