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Key Points
 
The American Academy of Pediatrics published a policy statement recommending oral health risk assessments in the pediatric office.
 
In keeping with AAP policy, a caries risk assessment and clinical evaluation should be performed at every well-child visit, beginning at 6 months of age.
 
The purpose of the risk assessment is to determine if an infant would benefit from early, aggressive dental intervention.
 
A complete oral examination should be part of every routine visit, starting at 6 months of age.
 
The most important tools include a good light source and a tongue depressor.
 
The knee-to-knee exam is often best for young children.
 
It is important to examine the gum line for plaque and all stages of dental caries, as caries usually begin along the gum line.
 
It is important to document all findings and refer any abnormalities to a dental provider.
 
The AAP Oral Health Risk Assessment Tool helps clinicians determine if a child is at low or high risk for caries.
 
A child's risk for developing decay is based on the highest level risk indicator.
 
High risk factors should be addressed through anticipatory guidance and education.
 
Children determined to be at high risk should be referred to a dentist.
 
According to AAP policy, high-risk patients should be directed to establish a dental home by 12 months of age.
 
Children who sleep with a bottle during the night are considered high risk for early childhood caries.
 
A list of high-risk groups is provided in the AAP policy statement.
 
Pediatric dentists are capable of treating children of all ages, and are ideal for children age 3 and younger.
 
Referrals to a dentist should be treated like those to any other health professional.
 
Ideally, dental referrals will involve a pre-existing pediatrician-dentist relationship.
 
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