Oral health is an integral component of overall general health. Poor
oral health can profoundly affect a child’s health and general
well-being. Dental caries is the most common chronic childhood disease,
being five times more common than asthma. It is an infectious,
transmissible disease with significant detrimental effects, if left
untreated.
Early childhood caries (ECC) formerly termed as
"nursing bottle caries" is a particularly virulent form of caries that
affects primary dentition. It begins soon after eruption and progresses
rapidly. Untreated caries can affect a child’s growth, result in
significant pain and potentially life threatening infection, and
diminish overall quality of life [1,2].
Risk factors which predispose to ECC include (i)
early colonization of mutans streptococci; (ii) lack of oral
hygiene routines; (iii) children who sleep with bottle or
breastfeed throughout the night; (iv) high frequency of sugar
consumption; (v) mothers with high caries rate; (vi) low
socioeconomic status; and (vii) low parental education [3].
Timely identification of risk factors and appropriate
intervention; however, can prevent this disease. Early intervention
provides the opportunity to examine the child before the initiation of
dental caries and educate parents about appropriate oral hygiene and
feeding practices. It is recommended that the first dental visit should
occur at or around one year of age [4].
In India; however, very few children visit a dentist
before 4 or 5 years of age and the first visit is usually a ‘problem’
visit with the child reporting most often with pain or swelling. Due to
the lack of access to parents of infants and toddlers, pediatric
dentists are unable to provide timely preventive guidance.
Pediatricians on the other hand see a large number of
children during their infant and toddler years and can play a
significant role in prevention and control of ECC. Establishing
collaborative relationship with these health professionals is therefore,
essential for increasing access to dental care [5].
An initial step in this regard can be integrating
preventive oral health care with the immunization visits of the child.
During these visits, pediatricians can provide counseling on caries
prevention and encourage parents to make well-child visit to a dentist.
The inclusion of oral health status of the child in the
immunization-card can serve as record of the preventive oral health
services provided and a reminder for subsequent interventions.
1. American Academy on Pediatric Dentistry. Policy on
Early Childhood Caries (ECC): Classifications, Consequences, and
Preventive Strategies. Available from: URL:
http://www.aapd.org/media/policies_guidelines/p_eccclassifications.pdf.
Accessed June14, 2012.
2. American Academy on Pediatric Dentistry. Guideline
on Infant Oral Health Care. Available from: URL:
http://www.aapd.org/media/policies_guidelines/g_infantoralhealthcare.pdf.
Accessed June 14, 2012.
3. Hale KJ. American Academy of Pediatrics Section on
Pediatric Dentistry. Oral Health Risk Assessment Timing and
Establishment of the Dental Home. Pediatrics. 2003;111:1113-6.
4. Lee JY, Bouwens TJ, Savage MF, Vann WF Jr.
Examining the cost-effectiveness of early dental visits. Pediatr Dent.
2006;28:102-5.
5. Section on Pediatric Dentistry and Oral Health.
Preventive Oral Health Intervention for Pediatricians. Pediatrics.
2008;122:1387-94.