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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Risk Groups
These risk factors that should prompt automatic referral to a dentist by 12 months of age:
Children with special health care needs
Children of mothers with a high caries rate
Later-order offspring
Children in families of low socioeconomic status
Demonstrable caries, plaque, demineralization, and/or staining
Children who continue nocturnal feeding (especially bottle-feeding) after tooth eruption

Any child determined to be at high risk for dental caries based on these risk groups, a formal risk assessment, or physical exam findings should be prioritized for referral to a dental home.

These patients should be directed to establish a dental home
6 months after the first tooth erupts or by 1 year of age (whichever
comes first)."
Fast Facts
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 or breastfeed during the night are considered high risk for early childhood caries.
A list of high-risk groups is provided in the AAP policy statement.

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