Resident: M. Swan
Article Title: Caries Prevention and Reversal Based on the Caries Balance
Author: John D.B. Featherstone, MSc, PhD
Journal: Pediatric Dentistry
Volume (number) 28:2 2006
Month/Year: March/April 2006
Major Topic: Using the caries balance concept to drive treatment planning
Minor Topic:
Type of Article: Conference Paper
Main Purpose: To encourage clinicians to make practical use of the caries balance model as they help patients combat the progression of caries
Overview of Method of research: This article is essentially a position paper, but one study regarding caries management by risk assessment is detailed in the article. The subjects in this study were adults, age 18 and older, with 1 to 7 cavitated lesions at baseline who were then randomized to either a "conventional care" control group or to a preventive intervention group. Saliva samples were taken each month for MS, lactobacilli, and fluoride evaluation. Caries exams conducted baseline and 2 years after all restorations of the cavitated lesions were completed. The intervention group used chlorhexidine gluconate .12% rinse, fluoride toothpaste daily, and .05 % NaF rinse. Caries risk status was assessed every 6 months.
Findings: MS counts fell greatly in the intervention group, and a reduction in caries risk status was strongly correlated with reduction in numbers of decayed teeth. The authors concluded that a targeted, combined antibacterial and fluoride therapy beneficially altered caries risk status and the incidence of caries.
Key Points/Summary: In this article, Dr. Featherstone highlights the "caries balance," or the balance between mineralization and demineralization that constantly fluctuates in the mouth. This balance is determined by the relative influence, or weights, of the various pathological factors, including
1. acid producing bacteria
2. frequent eating/drinking of fermentable carbs
3. inadequate saliva flow and function
and Protective Factors, such as
1. saliva flow and components
2. fluoride
3. antibacterials (Chlorhexidine, Xylitol, etc.)
The author observes that while we as clinicians know the science behind caries development, we fail to implement all the tools available to turn the process around. He advocates use of this caries balance model in treatment planning for individual patients. Simply put, we need to reduce pathological factors and increase protective factors for our patients.
Assessment of Article: Shenanigans are not an option for Dr. John D.B. Featherstone. This is a helpful article that uses a simple "seesaw" concept to explain a complex subject. I wonder if we should be prescribing more antibacterial mouth rinse and dispensing xylitol-containing products/fluoride rinses to our high-risk population in the clinic, particularly the older kids. Doing so could very possibly help curb the caries rate.
Thursday, July 29, 2010
Resident’s Name: Ara Cho Program:
Article title: Infant Oral Health Education for Pediatric and Family Practice Residents
Author(s): Douglass, J.M.
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2005. 27. 284-291.
Major topic: Oral Health Education
Minor topic: Fluoride
Type of Article: Scientific Article
Main Purpose: To examine whether infant oral health curriculum implemented in pediatric and family medicine residency programs can improve oral health knowledge and practice behaviors.
Overview of method of research: 120 residents and faculty from four pediatric and family residencies in
Findings: More practitioners referred children to the dentist at age 1 after the oral health education seminar. 28% initially were referring patients; after the training session at 1 YFU, 73% were referring children to the dentist at age 1. The percentage of participants giving dental nutrition advice and detailed tooth-brushing advice increased. Knowledge of fluoride prescription was limited at baseline reports and remained limited at 1 YFU.
Key points/Summary: From the results of the study, infant oral health education program did improve knowledge of oral health for pediatric and family practice residents, particularly for referring children to dentist at age 1 and “healthy snacks” However, improving the knowledge of prescribing fluoride remained limited. The use of well child care prompts was considered a key component in reinforcing oral care.
Assessment of Article: Relevant article. A weakness is that all the participants did not receive the same training. Some completed all of the training, while others completed the full two hours of training. This discrepancy may have affected the results of the study. This article demonstrates that there is value in training physicians in oral health prevention – it may guide patients to seek dental care at an earlier age, which may allow dentists to address oral problems before it is too late.
Oral colonization of Streptococcus mutans in Six-month-old Predentate Infants
Resident’s Name: Jessica Wilson
Program: Lutheran Medical Center - Providence
Article title: Oral colonization of Streptococcus mutans in Six-month-old Predentate Infants
Author(s): AKL Wan, WK Seow, DM Purdie, PS Bird, LJ Walsh, and DI Tudehope.
