Lupine Publishers | Journal of Pediatric Dentistry
Introduction
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.
