PEDIATRICS Vol. 54 No. 2 August 1974, pp. 176-182
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The Role of the Pediatrician in Dental Caries Detection and Prevention

Louis W. Ripa D.D.S., M.S.1

1 School of Dental Medicine, Health Sciences Center, State University of New York at Stony Brook

Dental caries is a disease that usually begins very early in life and from which few people remain unaffected. However, because caries is associated with local etiologic vectors, it can be controlled. Altering the diet to render it less cariogenic and making tooth surfaces more resistant to acid attack through the use of fluoride are two potent mechanisms of prevention.

Pediatricians are in a unique position to contribute to the dental health of their young patients because of the early age at which children are brought to their offices and because mothers are accustomed to accept their recommendations.

The pediatrician's role in caries control includes diagnosis, referral, and preventive therapy. Early referral of children who appear dentally healthy as well as those in which there are obvious cavities in the teeth has been stressed. As part of a caries preventive program, a system of systemic fluoride supplementation has been outlined for those children who are not drinking optimally fluoridated water. In addition, food-caries relationships have been discussed and practical suggestions for reducing the cariogenicity of a child's diet have been made.

Although toothbrushing is considered a traditional method of caries prevention, it has not been discussed in this article for two reasons. First, published evidence does not conclusively support the premise that toothbrushing per se significantly reduces dental caries. Second, the results of the general efforts of the dental profession to motivate patients to adopt either meticulous or frequent brushing habits have been poor. It would be unrealistic to expect the medical profession to initiate procedures that would significantly alter the behavior of their patients' toothbrushing habits. Toothbrushing in the young child, especially the preschooler, should be regarded as another method for providing topical fluoride to the teeth. Parents should be encouraged to brush their young children's teeth as soon as they erupt. A soft, child-size toothbrush should be employed with a scrubbing motion. An anticariogenic toothpastesect that has proven effective in controlled clinical trials should be recommended by the pediatrician or his nurse.

It is hoped that the mechanisms for influencing children's dental health that were discussed in this article can be incorporated with minimum effort into the normal routine of pediatricians' practices.




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J. R. Schulte, M. E. Druyan, and J. C. Hagen
Early Childhood Tooth Decay: Pediatric Interventions
Clinical Pediatrics, December 1, 1992; 31(12): 727 - 730.
[Abstract] [PDF]