Illinois pediatricians' and pediatric dentists' practices regarding infant oral health

Objectives: To assess pediatricians' and pediatric dentists' attitudes and practices towards infant oral health evaluations and the age 1 dental visit.

Methods: A random sample of 290 Illinois pediatricians and all 146 Illinois pediatric dentists were mailed a survey of their beliefs and practices regarding when a child should first see a dentist and the nature of the oral evaluation they performed on infants and children.

Results: 50% or 146 pediatricians and 75% or 109 pediatric dentists responded. Pediatricians named 2.2 (SD 0.8) years as the age when the first dental visit should occur, compared to 1.2 (SD 0.6) by the pediatric dentists (t test, p<.000), with both groups actually recommending the visit to the parents a few months later. No differences were noted by sex or year of graduation. Pediatricians reported less frequent screening for caries (84%), periodontal disease (44%) and occlusion (30%) than the pediatric dentists (98, 93 and 95%). 14% vs 40% of pediatricians and pediatric dentists routinely applied fluoride during a first oral exam. 84% and 80% of pediatricians and pediatric dentists routinely provided anticipatory guidance. Pediatricians were less likely to be aware of the Caries Risk Assessment Tool (57% unaware compared to 11%) and only 2% reported using it compared to 37% of pediatric dentists (Mann-Whitney U, p<.000).

Conclusions: Overall, pediatricians addressed oral health issues during infant examinations and routinely referred to dentists. However, they did not do it as early as is recommended by the American Academy of Pediatrics or the American Academy of Pediatric Dentists. Future research should determine whether this is related to knowledge or attitudes.