On a daily basis in pediatric dental practices across Canada, practitioners are confronted by a severely destructive form of tooth decay that is most commonly seen in children under the age of three years, referred to as early childhood caries (ECC).1 Although we are often times called upon to treat these children once the caries has advanced into the pulp of the tooth or an infection is present, we can’t help but think to ourselves “I wish I would have seen this child sooner to help prevent the caries!”
Although taught otherwise the majority of general dentists are still recommending that a child’s first dental visit take place at three years of age.2 This recommendation is most likely based upon two fundamental facts. Firstly, that there is an inability for most young children to cooperate in a dental setting and secondly, that there is a lack of general practitioner training and experience in the area of infant dental care.3 However such a recommendation definitely is not based on the absence of dental disease in children under the age of three years of age. In order to prevent ECC and other oral diseases, patients and their parents need to be seen much earlier than three years of age.
The Canadian and American Academies of Pediatric Dentistry (CAPD and AAPD) recommend that all children have their first visit to the dentist to establish a dental home no later than 12 months of age.1 The concept of a dental home refers to the establishment of an early relationship between the child, parent(s) and the dentist. This initial meeting allows the dentist to record a thorough medical and dental history, complete a thorough oral examination, establish the child’s risk of developing dental disease (including a caries-risk assessment, establish a patient-specific recall interval and educate the parent(s) or care-giver(s) early on to prevent dental disease.1 It is important at this initial visit that the dentist discuss with the parent(s) the relationship between the child’s diet and dental caries and stress the importance of infant specific oral hygiene instruction. Other relevant topics for discussion at this visit include the use of fluoride with young children and the potential spread of bacteria such as streptococcus mutans from parents to their infants. General dentists should be ready to answer any questions parents may have regarding their child’s oral health. Therefore, the responsibility is on the practitioner to stay current with guidelines and recommendations regarding infant oral health.
With this issue of Oral Health being my first as pediatric editor, I felt it fitting to start with the topic of infant oral health. The articles in this issue focus on making the general dentist more comfortable with topics such as how to conduct a comprehensive infant exam, and factors affecting early childhood caries. The intent is that if dentists are better informed in these areas they are more inclined to see and treat young children in their offices and therefore help start these patients off on the right foot. OH
1. Reference Manual 2009-10. Pediatric Dentistry. Special issue. 31(6):13. 2009.
2. Brickhouse TH, Unkel JH, Kancitis I, Best AM, Davis RD. Infant Oral Health: A Survey of General Dentists, Pediatric Dentists and Pediatricians in Virginia. Pediatric Dentistry. 30(2): 147-152. 2008.
3. Nowak AJ, Casamassimo PS. The dental home: A primary care oral health concept. J Am Dent Assoc. 110: 184-6. 2002.
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