Pediatricians ideally see young children 7 times in the first year of life and 11 times in the first 3 years for well child visits. These interactions provide a great opportunity for anticipatory guidance, screening, and health maintenance. The vast minority of children visit a dentist prior to their third birthday, despite the American Academy of Pediatric Dentistry, American Dental Association, and now American Academy of Pediatrics policies encouraging initial dental visits at 1 year of age. Thus, there is a great responsibility for oral health maintenance to be part of the pediatrician’s approach to well child care.
Limited access to dental care for children is a factor that increases pediatrician’s involvement in child oral heath. For every 1 child who is medically uninsured in the United States, nearly 3 are dentally uninsured. In addition, even the presence of insurance in the form of Medicaid does not ensure access, as only one-quarter to one-third of children with Medicaid had a preventive dental visit in the prior year.
Many dentists do not feel comfortable treating infants and young children. There are approximately 4,000 clinically active pediatric dentists (Pedodontists) in the United States who have been trained to care for young children and children with special health care needs. General dentists make up the vast majority of practicing dentists. Unfortunately, the educational curriculum of dental school does not expose general dentists to infants and young children to a level where they are comfortable treating them. Therefore, many general dentists will wait until children are preschool or school-age before treating them. This contributes to the limited access to dental care of very young children and infants. There is a responsibility of pediatricians to incorporate oral health into daily practice so that children with limited access to pediatric dental care can maintain good oral health until they are able to access the appropriate dental professionals. Limited access to preventive and restorative dental care makes disease prevention paramount.
In addition, minority status and low household income are both associated with higher dental disease rates and less access to dental care than majority or higher income children. Pediatricians have a responsibility, as do all other health care professionals, to reduce these disparities, and incorporating oral health care into daily practice may contribute to this effort.
Pediatr Dent JADA