Population: All children and adolescents.
Organizations
USPSTF 2021, AAP 2014, AAFP 2014, Bright Futures Oral Health Guide
Screening Recommendation
–Current evidence is insufficient to assess the balance of benefits and harms of routine screening examinations for dental caries performed by primary care clinicians in children younger than 5 y.
Prevention Recommendations
–Clean infant gums with clean, soft, damp cloth once daily.
–Apply fluoride varnish to the primary teeth of all infants and children starting at the age of primary teeth eruption. (See Table 13–1.)
–Prescribe oral fluoride supplementation starting at age 6 mo for children whose water supply is fluoride deficient (≤0.6 mg/L). (See Table 13–2 for dosing.)
TABLE 13–1 CLINICAL RECOMMENDATIONS FOR USE OF PROFESSIONALLY APPLIED OR PRESCRIPTION-STRENGTH, HOME-USE TOPICAL FLUORIDE AGENTS FOR CARIES PREVENTION IN PATIENTS AT ELEVATED RISK OF DEVELOPING CARIES
TABLE 13–2 RECOMMENDED FLUORIDE SUPPLEMENTATION BY AGE AND FLUORIDE LEVEL IN COMMUNITY WATER SUPPLY
Practice Pearls
• Fluoride mouthwash used regularly by children under 16 reduces risk of dental caries by >25%. (Cochrane Database Syst Rev. 2016;7:CD002284)
• The CDC’s My Water’s Fluoride resource provides county-level information on content of fluoride in the water system. https://nccd.cdc.gov/DOH_MWF/
• Brush infant teeth with a smear of fluoridated toothpaste at eruption of first tooth twice per day up to age 3. Children aged 3–6 y should brush with a pea-sized amount of fluoridated toothpaste twice daily; parents should be brushing child’s teeth once daily until age 7.
• Caries risk assessment tool can be found at: https://www.aapd.org/globalassets/media/policies_guidelines/bp_cariesriskassessment.pdf
Sources
–USPSTF. Screening and Interventions to Prevent Dental Caries in Children Younger than 5 Years. 2021.
–AAFP. Clinical Recommendation. 2014.
–Pediatrics. 2014;133(5):s1-s10.