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FROM THE AMERICAN ACADEMY OF PEDIATRICS: Section on Pediatric Dentistry and Oral Health Preventive Oral Health Intervention for Pediatricians Pediatrics 2008; 122: 1387-1394 [Abstract] [Full text] [PDF]

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Caries Risk Assessment in infants: should it be abbreviated?

M. Osita Nwaneri   (3 January 2009)

Caries Risk Assessment in infants: should it be abbreviated? 3 January 2009
M. Osita Nwaneri, PL1 Pediatric Resident Pediatric Residency Program, University of Minesota Send letter to journal: Re: Caries Risk Assessment in infants: should it be abbreviated? nwane003{at}umn.edu M. Osita Nwaneri	This updated policy statement by the AAP has pointed out several important aspects of pediatric oral health for the primary care pediatrician which are quite instructive and practical.(1) The authors state that "Early risk assessment targets infants and young children who traditionally have yet to establish a dental home." and this statement raises questions about the utility of the Caries Assessment Tool in infants under one year(2). All infants seen in a primary care clinic after 6 months irrespective of other caries risks should indeed be referred to a dentist for the establishment of a dental home, unless the infant already has one established. This approach would help reinforce the need for early establishment of dental care for infants by one year of age , prompted by the primary care pediatrician. This should reduce the strain on time for the office visit since obtaining more detailed oral health history of mother and other siblings is not likely to change risk classification of this infant beyond high risk. In the Policy Statement, Figure 1, titled 3) which recommends starting the oral hygiene education for families even before the child is born and to continue it all through the child's pediatric life.(3) Essentially, it is important for us to understand the thin line which we walk when it comes to infants and their oral health as pediatricians. Any omissions on the part of the primary care provider including delay in starting the discussion of oral health or not referring an infant for establishment of a dental home could significantly increase the child's dental caries risk. 1. American Academy of Pediatrics, Section on Pediatric Dentistry and Oral Health. Preventive oral health intervention for pediatricians. Pediatrics. 2008 ;122(6):1387-94 2. American Academy of Pediatric Dentistry, Council on Clinical Affairs. Policy on use of caries-risk assessment tool (CAT) for infants, children and adolescents. Pediatr Dent. 2005-2006;27(7 suppl):25-27. Available at http://www.aapd.org/media/Policies_Guidelines/P_CariesRiskAssess.pdf . Accessed December 31, 2008 3. American Academy of Pediatrics, Bright Futures Steering Committee. Promoting oral health. In: Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of infants, Children, and Adolescents. 3rd ed. Elk Grove Village, IL: American Academy of Pediatrics; 2008:155-168 Conflict of Interest: None declared