MONDAY, May 5, 2003 (HealthDayNews) -- Because pediatricians spend a lot more time with infants and children than dentists do, the American Academy of Pediatrics is calling on its members to help stem the rising incidence of tooth decay.
In new policy guidelines, published in the May issue of Pediatrics, the academy is recommending pediatric health-care providers begin oral health risk assessments when a child reaches 6 months -- often before the child cuts his first tooth. The new policy also says parents of high-risk youngsters should start taking their children to a dental-care provider by the time they're 1.
"Currently, a lot of children aren't seen by a dentist until there's a problem," says one of the policy's authors, Dr. Kevin Hale, a member of the executive committee of the section on pediatric dentistry at the academy. "This policy is much more proactive. We want to get them in to see a dentist before they have a problem."
Tooth decay, which is largely a preventable disease, affects almost 20 percent of children between the ages of 2 and 4. By the time a child is 8, chances are higher than 50 percent he'll already have some cavities, according to the U.S. Centers for Disease Control and Prevention. Dental cavities are five times more common than asthma and seven times more common than hay fever, reports the policy statement.
Cavities, which are also known as caries, occur when there is an overgrowth of bacteria on the teeth. Infants don't have the bacteria in their mouths when they're born. It's transmitted from adults or other children as the child grows by sharing utensils or even by kissing.
Caries tend to run in families, which is why the new policy suggests that a good preventative dental program would include prenatal dental visits for the mother to reduce the amount of bacteria.
"The best thing a new mother can do is visit her dentist and get her mouth in good shape before she has her baby," Hale says.
The policy also identifies groups at high risk of developing dental decay and suggests children in these groups see a dentist by the time they're 1. High-risk groups for tooth decay include:
- Children who sleep with a bottle or who breast-feed through the night;
- Children already showing signs of caries or plaque build-up;
- Children of mothers with a lot of cavities;
- Children with special health-care needs;
- Children in families with low socioeconomic status;
- And later-order children (i.e., the second, third, or fourth child in a family).
Hale says there are ways parents can "delay colonization of bacteria" in their children's mouths. He suggests you don't share utensils and never mouth-clean a dropped pacifier. And, of course, he recommends daily flossing and brushing for all family members.
Dr. Bella Silecchia, a pediatrician at Nassau University Medical Center in East Meadow, N.Y., points out that even kissing on the mouth can transmit bacteria to a baby.
Silecchia says she thinks the new policy is "very sound advice." She says it's an especially good idea for pediatricians to be looking for signs of dental disease because many people simply can't afford good dental care.
More information
To learn more about preventing cavities, go to the U.S. Centers for Disease Control and Prevention or to the American Academy of Pediatric Dentistry.
