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Pediatric dentists recommend early examination (11-23-99)

Contrary to the long-held belief that children need not see a dentist before age 3, practicing dentists, the American Dental Association and the American Academy of Pediatric Dentistry now recommend that children visit the dentist within six months after they get their first tooth or by age 1, whichever comes first.

"That is actually a radical change from common practice," says Huw F. Thomas, Ph.D, MS, BDS, professor and chairman of the Department of Pediatric Dentistry at The University of Texas Health Science Center at San Antonio. "The age of 3 became traditional for many reasons. Generally, the health of a child under 3 has been the purview of the physician. Also, by 3 children have all their primary (baby) teeth and are more able to follow directions."

However, says Dr. Thomas, by then the child already may have developed dental caries (cavities), which could become a chronic problem. "We used to think caries was an inevitable consequence of having teeth. But now we have mechanisms available to totally prevent it," he said.

One key is a very early oral examination and preventive care. The health of a babyís teeth can affect the childís overall development, weight gain, behavior, speech and the condition of his or her adult teeth. "We want children to be seen by a dentist when their teeth are sound, so we can teach parents what to do to keep them that way."

According to the U.S. Centers for Disease Control and Prevention, dental caries is the most prevalent preventable disease of childhood. Data from San Antonio suggest that in certain populations, 1 in 5 children under age 5 is affected by caries, Dr. Thomas said. Despite the fact that prevention methods have helped many children over the past several years, the disease is still prevalent in minority and indigent populations. Poor families often canít make dental care a priority for their children because they have so many more pressing issues to handle, Dr. Thomas added. Other factors include lack of community water fluoridation, access to care and health care delivery costs.

The traditional approach of expecting children to come to the dentistís office for a check-up may not work in these populations. Although outreach efforts in elementary schools are an excellent way to provide dental care to indigent children, Dr. Thomas emphasizes that children should be examined before they start school, when something can still be done to prevent the disease.

"We need to come up with some new approaches," he said. Dental School researchers are exploring the creation of community infant oral health programs in collaboration with local practitioners. In these programs, students would perform oral exams on children up to 5 years of age and provide prevention education to mothers. Dr. Thomas says his department will try to develop such programs in the future. "We wonít wait for them (the children) to come to us," he said.

Contact: Will Sansom or Jennifer Lorenzo