Journal: Dental Research
Year. Volume (number). Page #’s: 2001. 80(12). 2060-2065
Major topic: S. mutans colonization in infants
Overview of method of research:
Cotton swab samples were taken from 6o pre-term and 112 full-term six-month-old infants and their mothers (confirmed by repeat sampling 3 mo. later). Subjects were recruited randomly at birth at a hospital. SES, feeding habits and medical conditions were gathered by interview and questionnaires and confirmed with medical records.
Findings:
Every child that initially tested positive for S. mutans also tested positive at repeat sampling. Overall 50% pre-term and 60% pre-term predentate infants were found to be infected with S. mutans. Similar results were found when comparing pre-term and full-term infants throughout the study.
Key points/Summary:
-Most significant factor in the colonization of S. mutans in infants was an increased intake of sugar. Next was breastfeeding and then transfer from mother to child.
-Infants who slept next to their mothers, were breast fed on demand, received more than one feeding during the night and started solid foods at an earlier age were more likely to be infected.
-Mothers with infected infants had poorer oral hygiene, more perio disease, lower SES and snacked more frequently. However, a mother’s caries experience did not have a significant effect on their child’s S. mutans status.
-Multiple (at least 5) courses of antibiotics as well as daily cleaning of infants gums were found to be associated with the non-colonization of S. mutans.
Assessment of Article:
Good study, helps us to understand more of the underlying causes of the presence of cariogenic bacteria in infants as well as the possible modes of transmission from mother to child. It also reinforces the idea that antibiotic administration might one day be a preventative measure for oral colonization.
Program: Lutheran Medical Center - Providence
Article title: Oral colonization of Streptococcus mutans in Six-month-old Predentate Infants
Author(s): AKL Wan, WK Seow, DM Purdie, PS Bird, LJ Walsh, and DI Tudehope.
Journal: Dental Research
Year. Volume (number). Page #’s: 2001. 80(12). 2060-2065
Major topic: S. mutans colonization in infants
Overview of method of research:
Cotton swab samples were taken from 6o pre-term and 112 full-term six-month-old infants and their mothers (confirmed by repeat sampling 3 mo. later). Subjects were recruited randomly at birth at a hospital. SES, feeding habits and medical conditions were gathered by interview and questionnaires and confirmed with medical records.
Findings:
Every child that initially tested positive for S. mutans also tested positive at repeat sampling. Overall 50% pre-term and 60% pre-term predentate infants were found to be infected with S. mutans. Similar results were found when comparing pre-term and full-term infants throughout the study.
Key points/Summary:
-Most significant factor in the colonization of S. mutans in infants was an increased intake of sugar. Next was breastfeeding and then transfer from mother to child.
-Infants who slept next to their mothers, were breast fed on demand, received more than one feeding during the night and started solid foods at an earlier age were more likely to be infected.
-Mothers with infected infants had poorer oral hygiene, more perio disease, lower SES and snacked more frequently. However, a mother’s caries experience did not have a significant effect on their child’s S. mutans status.
-Multiple (at least 5) courses of antibiotics as well as daily cleaning of infants gums were found to be associated with the non-colonization of S. mutans.
Assessment of Article:
Good study, helps us to understand more of the underlying causes of the presence of cariogenic bacteria in infants as well as the possible modes of transmission from mother to child. It also reinforces the idea that antibiotic administration might one day be a preventative measure for oral colonization.
Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs
Resident: Adam J. Bottrill
Date: 29JUL10
Region: Providence
Article title: Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs
Author(s): Savage, M. et al
Journal: Pediatrics
Page #s: pp. 417-423
Year: 2004
Major topic: Early Preventative Visits
Minor topic(s): NA
Type of Article: Investigational Study
Main Purpose: To determine the effects of early preventive dental visits on subsequent utilization and costs of dental services among preschool-aged children.
Key points in the article discussion:
I. Methods:
A. 53,591 Medicaid-enrolled children born in 1992. 9204 continuously enrolled for 5 years and met inclusion criteria. The cohort study monitored these children longitudinally until their 5th birthday in 1997.
B. Mother's mean age: 23. Mother's mean educational level: grade 11.
C. First Dental Visit
1. 1/3 of these children received 1st dental visit during the study (seriously?)
