August Week 2: Oral Hygiene & Fluoride Use


Hale K, et al. Oral Health Rick Assessment Timing and Establishment of the Dental Home: AAP Policy Statement. Pediatrics. 111(5) 1113-16. May 2003.
Lewis C, et al. Fluoride. Peds in Review. 2003;24;327.

Further Reading:
Douglass JM, et al., A practical guide to infant oral health. Am Fam Physician. 2004 Dec 1;70(11):2113-20.

Case 1:

A 4 year old girl is brought in by mom for a well visit. She does not like brushing or flossing, although parents report trying to do it almost every night. She drinks 8-16 oz of juice and soda per day. Mom reports she drinks milk, juice and bottled water mostly.

What do you advise mom about brushing and flossing?
What do you advise her about fluoride?

Case 2

You are seeing a 12 month old girl in your office for a well visit. She has 4 maxillary incisors and 4 mandibular incisors and dad wants to know about her risk of getting cavities.

What are some risk factors for dental caries? 
What do caries typically look like? 
When should a child be referred to a dentist?

Case 3

A Mom brings in her 2 yo son for a well visit. She reports she is concerned about his teeth because she remembers getting a lot of cavities filled when she was child. She searched the internet and found that fluoride will protect her child’s teeth so she bought fluoride drops, fluoride toothpaste, and fluoride mouthwash and has been using them twice a day.

What do you think about this oral hygiene regimen?
How should you counsel mom about fluoride use in a 2 year old? What if the child was 5 years old? 
What dietary suggestions do you have to prevent dental caries?