Purpose: The purpose of this study was to create an early childhood caries (ECC) risk-screening tool that fits into the primary care provider (PCP) well-child workflow. Methods: Integrated health records were employed to develop a predictive model for infants/toddlers at ECC risk; 2,009 patients with 12-, 15-, or 18-month well-child visits and at least one dental visit were used to develop a predictive model for ECC risk at the first dental visit. Independent model validation used 880 18- to 48-month-olds at their first dental appointment after at least one well-child visit. Results: Age at the first dental visit strongly predicted caries risk (odds ratio for one-year increase in age equals 2.11; 95 percent confidence interval equals 1.80 to 2.47). Three factors predicted high-caries risk: breast feeding status, preferred language not English, and no-show rates for pediatric clinic visits greater than 20 percent. All three non-age risk factors in well-child exams prior to 18 months predicted 42 percent probability of having caries if present for the first dental visit at 18 months. If that child was not seen until four years of age for the first dental visit, the probability of high caries risk increased to 83 percent. Model performance for independent validation was very close to expected performance. Conclusions: Existing clinical documentation plus a validated predictive model enables an effective caries risk assessment within well-child visits.

Purpose: In spite of the importance of oral health to overall health, most young children do not receive an early dental visit by 12 months of age, as recommended by the American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD). By the time many children have a dental visit, a majority of the behavioral and dietary risk factors for dental caries have been established. Early childhood caries are often present at the first dental visit, frequently necessitating extensive treatment and the risks associated with conscious sedation or general anesthesia. With an aim of creating a history-based caries-risk screening tool that more easily assimilates into the workflow of a well-child visit, we sought to build a predictive model that characterizes the likelihood a child would have oral disease or risks of future disease at the time of their first dental visit based upon information noted in the early well-child visits. Methods: Medical and dental health information was gleaned from integrated records from a major tertiary pediatric center. Multiple logistic regression procedures were employed to develop a predictive model for each dependent variable, caries indicator and caries high-risk indicator. Over 60 independent variables pertaining to demographics, dietary factors, examination and history, lab reports, and screenings contained within the 12, 15, or 18-month well-child templates were analyzed and used to build a predictive model estimating future risk of caries when a child was seen for an early well-child examination. Results: 2,009 patients with 12, 15, or 18-month preventive medical visit(s) and at least one dental visit encounter. Age at first dental visit was a strong predictor of caries risk in both models. Four variables predicted caries risk in the High-Risk Indicator Model: age at first dental visit, breastfeeding status, language not English, and no show percentage greater than 20%. Three variables predicted caries in the Caries Indicator Model: age at first dental visit, language not English, and blood lead not tested. Conclusion: With such a predictive tool, health care providers could easily administer caries-risk assessment as a part of the well-child visit without taking time from other equally important health concerns. This type of model could aid health care providers in referring those at highest risk for a higher level of primary care intervention and observation for early childhood caries and increased urgency of referral to a dental home. Children referred to dental care as a result of having large predictive model values would be much more likely to have dental caries or “high” risk for dental caries at the time of their first visit to a dental clinic, thus offering valuable preventive services in a targeted, efficient and cost-effective manner.

Purpose: Medical pediatric providers should screen young children for caries using caries-risk assessment tools as part of the well-child exam, but adoption of this practice recommendation is low due to competing time demands at the well-child visit, minimal reimbursement, the limited availability of caries-risk assessment as part of electronic health records and scarce clinical dental experience/education (1). Primary risk factors for numerous chronic diseases frequently cluster in the same individual. Dental disease shares common risk factors with such major pediatric diseases as obesity, infection and atopic illnesses, asthma, …

PURPOSE:The purposes of this study were to collect information on involvement, training, and barriers to participation in advocacy efforts for Public Policy Advocates (PPAs) of the American Academy of Pediatric Dentistry (AAPD) and make recommendations to the AAPD.METHODS:Preliminary data were collected from the PPAs during structured AAPD program meetings, conference calls, and individual interviews. Based on these data, a survey was created, piloted, and sent electronically to all PPAs. Data were analyzed and collated by frequencies.RESULTS:Responses from 38 PPAs (100 percent) revealed they were involved with state legislatures and state chapters of the AAPD and American Dental Association. Eighty-two percent of the PPAs requested additional public policy training and clearer communication channels within the network. PPAs are funding their own advocacy efforts, and the time and resources spent away from patient care is a financial barrier.CONCLUSIONS:The Public Policy Advocate network holds a broad policy skill set and voluntarily commits time and resource to advocate for the support of the pediatric dental patient at state and federal government levels. The American Academy of Pediatric Dentistry can strengthen the PPA's self-directed leadership role at state and federal levels through formalized training, restructuring of the network, and increased resources.

OBJECTIVES Childhood obesity is a major US health concern, and oral health professionals have opportunities to participate in an interprofessional effort to intervene owing to their access to young patients and their abilities in addressing obesity-related dietary habits like consumption of sugar-sweetened beverages (SSBs). This study determined attitudes, behaviors, future intentions, and perceived barriers of pediatric dentists regarding efforts to prevent childhood obesity and reduce children's consumption of SSBs. METHODS The American Academy of Pediatric Dentistry conducted an online electronic survey with a convenience sample of approximately 7,450 pediatric dentists and pediatric dental residents during spring 2016. RESULTS Over 17 percent of pediatric dentists offer childhood obesity interventions. Of those not providing interventions, 67 percent were interested in offering obesity-prevention services. Nearly 94 percent of pediatric dentists offer information or other interventions on consumption of SSBs. Statistically significant barriers to providing healthy weight interventions were fear of offending parents, appearing judgmental, or creating parent dissatisfaction and a lack of parental acceptance of guidance about weight management from a dentist. Significant barriers to SSB interventions were sufficient time and health professional education. CONCLUSIONS More pediatric dentists stated they offer childhood obesity interventions than in previous surveys reporting 6 percent, but respondents suggested that a child's weight is seen as a medical rather than dental issue. Most pediatric dentists provide interventions related to consumption of SSBs, perceiving the issue as integral to their care of children.

Purpose: Pediatric oral health benefits were designated as one of 10 Essential Health Benefits (EHB) in the Affordable Care Act. Although it provided coverage for many children, several issues prevent its success. The purpose of this study was to document experience with, attitudes toward, and perceptions of the Affordable Care Act (ACA) among pediatric dentists. Methods: The study was conducted using a survey consisting of nine multiple choice questions and one open-ended item and was distributed electronically in November 2015 to active and life members of the American Academy of Pediatric Dentistry. Results: Respondents reported patients deferring treatment due to high out-of-pocket costs. Pro-viders perceive that patients do not have enough information to understand their benefits. Providers reported not having enough information to understand how these benefits affect their practices. Conclusions: Pediatric dentists report deferral of both preventive and restorative care due to high out-of-pocket costs. Pediatric dentists do not feel they have adequate information regarding the Affordable Care Act and its effect on their practices. The majority of pediatric dentists believe that parents have difficulty understanding their children's benefits.

Killeen, Patrick E. MS, PA-C; Mathew, Tanya BDS, MS; Royston, Leola MPH; Wright, Robin PhD Author Information