ORAL HEALTH CARE FOR CHILDREN -- Gilbert A. Handal, MD

The continuum of care for children mandates that the division of care concept be revised.The continuum of care for children mandates that the division of care concept be revised. Given the fact that every child is seen from birth by a pediatrician or primary care specialist, it is essential that this professional look more closely at the mouth and provide appropriate and timely guidance.Given the fact that every child is seen from birth by a pediatrician or primary care specialist, it is essential that this professional look more closely at the mouth and provide appropriate and timely guidance.

American Academy of Pediatrics and American Academy of Pediatric Dentists Joint Resolution calls for primary care to: 1.Develop a Children’s Oral Health electronic newsletter 2.Implement a structured Oral Health Risk Assessment Preceptorship program 3.Urge pediatricians and other health care professionals to offer an Oral Health Risk Assessment

a.Assess the mother’s and/or caregiver’s oral health b.Assess oral health risks of infant and children by recognizing the presence of dental cavities and severity depending upon the age of the child c.Proper performance of the oral examination d.Assess the child’s exposure to fluoride, application of fluoride to molar surfaces Oral Health Risk Assessment:

e. Provide nutritional and hygiene education: Basics of dental hygiene, flossing, brushing, etc.Basics of dental hygiene, flossing, brushing, etc. Avoidance of sugar exposure and appropriate snacksAvoidance of sugar exposure and appropriate snacks Preservation of primary teeth and treatment of early cavities (nursing cavities)Preservation of primary teeth and treatment of early cavities (nursing cavities) Advice re. the use of non carogenic gums such as Xilitol (decreases growth of MS)Advice re. the use of non carogenic gums such as Xilitol (decreases growth of MS) Oral Health Risk Assessment: (Cont.)

f. Make the appropriate referrals and teach the importance of the dental care home for children as soon as possible (one year old recommended). Oral Health Risk Assessment: (Cont.)

4. Provide specific advice for children with special needs: Cardiac prophylaxisCardiac prophylaxis Children with neurological problems i.e. Cerebral palsy, seizure disorder management, etc.Children with neurological problems i.e. Cerebral palsy, seizure disorder management, etc. Children with swallowing difficultiesChildren with swallowing difficulties Avoidance of trauma and appropriate management of dental trauma; car seatsAvoidance of trauma and appropriate management of dental trauma; car seats Recognition and early referral for children with oral/dental pathologyRecognition and early referral for children with oral/dental pathology Oral Health Risk Assessment: (Cont.)

Texas State Oral Health Plan Outline January, 2005 Goals: 1.Assessment: Establish Texas Oral Health Surveillance System to assess oral health burden and trends Establish Texas Oral Health Surveillance System to assess oral health burden and trends 2.Policy Development: Build state oral health infrastructure Build state oral health infrastructure Full-time state dental director Full-time state dental director Effective infrastructure within DSHS Effective infrastructure within DSHS Mobilize support for oral health Mobilize support for oral health Promote the integration of oral health components into Texas health policies and programs Promote the integration of oral health components into Texas health policies and programs Develop a Texas oral Health Coalition Develop a Texas oral Health Coalition Foster community oral health capacity Foster community oral health capacity Institute a Texas Oral Health Council Institute a Texas Oral Health Council

Texas State Oral Health Plan Outline January, 2005 (Cont.) 3.Assurance: Build collaborative partnerships to implement population based oral health Build collaborative partnerships to implement population based oral health Build collaborative partnerships to implement strategies to Build collaborative partnerships to implement strategies to increase access to and quality of the oral health care system. increase access to and quality of the oral health care system. Reference:

 Establish a State-wide Oral Health surveillance system  Build a State Oral Health Infrastructure  Mobilize support for oral health  Build collaborative partnerships to implement population-based oral health programs  Build collaborative partnerships to implement strategies to increase access to and quality of oral health care. Important Places to Start: