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Reporting on health and quality of life in South LA

Task force: Primary care providers can play 'important role' in preventing cavities in young children

The U.S. Preventive Services Task Force recommends that, in order to preserve the oral health of children five or younger, primary care clinicians administer fluoride varnish to all children and provide fluoride supplements to some others.
The U.S. Preventive Services Task Force recommends that, in order to preserve the oral health of children five or younger, primary care clinicians administer fluoride varnish to all children and provide fluoride supplements to some others. Vaughan Nelson/Flickr Creative Commons

A national task force is poised to recommend that doctors and nurses spend more time focusing on the oral health of their patients who are five or younger.

The U.S. Preventive Services Task Force (USPSTF) said in a preliminary recommendation on Tuesday that there are two ways primary care providers can help prevent cavities in young children:

  • Provide fluoride supplements to children whose water supply is "deficient in fluoride."
  • Administer fluoride varnish to the baby teeth of infants and young children as soon as the teeth start coming in.

Dr. Joanna Choi, a pediatrician at St. John's Well Child and Family Center in South Los Angeles, says that's a good idea.

"I think we'd see a dramatic decrease in incidents of dental cavities, as well as overall improved health in general for these patients, because having poor dental health is associated with lots of other chronic diseases in children," she said.

The doctor said while conditions like obesity or attention deficit hyperactivity disorder (ADHD) don't cause poor oral health, they'll often go hand-in-hand. Consuming too much sugar, for example, can cause cavities, contribute to obesity and prevent a child from being able to focus – in school, for example.

Choi noted that because South L.A.'s tap water is already fluoridated, the first recommendation doesn't really apply, as long as families drink the tap water. But applying the fluoride varnish is "super important," she said, and it wouldn't have a major impact on a clinic's workflow.

"Any medical provider can be trained to do it," she said, echoing the USPSTF's assertion that applying the varnish is easy. "It's super quick, and it tastes delicious – kids don't usually fight it because it tastes like bubble gum."

St. John's has a dentist at each of its clinic sites, said Choi, so they're usually the ones who apply the varnish. But for places where a dental team isn't so accessible, she said primary care clinicians taking charge and doing it themselves is the "next best thing."

The challenge, she said, will be getting families to understand how important oral health is after the varnish has been applied.

"Our patients don't necessarily think of teeth as something that are important, or the dentist as someone who's important," said Choi.

Dr. Virginia Moyer, the chair of the USPSTF, said in its statement that tooth decay "is the most common chronic disease in American children," but that only about 25 percent of those younger than age 6 see a dentist. She added that primary care clinicians have an "important role" to play in improving the oral health of children.

Tuesday's announcement was for a draft recommendation; the USPSTF will make its final recommendation regarding the role of primary clinicians in preventing cavities on June 17. Until then, the task force is leaving the recommendation open to public comment.

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