ORAL HEALTH ORAL HEALTH CARE FOR CARE FOR CHILDRENCHILDREN

-- Gilbert A. Handal, MD-- Gilbert A. Handal, MD

• The continuum of care for children The continuum of care for children mandates that the division of care concept mandates that the division of care concept be revised.be revised.

• Given the fact that every child is seen from Given the fact that every child is seen from birth by a pediatrician or primary care birth by a pediatrician or primary care specialist, it is essential that this specialist, it is essential that this professional look more closely at the professional look more closely at the mouth and provide appropriate and timely mouth and provide appropriate and timely guidance.guidance.

American Academy of Pediatrics American Academy of Pediatrics and American Academy of and American Academy of

Pediatric DentistsPediatric DentistsJoint Resolution calls for primary Joint Resolution calls for primary

care to:care to:1.1. Develop a Children’s Oral Health electronic Develop a Children’s Oral Health electronic

newsletternewsletter

2.2. Implement a structured Oral Health Risk Implement a structured Oral Health Risk Assessment Preceptorship programAssessment Preceptorship program

3.3. Urge pediatricians and other health care Urge pediatricians and other health care professionals to offer an professionals to offer an Oral Health Risk Oral Health Risk AssessmentAssessment

a.a. Assess the mother’s and/or caregiver’s oral Assess the mother’s and/or caregiver’s oral healthhealth

b.b. Assess oral health risks of infant and children Assess oral health risks of infant and children by recognizing the presence of dental cavities by recognizing the presence of dental cavities and severity depending upon the age of the and severity depending upon the age of the childchild

c.c. Proper performance of the oral examinationProper performance of the oral examination

d.d. Assess the child’s exposure to fluoride, Assess the child’s exposure to fluoride, application of fluoride to molar surfacesapplication of fluoride to molar surfaces

Oral Health Risk Assessment:

e. Provide nutritional and hygiene education:e. Provide nutritional and hygiene education:• Basics of dental hygiene, flossing, Basics of dental hygiene, flossing,

brushing, etc.brushing, etc.• Avoidance of sugar exposure and Avoidance of sugar exposure and

appropriate snacksappropriate snacks• Preservation of primary teeth and Preservation of primary teeth and

treatment of early cavities (nursing treatment of early cavities (nursing cavities)cavities)

• Advice re. the use of non carogenic gums Advice re. the use of non carogenic gums such as Xilitol (decreases growth of MS)such as Xilitol (decreases growth of MS)

Oral Health Risk Assessment: (Cont.)

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

Oral Health Risk Assessment: (Cont.)

4. Provide specific advice for children with special 4. Provide specific advice for children with special needs:needs:

• Cardiac prophylaxisCardiac prophylaxis• Children with neurological problems i.e. Children with neurological problems i.e.

Cerebral palsy, seizure disorder Cerebral palsy, seizure disorder management, etc.management, etc.

• Children with swallowing difficultiesChildren with swallowing difficulties• Avoidance of trauma and appropriate Avoidance of trauma and appropriate

management of dental trauma; car seatsmanagement of dental trauma; car seats• Recognition and early referral for children Recognition and early referral for children

with oral/dental pathologywith oral/dental pathology

Oral Health Risk Assessment: (Cont.)

Texas State Oral Health Plan OutlineTexas State Oral Health Plan OutlineJanuary, 2005January, 2005

Goals:Goals:1.1. Assessment:Assessment:

• • Establish Texas Oral Health Surveillance System to Establish Texas Oral Health Surveillance System to assess oral health burden and trendsassess oral health burden and trends

2.2. Policy Development:Policy Development: • • Build state oral health infrastructureBuild state oral health infrastructure

• • Full-time state dental directorFull-time state dental director• • Effective infrastructure within DSHSEffective infrastructure within DSHS• • Mobilize support for oral healthMobilize support for oral health• • Promote the integration of oral health components into Promote the integration of oral health components into

Texas health policies and programsTexas health policies and programs• • Develop a Texas oral Health CoalitionDevelop a Texas oral Health Coalition• • Foster community oral health capacityFoster community oral health capacity• • Institute a Texas Oral Health CouncilInstitute a Texas Oral Health Council

Texas State Oral Health Plan OutlineTexas State Oral Health Plan OutlineJanuary, 2005 January, 2005 (Cont.)(Cont.)

3.3. Assurance:Assurance:

• • Build collaborative partnerships to implement population Build collaborative partnerships to implement population based oral healthbased 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 increase access to and quality of the oral health care system.system.

Reference: http://www.tda.org/displaycommon.cfm?Reference: http://www.tda.org/displaycommon.cfm?an=1&subarticlenbr=682an=1&subarticlenbr=682

Establish a State-wide Oral Health Establish a State-wide Oral Health surveillance systemsurveillance system

Build a State Oral Health InfrastructureBuild a State Oral Health Infrastructure

Mobilize support for oral healthMobilize support for oral health

Build collaborative partnerships to implement Build collaborative partnerships to implement population-based oral health programspopulation-based oral health programs

Build collaborative partnerships to implement Build collaborative partnerships to implement strategies to increase access to and quality of strategies to increase access to and quality of oral health care.oral health care.

Important Places to Start: