![](media/image1.png){width="5.96875in" height="0.41944444444444445in"}

Top of Form

## Complete Summary

#### GUIDELINE TITLE

Clinical guideline on infant oral health care.

#### BIBLIOGRAPHIC SOURCE(S)

American Academy of Pediatric Dentistry. Clinical guideline on infant
oral health care. Chicago (IL): American Academy of Pediatric Dentistry;
2004. 4 p. \[42 references\]

#### GUIDELINE STATUS

This is the current release of the guideline.

### COMPLETE SUMMARY CONTENT

 SCOPE\
 METHODOLOGY - including Rating Scheme and Cost Analysis\
 RECOMMENDATIONS\
 EVIDENCE SUPPORTING THE RECOMMENDATIONS\
 BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS\
 IMPLEMENTATION OF THE GUIDELINE\
 INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT
CATEGORIES\
 IDENTIFYING INFORMATION AND AVAILABILITY\
 DISCLAIMER

### SCOPE

#### DISEASE/CONDITION(S)

Early childhood caries (ECC)

#### GUIDELINE CATEGORY

Counseling\
Management\
Prevention\
Risk Assessment\
Treatment

#### CLINICAL SPECIALTY

Dentistry\
Pediatrics

#### INTENDED USERS

Allied Health Personnel\
Dentists\
Nurses\
Physicians

#### GUIDELINE OBJECTIVE(S)

To propose recommendations for caries-risk assessment, anticipatory
guidance, preventive strategies, and appropriate therapeutic
interventions to be followed by the stakeholders in pediatric oral
health

#### TARGET POPULATION

Infants

#### INTERVENTIONS AND PRACTICES CONSIDERED

1.  Providing oral health counseling during pregnancy

2.  Incorporating infectious and transmissible nature of bacteria that
    cause early childhood caries (ECC) and methods of oral health risk
    assessment (Caries-risk Assessment Tool \[CAT\]), anticipatory
    guidance, and early intervention) in the curriculum of all medical,
    nursing, and allied health professional programs

3.  Providing oral health risk assessment and education by age 6 months

4.  Establishing a dental home for infant by 12 months of age

5.  Providing general anticipatory guidance/education for mother:

    -   Oral hygiene (tooth brushing/flossing)

    -   Diet

    -   Fluoride (fluoridated toothpaste/0.05% sodium fluoride rinse)

    -   Caries removal

    -   Delay of colonization

    -   Xylitol chewing gum

6.  Providing general anticipatory guidance for the young patient (age 0
    to 3 years):

    -   Oral hygiene (cleanse with washcloth or soft brush/dental floss)

    -   Diet

    -   Fluoride

#### MAJOR OUTCOMES CONSIDERED

Risk for caries

### METHODOLOGY

#### METHODS USED TO COLLECT/SELECT EVIDENCE

Searches of Electronic Databases

#### DESCRIPTION OF METHODS USED TO COLLECT/SELECT THE EVIDENCE

This guideline is based on a review of the current dental, medical, and
public health literature related to infant oral health care. A MEDLINE
search was conducted using the terms \"infant oral health\", \"infant
oral health care\", and \"early childhood caries\".

#### NUMBER OF SOURCE DOCUMENTS

Not stated

#### METHODS USED TO ASSESS THE QUALITY AND STRENGTH OF THE EVIDENCE

Not stated

#### RATING SCHEME FOR THE STRENGTH OF THE EVIDENCE

Not applicable

#### METHODS USED TO ANALYZE THE EVIDENCE

Review

#### DESCRIPTION OF THE METHODS USED TO ANALYZE THE EVIDENCE

Not stated

#### METHODS USED TO FORMULATE THE RECOMMENDATIONS

Expert Consensus

#### DESCRIPTION OF METHODS USED TO FORMULATE THE RECOMMENDATIONS

The oral health policies and clinical guidelines of the American Academy
of Pediatric Dentistry (AAPD) are developed under the direction of the
Board of Trustees, utilizing the resources and expertise of its
membership operating through the Council on Clinical Affairs (CCA).

Proposals to develop or modify policies and guidelines may originate
from 4 sources:

1.  the officers or trustees acting at any meeting of the Board of
    Trustees

2.  a council, committee, or task force in its report to the Board of
    Trustees

3.  any member of the AAPD acting through the Reference Committee
    hearing of the General Assembly at the Annual Session

4.  officers, trustees, council and committee chairs, or other
    participants at the AAPD\'s Annual Strategic Planning Session

Regardless of the source, proposals are considered carefully, and those
deemed sufficiently meritorious by a majority vote of the Board of
Trustees are referred to the CCA for development or review/revision.

Once a charge (directive from the Board of Trustees) for development or
review/revision of an oral health policy or clinical guideline is sent
to the CCA, it is assigned to 1 or more members of the CCA for
completion. CCA members are instructed to follow the specified format
for a policy or guideline. All oral health policies and clinical
guidelines are based on 2 sources of evidence: (1) the scientific
literature; and (2) experts in the field. Members may call upon any
expert as a consultant to the council to provide expert opinion. The
Council on Scientific Affairs provides input as to the scientific
validity of a policy or guideline.

The CCA meets on an interim basis (midwinter) to discuss proposed oral
health policies and clinical guidelines. Each new or reviewed/revised
policy and guideline is reviewed, discussed, and confirmed by the entire
council.

#### RATING SCHEME FOR THE STRENGTH OF THE RECOMMENDATIONS

Not applicable

#### COST ANALYSIS

A formal cost analysis was not performed and published cost analyses
were not reviewed.

#### METHOD OF GUIDELINE VALIDATION

Peer Review

#### DESCRIPTION OF METHOD OF GUIDELINE VALIDATION

Once developed by the Council on Clinical Affairs (CCA), the proposed
policy or guideline is submitted for the consideration of the Board of
Trustees. While the board may request revision, in which case it is
returned to the council for modification, once accepted by majority vote
of the board, it is referred for Reference Committee hearing at the
upcoming Annual Session. At the Reference Committee hearing, the
membership may provide comment or suggestion for alteration of the
document before presentation to the General Assembly. The final document
then is presented for ratification by a majority vote of the membership
present and voting at the General Assembly. If accepted by the General
Assembly, either as proposed or as amended by that body, the document
then becomes the official American Academy of Pediatric Dentistry (AAPD)
oral health policy or clinical guideline for publication in the AAPD\'s
Reference Manual and on the AAPD\'s Web site.

### RECOMMENDATIONS

#### MAJOR RECOMMENDATIONS

**Recommendations**

1.  All primary health care professionals who serve mothers and infants
    should provide parent/caregiver education on the etiology and
    prevention of early childhood caries (ECC). Oral health counseling
    during pregnancy is especially important for the mother.

2.  The infectious and transmissible nature of bacteria that cause early
    childhood caries and methods of oral health risk assessment (the
    Caries-risk Assessment Tool \[CAT\]), anticipatory guidance, and
    early intervention should be included in the curriculum of all
    medical, nursing, and allied health professional programs.

3.  Every infant should receive an oral health risk assessment from
    his/her primary health care provider or qualified health care
    professional by 6 months of age. This initial visit should consist
    of the following:

    -   Assessing the patient\'s risk of developing oral disease using
        CAT

    -   Providing education on infant oral health

    -   Evaluating and optimizing fluoride exposure

4.  Parents or caregivers should establish a dental home for infants by
    12 months of age. The following should be accomplished at that
    visit:

    -   Recording thorough medical (infant) and dental (mother or
        primary caregiver and infant) histories

    -   Completing a thorough oral examination

    -   Assessing the infant\'s risk of developing dental disease using
        CAT and determining an appropriate prevention plan and interval
        for periodic reevaluation based upon that assessment

    -   Providing anticipatory guidance regarding dental and oral
        development, fluoride status, nonnutritive sucking habits,
        teething, injury prevention, oral hygiene instruction, and the
        effects of diet on the dentition

    -   Planning for comprehensive care in accordance with accepted
        guidelines and periodicity schedules for pediatric oral health
        (\"Clinical guideline on periodicity,\" 2004)

    -   Referring patients to the appropriate health professional if
        intervention is necessary

5.  Health care professionals and all stakeholders in children\'s health
    should support the identification of a dental home for all infants
    at 12 months of age.

#### CLINICAL ALGORITHM(S)

None provided

### EVIDENCE SUPPORTING THE RECOMMENDATIONS

#### REFERENCES SUPPORTING THE RECOMMENDATIONS

[References open in a new
window](http://www.guideline.gov/summary/select_ref.aspx?doc_id=6267)

#### TYPE OF EVIDENCE SUPPORTING THE RECOMMENDATIONS

All oral health policies and clinical guidelines are based on 2 sources
of evidence: (1) the scientific literature; and (2) experts in the
field.