2. <1yo: 23, 1-2yo: 249, 2-3yo: 465, 3-4yo: 915, 4-5yo: 823
II. Results and Discussion:
A. Children with "1st visit" <1yo were more likely to have subsequent PREVENTATIVE visits. Those with later "1st visits" were more likely to have subsequent RESTORATIVE and EMERGENCY visits.
B. Average cost of dental care during the study period (by age of "1st visit")
1. <1yo: $262, 1-2: $340, 2-3: $450, 3-4: $492, 4-5: $547.
C. It was found that total dental vists of all types increased with those children who lived in counties where there was increased access to care.
III. Limitations:
A. This was a retrospective cohort study with possible selection bias.... however, a prospective study with the same scope would be very difficult.
B. This study is based on claims... NOT actual caries rate.
IV. Conclusions:
A. Broad generalizations of these findings should be made with caution.
B. Under the conditions of this study, however...
1. Preschool-aged children were more likely to receive dental services of all types in counties with increased concentration of dentists.
2. Preschool-aged children from minority groups had greater difficulty in finding access to dental care,
3. Preschool-aged children who had an early preventive appt were likely to use preventive services subsequently.
4. Preschool-aged children who used early preventive care incurred fewer dentally related costs, compared with children who began care at a later date.
Assessment of article: Great article. I know there are weaknesses and limitations, however I see the conclusions as "ammunition" to help us convince parents to bring their kids in EARLY! No shenanigans here.
Date: 29JUL10
Region: Providence
Article title: Early Preventive Dental Visits: Effects on Subsequent Utilization and Costs
Author(s): Savage, M. et al
Journal: Pediatrics
Page #s: pp. 417-423
Year: 2004
Major topic: Early Preventative Visits
Minor topic(s): NA
Type of Article: Investigational Study
Main Purpose: To determine the effects of early preventive dental visits on subsequent utilization and costs of dental services among preschool-aged children.
Key points in the article discussion:
I. Methods:
A. 53,591 Medicaid-enrolled children born in 1992. 9204 continuously enrolled for 5 years and met inclusion criteria. The cohort study monitored these children longitudinally until their 5th birthday in 1997.
B. Mother's mean age: 23. Mother's mean educational level: grade 11.
C. First Dental Visit
1. 1/3 of these children received 1st dental visit during the study (seriously?)
2. <1yo: 23, 1-2yo: 249, 2-3yo: 465, 3-4yo: 915, 4-5yo: 823
II. Results and Discussion:
A. Children with "1st visit" <1yo were more likely to have subsequent PREVENTATIVE visits. Those with later "1st visits" were more likely to have subsequent RESTORATIVE and EMERGENCY visits.
B. Average cost of dental care during the study period (by age of "1st visit")
1. <1yo: $262, 1-2: $340, 2-3: $450, 3-4: $492, 4-5: $547.
C. It was found that total dental vists of all types increased with those children who lived in counties where there was increased access to care.
III. Limitations:
A. This was a retrospective cohort study with possible selection bias.... however, a prospective study with the same scope would be very difficult.
B. This study is based on claims... NOT actual caries rate.
IV. Conclusions:
A. Broad generalizations of these findings should be made with caution.
B. Under the conditions of this study, however...
1. Preschool-aged children were more likely to receive dental services of all types in counties with increased concentration of dentists.
2. Preschool-aged children from minority groups had greater difficulty in finding access to dental care,
3. Preschool-aged children who had an early preventive appt were likely to use preventive services subsequently.
4. Preschool-aged children who used early preventive care incurred fewer dentally related costs, compared with children who began care at a later date.
Assessment of article: Great article. I know there are weaknesses and limitations, however I see the conclusions as "ammunition" to help us convince parents to bring their kids in EARLY! No shenanigans here.
