Oral Health: Opportunities for Prevention and Intervention - Melinda B. Clark, MD, MJ, FAAP

Clark, MD, MJ, FAAP Albany Medical Center & College Professor of Pediatrics AAP NY Chapter 1 COHA Goals and Objectives • Emphasize the impact of oral health on the overall well-being of children • Highlight the prevalence of oral disease, risk factors, and prevention methods • Review oral health and fluoride varnish guidelines and recommendations for guidance and referral • Discuss factors that ma. [...] 14 ERs: A Costly Dental Destination • Preventable (NT) dental conditions account for over 2 million ED annually ▫ Cost $1.5-2 billion • Children account for 10% of visits • >33% Uninsured patients • 40% Medicaid enrolled • 90% of dental-related ED visits result in prescription Rx for pain or infection The Pew Center on States Kim PC, Int. [...] Consequences of ECC • Pain • Increased caries in • Tooth loss permanent dentition • Impaired chewing • Future dental work and nutrition ▫ Pain and $$$ • Below average • School/work weight gain absences: • Infection ▫ 51 million school • Poor self esteem hours per year • Difficulty sleeping ▫ Missed learning opportunities Poor Performance Miss School 3 times Jackson SL, Vann WF Jr, Kotch JB, Pahel. [...] Fluoride Varnish: A Proven Intervention • Most extensive literature of PCP based preventive strategies • Nearly all studies include oral health education • Majority of studies emanate from “Into the Mouth of Babes” in NC Primary care clinicians apply fluoride varnish to the primary teeth of all infants and children starting at primary tooth eruption (B rec). [...] Fluoride Varnish • ADA recommends every 3-6 months • AAPD every 3-6 months • USPSTF 2014 Recommendations • AAP 2-4 times per year • Minimum 6 month intervals, 3 months for high-risk children Silver Diamine Fluoride 43 • Colorless liquid with silver particles • Antibacterial properties • Acts as a physical barrier • Fluoride strengthens enamel • Effective: Caries arrest ~70% • Biannual application.