Children's Oral Health and the Role of the Pediatrician

Oral health should be part of routine health screenings and physical exams of all children, especially those with special health care needs.

Pediatricians play an important role in the oral health of children. Oral disease (including dental caries) has health implications beyond the mouth, particularly for children with chronic diseases such as autism, Down syndrome, attention deficit hyperactivity disorder and congenital heart disease.

Disparities in rate of dental caries exist between races and ethnicities, and children in rich and poor families. Black non-Hispanic and Mexican-American children have higher caries rates than White children. Children age 2 to 4 in poor families have caries rates of 34.1 percent compared to 14.5 percent for children in wealthier families.

While most pediatricians (90%) thought that they should examine patients’ teeth for caries and educate families about preventive oral health, only 54 percent performed this examination in more than half their youngest patients (ages 0 to 3). The major reason cited for pediatricians not addressing oral health: lack of knowledge. A one-hour Web-based training session, however, increased pediatric residents’ knowledge and raised scores on a brief questionnaire from 69 percent to 81 percent. Even with more training, pediatricians often lack time during office visits to incorporate oral health into their practice, cannot bill for oral health and have difficulty making dentist referrals.

Other professionals responsible for child health—family physicians, nurse practitioners and school nurses—should incorporate oral health into their training and practices.