Development and Integration of Oral Health Services for Preschool age children
Resident: Roberts
Date: 7/30/10
Article title: Development and Integration of Oral Health Services for Preschool age children
Author: Crall, James
Journal: Pediatric Dentistry
Volume 27:4 pages:323 -329
Year: 2005
Discussion:
A National Health and Nutrition Examination Survery found that 60 percent of five year olds exhibited tooth decay by age 5. This number may be higher for low income and ethnic minorities that tend to have less access to health care facilities. Studies have shown that the prevalence of caries increases with age particularly with those that have limited access to oral health services. Considerable attention has been devoted to restructuring the framework that would allow underserved children better access to oral health care. Some of these issues include
- establishing a dental home at an early age
- using risk based approaches such as the “AAPD’s Caries Risk Assessment Tool” to better determine those at high risk for caries
- integrating and increasing coordination of dental and medical professionals
- allowing medical professionals to increase scope of services (including flouride varnish)
- educating both professionals and the public on the importance of oral health
Implementing these strategies to improve access to oral health care will take time and money. As pediatric dentist it is our responsiblity to insure better access to those with the greatest need.
Survey of Iowa General Dentists Regarding the Age 1 Dental Visit
Meghan Sullivan Walsh July 30, 2010 Department of Pediatric Dentistry/LMC -Providence Literature Review
Article Title:
Survey of Iowa General Dentists Regarding the Age 1 Dental Visit
Author:
Jennifer D. Wolfe, DDS; Karin Weber-Gasparoni, DDS, MS, PhD; Michael J. Kanellis, DDS, MS; Fang Qian, PhD
Journal:
Pediatric Dentistry
Volume (number), Year, Page #’s:
28:4, 2006, 325-331
Major topic:
Age one dental visit
Overview of method of research:
Statistical analysis of survey
.
Findings: A survey consisting of 15 items was distributed to Dentists in the state of Iowa. Of the 1,521 surveys, 47%, or 715 surveys, were deemed “useable.” The 15 items consisted of questions regarding the dentist’s demographics, knowledge, attitude, behavior and sources of information concerning the age one dental visit. The results of this survey showed significant differences in behavior and acceptance of young patients based on the following; dentist’s age, years out of dental school, hours worked per week, gender, knowledge of the AAPD’s recommendation, current practice seeing children 0-23 months old, and willingness to accept younger patients. Data indicates that Iowa Dentists with the following criteria are most likely to accept and treat children ages 0 to 23 months old.
1) Young
2) Recent graduates
3) Females
4) Prior knowledge of AAPD recommendations
5) Experience seeing children 0-23 months old
6) Practicing dentistry more hours per week
6) Belief that children should have their first visit at age 0-23
In addition, this study did prove that many positive changes have been made in the overall education, awareness and beliefs towards necessity for early dental care. In comparison from a previous study in Iowa in 1994, there was a significant increase in the willingness to accept a patient 0-23 months old as well as the belief that the children should be seen prior to age two.
Key Points/Summary
The majority of Iowa General Dentists are aware of the AAPD and ADA’s recommendation for the age one dental visit. Iowa General Dentists have made improvements in the past decade towards acceptance of treatment for a child age 0-23 months. There are, however, significant factors and limitations which affect a Dentists decision to treat young children. Improvement can be made regarding Iowa General Dentist’s beliefs, education, knowledge, behavior and intentions towards following the recommendations of the AAPD and the age one dental visit.
Assessment of Article
Although the editor seemed pleased with the percentage of Dentists who are aware of the AAPD recommendations (76%), I found it alarming that only 36% believed that children should be seen prior to age two. The data was predictable as far as the characteristics of the most likely Dentist to accept these young patients. Table One, page 327, which shows the responses of why an office chooses not to treat children ages 0-23 was most interesting. Perhaps use of this table, providing more information and assistance for these offices, can increase willingness and responsibility for the General Dentist.
Article Title:
Survey of Iowa General Dentists Regarding the Age 1 Dental Visit
Author:
Jennifer D. Wolfe, DDS; Karin Weber-Gasparoni, DDS, MS, PhD; Michael J. Kanellis, DDS, MS; Fang Qian, PhD
Journal:
Pediatric Dentistry
Volume (number), Year, Page #’s:
28:4, 2006, 325-331
Major topic:
Age one dental visit
Overview of method of research:
Statistical analysis of survey
.
