NC program reduces kids' dental caries

A preventive dental program targeting preschoolers younger than age 4 administered by physicians instead of dentists effectively reduces the need for tooth decay-related treatment among young children, a University of North Carolina (UNC) at Chapel Hill study found (Pediatrics, February 28, 2011).

The North Carolina program, Into the Mouths of Babes, trains physicians and nurses to screen and assess risks for dental caries and other problems, counsel parents about children's oral health, and apply fluoride varnish to children's teeth. It was established in 2000 by the North Carolina Medicaid program in response to rising early childhood tooth decay rates.

In the Pediatrics study, children up to age 6 who had four or more Into the Mouths of Babes visits before they turned 3 years old had, on average, 17% fewer treatments for dental caries than a similar group who did not, according to study author Gary Rozier, DDS, a professor of public health policy in the UNC Gillings School of Global Public Health.

"Parents rarely take their infants or toddlers to the dentist," Dr. Rozier stated in a press release. "They are much more likely to bring the children in to see a pediatrician or primary care doctor for well-baby visits."

Physicians have endorsed the program, wanting to help improve oral health, he said. Parents have expressed satisfaction with the preventive care services their children receive.

"What we didn't know, until we completed this study, was whether the program was effective in reducing the amount of treatment that children get for tooth decay, and thus hopefully leads to a reduction in Medicaid expenditures," Dr. Rozier said.

The program was most effective when children were seen for their first visit at about 1 year of age (when baby teeth are first starting to emerge) and when they have regular follow-up visits, he said. The best results came when well-baby visits happen most often; children who had preventive visits at 12 months and 15 months had 49% fewer dental caries treatments at 18 months compared to those with no visits.

For high-risk children, application of fluoride varnish is recommended every three to four months starting at age 6 months to 9 months.