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Take action to influence children's oral health

Hallas, Donna PhD, PNP-BC, CPNP

doi: 10.1097/01.NPR.0000367926.70364.66
Department: Guest Editorial

Dr. Donna Hallas is a clinical associate professor and the PNP program coordinator at the College of Nursing, New York University, New York.



For over 50 years the American Dental Association (ADA) has designated February as National Children's Dental Health Month (NCDHM).1 Dental professionals across the country plan activities to raise awareness about the value of oral health practices at home, regular check-ups, and the relationship of these activities to the overall health of children. Dental caries is the greatest unmet children's health need in the United States, especially among those between 2 and 5 years old.2 While NPs include oral health assessments and anticipatory guidance as part of routine maintenance healthcare for children, there is little evidence that we have taken an active role in supporting the efforts of dental health professionals to reduce the incidence of early childhood caries (ECC).3 ECC is defined as the presence of one or more decayed, missing (due to decay), or filled tooth surfaces in any primary tooth in children under 72 months old.4 The incidence of ECC is particularly troublesome in diverse populations with 21% of Latino children and 11% of African American and Native American children affected.5

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What can NPs do?

NPs can begin by making oral health education a priority for each routine healthcare visit. Oral health education starts at the prenatal visit and must be included in parent education and discharge teaching plans on the postpartum unit; a time when parents are eager to learn how to care for their newborn. At each infant visit, discuss caries prevention strategies and good oral hygiene practices. Parents should also be encouraged to establish a dental home for their infants and children. Refer parents to the ADA website for expert information on oral health.1

In addition, make the office visit fun and focus on engaging children as active participants in learning about their oral healthcare. Ask children to color one of the pictures available on the ADA website while in your waiting room. Challenge children to brush their teeth twice each day and recommend ways parents can recognize their accomplishments.

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Educate yourself

Are you familiar with the most up- to-date practice guidelines and recommendations for oral health care in infants, children, and adolescents?1 Do you know that the recommendation for the first dental visit has changed from 3 years to 12 months old? Do you perform a knee-to-knee examination of the oral cavity beginning at the 6- month-old visit?6 Have you attended an oral health lecture in the past year to enhance your oral health practice skills? Get involved by sharpening your oral health skills and implementing an active oral health assessment and action plan. It is time for NPs to join dental and medical professionals to win the battle against oral health disease in our pediatric and adolescent patients.

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1. American Academy of Pediatric Dentistry. National Children's Dental Health Month .
2. Newacheck PW, Hughes DC, Hung, YY., et al. The unmet health needs of America's children. Pediatrics. 2000;105(4 pt 2):989–997.
3. Hallas D, Shelley D. Role of pediatric nurse practitioners in oral health care. Academic Pediatrics, 2009;9(6):462–466.
4. American Academy of Pediatric Dentistry. Definition of early childhood caries .
5. Flores G, Tomnay-Korman SC. Racial and ethnic disparities in medical and dental health, access to care, and use of services in US children. Pediatrics. 2008; 121: e286–298.
6. Hallas D, Fernandez J, Lim L, Carobene M. Nursing strategies to reduce the incidence of early childhood caries in culturally diverse populations. Journal of Pediatric Nursing. 2009; DOI: 10.1016/j.pedn.2009.07.010. In press.
© 2010 Lippincott Williams & Wilkins, Inc.