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Physicians and Dentists: Allies in Preventive Health for Children

CHICAGO, Illinois – A recent survey of pediatricians and family practitioners shows that physicians who received little or no preventive oral education had less relevant oral knowledge and felt less confident about their overall dental knowledge than those who received some oral education. In the September/October issue of Pediatric Dentistry, the Journal of the American Academy of Pediatric Dentistry, Olga M. Sánchez, DMD, MS, et al., reports that 82 percent of physicians perform oral examinations during pediatric physical exams, but the lack of information physicians receive during medical training may actually limit patient access to preventive oral health. Physicians are often considered by the medical and dental communities to be responsible for the oral health of infants. Physicians who responded to the survey stated they frequently monitor fluoride intake and supplementation as a means of preventing dental decay. However preventive measures such as prenatal counseling, nutritional counseling and sealants were not consistently favored by respondents. Alarmingly, only 12 percent of the physicians felt they adequately understand the function of sealants, which can prevent almost half of dental decay.

Pediatric dentists hope to use the survey as evidence that pediatric primary care providers need further education on contemporary preventive dentistry for children. Overall, about 80 percent of the physicians surveyed received two hours or less of preventive dental education during their entire medical and specialty training.

Educating physicians-in-training, however, is not the only solution. A key finding of the survey was the lack of consistency on pediatric dental guidelines among health providers themselves. For example, the AAPD recommends first visits when the first tooth comes in, or no later than 12 months. The American Academy of Pediatrics (AAP) continues to recommend first visits at 36 months and the American Academy of Family Practice follows AAP guidelines.

In fact, the traditional time for the first dental visit was thought to be age three. The rationale was that children were more manageable and therefore treatment was more efficient. However by this time, children's oral health may already be compromised. Early intervention provides the opportunity to educate parents in proper oral hygiene, prevention of dental injuries and prevention of nursing caries by establishing proper feeding habits. All pediatric health providers are challenged with establishing common oral health guidelines to improve the health of children.

Pediatric Dentistry is the bimonthly didactic publication of the American Academy of Pediatric Dentistry. Pediatric dentists are primary care providers who also provide comprehensive treatment for infants, children, adolescents, and patients with special health care needs.

SOURCE: American Academy of Pediatric Dentistry

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