Taking a Bite Out of Kids' Tooth Decay

Preventive dental care for children in primary care offices improved oral health

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) The dental health of infants and toddlers may be more easily overlooked than other aspects of a child's health. But services in a pediatrician's offices might help address that.

A recent study found that children in North Carolina experienced improved dental health after a preventive dental care program by primary care doctors began.

As the number of visits in the preventive dental program increased, the number of decayed, missing or filled teeth in young children decreased.

One of the most common preventive dental services recommended by the American Academy of Pediatrics is fluoride varnish. Fluoride is known to reduce the risk of dental caries.

"Ask your pediatrician about preventive dental care."

The study, led by Leo N. Achembong, MPH, of the North Carolina Department of Health and Human Services Division of Public Health, evaluated a program designed to provide preventive dental care to low-income children.

The program, called Into the Mouth of Babes Program (IMBP), was assessed based on the number of decayed, missing or filled teeth on kindergarten students across North Carolina.

The program involved primary care doctors providing preventive dental care for infants, toddlers and preschoolers, such as a fluoride varnish. The findings can help guide parents and policymakers in understanding the effects of adequate preventive dental care.

The researchers compared the number of decayed, missing or filled teeth from 1998 through 2009 for 920,505 kindergarten students. They calculated the average number of decayed, missing or filled teeth per kindergarten student per school after taking into account other factors that might influence dental health.

Those other factors included the poverty-level of the school, the child's ethnicity, how many people were enrolled in Medicaid in that school's county and how many dentists and doctors were in that school's area.

The average number of decayed, missing or filled teeth for each student was 1.53 in 1998, which rose to 1.84 in 2004 before dropping to 1.59 in 2009.

Meanwhile, the average number of visits to the IMBP program increased substantially for children from infants to 4 years old between 2000 and 2009.

An analysis of these two trends found that the increase in dental health that occurred in the middle of the 2000s was linked to the increase in visits to the dental program.

The researchers calculated that each one-unit increase in visits to the dental program was linked to a decrease of .25 decayed, missing or filled teeth per kindergarten student per school.

In other words, steady increases in visits to the preventive dental care program mirrored steady decreases in decayed, missing and filled teeth in children throughout North Carolina counties.

In schools where children were already at higher risk for dental disease, the decrease in decayed, missing or filled teeth was even greater (0.32 per student per school).

"IMBP reduced dental caries among targeted vulnerable children, which helped reduce oral health disparities among preschool-aged children in North Carolina," the researchers concluded.

The study therefore revealed that providing children with preventive dental care in pediatricians' and primary care doctors' offices can make a difference on their dental health.

"The delivery of a comprehensive set of preventive dental services in primary medical care is a new idea, but evidence has emerged demonstrating its effectiveness in improving pediatric oral health," the researchers noted in their paper.

The study was published March 31 in the journal Pediatrics. The research was funded by a Dental Public Health Training Grant from the Health Resources and Services Administration. The authors reported no conflicts of interest.

Review Date: 
April 5, 2014
Last Updated:
April 16, 2014