Pediatrician’s Role in Children’s Oral
Health: An Indiana Survey
Marcus R. Ditto,
1
James E. Jones,
1
Brian Sanders,
1
James A. Weddell,
1
Richard Jackson,
2
and Angela Tomlin
1
Abstract
Objectives.To evaluate Indiana pediatricians’ current practices related to oral health, knowledge of oral health prevention,
and opinions on anticipatory guidance integration into their practices. Background. The American Academy of Pediatrics
(AAP) May 2003 policy statement on oral health risk assessment timing and establishment of a dental home has provided
pediatricians with guidelines to assess patients’ oral health and caries risk status. Methods. A survey of 31 questions was
distributed via mail to all active Indiana pediatricians (300) registered in the Indiana State Medical Association to evaluate
current practices relating to oral health prevention and guidance. Results. Of the 300 distributed surveys, 138 were
returned (46%).The authors found that 15% of pediatricians recognize the AAP-recommended age for a dental home as
12 months and practice this recommendation. Among the respondents, 7% believe application of fluoride should be part
of a well-child visit. The majority (89%) of respondents reported interest in obtaining further knowledge on oral health.
Keywords
dentistry, pediatrics, pediatrician, oral health care, children, dental caries
1
Riley Hospital for Children, Indiana University School of Dentistry,
Indianapolis, IN, USA
2
Department of Preventive and Community Dentistry, Indiana
University School of Dentistry, Indianapolis, IN, USA
Corresponding Author:
Marcus Ditto, 702 Barnhill Drive, Suite 4205, Indianapolis,
IN 46202, USA
Email: maditto@gmail.com
Articles
Background
Dental caries is the most prevalent chronic disease among
children and has been identified as the most prevalent
unmet health need among American children.
1
During the
past 50 years, successful intervention has led to a decrease
in its prevalence, especially in middle- to high-income
areas in the United States. This decline is partly because of
the introduction of fluoride into city water and improved
access to dental care.
1
Low-income and minority groups
continue to receive limited access to oral health care.
Children in these circumstances usually present with the
highest prevalence of dental disease. Factors involved in
limited access of low-income and minority groups are lack
of finances, lack of transportation, language and culture
barrier, and lack of perceived need of care.
2
Efforts have
been made to address financial factors through Medicaid
expansion programs aimed at providing early and periodic
health care.
2
However, the lack of perceived need for care
remains an important issue in terms of dental disease pre-
vention and timely treatment. Because parental education
does not occur early in the child’s life, many children pres-
ent to the dentist with established dental disease.
The American Dental Association (ADA) and the
American Academy of Pediatric Dentistry (AAPD) recom-
mend the first dental visit for children to occur at the
eruption of the first tooth (~6 months) or no later than 12
months of age.
3
Although this is the recommendation, little
education is given to new parents on the importance of
early dental care and establishment of a dental home. The
usual initial source for educating parents about general and
oral health care is the pediatrician. The American Academy
of Pediatrics (AAP) recommends a child to visit a pediatri-
cian 6 times in the first year of life and 10 times by 3 years
of age.
4
Pediatricians have the opportunity to provide care
to children 6 times before the recommended visit to a den-
tist. These initial visits are of importance in educating
Clinical Pediatrics
49(1) 12–19
© The Author(s) 2010
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DOI: 10.1177/0009922809343718
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