This is the current release of the guideline.

AAP Policies are reviewed every 3 years by the authoring body, at which time a recommendation is made that the policy be retired, revised, or reaffirmed without change. Until the Board of Directors approves a revision or reaffirmation, or retires a statement, the current policy remains in effect.

Early childhood dental caries

Counseling
Prevention
Risk Assessment

Dentistry
Family Practice
Pediatrics

Advanced Practice Nurses
Dentists
Health Care Providers
Nurses
Physician Assistants
Physicians

To present guidelines on oral health risk assessment and establishment of the dental home in early childhood

• Infants and young children at risk of dental caries
• Parents (or other caregivers) of young children

1. Prenatal oral health risk assessment in pregnant women
2. Risk assessment in infants beginning at 6 months of age using the Caries Risk Assessment Tool provided and continually updated by the American Academy of Pediatric Dentistry
3. Establishment of the dental home which provides:
   • Parent education regarding parents’ and children’s oral hygiene, diet, and fluoride exposure
   • Comprehensive dental care
   • Referrals to endodontists, oral surgeons, orthodontists, and periodontists, as needed

Not stated

Searches of Electronic Databases

Not stated

Not stated

Not stated

Not applicable

Review

Not applicable

Not stated

Not applicable

A formal cost analysis was not performed and published cost analyses were not reviewed.

Peer Review

Not stated

1. Early childhood caries is an infectious and preventable disease that is vertically transmitted from mothers or other intimate caregivers to infants. All health care professionals who serve mothers and infants should integrate parent and caregiver education into their practices that instruct effective methods of prevention of early childhood caries.
2. The infectious and transmissible nature of bacteria that cause early childhood caries and methods of oral health risk assessment, anticipatory guidance, and early intervention should be included in the curriculum of all pediatric medical residency programs and postgraduate continuing medical education curricula at an appropriate time.
3. Every child should begin to receive oral health risk assessments by 6 months of age from a pediatrician or a qualified pediatric health care professional.
4. Pediatricians, family practitioners, and pediatric nurse practitioners and physician assistants should be trained to perform an oral health risk assessment on all children beginning by 6 months of age to identify known risk factors for early childhood dental caries.
5. Infants identified as having significant risk of caries or assessed to be within 1 of the risk groups listed in the original guideline document should be entered into an aggressive anticipatory guidance and intervention program provided by a dentist between 6 and 12 months of age.
6. Pediatricians should support the concept of the identification of a dental home as an ideal for all children in the early toddler years.

For more information on the establishment of the dental home and anticipatory guidance and parent and patient education refer to the original guideline document.

None provided

The type of evidence supporting each recommendation is not specifically stated.

Judicious optimization of diet, fluoride intake, and hygiene can decrease bacterial levels of specific organisms responsible for dental caries residing within normal dental flora. Decreasing the levels of cariogenic flora in the mother before and during the colonization process coupled with counseling directed toward optimal practices of diet, oral hygiene, and fluoride exposure can significantly and positively impact the child's predisposition to early childhood caries.

Not stated

An implementation strategy was not provided.

Staying Healthy

Effectiveness
Patient-centeredness
Timeliness

Not applicable: Guideline was not adapted from another source.

2003 May

American Academy of Pediatrics - Medical Specialty Society

American Academy of Pediatrics

Section on Pediatric Dentistry

Members of the Section on Pediatric Dentistry, 2002-2003: Paul A. Weiss, DDS (Chairperson); Charles S. Czerepak, DMD, MS; *Kevin J. Hale, DDS; Martha Ann Keels, DDS, PhD; Huw F. Thomas, DDS, MS; Michael D. Webb, DDS; John E. Nathan, DDS, MDS (Past Executive Committee Member)

Liaison: Ray E. Stewart, DMD, MS (American Academy of Pediatric Dentistry)

Staff: Chelsea L. V. Kirk

*Lead author

Not stated

This is the current release of the guideline.

AAP Policies are reviewed every 3 years by the authoring body, at which time a recommendation is made that the policy be retired, revised, or reaffirmed without change. Until the Board of Directors approves a revision or reaffirmation, or retires a statement, the current policy remains in effect.

None available

None available

This summary was completed by ECRI on December 11, 2003. The information was verified by the guideline developer on February 2, 2004.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Please contact the Permissions Editor, American Academy of Pediatrics (AAP), 141 Northwest Point Blvd, Elk Grove Village, IL 60007.