Little People’s Dentist: The Benefits of Prevention

Dr. David M. Stewart DDS from Little People’s Dentistry answers common questions parents wonder about when taking their child to the dentist.

What is the reason for the current recommendation to have children seen by their first year of age or first tooth? Is dental decay actually an issue in young children?

“Prevention is the best medicine.” It is this concept that drives the current recommendation for children to be seen by their first year of age or first tooth. Dental decay is the number 1 chronic disease in children; with American children missing more than 750,000 school days each year as a result of dental conditions. In addition, millions of school hours are lost each year due to dental-related illness, and it has recently been found that dental caries in children under 3 is actually increasing. The majority of this disease is preventable. If we can catch the decay process early then we can prevent a large amount of decay and reduce significantly the extent of the decay when it occurs.

Does it really matter if children get decay in their primary teeth aren’t they just going to fall out anyway?

Primary teeth are important. They are the space maintainers for the permanent teeth, and the health of the primary teeth is often a good indicator of the potential health of the permanent teeth. And what many people do not realize is that many of the primary teeth need to maintain space in the mouth until a child is 12 or 13 years old.

What does the research teach us about early childhood exams? Does it make a difference if children are seen early?

Parents often ask the question what is the best dental insurance or the most economical way to do dentistry. The best and most economical way to care for your children’s teeth is to prevent decay before it occurs; one way that you can do this is by having them seen early and regularly. One study showed that the average cumulative 5 year dental costs for children seen regularly from 1 year of age to 5 years of age was almost half the cost of the children that were not seen until 5 years of age; and the children seen at an earlier age had less dental decay. Another study found that children who did not have an age 1 dental examination averaged more than twice as many cavities in between their teeth at age 15 years as those who did have such a visit.[Alm A, Wendt LK, et al. Oral Hygiene and Parent-Related Factors During Early Childhood in Relation to Approximal Caries at 15 Years of Age. Caries Res 2008; 42 (January):28-36]

What do you actually do during these exams besides look at teeth?

A regular exam should include an evaluation of the hard and soft tissues outside a child’s mouth in the head and neck area. Also, the tissues inside the mouth are evaluated including the child’s tonsils and throat. All of these tissues are evaluated to see if cancer or other disease processes are occurring. A child’s intra- and extra-oral growth and development are assessed, to make sure that they are growing correctly and to see if any interventional treatment needs to take place in order to help facilitate proper growth and development. We also evaluate their bite to see if orthodontic intervention is needed. The child’s risk factors for developing decay are determined; and often oral hygiene techniques are demonstrated and reinforced with the child and their parents. Dietary risk factors are determined and reviewed with the patient and parents. Preventive exams also include a cleaning of the teeth which can help decrease accumulations of plaque and calculus on the teeth that can lead to gingival and periodontal disease. Also fluoride is applied to the teeth which can significantly reduce the amount of decay that occurs in the future and help repair the start of decay that has occurred in the past. The goal of regular exams is prevention. We want to catch cancer early, correct growth and development problems before they become more of a problem, and prevent periodontal disease which has been shown to significantly affect many of the common diseases such as heart disease and diabetes. We want to stop dental decay if possible and if not stop it, at least catch it early when it is easier and less involved to treat. Again prevention is the goal.

How do you communicate all of this information to the parent?

In our office we utilize a report card for every child which helps review with the child’s parent exactly what is going on in each child’s mouth, what we found, and what we recommend for treatment.

As a board certified pediatric dentist what is your goal as you treat children?

The ideal is that we create a “dental home” for each child. This dental home is an ongoing relationship between the dentist and the patient, inclusive of all aspects of oral health care delivered in a comprehensive, continuously accessible, coordinated, and family-centered way. Establishment of a dental home begins no later than 12 months of age and includes referral to dental specialists when appropriate. This concept is derived from the American Academy of Pediatrics (AAP) definition of a medical home. Since its introduction in 1992 by the AAP is has been shown that health care provided to patients in a medical home environment is more effective and less costly in comparison to emergency care facilities or hospitals. Strong clinical evidence exists for the efficacy of early professional dental care complemented with caries-risk assessment, anticipatory guidance, and periodic supervision.

Ultimately the goal is to create positive preventive experiences for the child in and efficient and cost effective way. If a child’s first visit to the dentist is an emergency situation, perhaps a tooth ache or mouth injury; he or she is more likely to be unhappy during the visit and it makes it more difficult to create a positive experience for the child. On the other hand, if children visit the dentist when their mouths are comfortable, they are much more likely to find the visit pleasant and fun. And it is during these visits that treatments can be performed and educational information given that can decrease the child’s risk for decay and extensive dental problems in the future. Some of these treatments are fluoride, sealants, and early orthodontic intervention. Parents are taught how to prevent decay through simple techniques and interventions that can be done at home. This concept of a dental home involves the child, parent, doctor and dental team in a positive, preventive, comfortable environment that allows children to have comprehensive, positive dental experiences that can lead to a life time of excellent dental and overall improved medical health. This approach to dental care for children is the most cost effective way to provide positive, preventive dental experiences for children.

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You can contact Dr. David Stewart at 801 446-8007 Little People’s Dental is located at 1268 W. South Jordan Parkway, Suite 101 South Jordan Utah 84095

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