Findings: A survey consisting of 15 items was distributed to Dentists in the state of Iowa. Of the 1,521 surveys, 47%, or 715 surveys, were deemed “useable.” The 15 items consisted of questions regarding the dentist’s demographics, knowledge, attitude, behavior and sources of information concerning the age one dental visit. The results of this survey showed significant differences in behavior and acceptance of young patients based on the following; dentist’s age, years out of dental school, hours worked per week, gender, knowledge of the AAPD’s recommendation, current practice seeing children 0-23 months old, and willingness to accept younger patients. Data indicates that Iowa Dentists with the following criteria are most likely to accept and treat children ages 0 to 23 months old.
1) Young
2) Recent graduates
3) Females
4) Prior knowledge of AAPD recommendations
5) Experience seeing children 0-23 months old
6) Practicing dentistry more hours per week
6) Belief that children should have their first visit at age 0-23
In addition, this study did prove that many positive changes have been made in the overall education, awareness and beliefs towards necessity for early dental care. In comparison from a previous study in Iowa in 1994, there was a significant increase in the willingness to accept a patient 0-23 months old as well as the belief that the children should be seen prior to age two.
Key Points/Summary
The majority of Iowa General Dentists are aware of the AAPD and ADA’s recommendation for the age one dental visit. Iowa General Dentists have made improvements in the past decade towards acceptance of treatment for a child age 0-23 months. There are, however, significant factors and limitations which affect a Dentists decision to treat young children. Improvement can be made regarding Iowa General Dentist’s beliefs, education, knowledge, behavior and intentions towards following the recommendations of the AAPD and the age one dental visit.
Assessment of Article
Although the editor seemed pleased with the percentage of Dentists who are aware of the AAPD recommendations (76%), I found it alarming that only 36% believed that children should be seen prior to age two. The data was predictable as far as the characteristics of the most likely Dentist to accept these young patients. Table One, page 327, which shows the responses of why an office chooses not to treat children ages 0-23 was most interesting. Perhaps use of this table, providing more information and assistance for these offices, can increase willingness and responsibility for the General Dentist.
07/30/2010 Using Anticipatory Guidance to Provide Early dental Intervention
Resident: J. Hencler
Date: 07/30/2010
Article title: Using Anticipatory Guidance to Provide Early dental Intervention
Author(s): Nowak, Casamassimo
Journal: JADA, Vol. 126, 08/1995
Major topic: Preventative Dental Intervention
Type of Article: Review
Main Purpose:
Explore and consider the need for a different new and improved preventative dentistry approach for children.
Background:
Preventative dentistry for children, which addresses reduction of caries and gingival disease, is driven by an infectious disease model. This tri-factorial model of agent (bacteria), susceptible host (child or tooth surface), and substrate (carbohydrates) still directs the preventative dental counseling approach aimed at reducing or eliminating these factors. This model remains strong, but the limitations of its application are evident in recent changes in caries patterns and consistent high rates of disease in certain pediatric populations.
Key points in the article discussion:
Preventative dental efforts related to children often include efforts to reduce baby bottle tooth decay, dental trauma, and habits such as thumb sucking. Development and inherited disorders, as well as speech and language problems are common findings of dentists who see children of all ages. Dental caries remains a primary concern of the dental profession. Dentists have their hands full with a caries epidemic affecting all ages of patients. Physicians, the first medical practitioners to see a child rarely carry out basic caries prevention strategies such as fluoride supplementation, bottle weaning, and oral hygiene. The medical approach of anticipatory guidance is the process of providing developmentally appropriate info about children to their parents in anticipation of significant physical, emotional, and psychological milestones. This info guides parents by alerting them to impending change, teaching their role in maximizing their children’s development potential and identifying their children’s special needs. The dental approach to anticipatory guidance does not use a developmental approach to prevention, but relies on the infectious-disease model for a basic and often repetitive generic message of brushing, flossing, and using fluoride. Associating the comprehensive preventative message to dental milestones not only helps parents focus their children’s attention but also helps parents and doctors address realistic situations that characterize an age period. The growing trend toward treating children before 3yo provides a great opportunity for dentists to impart info that is truly preventative. As pediatric dentist, we should include the whole range of childhood in an anticipatory guidance program for dental health by developing a content base organized around dental milestones.
Summary of conclusions:
Pediatric dentists have seen a dramatic increase in children’s dental care, which can be attributed to their tendency to see children much earlier and thus capture parents’ interest in important dental milestones. Applying anticipatory guidance to dental preventative education is an organized was for all dental providers to enjoy the attention of parents and be more successful in preventative dentistry. Early dental intervention using an individual approach such as anticipatory guidance may be an ideal and efficient path to dental caries reduction.
