The increasing role of paediatricians: improving oral health skills will improve patient outcomes

More than ever, Australia’s paediatricians are working alongside paediatric dentists to help their young patients maintain good oral health.  This is good news for oral health professionals, and great news for patients.  

The importance of an increased focus on paediatric oral health is highlighted by a recent report from the Australian Institute of Health and Welfare[1]. It found that about 2 in 5 (42%) of children aged 5-10 had experienced decay in primary (baby) teeth and more than 1 in 4 (27%) had untreated decay in these teeth.  Of children aged 6 -14, almost 1 in 4 had experienced decay in their permanent teeth, and more than 1 in 10 (11%) had untreated decay in these teeth.

This should be of concern to all health professionals, as we know that poor oral health in childhood is a predictor of dental disease in adulthood[2]. We also know that, in the long-term, oral diseases such as tooth decay, gum disease and oral cancer have the potential to contribute to illness, disability and even death.[3]  

While paediatricians are interested in oral health and understand the role it plays in overall health, a recent study highlighted the fact that many feel they lack the training and knowledge to fully assess, refer and counsel patients on oral health issues.[4]

It is safe to say that paediatricians understand the importance of baby teeth, correct brushing and the implications of untreated dental decay.  However, there are some other aspects of oral health and care that might help paediatricians in assessing the oral health of patients, advising and/or referring patients.

  1. Knowing the correct sequence and likely timing of tooth eruption is important, not only to identify if there are signs of oral health complications, but also to help reassure parents about what to expect and when to expect it.
  2. When examining a child’s mouth, it is important to look for white spots or lines on the surface of the teeth, as these are the first signs of tooth decay.

  3. Most paediatricians understand the importance of community water fluoridation, and encouraging parents to give their children tap water is essential. However keep in mind that some children who are at greater risk of tooth decay may also require professionally-applied topical fluorides.

  4. An understanding of paediatric oral health issues is important, including:
    1. Being aware of other common oral health issues in babies and toddlers, as well as common dental injuries (eg the result of a toddler falling).
    2. Early Childhood Caries (ECC), and how to identify those at risk.
    3. Addressing feeding difficulties and identifying if there is a need for tongue tie release. Only a few individuals require this procedure.

  5. Other important oral health discussions for paediatricians to have with parents include:
    1. Promoting the oral health benefits of breast feeding, while also being aware of ECC.
    2. Advising when to start brushing a child’s teeth.
    3. Advising when to start dentist appointments.
    4. Explaining if and when to use a bottle and what to put in it.
    5. The use of teething gels and associated health concerns.
    6. The role of medications and vitamin supplements on oral health.

This list is by no means extensive, and demonstrates that ongoing professional education in regard to paediatric oral health is essential. Some resources that might be useful include:

  • https://www1.health.nsw.gov.au/pds/ActivePDSDocuments/GL2014_020.pdf
  • https://www.aapd.org.au/viewStory/view-resources
  • https://www.healthychildren.org/English/healthy-living/oral-health/Pages/default.aspx
  • https://services.aap.org/en/search/?context=all&k=oral%20health

It is also vital that paediatricians are confident to refer patients to a dental health allied professional (eg dentist, paediatric dentist, oral health therapist).  Being familiar with the criteria for free dental care in your state or territory, as well as knowing the private practitioners or specialist paediatric dentists in your region is a good starting point.

By increasing interaction and collaboration, together paediatricians and oral health professionals can ensure young patients receive the most complete oral health care possible.

 

[1] Australian Institute of Health and Welfare 2018. Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra: AIHW.

[2] 2018 Australia’s Children and Young People Oral Health Tracker: A report card on preventable oral diseases and their risk factors. Tracking progress for a healthier Australia by 2025. Australian Dental Association and Australian Health Policy Collaboration, 2018.

[3] 2018 Australia’s Adult Oral Health Tracker: A report card on preventable oral diseases and their risk factors. Tracking progress for a healthier Australia by 2025. Australian Dental Association and Australian Health Policy Collaboration, 2018.

[4] Oral Health Knowledge and Professional Practices of Australian Paediatricians. Gussy M, Dickson-Swift V, Kenny A, Bracksley-O’Grady S, McCarthy C. LaTrobe Rural Health School, LaTrobe University, Bendigo.  2016

 

Dr Eduardo Alcaino is a specialist paediatric dentist currently working in private practice, a lecturer nationally and internationally, involved in clinical research and teaches at a post-graduate and graduate level. He is the Immediate Past president of the International Association of Paediatric Dentistry (IAPD), with more than 10 years international board experience with this organisation.  Dr Alcaino is also a founding member of the Oral Health Advisory Panel.

 


The Oral Health Advisory Panel (OHAP), is a group of independent healthcare professionals with the aim of raising awareness of the importance of good oral health and its impact on general wellness.  The Panel aims to take oral health beyond the dental clinic.

Follow the Oral Health Advisory Panel via twitter @OHAPanel to stay up to date with practical advice on good oral health habits.


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Eduardo Alcaino
Eduardo Alcaino

Founding Member Oral Health Advisory Panel, Specialist Paediatric Dentist, Specialist Clinical Associate- University of Sydney, Visiting Specialist Westmead Centre for Oral Health

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