For Immediate Release
Date: Feb 25th, 2010
Contact: Dr. John Thompson
What is a Legacy?
2010 marks the 150th anniversary of the founding of the Kentucky Dental Association. While there are many great accomplishments that can be illustrated, I am choosing one event that I believe will have the greatest impact going forward. A legacy is anything handed down from the past, and we spent 10 years seeking passage of a children’s dental examination mandate. 2010 will now mark a new beginning in how our profession and the Kentucky Dental Association will make a demonstrable difference in the oral health of Kentuckians beginning with the most vulnerable. This issue will focus on the why and how we will fulfill our responsibility in providing the examination and care for the pediatric patient. The legacy for the next 150 years must be greatly improved oral health for all Kentuckians.
Our association is blessed with talented members that have contributed significantly to the advancement of this profession and Dr. Beverly Largent is at the forefront. Beverly just completed her term as president of the American Academy of Pediatric Dentistry where she distinguished herself as an outstanding spokesperson for pediatric dental care in this country. I asked Dr. Largent if she would serve as our “KDA Guest Editor” for this first issue of 2010 that will be published during Children’s Dental Health month. Beverly graciously and with great enthusiasm accepted this invitation and she writes:
This issue of the Journal is especially important to me because of the topic of Pediatric Dentistry. From my perspective, nothing is more important than children's oral health, and I thank John for the importance he is placing on the subject.
Nearly ten years ago the state of Kentucky did an oral health survey, and the results reflect the statistics we have today on the state of children's oral health. Oral health has improved for everyone with the exception of children less than five years of age. This is a tragedy in America today, and it will take all of us, including Pediatric Dentists to make a difference. The incidence of decay in young children is called Early Childhood Caries. ECC is defined as one or more decayed, missing or filled teeth in a child 71 months of age or younger. Children younger than three with any smooth surface decay are considered to have severe disease. Unfortunately the burden of ECC is carried primarily by poor children. Early tooth decay in toddlers is five times more prevalent than asthma, and lost school days for older children are most often caused by dental disease.
The buzz words in Pediatric Dentistry today are dental home, and age one visit. The dental home is defined as "the ongoing relationship between the dentist and the patient inclusive of all aspects of oral health care delivered in a comprehensive, continually accessible, coordinated and family centered way. Establishment of the dental home begins no later than 12 month of age, and includes referrals to specialists when necessary." This definition is from the American Academy of Pediatric Dentistry, but sounds as though it was written for the general dentist. In fact, without the general dentist, the dental home vision will never become a reality for all children. It is certainly within the preview of every general dentist to examine infants and toddlers, utilize known preventive procedures such as fluoride and parent education. If all children could/would see a dentist by their first birthday, referrals to the pediatric dentist for advanced restorative treatment would become less necessary. Anticipatory guidance is a part of the age one and early childhood visits. Topics ranging from eruption patterns of the primary teeth, proper oral hygiene, and the use of appropriate car seat restraints can be discussed. Caries risk assessment should be part of the infant oral exam. Risk assessment helps the provider understand the likelihood of dental decay, and the rate at which decay will progress, or the possibility of white spot lesions becoming cavitated. Caries risk is based on many factors including diet, social setting, presence of appliances, or special needs. The AAPD has a caries risk assessment that can be found on the web site, AAPD.org. Children at high risk are candidates for increased care, and monitoring. Risk assessment is a valuable tool in determining the types of restorations used. Nothing cements the relationship between the parent and the dentist like caring for a small child. Public health measures, such as school sealant programs, and fluoride varnish programs offer great opportunities to the public, but cannot replace the relationship and guidance from the dentist. Both the age one visit and the dental home have been adopted by the American Dental Association.
The public site of the American Academy of Pediatric Dentistry provides good information about the treatment of the child patient. The policies and guidelines of the AAPD are available to everyone. Just about every imaginable treatment for children is covered by these guidelines. They are revised every three to five years, and reflect current literature. These policies and guidelines are written by scientists, vetted by Pediatric Dentists, and have received national recognition. The guidelines are considered the standard of care for children.
As you read this, health care reform may be signed by the President. Dental health care reform is not at the center of the debate, but rest assured dentistry will be changed. It is my hope that all reform maintains the dental home as the model for dental health care delivery. If we maintain the dentist as the center of the dental home, then whatever legislation occurs about mid level providers will be acceptable, and increase access without a two tier system.
Kentucky has taken a giant step forward in legislating a preschool dental examination for children. This is our opportunity to make prevention work for the next generation, and change the statistics from 10 years ago.