Assessment of article:
Good article, much helpful info relating anticipatory guidance to the different milestones. See the tables at end of article. As furure pediatric dentists, I feel we already relate preventative anticipatory guidance with milestones.
In a perfect world this would work, but some people just don’t listen or simply don’t care. How many times have we heard “well aren’t they just baby teeth, they’re just gonna fall out anyway…right?” It’s our duty as pediatric dentists to convince the “non-believer” or simply neglectful parents that “lifetime oral health” begins by instilling the values of good oral hygiene at a very young age. Time to wake up parents! No more tomfoolery!!!
Date: 07/30/2010
Article title: Using Anticipatory Guidance to Provide Early dental Intervention
Author(s): Nowak, Casamassimo
Journal: JADA, Vol. 126, 08/1995
Major topic: Preventative Dental Intervention
Type of Article: Review
Main Purpose:
Explore and consider the need for a different new and improved preventative dentistry approach for children.
Background:
Preventative dentistry for children, which addresses reduction of caries and gingival disease, is driven by an infectious disease model. This tri-factorial model of agent (bacteria), susceptible host (child or tooth surface), and substrate (carbohydrates) still directs the preventative dental counseling approach aimed at reducing or eliminating these factors. This model remains strong, but the limitations of its application are evident in recent changes in caries patterns and consistent high rates of disease in certain pediatric populations.
Key points in the article discussion:
Preventative dental efforts related to children often include efforts to reduce baby bottle tooth decay, dental trauma, and habits such as thumb sucking. Development and inherited disorders, as well as speech and language problems are common findings of dentists who see children of all ages. Dental caries remains a primary concern of the dental profession. Dentists have their hands full with a caries epidemic affecting all ages of patients. Physicians, the first medical practitioners to see a child rarely carry out basic caries prevention strategies such as fluoride supplementation, bottle weaning, and oral hygiene. The medical approach of anticipatory guidance is the process of providing developmentally appropriate info about children to their parents in anticipation of significant physical, emotional, and psychological milestones. This info guides parents by alerting them to impending change, teaching their role in maximizing their children’s development potential and identifying their children’s special needs. The dental approach to anticipatory guidance does not use a developmental approach to prevention, but relies on the infectious-disease model for a basic and often repetitive generic message of brushing, flossing, and using fluoride. Associating the comprehensive preventative message to dental milestones not only helps parents focus their children’s attention but also helps parents and doctors address realistic situations that characterize an age period. The growing trend toward treating children before 3yo provides a great opportunity for dentists to impart info that is truly preventative. As pediatric dentist, we should include the whole range of childhood in an anticipatory guidance program for dental health by developing a content base organized around dental milestones.
Summary of conclusions:
Pediatric dentists have seen a dramatic increase in children’s dental care, which can be attributed to their tendency to see children much earlier and thus capture parents’ interest in important dental milestones. Applying anticipatory guidance to dental preventative education is an organized was for all dental providers to enjoy the attention of parents and be more successful in preventative dentistry. Early dental intervention using an individual approach such as anticipatory guidance may be an ideal and efficient path to dental caries reduction.
Assessment of article:
Good article, much helpful info relating anticipatory guidance to the different milestones. See the tables at end of article. As furure pediatric dentists, I feel we already relate preventative anticipatory guidance with milestones.
In a perfect world this would work, but some people just don’t listen or simply don’t care. How many times have we heard “well aren’t they just baby teeth, they’re just gonna fall out anyway…right?” It’s our duty as pediatric dentists to convince the “non-believer” or simply neglectful parents that “lifetime oral health” begins by instilling the values of good oral hygiene at a very young age. Time to wake up parents! No more tomfoolery!!!
Guideline on Infant Oral Health Care 7/30
Department of Pediatric Dentistry
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence
Article title: Guideline on Infant Oral Health Care
Author(s): Clinical Affairs Committee of the AAPD
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2008. Vol. 29 No. 7. 81-84
Major topic: OHI/ECC guidelines for health care providers
Minor topic(s):
Main Purpose: Review Guidelines
Overview of method of research: Review
Findings:
Caries results from an overgrowth of specific organisms normally occurring in the human oral flora, particularly Step mutans and lactobacillus. Vertical colonization from mother to infant is well documented, and can happen as early as when the child is born. Early education for the mother can help to diminish this.