### BENEFITS/HARMS OF IMPLEMENTING THE GUIDELINE RECOMMENDATIONS

#### POTENTIAL BENEFITS

-   Appropriate management of infant oral health needs

-   An oral health risk assessment before 1 year of age affords the
    opportunity to identify high-risk patients and provide timely
    referral and intervention for the child, thus allowing an invaluable
    opportunity to decrease colonization of the infant.

#### POTENTIAL HARMS

Not stated

### IMPLEMENTATION OF THE GUIDELINE

#### DESCRIPTION OF IMPLEMENTATION STRATEGY

An implementation strategy was not provided.

#### IMPLEMENTATION TOOLS

Chart Documentation/Checklists/Forms\
Resources

For information about
[availability](#identifying-information-and-availability), see the
\"Availability of Companion Documents\" and \"Patient Resources\" fields
below.

### INSTITUTE OF MEDICINE (IOM) NATIONAL HEALTHCARE QUALITY REPORT CATEGORIES

#### IOM CARE NEED

Staying Healthy

#### IOM DOMAIN

Effectiveness\
Patient-centeredness

### IDENTIFYING INFORMATION AND AVAILABILITY

#### BIBLIOGRAPHIC SOURCE(S)

American Academy of Pediatric Dentistry. Clinical guideline on infant
oral health care. Chicago (IL): American Academy of Pediatric Dentistry;
2004. 4 p. \[42 references\]

#### ADAPTATION

Not applicable: The guideline was not adapted from another source.

#### DATE RELEASED

2004

#### GUIDELINE DEVELOPER(S)

American Academy of Pediatric Dentistry - Professional Association

#### SOURCE(S) OF FUNDING

American Academy of Pediatric Dentistry

#### GUIDELINE COMMITTEE

Clinical Affairs Committee\
Infant Oral Health Subcommittee

#### COMPOSITION OF GROUP THAT AUTHORED THE GUIDELINE

Not stated

#### FINANCIAL DISCLOSURES/CONFLICTS OF INTEREST

Not stated

#### GUIDELINE STATUS

This is the current release of the guideline.

#### GUIDELINE AVAILABILITY

Electronic copies: Available from the [American Academy of Pediatric
Dentistry Web site](http://www.aapd.org/media/policies.asp).

Print copies: Available from the American Academy of Pediatric
Dentistry, 211 East Chicago Avenue, Suite 700, Chicago, Illinois 60611

#### AVAILABILITY OF COMPANION DOCUMENTS

Information about the American Academy of Pediatric Dentistry (AAPD)
mission and guideline development process is available on the [AAPD Web
site](http://www.aapd.org/media/Policies_Guidelines/Intro.pdf).

The following implementation tools are available for download from the
AAPD Web site:

-   [Dental growth and development
    chart](http://www.aapd.org/media/Policies_Guidelines/RS_DentGrowthandDev.pdf)

-   [American Academy of Pediatric Dentistry Caries-Risk Assessment Tool
    (CAT)](http://www.aapd.org/media/Policies_Guidelines/RS_CAT.pdf)

#### PATIENT RESOURCES

None available

#### NGC STATUS

This NGC summary was completed by ECRI on February 25, 2005. The
information was verified by the guideline developer on April 18, 2005.

#### COPYRIGHT STATEMENT

This summary is based on the original guideline, which is subject to the
guideline developer\'s copyright restrictions.

### DISCLAIMER

#### NGC DISCLAIMER

The National Guideline Clearinghouse™ (NGC) does not develop, produce,
approve, or endorse the guidelines represented on this site.

All guidelines summarized by NGC and hosted on our site are produced
under the auspices of medical specialty societies, relevant professional
associations, public or private organizations, other government
agencies, health care organizations or plans, and similar entities.

Guidelines represented on the NGC Web site are submitted by guideline
developers, and are screened solely to determine that they meet the NGC
Inclusion Criteria which may be found at
<http://www.guideline.gov/about/inclusion.aspx> .

NGC, AHRQ, and its contractor ECRI Institute make no warranties
concerning the content or clinical efficacy or effectiveness of the
clinical practice guidelines and related materials represented on this
site. Moreover, the views and opinions of developers or authors of
guidelines represented on this site do not necessarily state or reflect
those of NGC, AHRQ, or its contractor ECRI Institute, and inclusion or
hosting of guidelines in NGC may not be used for advertising or
commercial endorsement purposes.

Readers with questions regarding guideline content are directed to
contact the guideline developer.

Bottom of Form

© 1998-2008 National Guideline Clearinghouse

Date Modified: 11/3/2008