The CDC reports that caries is the most prevalent of infectious diseases in the US’s children. More than 40% of children have caries by the time they reach kindergarten. ECC, which is a particularly virulent form of caries, begins soon after tooth eruption, develops on smooth surfaces, rapidly progresses, and has a detrimental effect. The disease can affect any population, however it is 32 times MORE likely to occur in infants who are of low socioeconomic status(70% of caries lesions occurs in 20% of US kids), whose mother has a low education level, and who has a poor diet. Caries in children can cause missed school days, affect their growth, pain, possible life threatening infection, and diminish overall quality of life.
Preventive Strategies
Caries is preventable. The steps that need to be taken to prevent caries in a child start during the pre natal period. First, mom needs to be educated. No sharing utensils, no cleaning the pacifier with her mouth, no sugary or high-carb food, no bottle at bedtime, stop bottle use at 1, brush 2x daily, floss daily, use of fluoride, develop a dental home by 12 months, and need for consistent dental care. Also, the Caries Assessment Tool(CAT) can be used to give mom some tangible proof of the child’s overall caries risk.
Key points/Summary:
Recommendations
1.All primary health care prof. Who serve mothers and infants should provide parent/caregiver education on the etiology and prevention of ECC
2. The infectious and transmissible nature of bacteria that cause ECC and methods of oral health assessment(CAT), anticipatory guidance, and early intervention should be included in the curriculum of medical, nursing, and allied health prof. Programs
3. Every infant should receive a CAT by SIX MONTHS
4. Develop a dental home for baby by 12 months
5. Health care professionals and anyone involved with children should advocate for a dental home by 12 months.
Assessment of Article: Good article. No Shenanigans.
Resident’s Name: Murphy Program: Lutheran Medical Center - Providence
Article title: Guideline on Infant Oral Health Care
Author(s): Clinical Affairs Committee of the AAPD
Journal: Pediatric Dentistry
Year. Volume (number). Page #’s: 2008. Vol. 29 No. 7. 81-84
Major topic: OHI/ECC guidelines for health care providers
Minor topic(s):
Main Purpose: Review Guidelines
Overview of method of research: Review
Findings:
Caries results from an overgrowth of specific organisms normally occurring in the human oral flora, particularly Step mutans and lactobacillus. Vertical colonization from mother to infant is well documented, and can happen as early as when the child is born. Early education for the mother can help to diminish this.
The CDC reports that caries is the most prevalent of infectious diseases in the US’s children. More than 40% of children have caries by the time they reach kindergarten. ECC, which is a particularly virulent form of caries, begins soon after tooth eruption, develops on smooth surfaces, rapidly progresses, and has a detrimental effect. The disease can affect any population, however it is 32 times MORE likely to occur in infants who are of low socioeconomic status(70% of caries lesions occurs in 20% of US kids), whose mother has a low education level, and who has a poor diet. Caries in children can cause missed school days, affect their growth, pain, possible life threatening infection, and diminish overall quality of life.
Preventive Strategies
Caries is preventable. The steps that need to be taken to prevent caries in a child start during the pre natal period. First, mom needs to be educated. No sharing utensils, no cleaning the pacifier with her mouth, no sugary or high-carb food, no bottle at bedtime, stop bottle use at 1, brush 2x daily, floss daily, use of fluoride, develop a dental home by 12 months, and need for consistent dental care. Also, the Caries Assessment Tool(CAT) can be used to give mom some tangible proof of the child’s overall caries risk.
Key points/Summary:
Recommendations
1.All primary health care prof. Who serve mothers and infants should provide parent/caregiver education on the etiology and prevention of ECC
2. The infectious and transmissible nature of bacteria that cause ECC and methods of oral health assessment(CAT), anticipatory guidance, and early intervention should be included in the curriculum of medical, nursing, and allied health prof. Programs
3. Every infant should receive a CAT by SIX MONTHS
4. Develop a dental home for baby by 12 months
5. Health care professionals and anyone involved with children should advocate for a dental home by 12 months.
Assessment of Article: Good article. No Shenanigans.
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